AFP Clinical Answers
Tendinopathy, Medical Abortion, Counseling for Children and Adolescents, Cold Prevention
Am Fam Physician. 2020 Apr 1;101(7):398.
What conservative therapies are beneficial for tendinopathies?
Eccentric exercises are effective for treating rotator cuff tendinopathy, lateral epicondylitis, patellar tendinopathy, and midsubstance Achilles tendinopathy. Extracorporeal shock wave therapy may be beneficial for plantar fasciitis, greater trochanteric pain syndrome, and calcific rotator cuff tendinopathy that are resistant to initial treatment. With consistent use, topical nitroglycerin can reduce tendon pain associated with activity in tendinopathies. It is important for the patient to understand that it may take longer than six months for complete symptom resolution with tendinopathies.
How effective is misoprostol alone in first trimester medical abortion?
According to a meta-analysis, misoprostol (Cytotec) alone was associated with a nearly 80% success rate in the first trimester of pregnancy. The best associations were with 800-mcg dosing, three or more doses, nonoral route of administration, moistening of tablets before vaginal insertion, and a delay of three to seven days after completion of the misoprostol regimen before deciding to surgically evacuate. The safety of misoprostol alone was demonstrated by a rate of hospitalization or transfusion of less than 1%.
What counseling is recommended for all school-aged children at routine visits?
School-aged children should be counseled on healthy lifestyle habits, including eating a healthy diet, being active for at least 60 minutes per day, consistent screen media limits, obtaining adequate sleep, and practicing good dental hygiene. School-aged children should be taught safety precautions, and parents should be encouraged to model safe behaviors.
What counseling is recommended for adolescents at routine visits?
Adolescents 12 years and older should be screened for major depressive disorder using a validated tool such as the Patient Health Questionnaire for Adolescents or the Beck Depression Inventory for primary care. Sexually active adolescents should receive intensive behavioral counseling on the prevention of sexually transmitted infections. Sexually active females younger than 25 years should be screened for chlamydia and gonorrhea annually. Adolescents with multiple partners or high-risk sexual behavior should be screened for syphilis and HIV. All adolescents should be screened for HIV beginning at 15 years of age.
What interventions are effective for preventing the common cold?
The use of hand sanitizer or hand washing is the most effective way to prevent the common cold.
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