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hypertension

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Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician Restricted content. Login required.

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Evaluation of Acute Headaches in Adults - American Family Physician

Feb 15, 2001 - Classifying headaches as primary (migraine, tension-type or cluster) or secondary can facilitate evaluation and management A detailed headache history helps to distinguish among the primary headache disorders.

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p685.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0915/p369.html

Senile Dementia of the Binswanger's Type - American Family Physician

Dec 1, 1998 - Senile dementia of the Binswanger's type is a term used to describe a dementia syndrome characterized by onset in the sixth or seventh decade of life, subcortical neurologic deficits, psychiatric disorders and evidence of hypertension or systemic vascular disease. The status of senile ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1201/p2068.html

Orthostatic Hypotension - American Family Physician

Dec 15, 2003 - Orthostatic hypotension is a physical finding defined by the American Autonomic Society and the American Academy of Neurology as a systolic blood pressure decrease of at least 20 mm Hg or a diastolic blood pressure decrease of at least 10 mm Hg within three minutes of standing. The ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1215/p2393.html

Stroke: Part I. A Clinical Update on Prevention - American Family Physician

May 1, 1999 - Clinical trials conducted during the past five years have yielded important results that have allowed us to refine our approach to stroke prevention. Treatment of isolated systolic hypertension prevents stroke and is generally well tolerated. New antiplatelet agents (clopidogrel and the...

American Family Physician : Article

https://www.aafp.org/afp/1999/0501/p2475.html

Diagnostic Approach to Tinnitus - American Family Physician

Jan 1, 2004 - Tinnitus is a common disorder with many possible causes. Most cases of tinnitus are subjective, but occasionally the tinnitus can be heard by an examiner. Otologic problems, especially hearing loss, are the most common causes of subjective tinnitus. Common causes of conductive hearing ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0101/p120.html

Pharmacologic Interventions for Apathy in Patients with Alzheimer Disease - Cochrane ...

Jan 1, 2019 - Methylphenidate may improve apathy in select patients with AD (mean difference [MD] = –4.99 on the apathy evaluation scale; 95% confidence interval [CI], –9.55 to –0.43), although the clinical significance associated with these findings remains unclear and the evidence is considered low...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0101/p14.html

Evaluation and Management of Delirium in Hospitalized Older Patients - American Family ...

Dec 1, 2008 - Delirium is common in hospitalized older patients and may be a symptom of a medical emergency, such as hypoxia or hypoglycemia. It is characterized by an acute change in cognition and attention, although the symptoms may be subtle and usually fluctuate throughout the day. This ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1201/p1265.html

Syncope Evaluation and Treatment Guidelines from ACC, AHA, and HRS - Practice ...

Apr 1, 2018 - The American College of Cardiology (ACC), American Heart Association (AHA), and Heart Rhythm Society (HRS) have released guidelines to assist physicians in evaluating and treating syncope.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0401/p478.html

Identifying Patients with Headache Who Are at Risk of Subarachnoid Hemorrhage - ...

Aug 15, 2018 - When is urgent imaging warranted in patients presenting with sudden, severe, nontraumatic headache and normal findings on a neurologic examination?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0815/p256.html

Oral Analgesics for Acute Nonspecific Pain - American Family Physician

Mar 1, 2005 - Physicians most often recommend or prescribe oral medication for relief of acute pain. This review of the available evidence supports the use of acetaminophen in doses up to 1,000 mg as the initial choice for mild to moderate acute pain. In some cases, modest improvements in analgesic ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0301/p913.html

Management of Cluster Headache - American Family Physician

Feb 15, 2005 - Cluster headache, an excruciating, unilateral headache usually accompanied by conjunctival injection and lacrimation, can occur episodically or chronically, and can be difficult to treat. Existing effective treatments may be underused because of underdiagnosis of the syndrome. Oxygen ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0215/p717.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

