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Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults - Putting ...

Dec 15, 2017 - L.D., a 66-year-old generally healthy white man, presents for his annual physical. He has no history of cardiovascular disease (CVD); he has had consistent systolic blood pressure measurements of 140 mm Hg; he is not taking any medications; he does not smoke; he exercises three times ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/1215/p805.html

Acupuncture Is Ineffective for Treatment of Low Back Pain - Letters to the Editor - ...

Dec 15, 2017 - ...4. Zhao XF, Du Y, Liu PG, Wang S. Acupuncture for stroke: evidence of effectiveness, safety, and cost from systematic reviews. Top Stroke Rehabil. 2012;19(3):226–233. 5. Bergqvist D. Vascular injuries caused by acupuncture. A systematic review. Int Angiol. 2013;32(1):1–8. Read the...

American Family Physician : Letter

https://www.aafp.org/afp/2017/1215/ol2.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

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

Gout: Diagnosis and Management - Implementing AHRQ Effective Health Care Reviews - ...

Nov 15, 2017 - What is the accuracy of clinical decision tools and imaging for the diagnosis of gout in the primary care setting, and how effective are medications used to treat and prevent gout?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/1115/p668.html

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for ...

Nov 15, 2017 - The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/1115/od2.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Statins in Persons at Low Risk of Cardiovascular Disease - Medicine by the Numbers - ...

Nov 1, 2017 - Despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1101/od1.html

Recurrent Ischemic Stroke: Strategies for Prevention - American Family Physician

Oct 1, 2017 - Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p436.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

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

Treating Aging with Testosterone - Editorials - American Family Physician

Oct 1, 2017 - Most patients on testosterone are being treated for normal symptoms of aging. Given that the diagnostics are questionable and the benefits are unconvincing, the risks of testosterone, some of which may be life-threatening, are not worth taking.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1001/p428.html

Prolonged Dual Antiplatelet Therapy After MI Reduces Major Adverse Cardiac Events - ...

Oct 1, 2017 - In patients who are stable one year post-MI, prolonged use of dual antiplatelet therapy may be an effective treatment to decrease major cardiac events and cardiovascular mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1001/od1.html

Yoga for Cancer-Related Symptoms in Women with Breast Cancer - Cochrane for Clinicians ...

Oct 1, 2017 - Yoga improves health-related quality of life, reduces sleep disturbances, and decreases fatigue in the short term (up to 12 weeks) among women diagnosed with breast cancer who have completed cancer-related treatment or are receiving cancer treatment compared with no intervention.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1001/p434.html

Vitamin B12 Deficiency: Recognition and Management - American Family Physician

Sep 15, 2017 - Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p384.html

Exercise Stress Testing: Indications and Common Questions - American Family Physician

Sep 1, 2017 - Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p293.html

Newly Detected Atrial Fibrillation: AAFP Updates Guideline on Pharmacologic Management ...

Sep 1, 2017 - The American Academy of Family Physicians, with the American College of Physicians, has updated its 2003 guideline to provide guidance on atrial fibrillation treatment via medication in the primary care setting. The guideline focuses on adults with nonvalvular atrial fibrillation as ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0901/p332.html

Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS ...

Sep 1, 2017 - The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0901/p284.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

Lower Extremity Abnormalities in Children - American Family Physician

Aug 15, 2017 - Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p226.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

HIV-Associated Complications: A Systems-Based Approach - American Family Physician

Aug 1, 2017 - Persons with human immunodeficiency virus (HIV) infection often develop complications related directly to the infection, as well as to treatment. Aging, lifestyle factors, and comorbidities increase the risk of developing chronic conditions such as diabetes mellitus and chronic kidney ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p161.html

Antiplatelet vs. Anticoagulation Therapy for Patients with Heart Failure in Sinus ...

Aug 1, 2017 - Heart failure increases the risk of thrombotic complications, but use of warfarin does not lower all-cause mortality more than aspirin in patients with heart failure with reduced ejection fraction in sinus rhythm.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0801/p160.html

Pelvic Organ Prolapse - American Family Physician

Aug 1, 2017 - ...vaginal bleeding, problems passing urine or stool, or any change in your ability to take care of the pessary (for instance, if you have a stroke or arthritis). What are Kegel exercises? Kegels (KEE-guls) are exercises that strengthen the muscles of the pelvis. To do a Kegel, you...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2017/0801/p179-s1.html

Common Side Effects of HIV Medicines - American Family Physician

Aug 1, 2017 - ...People with HIV infection are at higher risk of heart disease and stroke. You have an even higher risk if you smoke, have high cholesterol, high blood pressure, or diabetes, or if heart attacks run in your family. You can lower your risk by exercising and eating a healthy diet, and...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2017/0801/p161-s1.html

Screening for Obstructive Sleep Apnea in Adults: Recommendation Statement - U.S. ...

Jul 15, 2017 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea (OSA) in asymptomatic adults.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/0715/od1.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

Acute and Chronic Urticaria: Evaluation and Treatment - American Family Physician

Jun 1, 2017 - Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p717.html

Expanded Newborn Screening: Information and Resources for the Family Physician - ...

