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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...
Which medications benefit patients with diastolic heart failure?
(Family Physicians Inquiries Network, 2011)
Angiotensin-converting enzyme inhibitors (ACEIs), propranolol, statins, furosemide, and some angiotensin receptor blockers (ARBs) benefit patients. Medications that reduce mortality in diastolic heart failure include ACEIs ...
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...
Brain Natriuretic Peptide Levels for Ruling Out Heart Failure
(Family Physicians Inquiries Network, 2011)
A BNP level less than 100 pg per mL (100 ng per L) can rule out heart failure. (Strength of Recommendation [SOR]: A, based on meta-analyses.) BNP levels should be used when the pretest probability of heart failure based on overall clinical...
Tension headache
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of tension headaches.
Do patients with type 2 diabetes who aren't taking insulin benefit from self-monitoring blood glucose?
(Family Physicians Inquiries Network, 2013)
reviews and meta-analyses of disease-oriented evidence). Patients with a baseline HbA1c <8% who self-monitor don't reduce their HbA1c levels, but patients with a baseline HbA1c >8% do (SOR: B, systematic reviews and meta-analyses of disease...
Time to routinely screen for intimate partner violence?
(Family Physicians Inquiries Network, 2013)
Use a validated tool to screen women of childbearing age for intimate partner violence (IPV) and follow up with any woman with a positive screen. Stength of recommendation: B: Based on a systematic review of 10 randomized controlled trials, 11...
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...
The benefits--and limits-- of PPIs with warfarin regimens
(Family Physicians Inquiries Network, 2017)
Patients on warfarin + antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story. PRACTICE CHANGER: Prescribe a proton pump inhibitor for patients taking...
What is the most effective way to relieve symptoms of acute stress disorder?
(Family Physicians Inquiries Network, 2010)
Cognitive behavioral therapy (CBT) that emphasizes exposure-based treatment is the most effective intervention for adults with acute stress disorder (ASD) (strength of recommendation [SOR]: B, meta-analysis of limited-quality randomized controlled...
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures. (Strength of Recommendation [SOR]: B, based on subgroup analysis of randomized controlled...
Which women should we screen for gestational diabetes mellitus?
(Family Physicians Inquiries Network, 2010)
, the common practice of universal screening is more sensitive than screening based on risk factors (strength of recommendation [SOR]: B, 1 randomized trial and 3 retrospective cohort studies without patient-oriented outcomes). Historic risk factors are poor...
Is arthroscopic subacromial decompression effective for shoulder impingement?
(Family Physicians Inquiries Network, 2015)
Q: Is arthroscopic subacromial decompression effective for shoulder impingement? Evidence-based answer: It's impossible to say for certain in the absence of randomized controlled trials. However, in patients whose impingement symptoms don't improve...
Is cinnamon safe and effective for treating lipid disorders?
(Family Physicians Inquiries Network, 2011)
Insufficient evidence exists to determine whether cinnamon improves outcomes in patients with lipid disorders. In healthy patients without hyperlipidemia, cinnamon doesn't change lipid levels but does cause mild gastrointestinal symptoms...
What's best for croup?
(Family Physicians Inquiries Network, 2011)
in moderate-to-severe croup (SOR: C, limited-quality disease-oriented evidence). The role of heliox in moderate to severe croup remains uncertain. Studies to date have been inadequate (SOR: C, limited-quality disease-oriented evidence). Humidified air provides...
Management of ADHD in preschool-aged children
(Family Physicians Inquiries Network, 2013)
RCTs.) Alternative therapies, such as elimination diets, have limited evidence of success and should generally be avoided or used in conjunction with standard therapies. (SOR: B, based on a systematic review of a small number of heterogeneous RCTs.)...
Which treatments help women with reduced libido?
(Family Physicians Inquiries Network, 2013)
Several treatments produce modest, but statistically significant, clinical increases in sexual desire and function in women. The testosterone transdermal patch improves hypoactive sexual desire disorder (HSDD) in postmenopausal ...
What's the best way to manage upper extremity venous thrombosis?
(Family Physicians Inquiries Network, 2010)
Standard management is best: Start with unfractionated heparin or low-molecular-weight heparin and follow with long-term therapy with a vitamin K antagonist (strength of recommendation [SOR]: C, expert consensus and case reports). Some evidence...
Antidepressant Use During Pregnancy
(Family Physicians Inquiries Network, 2011)
the risk of congenital malformations or miscarriage. (Strength of Recommendation [SOR]: B, based on limited-quality, patient-oriented evidence.) The use of SSRIs or TCAs during pregnancy may increase the risk of preterm birth, low birth weight, respiratory...
Childhood alopecia areata: What treatment works best?
(Family Physicians Inquiries Network, 2011)
There are no validated effective treatments for alopecia areata (AA). Topical immunotherapy (squaric acid dibutylester [SADBE] and diphenylcyclopropenone [DPCP]) induces the most significant short-term hair regrowth in ...