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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

Oxymetazoline Hydrochloride 1% Cream (Rhofade) for Persistent Facial Erythema ...

Jun 15, 2018 - Oxymetazoline cream has been shown to be safe and effective at reducing erythema in a small portion of treated patients, but research showing its effectiveness relative to other options is lacking.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0615/p808.html

Corticosteroids for Sore Throat: BMJ Rapid Recommendation - Practice Guidelines - ...

Jun 15, 2018 - The BMJ Rapid Recommendations team, a collaboration between BMJ and the MAGIC group, issued a weak recommendation to give a single dose of oral corticosteroids to most patients with acute sore throat.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0615/p821.html

Drugs for Chronic Idiopathic Constipation Are Similarly Effective - POEMs - American ...

Jun 15, 2018 - If nondrug measures are unsuccessful for chronic idiopathic constipation, the choice of a pharmacologic agent should be based on cost, tolerability, and long-term adherence rather than efficacy, because the efficacy is similar among drugs and drug classes.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819a.html

Antibiotics for Otitis Media in Children - Medicine by the Numbers - American Family ...

Jun 15, 2018 - This meta-analysis concludes that the risk of a prolonged course of antibiotics was twice as high for children younger than two years with bilateral acute otitis media than for children two years and older with unilateral acute otitis media, indicating that antibiotics might be ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0615/od3.html

Injectable Extended-Release Naltrexone Effective for Opioid Use Disorder - POEMs - ...

Jun 15, 2018 - Injectable extended-release naltrexone administered every four weeks is similar in efficacy to daily oral buprenorphine/naloxone for the treatment of opioid use disorder. Patients using extended-release naltrexone reported higher satisfaction with treatment and were more likely to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819.html

Oncologic Emergencies: Recognition and Initial Management - American Family Physician

Jun 1, 2018 - Most oncologic emergencies can be classified as metabolic, hematologic, structural, or treatment related. Tumor lysis syndrome is a metabolic emergency that presents as severe electrolyte abnormalities. Stabilization is focused on vigorous rehydration, maintaining urine output, and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p741.html

Hyperhidrosis: Management Options - American Family Physician

Jun 1, 2018 - Hyperhidrosis is excessive sweating that affects patients’ quality of life, resulting in social and work impairment and emotional distress. Primary hyperhidrosis is bilaterally symmetric, focal, excessive sweating of the axillae, palms, soles, or craniofacial region not caused by other ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p729.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

Combined Inhaled Short-Acting Beta2 Agonist and Anticholinergic Agents for Asthma - ...

Jun 1, 2018 - Although the quality of evidence included in this review was low to moderate, the potential benefits of decreased hospitalization and relapse rates and the comparatively mild and limited adverse events suggest that patients presenting with acute asthma exacerbations are likely to ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0601/od1.html

Atypical Antipsychotics for Disruptive Behavior Disorders in Children and Adolescents -...

Jun 1, 2018 - Risperidone reduces measures of aggression and improves conduct in children with disruptive behavior disorders; however, only short-term use is recommended. Weight gain of 2 to 2.5 kg (4.4 to 5.5 lb) is common. There is insufficient evidence to evaluate the benefits of other ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p715.html

NSAIDs for Postpartum Perineal Pain - FPIN's Help Desk Answers - American Family Physician

Jun 1, 2018 - Women with third- or fourth-degree perineal lacerations or who received an episiotomy can be given oral NSAIDs to reduce perineal pain in the first six hours postpartum.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od3.html

How the FDA Ensures High-Quality Generic Drugs - Editorials - American Family Physician

Jun 1, 2018 - We want to assure all stakeholders of the rigorous approval process that supports the FDA's commitment to ensuring the high quality of generic drugs marketed in the United States.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0601/p696.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

Hyperpronation Method for Reduction of Nursemaid's Elbow - Medicine by the Numbers - ...

May 15, 2018 - Although data are limited, the results have consistently shown a higher rate of success with first attempt reduction of nursemaids' elbow when the hyperpronation method was used. For other outcomes, including pain and adverse effects such as bruising, no conclusions could be drawn ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0515/od2.html

Maternal Obesity and Labor Induction - FPIN's Help Desk Answers - American Family ...

