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How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?
(Family Physicians Inquiries Network, 2001)
Acupuncture, biofeedback, and S-adenosyl methionine (SAMe) have been shown to have some efficacy in the treatment of fibromyalgia in randomized controlled trials. Spa treatments, hypnotherapy, massage, and meditation may ...
How effective are exercise and physical therapy for chronic low back pain?
(Family Physicians Inquiries Network, 2002)
Exercise is more effective for chronic low back pain than treatment with medication plus return to usual activity and as effective as conventional physiotherapy. The evidence is less consistent in showing that any particular exercise format provides...
Do oral contraceptives carry a significant risk of stroke for women with migranes?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly migraine with aura (strength of recommendation [SOR]: C, small case-control studies with methodological flaws...
How do antidepressants affect sexual function?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: patients treated with elective serotonin reuptake inhibitors (SSRIs) and the serotonin/norepinephrine reuptake inhibitor (SNRI) venlafaxine have significantly higher rates of overall sexual dysfunction--including desire...
What is the best beta-blocker for systolic heart failure?
(Family Physicians Inquiries Network, 2015)
Q: What is the best beta-blocker for systolic heart failure? Evidence-based answer: Three beta-blockers--carvedilol, metoprolol succinate, and bisoprolol--reduce mortality equally (by about 30% over one year) in patients with Class III or IV...
Does evidence support the use of supplements to aid in BP control?
(Family Physicians Inquiries Network, 2020)
Q: Does evidence support the use of supplements to aid in BP control? Evidence-based answer: Yes. A number of well-tolerated natural therapies have been shown to reduce systolic and diastolic blood pressure (BP). (See TABLE1-8 for summary.) However...
What is the best age to start vitamin D supplementation to prevent rickets in breastfed newborns?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: It's unclear what age is best to start vitamin D supplementation because no comparison studies exist. That said, breastfed infants who take vitamin D beginning at 3 to 5 days of life don't develop rickets (strength...
Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
(Family Physicians Inquiries Network, 2019)
Q: Is intra-articular platelet-rich plasma injection an effective treatment for knee OA? EVIDENCE-BASED ANSWER: PROBABLY NOT, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence...
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 with small patient numbers...
Is MRI useful for evaluation of acute low back pain?
(Family Physicians Inquiries Network, 2003)
is limited and weak2,3 (strength of recommendation: C, based on limited randomized controlled trials)....
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...
Which interventions can increase breastfeeding duration?
(Family Physicians Inquiries Network, 2015)
Q: Which interventions can increase breastfeeding duration? Evidence-based answer: Breastfeeding support, beyond standard care, from lay people or professionals increases both short- and long-term breastfeeding duration (strength of recommendation...
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 ...
What are the risks of long-term PPI use for GERD symptoms in patients > 65 years?
(Family Physicians Inquiries Network, 2019)
Q: What are the risks of long-term PPI for GERD symptoms in patients > 65 years? EVIDENCE-BASED ANSWER: THE USE OF PROTON PUMP INHIBITORS (PPIs) to control gastrointestinal esophageal reflux disease (GRED) is significantly associated with increased...
What is the best way to manage GERD symptoms in the elderly?
(Family Physicians Inquiries Network, 2006)
relapses than with placebo (SOR: B, double-blind RCT). Limited evidence suggests that such maintenance therapy for prior esophagitis with either H2RAs or PPIs, at half- and full-dose strength, decreases the frequency of relapse (SOR: B, extrapolation from...
Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties?
(Family Physicians Inquiries Network, 2015)
Q: Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties? Evidence-based answer: Probably not. No evidence exists for improved latching after frenotomy, and evidence concerning improvements in maternal comfort...
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
(Family Physicians Inquiries Network, 2005)
If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (strength of recommendation [SOR]: B, based on case series of dual energy x-ray absorptiometry [DEXA] scanning precision...
What clinical clues differentiate migraine from sinus headaches?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: Patients with sinus headaches have thick nasal discharge, fever, chills, sweats, or abnormally malodorous breath (SOR: B, cross-sectional study). The 5 symptoms that are most predictive of migraine are: pulsatile quality...
How often is coughing the presenting complaint in patients with gastroesophageal reflux disease?
(Family Physicians Inquiries Network, 2002)
patients with complaints of chronic cough, GERD may be the underlying cause in 40%. (Grade of recommendation: C, based on extrapolation from cohort studies.) However, no studies directly address prevalence of coughing as a presenting complaint in patients...
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 ...