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Does knuckle popping lead to arthritis?
(Family Physicians Inquiries Network, 2016)
Q: Does knuckle popping lead to arthritis? Evidence-based answer: No, habitual knuckle popping, or cracking (over the course of several decades) isn't associated with clinical or radiographic evidence of osteoarthritis (strength of recommendation...
Does caffeine intake during pregnancy affect birth weight?
(Family Physicians Inquiries Network, 2016)
Q: Does caffeine intake during pregnancy affect birth weight? Evidence-based answer: No. Reducing caffeinated coffee consumption by 180 mg of caffeine (the equivalent of 2 cups) per day after 16 weeks-gestation doesn't affect birth weight. Consuming...
Deliver or wait with late preterm membrane rupture?
(Family Physicians Inquiries Network, 2016)
of clinical indications for delivery, consider expectant management in women with premature rupture of membranes in late preterm stages (34 weeks to 36 weeks, 6 days). Stength of recommendation: B: Based on one well-designed randomized controlled trial: Morris...
Potential harms of long-term acne treatment with oral antibiotics
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What are the potential harms of long-term acne treatment with oral antibiotics? Evidence-based answer: Specific evidence attributing adverse effects to long-term acne treatment with oral antibiotics is lacking. However...
Aneuploidy screening: Newer noninvasive test gains traction
(Family Physicians Inquiries Network, 2016)
Favorable results from the 2 studies reviewed here have prompted ACOG to recommend that cell-free DNA screening be discussed with all pregnant patients. Practice changer: Discuss cell-free DNA testing when offering fetal aneuploidy screening...
Resistant hypertension? Time to consider this fourth-line drug
(Family Physicians Inquiries Network, 2016)
Resistant hypertension? Time to consider this fourth-line drug For most adults with resistant hypertension, spironolactone is superior to doxazosin and bisoprolol as an adjunct to triple therapy. Practice changer: When a ...
On-demand pill protocol protects against HIV
(Family Physicians Inquiries Network, 2016)
On-demand pill protocol protects against HIV: Finally, there's an effective prevention strategy -- other than condoms -- that can be used, as needed, by patients at high risk for HIV infection. Practice changer: Offer ...
Acupuncture for low back pain
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: Is acupuncture effective in improving pain relief for low back pain? Evidence-based answer: Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham...
Kidney stones? It's time to rethink those meds
(Family Physicians Inquiries Network, 2016)
Kidney stones? It's time to rethink those meds. Despite being recommended for ureteral stone expulsion, tamsulosin or nifedipine are no more effective than placebo. Practice changer: Do not prescribe tamsulosin or nifedipine ...
Which patients with metabolic syndrome benefit from metformin?
(Family Physicians Inquiries Network, 2016)
[SOR]: C, post-hoc analysis of a randomized controlled trial [RCT]). Intensive lifestyle modification reduces absolute risk in all patients proportionate to risk quartile (from 5% reduction for the lowest quartile to 28% for the highest). Over a 10-year...
Hypoglycemia with insulin and sulfonylureas
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: In patients with type 2 diabetes mellitus (T2DM), does the combination of insulin and sulfonylurea (SU) increase the risk of hypoglycemia? Evidence-based answer: The incidence of severe hypoglycemia in patients with T2DM...
Does breastfeeding affect the risk of childhood obesity?
(Family Physicians Inquiries Network, 2016)
Q: Does breastfeeding affect the risk of childhood obesity? Evidence-based answer: Yes. Even having breastfed during the first year of life is associated with a 15% lower risk of overweight or obesity over the next 2 to 14 years compared with never...
Ruling out PE in pregnancy
(Family Physicians Inquiries Network, 2020)
Can clinical probability and a high-sensitivity D-dimer test reliably and safely rule out pulmonary embolism during pregnancy? PRACTICE CHANGER: Use a clinical probability score to identify patients at low or intermediate risk for pulmonary embolism...
Do corticosteroid injections improve carpal tunnel syndrome symptoms?
(Family Physicians Inquiries Network, 2016)
Q: Do corticosteroid injections improve carpal tunnel syndrome symptoms? Evidence-based answer: Yes. injected corticosteroids reduce symptoms of carpal tunnel syndrome (CTS) more effectively than placebo or systemic steroids, ...
Which nonhormonal treatments are effective for hot flashes?
(Family Physicians Inquiries Network, 2016)
of recommendation [SOR]: A, systematic reviews and meta-analyses of randomized controlled trials [RCTs]). In comparison, estrogen reduces the frequency of hot flashes by about 75%, or 2.5 to 3 per day. The phytoestrogens (soy isoflavones, red clover extract, black...
Need an add-on to metformin? Consider this
(Family Physicians Inquiries Network, 2017)
Need an add-on to metformin? Consider this. Sulfonylureas have been the preferred add-on therapy to metformin for T2DM, but a study finds that DPP-4s have lower risks of death, CV events, and hypoglycemia. Practice changer: Consider a dipeptidyl...
Efficacy of a low-carbohydrate or ketogenic diet in preventing patient morbidity and mortality
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What is the efficacy of a low-carbohydrate or ketogenic diet in the prevention of patient morbidity and mortality? Evidence-based answer: Ketogenic diets can reduce seizure incidence in refractory epilepsy (strength...
Can early introduction of gluten reduce risk of celiac disease?
(Family Physicians Inquiries Network, 2022)
This UK study revealed the benefits of introducing gluten at age 4 months.
When to "CAP" off treatment for pneumonia
(Family Physicians Inquiries Network, 2017)
clinical success rates as longer treatment regimens, but is associated with fewer negative patient outcomes....
How often does long-term PPI therapy cause clinically significant hypomagnesemia?
(Family Physicians Inquiries Network, 2018)
/dL, especially when used concurrently with diuretics and loop diuretics (strength of recommendation [SOR]: C, disease-oriented outcomes based on cohort, case-control, and cross-sectional studies). Clinically significant or symptomatic hypomagnesemia (below 1.2 mg...