AFP DEPARTMENT COLLECTION

FPIN's Help Desk Answers

Aug 1, 2018 Issue
Diagnosis of Acute Coronary Syndrome
The best test to diagnose ACS is a risk score based on a clinical prediction rule such as the HEART (history, electrocardiography, age, risk factors, troponin level) or TIMI (Thrombolysis in Myocardial Infarction) risk score, which have positive likelihood ratios (LR+'s) of 13 and 6.8, respectively.


Aug 1, 2018 Issue
Treatment Duration for Etonogestrel Implant
The etonogestrel subdermal implant is approved by the U.S. Food and Drug Administration for contraception for up to three years, but it seems to be effective for up to five years.


Jul 1, 2018 Issue
Effects of Prenatal Yoga on Labor Pain
Participation in a prenatal yoga program may help reduce labor pain, but reported effects vary from modest to moderate.


Jul 1, 2018 Issue
Staples vs. Sutures After Cesarean Delivery
Patients believe that staples and subcuticular sutures provide similar cosmetic outcomes after cesarean deliveries. However, the risk of wound complications (e.g., infection, separation, hematoma, seroma) is doubled with staples.


Jun 15, 2018 Issue
Treatments for de Quervain Tenosynovitis
Corticosteroid injections are no better than thumb spica orthoses for decreasing pain in patients with de Quervain tenosynovitis. When combined with orthoses, corticosteroid injections and acupuncture are equally effective for improving function and decreasing pain.


Jun 1, 2018 Issue
NSAIDs for Postpartum Perineal Pain
Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.


Jun 1, 2018 Issue
High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients
In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).


May 15, 2018 Issue
Maternal Obesity and Labor Induction
Pregnant women who are obese have nearly double the rate of cesarean delivery, and obesity increases the median duration of active labor by up to four hours when labor is induced. The difference in cesarean delivery rate is larger in obese primigravida patients presenting with cervical dilation of less than 1 cm.


May 1, 2018 Issue
Effectiveness of Pneumococcal Vaccines
The 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23) decreases the relative risk of community-acquired pneumonia in adults by 13%. The risk is reduced by 28% in the population that includes adults older than 65 years, those with lung disease, and those living in a nursing home.


May 1, 2018 Issue
Primary Closure of Animal Bites
Dog bites can have a primary closure at the time of injury. Primary closure of dog bites does not increase the rate of wound infections compared with nonclosure.


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