RSS 1.0Clinical Inquiries, 2004
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How useful is ultrasound to evaluate patients with postmenopausal bleeding?
(Family Physicians Inquiries Network, 2004)Using a threshold of ≤5 mm, transvaginal ultrasound (TVUS) can be used to identify those patients with postmenopausal bleeding who are at low risk for endometrial cancer, polyps, or atypical hyperplasia at a sensitivity ... -
Should we screen women for hypothyroidism?
(Family Physicians Inquiries Network, 2004)Testing for thyroid-stimulating hormone (TSH) finds more cases of unrecognized hypothyroidism than history and physical examination (strength of recommendation [SOR]: A, based on cohort studies). Women with an initial ... -
How should we treat chronic daily headache when conservative measures fail?
(Family Physicians Inquiries Network, 2004)For the purposes of this review, we considered conservative measures to include such therapies as nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy, and acetaminophen with codeine. Amitriptyline is the ... -
Do ACE inhibitors decrease mortality in patients with hypertension?
(Family Physicians Inquiries Network, 2004)When used to treat patients with hypertension, ACE inhibitors reduce cardiovascular and all-cause mortality as effectively as diuretics, beta blockers, and calcium channel blockers. [Strength of recommendation: A, based ... -
Which Patients with Atrial Fibrillation Do Not Need Anticoagulation Therapy with Warfarin?
(Family Physicians Inquiries Network, 2004)Anticoagulation therapy with warfarin is not indicated for use in patients with non- valvular atrial fibrillation who are at low risk for embolic cerebral vascular events. The classification of "low risk for embolic stroke" ... -
Which Antidepressant Is Best to Avoid Sexual Dysfunction?
(Family Physicians Inquiries Network, 2004)Bupropion (Wellbutrin), nefazodone (Serzone), amitriptyline (Elavil), and moclobemide (Manerix, a reversible inhibitor of monoamine oxidase type A not available in the United States) have been shown to cause less sexual ... -
Antidepressant Medications in Pregnancy
(Family Physicians Inquiries Network, 2004)Selective serotonin reuptake inhibitors (SSRIs) are considered first-line agents for the treatment of depression in pregnant women. SSRIs and tricyclic antidepressants (TCAs) are considered safe and effective in pregnant ... -
What Is the Best Antiviral Agent for Influenza Infection?
(Family Physicians Inquiries Network, 2004)Four antiviral agents have been approved by the U.S. Food and Drug Administration for the treatment of influenza infection: amantadine (Symmetrel), oseltamivir (Tamiflu), rimantadine (Flumadine), and zanamivir (Relenza). ... -
What Clinical Findings Can Be Used to Diagnose Deep Venous Thrombosis?
(Family Physicians Inquiries Network, 2004)No single clinical finding can accurately diagnose DVT. [Strength of recommendation: A, based on a systematic review of homogeneous validating cohort studies with good reference standards.] However, when organized into ... -
Screening Mammography in Women 40 to 49 Years of Age
(Family Physicians Inquiries Network, 2004)While there is strong agreement among experts and evidence in the literature to recommend that women 50 to 69 years of age undergo screening with mammography for breast cancer, the question of screening women 40 to 49 years ... -
Does Screening for Tuberculosis in Children Decrease Morbidity or Mortality?
(Family Physicians Inquiries Network, 2004)Routine screening of low-risk children for tuberculosis infection before entering kindergarten is not necessary. [Strength of recommendation: C] Targeted screening of high-risk children for tuberculosis infection using the ... -
Does Lidocaine-Prilocaine Cream (EMLA) Decrease the Pain of Neonatal Circumcision?
(Family Physicians Inquiries Network, 2004)EMLA cream reduces the pain experienced by newborns during circumcision compared with placebo. [Strength of recommendation: A, based on a systematic review of randomized controlled trials (RCTs)]. However, dorsal penile ... -
Does a Low-Sodium Diet Reduce Blood Pressure?
(Family Physicians Inquiries Network, 2004)Reducing sodium intake does lead to a slightly lower average blood pressure. However, no evidence from controlled trials proves that reducing sodium intake decreases morbidity or mortality, or proves that modest sodium ... -
Do vitamin C supplements reduce mortality in patients with cardiovascular disease?
(Family Physicians Inquiries Network, 2004)Vitamin C, when taken as a dietary supplement, does not appear to reduce mortality in patients with cardiovascular disease. [Strength of recommendation: B, based on reviews of cohort studies and a single randomized controlled ... -
Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid Arthritis?
(Family Physicians Inquiries Network, 2004)The efficacy of COX-2 inhibitors is similar to that of nonselective NSAIDs in reducing the symptoms of rheumatoid arthritis. [Strength of Recommendation: A] -
Which healthy adults should take aspirin?
(Family Physicians Inquiries Network, 2004)In adults with no history of cardiovascular disease, aspirin reduces the risk of nonfatal myocardial infarction (MI). Aspirin prophylaxis does not decrease all-cause mortality, risk of fatal coronary heart disease, or risk ... -
Which blood tests are most helpful in evaluating pelvic inflammatory disease?
(Family Physicians Inquiries Network, 2004)No individual or combination of blood tests can reliably diagnose pelvic inflammatory disease (PID)(strength of recommendation [SOR]: A, metaanalysis). The combination of white blood cell count, C-reactive protein (CRP), ... -
When should we treat isolated high triglycerides?
(Family Physicians Inquiries Network, 2004)No evidence exists that treating isolated high triglyceride levels in the absence of other risk factors prevents coronary events. Although elevated triglycerides in some studies correlates with coronary events, the association ... -
When should patients with stroke receive thrombolytics?
(Family Physicians Inquiries Network, 2004)Thrombolytic therapy should be limited to patients with acute ischemic stroke who meet strict inclusion and exclusion criteria and who can adhere to strict treatment protocol. Patients treated under these conditions have ... -
When should patients with mitral valve prolapse get endocarditis prophylaxis?
(Family Physicians Inquiries Network, 2004)Patients with suspected mitral valve prolapse (MVP)should undergo echocardiography before any procedure that may place them at risk for bacteremia. Patients with MVP and documented absence of mitral regurgitation or valvular ...