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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

The Adult Well-Male Examination - American Family Physician

Dec 15, 2018 - The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodeficiency virus and other sexually transmitted infections, and diet and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p729.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

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with...

Dec 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for peripheral artery disease (PAD) and cardiovascular disease (CVD) risk with the ankle-brachial index (ABI) in asymptomatic adults.

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

https://www.aafp.org/afp/2018/1215/od1.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

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with...

Dec 15, 2018 - Advertisement << Previous article Next article >> Dec 15, 2018 Issue Putting Prevention into Practice An Evidence-Based Approach Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with the Ankle-Brachial Index JUSTIN MILLS, MD, MPH, U.S. Preventive...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1215/p754.html

Lung Cancer Screening Recommendations from the ACCP - Practice Guidelines - American ...

Dec 1, 2018 - The American College of Chest Physicians (ACCP) recently published recommendations for lung cancer screening based on key questions developed using the PICO (population, intervention, comparator, and outcome) format.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1201/p688.html

Preventing or Delaying Type 2 Diabetes Mellitus with Diet and Exercise - Cochrane for ...

Dec 1, 2018 - There is moderate-quality evidence that in patients with impaired glucose tolerance (IGT) defined by an abnormal 75-g two-hour glucose tolerance test, implementing changes in diet and adding physical activity together can prevent or delay the development of type 2 diabetes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p643.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

Incidental Findings Are Common with Chest CT and MRI of the Spine and Brain - POEMs - ...

Dec 1, 2018 - The risks of imaging, in addition to radiation exposure, include the identification of incidentalomas, which can lead to patient anxiety, further testing, and overtreatment. There is little research to guide what to do when they pop up on an imaging report (as the famous dodge clinical ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682.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

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.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

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

Care of Incarcerated Patients - American Family Physician

Nov 15, 2018 - The United States has the highest incarceration rate of any nation in the world. Approximately 870 of every 100,000 U.S. citizens are currently in jails or prisons. U.S. inmates are disproportionately young males, racial and ethnic minorities, and persons of low socioeconomic status. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p577.html

Screening for Osteoporosis to Prevent Fractures: Recommendation Statement - U.S. ...

Nov 15, 2018 - The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.

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

https://www.aafp.org/afp/2018/1115/od1.html

Screening for Osteoporosis to Prevent Fractures - Putting Prevention into Practice - ...

Nov 15, 2018 - A 57-year-old postmenopausal woman comes to your clinic for a wellness visit. She has no significant medical problems. She broke her left forearm as a child by falling out of a tree but has had no other fractures. She currently smokes one pack of cigarettes per day, rarely drinks one ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1115/p593.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

Overuse of Cardiac Testing - Lown Right Care: Reducing Overuse and Underuse - American ...

Nov 15, 2018 - This is the first of a new collaboration between AFP and the Lown Institute. This new feature 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/2018/1115/p561.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

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

Knee Pain in Adults and Adolescents: The Initial Evaluation - American Family Physician

Nov 1, 2018 - Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p576.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

Urinary Retention in Adults: Evaluation and Initial Management - American Family Physician

Oct 15, 2018 - Urinary retention is the acute or chronic inability to voluntarily pass an adequate amount of urine. The condition predominantly affects men. The most common causes are obstructive in nature, with benign prostatic hyperplasia accounting for 53% of cases. Infectious, inflammatory, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p496.html

Recombinant Zoster Vaccine (Shingrix) for the Prevention of Shingles - STEPS - American...

Oct 15, 2018 - Recombinant zoster vaccine is a relatively new shingles vaccine that has been shown to have greater effectiveness and protection than the existing live vaccine. Local and systemic adverse effects may occur after administration, but have been shown to resolve within one to three days.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/1015/p539.html

Counseling Patients About Prostate Cancer Screening - Editorials - American Family ...

Oct 15, 2018 - The AAFP finds that the net benefit of population screening for prostate cancer is small at best, and it does not recommend routinely discussing PSA-based screening if the patient does not request it.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1015/p478.html

Screening for Prostate Cancer - Putting Prevention into Practice - American Family ...

