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Medicine by the numbers

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Antibiotic and Corticosteroid Treatment Effective for Acute Exacerbations of COPD - ... Restricted content. Login required.

Nov 15, 2020 - Short-term antibiotic treatment and short-term systemic corticosteroids are both associated with a faster resolution of COPD symptoms and fewer treatment failures.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1115/od2.html

Antibiotics for Acute Bronchitis - Medicine by the Numbers - American Family Physician Restricted content. Login required.

Nov 1, 2020 - Acute bronchitis is a lower respiratory tract infection, most commonly viral, that accounts for a significant number of health care visits. This review discusses the benefits and harms of antibiotics for acute bronchitis or acute productive cough.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/1101/od2.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

Asthma - American Family Physician

Oct 1, 2020 - This collection features AFP content on asthma and related issues, including allergens, beta agonists, chronic cough, exercise-induced bronchoconstriction, inhalers, and wheezing. This collection features AFP content on asthma and related issues, including allergens, beta agonists, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=3

Pneumonia - American Family Physician

Sep 1, 2020 - This collection features AFP content on pneumonia and related issues, including community-acquired pneumonia, and nursing home care. This collection features AFP content on pneumonia and related issues, including community-acquired pneumonia, and nursing home care.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=22

Corticosteroids for Hospitalized Patients with Community-Acquired Pneumonia - Cochrane ... Restricted content. Login required.

Sep 1, 2020 - For adults hospitalized with severe CAP, the use of corticosteroids may reduce the likelihood of mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0901/p272.html

Tobacco Abuse and Dependence - American Family Physician

Aug 15, 2020 - This collection features AFP content on tobacco abuse and dependence and related issues, including addiction, behavioral and drug therapies, lifestyle counseling, and smoking cessation. This collection features AFP content on tobacco abuse and dependence and related issues, including ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=28

Increasing the D-dimer Threshold for Patients with Low Clinical Pretest Probability ... Restricted content. Login required.

Jul 15, 2020 - The Pulmonary Embolism Graduated d-Dimer strategy increases the number of patients in the emergency department and outpatient setting who have PE ruled out via d-dimer testing, thus decreasing the need for chest imaging.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p117a.html

Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2020 - This collection features AFP content on chronic obstructive pulmonary disease (COPD) and related issues, including acute and chronic COPD, spirometry, pulmonary rehabilitation, oxygen therapy, corticosteriods, and pulmonary complications. This collection features AFP content on chronic ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=32

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Jun 15, 2020 - Acute respiratory distress syndrome (ARDS) is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p730.html

Noninvasive Positive Pressure Ventilation for Exacerbation of Chronic Obstructive ... Restricted content. Login required.

Jun 1, 2020 - Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by hyperinflation of the lungs, including emphysema and chronic bronchitis. Learn more about the benefits and harms of using noninvasive positive pressure ventilation for exacerbation of COPD.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0601/od1.html

Therapies for COPD Exacerbations in Adults - Implementing AHRQ Effective Health Care ... Restricted content. Login required.

May 1, 2020 - What are the benefits and harms of pharmacologic and nonpharmacologic treatments for exacerbations of chronic obstructive pulmonary disease (COPD) in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0501/p557.html

Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness... Restricted content. Login required.

Apr 15, 2020 - Acute altitude illness comprises acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. The Wilderness Medical Society has updated prevention and treatment guidelines on acute altitude illness.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0415/p505.html

Office Spirometry: Indications and Interpretation - American Family Physician Restricted content. Login required.

Mar 15, 2020 - High-quality, office-based spirometry provides diagnostic information as useful and reliable as testing performed in a pulmonary function laboratory. Spirometry may be used to monitor progression of lung disease and response to therapy. A stepwise approach to spirometry allows for ease ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p362.html

Antibiotics for Exacerbations of Chronic Obstructive Pulmonary Disease - Medicine by ... Restricted content. Login required.

Feb 1, 2020 - Prescription of antibiotics for the treatment of chronic obstructive pulmonary disease (COPD) is controversial due to the variety of etiologies. This review examined the use of antibiotics to treat COPD in outpatient, inpatient, and ICU settings. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0201/od1.html

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ... Restricted content. Login required.

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ... Restricted content. Login required.

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients...

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

Electronic Cigarettes: Common Questions and Answers - American Family Physician

Aug 15, 2019 - Electronic cigarettes (e-cigarettes) are popular devices designed to heat a liquid solution, often containing nicotine, that generates an inhaled aerosol, or vapor. e-Cigarettes have been marketed as healthier alternatives to traditional cigarettes. Thus, most adult users are current or...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p227.html

Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia - Point-of-Care ...

