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What are the indications for tonsillectomy in children?
(Family Physicians Inquiries Network, 2002)
. (Grade of recommendation: B, based on low-quality randomized controlled trials [RCTs]). The evidence supporting tonsillectomy for recurrence of sore throat is controversial. There is insufficient evidence to recommend other potential indications. (Grade...
What's the best diagnostic evaluation of night sweats?
(Family Physicians Inquiries Network, 2007)
There is no single best evidence-based approach to the diagnostic evaluation of night sweats, given the limited number of studies on the subject. A detailed history, however, does appear to be the most important initial diagnostic tool (strength...
What environmental modifications improve pediatric asthma?
(Family Physicians Inquiries Network, 2002)
Reducing environmental tobacco smoke exposure decreases health care utilization among poor asthmatic children. Dust mite reduction by chemical measures is potentially harmful. (Grade of recommendations: B, based on single randomized controlled trial...
Is therapy based on endoscopy results better than empiric therapy for dyspepsia?
(Family Physicians Inquiries Network, 2005)
In the initial management of dyspepsia for patients without "alarm" symptoms (weight loss, recurrent vomiting, dysphagia, anemia, evidence of bleeding, onset of dyspepsia after age 45 years), therapy based on the results of early endoscopy...
What are the best treatments for herpes labialis?
(Family Physicians Inquiries Network, 2007)
, decreases the pain duration and healing time to loss of crust (strength of recommendation [SOR]: A, based on randomized controlled trials [RCTs]). Topical penciclovir 1%, acyclovir 5%, or docosanol 10% also decrease the duration of pain and healing time (SOR...
Does birth weight predict childhood obesity?
(Family Physicians Inquiries Network, 2008)
A birth weight greater than 4,000 g is associated with an increased risk of obesity in both childhood and adolescence (strength of recommendation [SOR]: B, systematic review and multiple cohort studies).
What is the evaluation and treatment strategy for Raynaud's phenomenon?
(Family Physicians Inquiries Network, 2005)
Raynaud's phenomenon is diagnosed by history,
which also plays a key role in distinguishing
primary from secondary Raynaud's phenomenon
(strength of recommendation [SOR]: C, based
on expert opinion). The initial treatment includes conservative...
What is appropriate management of iron deficiency for young children?
(Family Physicians Inquiries Network, 2006)
should continue for 2 additional months to replenish iron stores. Recheck hemoglobin at the end of treatment and again 6 months later (strength of recommendation [SOR]: C, based on expert opinion). For primary prevention, counsel parents on the use...
How do we decide when a patient with nonmalignant disease is eligible for hospice care?
(Family Physicians Inquiries Network, 2006)
Each hospice has its own policy, but Medicare requires 6 months or less life expectancy for certification of eligibility and reimbursement. Other important criteria include patient and family understanding and wishes. Evidence-based guidelines...
What is the best test for peripheral vascular disease?
(Family Physicians Inquiries Network, 2008)
An ankle-brachial index is best for evaluating patients with symptoms of claudication (strength of recommendation [SOR]: B, multiple cohort studies). That said, duplex ultrasonography or magnetic resonance angiography may ...
Best Alternatives to Statins for Treating Hyperlipidemia
(Family Physicians Inquiries Network, 2007)
but not total mortality. (SOR: A, based on review of RCTs). The effects of ezetimibe (Zetia) on cardiovascular outcomes and mortality are unknown. (SOR: C, based on a single RCT with disease-oriented evidence). Omega-3 fatty acid supplementation does not clearly...
How effective is desmopressin for primary nocturnal enuresis?
(Family Physicians Inquiries Network, 2003)
of recommendation [SOR]: A, based on meta-analysis). Evidence suggests that the benefits of desmopressin are temporary, with a high relapse rate once treatment is discontinued (SOR: B). However, long-term therapy with occasional weaning attempts is a safe option...
What are the repercussions of disclosing a medical error?
(Family Physicians Inquiries Network, 2008)
Physicians and their staff may experience a resolution of anxiety and guilt that can improve their well-being (strength of recommendation [SOR]: C, based on survey data). Full disclosure has little effect, however, on the likelihood that an injured...
What is the best strategy for impaired glucose tolerance in nonpregnant adults?
(Family Physicians Inquiries Network, 2005)
The best treatment strategy for impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) is lifestyle intervention with a structured weight loss program of diet and exercise (strength of recommendation [SOR]: B, based on high...
At what age do patients no longer need colorectal cancer screening?
(Family Physicians Inquiries Network, 2001)
Good evidence supports fecal occult blood testing (FOBT) for patients up to age 75 (grade of recommendation: A, based on systematic review of randomized controlled trials). There is insufficient evidence to recommend for or against colorectal cancer...
What best prevents exercise-induced bronchoconstriction for a child with asthma?
(Family Physicians Inquiries Network, 2006)
trials [RCTs]). Less evidence supports the use of leukotriene antagonists and inhaled corticosteroids, either individually or in combination (SOR: B). Underlying asthma, which commonly contributes to exercise-induced bronchoconstriction, should...
What's the most effective treatment for giardiasis?
(Family Physicians Inquiries Network, 2008)
A single 2-g dose of tinidazole is the best treatment (strength of recommendation [SOR]: A, based on meta-analysis). Other drugs, such as nitazoxanide, metronidazole, mebendazole, and albendazole, can also be used (SOR: A, based on randomized...
What is the prognosis of postherpetic neuralgia?
(Family Physicians Inquiries Network, 2003)
, based on a well-done prospective cohort study)....
Are major bleeding events from falls more likely in patients on warfarin?
(Family Physicians Inquiries Network, 2006)
There is no evidence of increased risk for major bleeding as a result of falls in hospitalized patients taking warfarin (strength of recommendation [SOR]: B, based on retrospective cohort studies). In the average patient taking warfarin for atrial...
Efficiency of Alternative Technologies and Cultural Practices for Cotton in Georgia
(AgBioForum, 2002)
Transgenic cotton varieties and conservation tillage practices are evaluated for technical and allocative efficiency, as well as net returns above variable costs. Data Envelopment Analysis is applied to a survey of Georgia cotton producers. Results...