Am Fam Physician. 2025;112(2):215
What treatments have been effective for Alzheimer disease–induced agitation?
Music therapy can be recommended to minimally improve behavioral disruption, mood, and cognition in patients with mild cognitive impairment or dementia. Brexpiprazole (Rexulti) is approved for agitation caused by Alzheimer disease, and risperidone is more effective than placebo for acutely treating neuropsychiatric symptoms in people with dementia; however, antipsychotics should not be used routinely because of an elevated risk of mortality.
Read more: Alzheimer Disease: Treatment of Cognitive and Functional Symptoms; September 2024
What physical examination findings are seen in de Quervain tenosynovitis?
Tenderness and swelling in the first dorsal compartment and a positive Finkelstein test suggest de Quervain tenosynovitis, whereas dorsal predominance of pain and a squeaking sound during wrist movement suggest intersection syndrome.
Is arthroscopic surgery superior to physical therapy for degenerative meniscal tears?
According to a Cochrane review, arthroscopic surgery does not result in any clinically significant differences in pain, symptoms, function, activities of daily living, knee-specific quality of life, or generic quality of life compared with physical therapy. Arthroscopic surgery may worsen range of motion in the knee and cartilage surface area compared with physical therapy.
Does pet therapy improve anxiety?
According to meta-analysis of randomized controlled trials, controlled trials, and observational studies, pet therapy reduces self-reported anxiety across multiple age groups. Most pet therapy studies involve dogs, but cats and horses also have been studied. In patients with dementia, animal-assisted therapy reduces behavioral and psychological symptoms of dementia and depression.
Read more: Pet Therapy as a Treatment for Anxiety [FPIN’s Help Desk Answers]; October 2024
What is the most reliable method to confirm suspected herpes simplex virus in a patient presenting with genital lesions?
Type-specific viral polymerase chain reaction assay is the preferred test for confirming herpes simplex virus in clinically apparent lesions.
Read more: Genital Herpes: Rapid Evidence Review; November 2024
Do all bone stress injuries require referrals?
No. Bone stress injury management depends on injury location and severity. Injuries at low-risk sites (eg, fibula, posterome-dial tibial shaft) are treated conservatively, whereas injuries at high-risk sites (eg, femoral neck, tarsal navicular) warrant sports medicine or orthopedic referral.
Read more: Bone Stress Injuries: Diagnosis and Management; December 2024
Additional Online Only AFP Clinical Answers
In adults with atrial fibrillation taking apixaban or rivaroxaban, does the serious bleeding risk increase based on rate control agent choice?
According to a government funded cohort study, adults with atrial fibrillation who take apixaban (Eliquis) or rivaroxaban (Xarelto) for stroke prevention are at a significantly increased risk of serious bleeding with the concurrent use of diltiazem compared with metoprolol for rate control. The risk is highest in patients taking diltiazem doses higher than 120 mg per day, those with a HAS-BLED (hypertension, abnormal kidney and liver function, stroke, bleeding risk, labile international normalized ratio, elderly [older than 65 years], drug and alcohol use) score of 4 or higher, and those taking rivaroxaban compared with apixaban.
What initial intervention is recommended for suspected melanoma?
All suspicious pigmented skin lesions should undergo excisional biopsy deep enough to prevent transection of the base of the lesion and include 1- to 3-mm circumferential margins excising the entire lesion.
What is the next step after an initial positive PSA test?
After a positive prostate-specific antigen (PSA) test result (> 4 ng/mL [4 mcg/L]), the test should be repeated in a few months to rule out laboratory error while also considering transient or treatable causes of PSA elevation (eg, prostatitis, benign prostatic hyperplasia, recent ejaculation, vigorous exercise).
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