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Probiotics for colic? A PURL update
(Family Physicians Inquiries Network, 2014)
In "Colicky baby? Here's a surprising remedy" (J Fam Pract. 2011;60:34-36), we summarized a 2010 doubleblind randomized controlled trial (RC T) that found the probiotic Lactobacillus reuteri DSM 17938 reduced daily crying ...
Azithromycin for PID beats doxycycline on all counts
(Family Physicians Inquiries Network, 2007)
Outpatient treatment of patients with mild pelvic inflammatory disease, using 1g of azithromycin weekly for 2 weeks, combined with 250mg of ceftriaxone intramuscularly on the first day, is superior to the current recommended ...
Stroke prevention: Age alone does not rule out warfarin
(Family Physicians Inquiries Network, 2007)
Warfarin is as safe as aspirin and more effective for stroke prevention in elders with atrial fibrillation. Stength of recommendation (SOR) A: Well-designed randomized controlled trial of elderly patients in the primary ...
Patients insist on antibiotics for sinusitis? Here is a good reason to say no
(Family Physicians Inquiries Network, 2008)
Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms Antibiotics have little if any positive effects on the severity and duration of symptoms, and ...
Have pedometer, will travel
(Family Physicians Inquiries Network, 2008)
Advise your patients to use a pedometer, set a step goal, and keep a step diary. This simple intervention takes only a few moments and is effective in increasing patients' physical activity and decreasing both body mass ...
Give vitamin C to avert lingering pain after fracture
(Family Physicians Inquiries Network, 2008)
Vitamin C 500 mg daily for 50 days reduced the risk of complex regional pain syndrome for patients with a wrist fracture. We think vitamin C 500 mg a day for 7 weeks is well worth recommending. Stength of recommendation: ...
Use anesthetic drops to relieve acute otitis media pain
(Family Physicians Inquiries Network, 2008)
Use 3 drops of topical 2% lidocaine drops or benzocaine to provide rapid pain relief for children with acute otitis media. Stength of recommendation: B: 2 good-quality, randomized controlled trials.
When not to use beta-blockers in seniors with hypertension
(Family Physicians Inquiries Network, 2008)
Beta-blockers should not be used to treat hypertension in patients older than age 60 unless they have another compelling indication to use these agents, such as heart failure or ischemic heart disease. Stength of recommendation: ...
For Bell's palsy, start steroids early; no need for an antiviral
(Family Physicians Inquiries Network, 2008)
A 10-day course of corticosteroids (prednisolone 25 mg twice daily) started within 72 hours significantly improves the chances of complete recovery. There is no added benefit from acyclovir. Stength of recommendation: A: ...
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 ...
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. ...
Glucose self-monitoring: Think twice for type 2 patients
(Family Physicians Inquiries Network, 2008)
Stop routinely recommending blood glucose self-monitoring for patients with newly diagnosed type 2 diabetes. Self-monitoring does not improve glycemic control for patients who are not taking insulin, and it increases the ...
Annual zoledronic acid infusion lowers risk of fracture, death
(Family Physicians Inquiries Network, 2007)
Patients with a prior hip fracture have 2.5 times the risk of a new fracture compared to age-matched persons without a previous hip fracture. For patients with a recent hip fracture, intravenous zoledronic acid annually ...
Migraine treatment tweak could reduce office visits
(Family Physicians Inquiries Network, 2009)
Add dexamethasone to the standard treatment of moderate to severe migraine headache; a single dose (8-24 mg) may prevent short-term recurrence, resulting in less need for medication and fewer repeat visits to the office ...
Antidepressants causing sexual problems? Give her Viagra
(Family Physicians Inquiries Network, 2008)
Tell women for whom you prescribe selective and nonselective serotonin reuptake inhibitors (SRIs) to let you know if they develop sexual dysfunction. Offer sildenafi (50 mg with the option to increase to 100 mg) to ...
Help smokers quit: Tell them their "lung age"
(Family Physicians Inquiries Network, 2008)
Perform spirometry on patients who smoke -- even if they're asymptomatic -- and show them their lung age that is, the average age of a nonsmoker with a forced expiratory volume at 1 second (FEV1) equal to theirs. Doing so ...
Arthroscopic surgery for knee osteoarthritis? Just say no
(Family Physicians Inquiries Network, 2009)
Do not recommend arthroscopic surgery to adults with osteoarthritis of the knee. Treat knee pain with medical and physical therapy instead. Stength of recommendation: A: Based on 2 high-quality randomized controlled trials.
Let them eat nuts -- this snack is safe for diverticulosis patients
(Family Physicians Inquiries Network, 2009)
Tell patients with diverticular disease that they can eat nuts, corn, and popcorn without fear. There is no truth to the long-held belief that these foods increase the risk of complications. Strength of recommendatin: B: ...
Acute gout: Oral steroids work as well as NSAIDs
(Family Physicians Inquiries Network, 2008)
Use a short course of oral steroids (prednisone 30-40mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line ...
Glucose control: How low should you go with the critically ill?
(Family Physicians Inquiries Network, 2009)
For hyperglycemic patients admitted to an intensive care unit (ICU), the target blood glucose level should be [less than or equal to] 180 mg/dL, not 81 to 108 mg/dL. More aggressive glucose lowering is associated with a ...