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Now showing items 41-60 of 824
How should you evaluate an asymptomatic patient with a femoral or iliac artery bruit?
(Family Physicians Inquiries Network, 2009)
(SOR: B, extrapolation from randomized clinical trials [RCTs])....
What is appropriate fetal surveillance for women with diet-controlled gestational diabetes?
(Family Physicians Inquiries Network, 2006)
retrospective cohort studies). However, a number of guidelines recommend beginning surveillance of some kind between 32 and 40 weeks based on cumulative risk factors, including gestational diabetes (SOR: C, expert opinion)....
What is the recommended approach to asymptomatic patients who develop a reactive PPD?
(Family Physicians Inquiries Network, 2006)
Clinical evaluation and chest x-ray are recommended for asymptomatic patients with a positive purified protein derivative (PPD) test result, to exclude the slight possibility of active tuberculosis (TB). Patients with radiographic evidence of old...
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...
Do beta-blockers worsen respiratory status for patients with COPD?
(Family Physicians Inquiries Network, 2005)
second (FEV1), or by changes in patients' self-reported symptoms. If such harmful effects do exist, they are likely to be less clinically important than the substantial proven benefits of beta-blockade for patients with concomitant cardiovascular disease...
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...
Does screening by primary care providers effectively detect melanoma and other skin cancers?
(Family Physicians Inquiries Network, 2020)
outcomes. Visual skin cancer screening overall is associated with false-positive rates as follows: 28 biopsies for each melanoma detected, 9 to 10 biopsies for each basal cell carcinoma, and 28 to 56 biopsies for squamous cell carcinoma. False...
What is the most beneficial diet for patients with diverticulosis?
(Family Physicians Inquiries Network, 2006)
A diet high in fiber (particularly fruit and vegetable fiber) and low in fat and red meat may help to decrease the risk of symptomatic diverticular disease (strength of recommendation [SOR]: C, case-control studies and a large prospective cohort...
Which medications can be split without compromising efficacy and safety?
(Family Physicians Inquiries Network, 2006)
for lowering cholesterol (SOR: B, based on retrospective cohort studies). Extended-release, entericcoated, or tablets that cannot be split accurately are not appropriate for splitting (SOR: C, based on observational studies); the accuracy of splitting also...
Treatment of Calf Deep Venous Thrombosis
(Family Physicians Inquiries Network, 2005)
(RCTs)] If anticoagulation is contra-indicated, physicians should monitor for proximal thrombus extension with duplex ultrasound twice weekly for two weeks. [Strength of recommendation: C, based on consensus guideline]...
How long is expectant management safe in first-trimester miscarriage?
(Family Physicians Inquiries Network, 2005)
More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that from surgical intervention (strength of recommendation [SOR]: A, based...
How can you prevent migraines during pregnancy?
(Family Physicians Inquiries Network, 2006)
must be used, base the selection on both effectiveness for nonpregnant patients and established pregnancy safety from surveillance studies (SOR: C, expert opinion)....
Are drug therapies effective in treating Bell's palsy?
(Family Physicians Inquiries Network, 2003)
Early use of corticosteroid therapy results in less autonomic synkinesis and possibly improved rates of recovery in adults (strength of recommendation: C); there is no proven benefit in children (SOR: B). Adding acyclovir (Zovirax) to prednisone...
What is the best approach to goiter in euthyroid patients?
(Family Physicians Inquiries Network, 2014)
In the absence of outcome studies, experts recommend ultrasound evaluation of nontoxic multinodular goiters (MNG) followed by fine-needle aspiration (FNA) of suspicious nodules (strength of recommendation [SOR]: C, consensus-based guidelines...
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 reports have noted...
Do abnormal fetal kick counts predict intrauterine death in average-risk pregnancies?
(Family Physicians Inquiries Network, 2009)
Structured daily monitoring of fetal movement doesn't decrease the rate of all- cause antenatal death in average-risk pregnancies (strength of recommendation [SOR]: B, single good-quality, randomized controlled trial [RCT]). ...
Using impact asthma echo to influence physician self-efficacy and guideline adherence
(University of Missouri--Columbia, 2018)
Asthma ECHO influence primary care provider self-efficacy? How does engagement in the learning activities of Impact Asthma ECHO promote clinical guideline adherence? Participants included 19 Primary Care providers participating in Impact Asthma ECHO via...
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 oral antifungal works best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2013)
, lipid-lowering agents, or "diabetic medications," don't manifest abnormal serum liver enzymes, creatinine, or glucose levels in the short term (SOR: C, 2 small cohort studies with disease-oriented outcomes)....
Do A-fib patients continue to benefit from vitamin K antagonists with advancing age?
(Family Physicians Inquiries Network, 2019)
(warfarin) (strength of recommendation [SOR]: A, meta-analysis of randomized controlled trials [RCTs] and large cohorts). Regardless of age, warfarin produces a reduction in risk of thrombotic events that is 2- to 4-fold greater than the risk of hemorrhagic...