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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 ...
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 ...
Glucosamine and Chondroitin for Osteoarthritis
(Family Physicians Inquiries Network, 2006)
Glucosamine reduces pain and improves function in patients with knee or hip osteoarthritis. (Strength of recommendation: B, based on systematic reviews and a meta-analysis) Glucosamine may be beneficial in other forms of ...
What dietary modifications are indicated for migraines?
(Family Physicians Inquiries Network, 2006)
Migraine frequency, duration, and severity are not increased by dietary choices (strength of recommendation [SOR]: A, individual randomized trial [RCT]); they can be decreased by a low-fat diet (SOR: B). Regular supplementation ...
What are effective medication combinations for dyslipidemia?
(Family Physicians Inquiries Network, 2006)
Many combination drug therapies are effective in treating dyslipidemia. Compared with statin monotherapy, combinations that include ezetimibe (Zetia), a bile acid sequestrant, or niacin further lower low- density lipoprotein ...
What is the dietary treatment for low HDL cholesterol?
(Family Physicians Inquiries Network, 2006)
Low-carbohydrate diets raise high-density lipoprotein (HDL) cholesterol levels by approximately 10%; soy protein with isoflavones raises HDL by 3% (strength of recommendation [SOR]: C, based on meta-analysis of physiologic ...
What blood tests help diagnose celiac disease?
(Family Physicians Inquiries Network, 2006)
Histological confirmation of infiltrative lesions via small bowel biopsy is the gold standard for diagnosing celiac disease. Four serum antibody assays may serve as a first- step diagnostic tool to identify biopsy candidates: ...
What best prevents exercise-induced bronchoconstriction for a child with asthma?
(Family Physicians Inquiries Network, 2006)
Inhaled short-acting beta-agonists (SABAs) are most effective in preventing exercise-induced bronchoconstriction, followed by inhaled mast cell stabilizers and anticholinergic agents (strength of recommendation [SOR]: A, ...
What are contraindications to IUDs?
(Family Physicians Inquiries Network, 2006)
Based on limited evidence, use of intrauterine devices (IUDs) is not contraindicated for women with HIV/AIDS (strength of recommendation [SOR]: C), multiple sexual partners (SOR: C), previous actinomyces colonization (SOR: ...
What causes a low TSH level with a normal free T4 level?
(Family Physicians Inquiries Network, 2006)
Subclinical hyperthyroidism (SCH) is defined as a low thyroid-stimulating hormone (TSH) level with normal free T4 and free T3 levels in patients without specific symptoms of hyperthyroidism. There is no evidence that ...
What is the best duration of steroid therapy for contact dermatitis (rhus)?
(Family Physicians Inquiries Network, 2006)
Scant evidence exists for the best duration of steroid therapy for contact dermatitis due to plants (rhus). Review articles recommend 10 to 21 days of treatment with topical or oral corticosteroids for moderate to severe ...
What is the role of combination therapy (insulin plus oral medication) in type 2 diabetes?
(Family Physicians Inquiries Network, 2006)
Combination therapy using insulin plus metformin (Glucophage), a sulfonylurea, or both produces glycemic control comparable with using insulin alone, but there is less weight gain when metformin is used (strength of ...
What are the risks to the fetus associated with diagnostic radiation exposure during pregnancy?
(Family Physicians Inquiries Network, 2006)
There is no evidence of significant risk to the developing fetus from any single diagnostic x-ray exposure (strength of recommendation: C, based on non-homogenous case-control studies). No studies were found on fetal ...
What are the risks and benefits of elective induction for uncomplicated term pregnancies?
(Family Physicians Inquiries Network, 2006)
Elective induction of labor for term, singleton, uncomplicated pregnancies appears safe for both the mother and infant (strength of recommendation [SOR]: B). The benefit of elective induction for nonmedical reasons is ...
What is the best management for patients who have a TIA while on aspirin therapy?
(Family Physicians Inquiries Network, 2006)
Alternative antiplatelet therapy for stroke prevention is indicated for patients who experience transient ischemic attacks (TIAs) while on aspirin therapy (strength of recommendation [SOR]: A, based on 1 meta- analysis and ...