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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

Screening for Obstructive Sleep Apnea in Adults: Recommendation Statement - U.S. ...

Jul 15, 2017 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea (OSA) in asymptomatic adults.

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

https://www.aafp.org/afp/2017/0715/od1.html

High False-Positive Rate with Lung Cancer Screening - POEMs - American Family Physician

Jul 15, 2017 - If you are thinking about adding lung cancer screening to your delivery of preventive care, be sure to prepare patients. They are likely to receive a positive result, most of the positive results will not be lung cancer, and one in four patients will require additional tracking (i.e., ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128a.html

Screening for Obstructive Sleep Apnea in Adults - Putting Prevention into Practice - ...

Jul 15, 2017 - R.K. is a 52-year-old white man who presents to your office for a preventive health visit. He is overweight and has a history of hypertension and hyperlipidemia, which are stable and well controlled with medication. One of his coworkers was recently diagnosed with obstructive sleep ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/0715/p123.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

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

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

Nonalcoholic Fatty Liver Disease: Identifying Patients at Risk of Inflammation or ...

Jun 15, 2017 - NAFLD is defined as hepatic steatosis on imaging or histology in the absence of other etiologies for secondary fat accumulation. It is usually identified during the evaluation of elevated transaminase levels in a patient without heavy alcohol intake, or found incidentally on imaging ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0615/p796.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

Subclinical Hyperthyroidism: When to Consider Treatment - American Family Physician

Jun 1, 2017 - Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p710.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

Bare Arm Best for Blood Pressure Measurement - POEMs - American Family Physician

Jun 1, 2017 - To get the most accurate measure, let patients sit for a few minutes, and then measure their blood pressure on a completely bare arm. Does a difference of 4 mm systolic and 6 to 7 mm diastolic matter?

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733.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

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

More Accurate Prediction of the Pretest Probability of Cardiovascular Disease with ...

May 15, 2017 - The European approach to determining the pretest likelihood of coronary artery disease (CAD) in patients with chest pain is superior to that of the Diamond-Forrester approach recommended by U.S. guidelines, and will result in less need for immediate invasive treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od1.html

Exophytic Digital Lesion - Photo Quiz - American Family Physician

May 15, 2017 - A man presented with a papule on the dorsum of the left third finger with slight scaling

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2017/0515/p667.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

Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? No: ...

May 15, 2017 - The AAFP will continue to evaluate different screening tests as more research becomes available, but currently can endorse only those options that have the strongest evidence that benefits exceed harms.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2017/0515/p618.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

Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? Yes: ...

May 15, 2017 - We need to emphasize the message that regardless of which test is used, patients should get screened for colorectal cancer.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2017/0515/p616.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.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

Estimating Cardiovascular Risk - Point-of-Care Guides - American Family Physician

May 1, 2017 - The primary prevention of cardiovascular disease (CVD) depends on accurate estimation of cardiovascular risk. However, a recent systematic review identified 363 prediction models.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0501/p580.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

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

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

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

Chronic Obstructive Pulmonary Disease: Diagnosis and Management - American Family ...

Apr 1, 2017 - The diagnosis of chronic obstructive pulmonary disease (COPD) should be suspected in patients with risk factors (primarily a history of smoking) who report dyspnea at rest or with exertion, chronic cough with or without sputum production, or a history of wheezing. COPD may be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p433.html

Exercise Prescriptions in Older Adults - American Family Physician

Apr 1, 2017 - Regular physical activity and exercise are important for healthy aging and are beneficial for chronic disease management. Exercise prescriptions for older adults should account for the individual’s health status and functional capacity. Any amount of exercise is better than being ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p425.html

Repeat Cytology Within Six Months Equals Colposcopy for Younger Women with ASCUS or ...

Apr 1, 2017 - Among women 22 to 27 years of age with an index cervical cytology showing abnormal squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), the incidence of invasive cervical cancer did not differ between repeat cytology within six months ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455.html

Alzheimer Disease: Monotherapy vs. Combination Therapy - FPIN's Help Desk Answers - ...

Apr 1, 2017 - Combination treatment with memantine and donepezil results in a small improvement in cognitive function that is of uncertain clinical significance in patients with moderate to severe Alzheimer disease, but no improvement in patients with mild to moderate disease.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0401/p452.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

Multiple Myeloma: Diagnosis and Treatment - American Family Physician

Mar 15, 2017 - Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p373.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

Screening for Latent Tuberculosis Infection in Adults: Recommendation Statement - U.S. ...

Mar 15, 2017 - The USPSTF recommends screening for latent tuberculosis infection (LTBI) in populations at increased risk.

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

https://www.aafp.org/afp/2017/0315/od4.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

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

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

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

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.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

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

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

Feb 15, 2017 - The USPSTF recommends screening for colorectal cancer starting at age 50 years and continuing until age 75 years.

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

https://www.aafp.org/afp/2017/0215/od1.html

Aspirin for the Prevention of Cardiovascular Disease and Colorectal Cancer: New ...

Feb 15, 2017 - In April 2016, the U.S. Preventive Services Task Force (USPSTF) updated its recommendation on the use of aspirin to prevent cardiovascular disease (CVD). Because emerging evidence suggested that aspirin may also be useful for the prevention of cancer, for the first time, the USPSTF ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0215/p222.html

ACIP Releases 2017 Adult Immunization Recommendations - Practice Guidelines - American ...

