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Does chocolate have cardiovascular benefits?
(Family Physicians Inquiries Network, 2010)
Eating chocolate reduces blood pressure in the short term (strength of recommendation [SOR]: B, a meta-analysis and individual randomized controlled trials [RCTs]). No studies, however, have evaluated the long-term ...
Add a fibrate to a statin?
(Family Physicians Inquiries Network, 2010)
Do not routinely add a fibrate to a statin for patients with type 2 diabetes who are at high risk for cardiovascular events. Stength of recommendation: B: Based on a good-quality randomized controlled trial....
Probiotics for colic? A PURL update
(Family Physicians Inquiries Network, 2014)
In "Colicky baby? Here's a surprising remedy" (J Fam Pract. 2011;60:34-36), we summarized a 2010 doubleblind randomized controlled trial (RC T) that found the probiotic Lactobacillus reuteri DSM 17938 reduced daily crying time in colicky...
Does lowering a fever >101F in children improve clinical outcomes?
(Family Physicians Inquiries Network, 2010)
Treating fever significantly increases comfort, activity, feeding, and fluid intake and decreases the patient's temperature compared with placebo (strength of recommendation (SOR): A, multiple randomized controlled trials ...
Screen teens for depression--it's quicker than you think
(Family Physicians Inquiries Network, 2010)
The US Preventive Services Task Force (The US Preventive Services Task Force (USPSTF) recommends screening all adolescents for depression -- provided that effective treatments and counseling are available for those who ...
A-fib and rate control: Don't go too low
(Family Physicians Inquiries Network, 2010)
Aim for a heart rate of <110 beats per minute (bpm) in patients with permanent atrial fibrillation. Maintaining this rate requires less medication than more stringent rate control, resulting in fewer side effects and no ...
Does exercise alleviate symptoms of depression?
(Family Physicians Inquiries Network, 2010)
Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves ...
Which history and physical findings are most useful in identifying rotator cuff tears?
(Family Physicians Inquiries Network, 2010)
It's unknown which -- if any -- historical factors are most useful, because no studies evaluating their accuracy with rotator cuff tears have been done. As for physical findings, no single physical examination finding is ...
In patients with a previous CVA, do antioxidants protect against subsequent stroke?
(Family Physicians Inquiries Network, 2002)
Most recent randomized controlled clinical trials have not found a benefit in antioxidants (vitamin C, vitamin E, and/or beta-carotene) for preventing cardiovascular disease, including stroke. These recent clinical studies have not confirmed earlier...
What's the most effective way to screen patients with a family history of colon cancer?
(Family Physicians Inquiries Network, 2010)
-degree relative or CRC in at least 2 second-degree relatives (strength of recommendation [SOR]: B, extrapolation from systematic reviews)....
Is nedocromil effective in preventing asthmatic attacks in patients with asthma?
(Family Physicians Inquiries Network, 2004)
In general, about 50% to 70% of patients respond to nedocromil (SOR: A, multiple RCTs and meta-analyses). Unfortunately, which patients respond is not predictable from clinical parameters. Nedocromil is worth trying in mild persistent asthma...
What's best when a patient doesn't respond to the maximum dose of an antidepressant?
(Family Physicians Inquiries Network, 2010)
Consider possible causes of the inadequate response, then weigh treatment options in light of the characteristics of the individual patient and therapy. When managing a patient with nonpsychotic depression and inadequate ...
Glucose self-monitoring: Think twice for type 2 patients
(Family Physicians Inquiries Network, 2008)
Stop routinely recommending blood glucose self-monitoring for patients with newly diagnosed type 2 diabetes. Self-monitoring does not improve glycemic control for patients who are not taking insulin, and it increases the risk of depression. Stength...
Azithromycin for PID beats doxycycline on all counts
(Family Physicians Inquiries Network, 2007)
Outpatient treatment of patients with mild pelvic inflammatory disease, using 1g of azithromycin weekly for 2 weeks, combined with 250mg of ceftriaxone intramuscularly on the first day, is superior to the current recommended treatment...
Suspect an eating disorder? Suggest CBT
(Family Physicians Inquiries Network, 2009)
Refer patients with eating disorder not otherwise specified (NOS) for cognitive behavioral therapy. CBT, which has proven to be the most useful behavioral treatment for bulimia, has now been shown to be effective for ...
This antiemetic may help kids skip that trip to the hospital
(Family Physicians Inquiries Network, 2009)
Give oral ondansetron to children with acute gastroenteritis and moderate dehydration who are unable to tolerate oral rehydration to reduce the vomiting and avoid the need for intravenous (IV) hydration or hospitalization. ...
Annual zoledronic acid infusion lowers risk of fracture, death
(Family Physicians Inquiries Network, 2007)
Patients with a prior hip fracture have 2.5 times the risk of a new fracture compared to age-matched persons without a previous hip fracture. For patients with a recent hip fracture, intravenous zoledronic acid annually is an option for reducing...
How should we monitor men receiving testosterone replacement therapy?
(Family Physicians Inquiries Network, 2010)
Monitor hematocrit and bone mineral density (BMD) (strength of recommendation [SOR]: B, meta-analysis of non−patient-oriented outcomes). Monitoring prostate-specific antigen (PSA), performing prostate digital rectal ...
Does cervical membrane stripping in women with group B Streptococcus put the fetus at risk?
(Family Physicians Inquiries Network, 2012)
No direct evidence points to fetal harm from cervical membrane stripping (CMS) to induce labor in term pregnancies complicated by group B Streptococcus (GBS) colonization (strength of recommendation [SOR]: B, a Cochrane ...
When not to use beta-blockers in seniors with hypertension
(Family Physicians Inquiries Network, 2008)
Beta-blockers should not be used to treat hypertension in patients older than age 60 unless they have another compelling indication to use these agents, such as heart failure or ischemic heart disease. Stength of recommendation: A: Based on a well...