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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 ...
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).
Suspect carpal tunnel? : Try this
(Family Physicians Inquiries Network, 2013)
For best results, use the modified Phalen's test (MPT) rather than the traditional Phalen's when you suspect carpal tunnel syndrome (CTS).
What's best for IBS?
(Family Physicians Inquiries Network, 2012)
Recommend antispasmodics or antidepressants for patients with irritable bowel syndrome (IBS) and explain that, while fiber may have other benefits, it is unlikely to relieve IBS symptoms. Stength of recommendation: A: Based ...
Combatting lice in a single treatment
(Family Physicians Inquiries Network, 2012)
Consider prescribing spinosad -- a recently approved topical pediculicide that is more effective than permethrin and eliminates the need for nit combing -- for children with head lice.
PSA testing: When it's useful, when it's not
(Family Physicians Inquiries Network, 2011)
Do not routinely screen all men over the age of 50 for prostate cancer with the prostate-specific antigen (PSA) test. Consider screening men younger than 75 with no cardiovascular or cancer risk factors -- the only patient ...
Steroids for acute COPD - but for how long?
(Family Physicians Inquiries Network, 2014)
Prescribe a 5-day regimen of glucocorticoid therapy for acute chronic obstructive pulmonary disease (COPD) exacerbations; the shorter course of treatment appears to be as effective as a 14-day regimen.
Is this pregnancy viable?
(Family Physicians Inquiries Network, 2013)
Measure serum progesterone levels of women with bleeding or pain and inconclusive ultrasound in early pregnancy to rule out viability, potentially eliminating the need for serial b-hormone human chorionic gonadotropin ...
Prescribing an antibiotic? Pair it with probiotics
(Family Physicians Inquiries Network, 2013)
Recommend that patients taking antibiotics also take probiotics, which have been found to be effective both for the prevention and treatment of antibiotic-associated diarrhea (AAD). Stength of recommendation: A: Based on ...
It's time to use an age-based approach to D-dimer
(Family Physicians Inquiries Network, 2014)
Use an age-adjusted D-dimer cutoff (patient's age in years [multiplied by] 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing ...
Is your patient still using rosiglitazone?
(Family Physicians Inquiries Network, 2011)
Do not initiate rosiglitazone therapy for patients with diabetes, and consider switching those who are already taking it to pioglitazone. Stength of recommendation: A: Based on a meta-analysis of 56 randomized trials.
Finally, a way to relieve cancer-related fatigue
(Family Physicians Inquiries Network, 2014)
A 4-week course of American ginseng, taken while patients are undergoing radiation or chemotherapy, can reduce cancer-related fatigue. PRACTICE CHANGER: Recommend American ginseng 1000 mg twice daily for 4 weeks to improve ...
An antiemetic for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2014)
An antiemetic for irritable bowel syndrome? A drug used for cancer patients may provide some relief to patients with IBS. Practice changer: Consider prescribing ondansetron up to 24 mg/d for patients who have irritable ...
This asthma treatment has a lasting side effect in children
(Family Physicians Inquiries Network, 2013)
Before prescribing inhaled corticosteroids (ICS) for a child with asthma, tell the patient -- and parents -- that their use could lead to a small but permanent effect on adult height. Stength of recommendation: B: Based ...
Think twice about nebulizers for asthma attacks
(Family Physicians Inquiries Network, 2014)
MDIs with spacers are as effective as nebulizers for delivering beta-agonists and less likely to cause adverse effects. Practice changer: Stop ordering nebulizers to deliver beta-agonists to patients over age 2 with mild ...
Mediterranean diet: Higher fat but lower risk
(Family Physicians Inquiries Network, 2013)
Counsel patients at high risk for cardiovascular disease and stroke to follow a Mediterranean diet, which is associated with a 30% risk reduction.
Sterile or non-sterile gloves for minor skin excisions?
(Family Physicians Inquiries Network, 2015)
Sterile or non-sterile gloves for minor skin excisions? Non-sterile gloves are just as effective as sterile gloves in preventing surgical site infection after minor skin surgeries. PRACTICE CHANGER: Consider using non-sterile ...
Monitoring home BP readings just got easier
(Family Physicians Inquiries Network, 2016)
Monitoring home BP readings just got easier. This novel method of identifying patients with uncontrolled hypertension correlates well with ambulatory BP monitoring. Practice changer: Use this easy "3 out of 10 rule" to ...
A new protocol for RhD-negative pregnant women?
(Family Physicians Inquiries Network, 2018)
Can cell-free DNA testing reduce unnecessary use of anti-D immunoglobulin in RhD-negative women and still prevent harm to their RhD-positive infants? PRACTICE CHANGER: Employ cell-free DNA testing at 27 weeks' gestation ...
Treating pulmonary embolism at home?
(Family Physicians Inquiries Network, 2012)
Treat low-risk patients with pulmonary embolism (PE) with low-molecular-weight heparin (LMWH) in an outpatient setting. Stength of recommendation: B: Based on one good quality randomized controlled trial (RCT).