Oct 15, 2018 - A.E., a 57-year-old black man, comes to your office for an annual visit. He has a history of diabetes mellitus, has never smoked, and has no family history of prostate cancer. He is current with preventive services, including screening for colorectal cancer and counseling for a healthy ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1015/p537.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

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

Oct 15, 2018 - Advertisement << Previous article Next article >> Oct 15, 2018 Issue U.S. Preventive Services Task Force Screening for Prostate Cancer: Recommendation Statement Am Fam Physician. 2018 Oct 15;98(8):online. Related Putting Prevention into Practice: Screening for Prostate Cancer...

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

https://www.aafp.org/afp/2018/1015/od1.html

Mechanical Low Back Pain - American Family Physician

Oct 1, 2018 - Low back pain is usually nonspecific or mechanical. Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. Clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p421.html

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.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

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

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

Screening for Cardiovascular Disease Risk with Electrocardiography - Putting Prevention...

Sep 15, 2018 - A 55-year-old man presents for an annual visit. He has no history of hypertension, cardiovascular disease (CVD), or diabetes mellitus; has never smoked; and has no family history of CVD. His lipid panel results from one year ago were normal, and he has no current symptoms of CVD.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0915/p375.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

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

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

Preoperative Assessment in Older Adults: A Comprehensive Approach - American Family ...

Aug 15, 2018 - Surgical outcomes are significantly influenced by patients’ overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p214.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

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

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

American Family Physician : Point-of-Care Guides

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

Interventions to Prevent Falls in Community-Dwelling Older Adults: Recommendation ...

Aug 15, 2018 - The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults 65 years or older who are at increased risk for falls.

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

https://www.aafp.org/afp/2018/0815/od1.html

Interventions to Prevent Falls and Fractures in Community-Dwelling Older Adults - ...

Aug 15, 2018 - Mr. and Mrs. J. present to your office for their annual wellness visits. He is 75 years of age, has well-controlled hypertension, does not smoke, and has a body mass index (BMI) of 26 kg per m2. He recently fell while walking from his home to a neighborhood barbeque.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0815/p253.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

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

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

Pulmonary Embolism Rule-Out Criteria Reduces the Need for CT Pulmonary Angiography in ...

Aug 15, 2018 - Use of the PERC clinical decision rule significantly reduces the need for CT pulmonary angiography in adults with an initial low-risk clinical estimate of suspected PE.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p250.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

Diagnosis of Acute Coronary Syndrome - FPIN's Help Desk Answers - American Family ...

Aug 1, 2018 - The best test to diagnose ACS is a risk score based on a clinical prediction rule such as the HEART (history, electrocardiography, age, risk factors, troponin level) or TIMI (Thrombolysis in Myocardial Infarction) risk score, which have positive likelihood ratios (LR+'s) of 13 and 6.8, ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0801/od2.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

Hepatitis B Virus Vaccination and Screening: Best Practices from the ACP and CDC - ...

Jul 15, 2018 - The American College of Physicians and Centers for Disease Control and Prevention highlights the consensus among these recommendations, with recent evidence, to develop a best practice advice statement for vaccination, screening, care, and treatment of patients at risk of or who ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0715/p121.html

Counseling Parents and Adolescents About Marijuana - Editorials - American Family ...

Jul 15, 2018 - Physicians are increasingly likely to be asked by adolescents or their parents whether recreational marijuana use is safe. Although many adults view marijuana as benign, there are major concerns about its use in adolescents because all illicit drug use, including marijuana, may have ...

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0715/p80.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

Behavioral Counseling to Prevent Skin Cancer: Recommendation Statement - U.S. ...

Jul 15, 2018 - The USPSTF recommends counseling young adults, adolescents, children, and parents of young children about minimizing exposure to ultraviolet (UV) radiation for persons aged 6 months to 24 years with fair skin types to reduce their risk of skin cancer.

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

https://www.aafp.org/afp/2018/0715/od1.html

Behavioral Counseling to Prevent Skin Cancer - Putting Prevention into Practice - ...

Jul 15, 2018 - A 25-year-old Irish American woman presents for a wellness visit for herself and her two young children, a two-year-old boy and a seven-month-old girl. All three have fair skin, red hair, and freckles. She reports that she is looking forward to an upcoming family vacation to the ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0715/p105.html

Evaluating Medical Decision-Making Capacity in Practice - American Family Physician

Jul 1, 2018 - Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). Capacity is the basis of informed consent. Patients have medical decision-making capacity if they...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p40.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

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

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

PCI Equal to Sham PCI for Exercise Tolerance in Patients with Stable Angina Plus Severe...

