RSS 1.0Clinical Inquiries, 2011
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What should you tell pregnant women about exposure to parvovirus?
(Family Physicians Inquiries Network, 2011-12)Tell patients that parvovirus infections before 20 weeks' gestation confer a risk of fetal morbidity and mortality as high as 16%, but don't significantly increase long-term developmental sequelae (strength of recommendation ... -
Ferning in amniotic fluid: Is it a useful indicator of ruptured membranes?
(Family Physicians Inquiries Network, 2011-12)The presence of arborized crystals (ferning) in amniotic fluid is both sensitive (74%-100%) and specific (77%-100%) for diagnosing rupture of membranes in laboring women who report loss of fluid (strength of recommendation ... -
Treatment of Nongenital Warts
(Family Physicians Inquiries Network, 2011-12)Topical salicylic acid, cryotherapy, and topical fluorouracil are effective for treating nongenital warts. (Strength of Recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs].) ... -
What treatment is best for hypertrophic scars and keloids?
(Family Physicians Inquiries Network, 2011-12)No one treatment is best (strength of recommendation [SOR]: C, meta-analysis of heterogenous studies); no good evidence exists comparing treatments with each other. Triamcinolone injections, triamcinolone injections ... -
Should you test for H pylori in patients with nonulcer dyspepsia?
(Family Physicians Inquiries Network, 2011-12)Helicobacter pylori in creases the risk of developing peptic ulcer disease (strength of recommendation [SOR]: B, cohort study), but there is no evidence that treating H pylori reduces that risk. Treating H pylori in patients ... -
How can we minimize recurrent ankle sprains?
(Family Physicians Inquiries Network, 2011-12)Using external ankle supports during physical activity significantly reduces the likelihood of primary and secondary sprains (strength of recommendation [SOR]: A, systematic review). Proprioception rehabilitation ... -
Antibody Testing for Systemic Lupus Erythematosus
(Family Physicians Inquiries Network, 2011-12)Antibody testing plays an important role when assessing patients, but should not be used alone to diagnose SLE. (Strength of Recommendation: C, based on expert opinion.) The antinuclear antibody (ANA) test is the most ... -
Which regimen treats vitamin D deficiency most effectively?
(Family Physicians Inquiries Network, 2011-11)Several vitamin D replacement regimens are effective. Cumulative dosing may be more important than frequency of dosing (strength of recommendation [SOR]: C, inconsistent results from randomized controlled trials [RCTs] ... -
Which combination drug therapies are most effective for hypertension?
(Family Physicians Inquiries Network, 2011-11)Insufficient evidence exists to determine which specific combinations most effectively decrease cardiovascular morbidity and mortality, although combinations of hypertension medications at lower doses generally reduce ... -
What's best for croup?
(Family Physicians Inquiries Network, 2011-11)A single dose of corticosteroids is the first-line treatment for croup, resulting in fewer return visits and hospital admissions, shorter lengths of stay in the emergency department (ED) or hospital, and less need for ... -
Ginger for the Treatment of Nausea and Vomiting in Pregnancy
(Family Physicians Inquiries Network, 2011-11)Ginger can be safely used to reduce nausea and vomiting in pregnancy. (Strength of Recommendation [SOR]: B, based on small, heterogeneous trials comparing ginger with placebo and unproven comparators). Ginger's effectiveness ... -
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011-11)There is no single antidepressant or class of antidepressants that is most effective for the treatment of insomnia in patients with depression. The use of antidepressant medications can have a positive impact on sleep ... -
Treatment of Recurrent Vulvovaginal Candidiasis
(Family Physicians Inquiries Network, 2011-06)A six-month treatment regimen with an antifungal agent decreases the recurrence of vulvovaginal candidiasis. (Strength of Recommendation [SOR]: A, based on good-quality randomized controlled trials [RCTs].) For women in ... -
Treatment of Hyperhidrosis
(Family Physicians Inquiries Network, 2011-02)OnabotulinumtoxinA injections (Botox; formerly botulinum toxin type A) are effective for the treatment of primary axillary and palmar hyperhidrosis. (Strength of Recommendation [SOR]: A, based on a systematic review of ... -
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011-04)Secondary causes of obesity can be detected by obtaining a patient history and performing a physical examination. Laboratory testing is recommended when additional findings are present, such as dysmorphic features, short ... -
Reducing ACL Injuries in Female Athletes
(Family Physicians Inquiries Network, 2011-01)Neuromuscular training programs that include plyometric and strengthening exercises significantly reduce noncontact ACL injuries in female soccer and handball players older than 14 years. (Strength of Recommendation: A, ... -
Preventing Acute Mountain Sickness
(Family Physicians Inquiries Network, 2011-08)Gradual ascent is the most effective method for preventing acute mountain sickness. (Strength of Recommendation [SOR]: B, based on good-quality prospective and retrospective cohort studies.) Acetazolamide should be used ... -
Hormone Therapy for Postmenopausal Women with Urinary Incontinence
(Family Physicians Inquiries Network, 2011-07)Postmenopausal women should not receive oral hormone therapy for treatment of urinary incontinence. Hormone therapy is associated with worsening urinary incontinence in postmenopausal women who are incontinent at baseline ... -
Effective Therapies for Intermittent Claudication
(Family Physicians Inquiries Network, 2011-09)Supervised exercise programs are recommended to produce clinically significant improvements in walking distance in patients with stable intermittent claudication. (Strength of Recommendation [SOR]: A, based on systematic ... -
Clinical Indicators of Obstructive Sleep Apnea
(Family Physicians Inquiries Network, 2011-05)Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study. (Strength of ...