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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

Glycopyrrolate (Seebri Neohaler) for Maintenance Therapy in Patients with COPD - STEPS ...

Sep 15, 2017 - Glycopyrrolate is a safe option for maintenance treatment to prevent moderate to severe exacerbations in patients with moderate to severe COPD, with only mild and rare adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0915/p395.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

Steroid Treatment Adds No Benefit to Antihistamines for Acute Hives - POEMs - American ...

Sep 15, 2017 - The combination approach of steroids and antihista-mines offers no added benefit to antihistamines alone for the treatment of simple urticaria.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p399a.html

No Benefit with Addition of TMP/SMX to Cephalexin for Nonpurulent Cellulitis - POEMs - ...

Sep 15, 2017 - Compared with cephalexin alone, covering for methicillin-resistant Staphylococcus aureus (MRSA) and streptococci with cephalexin plus TMP/SMX does not improve rates of clinical cure when treating nonpurulent cellulitis. However, a trend favoring the combination regimen was found in a ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p399.html

How Family Physicians Can Combat the Opioid Epidemic - Editorials - American Family ...

Sep 15, 2017 - Family physicians must commit to responsible prescribing of opioid medications. The decision to initiate opioid therapy should be a careful and deliberate one, especially in patients who are at risk of addiction.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0915/p357.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

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

Vitamin D for the Management of Asthma - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - Despite the authors' caution that further data are needed to clarify the role of vitamin D in care, this Cochrane review found that its use reduces the average number of asthma exacerbations requiring corticosteroid treatment from 0.44 to 0.28 per person per year.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p290.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

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Lixisenatide (Adlyxin) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Aug 15, 2017 - ixisenatide is an easy-to-use, once-daily injectable therapy for the treatment of type 2 diabetes in adults. It is at least as effective as exenatide at reducing A1C and body weight, with similar rates of gastrointestinal adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0815/p257.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

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

No Increased Risk of ASD, ADHD, or SGA with First-Trimester Antidepressant Use - POEMs ...

Aug 15, 2017 - This study found that maternal antidepressant use during the first trimester of pregnancy is associated with an increased risk of preterm birth, but not SGA, ASD, or ADHD. Another study in the same issue also reported no increased risk of ASD with in utero exposure to selective ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p261.html

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.html

Antiplatelet vs. Anticoagulation Therapy for Patients with Heart Failure in Sinus ...

Aug 1, 2017 - Heart failure increases the risk of thrombotic complications, but use of warfarin does not lower all-cause mortality more than aspirin in patients with heart failure with reduced ejection fraction in sinus rhythm.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0801/p160.html

Antipsychotics for Fibromyalgia in Adults - Medicine by the Numbers - American Family ...

Aug 1, 2017 - Quetiapine may be considered for a limited period (less than 12 weeks) to improve pain, sleep, and depression in fibromyalgia, while considering the potential for weight gain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0801/od1.html

Effects of Yoga in Patients with Asthma - Cochrane for Clinicians - American Family ...

Aug 1, 2017 - Regular yoga improves quality of life as measured on the Asthma Quality of Life Questionnaire (mean difference = 0.57 units on a seven-point scale; 95% confidence interval [CI], 0.37 to 0.77); improves asthma symptoms (standardized mean difference = 0.37; 95% CI, 0.09 to 0.65); and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0801/p159.html

Common Herbal Dietary Supplement—Drug Interactions - American Family Physician

Jul 15, 2017 - Nearly 25% of U.S. adults report concurrently taking a prescription medication with a dietary supplement. Some supplements, such as St. John’s wort and goldenseal, are known to cause clinically important drug interactions and should be avoided by most patients receiving any ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p101.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

Treatment for Calcaneal Apophysitis - FPIN's Clinical Inquiries - American Family ...

Jul 15, 2017 - Several treatments for calcaneal apophysitis may produce modest short-term improvements in pain scores. Heel inserts and prefabricated orthotics may initially improve pain scores and dysfunction, but patients have equal improvement by three months with or without therapy.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0715/p126.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Greater Benefit with Rivaroxaban Than Aspirin for Extended Treatment of VTE - POEMs - ...

Jul 15, 2017 - Compared with aspirin, the use of rivaroxaban (Xarelto) to extend anticoagulation beyond the initial six to 12 months to treat provoked or unprovoked VTE reduces the risk of recurrent symptomatic VTE without increasing the risk of bleeding. You would need to treat approximately 30 to 33...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Gluten-Free Diet for Irritable Bowel Syndrome - FPIN's Help Desk Answers - American ...