Aug 15, 2019 - In patients with acute cough, is it possible to identify a subset with a very low likelihood of community-acquired pneumonia?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0815/p246.html

Community-Acquired Pneumonia: Determining Safe Treatment in the Outpatient Setting - ...

Jun 15, 2019 - When is it safe to treat a patient with community-acquired pneumonia a an outpatient?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0615/p768.html

Antibiotic Prophylaxis in Patients with COPD - Medicine by the Numbers - American ...

Jun 1, 2019 - This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0601/od1.html

Intravenous Magnesium Sulfate for Acute Asthma Exacerbations - FPIN's Clinical ...

Jan 15, 2019 - Patients presenting to the emergency department with an acute asthma exacerbation that has not responded to first-line therapy (bronchodilators and corticosteroids) can be treated effectively with intravenous magnesium sulfate.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0115/p127.html

Liberal vs. Conservative Oxygen Therapy in the Acutely Ill - Medicine by the Numbers - ...

Jan 1, 2019 - This review compares liberal and conservative oxygen therapy in acutely ill adults and their effect on mortality (in-hospital, 30-day, and longest follow-up) and morbidity (disability at longest follow-up, risk of hospital-acquired pneumonia, any hospital-acquired infection, and length ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0101/od1.html

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations - ...

Jan 1, 2019 - Adding a LABA to an inhaled corticosteroid is safe but does not reduce the likelihood of a serious exacerbation requiring hospitalization. There is a small reduction in nonsevere asthma exacerbations, with one fewer exacerbation for every 53 patients treated for six months.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53.html

Deep Venous Thrombosis: Home vs. Inpatient Treatment - Cochrane for Clinicians - ...

Dec 1, 2018 - Patients treated at home with low-molecular-weight heparin (LMWH) have lower rates of recurrent VTE than those treated in a hospital.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p642.html

Culture-Specific Asthma Education Programs for Minority Groups - Cochrane for ...

Nov 1, 2018 - In children from minority groups, culture-specific asthma education programs (CAEPs) reduce the number of severe asthma exacerbations requiring hospitalization and improve asthma control as measured by the Childhood Asthma Control Test but not the Asthma Control Questionnaire. CAEPs ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1101/p572.html

Nebulized Hypertonic Saline for Bronchiolitis - Medicine by the Numbers - American ...

Jul 1, 2018 - Despite reported benefits associated with the use of hypertonic saline for bronchiolitis, we have chosen a yellow recommendation because the more recent trials and systematic reviews have shown either much smaller effect size or no benefit at all compared with the older trials. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0701/p23.html

Individual Behavioral Counseling for Smoking Cessation - Cochrane for Clinicians - ...

Jul 1, 2018 - Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p21.html

Identifying Patients with Newly Diagnosed Acute Pulmonary Embolism Who Are at Low Risk ...

Jun 15, 2018 - Standard management of acute PE includes five days of inpatient treatment with parenteral anticoagulation, followed by long-term oral anticoagulation as an outpatient. However, guidelines from the American College of Chest Physicians state that early discharge before five days can be ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0615/p811.html

Combined Inhaled Short-Acting Beta2 Agonist and Anticholinergic Agents for Asthma - ...

Jun 1, 2018 - Although the quality of evidence included in this review was low to moderate, the potential benefits of decreased hospitalization and relapse rates and the comparatively mild and limited adverse events suggest that patients presenting with acute asthma exacerbations are likely to ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0601/od1.html

Ruling Out Pulmonary Embolism in the Primary Care Setting - Point-of-Care Guides - ...

Jun 1, 2018 - What is the best approach to evaluate patients with suspected pulmonary embolism in the outpatient, primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0601/p750.html

Effectiveness of Pneumococcal Vaccines - FPIN's Help Desk Answers - American Family ...

May 1, 2018 - The 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23) decreases the relative risk of community-acquired pneumonia in adults by 13%. The risk is reduced by 28% in the population that includes adults older than 65 years, those with lung disease, and those living in a ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0501/od3.html

Qvar for Treatment of Chronic Asthma - Medicine by the Numbers - American Family Physician

Apr 15, 2018 - Learn the results of a Cochrane review which studied the effectiveness of Qvar in two sets of patients with chronic asthma: those receiving oral corticosteroids and those not receiving them.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0415/p538.html

Antibiotic Prophylaxis for COPD Exacerbations - FPIN's Clinical Inquiries - American ...

