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Now showing items 61-80 of 1158
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 visit by an appropriately...
Is screening urinalysis in children worthwhile?
(Family Physicians Inquiries Network, 2003)
Screening urinalysis in asymptomatic children has not been shown to be beneficial (strength of recommendation: B; based on extrapolation from 1 meta-analysis). It is unlikely to be cost-effective and should be discontinued. ...
Do vitamin C supplements reduce mortality in patients with cardiovascular disease?
(Family Physicians Inquiries Network, 2004)
Vitamin C, when taken as a dietary supplement, does not appear to reduce mortality in patients with cardiovascular disease. [Strength of recommendation: B, based on reviews of cohort studies and a single randomized controlled ...
Thiazolidinedione Therapy for Managing Metabolic Syndrome
(Family Physicians Inquiries Network, 2010)
There is no patient-oriented evidence supporting the use of TZD therapy in patients in the general population who have metabolic syndrome. Rosiglitazone (Avandia) use decreases cardiovascular morbidity and mortality in ...
Do preparticipation clinical exams reduce morbidity and mortality for athletes?
(Family Physicians Inquiries Network, 2005)
Though clinical preparticipation exams (PPE) are recommended by experts and required in most states, we found no medium- or better-quality evidence that demonstrates they reduce mortality or morbidity. PPEs detect only a very small percentage...
Should we discontinue Pap smear screening in women aged >65 years?
(Family Physicians Inquiries Network, 2004)
Women with a history of regular, normal Pap smear screening should discontinue screening by age 65 years (strength of recommendation [SOR]: B). Women without a history of serial normal Pap smears should continue screening ...
When should you suspect community-acquired MRSA? How should you treat it?
(Family Physicians Inquiries Network, 2009)
There are no clinical or epidemiologic features that will help you to clearly distinguish community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) from methicillin-sensitive (CA-MSSA) infections (strength of recommendation...
What is the prognosis for patients with chronic urticaria?
(Family Physicians Inquiries Network, 2011)
The prognosis for chronic urticaria in primary care is unknown; studies in dermatology clinics in multiple countries report complete resolution in approximately one-third of patients with idiopathic chronic urticaria over 1 to 5 years and partial...
When is neuroimaging warranted for headache?
(Family Physicians Inquiries Network, 2005)
Neuroimaging is warranted to evaluate headaches when patients present to an emergency department with signs or symptoms of an intracranial lesion. These signs or symptoms include abrupt onset of headache, focal neurological ...
What are hospital admission criteria for infants with bronchiolitis?
(Family Physicians Inquiries Network, 2006)
Clinical judgment remains the gold standard for hospital admission of infants with bronchiolitis, and it cannot be replaced by objective criteria (strength of recommendation [SOR]: B, based on prospective and retrospective cohort and retrospective...
Which tool is most useful in diagnosing bipolar disorder in children?
(Family Physicians Inquiries Network, 2007)
No single, well-validated screening instrument for clinical diagnosis of bipolar disorder in children exists. That said, the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS), a semi-structured interview, along with clinical...
Evaluation of asymptomatic atrial fibrillation
(Family Physicians Inquiries Network, 2012)
In hemodynamically stable patients without acute chest pain, the evaluation and treatment of atrial fibrillation should not change based on symptoms alone. (Strength of Recommendation: A, based on multiple cohort studies.) ...
Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese
(Family Physicians Inquiries Network, 2007)
No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 ...
Does digoxin decrease morbidity for those in sinus rhythm with heart failure?
(Family Physicians Inquiries Network, 2005)
In patients with congestive heart failure due to systolic dysfunction who are in normal sinus rhythm, digoxin therapy reduces rates of hospitalization, as well as clinical deterioration, defined as worsening New York Heart Association (NYHA...
What nonhormonal therapies are effective for postmenopausal vasomotor symptoms?
(Family Physicians Inquiries Network, 2003)
--inconsistent results of randomized trials). Clonidine, as an oral or transdermal preparation, reduces hot flushes (SOR: A--randomized clinical trials), as does gabapentin (SOR: A-- single randomized clinical trial). In cancer patients who have had surgical menopause...
Brain Natriuretic Peptide Levels for Ruling Out Heart Failure
(Family Physicians Inquiries Network, 2011)
A BNP level less than 100 pg per mL (100 ng per L) can rule out heart failure. (Strength of Recommendation [SOR]: A, based on meta-analyses.) BNP levels should be used when the pretest probability of heart failure based on overall clinical...
What is the best way to distinguish type 1 and 2 diabetes?
(Family Physicians Inquiries Network, 2005)
No clinical characteristic or diagnostic test is available to readily distinguish type 1 from type 2 diabetes mellitus. Although C-peptide levels, autoantibodies, and adiponectin-to-leptin ratios show some utility, they do not yet have a standard...
Are oral agents effective for the treatment of verruca vulgaris?
(Family Physicians Inquiries Network, 2006)
Of the available oral therapies for common warts, none has sufficient evidence to recommend it as an effective therapy (strength of recommendation [SOR]: B). To date, no oral agent has been shown to be effective in a ...
What's the best way to manage athletes with amenorrhea?
(Family Physicians Inquiries Network, 2008)
Ruling out secondary causes of amenorrhea is, of course, the first step. Once that's done, you can make a presumptive diagnosis of hypothalamic amenorrhea and advise the patient to increase caloric intake or decrease energy ...
What findings distinguish acute bacterial sinusitis?
(Family Physicians Inquiries Network, 2003)
No combination of clinical findings can reliably distinguish acute viral rhinosinusitis from acute bacterial rhinosinusitis in primary care. Although unreliable, the best clinical predictor of acute bacterial sinusitis is the combination...