Am Fam Physician. 2022;106(2):130
Which behavioral interventions help people quit smoking, and what factors influence how successful they are?
Individual or group counseling, guaranteed financial incentives, and text message–based counseling provide the greatest benefit to people trying to quit smoking. Population characteristics do not consistently affect the success of these interventions. Any of the interventions provide additional benefit even when smoking cessation pharmacotherapy is prescribed.
What are the available treatment options for aphthous stomatitis?
Aphthous stomatitis may be treated with topical corticosteroids (gel or rinse) or, less commonly, intralesional corticosteroids.
What are indications for parathyroidectomy in patients with primary hyperparathyroidism?
Parathyroidectomy is indicated for those with symptoms, significant renal impairment, osteoporosis, or serum calcium level more than 1 mg per dL (0.25 mmol per L) above the upper limit of normal.
Is azithromycin effective in treating patients with COVID-19?
According to a Cochrane review, azithromycin (Zithromax) is the most consistently studied antibiotic for treating patients infected with the SARS-CoV-2 virus; it does not improve mortality after 28 days or affect the clinical course for adults who are hospitalized with COVID-19. In outpatient adults with asymptomatic or mild COVID-19, azithromycin does not reduce mortality, risk of hospitalization, or disease progression.
What is the first step in the evaluation of a heart murmur in an infant?
When history or examination findings suggest a pathologic murmur in an infant, consultation with pediatric cardiology is indicated as a first step instead of echocardiography or other testing. Studies show that echocardiography can diagnose critical congenital heart disease; however, cost assessments support the approach of referral first instead of echocardiography.
In nonoperative management of scaphoid fractures, does using a thumb spica cast lead to superior outcomes?
The type of cast used does not affect outcomes. A short arm cast allows the patient to have better function and mobility during immobilization without compromising the healing process. Thumb spica casts are no better than casts that do not include the thumb in fracture healing rates or long-term improvement in range of motion, strength, or pain.
Additional Online Only AFP Clinical Answers
Are nonsteroidal anti-inflammatory drug (NSAID) injections as safe and effective as steroid injections for the treatment of trigger finger?
According to a Cochrane review, in patients with trigger finger, there is no significant difference in outcomes at 12 to 24 weeks—including resolution of symptoms, recurrence, total active motion, residual pain, patient satisfaction, or adverse events—when comparing treatment with NSAID injections vs. corticosteroid injections.
What outpatient interventions can increase the likelihood of spontaneous labor?
Regular, moderate exercise and breast massage both increase the likelihood of spontaneous labor. Membrane sweeping in the outpatient setting can increase the likelihood of spontaneous labor within 48 hours. Consider outpatient placement of a Foley catheter for cervical ripening in patients who are nulliparous with an unfavorable cervix (full Bishop score of less than 6).
Do mobile phone–based interventions improve patient adherence to medication for primary prevention of cardiovascular disease?
Mobile phone–based interventions improve adherence to cardiovascular medication regimens and may improve blood pressure control, but there is no patient-oriented evidence that these interventions are beneficial.
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