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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 ...
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, based on systematic reviews...
What treatments work best for constipation in children?
(Family Physicians Inquiries Network, 2009)
limited evidence supports this approach (strength of recommendation [SOR]: B for fiber, 1 randomized controlled trial [RCT]; C for behavior modification, 1 small trial). For pharmacologic management, the best evidence supports osmotic laxatives (SOR: A, 6...
What's the best way to monitor low-risk patients with a history of differentiated thyroid cancer?
(Family Physicians Inquiries Network, 2009)
-analysis). Low-risk patients are defined as patients who have undergone total thyroidectomy and radioactive iodine (I131) remnant ablation therapy and show no clinical evidence of recurrent disease....
How should you treat trochanteric bursitis?
(Family Physicians Inquiries Network, 2009)
(strength of recommendation [SOR]: C, usual practice). Patients whose symptoms persist despite conservative therapy are likely to benefit from an injection of 24 mg betamethasone and 1% lidocaine (or equivalent) into the inflamed bursa (SOR: B, limited...
How best to manage the patient in term labor whose group B strep status is unknown?
(Family Physicians Inquiries Network, 2009)
Monitor the patient and treat her with intrapartum chemoprophylaxis based on identified risk factors, unless a rapid, highly sensitive (greater than or equal to 85%) polymerase chain reaction (PCR) test is immediately available to evaluate for group...
What is the best diagnostic approach to alopecia in women?
(Family Physicians Inquiries Network, 2009)
Indirect evidence and expert opinion indicate that a careful history and thorough physical examination usually suggest the underlying cause of alopecia. Ancillary laboratory evaluation and scalp biopsy are sometimes necessary to make or confirm...
Are there any known health risks to early introduction of solids to an infant's diet?
(Family Physicians Inquiries Network, 2009)
Few studies support an association between early introduction of solid food and atopic conditions, obesity, or any other illness (strength of recommendation [SOR]: B, cohort studies with mixed results). Very weak evidence suggests an increased risk...
What are the most practical primary care screens for post-traumatic stress disorder?
(Family Physicians Inquiries Network, 2009)
The 4-item Primary Care Post-Traumatic Stress Disorder screen (PC-PTSD) is a simple and effective tool to identify symptoms of post-traumatic stress disorder (PTSD) in primary care patients (strength of recommendation [SOR ...
Aspirin in Patients with Acute Ischemic Stroke
(Family Physicians Inquiries Network, 2009)
Aspirin in a daily dose of 160 to 300 mg initiated within 48 hours of symptom onset results in a net decrease in morbidity and mortality caused by acute ischemic stroke (Strength of Recommendation [SOR]: A, based on a systematic review), regardless...
Missouri hospitalist, issue 23 (2009 November 25)
(University of Missouri. Department of Medicine. Division of Hospital Medicine, 2009-11)
What is the best treatment for chronic constipation in the elderly?
(Family Physicians Inquiries Network, 2007)
There is no one best evidence-based treatment for chronic constipation in the elderly. While the most common first-line treatments are dietary fiber and exercise, the evidence is insufficient to support this approach in the geriatric population...
When should you consider implanted nerve stimulators for lower back pain?
(Family Physicians Inquiries Network, 2009)
Patients can gain more pain relief from spinal cord stimulation (SCS) than from reoperation (strength of recommendation [SOR]: A, 2 randomized controlled trials [RCTs]). SCS can also treat chronic low back pain effectively ...
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]: ...
Treatment of Impetigo
(Family Physicians Inquiries Network, 2007)
of recommendation [SOR]: A) Based on the available evidence on effectiveness, no clear preference can be given for any one oral antibiotic over another. (SOR: A)...
What's the most practical way to rule out adrenal insufficiency?
(Family Physicians Inquiries Network, 2009)
A morning serum cortisol level >13 mcg/dL reliably rules out adrenal insufficiency, and the test is easy and safe to perform. Because of low specificity, patients with a level of ≤13 mcg/dL need further evaluation with the ...
Treatment of Otitis Media with Perforated Tympanic Membrane
(Family Physicians Inquiries Network, 2009)
Acute otitis media with tympanic membrane perforation in children should be treated with an oral antibiotic. (Strength of Recommendation [SOR]: A, based on meta- analysis of randomized controlled trials [RCTs]). Topical ciprofloxacin...
Can counseling prevent or treat postpartum depression?
(Family Physicians Inquiries Network, 2009)
In most cases, counseling does not prevent postpartum depression (PPD), though it can treat the disorder. Overall, psychosocial interventions don't offer a significantly greater benefit than standard care in preventing ...
Should you use antibiotics to treat acute otitis media in children?
(Family Physicians Inquiries Network, 2009)
Antibiotics are not necessary to treat uncomplicated acute otitis media (AOM) in an otherwise healthy child (strength of recommendation [SOR]: A, systematic review). Children younger than 2 years and children with bilateral ...
How should you evaluate an asymptomatic patient with a femoral or iliac artery bruit?
(Family Physicians Inquiries Network, 2009)
Perform an ankle-arm index (AAI, or ankle- brachial index) test to evaluate for peripheral artery disease (PAD) (strength of recommendation [SOR]: B, cohort studies). If the test detects PAD, recommend steps to modify ...