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Diabetes Mellitus: Management of Gastrointestinal Complications - American Family ...

Dec 15, 2016 - Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1215/p980.html

Empagliflozin (Jardiance) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Dec 15, 2016 - Empagliflozin can be added to existing type 2 diabetes treatment to lower A1C levels, although there are less expensive options. In older patients with preexisting cardiovascular disease, empagliflozin can decrease all-cause mortality, cardiovascular mortality, and hospitalization for ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1215/p1014.html

ACP/CDC Provide Guidelines on the Use of Antibiotics for Acute Respiratory Tract ...

Dec 15, 2016 - The American College of Physicians (ACP) and Centers for Disease Control and Prevention (CDC) guideline on appropriate antibiotic use in the treatment of healthy adults with acute respiratory tract infection outlines one of the medical community's top priorities.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/1215/p1016.html

Prognosis Following Mild Head Injury in Children - Point-of-Care Guides - American ...

Dec 15, 2016 - Concussion, also referred to as mild traumatic brain injury, is a common injury in children. It is defined as a transient disturbance in mental status following head trauma, and it can cause a variety of physical, cognitive, and emotional sequelae. Symptoms continuing for more than 28 ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/1215/p1006.html

Hormone Therapy and Other Treatments for Symptoms of Menopause - American Family Physician

Dec 1, 2016 - The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1201/p884.html

CDC Updates Eligibility Criteria for Contraceptive Use - Practice Guidelines - American...

Dec 1, 2016 - The Centers for Disease Control and Prevention (CDC) first published the U.S. Medical Eligibility Criteria for Contraceptive Use, which is a companion document to the U.S. Selected Practice Recommendations for Contraceptive Use, in 2010 to provide guidelines on safely using a variety of...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/1201/p942.html

Aripiprazole vs. Placebo or Haloperidol for Schizophrenia - Medicine by the Numbers - ...

Dec 1, 2016 - Aripiprazole was shown to have one major benefit over placebo, but favorable outcomes with haloperidol throw its effectiveness into question. Are the differences merely anomalies?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1201/p877.html

Lumbar Fusion No Better Than Exercise and Therapy in the Long Term - POEMs - American ...

Dec 1, 2016 - This trial is a good example of how to do just about everything wrong to get the results you want. The authors did not conceal allocation, did not mask anyone in the study, used an unvalidated and subjective primary outcome, and downplayed the intention-to-treat analysis. Funding for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p937.html

Impact of Exercise-Based Cardiac Rehabilitation - Cochrane for Clinicians - American ...

Dec 1, 2016 - Exercise-based cardiac rehabilitation reduces cardiovascular mortality and hospitalization. There is no evidence that it reduces the rates of total mortality, myocardial infarctions, coronary artery bypass grafts, or percutaneous coronary interventions.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p881.html

Interventions to Improve Antibiotic Prescribing for Uncomplicated Acute RTIs - ...

Dec 1, 2016 - What are the effectiveness and adverse consequences of strategies for reducing antibiotic use in adults and children with uncomplicated acute respiratory tract infections (RTIs)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2016/1201/p918.html

Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

Carpal Tunnel Syndrome - Clinical Evidence Handbook - American Family Physician

Nov 15, 2016 - What are the effects of drug, nondrug, and surgical treatments for carpal tunnel syndrome?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/1115/p830.html

Society for Vascular Surgery Releases Guideline on Managing the Diabetic Foot - ...

Nov 15, 2016 - The Society for Vascular Surgery collaborated with the American Podiatric Medical Association and the Society for Vascular Medicine to create evidence-based guidelines to improve the care of patients with a diabetic foot.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/1115/p834.html

Initial Management of Patients with HIV Infection - American Family Physician

Nov 1, 2016 - Human immunodeficiency virus (HIV) infection has become a treatable chronic disease with near-normal life expectancy when patients receive antiretroviral therapy (ART). Family physicians and other primary care clinicians commonly provide long-term comprehensive care for persons with HIV...

American Family Physician : Article

https://www.aafp.org/afp/2016/1101/p708.html

Pet Therapy: Enhancing Patient Care Through Time with Animals - Curbside Consultation -...

Nov 1, 2016 - A 16-year-old girl and her parents presented to my office for her wellness evaluation. The patient has generalized anxiety disorder with comorbid major depression, for which she has been prescribed a serotonergic antidepressant. She is a high school student, lives with her parents, and ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2016/1101/p737.html

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

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

American Family Physician : Cochrane for Clinicians

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

Primary Care for Patients with HIV Infection: It’s Not Who Should Provide It, It’s How ...

Nov 1, 2016 - The major challenge is not to address whether primary care clinicians without substantial HIV experience should provide HIV care, but to create a framework that allows all primary care clinicians to provide the best possible care for their patients living with HIV infection.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/1101/p687.html

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

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

American Family Physician : FPIN's Clinical Inquiries

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

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

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

American Family Physician : STEPS

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

Topical Tacrolimus for Eczema - Cochrane for Clinicians - American Family Physician

Oct 1, 2016 - For children and adults with moderate to severe eczema, topical tacrolimus is an effective, albeit costly, alternative to topical corticosteroids. Both tacrolimus strengths (0.03% and 0.1%) are superior to low-potency topical corticosteroids, whereas tacrolimus 0.1% has similar ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1001/p549.html

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

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

American Family Physician : Cochrane for Clinicians

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

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

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

American Family Physician : Medicine by the Numbers

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

Rural Opioid Use Disorder Treatment Depends on Family Physicians - Graham Center Policy...

