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Do oral contraceptives carry a significant risk of stroke for women with migranes?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly migraine with aura (strength of recommendation [SOR]: C, small case-control studies with methodological flaws...
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...
Pharmacologic therapy for eustachian tube dysfunction
(Family Physicians Inquiries Network, 2013)
There are no medications that improve patient-oriented outcomes in children or adults with eustachian tube dysfunction. (Strength of Recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs].) Oral corticosteroids...
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.)...
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...
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...
How best to treat agitation in patients with irreversible dementia?
(Family Physicians Inquiries Network, 2013)
Atypical antipsychotics modestly reduce agitation compared with placebo but have significant adverse effects (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Haloperidol ...
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 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...
How can pregnant women safely relieve low-back pain?
(Family Physicians Inquiries Network, 2013)
Acetaminophen is safe for use in pregnancy but lacks evidence of efficacy (strength of recommendation [SOR]: C, usual practice). Both physical therapy and water aerobics reduce sick days caused by low-back pain (strength of recommendation [SOR]: B...
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...
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.)...
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....
Does caffeine intake during pregnancy affect birth weight?
(Family Physicians Inquiries Network, 2016)
Q: Does caffeine intake during pregnancy affect birth weight? Evidence-based answer: No. Reducing caffeinated coffee consumption by 180 mg of caffeine (the equivalent of 2 cups) per day after 16 weeks-gestation doesn't affect birth weight. Consuming...
Is self-swabbing for STIs a good idea?
(Family Physicians Inquiries Network, 2013)
Ask women who are at risk for sexually transmitted infections (STIs) to self-swab for chlamydia and gonorrhea testing; self-collection of vulvovaginal swabs with nucleic acid amplification testing (NAAT) has excellent ...
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 ...
Who will build the better ape?
(Rhetoric and Composition Program, University of Missouri, 2013)
When I examine the driving forces of progress in modern humanity, I cannot help but recall author Leo Frankowski's musings on the subject of genetic manipulation as a way to drive human evolution. He posed a simple question: ...
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...
Does metformin prevent diabetes in at-risk adults?
(Family Physicians Inquiries Network, 2013)
Metformin therapy reduces the risk of developing diabetes for adults with one or more risk factors for at least 5 years (strength of recommendation [SOR]: A, consistent meta-analyses) and perhaps as long as 10 years (SOR: ...
Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
(Family Physicians Inquiries Network, 2019)
Q: Is intra-articular platelet-rich plasma injection an effective treatment for knee OA? EVIDENCE-BASED ANSWER: PROBABLY NOT, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence...