RSS 1.0Clinical Inquiries, 2003
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Is Fluoxetine an Effective Therapy for Weight Loss in Obese Patients?
(Family Physicians Inquiries Network, 2003)Fluoxetine (Prozac) use may result in an average, short-term weight loss of up to 3.3 kg (7 lb, 4 oz) in obese patients, but the longterm effects and maintenance of weight loss after discontinuation of the drug have not ... -
Who should have colposcopy?
(Family Physicians Inquiries Network, 2003)Colposcopy is the preferred test in the work-up of patients with abnormal cervical cytology: Low-grade squamous intraepithelial lesion (LSIL): mild dysplasia ; High-grade squamous intraepithelial lesion (HSIL): moderate ... -
Which postmenopausal women should be offered combined HRT?
(Family Physicians Inquiries Network, 2003)Recent studies have demonstrated a small but significant risk of adverse effects from combined hormone replacement therapy (HRT), including cardiovascular disease, thromboembolic disease, and breast cancer. Time-limited ... -
Which infants need lumbar puncture for suspected sepsis?
(Family Physicians Inquiries Network, 2003)Evidence from prospective and retrospective clinical trials suggests that for infants <2 months old, only those at high risk for serious bacterial infection by standardized criteria (eg, Rochester classification) require ... -
What treatments are effective for varicose veins?
(Family Physicians Inquiries Network, 2003)For larger trunk varicose veins, as in the saphenous vein, therapeutic options include conservative measures (such as leg elevation and compression stockings), injection sclerotherapy, and surgical vein ligation, with or ... -
What regimens eradicate Heliobacter pylori?
(Family Physicians Inquiries Network, 2003)Fourteen-day triple therapy with a proton pump inhibitor (PPI) plus clarithromycin and either amoxicillin or metronidazole is superior to 7-day therapy in eradicating Heliobacter pylori (strength of recommendation [SOR]: ... -
What is the prognosis of postherpetic neuralgia?
(Family Physicians Inquiries Network, 2003)Postherpetic neuralgia occurs rarely among patients aged <50 years with herpes zoster. The incidence, duration, and severity of post-herpetic neuralgia increases with age, but older patients usually have only mild pain. ... -
What nonhormonal therapies are effective for postmenopausal vasomotor symptoms?
(Family Physicians Inquiries Network, 2003)Regular exercise may reduce vasomotor symptoms of menopause (strength of recommendation [SOR]: C--single observational study). Soy products/isoflavones, either through diet or supplementation, may reduce the incidence of ... -
What is the most effective nicotine replacement therapy?
(Family Physicians Inquiries Network, 2003)No single nicotine replacement therapy is most effective for all smokers. All forms of nicotine replacement therapy (gum, transdermal patch, spray, inhaler, and lozenge) are equally effective, increasing smoking cessation ... -
What is the most effective beta-blocker for heart failure?
(Family Physicians Inquiries Network, 2003)Three beta-blockers--carvedilol, metoprolol, and bisoprolol--reduce mortality in chronic heart failure caused by left ventricular systolic dysfunction, when used in addition to diuretics and angiotensin converting enzyme ... -
What medication best prevents migraine in children?
(Family Physicians Inquiries Network, 2003)Propranolol, valproic acid, and amitriptyline are effective prophylaxis for migraine in children to varying degrees, are widely available, and have a reasonable safety profile (strength of recommendation [SOR]: B, based ... -
What findings distinguish acute bacterial sinusitis?
(Family Physicians Inquiries Network, 2003)No combination of clinical findings can reliably distinguish acute viral rhinosinusitis from acute bacterial rhinosinusitis in primary care. Although unreliable, the best clinical predictor of acute bacterial sinusitis is ... -
What is the best treatment for plantar fasciitis?
(Family Physicians Inquiries Network, 2003)Mechanical therapies -- such as taping, tension night splinting, and rigid arch support -- are the most effective treatment for plantar fasciitis (strength of recommendation: A, based on randomized controlled trials). If ... -
What is the best treatment for bronchiolitis?
(Family Physicians Inquiries Network, 2003)Nebulized epinephrine decreases oxygen requirements, respiratory rate, wheezing, and retractions and may lower hospitalization rates and length of stay (Grade of Recommendation: A, based on consistent randomized controlled ... -
What is the best way to manage benign paroxysmal positional vertigo?
(Family Physicians Inquiries Network, 2003)A simple repositioning maneuver, such as the Epley maneuver, performed by an experienced clinician, can provide symptom relief from benign paroxysmal positional vertigo (BPPV) lasting at least 1 month (strength of ... -
What is the best initial treatment of Parkinson's disease?
(Family Physicians Inquiries Network, 2003)No studies clearly demonstrate the best initial treatment for Parkinson's disease. Levodopa improves motor function in Parkinson's disease; however, long-term use is associated with irreversible dyskinesias and motor ... -
What is the best hypnotic for use in the elderly?
(Family Physicians Inquiries Network, 2003)Short-acting hypnotics such as zolpidem (Ambien) or zaleplon (Sonata) are the preferred hypnotics in the elderly because of an improved side-effect profile compared with traditional hypnotics such as benzodiazepines (strength ... -
Should we screen for ovarian cancer?
(Family Physicians Inquiries Network, 2003)Ovarian cancer screening using pelvic examination, CA-125 serum tumor marker, transvaginal ultrasound (TVU), or any combination of tests is not recommended in average-risk women, or in women with only 1 first-degree relative ... -
Should jaundiced infants be breastfed?
(Family Physicians Inquiries Network, 2003)No studies have demonstrated that cessation of breastfeeding in jaundiced infants improves clinical outcomes, although this has only been studied in term infants. Temporarily disrupting or supplementing breastfeeding in ... -
Is screening urinalysis in children worthwhile?
(Family Physicians Inquiries Network, 2003)Screening urinalysis in asymptomatic children has not been shown to be beneficial (strength of recommendation: B; based on extrapolation from 1 meta-analysis). It is unlikely to be cost-effective and should be discontinued. ...