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Paget Disease of Bone for Primary Care - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. It usually affects older adults, and men are at a higher risk than women. Any bone may be affected, but the disease has a high preference for the pelvis, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p224.html

Colorectal Cancer Screening: ACP Guidance Statements - Practice Guidelines - American ... Restricted content. Login required.

Aug 15, 2020 - The American College of Physicians developed a consensus statement for colorectal cancer screening of average-risk adults based on their review of six independent guidelines and supporting evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0815/p250.html

Colorectal Cancer Screening: BMJ Rapid Recommendation - Practice Guidelines - American ... Restricted content. Login required.

Aug 15, 2020 - Colorectal cancer (CRC) screening recommendations vary because the underlying evidence is low quality, with few screening methods evaluated by randomized trials. The BMJ/MAGIC Group performed a systematic review based on 15-year CRC risk models to compare screening options.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0815/p253.html

Daily Colchicine Post-MI Reduces Strokes and Recurrent Hospitalizations for Angina - ... Restricted content. Login required.

Aug 15, 2020 - Daily colchicine after MI reduces cardiovascular events, specifically strokes and hospitalizations for angina. It is inexpensive and well-tolerated and should be considered for patients with recent MIs who are already using guideline-directed therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p248.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

Acute Pyelonephritis in Adults: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis and should be suspected in patients with flank pain and laboratory evidence of urinary tract infection. Urine culture with antimicrobial susceptibility testing should be performed in all patients and used to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p173.html

VTE in Patients with Cancer: Guidelines from the American Society of Clinical Oncology ... Restricted content. Login required.

Aug 1, 2020 - The American Society of Clinical Oncology has updated recommendations for the prevention and treatment of venous thromboembolism (VTE) in patients with cancer.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0801/p188.html

Smoking Cessation with Text Messaging and App-Based Interventions - Cochrane for ... Restricted content. Login required.

Aug 1, 2020 - Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p148.html

Acupuncture for Knee Osteoarthritis - FPIN's Clinical Inquiries - American Family ... Restricted content. Login required.

Aug 1, 2020 - Electroacupuncture can be used to improve pain and physical function in adults with knee osteoarthritis.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0801/p184.html

Heart Failure - American Family Physician

Jul 15, 2020 - This collection features AFP content on heart failure and related issues, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), cardiomyopathy, cardioverter-defibrillators, congestive heart failure, and diastolic and systolic heart failure. This...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=26

Dapagliflozin (Farxiga) for Preventing Hospitalization for Heart Failure - STEPS - ... Restricted content. Login required.

Jul 15, 2020 - Dapagliflozin can be added to existing treatment to reduce the risk of hospitalization for heart failure in patients with type 2 diabetes who have established CVD or are at high risk of CVD. It may also decrease the risk of renal disease progression and death from renal failure.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0715/p115.html

Acetaminophen for Pain Relief in Osteoarthritis - FPIN's Help Desk Answers - American ... Restricted content. Login required.

Jul 15, 2020 - Acetaminophen is no better than placebo for relief of hip or knee pain due to osteoarthritis. Although acetaminophen does provide some pain relief, the effect is small and not clinically significant.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0715/p113.html

Mailing gFOBT or FIT Directly to Patients Increases Uptake of Colorectal Cancer ... Restricted content. Login required.

Jul 15, 2020 - Mailed outreach significantly increases rates of colorectal cancer screening, with four tests needing to be mailed to screen one person.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p117.html

Blood Product Transfusion in Adults: Indications, Adverse Reactions, and Modifications ... Restricted content. Login required.

Jul 1, 2020 - Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p30.html

Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2020 - This collection features AFP content on chronic obstructive pulmonary disease (COPD) and related issues, including acute and chronic COPD, spirometry, pulmonary rehabilitation, oxygen therapy, corticosteriods, and pulmonary complications. This collection features AFP content on chronic ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=32

Vitamin D Supplementation and All-Cause Mortality - Medicine by the Numbers - American ... Restricted content. Login required.

Jul 1, 2020 - Observational studies have shown that those with low vitamin D levels have higher cancer and cardiovascular mortality. Read more to learn about the effect of vitamin D supplementation on all-cause mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0701/od1.html

The Promise and Challenge of Home Health Services During the COVID-19 Pandemic - ...

