RSS 1.0Clinical Inquiries, 2013
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Do oral contraceptives carry a significant risk of stroke for women with migranes?
(Family Physicians Inquiries Network, 2013)Evidence-based answer: Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly migraine with aura (strength of recommendation [SOR]: C, small case-control studies ... -
What is the best age to start vitamin D supplementation to prevent rickets in breastfed newborns?
(Family Physicians Inquiries Network, 2013)Evidence-based answer: It's unclear what age is best to start vitamin D supplementation because no comparison studies exist. That said, breastfed infants who take vitamin D beginning at 3 to 5 days of life don't develop ... -
How do antidepressants affect sexual function?
(Family Physicians Inquiries Network, 2013)Evidence-based answer: patients treated with elective serotonin reuptake inhibitors (SSRIs) and the serotonin/norepinephrine reuptake inhibitor (SNRI) venlafaxine have significantly higher rates of overall sexual ... -
What clinical clues differentiate migraine from sinus headaches?
(Family Physicians Inquiries Network, 2013)Evidence-based answer: Patients with sinus headaches have thick nasal discharge, fever, chills, sweats, or abnormally malodorous breath (SOR: B, cross-sectional study). The 5 symptoms that are most predictive of migraine ... -
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 ... -
Elevated troponin but no CVD: what's the prognosis?
(Family Physicians Inquiries Network, 2013)Patients with elevated troponin levels and chronic renal disease, pulmonary hypertension, pulmonary embolism, chronic obstructive pulmonary disease, sepsis, or acute ischemic stroke have a 2- to 5-fold increased risk of ... -
Management of ADHD in preschool-aged children
(Family Physicians Inquiries Network, 2013)Behavior therapy interventions, such as parent training, are first-line treatment for ADHD in preschool-aged children (three to five years of age). (Strength of Recommendation [SOR]: B, based on a systematic review of a ... -
Do dietary choices alone alter the risk of developing metabolic syndrome?
(Family Physicians Inquiries Network, 2013)In studies of patient populations controlled for differences in dietary content alone, independent of weight loss or exercise changes, diets with high glycemic index foods, low whole grain and fiber content, and low fruit ... -
What is the best initial treatment for venous stasis ulcers?
(Family Physicians Inquiries Network, 2013)The mainstay of initial treatment of venous stasis ulcers is compression therapy (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). Multicomponent compression therapy is slightly ... -
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 ... -
Does metformin prevent diabetes in at-risk adults?
(Family Physicians Inquiries Network, 2013)Metformin therapy reduces the risk of developing diabetes for adults with one or more risk factors for at least 5 years (strength of recommendation [SOR]: A, consistent meta-analyses) and perhaps as long as 10 years (SOR: ... -
Do asymptomatic adults need screening EKGs?
(Family Physicians Inquiries Network, 2013)Although certain electrocardiogram (EKG) findings in asymptomatic adults are associated with increased mortality (strength of recommendation [SOR]: A, high-quality cohort studies), no randomized trials demonstrate that any ... -
Metformin use in adolescents
(Family Physicians Inquiries Network, 2013)There are no studies evaluating whether metformin prevents or delays the onset of diabetes in adolescents who are obese. In adults, metformin is as effective as lifestyle interventions in preventing increases in A1C and ... -
Should you test or treat pregnant women with a history of pregnancy-related VTE?
(Family Physicians Inquiries Network, 2013)No high-quality evidence supports testing for thrombophilia in pregnant patients who have experienced venous thromboembolism (VTE) in a previous pregnancy. Antepartum and postpartum anticoagulation with LMWH produces lower ... -
How best to treat agitation in patients with irreversible dementia?
(Family Physicians Inquiries Network, 2013)Atypical antipsychotics modestly reduce agitation compared with placebo but have significant adverse effects (strength of recommendation [SOR]: A, systematic reviews of randomized controlled trials [RCTs]). Haloperidol ... -
Corticosteroids for presumed pneumocystis pneumonia in patients with HIV infection
(Family Physicians Inquiries Network, 2013)Adjunctive corticosteroids decrease mortality in patients with HIV infection who have moderate to severe hypoxemia and suspected or confirmed pneumocystis pneumonia. Corticosteroids lead to a higher incidence of herpetic ... -
What is the best treatment for plant-induced contact dermatitis?
(Family Physicians Inquiries Network, 2013)It's unclear which treatment is best, because there have been no head-to-head comparisons of treatments for Rhus (plant-induced) contact dermatitis. That said, topical high-potency steroids slightly improve pruritus and ... -
Pharmacologic therapy for eustachian tube dysfunction
(Family Physicians Inquiries Network, 2013)There are no medications that improve patient-oriented outcomes in children or adults with eustachian tube dysfunction. (Strength of Recommendation [SOR]: A, based on a systematic review of randomized controlled trials ... -
How can pregnant women safely relieve low-back pain?
(Family Physicians Inquiries Network, 2013)Acetaminophen is safe for use in pregnancy but lacks evidence of efficacy (strength of recommendation [SOR]: C, usual practice). Both physical therapy and water aerobics reduce sick days caused by low-back pain (strength ... -
How much does weight loss affect hypertension?
(Family Physicians Inquiries Network, 2013)Weight loss of 4 kg by diet reduces systolic and diastolic blood pressure (BP) by 4.5 and 3.2 mm Hg, respectively (SOR: A, systematic review with consistent findings). Weight loss of 1 to 1.2 kg by exercise may produce ...