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Now showing items 21-40 of 660
What's best when a patient doesn't respond to the maximum dose of an antidepressant?
(Family Physicians Inquiries Network, 2010)
Consider possible causes of the inadequate response, then weigh treatment options in light of the characteristics of the individual patient and therapy. When managing a patient with nonpsychotic depression and inadequate ...
How should we monitor men receiving testosterone replacement therapy?
(Family Physicians Inquiries Network, 2010)
Monitor hematocrit and bone mineral density (BMD) (strength of recommendation [SOR]: B, meta-analysis of non−patient-oriented outcomes). Monitoring prostate-specific antigen (PSA), performing prostate digital rectal ...
Which drugs should post-MI patients routinely receive?
(Family Physicians Inquiries Network, 2010)
patients should be placed on the following medications: antiplatelet agents (strength of recommendation [SOR]: A, meta-analysis for aspirin; A, multiple randomized controlled trials [RCTs] for aspirin plus clopidogrel) a ...
Combination Therapy for Postmenopausal Osteoporosis
(Family Physicians Inquiries Network, 2010)
There is insufficient evidence to recommend combination therapy for the routine management of postmenopausal osteoporosis. (Strength of Recommendation [SOR]: C, based on expert opinion). Combination therapy with parathyroid ...
Is nedocromil effective in preventing asthmatic attacks in patients with asthma?
(Family Physicians Inquiries Network, 2004)
In general, about 50% to 70% of patients respond to nedocromil (SOR: A, multiple RCTs and meta-analyses). Unfortunately, which patients respond is not predictable from clinical parameters. Nedocromil is worth trying in mild persistent asthma...
How accurate is an MRI at diagnosing injured knee ligaments?
(Family Physicians Inquiries Network, 2010)
MRI is highly accurate in diagnosing injury to the anterior cruciate ligament (ACL) (strength of recommendation [SOR]: A, prospective blinded cohort studies) and posterior cruciate ligament (PCL) (SOR: B, limited number ...
Does office spirometry improve quit rates in smokers?
(Family Physicians Inquiries Network, 2010)
Simply performing spirometry and offering cessation advice doesn't improve quit rates in patients who smoke (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). However, when the ...
What's the best way to manage upper extremity venous thrombosis?
(Family Physicians Inquiries Network, 2010)
Standard management is best: Start with unfractionated heparin or low-molecular-weight heparin and follow with long-term therapy with a vitamin K antagonist (strength of recommendation [SOR]: C, expert consensus and case ...
Do endovascular filters prevent PE as effectively as anticoagulants in patients with DVT?
(Family Physicians Inquiries Network, 2010)
Although inferior vena cava filters (IVCFs) reduced the incidence of PE in a randomized controlled trial (RCT), patients treated with IVCFs and anticoagulation with unfractionated heparin or low-molecular- weight heparin ...
What's the most effective way to screen patients with a family history of colon cancer?
(Family Physicians Inquiries Network, 2010)
The best approach hinges on the number, degree, and age of relatives diagnosed with colorectal cancer (CRC) or adenomatous polyps (AP). Screening should begin at 40 years of age for patients with a family history of CRC ...
What is the most effective way to relieve symptoms of acute stress disorder?
(Family Physicians Inquiries Network, 2010)
Cognitive behavioral therapy (CBT) that emphasizes exposure-based treatment is the most effective intervention for adults with acute stress disorder (ASD) (strength of recommendation [SOR]: B, meta-analysis of limited-quality ...
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...
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's the best way to motivate patients to exercise?
(Family Physicians Inquiries Network, 2010)
There is no single best strategy to motivate patients to exercise, given the lack of data from rigorous comparison studies. There are, however, several interventions for adults that are effective. They include: writing a ...
How should you treat a child with flat feet?
(Family Physicians Inquiries Network, 2010)
Flexible flatfoot (FFF)doesn�۪t increase the risk of injury or pain during exercise (strength of recommendation [SOR]: B, 2 small prospective cohort studies). Treating FFF with orthotics doesn�۪t change the course of arch ...
How do clinical prediction rules compare with joint fluid analysis in diagnosing gout?
(Family Physicians Inquiries Network, 2016)
Q: How do clinical prediction rules compare with joint fluid analysis in diagnosing gout? Evidence-based answer: Clinical prediction rules effectively diagnose gout without joint fluid analysis. The American College of Rheumatology clinical...
Which women should we screen for gestational diabetes mellitus?
(Family Physicians Inquiries Network, 2010)
It's unclear which women we should screen. No randomized controlled trials (RCTs) demonstrate that either universal screening or risk factor screening for gestational diabetes mellitus (GDM) prevents maternal and fetal ...
What is the best noninvasive diagnostic test for women with suspected CAD?
(Family Physicians Inquiries Network, 2010)
Multidetector computed tomography (MDCT) may be the most sensitive and specific noninvasive diagnostic test for women with suspected coronary artery disease (CAD) (strength of recommendation [SOR]: A, multiple prospective ...
Do intra-articular steroid injections affect glycemic control in patients with diabetes?
(Family Physicians Inquiries Network, 2010)
A single intra-articular steroid injection into the knee produces acute hyperglycemia for 2 or 3 days in patients with diabetes who otherwise have good glucose control (strength of recommendation [SOR]: B, small cohort ...
Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid Arthritis?
(Family Physicians Inquiries Network, 2004)
The efficacy of COX-2 inhibitors is similar to that of nonselective NSAIDs in reducing the symptoms of rheumatoid arthritis. [Strength of Recommendation: A]