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Do NSAIDs impede fracture healing?
(Family Physicians Inquiries Network, 2011)
Nonsteroidal anti-inflammatory drugs (NSAIDs) don't appear to impair clinical fracture healing (strength of recommendation [SOR]: B, inconsistent evidence from a randomized controlled trial [RCT] and retrospective studies). Even though animal...
Is cinnamon safe and effective for treating lipid disorders?
(Family Physicians Inquiries Network, 2011)
Insufficient evidence exists to determine whether cinnamon improves outcomes in patients with lipid disorders. In healthy patients without hyperlipidemia, cinnamon doesn't change lipid levels but does cause mild gastrointestinal symptoms...
Colicky baby? Here's a surprising remedy
(Family Physicians Inquiries Network, 2011)
This article suggests that parents of colicky breastfed infants try probiotics (Lactobacillus reuteri), which can significantly reduce daily crying time with no adverse effects. Stength of recommendation: A: A good-quality ...
What is the most effective treatment for acne rosacea?
(Family Physicians Inquiries Network, 2011)
Topical metronidazole and azelaic acid are equally effective for the papulopustular lesions of acne rosacea, although metronidazole is better tolerated. Oral doxycycline, tetracycline, and metronidazole are also effective, but not enough evidence...
Antibiotic Prophylaxis to Prevent Recurrent UTI in Children
(Family Physicians Inquiries Network, 2011)
Antibiotic prophylaxis to prevent recurrent UTI may be considered in infants and children with or without vesicoureteral reflux (VUR) after a first UTI. (Strength of Recommendation [SOR]: B, based on inconsistent evidence from systematic reviews...
Brain Natriuretic Peptide Levels for Ruling Out Heart Failure
(Family Physicians Inquiries Network, 2011)
A BNP level less than 100 pg per mL (100 ng per L) can rule out heart failure. (Strength of Recommendation [SOR]: A, based on meta-analyses.) BNP levels should be used when the pretest probability of heart failure based on overall clinical...
Childhood alopecia areata: What treatment works best?
(Family Physicians Inquiries Network, 2011)
). Other commonly used treatments--topical and oral corticosteroids, topical cyclosporine, photodynamic therapy, and topical minoxidil--have no benefit over placebo (SOR: A, 14 randomized controlled trials [RCTs] and 3 within-patient studies)....
Is your patient still using rosiglitazone?
(Family Physicians Inquiries Network, 2011)
Do not initiate rosiglitazone therapy for patients with diabetes, and consider switching those who are already taking it to pioglitazone. Stength of recommendation: A: Based on a meta-analysis of 56 randomized trials....
Reducing ACL Injuries in Female Athletes
(Family Physicians Inquiries Network, 2011)
Neuromuscular training programs that include plyometric and strengthening exercises significantly reduce noncontact ACL injuries in female soccer and handball players older than 14 years. (Strength of Recommendation: A, based on a meta...
Antidepressant Use During Pregnancy
(Family Physicians Inquiries Network, 2011)
the risk of congenital malformations or miscarriage. (Strength of Recommendation [SOR]: B, based on limited-quality, patient-oriented evidence.) The use of SSRIs or TCAs during pregnancy may increase the risk of preterm birth, low birth weight, respiratory...
Melanoma
(Family Physicians Inquiries Network, 2011)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of melanoma.
Managing Intoeing in Children
(Family Physicians Inquiries Network, 2011)
Intoeing can be accurately diagnosed using a history, physical examination, and torsional profile. (Strength of Recommendation [SOR]: C, based on expert consensus.) The three most common causes of intoeing (i.e., metatarsus adductus, internal tibial...
Time to try this warfarin alternative?
(Family Physicians Inquiries Network, 2011)
Consider dabigatran, an oral anticoagulant that does not require monitoring, for the prevention of stroke and thromboembolism in patients with atrial fibrillation. Stength of recommendation: B: Based on a single well-done randomized controlled trial...
Arthritis pain? These supplements provide little relief
(Family Physicians Inquiries Network, 2011)
of recommendation: A: Based on a good-quality meta-analysis....
What is the most effective way to treat recurrent canker sores?
(Family Physicians Inquiries Network, 2011)
Amlexanox appears to be most effective overall. Amlexanox 5% paste reduces ulcer size, pain duration, and healing time (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs]). Topical steroids ...
PSA testing: When it's useful, when it's not
(Family Physicians Inquiries Network, 2011)
testing appears to provide even a small benefit. Stength of recommendation: B: Based on a meta-analysis of 6 randomized controlled trials (RCTs) with methodological limitations, and a post hoc analysis of a large RCT....
Missouri hospitalist, issue 39 (2011 July-August)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2011-07)
Missouri hospitalist, issue 39 (2011 July-August)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2011-07)
Thiazolidinedione Therapy for Managing Metabolic Syndrome
(Family Physicians Inquiries Network, 2010)
There is no patient-oriented evidence supporting the use of TZD therapy in patients in the general population who have metabolic syndrome. Rosiglitazone (Avandia) use decreases cardiovascular morbidity and mortality in patients with metabolic...
Do ACE inhibitors decrease mortality in patients with hypertension?
(Family Physicians Inquiries Network, 2004)
When used to treat patients with hypertension, ACE inhibitors reduce cardiovascular and all-cause mortality as effectively as diuretics, beta blockers, and calcium channel blockers. [Strength of recommendation: A, based on meta...