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In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

Diabetes Self-Management: Facilitating Lifestyle Change - American Family Physician

Sep 15, 2017 - Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p362.html

Low Back Pain: American College of Physicians Practice Guideline on Noninvasive ...

Sep 15, 2017 - The American College of Physicians has released a guideline, which partially updates its 2007 guideline, to provide recommendations for noninvasive treatment of acute (duration less than four weeks), subacute (duration of four to 12 weeks), and chronic (duration longer than 12 weeks) ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0915/p407.html

Steroid Treatment Adds No Benefit to Antihistamines for Acute Hives - POEMs - American ...

Sep 15, 2017 - The combination approach of steroids and antihista-mines offers no added benefit to antihistamines alone for the treatment of simple urticaria.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p399a.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

No Benefit with Addition of TMP/SMX to Cephalexin for Nonpurulent Cellulitis - POEMs - ...

Sep 15, 2017 - Compared with cephalexin alone, covering for methicillin-resistant Staphylococcus aureus (MRSA) and streptococci with cephalexin plus TMP/SMX does not improve rates of clinical cure when treating nonpurulent cellulitis. However, a trend favoring the combination regimen was found in a ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p399.html

Glycopyrrolate (Seebri Neohaler) for Maintenance Therapy in Patients with COPD - STEPS ...

Sep 15, 2017 - Glycopyrrolate is a safe option for maintenance treatment to prevent moderate to severe exacerbations in patients with moderate to severe COPD, with only mild and rare adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0915/p395.html

How Family Physicians Can Combat the Opioid Epidemic - Editorials - American Family ...

Sep 15, 2017 - Family physicians must commit to responsible prescribing of opioid medications. The decision to initiate opioid therapy should be a careful and deliberate one, especially in patients who are at risk of addiction.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0915/p357.html

Newly Detected Atrial Fibrillation: AAFP Updates Guideline on Pharmacologic Management ...

Sep 1, 2017 - The American Academy of Family Physicians, with the American College of Physicians, has updated its 2003 guideline to provide guidance on atrial fibrillation treatment via medication in the primary care setting. The guideline focuses on adults with nonvalvular atrial fibrillation as ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0901/p332.html

Noninvasive Treatments for Low Back Pain - Implementing AHRQ Effective Health Care ...

Sep 1, 2017 - What are the benefits and harms of noninvasive treatments for acute, subacute, and chronic low back pain?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2017/0901/p324.html

Varenicline for Smoking Cessation - Medicine by the Numbers - American Family Physician

Sep 1, 2017 - Do the benefits outweigh the harms of using varenicline (Chantix) for smoking cessation? Read more to find out.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0901/od1.html

Pregabalin for Fibromyalgia Pain in Adults - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - There is high-quality evidence that pregabalin in daily dosages of 300 mg, 450 mg, and 600 mg reduces pain associated with fibromyalgia. The most effective dosage seems to be 450 mg daily; this dosage is more effective than placebo at reducing pain by at least 50% (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p291.html

Differences Between the AAFP Atrial Fibrillation Guideline and the AHA/ACC/HRS ...

Sep 1, 2017 - The AAFP updated its guideline on pharmacologic management of newly detected atrial fibrillation, which differs in part from the AHA/ACC/HRS guideline. It specifically highlights two questions commonly faced by family physicians, and is based on updated data from the Agency for ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0901/p284.html

Vitamin D for the Management of Asthma - Cochrane for Clinicians - American Family ...

Sep 1, 2017 - Despite the authors' caution that further data are needed to clarify the role of vitamin D in care, this Cochrane review found that its use reduces the average number of asthma exacerbations requiring corticosteroid treatment from 0.44 to 0.28 per person per year.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0901/p290.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Lixisenatide (Adlyxin) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Aug 15, 2017 - ixisenatide is an easy-to-use, once-daily injectable therapy for the treatment of type 2 diabetes in adults. It is at least as effective as exenatide at reducing A1C and body weight, with similar rates of gastrointestinal adverse effects.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0815/p257.html

Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours - POEMs - American ...

