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Valproate for Adult Migraine Prophylaxis - Medicine by the Numbers - American Family ...

Nov 1, 2016 - Evidence supports current guideline recommendations on the use of valproate medications to prevent migraine.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1101/od1.html

Amiodarone for the Prevention of Sudden Cardiac Death - Cochrane for Clinicians - ...

Nov 1, 2016 - Although not a substitute for an implantable cardioverter-defibrillator (ICD), amiodarone is effective for the primary prevention of sudden cardiac death when compared with placebo (number needed to treat [NNT] = 47; 95% confidence interval [CI], 33 to 100), but it does not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p692.html

Intimate Partner Violence - American Family Physician

Oct 15, 2016 - Intimate partner violence (IPV) is a prevalent worldwide health problem, affecting women more commonly than men. IPV is underreported and underrecognized by health care professionals. Even when IPV is recognized, it remains an underaddressed issue. In addition to physical injury and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1015/p646.html

ACE Inhibitors or ARBs to Prevent CKD in Patients with Microalbuminuria - FPIN's ...

Oct 15, 2016 - ACE inhibitors reduce the risk of progression to macroalbuminuria in normotensive patients with microalbuminuria and type 1 diabetes mellitus.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/1015/p652.html

Sacubitril/Valsartan (Entresto) for Heart Failure - STEPS - American Family Physician

Oct 15, 2016 - Sacubitril/valsartan provides a small mortality benefit and decreases heart failure–related hospitalizations over and above an ACE inhibitor. It may be used in place of an ACE inhibitor in patients receiving optimal doses of guideline-directed medical therapy that includes ACE ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1015/p611.html

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

Oct 15, 2016 - The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at ...

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

https://www.aafp.org/afp/2016/1015/od1.html

Low-Dose Morphine Less Effective Than Diclofenac or Acetaminophen for Renal Colic - ...

Oct 15, 2016 - This is a good example of how a well-done study can lead to erroneous conclusions. The comparator most likely to be effective here—titrated morphine—was used at a low dose and found to be less effective than intramuscular diclofenac or intravenous paracetamol (acetaminophen).

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p665.html

Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer ...

Oct 15, 2016 - S.L. is a 55-year-old man who presents to your office for a routine refill of his antihypertension medication. He also takes a statin and an antidepressant. Although he smokes, his blood pressure and cholesterol are well controlled. His history and physical examination are unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/1015/p661.html

Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients - ...

Oct 15, 2016 - For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663a.html

All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD - POEMs - ...

Oct 15, 2016 - In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p664.html

Acute Bronchitis - American Family Physician

Oct 1, 2016 - Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1001/p560.html

ACR Appropriateness Criteria for Acute Onset of Flank Pain with Suspicion of Stone ...

Oct 1, 2016 - The American College of Radiology (ACR) has established appropriateness criteria to assist in the selection process. Procedures with a rating of 9 are considered most appropriate, and those with a rating of 1 least appropriate. These guidelines rate the suitability of computed ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/1001/p575.html

Selective Serotonin Reuptake Inhibitors for Fibromyalgia - Cochrane for Clinicians - ...

Oct 1, 2016 - SSRIs may have a small to moderate effect on pain (number needed to treat [NNT] = 10), global improvement (NNT = 7), and depression (NNT = 13) in patients with fibromyalgia, but the quality of evidence is very low because of bias and small studies. SSRIs do not reduce fatigue related to...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1001/p548.html

Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation ...

Oct 1, 2016 - Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1001/od1.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Pulmonary Hypertension: Diagnosis and Treatment - American Family Physician

Sep 15, 2016 - Pulmonary hypertension is a common, complex group of disorders that result from different pathophysiologic mechanisms but are all defined by a mean pulmonary arterial pressure of 25 mm Hg or greater. Patients often initially present to family physicians; however, because the symptoms ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p463.html

Clinical Diagnosis of Gout Without Joint Aspirate - Point-of-Care Guides - American ...

Sep 15, 2016 - Gout is ideally diagnosed through identification of characteristic negatively birefringent crystals under polarized light microscopy in fluid aspirated from end-organ deposits, typically from a joint. However, fewer than 10% of patients with gout see a rheumatologist, and most cases of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0915/p505.html

Diagnosis and Treatment of Obstructive Sleep Apnea in Adults - American Family Physician

Sep 1, 2016 - Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p355.html

Family Medicine: An Underutilized Resource in Addressing the Opioid Epidemic? - Graham ...

