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Am Fam Physician. 2020;102(12):718

Should children or pregnant women be screened for elevated blood lead levels?

The U.S. Preventive Services Task Force concluded that current evidence is insufficient to assess the balance of benefits and harms of screening for elevated blood lead levels in asymptomatic children and asymptomatic pregnant women.

Is pelvic floor muscle training effective for treating urinary incontinence in women?

Pelvic floor muscle training is effective for treating urinary incontinence. In a Cochrane review of more than 1,800 women, after pelvic floor muscle training, one in four patients with any type of urinary incontinence perceived they were cured. Pelvic floor training was also better for stress urinary incontinence; one in two patients perceived they were cured. No patients reported significant adverse effects from training.

What interventions are effective for preventing and treating low back pain?

Core strengthening exercises can prevent low back pain, whereas back braces and insoles are ineffective. Physical activity is an effective treatment of low back pain. Yoga can improve chronic low back pain.

How should hemorrhoids be treated?

Dietary modification including adequate fiber intake improves quality of life and is recommended in the treatment of multiple benign anal conditions including hemorrhoids. Along with dietary modification, topical treatments such as flavonoids, steroids, analgesics, and antiseptics may be used to treat hemorrhoids.

What is the role of long-acting reversible contraceptives in adolescents?

Long-acting reversible contraceptives are safe and effective in adolescents and should be offered as first-line options to prevent pregnancy.

Are fasting lipid levels more predictive of cardiovascular outcomes than nonfasting lipid levels?

A Scandinavian cohort study of more than 8,000 primary prevention patients supports current guidelines that recommend checking lipid levels in nonfasting patients. In this study, patients were administered both fasting and nonfasting lipid testing. Although triglyceride levels were higher in nonfasting patients, cholesterol levels were similar whether the patient was fasting or not. In addition to being easier to obtain, nonfasting lipids were equally predictive of subsequent cardiac events.

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