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Now showing items 121-140 of 1408
How should you further evaluate an adult with a testicular mass?
(Family Physicians Inquiries Network, 2007)
in which ultrasound and clinical exam are inconclusive or confl- icting, magnetic resonance imaging (MRI) can provide additional information to improve management and decrease unnecessary surgery (SOR: B, based on cohort trials of patient-oriented outcomes)....
Does injection of steroids and lidocaine in the shoulder relieve bursitis?
(Family Physicians Inquiries Network, 2004)
Subacromial steroid injection may provide a small, short-term benefit compared with placebo. The short-term effectiveness of steroid injection compared with nonsteroidal anti-inflammatory agents (NSAIDs) remains unclear. ...
When should you treat tongue-tie in a newborn?
(Family Physicians Inquiries Network, 2010)
Consider treatment when the infant is having difficulty breastfeeding. Infants with mild to moderate tongue-tie, or ankyloglossia, are likely to breastfeed successfully and usually require no treatment (strength of ...
Do insulin-sensitizing drugs increase ovulation rates for women with PCOS?
(Family Physicians Inquiries Network, 2005)
Short-term use of metformin (Glucophage) improves ovulation rates for women with polycystic ovary syndrome (PCOS) (strength of recommendation [SOR]: A, based on systematic reviews of randomized controlled trials [RCT]). ...
How often should you follow up on a patient with newly diagnosed hypothyroidism?
(Family Physicians Inquiries Network, 2009)
Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If ...
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. ...
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 ...
Which drugs are best when aggressive Alzheimer's patients need medication?
(Family Physicians Inquiries Network, 2010)
Atypical antipsychotics are an effective short-term (6-12 weeks) treatment for aggressive behavior in patients with Alzheimer's disease because they consistently decrease aggression scores (strength of recommendation [SOR]: ...
Can we prevent splenic rupture for patients with infectious mononucleosis?
(Family Physicians Inquiries Network, 2005)
All patients with infectious mononucleosis should be considered at risk for splenic rupture since clinical severity, laboratory results, and physical exam are not reliable predictors of rupture (strength of recommendation [SOR]: B, case...
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...
How effective is gastric bypass for weight loss?
(Family Physicians Inquiries Network, 2004)
Gastric bypass results in weight loss of approximately 33% at 2 years and 25% at 8 years (strength of recommendation [SOR]: B, based on a cohort study). Gastric bypass is one type of bariatric surgery, which also includes ...
Should liver enzymes be checked in a patient taking niacin?
(Family Physicians Inquiries Network, 2005)
No randomized trials directly address the question of frequency of liver enzyme monitoring with niacin use. Niacin use is associated with early and late hepatotoxicity (strength of recommendation [SOR]: B, based on incidence ...
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...
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 ...
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...
Does treatment with donepezil improve memory for patients with mild cognitive impairment?
(Family Physicians Inquiries Network, 2006)
Donepezil (Aricept) has potential benefit in delaying risk of progression to Alzheimer's disease in the first year of treatment, but this benefit is not seen at 3 years. Donepezil does not improve memory for patients with ...
Should we use appetite stimulants for malnourished elderly patients?
(Family Physicians Inquiries Network, 2007)
Only 1 appetite stimulate, megestrol acetate oral suspension (Megace) at 400 mg or 800 mg daily, has been studied in this population. The data show only limited benefit, mixed outcomes, and potential harm (strength of ...
Should patients receive 23-valent pneumococcal vaccination more than once?
(Family Physicians Inquiries Network, 2006)
No patient-oriented evidence supports pneumococcal revaccination of any patient (high-risk or otherwise). Antibody levels may be augmented by revaccination; however, the clinical efficacy of revaccination, even among high-risk patients, is unknown...
Do antipyretics prolong febrile illness?
(Family Physicians Inquiries Network, 2004)
Antipyretics appear to have minor and variable effects on the course of febrile illness. Aspirin and acetaminophen do not prolong the course of rhinovirus illness, although they may prolong the period of viral shedding and ...
What is the prognosis for acute low back pain?
(Family Physicians Inquiries Network, 2002)
The proportion of patients who are pain free or completely recovered after an acute episode of low back pain within 2 weeks to 6 months ranges from 21% to 90%, depending on the population studied and the method of measuring ...