Apr 15, 2018 - Prophylactic antibiotics may be used to reduce the overall rate of COPD exacerbations and delay their onset. However, the appropriate antibiotic regimen and target population are unclear.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0415/p527.html

Pneumococcal Vaccines in Chronic Obstructive Pulmonary Disease - Medicine by the ...

Apr 1, 2018 - Pneumococcal vaccines had no significant effect on mortality from cardiorespiratory disease when compared with control and had no significant effect on all-cause mortality. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0401/p463.html

Combination LABA Inhalers Compared with High-Dose Inhaled Steroids for Adults with ...

Mar 1, 2018 - We designated the use of long-acting beta agonist inhalers for adults with asthma as having no benefits because of a small potential benefit of questionable clinical utility (avoiding a brief burst of oral steroids) and the possibility of a fatal harm. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0301/od1.html

Written Action Plans for Self-Management of COPD Exacerbations - Cochrane for ...

Mar 1, 2018 - Written self-management plans, especially those that include guidance on smoking cessation, increase health-related quality of life in patients with COPD. They also decrease the need for respiratory-related hospital admissions among patients with high or low baseline risk.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0301/p310.html

Glycopyrrolate (Seebri Neohaler) for Maintenance Therapy in Patients with COPD - STEPS ...

Sep 15, 2017 - Glycopyrrolate is a safe option for maintenance treatment to prevent moderate to severe exacerbations in patients with moderate to severe COPD, with only mild and rare adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0915/p395.html

Vitamin D for the Management of Asthma - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - Despite the authors' caution that further data are needed to clarify the role of vitamin D in care, this Cochrane review found that its use reduces the average number of asthma exacerbations requiring corticosteroid treatment from 0.44 to 0.28 per person per year.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p290.html

Screening for Obstructive Sleep Apnea in Adults - Putting Prevention into Practice - ...

Jul 15, 2017 - R.K. is a 52-year-old white man who presents to your office for a preventive health visit. He is overweight and has a history of hypertension and hyperlipidemia, which are stable and well controlled with medication. One of his coworkers was recently diagnosed with obstructive sleep ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/0715/p123.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Beta2 Agonists for Acute Cough or a Clinical Diagnosis of Acute Bronchitis - Cochrane ...

May 1, 2017 - There is insufficient evidence to determine whether beta2 agonists can improve symptoms for children with acute cough or bronchitis with wheeze. Beta2 agonists are not likely to benefit and may cause adverse effects in adults who do not have evidence of airflow restriction (number ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0501/p551.html

Steroids at 34 to 36 Weeks’ and Before Term Cesarean Decrease Respiratory Distress ...

Feb 15, 2017 - For women admitted for imminent premature delivery at 34 to 36 weeks of gestation, one or two doses of betamethasone or dexamethasone (8 to 12 mg) decrease the likelihood of neonatal respiratory distress syndrome and shorten lengths of stay in the intensive care unit.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0215/od2.html

Interventions to Facilitate Shared Decision Making to Address Antibiotic Use for Acute ...

Jan 1, 2017 - Interventions to facilitate shared decision making reduce the prescribing of antibiotics for acute respiratory tract infections in the short term (within six weeks of the consultation) without increasing return visits or decreasing patient satisfaction (number needed to treat [NNT] = 6).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p11.html

Community-Acquired Pneumonia in Adults: Diagnosis and Management - American Family ...

Nov 1, 2016 - Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1101/p698.html

Acute Bronchitis - American Family Physician

Oct 1, 2016 - Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1001/p560.html

Medications for Chronic Asthma - American Family Physician

Sep 15, 2016 - Chronic asthma is a major health concern for children and adults worldwide. The goal of treatment is to prevent symptoms by reducing airway inflammation and hyperreactivity. Step-up therapy for symptom control involves initiation with low-dose treatment and increasing intensity at ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p454.html

Diagnosis and Treatment of Obstructive Sleep Apnea in Adults - American Family Physician

Sep 1, 2016 - Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p355.html

Procalcitonin-Guided Antibiotic Therapy for Acute Respiratory Infections - FPIN's ...

Jul 1, 2016 - A procalcitonin-guided antibiotic therapy algorithm should be used to decrease antibiotic use in adults with acute respiratory infections. The use of a procalcitonin-guided therapy algorithm reduces antibiotic use by 3.47 days without increasing morbidity or mortality in adults with ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/0701/p53.html

Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders ...

