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Do oral decongestants have a clinically significant effect on BP in patients with hypertension?
(Family Physicians Inquiries Network, 2017)
Q: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? Evidence-based answer: It is unclear. Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients...
Oral agent offers relief from generalized hyperhidrosis
(Family Physicians Inquiries Network, 2017)
Hyperhidrosis is a common, self-limiting problem affecting 2% to 3% of the population in the United States. Patients may complain of localized sweating of the hands, feet, face, or underarms or more systemic, generalized sweating in multiple...
Need an add-on to metformin? Consider this
(Family Physicians Inquiries Network, 2017)
Need an add-on to metformin? Consider this. Sulfonylureas have been the preferred add-on therapy to metformin for T2DM, but a study finds that DPP-4s have lower risks of death, CV events, and hypoglycemia. Practice changer: Consider a dipeptidyl...
Can mobile technology improve weight loss in overweight and obese patients?
(Family Physicians Inquiries Network, 2017)
loss (1.4 to 2.7 kg) in overweight and obese patients (strength of recommendation [SOR]: A, meta-analysis of good quality studies and randomized controlled trials [RCTs]). Interventions that combine nonelectronic measures with mobile technology increase...
Does azithromycin have a role in cesarean sections?
(Family Physicians Inquiries Network, 2017)
Does azithromycin have a role in cesarean sections? Yes, adding azithromycin to the usual antibiotic protocol in nonelective c-sections reduces infections. But not everyone can take advantage of it. PRACTICE CHANGER: Prescribe a one-time dose...
Consider melatonin for migraine prevention
(Family Physicians Inquiries Network, 2017)
An effective migraine prevention alternative with minimal adverse effects Melatonin is an accessible and affordable option for preventing migraine headaches in chronic sufferers.
The benefits--and limits-- of PPIs with warfarin regimens
(Family Physicians Inquiries Network, 2017)
Patients on warfarin + antiplatelet/NSAID regimens are likely to benefit from the gastroprotective effect of PPIs. For patients taking warfarin alone, it's a different story. PRACTICE CHANGER: Prescribe a proton pump inhibitor for patients taking...
How do hyaluronic acid and corticosteroid injections compare for knee OA relief?
(Family Physicians Inquiries Network, 2017)
Q How do hyaluronic acid and corticosteroid injections compare for knee OA relief? A: Inconsistent evidence shows a small amount of pain relief early (one week to 3 months) with corticosteroid (CS) injections and an equally ...
Do probiotics reduce C diff risk in hospitalized patients?
(Family Physicians Inquiries Network, 2019)
Do probiotics reduce C diff risk in hospitalized patients? A systematic review and meta-analysis says, "Yes," but that doesn't necessarily mean they will start appearing on hospital formularies. Practice changer: Start probiotics within 1 to 2 days...
Let low-risk moms eat during labor?
(Family Physicians Inquiries Network, 2018)
Let low-risk moms eat during labor? Allowing low-risk pregnant women to eat less restrictive diets during labor may not only make them happier, but may shorten labor, too. Practice changer: Allowing low-risk patients planning for a vaginal delivery...
Can unintended pregnancies be reduced by dispensing a year's worth of hormonal contraception?
(Family Physicians Inquiries Network, 2019)
larger number of pills at one time were more likely to continue using combined hormonal contraception 7 to 15 months later (strength of recommendation [SOR]: A, consistent evidence from 2 cohort studies and 1 randomized, controlled trial), which might...
Put down the electronics after a concussion?
(Family Physicians Inquiries Network, 2023-01)
Advise your teenaged and young adult patients with concussion to avoid electronic screens in the first 48 hours after a concussion to minimize time to symptom resolution.
What's the best VTE treatment for patients with cancer?
(Family Physicians Inquiries Network, 2018)
Q: What's the best VTE treatment for patients with cancer? Evidence-based answer: No. Head-to-head studies directly compare all the main treatments for venous thromboembolism (VTE) in cancer patients. Long-term treatment (3-12 months) with low...
Confidently rule out CAP in the outpatient setting
(Family Physicians Inquiries Network, 2021)
Confidently rule out CAP in the outpatient setting. A focus on specific signs and symptoms -- without imaging -- may rule out community-acquired pneumonia in outpatients. PRACTICE CHANGER: You can safely rule out community-acquired pneumonia (CAP...
Case Reports : Topiramate, a concealed cause of severe metabolic acidosis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-07)
Severe metabolic acidosis is common among critically ill patients, and topiramate is a rare cause that may fail recognition. We report a lady with acute encephalopathy who had severe non-anion gap metabolic acidosis that ...
Is self-administered DMPA an answer to contraception access in the post-Roe era?
(Family Physicians Inquiries Network, 2023-03)
Consider prescribing self-administered subcutaneous depot medroxyprogesterone acetate (DMPA) for contraception instead of provider-administered DMPA. Self-administration improves contraception continuation rates without ...
Do cinnamon supplements improve glycemic control in adults with T2DM?
(Family Physicians Inquiries Network, 2020)
Q: Do cinnamon supplements improve glycemic control in adults with T2DM? Evidence-based answer: the answer isn't clear. Cinnamon supplements for adults with type 2 diabetes haven't been shown to decrease hemoglobin A1C (strength of recommendation...
Immediate or delayed pushing in the second stage of labor?
(Family Physicians Inquiries Network, 2020)
Immediate or delayed pushing in the second stage of labor? Is there any advantage to delaying pushing in the second stage of labor for nulliparous women receiving epidural analgesia? PRACTICE CHANGER: Recommend immediate, rather than delayed...
Which anticoagulant is safest for frail elderly patients with nonvalvular A-fib?
(Family Physicians Inquiries Network, 2022-11)
Consider apixaban, which demonstrated a lower adverse event (AE) rate than warfarin regardless of frailty status, for anticoagulation treatment of older patients with nonvalvular atrial fibrillation (AF); by comparison, ...
What barriers delay treatment in patients with hepatitis C?
(Family Physicians Inquiries Network, 2022-09)
and variability in reporting or interpreting data associated with substance or alcohol use disorders (strength of recommendation: B, based on 2 prospective and 5 retrospective cohort studies)....