The Journal of family practice
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YES. Augmentation with second generation antipsychotics, especially aripiprazole and quetiapine, appears to be effective in patients with moderate-to-severe depression who have had a suboptimal response to a selective serotonin reuptake inhibitor or a serotonin-norepinephrine reuptake inhibitor (strength of recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs] and an individual RCT). Augmenting antidepressant therapy with cariprazine, ziprasidone, or olanzapine also appears to improve depressive symptoms over the short term. All antipsychotics studied carried an increased likelihood of adverse effects that could lead to discontinuation (SOR: A, based on a systematic review of RCTs).
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YES. Infants respond to behavioral interventions, although objective data are limited. Behavioral interventions include establishing regular daytime and sleep routines for the infant, reducing environmental noises or distractions, and allowing for self-soothing at bedtime (strength of recommendation: B, based on multiple randomized and nonrandomized studies).
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Asthma remains a substantial health burden, despite continued treatment advances. Patients with mild or moderate asthma, even those with intermittent symptoms, are at risk for severe or fatal exacerbations. Use of short-acting beta2-agonist (SABA)-only rescue therapy is associated with an increased risk of exacerbations, beginning at about the second fill annually. ⋯ There is a window of opportunity just prior to an asthma exacerbation during which use of fast-acting bronchodilator + ICS may play a significant role in mitigating the risk of exacerbation. Patients may respond better to a combination inhaler of a fast-acting bronchodilator and an ICS as needed for rescue therapy or as part of a maintenance and rescue therapy paradigm, rather than attempting to use separate inhalers. However, there is currently no fixed-dose, fast-acting bronchodilator + ICS approved in the United States for as-needed use.
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This UK study revealed the benefits of introducing gluten at age 4 months.
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The increasing prevalence of type 1 diabetes (T1D) suggests family physicians will regularly see first-degree relatives of patients with T1D with the genetic propensity for developing T1D. T1D autoantibody screening by family clinicians addresses an important need to identify at-risk individuals early and achieve short- and long-term health benefits. Multiple T1D screening options and programs are available to clinicians that provide patient education, testing, result analysis, follow-up, and opportunity for participation in T1D prevention trials. The provider-patient relationship in family medicine places clinicians in a unique position to provide monitoring and followup crucial to family members with positive autoantibody results.