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Practice Guidelines

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Anaphylaxis: Recognition and Management - American Family Physician

Nov 15, 2011 - Anaphylaxis is a severe, life-threatening, systemic allergic reaction that is almost always unanticipated and may lead to death by airway obstruction or vascular collapse. Anaphylaxis occurs as the result of an allergen response, usually immunoglobulin E–mediated, which leads to mast ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1111.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

Diagnosis and Treatment of Acute Uncomplicated Cystitis - American Family Physician

Oct 1, 2011 - Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p771.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Oct 1, 2011 - Bariatric surgery procedures, including laparoscopic adjustable gastric banding, laparoscopic sleeve gastrectomy, and Roux-en-Y gastric bypass, result in an average weight loss of 50 percent of excess body weight. Remission of diabetes mellitus occurs in approximately 80 percent of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p805.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

Diagnosis and Treatment of Plantar Fasciitis - American Family Physician

Sep 15, 2011 - Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in adults. It affects more than 1 million persons per year, and two-thirds of patients with plantar fasciitis will seek care from their family physician. Plantar fasciitis affects sedentary and athletic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p676.html

Diagnosis and Treatment of Acute Pyelonephritis in Women - American Family Physician

Sep 1, 2011 - Acute pyelonephritis is a common bacterial infection of the renal pelvis and kidney most often seen in young adult women. History and physical examination are the most useful tools for diagnosis. Most patients have fever, although it may be absent early in the illness. Flank pain is ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0901/p519.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

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

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

Jun 1, 2011 - Community-acquired pneumonia is diagnosed by clinical features (e.g., cough, fever, pleuritic chest pain) and by lung imaging, usually an infiltrate seen on chest radiography. Initial evaluation should determine the need for hospitalization versus outpatient management using validated ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1299.html

Caregiver Care - American Family Physician

Jun 1, 2011 - In 2009, nearly 66 million Americans (three in 10 U.S. households) reported at least one person providing unpaid care as a family caregiver. More adults with chronic conditions and disabilities are living at home than ever before, and family caregivers have an even higher level of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1309.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

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

Specialized Nutrition Support - American Family Physician

Jan 15, 2011 - Specialized nutrition support should be offered to patients who are malnourished or at risk of becoming malnour- ished when it would benefit patient outcomes or quality of life. Improving the nutritional value of ingested food and tailoring intake to the patient’s preferences, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p173.html

Atrial Fibrillation: Diagnosis and Treatment - American Family Physician

Jan 1, 2011 - Atrial fibrillation is the most common cardiac arrhythmia. It impairs cardiac function and increases the risk of stroke. The incidence of atrial fibrillation increases with age. Key treatment issues include deciding when to restore normal sinus rhythm, when to control rate only, and how...

American Family Physician : Article

https://www.aafp.org/afp/2011/0101/p61.html

Diagnosis, Initial Management, and Prevention of Meningitis - American Family Physician

Dec 15, 2010 - Although the annual incidence of bacterial meningitis in the United States is declining, it remains a medical emer- gency with a potential for high morbidity and mortality. Clinical signs and symptoms are unreliable in distinguishing bacterial meningitis from the more common forms of ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1215/p1491.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

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

Care of the Returning Veteran - American Family Physician

Jul 1, 2010 - Of the 23.8 million military veterans living in the United States, approximately 3 million have served in Operation Enduring Freedom or Operation Iraqi Freedom. The injuries and illnesses that affect veterans returning from combat are predictable. Blast injuries are common and most ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0701/p43.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

Diabetes Mellitus: Diagnosis and Screening - American Family Physician

Apr 1, 2010 - Based on etiology, diabetes is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, latent autoimmune diabetes, maturity-onset diabetes of youth, and miscellaneous causes. The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0401/p863.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

Cardiac Rehabilitation - American Family Physician

Nov 1, 2009 - An estimated 80 million (nearly one in three) Americans have cardiovascular disease, which is the leading cause of morbidity and mortality worldwide. In the United States alone, more than 850,000 deaths are attributed annually to cardiovascular disease, and more than 8 million Americans...

