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Use of Niacin for Primary or Secondary Prevention of Cardiovascular or Cerebrovascular ...

Apr 1, 2018 - Prescription niacin (nicotinic acid, vitamin B3) does not reduce myocardial infarctions, strokes, or overall mortality when used for primary or secondary prevention.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0401/p436.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

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

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

Chronic Pancreatitis: Diagnosis and Treatment - American Family Physician

Mar 15, 2018 - Chronic pancreatitis is an irreversible and progressive disorder of the pancreas characterized by inflammation, fibrosis, and scarring. Exocrine and endocrine functions are lost, often leading to chronic pain. The etiology is multifactorial, although alcoholism is the most significant ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p385.html

High Blood Pressure: ACC/AHA Releases Updated Guideline - Practice Guidelines - ...

Mar 15, 2018 - The American College of Cardiology (ACC) and American Heart Association (AHA) recently updated their guideline on the prevention, detection, evaluation, and treatment of high BP in adults. The ACC/AHA recommendations were based on a systematic review that addressed four questions ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0315/p413.html

ACC/AHA Hypertension Guideline: What Is New? What Do We Do? - Editorials - American ...

Mar 15, 2018 - Choosing a threshold and target for treatment should be based on the science supporting CVD risk reduction, while considering the benefits and harms in individual patient circumstances and respecting patient choice.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0315/p372.html

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

Mar 15, 2018 - The USPSTF recommends against screening for thyroid cancer in asymptomatic adults.

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

https://www.aafp.org/afp/2018/0315/od1.html

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

Mar 15, 2018 - A 45-year-old Korean American woman comes to your office for a wellness visit. She has a history of allergic rhinitis, and her family history is significant for diabetes mellitus in her father. She describes her health as good and has no concerns.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0315/p406.html

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.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

Care of the Colorectal Cancer Survivor - American Family Physician

Mar 1, 2018 - Colorectal cancer is the fourth most common cancer in the United States and has a five-year survival rate of 65%. The American Cancer Society and other experts have released guidelines on surveillance, health promotion, screening for other malignancies, and management of treatment ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0301/p331.html

Treatment of Low BMD and Osteoporosis to Prevent Fractures: Updated Guideline from the ...

Mar 1, 2018 - Osteoporosis, which most commonly occurs in the hip, spine, and wrist, puts persons at increased risk of fragility and fracture. The American College of Physicians (ACP) has updated its 2008 guideline to include new evidence regarding fracture prevention in adults with low bone mineral ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0301/p352.html

Life Expectancy with Hospice Care - FPIN's Help Desk Answers - American Family Physician

Mar 1, 2018 - Patients with terminal lung, pancreatic, or metastatic melanoma receiving hospice care have a minimally increased life expectancy. Receiving at least one day of hospice care may increase life expectancy by up to three months.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0301/od2.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

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

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

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

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions ...

Feb 15, 2018 - Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p254.html

Vitamin D Screening and Supplementation in Primary Care: Time to Curb Our Enthusiasm - ...

Feb 15, 2018 - Evidence for vitamin D screening and supplementation in adults shows that these commonplace practices have virtually no established health benefits.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0215/p226.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

Hemorrhoids: Diagnosis and Treatment Options - American Family Physician

Feb 1, 2018 - Many Americans between 45 and 65 years of age experience hemorrhoids. Hemorrhoidal size, thrombosis, and location (i.e., proximal or distal to the dentate line) determine the extent of pain or discomfort. The history and physical examination must assess for risk factors and clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p172.html

Tremor: Sorting Through the Differential Diagnosis - American Family Physician

Feb 1, 2018 - Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p180.html

Cancer Screening Recommendations from the ACS: A Summary of the 2017 Guidelines - ...

