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Practice Guidelines

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Type 2 Diabetes Mellitus in Children - American Family Physician

Nov 1, 2018 - The prevalence of type 2 diabetes mellitus in children and adolescents has increased worldwide over the past three decades. This increase has coincided with the obesity epidemic, and minority groups are disproportionately affected. The American Diabetes Association recommends screening ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p590.html

Cerumen Impaction: Diagnosis and Management - American Family Physician

Oct 15, 2018 - Cerumen production is a normal and protective process for the ear canal. However, cerumen should be removed when it causes symptoms (e.g., hearing loss, itching, pain, tinnitus) or prevents assessment of the external auditory canal, the tympanic membrane, or audiovestibular system. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p525.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

Top POEMs of 2017 Consistent with the Principles of the Choosing Wisely Campaign - ...

Jul 15, 2018 - This article discusses the POEMs (patient-oriented evidence that matters) of 2017 judged to be most consistent with the principles of the Choosing Wisely campaign. A POEM is a synopsis of a research study that reports patient-oriented outcomes, such as improvement in symptoms, quality ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0715/p93.html

Acute Appendicitis: Efficient Diagnosis and Management - American Family Physician

Jul 1, 2018 - Appendicitis is one of the most common causes of acute abdominal pain in adults and children, with a lifetime risk of 8.6% in males and 6.7% in females. It is the most common nonobstetric surgical emergency during pregnancy. Findings from the history, physical examination, and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p25.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.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

Top 20 Research Studies of 2017 for Primary Care Physicians - American Family Physician

May 1, 2018 - Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p581.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.html

Testicular Cancer: Diagnosis and Treatment - American Family Physician

Feb 15, 2018 - Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States. With effective treatment, the overall five-year survival rate is 97%. Risk factors for testicular cancer include ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p261.html

Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.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

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

Cardiomyopathy: An Overview - American Family Physician

Nov 15, 2017 - The definition and classification of cardiomyopathy have evolved considerably in recent years. Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p640.html

Chronic Cough: Evaluation and Management - American Family Physician

Nov 1, 2017 - Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p575.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention - American ...

Sep 1, 2017 - The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p314.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

Top POEMs of 2016 Consistent with the Principles of the Choosing Wisely Campaign - ...

Aug 15, 2017 - A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p234.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

Top 20 Research Studies of 2016 for Primary Care Physicians - American Family Physician

May 1, 2017 - This article summarizes the top 20 original research studies and four practice guidelines of 2016, based on regular literature surveillance and as selected by members of the Canadian Medical Association. The studies, known as POEMs (patient-oriented evidence that matters), were rated ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p572.html

Chronic Obstructive Pulmonary Disease: Diagnosis and Management - American Family ...

Apr 1, 2017 - The diagnosis of chronic obstructive pulmonary disease (COPD) should be suspected in patients with risk factors (primarily a history of smoking) who report dyspnea at rest or with exertion, chronic cough with or without sputum production, or a history of wheezing. COPD may be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p433.html

Deep Venous Thrombosis and Pulmonary Embolism: Current Therapy - American Family Physician

Mar 1, 2017 - Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p295.html

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.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

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.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

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

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

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.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

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Current Concepts in Adult Acute Rhinosinusitis - American Family Physician

Jul 15, 2016 - Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p97.html

Diagnosis and Management of Vertebral Compression Fractures - American Family Physician

Jul 1, 2016 - Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p44.html

Common Questions About Streptococcal Pharyngitis - American Family Physician

Jul 1, 2016 - Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p24.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Top 20 Research Studies of 2015 for Primary Care Physicians - American Family Physician

May 1, 2016 - In 2015, a group of primary care clinicians with expertise in evidence-based practice performed monthly surveillance of more than 110 English-language clinical research journals. They identified 251 studies that addressed a primary care question and had the potential to change practice ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p756.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Jan 1, 2016 - In 2013, approximately 179,000 bariatric surgery procedures were performed in the United States, including the laparoscopic sleeve gastrectomy (42.1%), Roux-en-Y gastric bypass (34.2%), and laparoscopic adjustable gastric banding (14.0%). Choice of procedure depends on the medical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p31.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

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

Common Questions About Pressure Ulcers - American Family Physician

Nov 15, 2015 - Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p888.html

Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children - American ...

Oct 15, 2015 - Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p705.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

Top 20 Research Studies of 2014 for Primary Care Physicians - American Family Physician

Sep 1, 2015 - A team of primary care clinicians with expertise in evidence-based medicine performed monthly surveillance of more than 110 English-language clinical research journals during 2014, and identified 255 studies that had the potential to change how family physicians practice. Each study was...

American Family Physician : Article

https://www.aafp.org/afp/2015/0901/p377.html

Diagnosis and Management of Osteoporosis - American Family Physician

Aug 15, 2015 - Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p261.html

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