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Practice Guidelines

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Diagnostic Approach to Pleural Effusion - American Family Physician

Jul 15, 2014 - Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p99.html

Diagnostic Evaluation of Urinary Incontinence in Geriatric Patients - American Family ...

Jun 1, 1998 - In most cases, the evaluation of urinary incontinence requires only a history, a physical examination, urinalysis and measurement of postvoid residual urine volume. The initial purposes of the evaluation are to identify conditions requiring referral or specialized work-up and to detect ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0601/p2675.html

Diastolic Heart Failure: The Challenges of Diagnosis and Treatment - American Family ...

Jun 1, 2004 - Diastolic heart failure, a major cause of morbidity and mortality, is defined as symptoms of heart failure in a patient with preserved left ventricular function. It is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2609.html

Diethylstilbestrol Exposure - American Family Physician

May 15, 2004 - Diethylstilbestrol is a synthetic nonsteroidal estrogen that was used to prevent miscarriage and other pregnancy complications between 1938 and 1971 in the United States. In 1971, the U.S. Food and Drug Administration issued a warning about the use of diethylstilbestrol during pregnancy...

American Family Physician : Article

https://www.aafp.org/afp/2004/0515/p2395.html

Drug Dosing Adjustments in Patients with Chronic Kidney Disease - American Family ...

May 15, 2007 - Chronic kidney disease affects renal drug elimination and other pharmacokinetic processes involved in drug disposition (e.g., absorption, drug distribution, nonrenal clearance [metabolism]). Drug dosing errors are common in patients with renal impairment and can cause adverse effects ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0515/p1487.html

Efficient Identification of Adults with Depression and Dementia - American Family ...

Sep 15, 2004 - Family physicians must decide how to screen for depression or dementia and which patients to screen. Mental health questionnaires can be helpful. In practice-based screening, questionnaires are administered to all patients, regardless of risk status. In case-finding screening, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1101.html

End-Stage Renal Disease: Symptom Management and Advance Care Planning - American Family...

Apr 1, 2012 - The prevalence of end-stage renal disease continues to increase, and dialysis is offered to older and more medically complex patients. Pain is problematic in up to one-half of patients receiving dialysis and may result from renal and nonrenal etiologies. Opioids can be prescribed ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0401/p705.html

Evaluating Obesity and Cardiovascular Risk Factors in Children and Adolescents - ...

Nov 1, 2008 - Obesity continues to be a growing public health problem. According to the 2003-2004 National Health and Nutrition Examination Survey, 17 percent of persons two to 19 years of age are overweight. The number of obese children and adolescents has tripled in the past 20 years. Obesity in ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1101/p1052.html

Evaluation and Management of Infants and Young Children with Fever - American Family ...

Oct 1, 2001 - A practice guideline for the management of febrile infants and children younger than three years of age sparked controversy when it was published in 1993. Surveys indicate that many office-based physicians do not agree with recommendations for venipuncture and bladder catheterization in...

American Family Physician : Article

https://www.aafp.org/afp/2001/1001/p1219.html

Evaluation and Management of Neck Masses in Children - American Family Physician

Mar 1, 2014 - Neck masses in children usually fall into one of three categories: developmental, inflammatory/reactive, or neoplastic. Common congenital developmental masses in the neck include thyroglossal duct cysts, branchial cleft cysts, dermoid cysts, vascular malformations, and hemangiomas. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p353.html

Evaluation and Treatment of ADHD - American Family Physician

Sep 1, 2001 - Symptoms of attention-deficit/hyperactivity disorder (ADHD) are present in as many as 9 percent of school-age children. ADHD-specific questionnaires can help determine whether children meet diagnostic criteria for the disorder. The recommended evaluation also includes documenting the ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0901/p817.html

Evaluation and Treatment of the Suicidal Patient - American Family Physician

Mar 15, 2012 - Evaluation and treatment of a suicidal patient are challenging tasks for the physician. Because no validated predictive tools exist, clinical judgment guides the decision-making process. Although there is insufficient evidence to support routine screening, evidence shows that asking ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0315/p602.html

