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FPIN's Clinical Inquiries

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Dipstick Urinalysis for the Diagnosis of Acute UTI - FPIN's Clinical Inquiries - ...

May 15, 2013 - Approximately two-thirds of women who present with classic symptoms of acute UTI have bacterial infection of the bladder. Dipstick urinalysis moderately improves the accuracy of clinical symptoms in establishing or excluding acute UTI in women.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0515/od2.html

Medications for Treatment of Interstitial Cystitis - FPIN's Clinical Inquiries - ...

Jan 15, 2015 - There are no long-term clinically effective oral medications. Pentosan (Elmiron) can improve overall symptom scores for interstitial cystitis over three to six months, but it does not improve scores for any of three individual symptoms (dysuria, urgency, frequency) compared with placebo.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0115/p116.html

Topical Preparations for Wound Healing - FPIN's Clinical Inquiries - American Family ...

Jun 15, 2014 - Topical silver should not be used for treatment of nonburn wounds because it does not hasten healing. Medical-grade topical honey can be used to reduce healing time for partial-thickness burns, but it produces no effect on lacerations, surgical wounds, chronic wounds, or vascular ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0615/p978.html

Antibiotic Prophylaxis for COPD Exacerbations - FPIN's Clinical Inquiries - American ...

Apr 15, 2018 - Prophylactic antibiotics may be used to reduce the overall rate of COPD exacerbations and delay their onset. However, the appropriate antibiotic regimen and target population are unclear.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0415/p527.html

Diabetes Education and Glycemic Control - FPIN's Clinical Inquiries - American Family ...

Feb 15, 2018 - Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this group had ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0215/p269.html

Testosterone Therapy and Risk Recurrence After Treatment of Prostate Cancer - FPIN's ...

Oct 15, 2013 - Men with symptomatic androgen deprivation who have had clinically curative treatment for organ-confined prostate cancer may have symptomatic improvement with testosterone replacement therapy. There are no studies evaluating the risk of cancer recurrence in patients receiving ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1015/od5.html

Rivaroxaban vs. Warfarin for Treatment of DVT and PE - FPIN's Clinical Inquiries - ...

Oct 15, 2017 - Rivaroxaban, along with the other factor Xa inhibitors, is as effective as or better in the short term (three months) than warfarin (Coumadin) for preventing recurrent DVT, nonfatal PE, and fatal PE, with no differences in mortality or bleeding events.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/1015/p532.html

ACE Inhibitors or ARBs to Prevent CKD in Patients with Microalbuminuria - FPIN's ...

Oct 15, 2016 - ACE inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/1015/p652.html

Treatment for Calcaneal Apophysitis - FPIN's Clinical Inquiries - American Family ...

Jul 15, 2017 - Several treatments for calcaneal apophysitis may produce modest short-term improvements in pain scores. Heel inserts and prefabricated orthotics may initially improve pain scores and dysfunction, but patients have equal improvement by three months with or without therapy.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0715/p126.html

Iron Deficiency in Heart Failure - FPIN's Clinical Inquiries - American Family Physician

Apr 15, 2017 - Treatment of iron deficiency in patients with heart failure using intravenous iron improves function, fatigue, and quality of life, and decreases risk of hospitalizations compared with placebo.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0415/p514.html

Angiotensin-Converting Enzyme Inhibitors vs. Angiotensin Receptor Blockers - FPIN's ...

Feb 1, 2015 - ACE inhibitors should be used in patients with hypertension because they reduce all-cause mortality, whereas ARBs do not.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0201/p193.html

Giant Cell Arteritis: Biopsy After Corticosteroid Initiation - FPIN's Clinical ...

Jan 15, 2017 - Corticosteroid therapy in patients with suspected giant cell arteritis should not degrade the accuracy of temporal artery biopsy if the biopsy is performed within four weeks of corticosteroid initiation. Temporal artery biopsy can be performed up to four weeks after starting high-dose ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0115/p116.html

Procalcitonin-Guided Antibiotic Therapy for Acute Respiratory Infections - FPIN's ...