When to Operate in Carotid Artery Disease - American Family Physician

Jan 15, 2000 - Carotid endarterectomy has proved to be beneficial in the prevention of stroke in selected patients. The procedure is indicated in symptomatic patients with carotid-territory transient ischemic attacks or minor strokes who have carotid artery stenosis of 70 to 99 percent. With a low ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0115/p400.html

Tension-Type Headache - American Family Physician

Sep 1, 2002 - Tension-type headache typically causes pain that radiates in a band-like fashion bilaterally from the forehead to the occiput. Pain often radiates to the neck muscles and is described as tightness, pressure, or dull ache. Migraine-type features (unilateral, throbbing pain, nausea, ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0901/p797.html

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Sep 15, 2005 - The recognizable appearance and the dermatomal distribution of herpes zoster lesions usually enable a clinical diagnosis to be made easily. Herpes zoster and postherpetic neuralgia occur mainly in older patients. The role of the varicella vaccine in preventing herpes zoster is ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0915/p1075.html

Use of Atypical Antipsychotics in Patients with Dementia - American Family Physician

Jun 1, 2003 - Increasingly, atypical antipsychotic drugs are prescribed for elderly patients with symptoms of psychosis and behavioral disturbances. These symptoms often occur in patients with Alzheimer's disease, other dementias, or Parkinson's disease. As the average age of Americans increases, the...

American Family Physician : Article

https://www.aafp.org/afp/2003/0601/p2335.html

Gabapentin for Chronic Neuropathic Pain - Medicine by the Numbers - American Family ...

Dec 1, 2015 - Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1201/od1.html

Evaluation and Prevention of Diabetic Neuropathy - American Family Physician

Jun 1, 2005 - Diabetic neuropathy is a debilitating disorder that occurs in nearly 50 percent of patients with diabetes. It is a late finding in type 1 diabetes but can be an early finding in type 2 diabetes. The primary types of diabetic neuropathy are sensorimotor and autonomic. Patients may ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0601/p2123.html

Transient Ischemic Attacks: Part I. Diagnosis and Evaluation - American Family Physician

Apr 1, 2004 - Transient ischemic attack is no longer considered a benign event but, rather, a critical harbinger of impending stroke. Failure to quickly recognize and evaluate this warning sign could mean missing an opportunity to prevent permanent disability or death. The 90-day risk of stroke after...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1665.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Mar 15, 2015 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment.

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

https://www.aafp.org/afp/2015/0315/od2.html

Guillain-Barre Syndrome - American Family Physician

May 15, 2004 - Guillain-Barré syndrome (GBS) is a group of autoimmune syndromes consisting of demyelinating and acute axonal degenerating forms of the disease. Nerve conduction study helps differentiate the heterogeneous subtypes of GBS. Patients exhibit a progressive paralysis that reaches a plateau ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0515/p2405.html

Antidepressants and Antiepileptic Drugs for Chronic Non-Cancer Pain - American Family ...

Feb 1, 2005 - The development of newer classes of antidepressants and second-generation antiepileptic drugs has created unprecedented opportunities for the treatment of chronic pain. These drugs modulate pain transmission by interacting with specific neurotransmitters and ion channels. The actions of...

American Family Physician : Article

https://www.aafp.org/afp/2005/0201/p483.html

AHA/ASA Release Guideline on Stroke Prevention in Women - Practice Guidelines - ...

Mar 1, 2015 - The American Heart Association and American Stroke Association (AHA/ASA) have released a guideline to help physicians identify women with increased risk of stroke and initiate appropriate preventive measures. The guideline includes recommendations on pregnancy and stroke; cerebral ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0301/p330.html

Diagnosis and Management of Multiple Sclerosis - American Family Physician

Nov 15, 2004 - Multiple sclerosis, an idiopathic inflammatory disease of the central nervous system, is characterized pathologically by demyelination and subsequent axonal degeneration. The disease commonly presents in young adults and affects twice as many women as men. Common presenting symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1115/p1935.html

Pitfalls of Direct-to-Consumer Vascular Screening Tests - Editorials - American Family ...

