AFP Clinical Answers

Statin Treatment, Early Pregnancy Loss, Ingrown Toenails, Blood Pressure, ADHD, Colorectal Adenomas

 

Am Fam Physician. 2019 Dec 1;100(11):671.

In older people without a history of CVD, is statin treatment associated with better outcomes?

In a retrospective study, statin treatment in patients 75 years or older without preexisting cardiovascular disease (CVD) did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results support the results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

https://www.aafp.org/afp/2019/0401/p461.html

What findings on ultrasonography confirm early pregnancy loss in first trimester bleeding?

Early pregnancy loss can be definitively diagnosed in women with ultrasound findings of a mean gestational sac diameter of 25 mm or greater and no embryo or embryonic cardiac activity when the crown-rump length is at least 7 mm.

https://www.aafp.org/afp/2019/0201/p166.html

Should oral antibiotics be routinely given for ingrown toenails?

Oral antibiotics are not recommended for ingrown toenails unless there is cellulitis.

https://www.aafp.org/afp/2019/0801/p158.html

Which is a better predictor of mortality: ambulatory or office-based measurement of blood pressure?

Ambulatory blood pressure is considerably lower, on average, than office-based blood pressure (in one study cohort, the mean difference between the two measurements was 19/11 mm Hg), and blood pressure readings from an ambulatory blood pressure device are more predictive of all-cause mortality than office-based blood pressure readings. Treatment decisions should be based on ambulatory blood pressure monitoring rather than in-office blood pressure results.

https://www.aafp.org/afp/2019/0501/p565.html

What are the best screening tools for the evaluation and diagnosis of ADHD?

The Conners Abbreviated Symptom Questionnaire has the highest sensitivity and specificity. The Vanderbilt Attention Deficit/Hyperactivity Disorder (ADHD) Diagnostic Teacher and Parent Rating Scales also have moderate

 

 

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