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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...
Transportation Equity Act: Adopting a Statewide Open Container Law in Missouri
(University of Missouri - Columbia Institute of Public Policy, 2005)
According to the National Highway Traffic Safety Administration (NHTSA), 1,232 fatal vehicle crashes occurredin 2003 on Missouri's highways. Approximately 41 percent of these fatalities involved alcohol. These incidents ...
How does tissue adhesive compare with suturing for superficial lacerations?
(Family Physicians Inquiries Network, 2005)
Tissue adhesives are effective and yield results comparable to those with conventional suturing of superficial, linear, and low-tension lacerations. The cosmetic outcome is similar; wound complications, such as infection ...
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...
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...
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...
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...
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] ...
Missouri State and Local Open Container Laws
(University of Missouri - Columbia Institute of Public Policy, 2005)
and the
consumption of any alcoholic beverage by both the driver and passenger (see Report 29-2005 for more detail). The current Missouri open container law applies only to the driver, making Missouri one of thirteen states (AK, AR, CO, CT, DE, IN, MO, MS, MT, TN, VA...
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 ...
For fibromyalgia, which treatments are the most effective?
(Family Physicians Inquiries Network, 2005)
capacity and sense of well-being for patients with fibromyalgia (SOR: A, based on a systematic review of RCT). Cognitive behavioral therapy improves patients' self-reported symptoms (SOR: A, based on RCTs)....
What are the best therapies for acute migraine in pregnancy?
(Family Physicians Inquiries Network, 2005)
No randomized controlled trials of pharmacologic therapy for acute migraine in pregnant women are available. Three treatment studies suggest that nonpharmacological therapies (combinations of skin warming, relaxation, ...
What is the best treatment for pertussis?
(Family Physicians Inquiries Network, 2005)
A short-term course of erythromycin, azithromycin, or clarithromycin is as effective as a long-term (2-week) erythromycin therapy in eradicating Bordetella pertussis from the nasopharynx (strength of recommendation [SOR]: ...
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 ...
Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
Both antidepressant medications and psychologic treatment are beneficial for adult patients with mild to moderate depression, with no consistent evidence that one type of treatment is more effective than the other. [Strength ...
How should we follow athletes after a concussion?
(Family Physicians Inquiries Network, 2005)
Athletes sustaining a concussion should be held from contact activities a minimum of 7 days; they must be asymptomatic and their coordination and neuropsychological tests should have returned to their pre-injury baseline ...
Is therapy based on endoscopy results better than empiric therapy for dyspepsia?
(Family Physicians Inquiries Network, 2005)
In the initial management of dyspepsia for patients without "alarm" symptoms (weight loss, recurrent vomiting, dysphagia, anemia, evidence of bleeding, onset of dyspepsia after age 45 years), therapy based on the results ...
Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?
(Family Physicians Inquiries Network, 2005)
Short-term use of metformin (Glucophage) improves ovulation rates for women with polycystic ovary syndrome (PCOS) (strength of recommendation [SOR]: A, based on systematic reviews of randomized controlled trials [RCT]). ...
What is the best treatment for gastroesophageal reflux and vomiting in infants?
(Family Physicians Inquiries Network, 2005)
The literature on pediatric reflux can be divided into studies addressing clinically apparent reflux (vomiting or regurgitation) and reflux as measured by pH probe or other methods. Sodium alginate reduces vomiting and ...
Combined Sewer Overflows in Missouri: Costs and Alternative Approaches
(University of Missouri - Columbia Institute of Public Policy, 2005)
of correcting the problems posed by CSOs is a daunting task that will force decisions affecting CSO communities economically and socially. Currently, the State of Missouri does not provide a regulatory framework for effectively addressing CSOs (See Report 27-2005...