Jul 1, 2020 - The COVID-19 pandemic presents family physicians with unique opportunities to work with home health providers to combat the pandemic, provide quality care, and ease the burden of fear among patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0701/p8.html

Nicotine Replacement Therapy for Smoking Cessation - Cochrane for Clinicians - American... Restricted content. Login required.

Jul 1, 2020 - Patients using a combination of nicotine patch and fast-acting NRT are more likely to quit smoking than those on any single therapy alone (number needed to treat [NNT] = 29; 95% CI, 20 to 47).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0701/p17.html

Role of Mucolytics in the Treatment of Chronic Bronchitis or COPD - Cochrane for ... Restricted content. Login required.

Jul 1, 2020 - Oral mucolytic agents may reduce the number of acute exacerbations in patients with chronic bronchitis or COPD (number needed to treat [NNT] = 8 over an average of nine months; 95% CI, 7 to 10).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0701/p16.html

Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder ...

Jul 1, 2020 - Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2020/0701/p10.html

PAULA’s Test for Lung Cancer Screening - Diagnostic Tests: What Physicians Need to Know... Restricted content. Login required.

Jul 1, 2020 - Because of insufficient evidence of benefit, no recommendations can be made regarding PAULA's test. Prospective cohort studies of a screening population and randomized controlled trials comparing cancer mortality outcomes using PAULA's test vs. low-dose CT and no screening are needed ...

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

https://www.aafp.org/afp/2020/0701/p53.html

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Jun 15, 2020 - Acute respiratory distress syndrome (ARDS) is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p730.html

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

Jun 15, 2020 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults.

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

https://www.aafp.org/afp/2020/0615/od1.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -... Restricted content. Login required.

Jun 15, 2020 - L.C. is a 70-year-old Asian American woman who retired from teaching middle school five years ago. She lives independently and has a daughter and grandchildren who live within 30 miles of her. She presents for a follow-up visit to renew her hypertension medications. Her blood pressure ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0615/p753.html

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

Jun 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health 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/2020/0615/p748.html

Continuous Glucose Monitoring in Type 2 Diabetes Is Not Ready for Widespread Adoption -...

Jun 1, 2020 - Although continuous glucose monitoring may benefit patients with type 1 diabetes mellitus, there is limited evidence that it offers similar benefits in patients with type 2 diabetes, regardless of whether they are taking insulin.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0601/p646.html

No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low ... Restricted content. Login required.

Jun 1, 2020 - Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695.html

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs... Restricted content. Login required.

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

Supplemental Oxygen Therapy for Nonhypoxemic Patients with Acute Coronary Syndrome - ... Restricted content. Login required.

Jun 1, 2020 - No conclusive evidence demonstrates that routine use of supplemental oxygen therapy is associated with clinical benefit or harm in nonhypoxemic patients with acute myocardial infarction (MI).

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0601/p687.html

Noninvasive Positive Pressure Ventilation for Exacerbation of Chronic Obstructive ... Restricted content. Login required.

Jun 1, 2020 - Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by hyperinflation of the lungs, including emphysema and chronic bronchitis. Learn more about the benefits and harms of using noninvasive positive pressure ventilation for exacerbation of COPD.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0601/od1.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ... Restricted content. Login required.

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.html

Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis - POEMs - American Family ... Restricted content. Login required.

Jun 1, 2020 - Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p696.html

Screening for Abdominal Aortic Aneurysm: Recommendation Statement - U.S. Preventive ...

May 15, 2020 - The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.

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

https://www.aafp.org/afp/2020/0515/od1.html

Equivalent Pain Relief with Different Doses of Ibuprofen - POEMs - American Family ... Restricted content. Login required.

May 15, 2020 - Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631.html

Screening for Abdominal Aortic Aneurysm - Putting Prevention into Practice - American ... Restricted content. Login required.

May 15, 2020 - A 65-year-old man with no significant medical history presents to your clinic for a wellness visit. His social history includes smoking periodically in his 20s, and his family history includes a father who died from an abdominal aortic aneurysm (AAA) in his 60s. The patient wants to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0515/p621.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American... Restricted content. Login required.

