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How often should you follow up on a patient with newly diagnosed hypothyroidism?
(Family Physicians Inquiries Network, 2009)
Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If thyroid function is normal...
Saline irrigation spells relief for sinusitis sufferers
(Family Physicians Inquiries Network, 2009)
Recommend nasal irrigation to patients with chronic rhinosinusitis. Large-volume, low- pressure saline irrigation decreases the severity and frequency of symptoms. Stength of recommendation: B: Single well-done randomized ...
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 should you evaluate an asymptomatic patient with a femoral or iliac artery bruit?
(Family Physicians Inquiries Network, 2009)
Perform an ankle-arm index (AAI, or ankle- brachial index) test to evaluate for peripheral artery disease (PAD) (strength of recommendation [SOR]: B, cohort studies). If the test detects PAD, recommend steps to modify ...
What is the best diagnostic approach to alopecia in women?
(Family Physicians Inquiries Network, 2009)
Indirect evidence and expert opinion indicate that a careful history and thorough physical examination usually suggest the underlying cause of alopecia. Ancillary laboratory evaluation and scalp biopsy are sometimes necessary ...
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 ...
How do we evaluate a marginally low B12 level?
(Family Physicians Inquiries Network, 2007)
The best way to evaluate a low-normal B12 level is to check serum methylmalonic acid and homocysteine levels1 (strength of recommendation [SOR]: B, based on consistent level 2 or 3 studies). Give 1 or 2 mg of oral vitamin ...
What are the most effective nonpharmacologic therapies for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2008)
Herbal formulations, certain probiotics, elimination diets based on immunoglobulin G (IgG) antibodies, cognitive behavioral therapy, and self-help books have been shown to decrease global symptoms of irritable bowel syndrome ...
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) ...
What are the indications for evaluating a patient with cough for pertussis?
(Family Physicians Inquiries Network, 2005)
Pertussis should be considered in infants with apnea or severe coughing illnesses of any duration, and in older children or adults with prolonged cough (eg, longer than 2 weeks), especially if accompanied by inspiratory ...
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 ...
What GI stress ulcer prophylaxis should we provide hospitalized patients?
(Family Physicians Inquiries Network, 2007)
Patients in intensive care unit (ICE) settings who are receiving prolonged mechanical ventilation (for >48 hours) or who have a coagulopathy or multiple organ dysfunction (especially renal failure) should receive stress ...
What is the addiction risk associated with tramadol?
(Family Physicians Inquiries Network, 2005)
Tramadol (Ultram, generic and with acetaminophen in Ultracet) carries a risk of substance abuse (strength of recommendation [SOR]: B, based on case report surveillance programs). While it appears that tramadol's risk of ...
Can extended anticoagulation prophylaxis after discharge prevent thromboembolism?
(Family Physicians Inquiries Network, 2022)
A meta-analysis confirmed the benefit of thromboprophylaxis with a direct oral anticoagulant for high-risk nonsurgical patients after hospital discharge.
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 ...
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).
Do patients with type 2 diabetes who aren't taking insulin benefit from self-monitoring blood glucose?
(Family Physicians Inquiries Network, 2013)
Patients with type 2 diabetes who aren't on insulin and perform self-monitoring of blood glucose (SMBG) show small but significant reductions in hemoglobin A1c (HbA1c) at 6 months but not at 12 months (strength of ...
Should you test or treat partners of patients with gonorrhea, chlamydia, or trichomoniasis?
(Family Physicians Inquiries Network, 2010)
Empiric treatment of partners of female or heterosexual male patients diagnosed with gonorrhea or chlamydia using expedited partner therapy (having the index patient deliver therapy to the partner) decreases the risk of ...