Jul 1, 2016 - A procalcitonin-guided antibiotic therapy algorithm should be used to decrease antibiotic use in adults with acute respiratory infections. The use of a procalcitonin-guided therapy algorithm reduces antibiotic use by 3.47 days without increasing morbidity or mortality in adults with ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/0701/p53.html

Effective Therapies for Intermittent Claudication - FPIN's Clinical Inquiries - ...

Sep 15, 2011 - Supervised exercise programs are recommended to produce clinically significant improvements in walking distance in patients with stable intermittent claudication.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/0915/p699.html

Clinical Indicators of Obstructive Sleep Apnea - FPIN's Clinical Inquiries - American ...

May 1, 2011 - 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.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/0501/od1.html

FPIN's Clinical Inquiries Department Collection - American Family Physician

Clinical Inquiries from the Family Physicians Inquiries Network (FPIN) provide short, concise, evidence-based answers to clinical questions common in family medicine. The answers include a summary of the evidence and commentary that puts the answers into perspective.

American Family Physician : Department Collection

https://www.aafp.org/afp/viewRelatedDepartmentsByDepartment.htm?departmentId=12&page=0

FPIN's Clinical Inquiries Department Collection - American Family Physician

Clinical Inquiries from the Family Physicians Inquiries Network (FPIN) provide short, concise, evidence-based answers to clinical questions common in family medicine. The answers include a summary of the evidence and commentary that puts the answers into perspective.

American Family Physician : Department Collection

https://www.aafp.org/afp/viewRelatedDepartmentsByDepartment.htm?departmentId=12

Treatments for Sciatica - FPIN's Clinical Inquiries - American Family Physician

May 1, 2015 - Surgical diskectomy can be offered to patients with refractory sciatica, but there is only modest, short-term improvement in leg pain and disability scores. Epidural steroid injections may be offered to patients with sciatica of more than six months' duration.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0501/p612.html

Risk of Gout with the Use of Thiazide Diuretics - FPIN's Clinical Inquiries - American ...

Oct 1, 2015 - Thiazide diuretics may be used in most patients with hypertension who have only minimally increased risk of gout.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/1001/p622.html

Atopic Eczema and Early Introduction of Solid Foods - FPIN's Clinical Inquiries - ...

Sep 15, 2015 - In most children, solid foods may be introduced before four to six months of age without increasing the risk of atopic eczema.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0915/p523.html

Micronutrient Supplementation During Pregnancy - FPIN's Clinical Inquiries - American ...

Aug 1, 2015 - A multimicronutrient supplement is an oral tablet containing the recommended daily allowance of several vitamins and minerals. The World Health Organization does not recommend multimicronutrient supplementation because of the potential for increased neonatal mortality in some situations.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0801/p222.html

Evaluation of Newborns with Preauricular Skin Lesions - FPIN's Clinical Inquiries - ...

May 15, 2012 - All newborns should be screened for hearing loss, whether or not they have preauricular skin lesions. Newborns with these anomalies may be at increased risk of hearing impairment.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/0515/p993.html

Management of Acute Achilles Tendon Rupture - FPIN's Clinical Inquiries - American ...

Jun 1, 2015 - There are no clear evidence-based criteria to decide which patients should undergo operative vs. nonoperative management of acute Achilles tendon rupture.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0601/p794.html

Cardiovascular Effects of NSAIDs - FPIN's Clinical Inquiries - American Family Physician

Aug 15, 2014 - Aspirin does not elevate blood pressure. Among nonselective NSAIDs, ibuprofen increases the risk of hypertension and stroke. Diclofenac does not increase the risk of hypertension, but does increase the risk of stroke. Naproxen (Naprosyn) does not increase the risk of hypertension or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0815/od2.html

Exercise and Pregnancy Loss - FPIN's Clinical Inquiries - American Family Physician

Apr 1, 2015 - Regular exercise for up to seven or more hours per week (including low-intensity and high-intensity aerobics, jogging, cycling, and swimming) is not associated with increased rates of miscarriage in the first to mid-second trimesters. Patients may continue bending and lifting at work, ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0401/p437.html

Diagnosing Von Willebrand Disease - FPIN's Clinical Inquiries - American Family Physician

Jun 15, 2010 - The diagnosis of vWD requires two clinical criteria: (1) a personal history, family history, or physical evidence of mucocutaneous bleeding and (2) a qualitative or quantitative decrease in functional activity of von Willebrand factor (vWF).

