SGLT-2 for Diabetes, Biliary Pain, Depression in Adolescents, Intermittent Catheterization, Labor Induction, Umbilical Hernias, Multivitamins
Am Fam Physician. 2025;111(2):118
When should you recommend a sodium-glucose cotransporter-2 inhibitor (SGLT-2) for a patient with diabetes?
Coexisting diabetes and arteriosclerotic heart disease, chronic kidney disease, microalbuminuria, or heart failure are indications to recommend an SGLT-2 inhibitor.
What is an effective method of pain control for biliary colic and acute cholecystitis?
Nonsteroidal anti-inflammatory drugs are safe and effective for relieving pain from biliary colic and acute cholecystitis. A 2016 Cochrane review showed nonsteroidal anti-inflammatory drugs provide greater relief of biliary pain compared with placebo and antispasmodics, with no difference in pain control compared with opiates.
Is bupropion a safe and effective antidepressant for adolescents 12 to 20 years of age?
Retrospective studies showed bupropion is an effective therapy for adolescents with major depressive disorder. Bupropion may decrease rates of hospitalizations for depression and medication discontinuation. There is an increased risk of overdose and seizures up to 24 hours after dosing. Bupropion may be an option for adolescents with major depressive disorder, excluding those at increased risk of suicide, seizures, or eating disorders.
What types of catheters are recommended for intermittent catheterization?
Hydrophilic-coated catheters are recommended for intermittent catheterization in appropriate cases because they decrease urethral microtrauma and risk of urinary tract infections compared with nonhydrophilic catheters.
Read more: Urinary Catheter Management; September 2024
When is induction of labor recommended in late-term or postterm pregnancy?
Labor induction should be considered at 41 weeks' gestation and is recommended at 42 weeks' gestation to reduce perinatal morbidity and mortality compared with expectant management.
By what age are umbilical hernias in children likely to spontaneously close?
In a cohort study that included 4,486 children diagnosed with umbilical hernias, 89% of the hernias spontaneously closed by 5 years of age, regardless of size.
Does regular dietary supplementation with multivitamins reduce the risk of premature mortality?
In a 2022 update, the US Preventive Services Task Force found insufficient evidence to assess the benefits and harms for use of multivitamin supplements (I statement). A government-funded cohort study with 390,124 participants followed up to 27 years found no reduction in cardiovascular, cancer, cerebrovascular, or all-cause mortality from regular multivitamin use.
Additional Online Only AFP Clinical Answers
What test is recommended for intermediate-risk patients with stable chest pain?
Based on randomized controlled trials and observational studies, the American College of Cardiology/American Heart Association Joint Committee recommended coronary computed tomographic angiography over invasive coronary angiography for intermediate-risk patients with stable chest pain and no known coronary artery disease to rule out coronary stenosis. Coronary computed tomographic angiography is noninvasive, widely available, and has high patient satisfaction and lower procedural complications.
How effective is adding or increasing treatment regimens in adolescents and adults with uncontrolled asthma who are already taking a medium-dose inhaled corticosteroid (ICS)?
A Cochrane review found that adding a long-acting beta2 agonist to a medium- or high-dose ICS likely reduces the frequency of moderate to severe asthma exacerbations compared with a medium-dose ICS alone. Adding a long-acting muscarinic antagonist possibly reduces the frequency of moderate to severe asthma exacerbations compared with a medium-dose ICS alone. A high-dose ICS alone likely does not reduce the frequency of moderate to severe asthma exacerbations.
Does regular dietary supplementation with multivitamins reduce the risk of premature mortality?
In a 2022 update, the US Preventive Services Task Force found insufficient evidence to assess the benefits and harms for use of multivitamin supplements (I statement). A government-funded cohort study with 390,124 participants followed up to 27 years found no reduction in cardiovascular, cancer, cerebrovascular, or all-cause mortality from regular multivitamin use.
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