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Influenza 2015-2016: Challenges and Recommendations - Editorials - American Family ...

Dec 15, 2015 - The influenza season is here. This editorial summarizes some of the recent changes in guidance and provides an updated overview of influenza prevention and management for 2015–2016.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/1215/p1048.html

Treatment of Allergic Rhinitis - American Family Physician

Dec 1, 2015 - Allergic rhinitis is a common and chronic immunoglobulin E–mediated respiratory illness that can affect quality of life and productivity, as well as exacerbate other conditions such as asthma. Treatment should be based on the patient’s age and severity of symptoms. Patients should be ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1201/p985.html

Chlorthalidone vs. Hydrochlorothiazide for Treatment of Hypertension - FPIN's Help Desk...

Dec 1, 2015 - Chlorthalidone produces slightly greater reductions in blood pressure compared with hydrochlorothiazide (HCTZ), but it is associated with greater declines in serum potassium levels. Chlorthalidone lowers the risk of cardiovascular events about 18% more than HCTZ at the same achieved ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2015/1201/p1015.html

AHA/ACC/ASH Release Guideline on the Treatment of Hypertension and CAD - Practice ...

Dec 1, 2015 - The American Heart Association (AHA), American College of Cardiology (ACC), and American Society of Hypertension (ASH) have released a guideline on the management of hypertension in patients with coronary artery disease (CAD). It updates a previous AHA guideline to reflect newer data.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/1201/p1023.html

Chewing Gum for Postoperative Recovery of Gastrointestinal Function - Cochrane for ...

Dec 1, 2015 - Having patients chew gum reduces the time to first flatus and time to first bowel movement, as well as the length of hospitalization by about half a day.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1201/p974.html

Gabapentin for Chronic Neuropathic Pain - Medicine by the Numbers - American Family ...

Dec 1, 2015 - Studies show that 1 in 6 patients were helped with diabetic neuropathy and 1 in 8 were helped with postherpetic neuralgia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1201/od1.html

Some Benefit to Treating Mild Hypertension to Prevent Stroke, CV Deaths, and Overall ...

Dec 1, 2015 - Treating mild hypertension over five years decreases the risk of stroke, cardiovascular (CV) death, and overall mortality in a small proportion of patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020.html

Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular Outcomes - ...

Dec 1, 2015 - The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020a.html

An Oral Appliance Does Not Improve Sleep in Patients with Less Severe Sleep Apnea - ...

Dec 1, 2015 - An oral appliance does not improve daytime sleepiness or other measures of a good night's sleep. It does, however, decrease apnea scores, snoring, and restless legs. Although not studied, these improvements may be valuable for bed partners who sleep each night enduring patients' lower ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1021.html

Psychological Interventions for Medically Unexplained Physical Symptoms - Cochrane for ...

Dec 1, 2015 - Psychological therapy, specifically cognitive behavior therapy (CBT), has been shown to reduce the severity of medically unexplained physical symptoms in patients with somatoform disorders. The effect is small to moderate in magnitude, but in these studies CBT was as acceptable as usual...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1201/p975.html

Nonsurgical Management of Knee Pain in Adults - American Family Physician

Nov 15, 2015 - The role of the family physician in managing knee pain is expanding as recent literature supports nonsurgical management for many patients. Effective treatment depends on the etiology of knee pain. Oral analgesics—most commonly nonsteroidal anti-inflammatory drugs and acetaminophen—are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p875.html

Effectiveness, Adverse Effects, and Safety of Medical Marijuana - Editorials - American...

Nov 15, 2015 - Increasingly, physicians across the country are being asked about medical marijuana. Although marijuana has been around for centuries, there is no consensus on its safety and effectiveness.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/1115/p856.html

Scabies - Clinical Evidence Handbook - American Family Physician

Nov 15, 2015 - What are the effects of topical and systemic treatments for scabies?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/1115/p919.html

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders - American ...

