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C-Reactive Protein Is the Most Useful Biomarker for Diagnosis of Outpatient CAP - POEMs... Restricted content. Login required.

Oct 15, 2020 - This review found that the best evidence supports C-reactive protein as the most useful and accurate biomarker for diagnosing CAP in adults presenting with lower respiratory tract symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1015/od6.html

Terbinafine and Itraconazole Are Most Effective for Toenail Onychomycosis - POEMs - ... Restricted content. Login required.

Oct 15, 2020 - For toenail onychomycosis, continuous terbinafine (Lamisil), 250 mg, and continuous itraconazole (Sporanox), 200 mg, for 12 to 24 weeks are the preferred therapies.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1015/od5.html

Increased Daily Steps Associated with Reduced All-Cause Mortality - POEMs - American ... Restricted content. Login required.

Oct 15, 2020 - This study found that a greater number of daily steps was significantly associated with lower all-cause mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1015/od4.html

Cycled Hyperbaric Oxygen Improves the Healing of Diabetic Foot Ulcers - POEMs - ... Restricted content. Login required.

Oct 15, 2020 - Hyperbaric oxygen provided with a device that cycles oxygen from high pressure to low pressure increased the likelihood of complete healing of diabetic foot ulcers when combined with standard dressing and an offloading boot.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/1015/od3.html

Denosumab No Better than Bisphosphonates for Preventing Fracture, and the Cost Is Much ... Restricted content. Login required.

Sep 15, 2020 - This meta-analysis found no evidence that the monoclonal antibody denosumab reduces the risk of fracture more than bisphosphonates.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p375a.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Fecal Microbiota Transplant Effective for Irritable Bowel Syndrome - POEMs - American ... Restricted content. Login required.

Sep 15, 2020 - This is the largest and best study to date of fecal microbiota transplant for irritable bowel syndrome —with impressive results.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p377.html

Equivalent Pain Relief with Different Doses of Ibuprofen - POEMs - American Family ... Restricted content. Login required.

May 15, 2020 - Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631.html

ACR Guideline for Managing Patients with Degenerative Joint Disease of the Hand, Knee, ... Restricted content. Login required.

Sep 15, 2020 - This meta-analysis found no evidence that the monoclonal antibody denosumab reduces the risk of fracture more than bisphosphonates.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p376.html

Similar Long-Term Morbidity and Mortality with Human Insulin and Analogue Insulin - ... Restricted content. Login required.

Sep 15, 2020 - This study found no difference in long-term patient-oriented outcomes between human and analogue insulins in adults with type 2 diabetes.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0915/p375.html

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

Daily Colchicine Post-MI Reduces Strokes and Recurrent Hospitalizations for Angina - ... Restricted content. Login required.

Aug 15, 2020 - Daily colchicine after MI reduces cardiovascular events, specifically strokes and hospitalizations for angina. It is inexpensive and well-tolerated and should be considered for patients with recent MIs who are already using guideline-directed therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p248.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

Increasing the D-dimer Threshold for Patients with Low Clinical Pretest Probability ... Restricted content. Login required.

Jul 15, 2020 - The Pulmonary Embolism Graduated d-Dimer strategy increases the number of patients in the emergency department and outpatient setting who have PE ruled out via d-dimer testing, thus decreasing the need for chest imaging.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p117a.html

Small Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, ... Restricted content. Login required.

Aug 15, 2020 - A lower LDL target slightly reduced the likelihood of a broad composite outcome (number needed to treat [NNT] = 43 over 3.5 years), largely by reducing nonfatal strokes (NNT = 77; statistical significance not reported).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p247.html

Rates of Adverse Effects of Treatment for Otitis Media Vary by Antibiotic and Dose - ... Restricted content. Login required.

Aug 1, 2020 - The rates of diarrhea and rashes associated with the treatment of children with acute otitis media vary depending on each specific antibiotic and its dosing. The rates of diarrhea and generalized rash were highest with amoxicillin/clavulanate (Augmentin) and high-dose amoxicillin, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0801/p186.html

Oseltamivir of Uncertain Benefit in Patients with Flulike Symptoms - POEMs - American ... Restricted content. Login required.

Aug 15, 2020 - Although the authors report that compared with usual care oseltamivir shortens the duration of symptoms, the methodologic biases in this study make their conclusions suspect.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p248a.html

Mind-Body Treatments Enhance Opioid Treatment of Patients with Acute or Chronic Pain - ... Restricted content. Login required.

Jul 15, 2020 - Using mindfulness, meditation, hypnosis, therapeutic suggestion, and cognitive behavior therapy, in addition to opioid treatment of acute or chronic pain, provides an additional benefit to patients by reducing pain scores.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p119.html

No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low ... Restricted content. Login required.

Jun 1, 2020 - Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ... Restricted content. Login required.

