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Now showing items 21-40 of 227
What are appropriate screening tests for adolescents?
(Family Physicians Inquiries Network, 2006)
Screen all women of childbearing age, including adolescents, for rubella susceptibility (strength of recommendation [SOR]: B). Screen all sexually active adolescent females for chlamydia (SOR: A), gonorrhea (SOR: B), and ...
Urine Dipstick for Diagnosing Urinary Tract Infection
(Family Physicians Inquiries Network, 2006)
The sensitivity and specificity of the urine dipstick varies somewhat with the setting and population, as does its recommended interpretation. In low-risk patients with a low pretest probability of UTI, the urine dipstick ...
Do glucosamine and chondroitin worsen blood sugar control in diabetes?
(Family Physicians Inquiries Network, 2006)
Despite theoretical risks based on animal models given high intravenous doses, glucosamine/chondroitin (1500 mg/1200 mg daily) does not adversely affect short-term glycemic control for patients whose diabetes is well-controlled, ...
Does stopping a statin increase the short-term risk of a cardiovascular event?
(Family Physicians Inquiries Network, 2006)
When hydroxymethyl glutaryl coenzyme A (HMG CoA) inhibitors (statins) are stopped by asymptomatic patients, there appears to be no increased risk of cardiovascular events (strength of recommendation [SOR]: B). However, for ...
Does psychiatric treatment help patients with intractable chronic pain?
(Family Physicians Inquiries Network, 2006)
Tricyclic antidepressants and intensive multidisciplinary programs are moderately effective for reducing chronic back pain; tricyclics are also effective for diabetic neuropathy and irritable bowel syndrome (strength of ...
Can patients with steatohepatitis take statins?
(Family Physicians Inquiries Network, 2006)
Patients with steatohepatitis who take HMG
Co-A reductase inhibitors (statins) lower
their elevated liver enzymes and show evidence of improvement in fatty liver on
follow-up imaging (strength of recommendation
[SOR]: C, ...
Do allergy shots help seasonal allergies more than antihistamines and nasal steroids?
(Family Physicians Inquiries Network, 2006)
Multiple randomized controlled trials (RCTs)
demonstrate the effectiveness of both allergen immunotherapy and antihistamines, with or without nasal steroids, in the treatment of seasonal allergic rhinitis (strength of ...
Does treatment with donepezil improve memory for patients with mild cognitive impairment?
(Family Physicians Inquiries Network, 2006)
Donepezil (Aricept) has potential benefit in delaying risk of progression to Alzheimer's disease in the first year of treatment, but this benefit is not seen at 3 years. Donepezil does not improve memory for patients with ...
Are oral agents effective for the treatment of verruca vulgaris?
(Family Physicians Inquiries Network, 2006)
Of the available oral therapies for common warts, none has sufficient evidence to recommend it as an effective therapy (strength of recommendation [SOR]: B). To date, no oral agent has been shown to be effective in a ...
Should patients receive 23-valent pneumococcal vaccination more than once?
(Family Physicians Inquiries Network, 2006)
No patient-oriented evidence supports pneumococcal revaccination of any patient (high-risk or otherwise). Antibody levels may be augmented by revaccination; however, the clinical efficacy of revaccination, even among ...
When should COX-2 selective NSAIDs be used for osteoarthritis and rheumatoid arthritis?
(Family Physicians Inquiries Network, 2006)
Cyclo-oxygenase-2 (COX-2) selective nonsteroidal anti-inflammatory drugs (NSAIDs) are as effective as acetaminophen and nonselective NSAIDs in treating of osteoarthritis, and are equally effective in reducing pain and ...
When are empiric antibiotics appropriate for urinary tract infection symptoms?
(Family Physicians Inquiries Network, 2006)
Healthy, nonpregnant women presenting with the triad of frequency, dysuria, and no vaginal symptoms have about a 96% chance of having an urinary tract infection (UTI) (positive likelihood ratio [LR+]=24.6). Since no ...
When should we screen children for hyperlipidemia?
(Family Physicians Inquiries Network, 2006)
Children should be screened for hyperlipidemia when there is a history of familial hypercholesterolemia (strength of recommendation [SOR]: C). No clear evidence supports screening all children or just those with family ...
When are antibiotics indicated for acute COPD exacerbations?
(Family Physicians Inquiries Network, 2006)
Antibiotics (including those given orally) reduce mortality and treatment failures for hospitalized patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) (strength of recommendation [SOR]: A, ...
How should you manage a depressed patient unresponsive to an SSRI?
(Family Physicians Inquiries Network, 2006)
The best approach among studied alternatives to manage a patient with treatment-resistant depression is not clear from the evidence. All of the options reviewed seem to have about a 25% to 30% success rate. Switching to ...
How should we manage a patient with a positive PPD and prior BCG vaccination?
(Family Physicians Inquiries Network, 2006)
Prior bacille Calmette-Guérin (BCG) vaccination increases the likelihood of a positive tuberculosis (TB) 5TU purified protein derivative (PPD) skin test. The PPD response following BCG vaccine varies with age at vaccination, ...
How do we decide when a patient with nonmalignant disease is eligible for hospice care?
(Family Physicians Inquiries Network, 2006)
Each hospice has its own policy, but Medicare requires 6 months or less life expectancy for certification of eligibility and reimbursement. Other important criteria include patient and family understanding and wishes. ...
How can you prevent migraines during pregnancy?
(Family Physicians Inquiries Network, 2006)
No randomized controlled trials (RCT) have addressed pharmacologic prophylaxis of migraine for pregnant women. Two studies suggest that nonpharmacologic therapies (combinations of skin warming, relaxation, biofeedback, and ...
How accurate is the use of ECGs in the diagnosis of myocardial infarct?
(Family Physicians Inquiries Network, 2006)
The electrocardiogram (ECG) is a fairly accurate test in the diagnosis of myocardial infarction (MI). However, given more sensitive technologies, such as cardiac biomarker testing, its primary role should be as an important ...
How effective are lifestyle changes for controlling hypertension?
(Family Physicians Inquiries Network, 2006)
Regular aerobic exercise, weight loss of 3% to 9% of body weight, reduced dietary salt, the DASH diet, and moderation of alcohol intake are all lifestyle interventions that lower blood pressure. Average blood pressure ...