Aug 15, 2017 - A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260a.html

Pregabalin Does Not Decrease the Pain of Sciatica - POEMs - American Family Physician

Aug 15, 2017 - Pregabalin does not relieve pain in patients with sciatica.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260.html

No Increased Risk of ASD, ADHD, or SGA with First-Trimester Antidepressant Use - POEMs ...

Aug 15, 2017 - This study found that maternal antidepressant use during the first trimester of pregnancy is associated with an increased risk of preterm birth, but not SGA, ASD, or ADHD. Another study in the same issue also reported no increased risk of ASD with in utero exposure to selective ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p261.html

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.html

Antipsychotics for Fibromyalgia in Adults - Medicine by the Numbers - American Family ...

Aug 1, 2017 - Quetiapine may be considered for a limited period (less than 12 weeks) to improve pain, sleep, and depression in fibromyalgia, while considering the potential for weight gain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0801/od1.html

Antiplatelet vs. Anticoagulation Therapy for Patients with Heart Failure in Sinus ...

Aug 1, 2017 - Heart failure increases the risk of thrombotic complications, but use of warfarin does not lower all-cause mortality more than aspirin in patients with heart failure with reduced ejection fraction in sinus rhythm.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0801/p160.html

Effects of Yoga in Patients with Asthma - Cochrane for Clinicians - American Family ...

Aug 1, 2017 - Regular yoga improves quality of life as measured on the Asthma Quality of Life Questionnaire (mean difference = 0.57 units on a seven-point scale; 95% confidence interval [CI], 0.37 to 0.77); improves asthma symptoms (standardized mean difference = 0.37; 95% CI, 0.09 to 0.65); and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0801/p159.html

Common Herbal Dietary Supplement—Drug Interactions - American Family Physician

Jul 15, 2017 - Nearly 25% of U.S. adults report concurrently taking a prescription medication with a dietary supplement. Some supplements, such as St. John’s wort and goldenseal, are known to cause clinically important drug interactions and should be avoided by most patients receiving any ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p101.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.html

Treatment for Calcaneal Apophysitis - FPIN's Clinical Inquiries - American Family ...

Jul 15, 2017 - Several treatments for calcaneal apophysitis may produce modest short-term improvements in pain scores. Heel inserts and prefabricated orthotics may initially improve pain scores and dysfunction, but patients have equal improvement by three months with or without therapy.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0715/p126.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Greater Benefit with Rivaroxaban Than Aspirin for Extended Treatment of VTE - POEMs - ...

Jul 15, 2017 - Compared with aspirin, the use of rivaroxaban (Xarelto) to extend anticoagulation beyond the initial six to 12 months to treat provoked or unprovoked VTE reduces the risk of recurrent symptomatic VTE without increasing the risk of bleeding. You would need to treat approximately 30 to 33...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Gluten-Free Diet for Irritable Bowel Syndrome - FPIN's Help Desk Answers - American ...

Jul 1, 2017 - The evidence is conflicting on whether gluten-free diets improve symptoms of IBS. Gluten-free diets may improve symptoms such as abdominal pain, stool consistency, and tiredness, and they can be recommended to patients with IBS.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/0701/p52.html

Surgery vs. Medical Therapy for Heavy Menstrual Bleeding - Cochrane for Clinicians - ...

Jul 1, 2017 - In women of reproductive age with chronic heavy menstrual bleeding, hysterectomy is the most effective treatment for controlling symptoms. Conservative surgery is more effective for controlling bleeding symptoms at one and two years than oral medications or the levonorgestrel-releasing ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0701/p24.html

Problematic Jumps in Drug Prices and What You Can Do - Editorials - American Family ...

Jul 1, 2017 - Health professionals can help patients lower their medication costs, whether they pay the whole charge or only part of it.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0701/p16.html

Drug Price Gouging: When Will it End? - Editorials - American Family Physician

Jul 1, 2017 - Price gouging will end only when the structural elements responsible for the unchecked costs of drugs are addressed in a systematic way.

