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Antiepileptic Drug Level Monitoring
(Family Physicians Inquiries Network, 2008)
monitoring may be clinically useful in special populations, including patients with suspected drug toxicity or noncompliance, pregnant patients, and patients with renal failure. Monitoring dosage increases of drugs with nonlinear kinetics, such as phenytoin...
What is the differential diagnosis of chronic leg edema in primary care?
(Family Physicians Inquiries Network, 2008)
The differential diagnosis, in descending order, includes: elevated pulmonary artery pressure (often due to obstructive sleep apnea), congestive heart failure, idiopathic causes, venous insufficiency, use of nonsteroidal ...
Is there a well-tested tool to detect drug-seeking behaviors in chronic pain patients?
(Family Physicians Inquiries Network, 2008)
There is no well-tested, easily administered screening tool to detect drug-seeking behaviors in primary care patients taking long-term opioids or being considered for such therapy (strength of recommendation [SOR]: C, ...
Does birth weight predict childhood obesity?
(Family Physicians Inquiries Network, 2008)
A birth weight greater than 4,000 g is associated with an increased risk of obesity in both childhood and adolescence (strength of recommendation [SOR]: B, systematic review and multiple cohort studies).
What is the clinical workup for failure to thrive?
(Family Physicians Inquiries Network, 2008)
The clinical evaluation of failure to thrive (FTT) includes a thorough history and physical examination; observation of parent-child interactions; observation and documentation of the child's feeding patterns; and a home visit by an appropriately...
What's the best way to manage athletes with amenorrhea?
(Family Physicians Inquiries Network, 2008)
Ruling out secondary causes of amenorrhea is, of course, the first step. Once that's done, you can make a presumptive diagnosis of hypothalamic amenorrhea and advise the patient to increase caloric intake or decrease energy ...
Clinical Indicators of Obstructive Sleep Apnea
(Family Physicians Inquiries Network, 2011)
Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study. (Strength of Recommendation: B, based...
Prophylactic oxytocin: Before or after placental delivery?
(Family Physicians Inquiries Network, 2008)
Timing alone doesn't influence the drug's efficacy in preventing postpartum bleeding (strength of recommendation: B, randomized controlled trial [RCT] and prospective cohort studies).
Should you evaluate for CAD in seniors with premature ventricular contractions?
(Family Physicians Inquiries Network, 2008)
Current guidelines suggest evaluating patients with premature ventricular contractions (PVCs) and associated risk factors for underlying coronary artery disease (strength of recommendation [SOR]: C, expert opinion).
Which clinical features and lab findings increase the likelihood of temporal arteritis?
(Family Physicians Inquiries Network, 2008)
Jaw claudication, diplopia, or a temporal artery abnormality on physical exam increase the likelihood of temporal arteritis. A finding of thrombocytosis in a patient with suspected temporal arteritis moderately increases ...
How does pentoxifylline affect survival of patients with alcoholic hepatitis?
(Family Physicians Inquiries Network, 2008)
Pentoxifylline improves short-term survival in patients admitted to the hospital with severe alcoholic hepatitis (strength of recommendation [SOR]: B, a single published randomized controlled trial [RCT]). Pentoxifylline ...
What is the best way to screen for breast cancer in women with implants?
(Family Physicians Inquiries Network, 2008)
Mammography is best. It is considered as effective for screening women who have undergone augmentation mammoplasty as those who have not (strength of recommendation [SOR]: B, limited number of retrospective and prospective ...
How much can exercise raise creatine kinase level-- and does it matter?
(Family Physicians Inquiries Network, 2008)
, such as weight lifting or downhill running (strength of recommendation [SOR]: C, small observational studies). The clinical significance of exercise-induced elevations in CK is unclear because the renal complications associated with classic rhabdomyolysis haven...
Does case management improve diabetes outcomes?
(Family Physicians Inquiries Network, 2008)
cardiovascular events and decreased retinopathy and clinical neuropathy (SOR: B, 1 large, good-quality RCT)....
What's the most effective treatment for giardiasis?
(Family Physicians Inquiries Network, 2008)
controlled trial [RCT] of patient-oriented outcomes), but tinidazole has a higher clinical cure rate than these drugs. It also has a comparable side-effect profile and requires only 1 dose....
Leukotriene Receptor Antagonists for the Treatment of Allergic Skin Disorders
(Family Physicians Inquiries Network, 2008)
Evidence from small trials suggests that leukotriene receptor antagonists may have short-term effectiveness in reducing sleep disturbance and the observed intensity of atopic dermatitis in adults and children. (Strength ...
Management of Cervical Lymphadenitis in Children
(Family Physicians Inquiries Network, 2008)
Cervical lymphadenitis, defined as an acute symptomatic enlargement of the cervical lymph nodes, is a common condition in children of all ages. Most cases of cervical lymphadenitis in children are self-limited and can ...
Treatment of Bulimia Nervosa
(Family Physicians Inquiries Network, 2008)
Cognitive behavior therapy (CBT) is the most effective treatment for bulimia nervosa based on multiple consistent randomized-controlled trials (RCTs). (Strength of Recommendation [SOR]: A). Guided self-help has not been ...
What could be behind your elderly patient's subjective memory complaints?
(Family Physicians Inquiries Network, 2008)
Depression, anxiety, and dementia, as well as older age, female gender, lower education level, and decreased physical activity, have all been associated with memory loss reported by patients or family members (strength of ...
Effect of Antiepileptic Drugs on Oral Contraceptives
(Family Physicians Inquiries Network, 2008)
We found no studies that measure, or even estimate, any increase in pregnancy rates in women taking antiepileptic drugs. Antiepileptic drugs known to induce the hepatic cytochrome P450 (CYP450) isoenzyme cause decreased ...