Evaluation of a First Seizure - American Family Physician

May 1, 2007 - Seizure is a common presentation in the emergency care setting, and new-onset epilepsy is the most common cause of unprovoked seizures. The patient history and physical examination should direct the type and timing of laboratory and imaging studies. No single sign, symptom, or test ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0501/p1342.html

Evaluation of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Sep 15, 1999 - In patients without significant urologic symptoms, microscopic hematuria is occasionally detected on routine urinalysis. At present, routine screening of all adults for microscopic hematuria with dipstick testing is not recommended because of the intermittent occurrence of this finding ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0915/p1143.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Evaluation of Syncope - American Family Physician

Sep 15, 2011 - Syncope is a transient and abrupt loss of consciousness with complete return to preexisting neurologic function. It is classified as neurally mediated (i.e., carotid sinus hypersensitivity, situational, or vasovagal), cardiac, orthostatic, or neurogenic. Older adults are more likely to ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p640.html

Evaluation of the Patient with Chronic Cough - American Family Physician

Oct 15, 2011 - Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. Patients who are taking an angiotensin-converting enzyme inhibitor should switch to a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p887.html

Evaluation of the Patient with Chronic Cough - American Family Physician

May 1, 2004 - Patients with chronic cough should avoid exposure to irritants that can trigger cough, and those who smoke should stop smoking. Patients who develop chronic cough in association with angiotensin-converting enzyme inhibitor therapy should be switched to an agent from another drug class. ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2159.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Oct 15, 2009 - Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed tomography of the neck, chest, and abdomen. Primary care physicians must decide how to pursue an evaluation of a nodule once it has been identified. The ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p827.html

Family History: The Three-Generation Pedigree - American Family Physician

Aug 1, 2005 - The collection of a family history ranges from simply asking patients if family members have the same presenting illness to diagramming complex medical and psychosocial relationships as part of a family genogram. The three-generation pedigree provides a pictorial representation of ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0801/p441.html

Fetal Chromosomal Abnormalities: Antenatal Screening and Diagnosis - American Family ...

Jan 15, 2009 - Pregnant women of all ages should be offered screening and invasive diagnostic testing for chromosomal abnormalities before 20 weeks' gestation. New developments in screening methods have increased the number of options for patients. Diagnostic options include chorionic villus sampling ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0115/p117.html

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues - ...

May 15, 2018 - Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p642.html

Guideline for Management of Heart Failure Caused by Systolic Dysfunction: Part II. ...

Sep 15, 2001 - Several large clinical trials conducted over the past decade have shown that pharmacologic interventions can dramatically reduce the morbidity and mortality associated with heart failure. These trials have modified and enhanced the therapeutic paradigm for heart failure and extended ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0915/p1045.html

Guideline for the Management of Heart Failure Caused by Systolic Dysfunction: Part I. ...

Sep 1, 2001 - Over the past decade, the conceptual understanding of heart failure has changed significantly. Several large clinical trials have demonstrated that pharmacologic interventions can dramatically reduce the morbidity and mortality associated with heart failure. These trials have extended ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0901/p769.html

Guidelines for the Use of Antibiotics in Acute Upper Respiratory Infections - American ...

Sep 15, 2006 - To help physicians with the appropriate use of antibiotics in children and adults with upper respiratory tract infection, a multidisciplinary team evaluated existing guidelines and summarized key practice points. Acute otitis media in children should be diagnosed only if there is abrupt...

American Family Physician : Article

https://www.aafp.org/afp/2006/0915/p956.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Hepatitis A - American Family Physician

Jun 15, 2006 - The introduction of hepatitis A vaccines in 1995 led to a drop in the number of reported cases of hepatitis A and a shift to a higher percentage of cases occurring in older age groups. The hepatitis A virus survives for extended periods in the environment. Transmission primarily is ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0615/p2162.html

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Hepatitis C: Part II. Prevention Counseling and Medical Evaluation - American Family ...