May 15, 2018 - Pregnant women who are obese have nearly double the rate of cesarean delivery, and obesity increases the median duration of active labor by up to four hours when labor is induced. The difference in cesarean delivery rate is larger in obese primigravida patients presenting with cervical ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0515/p671.html

Primary Closure of Animal Bites - FPIN's Help Desk Answers - American Family Physician

May 1, 2018 - Dog bites can have a primary closure at the time of injury. Primary closure of dog bites does not increase the rate of wound infections compared with nonclosure.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0501/od2.html

Antiepileptic Drug Monotherapy for Epilepsy - Cochrane for Clinicians - American Family...

May 1, 2018 - In patients with partial-onset (focal) seizures, levetiracetam (Keppra), lamotrigine (Lamictal), and carbamazepine (Tegretol) were associated with the longest time to treatment withdrawal (i.e., the recommended patient-oriented outcome measure that balances tolerability with ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0501/p572.html

One-Third of Patients with Anxiety Disorder Will Relapse When Antidepressant Treatment ...

May 1, 2018 - Discontinuing the antidepressant treatment in patients with anxiety disorders will cause a relapse in almost one-third of them. One in six patients previously treated successfully will also relapse despite continued treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605.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

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

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

The Female Athlete Triad: Recommendations for Management - Editorials - American Family...

Apr 15, 2018 - Family physicians should be familiar with recommendations regarding the female athlete triad, because prevention and early intervention can significantly reduce morbidity from this disorder.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0415/p499.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

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

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

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

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

American Family Physician : Medicine by the Numbers

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

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: 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

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

Short-Term Antipsychotics for Alzheimer Disease - FPIN's Help Desk Answers - American ...

Apr 1, 2018 - Physicians should consider not using antipsychotics in patients with dementia. Patients with dementia, including Alzheimer disease, who are treated with antipsychotics for any length of time have a higher mortality rate than those not taking antipsychotics.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0401/od2.html

Broad-Spectrum Antibiotics Increase Adverse Events in Children with Acute Respiratory ...

Apr 1, 2018 - Broad-spectrum antibiotics are no more effective than narrow-spectrum antibiotics for treating acute respiratory tract infections in infants and children, and adverse events are significantly more common in children treated with broad-spectrum antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474a.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Stable Coronary Artery Disease: Treatment - American Family Physician

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

American Family Physician : Article

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

Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer...

Mar 15, 2018 - This carefully designed and adequately powered study found no difference in pain reduction between ibuprofen and oral morphine in children with postoperative pain. Adverse effects, however, were much more likely with morphine.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408a.html

Lesinurad (Zurampic) for Gout - STEPS - American Family Physician

Mar 15, 2018 - Lesinurad taken in addition to a xanthine oxidase inhibitor reduces serum uric acid levels. However, it does not reduce the likelihood of experiencing a gout flare-up or completely resolving tophi.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0315/p374.html

Minimal Effect of ERT on Sexual Function in Menopausal Women - POEMs - American Family ...

Mar 15, 2018 - Transdermal, but not oral, estrogen produced a small improvement in sexual function scores in menopausal women. The increases were very small and may not be noticeable by most women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408.html

Buprenorphine Therapy for Opioid Use Disorder - American Family Physician

Mar 1, 2018 - Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p313.html

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

Combination LABA Inhalers Compared with High-Dose Inhaled Steroids for Adults with ...

Mar 1, 2018 - We designated the use of long-acting beta agonist inhalers for adults with asthma as having no benefits because of a small potential benefit of questionable clinical utility (avoiding a brief burst of oral steroids) and the possibility of a fatal harm. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0301/od1.html

Medical Aid in Dying - Curbside Consultation - American Family Physician

Mar 1, 2018 - Requests for hastened death are not unusual from patients with life-limiting illness, and many primary care physicians encounter these requests over the course of their career. Medical aid in dying is the practice of a physician providing a competent, terminally ill patient—at the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0301/p339.html

Written Action Plans for Self-Management of COPD Exacerbations - Cochrane for ...

Mar 1, 2018 - Written self-management plans, especially those that include guidance on smoking cessation, increase health-related quality of life in patients with COPD. They also decrease the need for respiratory-related hospital admissions among patients with high or low baseline risk.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0301/p310.html

Treating Opioid Use Disorder as a Family Physician: Taking the Next Step - Editorials -...

Mar 1, 2018 - An AHRQ review showed that there are different ways in which buprenorphine-based MAT can be safely and effectively delivered in primary care settings.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0301/p302.html

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

Single-Dose Oral Dexamethasone Decreases Sore Throat Pain - POEMs - American Family ...

Feb 15, 2018 - Sore throats are rarely fatal anymore, but there is really no such thing as just a sore throat. Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10 mg for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od1.html

Diabetes Education and Glycemic Control - FPIN's Clinical Inquiries - American Family ...

