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Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).
When you suspect ACS, which serologic marker is best?
(Family Physicians Inquiries Network, 2014)
Measurement of troponin levels provides the most sensitive and accurate serologic information in evaluating a patient with acute coronary syndrome (ACS); troponin elevations are more sensitive than elevations of creatine ...
Whom should you test for secondary causes of hypertension?
(Family Physicians Inquiries Network, 2014)
Evidence-based answer: It's recommended that all children and adolescents with a new diagnosis of hypertension undergo renal ultrasound and laboratory evaluation for renal pathology (strength of recommendation [SOR]: C, consensus-based guidelines...
It's time to use an age-based approach to D-dimer
(Family Physicians Inquiries Network, 2014)
Use an age-adjusted D-dimer cutoff (patient's age in years [multiplied by] 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing ...
What treatments relieve arthritis and fatigue associated with systemic lupus erythematosus?
(Family Physicians Inquiries Network, 2014)
arthritis symptoms by about 35% (SOR: b, RCTs with inconsistent evidence). Abatacept and dehydroepiandrosterone don't produce clinically meaningful improvements in fatigue associated with SLE, and abatacept causes significant adverse effects (SOR: b, posthoc...
Apolipoproteins for Cardiovascular Risk Assessment
(Family Physicians Inquiries Network, 2014)
Clinical Question: Is measurement of apolipoproteins better than traditional lipid measurements for predicting cardiovascular risk? Evidence-Based Answer: Measurement of apolipoprotein B and apolipoprotein A-I is no better than traditional lipid...
An antiemetic for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2014)
An antiemetic for irritable bowel syndrome? A drug used for cancer patients may provide some relief to patients with IBS. Practice changer: Consider prescribing ondansetron up to 24 mg/d for patients who have irritable bowel syndrome with diarrhea...
Surgery for persistent knee pain
(Family Physicians Inquiries Network, 2014)
Surgery for persistent knee pain? Not so fast. Practice changer: Do not refer patients with a degenerative medial meniscus tear for arthroscopic partial meniscectomy because outcomes are no better than those of conservative treatment....
Does any antidepressant besides bupropion help smokers quit?
(Family Physicians Inquiries Network, 2014)
Q: Does any antidepressant besides bupropion help smokers quite? Evidence-based answer: Yes, nortriptyline approximately doubles smoking cessation rates, an effect comparable to bupropion. Adding nortriptyline to nicotine replacement therapy (NRT...
Skip the compression stockings following DVT
(Family Physicians Inquiries Network, 2014)
Although commonly used, compression stockings do not effectively prevent post-thrombotic syndrome. Practice changer: Do not recommend elastic compression stockings (ECS) to decrease the incidence of post-thrombotic syndrome (PTS) after deep vein...
Suctioning neonates at birth: time to change our approach
(Family Physicians Inquiries Network, 2014)
There's a better way to clear secretions from a neonate's mouth and nose, and it's less likely to cause adverse effects. Practice Changer: Stop suctioning neonates at birth. There is no benefit to this practice, and it can cause bradycardia...
Finally, a way to relieve cancer-related fatigue
(Family Physicians Inquiries Network, 2014)
A 4-week course of American ginseng, taken while patients are undergoing radiation or chemotherapy, can reduce cancer-related fatigue. PRACTICE CHANGER: Recommend American ginseng 1000 mg twice daily for 4 weeks to improve cancer-related fatigue...
What is the best approach to goiter in euthyroid patients?
(Family Physicians Inquiries Network, 2014)
In the absence of outcome studies, experts recommend ultrasound evaluation of nontoxic multinodular goiters (MNG) followed by fine-needle aspiration (FNA) of suspicious nodules (strength of recommendation [SOR]: C, consensus-based guidelines...
Low-dose penicillin for recurrent cellulitis?
(Family Physicians Inquiries Network, 2014)
Practice changer: Prescribe low-dose penicillin to patients with recurrent leg cellulitis to decrease the frequency of recurrent episodes....
Think twice about nebulizers for asthma attacks
(Family Physicians Inquiries Network, 2014)
MDIs with spacers are as effective as nebulizers for delivering beta-agonists and less likely to cause adverse effects. Practice changer: Stop ordering nebulizers to deliver beta-agonists to patients over age 2 with mild or moderate asthma...
Prolotherapy: A nontraditional approach to knee osteoarthritis
(Family Physicians Inquiries Network, 2014)
Recommend prolotherapy for patients with knee osteoarthritis (OA) that does not respond to conventional therapies.
What is the best treatment for impetigo?
(Family Physicians Inquiries Network, 2014)
Q. What is the best treatment for impetigo? A. Although evidence is lacking to support a single best treatment for impetigo, topical mupirocin, fusidic acid, gentamicin, and retapamulin are all at least 20% more likely than placebo to produce cure...
Treating migrane : the case for aspirin
(Family Physicians Inquiries Network, 2014)
Recommend aspirin 975 mg (3 adult tablets) as a viable first-line treatment for acute migraine. Consider prescribing metoclopramide 10 mg to be taken with aspirin to markedly decrease associated nausea and help achieve ...
What is the best imaging method for patients with a presumed acute stroke?
(Family Physicians Inquiries Network, 2014)
Evidence-based answer: It depends on whether the stroke is ischemic or hemorrhagic. For early detection of ischemic stroke, magnetic resonance imaging (MRI) using diffusion-weighted imaging (DWI) is highly sensitive and specific, whereas computed...
Do complementary agents lower HbA1c when used with standard type 2 diabetes therapy?
(Family Physicians Inquiries Network, 2014)
Q. Do complementary agents lower HbA1c when used with standard type 2 diabetes therapy? A. No, there is no high-quality evidence that supports using complementary or alternative agents to lower hemoglobin A1c (HbA1c) in patients with noninsulin...