Am Fam Physician. 2024;109(3):208
What is a best practice for thoracentesis to evaluate pleural effusion?
Expert consensus and guidelines recommend ultrasound-guided thoracentesis because it decreases complications from pneumothorax and solid organ puncture.
What is the preferred treatment for Giardia in people older than three years?
A systematic review and network meta-analysis support a single dose of tinidazole as the most effective treatment for Giardia infection in people older than three years, with a cure rate of greater than 90%.
When should you refer a patient with an adnexal mass to a gynecologic oncologist?
Patients with a markedly elevated cancer antigen 125 level, high-risk ultrasound finding, nodular or fixed adnexal mass, or a high score on a risk evaluation tool should be referred.
Is transdermal testosterone replacement safe in men with known heart disease or at high risk of heart disease?
A randomized, double-blinded, controlled trial of more than 5,000 men with hypogonadism and increased risk of cardiovascular events explored the safety of testosterone gel. Although the most serious cardiovascular events were not more common in high-risk men using testosterone gel, there were higher incidence rates of acute kidney injury, atrial fibrillation, nonfatal arrhythmias, and pulmonary embolism. Testosterone supplementation should be used with caution in men with a history of these conditions.
What are important lifestyle recommendations for patients with chronic kidney disease?
Recommendations include smoking cessation, moderate physical activity of at least 150 minutes per week, and the reduction of dietary sodium to less than 2,300 mg per day.
What is the best treatment for scalp psoriasis?
Randomized controlled trials have shown that calcipotriene foam or calcipotriene/betamethasone dipropionate gel used for four to 12 weeks are effective treatments for mild to moderate scalp psoriasis.
Additional Online Only AFP Clinical Answers
When should primary closure be considered for a dog bite?
Primary closure in areas of cosmetic concern may be performed at the time of injury for dog bite wounds at low risk of infection; wounds that are at risk of infection should be allowed to heal by secondary intention.
What is a best practice when trying to reduce the dose for a patient on chronic opioid medications for noncancer pain?
The Centers for Disease Control and Prevention clinical practice guideline on prescribing opioids for pain recommends a slow taper to minimize withdrawal symptoms. Slow tapers are often a reduction of less than 10% of the daily dosage per month, especially after one year or more of use.
Should you screen for chronic obstructive pulmonary disease (COPD) in asymptomatic adults?
The U.S. Preventive Services Task Force confirmed a previous recommendation: do not screen for COPD in asymptomatic adults. Clinicians can help decrease the risk of COPD by supporting patients in not starting to smoke and by helping them quit if they do.
Tip for Using AFP at the Point of Care
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