Feb 15, 2018 - Counseling by a diabetes educator or a team of educators delivered in a variety of formats may reduce A1C levels by 0.2% to 0.8% compared with usual care alone. Diabetes educators should be considered for patients who have higher baseline A1C levels (8% to 9%) because this group had ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2018/0215/p269.html

Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer ...

Feb 15, 2018 - Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od4.html

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI -...

Feb 15, 2018 - In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all subgroups,...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od3.html

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.html

Beta Blockers Compared with Other Drug Options for the Treatment of Hypertension - ...

Feb 1, 2018 - Although beta blockers seem to have a positive impact on patient-oriented evidence that matters in patients with hypertension, they appear to be inferior when compared with other medications.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0201/od1.html

Effectiveness of Skin-to-Skin Care for Procedure-Related Pain in Newborns - Cochrane ...

Feb 1, 2018 - Skin-to-skin care, also known as kangaroo care, effectively reduces physiologic and behavioral measures of pain in neonates during painful procedures and has no identified adverse effects. Infants who received skin-to-skin care during painful procedures had a heart rate of 10.8 beats ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0201/p170.html

Injected Corticosteroids for Plantar Heel Pain - Cochrane for Clinicians - American ...

Feb 1, 2018 - There is low-quality evidence that corticosteroid injections slightly reduce heel pain at one month, but they make no significant difference beyond that time. Patients treated with corticosteroid injections were less likely to experience treatment failure—a designation that was defined ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0201/p169.html

OnabotulinumtoxinA Injections for Urge Incontinence - FPIN's Help Desk Answers - ...

Feb 1, 2018 - Detrusor muscle injections of onabotulinumtoxinA can be used to decrease the number of episodes of urinary incontinence in women for whom treatment with anticholinergic agents has been ineffective.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0201/od3.html

H. pylori Infection: ACG Updates Treatment Recommendations - Practice Guidelines - ...

Jan 15, 2018 - Helicobacter pylori infection is one of the most common chronic bacterial infections. The American College of Gastroenterology (ACG) has updated its clinical guidelines in response to significant scientific advances in the management of this disease.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0115/p135.html

Nebivolol/Valsartan (Byvalson) for Hypertension - STEPS - American Family Physician

Jan 15, 2018 - Nebivolol/valsartan is an option for the treatment of patients with newly diagnosed or poorly controlled hypertension. Although it offers a new beta-blocker option, no research has demonstrated its benefit over existing treatments.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0115/p124.html

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.html

Effectiveness of Moisturizers in the Treatment of Patients with Eczema - Cochrane for ...

Jan 1, 2018 - Moisturizers decrease the rate of eczema flare-ups by 3.7 times vs. no treatment (number needed to treat [NNT] = 4), as well as the amount of topical corticosteroids used per eczema flare-up (9.3 g less). Adverse effects are minimal.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0101/p18.html

Stents for Stable Coronary Artery Disease - Medicine by the Numbers - American Family ...

Jan 1, 2018 - Most published trials fail to show a benefit from coronary stenting in patients with stable obstructive coronary artery disease. However, stent technology has evolved significantly in recent years, and it is possible that newer-generation drug-eluting stents may offer different results.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2018/0101/od1.html

Long-Term Use of Bisphosphonates Increases the Risk of Fractures in Older Women - POEMs...

Jan 1, 2018 - In this cohort study, older women at a high risk of fractures who used oral bisphosphonates for 10 to 13 years had a higher risk of fractures than women who used bisphosphonates for only two years.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53a.html

Delayed Antibiotic Prescription for New-Onset Cough Associated with Decreased ...

Jan 1, 2018 - Delayed antibiotic treatment (that is, giving a prescription with a suggestion to fill it only if symptoms are still present after three days) was associated with decreased revisits by adults with new-onset cough deemed to be infective.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53.html

Oral Steroids Not Helpful for Acute Lower Respiratory Tract Infection in Nonasthmatic ...

Jan 1, 2018 - This study found no clinically significant benefit of steroids for the treatment of acute LRTI in adults without asthma, including those presenting with wheezing or shortness of breath.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p55.html

Dietary Interventions for Recurrent Abdominal Pain in Childhood - Cochrane for ...

Jan 1, 2018 - Probiotics relieve pain in children with recurrent abdominal pain in the short term (number needed to treat [NNT] = 8). There is no convincing evidence that fiber supplements improve pain in children with recurrent abdominal pain.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0101/p19.html

Intensive Blood Pressure Control in Older Patients Can Decrease Renal Function - POEMs ...

