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What illnesses contraindicate immunization?
(Family Physicians Inquiries Network, 2005)
The Advisory Council on Immunization Practices (ACIP) reports that the only contraindication for all vaccines is a history of severe allergic reaction to a previous vaccine or vaccine constituent (strength of recommendations: C, based predominantly...
Should we recommend universal neonatal hearing screening?
(Family Physicians Inquiries Network, 2005)
Universal neonatal hearing screening leads to both earlier detection and earlier treatment of infants with hearing loss (strength of recommendation [SOR]: A, based on a systematic review). Available evidence suggests early ...
What is the best way to distinguish type 1 and 2 diabetes?
(Family Physicians Inquiries Network, 2005)
No clinical characteristic or diagnostic test is available to readily distinguish type 1 from type 2 diabetes mellitus. Although C-peptide levels, autoantibodies, and adiponectin-to-leptin ratios show some utility, they ...
Does anticoagulation prevent thrombosis for persons with fractures distal to the hip?
(Family Physicians Inquiries Network, 2005)
Low-molecular-weight heparin (LMWH) prophylaxis significantly reduces the total incidence of deep venous thrombosis (DVT) for patients with lower-limb fractures managed with surgical fixation and cast immobilization (strength ...
What are the indications for bariatric surgery?
(Family Physicians Inquiries Network, 2005)
No studies evaluate the commonly used indications for bariatric surgery. Consensus guidelines suggest that the surgical treatment of obesity should be reserved for patients with a body-mass index (BMI) >40 kg/m2 or with ...
Who should get hepatitis A vaccination?
(Family Physicians Inquiries Network, 2005)
The following groups are at increased risk of contracting or having severe outcomes from hepatitis A and should receive vaccination.Persons traveling to or working in countries that have high or intermediate rates of ...
Do statins delay onset or slow progression of Alzheimer's dementia?
(Family Physicians Inquiries Network, 2005)
Statins (coenzyme-A reductase inhibitors) should not be used with the single intent to delay the onset or slow the progression of dementia. Large randomized control trials (RCTs) found that the administration of a statin ...
Do preparticipation clinical exams reduce morbidity and mortality for athletes?
(Family Physicians Inquiries Network, 2005)
Though clinical preparticipation exams (PPE) are recommended by experts and required in most states, we found no medium- or better-quality evidence that demonstrates they reduce mortality or morbidity. PPEs detect only a ...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating ...
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
(Family Physicians Inquiries Network, 2005)
If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (strength of recommendation [SOR]: B, based on case series of dual energy x-ray absorptiometry [DEXA] ...
What are effective therapies for Clostridium difficile- associated diarrhea?
(Family Physicians Inquiries Network, 2005)
Oral metronidazole and oral vancomycin are
equally effective treatments for Clostridium difficile- associated diarrhea (CDAD) (strength of recommendation [SOR]: A, based on randomized trials). Oral vancomycin is considerably ...
Is therapy based on endoscopy results better than empiric therapy for dyspepsia?
(Family Physicians Inquiries Network, 2005)
In the initial management of dyspepsia for patients without "alarm" symptoms (weight loss, recurrent vomiting, dysphagia, anemia, evidence of bleeding, onset of dyspepsia after age 45 years), therapy based on the results ...
Which imaging modality is best for suspected stroke?
(Family Physicians Inquiries Network, 2005)
Patients exhibiting stroke symptoms should have brain imaging immediately within 3 hours of symptom onset (strength of recommendation [SOR]: A, based on systematic review). In the first 3 hours after a suspected cerebrovascular ...
What is the role of tacrolimus and pimecrolimus in atopic dermatitis?
(Family Physicians Inquiries Network, 2005)
When the standard therapies -- mild topical
corticosteroids and moisturizers -- fail in the
treatment of atopic dermatitis, patients are left with few proven remedies. The recently introduced topical immunosuppressive ...
How best to help kids lose weight
(Family Physicians Inquiries Network, 2010)
Screen children and adolescents for obesity and offer them multifaceted weight loss interventions, based on new evidence (and a recent US Preventive Services Task Force [USPSTF] recommendation) of their effectiveness. ...
What are the best treatments for herpes labialis?
(Family Physicians Inquiries Network, 2007)
There are 3: valacyclovir, acyclovir, and topical penciclovir. Valacyclovir, 2g twice in 1 day taken during the prodromal stage of herpes labialis, reduces the episode duration and time to healing. Acyclovir, 400 mg, taken ...
Light therapy for nonseasonal major depressive disorder?
(Family Physicians Inquiries Network, 2016)
Light therapy for nonseasonal major depressive disorder? While bright light therapy already has a place in the treatment of seasonal affective disorder, a recent trial spotlights its utility beyond the winter months. Practice changer: Consider...
What's the best approach to diagnosing food allergies in infants?
(Family Physicians Inquiries Network, 2010)
A well-designed oral food challenge (OFC) is the most reliable diagnostic test for infants whose clinical history and physical examination suggest a specific food allergy (strength of recommendation [SOR]: C, consensus ...
Can yoga reduce symptoms of anxiety and depression?
(Family Physicians Inquiries Network, 2014)
Q. Can yoga reduce symptoms of anxiety and depression? A. Yes, yoga can reduce symptoms of anxiety and depression (strength of recommendation [SOR]: B, systematic reviews of randomized controlled trials [RCTs] with significant ...
What measures relieve postherpetic neuralgia?
(Family Physicians Inquiries Network, 2009)
Tricyclic antidepressants, gabapentin, and pregabalin effectively reduce pain (strength of recommendation [SOR]: A, at least 2 good-quality randomized controlled trials [RCTs] and/or meta-analyses). Opioids have demonstrated ...