Jul 1, 2018 - In patients with stable angina and severe coronary artery disease (CAD), PCI plus optimal medical treatment does not improve exercise tolerance or angina more than sham PCI plus optimal medical treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p55.html

Surgery Equal to No Surgery for Patients with Subacromial Shoulder Pain - POEMs - ...

Jul 1, 2018 - In patients with subacromial shoulder pain of at least three months' duration who receive physical therapy, surgical decompression is no better than arthroscopy without decompression in improving pain or function, and neither is much better than no invasive intervention at all.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54.html

Localized Prostate Cancer: Treatment Options - American Family Physician

Jun 15, 2018 - In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p798.html

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

Jun 15, 2018 - The USPSTF recommends against screening for ovarian cancer in asymptomatic women.

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

https://www.aafp.org/afp/2018/0615/od1.html

Identifying Patients with Newly Diagnosed Acute Pulmonary Embolism Who Are at Low Risk ...

Jun 15, 2018 - Standard management of acute PE includes five days of inpatient treatment with parenteral anticoagulation, followed by long-term oral anticoagulation as an outpatient. However, guidelines from the American College of Chest Physicians state that early discharge before five days can be ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0615/p811.html

FIT More Acceptable with Better Detection Rate Than gFOBT for Colorectal Cancer ...

Jun 15, 2018 - FIT is more sensitive and specific than the older guaiac-based fecal occult blood tests (gFOBTs) when screening for colorectal cancer. We now know that it is also more acceptable to patients and increases uptake in a centrally administered screening program.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p818.html

Screening for Ovarian Cancer - Putting Prevention into Practice - American Family ...

Jun 15, 2018 - A 61-year-old woman presents to your office for a well-woman examination. She had a normal Papanicolaou (Pap) test last year and has no medical problems. She quit smoking 10 years ago, reports a family history significant only for cardiovascular disease, and is sexually active with her ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0615/p813.html

Diets for Health: Goals and Guidelines - American Family Physician

Jun 1, 2018 - Diet is the single most significant risk factor for disability and premature death. Patients and physicians often have difficulty staying abreast of diet trends, many of which focus primarily on weight loss rather than nutrition and health. Recommending an eating style can help patients...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p721.html

High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients - FPIN's Help...

Jun 1, 2018 - In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od2.html

Ruling Out Pulmonary Embolism in the Primary Care Setting - Point-of-Care Guides - ...

Jun 1, 2018 - What is the best approach to evaluate patients with suspected pulmonary embolism in the outpatient, primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0601/p750.html

Cerebrospinal Fluid Biomarkers for Detection of Alzheimer Disease in Patients with Mild...

Jun 1, 2018 - There is insufficient evidence to support the routine use of cerebrospinal fluid (CSF) biomarkers for the detection of progressive dementias in patients with mild cognitive impairment (MCI). These tests carry the risk of overdiagnosis of dementia and, therefore, overtreatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p714.html

Adults with Developmental Disabilities: A Comprehensive Approach to Medical Care - ...

May 15, 2018 - Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p649.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

Eosinophilic Esophagitis: A Mimic of Gastroesophageal Reflux Disease - Editorials - ...

May 15, 2018 - Pathologic diseases, besides GERD, are becoming more prevalent and should be considered in the differential diagnosis of patients presenting with symptoms of esophageal dysfunction.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0515/p628.html

Implantable Buprenorphine (Probuphine) for Maintenance Treatment of Opioid Use Disorder...

May 15, 2018 - Implantable buprenorphine is an expensive alternative for patients on a stable dosage of transmucosal buprenorphine. Based on current research and guidance, implantable buprenorphine should not be used as initial treatment for opioid dependence or as a substitute for medication-assisted...

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0515/p668.html

Charcot Foot: Clinical Clues, Diagnostic Strategies, and Treatment Principles - ...

May 1, 2018 - Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0501/p594.html

Effectiveness of Pneumococcal Vaccines - FPIN's Help Desk Answers - American Family ...

May 1, 2018 - The 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23) decreases the relative risk of community-acquired pneumonia in adults by 13%. The risk is reduced by 28% in the population that includes adults older than 65 years, those with lung disease, and those living in a ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0501/od3.html

Omega-3 Fatty Acids and Cardiovascular Disease - Implementing AHRQ Effective Health ...