Jan 1, 2018 - In this post-hoc analysis of the previously published SPRINT trial, lowering the systolic blood pressure of patients who are at increased risk of cardiovascular events (average age = 66 years) will decrease their risk of cardiovascular disease but increase their likelihood of developing...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p54.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults - Putting ...

Dec 15, 2017 - L.D., a 66-year-old generally healthy white man, presents for his annual physical. He has no history of cardiovascular disease (CVD); he has had consistent systolic blood pressure measurements of 140 mm Hg; he is not taking any medications; he does not smoke; he exercises three times ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/1215/p805.html

Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin - POEMs - ...

Dec 15, 2017 - Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od4.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

In Hospitalized Patients with Influenza and an Infiltrate, Adding Clarithromycin and ...

Dec 15, 2017 - Adding clarithromycin and naproxen to oseltamivir significantly lowered all-cause mortality at 30 days and at 90 days. This study was limited by its open-label design. The outcome of mortality would not be subject to observer bias, though, and the groups were balanced.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od5.html

Hyperosmolar Hyperglycemic State - American Family Physician

Dec 1, 2017 - Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common. Other causes include certain ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p729.html

Local Anesthesia for IUD Insertion or Endometrial Biopsy - FPIN's Help Desk Answers - ...

Dec 1, 2017 - Topical application of lidocaine/prilocaine cream to the cervix reduces mean pain scores during IUD insertion. Intrauterine instillation of liquid anesthesia reduces median pain scores during endometrial biopsy.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1201/od3.html

Topical Capsaicin for Treatment of Chronic Neuropathic Pain in Adults - Medicine by the...

Dec 1, 2017 - Based on low-quality evidence, high-concentration capsaicin patches reduce neuropathic pain from herpes and human immunodeficiency virus infection by 30% to 50% compared with the low-concentration capsaicin control group.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1201/od1.html

Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal Vasomotor ...

Dec 1, 2017 - Transdermal estrogen plus progestogen, or oral estrogen plus progestogen, is the treatment most likely to effectively reduce the frequency of vasomotor symptoms among menopausal women. Isoflavones and black cohosh were found to be better than placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1201/p744.html

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

Reslizumab (Cinqair) for Eosinophilic Asthma - STEPS - American Family Physician

Nov 15, 2017 - Reslizumab is an expensive treatment option for decreasing exacerbations in patients with severe asthma and pronounced eosinophilia. Because of the risk of anaphylaxis, it should only be administered in an appropriate facility by a medical professional. Reslizumab is best considered ...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/1115/p671.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Treating Sleep Apnea with Positive Airway Pressure Does Not Reduce Adverse CV Outcomes ...

Nov 15, 2017 - The use of PAP for adults with sleep apnea does not reduce adverse CV events or mortality. Patients who experience daytime fatigue at baseline benefit from reduced sleepiness and improved physical and mental well-being. Order sleep testing only in patients with signs or symptoms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od5.html

Tapering Patients Off of Benzodiazepines - Curbside Consultation - American Family ...

Nov 1, 2017 - When prescribed at a low dosage for a short time (fewer than 30 days), benzodiazepines can effectively treat generalized and social anxiety, panic disorder, and sleep disorders. Long-term use for anxiety and sleep disorders is not supported by research because it is associated with the ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1101/p606.html

Statins in Persons at Low Risk of Cardiovascular Disease - Medicine by the Numbers - ...

Nov 1, 2017 - Despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1101/od1.html

History and Physical Examination for Identifying Rotator Cuff Tears - FPIN's Help Desk ...

Nov 1, 2017 - There are no historical features that reliably identify full-thickness rotator cuff tears. The physical examination maneuvers that best identify the presence of a full-thickness rotator cuff tear are the internal rotation lag test, the external rotation lag test, and a positive ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1101/od2.html

Topical NSAIDs for Chronic Musculoskeletal Pain in Adults - Cochrane for Clinicians - ...

Nov 1, 2017 - Topical diclofenac and ketoprofen are slightly more effective than placebo for relieving chronic pain associated with osteoarthritis in adults. Evidence is lacking to determine the effectiveness of topical NSAIDs compared with oral NSAIDs.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1101/p573.html

Reflux-Cough Syndrome: Guidelines from the ACCP - Practice Guidelines - American Family...

