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Practice Pearls - Jan-Feb 2020 -- FPM Restricted content. Login required.

Feb 1, 2020 - Navigate patients’ anxiety about pelvic exams | Ask older patients these questions to assess dementia risk | Tell patients up front how much time you have

Family Practice Management : Practice Pearls

https://www.aafp.org/fpm/2020/0100/p34.html

Listening to the Little Voice Inside -- FPM Restricted content. Login required.

Feb 1, 2020 - That nagging little voice can sometimes save you from a medical mistake, so don’t ignore it.

Family Practice Management : The Last Word

https://www.aafp.org/fpm/2020/0100/p38.html

Thank You, FPM Peer Reviewers (2019) -- FPM

Feb 1, 2020 - We would like to thank the following peer reviewers for their valuable contributions to FPM during 2019.

Family Practice Management : From the Editor

https://www.aafp.org/fpm/2020/0100/p4.html

Painful Lower Extremity Ulcerations with Hyperpigmentation - Photo Quiz - American ... Restricted content. Login required.

Feb 1, 2020 - << Previous article Next article >> Feb 1, 2020 Issue Photo Quiz Painful Lower Extremity Ulcerations with Hyperpigmentation ERIK A KUMETZ, MD, 36th Medical Group, Andersen Air Force Base, Yigo, Guam NICHOLAS F. LOGEMANN, DO, Walter Reed National Medical Center, Bethesda, Maryland...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2020/0201/p177.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Jan 15, 2020 - Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p95.html

Functional Dyspepsia: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p84.html

Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care - American Family ... Restricted content. Login required.

Jan 15, 2020 - Short-term systemic corticosteroids, also known as steroids, are frequently prescribed for adults in the outpatient setting by primary care physicians. There is a lack of supporting evidence for most diagnoses for which steroids are prescribed, and there is evidence against steroid use ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p89.html

Management of Atrial Fibrillation: Updated Guidance from the AHA, ACC, and HRS - ... Restricted content. Login required.

Jan 15, 2020 - This guideline on atrial fibrillation (AF) management from the American Heart Association (AHA), American College of Cardiology (ACC), and Heart Rhythm Society (HRS) is an update of the 2014 version and is based on new evidence from clinical trials and the U.S. Food and Drug ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0115/p123.html

Screening for Hepatitis B Virus Infection in Pregnant Women: Recommendation Statement -...

Jan 15, 2020 - The USPSTF recommends screening for hepatitis B virus (HBV) infection in pregnant women at their first prenatal visit.

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

https://www.aafp.org/afp/2020/0115/p112.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ... Restricted content. Login required.

Jan 15, 2020 - Revefenacin is a once-daily nebulized alternative to metered dose long-acting muscarinic antagonists for patients with moderate to severe COPD. Given its expense, complicated administration process, and lack of evidence that it improves key patient-oriented outcomes, its use should be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0115/p121.html

Pain Medications Before IUD Placement - FPIN's Help Desk Answers - American Family ... Restricted content. Login required.

Jan 15, 2020 - Topical lidocaine preparations including gels, creams, and sprays may modestly decrease pain with tenaculum placement but not during IUD insertion.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0115/p119.html

Screening for Hepatitis B Virus in Pregnant Women - Putting Prevention into Practice - ... Restricted content. Login required.

Jan 15, 2020 - A 33-year-old U.S.-born pregnant clinician comes to your office for a first prenatal visit. Her most recent menstrual period was six weeks ago, and she has been taking prenatal vitamins for the past eight weeks. She was pregnant once more than two years ago, and at the time she screened...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0115/p115.html

Depression After ACS, Amenorrhea, Physical Activity, Heart Failure, Erythema Multiforme... Restricted content. Login required.

Jan 15, 2020 - Key clinical questions and their evidence-based answers directly from the journal's content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2020/0115/p75.html

America Needs More Family Doctors: The 25x2030 Collaborative Aims to Get More Medical ...

Jan 15, 2020 - << Previous article Next article >> Jan 15, 2020 Issue Editorials America Needs More Family Doctors: 25×2030 Collaborative Aims to Get More Medical Students into Family Medicine JACOB PRUNUSKE, MD, MSPH, Medical College of Wisconsin, Wausau, Wisconsin Am Fam Physician. 2020 Jan...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0115/p82.html

Acute Heart Failure in a 39-Year-Old Man - Photo Quiz - American Family Physician Restricted content. Login required.