Jun 1, 2017 - Each year, 4 to 5 million newborns receive state-mandated screening. Although the Advisory Committee on Heritable Disorders in Newborns and Children has identified 34 core conditions that should be incorporated into screening programs, each state manages, funds, and maintains its own ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p703.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.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

Pharmacologic Treatment of Hypertension: ACP and AAFP Release Recommendations for ...

May 1, 2017 - The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) have made recommendations for all clinicians to treat hypertension in persons 60 years and older, based on the benefits and harms of higher (less than 150 mm Hg) and lower (140 mm Hg or less) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0501/p588.html

Estimating Cardiovascular Risk - Point-of-Care Guides - American Family Physician

May 1, 2017 - The primary prevention of cardiovascular disease (CVD) depends on accurate estimation of cardiovascular risk. However, a recent systematic review identified 363 prediction models.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0501/p580.html

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older: A Guideline ...

May 1, 2017 - A high standard must be met when guidelines recommend lifelong preventive medications, knowing that at best, a small minority of patients will benefit and that all are risking harm.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0501/p547.html

Severe Asymptomatic Hypertension: Evaluation and Treatment - American Family Physician

Apr 15, 2017 - Hypertension affects one-third of Americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Severe asymptomatic hypertension is defined as severely elevated blood pressure (180 mm Hg or more systolic, or 110 mm Hg or more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p492.html

Alzheimer Disease: Monotherapy vs. Combination Therapy - FPIN's Help Desk Answers - ...

Apr 1, 2017 - Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0401/p452.html

PCI Has More Benefits and Harms Than CABG for Selected Patients with Left Main Coronary...

Apr 1, 2017 - Patients undergoing PCI had fewer early myocardial infarctions, but more later deaths and later myocardial infarctions. There are other benefits to PCI, including shorter hospital stay, lower cost, and faster recovery. But patients should be informed of the tradeoffs, and it is ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455a.html

Multiple Myeloma: Diagnosis and Treatment - American Family Physician

Mar 15, 2017 - Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p373.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.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

Management of Binge-Eating Disorder in Adults - Implementing AHRQ Effective Health Care...

Mar 1, 2017 - What are the benefits and harms of treatments for adults with binge-eating disorder?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0301/p324.html

Fainting: What You Should Know - American Family Physician

Mar 1, 2017 - ...National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/syncope/syncope.htm National Library of Medicine https://www.nlm.nih.gov/medlineplus/fainting.html Read the full article. Get immediate access, anytime, anywhere. Choose a single...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2017/0301/p303-s1.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

Aspirin for the Prevention of Cardiovascular Disease and Colorectal Cancer: New ...

Feb 15, 2017 - In April 2016, the U.S. Preventive Services Task Force (USPSTF) updated its recommendation on the use of aspirin to prevent cardiovascular disease (CVD). Because emerging evidence suggested that aspirin may also be useful for the prevention of cancer, for the first time, the USPSTF ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0215/p222.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.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

The Health Hazards of Air Pollution—Implications for Your Patients - Editorials - ...

Feb 1, 2017 - Air pollution has many deleterious health effects. Physicians can encourage their patients to recognize the health cobenefits of actions to support the environment.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0201/p146.html

What's Making Me Dizzy? - American Family Physician

Feb 1, 2017 - ...nervous system problems are possible, but these are rare. If your dizziness doesn't let up between spells, it may be due to a stroke, or might mean that a stroke is about to happen. This is quite rare. Some medicines can cause dizziness. Tell your doctor what medicines you are...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2017/0201/p154-s1.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

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: ...

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2017/0115/od1.html

In Patients with Vascular Disease, Treating Sleep Apnea Does Not Reduce the Risk of ...

Jan 15, 2017 - Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123.html

ADA Updates Standards of Medical Care for Patients with Diabetes Mellitus - Practice ...

Jan 1, 2017 - The American Diabetes Association (ADA) recently updated its standards of care to provide the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Key changes in the 2016 update include new screening recommendations, clarification of ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0101/p40.html

Screening for Lipid Disorders in Children and Adolescents: Recommendation Statement - ...

Dec 15, 2016 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for lipid disorders in children and adolescents 20 years or younger.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2016/1215/od1.html

Autism Spectrum Disorder - American Family Physician

Dec 15, 2016 - ...National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/disorders/autism/detail_autism.htm National Library of Medicine https://medlineplus.gov/autismspectrumdisorder.html Read the full article. Get immediate access, anytime, anywhere. Choose a single...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/1215/p972-s1.html

Hormone Therapy and Other Treatments for Symptoms of Menopause - American Family Physician

Dec 1, 2016 - The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p884.html

Erectile Dysfunction - American Family Physician

Nov 15, 2016 - Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is common, affecting at least 12 million U.S. men. The five-question International Index of Erectile Function allows rapid clinical assessment of ED. The ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p820.html

Acute Monoarthritis: Diagnosis in Adults - American Family Physician

Nov 15, 2016 - Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities....