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2010/0615/p1415.html

Obesity and Joint Injuries in Children - FPIN's Clinical Inquiries - American Family ...

Mar 1, 2015 - Lower extremity injuries are 18% more likely in overweight children, 24% more likely in obese children, and 34% more likely in extremely obese children when compared with normal weight peers. The risk of lower extremity fractures is also increased by 17% in overweight children, 23% in ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0301/p320.html

Self-Administered GBS Testing in Pregnant Women - FPIN's Clinical Inquiries - American ...

Nov 15, 2014 - There is no difference in the sensitivity of swabs for detecting GBS when collected by patients vs. physicians; therefore, either method can be used. Patients do not express a consistent preference for self-collection of samples vs. collection by a physician.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/1115/p729.html

Surgical Treatment for Asymptomatic Cholelithiasis - FPIN's Clinical Inquiries - ...

Mar 15, 2014 - Surgery should not be offered to patients with asymptomatic cholelithiasis. Cholecystectomy may be beneficial for patients who are at high risk of biliary cancer, infection, or other complications, including younger patients and those with choledocholithiasis, sickle cell disease, ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0315/p468.html

Prostaglandins to Induce Labor in Women with Asthma - FPIN's Clinical Inquiries - ...

Sep 15, 2014 - There is little evidence evaluating whether prostaglandins used to induce labor increase the risk of bronchospasm in patients with asthma. The use of dinoprostone to induce labor is not associated with asthma exacerbations or reduced oxygen saturation in patients with active asthma or a...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0915/p415.html

Screening for Autism Spectrum Disorders - FPIN's Clinical Inquiries - American Family ...

Oct 15, 2014 - There are no studies directly comparing the various screening tools. The Modified Checklist for Autism in Toddlers (M-CHAT) is the tool most commonly used by physicians, followed by the Checklist for Autism in Toddlers (CHAT). All other tools account for about 3% of usage.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/1015/p574.html

Intra-articular Corticosteroid Injections for Osteoarthritis of the Knee - FPIN's ...

Jul 15, 2014 - Intra-articular corticosteroid injections can be used to reduce pain by about 20% in the short term (one to three weeks) in patients with osteoarthritis of the knee.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0715/p115.html

Treatment of Otitis Media with Perforated Tympanic Membrane - FPIN's Clinical Inquiries...

Apr 15, 2009 - Acute otitis media with tympanic membrane perforation in children should be treated with an oral antibiotic.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2009/0415/p650.html

Treatment of Motion Sickness - FPIN's Clinical Inquiries - American Family Physician

Jul 15, 2012 - Scopolamine should be used to reduce nausea associated with motion sickness, but it does not reduce vomiting.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/0715/p192.html

Treatment of Jellyfish Envenomation - FPIN's Clinical Inquiries - American Family ...

May 15, 2014 - There is limited patient-oriented evidence upon which to base recommendations for treatment of jellyfish envenomation. Patients should be removed from the water, and an attempt should be made to prevent the discharge of adherent nematocysts (i.e., microscopic stinging cells), remove ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0515/od1.html

Fish Oil for Treatment of Dyslipidemia - FPIN's Clinical Inquiries - American Family ...

Feb 15, 2014 - Supplementation with omega-3 fatty acids decreases triglyceride and very low-density lipoprotein cholesterol levels. However, it can also increase low-density lipoprotein (LDL) cholesterol levels. Treatment with omega-3 fatty acids does not decrease total mortality, cardiovascular ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0215/p288.html

Apolipoproteins for Cardiovascular Risk Assessment - FPIN's Clinical Inquiries - ...

Apr 15, 2014 - Measurement of apolipoprotein B and apolipoprotein A-I is no better than traditional lipid measurements and should not be used to predict cardiovascular risk.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0415/od2.html

Treatments for Symptoms of the Common Cold - FPIN's Clinical Inquiries - American ...