Sep 1, 2016 - Opioid overdose rates have tripled since 2000, and although overprescribing of opioids by physicians is widely accepted as a causal factor, the physician's role in providing medication-assisted treatment for opioid use disorder is less appreciated. Despite a clear willingness to ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/0901/p350.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

Screening for Depression in Adults: Recommendation Statement - U.S. Preventive Services...

Aug 15, 2016 - The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.

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

https://www.aafp.org/afp/2016/0815/od1.html

Screening for Depression in Adults - Putting Prevention into Practice - American Family...

Aug 15, 2016 - A.B., a 29-year-old man, presents to your office for a routine visit. He has a history of being overweight and has hypertension that is controlled by diet and exercise.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0815/p305.html

Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear - ...

Aug 15, 2016 - Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317a.html

Alirocumab (Praluent) for Treatment of Hyperlipidemia - STEPS - American Family Physician

Aug 15, 2016 - Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0815/p310.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Vision Loss in Older Adults - American Family Physician

Aug 1, 2016 - Vision loss affects 37 million Americans older than 50 years and one in four who are older than 80 years. The U.S. Preventive Services Task Force concludes that current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in adults...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p219.html

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

Current Concepts in Adult Acute Rhinosinusitis - American Family Physician

Jul 15, 2016 - Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p97.html

Acute Shoulder Injuries in Adults - American Family Physician

Jul 15, 2016 - Acute shoulder injuries in adults are often initially managed by family physicians. Common acute shoulder injuries include acromioclavicular joint injuries, clavicle fractures, glenohumeral dislocations, proximal humerus fractures, and rotator cuff tears. Acromioclavicular joint ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p119.html

Liraglutide (Saxenda) for Weight Loss - STEPS - American Family Physician

Jul 15, 2016 - Liraglutide, combined with lifestyle counseling, produces a clinically significant and sustained weight loss that continues as long as it is used. Nausea and vomiting, however, are common adverse effects, and about one in 10 patients will discontinue treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0715/p161.html

Pharmacotherapy for Adults with Alcohol Use Disorder - Implementing AHRQ Effective ...

Jul 15, 2016 - What are the potential benefits and adverse effects of medications used to treat alcohol use disorder (AUD) in adult outpatients?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2016/0715/p155.html

Screening for Chronic Obstructive Pulmonary Disease: Recommendation Statement - U.S. ...

Jul 15, 2016 - The USPSTF recommends against screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults.

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

https://www.aafp.org/afp/2016/0715/od1.html

Screening for Breast Cancer - Putting Prevention into Practice - American Family Physician

Jul 15, 2016 - S.O. is a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0715/p143.html

Caring for Patients with Job Insecurity Who Are Experiencing Chronic Work-Related Pain ...

Jul 15, 2016 - In addition to providing direct medical care, the physician can help this patient by obtaining an occupational history, formulating hypotheses about the cause of the pain and potential interventions, and establishing a therapeutic relationship.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/0715/p145.html

No Reduction in Readmissions with Telemonitoring, Coaching for Patients with Heart ...

Jul 15, 2016 - A care transition intervention that incorporates remote monitoring of weight, blood pressure, and heart rate with scheduled telephone coaching did not reduce readmission rates at 30 days or 180 days for patients with heart failure. However, patients in the study were only modestly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0715/p168a.html

Diagnosis and Management of Vertebral Compression Fractures - American Family Physician

Jul 1, 2016 - Vertebral compression fractures (VCFs) are the most common complication of osteoporosis, affecting more than 700,000 Americans annually. Fracture risk increases with age, with four in 10 white women older than 50 years experiencing a hip, spine, or vertebral fracture in their lifetime. ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p44.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

APA Updates Guidelines on Psychiatric Evaluation in Adults - Practice Guidelines - ...

Jul 1, 2016 - The American Psychiatric Association (APA) recently released the third edition of its guidelines on psychiatric evaluation of adults. The nine-part guideline has been updated based on new evidence identified since the previous edition was released in 2006.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0701/p62.html

Topical NSAIDs for Acute Musculoskeletal Pain in Adults - Medicine by the Numbers - ...

Jul 1, 2016 - Studies show that patients had improved pain control with diclofenac gel, ketoprofen gel, and ibuprofen gel with no increase in local or systemic adverse events. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0701/od1.html

Mediterranean Diet Produces Moderate Weight Loss - POEMs - American Family Physician

Jul 1, 2016 - In addition to improving cardiovascular outlook, a Mediterranean diet produced greater sustained weight loss than a low-fat diet and similar weight loss to other diets in patients who were overweight or obese, most of whom had type 2 diabetes mellitus.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Common Occupational Disorders: Asthma, COPD, Dermatitis, and Musculoskeletal Disorders ...

