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Does tamoxifen prevent breast cancer?
(Family Physicians Inquiries Network, 2001)
Tamoxifen prevents breast cancer in women older than 60 years and in younger women with equally high risk because of breast disease and reproductive and family history, but there is no current evidence for or against long-term survival or overall...
What is the best approach to prevention and treatment of osteoporosis?
(Family Physicians Inquiries Network, 2001)
Randomized controlled trials (RCTs) have demonstrated decreased vertebral and nonvertebral fracture rates in postmenopausal osteoporotic women taking a bisphosphonate (alendronate or risedronate). Hormone replacement therapy ...
What are the benefits of treating sleep apnea?
(Family Physicians Inquiries Network, 2001)
There is little benefit to treating patients with sleep apnea who do not have daytime sleepiness. For patients with symptoms, treating those with moderate to severe sleep apnea is more reliably associated with benefits ...
Prophylactic oxytocin: Before or after placental delivery?
(Family Physicians Inquiries Network, 2008)
Timing alone doesn't influence the drug's efficacy in preventing postpartum bleeding (strength of recommendation: B, randomized controlled trial [RCT] and prospective cohort studies).
When should we stop mammography screening for breast cancer in elderly women?
(Family Physicians Inquiries Network, 2001)
There is insufficient evidence to recommend for or against routine screening mammography beyond the age of 69 years. The best candidates to stop screening are elderly women who have significant comorbidities, poor functional ...
Antidepressants causing sexual problems? Give her Viagra
(Family Physicians Inquiries Network, 2008)
Tell women for whom you prescribe selective and nonselective serotonin reuptake inhibitors (SRIs) to let you know if they develop sexual dysfunction. Offer sildenafi (50 mg with the option to increase to 100 mg) to premenopausal women on stable...
Vertebroplasty for osteoporotic fracture? Think twice
(Family Physicians Inquiries Network, 2009)
Think twice before recommending vertebroplasty (VP) for symptomatic osteoporotic compression fractures. New studies suggest that it has little benefit; thus, VP should be considered only after other, more conservative ...
What is the dietary treatment for low HDL cholesterol?
(Family Physicians Inquiries Network, 2006)
Low-carbohydrate diets raise high-density lipoprotein (HDL) cholesterol levels by approximately 10%; soy protein with isoflavones raises HDL by 3% (strength of recommendation [SOR]: C, based on meta-analysis of physiologic ...
Are antibiotics effective in preventing pneumonia for nursing home patients?
(Family Physicians Inquiries Network, 2004)
Antibiotics should not be used for prophylaxis of pneumonia in nursing homes. We found no studies testing the effectiveness of antibiotics in preventing pneumonia in any population, including persons with predisposing ...
Do intercontraction intervals predict when a woman at term should seek evaluation of labor?
(Family Physicians Inquiries Network, 2009)
A reduction in the intercontraction interval is associated with active labor (strength of recommendation [SOR]: B, cohort study). Most primigravidas who have had regular contractions for 2 hours and multigravidas who have ...
Should you test for H pylori in patients with nonulcer dyspepsia?
(Family Physicians Inquiries Network, 2011)
Helicobacter pylori in creases the risk of developing peptic ulcer disease (strength of recommendation [SOR]: B, cohort study), but there is no evidence that treating H pylori reduces that risk. Treating H pylori in patients ...
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 ...
When should a chest x-ray be used to evaluate acute-onset productive cough for adults?
(Family Physicians Inquiries Network, 2005)
Even though the most common reason to order
a chest x-ray in the evaluation of an acute-onset, productive cough is to rule out pneumonia, there is no strong evidence to help a physician decide when to order this chest ...
Which patients benefit from lowering LDL to <100 mg/dL?
(Family Physicians Inquiries Network, 2010)
Patients who have coronary heart disease (CHD) or are at high risk for CHD should aim for a low-density lipoprotein (LDL) target of <100 mg/dL. An LDL target of <70 mg/dL is an option for very-high-risk patients (strength ...
What vitamins and minerals should be given to breastfed and bottle-fed infants?
(Family Physicians Inquiries Network, 2005)
supplementation for all term, healthy, breastfed infants is not proven to be safe or necessary. Formula-fed infants should be consuming formula that contains 10 to 12 mg/L of iron (SOR: A,
2 small randomized controlled trials)....
What blood tests help diagnose celiac disease?
(Family Physicians Inquiries Network, 2006)
Histological confirmation of infiltrative lesions via small bowel biopsy is the gold standard for diagnosing celiac disease. Four serum antibody assays may serve as a first- step diagnostic tool to identify biopsy candidates: ...
Are steroid injections effective for tenosynovitis of the hand?
(Family Physicians Inquiries Network, 2007)
Yes. Steroid injections are an effective first-line therapy for flexor tenosynovitis of the hand, with a number needed to treat [NNT] of 2.3 for injection of steroids and lidocaine (strength of recommendation [SOR]: B, ...
What is the best hypnotic for use in the elderly?
(Family Physicians Inquiries Network, 2003)
Short-acting hypnotics such as zolpidem (Ambien) or zaleplon (Sonata) are the preferred hypnotics in the elderly because of an improved side-effect profile compared with traditional hypnotics such as benzodiazepines (strength ...
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] ...
Saline irrigation spells relief for sinusitis sufferers
(Family Physicians Inquiries Network, 2009)
Recommend nasal irrigation to patients with chronic rhinosinusitis. Large-volume, low- pressure saline irrigation decreases the severity and frequency of symptoms. Stength of recommendation: B: Single well-done randomized ...