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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...
Does the presence of a trained support person during labor decrease C-section rates?
(Family Physicians Inquiries Network, 2015)
Q: Does the presence of a trained support person during labor decrease C-section rates? Evidence-based answer: sometimes. The continuous presence of a support person during labor slightly decreases (by about 2%) the likelihood of a cesarean section...
Is arthroscopic subacromial decompression effective for shoulder impingement?
(Family Physicians Inquiries Network, 2015)
Q: Is arthroscopic subacromial decompression effective for shoulder impingement? Evidence-based answer: It's impossible to say for certain in the absence of randomized controlled trials. However, in patients whose impingement symptoms don't improve...
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...
Does qHPV vaccine prevent anal intraepithelial neoplasia and condylomata in men?
(Family Physicians Inquiries Network, 2015)
Q: Does qHPV vaccine prevent anal intraepithelial neoplasia and condylomata in men? Evidence-based answer: Yes. Quadrivalent human papillomavirus (qHPV) vaccine reduces rates of anal intraepithelial neoplasia (AIN) by 50% to 54%, and persistent anal...
What's the best test for underlying osteomyelitis in patients with diabetic foot ulcers?
(Family Physicians Inquiries Network, 2015)
, evidence-based guidelines)....
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...
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...
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...
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 way to predict the success of a trial of labor after a previous C-section?
(Family Physicians Inquiries Network, 2015)
Q: What's the best way to predict the success of a trial of labor after a previous C-section? Evidence-based answer: while 8 scoring tools predict success rates for a trial of labor after previous cesarean section (TOLAC), it's unclear which...
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...
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...
What therapies alleviate symptoms of polycystic ovary syndrome?
(Family Physicians Inquiries Network, 2015)
]). Spironolactone improves hirsutism scores by an absolute 8% to 22% (SOR: A, multiple RCTs); adding metformin to spironolactone improves Ferriman-Gallwey (FG) hirsutism scores an additional absolute 1.4% (SOR: B, RCT). Oral contraceptive pills (OCPs) are 12 times...
How to dry foods at home (2015)
(University of Missouri--Columbia. Extension Division, 2015)
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 ...
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...
Toxic Stress Education for Pediatric Practitioners to Improve Health Outcomes
(University of Missouri--Kansas City, 2018)
Toxic stress associated with adverse childhood experiences during childhood can have
catastrophic lifelong neurobiological, social, and emotional effects and has been shown to
decrease life expectancy up to 20 years. ...
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)....