Jan 15, 2020 - << Previous article Next article >> Jan 15, 2020 Issue Photo Quiz Acute Heart Failure in a 39-Year-Old Man DREW ASHBY, MD; FRANKLIN NIBLOCK, MD, MPH; KENNETH HERRING, MD; and LOGAN MIMS, MD, University of Colorado, Denver, Colorado Am Fam Physician. 2020 Jan 15;101(2):117-118. A...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2020/0115/p117.html

Identify Patients Likely to Benefit from Lung Cancer Screening - Letters to the Editor ...

Jan 15, 2020 - Jan 15, 2020 Issue Letters to the Editor Identify Patients Likely to Benefit from Lung Cancer Screening Am Fam Physician. 2020 Jan 15;101(2):69-70. Original Article: Lung Cancer Screening: Pros and Cons [Lown Right Care] Issue Date: June 15, 2019 Available at:...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0115/p69.html

Lung Cancer Screening Effective for Reducing Cancer Deaths - Letters to the Editor - ...

Jan 15, 2020 - << Previous article Next article >> Jan 15, 2020 Issue Letters to the Editor Lung Cancer Screening Effective for Reducing Cancer Deaths Am Fam Physician. 2020 Jan 15;101(2):70-71. Original Article: Lung Cancer Screening: Pros and Cons [Lown Right Care] Issue Date: June 15, 2019...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0115/p70.html

Lymphoma: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Lymphoma is a group of malignant neoplasms of lymphocytes with more than 90 subtypes. It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Approximately 82,000 new U.S. patients are diagnosed with lymphoma annually. Any tobacco use and obesity are major modifiable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p34.html

Benign Anorectal Conditions: Evaluation and Management - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.html

Adolescent Idiopathic Scoliosis: Common Questions and Answers - American Family Physician Restricted content. Login required.

Jan 1, 2020 - Adolescent idiopathic scoliosis affects 1% to 3% of U.S. adolescents. It is defined by a lateral curvature of the spine (Cobb angle) of at least 10 degrees in the absence of underlying congenital or neuromuscular abnormalities. Adolescent idiopathic scoliosis may be detected via the ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p19.html

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ... Restricted content. Login required.

Jan 1, 2020 - The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions, medications that ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0101/p56.html

PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease - Diagnostic Tests: ... Restricted content. Login required.

Jan 1, 2020 - The PLAC test is a blood test used to measure serum activity of lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2020/0101/p44.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

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ... Restricted content. Login required.

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

Antepartum Omega-3 Fatty Acid Intake and Length of Gestation - Cochrane for Clinicians ... Restricted content. Login required.

Jan 1, 2020 - Omega-3 fatty acids, whether taken as supplements or consumed as part of the diet, reduce the risk of preterm birth (number needed to treat = 68) and early preterm birth (number needed to treat = 55).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p17.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician Restricted content. Login required.

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Exercise to Reduce Falls in Older Adults - FPIN's Clinical Inquiries - American Family ... Restricted content. Login required.

Jan 1, 2020 - Exercise programs should be recommended for community-dwelling adults 60 years and older because they lead to fewer falls.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0101/p42.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

Breast Implant—Associated Anaplastic Large Cell Lymphoma - Editorials - American Family...

Jan 1, 2020 - In October 2019, the FDA released draft guidance offering numerous recommendations to help ensure women have access to breast implant benefit and risk information, including that manufacturers incorporate a boxed warning and patient decision checklist in the device’s labeling, and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0101/p8.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

Warfarin Dosages, PCOS, Varicose Veins, Gastroenteritis in Children, Plantar Fasciitis ... Restricted content. Login required.

Jan 1, 2020 - Key clinical questions and their evidence-based answers directly from the journal's content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2020/0101/p10.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

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy - Medicine by the ... Restricted content. Login required.

Jan 1, 2020 - Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0101/od1.html

A Shrinking Primary Care Workforce in Puerto Rico - Graham Center Policy One-Pagers - ...

Jan 1, 2020 - In 2018, two-thirds of primary care physicians in Puerto Rico were older than 55 years, compared with 43% nationwide. Meanwhile, only four out of every 10 graduates of family medicine residencies from 2011 to 2017 remained on the island in 2018, placing Puerto Rico’s new family ...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2020/0101/p13.html

Nodules on the Knuckles - Photo Quiz - American Family Physician Restricted content. Login required.