Nov 1, 2015 - Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p807.html

Effectiveness of Selective Serotonin Reuptake Inhibitors for Irritable Bowel Syndrome -...

Nov 1, 2015 - Studies show that 1 in 4 had improved bloating and stool consistency, and less interference with daily life, while only 1 in 9 experiences medication related adverse effects. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/1101/od1.html

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.html

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p820.html

Menstrual Concerns in an Adolescent with Disabilities - Curbside Consultation - ...

Nov 1, 2015 - Clinicians who care for female adolescents with cognitive and physical disabilities are often consulted on the management of menstrual bleeding for purposes of hygiene, dysmenorrhea, and treatment of premenstrual symptoms. Contraception is also commonly discussed to mitigate pregnancy ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/1101/p823.html

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.html

Exercise for Osteoarthritis of the Knee - Cochrane for Clinicians - American Family ...

Nov 1, 2015 - Land-based exercise programs reduce knee pain and improve quality of life and physical function following treatment in patients with knee osteoarthritis.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1101/p774.html

Corticosteroid Injections for Common Musculoskeletal Conditions - American Family ...

Oct 15, 2015 - Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p694.html

Levomilnacipran (Fetzima) for Major Depressive Disorder - STEPS - American Family ...

Oct 15, 2015 - Levomilnacipran should not be used in patients with mild to moderate depression until studies have proven its effectiveness. It is somewhat effective in patients with moderate to severe depression. The short-term adverse effect profile of levomilnacipran is similar to that of other SNRIs.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/1015/p727.html

Pharmacogenetics: Using Genetic Information to Guide Drug Therapy - American Family ...

Oct 1, 2015 - Clinical pharmacogenetics, the use of genetic data to guide drug therapy decisions, is beginning to be used for medications commonly prescribed by family physicians. However, clinicians are largely unfamiliar with principles supporting clinical use of this type of data. For example, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1001/p588.html

Risk of Gout with the Use of Thiazide Diuretics - FPIN's Clinical Inquiries - American ...

Oct 1, 2015 - Thiazide diuretics may be used in most patients with hypertension who have only minimally increased risk of gout.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/1001/p622.html

Calcium Supplementation for Preventing Hypertensive Disorders in Pregnancy - Cochrane ...

Oct 1, 2015 - High-dose calcium supplementation (i.e., at least 1,000 mg per day) during pregnancy reduces the risk of developing hypertension and preeclampsia. The most significant risk reduction occurs in women at risk of hypertensive disorders and those with low-calcium diets.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1001/p570.html

Point-of-Care C-Reactive Protein Testing to Help Guide Treatment of Acute Respiratory ...

Oct 1, 2015 - Point-of-care C-reactive protein (CRP) testing used as an adjunct to a physician's clinical examination can modestly reduce antibiotic use. Measurement of CRP to guide antibiotic prescription does not appear to affect the duration of illness or recovery, although one study suggests that...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/1001/p571.html

Reducing Obstetric Hemorrhage: Recommendations from the National Partnership for ...

Oct 1, 2015 - A consensus bundle, with recommendations for reducing and managing obstetric hemorrhage and improving overall maternal care, has been published by the National Partnership for Maternal Safety.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/1001/p643.html

Focused Extracorporeal Shock Wave Therapy Better Than Placebo to Relieve Pain in ...

Oct 1, 2015 - In this study, unlike others, patients with chronic plantar fasciitis treated with extra-corporeal shock wave therapy had greater pain relief than those treated with placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p635.html

Pharmacogenetic Testing—An Unfulfilled Promise - Editorials - American Family Physician

Oct 1, 2015 - Family physicians should not naively accept a new technology because it is the latest trend. We need to assess the clinical utility of potential applications of genetic information, adopting them when they improve patient-oriented outcomes and avoiding them when they simply add costs ...

