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Now showing items 61-80 of 595
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...
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 ...
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...
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 ...
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...
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...
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...
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 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...
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 ...
Treatments for Chronic Prostatitis
(Family Physicians Inquiries Network, 2006)
Because the etiology of chronic nonbacterial prostatitis is unknown, a variety of treatments have been proposed. The best- designed, largest clinical trials have not found the most commonly used therapies (i.e., alpha blockers, quinolone antibiotics...
Does screening for diabetes in at-risk patients improve long-term outcomes?
(Family Physicians Inquiries Network, 2004)
No randomized clinical trials or prospective studies have demonstrated adequate evidence to screen individuals for diabetes mellitus. A recently published meta-analysis for the United States Preventative Services Task Force (USPSTF) stated...
Heat or ice for acute ankle sprain?
(Family Physicians Inquiries Network, 2003)
at any time after injury (SOR: B, based on head-to-head randomized trials). Ice therapy also reduces edema, but the clinical significance of this finding is unclear....
Should you treat a symptomatic patient by phone when his child has confirmed strep throat?
(Family Physicians Inquiries Network, 2007)
on consensus guidelines) due to poor diagnostic accuracy. When you suspect GABHS pharyngitis either clinically or epidemio-logically, confirm the diagnosis of pharyngitis by a laboratory test. Patients with a positive throat culture or a rapid antigen detection...
What is the best treatment for gastroesophageal reflux and vomiting in infants?
(Family Physicians Inquiries Network, 2005)
The literature on pediatric reflux can be divided into studies addressing clinically apparent reflux (vomiting or regurgitation) and reflux as measured by pH probe or other methods. Sodium alginate reduces vomiting and improves parents' assessment...
What illnesses contraindicate immunization?
(Family Physicians Inquiries Network, 2005)
The Advisory Council on Immunization Practices (ACIP) reports that the only contraindication for all vaccines is a history of severe allergic reaction to a previous vaccine or vaccine constituent (strength of recommendations: ...