Am Fam Physician. 2024;110(3):294
What is the likelihood of overdiagnosis of breast cancer after screening in women 70 years and older?
A retrospective cohort study of 54,635 women found that overdiagnosis of breast cancer—or identification, in this case— that would not have caused symptoms in a person's lifetime seems to increase with age. In this study, the overdiagnosis rate was 31% for women 70 to 74 years of age, 47% for women 75 to 84 years of age, and 51% for women 85 years and older who were screened and found to be positive.
What can be used for treatment of nausea and vomiting caused by migraine headaches?
Metoclopramide combined with aspirin should be considered for nausea and vomiting caused by acute migraine.
Does percutaneous coronary intervention (PCI) reduce symptoms of stable angina compared with a placebo procedure in patients who are not taking antianginal medications?
A randomized controlled trial demonstrated that PCI is effective in patients with stable angina who are not taking antianginal medications. The study suggests there is little or no benefit of PCI for patients who can tolerate a maximal antianginal medical regimen, but it provides an important benefit for those unable to adhere to medication.
What topical treatments can be used for rosacea?
Ivermectin 1% cream, metronidazole 0.75% gel, and azelaic acid 15% gel are first-line topical treatments for rosacea with papules and pustules.
Does delivery of bad news via telephone increase psychological stress more than in-person communication?
According to a meta-analysis of 11 observational and randomized controlled clinical trials, delivering bad news by telephone does not affect levels of anxiety, depression, or satisfaction with care vs. delivering the news in person.
What is the initial imaging choice for suspected symptomatic gallstone disease?
Abdominal ultrasonography is the initial imaging choice in patients with right upper quadrant pain and suspected symptomatic cholelithiasis or cholecystitis.
Additional Online Only AFP Clinical Answers
Which antibiotics should be used to treat group A beta-hemolytic streptococcal (GABHS) pharyngitis?
Penicillin and amoxicillin are the first-line antibiotic treatments for GABHS pharyngitis. Because of increasing resistance to azithromycin, it should not be prescribed unless the patient is allergic to beta-lactam antibiotics.
For patients with treatment-resistant depression, is esketamine (Spravato) nasal spray superior to the antipsychotic quetiapine?
In a randomized controlled trial of 676 patients already taking a selective serotonin reuptake inhibitor or a serotonin-norepinephrine reuptake inhibitor, esketamine nasal spray was safe and slightly more effective than extended-release quetiapine at inducing remission at 8 weeks (number needed to treat [NNT] = 10) and 32 weeks (NNT = 7) in patients with treatment-resistant depression.
Is tadalafil effective in treating lower urinary tract symptoms in men with benign prostatic hyperplasia?
A meta-analysis of randomized controlled trials showed that tadalafil may be useful in improving symptoms and quality of life in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia. Tadalafil is superior to tamsulosin (Flomax) when lower urinary tract symptoms are associated with erectile dysfunction.
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