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Chronic Dyspnea: Diagnosis and Evaluation - American Family Physician Restricted content. Login required.

May 1, 2020 - Dyspnea is a symptom arising from a complex interplay of diseases and physiologic states and is commonly encountered in primary care. It is considered chronic if present for more than one month. As a symptom, dyspnea is a predictor for all-cause mortality. The likeliest causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p542.html

Endometrial Biopsy: Tips and Pitfalls - American Family Physician Restricted content. Login required.

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.html

Therapies for COPD Exacerbations in Adults - Implementing AHRQ Effective Health Care ... Restricted content. Login required.

May 1, 2020 - What are the benefits and harms of pharmacologic and nonpharmacologic treatments for exacerbations of chronic obstructive pulmonary disease (COPD) in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0501/p557.html

Antidepressants Plus Benzodiazepines for Adults with Major Depression - Cochrane for ... Restricted content. Login required.

May 1, 2020 - A combination of tricyclic antidepressants and benzodiazepines is more effective for major depression in adults than tricyclic antidepressants alone in the first four weeks of treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p527.html

Lithium for Acute Mania - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

May 1, 2020 - Lithium is more effective at inducing a reduction of at least 50% on the validated Young Mania Rating Scale compared with placebo (number needed to treat [NNT] = 6; 95% CI, 5 to 8; six studies; n = 1,707).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p528.html

IBSchek for Irritable Bowel Syndrome - Diagnostic Tests: What Physicians Need to Know -... Restricted content. Login required.

May 1, 2020 - IBSchek is a blood test marketed to assist in the diagnosis of irritable bowel syndrome with predominant diarrhea (IBS-D) or with mixed bowel habits (IBS-M) in adults.

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

https://www.aafp.org/afp/2020/0501/p564.html

Megestrol for Palliative Care in Patients with Cancer - FPIN's Clinical Inquiries - ... Restricted content. Login required.

May 1, 2020 - Megestrol may be considered as a component of palliative care nutritional support in patients with cancer.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0501/od1.html

Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ...

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.html

Prescribing Opioids for Chronic Pain: Unintended Consequences of the 2016 CDC Guideline...

Apr 15, 2020 - Since the 2016 CDC guideline for the use of opioid pain relievers was released, there has been a significant reduction in opioid prescribing, and the guideline has been adopted by state Medicaid agencies, insurers, and others. Widespread implementation of the guideline has had ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0415/p458.html

Screening for Asymptomatic Bacteriuria in Adults: Recommendation Statement - U.S. ...

Apr 15, 2020 - The USPSTF recommends screening for asymptomatic bacteriuria using urine culture in pregnant persons. The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults.

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

https://www.aafp.org/afp/2020/0415/p489.html

Screening for Asymptomatic Bacteriuria in Adults - Putting Prevention into Practice - ...

Apr 15, 2020 - A 33-year-old woman presents to your clinic for a first prenatal visit at 8 weeks' gestation. She reported morning nausea and breast tenderness. Review of systems and physical examination were consistent with early pregnancy but were otherwise unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0415/p493.html

Sepsis: Diagnosis and Management - American Family Physician

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

Benzodiazepines for Panic Disorder in Adults - Medicine by the Numbers - American ...

Apr 1, 2020 - Should benzodiazepeines continue to be prescribed during the initiation phase of selective serotonin reuptake inhibitors for acute relief of panic attacks? Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0401/od1.html

Pelvic Floor Muscle Training vs. Control for Urinary Incontinence in Women - Cochrane ...

Apr 1, 2020 - Use of pelvic floor muscle training to treat women with all subtypes of urinary incontinence results in improvement or cure vs. no treatment (number needed to treat [NNT] = 2.5; 95% CI, 1.4 to 5.4). Treatment with pelvic floor muscle training also results in one fewer episode of leakage...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0401/p393.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ...

Apr 1, 2020 - Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435a.html

Results of Fecal Immunochemical Tests for Colorectal Cancer Screening Not Affected by ...

