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This antiemetic may help kids skip that trip to the hospital
(Family Physicians Inquiries Network, 2009)
Give oral ondansetron to children with acute gastroenteritis and moderate dehydration who are unable to tolerate oral rehydration to reduce the vomiting and avoid the need for intravenous (IV) hydration or hospitalization. ...
Annual zoledronic acid infusion lowers risk of fracture, death
(Family Physicians Inquiries Network, 2007)
Patients with a prior hip fracture have 2.5 times the risk of a new fracture compared to age-matched persons without a previous hip fracture. For patients with a recent hip fracture, intravenous zoledronic acid annually ...
Glucose control: How low should you go with the critically ill?
(Family Physicians Inquiries Network, 2009)
For hyperglycemic patients admitted to an intensive care unit (ICU), the target blood glucose level should be [less than or equal to] 180 mg/dL, not 81 to 108 mg/dL. More aggressive glucose lowering is associated with a ...
Ovary-sparing hysterectomy: Is it right for your patient?
(Family Physicians Inquiries Network, 2009)
Advise patients undergoing hysterectomy for benign conditions that there are benefits to conserving their ovaries. The risk of coronary heart disease (CHD) and death is lower in women whose ovaries are conserved, compared ...
Bisphosphonate therapy: When not to monitor BMD
(Family Physicians Inquiries Network, 2009)
After starting patients on bisphosphonates for osteoporosis, wait at least 3 years before ordering a repeat dual-energy x-ray absorptiometry (DXA) scan. Stength of recommendation: C: Based on a secondary analysis of a large ...
Vertebroplasty for osteoporotic fracture? Think twice
(Family Physicians Inquiries Network, 2009)
Think twice before recommending vertebroplasty (VP) for symptomatic osteoporotic compression fractures. New studies suggest that it has little benefit; thus, VP should be considered only after other, more conservative ...
PT or cervical collar for cervical radiculopathy?
(Family Physicians Inquiries Network, 2010)
To shorten recovery time for adults with acute cervical radiculopathy, recommend either physical therapy (PT) and a home exercise plan or a cervical collar and rest. Both are more effective than a wait-and-see strategy. ...
Treat depressed teens with medication and psychotherapy
(Family Physicians Inquiries Network, 2008)
Refer adolescents with moderate to severe depression for cognitive behavioral therapy (CBT) to improve their outcomes. Stength of recommendation: B: Two well-done randomized controlled trials (RCTs).
Antidepressants causing sexual problems? Give her Viagra
(Family Physicians Inquiries Network, 2008)
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 ...
Can metformin undo weight gain induced by antipsychotics?
(Family Physicians Inquiries Network, 2008)
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 ...
Glucose self-monitoring: Think twice for type 2 patients
(Family Physicians Inquiries Network, 2008)
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 ...
Saline irrigation spells relief for sinusitis sufferers
(Family Physicians Inquiries Network, 2009)
Recommend nasal irrigation to patients with chronic rhinosinusitis. Large-volume, low- pressure saline irrigation decreases the severity and frequency of symptoms. Stength of recommendation: B: Single well-done randomized ...
Acute gout: Oral steroids work as well as NSAIDs
(Family Physicians Inquiries Network, 2008)
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 ...
Help smokers quit: Tell them their "lung age"
(Family Physicians Inquiries Network, 2008)
Perform spirometry on patients who smoke -- even if they're asymptomatic -- and show them their lung age that is, the average age of a nonsmoker with a forced expiratory volume at 1 second (FEV1) equal to theirs. Doing so ...
Colicky baby? Here's a surprising remedy
(Family Physicians Inquiries Network, 2011)
This article suggests that parents of colicky breastfed infants try probiotics (Lactobacillus reuteri), which can significantly reduce daily crying time with no adverse effects. Stength of recommendation: A: A good-quality ...
Double-dose vitamin D lowers cancer risk in women over 55
(Family Physicians Inquiries Network, 2007)
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. ...
Stroke prevention: Age alone does not rule out warfarin
(Family Physicians Inquiries Network, 2007)
Warfarin is as safe as aspirin and more effective for stroke prevention in elders with atrial fibrillation. Stength of recommendation (SOR) A: Well-designed randomized controlled trial of elderly patients in the primary ...
When not to use beta-blockers in seniors with hypertension
(Family Physicians Inquiries Network, 2008)
Beta-blockers should not be used to treat hypertension in patients older than age 60 unless they have another compelling indication to use these agents, such as heart failure or ischemic heart disease. Stength of recommendation: ...
Azithromycin for PID beats doxycycline on all counts
(Family Physicians Inquiries Network, 2007)
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 ...
Is it DVT? Wells score and D-dimer may avert costly workup
(Family Physicians Inquiries Network, 2007)
Use a combination of Wells score and D-dimer test to exclude deep vein thrombosis in low- to intermediate-risk outpatients with suggestive symptoms. Stength of recommendation (SOR) A: B ased on one good meta-analysis.