Jul 1, 2017 - The evidence is conflicting on whether gluten-free diets improve symptoms of IBS. Gluten-free diets may improve symptoms such as abdominal pain, stool consistency, and tiredness, and they can be recommended to patients with IBS.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0701/p52.html

Surgery vs. Medical Therapy for Heavy Menstrual Bleeding - Cochrane for Clinicians - ...

Jul 1, 2017 - In women of reproductive age with chronic heavy menstrual bleeding, hysterectomy is the most effective treatment for controlling symptoms. Conservative surgery is more effective for controlling bleeding symptoms at one and two years than oral medications or the levonorgestrel-releasing ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0701/p24.html

Arthroscopic Meniscal Surgery Is Equivalent to Nonoperative Management - POEMs - ...

Jul 1, 2017 - The existing research base, with biases that typically make interventions look better, is unable to demonstrate that arthroscopy for meniscal injuries is any better than nonoperative approaches. Because this is a costly intervention and is being used more often, perhaps insurance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0701/p55.html

Drug Price Gouging: When Will it End? - Editorials - American Family Physician

Jul 1, 2017 - Price gouging will end only when the structural elements responsible for the unchecked costs of drugs are addressed in a systematic way.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0701/p20.html

Problematic Jumps in Drug Prices and What You Can Do - Editorials - American Family ...

Jul 1, 2017 - Health professionals can help patients lower their medication costs, whether they pay the whole charge or only part of it.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0701/p16.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Idarucizumab (Praxbind) for Dabigatran (Pradaxa) Anticoagulant Reversal - STEPS - ...

Jun 15, 2017 - Idarucizumab is the only anticoagulant reversal agent for dabigatran. Because of its high cost and limited data regarding clinical benefit, therapy should be reserved for patients taking dabigatran who have life-threatening bleeding or are in need of emergency surgery.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0615/p798.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Acne Vulgaris: Treatment Guidelines from the AAD - Practice Guidelines - American ...

Jun 1, 2017 - Acne vulgaris, which occurs in 50 million persons living in the United States, is associated with physical and psychological morbidity (e.g., scarring, poor self-image, depression) and results in more than $3 billion in direct costs annually. In addition, knowledge about its ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0601/p740.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C - ...

Jun 1, 2017 - Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0601/od1.html

Antibiotics May Equal Surgery for Children with Appendicitis - POEMs - American Family ...

Jun 1, 2017 - Antibiotic treatment appears to be effective for children with uncomplicated appendicitis without evidence of perforation or rupture, with 97% of children discharged without surgery. Approximately one in seven children will eventually have recurrence and require surgery. A couple of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p737.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

Testosterone Does Not Improve Cognition in Memory-Impaired Older Men with Low ...

Jun 1, 2017 - Testosterone supplementation for men 65 years or older with age-associated memory impairment and a low baseline testosterone level was not associated with significant improvements in memory or other cognitive functions.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733a.html

Laceration Repair: A Practical Approach - American Family Physician

May 15, 2017 - The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p628.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK - American...

May 15, 2017 - A variety of refractive surgery techniques, which reshape the corneal stroma using laser energy, have been marketed as simple and safe alternatives to glasses or contact lenses. Laser-assisted in-situ keratomileusis (LASIK) is the most common of these procedures. Although there are few ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p637.html

Treatment of Chronic Insomnia in Adults: ACP Guideline - Practice Guidelines - American...

May 15, 2017 - The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0515/p669.html

Sofosbuvir/Velpatasvir (Epclusa) for Hepatitis C - STEPS - American Family Physician

May 15, 2017 - Sofosbuvir/velpatasvir is an effective treatment for patients with HCV and has minimal adverse effects. It is the preferred treatment for patients with genotype 2 or 3. As with other curative treatments, it is very expensive.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0515/p664.html

Venous Leg Ulcers - Clinical Evidence Handbook - American Family Physician

May 15, 2017 - What are the effects of treatments for venous leg ulcers? What are the effects of various interventions for venous leg ulcers?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2017/0515/p662.html

Topiramate and Amitriptyline Not Effective for Migraine in Children - POEMs - American ...

May 15, 2017 - Topiramate, amitriptyline, and placebo all led to a similar, substantial improvement in migraine frequency and disability. How to harness this strong placebo effect for our patients is an important, but unanswered, question.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od2.html

Pelvic Floor Exercises Modestly Improve Pelvic Floor Prolapse Symptoms - POEMs - ...