Jan 15, 1999 - An estimated 3.9 million Americans are infected with hepatitis C virus (HCV), and most do not know that they are infected. This group includes persons who are at risk for HCV-associated chronic liver disease and who also serve as reservoirs for transmission of HCV to others. Because ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0115/p349.html

Hereditary Hemochromatosis - American Family Physician

Feb 1, 2013 - Hereditary hemochromatosis is an autosomal recessive disorder that disrupts the body’s regulation of iron. It is the most common genetic disease in whites. Men have a 24-fold increased rate of iron-overload disease compared with women. Persons who are homozygous for the HFE gene ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0201/p183.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Jun 15, 2011 - Herpes zoster (shingles) is diagnosed clinically by recognition of the distinctive, painful vesicular rash appearing in a unilateral, dermatomal distribution. An estimated 1 million cases occur in the United States each year, and increasing age is the primary risk factor. Laboratory ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1432.html

High Blood Pressure in Children and Adolescents - American Family Physician

Oct 15, 2018 - High blood pressure in children and adolescents is a growing health problem that is often overlooked. Children should be screened for elevated blood pressure annually beginning at three years of age or at every visit if risk factors are present. In children younger than 13 years, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p486.html

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.html

Hoarseness in Adults - American Family Physician

Dec 1, 2017 - Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p720.html

How to Find Answers to Clinical Questions - American Family Physician

Feb 15, 2009 - Many barriers exist to finding answers to physicians' clinical questions. Lack of time, resources, and computer skills, as well as physicians' environment and attitudes about problem solving, all contribute to unanswered questions. Making use of computer-based information resources can ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0215/p293.html

How to Write an Evidence-Based Clinical Review Article - American Family Physician

Jan 15, 2002 - Traditional clinical review articles, also known as updates, differ from systematic reviews and meta-analyses. Updates selectively review the medical literature while discussing a topic broadly. Non-quantitative systematic reviews comprehensively examine the medical literature, seeking ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0115/p251.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.html

Identification and Evaluation of Mental Retardation - American Family Physician

Feb 15, 2000 - Mental retardation in young children is often missed by clinicians. The condition is present in 2 to 3 percent of the population, either as an isolated finding or as part of a syndrome or broader disorder. Causes of mental retardation are numerous and include genetic and environmental ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1059.html

Identifying and Using Good Practice Guidelines - American Family Physician

Jul 1, 2009 - Performance measurement and payment are increasingly linked to goals established by practice guidelines. The best guidelines are based on systematic reviews and patient-oriented evidence, use an evidence-rating system such as the Strength of Recommendation Taxonomy, and are ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p67.html

Influenza: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Influenza is an acute viral respiratory infection that causes significant morbidity and mortality worldwide. Three types of influenza cause disease in humans. Influenza A is the type most responsible for causing pandemics because of its high susceptibility to antigenic variation. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p751.html

Interventional Radiology: Indications and Best Practices - American Family Physician

May 1, 2019 - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p547.html

Interventions to Facilitate Smoking Cessation - American Family Physician

Jul 15, 2006 - Tobacco use, primarily cigarette smoking, is the leading cause of preventable morbidity and mortality in the United States, and nearly one third of those who try a cigarette become addicted to nicotine. Family physicians, who see most of these patients in their offices every year, have ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p262.html

Intrapartum Fetal Monitoring - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Continuous electronic fetal monitoring was developed to screen for signs of hypoxic-ischemic encephalopathy, cerebral palsy, and impending fetal death during labor. Because these events have a low prevalence, continuous electronic fetal monitoring has a false-positive rate of 99%. The ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p158.html

Intrauterine Devices: An Update - American Family Physician

Mar 15, 2014 - Three intrauterine devices (IUDs) are available in the United States: the copper T 380A and two levonorgestrel-releasing IUDs, one that releases 20 mcg of levonorgestrel per 24 hours, and one that releases 14 mcg per 24 hours. All are safe and effective methods of contraception that ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p445.html

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Lung Cancer: Diagnosis, Treatment Principles, and Screening - American Family Physician

Feb 15, 2015 - Lung cancer is classified histologically into small cell and non–small cell lung cancers. The most common symptoms of lung cancer are cough, dyspnea, hemoptysis, and systemic symptoms such as weight loss and anorexia. High-risk patients who present with symptoms should undergo chest ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p250.html

Management of Ankle Sprains - American Family Physician

Jan 1, 2001 - Without adequate care, acute ankle trauma can result in chronic joint instability. Use of a standardized protocol enhances the management of ankle sprains. In patients with grades I or II sprains, emphasis should be placed on accurate diagnosis, early use of RICE (rest, ice, compression...