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p810.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

Erectile Dysfunction - American Family Physician

Nov 15, 2016 - ...to the nerves and blood vessels in the penis. This allows the penis to fill with blood. Some medical conditions block these signals, such as strokes, spine or pelvic injuries, Parkinson disease, and multiple sclerosis. Nerve damage from diabetes or prostate surgery can also cause...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/1115/p820-s1.html

The Risk of MI and Ischemic Stroke with Combined Oral Contraceptives - Cochrane for ...

Nov 1, 2016 - The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are used.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p691.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

Primary Care for Patients with HIV Infection: It’s Not Who Should Provide It, It’s How ...

Nov 1, 2016 - The major challenge is not to address whether primary care clinicians without substantial HIV experience should provide HIV care, but to create a framework that allows all primary care clinicians to provide the best possible care for their patients living with HIV infection.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/1101/p687.html

High-Deductible Plans May Reduce Ambulatory Care Use - Graham Center Policy One-Pagers ...

Nov 1, 2016 - Although rates of uninsured Americans are declining because of the Affordable Care Act (ACA), there is growing concern about out-of-pocket expenditures associated with private high-deductible insurance plans.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1101/p727.html

Amiodarone for the Prevention of Sudden Cardiac Death - Cochrane for Clinicians - ...

Nov 1, 2016 - Although not a substitute for an implantable cardioverter-defibrillator (ICD), amiodarone is effective for the primary prevention of sudden cardiac death when compared with placebo (number needed to treat [NNT] = 47; 95% confidence interval [CI], 33 to 100), but it does not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p692.html

Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663.html

The Mental Status Examination - American Family Physician

Oct 15, 2016 - The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1015/p635.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer:...

Oct 15, 2016 - The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2016/1015/od1.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer ...

Oct 15, 2016 - S.L. is a 55-year-old man who presents to your office for a routine refill of his antihypertension medication. He also takes a statin and an antidepressant. Although he smokes, his blood pressure and cholesterol are well controlled. His history and physical examination are unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/1015/p661.html

Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients - ...

Oct 15, 2016 - For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663a.html

Top POEMs of 2015 Consistent with the Principles of the Choosing Wisely Campaign - ...

Oct 1, 2016 - The authors applied a novel method to identify recent clinical studies that showed results consistent with the principles of the Choosing Wisely campaign. The method, based on crowdsourcing studies known as POEMs (patientoriented evidence that matters), involved analyzing POEM ratings ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1001/p566.html

Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation ...

Oct 1, 2016 - Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1001/od1.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

Clinical Diagnosis of Gout Without Joint Aspirate - Point-of-Care Guides - American ...

Sep 15, 2016 - Gout is ideally diagnosed through identification of characteristic negatively birefringent crystals under polarized light microscopy in fluid aspirated from end-organ deposits, typically from a joint. However, fewer than 10% of patients with gout see a rheumatologist, and most cases of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0915/p505.html

Atrial Fibrillation - American Family Physician

Sep 15, 2016 - ...of your heart to shake, and not pump blood well. Sometimes a clot can form in this chamber, and if that clot breaks free it can cause a stroke. What are the symptoms? Your heartbeat may feel fast and uneven. You may also feel weak, tired, or short of breath. You may find it hard to...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/0915/p442-s1.html

AAFP News - Sep 15, 2016 - American Family Physician

Sep 15, 2016 - Selected policy and health issues news briefs from AAFP News.

American Family Physician : AAFP News: AFP Edition

https://www.aafp.org/afp/2016/0915/p420.html

Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes - POEMs - ...

Sep 1, 2016 - In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p386.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

Update on Office-Based Strategies for the Management of Obesity - American Family ...

Sep 1, 2016 - Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p361.html

Perioperative Beta Blockers - Medicine by the Numbers - American Family Physician

Sep 1, 2016 - Studies show that 1 in 72 patients had a nonfatal myocardial infarction prevents while harm end points included nonfatal stroke, hypotension, and bradycardia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0901/od1.html

Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe ...

Sep 1, 2016 - The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p387.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

How to Recognize OSA and What It Means for Your Health - American Family Physician

Sep 1, 2016 - ...Stroke Hypertension (not controlled with medicine) Depression Increased risk of motor vehicle crashes Overall increased risk of death Where can I get more information? Your doctor American Sleep Apnea Association http://www.sleepapnea.org/ National Heart, Lung, and Blood...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/0901/p355-s1.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

AAP Updates Recommendations for Routine Preventive Pediatric Health Care - Practice ...

Aug 15, 2016 - The American Academy of Pediatrics (AAP) has updated recommendations for preventive pediatric health care services, including evidence-based screenings and assessments that should be addressed at well-child visits. The recommendations are organized by age: infancy, early childhood, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0815/p324.html

Alirocumab (Praluent) for Treatment of Hyperlipidemia - STEPS - American Family Physician

Aug 15, 2016 - Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0815/p310.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.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

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

Trigeminal Neuralgia - Clinical Evidence Handbook - American Family Physician

Jul 15, 2016 - What are the effects of ongoing treatments in persons with trigeminal neuralgia?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0715/p133.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Meta-Analysis: Intensive BP Control Decreases Major CV Events and Stroke, but Not MI, ...

Jun 15, 2016 - Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure,...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1036.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

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