Apr 1, 2020 - The use of aspirin, NSAIDs, and oral anticoagulants has no clinically important effects on the positive predictive value of FIT in a screening population.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435.html

Office Spirometry: Indications and Interpretation - American Family Physician

Mar 15, 2020 - High-quality, office-based spirometry provides diagnostic information as useful and reliable as testing performed in a pulmonary function laboratory. Spirometry may be used to monitor progression of lung disease and response to therapy. A stepwise approach to spirometry allows for ease ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p362.html

Genital Ulcers: Differential Diagnosis and Management - American Family Physician

Mar 15, 2020 - Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. Herpes simplex virus is the most common cause of genital ulcers in the United States. A diagnosis of genital herpes simplex virus infection is made through ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p355.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

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ...

Mar 15, 2020 - Esketamine is an in-office treatment for patients with a severe major depressive disorder to be used in addition to oral antidepressant therapy.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0315/p339.html

Medication Use to Reduce Risk of Breast Cancer - Putting Prevention into Practice - ...

Mar 15, 2020 - E.F., a 40-year-old woman, comes to your office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0315/p373.html

Integrating Breast Cancer Risk Management into Primary Care - Editorials - American ...

Mar 15, 2020 - It is important that primary care physicians have the ability and resources to identify women eligible for genetic counseling and testing for breast cancer.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0315/p330.html

Upper Gastrointestinal Bleeding in Adults: Evaluation and Management - American Family ...

Mar 1, 2020 - Upper gastrointestinal (GI) bleeding is defined as hemorrhage from the mouth to the ligament of Treitz. Common risk factors for upper GI bleeding include prior upper GI bleeding, anticoagulant use, high-dose nonsteroidal anti-inflammatory drug use, and older age. Causes of upper GI ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0301/p294.html

IDx-DR for Diabetic Retinopathy Screening - Diagnostic Tests: What Physicians Need to ...

Mar 1, 2020 - IDx-DR is a reliable screening tool used to diagnose diabetic retinopathy in the primary care office and may reduce barriers to screening and improve gaps in eye care for those with diabetes.

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

https://www.aafp.org/afp/2020/0301/p307.html

Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in ...

Mar 1, 2020 - Vitamin and mineral supplementation has little to no beneficial effect on preserving cognitive functioning or preventing dementia in cognitively healthy adults 40 years and older.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p272.html

HIV Status, Preexposure Prophylaxis, Sexual Health, and the Critical Role of Family ...

Mar 1, 2020 - Family physicians play a key role in expanding HIV testing and treatment, as well as providing sexual health services in areas where specialty sexual health services are not readily available.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0301/p262.html

Tai Chi for Fibromyalgia - FPIN's Clinical Inquiries - American Family Physician

Mar 1, 2020 - The practice of Yang-style tai chi for one hour twice weekly for 12 to 24 weeks is moderately effective in improving quality of life in patients with fibromyalgia.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0301/od1.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ...

Mar 1, 2020 - This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309a.html

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ...

Mar 1, 2020 - Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309.html

Cerebral Palsy: An Overview - American Family Physician

Feb 15, 2020 - Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. The movement disorders associated with cerebral palsy are categorized as spasticity, dyskinesia, ataxia, or mixed/other. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p213.html

Acute Lower Gastrointestinal Bleeding: Evaluation and Management - American Family ...

Feb 15, 2020 - Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p206.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: ...

Feb 15, 2020 - The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk...

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

https://www.aafp.org/afp/2020/0215/p233.html

Diagnosis of Heart Failure with Reduced Ejection Fraction - Point-of-Care Guides - ...

Feb 15, 2020 - Can signs, symptoms, and simple tests be used to determine the likelihood of heart failure with reduced ejection fraction?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2020/0215/p230.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer - ...

Feb 15, 2020 - A 31-year-old woman presents to your office for a well-woman examination. She is sexually active in a monogamous relationship and has never been pregnant. She tells you that her mother was diagnosed with tubal cancer at age 40 and that her sister, who is 42 years of age, was recently ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0215/p239.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ...

Feb 15, 2020 - Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ...

