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  • When should patients with asymptomatic aortic stenosis be evaluated for valve replacement? 

    Colen, Michelle; Lindbloom, Erik; Meadows, Susan E. (Family Physicians Inquiries Network, 2002)
    For patients whose echocardiograms show advanced calcification of the aortic valves, a jet velocity of > 4.0 m/s, or a progression in jet velocity of 0.3m/s/year; and for patients who have an abnormal exercise response or ...
  • When should acute nonvenereal conjunctivitis be treated with topical antibiotics? 

    Kane, Kevin Y.; Meadows, Susan E.; Ellis, Mark R. (Family Physicians Inquiries Network, 2002)
    Children with suspected or culture-proven acute nonvenereal bacterial conjunctivitis should be treated with topical antibiotics, which hastens clinical and microbiological remission and may prevent potentially serious ...
  • What is the best way to evaluate acute diarrhea? 

    Montgomery, Lynda; Scoville, Caryn (Family Physicians Inquiries Network, 2002)
    Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric ...
  • What is the best treatment for impacted cerumen? 

    Wilson, Stephen A.; Scoville, Caryn (Family Physicians Inquiries Network, 2002)
    Docusate sodium given 15 minutes before irrigation is most effective for facilitating cerumen removal during a single office visit. (Grade of recommendation: B, based on head-to-head trials that lacked irrigationonly arms.) ...
  • What is the most effective treatment for acute low back pain? 

    Harwood, Marc I.; St. Anna, Leilani (Family Physicians Inquiries Network, 2002)
    Nonsteroidal anti-inflammatory drugs (NSAIDs) are more effective than placebo for pain relief in patients with acute low back pain (grade of recommendation: A). There is no consistent evidence that NSAIDs are more effective ...
  • What is the target for low-density lipoprotein cholesterol in patients with heart disease? 

    Stevermer, James J.; Meadows, Susan E. (Family Physicians Inquiries Network, 2002)
    Large published randomized controlled trials (RCTs) show that pravastatin and simvastatin are well-tolerated and reduce major coronary events such as death, myocardial infarction, and revascularization by about 25%. The ...
  • What is the prognosis for acute low back pain? 

    Bielanski, Thomas E.; Nashelsky, Joan (Family Physicians Inquiries Network, 2002)
    The proportion of patients who are pain free or completely recovered after an acute episode of low back pain within 2 weeks to 6 months ranges from 21% to 90%, depending on the population studied and the method of measuring ...
  • What are the treatment options for SSRI-related sexual dysfunction? 

    Sturpe, Deborah A.; Mertens, Marsha K.; Scoville, Caryn (Family Physicians Inquiries Network, 2002)
    Substituting bupropion, nefazodone, or mirtazapine is beneficial. (Grade of recommendation: B, randomized controlled trials [RCTs].) Augmentation therapy with amantadine, bupropion, and buspirone is no better than placebo. ...
  • What are the indications for urodynamic testing in older adults with incontinence? 

    Lopez, Ricardo; Smith, Peter C.; Thering, Ann (Family Physicians Inquiries Network, 2002)
    Urodynamic testing is indicated for older adults with incontinence when the underlying cause remains unclear (Grade of Recommendation: B, based on multiple well designed, but inconsistent, randomized controlled trials ...
  • What are the indications for tonsillectomy in children? 

    Neill, Richard A.; Scoville, Caryn (Family Physicians Inquiries Network, 2002)
    Tonsillectomy with or without adenoidectomy is minimally effective when combined with tympanostomy tube placement in preventing recurrent otitis media in the 3 years following surgery. The risks of surgery must be weighed ...
  • What environmental modifications improve pediatric asthma? 

    Dudley, Timothy; Nashelsky, Joan (Family Physicians Inquiries Network, 2002)
    Reducing environmental tobacco smoke exposure decreases health care utilization among poor asthmatic children. Dust mite reduction by chemical measures is potentially harmful. (Grade of recommendations: B, based on single ...
  • What is the most effective treatment for tinea pedis (athlete's foot)? 

    Markova, Tsveti; Johnson, E. Diane (Family Physicians Inquiries Network, 2002)
    Topical therapy is effective for tinea pedis. Topical terbinafine has a 70% cure rate, is available over the counter (OTC), and requires only 1 to 2 weeks of therapy. Two other OTC topicals, tolnaftate and miconazole, ...
  • What are effective treatments for panic disorder? 

    Sturpe, Deborah A.; Weissman, Alicia M. (Family Physicians Inquiries Network, 2002)
    Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), benzodiazepines (BDZs), and cognitive behavioral therapy (CBT) are effective for panic disorder (PD) with or without agoraphobia (NNT5 for ...
  • What is the most effective treatment for external genital warts? 

    French, Linda; Nashelsky, Joan (Family Physicians Inquiries Network, 2002)
    Podofilox (Condylox), imiquimod (Aldara), cryotherapy, and surgical options all seem reasonable alternatives that are superior to podophyllin. (Grade of recommendation: B, based on systematic review.) No studies of surgical ...
  • What are effective strategies for reducing the risk of steroid-induced osteoporosis? 

    Koval, Peter G.; Hutton, Sarah F.; Thering, Ann (Family Physicians Inquiries Network, 2002)
    Calcium, in combination with vitamin D, prevents bone loss and is recommended in all patients. (Grade of recommendation: A, based on systematic reviews of randomized controlled trials [RCTs]). Alendronate and risedronate ...
  • What is the differential diagnosis of chronic diarrhea in immunocompetent patients? 

    Kruszka, Paul S.; Stigleman, Sue (Family Physicians Inquiries Network, 2002)
    Case series from tertiary-care centers report toddler's diarrhea, cow's milk sensitivity enteropathy, infection, celiac disease, and idiopathic chronic diarrhea as the most common etiologies in the pediatric population. ...
  • What is the best therapy for constipation in infants? 

    Ellis, Mark R.; Meadows, Susan E. (Family Physicians Inquiries Network, 2002)
    The best treatment for minor, self-limited constipation (infant dyschezia) may be observation and parental education about its benign nature. (Grade of recommendation: D, expert opinion.) For cases requiring treatment, ...
  • What is the best diagnostic approach to paresthesias of the hand? 

    Corrington, Kip A.; Fields, Karl B.; Nashelsky, Joan (Family Physicians Inquiries Network, 2002)
    There have been no good studies comparing different strategies for the evaluation of the patient with hand paresthesias. A reasonable strategy is to first evaluate for carpal tunnel syndrome (CTS), the most common condition ...
  • Should we treat elevated cholesterol in elderly patients? 

    Korsen, Neil; Nowicki, Edward; Thering, Ann (Family Physicians Inquiries Network, 2002)
    HMG-CoA reductase inhibitors, or statins, have been shown to decrease all-cause mortality in individuals aged 65 and older with known coronary heart disease (CHD) and elevated cholesterol levels. (Grade of recommendation: ...
  • Is there a role for theophylline in treating patients with asthma? 

    Fotinos, Charissa; Dodson, Sherry (Family Physicians Inquiries Network, 2002)
    With adults, oral theophylline may help lower the dosage of inhaled steroids needed to control chronic asthma. It offers no benefit for acute asthma exacerbations. For children, intravenous aminophylline may improve the ...

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