AFP Clinical Answers
Ankle Sprains, Counseling Strategies, Dysphonia, Acute Coronary Syndrome, Egg Allergy
Am Fam Physician. 2019 Jul 15;100(2):81.
What type of ankle brace is recommended for ankle sprains?
Use of a functional ankle brace is more effective than immobilization or a compression wrap in terms of functional outcomes after an acute ankle sprain and for the prevention of ankle sprains.
What are some effective, structured counseling strategies that can be used in primary care?
The five A's (ask, advise, assess, assist, arrange) technique has been associated with reduced smoking and alcohol use as well as modest weight loss. The FRAMES (feedback about personal risk, responsibility of patient, advice to change, menu of options, empathy, self-efficacy enhancement) technique has been associated with reductions in alcohol-related risk behavior and reduced cannabis use. For patients ambivalent about change, motivational interviewing is more likely to be successful and is associated with decreases in weight, blood pressure, and alcohol use.
When is laryngoscopy indicated for dysphonia (hoarseness)?
Laryngoscopy should be performed if dysphonia does not resolve within four weeks or if a serious underlying condition is suspected.
What are the benefits and harms of early invasive therapy in acute coronary syndromes?
Coronary angiography with revascularization as needed in acute coronary syndromes does not prevent deaths, but one in 62 patients avoided a new heart attack in the next year; one in nine patients experienced less chest pain; and one in 15 patients avoided rehospitalization. However, one in 39 patients experienced a heart attack during or immediately after the procedure, and one in 33 patients experienced a major bleeding episode during the procedure.
Is oral immunotherapy an effective method for desensitizing children with egg allergy?
Providing daily, steadily increasing doses of egg protein over an extended period of time effectively diminishes the immunoglobulin E–mediated allergic response among children with egg allergy. Continued egg consumption maintains this desensitizing effect, with a return of the allergic response in the case of egg avoidance. However, this benefit is not achieved without risk; 75% of children in intervention groups experienced at least one adverse effect, with 8.4% of children experiencing a serious adverse effect requiring medication.
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