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Practice Guidelines

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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

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

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

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

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

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

Assessment and Management of Acute Low Back Pain - American Family Physician

Nov 15, 1999 - Acute low back pain is commonly treated by family physicians. In most cases, only conservative therapy is needed. However, the history and physical examination may elicit warning signals that indicate the need for further work-up and treatment. These

American Family Physician : Article

https://www.aafp.org/afp/1999/1115/p2299.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

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

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

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

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

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

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

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

Diagnosis and Treatment of Pulmonary Hypertension - American Family Physician

May 1, 2001 - Primary pulmonary hypertension is a rare disease of unknown etiology, whereas secondary pulmonary hypertension is a complication of many pulmonary, cardiac and extrathoracic conditions. Chronic obstructive pulmonary disease, left ventricular dysfunction and disorders associated with ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0501/p1789.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

Diagnosis of Acute Coronary Syndrome - American Family Physician

Jul 1, 2005 - The term 'acute coronary syndrome' encompasses a range of thrombotic coronary artery diseases, including unstable angina and both ST-segment elevation and non-ST-segment elevation myocardial infarction. Diagnosis requires an electrocardiogram and a careful review for signs and symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0701/p119.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 and Management of Scaphoid Fractures - American Family Physician

Sep 1, 2004 - Scaphoid fracture is a common injury encountered in family medicine. To avoid missing this diagnosis, a high index of suspicion and a thorough history and physical examination are necessary, because early imaging often is unrevealing. Anatomic snuffbox tenderness is a highly sensitive ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0901/p879.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

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

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

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

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

Diagnosis and Treatment of Sick Sinus Syndrome - American Family Physician

Apr 15, 2003 - Sick sinus syndrome comprises a variety of conditions involving sinus node dysfunction and commonly affects elderly persons. While the syndrome can have many causes, it usually is idiopathic. Patients may experience syncope, pre-syncope, palpitations, or dizziness; however, they often ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0415/p1725.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

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

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

Update on Helicobacter pylori Treatment - American Family Physician

Feb 1, 2007 - One half of the world's population has Helicobacter pylori infection, with an estimated prevalence of 30 percent in North America. Although it is unclear whether eradication of H. pylori improves symptoms in patients with nonulcer dyspepsia, there is strong evidence that eradication of ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0201/p351.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

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

A Practical Guide to Crisis Management - American Family Physician

Oct 1, 2006 - Family physicians often treat patients who are experiencing psychological or medical crises. Any event perceived as overwhelming by the patient may trigger a crisis reaction consisting of psychological and physiological symptoms. Physicians are encouraged to assist patients who are ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1001/p1159.html

Abdominal Aortic Aneurysm - American Family Physician

Apr 1, 2006 - Most abdominal aortic aneurysms (AAAs) are asymptomatic, not detectable on physical examination, and silent until discovered during radiologic testing for other reasons. Tobacco use, hypertension, a family history of AAA, and male sex are clinical risk factors for the development of an ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1198.html

Detection and Evaluation of Chronic Kidney Disease - American Family Physician

Nov 1, 2005 - Chronic kidney disease affects approximately 19 million adult Americans, and its incidence is increasing rapidly. Diabetes and hypertension are the underlying causes in most cases of chronic kidney disease. Evidence suggests that progression to kidney failure can be delayed or prevented...

American Family Physician : Article

https://www.aafp.org/afp/2005/1101/p1723.html

Common Hyperpigmentation Disorders in Adults: Part I. Diagnostic Approach, Cafe au Lait...

Nov 15, 2003 - The cause of hyperpigmentation usually is traced to the activity and presence of melanocytes. Cafe au lait macules may be solitary benign findings or may indicate the presence of neurofibromatosis with its associated complications. Diffuse hyperpigmentation should prompt a search for ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1955.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

Atypical Pathogens and Challenges in Community-Acquired Pneumonia - American Family ...

Apr 1, 2004 - Atypical organisms such as Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila are implicated in up to 40 percent of cases of community-acquired pneumonia. Antibiotic treatment is empiric and includes coverage for both typical and atypical organisms. Doxycycline, a ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1699.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

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

Update on Exercise Stress Testing - American Family Physician

Nov 15, 2006 - Exercise stress testing is an important diagnostic tool for the evaluation of suspected or known cardiac disease. In 2002, the American College of Cardiology (ACC) and the American Heart Association (AHA) revised their guidelines for exercise testing. Ten categories from the ACC/ AHA ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1115/p1749.html

Selecting Medications for the Treatment of Urinary Incontinence - American Family ...

Jan 15, 2005 - In response to the growing population of older patients with incontinence, pharmaceutical companies are developing new drugs to treat the condition. Before prescribing medications for incontinence, however, physicians should determine the nature and cause of the patient's incontinence. ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0115/p315.html

Anemia in Children - American Family Physician

Oct 15, 2001 - Anemia in children is commonly encountered by the family physician. Multiple causes exist, but with a thorough history, a physical examination and limited laboratory evaluation a specific diagnosis can usually be established. The use of the mean corpuscular volume to classify the anemia...

American Family Physician : Article

https://www.aafp.org/afp/2001/1015/p1379.html

The Homeless in America: Adapting Your Practice - American Family Physician

Oct 1, 2006 - In 2004, the National Guidelines Clearinghouse placed eight guidelines from the National Health Care for the Homeless Council on its Web site. Seven of the guidelines are on specific disease processes and one is on general care. In addition to straightforward clinical decision making, ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1001/p1132.html

Treatment of Ethylene Glycol Poisoning - American Family Physician

Sep 1, 2002 - Ingestion of ethylene glycol may be an important contributor in patients with metabolic acidosis of unknown cause and subsequent renal failure. Expeditious diagnosis and treatment will limit metabolic toxicity and decrease morbidity and mortality. Ethylene glycol poisoning should be ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p807.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

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

Strength of Recommendation Taxonomy (SORT): A Patient-Centered Approach to Grading ...

Feb 1, 2004 - A large number of taxonomies are used to rate the quality of an individual study and the strength of a recommendation based on a body of evidence. We have developed a new grading scale that will be used by several family medicine and primary care journals (required or optional), with ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0201/p548.html

Diagnosis of Eating Disorders in Primary Care - American Family Physician

Jan 15, 2003 - Eating disorders, particularly anorexia nervosa and bulimia nervosa, are significant causes of morbidity and mortality among adolescent females and young women. Eating disorders are associated with devastating medical and psychologic consequences, including death, osteoporosis, growth ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0115/p297.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

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