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Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
, based on randomized controlled trials (RCTs) and systematic reviews] There is limited evidence that antidepressant medications and cognitive behavioral therapy are similarly effective for patients with severe depression [Strength of recommendation: B...
What are the most practical primary care screens for post-traumatic stress disorder?
(Family Physicians Inquiries Network, 2009)
The 4-item Primary Care Post-Traumatic Stress Disorder screen (PC-PTSD) is a simple and effective tool to identify symptoms of post-traumatic stress disorder (PTSD) in primary care patients (strength of recommendation [SOR ...
Are there any known health risks to early introduction of solids to an infant's diet?
(Family Physicians Inquiries Network, 2009)
Few studies support an association between early introduction of solid food and atopic conditions, obesity, or any other illness (strength of recommendation [SOR]: B, cohort studies with mixed results). Very weak evidence suggests an increased risk...
Missouri hospitalist, issue 14 (2009 February 25)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2009-02)
Does cranberry juice prevent or treat urinary tract infection?
(Family Physicians Inquiries Network, 2003)
Cranberry juice (200 mL daily to 250 mL 3 times daily) or cranberry concentrate tablets (at least 1:30 parts concentrated juice twice daily) reduce recurrent, symptomatic urinary tract infection (UTI) in women by 12% to 20% (absolute risk reduction...
Does a Low-Sodium Diet Reduce Blood Pressure?
(Family Physicians Inquiries Network, 2004)
Reducing sodium intake does lead to a slightly lower average blood pressure. However, no evidence from controlled trials proves that reducing sodium intake decreases morbidity or mortality, or proves that modest sodium restriction is harmful...
What is the best diagnostic approach to postmenopausal vaginal bleeding in women taking hormone replacement therapy?
(Family Physicians Inquiries Network, 2001)
continues. (Grade of recommendation: C, based on case series.) Evaluation of this bleeding should begin with a pelvic examination and Papanicolaou (Pap) test (if not done in the previous 12 months), then transvaginal ultrasound (TVUS), followed...
Do patients at high risk of Alzheimer's disease benefit from early treatment?
(Family Physicians Inquiries Network, 2009)
Treating patients with early-stage Alzheimer's disease yields statistically significant, though perhaps not clinically significant, improvement in cognition and global function (strength of recommendation [SOR]: A, consistent evidence from multiple...
What is the best approach to prevention and treatment of osteoporosis?
(Family Physicians Inquiries Network, 2001)
evidence for osteoporotic fracture prevention. Concurrent calcium and vitamin D may also prevent fractures. Physical exercise and smoking cessation have been associated with increased bone density, but fracture prevention has not been reported (Grade...
Vertebroplasty for osteoporotic fracture? Think twice
(Family Physicians Inquiries Network, 2009)
Think twice before recommending vertebroplasty (VP) for symptomatic osteoporotic compression fractures. New studies suggest that it has little benefit; thus, VP should be considered only after other, more conservative ...
What is the best strategy for monitoring the lipid-lowering effects of medical therapy used for the primary prevention of coronary artery disease (CAD)?
(Family Physicians Inquiries Network, 2001)
There is good evidence that treatment for primary prevention of CAD decreases risk of major first coronary events and cardiovascular mortality, though all-cause mortality has not been shown to be reduced. There is no evidence identifying the best...
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)....
What laboratory monitoring is appropriate to detect adverse drug reactions in patients on cholesterol-lowering agents?
(Family Physicians Inquiries Network, 2001)
Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not recommended that serum...
What treatments work best for constipation in children?
(Family Physicians Inquiries Network, 2009)
limited evidence supports this approach (strength of recommendation [SOR]: B for fiber, 1 randomized controlled trial [RCT]; C for behavior modification, 1 small trial). For pharmacologic management, the best evidence supports osmotic laxatives (SOR: A, 6...
What's the best test for renal artery stenosis in patients with refractory hypertension?
(Family Physicians Inquiries Network, 2009)
Magnetic resonance angiography (MRA) and computed tomography angiography (CTA) are the most consistently accurate, noninvasive screening methods. MRA is likely the preferred option because of its lack of radiation and ...
Treatment of Impetigo
(Family Physicians Inquiries Network, 2007)
of recommendation [SOR]: A) Based on the available evidence on effectiveness, no clear preference can be given for any one oral antibiotic over another. (SOR: A)...
What is the appropriate management for a patient with CIN1 on colposcopy?
(Family Physicians Inquiries Network, 2006)
Of the different strategies available for managing cervical intraepithelial neoplasia grade 1 (CIN1), testing for high-risk subtypes of the human papillomavirus (hr-HPV) DNA at 12 months has the highest sensitivity for predicting the development...
Can counseling prevent or treat postpartum depression?
(Family Physicians Inquiries Network, 2009)
In most cases, counseling does not prevent postpartum depression (PPD), though it can treat the disorder. Overall, psychosocial interventions don't offer a significantly greater benefit than standard care in preventing ...
Initiating antidepressant therapy? Try these 2 drugs first
(Family Physicians Inquiries Network, 2009)
When you initiate antidepressant therapy for patients who have not been treated for depression previously, select either sertraline or escitalopram. A large meta- analysis found these medications to be superior to other ...
Arthroscopic surgery for knee osteoarthritis? Just say no
(Family Physicians Inquiries Network, 2009)
Do not recommend arthroscopic surgery to adults with osteoarthritis of the knee. Treat knee pain with medical and physical therapy instead. Stength of recommendation: A: Based on 2 high-quality randomized controlled trials....