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Which drugs are most effective for moderate to severe depression in adolescents?
(Family Physicians Inquiries Network, 2008)
Fluoxetine is the only selective serotonin-reuptake inhibitor (SSRI) approved by the US Food and Drug Administration (FDA) to treat depression in children 8 years of age and older; it also has the most favorable benefit-to-risk ...
Which drugs are safest for moderate to severe depression in adolescents?
(Family Physicians Inquiries Network, 2008)
Selective serotonin-reuptake inhibitors (SSRIs) appear to be the safest, given current data. Major safety concerns--prompting a US Food and Drug administration (FDA) black box label warning--have been raised about increased ...
Which patients undergoing noncardiac surgery benefit from perioperative beta-blockers?
(Family Physicians Inquiries Network, 2008)
Patients with moderate to high cardiac risk (a Revised Cardiac Risk Index [RCRI] score of 2 or higher [Table]) have a reduced risk of in-hospital death following perioperative beta-blocker therapy (strength of recommendation ...
Which lab tests are best when you suspect hypothyroidism?
(Family Physicians Inquiries Network, 2008)
Thyroid-stimulating hormone (TSH) level is the preferred test for initial evaluation of suspected primary hypothyroidism (strength of recommendation [SOR]: C, expert opinion). If TSH is abnormal, a free thyroxine (T4) level ...
Which clinical features and lab findings increase the likelihood of temporal arteritis?
(Family Physicians Inquiries Network, 2008)
Jaw claudication, diplopia, or a temporal artery abnormality on physical exam increase the likelihood of temporal arteritis. A finding of thrombocytosis in a patient with suspected temporal arteritis moderately increases ...
What's the best drug treatment for premature ejaculation?
(Family Physicians Inquiries Network, 2008)
Antidepressants--specifically clomipramine, fluoxetine, paroxetine, and sertraline--are best and have been shown to improve symptoms of premature ejaculation (strength of recommendation [SOR]: A, meta-analysis of randomized ...
How do you evaluate macrocytosis without anemia?
(Family Physicians Inquiries Network, 2008)
Start with a detailed history, paying particular attention to medications and alcohol use (strength of recommendation [SOR]: B, prospective cohort studies). Blood testing can include a peripheral smear, evaluation for ...
How much does smoking cessation cut CHD risk?
(Family Physicians Inquiries Network, 2008)
Patients with coronary heart disease (CHD) who refrain from smoking over a 2-year follow-up period decrease their relative risk (RR) for morbidity and mortality by about one third (strength of recommendation [SOR]: A, ...
What are the most effective nonpharmacologic therapies for irritable bowel syndrome?
(Family Physicians Inquiries Network, 2008)
Herbal formulations, certain probiotics, elimination diets based on immunoglobulin G (IgG) antibodies, cognitive behavioral therapy, and self-help books have been shown to decrease global symptoms of irritable bowel syndrome ...
Is there much risk in using fluoroquinolones in children?
(Family Physicians Inquiries Network, 2008)
Arthralgias and myalgias have been observed clinically in children and adolescents exposed to fluoroquinolones, but they're transient, disappear when the drug is discontinued, and appear to be no more prevalent than with ...
Medical Treatment of Benign Prostatic Hyperplasia
(Family Physicians Inquiries Network, 2008)
Although alpha blockers and 5-alpha reductase inhibitors each reduce BPH symptoms more than placebo (Strength of Recommendation [SOR]: A), alpha blockers are more effective than 5-alpha reductase inhibitors. (SOR: B). ...
Medications for Insomnia Treatment in Children
(Family Physicians Inquiries Network, 2008)
Melatonin may be effective for treating insomnia in healthy children and in those with physical or learning disabilities (Strength of Recommendation [SOR]: B). Short-term use of melatonin is safe in children, but there is ...
Is osteopathic manipulation effective for headaches?
(Family Physicians Inquiries Network, 2008)
Spinal manipulative therapy (SMT), a component of osteopathy, has been shown to be variably effective for the treatment of headaches. For the prophylactic treatment of cervicogenic headaches and for acute tension headaches, ...
Prophylactic oxytocin: Before or after placental delivery?
(Family Physicians Inquiries Network, 2008)
Timing alone doesn't influence the drug's efficacy in preventing postpartum bleeding (strength of recommendation: B, randomized controlled trial [RCT] and prospective cohort studies).
Effect of Antiepileptic Drugs on Oral Contraceptives
(Family Physicians Inquiries Network, 2008)
We found no studies that measure, or even estimate, any increase in pregnancy rates in women taking antiepileptic drugs. Antiepileptic drugs known to induce the hepatic cytochrome P450 (CYP450) isoenzyme cause decreased ...
Do any folk remedies or herbals help induce labor?
(Family Physicians Inquiries Network, 2008)
Breast stimulation and electroacupuncture help, while other common remedies that have been studied are ineffective, possibly unsafe, or both. Unilateral breast stimulation shortens the time until the onset of labor in women ...
Does case management improve diabetes outcomes?
(Family Physicians Inquiries Network, 2008)
Patients with type 2 diabetes benefit from case management, as evidenced by decreased glycated hemoglobin (HbA1c). The improvement in HbA1c appeared larger when case managers could make changes in medications independently ...
Quality of Life in Older Persons with Dementia Living in Nursing Homes
(Family Physicians Inquiries Network, 2008)
There is no "gold standard" to measure the QOL in older persons with dementia. For those requiring increased care, nursing homes may offer some benefit, including more frequent physician assessment and treatment of pain ...
Leukotriene Receptor Antagonists for the Treatment of Allergic Skin Disorders
(Family Physicians Inquiries Network, 2008)
Evidence from small trials suggests that leukotriene receptor antagonists may have short-term effectiveness in reducing sleep disturbance and the observed intensity of atopic dermatitis in adults and children. (Strength ...
Does screening reduce lung cancer mortality?
(Family Physicians Inquiries Network, 2008)
Neither routine chest x-ray (with or without sputum cytology) nor low-dose computed tomography (CT) have been proven to reduce mortality when used for lung cancer screening, although low-dose CT screening does identify ...