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No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

HIV Prevention and Treatment with ART: International Antiviral Society Updates ...

Mar 15, 2019 - Antiretroviral therapy is the key to preventing and managing human immunodeficiency virus infection. Based on the availability of new medications and treatment options, the USA Panel of the International Antiviral Society has updated its 2016 recommendations.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0315/p395.html

Coaching Patients About Successful Blood Pressure Management - Lown Right Care: ...

Mar 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/2019/0315/p357.html

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.html

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Pharmacologic Treatment of Borderline Personality Disorder - FPIN's Help Desk Answers -...

Mar 1, 2019 - There is no pharmacotherapy regimen that improves the overall symptoms of borderline personality disorder. When used for six months or less, antipsychotics can improve paranoia, dissociation, mood lability, anger, and global functioning.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0301/od2.html

Different Durations of Corticosteroid Therapy for COPD Exacerbations - Cochrane for ...

Mar 1, 2019 - Treatment of acute exacerbations of COPD with a shorter course of systemic corticosteroids (seven or fewer days) is likely to be as effective and safe as treating with longer courses (more than seven days).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p295.html

Preparing for Serious Illness: A Model for Better Conversations over the Continuum of ...

Mar 1, 2019 - How can we ensure that our seriously ill patients routinely get the right care without relying on individual sacrifice and luck?

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0301/p281.html

Management of Uterine Fibroids - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2019 - What are the comparative effectiveness and harms of treatments for uterine fibroids, and what is the risk of finding unexpected leiomyosarcoma in women with fibroids?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0301/p330.html

Smectite for Acute Infectious Diarrhea in Children - Cochrane for Clinicians - American...

Mar 1, 2019 - When compared with placebo, smectite decreases the duration of diarrhea by about a day, with a mean difference of 24.4 fewer hours of diarrhea (95% confidence interval [CI], 17.9 to 30.9 hours). Smectite also decreases stool output by 11.4 g per kg (95% CI, 0.8 to 22 g per kg).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p294.html

Metformin for Improving Maternal and Infant Outcomes in Pregnant Women Who Are Obese - ...

Mar 1, 2019 - This meta-analysis showed no clear benefit for metformin in reducing the risk of large for gestational age infants. Additionally, there was no difference in important secondary outcomes such as gestational diabetes, hypertensive disease in pregnancy, shoulder dystocia, advanced perineal...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0301/od1.html

Type 2 Diabetes Therapies: A STEPS Approach - American Family Physician

Feb 15, 2019 - A concise way to evaluate pharmacotherapy options for type 2 diabetes mellitus is to use the five patient-oriented STEPS criteria: safety, tolerability, efficacy, price, and simplicity. The first-line treatment option, metformin, is safe and fairly well-tolerated, has excellent ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p237.html

Acute Hand Infections - American Family Physician

Feb 15, 2019 - Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p228.html

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

Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis - ...

Feb 15, 2019 - Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0215/p262.html

Abaloparatide (Tymlos) for Osteoporosis - STEPS - American Family Physician

Feb 15, 2019 - Abaloparatide is a safe and effective medication used to reduce the likelihood of vertebral and nonvertebral fractures in women at high risk. However, it is expensive and requires daily injections. It has not been evaluated for its effect on decreasing hip fractures.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0215/p260.html

Osteopathic Manipulative Treatment: A Primary Care Approach - Editorials - American ...

Feb 15, 2019 - Osteopathic manipulative treatment is a valuable modality that has the potential to decrease cost and improve pain/function in patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0215/p214.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.html

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.html

Dyspnea Due to Acute Heart Failure Syndrome - Medicine by the Numbers - American Family...

Feb 1, 2019 - This review concluded that the individual components of the clinical history and physical examination, electrocardiography, and chest radiography are not useful independently for confirming or excluding the diagnosis of acute heart failure syndrome in patients presenting to the ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0201/od1.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome...

Feb 1, 2019 - Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p190.html

Complementary and Integrative Treatments for Pain Management in Labor - Cochrane for ...