Jun 15, 2016 - An occupational illness is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. If an occupational disorder is suspected, a directed history should be taken with particular attention to establishing a temporal ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p1000.html

Corticosteroids for Community-Acquired Pneumonia - Medicine by the Numbers - American ...

Jun 1, 2016 - Studies show that 1 in 20 patients avoided mechanical ventilation and 1 in 16 patients avoided ARDS; 1 in 29 patients developed hyperglycemia requiring treatment. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0601/od1.html

Leukotriene Receptor Antagonists in the Treatment of Acute Asthma - Medicine by the ...

Apr 1, 2016 - Studies show there were no patient-important benefits and no hospital admissions were prevented. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0401/p552.html

Electronic Cigarettes for Smoking Cessation - FPIN's Help Desk Answers - American ...

Mar 15, 2016 - Nicotine-containing e-cigarettes may be more effective than placebo devices for smoking cessation. They may also aid in smoking reduction, but the quality of available evidence is low. Little is known about their safety.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0315/p492.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

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

Newborn Respiratory Distress - American Family Physician

Dec 1, 2015 - Newborn respiratory distress presents a diagnostic and management challenge. Newborns with respiratory distress commonly exhibit tachypnea with a respiratory rate of more than 60 respirations per minute. They may present with grunting, retractions, nasal flaring, and cyanosis. Common ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1201/p994.html

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.html

Common Questions About Pneumonia in Nursing Home Residents - American Family Physician

Oct 1, 2015 - Pneumonia in older adults residing in nursing homes can be challenging to diagnose and treat. Pneumococcal and influenza immunizations decrease the risk of pneumonia and are recommended for all nursing home patients. Older adults with pneumonia may not display classic signs and symptoms...

American Family Physician : Article

https://www.aafp.org/afp/2015/1001/p612.html

Bronchodilators for Bronchiolitis - Medicine by the Numbers - American Family Physician

Sep 1, 2015 - Studies show that none were helped and the impact of harms such as decreased oxygen saturation and tachycardia was uncertain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0901/od1.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

Bronchodilators for Bronchiolitis - Cochrane for Clinicians - American Family Physician

Nov 1, 2014 - Albuterol does not improve any clinical outcomes in the outpatient or inpatient setting and should not be used in the treatment of bronchiolitis in a child 24 months or younger.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/1101/p622.html

Indacaterol (Arcapta) for COPD - STEPS - American Family Physician

Aug 15, 2014 - Indacaterol provides a similar benefit to other long-acting bronchodilators for the treatment of moderate to severe COPD, with once-daily dosing. As with other LABAs, it should be used only as add-on therapy in patients already taking inhaled corticosteroids.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0815/p252.html

Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? ...

Jul 15, 2014 - When offered to the appropriate population in the appropriate context, CT-based lung cancer screening will reduce the number of deaths caused by this difficult disease.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0715/od2.html

One in Five Patients Overdiagnosed with Lung Cancer Screening - POEMs - American Family...

Jul 15, 2014 - In patients screened for lung cancer using low-dose computed tomography (LDCT), more than 18% of all lung cancers found are slow-growing and will not cause symptoms or harm during an average 6.4 years of follow-up. This risk of overdiagnosis should be part of the discussion regarding ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p112.html

Update on Latent Tuberculosis Infection - American Family Physician

Jun 1, 2014 - Latent tuberculosis infection refers to an asymptomatic, nontransmissible infection with Mycobacterium tuberculosis, carrying a 5% to 10% lifetime risk of progressing to active disease. One-half of this risk occurs within the first two years after infection. High-risk groups include ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0601/p889.html

Prophylactic Antibiotics for the Prevention of COPD Exacerbation - Cochrane for ...

Jun 1, 2014 - Continuous prophylactic antibiotic therapy significantly decreases COPD exacerbations for up to three years. However, it does not decrease mortality, and it puts the patient at risk of antibiotic-resistant colonization and infection.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2014/0601/p870.html

PPIs, Childhood Asthma, and the Problem of Therapeutic Creep - AFP Journal Club - ...

Mar 15, 2014 - The use of a therapy in patients one would intuitively think might benefit, but in whom no benefit has been documented, is called therapeutic creep. The use of proton pump inhibitors for poorly controlled asthma is an example of this phenomenon.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0315/p476.html

Roflumilast (Daliresp) for Chronic Obstructive Pulmonary Disease - STEPS - American ...

