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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....
Patients insist on antibiotics for sinusitis? Here is a good reason to say no
(Family Physicians Inquiries Network, 2008)
and create unnecessary expense. Stength of recommendation: A: Based on a meta-analysis of 9 randomized trials in primary care practice....
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...
Which patients undergoing noncardiac surgery benefit from perioperative beta-blockers?
(Family Physicians Inquiries Network, 2008)
Patients with moderate to high cardiac risk (a Revised Cardiac Risk Index [RCRI] score of 2 or higher [Table]) have a reduced risk of in-hospital death following perioperative beta-blocker therapy (strength of recommendation [SOR]: B, based on a...
Glucose self-monitoring: Think twice for type 2 patients
(Family Physicians Inquiries Network, 2008)
Stop routinely recommending blood glucose self-monitoring for patients with newly diagnosed type 2 diabetes. Self-monitoring does not improve glycemic control for patients who are not taking insulin, and it increases the ...
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...
Dust mite control measures don't help asthma patients
(Family Physicians Inquiries Network, 2008)
Stop recommending dust mite control measures to your asthma patients. Neither chemical nor physical reduction measures are effective in improving peak flow, symptoms of asthma, or medication usage. Stength of recommendation: B: Based on a meta...
When not to use beta-blockers in seniors with hypertension
(Family Physicians Inquiries Network, 2008)
Beta-blockers should not be used to treat hypertension in patients older than age 60 unless they have another compelling indication to use these agents, such as heart failure or ischemic heart disease. Stength of recommendation: A: Based on a well...
What is the best way to evaluate an acute traumatic knee injury?
(Family Physicians Inquiries Network, 2008)
The Ottawa Knee Rules can guide the use of radiography in adults who present with isolated knee pain. However, information on use of these rules in the pediatric population is limited (strength of recommendation [SOR ]: A, based on systematic review...
For Bell's palsy, start steroids early; no need for an antiviral
(Family Physicians Inquiries Network, 2008)
A 10-day course of corticosteroids (prednisolone 25 mg twice daily) started within 72 hours significantly improves the chances of complete recovery. There is no added benefit from acyclovir. Stength of recommendation: A: Based on a large, well...
Treat depressed teens with medication and psychotherapy
(Family Physicians Inquiries Network, 2008)
Refer adolescents with moderate to severe depression for cognitive behavioral therapy (CBT) to improve their outcomes. Stength of recommendation: B: Two well-done randomized controlled trials (RCTs).
Antidepressants causing sexual problems? Give her Viagra
(Family Physicians Inquiries Network, 2008)
Tell women for whom you prescribe selective and nonselective serotonin reuptake inhibitors (SRIs) to let you know if they develop sexual dysfunction. Offer sildenafi (50 mg with the option to increase to 100 mg) to ...
Acute gout: Oral steroids work as well as NSAIDs
(Family Physicians Inquiries Network, 2008)
Use a short course of oral steroids (prednisone 30-40mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line ...
Drugs help pass more ureteral stones
(Family Physicians Inquiries Network, 2008)
Prescribe tamsulosin (typically 0.4 mg daily) or nifedipine (typically 30 mg daily) for patients with lower ureteral calculi, to speed stone passage and to avoid surgical intervention. Stength of recommendation: A: ...
Which clinical features and lab findings increase the likelihood of temporal arteritis?
(Family Physicians Inquiries Network, 2008)
of this diagnosis (strength of recommendation: B, based on systematic reviews of retrospective cohort studies). Patients with temporal arteritis frequently complain of headaches, and often have mildly abnormal erythrocyte sedimentation rates (ESR), but neither...
Effects of Soy Protein-Based Formula in Full-Term Infants
(Family Physicians Inquiries Network, 2008)
There are no significant long-term detrimental effects associated with the use of currently available, commercially produced, isolated soy protein-based formula in full-term infants. (Strength of Recommendation: B, based primarily on cohort studies...
Does regular exercise reduce the pain and stiffness of osteoarthritis?
(Family Physicians Inquiries Network, 2008)
Exercise helps reduce the pain, but it's unclear whether it helps with stiffness. Exercise moderately reduces pain in elderly patients with osteoarthritis (strength of recommendation [SOR]: A, 3 systematic reviews, including ...
How much does smoking cessation cut CHD risk?
(Family Physicians Inquiries Network, 2008)
Patients with coronary heart disease (CHD) who refrain from smoking over a 2-year follow-up period decrease their relative risk (RR) for morbidity and mortality by about one third (strength of recommendation [SOR]: A, ...
Can metformin undo weight gain induced by antipsychotics?
(Family Physicians Inquiries Network, 2008)
of recommendation: B: Based on a single, well-designed, randomized controlled trial....
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...