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Thiazolidinedione Therapy for Managing Metabolic Syndrome
(Family Physicians Inquiries Network, 2010)
syndrome who are undergoing coronary stenting. (Strength of Recommendation: B, based on a single randomized controlled trial). Effects of TZD therapy on nonglycemic markers of metabolic syndrome are inconsistent compared with the effects of other...
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...
Do intra-articular steroid injections affect glycemic control in patients with diabetes?
(Family Physicians Inquiries Network, 2010)
A single intra-articular steroid injection into the knee produces acute hyperglycemia for 2 or 3 days in patients with diabetes who otherwise have good glucose control (strength of recommendation [SOR]: B, small cohort studies). Intra...
Management of Alcohol Withdrawal Syndrome
(Family Physicians Inquiries Network, 2010)
AWS may be managed with outpatient therapy if the patient has mild to moderate symptoms. (Strength of Recommendation [SOR]: B, based on one randomized, prospective trial). The Clinical Institute Withdrawal Assessment Scale for Alcohol, Revised (CIWA...
What is the best way to diagnose menopause?
(Family Physicians Inquiries Network, 2005)
No single test for menopause is highly sensitive and specific. The best predictors that a woman will enter menopause within 4 years include age at least 50 years, amenorrhea for 3 to 11 months, and menstrual cycle irregularity within 12 months...
What's the best way to motivate patients to exercise?
(Family Physicians Inquiries Network, 2010)
There is no single best strategy to motivate patients to exercise, given the lack of data from rigorous comparison studies. There are, however, several interventions for adults that are effective. They include: writing a ...
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures. (Strength of Recommendation [SOR]: B, based on subgroup analysis of randomized controlled...
Polycystic ovarian syndrome
(Family Physicians Inquiries Network, 2010)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of polycystic ovarian syndrome.
Medications for weight loss in patients with Type 2 diabetes mellitus
(Family Physicians Inquiries Network, 2012)
Fluoxetine (Prozac) and orlistat (Xenical) produce modest short-term weight loss, but their long-term benefits are unclear and their safety is uncertain. (Strength of Recommendation [SOR]: B, based on a meta-analysis of randomized controlled trials...
What effect do inhaled steroids have on delaying the progression of COPD?
(Family Physicians Inquiries Network, 2004)
have a statistically significant impact on FEV1 decline, and thus on the progression of COPD (strength of recommendation [SOR]: B, 2 conflicting meta-analyses and numerous conflicting randomized controlled trials). In those studies that did show...
How do exercise and diet compare for weight loss?
(Family Physicians Inquiries Network, 2007)
Exercise alone produces short-term weight loss that is comparable with that induced by diet, after which a plateau in weight loss appears to occur (strength of recommendation [SOR]: B). Exercise in combination with diet promotes maintenance...
Combined Oral Contraceptives for Mothers Who Are Breastfeeding
(Family Physicians Inquiries Network, 2005)
that combined oral contraceptives may reduce the volume of breast milk but not affect the growth of infants. [Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence]...
Rubella in pregnancy
(Family Physicians Inquiries Network, 2010)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of rubella in pregnancy.
Ginger for the Treatment of Nausea and Vomiting in Pregnancy
(Family Physicians Inquiries Network, 2011)
Ginger can be safely used to reduce nausea and vomiting in pregnancy. (Strength of Recommendation [SOR]: B, based on small, heterogeneous trials comparing ginger with placebo and unproven comparators). Ginger's effectiveness appears to be similar...
Clinical Pathway for the Fontan Patient to Standardize Care
(University of Missouri -- Kansas City, 2019)
The Fontan repair is the final stage of surgical palliation for the pediatric patient with a single
ventricle heart. The post-operative medical management of this patient population can be
variable and hospital length ...
How should you manage an overweight breastfed infant?
(Family Physicians Inquiries Network, 2009)
weight gain in infants who are breastfeeding easily without supplementation has no known adverse effects. Advise parents to change behaviors that result in overfeeding or insufficient physical activity (SOR: C, expert opinion)....
Q Does inadequate sleep increase obesity risk in children?
(Family Physicians Inquiries Network, 2021-12)
Evidence-based answer: Yes, a link has been established but not a cause-effect relationship. Shorter reported sleep duration in childhood is associated with an increased risk of overweight or obesity years later (strength of recommendation [SOR]: B...
Is it time to approach spontaneous pneumothorax more conservatively?
(Family Physicians Inquiries Network, 2022)
A recent study provides modest evidence for observational management over interventional treatment, sparing patients from invasive procedures.
Premature rupture of membranes (PROM)
(Family Physicians Inquiries Network, 2011)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of premature rupture of membranes.
Pharmacogenetic Testing to Reduce Depression and Anxiety in Adults Treated with Low-Dose Lithium
(University of Missouri -- Kansas City, 2023)
effectively decreases depression and anxiety in adults with a risk allele on CACNA1C genotypes. The study design was correlational. Fifty patients were treated at a nurse practitioner-owned clinic specializing in psychiatric services in Prairie Village, Kansas...