American Family Physician : Editorials

https://www.aafp.org/afp/2015/1001/p558.html

High-Risk Subgroups Have Little, if Any, Net Benefit from Antibiotics for Acute LRTI - ...

Oct 1, 2015 - Patients with acute LRTI and green sputum or cardiopulmonary comorbidities experience a slightly greater benefit with amoxicillin treatment. That outcome must be balanced against the harms of antibiotics on the individual and population level.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p640.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Potassium Disorders: Hypokalemia and Hyperkalemia - American Family Physician

Sep 15, 2015 - Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p487.html

Management of Constipation in Older Adults - American Family Physician

Sep 15, 2015 - Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home residents. Primary constipation is also referred to as functional constipation. Secondary constipation is associated with chronic disease processes, medication use, and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p500.html

Skin and Soft Tissue Infections - American Family Physician

Sep 15, 2015 - Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. Management is determined by the severity and location of the infection and by patient comorbidities. Infections can be classified as simple (uncomplicated) or complicated ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p474.html

Nausea and Vomiting in Early Pregnancy - Clinical Evidence Handbook - American Family ...

Sep 15, 2015 - What are the effects of treatment for hyperemesis gravidarum and nausea and vomiting in early pregnancy?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0915/p516.html

Spinal Stenosis: Physical Therapy Before Surgery - POEMs - American Family Physician

Sep 15, 2015 - Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528.html

Prednisone Speeds Recovery, Shortens Stay in Patients Hospitalized with CAP - POEMs - ...

Sep 15, 2015 - Among patients hospitalized with CAP, adjunctive prednisone speeds time to recovery by 1.5 days and shortens hospital length of stay by approximately one day, but produces no difference in pneumonia complications at 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528a.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

Tricyclic Antidepressants for the Treatment of ADHD in Children and Adolescents - ...

Sep 1, 2015 - TCAs, specifically desipramine and nortriptyline (Pamelor), are superior to placebo at reducing ADHD symptoms in the short term (two to six weeks); however, the quality of evidence is low. Increased heart rate and diastolic blood pressure may be noted with treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0901/p352.html

Bronchodilators for Bronchiolitis - Medicine by the Numbers - American Family Physician

Sep 1, 2015 - Studies show that none were helped and the impact of harms such as decreased oxygen saturation and tachycardia was uncertain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0901/od1.html

Pharmacologic Therapy for Gastroesophageal Reflux Disease in Children - Cochrane for ...

Sep 1, 2015 - Among infants younger than 12 months diagnosed with GERD, weak evidence supports the use of proton pump inhibitors (PPIs) and histamine H2 antagonists. Among children 12 months and older, studies have shown moderate benefit from PPIs and weak benefit from H2 antagonists for providing ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0901/p351.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Management of Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2015 - Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p202.html

Management of ACL Injuries: Clinical Practice Guideline from the AAOS - Practice ...

Aug 1, 2015 - Anterior cruciate ligament (ACL) injuries, which are usually related to sports, have an incidence of approximately 252,000 yearly. The American Academy of Orthopaedic Surgeons (AAOS) has provided guidance in determining the best options for treating an ACL injury.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0801/p232.html

Tap Water vs. Sterile Saline for Wound Irrigation - Medicine by the Numbers - American ...

Aug 1, 2015 - Studies show that there was no significant difference and none were harmed by using tap water. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0801/od1.html

The Epley Maneuver for Treatment of Benign Paroxysmal Positional Vertigo - Cochrane for...

Aug 1, 2015 - Treatment with the Epley maneuver resolves benign paroxysmal positional vertigo better than sham therapy or control. Minor adverse effects are uncommon.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0801/p184.html

Micronutrient Supplementation During Pregnancy - FPIN's Clinical Inquiries - American ...