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0701/p20.html

Arthroscopic Meniscal Surgery Is Equivalent to Nonoperative Management - POEMs - ...

Jul 1, 2017 - The existing research base, with biases that typically make interventions look better, is unable to demonstrate that arthroscopy for meniscal injuries is any better than nonoperative approaches. Because this is a costly intervention and is being used more often, perhaps insurance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0701/p55.html

Alzheimer Disease: Pharmacologic and Nonpharmacologic Therapies for Cognitive and ...

Jun 15, 2017 - Alzheimer disease comprises a syndrome of progressive cognitive and functional decline. Treatments should target cognitive and functional symptoms. Cholinesterase inhibitors, memantine, and a combination of a cholinesterase inhibitor and memantine have produced statistically significant...

American Family Physician : Article

https://www.aafp.org/afp/2017/0615/p771.html

Idarucizumab (Praxbind) for Dabigatran (Pradaxa) Anticoagulant Reversal - STEPS - ...

Jun 15, 2017 - Idarucizumab is the only anticoagulant reversal agent for dabigatran. Because of its high cost and limited data regarding clinical benefit, therapy should be reserved for patients taking dabigatran who have life-threatening bleeding or are in need of emergency surgery.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0615/p798.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Dementia Care: More Than Just Prescription Drugs - Editorials - American Family Physician

Jun 15, 2017 - Rather than focusing on medications to achieve a small temporary difference in cognition, patients and families might be better served if we focused more on nonpharmacologic treatments, and on more important issues, such as advance directives, driving, living arrangements, caregiver ...

American Family Physician : Editorials

https://www.aafp.org/afp/2017/0615/p766.html

Acne Vulgaris: Treatment Guidelines from the AAD - Practice Guidelines - American ...

Jun 1, 2017 - Acne vulgaris, which occurs in 50 million persons living in the United States, is associated with physical and psychological morbidity (e.g., scarring, poor self-image, depression) and results in more than $3 billion in direct costs annually. In addition, knowledge about its ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0601/p740.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

Efficacy of Direct-Acting Antivirals Compared with Older Agents for Hepatitis C - ...

Jun 1, 2017 - Although they help patients achieve sustained viralogic response, expensive direct-acting antivirals have yet to show that they can succeed in meeting top-priority treatment goals.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2017/0601/od1.html

Testosterone Does Not Improve Cognition in Memory-Impaired Older Men with Low ...

Jun 1, 2017 - Testosterone supplementation for men 65 years or older with age-associated memory impairment and a low baseline testosterone level was not associated with significant improvements in memory or other cognitive functions.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733a.html

Antibiotics May Equal Surgery for Children with Appendicitis - POEMs - American Family ...

Jun 1, 2017 - Antibiotic treatment appears to be effective for children with uncomplicated appendicitis without evidence of perforation or rupture, with 97% of children discharged without surgery. Approximately one in seven children will eventually have recurrence and require surgery. A couple of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p737.html

Laceration Repair: A Practical Approach - American Family Physician

May 15, 2017 - The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p628.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK - American...

May 15, 2017 - A variety of refractive surgery techniques, which reshape the corneal stroma using laser energy, have been marketed as simple and safe alternatives to glasses or contact lenses. Laser-assisted in-situ keratomileusis (LASIK) is the most common of these procedures. Although there are few ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p637.html

Treatment of Chronic Insomnia in Adults: ACP Guideline - Practice Guidelines - American...

May 15, 2017 - The American College of Physicians (ACP) has provided recommendations for treatment of chronic insomnia in adults. Treatment, which can include psychological or pharmacologic therapy, alone or combined, as well as complementary and alternative methods, is aimed at improving sleep, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2017/0515/p669.html

Venous Leg Ulcers - Clinical Evidence Handbook - American Family Physician

May 15, 2017 - What are the effects of treatments for venous leg ulcers? What are the effects of various interventions for venous leg ulcers?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2017/0515/p662.html

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