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How does smoking in the home affect children with asthma?
(Family Physicians Inquiries Network, 2012)
Children with asthma who are exposed to smoking in the home are likely to have more severe asthma symptoms, more asthma-related doctor visits (strength of recommendation [SOR]: B, a preponderance of evidence from heterogeneous cohort studies), and a...
What's best for IBS?
(Family Physicians Inquiries Network, 2012)
Recommend antispasmodics or antidepressants for patients with irritable bowel syndrome (IBS) and explain that, while fiber may have other benefits, it is unlikely to relieve IBS symptoms. Stength of recommendation: A: Based on a meta-analysis....
Complementary and alternative therapies for atopic dermatitis
(Family Physicians Inquiries Network, 2012)
Evening primrose oil may be effective for the treatment of atopic dermatitis. (Strength of Recommendation [SOR]: B, based on one randomized controlled trial [RCT].) Homeopathy may be as good as conventional therapy for eczema. Probiotics (SOR: A...
Should breastfeeding babies be given pacifiers?
(Family Physicians Inquiries Network, 2012)
Do not discourage the use of pacifiers by healthy infants who are breastfeeding. Stength of recommendation: A: Based on a good-quality meta-analysis...
Screening Mammography for Reducing Breast Cancer Mortality
(Family Physicians Inquiries Network, 2012)
Screening mammography reduces breast cancer mortality in women 40 to 49 years of age who have an average risk of breast cancer. (Strength of Recommendation: A, based on eight randomized controlled trials [RCTs].) The relative risk reduction...
Rethinking antibiotics for sinusitis-again
(Family Physicians Inquiries Network, 2012)
Stop prescribing amoxicillin for acute rhinosinusitis. It's unlikely to provide a speedier recovery than over-the-counter (OTC) remedies alone. Stength of recommendation: B: Based on a single high-quality randomized controlled trial....
Medication vs. radioablation for Graves' disease: how do they compare?
(Family Physicians Inquiries Network, 2012)
The benefits are similar; the risks vary. Treating Graves' disease initially with medication or radioablation (or surgery) produces comparable resolution of hyperthyroidism at 2 years (strength of recommendation [SOR]: B, ...
Treatment of motion sickness
(Family Physicians Inquiries Network, 2012)
Scopolamine should be used to reduce nausea associated with motion sickness, but it does not reduce vomiting. (Strength of Recommendation [SOR]: A, based on multiple randomized controlled trials [RCTs].) Firstgeneration antihistamines...
Advantages of the no-scalpel vasectomy technique
(Family Physicians Inquiries Network, 2012)
The no-scalpel vasectomy (NSV) technique should be used instead of the standard incisional method. (Strength of Recommendation: A, based on systematic reviews, mixed-quality randomized controlled trials [RCTs], cohort studies, and case...
Intranasal steroids vs antihistamines: which is better for seasonal allergies and conjunctivitis?
(Family Physicians Inquiries Network, 2012)
Intranasal steroids provide better relief for adult sufferers, according to nonstandardized, nonclinically validated scales. Steroids reduce subjective total nasal symptom scores (TNSS)--representing sneezing, itching, ...
Does ultrasound screening for abdominal aortic aneurysm reduce mortality?
(Family Physicians Inquiries Network, 2012)
population-based randomized controlled trials [RCTs]). Evidence is inadequate to demonstrate benefits of screening in women....
Evaluation of elevated serum transaminase levels
(Family Physicians Inquiries Network, 2012)
The evaluation of patients with elevated transaminase levels should be individualized based on the presence of symptoms or physical examination findings that suggest serious disease or hepatic decompensation. (Strength of Recommendation [SOR]: C...
Evaluation of newborns with preauricular skin lesions
(Family Physicians Inquiries Network, 2012)
All newborns should be screened for hearing loss, whether or not they have preauricular skin lesions. Newborns with these anomalies may be at increased risk of hearing impairment. (Strength of Recommendation [SOR]: C, based on small observational...
Treatment of HSV infection in late pregnancy
(Family Physicians Inquiries Network, 2012)
, based on one systematic review.) Suppressive therapy at the time of delivery can reduce the rate of recurrence, the risk of asymptomatic viral shedding, and the number of cesarean deliveries because of active HSV infection. Women with active lesions...
Coronary artery disease: screening, prevention, prognosis
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the screening for, prevention and prognosis of coronary artery disease.
Crohn's disease and enterocutaneous fistulas
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2012-03)
Fistulas that arise in association with Crohn's Disease are classified as those with no evidence of active disease (type 1) and those associated with intra-abdominal abscess formation (type 2). This distinction is important since conservative...
Can calcium supplements cause serious adverse effects in healthy people?
(Family Physicians Inquiries Network, 2012)
Calcium supplements with or without vitamin D increase the risk of myocardial infarction (MI), with numbers needed to harm (NNH) over 5 years of 69 to 240 (strength of recommendation [SOR]: B, meta-analyses of randomized ...
Cardiovascular risks of combined oral contraceptive use
(Family Physicians Inquiries Network, 2012)
Because of an increased risk of cardiovascular disease, the use of combined oral contraceptives (OCs) should be considered carefully in women who smoke and in those with hypertension or hyperlipidemia. (Strength of Recommendation: B, based...
Do antibiotics shorten symptoms in patients with purulent nasal discharge?
(Family Physicians Inquiries Network, 2012)
For most patients with purulent nasal discharge, antibiotics don't decrease symptom duration; they do increase adverse events (strength of recommendation [SOR]: A, 3 meta-analyses and 2 randomized controlled trials [RCTs]). ...
Missouri hospitalist, issue 44 (2012 May-June)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2012-05)