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.

Dec 1, 2018 Issue
Wearable Devices for Weight Loss

Nov 1, 2018 Issue
Epidural Analgesia and Risk of Cesarean Delivery
There is no difference in the risk of cesarean delivery in women who receive epidural analgesia before 4 to 5 cm cervical dilation compared with later dilation.

Oct 1, 2018 Issue
Therapist-Guided, Internet-Delivered Cognitive Behavior Therapy for Anxiety
Therapist-guided, Internet-delivered CBT can be used as an effective treatment for anxiety in adults and is similar in effectiveness to face-to-face CBT.

Sep 1, 2018 Issue
Effect of Dietary Changes on IBS Symptoms
A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FOD-MAPs) decreases IBS symptoms and improves quality of life compared with usual diet.

Aug 1, 2018 Issue
Diagnosis of Acute Coronary Syndrome
The best test to diagnose ACS is a risk score based on a clinical prediction rule such as the HEART (history, electrocardiography, age, risk factors, troponin level) or TIMI (Thrombolysis in Myocardial Infarction) risk score, which have positive likelihood ratios (LR+'s) of 13 and 6.8, respectively.

Aug 1, 2018 Issue
Treatment Duration for Etonogestrel Implant
The etonogestrel subdermal implant is approved by the U.S. Food and Drug Administration for contraception for up to three years, but it seems to be effective for up to five years.

Jul 1, 2018 Issue
Effects of Prenatal Yoga on Labor Pain
Participation in a prenatal yoga program may help reduce labor pain, but reported effects vary from modest to moderate.

Jul 1, 2018 Issue
Staples vs. Sutures After Cesarean Delivery
Patients believe that staples and subcuticular sutures provide similar cosmetic outcomes after cesarean deliveries. However, the risk of wound complications (e.g., infection, separation, hematoma, seroma) is doubled with staples.

Jun 15, 2018 Issue
Treatments for de Quervain Tenosynovitis
Corticosteroid injections are no better than thumb spica orthoses for decreasing pain in patients with de Quervain tenosynovitis. When combined with orthoses, corticosteroid injections and acupuncture are equally effective for improving function and decreasing pain.

Jun 1, 2018 Issue
NSAIDs for Postpartum Perineal Pain
Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.

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