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What is the best way to treat Morton's neuroma?
(Family Physicians Inquiries Network, 2011)
No single treatment for Morton's neuroma has been identified in the literature.A protocol of stepped care that showed good results in an uncontrolled trial seems reasonable: patient education and footwear or insole changes, ...
Does turmeric relieve inflammatory conditions?
(Family Physicians Inquiries Network, 2011)
Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory conditions (strength of recommendation [SOR]: C, primarily low-quality cohort studies ...
What is the most effective treatment for acne rosacea?
(Family Physicians Inquiries Network, 2011)
Topical metronidazole and azelaic acid are equally effective for the papulopustular lesions of acne rosacea, although metronidazole is better tolerated. Oral doxycycline, tetracycline, and metronidazole are also effective, ...
What is the prognosis for patients with chronic urticaria?
(Family Physicians Inquiries Network, 2011)
The prognosis for chronic urticaria in primary care is unknown; studies in dermatology clinics in multiple countries report complete resolution in approximately one-third of patients with idiopathic chronic urticaria over ...
What are the adverse effects of prolonged opioid use in patients with chronic pain?
(Family Physicians Inquiries Network, 2011)
Constipation, nausea, and dyspepsia are the most common long-term adverse effects of chronic opioid use (strength of recommendation [SOR]: B, systematic review of low-quality studies). Men may experience depression, fatigue, ...
How can we minimize recurrent ankle sprains?
(Family Physicians Inquiries Network, 2011)
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 substantially ...
Chronic urticaria: What diagnostic evaluation is best?
(Family Physicians Inquiries Network, 2011)
A detailed history and 6-week trial of an H1 antihistamine are the best diagnostic evaluations for chronic urticaria. More extensive diagnostic work-up adds little, unless the patient's history specifically indicates a ...
Does pneumococcal conjugate vaccine prevent otitis media?
(Family Physicians Inquiries Network, 2011)
Yes, if the pneumococcal conjugate vaccine (PCV) series is given before 12 months of age. Vaccination before 12 months is associated with a statistically significant reduction in the incidence of both acute (AOM) and ...
Antibody Testing for Systemic Lupus Erythematosus
(Family Physicians Inquiries Network, 2011)
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 ...
Should you test for H pylori in patients with nonulcer dyspepsia?
(Family Physicians Inquiries Network, 2011)
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 ...
What's best for croup?
(Family Physicians Inquiries Network, 2011)
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 ...
When is the best time to clamp the umbilical cord after routine vaginal delivery?
(Family Physicians Inquiries Network, 2011)
Sometime between 30 seconds and 2 minutes after delivery appears to be the best interval. In term infants, delayed clamping (waiting 1 or 2 minutes or until the cord stops pulsating) improves hemoglobin and ferritin levels, ...
Antibiotics for Viral Upper Respiratory Tract Infections in Children
(Family Physicians Inquiries Network, 2011)
Antibiotic therapy does not benefit children with bronchiolitis, the common cold, or nonstreptococcal pharyngitis. If purulent rhinitis is present for more than 10 days, antibiotics shorten the duration of runny nose ...
How should we use the coronary artery calcium score to predict cardiovascular risk?
(Family Physicians Inquiries Network, 2011)
The coronary artery calcium (CAC) score--an independent predictor of cardiovascular events (strength of recommendation [SOR]: C, systematic review of disease-oriented outcomes)--can be used, in addition to traditional risk ...
Treatment of Nongenital Warts
(Family Physicians Inquiries Network, 2011)
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)
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 combined ...
Which regimen treats vitamin D deficiency most effectively?
(Family Physicians Inquiries Network, 2011)
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] of ...
Antidepressants for the Treatment of Insomnia in Patients with Depression
(Family Physicians Inquiries Network, 2011)
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 ...
Which smoking cessation interventions work best?
(Family Physicians Inquiries Network, 2011)
Nicotine replacement therapy (NRT), bupropion, nortriptyline, clonidine, and varenicline are all effective, although insufficient evidence exists to recommend one intervention over another (SOR: A, systematic reviews). ...
What's the best way to relieve mastitis in breastfeeding mothers?
(Family Physicians Inquiries Network, 2011)
Frequent breast emptying helps both infectious and noninfectious mastitis (strength of recommendation [SOR]: A, 1 randomized controlled trial [RCT]). Antibiotics may be useful for women with positive milk cultures (SOR: ...