Jan 1, 2020 - << Previous article Next article >> Jan 1, 2020 Issue Photo Quiz Nodules on the Knuckles MICAH PIPPIN, MD, Louisiana State University Health Sciences Center, Family Medicine Residency, Alexandria, Louisiana Am Fam Physician. 2020 Jan 1;101(1):47-48. A 55-year-old man presented with...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2020/0101/p47.html

Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy - Letters to ...

Jan 1, 2020 - << Previous article Next article >> Jan 1, 2020 Issue Letters to the Editor Screening for Atrial Fibrillation to Initiate Stroke-Protective Therapy Am Fam Physician. 2020 Jan 1;101(1):6-7. Original Article: Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0101/p6.html

Physicians Can Help Patients Begin Grieving Process for Loss of a Loved One - Letters ...

Jan 1, 2020 - Jan 1, 2020 Issue Letters to the Editor Physicians Can Help Patients Begin Grieving Process for Loss of a Loved One Am Fam Physician. 2020 Jan 1;101(1):7. Original Article: Helping Patients Cope with Grief [Curbside Consultation] Issue Date: July 1, 2019 See additional reader...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0101/p7.html

Positive Chest Radiograph Findings Are Not Enough to Warrant Antibiotics in Patients ...

Jan 1, 2020 - Jan 1, 2020 Issue Letters to the Editor Positive Chest Radiograph Findings Are Not Enough to Warrant Antibiotics in Patients with Acute Cough Am Fam Physician. 2020 Jan 1;101(1):5. Original Article: Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia [Point-of-Care...

American Family Physician : Letter

https://www.aafp.org/afp/2020/0101/p5.html

Lymphoma: Diagnosis and Treatment - American Family Physician

Jan 1, 2020 - << Previous article Next article >> Jan 1, 2020 Issue Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics,...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2020/0101/p34-s1.html

Cirrhosis: Diagnosis and Management - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p759.html

Influenza: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Influenza is an acute viral respiratory infection that causes significant morbidity and mortality worldwide. Three types of influenza cause disease in humans. Influenza A is the type most responsible for causing pandemics because of its high susceptibility to antigenic variation. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p751.html

Amblyopia: Detection and Treatment - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services Task Force recommends vision screening for all children at least once between three and five years of age to detect the...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p745.html

The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk ...

Dec 15, 2019 - Although coronary artery calcium testing may slightly improve future risk prediction, this theoretical benefit is outweighed by its potential harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1215/p734.html

Managing Chronic Hypertension in Pregnant Women: ACOG Releases Updated Practice ... Restricted content. Login required.

Dec 15, 2019 - The American College of Obstetricians and Gynecologists (ACOG) has released an updated practice bulletin to outline diagnosis, effects on pregnancy outcomes, and approaches for management based on new evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1215/p782.html

Diagnosing DVT in Nonpregnant Adults in the Primary Care Setting - Point-of-Care Guides... Restricted content. Login required.

Dec 15, 2019 - What is the best approach to the evaluation of nonpregnant adults with suspected first lower extremity deep venous thrombosis (DVT) in the outpatient primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/1215/p778.html

Overuse of Statins in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ... Restricted content. Login required.

Dec 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/1215/p742.html

Screening for Pancreatic Cancer - Putting Prevention into Practice - American Family ... Restricted content. Login required.

Dec 15, 2019 - A 71-year-old woman comes to your office for a regularly scheduled visit. She has type 2 diabetes mellitus and a 50-pack-year smoking history, and had non-ulcer dyspepsia two years ago. Her body mass index is 32 kg per m2, and her blood pressure is normal.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/1215/p771.html

Rash on the Ankle - Photo Quiz - American Family Physician Restricted content. Login required.

Dec 15, 2019 - A man presented with a vesicular rash on his ankle in a serpentine-like pattern.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/1215/p773.html

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

Dec 15, 2019 - The USPSTF recommends against screening for pancreatic cancer in asymptomatic adults.

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

https://www.aafp.org/afp/2019/1215/od1.html

Baloxavir Marboxil (Xofluza) for Influenza - STEPS - American Family Physician Restricted content. Login required.

Dec 15, 2019 - Single-dose baloxavir should be limited to ill patients who cannot tolerate or comply with a course of oseltamivir. For otherwise healthy adults with confirmed influenza or influenza-like illness, the high cost of baloxavir may not justify the one-day reduction in symptoms of a ...

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1215/p776.html

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