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).
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.
Should oral antibiotics be routinely given for ingrown toenails?
Oral antibiotics are not recommended for ingrown toenails unless there is cellulitis.
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.
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 sensitivity and specificity in elementary school–aged children.
Is aspirin or fish oil effective in preventing colorectal adenomas in patients with previous high-risk colorectal neoplasia?
The Systematic Evaluation of Aspirin and Fish Oil Polyp Prevention Trial demonstrated after 12 months that neither aspirin nor fish oil (eicosapentaenoic acid), alone or in combination, is any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.
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