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What's the best way to manage athletes with amenorrhea?
(Family Physicians Inquiries Network, 2008)
Ruling out secondary causes of amenorrhea is, of course, the first step. Once that's done, you can make a presumptive diagnosis of hypothalamic amenorrhea and advise the patient to increase caloric intake or decrease energy ...
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 screening tests should you use to evaluate a man with low testosterone?
(Family Physicians Inquiries Network, 2008)
Obtain a repeat morning testosterone level, as well as levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin to help understand the cause of low testosterone when there is a lack of adequate empiric evidence to guide...
Prophylactic oxytocin: Before or after placental delivery?
(Family Physicians Inquiries Network, 2008)
Timing alone doesn't influence the drug's efficacy in preventing postpartum bleeding (strength of recommendation: B, randomized controlled trial [RCT] and prospective cohort studies).
Does heat or cold work better for acute muscle strain?
(Family Physicians Inquiries Network, 2008)
Cryotherapy is better than heat for treating acute muscle strain (strength of recommendation [SOR]: C, consensus, usual practice, and expert opinion). Insufficient patient-oriented evidence exists regarding use of heat to treat acute soft...
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....
Effect of Antiepileptic Drugs on Oral Contraceptives
(Family Physicians Inquiries Network, 2008)
taking oral contraceptives, raising the potential for decreased effectiveness of oral contraceptives and increased risk of unplanned pregnancy. (Strength of Recommendation [SOR]: C, based on small cohort studies). Antiepileptic drugs that do not induce...
Treatment of Bulimia Nervosa
(Family Physicians Inquiries Network, 2008)
Cognitive behavior therapy (CBT) is the most effective treatment for bulimia nervosa based on multiple consistent randomized-controlled trials (RCTs). (Strength of Recommendation [SOR]: A). Guided self-help has not been shown to be beneficial...
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...
Does case management improve diabetes outcomes?
(Family Physicians Inquiries Network, 2008)
Patients with type 2 diabetes benefit from case management, as evidenced by decreased glycated hemoglobin (HbA1c). The improvement in HbA1c appeared larger when case managers could make changes in medications independently ...
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....
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...
Leukotriene Receptor Antagonists for the Treatment of Allergic Skin Disorders
(Family Physicians Inquiries Network, 2008)
Evidence from small trials suggests that leukotriene receptor antagonists may have short-term effectiveness in reducing sleep disturbance and the observed intensity of atopic dermatitis in adults and children. (Strength of Recommendation [SOR]: B...
What could be behind your elderly patient's subjective memory complaints?
(Family Physicians Inquiries Network, 2008)
Depression, anxiety, and dementia, as well as older age, female gender, lower education level, and decreased physical activity, have all been associated with memory loss reported by patients or family members (strength of ...
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...
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...
Quality of Life in Older Persons with Dementia Living in Nursing Homes
(Family Physicians Inquiries Network, 2008)
with assisted living/residential care facilities. However, evidence suggests a gradual decline in average functioning in persons with dementia, regardless of living situation. (Strength of Recommendation: B; based on cohort studies)....