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Is red-yeast rice a safe and effective alternative to statins?
(Family Physicians Inquiries Network, 2015)
Q: Is red-yeast rice a safe and effective alternative to statins? Evidence-based answer: Yes, but perhaps not the red yeast rice extracts available in the United States. In patients with known coronary artery disease and dyslipidemia (secondary...
Treatment for Anogenital Molluscum Contagiosum
(Family Physicians Inquiries Network, 2009)
lesions. (Strength of Recommendation: B, based on inconsistent or limited quality patient-oriented evidence). There are no comparative trials of other commonly used treatments, such as carbon dioxide laser, cryotherapy, or curettage....
What is the best approach to goiter in euthyroid patients?
(Family Physicians Inquiries Network, 2014)
and subsequent follow-up of stable nodules every 3 to 5 years (SOR: C, consensus-based guidelines)....
The index of tobacco treatment quality: development of a tool to assess evidence-based treatment in a national sample of drug treatment facilities
(2013-03-15)
, expert input, and qualitative research. We administered the survey to a stratified sample of 405 facility administrators selected from all 3,800 U.S. adult outpatient facilities listed in the SAMHSA Inventory of Substance Abuse Treatment Services. We...
Role of ID Consultation in Candidemia
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2019-10)
and possible metastatic complications, such as endocarditis, endophthalmitis and invasive organ disease. The Infectious Disease Society of America has created evidence-based guidelines for the management of invasive candidiasis 3."...
A spoonful of honey helps a coughing child sleep
(Family Physicians Inquiries Network, 2013)
When a parent brings in a child (ages 1-5 years) with cough, runny nose, and other symptoms of a viral upper respiratory infection (URI), recommend that honey be given at bedtime. Stength of recommendation: A: Based on a well-designed, randomized...
When should patients with asymptomatic aortic stenosis be evaluated for valve replacement?
(Family Physicians Inquiries Network, 2002)
For patients whose echocardiograms show advanced calcification of the aortic valves, a jet velocity of > 4.0 m/s, or a progression in jet velocity of 0.3m/s/year; and for patients who have an abnormal exercise response or an impaired functional...
Treatment-Resistant Depression Diagnosis in the Outpatient Behavioral Health Setting
(University of Missouri -- Kansas City, 2023)
Treatment-resistant depression can be challenging to identify in the outpatient behavioral health setting due to a lack of clear diagnostic guidelines. The evidence-based quality improvement project examined current practices in diagnosing treatment...
Screening for hepatocellular carcinoma in patients with hepatitis C virus infection
(Family Physicians Inquiries Network, 2013)
There is no evidence that it is beneficial to screen for hepatocellular carcinoma in symptomatic patients with HCV. (Strength of Recommendation [SOR]: C, based on a systematic review and case series studies.) Neither serum AFP measurement nor...
What's the best test for underlying osteomyelitis in patients with diabetic foot ulcers?
(Family Physicians Inquiries Network, 2015)
osteomyelitis. MRI performs somewhat better than any of several common tests--probe to bone (PTB), erythrocyte sedimentation rate (ESR) >70 mm/ hr, C-reactive protein (CRP) >14 mg/L, procalcitonin >0.3 ng/mL, and ulcer size >2 cm2--although PTB has the highest...
What's best for croup?
(Family Physicians Inquiries Network, 2011)
(strength of recommendation [SOR]: A, meta-analysis and randomized controlled trials [RCTs]). A 0.15 mg/kg dose of oral dexame thasone is as effective as larger doses (SOR: B, small RCTs). Nebulized racemic or L-epinephrine reduces severity of symptoms...
Acute fever without source: 3-36 months
(Family Physicians Inquiries Network, 2008)
This issue of eMedRef provides information to clinicians on the pathophysiology, diagnosis, and therapeutics of acute fever without cause in young children.
How best to diagnose iron-deficiency anemia in patients with inflammatory disease?
(Family Physicians Inquiries Network, 2012)
TfR-ferritin index (ratio of sTfR to log ferritin) are highly sensitive and specific. An sTfR-ferritin index of ≥1.5 is diagnostic of IDA, even in the presence of acute or chronic inflammation (SOR: B, systematic review of prospective validating cohort studies...
Does tranexamic acid reduce mortality in women with postpartum hemorrhage?
(Family Physicians Inquiries Network, 2019)
Q: Does tranexamic acid reduce mortality in women with postpartum hemorrhage? EVIDENCE-BASED ANSWER: Yes. When used in conjunction with the standard of care, 1 g intravenous (IV) tranexamic acid given 1 to 3 hours after delivery is associated with a...
Which UTI therapies are safe and effective during breastfeeding?
(Family Physicians Inquiries Network, 2007)
Trimethoprim/sulfamethoxazole (TMP/SM X) has a high success rate in eradicating bacteriuria for women with urinary tract infection and is compatible with breastfeeding (strength of recommendation: C, based on extrapolation from studies...
How effective are hypertension self-care interventions?
(Family Physicians Inquiries Network, 2007)
Simplification of the dosing regimen (eg, once-daily instead of multiple dosing) improves patients' adherence to anti- hypertensive medications (strength of recommendation [SOR]: B, based on a high- quality systematic review of lower...
How do hyaluronic acid and corticosteroid injections compare for knee OA relief?
(Family Physicians Inquiries Network, 2017)
Q How do hyaluronic acid and corticosteroid injections compare for knee OA relief? A: Inconsistent evidence shows a small amount of pain relief early (one week to 3 months) with corticosteroid (CS) injections and an equally small improvement in pain...
An alternative to oral NSAIDs for acute musculoskeletal injuries
(Family Physicians Inquiries Network, 2011)
For patients with acute musculoskeletal injuries, topical NSAIDs are an effective alternative for pain relief. Stength of recommendation: A: Based on a meta-analysis of 47 high-quality randomized clinical trials....
Does ambulatory blood pressure monitoring aid in the management of patients with hypertension?
(Family Physicians Inquiries Network, 2002)
Twenty-four hour ambulatory blood pressure monitoring (ABPM) has a higher correlation with target end-organ damage than standard office measurements and is superior for risk stratification. Because it is more complicated to implement than office-based...