AFP DEPARTMENT COLLECTION
FPIN's Help Desk Answers
Help Desk Answers 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.
Jan 15, 2020 Issue
Pain Medications Before IUD Placement
Topical lidocaine preparations including gels, creams, and sprays may modestly decrease pain with tenaculum placement but not during IUD insertion.
Oct 1, 2019 Issue
Thickened Feedings for Infants with Gastroesophageal Reflux
Bottle-fed infants with gastroesophageal reflux should be given thickened formula feedings.
Aug 15, 2019 Issue
Cognitive Behavior Therapy for Postpartum Depression
In women with postpartum depression, the addition of CBT reduces depressive symptoms more effectively than usual care alone (medication and other therapies), with a medium effect size at the end of the intervention and a residual small effect size six months later.
Aug 1, 2019 Issue
Skin-to-Skin Contact for Improved Duration of Breastfeeding
Skin-to-skin-contact in the immediate postnatal period should be recommended to all mothers because it is associated with a higher likelihood of exclusive breastfeeding at hospital discharge and for up to six months afterward (number needed to treat [NNT] = 5 to 8).
Jul 1, 2019 Issue
Pharmacologic Therapy for Heart Failure
Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.
Jun 1, 2019 Issue
Attention Deficit/Hyperactivity Disorder: Screening and Evaluation
The Conners Abbreviated Symptom Questionnaire has the best combination of positive and negative likelihood ratios.
May 1, 2019 Issue
Risks of Elective Labor Induction vs. Expectant Management
Elective labor induction at 39 weeks’ gestation leads to a mean 145-g (5.1-oz) lower birth weight compared with expectant management, but there is conflicting evidence about the effects on rates of cesarean delivery, perinatal mortality, operative vaginal birth, and admission to the neonatal intensive care unit (NICU).
Apr 1, 2019 Issue
Maternal Pertussis Vaccination During Pregnancy
Women should receive the Tdap vaccine during pregnancy regardless of previous immunization history. Infants whose mothers received prenatal immunization had 50% fewer cases of pertussis compared with those whose mothers received postpartum immunization.
Mar 1, 2019 Issue
Pharmacologic Treatment of Borderline Personality Disorder
There is no pharmacotherapy regimen that improves the overall symptoms of borderline personality disorder. When used for six months or less, antipsychotics can improve paranoia, dissociation, mood lability, anger, and global functioning.
Feb 1, 2019 Issue
Antibiotic Prophylaxis for UTIs in Patients with Neurogenic Bladder
Daily antibiotic prophylaxis should not be used in patients with acute and nonacute spinal cord injuries.