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Management of Cervical Lymphadenitis in Children
(Family Physicians Inquiries Network, 2008)
for spontaneous resolution over four to six weeks. (Strength of Recommendation [SOR]: C, based on expert opinion)....
Integrated pest management in Missouri's green industries (2008)
(University of Missouri Extension, 2008)
How does VTE risk for the patch and vaginal ring compare with oral contraceptives?
(Family Physicians Inquiries Network, 2008)
Evidence is conflicting with regard to the comparative frequency of venous thrombolic events (VTE) among women using the transdermal patch when compared to an oral contraceptive (OC), even though the patch produces a relatively high serum ethinyl...
Acute gout: Oral steroids work as well as NSAIDs
(Family Physicians Inquiries Network, 2008)
Use a short course of oral steroids (prednisone 30-40mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line ...
How much can exercise raise creatine kinase level-- and does it matter?
(Family Physicians Inquiries Network, 2008)
Moderate-intensity exercise (maintaining heart rate between 55% and 90% of maximum) may elevate creatine kinase (CK) to levels that meet the diagnostic criteria for rhabdomyolysis if the exercises involve eccentric muscle ...
How useful are autoantibodies in diagnosing thyroid disorders?
(Family Physicians Inquiries Network, 2008)
Thyrotropin receptor antibodies (TRAb) may be mildly elevated in a variety of thyroid disorders, but a TRAb level >10 U/L increases the probability of Graves' disease by a moderate to large degree (strength of recommendation ...
What are the most effective nonpharmacologic therapies for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2008)
Herbal formulations, certain probiotics, elimination diets based on immunoglobulin G (IgG) antibodies, cognitive behavioral therapy, and self-help books have been shown to decrease global symptoms of irritable bowel syndrome (IBS) and improve...
Which lab tests are best when you suspect hypothyroidism?
(Family Physicians Inquiries Network, 2008)
Thyroid-stimulating hormone (TSH) level is the preferred test for initial evaluation of suspected primary hypothyroidism (strength of recommendation [SOR]: C, expert opinion). If TSH is abnormal, a free thyroxine (T4) level ...
Differential Diagnosis of Tremor
(Family Physicians Inquiries Network, 2008)
The most common tremor in primary care is an exaggerated physiologic tremor, followed by essential tremor and tremors caused by Parkinson's disease. (Strength of Recommendation [SOR]: C, based on extrapolation from a prospective cohort study...
Is there much risk in using fluoroquinolones in children?
(Family Physicians Inquiries Network, 2008)
Arthralgias and myalgias have been observed clinically in children and adolescents exposed to fluoroquinolones, but they're transient, disappear when the drug is discontinued, and appear to be no more prevalent than with ...
What is the clinical workup for failure to thrive?
(Family Physicians Inquiries Network, 2008)
The clinical evaluation of failure to thrive (FTT) includes a thorough history and physical examination; observation of parent-child interactions; observation and documentation of the child's feeding patterns; and a home ...
Which drugs are most effective for moderate to severe depression in adolescents?
(Family Physicians Inquiries Network, 2008)
Fluoxetine is the only selective serotonin-reuptake inhibitor (SSRI) approved by the US Food and Drug Administration (FDA) to treat depression in children 8 years of age and older; it also has the most favorable benefit-to-risk ...
Which drugs are safest for moderate to severe depression in adolescents?
(Family Physicians Inquiries Network, 2008)
Selective serotonin-reuptake inhibitors (SSRIs) appear to be the safest, given current data. Major safety concerns--prompting a US Food and Drug administration (FDA) black box label warning--have been raised about increased ...
Can recombinant growth hormone effectively treat idiopathic short stature?
(Family Physicians Inquiries Network, 2008)
Yes--treatment can increase a child's final height. Injections of recombinant human growth hormone (rGH) at least 3 times a week for 4 to 6 years add 3.7 to 7.5 cm to final height in children between 8 and 16 years of age ...
How should you evaluate elevated calcium in an asymptomatic patient?
(Family Physicians Inquiries Network, 2008)
Patients with unexplained asymptomatic true hypercalcemia should be screened for primary hyperparathyroidism (PHPT) and malignancy using an intact parathyroid hormone (PTH) level by immunoradioassay (SOR: C, expert opinion). ...
Medications for Insomnia Treatment in Children
(Family Physicians Inquiries Network, 2008)
Melatonin may be effective for treating insomnia in healthy children and in those with physical or learning disabilities (Strength of Recommendation [SOR]: B). Short-term use of melatonin is safe in children, but there is insufficient evidence...
Does antepartum perineal massage reduce intrapartum lacerations?
(Family Physicians Inquiries Network, 2008)
Yes--to a point. Antepartum perineal massage reduces both the incidence of perineal trauma requiring suturing and the likelihood of episiotomy in women who have never given birth vaginally. It reduces the incidence of ...
Which clinical features and lab findings increase the likelihood of temporal arteritis?
(Family Physicians Inquiries Network, 2008)
of this diagnosis (strength of recommendation: B, based on systematic reviews of retrospective cohort studies). Patients with temporal arteritis frequently complain of headaches, and often have mildly abnormal erythrocyte sedimentation rates (ESR), but neither...
What's the best way to treat Achilles tendonopathy?
(Family Physicians Inquiries Network, 2008)
Rest and ice are considered first-line therapy for acute Achilles tendonopathy (strength of recommendation [SOR]: C, expert opinion), as is nonsteroidal anti- inflammatory drugs (NSAIDs) (SOR: B, systematic review). Chronic ...
Medical Treatment of Benign Prostatic Hyperplasia
(Family Physicians Inquiries Network, 2008)
Although alpha blockers and 5-alpha reductase inhibitors each reduce BPH symptoms more than placebo (Strength of Recommendation [SOR]: A), alpha blockers are more effective than 5-alpha reductase inhibitors. (SOR: B). ...