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Bisphosphonate therapy: When not to monitor BMD
(Family Physicians Inquiries Network, 2009)
After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. Stength of recommendation: C: Based on a secondary analysis of a large ...
What are the best prophylactic drugs for migraine?
(Family Physicians Inquiries Network, 2009)
Beta-blockers without intrinsic sympathomimetic activity, amitriptyline, divalproex sodium/sodium valproate, and topiramate are the most effective drugs for preventing episodic migraine (strength of recommendation: A, ...
Which asthma patients should get the pneumococcal vaccine?
(Family Physicians Inquiries Network, 2009)
Adults between the ages of 19 and 64 years who have chronic lung disease, including asthma, should get the vaccine, as should all patients 65 years and older (strength of recommendation [SOR]: C, consensus guide-lines). ...
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 ...
Should you use antibiotics to treat acute otitis media in children?
(Family Physicians Inquiries Network, 2009)
Antibiotics are not necessary to treat uncomplicated acute otitis media (AOM) in an otherwise healthy child (strength of recommendation [SOR]: A, systematic review). Children younger than 2 years and children with bilateral ...
Which interventions are best for alleviating nipple pain in nursing mothers?
(Family Physicians Inquiries Network, 2009)
The best intervention is education on proper positioning and attachment of the infant (strength of recommendation [SOR]: A, a systematic review of randomized controlled trials [RCTs]). No single topical preparation has ...
Treatment for Anogenital Molluscum Contagiosum
(Family Physicians Inquiries Network, 2009)
There is no evidence from comparative trials to suggest a single best treatment method for anogenital molluscum contagiosum. Randomized controlled trials suggest self-administered topical imiquimod or podophyllotoxin cream ...
What laboratory monitoring is appropriate to detect adverse drug reactions in patients on cholesterol-lowering agents?
(Family Physicians Inquiries Network, 2001)
Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not ...
Do intercontraction intervals predict when a woman at term should seek evaluation of labor?
(Family Physicians Inquiries Network, 2009)
A reduction in the intercontraction interval is associated with active labor (strength of recommendation [SOR]: B, cohort study). Most primigravidas who have had regular contractions for 2 hours and multigravidas who have ...
What's the best way to monitor low-risk patients with a history of differentiated thyroid cancer?
(Family Physicians Inquiries Network, 2009)
Recombinant human thyrotropin (rhTSH)-stimulated serum thyroglobulin (Tg) level alone is sufficient to monitor for recurrent disease in low-risk patients with a history of differentiated thyroid cancer (DTC) (strength of ...
Can counseling prevent or treat postpartum depression?
(Family Physicians Inquiries Network, 2009)
In most cases, counseling does not prevent postpartum depression (PPD), though it can treat the disorder. Overall, psychosocial interventions don't offer a significantly greater benefit than standard care in preventing ...
What is the role of prokinetic agents for constipation?
(Family Physicians Inquiries Network, 2009)
Erythromycin has a limited role in treating pediatric patients (strength of recommendation [SOR]: B, limited-quality, patient-oriented evidence). Tegaserod and cisapride are the only prokinetic agents available for constipated ...
How effective is gastric bypass for weight loss?
(Family Physicians Inquiries Network, 2004)
Gastric bypass results in weight loss of approximately 33% at 2 years and 25% at 8 years (strength of recommendation [SOR]: B, based on a cohort study). Gastric bypass is one type of bariatric surgery, which also includes ...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of ...
What steps can reduce morbidity and mortality caused by hip fractures?
(Family Physicians Inquiries Network, 2007)
Surgery within 24 hours of hip fracture is a critical step in reducing complications, and may decrease mortality compared with conservative care (strength of recommendation [SOR]: B, cohort studies). Give patients heparin ...
Does stimulant therapy help adult ADHD?
(Family Physicians Inquiries Network, 2003)
Central nervous system stimulants improve symptoms of attention deficit-hyperactivity disorder (ADHD) in adults (strength of recommendation: B, based on an older, inconclusive systematic review, a lesser-quality systematic ...
Does case management improve diabetes outcomes?
(Family Physicians Inquiries Network, 2008)
Patients with type 2 diabetes benefit from case management, as evidenced by decreased glycated hemoglobin (HbA1c). The improvement in HbA1c appeared larger when case managers could make changes in medications independently ...
What is the best medical therapy for new-onset type 2 diabetes?
(Family Physicians Inquiries Network, 2006)
Sulfonylureas, metformin, thiazolidinediones, and non-sulfonylurea secretagogues differ little in their ability to decrease glycosylated hemoglobin (HbA1c) levels when used as initial monotherapy for diabetes mellitus type ...
What lifestyle changes should we recommend for the patient with newly diagnosed hypertension?
(Family Physicians Inquiries Network, 2006)
Hypertensive patients should reduce sodium intake (strength of recommendation [SOR]: A). The Dietary Approaches to Stop Hypertension diet (DASH diet)--with salt restriction and increased fruit, vegetable, calcium, and ...
Which late-stage Alzheimer's patients should be referred for hospice care?
(Family Physicians Inquiries Network, 2005)
Medicare guidelines are used to determine eligibility for hospice care (strength of recommendation [SOR]: C, based on expert opinion), but they correlate with 6-month mortality no better than an experienced clinician's ...