Feb 15, 2014 - Roflumilast therapy has a limited role in patients with severe COPD, and no role in patients with mild to moderate COPD. It will not decrease the number of hospitalizations.

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0215/p300.html

Amoxicillin/Clavulanate or Ibuprofen No Better Than Placebo for Acute Bronchitis - ...

Feb 1, 2014 - Treating acute bronchitis with amoxicillin/clavulanate or the nonsteroidal anti-inflammatory drug ibuprofen is no more effective than placebo in decreasing symptoms in general or duration of frequent cough. Treatment does, however, produce adverse effects in one in eight patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p225.html

Treatment of Stable Chronic Obstructive Pulmonary Disease: the GOLD Guidelines - ...

Nov 15, 2013 - Chronic obstructive pulmonary disease (COPD) is a common problem in primary care. COPD is diagnosed with spirometry only in clinically stable patients with a postbronchodilator forced expiratory volume in one second/forced vital capacity ratio of less than 0.70. All patients with COPD ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1115/p655.html

A Simple Cough Algorithm for Children with Chronic Cough - POEMs - American Family ...

Nov 15, 2013 - In children with chronic cough, a simple approach of ruling out specific indicators of cause, followed by treating a wet cough with antibiotics, results in a significant decrease in the duration of cough. Some of the causes of chronic cough were reactive airway disease, bronchiectasis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1115/od1.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

Pulmonary Embolism Rule-Out Criteria: A Clinical Decision Rule That Works - AFP Journal...

Jul 15, 2013 - A number of clinical decision rules have been released recently. The PERC rule is an example of one that works well because it was derived from a large number of patients, and it was internally and externally validated.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0715/p98.html

Corticosteroids for Presumed Pneumocystis Pneumonia in Patients with HIV Infection - ...

Jul 15, 2013 - Adjunctive corticosteroids decrease mortality in patients with HIV infection who have moderate to severe hypoxemia and suspected or confirmed pneumocystis pneumonia. Corticosteroids lead to a higher incidence of herpetic lesions, but not other opportunistic conditions.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2013/0715/od1.html

Is Rivaroxaban Noninferior to Standard Warfarin Therapy in Preventing Recurrent PE and ...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0615/p872.html

Updated Guidelines from AASM for the Treatment of Central Sleep Apnea Syndromes - ...

Nov 15, 2012 - The updated guidelines on central sleep apnea from the American Academy of Sleep Medicine (AASM) includes levels of recommendations (standard or option) based on the overall quality of evidence (high, moderate, low, or very low). Central sleep apnea syndromes are characterized by ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2012/1115/p968.html

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Feb 15, 2012 - Acute respiratory distress syndrome manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include acute onset, profound hypoxemia, bilateral pulmonary infiltrates, and the absence of left atrial hypertension. Acute respiratory distress syndrome is ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0215/p352.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

GERD Treatment for Chronic Nonspecific Cough in Children and Adults - Cochrane for ...

Sep 1, 2011 - Acid suppressants or prokinetic agents should not be used to treat chronic nonspecific cough in infants or children. There is insufficient evidence to support or discourage use of these agents to treat chronic non-specific cough in adults, even in those with a history of GERD.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/0901/p502.html

Effectiveness of Bronchodilators for Bronchiolitis Treatment - Cochrane for Clinicians ...

May 1, 2011 - Bronchodilators may transiently improve the clinical status of infants with bronchiolitis and no prior history of wheezing. However, moderately strong evidence shows that key outcomes such as oxygen saturation, need for hospitalization, length of hospitalization, and duration of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2011/0501/p1045.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

Diagnosis and Treatment of Acute Bronchitis - American Family Physician

Dec 1, 2010 - Cough is the most common symptom bringing patients to the primary care physician’s office, and acute bronchitis is usually the diagnosis in these patients. Acute bronchitis should be differentiated from other common diagnoses, such as pneumonia and asthma, because these conditions may ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1345.html

Medical Therapy for Asthma: Updates from the NAEPP Guidelines - American Family Physician

Nov 15, 2010 - Proper care of patients with asthma involves the triad of systematic chronic care plans, self-management support, and appropriate medical therapy. Controller medications (inhaled corticosteroids, long-acting beta2 agonists, and leukot- riene receptor antagonists) are the foundation of ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1115/p1242.html

ACCP Releases Statement on Dyspnea Treatment in Patients with Advanced Lung or Heart ...