Feb 1, 2019 - There is evidence that all of the studied interventions have some benefit in labor, but the evidence is of low to very low quality. Massage, thermal interventions (warm and cold packs), relaxation techniques, yoga, and music reduce pain during latent labor, but not during active labor.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0201/p154.html

Oral Immunotherapy for Egg Allergy - Cochrane for Clinicians - American Family Physician

Feb 1, 2019 - Providing daily, steadily increasing doses of egg protein over an extended period of time effectively diminishes the immunoglobulin E (IgE)-mediated allergic response among children with egg allergy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0201/p156.html

Intravenous Magnesium Sulfate for Acute Asthma Exacerbations - FPIN's Clinical ...

Jan 15, 2019 - Patients presenting to the emergency department with an acute asthma exacerbation that has not responded to first-line therapy (bronchodilators and corticosteroids) can be treated effectively with intravenous magnesium sulfate.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0115/p127.html

Prasterone (Intrarosa) for Dyspareunia - STEPS - American Family Physician

Jan 15, 2019 - Prasterone is similarly effective to nonprescription options for treating vaginal dryness and itching associated with menopause and may offer a small benefit in the treatment of dyspareunia.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0115/p117.html

Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Deprescribing Is an Essential Part of Good Prescribing - Editorials - American Family ...

Jan 1, 2019 - There are four important medication issues to discuss with patients as they get older. Find out more and learn the five steps to individualize deprescribing practices for each patient.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0101/p7.html

Deprescribing Benzodiazepine Receptor Agonists for Insomnia in Adults - Practice ...

Jan 1, 2019 - A multidisciplinary group of clinicians as part of the Deprescribing Guidelines in the Elderly project has developed evidence-based guidelines focused on deprescribing long-term Benzodiazepine receptor agonists (BZRAs) in patients taking them for insomnia, with the goal of helping ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0101/p57.html

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half ...

Jan 1, 2019 - This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53a.html

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy - ...

Jan 1, 2019 - Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p55.html

Antibiotic Prophylaxis for Severe Acute Pancreatitis - FPIN's Help Desk Answers - ...

Jan 1, 2019 - No, antibiotic prophylaxis does not decrease mortality in patients with severe acute pancreatitis, defined as pancreatitis associated with pancreatic necrosis.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0101/p49.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

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations - ...

Jan 1, 2019 - Adding a LABA to an inhaled corticosteroid is safe but does not reduce the likelihood of a serious exacerbation requiring hospitalization. There is a small reduction in nonsevere asthma exacerbations, with one fewer exacerbation for every 53 patients treated for six months.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53.html

Liberal vs. Conservative Oxygen Therapy in the Acutely Ill - Medicine by the Numbers - ...

Jan 1, 2019 - This review compares liberal and conservative oxygen therapy in acutely ill adults and their effect on mortality (in-hospital, 30-day, and longest follow-up) and morbidity (disability at longest follow-up, risk of hospital-acquired pneumonia, any hospital-acquired infection, and length ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0101/od1.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Counseling Patients in Primary Care: Evidence-Based Strategies - American Family Physician

Dec 15, 2018 - Family physicians spend substantial time counseling patients with psychiatric conditions, unhealthy behaviors, and medical adherence issues. Maintaining efficiency while providing counseling is a major challenge. There are several effective, structured counseling strategies developed ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p719.html

Evaluating Benefits and Harms of Anticoagulation in Patients with Atrial Fibrillation -...

Dec 15, 2018 - In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%. However, they also significantly increase the risk of a major bleeding event or intracranial hemorrhage.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/1215/p751.html

Deep Venous Thrombosis: Home vs. Inpatient Treatment - Cochrane for Clinicians - ...

Dec 1, 2018 - Patients treated at home with low-molecular-weight heparin (LMWH) have lower rates of recurrent VTE than those treated in a hospital.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p642.html

Early Invasive Management of Acute Coronary Syndromes - Medicine by the Numbers - ...

Dec 1, 2018 - Does early invasive management help patients with unstable angina or acute non–ST-segment elevation myocardial infarction (NSTEMI) in reducing occurence of death, myocardial infarction, angina symptoms, and rehospitalization at six- to 12-month follow-up? Find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1201/od1.html

Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation ...

