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Should we identify and treat hyperlipidemia in the advanced elderly?
(Family Physicians Inquiries Network, 2006)
No randomized controlled trials exist that identify and treat hyperlipidemia for advanced elderly patients (age >80 years). Expert and consensus guidelines state that hyperlipidemia found in any patient with coronary artery ...
What are effective medical treatments for adults with acute migraine?
(Family Physicians Inquiries Network, 2006)
Medications collectively referred to as "triptans" (eg, sumatriptan, naratriptan, etc) have been shown to be effective for acute migraine (strength of recommendation [SOR]: A). Nonsteroidal anti-inflammatory drugs ...
What are hospital admission criteria for infants with bronchiolitis?
(Family Physicians Inquiries Network, 2006)
Clinical judgment remains the gold standard for hospital admission of infants with bronchiolitis, and it cannot be replaced by objective criteria (strength of recommendation [SOR]: B, based on prospective and retrospective ...
What are effective treatments for oppositional defiant behaviors in adolescents?
(Family Physicians Inquiries Network, 2006)
Psychological interventions for the family-- such as parenting skills training and behavioral therapy for the child, the parents, or the whole family--reduce conflict behaviors in adolescents with oppositional defiant ...
What is appropriate fetal surveillance for women with diet-controlled gestational diabetes?
(Family Physicians Inquiries Network, 2006)
No evidence clearly supports the practice of increased fetal surveillance in the pregnancies of women with well-controlled (ie, fasting blood sugar <105 mg/dL) class A1 gestational diabetes (strength of recommendation ...
What is the appropriate evaluation and treatment of children who are "toe walkers"?
(Family Physicians Inquiries Network, 2006)
The evaluation of toe-walking focuses on differentiating normal children from those with mild cerebral palsy. Gait analysis may be a useful diagnostic tool, but further investigation is needed to confirm its reliability ...
Are there big differences among beta-blockers in treating essential hypertension?
(Family Physicians Inquiries Network, 2007)
Yes, a number of beta-blockers are effective in lowering blood pressure (strength of recommendation [SOR]: A, multiple, consistent randomized controlled trials [RCTs]). Cardioselective beta-blockers do not alter lung ...
Are DMARDs effective for rheumatologic diseases besides rheumatoid arthritis?
(Family Physicians Inquiries Network, 2007)
It's unclear whether disease-modifying antirheumatic agents (DMARDs) as first-line therapy in nonrheumatoid rheumatologic diseases are effective because the question has not been studied. As second-line therapy, the use ...
Are steroid injections effective for tenosynovitis of the hand?
(Family Physicians Inquiries Network, 2007)
Yes. Steroid injections are an effective first-line therapy for flexor tenosynovitis of the hand, with a number needed to treat [NNT] of 2.3 for injection of steroids and lidocaine (strength of recommendation [SOR]: B, ...
Are any alternative therapies effective in treating asthma?
(Family Physicians Inquiries Network, 2007)
Yes, some are. Acupuncture relieves subjective symptoms of asthma and reduces medication use in mild to moderate asthma (strength of recommendation [SOR]: A, based on systematic review of randomized controlled trials [RCTs] ...
When should a child with an undescended testis be referred to a urologist?
(Family Physicians Inquiries Network, 2006)
Infants with an undescended testis should be referred between ages 6 and 15 months, since almost all who experience spontaneous descent do so by 6 months (strength of recommendation [SOR]: A, extrapolation from cohort ...
Alcoholic liver disease: Is acetaminophen safe?
(Family Physicians Inquiries Network, 2007)
Yes, "acetaminophen is a safe and effective analgesic that can be appropriately used for adult patients with stable chronic alcoholic liver disease for at least a short period of time (studies have been limited to a maximum ...
Angiotensin blockade for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and ...
Can infants/toddlers get enough fluoride through brushing?
(Family Physicians Inquiries Network, 2007)
Yes. Brushing twice daily with topical fluoride toothpaste decreases the incidence of dental caries in infants and toddlers (strength of recommendation [SOR]: A, based on meta-analyses of randomized controlled trials ...
How should we treat major depression combined with anxiety?
(Family Physicians Inquiries Network, 2007)
One approach is to use antidepressants alone, which reduce symptoms for patients with major depression plus symptoms of anxiety or major depression plus generalized anxiety disorder. Selective serotonin reuptake inhibitors ...
How should you further evaluate an adult with a testicular mass?
(Family Physicians Inquiries Network, 2007)
Perform a scrotal ultrasonography immediately to determine whether emergency surgery is necessary for patients with an exam or history that suggests testicular torsion or rupture (strength of recommendation [SOR]: B, based ...
How effective are dietary interventions in lowering lipids in adults with dyslipidemia?
(Family Physicians Inquiries Network, 2007)
Diets lower in fat, higher in soy protein, or higher in fiber reduce serum total cholesterol, low-density lipoprotein (LDL), and triglycerides. More restrictive low-fat diets also lower high-density lipoprotein (HDL), while ...
How should you treat Candida vaginitis in patients on antibiotics?
(Family Physicians Inquiries Network, 2007)
Oral and intravaginal antifungals for the treatment of uncomplicated vulvovaginal candidiasis (VVC) have similar effectiveness (strength of recommendation [SOR]: A, systematic review). However, no randomized controlled ...
Should you restrict your cardiac patient from driving?
(Family Physicians Inquiries Network, 2007)
That depends, of course, on your patient's particular condition, but your decision can be guided by various cardiovascular society consensus conferences, such as the one from the Canadian Cardiovascular Society, since no ...
Is guaifenesin safe during pregnancy?
(Family Physicians Inquiries Network, 2007)
It's not clear; little evidence supports or refutes the safety of guaifenesin, a common expectorant, in pregnancy. A small number of observational and case-control studies suggest a weak association between guaifenesin use ...