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Introduction to Clinical Inquiries : new series by the Family Physicians Inquiries Network
(Family Physicians Inquiries Network, 2020)
Introduction to Clinical Inquiries and FPIN. The Clinical Inquiries were included in Canadian Family Physician beginning March 2020....
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...
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011)
There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep ...
Antibiotics for Viral Upper Respiratory Tract Infections in Children
(Family Physicians Inquiries Network, 2011)
Antibiotic therapy does not benefit children with bronchiolitis, the common cold, or nonstreptococcal pharyngitis. If purulent rhinitis is present for more than 10 days, antibiotics shorten the duration of runny nose ...
Appetite Suppressants as Adjuncts for Weight Loss
(Family Physicians Inquiries Network, 2011)
Phentermine and diethylpropion are appetite suppressants approved for use in the United States as adjuncts in the treatment of obesity. These agents demonstrate a modest weight loss benefit when combined with dietary ...
What is the prognosis for patients with chronic urticaria?
(Family Physicians Inquiries Network, 2011)
The prognosis for chronic urticaria in primary care is unknown; studies in dermatology clinics in multiple countries report complete resolution in approximately one-third of patients with idiopathic chronic urticaria over 1 to 5 years and partial...
Hormone Therapy for Postmenopausal Women with Urinary Incontinence
(Family Physicians Inquiries Network, 2011)
Postmenopausal women should not receive oral hormone therapy for treatment of urinary incontinence. Hormone therapy is associated with worsening urinary incontinence in postmenopausal women who are incontinent at baseline ...
Does turmeric relieve inflammatory conditions?
(Family Physicians Inquiries Network, 2011)
Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory conditions (strength of recommendation [SOR]: C, primarily low-quality cohort studies ...
When is discectomy indicated for lumbar disc disease?
(Family Physicians Inquiries Network, 2011)
Emergent discectomy is indicated in the presence of cauda equina and severe, progressive neuromotor deficits (strength of recommendation [SOR]: C, expert opinion). Elective discectomy for sciatica caused by lumbar disc ...
How can we minimize recurrent ankle sprains?
(Family Physicians Inquiries Network, 2011)
Using external ankle supports during physical activity significantly reduces the likelihood of primary and secondary sprains (strength of recommendation [SOR]: A, systematic review). Proprioception rehabilitation substantially ...
Brain Natriuretic Peptide Levels for Ruling Out Heart Failure
(Family Physicians Inquiries Network, 2011)
A BNP level less than 100 pg per mL (100 ng per L) can rule out heart failure. (Strength of Recommendation [SOR]: A, based on meta-analyses.) BNP levels should be used when the pretest probability of heart failure based on overall clinical...
What's the best way to relieve mastitis in breastfeeding mothers?
(Family Physicians Inquiries Network, 2011)
Frequent breast emptying helps both infectious and noninfectious mastitis (strength of recommendation [SOR]: A, 1 randomized controlled trial [RCT]). Antibiotics may be useful for women with positive milk cultures (SOR: ...
What treatment is best for hypertrophic scars and keloids?
(Family Physicians Inquiries Network, 2011)
No one treatment is best (strength of recommendation [SOR]: C, meta-analysis of heterogenous studies); no good evidence exists comparing treatments with each other. Triamcinolone injections, triamcinolone injections combined ...
Chronic urticaria: What diagnostic evaluation is best?
(Family Physicians Inquiries Network, 2011)
A detailed history and 6-week trial of an H1 antihistamine are the best diagnostic evaluations for chronic urticaria. More extensive diagnostic work-up adds little, unless the patient's history specifically indicates a ...
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011)
velocity, delayed puberty, or clinical signs and symptoms of endocrine abnormalities (e.g., hirsutism, truncal obesity, violaceous striae). (Strength of recommendation [SOR]: C, based on expert opinion.) Underlying metabolic and genetic causes of obesity...
Postcholecystectomy diarrhea: What relieves it?
(Family Physicians Inquiries Network, 2011)
A trial of a bile acid binder such as cholestyramine or colestipol may benefit patients with postcholecystectomy diarrhea (strength of recommendation [SOR]: C, case series). Although postcholecystectomy diarrhea is uncommon ...
Effective Therapies for Intermittent Claudication
(Family Physicians Inquiries Network, 2011)
Supervised exercise programs are recommended to produce clinically significant improvements in walking distance in patients with stable intermittent claudication. (Strength of Recommendation [SOR]: A, based on systematic reviews of randomized...
Treatment of Recurrent Vulvovaginal Candidiasis
(Family Physicians Inquiries Network, 2011)
-month treatment regimen with an antifungal agent may result in an additional five to 10 months of clinical cure. (SOR: A, based on good-quality RCTs.) Suitable therapies include oral fluconazole (Diflucan; 150 mg once per week for six months) or oral itraconazole...
Antibody Testing for Systemic Lupus Erythematosus
(Family Physicians Inquiries Network, 2011)
Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE. (Strength of Recommendation: C, based on expert opinion.) The antinuclear antibody (ANA) test is the most ...
Managing Intoeing in Children
(Family Physicians Inquiries Network, 2011)
Intoeing can be accurately diagnosed using a history, physical examination, and torsional profile. (Strength of Recommendation [SOR]: C, based on expert consensus.) The three most common causes of intoeing (i.e., metatarsus ...