Aug 1, 2015 - A multimicronutrient supplement is an oral tablet containing the recommended daily allowance of several vitamins and minerals. The World Health Organization does not recommend multimicronutrient supplementation because of the potential for increased neonatal mortality in some situations.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0801/p222.html

Walking Program Effective for Chronic Low Back Pain - POEMs - American Family Physician

Aug 1, 2015 - Giving patients a pedometer, a walking diary, and instructions to walk at least four days per week, then gradually increase the walk's duration and intensity (see synopsis) results in improvement in pain and disability similar to usual physical therapy or a group exercise program.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p230.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Management of Non-ST Elevation Acute Coronary Syndrome: A Guideline from the AHA and ...

Jul 15, 2015 - Acute coronary syndrome (ACS), a term that encompasses a range of conditions, is caused when blood flow to the heart is suddenly reduced. The American College of Cardiology (ACC), with the American Heart Association (AHA), has provided recommendations for managing non–ST elevation ACS.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0715/p151.html

Fungal Toenail Infections - Clinical Evidence Handbook - American Family Physician

Jul 15, 2015 - What are the effects of oral and topical treatments for fungal toenail infections in adults?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0715/p132.html

Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes - American ...

Jul 1, 2015 - A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p27.html

The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms - Cochrane for ...

Jul 1, 2015 - Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0701/p23.html

AAO-HNSF Releases Guideline on Managing Tinnitus - Practice Guidelines - American ...

Jul 1, 2015 - Tinnitus, the perception of sound without an external source, can be caused by a variety of conditions. Prevalence in the United States is approximately 10% to 15%. It can be categorized as primary (idiopathic and accompanied by or not by sensorineural hearing loss) and secondary ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0701/p65.html

Are Some Antidepressants Safer than Others Regarding Suicide Risk? - POEMs - American ...

Jul 1, 2015 - Mirtazapine (Remeron) and venlafaxine are associated with higher rates of completed suicide in primary care patients. Rates of suicide attempts and completion are similar with the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52a.html

Type 2 Diabetes: Updated Evidence Requires Updated Decision Making - Editorials - ...

Jul 1, 2015 - Clinicians need to consider the best available research findings, their own experience, and their patients' needs and values.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0701/p22.html

Nicotine Replacement Therapy for Smoking Cessation - Medicine by the Numbers - American...

Jul 1, 2015 - Studies show that 1 in 15 patients successfully quit smoking and 1 in 94 patients experienced chest pain or palpitations. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0701/od1.html

CEA vs. Stenting: Mixed Results, Mostly Bad - POEMs - American Family Physician

Jul 1, 2015 - These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52.html

Growth Hormone for Treatment of Idiopathic Short Stature in Children - FPIN's Help Desk...

Jul 1, 2015 - Advertisement << Previous article Next article >> Jul 1, 2015 Issue FPIN's Help Desk Answers Growth Hormone for Treatment of Idiopathic Short Stature in Children SUFIAN ZAYED, MD, and DIANE J. MADLON-KAY, MD, MS, University of Minnesota Medical Center, Smiley's Family Medicine...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2015/0701/p64.html

Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2015 - Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0615/p828.html

Amoxiclav Causes Diarrhea in 1 of 8 Persons Who Take It - POEMs - American Family ...

Jun 15, 2015 - The risk of diarrhea is significantly higher with amoxicillin/clavulanate (amoxiclav; Augmentin) than placebo, with a number needed to treat to harm (NNTH) of 8, which is not dissimilar from the number needed to treat for conditions such as otitis media. Contrary to popular belief, the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p877.html

Patients with Initial Unprovoked DVT or PE Benefit from Long-Term Low-Dose Aspirin - ...

Jun 15, 2015 - Aspirin improves long-term cardiovascular and thrombotic outcomes in patients who have had an initial unprovoked episode of VTE. The risk of bleeding was no higher in the aspirin group, perhaps because those at risk of bleeding were uncovered during the initial period of anticoagulation.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p872.html

Sterile Gloves Not Necessary for Minor Skin Surgery - POEMs - American Family Physician

Jun 15, 2015 - Infection rates in patients undergoing uncomplicated minor skin surgery were not different when sterile gloves, rather than simply clean gloves, were worn. A previous study similarly found no difference in infection rates between sterile and nonsterile gloves in patients undergoing ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p872a.html

Role of the Family Physician in the Management of Cystic Fibrosis - Editorials - ...