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.html

No Cow's Milk Formula for the First Three Days of Life Prevents Food Allergies - POEMs ... Restricted content. Login required.

Jul 15, 2020 - In infants at increased risk of atopy, restricting cow's milk supplementation for the first three days of life is associated with a significantly lower risk of developing a cow's milk allergy or food allergies by 24 months of age.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p118.html

Mailing gFOBT or FIT Directly to Patients Increases Uptake of Colorectal Cancer ... Restricted content. Login required.

Jul 15, 2020 - Mailed outreach significantly increases rates of colorectal cancer screening, with four tests needing to be mailed to screen one person.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p117.html

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs... Restricted content. Login required.

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis - POEMs - American Family ... Restricted content. Login required.

Jun 1, 2020 - Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p696.html

Five Days of Penicillin for Strep Throat Is Equal to 10 Days - POEMs - American Family ... Restricted content. Login required.

Apr 1, 2020 - Five days of 800-mg penicillin four times a day produced noninferior results to 10 days of 1,000-mg penicillin three times a day, with shorter symptom duration. This is not the first study to show similar benefits with a shorter duration of oral antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434.html

Autism Screening with Follow-Up Overidentifies Autism Spectrum Disorder - POEMs - ... Restricted content. Login required.

May 15, 2020 - Screening for ASD with the Modified Checklist for Autism in Toddlers with Follow-Up is effective in ruling out ASD in children who screen positive (negative predictive value of 98.6% at 2.2% prevalence).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American... Restricted content. Login required.

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Results of Fecal Immunochemical Tests for Colorectal Cancer Screening Not Affected by ... Restricted content. Login required.

Apr 1, 2020 - The use of aspirin, NSAIDs, and oral anticoagulants has no clinically important effects on the positive predictive value of FIT in a screening population.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435.html

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ... Restricted content. Login required.

Apr 1, 2020 - Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435a.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ... Restricted content. Login required.

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk - ... Restricted content. Login required.

Jan 1, 2020 - Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was fasting or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53.html

Guideline for Chronic Diarrhea: Screening for IBD and Celiac Disease Is In, Screening ... Restricted content. Login required.

Mar 1, 2020 - Although an algorithm to guide the workup is not offered, the American Gastroenterological Association suggests the following tests for patients with chronic diarrhea (i.e., watery diarrhea for at least four weeks): fecal calprotectin or fecal lactoferrin to screen for inflammatory ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p310a.html

Fewer Severe Exacerbations in Patients with Mild to Moderate Asthma Treated with ... Restricted content. Login required.

Mar 1, 2020 - Patients with mild to moderate asthma only need relief treatment. In this study, patients taking the combination of budesonide/formoterol (Symbicort) as needed had slightly fewer severe exacerbations than patients treated with twice daily budesonide (Pulmicort).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p310.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ... Restricted content. Login required.

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ... Restricted content. Login required.

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ... Restricted content. Login required.

Mar 1, 2020 - Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ... Restricted content. Login required.

Feb 15, 2020 - Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ... Restricted content. Login required.

Mar 1, 2020 - This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309a.html

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ... Restricted content. Login required.

Feb 15, 2020 - Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p249.html

Do Not Change Antidepressant Treatment Early Based on a Lack of Response - POEMs - ... Restricted content. Login required.

Feb 15, 2020 - Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p250.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ... Restricted content. Login required.

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ... Restricted content. Login required.

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Addition of Steroids Improves Outcomes in Children and Adults with CAP - POEMs - ... Restricted content. Login required.

Jan 1, 2020 - Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p55.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ... Restricted content. Login required.

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

Baloxavir Reduces Symptom Duration Similar to Oseltamivir, Primarily Within 24 Hours of... Restricted content. Login required.

Dec 15, 2019 - Baloxavir has similar efficacy to oseltamivir (Tamiflu) (33-hour reduction in duration of symptoms compared with placebo) and, like oseltamivir, is most effective when given within 24 hours of the onset of symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od4.html

Augmentation of Antidepressant Treatment Offers Little Benefit - POEMs - American ... Restricted content. Login required.

Dec 15, 2019 - The available evidence that treatment-resistant depression (depression that is unresponsive to two different treatments of adequate dose and length) responds well to augmentation treatment (i.e., adding psychotherapy, lithium, or aripiprazole [Abilify] to current treatment) is weak.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od3.html

Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator ... Restricted content. Login required.

Nov 15, 2019 - The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p647.html

Platelet-Rich Plasma is Equal to Saline for Patients with Patellar Tendinopathy - POEMs... Restricted content. Login required.

Dec 15, 2019 - In this study, platelet-rich plasma injections were no better than saline injections in improving pain or activity in patients with patellar tendinopathy. It did not matter whether the plasma was leukocyte rich or leukocyte poor.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od2.html

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients... Restricted content. Login required.

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ... Restricted content. Login required.

