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What is the best test to diagnose urinary tract stones?
(Family Physicians Inquiries Network, 2001)
Over the past 3 years, helical (or spiral) computerized tomography (CT) has proved the best method of testing for urinary tract stones. All reviewed studies published since mid-1998 found helical CT scan to be the safest ...
Which patients with gastroesophageal reflux disease (GERD) should have esophagogastroduoudenoscopy (EGD)?
(Family Physicians Inquiries Network, 2001)
No evidence was identified that provides a basis for determining whether EGD leads to improved outcomes in patients with GERD. However, patients with GERD referred for elective EGD who were found to have Barrett's esophagus ...
What are the treatment options for SSRI-related sexual dysfunction?
(Family Physicians Inquiries Network, 2002)
Substituting bupropion, nefazodone, or mirtazapine is beneficial. (Grade of recommendation: B, randomized controlled trials [RCTs].) Augmentation therapy with amantadine, bupropion, and buspirone is no better than placebo. ...
Which vaccinations are indicated after splenectomy?
(Family Physicians Inquiries Network, 2006)
Immunization against encapsulated bacterial pathogens decreases the incidence of post- splenectomy sepsis. Pneumococcal, meningococcal, and Haemophilus influenzae (Hib) vaccinations are indicated for patients after ...
What is the best therapy for constipation in infants?
(Family Physicians Inquiries Network, 2002)
The best treatment for minor, self-limited constipation (infant dyschezia) may be observation and parental education about its benign nature. (Grade of recommendation: D, expert opinion.) For cases requiring treatment, ...
When should we screen children for hyperlipidemia?
(Family Physicians Inquiries Network, 2006)
Children should be screened for hyperlipidemia when there is a history of familial hypercholesterolemia (strength of recommendation [SOR]: C). No clear evidence supports screening all children or just those with family history of cardiovascular...
What is the best approach for managing recurrent bacterial vaginosis?
(Family Physicians Inquiries Network, 2004)
vaginosis (20% vs 34%-50% for other agents) (strength of recommendation [SOR]: A). Women should be treated if they are symptomatic (SOR: A), undergoing gynecologic surgery (SOR: B), or at risk for preterm labor (SOR: B)....
Which women should we screen for gestational diabetes mellitus?
(Family Physicians Inquiries Network, 2010)
, the common practice of universal screening is more sensitive than screening based on risk factors (strength of recommendation [SOR]: B, 1 randomized trial and 3 retrospective cohort studies without patient-oriented outcomes). Historic risk factors are poor...
Is methylphenidate useful for treating adolescents with ADHD?
(Family Physicians Inquiries Network, 2004)
Methylphenidate (Ritalin) is effective in the shortterm treatment of attention deficit/hyperactivity disorder (ADHD) (strength of recommendation [SOR]: A, multiple randomized control trials). Though the immediate-release ...
Glucose control: How low should you go with the critically ill?
(Family Physicians Inquiries Network, 2009)
For hyperglycemic patients admitted to an intensive care unit (ICU), the target blood glucose level should be [less than or equal to] 180 mg/dL, not 81 to 108 mg/dL. More aggressive glucose lowering is associated with a ...
What is the best initial treatment for orbital cellulitis in children?
(Family Physicians Inquiries Network, 2007)
Although antibiotics are the best initial treatment, surgical intervention is warranted when a child has: visual impairment, complete ophthalmoplegia, or well-defined abscess on presentation, or no clearly apparent clinical ...
When should patients with stroke receive thrombolytics?
(Family Physicians Inquiries Network, 2004)
Thrombolytic therapy should be limited to patients with acute ischemic stroke who meet strict inclusion and exclusion criteria and who can adhere to strict treatment protocol. Patients treated under these conditions have ...
What's the best strategy for bipolar disorder during pregnancy?
(Family Physicians Inquiries Network, 2007)
Lithium is the first-line treatment for pregnant patients requiring medication (SOR: C, based on expert opinion). Monotherapy is preferred for women of childbearing age who have bipolar disorder (strength of recommendation ...
How do you evaluate macrocytosis without anemia?
(Family Physicians Inquiries Network, 2008)
Start with a detailed history, paying particular attention to medications and alcohol use (strength of recommendation [SOR]: B, prospective cohort studies). Blood testing can include a peripheral smear, evaluation for ...
How useful is a physical exam in diagnosing testicular torsion?
(Family Physicians Inquiries Network, 2009)
the opposite to be true (SOR: C, case series). An abnormal testicular lie can help establish the diagnosis, but occurs in fewer than 50% of cases (SOR: C, case series). Other findings are less reliable (SOR: C, case series). The standard of care for diagnosing...
How much can exercise raise creatine kinase level-- and does it matter?
(Family Physicians Inquiries Network, 2008)
Moderate-intensity exercise (maintaining heart rate between 55% and 90% of maximum) may elevate creatine kinase (CK) to levels that meet the diagnostic criteria for rhabdomyolysis if the exercises involve eccentric muscle ...
What is the recommended workup for a man with a first UTI?
(Family Physicians Inquiries Network, 2007)
Obtain a urine culture in all men with suspected urinary tract infection (UTI), to reliably diagnose an infection (strength of recommendation [SOR]: C). For further evaluation, ultrasonography with abdominal radiography ...
What are contraindications to IUDs?
(Family Physicians Inquiries Network, 2006)
Based on limited evidence, use of intrauterine devices (IUDs) is not contraindicated for women with HIV/AIDS (strength of recommendation [SOR]: C), multiple sexual partners (SOR: C), previous actinomyces colonization (SOR: ...
Should we treat elevated cholesterol in elderly patients?
(Family Physicians Inquiries Network, 2002)
HMG-CoA reductase inhibitors, or statins, have been shown to decrease all-cause mortality in individuals aged 65 and older with known coronary heart disease (CHD) and elevated cholesterol levels. (Grade of recommendation: ...
Are nasal steroid sprays effective for otitis media with effusion?
(Family Physicians Inquiries Network, 2003)
Treatment of otitis media with effusion (OME) with nasal steroids is not recommended (strength of recommendation [SOR]=A, based on systematic review). Limited evidence exists that shows nasal steroids may increase the rate ...