Am Fam Physician. 2022;106(3):246
How long should patients with provoked venous thromboembolism be treated with anticoagulation therapy?
Patients with venous thromboembolism due to a transient risk factor (provoked) can stop anticoagulation after three months of treatment.
When is iron chelation therapy recommended in patients with thalassemia?
Iron chelation therapy corrects iron overload caused by hemolytic anemia, increased intestinal iron absorption, and repeated transfusions. It is recommended in transfusion-dependent thalassemia when ferritin levels exceed 1,000 ng per mL (1,000 mcg per L) and non–transfusion-dependent thalassemia when ferritin levels exceed 800 ng per mL (800 mcg per L).
When should nonpregnant people be retested after treatment for chlamydia or gonorrhea?
Nonpregnant people treated for chlamydial or gonococcal infections should be tested for reinfection three months after treatment.
Are SSRIs or SNRIs more effective for the treatment of vasomotor symptoms of menopause?
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective at relieving vasomotor symptoms of menopause. No studies have directly compared the two drug classes. SNRIs are associated with more adverse effects. Venlafaxine is preferred in women with breast cancer because SSRIs may interfere with tamoxifen metabolism.
Is cilostazol therapy safe and effective for improving walking distance in patients with intermittent claudication due to peripheral artery disease (PAD)?
Cilostazol (Pletal) improves initial and absolute walking distances in patients with intermittent claudication secondary to PAD and appears to be equivalent in effect to pentoxifylline (Trental). Adverse effects of cilostazol include headache, diarrhea, dizziness, and palpitations.
Do patient education interventions improve A1C values in patients with type 2 diabetes mellitus?
Patient education interventions, specifically those including face-to-face interactions with trained educators or nurses, improve A1C values in patients by 0.3% to 1.4% compared with usual diabetes care.
Additional Online Only AFP Clinical Answers
What treatment options are available for restless legs syndrome?
Nonpharmacologic interventions are first-line treatment for restless legs syndrome, followed by the use of alpha-2-delta ligands (i.e., gabapentin [Neurontin], pregabalin [Lyrica]). Dopamine agonists (e.g., ropinirole [Requip], pramipexole [Mirapex], rotigotine [Neupro]) should be used if there is an inadequate response.
What exercises are recommended to treat posterior tibial tendinopathy?
Patients who have posterior tibial tendinopathy present with medial ankle pain, pes planovalgus deformity, and a positive too many toes sign. Eccentric exercises (i.e., contraction where the muscle lengthens under load or tension) are recommended over concentric exercises (i.e., contraction with muscle shortening) for posterior tibial tendinopathy. See Figure 3 and the video in the article for more details.
What is the best approach to determine the severity, prognosis, and treatment options for alcoholic hepatitis?
Use laboratory-based prognostic tools, including the Maddrey Discriminant Function, Model for End-Stage Liver Disease, and Lille Model scores, to determine severity and prognosis of alcoholic hepatitis and treatment options.
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