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Is lower BP worth it in higher-risk patients with diabetes or coronary disease?
(Family Physicians Inquiries Network, 2016)
Q: Is lower BP worth it in higher-risk patients with diabetes or coronary disease? Evidence-based answer: There is no simple answer; the risk/benefit picture is complicated. Controlling blood pressure to a target of 130/80 mm Hg or lower produces...
What laboratory monitoring is appropriate to detect adverse drug reactions in patients on cholesterol-lowering agents?
(Family Physicians Inquiries Network, 2001)
Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not recommended that serum...
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, but no better than anti...
What's the best secondary treatment for patients who fail initial triple therapy for H pylori?
(Family Physicians Inquiries Network, 2018)
Q: What's the best secondary treatment for patients who fail initial triple therapy for H pylori? Evidence-based answer: treating patients with Helicobacter pylori infection who have failed clarithromycin-based triple therapy with either...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating characteristics...
What is a reasonable initial approach to the patient with fatigue?
(Family Physicians Inquiries Network, 2001)
with sedimentation rate, blood count, and glycohemoglobin and thyroid stimulating hormone (TSH) levels, particularly in older patients. Grade of Recommendation: C, based on case series and expert opinion...
Does tranexamic acid reduce mortality in women with postpartum hemorrhage?
(Family Physicians Inquiries Network, 2019)
Q: Does tranexamic acid reduce mortality in women with postpartum hemorrhage? EVIDENCE-BASED ANSWER: Yes. When used in conjunction with the standard of care, 1 g intravenous (IV) tranexamic acid given 1 to 3 hours after delivery is associated with a...
What are the indications for treatment with angiotensin-converting enzyme (ACE) inhibitors in patients with diabetes?
(Family Physicians Inquiries Network, 2001)
of recommendation: A, based on randomized controlled trials.)...
How effectively do ACE inhibitors and ARBs prevent migraines?
(Family Physicians Inquiries Network, 2018)
Q: How effectively do ACE inhibitors and ARBs prevent migraines? Evidence-based answer: The angiotensin-converting enzyme (ACE) inhibitor lisinopril reduces the number of migraines by about 1.5 per month in patients experiencing 2 to 6 migraines...
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...
What medical therapies work for gastroparesis?
(Family Physicians Inquiries Network, 2018)
Q: What medical therapies work for gastroparesis? Evidence-based answer: It's unclear if there are any highly effective medications for gastroparesis (TABLE1-10). Metoclopramide improves the sense of fullness by about 40% for as long as 3 weeks, may...
What is the best test to diagnose urinary tract stones?
(Family Physicians Inquiries Network, 2001)
. (Grade of recommendation: A, based on independent blind comparison of an appropriate spectrum of patients.)...
Should patients receive 23-valent pneumococcal vaccination more than once?
(Family Physicians Inquiries Network, 2006)
. Revaccination is recommended by the Advisory Committee on Immunization Practices (ACIP) in certain circumstances. (strength of recommendation [SOR]: C, expert opinion based on physiology/bench research). Revaccination once appears to be safe, especially...
Have pedometer, will travel
(Family Physicians Inquiries Network, 2008)
blood pressure. Stength of recommendation: A: Based on a meta-analysis of randomized controlled trials (RCTs) and observational studies....
Focus on Leadership, Climate, Culture, and Instructional Practices: Practical Strategies for School Improvement.
(2007-02)
This presentation discusses leadership, climate, culture and instructional practices. It raises questions and links topics together for a big-picture view....
When should we stop mammography screening for breast cancer in elderly women?
(Family Physicians Inquiries Network, 2001)
There is insufficient evidence to recommend for or against routine screening mammography beyond the age of 69 years. The best candidates to stop screening are elderly women who have significant comorbidities, poor functional status, low bone mineral...
Tension headache
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of tension headaches.
How should you manage a depressed patient unresponsive to an SSRI?
(Family Physicians Inquiries Network, 2006)
The best approach among studied alternatives to manage a patient with treatment-resistant depression is not clear from the evidence. All of the options reviewed seem to have about a 25% to 30% success rate. Switching to other antidepressants...
Give vitamin C to avert lingering pain after fracture
(Family Physicians Inquiries Network, 2008)
Vitamin C 500 mg daily for 50 days reduced the risk of complex regional pain syndrome for patients with a wrist fracture. We think vitamin C 500 mg a day for 7 weeks is well worth recommending. Stength of recommendation: A: Based on 2 consistent...
Can mobile technology improve weight loss in overweight and obese patients?
(Family Physicians Inquiries Network, 2017)
Q: Can mobile technology improve weight loss in overweight and obese patients? Evidence-based answer: Yes, this technology can help in the short term. Mobile technology compared with minimal or no intervention increases short-term (<6 months) weight...