Apr 15, 2015 - As concerned primary care physicians, we should take a more active role in educating the public and our patients about the risks of nonindicated screening tests before those purchases are made. Harms of downstream testing or treatment for a positive test result are real and significant.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0415/p518.html

The Management of the Acute Migraine Headache - American Family Physician

Dec 1, 2002 - As many as 30 million Americans have migraine headaches. The impact on patients and their families can be tremendous, and treatment of migraines can present diagnostic and therapeutic challenges for family physicians. Abortive treatment options include nonspecific and migraine-specific ...

American Family Physician : Article

https://www.aafp.org/afp/2002/1201/p2123.html

AHA and ASA Release Guideline for Prevention of Future Stroke in Patients with Stroke ...

Jan 15, 2015 - The American Heart Association (AHA) and American Stroke Association (ASA) have updated their guideline on prevention of future stroke in patients with a history of stroke or transient ischemic attack (TIA). Currently, the average annual rate of future stroke in these patients is at a ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0115/p136.html

The Patient with Daily Headaches - American Family Physician

Dec 15, 2004 - The term 'chronic daily headache' (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of ...

American Family Physician : Article

https://www.aafp.org/afp/2004/1215/p2299.html

Benzodiazepines and Alzheimer Disease - AFP Journal Club - American Family Physician

Feb 1, 2015 - Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0201/p191.html

Early Diagnosis of Dementia - American Family Physician

Feb 15, 2001 - Until recently, the most significant issue facing a family physician regarding the diagnosis and treatment of dementia was ruling out delirium and potentially treatable etiologies. However, as more treatment options become available, it will become increasingly important to diagnose ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p703.html

Transient Ischemic Attacks: Part II. Treatment - American Family Physician

Apr 1, 2004 - Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1681.html

Principles of Office Anesthesia: Part I. Infiltrative Anesthesia - American Family ...

Jul 1, 2002 - The use of effective analgesia is vital for any office procedure in which pain may be inflicted. The ideal anesthetic achieves 100 percent analgesia in a short period of time, works on intact or nonintact skin without systemic side effects, and invokes neither pain nor toxicity. Because...

American Family Physician : Article

https://www.aafp.org/afp/2002/0701/p91.html

Dementia - Clinical Evidence Handbook - American Family Physician

Jan 15, 2014 - What are the effects of treatments on cognitive, behavioral, and psychological symptoms of dementia (Alzheimer disease, Lewy body dementia, or vascular dementia)?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2014/0115/p117.html

Is Intensive Blood Pressure Control Beneficial in Patients with Acute Intracerebral ...

Jan 15, 2014 - It seems to be safe to lower systolic blood pressure to a target of 140 mm Hg in those with an acute hemorrhagic stroke. However, there seems to be no clinical benefit to this approach when the data are adjusted for baseline NIH Stroke Scale scores.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0115/p120.html

Headaches in Children and Adolescents - American Family Physician

Feb 15, 2002 - Headaches are common during childhood and become more common and increase in frequency during adolescence. The rational, cost-effective evaluation of children with headache begins with a careful history. The first step is to identify the temporal pattern of the headache--acute, ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0215/p625.html

AHA/ASA Guidelines on Prevention of Recurrent Stroke - Practice Guidelines - American ...

Apr 15, 2011 - Persons who survive a stroke or transient ischemic attack (TIA) are at increased risk of experiencing another stroke. The American Heart Association (AHA) and the American Stroke Association (ASA) have released updated guidelines on preventing recurrent stroke in patients who have had a...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2011/0415/p993.html

Hard-to-Diagnose Headache: Practical Tips for Diagnosis and Treatment - Editorials - ...

May 15, 2013 - w/ Hainer

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0515/p672.html

AHA/ASA Publish Advisory on Oral Antithrombotics for Stroke Prevention in Nonvalvular ...

