CLINICAL PEARLS FROM “AMERICAN FAMILY PHYSICIAN” JOURNAL

JOURNAL OF THE AMERICAN ACADEMY OF FAMILY PHYSICIANS

DIABETES: What is the preferred medication in diabetics on dialysis? 

                     INSULIN  (metformin is contraindicated)

VOCAL CORD PROBLEMS: What is the best test to evaluate vocal cord problems?

                      NASOLARYNGOSCOPY — flexible fiber scope passed through the nose into

                            the throat and vocal cord area for direct visual examination.

ORAL GUM (PERIODONTAL) DISEASE:  Does gum disease contribute to the development

                               of other chronic diseases?

                       YES! Patients with periodontal disease are more likely to have chronic

                                diseases—cardiovascular disease, autoimmune disease, mental

                                illness, it worsens diabetes mellitus.

DEPRESSION:  Does light therapy decrease depression in older adults with seasonal

                                  depression?

                        YES! Light therapy is mildly effective in older adults with depression.

ROUTINE DENTAL CLEANING:  Should oral blood thinners be stopped before routine 

                                    dental cleaning?

                          NO!  Therapeutic dose may be maintained.

TOOTH EXTRACTIONS:  Should oral blood thinners be stopped before a tooth

                                    extraction?

                           NO! Therapeutic dose may be maintained.

CARDIOVASCULAR DISEASE:  Is aspirin recommended for prevention of a first

                                    cardiovascular disease event?

                            YES! Low dose (<100mg/day) is recommended for adults 40-60 years old

ALL CAUSE MORTALITY:  Does daily low dose aspirin reduce deaths by all causes?

                             NO!

Reference: AFP Clinical Answers Am Fam Phys 2022 May;105(5):462.