Dec 1, 2018 - The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.html

Wearable Devices for Weight Loss - FPIN's Help Desk Answers - American Family Physician

Dec 1, 2018 - Advertisement << Previous article Next article >> Dec 1, 2018 Issue FPIN's Help Desk Answers Wearable Devices for Weight Loss This is a corrected version of the article that appeared in print. KEVIN STEPHENS JR., MD, MBA, and ELISE MORRIS, MD, Georgetown University–Providence...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1201/p670.html

Braces and Splints for Common Musculoskeletal Conditions - American Family Physician

Nov 15, 2018 - Braces and splints can immobilize and protect joints, reduce pain, decrease swelling, and facilitate healing of acute injuries. They are also used for injury prevention and chronic pain reduction, and to alter the function of a joint. The medial unloading (valgus) knee brace is an ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p570.html

Estrogen No Better Than Vaginal Lubricant for Postmenopausal Vaginal Symptoms - POEMs -...

Nov 15, 2018 - It is time to rethink the idea that vaginal atrophy caused by diminished estrogen is the cause of vaginal symptoms associated with menopause. Vaginal estradiol is no more effective than a non-prescription vaginal lubricant or placebo lubricant in the treatment of women with painful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od3.html

Glecaprevir/Pibrentasvir (Mavyret) for the Treatment of Chronic Hepatitis C - STEPS - ...

Nov 15, 2018 - Glecaprevir/pibrentasvir is an effective treatment for any of six genotypes of HCV infection and has few adverse effects. It can be used to treat more genotypes over a shorter duration (eight weeks for patients without cirrhosis) and is substantially less expensive than other available ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/1115/p601.html

Dysphonia (Hoarseness): AAO-HNSF Releases Updated Clinical Guideline for Treatment - ...

Nov 15, 2018 - To improve the quality of care for patients of all ages with dysphonia, the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF) updated guidelines to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1115/p606.html

As-Needed Use of Budesonide Plus Formoterol As Good As Daily Use of Steroid - POEMs - ...

Nov 15, 2018 - As-needed use of budesonide/formoterol is as effective as the daily use of maintenance budesonide plus as-needed terbutaline at preventing severe exacerbations, and results in a much lower cumulative steroid dose.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od4.html

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

The Pregnant Patient: Managing Common Acute Medical Problems - American Family Physician

Nov 1, 2018 - Women often see their primary care physicians for common acute conditions during pregnancy. These conditions may be caused by pregnancy (obstetric problems) or worsened by pregnancy (obstetrically aggravated problems), or they may require special consideration during pregnancy because ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p595.html

Type 2 Diabetes Mellitus: ACP Releases Updated Guidance Statement on A1C Targets for ...

Nov 1, 2018 - This guidance statement from the American College of Physicians (ACP) aims to help physicians achieve appropriate A1C targets via medication for nonpregnant patients with type 2 diabetes based on a review of six health care organization guidelines.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1101/p613.html

Treatment of Knee Osteoarthritis - Implementing AHRQ Effective Health Care Reviews - ...

Nov 1, 2018 - What are the clinical effectiveness and harms of cell-based therapies, oral glucosamine and/or chondroitin, physical treatment interventions, weight loss, and home-based and self-management therapies for knee osteoarthritis?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/1101/p603.html

Epidural Analgesia and Risk of Cesarean Delivery - FPIN's Help Desk Answers - American ...

Nov 1, 2018 - There is no difference in the risk of cesarean delivery in women who receive epidural analgesia before 4 to 5 cm cervical dilation compared with later dilation.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1101/od2.html

Effectiveness of Intrapartum Antibiotics for Meconium-Stained Amniotic Fluid - Medicine...

Nov 1, 2018 - This review concluded that there is insufficient evidence to recommend prophylactic intrapartum antibiotics in laboring women with meconium-stained amniotic fluid because of the lack of difference in rates of neonatal sepsis between the antibiotic and placebo groups.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1101/od1.html

Culture-Specific Asthma Education Programs for Minority Groups - Cochrane for ...

