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Now showing items 101-120 of 410
Trauma care : don't delay with TXA
(Family Physicians Inquiries Network, 2009)
Ensure that patients who incur serious trauma receive tranexamic acid (TXA) within 3 hours of the injury. Stength of recommendation: B: An analysis of a large randomized controlled trial (RCT).
Who should receive vertebroplasty?
(Family Physicians Inquiries Network, 2006)
related to one of these lesions who have failed a reasonable course of medical therapy (strength of recommendation [SOR]: B, based on structured reviews of observational studies). Contraindications include an uncorrectable coagulation disorder, infection...
Should you use steroids to treat infectious mononucleosis?
(Family Physicians Inquiries Network, 2008)
Studies of steroids to treat infectious mononucleosis have found no significant effect on the clinical course of the illness at 1 to 3 months (strength of recommendation [SOR]: B, 1 randomized controlled trial [RCT] and 1 ...
What are effective strategies for reducing the risk of steroid-induced osteoporosis?
(Family Physicians Inquiries Network, 2002)
Calcium, in combination with vitamin D, prevents bone loss and is recommended in all patients. (Grade of recommendation: A, based on systematic reviews of randomized controlled trials [RCTs]). Alendronate and risedronate prevent fractures and should...
How effective is prophylactic therapy for gout in people with prior attacks?
(Family Physicians Inquiries Network, 2004)
of gout, although the data to support their use is limited. Some evidence suggests that despite their serum uric acid-lowering effects, uricosurics (such as probenecid) fail to reduce gout attacks (SOR: B, based on 2 cohort studies). We were unable to find...
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 ...
Do statins reduce the risk of stroke?
(Family Physicians Inquiries Network, 2004)
have coronary disease, statins prevent recurrent ischemic stroke; evidence is conflicting about whether this benefit is proportional to initial cholesterol levels (SOR: A, systematic review). Statins do not prevent hemorrhagic stroke (SOR: A, based...
What is the best strategy for impaired glucose tolerance in nonpregnant adults?
(Family Physicians Inquiries Network, 2005)
The best treatment strategy for impaired glucose tolerance (IGT) and impaired fasting glucose (IFG) is lifestyle intervention with a structured weight loss program of diet and exercise (strength of recommendation [SOR]: B, based on high...
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). ...
Should jaundiced infants be breastfed?
(Family Physicians Inquiries Network, 2003)
is associated with premature cessation of breastfeeding (strength of recommendation [SOR]: B, based on a nonrandomized, nonblinded trial). Jaundiced breastfed term infants have no significant difference in length of phototherapy, and no increased rate...
When should a chest x-ray be used to evaluate acute-onset productive cough for adults?
(Family Physicians Inquiries Network, 2005)
Even though the most common reason to order
a chest x-ray in the evaluation of an acute-onset, productive cough is to rule out pneumonia, there is no strong evidence to help a physician decide when to order this chest x-ray. However, acute cough...
What is the best way to diagnose a suspected rotator cuff tear?
(Family Physicians Inquiries Network, 2006)
The evaluation of a suspected rotator cuff tear should start with a history and a clinical exam of the shoulder (strength of recommendation [SOR]: B, based on a systematic review of cohort studies). Three clinical test results in particular...
What drugs are best for bipolar depression?
(Family Physicians Inquiries Network, 2008)
Antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs), are useful adjuncts in short-term treatment of bipolar depression and have low rates of inducing mania (strength of recommendation ...
Does regular exercise reduce the pain and stiffness of osteoarthritis?
(Family Physicians Inquiries Network, 2008)
Exercise helps reduce the pain, but it's unclear whether it helps with stiffness. Exercise moderately reduces pain in elderly patients with osteoarthritis (strength of recommendation [SOR]: A, 3 systematic reviews, including ...
What are effective therapies for Clostridium difficile- associated diarrhea?
(Family Physicians Inquiries Network, 2005)
Oral metronidazole and oral vancomycin are
equally effective treatments for Clostridium difficile- associated diarrhea (CDAD) (strength of recommendation [SOR]: A, based on randomized trials). Oral vancomycin is considerably more expensive and may...
What treatment approach to intrapartum maternal fever has the best fetal outcomes?
(Family Physicians Inquiries Network, 2007)
A combination of beta-lactam and amino-glycoside antibiotics are the recommended empiric agents for the treatment of acute chorioamnionitis, given that no head-to-head trials exist (strength of recommendation [SOR]: C, based on expert opinion...
Which nondrug alternatives can help with insomnia?
(Family Physicians Inquiries Network, 2007)
of
recommendation: A, based on systematic reviews). The long-term efficacy of CBT interventions, and their successful implementation by primary care physician (as compared with behavioral science providers), is unclear....
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...
What is the best workup for hypocalcemia?
(Family Physicians Inquiries Network, 2008)
Unexplained hypocalcemia can usually be diagnosed by a limited number of serum tests when the cause isn't obvious from the history (recent neck surgery or renal failure): calcium corrected for serum albumin); creatinine; ...
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 ...