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Oral Antibiotics Are Equal to IV Antibiotics for Serous Bone and Joint Infections - ...

Oct 1, 2019 - Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p441.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

Normal Vital Signs and Pulmonary Examination Results Rule Out CAP in Adults with Acute ...

Sep 15, 2019 - Community-dwelling adults who present to a primary care office with acute respiratory infection symptoms but normal vital signs and normal findings on a pulmonary examination have only a 0.4% likelihood of community-acquired pneumonia (CAP).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p375.html

5% Fluorouracil Is the Preferred Treatment for Actinic Keratoses - POEMs - American ...

Aug 15, 2019 - The use of topical 5% fluorouracil is most likely to result in successful elimination of actinic keratoses in a field on the head or face.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249a.html

Pneumatic Compression in Addition to Pharmacologic Thromboprophylaxis Does Not Further ...

Oct 1, 2019 - This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440a.html

Laboratory-Based Prediction Model Can Rule Out Serious Bacterial Infections in Febrile ...

Oct 1, 2019 - In febrile infants up to 60 days of age, the combination of a normal urinalysis result, an absolute neutrophil count of less than 4,090 per mL (4.1 × 109 per L), and a serum procalcitonin level of less than 1.71 ng per mL is accurate at ruling out serious bacterial infections.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Weak Evidence Supports Augmentation Therapy for Treatment-Resistant Depression - POEMs ...

Sep 15, 2019 - There is weak research to guide treatment decisions for patients who have not responded to two adequate courses of antidepressant treatment. One study of cognitive behavior therapy showed benefit over placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p376.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

More Evidence Against Antibiotics for Acute Asthma Exacerbations - POEMs - American ...

Aug 1, 2019 - Antibiotics do not benefit patients hospitalized with an asthma exacerbation. Evidence from this study suggests worse outcomes with antibiotic use, including a longer hospital stay, higher costs, and greater risk of diarrhea.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p185.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Single-Dose Oral Dexamethasone Decreases Sore Throat Pain - POEMs - American Family ...

Feb 15, 2018 - Sore throats are rarely fatal anymore, but there is really no such thing as just a sore throat. Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10 mg for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od1.html

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy - ...

Jan 1, 2019 - Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p55.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal ...

Jun 1, 2019 - After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717.html

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.html

Limited Data: Deprescribing is Safe, But at the Risk of Symptom Recurrence - POEMs - ...

May 15, 2019 - The limited rigorous data on deprescribing suggest that many patients can safely stop unnecessary medication, but symptom relapse is significant.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od2.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half ...

Jan 1, 2019 - This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53a.html

Increased Water Intake Decreases UTI Recurrence in Women - POEMs - American Family ...

Mar 15, 2019 - Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od3.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome...

Feb 1, 2019 - Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p190.html

Digital Media Use Associated with ADHD Symptom Development Among Adolescents - POEMs - ...

Feb 1, 2019 - High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting rate).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p189.html

Estrogen No Better Than Vaginal Lubricant for Postmenopausal Vaginal Symptoms - POEMs -...

Nov 15, 2018 - It is time to rethink the idea that vaginal atrophy caused by diminished estrogen is the cause of vaginal symptoms associated with menopause. Vaginal estradiol is no more effective than a non-prescription vaginal lubricant or placebo lubricant in the treatment of women with painful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od3.html

Incidental Findings Are Common with Chest CT and MRI of the Spine and Brain - POEMs - ...

Dec 1, 2018 - The risks of imaging, in addition to radiation exposure, include the identification of incidentalomas, which can lead to patient anxiety, further testing, and overtreatment. There is little research to guide what to do when they pop up on an imaging report (as the famous dodge clinical ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682.html

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations - ...

Jan 1, 2019 - Adding a LABA to an inhaled corticosteroid is safe but does not reduce the likelihood of a serious exacerbation requiring hospitalization. There is a small reduction in nonsevere asthma exacerbations, with one fewer exacerbation for every 53 patients treated for six months.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

Long-Acting Muscarinic Antagonists plus Inhaled Steroids is Equal to Long-Acting ...

Oct 15, 2018 - Long-acting muscarinic antagonists added to inhaled corticosteroids are a superior treatment to placebo for improving asthma control in adults and children 12 years or older. Long-acting muscarinic antagonist add-on therapy is not superior to long-acting beta agonist (LABA) add-on therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od2.html

Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation ...

Dec 1, 2018 - The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.html

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.html

As-Needed Use of Budesonide Plus Formoterol As Good As Daily Use of Steroid - POEMs - ...

Nov 15, 2018 - As-needed use of budesonide/formoterol is as effective as the daily use of maintenance budesonide plus as-needed terbutaline at preventing severe exacerbations, and results in a much lower cumulative steroid dose.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od4.html

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated...

Oct 15, 2018 - A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od4.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

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