This is my second shot at summarizing the American Family Physician journal. This volume has two articles likely of interest to the non-physician reader. The article on breast cancer is a fine review of treatment issues in language most could follow, and will be an interesting read if you have breast cancer or have a loved one who does. The hepatitis C article is also a good summary of this incredibly common disease that affects 2% of adult Americans.
First Line Treatment for Hypertension: An excellent review of the data, primarily reminding us that thiazide diuretics in low dose are almost always the best first choice, alone or in combination with an ACE. Also reminds us that beta-blockers are rarely the best first line option. Treatment of hypertension is especially important in secondary prevention, i.e. those with prior cardiovascular disease.
Cochrane Briefs: Aripiprazole (Abilify) vs. other atypical Antipsychotics for Schizophrenia: Compared to Olanzapine (Zyprexa) Aripiprazole may lead to less weight gain side effects, but may be less effective at 6 weeks in treating symptoms. Minimal differences compared to risperidol. Overall little reason to use this as a first line med.
Treatment of Breast Cancer: A nice review of the treatment options for all stages of breast cancer. A good reference for patients and physicians alike. Very clear and understandable discussions of the staging of breast cancer, pros and cons of sentinel node biopsy vs. lymph node dissection as well as hormone receptor and ERBB2 as guides to treatment options.
Hepatitis C: Diagnosis and Treatment: Another good review. Hep C affects 2% of adults in the US. No vaccination available, but if you have Hepatitis C you should get vaccines for Hepatitis A & B because they are more dangerous as a second hepatitis virus. Don’t drink alcohol if you have Hep. C.
Radiologic Evaluation of Incidentaly Discovered Adrenal Masses: With all the sophisticated imaging we do these days, it’s really common to find adrenal masses when looking for other things. A discussion of recommended management of these masses. Most are benign, few need biopsied.
Tips from Other Journals: Chlorhexidine-Alcohol works as well as and maybe better than Betadine in preventing post-op infections when used preop. — Discussed an article reviewing psychotropic meds in breastfeeding. The best SSRIs are sertraline (Zoloft); Paroxeting (Paxil). Avoid fluoxitine (Prozac); citalopram (celexa) and escitalopram (Lexapro).