American Family Physician : Article

https://www.aafp.org/afp/2001/0101/p93.html

Management of Common Sleep Disorders - American Family Physician

Aug 15, 2013 - Sleep disorders are common and affect sleep quality and quantity, leading to increased morbidity. Patients with sleep disorders can be categorized as those who cannot sleep, those who will not sleep, those with excessive daytime sleepiness, and those with increased movements during ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0815/p231.html

Management of Falls in Older Persons: A Prescription for Prevention - American Family ...

Dec 1, 2011 - Although falls are a common cause of injury in older persons, they are not just a normal part of the aging process. The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1201/p1267.html

Management of Foreign Bodies in the Skin - American Family Physician

Sep 1, 2007 - Although puncture wounds are common, retained foreign bodies are not. Wounds with a foreign body sensation should be evaluated. The presence of wood or vegetative material, graphite or other pigmenting materials, and pain is an indication for foreign body removal. Radiography may be ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0901/p683.html

Management of Group A Beta-Hemolytic Streptococcal Pharyngitis - American Family Physician

Apr 15, 2001 - Bacteria are responsible for approximately 5 to 10 percent of pharyngitis cases, with group A beta-hemolytic streptococci being the most common bacterial etiology. A positive rapid antigen detection test may be considered definitive evidence for treatment; a negative test should be ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0415/p1557.html

Management of Normal Pressure Hydrocephalus - American Family Physician

Sep 15, 2004 - Gait instability, urinary incontinence, and dementia are the signs and symptoms typically found in patients who have normal pressure hydrocephalus. Estimated to cause no more than 5 percent of cases of dementia, normal pressure hydrocephalus often is treatable, and accurate recognition ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1071.html

Management of Patellofemoral Pain Syndrome - American Family Physician

Jan 15, 2007 - Patellofemoral pain syndrome (PFPS) is the most common cause of knee pain in the outpatient setting. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint. Risk factors include overuse, ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0115/p194.html

Managing Benign Prostatic Hyperplasia - American Family Physician

Jul 1, 2002 - Medical and surgical options for the treatment of benign prostatic hyperplasia have expanded in recent years. Saw palmetto, the most widely used complementary medication, is less effective than standard medical therapy but has fewer side effects. Although non-selective alpha blockers ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p77.html

Managing the Adverse Effects of Radiation Therapy - American Family Physician

Aug 15, 2010 - Nearly two thirds of patients with cancer will undergo radiation therapy as part of their treatment plan. Given the increased use of radiation therapy and the growing number of cancer survivors, family physicians will increasingly care for patients experiencing adverse effects of ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p381.html

Multiple Sclerosis: A Primary Care Perspective - American Family Physician

Nov 1, 2014 - Multiple sclerosis (MS) is the most common permanently disabling disorder of the central nervous system in young adults. Relapsing remitting MS is the most common type, and typical symptoms include sensory disturbances, Lhermitte sign, motor weakness, optic neuritis, impaired ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1101/p644.html

Nephrotic Syndrome in Adults: Diagnosis and Management - American Family Physician

Nov 15, 2009 - Nephrotic syndrome may be caused by primary (idiopathic) renal disease or by a variety of secondary causes. Patients present with marked edema, proteinuria, hypoalbuminemia, and often hyperlipidemia. In adults, diabetes mellitus is the most common secondary cause, and focal segmental ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1115/p1129.html

New Drugs for Alzheimer's Disease - American Family Physician

Oct 1, 1998 - Alzheimer's disease is characterized by degeneration of various structures in the brain, with development of amyloid plaques and neurofibrillary tangles. Deficiencies of acetylcholine and other neurotransmitters also occur. Pharmacologic treatment of the disease generally seeks to ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1001/p1175.html

Nursing Home Care: Part I. Principles and Pitfalls of Practice - American Family Physician

May 15, 2010 - Approximately 1.5 million Americans reside in nursing homes. A family physician often leads the interdisciplinary team that provides for the medical, functional, emotional, nutritional, social, and environmental needs of these patients. The treatment of nursing home residents is a ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0515/p1219.html