Jun 15, 2015 - Advertisement << Previous article Next article >> Jun 15, 2015 Issue Editorials Role of the Family Physician in the Management of Cystic Fibrosis DOUGLAS LEWIS, MD, Via Christi Family Medicine Residency, Via Christi Adult Cystic Fibrosis Specialty Clinic, Wichita, Kansas Am Fam...

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0615/p822.html

Nonpharmacologic Management of Hypertension: What Works? - American Family Physician

Jun 1, 2015 - Hypertension is one of the most common conditions encountered in primary care. Nonpharmacologic strategies have been shown to help lower blood pressure. Lifestyle modifications are recommended for all patients with hypertension. The American Heart Association/American College of ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0601/p772.html

Colchicine for Acute Gout - Cochrane for Clinicians - American Family Physician

Jun 1, 2015 - Low-quality evidence shows that low-dose colchicine (up to 1.8 mg over one hour) is an effective therapy for acute gout.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0601/p759.html

Tight Glycemic Control for Type 2 Diabetes Mellitus (Over Five Years) - Medicine by the...

Jun 1, 2015 - Studies show that none were helped and 1 in 6 patients were harmed. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0601/od2.html

Management of Acute Achilles Tendon Rupture - FPIN's Clinical Inquiries - American ...

Jun 1, 2015 - There are no clear evidence-based criteria to decide which patients should undergo operative vs. nonoperative management of acute Achilles tendon rupture.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0601/p794.html

Individualizing Target Goals and Treatment in Patients with Type 2 Diabetes - POEMs - ...

Jun 1, 2015 - This statement from American and European diabetes societies suggests that tighter control of hyperglycemia be attempted only in patients with a recent diagnosis and a low risk of hypoglycemia; who have a long life expectancy with few or no comorbidities, including cardiovascular ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0601/p788.html

Aclidinium for Stable COPD - Cochrane for Clinicians - American Family Physician

Jun 1, 2015 - Aclidinium did not decrease all-cause mortality or exacerbations requiring oral steroids, antibiotics, or both. However, aclidinium decreased the number of patients with exacerbations requiring hospitalization and improved quality of life in those with stable COPD.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0601/p760.html

Common Questions About the Management of Gastroesophageal Reflux Disease - American ...

May 15, 2015 - Common questions that arise regarding treatment of gastroesophageal reflux disease (GERD) include which medications are most effective, when surgery may be indicated, which patients should be screened for Barrett esophagus and Helicobacter pylori infection, and which adverse effects ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p692.html

Common Questions About Chronic Low Back Pain - American Family Physician

May 15, 2015 - More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p708.html

Acute Infective Sore Throat - Clinical Evidence Handbook - American Family Physician

May 15, 2015 - What are the effects of interventions to reduce symptoms of acute infective sore throat?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0515/p689.html

Beta-Lactam Not as Effective as Beta-Lactam Plus Macrolide for Treating CAP in the ...

May 15, 2015 - In this noninferiority trial, monotherapy with a beta-lactam was not as effective as combination therapy with a beta-lactam and a macrolide for achieving clinical stability in seven days for hospitalized patients with moderately severe CAP.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0515/p720.html

Provision of Contraception: Key Recommendations from the CDC - American Family Physician

May 1, 2015 - The Centers for Disease Control and Prevention has released comprehensive recommendations for provision of family planning services. Contraceptive services may be addressed in five steps, and counseling may be provided in a tiered approach, whereby the most effective options are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p625.html

Treatments for Sciatica - FPIN's Clinical Inquiries - American Family Physician

May 1, 2015 - Surgical diskectomy can be offered to patients with refractory sciatica, but there is only modest, short-term improvement in leg pain and disability scores. Epidural steroid injections may be offered to patients with sciatica of more than six months' duration.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0501/p612.html

No Long-Term Benefit of Arthroscopic Surgery for Meniscal Tears in Middle-Aged Persons ...

