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Hip Pain in Preschool-Age Children
(Family Physicians Inquiries Network, 2009)
Evidence is lacking on the most common causes of hip pain in children because most data come from cohort studies and include referred patients. Based on these studies, transient synovitis is the most common cause of hip pain in preschool...
What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?
(Family Physicians Inquiries Network, 2009)
No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in very-high-risk patients. However, no evidence suggests a "floor" for LDL cholesterol levels beyond which further reductions of heart disease...
How often should you follow up on a patient with newly diagnosed hypothyroidism?
(Family Physicians Inquiries Network, 2009)
Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If thyroid function is normal...
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...
Treatment for Anogenital Molluscum Contagiosum
(Family Physicians Inquiries Network, 2009)
lesions. (Strength of Recommendation: B, based on inconsistent or limited quality patient-oriented evidence). There are no comparative trials of other commonly used treatments, such as carbon dioxide laser, cryotherapy, or curettage....
Are overweight children more likely to be overweight adults?
(Family Physicians Inquiries Network, 2009)
Overweight at any age in childhood increases the risk for overweight in adulthood. The relative risk (RR) ranges from 1.9 to 10.1 and increases as children get older. Not all overweight children become overweight adults, ...
Effective Management of Flatulence
(Family Physicians Inquiries Network, 2009)
benefit in reducing flatus-associated odor. (SOR: C, based on disease-oriented evidence). Evidence for oral activated charcoal and simethicone has been inconsistent and does not support their use. (SOR: B, based on multiple small RCTs)....
Which treatments work best for hemorrhoids?
(Family Physicians Inquiries Network, 2009)
Excision is the most effective treatment for thrombosed external hemorrhoids (strength of recommendation [SOR]: B, retrospective studies). For prolapsed internal hemorrhoids, the best definitive treatment is traditional ...
How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?
(Family Physicians Inquiries Network, 2001)
Acupuncture, biofeedback, and S-adenosyl methionine (SAMe) have been shown to have some efficacy in the treatment of fibromyalgia in randomized controlled trials. Spa treatments, hypnotherapy, massage, and meditation may ...
How can you help prevent a recurrence of diverticulitis?
(Family Physicians Inquiries Network, 2009)
A high-fiber diet is often prescribed after recovery from acute diverticulitis, based on extrapolation from epidemiologic data showing an association between low-fiber diets and diverticulosis (strength of recommendation [SOR]: C, expert opinion...
Which complementary therapies can help patients with PMS?
(Family Physicians Inquiries Network, 2009)
doses of pyridoxine can cause neuropathy (SOR: B, RCT and meta-analysis of lower-quality studies). Insufficient evidence exists to recommend magnesium. St. John's wort and evening primrose oil aren't effective for managing PMS (SOR: B, inconsistent...
What are the best prophylactic drugs for migraine?
(Family Physicians Inquiries Network, 2009)
Beta-blockers without intrinsic sympathomimetic activity, amitriptyline, divalproex sodium/sodium valproate, and topiramate are the most effective drugs for preventing episodic migraine (strength of recommendation: A, ...
Do patients at high risk of Alzheimer's disease benefit from early treatment?
(Family Physicians Inquiries Network, 2009)
Treating patients with early-stage Alzheimer's disease yields statistically significant, though perhaps not clinically significant, improvement in cognition and global function (strength of recommendation [SOR]: A, consistent evidence from multiple...
Which asthma patients should get the pneumococcal vaccine?
(Family Physicians Inquiries Network, 2009)
Adults between the ages of 19 and 64 years who have chronic lung disease, including asthma, should get the vaccine, as should all patients 65 years and older (strength of recommendation [SOR]: C, consensus guide-lines). Evidence doesn't support...
Which strategies work best to prevent obesity in adults?
(Family Physicians Inquiries Network, 2009)
Regular physical activity decreases long-term weight gain (strength of recommendation [SOR]: B, 2 high-quality, randomized controlled trials [RCTs]). Decreasing fat intake (SOR: B, 1 high-quality systematic review) and ...
What is the role of prokinetic agents for constipation?
(Family Physicians Inquiries Network, 2009)
Erythromycin has a limited role in treating pediatric patients (strength of recommendation [SOR]: B, limited-quality, patient-oriented evidence). Tegaserod and cisapride are the only prokinetic agents available for constipated adults (SOR: A...
Do OTC remedies relieve cough in acute URIs?
(Family Physicians Inquiries Network, 2009)
Dextromethorphan (DM) for adults and honey for children provide some relief. DM may modestly decrease cough in adults compared with placebo (strength of recommendation [SOR]: B, systematic review of inconsistent or limited evidence). The data...
Which interventions are best for alleviating nipple pain in nursing mothers?
(Family Physicians Inquiries Network, 2009)
to be superior to others for relieving nipple pain (SOR: B, inconsistent RCTs). Topical agents that show some evidence of benefit include expressed breast milk, lanolin, warm water compresses, tea bag compresses, hydrogel dressings, a chlorhexidinealcohol spray...
Antiviral Agents for Pregnant Women with Genital Herpes
(Family Physicians Inquiries Network, 2005)
There is no evidence that the use of antiviral agents in women who are pregnant and have a history of genital herpes prevents perinatal transmission of herpes simplex virus (HSV) to neonates. [Strength of recommendation: A, based on multiple...
When is neuroimaging warranted for headache?
(Family Physicians Inquiries Network, 2005)
of recommendation [SOR]: B, based on a validating cohort study), decreased level of
consciousness (SOR: B, based on a retrospective, nonconsecutive case study), occipitonuchal location, multiple associated symptoms, and age older than 55 years (SOR: B, based on a...