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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...
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...
Efficacy of an online problem-based learning course in occupational therapy education
(2012)
Problem-based learning (PBL) is a teaching method created in the 1960's that encourages students to improve their critical thinking and clinical reasoning skills through case studies, group work, discussions with faculty facilitation, and no lecture...
Evaluation of asymptomatic atrial fibrillation
(Family Physicians Inquiries Network, 2012)
In hemodynamically stable patients without acute chest pain, the evaluation and treatment of atrial fibrillation should not change based on symptoms alone. (Strength of Recommendation: A, based on multiple cohort studies.) As many as 75 percent...
What are the benfits and risks of IUDs in adolescents?
(Family Physicians Inquiries Network, 2012)
Little available evidence specifically addresses the benefits and risks of intrauterine devices (IUDs) in adolescents. Most studies have evaluated IUD use in nulliparous adults. Levonorgestrel IUDs cause less menstrual bleeding than oral...
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....
A safer way to prevent VTE recurrence
(Family Physicians Inquiries Network, 2012)
After patients with unprovoked venous thromboembolism (VTE) complete a 6- to 18-month course of oral anticoagulation therapy, consider a switch to aspirin. Stength of recommendation: A: Based on one well-designed, randomized controlled trial (RCT)....
Tension headache
(Family Physicians Inquiries Network, 2012)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of tension headaches.
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....
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...
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, ...
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...
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...
DEXA screening: are we doing too much?
(Family Physicians Inquiries Network, 2012)
Reconsider the intervals at which you recommend rescreening for osteoporosis; for postmenopausal women with a baseline of normal bone mineral density (BMD) or mild osteopenia, a 15-year interval is probably sufficient. Strength of recommendation B...
How best to diagnose iron-deficiency anemia in patients with inflammatory disease?
(Family Physicians Inquiries Network, 2012)
TfR-ferritin index (ratio of sTfR to log ferritin) are highly sensitive and specific. An sTfR-ferritin index of ≥1.5 is diagnostic of IDA, even in the presence of acute or chronic inflammation (SOR: B, systematic review of prospective validating cohort studies...
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...
Human parathyroid hormone for treating osteoporosis
(Family Physicians Inquiries Network, 2012)
Human parathyroid hormone should be used in patients with severe osteoporosis to decrease the rate of vertebral and nonvertebral fractures. (Strength of Recommendation [SOR]: A, based on a systematic review and randomized controlled trial [RCT...
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 ...
BP meds: this simple change improves outcomes
(Family Physicians Inquiries Network, 2012)
of recommendation: B: Based on a well-done randomized clinical trial (RCT) and a subgroup analysis....
Medications for weight loss in patients with Type 2 diabetes mellitus
(Family Physicians Inquiries Network, 2012)
Fluoxetine (Prozac) and orlistat (Xenical) produce modest short-term weight loss, but their long-term benefits are unclear and their safety is uncertain. (Strength of Recommendation [SOR]: B, based on a meta-analysis of randomized controlled trials...