May 15, 2017 - In women with mild to moderate pelvic floor prolapse, a formal program including physiotherapist-guided pelvic floor exercises only modestly improved symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od3.html

Antibiotic Prophylaxis in Patients with Cirrhosis and Upper Gastrointestinal Bleeding -...

May 1, 2017 - Antibiotics should be used for prophylaxis in hospitalized patients with cirrhosis and upper gastrointestinal bleeding. Prophylaxis reduces all-cause mortality by 21%, as well as bacterial infections and rebleeding.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0501/p582.html

Pharmacologic Treatment of Hypertension: ACP and AAFP Release Recommendations for ...

May 1, 2017 - The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) have made recommendations for all clinicians to treat hypertension in persons 60 years and older, based on the benefits and harms of higher (less than 150 mm Hg) and lower (140 mm Hg or less) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0501/p588.html

Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older: A Guideline ...

May 1, 2017 - A high standard must be met when guidelines recommend lifelong preventive medications, knowing that at best, a small minority of patients will benefit and that all are risking harm.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0501/p547.html

Beta2 Agonists for Acute Cough or a Clinical Diagnosis of Acute Bronchitis - Cochrane ...

May 1, 2017 - There is insufficient evidence to determine whether beta2 agonists can improve symptoms for children with acute cough or bronchitis with wheeze. Beta2 agonists are not likely to benefit and may cause adverse effects in adults who do not have evidence of airflow restriction (number ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0501/p551.html

Citrate Salts for Preventing and Treating Calcium-Containing Kidney Stones in Adults - ...

May 1, 2017 - Citrate supplementation reduces stone size to less than 5 mm and prevents new stone formation when compared with placebo or no intervention. Citrate therapy also stabilizes existing stones and decreases the need for retreatment. These benefits come at the expense of upper ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0501/p552.html

Oral NSAIDs for Perineal Pain in the Early Postpartum Period - Medicine by the Numbers ...

May 1, 2017 - Oral nonsteroidal anti-inflammatory drugs were able to adequately relieve perineal pain for many postpartum women at four hours and longer.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0501/od1.html

One-Third of Adults with Diagnosed Asthma Can Be Weaned Off All Asthma Medications - ...

May 1, 2017 - This study found that current asthma was ruled out after repeated testing in one-third of adults with physician-diagnosed asthma. Patients ruled out for current asthma were less likely to be using asthma medications or daily controlling medications and less likely to have undergone ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0501/p586.html

Severe Asymptomatic Hypertension: Evaluation and Treatment - American Family Physician

Apr 15, 2017 - Hypertension affects one-third of Americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Severe asymptomatic hypertension is defined as severely elevated blood pressure (180 mm Hg or more systolic, or 110 mm Hg or more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p492.html

Albiglutide (Tanzeum) for Diabetes Mellitus - STEPS - American Family Physician

Apr 15, 2017 - Reductions in A1C are less with albiglutide than with the first-line therapy metformin, and albiglutide costs significantly more than metformin and sulfonylureas. Albiglutide's ability to reduce diabetes-related morbidity and major cardiovascular events is unknown.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0415/p521.html

Iron Deficiency in Heart Failure - FPIN's Clinical Inquiries - American Family Physician

Apr 15, 2017 - Treatment of iron deficiency in patients with heart failure using intravenous iron improves function, fatigue, and quality of life, and decreases risk of hospitalizations compared with placebo.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0415/p514.html

Vitamin E in Pregnancy - Medicine by the Numbers - American Family Physician

Apr 1, 2017 - Vitamin E supplementation in pregnant women does not show any benefit among the most patient-important outcomes.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0401/od1.html

If You Give Amoxicillin/Clavulanate to Six- to 23-Month-Olds with AOM, 10 Days Is ...

Apr 1, 2017 - These authors begin with the assumption that we should treat children who have AOM with amoxicillin/clavulanate. The greatest benefit was in children one to two years of age who had more severe pain and fever. In children with less severe symptoms, observation should still be the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p457.html

Effects of Altered Dietary Salt Intake in Patients with Chronic Kidney Disease - ...

Apr 1, 2017 - Reducing salt intake lowers blood pressure and reduces proteinuria in patients with CKD, but there is no evidence to determine whether lowering salt consumption leads to clinically significant reductions in end-stage renal disease, cardiovascular events, or all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0401/p423.html

PCI Has More Benefits and Harms Than CABG for Selected Patients with Left Main Coronary...