Jun 15, 2016 - An occupational illness is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. If an occupational disorder is suspected, a directed history should be taken with particular attention to establishing a temporal ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p1000.html

Screening for Abnormal Blood Glucose and Type 2 Diabetes Mellitus - Putting Prevention ...

Jun 15, 2016 - M.A. is a 43-year-old woman with a seven pack-year smoking history. She has no health concerns and has not visited a physician in four years. Her blood pressure and pulse are normal, and her body mass index (BMI) is 27 kg per m2. She does not have a family history of diabetes mellitus ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0615/p1025.html

Rapid Protocols to Rule out Myocardial Infarction - Point-of-Care Guides - American ...

Jun 15, 2016 - Cardiac troponin T and I are released into the bloodstream when cardiac muscle is damaged. Cardiac troponin tests have been available for decades and are the preferred biomarkers for the diagnosis of acute myocardial infarction (AMI). However, until recently, they lacked sensitivity in ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0615/p1008.html

Screening for Impaired Visual Acuity in Older Adults: Recommendation Statement - U.S. ...

Jun 15, 2016 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in older adults.

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

https://www.aafp.org/afp/2016/0615/od1.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Using the CDC Guideline and Tools for Opioid Prescribing in Patients with Chronic Pain ...

Jun 15, 2016 - The new CDC guideline is intended to help clinicians decide whether and how to prescribe opioids for chronic pain; offer safer, more effective care for patients with chronic pain; improve clinician-patient communication; and prevent opioid use disorder and opioid-related overdose.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0615/p970.html

Colorectal Cancer Screening Modalities: Variable Uptake, Variable Yield - POEMs - ...

Jun 15, 2016 - Based on the initial round of screening in this randomized trial, it appears that more patients complete fecal immunochemical testing than colonography or colonoscopy. Using the most conservative estimate, the yields of advanced adenomas and advanced neoplasms are similar.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032a.html

Meta-Analysis: Intensive BP Control Decreases Major CV Events and Stroke, but Not MI, ...

Jun 15, 2016 - Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure,...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1036.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Diet and Physical Activity for Cardiovascular Disease Prevention - American Family ...

Jun 1, 2016 - Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p919.html

ACCP Releases Guideline for the Treatment of Unexplained Chronic Cough - Practice ...

Jun 1, 2016 - Persistent cough with an unknown etiology is difficult to treat and can significantly affect quality of life. Although the evidence for the diagnosis and treatment of adults with unexplained chronic cough is limited, the American College of Chest Physicians (ACCP) has released ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0601/p950.html

Levonorgestrel-Releasing Intrauterine System vs. Oral Progestins for Treatment of ...

Jun 1, 2016 - The levonorgestrel-releasing intrauterine system achieves significantly higher resolution rates of endometrial hyperplasia without atypia compared with cyclic oral progestins (68% to 100% vs. 48% to 69%, respectively).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0601/p948.html

What Women and Their Physicians Need to Know About the UKCTOCS Study and Ovarian Cancer...

Jun 1, 2016 - An overview of the recent results from the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and implications for clinical practice and public health.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0601/p903.html

Screening for Ovarian Cancer—More Hype Than Hope? - Editorials - American Family Physician

Jun 1, 2016 - In keeping with the principles of the Choosing Wisely campaign, physicians and patients would do well to avoid the pitfalls of overscreening and wait for results that promise more hope than hype.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0601/p906.html

Diagnosis and Management of Sarcoidosis - American Family Physician

May 15, 2016 - Sarcoidosis is a systemic disease of unknown etiology characterized by the presence of noncaseating granulomas in any organ, most commonly the lungs and intrathoracic lymph nodes. A diagnosis of sarcoidosis should be suspected in any young or middle-aged adult presenting with ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p840.html

Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, ...

May 15, 2016 - The USPSTF recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and U.S. Food and Drug Administration (FDA)–approved pharmacotherapy for cessation to adults who use tobacco.

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

https://www.aafp.org/afp/2016/0515/od1.html

Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, ...

May 15, 2016 - A 40-year-old woman presents for a routine antepartum visit. She is 20 weeks pregnant and smokes half a pack of cigarettes per day despite efforts to quit. She has no other concerns, and her physical examination findings are normal. The patient asks if your clinic offers services to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0515/p861.html

Breast Pain - Clinical Evidence Handbook - American Family Physician

May 15, 2016 - What are the effects of treatments for breast pain?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0515/p872.html

Flibanserin (Addyi) for Hypoactive Sexual Desire Disorder in Premenopausal Women - ...

