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Does treatment with donepezil improve memory for patients with mild cognitive impairment?
(Family Physicians Inquiries Network, 2006)
Donepezil (Aricept) has potential benefit in delaying risk of progression to Alzheimer's disease in the first year of treatment, but this benefit is not seen at 3 years. Donepezil does not improve memory for patients with ...
When are antibiotics indicated for acute COPD exacerbations?
(Family Physicians Inquiries Network, 2006)
). Antibiotics may be prescribed in the outpatient setting for those with severe exacerbations (SOR: C, based on expert opinion)....
How can you prevent migraines during pregnancy?
(Family Physicians Inquiries Network, 2006)
relieved acute pain, but also decreased the frequency of headaches (strength of recommendation [SOR]: B, poor-quality cohort and RCTs). Practice guidelines and most review articles recommend avoiding prophylactic medications if possible. If a medication...
What is the role of herpes virus serology in sexually transmitted disease screening?
(Family Physicians Inquiries Network, 2006)
is not indicated for asymptomatic pregnant women (SOR: B, 1 cohort study). You may consider offering testing to asymptomatic patients with an HSV-positive partner, patients with HIV infection, and those with current or recent sexually transmitted infection or high...
What is the appropriate use of sunscreen for infants and children?
(Family Physicians Inquiries Network, 2006)
-control and extrapolation of studies). Effectiveness may be increased if sunscreen is applied 30 minutes before exposure and reapplied every 2 hours, particularly if swimming (SOR: C, expert opinion). Tightly woven protective clothing, a wide-brimmed cap, and eye protection...
What is the appropriate evaluation and treatment of children who are "toe walkers"?
(Family Physicians Inquiries Network, 2006)
The evaluation of toe-walking focuses on differentiating normal children from those with mild cerebral palsy. Gait analysis may be a useful diagnostic tool, but further investigation is needed to confirm its reliability (strength of recommendation...
What are the risks to the fetus associated with diagnostic radiation exposure during pregnancy?
(Family Physicians Inquiries Network, 2006)
There is no evidence of significant risk to the developing fetus from any single diagnostic x-ray exposure (strength of recommendation: C, based on non-homogenous case-control studies). No studies were found on fetal ...
Who should receive vertebroplasty?
(Family Physicians Inquiries Network, 2006)
vertebral fractures may be less for older fractures (SOR: C)....
What are effective treatments for oppositional defiant behaviors in adolescents?
(Family Physicians Inquiries Network, 2006)
Psychological interventions for the family-- such as parenting skills training and behavioral therapy for the child, the parents, or the whole family--reduce conflict behaviors in adolescents with oppositional defiant disorder (ODD) (strength...
Should people with a first-degree relative who died from subarachnoid hemorrhage be screened for aneurysms?
(Family Physicians Inquiries Network, 2006)
Patients whose family history includes 1 first-degree relative with subarachnoid hemorrhage caused by intracranial aneurysm (ICA) need not be screened for ICAs (strength of recommendation [SOR]: B, based on a single case series). Hypertension...
What blood tests help diagnose celiac disease?
(Family Physicians Inquiries Network, 2006)
Histological confirmation of infiltrative lesions via small bowel biopsy is the gold standard for diagnosing celiac disease. Four serum antibody assays may serve as a first- step diagnostic tool to identify biopsy candidates: immunoglobulin A tissue...
What dietary modifications are indicated for migraines?
(Family Physicians Inquiries Network, 2006)
Migraine frequency, duration, and severity are not increased by dietary choices (strength of recommendation [SOR]: A, individual randomized trial [RCT]); they can be decreased by a low-fat diet (SOR: B). Regular supplementation ...
Do allergy shots help seasonal allergies more than antihistamines and nasal steroids?
(Family Physicians Inquiries Network, 2006)
). No RCTs directly compare immunotherapy with conservative management. Treatment decisions are driven by the clinical presentation, patient and physician preferences, practice guidelines, and expert opinion (SOR: C, based on expert opinion). In standard...
What are effective medical treatments for adults with acute migraine?
(Family Physicians Inquiries Network, 2006)
Medications collectively referred to as "triptans" (eg, sumatriptan, naratriptan, etc) have been shown to be effective for acute migraine (strength of recommendation [SOR]: A). Nonsteroidal anti-inflammatory drugs ...
How safe is vaginal birth after cesarean section for the mother and fetus?
(Family Physicians Inquiries Network, 2006)
Compared with planned repeat low-transverse cesarean section, vaginal birth after cesarean section (VBAC) is not associated with increased risk of maternal or neonatal mortality (strength of recommendation [SOR]: B). ...
When should a child with an undescended testis be referred to a urologist?
(Family Physicians Inquiries Network, 2006)
study). Orchiopexy may allow earlier detection of testicular tumors (SOR: C, expert opinion), but it has not been shown to reduce the risk of testicular cancer (SOR: B, retrospective cohort study) or improve 5-year survival rates for those patients...
How should patients with Barrett's esophagus be monitored?
(Family Physicians Inquiries Network, 2006)
Some patients who have been diagnosed with Barrett's esophagus will develop dysplasia and, in some cases, esophageal carcinoma (strength of recommendation [SOR]: A, based on consistent cohort studies). Endoscopic surveillance ...
When are empiric antibiotics appropriate for urinary tract infection symptoms?
(Family Physicians Inquiries Network, 2006)
Healthy, nonpregnant women presenting with the triad of frequency, dysuria, and no vaginal symptoms have about a 96% chance of having an urinary tract infection (UTI) (positive likelihood ratio [LR+]=24.6). Since no ...
What is the best way to manage GERD symptoms in the elderly?
(Family Physicians Inquiries Network, 2006)
No evidence supports one method over another in managing uncomplicated gastroesophageal reflux disease (GERD) for patients aged >65 years. For those with endoscopically documented esophagitis, proton pump inhibitors (PPIs) ...
What is the best treatment for mild to moderate acne?
(Family Physicians Inquiries Network, 2006)
For mild comedonal acne, monotherapy with topical retinoids is the treatment of choice (strength of recommendation [SOR]: A). For moderate comedonal and mild to moderate papulopustular acne, combination therapy with either ...