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Now showing items 21-40 of 77
For those intolerant to ACE inhibitors and ARBs, what is the best therapy for reducing the risk of diabetic nephropathy?
(Family Physicians Inquiries Network, 2005)
Angiotensin-converting enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs) are the first-line agents for reducing the risk of diabetic nephropathy. For patients intolerant to these agents, non-dihydropyridine ...
Which late-stage Alzheimer's patients should be referred for hospice care?
(Family Physicians Inquiries Network, 2005)
Medicare guidelines are used to determine eligibility for hospice care (strength of recommendation [SOR]: C, based on expert opinion), but they correlate with 6-month mortality no better than an experienced clinician's judgment (SOR: B, based on 1...
Do oral decongestants have a clinically significant effect on BP in patients with hypertension?
(Family Physicians Inquiries Network, 2017)
Q: Do oral decongestants have a clinically significant effect on BP in patients with hypertension? Evidence-based answer: It is unclear. Pseudoephedrine causes an average increase of 1.2 mm Hg in systolic blood pressure (BP) in patients...
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...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of recommendation [SOR]: B, meta...
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...
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's the best approach to diagnosing food allergies in infants?
(Family Physicians Inquiries Network, 2010)
A well-designed oral food challenge (OFC) is the most reliable diagnostic test for infants whose clinical history and physical examination suggest a specific food allergy (strength of recommendation [SOR]: C, consensus guidelines)....
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...
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011)
velocity, delayed puberty, or clinical signs and symptoms of endocrine abnormalities (e.g., hirsutism, truncal obesity, violaceous striae). (Strength of recommendation [SOR]: C, based on expert opinion.) Underlying metabolic and genetic causes of obesity...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating ...
How can we effectively treat stress urinary incontinence without drugs or surgery?
(Family Physicians Inquiries Network, 2014)
on SUI symptoms, and produces no clinically meaningful improvement in QOL (SOR: B, heterogeneous RCTs with conflicting results). Vaginal cones don't increase continence or QOL (SOR: B, 2 RCTs with methodoligic flaws)....
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...
What risk factors contribute to C difficile diarrhea?
(Family Physicians Inquiries Network, 2011)
). Hospital risk factors include proximity to other patients with C difficile and longer length of stay (SOR: B, several good-quality cohort studies). Patient risk factors include advanced age and comorbid conditions (SOR: B, several good-quality cohort...
Do annual pelvic exams benefit asymptomatic women who receive regular Pap smears?
(Family Physicians Inquiries Network, 2015)
Q: Do annual pelvic exams benefit asymptomatic women who receive regular Pap smears? Evidence-based answer: No evidence exists to support a clinical benefit from annual pelvic examinations for asymptomatic women who receive Pap smears every 3 to 5...
Antidepressant Use During Pregnancy
(Family Physicians Inquiries Network, 2011)
There are no studies that have shown any antidepressant to be absolutely safe for use during any stage of pregnancy. The use of selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) during ...
Which lifestyle interventions effectively lower LDL cholesterol?
(Family Physicians Inquiries Network, 2007)
Counseling, weight loss, exercise, and drinking alcohol all effectively lower low- density lipoprotein cholesterol (LDL-C). Specifically, one to 2 daily drinks of alcohol lowers L DL-C, if consumed regularly for more than 4 weeks (strength...
Pharmacologic therapy for vitamin D deficiency
(Family Physicians Inquiries Network, 2013)
trials [RCTs].) Cholecalciferol produces higher serum 25-hydroxyvitamin D levels than ergocalciferol (vitamin D2). Vitamin D therapy may be given daily or weekly with equal effectiveness; the dosage depends on the degree of deficiency. (SOR: C, based...
Can you differentiate bacterial from viral pediatric infections based on the CBC?
(Family Physicians Inquiries Network, 2007)
No--the complete blood count (CBC) alone does not have adequate sensitivity or specificity to tell bacterial from viral infections (strength of recommendation [SOR]: B, cohort studies). When used in conjunction with other clinical parameters...
What measures relieve postherpetic neuralgia?
(Family Physicians Inquiries Network, 2009)
Tricyclic antidepressants, gabapentin, and pregabalin effectively reduce pain (strength of recommendation [SOR]: A, at least 2 good-quality randomized controlled trials [RCTs] and/or meta-analyses). Opioids have demonstrated pain relief in 3 RCTs...