May 1, 2018 - What is the effect of omega-3 fatty acid supplementation on cardiovascular outcomes?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2018/0501/p562.html

Gender-Dysphoric/Gender-Incongruent Persons: Treatment Recommendations from the ...

May 1, 2018 - Gender-dysphoric/gender-incongruent persons require a safe and effective hormone regimen. These recommendations are an update to the clinical practice guideline on endocrine treatment of transsexual persons published in 2009 by the Endocrine Society.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0501/p608.html

Effectiveness and Safety of Celecoxib for the Treatment of Rheumatoid Arthritis - ...

May 1, 2018 - Compared with placebo, celecoxib improves pain (number needed to treat [NNT] = 4) and clinical symptoms (NNT = 7), but it has no effect on physical function in patients with RA.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0501/p573.html

Pregabalin (Lyrica) for Acute Fibromyalgia Pain - Medicine by the Numbers - American ...

May 1, 2018 - Pregabalin (Lyrica) provides good pain relief to some patients with acute fibromyalgia pain but does not work for most persons. Learn more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0501/od1.html

Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant ...

May 1, 2018 - Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605a.html

Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious ...

May 1, 2018 - Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p606.html

Single Question Is Useful for Identifying Acute Mountain Sickness in Travelers at High ...

May 1, 2018 - Three different diagnostic scoring tools have similar accuracy for identifying adults at risk of AMS. One tool, the clinical functional score, is the simplest to use and consists of asking a single question.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p607.html

Osteoarthritis: Rapid Evidence Review - American Family Physician

Apr 15, 2018 - Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography...

American Family Physician : Article

https://www.aafp.org/afp/2018/0415/p523.html

Antibiotic Prophylaxis for COPD Exacerbations - FPIN's Clinical Inquiries - American ...

Apr 15, 2018 - Prophylactic antibiotics may be used to reduce the overall rate of COPD exacerbations and delay their onset. However, the appropriate antibiotic regimen and target population are unclear.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0415/p527.html

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal ...

Apr 15, 2018 - The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal women and the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal women who have had a hysterectomy.

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

https://www.aafp.org/afp/2018/0415/od1.html

Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal ...

Apr 15, 2018 - D.M. is a 52-year-old woman who presents to your office for a well-woman visit. She has been menopausal since 50 years of age and has no significant medical or surgical history. She is up to date on her recommended screenings, with normal mammography and colonoscopy results, and has no ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0415/p541.html

Edoxaban (Savaysa) for the Prevention of Thromboembolic Events - STEPS - American ...

Apr 15, 2018 - Edoxaban is an alternative to warfarin and other oral anticoagulants for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of deep venous thrombosis and pulmonary embolism.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0415/p529.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

Cervical Cancer Screening - American Family Physician

Apr 1, 2018 - Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p441.html

Cervical Cancer: Evaluation and Management - American Family Physician

Apr 1, 2018 - Human papillomavirus infection is the precursor for the development of cervical cancer and is detectable in 99.7% of squamous cell carcinoma and adenocarcinoma cases. Early detection of precancerous lesions with Papanicolaou testing remains the primary mechanism for cancer prevention. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p449.html

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

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

American Family Physician : Practice Guidelines

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

Pneumococcal Vaccines in Chronic Obstructive Pulmonary Disease - Medicine by the ...

Apr 1, 2018 - Pneumococcal vaccines had no significant effect on mortality from cardiorespiratory disease when compared with control and had no significant effect on all-cause mortality. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0401/p463.html

Duration of Bisphosphonate Therapy - FPIN's Help Desk Answers - American Family Physician

Apr 1, 2018 - Oral bisphosphonates significantly reduce clinical fracture risk at four years in women with postmenopausal osteoporosis (T-score less than −2.5). Treatment beyond five years is associated with further reductions in fractures in women with persistent femoral neck T-scores less than −2.5.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od1.html

DPP-4 Inhibitors and GLP-1 Receptor Agonists for Prevention or Delay of Type 2 Diabetes...

Apr 1, 2018 - There is only limited-quality evidence that at-risk patients taking GLP-1 receptor agonists are less likely to progress to diabetes (number needed to treat [NNT] = 23). Serious adverse events were more likely in patients taking GLP-1 receptor agonists than in patients taking placebo ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0401/p437.html

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