May 1, 2015 - Arthroscopic repair of degenerative meniscal tears in middle-aged adults does not significantly improve long-term pain or function. Patients should do physical therapy and try to avoid surgery if possible.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p643.html

Increased GI Bleeding After Switch from Warfarin to Dabigatran - POEMs - American ...

May 1, 2015 - The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p648.html

Options for Women with Unintended Pregnancy - American Family Physician

Apr 15, 2015 - Unintended pregnancy refers to unwanted, unplanned, or mistimed pregnancies. One-half of all pregnancies in the United States are unintended, and family physicians are often asked to provide counseling, support, and resources for women with unintended pregnancies. Options include ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p544.html

Naltrexone/Bupropion (Contrave) for Weight Loss - STEPS - American Family Physician

Apr 15, 2015 - Naltrexone/bupropion produces clinically significant weight loss when combined with a diet and exercise program. It decreases body weight in patients with diabetes, but its effect on diabetic outcomes is not known. A significant proportion of patients will experience adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0415/p554.html

ACE Inhibitors vs. ARBs for Primary Hypertension - Cochrane for Clinicians - American ...

Apr 15, 2015 - ACE inhibitors and ARBs have similar effects on cardiovascular outcomes and total mortality in head-to-head trials. However, slightly more adverse effects were noted in patients assigned to ACE inhibitor therapy.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0415/p522.html

Counseling Patients with Unintended Pregnancy - Curbside Consultation - American Family...

Apr 15, 2015 - Nearly one-half of all pregnancies in the United States are unintended. Risk factors for unintended pregnancy include limited access to contraception, less than a college education, poor social support, age between 20 and 24 years, and black race. Family physicians are often the initial...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0415/p574.html

Advance Directives: Navigating Conflicts Between Expressed Wishes and Best Interests - ...

Apr 1, 2015 - Clinicians and surrogates can be faced with challenging decisions when a patient loses the capacity to participate in medical decision making. A significant number of hospitalized and critically ill adults lose decision-making capacity during hospital stays and cannot make treatment ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2015/0401/p480.html

Magnesium Sulfate for Prevention of Preterm Birth - Cochrane for Clinicians - American ...

Apr 1, 2015 - Magnesium sulfate does not delay delivery when used in patients with preterm labor. Although magnesium sulfate is not associated with any serious adverse maternal outcomes, it may be associated with an increase in total fetal, neonatal, and infant mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0401/p444.html

Ondansetron for Gastroenteritis in Children and Adolescents - Medicine by the Numbers -...

Apr 1, 2015 - Studies show vomiting stopped in 1 in 5 patients and diarrhea was a consistent adverse effect. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0401/od3.html

Immediate-Release Methylphenidate for the Treatment of ADHD in Adults - Cochrane for ...

Apr 1, 2015 - In adults with ADHD, immediate-release methylphenidate improves symptoms of hyperactivity, impulsiveness, and inattentiveness compared with placebo. Short-term adverse effects such as weight loss and decreased appetite do not appear to be serious. However, larger studies of longer ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0401/p445.html

CIN Treatment May Increase Miscarriages but Does Not Affect Fertility - POEMs - ...

Apr 1, 2015 - In this analysis of 15 observational studies (it would be difficult and unethical to do randomized research on this topic), excision using any method for CIN did not affect fertility, although second trimester miscarriages were more likely. A study published at the same time found the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p490.html

Thrombolysis for DVT: Has the Time Arrived? - AFP Journal Club - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

Valsartan/Sacubitril Reduces Mortality More Than Enalapril 10 mg Twice Daily in ...