May 15, 2016 - Although flibanserin results in a modest improvement in the number of satisfying sexual events (approximately one more per month vs. placebo), it does not improve other measures, is considerably expensive, and has significant adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0515/p826.html

Nonoperative Management of Cervical Radiculopathy - American Family Physician

May 1, 2016 - Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p746.html

Primary Care of the Prostate Cancer Survivor - American Family Physician

May 1, 2016 - This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p764.html

Introducing a One-Page Adult Preventive Health Care Schedule: USPSTF Recommendations at...

May 1, 2016 - The Adult Preventive Health Care Schedule provides a concise and informative visual representation of USPSTF recommendations.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0501/p738.html

Long-Acting Nitrates No Good for Heart Failure with Preserved Ejection Fraction - POEMs...

May 1, 2016 - Patients who have heart failure with preserved ejection fraction had decreased levels of activity and more adverse events when they were receiving isosorbide mononitrate than when they were taking a placebo. Moreover, activity levels decreased with increases in the dose of the drug, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p790.html

Tamsulosin Effective as Expulsion Therapy for 5- to 10-mm Distal Ureteric Stones - ...

May 1, 2016 - Tamsulosin promotes stone passage of ureteric stones that are 5 to 10 mm. Five patients would need to be treated with tamsulosin to cause the expulsion of one such stone. Stones smaller than 5 mm have a high rate of spontaneous passage without any intervention.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p788a.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Glaucoma - American Family Physician

Apr 15, 2016 - Glaucoma is a set of irreversible, progressive optic neuropathies that can lead to severe visual field loss and blindness. The two most common forms of glaucoma, primary open-angle glaucoma and primary angle-closure glaucoma, affect more than 2 million Americans and are increasing in ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p668.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

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

Apr 15, 2016 - The USPSTF recommends biennial screening mammography for women aged 50 to 74 years.

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

https://www.aafp.org/afp/2016/0415/od1.html

ACS Releases Guideline on Breast Cancer Screening - Practice Guidelines - American ...

Apr 15, 2016 - The American Cancer Society (ACS) organized an interdisciplinary guideline development group to review the available evidence on breast cancer mortality, quality of life, life expectancy, false-positive findings, overdiagnosis, and overtreatment, and to update their 2003 guideline on ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0415/p711.html

Ivabradine (Corlanor) for Heart Failure - STEPS - American Family Physician

Apr 15, 2016 - In patients with stable systolic heart failure already on maximal medication therapy, adding ivabradine may reduce the number of hospitalizations related to heart failure (NNT for two years = 20), but it does not reduce cardiovascular mortality. In addition, many patients will not ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0415/p682.html

Counseling Women About Breast Cancer Screening - Editorials - American Family Physician

Apr 15, 2016 - Practical strategies can help family physicians and women in their 40s make more informed decisions about breast cancer screening.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0415/p652.html

Low High-Sensitivity Troponin I Level Accurate in Identifying Patients at Low Risk of ...

Apr 15, 2016 - The high-sensitivity troponin I assay used in this study was fairly accurate in identifying patients with chest pain who are at low risk of cardiac events.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704a.html

Hyaluronic Acid Equivalent to Sham Injections in Patients with Knee DJD - POEMs - ...

Apr 15, 2016 - The highest quality studies, which are now fairly plentiful, show that hyaluronic acid injections are only minimally better than sham injections in improving pain and function in patients with knee DJD.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704.html

Common Questions About Recurrent Urinary Tract Infections in Women - American Family ...

Apr 1, 2016 - Recurrent urinary tract infections (UTIs) are common in women, including healthy women with normal genitourinary anatomy. Recurrent UTI is typically defined as three or more UTIs within 12 months, or two or more occurrences within six months. The same species that caused previous ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p560.html

Pilates for the Treatment of Low Back Pain - Cochrane for Clinicians - American Family ...

Apr 1, 2016 - There is low- to moderate-quality evidence that Pilates exercises taught by certified instructors improve pain and reduce disability in patients with chronic low back pain. It is unclear whether a Pilates regimen is superior to other exercise plans for the treatment of low back pain. ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0401/p556.html

Nonpharmaceutical Treatment of Anxiety in Institutionalized Older Adults - FPIN's Help ...

