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Am Fam Physician. 2022;106(6):622

Is treatment with medication effective for patients with panic disorder?

In a meta-analysis of studies of short duration on benzodiazepines, tricyclic antidepressants, and selective serotonin reuptake inhibitors, all were effective, but serotonin reuptake inhibitors showed the best balance of effectiveness vs. risk.

What is the best topical treatment for patients with mild to moderate acne vulgaris?

For patients with mild to moderate acne, a network meta-analysis suggests starting with adapalene/benzoyl peroxide (Epiduo), clindamycin/benzoyl peroxide (Neuac), or adapalene (Differin) alone. Patients who do not tolerate either combination containing benzoyl peroxide are likely to tolerate adapalene alone.

Is a urine collection bag specimen sufficient to diagnose a urinary tract infection (UTI) in infants and children?

In infants and children, the presence of leukocyte esterase or nitrites in a urine collection bag urinalysis requires follow-up urinalysis using clean urine collection by urethral catheterization or suprapubic aspiration.

What treatments are recommended for moderate to severe cases of travelers diarrhea?

Empiric antibiotics, which typically include a fluoroquinolone or macrolide for one or three days, can lessen the duration and severity of symptoms in moderate to severe cases of travelers diarrhea. When using antibiotics for travelers diarrhea, adjunct loperamide shortens the duration of symptoms and increases the likelihood of a cure.

Does exercise during pregnancy decrease the risk of developing hypertensive disorders of pregnancy?

Yes. Aerobic exercise regimens initiated early in pregnancy and performed for at least 30 minutes three to four times per week reduce a patient’s risk of developing hypertensive disorders of pregnancy.

What testing should be done in patients with a history of a systemic reaction to an insect sting?

Patients with a history of a systemic reaction to an insect sting should be evaluated with skin testing and, if positive, treated with venom immunotherapy to decrease the risk of recurrent reactions.

Additional Online Only AFP Clinical Answers

What nonsurgical treatment is recommended for mallet finger? 

Mallet finger occurs when the distal interphalangeal joint (DIP) is forced to flex against resistance. In the absence of indications for referral, mallet finger (with or without an avulsion fracture) can be effectively treated with strict immobilization. The DIP joint should be splinted in full extension to slight hyperextension for eight weeks.

What steps can be taken to reduce ACL injuries?

Preventive strategies for anterior cruciate ligament (ACL) injury during athletics include lower extremity strengthening exercises and neuromuscular training focused on landing mechanics.

Are GLP-1 receptor agonists, SGLT-2 inhibitors, or DPP-4 inhibitors safe and effective at reducing cardiovascular mortality, all-cause mortality, and other cardiovascular outcomes (e.g., myocardial infarction, stroke, hospitalization from heart failure) in people with cardiovascular disease regardless of whether they have diabetes?

Glucagon-like peptide-1 (GLP-1) receptor agonists reduce cardiovascular mortality, all-cause mortality, and stroke in people with cardiovascular disease. Sodium-glucose cotransporter-2 (SGLT-2) inhibitors reduce cardiovascular mortality, all-cause mortality, and hospitalization from heart failure in people with cardiovascular disease. Dipeptidyl-peptidase-4 (DPP-4) inhibitors do not reduce mortality or cardiovascular outcomes in people with cardiovascular disease, and they increase the risk of pancreatitis.

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