Nov 1, 2018 - In children from minority groups, culture-specific asthma education programs (CAEPs) reduce the number of severe asthma exacerbations requiring hospitalization and improve asthma control as measured by the Childhood Asthma Control Test but not the Asthma Control Questionnaire. CAEPs ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1101/p572.html

Cerumen Impaction: Diagnosis and Management - American Family Physician

Oct 15, 2018 - Cerumen production is a normal and protective process for the ear canal. However, cerumen should be removed when it causes symptoms (e.g., hearing loss, itching, pain, tinnitus) or prevents assessment of the external auditory canal, the tympanic membrane, or audiovestibular system. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p525.html

Morning vs. Evening Administration of Levothyroxine - FPIN's Clinical Inquiries - ...

Oct 15, 2018 - The effectiveness of levothyroxine for reducing TSH levels is most dependent on the timing of meals in relation to drug administration. There is conflicting evidence. In two studies, levothyroxine taken at least two hours after eating in the evening maintained or improved TSH levels ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/1015/p532.html

Long-Acting Muscarinic Antagonists plus Inhaled Steroids is Equal to Long-Acting ...

Oct 15, 2018 - Long-acting muscarinic antagonists added to inhaled corticosteroids are a superior treatment to placebo for improving asthma control in adults and children 12 years or older. Long-acting muscarinic antagonist add-on therapy is not superior to long-acting beta agonist (LABA) add-on therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od2.html

Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated...

Oct 15, 2018 - A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od4.html

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not ...

Oct 15, 2018 - This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od3.html

Family Physicians Can Manage Adults with Hepatitis C - Editorials - American Family ...

Oct 1, 2018 - The Centers for Disease Control and Prevention encourages family physicians to treat patients with hepatitis C. Outcomes when primary care physicians prescribe direct-acting antivirals to patients with uncomplicated hepatitis C are comparable to those of subspecialists.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1001/p413.html

Hormone Therapy for Primary Prevention of Cardiovascular Disease in Postmenopausal ...

Oct 1, 2018 - No benefit was observed in postmenopausal women receiving hormone therapy for primary prevention of cardiovascular disease. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/1001/od1.html

Therapist-Guided, Internet-Delivered Cognitive Behavior Therapy for Anxiety - FPIN's ...

Oct 1, 2018 - Therapist-guided, Internet-delivered CBT can be used as an effective treatment for anxiety in adults and is similar in effectiveness to face-to-face CBT.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/1001/p459.html

Interventions for Increasing Fruit and Vegetable Consumption in Children Five Years and...

Oct 1, 2018 - Child feeding interventions are effective in the short term (i.e., less than 12 months) for increasing a child's intake of fruits and vegetables, but only by less than 5% of the recommended daily allowance. Conversely, parental nutrition education and multicomponent interventions, such ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1001/p419.html

Crisaborole (Eucrisa) for Mild to Moderate Atopic Dermatitis - STEPS - American Family ...

Sep 15, 2018 - Crisaborole has been shown to be effective in about one-third of patients who use it, but it is much more expensive than other available products. Although crisaborole is a safe option for patients in whom topical corticosteroids are considered risky (e.g., children at least two years ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0915/p379.html

Deprescribing Antipsychotics for Behavioral and Psychological Symptoms of Dementia and ...

Sep 15, 2018 - As part of the Deprescribing Guidelines in the Elderly Project, a Canadian team consisting of two family physicians, one geriatric psychiatrist, two geriatricians, and four pharmacists has provided recommendations to guide physicians in deprescribing antipsychotics for behavioral and ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0915/p394.html

Single Maintenance and Reliever Therapy More Effective Than Inhaled Corticosteroids and...

Sep 15, 2018 - When compared with standard therapy (inhaled corticosteroids with or without LABAs and SABAs as relief therapy), SMART is associated with a reduced risk of acute asthma exacerbations in patients 12 years or older.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p383.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

Common Foot Problems: Over-the-Counter Treatments and Home Care - American Family ...

Sep 1, 2018 - Most foot disorders do not require podiatry referral or complex interventions. After the clinical diagnosis is made, these conditions can typically be managed with over-the-counter (OTC) and home remedies, with guidance from the primary care physician. Stretching and strengthening ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0901/p298.html

Antibiotics for Uncomplicated Skin Abscesses After Incision and Drainage: BMJ Rapid ...

