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Which prophylactic therapies best prevent gout attacks?
(Family Physicians Inquiries Network, 2014)
Q. Which prophylactic therapies best prevent gout attacks? A. Allopurinol and febuxostat reduce the frequency of gout attacks equally after 8 weeks of treatment (strength of recommendation [SOR]: B, multiple randomized ...
How can we effectively treat stress urinary incontinence without drugs or surgery?
(Family Physicians Inquiries Network, 2014)
Q. How can we effectively treat stress urinary incontinence without drugs or surgery? A. Pelvic floor muscle training (PFMT) and intravaginal electrical stimulation seem to be the best bets. PFMT increases urinary continence ...
Low-dose penicillin for recurrent cellulitis?
(Family Physicians Inquiries Network, 2014)
Practice changer: Prescribe low-dose penicillin to patients with recurrent leg cellulitis to decrease the frequency of recurrent episodes.
What is the best treatment for impetigo?
(Family Physicians Inquiries Network, 2014)
Q. What is the best treatment for impetigo? A. Although evidence is lacking to support a single best treatment for impetigo, topical mupirocin, fusidic acid, gentamicin, and retapamulin are all at least 20% more likely ...
An antiemetic for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2014)
An antiemetic for irritable bowel syndrome? A drug used for cancer patients may provide some relief to patients with IBS. Practice changer: Consider prescribing ondansetron up to 24 mg/d for patients who have irritable ...
What treatments relieve arthritis and fatigue associated with systemic lupus erythematosus?
(Family Physicians Inquiries Network, 2014)
Q: What treatments relieve arthritis and fatigue associated with systemic lupus erythematosus? A: Hydroxychloroquine and chloroquine improve the arthritis associated with mild systemic lupus erythematosus (SLE)--producing ...
Probiotics for colic? A PURL update
(Family Physicians Inquiries Network, 2014)
In "Colicky baby? Here's a surprising remedy" (J Fam Pract. 2011;60:34-36), we summarized a 2010 doubleblind randomized controlled trial (RC T) that found the probiotic Lactobacillus reuteri DSM 17938 reduced daily crying ...
Skip the compression stockings following DVT
(Family Physicians Inquiries Network, 2014)
Although commonly used, compression stockings do not effectively prevent post-thrombotic syndrome. Practice changer: Do not recommend elastic compression stockings (ECS) to decrease the incidence of post-thrombotic syndrome ...
Do complementary agents lower HbA1c when used with standard type 2 diabetes therapy?
(Family Physicians Inquiries Network, 2014)
Q. Do complementary agents lower HbA1c when used with standard type 2 diabetes therapy? A. No, there is no high-quality evidence that supports using complementary or alternative agents to lower hemoglobin A1c (HbA1c) in ...
Do oral contraceptives put women with a family history of breast cancer at increased risk?
(Family Physicians Inquiries Network, 2014)
Q. Do oral contraceptives put women with a family history of breast cancer at increased risk? Evidence-based answer: No. Modern combined oral contraceptive pills (OCPs) don't increase breast cancer risk in women with a ...
Think twice about nebulizers for asthma attacks
(Family Physicians Inquiries Network, 2014)
MDIs with spacers are as effective as nebulizers for delivering beta-agonists and less likely to cause adverse effects. Practice changer: Stop ordering nebulizers to deliver beta-agonists to patients over age 2 with mild ...
Apolipoproteins for Cardiovascular Risk Assessment
(Family Physicians Inquiries Network, 2014)
Clinical Question: Is measurement of apolipoproteins better than traditional lipid measurements for predicting cardiovascular risk? Evidence-Based Answer: Measurement of apolipoprotein B and apolipoprotein A-I is no better ...
It's time to use an age-based approach to D-dimer
(Family Physicians Inquiries Network, 2014)
Use an age-adjusted D-dimer cutoff (patient's age in years [multiplied by] 10 mcg/L) for patients over age 50 years when evaluating for venous thromboembolism (VTE); it reduces false positives without substantially increasing ...
Is there a primary care tool to detect aberrant drug-related behaviors in patients on opioids?
(Family Physicians Inquiries Network, 2014)
Of the several screening instruments developed and originally validated in patients in a pain center population (TABLE), one also has been validated in primary care. The Current Opioid Misuse Measure (COMM) predicts aberrant ...
Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).
How do hydrochlorothiazide and chlorthalidone compare for treating hypertension?
(Family Physicians Inquiries Network, 2014)
Q. How do hydrochlorothiazide and chlorthalidone compare for treating hypertension? A. Both medications reduce theincidence of cardiovascular events in patients with hypertension, but chlorthalidone may confer additional ...
A simple way to reduce catheter-associated UTIs
(Family Physicians Inquiries Network, 2014)
The administration of a prophylactic antibiotic when a surgical patient's urinary catheter is removed can cut the rate of urinary tract infections in half. PRACTICE CHANGER: Ensure that antibiotics are administered to ...
What are the benefits and risks of inhaled corticosteroids for COPD?
(Family Physicians Inquiries Network, 2014)
Q: What are the benefits and risks of inhaled corticosteroids for COPD? A: Inhaled corticosteroids (ICS), either alone or with a long-acting [beta] agonist (LABA), reduce the frequency of exacerbations of chronic obstructive ...
Suctioning neonates at birth: time to change our approach
(Family Physicians Inquiries Network, 2014)
There's a better way to clear secretions from a neonate's mouth and nose, and it's less likely to cause adverse effects. Practice Changer: Stop suctioning neonates at birth. There is no benefit to this practice, and it can ...
Which drugs are most effective for recurrent herpes labialis?
(Family Physicians Inquiries Network, 2014)
Evidence based answer: Daily oral acyclovir or valacyclovir may help prevent herpes simplex labialis (HSL) recurrences (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with ...