Dec 15, 2013 - There is no single treatment that produces significant improvements in symptoms of the common cold. Intranasal ipratropium (Atrovent) can be given to reduce rhinorrhea. Oral zinc can be given therapeutically to shorten cold duration and severity, and can be taken prophylactically to ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1215/od3.html

Methylphenidate for Management of Fatigue in the Palliative Care Setting - FPIN's ...

Jan 15, 2014 - No recent evidence demonstrates that methylphenidate improves fatigue in patients receiving palliative care. Methylphenidate can be used to minimally improve fatigue symptom scores in patients with cancer-related fatigue.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2014/0115/p124.html

Antidepressants for the Treatment of Insomnia in Patients with Depression - FPIN's ...

Nov 1, 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 physiology, but does not seem to improve subjective ratings of sleep ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2011/1101/od1.html

Risks of Bisphosphonate Use - FPIN's Clinical Inquiries - American Family Physician

Nov 15, 2013 - Bisphosphonates are associated with a small risk of atypical femoral shaft fractures, which increases with duration of use. Bisphosphonates are associated with a small risk of osteonecrosis of the jaw, which is more common in patients who are older, female, or have poor dental hygiene ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/1115/p697.html

Pharmacologic Therapy for Eustachian Tube Dysfunction - FPIN's Clinical Inquiries - ...

Jun 15, 2013 - There are no medications that improve patient-oriented outcomes in children or adults with eustachian tube dysfunction. Oral corticosteroids, with or without antibiotics, improve pneumatic otoscopy and tympanometry findings in the short term, but these agents have no long-term benefit.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0615/p883.html

Management of ADHD in Preschool-Aged Children - FPIN's Clinical Inquiries - American ...

Sep 15, 2013 - Behavior therapy interventions, such as parent training, are first-line treatment for ADHD in preschool-aged children (three to five years of age). Medication is an option for children with moderate to severe ADHD if behavior therapy has not been effective and if the benefits outweigh ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0915/p398.html

Interventions for Lower-Extremity Lymphedema - FPIN's Clinical Inquiries - American ...

Aug 15, 2013 - Complete decongestive physiotherapy (i.e., a noninvasive protocol consisting of skin care, lymph drainage massage, exercises, and compression bandaging1) effectively improves edema, rates of infection, and quality of life in patients with lower-extremity lymphedema.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0815/od1.html

Corticosteroids for Presumed Pneumocystis Pneumonia in Patients with HIV Infection - ...

Jul 15, 2013 - Adjunctive corticosteroids decrease mortality in patients with HIV infection who have moderate to severe hypoxemia and suspected or confirmed pneumocystis pneumonia. Corticosteroids lead to a higher incidence of herpetic lesions, but not other opportunistic conditions.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0715/od1.html

Pharmacologic Therapy for Vitamin D Deficiency - FPIN's Clinical Inquiries - American ...

Feb 15, 2013 - Cholecalciferol (vitamin D3) supplementation should be used for vitamin D repletion because it may be more effective in preventing nonvertebral fractures.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0215/od2.html

FPIN's Clinical Inquiries - FPIN's Clinical Inquiries - American Family Physician

Aug 15, 2012 - The evaluation of hip pain in patients 65 years and older should include a history and physical examination, followed by pertinent imaging studies.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/0815/od1.html

Metformin Use in Adolescents - FPIN's Clinical Inquiries - American Family Physician

Apr 15, 2013 - There are no studies evaluating whether metformin prevents or delays the onset of diabetes in adolescents who are obese. In adults, metformin is as effective as lifestyle interventions in preventing increases in A1C and fasting glucose levels, but it is less effective in preventing or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0415/od4.html

Evaluation of Elevated Serum Transaminase Levels - FPIN's Clinical Inquiries - American...

Oct 15, 2012 - The evaluation of patients with elevated transaminase levels should be individualized based on the presence of symptoms or physical examination findings that suggest serious disease or hepatic decompensation.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2012/1015/od4.html

Screening for Hepatocellular Carcinoma in Patients with Hepatitis C Virus Infection - ...

Mar 15, 2013 - There is no evidence that it is beneficial to screen for hepatocellular carcinoma in symptomatic patients with HCV.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0315/od2.html

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