Clinical Inquiries, 2009: Recent submissions

Now showing items 21-40 of 51

  • What measures relieve postherpetic neuralgia? 

    Garroway, Neil; Chhabra, Shalini; Landis, Suzanne E.; Skolnik, Deborah C. (Family Physicians Inquiries Network, 2009)
    Tricyclic antidepressants, gabapentin, and pregabalin effectively reduce pain (strength of recommendation [SOR]: A, at least 2 good-quality randomized controlled trials [RCTs] and/or meta-analyses). Opioids have demonstrated ...

  • What is the best diagnostic approach to alopecia in women? 

    Rulon, Elizabeth; Safranek, Sarah (Family Physicians Inquiries Network, 2009)
    Indirect evidence and expert opinion indicate that a careful history and thorough physical examination usually suggest the underlying cause of alopecia. Ancillary laboratory evaluation and scalp biopsy are sometimes necessary ...

  • Treatment of Otitis Media with Perforated Tympanic Membrane 

    Wright, Derek; Safranek, Sarah (Family Physicians Inquiries Network, 2009)
    Acute otitis media with tympanic membrane perforation in children should be treated with an oral antibiotic. (Strength of Recommendation [SOR]: A, based on meta- analysis of randomized controlled trials [RCTs]). Topical ...

  • Sleep apnea in adults: How accurate is clinical prediction? 

    Jacobs, Christine K.; Coffey, John B. (Family Physicians Inquiries Network, 2009)
    Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of ...

  • Should you use antibiotics to treat acute otitis media in children? 

    Gamboa, Stephen; Park, Michael K.; Wanserski, Gerri R. (Family Physicians Inquiries Network, 2009)
    Antibiotics are not necessary to treat uncomplicated acute otitis media (AOM) in an otherwise healthy child (strength of recommendation [SOR]: A, systematic review). Children younger than 2 years and children with bilateral ...

  • Menstrual disturbances in perimenopausal women: What's best? 

    Chen, Edward C.; Danis, Peter G.; Tweed, Elizabeth M. (Family Physicians Inquiries Network, 2009)
    It's best to start with nonsteroidal anti- inflammatory drugs (NSAIDs), which effectively reduce heavy menstrual bleeding (strength of recommendation [SOR]: B, systematic review of randomized clinical trials [RCTs]). ...

  • How useful is a physical exam in diagnosing testicular torsion? 

    Schmitz, David; Safranek, Sarah (Family Physicians Inquiries Network, 2009)
    Physical exam is useful, but imperfect, in ruling out testicular torsion (strength of recommendation [SOR]: C, expert opinion). The cremasteric reflex or a nontender testicle usually excludes testicular torsion, but case ...

  • How should you treat trochanteric bursitis? 

    Rowand, Mark; Chambliss, M. Lee; Mackler, Leslie (Family Physicians Inquiries Network, 2009)
    Conservative measures--followed by corticosteroid injection, if necessary--are best. Conservative therapy includes rest, nonsteroidal anti-inflammatory drugs (NSAIDs), and stretching exercises focused on the lower back and ...

  • How can you help prevent a recurrence of diverticulitis? 

    Weisberger, Lise; Jamieson, Barbara (Family Physicians Inquiries Network, 2009)
    A high-fiber diet is often prescribed after recovery from acute diverticulitis, based on extrapolation from epidemiologic data showing an association between low-fiber diets and diverticulosis (strength of recommendation ...

  • How often should you follow up on a patient with newly diagnosed hypothyroidism? 

    Wirsing, Nellie; Hamilton, Andrew (Family Physicians Inquiries Network, 2009)
    Six to 8 weeks after the start of levothyroxine therapy you should reexamine patients and measure their serum thyroid-stimulating hormone (TSH) (strength of recommendation [SOR]: C, common practice and expert opinion). If ...

  • How should you manage an overweight breastfed infant? 

    Osayande, Amimi; Watson, Ricky; Kolasa, Kathryn; Blevins, Amy (Family Physicians Inquiries Network, 2009)
    Monitor the growth of exclusively breastfed babies by plotting routine weights and lengths on the World Health Organization (WHO) growth curve (strength of recommendation [SOR]: A, systematic reviews). Reassure parents ...

  • How best to manage the patient in term labor whose group B strep status is unknown? 

    Brooke, Shannon; Whitworth, James D.; Calabretta, Nancy (Family Physicians Inquiries Network, 2009)
    Monitor the patient and treat her with intrapartum chemoprophylaxis based on identified risk factors, unless a rapid, highly sensitive (greater than or equal to 85%) polymerase chain reaction (PCR) test is immediately ...

  • How should you evaluate an asymptomatic patient with a femoral or iliac artery bruit? 

    Walker, Katherine M.; Messick, Brent H.; Kaufman, Leonora (Family Physicians Inquiries Network, 2009)
    Perform an ankle-arm index (AAI, or ankle- brachial index) test to evaluate for peripheral artery disease (PAD) (strength of recommendation [SOR]: B, cohort studies). If the test detects PAD, recommend steps to modify ...

  • Which treatments are effective for cervical radiculopathy? 

    Brown, Sara; Guthmann, Richard A.; Hitchcock, Kristin (Family Physicians Inquiries Network, 2009)
    Initial treatment options comprise rest, cervical immobilization, anti-inflammatory drugs (nonsteroidal and steroidal), pain relievers (including muscle relaxants and antiepileptics), and physical therapy (strength of ...

  • Which treatments work best for hemorrhoids? 

    Mounsey, Anne L.; Henry, Susan L. (Family Physicians Inquiries Network, 2009)
    Excision is the most effective treatment for thrombosed external hemorrhoids (strength of recommendation [SOR]: B, retrospective studies). For prolapsed internal hemorrhoids, the best definitive treatment is traditional ...

  • Which factors increase the risk of an infant becoming an overweight child? 

    Rowland, Kathleen; Wallace, Rick (Family Physicians Inquiries Network, 2009)
    Variables that increase the risk of overweight in childhood include formula feeding, high birth weight, high rate of weight gain in the first 4 months of life, low socioeconomic status, and maternal obesity (strength of ...

  • Which complementary therapies can help patients with PMS? 

    Labruzzo, Brice A.; Chasuk, Robert; Kendall, Susan K. (Family Physicians Inquiries Network, 2009)
    Chasteberry tree and calcium have demonstrated efficacy and safety in treating symptoms of premenstrual syndrome (PMS) (strength of recommendation [SOR]: A, randomized controlled trials [RCTs]). Pyridoxine and saffron may ...

  • Hip Pain in Preschool-Age Children 

    Bhargava, Sital; Jamieson, Barbara (Family Physicians Inquiries Network, 2009)
    Evidence is lacking on the most common causes of hip pain in children because most data come from cohort studies and include referred patients. Based on these studies, transient synovitis is the most common cause of hip ...

  • Effective Management of Flatulence 

    Bailey, Justin; Carter, Nakia Joyce (Family Physicians Inquiries Network, 2009)
    Probiotics and rifaximin (Xifaxan) have been shown to reduce total number of flatus episodes and associated discomfort. (Strength of Recommendation [SOR]: B, based on small randomized controlled trials [RCTs]). Oral ...

  • Do patients at high risk of Alzheimer's disease benefit from early treatment? 

    Holt, James; Stiltner, Lynetta; Wallace, Rick (Family Physicians Inquiries Network, 2009)
    Treating patients with early-stage Alzheimer's disease yields statistically significant, though perhaps not clinically significant, improvement in cognition and global function (strength of recommendation [SOR]: A, consistent ...