Nursing Home Care: Part II. Clinical Aspects - American Family Physician

May 15, 2010 - Understanding the distinctions between the management of clinical problems in nursing homes compared with the community setting helps improve the overall care of nursing home residents. Liberalizing diets helps avoid unintentional weight loss in nursing home residents, although the use ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0515/p1229.html

Obsessive Compulsive Disorder: Diagnosis and Management - American Family Physician

Aug 1, 2009 - Obsessive-compulsive disorder is an illness that can cause marked distress and disability. It often goes unrecognized and is undertreated. Primary care physicians should be familiar with the various ways obsessive-compulsive disorder can present and should be able to recognize clues to ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0801/p239.html

Obsessive-Compulsive Disorder: Diagnosis and Management - American Family Physician

Nov 15, 2015 - Obsessive-compulsive disorder (OCD) is a chronic illness that can cause marked distress and disability. It is a complex disorder with a variety of manifestations and symptom dimensions, some of which are underrecognized. Early recognition and treatment with OCD-specific therapies may ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p896.html

Oral Health During Pregnancy - American Family Physician

Apr 15, 2008 - Oral health care in pregnancy is often avoided and misunderstood by physicians, dentists, and patients. Evidence-based practice guidelines are still being developed. Research suggests that some prenatal oral conditions may have adverse consequences for the child. Periodontitis is ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1139.html

Oral Manifestations of Commonly Prescribed Drugs - American Family Physician Restricted content. Login required.

Nov 15, 2020 - Drugs are being prescribed with more frequency and in higher quantities. A serious adverse drug event from prescribed medications constitutes 2.4% to 16.2% of all hospital admissions. Many of the adverse drug events present intraorally or periorally in isolation or as a clinical symptom...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p613.html

Osteoarthritis: Diagnosis and Treatment - American Family Physician

Jan 1, 2012 - Osteoarthritis is a common degenerative disorder of the articular cartilage associated with hypertrophic bone changes. Risk factors include genetics, female sex, past trauma, advancing age, and obesity. The diagnosis is based on a history of joint pain worsened by movement, which can ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p49.html

Osteoporosis: Part I. Evaluation and Assessment - American Family Physician

Mar 1, 2001 - Osteoporosis afflicts 75 million persons in the United States, Europe and Japan and results in more than 1.3 million fractures annually in the United States. Because osteoporosis is usually asymptomatic until a fracture occurs, family physicians must identify the appropriate timing and ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0301/p897.html

Osteoporosis: Part II. Nonpharmacologic and Pharmacologic Treatment - American Family ...

Mar 15, 2001 - Family physicians will frequently encounter patients with osteoporosis, a condition that is often asymptomatic until a fracture occurs. Treatment of the fracture can be initiated without further diagnostic testing. Thereafter, treatment of osteoporosis includes (1) prevention of further...

American Family Physician : Article

https://www.aafp.org/afp/2001/0315/p1121.html

Otitis Media: Rapid Evidence Review - American Family Physician

Sep 15, 2019 - Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p350.html

Outpatient Management of Anticoagulation Therapy - American Family Physician

Apr 1, 2007 - The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0401/p1031.html

Outpatient Management of COVID-19: Rapid Evidence Review - American Family Physician

Oct 15, 2020 - Common presenting symptoms of coronavirus disease 2019 include fever, dry cough, shortness of breath, and fatigue. However, patients may have a wide range of symptoms representing a spectrum of mild to severe illness. Symptoms in children tend to be milder and may include fever, cough, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p478.html

Outpatient Treatment of Systolic Heart Failure - American Family Physician

Dec 1, 2004 - Optimal outpatient treatment of systolic heart failure has three goals that should be pursued simultaneously: (1) control of risk factors for the development and progression of heart failure, (2) treatment of heart failure, and (3) education of patients. Control of risk factors includes...