Feb 1, 2018 - Each year, the American Cancer Society (ACS) releases guidelines for health care professionals and patients on current cancer screening recommendations. The annual report updates previous recommendations, provides data on cancer screening rates, and discusses issues relating to early ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0201/p208.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

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

Noninfectious Penile Lesions - American Family Physician

Jan 15, 2018 - Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angiokeratomas), or neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p102.html

Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.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

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

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

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

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

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

Mildly Elevated Liver Transaminase Levels: Causes and Evaluation - American Family ...

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.html

Hoarseness in Adults - American Family Physician

Dec 1, 2017 - Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p720.html

Screening Tools for Unhealthy Alcohol Use - FPIN's Help Desk Answers - American Family ...

Dec 1, 2017 - A single-question alcohol use screen and the Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) can be used to detect unhealthy alcohol use and alcohol use disorder. Their performance is similar between sexes and across races.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1201/od2.html

Acute Gout: ACP Provides Guideline on Diagnosis - Practice Guidelines - American Family...

Dec 1, 2017 - The diagnostic standard for acute gout is joint aspiration with synovial fluid analysis for monosodium urate crystals; however, many patients are seen in a primary care or emergency medicine situation where synovial fluid analysis is rarely performed. The American College of Physicians ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/1201/p746.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

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

Herpes Zoster and Postherpetic Neuralgia: Prevention and Management - American Family ...

Nov 15, 2017 - Herpes zoster, or shingles, is caused by reactivation of varicella zoster virus, which causes chickenpox. There are an estimated 1 million cases in the Unites States annually, with an individual lifetime risk of 30%. Patients with conditions that decrease cell-mediated immunity are 20 ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p656.html

Cardiomyopathy: An Overview - American Family Physician

Nov 15, 2017 - The definition and classification of cardiomyopathy have evolved considerably in recent years. Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p640.html

Gout: Diagnosis and Management - Implementing AHRQ Effective Health Care Reviews - ...

Nov 15, 2017 - What is the accuracy of clinical decision tools and imaging for the diagnosis of gout in the primary care setting, and how effective are medications used to treat and prevent gout?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/1115/p668.html

The AAFP Cognitive Care Kit: A Resource for Family Physicians - Editorials - American ...

Nov 15, 2017 - The AAFP Cognitive Care Kit was designed to give primary care physicians access to recommended materials to identify, screen, care for, and educate patients with cognitive impairment, as well as assist caregivers.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1115/p630.html

Behavioral Counseling to Promote a Healthful Diet and Physical Activity for ...

Nov 15, 2017 - The USPSTF recommends that primary care professionals individualize the decision to offer or refer adults without obesity who do not have hypertension, dyslipidemia, abnormal blood glucose levels, or diabetes to behavioral counseling to promote a healthful diet and physical activity.

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

https://www.aafp.org/afp/2017/1115/od2.html

Screening for Latent Tuberculosis Infection in Adults - Putting Prevention into ...

Nov 15, 2017 - G.R. is a 21-year-old nonpregnant woman who is new to the area and your office. She is applying to graduate school and wants to make sure her vaccinations are up to date. She reports she is doing well and has no concerns.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/1115/p675.html

Home Sleep Testing for Diagnosing Obstructive Sleep Apnea - FPIN's Help Desk Answers - ...

Nov 15, 2017 - Home portable monitoring can be used as a substitute for in-laboratory polysomnography for the diagnosis of OSA in patients with a high pretest probability. Most patients prefer home monitoring, and clinical outcomes among patients diagnosed by either method are comparable regarding ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1115/od1.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

YEARS Clinical Decision Tool Decreases CTA in Patients with Suspected Pulmonary ...

Nov 15, 2017 - In this study, using a simplified algorithm in patients with suspected pulmonary embolism can safely decrease the number of CTAs.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od3.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Chronic Cough: Evaluation and Management - American Family Physician

Nov 1, 2017 - Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p575.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

Bladder Cancer: Diagnosis and Treatment - American Family Physician

Oct 15, 2017 - Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1015/p507.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

Preconception Care Is Primary Care: A Call to Action - Editorials - American Family ...