Apr 1, 2017 - Patients undergoing PCI had fewer early myocardial infarctions, but more later deaths and later myocardial infarctions. There are other benefits to PCI, including shorter hospital stay, lower cost, and faster recovery. But patients should be informed of the tradeoffs, and it is ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455a.html

Placebo Plus Message of Benefit Decreases Chronic Low Back Pain - POEMs - American ...

Apr 1, 2017 - These investigators gave twice daily placebo to patients with chronic back pain and told them it was placebo. They also told them that placebos can have a pronounced effect (which is true). The addition of placebo to usual care improved patients' pain and disability scores over the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p456.html

End-of-Life Care: Managing Common Symptoms - American Family Physician

Mar 15, 2017 - Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p356.html

Single-Dose Dexamethasone an Option for Acute Adult Asthma - POEMs - American Family ...

Mar 15, 2017 - A single dose of 12-mg dexamethasone, which has a longer duration of action than prednisone, is almost as effective as five days of 60-mg prednisone for the prevention of relapse in adults with acute asthma treated in an emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od1.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

Elbasvir/Grazoprevir (Zepatier) for Hepatitis C Virus Infection - STEPS - American ...

Mar 15, 2017 - Elbasvir/grazoprevir is a safe and effective treatment for HCV genotypes 1 and 4, with or without compensated cirrhosis or HIV-1 coinfection. Patients with renal impairment, including those on hemodialysis, can use the medication.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0315/p393.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Fecal Microbiota Transplantation in Clostridium difficile Infection: Evidence and ...

Mar 15, 2017 - Fecal microbiota transplantation is an effective treatment to prevent recurrent episodes of moderate to severe C. difficile infection. Nevertheless, because of the uncertainty regarding long-term safety and effectiveness, and the high burden of recurrent C. difficile infection, large, ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0315/p351.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Deep Venous Thrombosis and Pulmonary Embolism: Current Therapy - American Family Physician

Mar 1, 2017 - Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p295.html

Radioactive Iodine Therapy vs. Antithyroid Medications for Graves Disease - Cochrane ...

Mar 1, 2017 - Radioactive iodine therapy and antithyroid medications produce similar health-related quality-of-life outcomes in patients with Graves disease. Radioactive iodine therapy is an appropriate choice for patients who prefer definitive treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0301/p292.html

Topical Medications for Seborrheic Dermatitis - FPIN's Help Desk Answers - American ...

Mar 1, 2017 - Steroids and antifungal agents can be used to effectively treat seborrheic dermatitis. Calcineurin inhibitors are as effective as steroids, but have a higher incidence of short-term adverse effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0301/p329.html

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

Mar 1, 2017 - What are the benefits and harms of treatments for adults with binge-eating disorder?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0301/p324.html

Buprenorphine Maintenance vs. Placebo for Opioid Dependence - Medicine by the Numbers -...

Mar 1, 2017 - Buprenorphine causes lower physical dependence, milder withdrawal symptoms, and is less likely to cause an overdose than methadone in the treatment of opioid dependence.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0301/od1.html

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.html

Rifaximin (Xifaxan) for Irritable Bowel Syndrome - STEPS - American Family Physician

Feb 15, 2017 - Rifaximin has good overall tolerability. A relatively short course of treatment results in sustained clinical benefit for at least 10 weeks, eliminating the need for continued therapy, with an NNT of 10. However, it is expensive and should be reserved for patients who cannot tolerate or...

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0215/p258.html

Peripheral Vascular Disease: Treatment in Older Adults - FPIN's Help Desk Answers - ...

Feb 1, 2017 - PVD can be effectively treated with supervised exercise therapy, cilostazol, lipid-lowering therapy, and antiplatelet therapy. All of these treatments increase pain-free walking distance. Antiplatelet therapy also decreases the need for surgical revascularization. The best treatment is ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0201/p182.html

Antiepileptic Drugs After First Unprovoked Seizure - Medicine by the Numbers - American...

Feb 1, 2017 - The decision to start an antiepileptic drug after a first unprovoked seizure has long been a clinically challenging one.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0201/od1.html

AAN Updates Guidelines on the Uses of Botulinum Neurotoxin - Practice Guidelines - ...

