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What's the best test for underlying osteomyelitis in patients with diabetic foot ulcers?
(Family Physicians Inquiries Network, 2015)
, evidence-based guidelines)....
Another good reason to recommend low-dose aspirin
(Family Physicians Inquiries Network, 2015)
Evidence shows that daily low-dose aspirin during pregnancy can safely lower the risk of preeclampsia and other adverse outcomes. Practice changer: Prescribe low-dose aspirin (eg, 81 mg/d) to pregnant women who are at high risk for preeclampsia...
Consider these medications to help patients stay sober
(Family Physicians Inquiries Network, 2015)
Naltrexone can help prevent relapse in recently detoxified patients with alcohol use disorder. The evidence for acamprosate is not quite as strong. Practice changer: Consider prescribing oral naltrexone (50 mg/d) for patients with alcohol use...
Does high dietary soy intake affect a woman's risk of primary or recurrent breast cancer?
(Family Physicians Inquiries Network, 2015)
Q. Does high dietary soy intake affect a woman's risk of primary or recurrent breast cancer? Evidence-based answer: No, it doesn't affect the risk of primary breast cancer, but it does (favorably) affect the risk of cancer recurrence. Compared...
How effective are opioids for chronic low back pain?
(Family Physicians Inquiries Network, 2015)
Q: How effective are opioids for chronic low back pain? Evidence-based answer: Short-term (<4 months) treatment with opioids provides modest relief of chronic low back pain, but only minimal improvement in function compared with placebo (strength...
Do statins increase the risk of developing diabetes?
(Family Physicians Inquiries Network, 2015)
Q: Do statins increase the risk of developing diabetes? A: Yes. Statin therapy produces a small increase in the incidence of diabetes: one additional case per 255 patients taking statins over 4 years (strength of recommendation ...
Does topical diclofenac relieve osteoarthritis pain?
(Family Physicians Inquiries Network, 2015)
Q: Does topical diclofenac relieve osteoarthritis pain? Evidence-based answer: Yes, at least in the short term. Topical diclofenac, with and without dimethyl sulfoxide (DMSO), modestly improves pain and function scores (by 4%-8%) for as long as 12...
What therapies alleviate symptoms of polycystic ovary syndrome?
(Family Physicians Inquiries Network, 2015)
Q: What therapies alleviate symptoms of polycystic ovary syndrome? A: Treatment of polycystic ovary syndrome (PCOS) in women not actively seeking to become pregnant is symptom-specific. Lifestyle modification (LSM) reduces ...
Sterile or non-sterile gloves for minor skin excisions?
(Family Physicians Inquiries Network, 2015)
Sterile or non-sterile gloves for minor skin excisions? Non-sterile gloves are just as effective as sterile gloves in preventing surgical site infection after minor skin surgeries. PRACTICE CHANGER: Consider using non-sterile gloves during minor...
This adjunct medication can speed CAP recovery
(Family Physicians Inquiries Network, 2015)
This adjunct medication can speed CAP recovery: Adding prednisone to the antibiotic regimen can help patients hospitalized with community-acquired pneumonia to stabilize more quickly and leave the hospital sooner. PRACTICE CHANGER: Prescribe oral...
Should you bypass anticoagulant bridging before and after surgery?
(Family Physicians Inquiries Network, 2015)
Should you bypass anticoagulant "bridging" before and after surgery? Skipping perioperative use of LMWH in low- and moderate-risk patients on warfarin for atrial fibrillation doesn't increase their risk of stroke or bleeding. Practice changer: Stop...
What's the best secondary treatment for patients who fail initial triple therapy for H pylori?
(Family Physicians Inquiries Network, 2018)
Q: What's the best secondary treatment for patients who fail initial triple therapy for H pylori? Evidence-based answer: treating patients with Helicobacter pylori infection who have failed clarithromycin-based triple therapy with either...
Antibiotic de-escalation in culture-negative healthcare-associated pneumonia
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2015-04)
therapy,based on microbiologic cultures and the clinical response of the patient, and shortening the duration of therapy to the minimum effective period"1. But they offer no recommendations on how to de-escalate when the cultures are negative. They do...
Acute Care Update
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2016-04)
Time to stop glucosamine and chondroitin for knee OA?
(Family Physicians Inquiries Network, 2018)
Time to stop glucosamine and chondroitin for knee OA? Prior studies provided conflicting results regarding the efficacy of these medications. This study offers evidence for discontinuing them. Practice changer: Tell patients with moderately severe...
How do hyaluronic acid and corticosteroid injections compare for knee OA relief?
(Family Physicians Inquiries Network, 2017)
for symptomatic knee osteoarthritis (OA), but that insufficient evidence exists to recommend HA injections (SOR: B, evidence-based guidelines)....
How often does long-term PPI therapy cause clinically significant hypomagnesemia?
(Family Physicians Inquiries Network, 2018)
Q: How often does long-term PPI therapy cause clinically significant hypomagnesemia? EVIDENCE-BASED ANSWER: Rarely. Proton pump inhibitors (PPIs) may be associated with decreases in serum magnesium laboratory values to below 1.6 to 1.8 mg...
How effective and safe is fecal microbial transplant in preventing C difficile recurrence?
(Family Physicians Inquiries Network, 2018)
Q: How effective and safe is fecal microbial transplant in preventing C difficile recurrence? Evidence-based answer: fecal microbial transplant (fmt) is reasonably safe and effective. In patients who have had multiple Clostridium difficile...
How effectively do ACE inhibitors and ARBs prevent migraines?
(Family Physicians Inquiries Network, 2018)
Q: How effectively do ACE inhibitors and ARBs prevent migraines? Evidence-based answer: The angiotensin-converting enzyme (ACE) inhibitor lisinopril reduces the number of migraines by about 1.5 per month in patients experiencing 2 to 6 migraines...
Can CBT effectively treat adult insomnia disorder?
(Family Physicians Inquiries Network, 2018)
Q: Can CBT effectively treat adult insomnia disorder? Evidence-based answer: Yes. Cognitive behavioral therapy (CBT) administered individually, in a group setting, or on the internet is effective for treating insomnia in adults compared with control...