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Treatment of Bulimia Nervosa
(Family Physicians Inquiries Network, 2008)
Cognitive behavior therapy (CBT) is the most effective treatment for bulimia nervosa based on multiple consistent randomized-controlled trials (RCTs). (Strength of Recommendation [SOR]: A). Guided self-help has not been shown to be beneficial...
Initiating antidepressant therapy? Try these 2 drugs first
(Family Physicians Inquiries Network, 2009)
When you initiate antidepressant therapy for patients who have not been treated for depression previously, select either sertraline or escitalopram. A large meta- analysis found these medications to be superior to other ...
Should you evaluate for CAD in seniors with premature ventricular contractions?
(Family Physicians Inquiries Network, 2008)
Current guidelines suggest evaluating patients with premature ventricular contractions (PVCs) and associated risk factors for underlying coronary artery disease (strength of recommendation [SOR]: C, expert opinion).
Glycemic Control in Patients with Type 2 Diabetes
(Family Physicians Inquiries Network, 2007)
There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes. (Strength of Recommendation [SOR]: C) Metformin (Glucophage) has shown additional benefit when compared with other treatments ...
Quality of Life in Older Persons with Dementia Living in Nursing Homes
(Family Physicians Inquiries Network, 2008)
with assisted living/residential care facilities. However, evidence suggests a gradual decline in average functioning in persons with dementia, regardless of living situation. (Strength of Recommendation: B; based on cohort studies)....
Do hyaluronic acid injections relieve OA knee pain?
(Family Physicians Inquiries Network, 2009)
Hyaluronic acid (HA) injections relieve pain more than placebo. The effect is small but similar to results from oral nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid injection (strength of recommendation ([SOR]: ...
What is the prognosis for acute low back pain?
(Family Physicians Inquiries Network, 2002)
The proportion of patients who are pain free or completely recovered after an acute episode of low back pain within 2 weeks to 6 months ranges from 21% to 90%, depending on the population studied and the method of measuring ...
Does a low-salt diet reduce morbidity and mortality in congestive heart failure?
(Family Physicians Inquiries Network, 2002)
No randomized controlled trials (RCTs) have addressed the independent role of sodium restriction in the morbidity or mortality of congestive heart failure. However, current guidelines recommend sodium restriction for ...
What is the evaluation and treatment strategy for Raynaud's phenomenon?
(Family Physicians Inquiries Network, 2005)
Raynaud's phenomenon is diagnosed by history,
which also plays a key role in distinguishing
primary from secondary Raynaud's phenomenon
(strength of recommendation [SOR]: C, based
on expert opinion). The initial treatment includes conservative...
What screening tests should you use to evaluate a man with low testosterone?
(Family Physicians Inquiries Network, 2008)
Obtain a repeat morning testosterone level, as well as levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin to help understand the cause of low testosterone when there is a lack of adequate empiric evidence to guide...
Which oral antifungal is best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2007)
Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and mycologic cure rates, tolerability, and cost effectiveness (strength of recommendation [SOR]: A, meta-analyses)....
Combined Oral Contraceptives for Mothers Who Are Breastfeeding
(Family Physicians Inquiries Network, 2005)
that combined oral contraceptives may reduce the volume of breast milk but not affect the growth of infants. [Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence]...
What is the most effective and safe malaria prophylaxis during pregnancy?
(Family Physicians Inquiries Network, 2008)
the incidence of low birth weight and perinatal death in women having their first or second baby (strength of recommendation [SOR]: A, based on systematic review of consistent, good-quality patient-oriented evidence)....
Is an outpatient workup safe for patients with a transient ischemic attack?
(Family Physicians Inquiries Network, 2004)
There is no compelling evidence that outpatient diagnostic workup of patients with transient ischemic attack (TIA) is less safe than inpatient workup, or that hospitalization prevents stroke or improves stroke outcomes after TIA (strength...
Is neurosurgery referral warranted for small brain aneurysms?
(Family Physicians Inquiries Network, 2003)
that of nonsurgical monitoring for this group, primary care physicians do not need to refer patients with this condition to a neurosurgeon for clipping (strength of recommendation [SOR]: B, based on cohort and case-control studies). For patients managed conservatively...
How useful is a physical exam in diagnosing testicular torsion?
(Family Physicians Inquiries Network, 2009)
Physical exam is useful, but imperfect, in ruling out testicular torsion (strength of recommendation [SOR]: C, expert opinion). The cremasteric reflex or a nontender testicle usually excludes testicular torsion, but case ...
At what age do patients no longer need colorectal cancer screening?
(Family Physicians Inquiries Network, 2001)
Good evidence supports fecal occult blood testing (FOBT) for patients up to age 75 (grade of recommendation: A, based on systematic review of randomized controlled trials). There is insufficient evidence to recommend for or against colorectal cancer...
Does birth weight predict childhood obesity?
(Family Physicians Inquiries Network, 2008)
A birth weight greater than 4,000 g is associated with an increased risk of obesity in both childhood and adolescence (strength of recommendation [SOR]: B, systematic review and multiple cohort studies).
Other than anticoagulation, what is the best therapy for those with atrial fibrillation?
(Family Physicians Inquiries Network, 2004)
Rate control with long-term anticoagulation is recommended for most patients with atrial fibrillation (strength of recommendation [SOR]: A, based on randomized controlled trials [RCTs]). A rhythm-control strategy provides no survival or quality...
Treatment of Early Parkinson's Disease
(Family Physicians Inquiries Network, 2005)
with entacapone (Stalevo) improves symptoms and quality of life, but all medication regimens are associated with significant side effects (Table 1). There is no compelling evidence favoring a medication option, so treatment should be individualized. [Strength...