Apr 1, 2015 - The combination of an angiotensin receptor blocker (valsartan) and neprilysin inhibitor (sacubitril) reduces cardiovascular mortality more than an angiotensin-converting enzyme (ACE) inhibitor (enalapril [Vasotec]) alone, with an acceptable safety and tolerability profile. The choice of...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p490a.html

Optimal Treatment of Acute Venous Thromboembolism - POEMs - American Family Physician

Apr 1, 2015 - This complex network meta-analysis of eight treatment regimens for acute venous thromboembolism found that a combination of unfractionated heparin and vitamin K antagonists is associated with the least effective strategy with the highest risk of recurrent events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p492.html

Primary Hypothyroidism - Clinical Evidence Handbook - American Family Physician

Mar 15, 2015 - What are the effects of treatments for clinical (overt) hypothyroidism and subclinical hypothyroidism?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0315/p359.html

ART for HIV: Recommendations from the International Antiviral Society—USA Panel - ...

Mar 15, 2015 - The International Antiviral Society—USA Panel has provided recommendations for management of HIV infection with antiretroviral therapy (ART). Evidence has shown that ART for treatment of human immunodeficiency virus (HIV) infection is effective in preventing transmission among couples. ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0315/p396.html

Mixed Benefits of Gluten-Free Diet in Asymptomatic Patients with Celiac Disease - POEMs...

Mar 15, 2015 - Screening of asymptomatic relatives of patients with known celiac disease identified approximately 5% who were antibody-positive. Compared with their normal diet, a gluten-free diet improved some yet unrecognized symptoms but seemed to interfere with normal social activities in these ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402.html

Post-Myocardial Infarction Beta Blockers Do Not Decrease Mortality - POEMs - American ...

Mar 15, 2015 - Although recommended by guidelines and used as a so-called quality indicator of hospital care, the use of beta blockers following myocardial infarction, when combined with optimal acute and chronic treatment, does not provide a further survival benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402a.html

Practical Selection of Antiemetics in the Ambulatory Setting - American Family Physician

Mar 1, 2015 - Nausea and vomiting are mediated primarily by three neurotransmitter pathways: visceral stimulation releases dopamine and serotonin; vestibular and central nervous system activation release histamine and acetylcholine; and chemoreceptor trigger zone activation releases dopamine and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0301/p293.html

Vortioxetine (Brintellix) for the Treatment of Depression - STEPS - American Family ...

Mar 1, 2015 - Current evidence does not support the routine use of vortioxetine in the treatment of depression. Family physicians most often encounter patients with mild to moderate depression, and vortioxetine has not been studied in this population. There is no clear benefit of using vortioxetine ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0301/p325.html

Risk of Venous Thromboembolism with Use of Combined Oral Contraceptives - Cochrane for ...

Mar 1, 2015 - All combined oral contraceptives increase VTE risk. The risk is greater for those containing desogestrel, drospirenone, gestodene (not available in the United States), and cyproterone acetate (not available in the United States) when compared with levonorgestrel. All combined oral ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0301/p287.html

Improving Quality by Doing Less: Overtreatment - Editorials - American Family Physician

Mar 1, 2015 - The third in a series of AFP editorials that addresses the related issues of over-screening, overdiagnosis, and overtreatment. Overtreatment is an important harm that commonly follows overscreening and overdiagnosis.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0301/p289.html

Controlled-Release Oxycodone for Neuropathic Pain and Fibromyalgia in Adults - Cochrane...

Mar 1, 2015 - Oxycodone CR has limited effectiveness for the treatment of diabetic neuropathy or postherpetic neuralgia. Evidence is lacking regarding treatment benefit for other neuropathic pain syndromes or fibromyalgia. Adverse effects of oxycodone CR therapy are common.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0301/p286.html

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