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What illnesses contraindicate immunization?
(Family Physicians Inquiries Network, 2005)
The Advisory Council on Immunization Practices (ACIP) reports that the only contraindication for all vaccines is a history of severe allergic reaction to a previous vaccine or vaccine constituent (strength of recommendations: C, based predominantly...
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 substance abuse is low (SOR...
Pelvic measurements and calving difficulty (2005)
(University of Missouri--Columbia. Extension Division, 2005)
Although researchers agree that birth weight is the most important measurable trait affecting calving difficulty, there is evidence that the size and shape of the pelvis also affect a heifer's ability to calve.
For fibromyalgia, which treatments are the most effective?
(Family Physicians Inquiries Network, 2005)
improve fibromyalgia-related symptoms (SOR: B, based on a few RCTs). The serotonin and norepinephrine reuptake inhibitors (SNRIs) duloxetine (Cymbalta) and milnacipran (Ixel, not currently available in the US) improve pain and other symptoms (SOR: B, based...
In menopausal women, does fatigue indicate disease?
(Family Physicians Inquiries Network, 2005)
Though fatigue is a commonly reported symptom, high-quality studies evaluating it as a marker for diseases among menopausal women are lacking. Middle-aged women who report fatigue are more apt to screen positive for clinical depression or anxiety...
Missouri Medicaid Program: The A Graphical Profile
(University of Missouri - Columbia Institute of Public Policy, 2005)
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The report uses the most current summary information available and many FY2005 charts are included. However, for some graphics, it was necessary to use older data to achieve a consistent frame of reference. Some Medicaid service types, particularly managed...
Should liver enzymes be checked in a patient taking niacin?
(Family Physicians Inquiries Network, 2005)
No randomized trials directly address the question of frequency of liver enzyme monitoring with niacin use. Niacin use is associated with early and late hepatotoxicity (strength of recommendation [SOR]: B, based on incidence data from randomized...
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
(Family Physicians Inquiries Network, 2005)
If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (strength of recommendation [SOR]: B, based on case series of dual energy x-ray absorptiometry [DEXA] scanning precision...
Missouri Medicaid Program: A Graphical Profile
(University of Missouri Extension, 2005)
This report provides a graphical summary of the Missouri Medicaid program. It is intended to provide background information of the policy issues being considered by the Missouri Medicaid Reform Commission. Medicaid at the national level...
What is the best treatment for gastroesophageal reflux and vomiting in infants?
(Family Physicians Inquiries Network, 2005)
of symptoms (strength of recommendation [SOR]: B, small randomized controlled trial [RCT]). Formula thickened with rice cereal decreases the number of postprandial emesis episodes in infants with gastroesophageal reflux disease (GERD) (SOR: B, small RCT)....
Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
, based on randomized controlled trials (RCTs) and systematic reviews] There is limited evidence that antidepressant medications and cognitive behavioral therapy are similarly effective for patients with severe depression [Strength of recommendation: B...
Morning Report and All That [poster]
(2007)
In October 2005, the Health Sciences Library at the University of Missouri-Columbia introduced a clinical librarian service for interns, residents, and faculty of the Department of Child Health. The clinical librarian attends Morning Report...
Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?
(Family Physicians Inquiries Network, 2005)
menstrual irregularities (SOR: B, extrapolated from a systematic review). When added to clomiphene, metformin increases ovulation and pregnancy rates when compared with clomiphene alone (SOR: A, systematic review). Thiazolidinediones (TZDs) improve ovulation...
How does colonoscopy compare with fecal occult blood testing as a screening tool for colon cancer?
(Family Physicians Inquiries Network, 2005)
No studies have directly compared colonoscopy with fecal occult blood testing (FOBT). Multiple screening trials have demonstrated that a primary strategy of 3-card home FOBT with follow-up colonoscopy for positive results is associated with a...
What are the indications for evaluating a patient with cough for pertussis?
(Family Physicians Inquiries Network, 2005)
to a prolonged cough illness (strength of recommendation [SOR]: B, based on consecutive cohort studies with poor reference standards). Coughing paroxysms, posttussive vomiting, and absence of fever, while typical of pertussis, are of little help...
Is DEET safe for children?
(Family Physicians Inquiries Network, 2005)
Reported evidence suggests that DEET use is safe for children older than 2 months, with only very rare incidence of major adverse effects (strength of recommendation [SOR]: C). Typically, a topical concentration between 10% and 30% should be used...
Intravenous Fluids for Children with Gastroenteritis
(Family Physicians Inquiries Network, 2005)
of recommendation: B]...
How should we follow athletes after a concussion?
(Family Physicians Inquiries Network, 2005)
[SOR]: B, based on multiple prospective cohort studies). High-risk athletes (eg, those with a history of previous concussion, high- school age or younger, or female) may need to avoid contact even after all these criteria are met (SOR: C, expert opinion)....
What are effective treatments for oppositional and defiant behaviors in preadolescents?
(Family Physicians Inquiries Network, 2005)
Parent training is effective for treating oppositional and defiant behaviors (strength of recommendation [SOR]: A, based on systematic reviews). Parent training programs are standardized, short-term interventions that teach ...