Sep 1, 2018 - A collaboration between the BMJ and the MAGIC group led an international panel made up of a variety of health care professionals (e.g., family physicians, internists, dermatologists) and adults with experience treating and living with skin abscesses to create recommendations regarding ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0901/p323.html

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

Sep 1, 2018 - What are the effectiveness, comparative effectiveness, and adverse effects of interventions for insomnia disorder in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0901/p319.html

Feed Thickener for Newborn Infants with Gastroesophageal Reflux - Cochrane for ...

Sep 1, 2018 - Feed thickeners decrease the number of reflux episodes in full-term formula-fed infants. Additionally, full-term formula-fed infants with GER who are given thickeners are more than twice as likely to be asymptomatic compared with infants not receiving thickeners at one to eight weeks of...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p275.html

Blood Pressure Targets for Patients with Hypertension and Cardiovascular Disease - ...

Sep 1, 2018 - Achieving a target BP of 135/85 mm Hg or less does not decrease the risk of total cardiovascular events vs. treating to a target of 140 to 160/90 to 100 mm Hg. Further, treating to the lower BP target does not improve total mortality, cardiovascular mortality, or serious adverse effects.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0901/p276.html

Effect of Dietary Changes on IBS Symptoms - FPIN's Help Desk Answers - American Family ...

Sep 1, 2018 - A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FOD-MAPs) decreases IBS symptoms and improves quality of life compared with usual diet.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0901/od1.html

Chewing Gum for Reducing Post-Cesarean Section Ileus - Medicine by the Numbers - ...

Sep 1, 2018 - Although the current body of literature suggests a need for higher-quality, more robust research, the simplicity, frugality, and safety of chewing gum makes it a viable option to offer women undergoing cesarean section.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0901/od2.html

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Epistaxis: Outpatient Management - American Family Physician

Aug 15, 2018 - Epistaxis is a common emergency encountered by primary care physicians. Up to 60% of the general population experience epistaxis, and 6% seek medical attention for it. More than 90% of cases arise from the anterior nasal circulation, and most treatments can be easily performed in the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p240.html

Vitamin D, Calcium, or Combined Supplementation for the Primary Prevention of Fractures...

Aug 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of the benefits and harms of vitamin D and calcium supplementation, alone or combined, for the primary prevention of fractures in men and premenopausal women.

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

https://www.aafp.org/afp/2018/0815/od2.html

Delafloxacin (Baxdela) for Skin Infections - STEPS - American Family Physician

Aug 15, 2018 - Delafloxacin is a new fluoroquinolone antibiotic available in intravenous and oral formulations for the treatment of serious skin and skin structure infections in patients requiring initial intravenous therapy. It is effective for infections caused by MRSA or P. aeruginosa, in addition ...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0815/p246.html

Aspirin No Different Than Rivaroxaban for Prevention of VTE After TKA or THA - POEMs - ...

Aug 15, 2018 - Extended prophylaxis with low-dose aspirin is similar in efficacy to rivaroxaban for the prevention of symptomatic VTE following TKA or THA. Aspirin is cheap, widely available, and effective, making it a good alternative to the more costly direct oral anticoagulants.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

Systolic Blood Pressure of At Least 140 mm Hg Best Place to Begin Treatment - POEMs - ...

Aug 15, 2018 - Beginning antihypertensive treatment when the systolic blood pressure is greater than 140 mm Hg delays death and prevents major cardiovascular events in some persons without preexisting heart disease; in patients with existing heart disease, it prevents further events, but does not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p249.html

Type 1 Diabetes: Management Strategies - American Family Physician

Aug 1, 2018 - There is considerable benefit of tight glucose control in patients with type 1 diabetes mellitus. Tight blood glucose control dramatically decreases the incidence of microvascular and macrovascular complications. Although glycemic goals should be individualized, most nonpregnant adults ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0801/p154.html

Treatment Duration for Etonogestrel Implant - FPIN's Help Desk Answers - American ...