American Family Physician : Article

https://www.aafp.org/afp/2004/1201/p2157.html

Overview of Histoplasmosis - American Family Physician

Dec 15, 2002 - Histoplasmosis is an endemic infection in most of the United States and can be found worldwide. The spectrum of this illness ranges from asymptomatic infection to severe disseminated disease. Life-threatening illness is usually associated with an immunocompromised state; however, 20 ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1215/p2247.html

Paget Disease of Bone for Primary Care - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. It usually affects older adults, and men are at a higher risk than women. Any bone may be affected, but the disease has a high preference for the pelvis, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p224.html

Pediatric Urinary Tract Infection and Reflux - American Family Physician

Mar 15, 1999 - Urinary tract infections in children are sometimes associated with vesicoureteral reflux, which can lead to renal scarring if it remains unrecognized. Since the risk of renal scarring is greatest in infants, any child who presents with a urinary tract infection prior to toilet training ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1472.html

Perioperative Cardiac Risk Reduction - American Family Physician

Feb 1, 2012 - Cardiovascular complications are the most common cause of perioperative morbidity and mortality. Noninvasive stress testing is rarely helpful in assessing risk, and for most patients there is no evidence that coronary revascularization provides more protection against perioperative ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0201/p239.html

Pharmacologic Treatment of Hyperlipidemia - American Family Physician

Sep 1, 2011 - Pharmacologic treatment of hyperlipidemia in conjunction with therapeutic lifestyle changes can be used for both primary and secondary prevention of cardiovascular disease. Statins have the most convincing data for primary prevention, especially for higher risk patients. Therefore, risk...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p551.html

Pigmentation Disorders: Diagnosis and Management - American Family Physician

Dec 15, 2017 - Pigmentation disorders are commonly diagnosed, evaluated, and treated in primary care practices. Typical hyperpigmentation disorders include postinflammatory hyperpigmentation, melasma, solar lentigines, ephelides (freckles), and café au lait macules. These conditions are generally ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p797.html

Pituitary Adenomas: An Overview - American Family Physician

Sep 1, 2013 - Prolactinomas and nonfunctioning adenomas are the most common types of pituitary adenomas. Patients with pituitary adenomas may present initially with symptoms of endocrine dysfunction such as infertility, decreased libido, and galactorrhea, or with neurologic symptoms such as headache ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p319.html

Practical Steps to Smoking Cessation for Recovering Alcoholics - American Family Physician

Apr 15, 1998 - Smoking rates among persons with a history of alcohol abuse are triple that of the general public. Strong evidence indicates that the risk of cancer and cardiovascular disease is higher in recovering alcoholics than in peers who smoke, but do not drink alcohol. Yet these persons often ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0415/p1869.html

Pregnancy Myths and Practical Tips - American Family Physician Restricted content. Login required.

Oct 1, 2020 - For many patients, pregnancy is a highly anticipated and exciting phase of life, but it can also be anxiety provoking. Family physicians can resolve some of this anxiety and promote maternal and fetal health by making specific recommendations at prenatal visits. A daily prenatal vitamin...

American Family Physician : Article

https://www.aafp.org/afp/2020/1001/p420.html

Preoperative Cardiac Risk Assessment - American Family Physician

Nov 15, 2002 - Heart disease is the leading cause of mortality in the United States. An important subset of heart disease is perioperative myocardial infarction, which affects approximately 50,000 persons each year. The American College of Cardiology (ACC) and American Heart Association (AHA) have ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1115/p1889.html

Preoperative Testing Before Noncardiac Surgery: Guidelines and Recommendations - ...

Mar 15, 2013 - Preoperative testing (e.g., chest radiography, electrocardiography, laboratory testing, urinalysis) is often performed before surgical procedures. These investigations can be helpful to stratify risk, direct anesthetic choices, and guide postoperative management, but often are obtained ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0315/p414.html

Preparation of the Cardiac Patient for Noncardiac Surgery - American Family Physician

Mar 1, 2007 - Approximately 20 to 40 percent of patients at high risk of cardiac-related morbidity develop myocardial ischemia perioperatively. The preferred approach to diagnostic evaluation depends on the interactions of patient-specific risk factors, surgery-specific risk factors, and exercise ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p656.html

Preventing Cardiovascular Disease in Women - American Family Physician

Oct 15, 2006 - Cardiovascular disease (CVD) has been the primary cause of death in women for almost a century, and more women than men have died of CVD every year since 1984. Although CVD incidence can be reduced by adherence to a heart-healthy lifestyle and detection and treatment of major risk ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1015/p1331.html

Preventing Falls in Older Persons - American Family Physician

Aug 15, 2017 - The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p240.html

Primary Care Issues in Patients with Mental Illness - American Family Physician

Aug 1, 2008 - Family physicians commonly care for patients with serious mental illness. Patients with psychotic and bipolar disorders have more comorbid medical conditions and higher mortality rates than patients without serious mental illness. Many medications prescribed for serious mental illness ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0801/p355.html

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.html

Pulmonary Rehabilitation in the Treatment of Chronic Obstructive Pulmonary Disease - ...

