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Go low or say No to aggressive systolic BP goals?
(Family Physicians Inquiries Network, 2016)
"Go low" or say "No" to aggressive systolic BP goals? The SPRINT trial demonstrated the benefits -- and risks -- of reaching a systolic target <120 mm Hg in non-diabetic patients at high risk for CV events. Here's who might benefit. Practice changer...
Deliver or wait with late preterm membrane rupture?
(Family Physicians Inquiries Network, 2016)
Deliver or wait with late preterm membrane rupture? While ACOG recommends delivery for all women with ruptured membranes after 34 weeks' gestation, a new study finds expectant management may be the way to go. Practice changer: In the absence...
Resistant hypertension? Time to consider this fourth-line drug
(Family Physicians Inquiries Network, 2016)
Resistant hypertension? Time to consider this fourth-line drug For most adults with resistant hypertension, spironolactone is superior to doxazosin and bisoprolol as an adjunct to triple therapy. Practice changer: When a triple regimen of an ACE...
Which nonhormonal treatments are effective for hot flashes?
(Family Physicians Inquiries Network, 2016)
Q: Which nonhormonal treatments are effective for hot flashes? Evidence-based answer: Selective serotonin reuptake inhibitors (SSRIs [fluoxetine, sertraline, paroxetine]) and the selective norepinephrine reuptake inhibitor ...
Kidney stones? It's time to rethink those meds
(Family Physicians Inquiries Network, 2016)
Kidney stones? It's time to rethink those meds. Despite being recommended for ureteral stone expulsion, tamsulosin or nifedipine are no more effective than placebo. Practice changer: Do not prescribe tamsulosin or nifedipine for stone expulsion...
Which SSRIs most effectively treat depression in adolescents?
(Family Physicians Inquiries Network, 2016)
Q: Which SSRIs most effectively treat depression in adolescents? Evidence-based answer: We don' t know which selective serotonin reuptake inhibitors (SSRIs) are the most effective and safe because no studies have compared ...
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 ...
Which patients with metabolic syndrome benefit from metformin?
(Family Physicians Inquiries Network, 2016)
Q Which patients with metabolic syndrome benefit from metformin? Evidence-based answer: Patients at highest risk for progression to diabetes benefit from metformin. In patients with metabolic syndrome who are in the ...
Which treatments are safe and effective for chronic sinusitis?
(Family Physicians Inquiries Network, 2016)
Q: Which treatments are safe and effective for chronic sinusitis? Evidence-based answer: for adults with chronic rhinosinusitis (crs), intranasal steroid (ins) therapy is more likely than placebo to improve symptoms (50% ...
Does breastfeeding affect the risk of childhood obesity?
(Family Physicians Inquiries Network, 2016)
Q: Does breastfeeding affect the risk of childhood obesity? Evidence-based answer: Yes. Even having breastfed during the first year of life is associated with a 15% lower risk of overweight or obesity over the next 2 to ...
Does vitamin D without calcium reduce fracture risk?
(Family Physicians Inquiries Network, 2016)
Q: Does vitamin D without calcium reduce fracture risk? Evidence-based answer: No. Supplemental vitamin D without calcium -- in doses averaging as much as 800 IU per day -- doesn't reduce the risk of hip, vertebral, or nonvertebral fractures...
Consider melatonin for migraine prevention
(Family Physicians Inquiries Network, 2017)
An effective migraine prevention alternative with minimal adverse effects Melatonin is an accessible and affordable option for preventing migraine headaches in chronic sufferers.
Tamsulosin for patients with ureteral stones?
(Family Physicians Inquiries Network, 2018)
Tamsulosin for patients with ureteral stones? Yes, but only for some. Find out which of your patients can benefit. PRACTICE CHANGER: Prescribe tamsulosin for stone expulsion in patients with distal ureteral stones 5 to 10 mm in size....
Can vitamin D prevent acute respiratory infections?
(Family Physicians Inquiries Network, 2019)
Can vitamin D prevent acute respiratory infections? A systematic review and meta-analysis says Yes, but the dosages used may not be what you'd expect. PRACTICE CHANGER: Reduce acute respiratory tract infections in those with significant vitamin D...
Do statins alter the risk or progression of dementia?
(Family Physicians Inquiries Network, 2018)
Q: Do statins alter the risk or progression of dementia? Evidence-based answer: No. Moderate-intensity statin therapy (with pravastatin or simvastatin) doesn't prevent progression to dementia in patients at increased risk. No prevention studies...
Bariatric surgery plus medical therapy : effective Tx for T2DM?
(Family Physicians Inquiries Network, 2019)
Bariatric surgery + medical therapy: Effective Tx for T2DM? Short-term studies have indicated "Yes," but does a longterm randomized controlled trial give it a thumbs up? PRACTICE CHANGER: Consider bariatric surgery with medical therapy as a...
How effective is spironolactone for treating resistant hypertension?
(Family Physicians Inquiries Network, 2019)
Q: How effective is spironolactone for treating resistant hypertension? EVIDENCE-BASED ANSWER: VERY EFFECTIVE. Spironolactone reduces systolic blood pressure (SPB) by 11 to 17 mm Hg and diastolic blood pressure (DPB) by ...
Are oral emergency contraceptives a safe & effective form of long-term birth control?
(Family Physicians Inquiries Network, 2017)
of pericoital levonorgestrel 1.5 mg results in an annual pregnancy rate of 11% (SOR:B,one large prospective, open-label trial). Pericoital contraception is less effective than long-acting reversible contraceptives (annual pregnancy rates of 0.05...
Does left atrial appendage closure reduce stroke rates as well as oral anticoagulants and antiplatelet meds in A-fib patients?
(Family Physicians Inquiries Network, 2019)
Q: Does left atrial appendage closure reduce stroke rates as well as oral anticoagulants and antiplatelet meds in A-fib patients? EVIDENCE-BASED ANSWER: Yes. Left atrial appendage closure (LAAC) with the Watchman device ...
Can unintended pregnancies be reduced by dispensing a year's worth of hormonal contraception?
(Family Physicians Inquiries Network, 2019)
Q. Can unintended pregnancies be reduced by dispensing a year's worth of hormonal contraception? Evidence-based answer: probably, although studies that looked directly at this outcome are limited. A systematic review showed ...