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How best to manage the patient in term labor whose group B strep status is unknown?
(Family Physicians Inquiries Network, 2009)
Monitor the patient and treat her with intrapartum chemoprophylaxis based on identified risk factors, unless a rapid, highly sensitive (greater than or equal to 85%) polymerase chain reaction (PCR) test is immediately ...
ACE inhibitors and ARBs: One or the other -- not both -- for high-risk patients
(Family Physicians Inquiries Network, 2009)
Avoid prescribing an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin receptor blocker (ARB) for patients at high risk of vascular events or renal dysfunction. The combination does not reduce poor outcomes, ...
How accurate is the clinical diagnosis of pneumonia?
(Family Physicians Inquiries Network, 2003)
No element or combination of elements from the clinical history and physical examination are sufficiently sensitive or specific to confirm or exclude acute community-acquired pneumonia (CAP). A chest x-ray is recommended ...
This antiemetic may help kids skip that trip to the hospital
(Family Physicians Inquiries Network, 2009)
Give oral ondansetron to children with acute gastroenteritis and moderate dehydration who are unable to tolerate oral rehydration to reduce the vomiting and avoid the need for intravenous (IV) hydration or hospitalization. ...
Does low-dose aspirin reduce preeclampsia and other maternal-fetal complications?
(Family Physicians Inquiries Network, 2008)
The use of low-dose aspirin during pregnancy decreases the risk of preeclampsia for women considered at increased risk. The effect is smaller for women without risk factors (strength of recommendation [SOR]: A, based on ...
When should you consider implanted nerve stimulators for lower back pain?
(Family Physicians Inquiries Network, 2009)
Patients can gain more pain relief from spinal cord stimulation (SCS) than from reoperation (strength of recommendation [SOR]: A, 2 randomized controlled trials [RCTs]). SCS can also treat chronic low back pain effectively ...
Initiating antidepressant therapy? Try these 2 drugs first
(Family Physicians Inquiries Network, 2009)
When you initiate antidepressant therapy for patients who have not been treated for depression previously, select either sertraline or escitalopram. A large meta- analysis found these medications to be superior to other ...
How accurate is stress radionuclide imaging for diagnosis of CAD?
(Family Physicians Inquiries Network, 2004)
Stress radionuclide testing is a moderately accurate test compared with coronary angiography for the diagnosis of coronary artery disease (CAD) in intermediate-risk individuals. Variations in technique of imaging (planar ...
Can type 2 diabetes be prevented through diet and exercise?
(Family Physicians Inquiries Network, 2005)
Diets that result in long-term weight loss of 5% to 7%, along with moderate-intensity exercise for more than 150 minutes per week, reduce the incidence of type 2 diabetes for patients with impaired glucose tolerance (IGT) ...
Do antipyretics prolong febrile illness?
(Family Physicians Inquiries Network, 2004)
Antipyretics appear to have minor and variable effects on the course of febrile illness. Aspirin and acetaminophen do not prolong the course of rhinovirus illness, although they may prolong the period of viral shedding and ...
What's the best treatment for pyogenic granuloma?
(Family Physicians Inquiries Network, 2010)
Simple surgical excision is associated with a low risk of recurrence, but often leaves a visible scar. Curettage or shave excision, with cautery, is more likely to succeed in 1 session than cryotherapy; both may leave a ...
How effective are dietary interventions in lowering lipids in adults with dyslipidemia?
(Family Physicians Inquiries Network, 2007)
Diets lower in fat, higher in soy protein, or higher in fiber reduce serum total cholesterol, low-density lipoprotein (LDL), and triglycerides. More restrictive low-fat diets also lower high-density lipoprotein (HDL), while ...
What is the best management for patients with evidence of asymptomatic ischemia on exercise stress testing?
(Family Physicians Inquiries Network, 2007)
Patients with intermediate- or high-risk Duke Treadmill Score (DTS) on exercise stress testing (EST) should undergo myocardial perfusion imaging or exercise echocardiography, especially if they have abnormal values of ...
Helmets for positional skull deformities: A good idea, or not?
(Family Physicians Inquiries Network, 2015)
Helmets for positional skull deformities: A good idea, or not? Probably not. Helmets appear to be no more effective than waiting for natural skull growth to correct the shape of an infant's head. Practice Changer: Do not recommend helmet therapy...
Is folate supplementation indicated for patients with CAD?
(Family Physicians Inquiries Network, 2004)
There is insufficient evidence to advocate the routine use of folate supplementation for the treatment of coronary artery disease (CAD). High levels of serum homocysteine have been associated in several studies with an ...
Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).
What is the most effective treatment for ADHD in children?
(Family Physicians Inquiries Network, 2005)
[SOR]: A, based on multiple randomized controlled trials [RCTs]). Nonpharmacologic therapies, such as behavior therapy, school- based interventions, and family therapy, are not as effective as stimulants but may add modest benefit to the effects...
What is the best treatment for pertussis?
(Family Physicians Inquiries Network, 2005)
-analysis of randomized controlled trials [RCTs]). Evidence is insufficient to determine the benefit of antibiotic prophylaxis for pertussis contacts. However, due to high mortality and morbidity, prophylaxis is recommended for families who have an infant less than 6...
What is the best treatment for Osgood-Schlatter disease?
(Family Physicians Inquiries Network, 2004)
Osgood-Schlatter disease is a common cause of pain and tenderness at the tibial tuberosity in active adolescents. It is typically a self-limited condition that waxes and wanes, but which often takes months to years to ...
Counseling is a must with this smoking cessation aid
(Family Physicians Inquiries Network, 2012)
Inform patients who are interested in taking varenicline (Chantix) that there is a small cardiovascular (CV) risk associated with it, as well as neuropsychiatric risks -- and consider recommending that smokers with a history ...