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A-fib and rate control: Don't go too low
(Family Physicians Inquiries Network, 2010)
Aim for a heart rate of <110 beats per minute (bpm) in patients with permanent atrial fibrillation. Maintaining this rate requires less medication than more stringent rate control, resulting in fewer side effects and no ...
Does red wine reduce cardiovascular risks?
(Family Physicians Inquiries Network, 2010)
Moderate daily red wine consumption decreases cardiovascular risk compared with either abstinence or heavy and binge drinking (strength of recommendation [SOR]: B, meta-analysis of prospective cohort and case-control ...
Does spinal manipulation relieve back pain?
(Family Physicians Inquiries Network, 2010)
Spinal manipulation therapy (SMT) reduces lower back pain and improves the ability to perform everyday activities more than sham therapies (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs] ...
How should you treat a child with flat feet?
(Family Physicians Inquiries Network, 2010)
Flexible flatfoot (FFF)doesn�۪t increase the risk of injury or pain during exercise (strength of recommendation [SOR]: B, 2 small prospective cohort studies). Treating FFF with orthotics doesn�۪t change the course of arch ...
How best to help kids lose weight
(Family Physicians Inquiries Network, 2010)
Screen children and adolescents for obesity and offer them multifaceted weight loss interventions, based on new evidence (and a recent US Preventive Services Task Force [USPSTF] recommendation) of their effectiveness. ...
What's the best approach to diagnosing food allergies in infants?
(Family Physicians Inquiries Network, 2010)
A well-designed oral food challenge (OFC) is the most reliable diagnostic test for infants whose clinical history and physical examination suggest a specific food allergy (strength of recommendation [SOR]: C, consensus ...
How useful are genital exams during boys' sports physicals?
(Family Physicians Inquiries Network, 2010)
Examination may be useful to identify hernia but not testicular cancer. Insufficient evidence exists to recommend for or against screening genital exams for boys playing sports. Given the low risk of harm, screening for ...
Is aspirin effective for primary prevention of colon cancer?
(Family Physicians Inquiries Network, 2010)
Aspirin probably shouldn't be used for routine prevention because of its potential risks (strength of recommendation [SOR]: B, systematic review of inconsistent evidence). However, aspirin is likely to be effective for ...
Do dietary interventions improve ADHD symptoms in children?
(Family Physicians Inquiries Network, 2010)
Insufficient evidence exists to suggest that dietary interventions improve the symptoms of attention deficit hyperactivity disorder (ADHD) in children (strength of recommendation: B, extrapolation from randomized controlled ...
Does surgery relieve the pain of a herniated disc?
(Family Physicians Inquiries Network, 2010)
Patients with an acute episode of low back pain, radicular symptoms, and evidence of a herniated disc on imaging may experience short-term pain relief from discectomy if their symptoms haven�۪t improved after initial ...
Do standing orders help with chronic disease care and health maintenance in ambulatory practice?
(Family Physicians Inquiries Network, 2010)
Studies of standing orders tend to examine their effect on compliance with preventive interventions for chronic disease rather than disease outcomes. In the ambulatory setting, they improve rates of influenza vaccination ...
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).
Does hypercoagulopathy testing benefit patients with DVT?
(Family Physicians Inquiries Network, 2010)
There is no evidence to suggest that testing for hypercoagulopathy benefits most patients with deep venous thrombosis (DVT). Nor has research established that thrombophilia test results improve the ability to predict ...
What's the best way to manage upper extremity venous thrombosis?
(Family Physicians Inquiries Network, 2010)
Standard management is best: Start with unfractionated heparin or low-molecular-weight heparin and follow with long-term therapy with a vitamin K antagonist (strength of recommendation [SOR]: C, expert consensus and case ...
What is the most effective way to relieve symptoms of acute stress disorder?
(Family Physicians Inquiries Network, 2010)
Cognitive behavioral therapy (CBT) that emphasizes exposure-based treatment is the most effective intervention for adults with acute stress disorder (ASD) (strength of recommendation [SOR]: B, meta-analysis of limited-quality ...
Which women should we screen for gestational diabetes mellitus?
(Family Physicians Inquiries Network, 2010)
It's unclear which women we should screen. No randomized controlled trials (RCTs) demonstrate that either universal screening or risk factor screening for gestational diabetes mellitus (GDM) prevents maternal and fetal ...
Diagnosing Von Willebrand Disease
(Family Physicians Inquiries Network, 2010)
The diagnosis of vWD requires two clinical criteria: (1) a personal history, family history, or physical evidence of mucocutaneous bleeding and (2) a qualitative or quantitative decrease in functional activity of von ...
Screen teens for depression--it's quicker than you think
(Family Physicians Inquiries Network, 2010)
The US Preventive Services Task Force (The US Preventive Services Task Force (USPSTF) recommends screening all adolescents for depression -- provided that effective treatments and counseling are available for those who ...
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]: ...
How can we keep impaired glucose tolerance and impaired fasting glucose from progressing to diabetes?
(Family Physicians Inquiries Network, 2010)
Lifestyle interventions aimed at weight loss of 5% to 10% of body weight along with moderate aerobic exercise such as brisk walking for 150 minutes a week are the most effective means to prevent impaired fasting glucose ...