Feb 15, 2020 - Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p249.html

Clostridioides difficile Infection: Update on Management - American Family Physician

Feb 1, 2020 - Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. difficile infection is characterized by a wide range of symptoms, from ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p168.html

Chronic Wounds: Evaluation and Management - American Family Physician

Feb 1, 2020 - Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. They are common and are often incorrectly treated. The morbidity and associated costs of chronic wounds highlight the need to implement wound prevention and treatment guidelines. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p159.html

Menopause - American Family Physician

Feb 1, 2020 - This collection features AFP content on menopause and related issues, including estrogen and progestogen therapy, hormone therapy, hot flashes, mood symptoms, sexual difficulties, and postmenopause. This collection features AFP content on menopause and related issues, including estrogen...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=59

Breast Cancer Screening: ACP Releases Guidance Statements - Practice Guidelines - ...

Feb 1, 2020 - The American College of Physicians reviewed guidelines from other organizations and developed four statements to provide advice to clinicians about breast cancer screening for women who are at average risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0201/p184.html

Shared Decision-Making for Administering PCV13 in Older Adults - Editorials - American ...

Feb 1, 2020 - In June 2019, the Advisory Committee on Immunization Practices approved a change from its age-based 13-valent pneumococcal conjugate vaccine recommendations to a shared clinical decision-making process.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0201/p134.html

Treatments for Postmenopausal Hypoactive Sexual Desire Disorder - FPIN's Clinical ...

Feb 1, 2020 - Transdermal testosterone for the treatment of hypoactive sexual desire disorder in postmenopausal women results in an additional 0.92 sexually satisfying events per month, acne, and increased androgenic effects without major complications

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0201/p182.html

OnabotulinumtoxinA for Prevention of Migraine in Adults - Cochrane for Clinicians - ...

Feb 1, 2020 - OnabotulinumtoxinA reduces the number of migraine days per month by two days compared with placebo in adults with chronic migraines.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0201/p144.html

Adverse Events of Pharmacologic Treatments of Major Depression in Older Adults - ...

Feb 1, 2020 - What are the adverse events of antidepressants prescribed to treat major depressive disorder in adults 65 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0201/p179.html

Antibiotics for Exacerbations of Chronic Obstructive Pulmonary Disease - Medicine by ...

Feb 1, 2020 - Prescription of antibiotics for the treatment of chronic obstructive pulmonary disease (COPD) is controversial due to the variety of etiologies. This review examined the use of antibiotics to treat COPD in outpatient, inpatient, and ICU settings. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0201/od1.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ...

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

Functional Dyspepsia: Evaluation and Management - American Family Physician

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p84.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ...

Jan 15, 2020 - Revefenacin is a once-daily nebulized alternative to metered dose long-acting muscarinic antagonists for patients with moderate to severe COPD. Given its expense, complicated administration process, and lack of evidence that it improves key patient-oriented outcomes, its use should be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0115/p121.html

Acute Heart Failure in a 39-Year-Old Man - Photo Quiz - American Family Physician

Jan 15, 2020 - Advertisement << Previous article Next article >> Jan 15, 2020 Issue Photo Quiz Acute Heart Failure in a 39-Year-Old Man DREW ASHBY, MD; FRANKLIN NIBLOCK, MD, MPH; KENNETH HERRING, MD; and LOGAN MIMS, MD, University of Colorado, Denver, Colorado Am Fam Physician. 2020 Jan...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2020/0115/p117.html

Benign Anorectal Conditions: Evaluation and Management - American Family Physician

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.html

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ...

Jan 1, 2020 - The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions, medications that ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0101/p56.html

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

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

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk - ...

Jan 1, 2020 - Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was fasting or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician

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

Exercise to Reduce Falls in Older Adults - FPIN's Clinical Inquiries - American Family ...

Jan 1, 2020 - Exercise programs should be recommended for community-dwelling adults 60 years and older because they lead to fewer falls.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0101/p42.html

Breast Implant—Associated Anaplastic Large Cell Lymphoma - Editorials - American Family...

Jan 1, 2020 - In October 2019, the FDA released draft guidance offering numerous recommendations to help ensure women have access to breast implant benefit and risk information, including that manufacturers incorporate a boxed warning and patient decision checklist in the device’s labeling, and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0101/p8.html

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ...

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

Addition of Steroids Improves Outcomes in Children and Adults with CAP - POEMs - ...

Jan 1, 2020 - Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p55.html

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy - Medicine by the ...

Jan 1, 2020 - Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0101/od1.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ...

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ...

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

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