A 50-year-old man presented to the dermatology department with a 1-year history of itchy axillary and groin lesions. He had been treated with a topical antifungal preparation (cyclopyroxolamin), without improvement, by his family physician, who had suspected fungal intertrigo. On physical...
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Maintenance or Discontinuation of Antidepressants in Primary Care
BACKGROUND
Patients with depression who are treated in primary care practices may receive antidepressants for prolonged periods. Data are limited on the effects of maintaining or discontinuing antidepressant therapy in this setting.
METHODS
We conducted a randomized, double-...
Button battery ingestions in children
1. Injuries in children from ingesting button batteries are
increasing
2. The type and size of the ingested battery influence the
likelihood of complications
3. Urgency of management depends on the location of the battery
4. Honey or sucralfate should be...
Effect of 7 vs 14 Days of Antibiotic Therapy on Resolution of Symptoms Among Afebrile Men With Urinary Tract Infection: A Randomized Clinical Trial
Importance Determination of optimal treatment durations for common infectious diseases is an important strategy to preserve antibiotic effectiveness.
Objective To determine whether 7 days of treatment is noninferior to 14 days when using ciprofloxacin or trimethoprim/sulfamethoxazole to...
Can family physicians accurately screen for AAA with point-of-care ultrasound?
EVIDENCE-BASED ANSWER:
LIKELY YES. POINT-OF-CARE ULTRASOUND (POCUS) SCREENING FOR ABDOMINAL AORTIC ANEURYSM (AAA) BY NONRADIOLOGIST PHYSICIANS IS 98% SENSITIVE AND 99% SPECIFIC, COMPARED WITH IMAGING PERFORMED BY RADIOLOGISTS (STRENGTH OF RECOMMENDATION [SOR]: B, META-ANALYSIS OF...
Do carotid artery calcifications seen on radiographs predict stenosis in asymptomatic adults?
EVIDENCE-BASED ANSWER:
NOT VERY WELL. IN ASYMPTOMATIC PATIENTS, CAROTID ARTERY CALCIFICATION SEEN ON RADIOGRAPH HAS A POSITIVE PREDICTIVE VALUE OF 70% AND A NEGATIVE PREDICTIVE VALUE OF 75% FOR CAROTID ARTERY STENOSIS (STRENGTH OF RECOMMENDATION [SOR]: B, SYSTEMATIC REVIEW OF OBSERVATIONAL...
Role of biofilm in catheter-associated urinary tract infection
The predominant form of life for the majority of microorganisms in any hydrated biologic system is a cooperative community termed a “biofilm.” A biofilm on an indwelling urinary catheter consists of adherent microorganisms, their extracellular products, and host components deposited on the...
Recombinant Zoster Vaccine (Shingrix): Real-World Effectiveness in the First 2 Years Post-Licensure
Background
Shingrix (recombinant zoster vaccine) was licensed to prevent herpes zoster, dispensed as 2 doses given 2–6 months apart among adults aged ≥50 years. Clinical trials yielded efficacy of >90% for confirmed herpes zoster, but post-market performance has not been evaluated....
Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection A State-of-the-Art Review
The vast majority of patients (>99%) with severe acute respiratory syndrome coronavirus 2 survive immediate infection
but remain at risk for persistent and/or delayed multisystem. This review of published reports through May 31, 2021,
found that manifestations of postacute...
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Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement
Importance: Chlamydia and gonorrhea are among the most common sexually transmitted infections in the US. Infection rates are highest among adolescents and young adults of both sexes. Chlamydial and gonococcal infections in women are usually asymptomatic and may lead to pelvic inflammatory...
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