• ACE inhibitors and ARBs: One or the other—not both—for high-risk patients 

    Misra, Shamita; Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2009-01)
    Avoid prescribing an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin receptor blocker (ARB) for patients at high risk of vascular events or renal dysfunction. The combination does not reduce poor outcomes, ...
  • Acute gout: Oral steroids work as well as NSAIDs 

    Prasad, Shailendra; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2008-10)
    Use a short course of oral steroids (prednisone 30-40mg/d for 5 days) for treatment of acute gout when nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated. Steroids are also a reasonable choice as first-line ...
  • Another option for patients with liver disease 

    Sharma, Umang; Ewigman, Bernard (Family Physicians Inquiries Network, 2010-09)
    Consider prescribing rifaximin for patients with hepatic encephalopathy, not only as a treatment for acute episodes but also to prevent a recurrence. Strength of recommendation: A: Based on a high-quality randomized ...
  • Antidepressants causing sexual problems? Give her Viagra 

    Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2008-12)
    Tell women for whom you prescribe selective and nonselective serotonin reuptake inhibitors (SRIs) to let you know if they develop sexual dysfunction. Offer sildenafi (50 mg with the option to increase to 100 mg) to ...
  • Arthroscopic surgery for knee osteoarthritis? Just say no 

    Mounsey, Anne L.; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2009-03)
    Do not recommend arthroscopic surgery to adults with osteoarthritis of the knee. Treat knee pain with medical and physical therapy instead. Strength of recommendation A: Based on 2 high-quality randomized controlled trials.
  • Azithromycin for PID beats doxycycline on all counts 

    Rowland, Kate; Ewigman, Bernard (Family Physicians Inquiries Network, 2007-12)
    Outpatient treatment of patients with mild pelvic inflammatory disease, using 1g of azithromycin weekly for 2 weeks, combined with 250mg of ceftriaxone intramuscularly on the first day, is superior to the current recommended ...
  • Can metformin undo weight gain induced by antipsychotics? 

    Schumann, Sarah-Anne; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2008-08)
    Recommend metformin 250mg 3 times a day, along with lifestyle modifications, to promote weight loss and decrease insulin resistance in patients who gain more than 10% of their pretreatment body weigh on antipsychotic ...
  • Double-dose vitamin D lowers cancer risk in women over 55 

    Schumann, Sarah-Anne; Ewigman, Bernard (Family Physicians Inquiries Network, 2007-11)
    Increasing the dose of vitamin D3 from the current standard of 400-600 IU per day to 1000 IU per day lowers future risk of cancer in women older than age 55 who do not get adequate vitamin D from sun exposure or diet. ...
  • Drugs help pass more ureteral stones 

    Stevermer, James J.; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2008-04)
    Prescribe tamsulosin (typically 0.4 mg daily) or nifedipine (typically 30 mg daily) for patients with lower ureteral calculi, to speed stone passage and to avoid surgical intervention. Strength of recommendation A: ...
  • Dust mite control measures don't help asthma patients 

    Schumann, Sarah-Anne; Hickner, John; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-12)
    Stop recommending dust mite control measures to your asthma patients. Neither chemical nor physical reduction measures are effective in improving peak flow, symptoms of asthma, or medication usage. Strength of recommendation ...
  • For Bell's palsy, start steroids early; no need for an antiviral 

    Vargish, Lisa; Schumann, Sarah-Anne; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-01)
    A 10-day course of corticosteroids (prednisolone 25 mg twice daily) started within 72 hours significantly improves the chances of complete recovery. There is no added benefit from acyclovir. Strength of recommendation A: ...
  • Give vitamin C to avert lingering pain after fracture 

    Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-02)
    Vitamin C 500 mg daily for 50 days reduced the risk of complex regional pain syndrome for patients with a wrist fracture. We think vitamin C 500 mg a day for 7 weeks is well worth recommending. Strength of recommendation ...
  • Glucose self-monitoring: Think twice for type 2 patients 

    Mendoza, Michael D.; Hickner, John; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-11)
    Stop routinely recommending blood glucose self-monitoring for patients with newly diagnosed type 2 diabetes. Self-monitoring does not improve glycemic control for patients who are not taking insulin, and it increases the ...
  • Help for recurrent bacterial vaginosis 

    Jones, Kohar; Ewigman, Bernard; Stevermer, James J. (Family Physicians Inquiries Network, 2011-02)
    Recommend high-dose vaginal probiotic capsules to prevent recurrent bacterial vaginosis. Strength of recommendation B: Based on a single high-quality randomized controlled trial (RCT).
  • Is it DVT? Wells score and D-dimer may avert costly workup 

    Schumann, Sarah-Anne; Ewigman, Bernard (Family Physicians Inquiries Network, 2007-12)
    Use a combination of Wells score and D-dimer test to exclude deep vein thrombosis in low- to intermediate-risk outpatients with suggestive symptoms. Strength of recommendation (SOR) A: B ased on one good meta-analysis.
  • Let them eat nuts—this snack is safe for diverticulosis patients 

    Prasad, Shailendra; Ewigman, Bernard; Hickner, John (Family Physicians Inquiries Network, 2009-02)
    Tell patients with diverticular disease that they can eat nuts, corn, and popcorn without fear. There is no truth to the long-held belief that these foods increase the risk of complications. Strength of recommendation B: ...
  • Migraine treatment “tweak” could reduce office visits 

    Wells, Jack; Stevermer, James J.; Ewigman, Bernard (Family Physicians Inquiries Network, 2009-07)
    Add dexamethasone to the standard treatment of moderate to severe migraine headache; a single dose (8-24 mg) may prevent short-term recurrence, resulting in less need for medication and fewer repeat visits to the office ...
  • Patients insist on antibiotics for sinusitis? Here is a good reason to say “no” 

    Schumann, Sarah-Anne; Hickner, John; Ewigman, Bernard (Family Physicians Inquiries Network, 2008-07)
    Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms Antibiotics have little if any positive effects on the severity and duration of symptoms, and ...
  • Saline irrigation spells relief for sinusitis sufferers 

    Egan, Mari E.; Hickner, John; Ewigman, Bernard (Family Physicians Inquiries Network, 2009-01)
    Recommend nasal irrigation to patients with chronic rhinosinusitis. Large-volume, low- pressure saline irrigation decreases the severity and frequency of symptoms. Strength of recommendation B: Single well-done randomized ...
  • Stroke prevention: Age alone does not rule out warfarin 

    Schumann, Sarah-Anne; Ewigman, Bernard (Family Physicians Inquiries Network, 2007-11)
    Warfarin is as safe as aspirin and more effective for stroke prevention in elders with atrial fibrillation. Strength of recommendation (SOR) A: Well-designed randomized controlled trial of elderly patients in the primary ...