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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, however (strength...
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 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...
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 ...
Is MRI useful for evaluation of acute low back pain?
(Family Physicians Inquiries Network, 2003)
Magnetic resonance imaging (MRI) is rarely helpful in the evaluation of acute low back pain. Limited evidence suggests that MRI may be useful in further assessing "red flag" in the history or physical exam. MRI has a high sensitivity and specificity...
Should we recommend universal neonatal hearing screening?
(Family Physicians Inquiries Network, 2005)
Universal neonatal hearing screening leads to both earlier detection and earlier treatment of infants with hearing loss (strength of recommendation [SOR]: A, based on a systematic review). Available evidence suggests early identification...
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....
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...
Is the long-term use of proton pump inhibitors safe?
(Family Physicians Inquiries Network, 2004)
Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials...
Do nasal decongestants relieve symptoms?
(Family Physicians Inquiries Network, 2003)
Oral and topical nasal decongestants result in a statistically significant improvement in subjective symptoms of nasal congestion and objective nasal airway resistance in adults' common colds (strength of recommendation [SOR]: A, based on randomized...
When is neuroimaging warranted for headache?
(Family Physicians Inquiries Network, 2005)
of recommendation [SOR]: B, based on a validating cohort study), decreased level of
consciousness (SOR: B, based on a retrospective, nonconsecutive case study), occipitonuchal location, multiple associated symptoms, and age older than 55 years (SOR: B, based on a...
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...
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 ...
How accurate is the clinical diagnosis of pneumonia?
(Family Physicians Inquiries Network, 2003)
of Recommendation: A, based on well-designed cohort studies). No studies specifically demonstrate improved patient outcomes through use of chest x-ray in adults; however, accurate diagnosis is expected to reduce the number of unnecessary antibiotic prescriptions...
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...
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...
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...