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Hip Pain in Preschool-Age Children
(Family Physicians Inquiries Network, 2009)
Evidence is lacking on the most common causes of hip pain in children because most data come from cohort studies and include referred patients. Based on these studies, transient synovitis is the most common cause of hip pain in preschool...
What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?
(Family Physicians Inquiries Network, 2009)
No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in very-high-risk patients. However, no evidence suggests a "floor" for LDL cholesterol levels beyond which further reductions of heart disease...
Are overweight children more likely to be overweight adults?
(Family Physicians Inquiries Network, 2009)
Overweight at any age in childhood increases the risk for overweight in adulthood. The relative risk (RR) ranges from 1.9 to 10.1 and increases as children get older. Not all overweight children become overweight adults, ...
How often should you follow up on a patient with newly diagnosed hypothyroidism?
(Family Physicians Inquiries Network, 2009)
Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If thyroid function is normal...
How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?
(Family Physicians Inquiries Network, 2001)
Acupuncture, biofeedback, and S-adenosyl methionine (SAMe) have been shown to have some efficacy in the treatment of fibromyalgia in randomized controlled trials. Spa treatments, hypnotherapy, massage, and meditation may ...
Effective Management of Flatulence
(Family Physicians Inquiries Network, 2009)
benefit in reducing flatus-associated odor. (SOR: C, based on disease-oriented evidence). Evidence for oral activated charcoal and simethicone has been inconsistent and does not support their use. (SOR: B, based on multiple small RCTs)....
Which treatments work best for hemorrhoids?
(Family Physicians Inquiries Network, 2009)
Excision is the most effective treatment for thrombosed external hemorrhoids (strength of recommendation [SOR]: B, retrospective studies). For prolapsed internal hemorrhoids, the best definitive treatment is traditional ...
Treatment for Anogenital Molluscum Contagiosum
(Family Physicians Inquiries Network, 2009)
lesions. (Strength of Recommendation: B, based on inconsistent or limited quality patient-oriented evidence). There are no comparative trials of other commonly used treatments, such as carbon dioxide laser, cryotherapy, or curettage....
How can you help prevent a recurrence of diverticulitis?
(Family Physicians Inquiries Network, 2009)
A high-fiber diet is often prescribed after recovery from acute diverticulitis, based on extrapolation from epidemiologic data showing an association between low-fiber diets and diverticulosis (strength of recommendation [SOR]: C, expert opinion...
Which complementary therapies can help patients with PMS?
(Family Physicians Inquiries Network, 2009)
doses of pyridoxine can cause neuropathy (SOR: B, RCT and meta-analysis of lower-quality studies). Insufficient evidence exists to recommend magnesium. St. John's wort and evening primrose oil aren't effective for managing PMS (SOR: B, inconsistent...
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...
Which strategies work best to prevent obesity in adults?
(Family Physicians Inquiries Network, 2009)
Regular physical activity decreases long-term weight gain (strength of recommendation [SOR]: B, 2 high-quality, randomized controlled trials [RCTs]). Decreasing fat intake (SOR: B, 1 high-quality systematic review) and ...
Do OTC remedies relieve cough in acute URIs?
(Family Physicians Inquiries Network, 2009)
Dextromethorphan (DM) for adults and honey for children provide some relief. DM may modestly decrease cough in adults compared with placebo (strength of recommendation [SOR]: B, systematic review of inconsistent or limited evidence). The data...
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...
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's the most practical way to rule out adrenal insufficiency?
(Family Physicians Inquiries Network, 2009)
A morning serum cortisol level >13 mcg/dL reliably rules out adrenal insufficiency, and the test is easy and safe to perform. Because of low specificity, patients with a level of ≤13 mcg/dL need further evaluation with the ...
What's the best way to monitor low-risk patients with a history of differentiated thyroid cancer?
(Family Physicians Inquiries Network, 2009)
-analysis). Low-risk patients are defined as patients who have undergone total thyroidectomy and radioactive iodine (I131) remnant ablation therapy and show no clinical evidence of recurrent disease....
What is the role of prokinetic agents for constipation?
(Family Physicians Inquiries Network, 2009)
Erythromycin has a limited role in treating pediatric patients (strength of recommendation [SOR]: B, limited-quality, patient-oriented evidence). Tegaserod and cisapride are the only prokinetic agents available for constipated adults (SOR: A...
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...
How best to manage the patient in term labor whose group B strep status is unknown?
(Family Physicians Inquiries Network, 2009)
Monitor the patient and treat her with intrapartum chemoprophylaxis based on identified risk factors, unless a rapid, highly sensitive (greater than or equal to 85%) polymerase chain reaction (PCR) test is immediately available to evaluate for group...