American Family Physician : Article

https://www.aafp.org/afp/2009/1101/p955.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

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

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

Diagnosis and Management of Gestational Diabetes Mellitus - American Family Physician

Jul 1, 2009 - Gestational diabetes occurs in 5 to 9 percent of pregnancies in the United States and is growing in prevalence. It is a controversial entity, with conflicting guidelines and treatment protocols. Recent studies show that diagnosis and management of this disorder have beneficial effects ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p57.html

Chronic Low Back Pain: Evaluation and Management - American Family Physician

Jun 15, 2009 - Chronic low back pain is a common problem in primary care. A history and physical examination should place patients into one of several categories: (1) nonspecific low back pain; (2) back pain associated with radiculopathy or spinal stenosis; (3) back pain referred from a nonspinal ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0615/p1067.html

ACC/AHA Guideline Update for the Management of ST-Segment Elevation Myocardial ...

Jun 15, 2009 - The American College of Cardiology and American Heart Association, in collaboration with the Canadian Cardiovascular Society, have issued an update of the 2004 guideline for the management of patients with ST-segment elevation myocardial infarction. The American Academy of Family ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0615/p1080.html

Cardiomyopathy: An Overview - American Family Physician

May 1, 2009 - Cardiomyopathy is an anatomic and pathologic diagnosis associated with muscle or electrical dysfunction of the heart. Cardiomyopathies represent a heterogeneous group of diseases that often lead to progressive heart failure with significant morbidity and mortality. Cardiomyopathies may ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0501/p778.html

Current Strategies in the Diagnosis and Treatment of Childhood ...

Apr 15, 2009 - Symptoms of childhood attention-deficit/hyperactivity disorder affect cognitive, academic, behavioral, emotional, social, and developmental functioning. Attention-deficit/hyperactivity disorder is the most commonly diagnosed neurodevelopmental disorder in children and adolescents. An ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0415/p657.html

Diagnosis: Making the Best Use of Medical Data - American Family Physician

Mar 15, 2009 - To take the best possible care of patients, physicians must understand the basic principles of diagnostic test interpretation. Pretest probability is an important factor in interpreting test results. Some tests are useful for ruling in disease when positive or ruling out disease when ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0315/p478.html

Diagnosis and Treatment of Streptococcal Pharyngitis - American Family Physician

Mar 1, 2009 - Common signs and symptoms of streptococcal pharyngitis include sore throat, temperature greater than 100.4 degrees F (38 degrees C), tonsillar exudates, and cervical adenopathy. Cough, coryza, and diarrhea are more common with viral pharyngitis. Available diagnostic tests include throat...

American Family Physician : Article

https://www.aafp.org/afp/2009/0301/p383.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

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

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

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Sep 15, 2008 - Aortic stenosis is the most important cardiac valve disease in developed countries, affecting 3 percent of persons older than 65 years. Although the survival rate in asymptomatic patients with aortic stenosis is comparable to that in age- and sex-matched control patients, the average ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0915/p717.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

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

Venous Thromboembolism During Pregnancy - American Family Physician

Jun 15, 2008 - Venous thromboembolism is the leading cause of maternal death in the United States. Pregnancy is a risk factor for deep venous thrombosis, and risk is further increased with a personal or family history of thrombosis or thrombophilia. Screening for thrombophilia is not recommended for ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0615/p1709.html

A Practical Approach to Neonatal Jaundice - American Family Physician

May 1, 2008 - Kernicterus and neurologic sequelae caused by severe neonatal hyperbilirubinemia are preventable conditions. A structured and practical approach to the identification and care of infants with jaundice can facilitate prevention, thus decreasing rates of morbidity and mortality. Primary ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0501/p1255.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

Adolescent Substance Use and Abuse: Recognition and Management - American Family Physician

Feb 1, 2008 - Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0201/p331.html

Treating Eating Disorders in Primary Care - American Family Physician

Jan 15, 2008 - Binge-eating disorder, bulimia nervosa, and anorexia nervosa are potentially life-threatening disorders that involve complex psychosocial issues. A strong therapeutic relationship between the physician and patient is necessary for assessing the psychosocial and medical factors used to ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0115/p187.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

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

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

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

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

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