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What are the current treatment and monitoring recommendations for hepatitis C virus (HCV)?
(Family Physicians Inquiries Network, 2001)
Patients diagnosed with HCV should have serum liver function tests and get a baseline HCV RNA level (viral load), since treatment decisions are affected by these laboratory values. Genotype testing is indicated for treatment ...
What are the benefits of treating sleep apnea?
(Family Physicians Inquiries Network, 2001)
There is little benefit to treating patients with sleep apnea who do not have daytime sleepiness. For patients with symptoms, treating those with moderate to severe sleep apnea is more reliably associated with benefits ...
What is the best strategy for monitoring the lipid-lowering effects of medical therapy used for the primary prevention of coronary artery disease (CAD)?
(Family Physicians Inquiries Network, 2001)
There is good evidence that treatment for primary prevention of CAD decreases risk of major first coronary events and cardiovascular mortality, though all-cause mortality has not been shown to be reduced. There is no ...
What is the best oral antifungal medication for tinea capitis?
(Family Physicians Inquiries Network, 2001)
Terbinafine is effective, safe for use in children, and relatively inexpensive, and it offers a shorter course of therapy than griseofulvin. Unfortunately, it is not available in liquid form. Fluconazole is available in ...
How soon should serum potassium levels be monitored for patients started on diuretics?
(Family Physicians Inquiries Network, 2001)
Case series show that hypokalemia following initiation of diuretic therapy occurs in most patients within 2 to 8 weeks. However, no studies are available that adequately predict the risk of this complex and multifactorial ...
Is surgery effective for reducing symptoms in adults with obstructive sleep apnea?
(Family Physicians Inquiries Network, 2001)
Current evidence is insufficient to recommend surgery for symptom relief for patients with obstructive sleep apnea. More convincing evidence exists supporting the use of Continuous Positive Airway Pressure (CPAP) or dental ...
How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?
(Family Physicians Inquiries Network, 2001)
Acupuncture, biofeedback, and S-adenosyl methionine (SAMe) have been shown to have some efficacy in the treatment of fibromyalgia in randomized controlled trials. Spa treatments, hypnotherapy, massage, and meditation may ...
How can I improve patient adherence to prescribed medication?
(Family Physicians Inquiries Network, 2001)
Two randomized clinical trials have shown that simplified dosing schedules have improved patient adherence to medication as prescribed. Some, but not all, randomized controlled trials show multidimensional interventions ...
Does tamoxifen prevent breast cancer?
(Family Physicians Inquiries Network, 2001)
Tamoxifen prevents breast cancer in women older than 60 years and in younger women with equally high risk because of breast disease and reproductive and family history, but there is no current evidence for or against ...
What medications are safe and effective for heartburn during pregnancy?
(Family Physicians Inquiries Network, 2001)
Ranitidine is the best-studied agent effective for treatment of heartburn in pregnancy. Some antacids are effective, but it may be prudent to avoid them in the first trimester until better safety studies are published. ...
When should we stop mammography screening for breast cancer in elderly women?
(Family Physicians Inquiries Network, 2001)
There is insufficient evidence to recommend for or against routine screening mammography beyond the age of 69 years. The best candidates to stop screening are elderly women who have significant comorbidities, poor functional ...
What is a reasonable initial approach to the patient with fatigue?
(Family Physicians Inquiries Network, 2001)
Half of all patients presenting with fatigue have a psychological cause. Patients with a history of anxiety or depression or those with a duration of symptoms for more than 3 months are more likely to remain symptomatic 6 ...
What is the best test to diagnose urinary tract stones?
(Family Physicians Inquiries Network, 2001)
Over the past 3 years, helical (or spiral) computerized tomography (CT) has proved the best method of testing for urinary tract stones. All reviewed studies published since mid-1998 found helical CT scan to be the safest ...
What are the most effective treatments for bacterial vaginosis in nonpregnant women?
(Family Physicians Inquiries Network, 2001)
Either oral or vaginal metronidazole or vaginal clindamycin provides equivalent treatment for bacterial vaginosis in nonpregnant women. Oral clindamycin 300 mg twice daily for 7 days is an effective alternative. There is ...
What laboratory monitoring is appropriate to detect adverse drug reactions in patients on cholesterol-lowering agents?
(Family Physicians Inquiries Network, 2001)
Recommendations for measuring serum aminotransferase levels before initiating pharmacologic treatment for hypercholesterolemia, after 12 weeks of therapy, and periodically afterward are based on expert opinion. It is not ...
What are the indications for treatment with angiotensin-converting enzyme (ACE) inhibitors in patients with diabetes?
(Family Physicians Inquiries Network, 2001)
Tight control of hypertension treatment is key in preventing the vascular complications of diabetes. ACE inhibitors appear to have a protective effect that is independent of their antihypertensive effect. Unless there is ...
What is the value of screening for heart disease with an exercise stress test (EST) in an asymptomatic person?
(Family Physicians Inquiries Network, 2001)
There is insufficient evidence to recommend for or against an EST for screening asymptomatic individuals of any age. (Grade of Recommendation: C, based on case series.)
Which patients with gastroesophageal reflux disease (GERD) should have esophagogastroduoudenoscopy (EGD)?
(Family Physicians Inquiries Network, 2001)
No evidence was identified that provides a basis for determining whether EGD leads to improved outcomes in patients with GERD. However, patients with GERD referred for elective EGD who were found to have Barrett's esophagus ...
Should we change formula for a formula-fed infant with persistent spitting up, but with adequate weight gain?
(Family Physicians Inquiries Network, 2001)
We found no controlled trials evaluating the efficacy of changing formulas in the management of uncomplicated regurgitation. However, the evidence suggests that no benefit can be expected from changing formulas, including ...
Is there any benefit to Papanicolaou (Pap) test screening in women who have had a hysterectomy for benign disease?
(Family Physicians Inquiries Network, 2001)
The primary motivation to screen asymptomatic women after a hysterectomy is to prevent morbidity and mortality from gynecologic cancer. However, primary vaginal cancer is rare, the vaginal Pap test is not particularly ...