Oct 15, 2010 - The American College of Chest Physicians (ACCP) wrote a consensus statement to influence clinical practice and provide suggestions regarding the management of dyspnea in patients with advanced lung or heart disease.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2010/1015/p999.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

Pulmonary Arterial Hypertension: An Update on Diagnosis and Treatment - American Family...

Aug 15, 2010 - Pulmonary arterial hypertension is defined as a mean pulmonary arterial pressure greater than 25 mm Hg at rest or 30 mm Hg during physical activity. Pulmonary arterial hypertension is classified into subgroups, including idiopathic, heritable, and pulmonary arterial hypertension ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0815/p370.html

Outdoor Air Pollutants and Patient Health - American Family Physician

Jan 15, 2010 - Almost 160 million persons live in areas of the United States that exceed federal health-based air pollution standards. The two air pollutants that most commonly exceed standards are ozone and particulate matter. Ozone and particulate matter can harm anyone if levels are sufficiently ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0115/p175.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

Treatment of Nursing Home-Acquired Pneumonia - American Family Physician

Jun 1, 2009 - Pneumonia is an important cause of morbidity and mortality in nursing home residents, with 30-day mortality rates ranging from 10 to 30 percent. Streptococcus pneumoniae is the most common cause of nursing home-acquired pneumonia, although Staphylococcus aureus and gram-negative ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0601/p976.html

Should Salmeterol Be Used for Long-Term Asthma Control? - Cochrane for Clinicians - ...

Jun 1, 2009 - Salmeterol may help improve asthma symptoms, but it should only be used as part of a comprehensive asthma management plan including inhaled corticosteroids and a short-acting beta agonist. There is currently insufficient evidence to confirm that salmeterol does not increase the risk of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2009/0601/p957.html

Identification and Management of Latent Tuberculosis Infection - American Family Physician

May 15, 2009 - Latent tuberculosis infection (LTBI) is a condition in which a person is infected with Mycobacterium tuberculosis, but does not currently have active tuberculosis disease. An estimated 10 to 15 million persons in the United States have LTBI. Because 5 to 10 percent of persons with LTBI ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0515/p879.html

Latent Tuberculosis Infection: The Physician's Role in Tuberculosis Control - ...

May 15, 2009 - ...FERN R. HAUCK, MD, MS, and AMIESHA S. PANCHAL, MD, University of Virginia School of Medicine, Charlottesville, Virginia Am Fam Physician. 2009 May 15;79(10):845-846. Related Article Active tuberculosis continues to be a major cause of mortality worldwide. In response to the...

American Family Physician : Editorials

https://www.aafp.org/afp/2009/0515/p845.html

Overview of Changes to Asthma Guidelines: Diagnosis and Screening - American Family ...

May 1, 2009 - The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a major advance in the approach to asthma care by emphasizing the monitoring of clinically relevant aspects of care and the importance of planned primary care, and by providing patients ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0501/p761.html

The Role of Chest CT in Diagnosing Pulmonary Embolism - AFP Journal Club - American ...

Sep 1, 2008 - How good is chest CT at identifying pulmonary embolism? It might have higher false-positive and false-negative rates than previously thought.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0901/p554.html

Update on the Treatment of Tuberculosis - American Family Physician

Aug 15, 2008 - Approximately one third of the world's population, including more than 11 million persons in the United States, is latently infected with Mycobacterium tuberculosis. Although most cases of tuberculosis in the United States occur in foreign-born persons from endemic countries, the ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0815/p457.html

Diagnosis of Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2008 - Chronic obstructive pulmonary disease affects more than 26 million adults in the United States. Family physicians provide care for most of these patients. Cigarette smoking is the leading risk factor for chronic obstructive pulmonary disease, although other risk factors, including ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p87.html

Inhaled Steroid Use and Asthma Control in Patients with Mild Persistent Asthma - AFP ...

Jul 1, 2008 - Can patients with mild persistent asthma safely decrease or eliminate inhaled steroids? The results of these studies may not be generalizable to the average primary care patient. Patients should be appropriately classified and treated using 2007 National Asthma Education and Prevention ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0701/p21.html

Is Unfractionated Heparin Equivalent to Low-Molecular-Weight Heparin for Venous ...

Jun 1, 2008 - Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0601/p1492.html

Albuterol vs. Levalbuterol for Asthma Treatment in Children - AFP Journal Club - ...

May 1, 2008 - For children with acute asthma exacerbations, is levalbuterol better than albuterol? There is no difference between the medications in effectiveness or side effects.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0501/p1214.html

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