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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 ...
What is the differential diagnosis of chronic leg edema in primary care?
(Family Physicians Inquiries Network, 2008)
(NSAIDs), and proteinuria (>1 g daily) (strength of recommendation: B, based on a nonconsecutive diagnostic cohort study with good reference standards)....
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).
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...
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...
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).
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)....
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....
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...
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 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...
What's the best drug treatment for premature ejaculation?
(Family Physicians Inquiries Network, 2008)
]). The topical application of prilocaine-lidocaine cream (trade name EMLA) improves intravaginal ejaculatory latency time (IELT), but penile numbness and loss of erection may occur (SOR: B, based on several small RCTs)....
What is the best portable method of purifying water to prevent infectious disease?
(Family Physicians Inquiries Network, 2008)
dioxide tablets, 3) MIOX purifier, 4) ultraviolet light (SteriPEN ), and 5) portable filtration with a absolute pore size <1 micrometer combined with halogenation or charcoal filtration (strength of recommendation [SOR ]: C, based on expert opinion...
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...
Should you use steroids to treat infectious mononucleosis?
(Family Physicians Inquiries Network, 2008)
Studies of steroids to treat infectious mononucleosis have found no significant effect on the clinical course of the illness at 1 to 3 months (strength of recommendation [SOR]: B, 1 randomized controlled trial [RCT] and 1 ...
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 ...
What are the most effective ways you can help patients stop smoking?
(Family Physicians Inquiries Network, 2008)
Brief counseling, nicotine replacement therapy, antidepressants, and varenicline all work well. Physician intervention should begin with routine assessment of smoking status for all patients. Brief (3 minutes or less) ...
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 ...
What drugs are best for bipolar depression?
(Family Physicians Inquiries Network, 2008)
Antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs), are useful adjuncts in short-term treatment of bipolar depression and have low rates of inducing mania (strength of recommendation ...