Feb 1, 2017 - In 2008, the American Academy of Neurology (AAN) published guidelines on the use of botulinum neurotoxin. This summary highlights updates on four indications: blepharospasm, cervical dystonia, spasticity in adults, and headache.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0201/p198.html

Sertraline Reduces Risk of Depression in Adults After Traumatic Brain Injury - POEMs - ...

Feb 1, 2017 - This study found that sertraline is more effective than placebo (number needed to treat = 6) in preventing the onset of a major depressive disorder in adults following a TBI. This study included patients with mild, moderate, and severe TBI.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194.html

Brief Interventions for Weight Management in Kids Are Not Effective - POEMs - American ...

Feb 1, 2017 - Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194a.html

Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher ...

Feb 1, 2017 - This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p196.html

Hyperlipidemia: Drugs for Cardiovascular Risk Reduction in Adults - American Family ...

Jan 15, 2017 - Guidelines from the American College of Cardiology/American Heart Association (ACC/AHA) and the U.K. National Institute for Health and Care Excellence (NICE) indicate that lipid-lowering drugs have benefit for primary and secondary prevention of atherosclerotic cardiovascular disease ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p78.html

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

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

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

https://www.aafp.org/afp/2017/0115/od1.html

Acute Otitis Media in Children - Clinical Evidence Handbook - American Family Physician

Jan 15, 2017 - What are the effects of treatments (analgesics, antibiotics, and myringotomy) in children with acute otitis media?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2017/0115/p109.html

CDC Updates Recommendations for Contraceptive Use - Practice Guidelines - American ...

Jan 15, 2017 - The Centers for Disease Control and Prevention (CDC) first published the U.S. Selected Practice Recommendations for Contraceptive Use (U.S. SPR) in 2013 to provide direction for safe and effective use of contraceptive methods. These guidelines update the 2013 report.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0115/p125.html

The Cholesterol Dilemma: Treating the Risk or Treating to LDL-C Goal? - Editorials - ...

Jan 15, 2017 - Statins will long remain the cornerstone of treatment because of their proven benefits and cost-effectiveness, especially in the four statin benefit groups. However, emerging RCT evidence shows that the degree of LDL-C lowering may be more important than the drug used to achieve it.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0115/p66.html

Umeclidinium (Incruse Ellipta) for COPD - STEPS - American Family Physician

Jan 15, 2017 - Umeclidinium is an easy-to-use, once-daily, well-tolerated, and relatively low-cost anti-cholinergic agent for maintenance therapy in patients with moderate to severe COPD.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0115/p120.html

Tamsulosin Beneficial for Passage of 5- to 10-mm Distal Ureteral Stones - POEMs - ...

Jan 15, 2017 - Tamsulosin promotes stone passage of distal ureteral stones that are 5 to 10 mm in size. You would need to treat five such patients to get one stone passage. Smaller stones tend to pass on their own at a rate of 86% in this study.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123a.html

Heart Failure Due to Reduced Ejection Fraction: Medical Management - American Family ...

Jan 1, 2017 - Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p13.html

Extended-Release Bupropion for Preventing Seasonal Affective Disorder in Adults - ...

Jan 1, 2017 - When started in the fall, extended-release bupropion, 300 mg once daily, is effective in preventing recurrent symptoms in high-risk adults with a history of SAD (number needed to treat [NNT] = 5), as well as those at lower risk (NNT = 8). Headaches, nausea, and insomnia may limit ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p10.html

Membrane Sweeping to Decrease Rates of Postdate Induction - FPIN's Help Desk Answers - ...

Jan 1, 2017 - In uncomplicated pregnancies, membrane sweeping at 38 to 40 weeks' gestation safely decreases the rate of postdate inductions. Membrane sweeping increases the incidence of spontaneous labor, especially in the subsequent seven days, and results in fewer pregnancies extending beyond 41 ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0101/p35.html

Alpha-adrenergic Agonists for the Management of Opioid Withdrawal - Medicine by the ...

Jan 1, 2017 - Alpha-adrenergic agonists were more efficacious than placebo in the management of opioid withdrawal, but are best reserved as an alternative to methadone.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0101/od1.html

Interventions to Facilitate Shared Decision Making to Address Antibiotic Use for Acute ...

Jan 1, 2017 - Interventions to facilitate shared decision making reduce the prescribing of antibiotics for acute respiratory tract infections in the short term (within six weeks of the consultation) without increasing return visits or decreasing patient satisfaction (number needed to treat [NNT] = 6).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0101/p11.html

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