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What could be behind your elderly patient's subjective memory complaints?
(Family Physicians Inquiries Network, 2008)
Depression, anxiety, and dementia, as well as older age, female gender, lower education level, and decreased physical activity, have all been associated with memory loss reported by patients or family members (strength of ...
What is the best test for peripheral vascular disease?
(Family Physicians Inquiries Network, 2008)
An ankle-brachial index is best for evaluating patients with symptoms of claudication (strength of recommendation [SOR]: B, multiple cohort studies). That said, duplex ultrasonography or magnetic resonance angiography may ...
What is the clinical workup for failure to thrive?
(Family Physicians Inquiries Network, 2008)
The clinical evaluation of failure to thrive (FTT) includes a thorough history and physical examination; observation of parent-child interactions; observation and documentation of the child's feeding patterns; and a home ...
What are the causes of elevated TSH in a newborn?
(Family Physicians Inquiries Network, 2008)
Congenital hypothyroidism is a critical cause of elevated thyroid-stimulating hormone (TSH) in newborns; evaluate all neonates with an elevated TSH for congenital hypothyroidism (strength of recommendation [SOR]: A). Other ...
Is there a well-tested tool to detect drug-seeking behaviors in chronic pain patients?
(Family Physicians Inquiries Network, 2008)
There is no well-tested, easily administered screening tool to detect drug-seeking behaviors in primary care patients taking long-term opioids or being considered for such therapy (strength of recommendation [SOR]: C, ...
What is the differential diagnosis of chronic leg edema in primary care?
(Family Physicians Inquiries Network, 2008)
The differential diagnosis, in descending order, includes: elevated pulmonary artery pressure (often due to obstructive sleep apnea), congestive heart failure, idiopathic causes, venous insufficiency, use of nonsteroidal ...
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 ...
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 ...
Should you treat carriers of pharyngeal group A strep?
(Family Physicians Inquiries Network, 2008)
The jury is out as to whether you should treat asymptomatic carriers of group A streptococci (GAS), because no studies specifically address the issue. In addition, many patients are unlikely to care about their carrier ...
Should you use steroids to treat infectious mononucleosis?
(Family Physicians Inquiries Network, 2008)
Studies of steroids to treat infectious mononucleosis have found no significant effect on the clinical course of the illness at 1 to 3 months (strength of recommendation [SOR]: B, 1 randomized controlled trial [RCT] and 1 ...
Should you evaluate for CAD in seniors with premature ventricular contractions?
(Family Physicians Inquiries Network, 2008)
Current guidelines suggest evaluating patients with premature ventricular contractions (PVCs) and associated risk factors for underlying coronary artery disease (strength of recommendation [SOR]: C, expert opinion).
What drugs are best for bipolar depression?
(Family Physicians Inquiries Network, 2008)
Antidepressants, including tricyclics and selective serotonin reuptake inhibitors (SSRIs), are useful adjuncts in short-term treatment of bipolar depression and have low rates of inducing mania (strength of recommendation ...
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 ...
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 ...
Differential Diagnosis of Tremor
(Family Physicians Inquiries Network, 2008)
The most common tremor in primary care is an exaggerated physiologic tremor, followed by essential tremor and tremors caused by Parkinson's disease. (Strength of Recommendation [SOR]: C, based on extrapolation from a ...
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 ...
Does birth weight predict childhood obesity?
(Family Physicians Inquiries Network, 2008)
A birth weight greater than 4,000 g is associated with an increased risk of obesity in both childhood and adolescence (strength of recommendation [SOR]: B, systematic review and multiple cohort studies).
Does antepartum perineal massage reduce intrapartum lacerations?
(Family Physicians Inquiries Network, 2008)
Yes--to a point. Antepartum perineal massage reduces both the incidence of perineal trauma requiring suturing and the likelihood of episiotomy in women who have never given birth vaginally. It reduces the incidence of ...
How much can exercise raise creatine kinase level-- and does it matter?
(Family Physicians Inquiries Network, 2008)
Moderate-intensity exercise (maintaining heart rate between 55% and 90% of maximum) may elevate creatine kinase (CK) to levels that meet the diagnostic criteria for rhabdomyolysis if the exercises involve eccentric muscle ...