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Hypoglycemia with insulin and sulfonylureas
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: In patients with type 2 diabetes mellitus (T2DM), does the combination of insulin and sulfonylurea (SU) increase the risk of hypoglycemia? Evidence-based answer: The incidence of severe hypoglycemia in patients with T2DM...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of recommendation [SOR]: B, meta...
Which patients undergoing noncardiac surgery benefit from perioperative beta-blockers?
(Family Physicians Inquiries Network, 2008)
Patients with moderate to high cardiac risk (a Revised Cardiac Risk Index [RCRI] score of 2 or higher [Table]) have a reduced risk of in-hospital death following perioperative beta-blocker therapy (strength of recommendation ...
What is the most effective and safe malaria prophylaxis during pregnancy?
(Family Physicians Inquiries Network, 2008)
Chloroquine and mefloquine have superior safety profiles in pregnancy, though all antimalarials are effective for prophylaxis. Antimalarials will decrease the severity of maternal malaria infection and malaria-associated ...
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 ...
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011)
There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep ...
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...
Complementary and alternative therapies for atopic dermatitis
(Family Physicians Inquiries Network, 2012)
Evening primrose oil may be effective for the treatment of atopic dermatitis. (Strength of Recommendation [SOR]: B, based on one randomized controlled trial [RCT].) Homeopathy may be as good as conventional therapy for ...
Antibiotics for Viral Upper Respiratory Tract Infections in Children
(Family Physicians Inquiries Network, 2011)
Antibiotic therapy does not benefit children with bronchiolitis, the common cold, or nonstreptococcal pharyngitis. If purulent rhinitis is present for more than 10 days, antibiotics shorten the duration of runny nose ...
Are overweight children more likely to be overweight adults?
(Family Physicians Inquiries Network, 2009)
Overweight at any age in childhood increases the risk for overweight in adulthood. The relative risk (RR) ranges from 1.9 to 10.1 and increases as children get older. Not all overweight children become overweight adults, ...
Testosterone Therapy and Risk of Recurrence After Treatment for Prostate Cancer
(Family Physicians Inquiries Network, 2013)
Evidence-Based Answer: Men with symptomatic androgen deprivation who have had clinically curative treatment for organ-confined prostate cancer may have symptomatic improvement with testosterone replacement therapy. (Strength of Recommendation [SOR...
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...
Acupuncture for migraine headaches
(Family Physicians Inquiries Network, 2010)
Acupuncture reduces the frequency of migraine headaches when used as an adjunct to, or in place of, medical management. (Strength of Recommendation: A, based on meta-analyses).
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])....
Interventions for lower-extremity lymphedema
(Family Physicians Inquiries Network, 2013)
Complete decongestive physiotherapy (i.e., a noninvasive protocol consisting of skin care, lymph drainage massage, exercises, and compression bandaging1) effectively improves edema, rates of infection, and quality of life ...
Do patients at high risk of Alzheimer's disease benefit from early treatment?
(Family Physicians Inquiries Network, 2009)
Treating patients with early-stage Alzheimer's disease yields statistically significant, though perhaps not clinically significant, improvement in cognition and global function (strength of recommendation [SOR]: A, consistent evidence from multiple...
Dipstick urinalysis for the diagnosis of acute UTI
(Family Physicians Inquiries Network, 2013)
Approximately two-thirds of women who present with classic symptoms of acute UTI have bacterial infection of the bladder. Dipstick urinalysis moderately improves the accuracy of clinical symptoms in establishing or excluding acute UTI in women...
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011)
velocity, delayed puberty, or clinical signs and symptoms of endocrine abnormalities (e.g., hirsutism, truncal obesity, violaceous striae). (Strength of recommendation [SOR]: C, based on expert opinion.) Underlying metabolic and genetic causes of obesity...
What treatments relieve arthritis and fatigue associated with systemic lupus erythematosus?
(Family Physicians Inquiries Network, 2014)
arthritis symptoms by about 35% (SOR: b, RCTs with inconsistent evidence). Abatacept and dehydroepiandrosterone don't produce clinically meaningful improvements in fatigue associated with SLE, and abatacept causes significant adverse effects (SOR: b, posthoc...
Effective Therapies for Intermittent Claudication
(Family Physicians Inquiries Network, 2011)
Supervised exercise programs are recommended to produce clinically significant improvements in walking distance in patients with stable intermittent claudication. (Strength of Recommendation [SOR]: A, based on systematic reviews of randomized...