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What treatment is best for hypertrophic scars and keloids?
(Family Physicians Inquiries Network, 2011)
No one treatment is best (strength of recommendation [SOR]: C, meta-analysis of heterogenous studies); no good evidence exists comparing treatments with each other. Triamcinolone injections, triamcinolone injections combined with excision...
How can we minimize recurrent ankle sprains?
(Family Physicians Inquiries Network, 2011)
Using external ankle supports during physical activity significantly reduces the likelihood of primary and secondary sprains (strength of recommendation [SOR]: A, systematic review). Proprioception rehabilitation substantially ...
What's the best way to relieve mastitis in breastfeeding mothers?
(Family Physicians Inquiries Network, 2011)
for treating undifferentiated mastitis is unknown (SOR: A, 1 systematic review). Consider prescribing antibiotics for women whose mastitis symptoms don't improve after 12 to 24 hours of frequent breast emptying (SOR: C, consensus guideline)....
Does turmeric relieve inflammatory conditions?
(Family Physicians Inquiries Network, 2011)
Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory conditions (strength of recommendation [SOR]: C, primarily low-quality cohort studies with small patient numbers...
Appetite Suppressants as Adjuncts for Weight Loss
(Family Physicians Inquiries Network, 2011)
. (Strength of Recommendation: B, based on a randomized trial and a meta-analysis.) No current evidence is available on the long-term risks and benefits of these medications, or the most appropriate time to initiate appetite suppressant therapy as part of a...
Chronic urticaria: What diagnostic evaluation is best?
(Family Physicians Inquiries Network, 2011)
(strength of recommendation: B, inconsistent or limited-quality evidence)....
Clinical Indicators of Obstructive Sleep Apnea
(Family Physicians Inquiries Network, 2011)
Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study. (Strength of Recommendation: B, based...
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011)
to improve subjective ratings of sleep quality. (Strength of Recommendation: B, based on one qualitative study and one meta-analysis.)...
What is the prognosis for patients with chronic urticaria?
(Family Physicians Inquiries Network, 2011)
The prognosis for chronic urticaria in primary care is unknown; studies in dermatology clinics in multiple countries report complete resolution in approximately one-third of patients with idiopathic chronic urticaria over ...
Ferning in amniotic fluid: Is it a useful indicator of ruptured membranes?
(Family Physicians Inquiries Network, 2011)
The presence of arborized crystals (ferning) in amniotic fluid is both sensitive (74%-100%) and specific (77%-100%) for diagnosing rupture of membranes in laboring women who report loss of fluid (strength of recommendation ...
When is discectomy indicated for lumbar disc disease?
(Family Physicians Inquiries Network, 2011)
Emergent discectomy is indicated in the presence of cauda equina and severe, progressive neuromotor deficits (strength of recommendation [SOR]: C, expert opinion). Elective discectomy for sciatica caused by lumbar disc ...
Postcholecystectomy diarrhea: What relieves it?
(Family Physicians Inquiries Network, 2011)
A trial of a bile acid binder such as cholestyramine or colestipol may benefit patients with postcholecystectomy diarrhea (strength of recommendation [SOR]: C, case series). Although postcholecystectomy diarrhea is uncommon ...
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...
Postprostatectomy incontinence? Here's help
(Family Physicians Inquiries Network, 2011)
Postprostatectomy incontinence? Here's help. Behavioral therapy is an effective treatment for incontinence related to prostatectomy. Practice changer: Recommend behavioral therapy--incorporating pelvic floor muscle training and bladder control...
Which smoking cessation interventions work best?
(Family Physicians Inquiries Network, 2011)
Nicotine replacement therapy (NRT), bupropion, nortriptyline, clonidine, and varenicline are all effective, although insufficient evidence exists to recommend one intervention over another (SOR: A, systematic reviews). Effective nonpharmacologic...
What is the best way to treat Morton's neuroma?
(Family Physicians Inquiries Network, 2011)
by corticosteroid injections and, finally, surgery (strength of recommendation [SOR]: C, case series). Injecting sclerosing alcohol depends on the provider's access to and comfort with ultrasound, but the evidence is insufficient to recommend it routinely (SOR: C...
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....
Antibody Testing for Systemic Lupus Erythematosus
(Family Physicians Inquiries Network, 2011)
Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE. (Strength of Recommendation: C, based on expert opinion.) The antinuclear antibody (ANA) test is the most commonly used screening test...
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...
Should you test for H pylori in patients with nonulcer dyspepsia?
(Family Physicians Inquiries Network, 2011)
Helicobacter pylori in creases the risk of developing peptic ulcer disease (strength of recommendation [SOR]: B, cohort study), but there is no evidence that treating H pylori reduces that risk. Treating H pylori in patients with nonulcer dyspepsia...