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Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Medication Use to Reduce Risk of Breast Cancer: Recommendation Statement - U.S. ...

Mar 15, 2020 - The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.

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

https://www.aafp.org/afp/2020/0315/od1.html

Metformin to Prevent Diabetes in Patients at Increased Risk - Cochrane for Clinicians -... Restricted content. Login required.

Nov 1, 2020 - In patients at increased risk of developing type 2 diabetes, metformin reduces the risk (number needed to treat [NNT] = 7; 95% CI, 6 to 10) compared with counseling on standard diet and exercise.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/1101/p531.html

Misoprostol Dosing for First-Trimester Abortion - FPIN's Clinical Inquiries - American ... Restricted content. Login required.

Sep 1, 2020 - Vaginal, oral, and sublingual misoprostol in single doses of 600 to 800 mcg are equally effective for promoting completed abortion in patients with an incomplete first-trimester spontaneous abortion.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0901/od1.html

More Evidence Against Antibiotics for Acute Asthma Exacerbations - POEMs - American ...

Aug 1, 2019 - Antibiotics do not benefit patients hospitalized with an asthma exacerbation. Evidence from this study suggests worse outcomes with antibiotic use, including a longer hospital stay, higher costs, and greater risk of diarrhea.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p185.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Jan 15, 2020 - Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p95.html

Nausea in Pregnancy, Knee Osteoarthritis, Hormone Replacement Therapy, Shingles - AFP ...

Jan 1, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0101/p10.html

Neck Pain: Initial Evaluation and Management - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Neck pain is a common presenting symptom in the primary care setting and causes significant disability. The broad differential diagnosis requires an efficient but global assessment; therefore, emphasis is typically placed on red flags that can assist in the early recognition and ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p150.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Nonalcoholic Fatty Liver Disease: Common Questions and Answers on Diagnosis and ... Restricted content. Login required.

Nov 15, 2020 - Nonalcoholic fatty liver disease (NAFLD) is the most common form of liver disease in the United States, affecting up to 30% of adults. There are two forms of NAFLD: nonalcoholic fatty liver (NAFL), defined as 5% or greater hepatic steatosis without hepatocellular injury or fibrosis, and...

American Family Physician : Article

https://www.aafp.org/afp/2020/1115/p603.html

Omega-3 Fatty Acids and Cardiovascular Disease Prevention - Medicine by the Numbers - ...

Aug 15, 2019 - High-quality evidence suggests that long-chain omega-3 polyunsaturated fatty acids do not prevent mortality (all-cause or cardiovascular) or cardiovascular disease events when used as primary or secondary prevention. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0815/p209.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ... Restricted content. Login required.

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Oral Semaglutide (Rybelsus) for the Treatment of Type 2 Diabetes Mellitus - STEPS - ... Restricted content. Login required.

Nov 15, 2020 - Oral semaglutide (Rybelsus) is labeled as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

American Family Physician : STEPS

https://www.aafp.org/afp/2020/1115/p627.html

Oseltamivir of Uncertain Benefit in Patients with Flulike Symptoms - POEMs - American ... Restricted content. Login required.

Aug 15, 2020 - Although the authors report that compared with usual care oseltamivir shortens the duration of symptoms, the methodologic biases in this study make their conclusions suspect.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p248a.html

Outpatient Management of COVID-19: Rapid Evidence Review - American Family Physician

Oct 15, 2020 - Common presenting symptoms of coronavirus disease 2019 include fever, dry cough, shortness of breath, and fatigue. However, patients may have a wide range of symptoms representing a spectrum of mild to severe illness. Symptoms in children tend to be milder and may include fever, cough, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/1015/p478.html

Overuse of Statins in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ... Restricted content. Login required.

Dec 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/2019/1215/p742.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

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

Papular Lesions on Bilateral Elbows and Knees - Photo Quiz - American Family Physician

Jan 1, 2019 - A man presented with new-onset foot pain, as well as long-standing red-yellow lesions on his elbows and knees.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0101/p47.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.html

Physical Activity: Updated Recommendations from HHS - Practice Guidelines - American ...

Jul 1, 2019 - The U.S. Department of Health and Human Services recently published updated recommendations on physical activity based on a systematic review of the effect of physical activity on health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0701/p58.html

PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease - Diagnostic Tests: ... Restricted content. Login required.

Jan 1, 2020 - The PLAC test is a blood test used to measure serum activity of lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2020/0101/p44.html

Placental Alpha Macroglobulin-1 (PartoSure) Immunoassay to Assess the Risk of ... Restricted content. Login required.

Sep 1, 2020 - Placental alpha macroglobulin-1 (PartoSure) is an immunoassay that measures the presence of placental alpha macroglobulin-1 (PAMG-1). PartoSure is used to assess the risk of spontaneous preterm birth and may be a useful adjunct to determine which patients with threatened preterm labor ...

