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Glycemic Control in Patients with Type 2 Diabetes
(Family Physicians Inquiries Network, 2007)
There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes. (Strength of Recommendation [SOR]: C) Metformin (Glucophage) has shown additional benefit when compared with other treatments (including insulin...
Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese
(Family Physicians Inquiries Network, 2007)
No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated...
When should you suspect community-acquired MRSA? How should you treat it?
(Family Physicians Inquiries Network, 2009)
There are no clinical or epidemiologic features that will help you to clearly distinguish community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) from methicillin-sensitive (CA-MSSA) infections (strength of recommendation...
How useful is high-sensitivity CRP as a risk factor for coronary artery disease?
(Family Physicians Inquiries Network, 2005)
risk for cardiovascular disease, with some evidence suggesting its use if the results of the test will alter treatment recommendations (strength of recommendation [SOR]: C, based on extrapolation of consistent level 2 studies). Research to date...
Do imaging studies aid diagnosis of acute sinusitis?
(Family Physicians Inquiries Network, 2003)
Accurate diagnosis of acute sinusitis in both children and adults depends on the history and clinical examination of the patient. While the clinical signs and symptoms of acute sinusitis are often difficult to distinguish from viral upper...
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 ...
What is the best way to treat tinea cruris?
(Family Physicians Inquiries Network, 2006)
After clinical diagnosis and microscopic confirmation, tinea cruris is best treated with a topical allylamine or an azole antifungal (strength of recommendation: A, based on multiple randomized controlled trials [RCTs]). Differences in current...
What nonhormonal therapies are effective for postmenopausal vasomotor symptoms?
(Family Physicians Inquiries Network, 2003)
Regular exercise may reduce vasomotor symptoms of menopause (strength of recommendation [SOR]: C--single observational study). Soy products/isoflavones, either through diet or supplementation, may reduce the incidence of hot flushes (SOR: D...
When are antibiotics indicated for acute COPD exacerbations?
(Family Physicians Inquiries Network, 2006)
). Antibiotics may be prescribed in the outpatient setting for those with severe exacerbations (SOR: C, based on expert opinion)....
What are effective therapies for Clostridium difficile- associated diarrhea?
(Family Physicians Inquiries Network, 2005)
select for colonization with vancomycin-resistant enterococci, leading the American College of Gastroenterology to recommend oral metronidazole as preferred therapy (SOR: C, expert opinion). They recommend therapy with vancomycin for those who...
What are the causes of hypomagnesemia?
(Family Physicians Inquiries Network, 2005)
, and malnutrition (strength of recommendation: C, based on expert opinion, physiology, and case series). Evidence suggests that magnesium deficiency is both more common and more clinically significant than generally appreciated....
Does early detection of suspected atherosclerotic renovascular hypertension change outcomes
(Family Physicians Inquiries Network, 2005)
We found no evidence for changed outcomes from early detection of renal artery stenosis (RAS). Treatment of RAS in refractory hypertension modestly improves blood pressure control. There was a trend toward improved clinical outcomes but studies were...
What is the best strategy for impaired glucose tolerance in nonpregnant adults?
(Family Physicians Inquiries Network, 2005)
The best treatment strategy for impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) is lifestyle intervention with a structured weight loss program of diet and exercise (strength of recommendation [SOR]: ...
Can we prevent splenic rupture for patients with infectious mononucleosis?
(Family Physicians Inquiries Network, 2005)
All patients with infectious mononucleosis should be considered at risk for splenic rupture since clinical severity, laboratory results, and physical exam are not reliable predictors of rupture (strength of recommendation [SOR]: B, case...
What is the role of combination therapy (insulin plus oral medication) in type 2 diabetes?
(Family Physicians Inquiries Network, 2006)
on systematic review of randomized controlled trials [RCTs] with some heterogeneity). Combination therapy using insulin and pioglitazone (Actos) reduces glycosylated hemoglobin (HbA1c) more than either insulin alone or adding pioglitazone to a sulfonylurea...
Statin Therapy in Patients with Type 2 Diabetes
(Family Physicians Inquiries Network, 2005)
Based on current evidence, statin therapy should be offered to all patients with type 2 diabetes who are known to have coronary artery disease. [Strength of recommendation: A] For patients older than 40 years with type 2 diabetes who are not known...
Does quinine reduce leg cramps for young athletes?
(Family Physicians Inquiries Network, 2005)
Very little evidence exists regarding the use of quinine for cramps in young adult athletes. Quinine may be an effective treatment for heat cramps in athletes (strength of recommendation [SOR]: C, 1 case series involving 2 patients). Quinine...
What are the indications for evaluating a patient with cough for pertussis?
(Family Physicians Inquiries Network, 2005)
Pertussis should be considered in infants with apnea or severe coughing illnesses of any duration, and in older children or adults with prolonged cough (eg, longer than 2 weeks), especially if accompanied by inspiratory whoop or household exposure...
What is the best medical therapy for new-onset type 2 diabetes?
(Family Physicians Inquiries Network, 2006)
Sulfonylureas, metformin, thiazolidinediones, and non-sulfonylurea secretagogues differ little in their ability to decrease glycosylated hemoglobin (HbA1c) levels when used as initial monotherapy for diabetes mellitus type 2 (strength...
What are effective treatments for oppositional and defiant behaviors in preadolescents?
(Family Physicians Inquiries Network, 2005)
strategies--including positive attending, ignoring, the effective use of rewards and punishments, token economies, and time out --to address clinically significant behavior problems. In addition to parent training, other psychosocial interventions...