Oct 1, 2016 - The nation's growing opioid use disorder epidemic disproportionately impacts rural areas, where physicians who can prescribe buprenorphine are scarcest. Among physicians approved to prescribe buprenorphine, family physicians (FPs) are the most likely to work in rural areas.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1001/p546.html

Medications for Chronic Asthma - American Family Physician

Sep 15, 2016 - Chronic asthma is a major health concern for children and adults worldwide. The goal of treatment is to prevent symptoms by reducing airway inflammation and hyperreactivity. Step-up therapy for symptom control involves initiation with low-dose treatment and increasing intensity at ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p454.html

Ivermectin 1% Cream (Soolantra) for Inflammatory Lesions of Rosacea - STEPS - American ...

Sep 15, 2016 - Ivermectin cream is an effective treatment for moderate to severe pustular rosacea, but it is more expensive than some other available treatments and has not been studied in patients with milder forms of rosacea. Generic metronidazole cream is a less expensive alternative, and long-term...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0915/p512.html

Croup - Clinical Evidence Handbook - American Family Physician

Sep 15, 2016 - What are the effects of treatments (dexamethasone or humidification) in children with mild and moderate to severe croup?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0915/p476.html

Update on Office-Based Strategies for the Management of Obesity - American Family ...

Sep 1, 2016 - Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p361.html

Complementary/Integrative Therapies That Work: A Review of the Evidence - American ...

Sep 1, 2016 - Significant evidence supports the effectiveness and safety of several complementary or integrative treatment approaches to common primary care problems. Acupuncture is effective in the management of chronic low back pain. Mind-body interventions such as cognitive behavior therapy, yoga,...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p369.html

Family Physicians Are Well Suited to Prescribe Isotretinoin - Editorials - American ...

Sep 1, 2016 - A few minutes (and a few clicks on the computer) can open up rewarding therapeutic opportunities when registering with iPledge to prescribe isotretinoin.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0901/p342.html

Second-Generation H1-Antihistamines for Chronic Spontaneous Urticaria - Cochrane for ...

Sep 1, 2016 - There is good evidence that second-generation H1-antihistamines are helpful in the short- and intermediate-term suppression of urticaria. Cetirizine (Zyrtec) in a dosage of 10 mg daily is effective at completely suppressing symptoms of chronic spontaneous urticaria (number needed to ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0901/p352.html

CDC Releases Updated Guidelines for Postexposure Prophylaxis After Sexual, Injection ...

Sep 1, 2016 - Postexposure prophylaxis (PEP) with anti-retroviral drugs to prevent transmission of human immunodeficiency virus (HIV) following sexual or injection drug use exposures (nonoccupational PEP or nPEP) is an essential intervention requiring a timely response. Updated guidelines from the ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0901/p392.html

Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe ...

Sep 1, 2016 - The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p387.html

Alternatives to Metformin for Patients with PCOS - FPIN's Help Desk Answers - American ...

Sep 1, 2016 - Compared with placebo, thiazolidinediones (TZDs) decrease systolic blood pressure and fasting blood glucose and insulin levels while improving menstrual irregularities in women with PCOS. Metformin and TZDs have similar effects on pregnancy rates, ovulation, and menstrual frequency, but...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0901/p378.html

CBT Effective in Adolescents with Depression Who Do Not Want Medication - POEMs - ...

Sep 1, 2016 - In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384.html

Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes - POEMs - ...

Sep 1, 2016 - In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p386.html

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

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

American Family Physician : Graham Center Policy One-Pagers

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Article

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

Single-Dose Dexamethasone Equals Three Days of Steroids in Children with Acute Asthma -...

Aug 15, 2016 - In addition to usual beta-agonist treatment, a single dose of oral dexamethasone is as effective as three days of prednisolone (with less vomiting) in decreasing respiratory symptoms without increasing hospitalizations, follow-up visits, and days lost from school. Additional treatment ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317.html

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : STEPS

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Article

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

How to Prescribe Fewer Unnecessary Antibiotics: Talking Points That Work with Patients ...

Aug 1, 2016 - Appropriate antibiotic prescribing is a quality-of-care issue; all clinicians have the responsibility to provide the right treatments to their patients while minimizing harm. Effective communication, public commitments, and delayed antibiotic prescriptions are evidence-based tools ...

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0801/p200.html

Acetaminophen for the Treatment of Pain in Newborns - Cochrane for Clinicians - ...

Aug 1, 2016 - Acetaminophen does not significantly reduce pain associated with heel lance, eye examinations, or assisted vaginal births in newborns. Acetaminophen may reduce the total amount of morphine a newborn needs in the first 48 hours following major abdominal or thoracic surgery.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0801/p216.html

Capsaicin for Nonallergic Rhinitis - Cochrane for Clinicians - American Family Physician

Aug 1, 2016 - Intranasal capsaicin is safe and effective for reducing symptoms of nonallergic rhinitis (number needed to treat = 4; 95% confidence interval [CI], 1 to 22). There is insufficient evidence to compare the effectiveness of capsaicin to other topical or systemic medications.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0801/p217.html

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