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2020/0901/p269.html

Point-of-Care Guides - American Family Physician

Sep 15, 2020 - This collection features AFP content from the Point-of-Care Guides collection on topics related to anticoagulation, cancer, cardiovascular issues, diabetes, gastrointestinal issues, infectious diseases, mortality risk, musculoskeletal issues, neurologic issues, obstetric issues, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=75

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ... Restricted content. Login required.

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

Postoperative Pain, Acute Stroke, Hormone Therapy, Diet to Improve Cardiovascular Risk,...

May 15, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0515/p606.html

Preparticipation Physical Evaluation: AAFP and Others Update Recommendations - Practice... Restricted content. Login required.

Jun 1, 2020 - The American Academy of Family Physicians (AAFP)and others have published the 5th edition of the preparticipation physical evaluation monograph. Revisions include new mental health and transgender sections and expansion of the female athlete chapter.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0601/p692.html

Pulse Oximetry Screening for Critical Congenital Heart Defects in Newborns - Cochrane ...

Apr 1, 2019 - Pulse oximetry is an accurate screening test for critical congenital heart defects in newborns. Pulse oximetry is simple to use, widely available, and has moderate sensitivity (76.3%) and good specificity (99.9%). However, the prevalence of critical congenital heart defects is low, and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p421.html

Quality Measures: How to Get Them Right -- FPM

Aug 1, 2018 - Pay-for-performance programs have produced disappointing results. Fewer and more appropriate, evidence-based quality measures could help.

Family Practice Management : Articles

https://www.aafp.org/fpm/2018/0700/p23.html

Qvar for Treatment of Chronic Asthma - Medicine by the Numbers - American Family Physician

Apr 15, 2018 - Learn the results of a Cochrane review which studied the effectiveness of Qvar in two sets of patients with chronic asthma: those receiving oral corticosteroids and those not receiving them.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0415/p538.html

Renin-Angiotensin System Inhibitors vs. Other Antihypertensive Drug Classes for ...

Nov 1, 2019 - RAS inhibitors, which include angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and renin inhibitors, should not be used as first-line agents.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1101/p540.html

Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease - Editorials - ...

Jun 1, 2019 - Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0601/p670.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors: ...

Jan 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adding the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, or coronary artery calcium score to traditional risk assessment for cardiovascular ...

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

https://www.aafp.org/afp/2019/0115/od1.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

Sarecycline (Seysara) for the Treatment of Acne - STEPS - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Sarecycline is a once-daily oral medication for patients with moderate to severe non-nodular acne. Its benefit over less expensive options has not been demonstrated.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0815/p245.html

Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy - Letters to ...

Jan 1, 2020 - ...Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy Am Fam Physician. 2020 Jan 1;101(1):6-7. Original Article: Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients [Editorials] Issue Date: March 15, 2019 See additional reader comments at:...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0101/p6.html

Screening for Atrial Fibrillation with Electrocardiography - Putting Prevention into ...

Mar 15, 2019 - M.T. is a 67-year-old woman who presents to your office requesting electrocardiography (ECG). Her brother was recently diagnosed with atrial fibrillation after screening with ECG, and she is concerned that she may have the same condition.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0315/p383.html

Screening for Atrial Fibrillation with Electrocardiography: Recommendation Statement - ...

Mar 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography.

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

https://www.aafp.org/afp/2019/0315/od1.html

Screening for Cardiovascular Disease Risk with Electrocardiography: Recommendation ...

Sep 15, 2018 - The USPSTF recommends against screening with resting or exercise electrocardiography (ECG) to prevent cardiovascular disease (CVD) events in asymptomatic adults at low risk of CVD events.

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

https://www.aafp.org/afp/2018/0915/od1.html

Screening for Preeclampsia: Recommendation Statement - U.S. Preventive Services Task ...

Jan 15, 2018 - The USPSTF recommends screening for preeclampsia in pregnant women with blood pressure measurements throughout pregnancy.

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

https://www.aafp.org/afp/2018/0115/od1.html

Segesterone Acetate and Ethinyl Estradiol Vaginal Ring (Annovera) for Contraception - ... Restricted content. Login required.

May 15, 2020 - Annovera is an effective combined progestin/estrogen contraceptive device that can be used for one year.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0515/p618.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Sepsis: Diagnosis and Management - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Guidelines published in 2016 provide a revised definition of sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection. The guidelines define septic shock as sepsis with circulatory, cellular, and metabolic dysfunction that is associated with a ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p409.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Small Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, ... Restricted content. Login required.

Aug 15, 2020 - A lower LDL target slightly reduced the likelihood of a broad composite outcome (number needed to treat [NNT] = 43 over 3.5 years), largely by reducing nonfatal strokes (NNT = 77; statistical significance not reported).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p247.html

Stable Coronary Artery Disease: Treatment - American Family Physician

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

American Family Physician : Article

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

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

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