FPIN's Clinical Inquiries

Clinical Inquiries from the Family Practice 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.

Jul 1, 2008 Issue
Leukotriene Receptor Antagonists for the Treatment of Allergic Skin Disorders
Evidence from small trials suggests that leukotriene receptor antagonists may have short-term effectiveness in reducing sleep disturbance and the observed intensity of atopic dermatitis in adults and children.

Jun 1, 2008 Issue
Treatment of Bulimia Nervosa
Cognitive behavior therapy (CBT) is the most effective treatment for bulimia nervosa based on multiple consistent randomized-controlled trials (RCTs).

May 1, 2008 Issue
Differential Diagnosis of Tremor
The most common tremor in primary care is an exaggerated physiologic tremor, followed by essential tremor and tremors caused by Parkinson's disease.

Apr 1, 2008 Issue
Quality of Life in Older Persons with Dementia Living in Nursing Homes
There is no “gold standard” to measure the QOL in older persons with dementia. For those requiring increased care, nursing homes may offer some benefit, including more frequent physician assessment and treatment of pain and depression, compared with assisted living/residential care facilities.

Mar 1, 2008 Issue
Medical Treatment of Benign Prostatic Hyperplasia
Although alpha blockers and 5-alpha reductase inhibitors each reduce BPH symptoms more than placebo, alpha blockers are more effective than 5-alpha reductase inhibitors.

Feb 1, 2008 Issue
Medications for Insomnia Treatment in Children
Melatonin may be effective for treating insomnia in healthy children and in those with physical or learning disabilities.

Jan 1, 2008 Issue
Effects of Soy Protein-Based Formula in Full-Term Infants
There are no significant long-term detrimental effects associated with the use of currently available, commercially produced, isolated soy protein-based formula in full-term infants.

Dec 1, 2007 Issue
Group Medical Visits for the Management of Chronic Pain
Improvements of possible practical significance were seen for various clinical measures in studies of group treatment sessions for patients with back pain, arthritis, and rheumatic disease. However, studies on group treatment for patients with nonspecific pain are lacking, especially in the primary care setting.

Nov 1, 2007 Issue
Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese
No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated body mass index (BMI), fasting insulin levels, and fasting glucose levels.

Oct 1, 2007 Issue
Best Alternatives to Statins for Treating Hyperlipidemia
Most alternatives to statin therapy reduce cholesterol levels but do not consistently demonstrate a reduction in cardiac-related and all-cause mortality in patients with or without coronary heart disease (CHD). Fibrates and niacin decrease the risk of major coronary events; however, no statistically significant reductions in mortality have been shown.

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