Apr 1, 2016 - Cognitive behavior therapy (CBT) or relaxation training, alone or in combination, can be used to treat anxiety in older adults. Music therapy can also be used to reduce anxiety in older adults. Appropriate training of institutional caregivers is also helpful in reducing anxiety in older...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0401/p592.html

Diagnosis and Management of Nephrotic Syndrome in Adults - American Family Physician

Mar 15, 2016 - Nephrotic syndrome (NS) consists of peripheral edema, heavy proteinuria, and hypoalbuminemia, often with hyperlipidemia. Patients typically present with edema and fatigue, without evidence of heart failure or severe liver disease. The diagnosis of NS is based on typical clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p479.html

Medications for Alcohol Use Disorder - American Family Physician

Mar 15, 2016 - The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p457.html

Diagnosis and Management of Endometrial Cancer - American Family Physician

Mar 15, 2016 - Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p468.html

Screening for High Blood Pressure in Adults - Putting Prevention into Practice - ...

Mar 15, 2016 - A 55-year-old black man presents for a blood pressure evaluation. He is trying to be more physically active and health conscious but has not seen a physician for five years. He takes no medications, has no concerns, and his physical examination findings are unremarkable. According to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0315/p511.html

Eating Less Meat: A Healthy and Environmentally Responsible Dietary Choice - Editorials...

Mar 15, 2016 - What should physicians tell their patients about eating meat?

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0315/p451.html

Systolic BP of 120 Instead of 140 in High-Risk Older Patients Without Diabetes Leads to...

Mar 15, 2016 - In this group of older patients (mean age = 68 years) who do not have diabetes but are at high risk of cardiovascular disease, a more aggressive systolic BP target of 120 mm Hg instead of 140 mm Hg led to benefits (lower all-cause mortality, lower cardiovascular mortality, less heart ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0315/p520a.html

Preexposure Prophylaxis with Tenofovir/Emtricitabine Prevents HIV Infection in Men Who ...

Mar 15, 2016 - Preexposure prophylaxis in high-risk men who have unprotected anal intercourse reduces the likelihood of developing HIV (number needed to treat = 17 per year). Participants averaged 15 pills per month, which costs approximately $700 per month ($8,400 per year). Condoms would be a much ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0315/p520.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Transitional Care Interventions to Prevent Readmissions for Patients with Heart Failure...

Mar 1, 2016 - Home visiting programs and multidisciplinary clinic interventions for adult patients with heart failure reduced all-cause readmissions and mortality over three to six months. Structured telephone support reduced heart failure–specific readmissions and mortality over three to six months....

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2016/0301/p401.html

Influenza Vaccination for the Prevention of Cardiovascular Disease - Cochrane for ...

Mar 1, 2016 - Influenza vaccination may reduce cardiovascular mortality in patients with established cardiovascular disease. The effect of vaccination is unclear among patients in the general population without known cardiovascular disease.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0301/p357.html

Common Questions About Chronic Prostatitis - American Family Physician

Feb 15, 2016 - Chronic prostatitis is relatively common, with a lifetime prevalence of 1.8% to 8.2%. Risk factors include conditions that facilitate introduction of bacteria into the urethra and prostate (which also predispose the patient to urinary tract infections) and conditions that can lead to ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0215/p290.html

Screening for High Blood Pressure in Adults: Recommendation Statement - U.S. Preventive...

Feb 15, 2016 - The USPSTF recommends screening for high blood pressure in adults aged 18 years or older.

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

https://www.aafp.org/afp/2016/0215/p300.html

Naproxen Alone May Be Best for Acute Low Back Pain - POEMs - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p316.html

Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms - STEPS - American ...

Feb 15, 2016 - Conjugated estrogens/bazedoxifene is effective for the treatment of menopausal symptoms and may be better tolerated than conjugated estrogens/medroxyprogesterone. It will maintain bone mineral density in the lumbar spine and hip, but its effect on fractures is not known. Cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0215/p307.html

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315a.html

Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - POEMs - American...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315.html

ACIP Releases 2016 Adult Immunization Recommendations - Practice Guidelines - American ...

Feb 15, 2016 - 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.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0215/p323.html

Primary Brain Tumors in Adults: Diagnosis and Treatment - American Family Physician

Feb 1, 2016 - Primary intracranial tumors of the brain structures, including meninges, are rare with an overall five-year survival rate of 33.4%; they are collectively called primary brain tumors. Proven risk factors for these tumors include certain genetic syndromes and exposure to high-dose ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/p211.html

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