Sep 15, 2010 - Pulmonary rehabilitation is a nonpharmacologic therapy that has emerged as a standard of care for patients with chronic obstructive pulmonary disease. It is a comprehensive, multidisciplinary, patient-centered intervention that includes patient assessment, exercise training, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0915/p655.html

Recognition and Management of Hereditary Hemochromatosis - American Family Physician

Mar 1, 2002 - Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent. It is characterized by increased intestinal absorption of iron, with deposition of the iron in multiple organs. Previously, the classic description was combined diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p853.html

Recurrent Venous Thromboembolism - American Family Physician

Feb 1, 2011 - A previous venous thromboembolism is the most important risk factor for predicting recurrence of the condition. Several studies have shown that routine testing for inherited thrombophilias is not helpful in predicting the risk of recurrence or altering treatment decisions, and therefore...

American Family Physician : Article

https://www.aafp.org/afp/2011/0201/p293.html

Reducing Adverse Effects of Proton Pump Inhibitors - American Family Physician

Jul 1, 2012 - Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p66.html

Reducing the Risk of Adverse Drug Events in Older Adults - American Family Physician

Mar 1, 2013 - Adverse drug events occur in 15 percent or more of older patients presenting to offices, hospitals, and extended care facilities. These events are potentially preventable up to 50 percent of the time. Common serious manifestations include falls, orthostatic hypotension, heart failure, ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0301/p331.html

Respiratory Syncytial Virus Bronchiolitis in Children - American Family Physician

Jan 15, 2017 - Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p94.html

Respiratory Syncytial Virus Infection in Children - American Family Physician

Jan 15, 2011 - Respiratory syncytial virus (RSV) is an RNA virus that causes respiratory tract infections in children. In the North- ern Hemisphere, the peak infection season is November through April. By two years of age, most children will have had an RSV infection. Bronchiolitis, a lower ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p141.html

Revised AAP Guideline on UTI in Febrile Infants and Young Children - American Family ...

Nov 15, 2012 - In 2011, the American Academy of Pediatrics released a revision of its 1999 clinical practice guideline on urinary tract infections in febrile infants and young children two to 24 months of age. The new clinical practice guideline has several important updates based on evidence ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1115/p940.html

Right Care for Children: Top Five Do's and Don'ts - American Family Physician

Mar 15, 2019 - Underuse and overuse of medical interventions, failure to use interventions known to be effective, and provision of tests or interventions in which benefits do not exceed harms are types of low-value care. The Lown Institute’s Right Care Alliance Children’s Health Council identified ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p376.html

Role of the Primary Care Physician in Hodgkin Lymphoma - American Family Physician

Sep 1, 2008 - Approximately 8,200 new cases of Hodgkin lymphoma are diagnosed annually in the United States. Common presenting features include painless lymphadenopathy (usually above the diaphragm), cough, fever, night sweats, and weight loss. To decrease late complications, treatment has gradually ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0901/p615.html

Screening for Breast Cancer: Current Recommendations and Future Directions - American ...

Jun 1, 2007 - Breast cancer is one of the most significant health concerns in the United States. Recent reviews have questioned the value of traditional breast cancer screening methods. Breast self-examination has been shown not to improve cancer-specific or all-cause mortality in large studies, but ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0601/p1660.html

Seasonal Affective Disorder - American Family Physician

Dec 1, 2012 - Seasonal affective disorder is a combination of biologic and mood disturbances with a seasonal pattern, typically occurring in the autumn and winter with remission in the spring or summer. In a given year, about 5 percent of the U.S. population experiences seasonal affective disorder, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1037.html

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