Aug 1, 2018 - The etonogestrel subdermal implant is approved by the U.S. Food and Drug Administration for contraception for up to three years, but it seems to be effective for up to five years.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0801/od3.html

Interventions for Treatment of Overweight and Obese Children - Cochrane for Clinicians ...

Aug 1, 2018 - Interventions that include combinations of diet, physical activity, and behavior changes may reduce weight, body mass index (BMI), and BMI z-score (equivalent to BMI-for-age percentile) in overweight and obese children six to 11 years of age.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0801/p151.html

The Role of Proton Pump Inhibitor Therapy in Patients with Functional Dyspepsia - ...

Aug 1, 2018 - There is moderate-quality evidence that PPIs are more effective than placebo at relieving overall symptoms in patients with functional dyspepsia (number needed to treat [NNT] = 11). Low-quality evidence suggests a small benefit of PPI therapy compared with prokinetics, and little to no ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0801/p152.html

Terbinafine for Onychomycosis - Medicine by the Numbers - American Family Physician

Aug 1, 2018 - Preliminary evidence indicates that combining terbinafine with an azole appears to be superior to terbinafine alone. Further study is necessary to compare combined treatment with terbinafine plus an azole vs. terbinafine alone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0801/od1.html

Lifitegrast Ophthalmic Solution 5% (Xiidra) for Dry Eye Disease - STEPS - American ...

Jul 15, 2018 - Studies have shown that lifitegrast will reduce the symptoms of dry eye disease in some patients, although the benefit is borderline clinically significant. It is much more expensive than over-the-counter ointments, artificial tears, and lubricant eye drops.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0715/p119.html

The Risk of Cardiovascular Disease, Fracture, Dementia, and Cancer After Long-Term ...

Jul 15, 2018 - Long-term hormone therapy decreased the risk of all fractures, including hip and vertebral fractures. However, the risks far outweighed the benefits of this intervention.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0715/p117.html

Physical Therapy for Low Back Pain - FPIN's Clinical Inquiries - American Family Physician

Jul 15, 2018 - There is some evidence that early physical therapy may decrease posttreatment health care utilization for low back pain.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0715/p115.html

Short Courses of Oral Corticosteroids: Lack of Benefit and Potential Harms for Common ...

Jul 1, 2018 - A short course of oral corticosteroids is appropriate for many patients with specific conditions. However, widespread use of corticosteroids in patients with non-pneumonia lower respiratory tract infection, nonsevere sore throat, or low back pain is inappropriate and not worth the risk ...

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0701/p12.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

Nebulized Hypertonic Saline for Bronchiolitis - Medicine by the Numbers - American ...

Jul 1, 2018 - Despite reported benefits associated with the use of hypertonic saline for bronchiolitis, we have chosen a yellow recommendation because the more recent trials and systematic reviews have shown either much smaller effect size or no benefit at all compared with the older trials. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0701/p23.html

Individual Behavioral Counseling for Smoking Cessation - Cochrane for Clinicians - ...

Jul 1, 2018 - Individual behavioral counseling conducted by a trained therapist provides some benefit when compared with brief counseling and support; however, this benefit is less pronounced in the context of pharmacotherapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p21.html

Staples vs. Sutures After Cesarean Delivery - FPIN's Help Desk Answers - American ...

Jul 1, 2018 - Patients believe that staples and subcuticular sutures provide similar cosmetic outcomes after cesarean deliveries. However, the risk of wound complications (e.g., infection, separation, hematoma, seroma) is doubled with staples.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0701/p50.html

Bleeding with Anticoagulants: ACC Releases Expert Consensus Decision Pathway to Guide ...

Jul 1, 2018 - This Expert Consensus Decision Pathway from the American College of Cardiology (ACC) aims to provide physicians with decision-making assistance for managing bleeding events in patients taking anticoagulants.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0701/p57.html

Procalcitonin to Guide Antibiotic Therapy in Acute Respiratory Infections - Cochrane ...

Jul 1, 2018 - Procalcitonin-guided antibiotic therapy, when compared with routine treatments, results in decreased mortality in patients with acute respiratory infections (absolute risk reduction [ARR] = 1.4%; number needed to treat [NNT] = 71).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0701/p20.html

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