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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...
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...
What is the best diagnostic approach to alopecia in women?
(Family Physicians Inquiries Network, 2009)
Indirect evidence and expert opinion indicate that a careful history and thorough physical examination usually suggest the underlying cause of alopecia. Ancillary laboratory evaluation and scalp biopsy are sometimes necessary to make or confirm...
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...
What measures relieve postherpetic neuralgia?
(Family Physicians Inquiries Network, 2009)
Tricyclic antidepressants, gabapentin, and pregabalin effectively reduce pain (strength of recommendation [SOR]: A, at least 2 good-quality randomized controlled trials [RCTs] and/or meta-analyses). Opioids have demonstrated ...
What is the best way to screen for breast cancer in women with implants?
(Family Physicians Inquiries Network, 2008)
Mammography is best. It is considered as effective for screening women who have undergone augmentation mammoplasty as those who have not (strength of recommendation [SOR]: B, limited number of retrospective and prospective ...
Do vitamin C supplements reduce mortality in patients with cardiovascular disease?
(Family Physicians Inquiries Network, 2004)
Vitamin C, when taken as a dietary supplement, does not appear to reduce mortality in patients with cardiovascular disease. [Strength of recommendation: B, based on reviews of cohort studies and a single randomized controlled trial (RCT).]...
Missouri hospitalist, issue 19 (2009 July 23)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2009-07)
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 illnesses contraindicate immunization?
(Family Physicians Inquiries Network, 2005)
The Advisory Council on Immunization Practices (ACIP) reports that the only contraindication for all vaccines is a history of severe allergic reaction to a previous vaccine or vaccine constituent (strength of recommendations: C, based predominantly...
How effective is desmopressin for primary nocturnal enuresis?
(Family Physicians Inquiries Network, 2003)
of recommendation [SOR]: A, based on meta-analysis). Evidence suggests that the benefits of desmopressin are temporary, with a high relapse rate once treatment is discontinued (SOR: B). However, long-term therapy with occasional weaning attempts is a safe option...
Does group prenatal care improve pregnancy outcomes?
(Family Physicians Inquiries Network, 2009)
It may decrease preterm births, especially among higher-risk women--minority women, women of low socioeconomic status, and adolescents (strength of recommendation [SOR]: B, 1 randomized, controlled trial [RCT] and 1 matched ...
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 routine amniotomy have a role in normal labor?
(Family Physicians Inquiries Network, 2009)
Routine amniotomy doesn't significantly reduce the duration of first-stage labor in either primiparous or multiparous women (strength of recommendation [SOR]: A, systematic review of several randomized, controlled trials ...
Which factors increase the risk of an infant becoming an overweight child?
(Family Physicians Inquiries Network, 2009)
Variables that increase the risk of overweight in childhood include formula feeding, high birth weight, high rate of weight gain in the first 4 months of life, low socioeconomic status, and maternal obesity (strength of ...
For fibromyalgia, which treatments are the most effective?
(Family Physicians Inquiries Network, 2005)
well-being and have a moderate beneficial effect on tenderness and stiffness (strength of recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs]). Selective serotonin reuptake inhibitors (SSRIs) may moderately...
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...
How effective are nasal steroids combined with nonsedating antihistamines for seasonal allergic rhinitis?
(Family Physicians Inquiries Network, 2002)
For treating seasonal allergic rhinitis, inhaled nasal corticosteroids are superior to nonsedating antihistamines (Grade of recommendation: A, based on a large meta-analysis of randomized controlled trials [RCTs]). Combining nasal steroids...
Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid Arthritis?
(Family Physicians Inquiries Network, 2004)
The efficacy of COX-2 inhibitors is similar to that of nonselective NSAIDs in reducing the symptoms of rheumatoid arthritis. [Strength of Recommendation: A]
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 ...