Nov 1, 2017 - In their updated guideline, the American College of Chest Physicians offers recommendations addressing: (1) whether treating gastroesophageal reflux disease (GERD) improves cough in patients with chronic cough, and (2) which clinical criteria suggest that chronic cough will respond to ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1101/p611.html

Interventions for Tobacco Cessation in Patients Being Treated for or Recovering from ...

Nov 1, 2017 - Pharmacotherapy alone and pharmacotherapy plus counseling are effective for tobacco cessation among patients being treated for or recovering from alcohol and substance use disorders. Counseling interventions without pharmacotherapy are not effective for tobacco cessation among patients ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1101/p572.html

Rivaroxaban vs. Warfarin for Treatment of DVT and PE - FPIN's Clinical Inquiries - ...

Oct 15, 2017 - Rivaroxaban, along with the other factor Xa inhibitors, is as effective as or better in the short term (three months) than warfarin (Coumadin) for preventing recurrent DVT, nonfatal PE, and fatal PE, with no differences in mortality or bleeding events.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/1015/p532.html

Dulaglutide (Trulicity) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Oct 15, 2017 - Dulaglutide is an easy-to-use, once-weekly injectable therapy for the treatment of type 2 diabetes in adults. It produces a modest decrease in A1C levels with only a small risk of severe hypoglycemia. The small average weight loss it induces may be an advantage for some patients.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/1015/p540.html

Social Media Use and Mood Disorders: When Is It Time to Unplug? - Curbside Consultation...

Oct 15, 2017 - Americans spend more time on Facebook, the world's largest online social network, than any other website. On the surface, social media networks provide an invaluable resource for fulfilling the basic human need for social connection. However, rather than enhancing well-being by ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2017/1015/p537.html

Treatment of Subclinical Hypothyroidism Ineffective in Older Adults - POEMs - American ...

Oct 15, 2017 - Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od3.html

Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality - POEMs - American ...

Oct 15, 2017 - This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od2.html

Tranexamic Acid Decreased Death from Bleeding but Not All-Cause Mortality in Women with...

Oct 15, 2017 - In this really large study, tranexamic acid did not decrease the frequency of the primary outcome of death or hysterectomy in women with postpartum hemorrhage. However, there was a very small reduction in the rate of death from bleeding in the women treated with tranexamic acid.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od1.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Type 2 Diabetes Mellitus: ACP Releases Updated Recommendations for Oral Pharmacologic ...

Oct 1, 2017 - The American College of Physicians (ACP) previously released guidelines in 2012 regarding the effectiveness and safety of oral pharmacologic treatment for type 2 diabetes; however, new evidence has emerged and new drugs have been approved by the U.S. Food and Drug Administration. For ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1001/p472.html

Treatments for Nocturnal Leg Cramps - FPIN's Help Desk Answers - American Family Physician

Oct 1, 2017 - Calcium channel blockers or B vitamins may lead to short-term improvement in nocturnal leg cramps. Stretching has mixed results. Quinine is effective but is no longer recommended, and it is not approved for treatment of leg cramps because of potential toxicity.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1001/od3.html

Treating Aging with Testosterone - Editorials - American Family Physician

Oct 1, 2017 - Most patients on testosterone are being treated for normal symptoms of aging. Given that the diagnostics are questionable and the benefits are unconvincing, the risks of testosterone, some of which may be life-threatening, are not worth taking.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1001/p428.html

Laxatives for the Management of Childhood Constipation - Cochrane for Clinicians - ...

Oct 1, 2017 - Polyethylene glycol (PEG) is superior to placebo (mean difference [MD] = 2.61 more stools per week; 95% confidence interval [CI], 1.15 to 4.08), lactulose (MD = 0.70; 95% CI, 0.10 to 1.31), and milk of magnesia (MD = 0.69; 95% CI, 0.48 to 0.89) at increasing the number of bowel ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1001/p433.html

Prolonged Dual Antiplatelet Therapy After MI Reduces Major Adverse Cardiac Events - ...

Oct 1, 2017 - In patients who are stable one year post-MI, prolonged use of dual antiplatelet therapy may be an effective treatment to decrease major cardiac events and cardiovascular mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/1001/od1.html

Yoga for Cancer-Related Symptoms in Women with Breast Cancer - Cochrane for Clinicians ...

Oct 1, 2017 - Yoga improves health-related quality of life, reduces sleep disturbances, and decreases fatigue in the short term (up to 12 weeks) among women diagnosed with breast cancer who have completed cancer-related treatment or are receiving cancer treatment compared with no intervention.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/1001/p434.html

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