Recent Submissions

  • What is the safest antidepressant medication for use in pregnancy? 

    Miller, Tim; Kraus, Connie (Family Physicians Inquiries Network, 2011-12)
    In treating pregnant patients with depression, no single agent stands out as offering a clear safety advantage over another. The most consistently noted morbidity with maternal antidepressant use is preterm birth. Paroxetine ...
  • Intramuscular vs intravenous oxytocin for active management of the third stage of labor 

    Dresang, Lee T. (Family Physicians Inquiries Network, 2011-12)
    There are no RCTs or other quality evidence to recommend either intramuscular (IM) or intravenous (IV) oxytocin over the other for management of the third stage of labor. Professional bodies recommend both routes of ...
  • Interventions for heart failure 

    Glickman, Michael; Rodríguez, José E. (Family Physicians Inquiries Network, 2011-12)
    The following interventions improve important outcomes in patients with systolic heart failure (all SORs: A, based on meta-analyses): • Angiotensin converting enzyme (ACE) inhibitors reduce mortality, repeat myocardial ...
  • What impact does hCG therapy have on patients with obesity? 

    Lateef, Humaira (Family Physicians Inquiries Network, 2011-12)
    Human chorionic gonadotropin (hCG) does not cause weight loss, reduce hunger, redistribute fat from the abdomen and hips, or create a feeling of well-being without weakness. (SOR: A, based on a meta-analysis.)
  • First Jeopardy, then the world! 

    Neher, Jon O. (Family Physicians Inquiries Network, 2011-12)
    This letter from the editor of Evidence Based Practice speculates on the usefulness of a computerized diagnostician.
  • eMedRef (December 2011) 

    Fashner, Julia; Bell, Amanda; Cadwallader, Kara; Labatia, Sherif; Marshall, Robert (Family Physicians Inquiries Network, 2011-12)
    eMedRef is FPIN's electronic Medical Reference, and we are excited to share with you portions of these clinical topic reviews as they are completed or updated each month.
  • Do NSAIDs delay bone healing in patients with acute fractures? 

    Grames, Chase; Gauer, Robert (Family Physicians Inquiries Network, 2011-12)
    There appears to be an association between nonsteroidal anti-inflammatory drug (NSAID) use and delayed bone healing in the setting of acute fractures. (SOR: B, based on inconsistent RCTs and retrospective cohort trials.)
  • Diving for PURLs (December 2011) 

    Sharma, Umang; Kirley, Kate; Rogers, Nina Vergari; Jones, Kohar (Family Physicians Inquiries Network, 2011-12)
    In the PURLs series, we attempt to select and summarize all new research studies that should change your clinical practice. Diving for PURLs will provide you with a synopsis of important studies that may not meet all of ...
  • What are the appropriate clinical endpoints for managing acute fluid overload in a patient with diastolic heart failure? 

    Beetham, Porsche; Smith, Steven R.; Bodi, Shirley M.; Haley, Andrea (Family Physicians Inquiries Network, 2011-12)
    Therapeutic endpoints for managing acute fluid overload in patients with diastolic failure are the same as those used in managing acute systolic heart failure: resolution of rales and dyspnea, reduction of weight, improvement ...
  • Does an aerobic exercise regimen affect glycemic control in patients with type 2 diabetes? 

    Chao, Amy; Womack, Jason; Roemheld-Hamm, Beatrix (Family Physicians Inquiries Network, 2011-12)
    Improvements are clearly seen with 1 hour of moderate intensity exercise 3 to 4 times a week. (SOR: A, based on a meta-analysis.) Increasing energy expenditure as little as 10 metabolic equivalents (METS) per hour per week ...
  • Are adult patients with multiple skin lipomas at risk for other serious medical conditions? 

    Bah, Elizabeth; Lameh, Rahele; Wilder, Laura (Family Physicians Inquiries Network, 2011-12)
    No evidence suggests that otherwise normal adult patients with multiple lipomas (>10) have increased health risks. However, several uncommon but serious syndromes are associated with multiple lipomas and some of these ...
  • Are topical heat wraps effective for acute low-back pain? 

    Kelley, Jennifer; Arabindoo, Kavitha; Parvin, Gazala; Lepinski, Sandy; Ommen, Shari (Family Physicians Inquiries Network, 2011-12)
    Yes, topical heat wraps are effective treatment of acute and subacute low-back pain. (SOR: A, based on a systematic review and RCTs with consistent findings.)
  • What is the target heart rate in a patient with chronic atrial fibrillation? 

    Singh, Jasvir; Satre, Thomas J. (Family Physicians Inquiries Network, 2011-12)
    Strict heart rate control is not beneficial compared with more lenient heart rate control in well-compensated ambulatory patients with chronic atrial fibrillation. An acceptable target for resting heart rate is less than ...
  • When is discectomy indicated for lumbar disc disease? 

    Young, Kisha; Brown, Rhett; Kaufmann, Leonora (Family Physicians Inquiries Network, 2011-11)
    Emergent discectomy is indicated in the presence of cauda equina and severe, progressive neuromotor deficits (strength of recommendation [SOR]: C, expert opinion). Elective discectomy for sciatica caused by lumbar disc ...
  • What is a safe platelet count prior to invasive procedures? 

    Hoogesteger, Carl; Gauer, Robert (Family Physicians Inquiries Network, 2011-11)
    Epidural anesthesia and central line placement can be performed with platelet counts above 50,000/μL. (SOR: B, based on retrospective studies.) Lumbar puncture (LP) can be performed with platelet counts above 20,000/μL. ...
  • What is the best strategy to determine the cause of chronic urticaria? 

    Khokher, Sairah; Remde, Alan (Family Physicians Inquiries Network, 2011-11)
    A thorough clinical history is the best strategy to identify the cause of chronic urticaria. Supplementation of the history with a standardized patient questionnaire may help. (SOR: B, based on a small diagnostic cohort ...
  • Is the use of prophylactic antibiotics or decongestants/antihistamines a viable alternative to placement of tympanostomy tubes for children with chronic otitis media? 

    Nybakken, Mary; Hostetter, Jeffrey (Family Physicians Inquiries Network, 2011-11)
    Decongestants/antihistamines show no benefit in resolving persistent otitis media with effusion (OME) or preventing recurrent acute otitis media (rAOM). Prophylactic antibiotics, however, are equivalent to tympanostomy ...
  • Talking with patients about weight 

    Rollins, Vanessa (Family Physicians Inquiries Network, 2011-11)
    Use of the 5As counseling model appears effective, both objectively and by patient report, in increasing patients' motivation to lose weight and improve diet.
  • Is inhaled cannabis an effective treatment for chronic neuropathic pain? 

    Starkman, Joseph; Rowland, Kate (Family Physicians Inquiries Network, 2011-11)
    When taken with standard analgesics, inhaled cannabis relieves refractory neuropathic pain better than inhaled placebo in short-term studies. (SOR: B, based on small RCTs.)
  • In hospitalized patients with coronary artery disease, what level of anemia should prompt transfusion? 

    Atkins, Justin; Gauer, Robert (Family Physicians Inquiries Network, 2011-11)
    Among critically ill patients with stable coronary artery disease (CAD), a restrictive transfusion strategy (transfusion for hemoglobin [Hgb] concentrations <7 g/dL) compared with a liberal strategy (transfusion for Hgb ...

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