May 15, 2013 - New antithrombotics provide alternatives to warfarin, and may lower the threshold for thromboembolic risk for initiating therapy in patients with atrial fibrillation. This advisory summarizes existing American Heart Association/American Stroke Association (AHA/ASA) recommendations on ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0515/p732.html

West Nile Virus in the United States: An Update on an Emerging Infectious Disease - ...

Aug 15, 2003 - West Nile virus is a mosquito-borne flavivirus and human neuropathogen. Since the virus was recognized in New York City in 1999, it has spread rapidly across the United States, with human disease documented in 39 states and the District of Columbia. West Nile virus can cause a broad ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0815/p653.html

Preventing Stroke in Patients with Transient Ischemic Attacks - American Family Physician

Nov 15, 1999 - Stroke is the third most common overall cause of death and the leading cause of adult disability in the United States. New therapeutic interventions instituted in the period immediately after a stroke have revolutionized the approach to ischemic cerebrovascular disease. Recognition of a...

American Family Physician : Article

https://www.aafp.org/afp/1999/1115/p2329.html

Intracranial Aneurysms: Current Evidence and Clinical Practice - American Family Physician

Aug 15, 2002 - Unruptured intracranial aneurysms occur in up to 6 percent of the general population. Most persons with these aneurysms remain asymptomatic and are usually unaware of their presence. Risk factors for the formation of aneurysms include a family history of aneurysm, various inherited ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0815/p601.html

Cyclooxygenase-2 Enzyme Inhibitors: Place in Therapy - American Family Physician

Jun 15, 2000 - Nonsteroidal anti-inflammatory drugs (NSAIDs) play a major role in the management of inflammation and pain caused by arthritis. A new class of NSAIDs that selectively inhibit the cyclooxygenase-2 (COX-2) enzyme has been developed. The first COX-2 inhibitors, celecoxib and rofecoxib, are...

American Family Physician : Article

https://www.aafp.org/afp/2000/0615/p3669.html

Guidelines for Managing Alzheimer's Disease: Part II. Treatment - American Family ...

Jun 15, 2002 - Once the clinical diagnosis of Alzheimer's disease has been made, a treatment plan must be developed. This plan should include cholinesterase inhibitor therapy to temporarily improve cognition or slow the rate of cognitive decline, management of comorbid conditions, treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0615/p2525.html

Stroke: Part II. Management of Acute Ischemic Stroke - American Family Physician

May 15, 1999 - Optimal treatment of the patient who has sustained an acute ischemic stroke requires rapid assessment and early intervention. The leisurely approach to acute stroke management sometimes taken in the past should be replaced by an approach that treats stroke as a true medical emergency. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0515/p2828.html

Newer Intranasal Migraine Medications - American Family Physician

Jan 1, 2000 - Two new intranasal migraine medications, sumatriptan and dihydroergotamine mesylate, may offer specific advantages for patients who are seeking alternatives to various oral or parenteral migraine abortive therapies. Placebo-controlled clinical studies demonstrate that both intranasal ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0101/p180.html

Update on Parkinson's Disease - American Family Physician

Apr 15, 1999 - Parkinson's disease is a progressive degenerative disorder of the central nervous system. The hallmark physical signs are tremor, rigidity and bradykinesia. Idiopathic Parkinson's disease is caused by the progressive loss of dopaminergic neurons in the substantia nigra and nigrostriatal...

American Family Physician : Article

https://www.aafp.org/afp/1999/0415/p2155.html

Advances in the Treatment of Alzheimer's Disease - American Family Physician

Nov 1, 1998 - Management of the most common type of dementia--Alzheimer's disease--is becoming increasingly sophisticated. Differentiation of Alzheimer's disease from vascular dementia has become therapeutically important, since the choice of treatments depends on the diagnosis. Two cholinesterase ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1101/p1577.html

Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with Nonvalvular Atrial ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

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