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What is the best treatment for plant-induced contact dermatitis?
(Family Physicians Inquiries Network, 2013)
It's unclear which treatment is best, because there have been no head-to-head comparisons of treatments for Rhus (plant-induced) contact dermatitis. That said, topical high-potency steroids slightly improve pruritus and ...
How do antidepressants affect sexual function?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: patients treated with elective serotonin reuptake inhibitors (SSRIs) and the serotonin/norepinephrine reuptake inhibitor (SNRI) venlafaxine have significantly higher rates of overall sexual dysfunction--including desire...
Do patients with type 2 diabetes who aren't taking insulin benefit from self-monitoring blood glucose?
(Family Physicians Inquiries Network, 2013)
reviews and meta-analyses of disease-oriented evidence). Patients with a baseline HbA1c <8% who self-monitor don't reduce their HbA1c levels, but patients with a baseline HbA1c >8% do (SOR: B, systematic reviews and meta-analyses of disease...
Management of ADHD in preschool-aged children
(Family Physicians Inquiries Network, 2013)
RCTs.) Alternative therapies, such as elimination diets, have limited evidence of success and should generally be avoided or used in conjunction with standard therapies. (SOR: B, based on a systematic review of a small number of heterogeneous RCTs.)...
Is this pregnancy viable?
(Family Physicians Inquiries Network, 2013)
of recommendation: A: Based on a systematic review and meta-analysis of 26 diagnostic accuracy studies....
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures. (Strength of Recommendation [SOR]: B, based on subgroup analysis of randomized controlled...
Which oral antifungal works best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2013)
Terbinafine, 250 mg daily for 12 to 16 weeks, produces higher clinical cure rates than either pulsed-dose itraconazole or weekly fluconazole (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs]). Daily oral dosing...
Which treatments help women with reduced libido?
(Family Physicians Inquiries Network, 2013)
Several treatments produce modest, but statistically significant, clinical increases in sexual desire and function in women. The testosterone transdermal patch improves hypoactive sexual desire disorder (HSDD) in postmenopausal ...
Consider this strategy for upper GI bleeds
(Family Physicians Inquiries Network, 2013)
Do not order transfusions of red blood cells for patients with acute upper gastrointestinal bleeding unless their hemoglobin level <7 g/dL. A: Based on a single randomized controlled trial (RCT) consistent with other RCTs on recommendations...
Elevated troponin but no CVD: what's the prognosis?
(Family Physicians Inquiries Network, 2013)
of known cardiovascular disease (TABLE)1-6 (strength of recommendation: B, meta-analysis, multiple prospective and retrospective observational studies.)...
Should you screen for postpartum depression?
(Family Physicians Inquiries Network, 2013)
Should you screen for postpartum depression? Yes. Evidence suggests that screening new moms for depression leads to better outcomes, and should be routine. Practice changer: Make depression screening a routine part of the postpartum visit....
Do asymptomatic adults need screening EKGs?
(Family Physicians Inquiries Network, 2013)
Although certain electrocardiogram (EKG) findings in asymptomatic adults are associated with increased mortality (strength of recommendation [SOR]: A, high-quality cohort studies), no randomized trials demonstrate that any intervention based...
What is the best beta-blocker for systolic heart failure?
(Family Physicians Inquiries Network, 2015)
Q: What is the best beta-blocker for systolic heart failure? Evidence-based answer: Three beta-blockers--carvedilol, metoprolol succinate, and bisoprolol--reduce mortality equally (by about 30% over one year) in patients with Class III or IV...
Ramipril for claudication?
(Family Physicians Inquiries Network, 2013)
This ACE inhibitor can help patients with peripheral artery disease walk longer while remaining pain free.
What is the best initial treatment for venous stasis ulcers?
(Family Physicians Inquiries Network, 2013)
The mainstay of initial treatment of venous stasis ulcers is compression therapy (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). Multicomponent compression therapy is slightly ...
Dipstick urinalysis for the diagnosis of acute UTI
(Family Physicians Inquiries Network, 2013)
. (Strength of Recommendation [SOR]: A, based on systematic reviews of cross-sectional studies and a validated clinical decision rule.) A positive nitrite test is more useful than a positive leukocyte esterase (LE) test, although both increase the odds of a...
Do dietary choices alone alter the risk of developing metabolic syndrome?
(Family Physicians Inquiries Network, 2013)
In studies of patient populations controlled for differences in dietary content alone, independent of weight loss or exercise changes, diets with high glycemic index foods, low whole grain and fiber content, and low fruit ...
Metformin use in adolescents
(Family Physicians Inquiries Network, 2013)
, but it is less effective in preventing or delaying the onset of overt type 2 diabetes. Metformin use reduces body mass index (BMI) for up to six months in adolescents who are obese (Strength of Recommendation [SOR]: C, based on disease-oriented randomized...
Corticosteroids for a sore throat?
(Family Physicians Inquiries Network, 2013)
Consider prescribing a single dose of corticosteroids for patients with sore throat, which has been found to bring quicker pain relief and resolution of symptoms. Stength of recommendationA: Based on a meta-analysis of randomized controlled trials...
Is lower BP worth it in higher-risk patients with diabetes or coronary disease?
(Family Physicians Inquiries Network, 2016)
Q: Is lower BP worth it in higher-risk patients with diabetes or coronary disease? Evidence-based answer: There is no simple answer; the risk/benefit picture is complicated. Controlling blood pressure to a target of 130/80 mm Hg or lower produces...