Feb 15, 2017 - Each year the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention reviews and updates the adult immunization schedule to incorporate any published updates or corrections from the previous year. The 2017 adult immunization schedule ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0215/p262.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.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

The Effect of Statins on Dementia and Cognitive Decline - Cochrane for Clinicians - ...

Feb 1, 2017 - Statins given in later life to patients at risk of vascular disease do not prevent dementia or cognitive decline compared with placebo. Adverse effects are similar between groups.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0201/p151.html

Interventions for Preventing Falls Among Older Adults Living in the Community - ...

Feb 1, 2017 - Structured exercise programs and home safety interventions reduce both the rate and the risk of falling among community-dwelling adults 65 years and older, whereas multifactorial assessment and intervention programs reduce the rate of falls but not the risk of falling. Vitamin D ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0201/p152.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

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

Uterine Fibroids: Diagnosis and Treatment - American Family Physician

Jan 15, 2017 - Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p100.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

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

Giant Cell Arteritis: Biopsy After Corticosteroid Initiation - FPIN's Clinical ...

Jan 15, 2017 - Corticosteroid therapy in patients with suspected giant cell arteritis should not degrade the accuracy of temporal artery biopsy if the biopsy is performed within four weeks of corticosteroid initiation. Temporal artery biopsy can be performed up to four weeks after starting high-dose ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0115/p116.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

In Patients with Vascular Disease, Treating Sleep Apnea Does Not Reduce the Risk of ...

Jan 15, 2017 - Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123.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

Esophageal Cancer - American Family Physician

Jan 1, 2017 - Esophageal cancer has a poor prognosis and high mortality rate, with an estimated 16,910 new cases and 15,910 deaths projected in 2016 in the United States. Squamous cell carcinoma and adenocarcinoma account for more than 95% of esophageal cancers. Squamous cell carcinoma is more common...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p22.html

ADA Updates Standards of Medical Care for Patients with Diabetes Mellitus - Practice ...

Jan 1, 2017 - The American Diabetes Association (ADA) recently updated its standards of care to provide the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Key changes in the 2016 update include new screening recommendations, clarification of ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0101/p40.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

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

Carpal Tunnel Syndrome: Diagnosis and Management - American Family Physician

Dec 15, 2016 - Carpal tunnel syndrome, the most common entrapment neuropathy of the upper extremity, is caused by compression of the median nerve as it travels through the carpal tunnel. Classically, patients with the condition experience pain and paresthesias in the distribution of the median nerve, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p993.html

Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Dec 15, 2016 - Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1215/p1014.html

Hormone Therapy and Other Treatments for Symptoms of Menopause - American Family Physician

Dec 1, 2016 - The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p884.html

Mini-Mental State Examination for the Detection of Dementia in Older Patients - ...

Dec 1, 2016 - When scores are adjusted based on a patient's education level, the MMSE may be useful to rule out a diagnosis of dementia in clinically unevaluated patients 65 years and older (sensitivity = 97%; specificity = 70%). Scores of less than 24 may also be useful to rule in dementia in ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p880.html

Rotator Cuff Disease: Diagnostic Tests - FPIN's Help Desk Answers - American Family ...

Dec 1, 2016 - A positive lag sign with external rotation is the best test for full-thickness tears of the infraspinatus and supraspinatus (positive likelihood ratio = 7.2). A positive lag sign with internal rotation is best for assessing full-thickness tears of the subscapularis (positive likelihood ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/1201/p925.html

Impact of Exercise-Based Cardiac Rehabilitation - Cochrane for Clinicians - American ...

Dec 1, 2016 - Exercise-based cardiac rehabilitation reduces cardiovascular mortality and hospitalization. There is no evidence that it reduces the rates of total mortality, myocardial infarctions, coronary artery bypass grafts, or percutaneous coronary interventions.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p881.html

Lumbar Fusion No Better Than Exercise and Therapy in the Long Term - POEMs - American ...

Dec 1, 2016 - This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p937.html

Erectile Dysfunction - American Family Physician

Nov 15, 2016 - Erectile dysfunction (ED) is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. It is common, affecting at least 12 million U.S. men. The five-question International Index of Erectile Function allows rapid clinical assessment of ED. The ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p820.html

Acute Monoarthritis: Diagnosis in Adults - American Family Physician

Nov 15, 2016 - Acute monoarthritis can be the initial manifestation of many joint disorders. The most common diagnoses in the primary care setting are osteoarthritis, gout, and trauma. It is important to understand the prevalence of specific etiologies and to use the appropriate diagnostic modalities....

American Family Physician : Article

https://www.aafp.org/afp/2016/1115/p810.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

How to Counsel Men About PSA Screening - Editorials - American Family Physician

Nov 15, 2016 - For family physicians to put PSA screening guidance into practice, they must elicit patients' preferences and provide accurate, understandable information about the benefits and harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/1115/p782.html

Community-Acquired Pneumonia in Adults: Diagnosis and Management - American Family ...

Nov 1, 2016 - Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1101/p698.html

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