Oct 15, 2017 - Alarmingly, the United States is the only developed country with a rising maternal mortality rate; women are more likely to die in or around childbirth now than 20 years ago. Regardless of community, profession, or political affiliation, this should create a sense of urgency for action ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/1015/p492.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

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

Recurrent Ischemic Stroke: Strategies for Prevention - American Family Physician

Oct 1, 2017 - Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p436.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

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

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

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

Diabetes Self-Management: Facilitating Lifestyle Change - American Family Physician

Sep 15, 2017 - Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p362.html

Low Back Pain: American College of Physicians Practice Guideline on Noninvasive ...

Sep 15, 2017 - The American College of Physicians has released a guideline, which partially updates its 2007 guideline, to provide recommendations for noninvasive treatment of acute (duration less than four weeks), subacute (duration of four to 12 weeks), and chronic (duration longer than 12 weeks) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0915/p407.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

Pleuritic Chest Pain: Sorting Through the Differential Diagnosis - American Family ...

Sep 1, 2017 - Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p306.html

Exercise Stress Testing: Indications and Common Questions - American Family Physician

Sep 1, 2017 - Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p293.html

Newly Detected Atrial Fibrillation: AAFP Updates Guideline on Pharmacologic Management ...

Sep 1, 2017 - The American Academy of Family Physicians, with the American College of Physicians, has updated its 2003 guideline to provide guidance on atrial fibrillation treatment via medication in the primary care setting. The guideline focuses on adults with nonvalvular atrial fibrillation as ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0901/p332.html

Predictors of Acute Myocardial Infarction - FPIN's Help Desk Answers - American Family ...

Sep 1, 2017 - The most useful element for ruling in acute MI is chest pain with radiation to both arms, followed by radiation to the right arm. The most useful elements for ruling out acute MI are pleuritic chest pain, sharp pain, and pain reproduced by palpation.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0901/p328.html

Noninvasive Treatments for Low Back Pain - Implementing AHRQ Effective Health Care ...

Sep 1, 2017 - What are the benefits and harms of noninvasive treatments for acute, subacute, and chronic low back pain?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0901/p324.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.html

Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS ...

Sep 1, 2017 - The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0901/p284.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

Preventing Falls in Older Persons - American Family Physician

Aug 15, 2017 - The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p240.html

Screening for Gynecologic Conditions with Pelvic Examination: Recommendation Statement ...

Aug 15, 2017 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of performing screening pelvic examinations in asymptomatic, non-pregnant adult women.

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

https://www.aafp.org/afp/2017/0815/od1.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

Screening for Gynecologic Conditions with Pelvic Examination - Putting Prevention into ...

Aug 15, 2017 - A 37-year-old woman presents to your office for her annual wellness visit. She is not due for a Papanicolaou (Pap) smear this year. She is not pregnant, reports no problems, and has no risk factors for sexually transmitted infections. She asks if she should have a pelvic examination today.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/0815/p253.html

Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours - POEMs - American ...

Aug 15, 2017 - A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260a.html

The CDC’s STEADI Initiative: Promoting Older Adult Health and Independence Through Fall...

Aug 15, 2017 - Advertisement << Previous article Next article >> Aug 15, 2017 Issue Editorials The CDC's STEADI Initiative: Promoting Older Adult Health and Independence Through Fall Prevention ROBIN LEE, PhD, MPH, Centers for Disease Control and Prevention, Atlanta, Georgia Am Fam Physician. 2017...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0815/p220.html

Pelvic Organ Prolapse - American Family Physician

Aug 1, 2017 - Pelvic organ prolapse is the descent of one or more of the anterior vaginal wall, posterior vaginal wall, the uterus (cervix), or the apex of the vagina (vaginal vault or cuff scar after hysterectomy). Prevalence increases with age. The cause of prolapse is multifactorial but is ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p179.html

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