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The Impact of Contraception on Lactation - Cochrane for Clinicians - American Family ...

Mar 1, 2016 - Use of hormonal contraception does not appear to shorten breastfeeding duration or negatively impact infant growth, based on inconsistent evidence of moderate quality. It is unclear if hormonal contraception negatively impacts breast milk volume or composition. Overall, there was ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0301/p356.html

Transitional Care Interventions to Prevent Readmissions for Patients with Heart Failure...

Mar 1, 2016 - Home visiting programs and multidisciplinary clinic interventions for adult patients with heart failure reduced all-cause readmissions and mortality over three to six months. Structured telephone support reduced heart failure–specific readmissions and mortality over three to six months....

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2016/0301/p401.html

Conjugated Estrogens/Bazedoxifene (Duavee) for Menopausal Symptoms - STEPS - American ...

Feb 15, 2016 - Conjugated estrogens/bazedoxifene is effective for the treatment of menopausal symptoms and may be better tolerated than conjugated estrogens/medroxyprogesterone. It will maintain bone mineral density in the lumbar spine and hip, but its effect on fractures is not known. Cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0215/p307.html

Naproxen Alone May Be Best for Acute Low Back Pain - POEMs - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p316.html

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315a.html

Labor Induction at Term - FPIN's Help Desk Answers - American Family Physician

Feb 15, 2016 - Oral misoprostol (Cytotec), vaginal and intracervical prostaglandins, and mechanical methods are effective for induction of labor at term. The use of intravenous oxytocin (Pitocin) increases the risk of failure to achieve vaginal delivery at 24 hours and the risk of cesarean delivery ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0215/p266.html

Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - POEMs - American...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315.html

Cyclobenzaprine in the Treatment of Low Back Pain - Medicine by the Numbers - American ...

Feb 1, 2016 - Studies show that 1 in 3 patients experiences global improvement in back pain symptoms at 10 days, while 1 in 4 patients experiences medication adverse effects. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0201/od2.html

Quinine for Leg Cramps - Cochrane for Clinicians - American Family Physician

Feb 1, 2016 - Quinine is moderately effective in decreasing the frequency and intensity of muscle cramps, but it is also associated with an increase in minor adverse effects. In addition, there is a risk of rare but serious adverse effects.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0201/p177.html

Electronic Cigarettes for Smoking Cessation - Cochrane for Clinicians - American Family...

Feb 1, 2016 - Electronic cigarettes with nicotine increase smoking cessation rates compared with placebo, with effectiveness similar to that of nicotine patches. In addition, more patients using electronic cigarettes with nicotine were able to halve their use of cigarettes than those using placebo ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0201/p178.html

Steroids Beneficial As Adjunctive Treatment for Community-Acquired Pneumonia - POEMs - ...

Feb 1, 2016 - Moderate-quality to high-quality evidence suggests that steroids, when added to antibiotics and usual care, can improve outcomes in the treatment of CAP. Benefits include reduced hospital length of stay, decreased time to clinical stability, and lower rates of mechanical ventilation and...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0201/p227.html

Appendicitis - Clinical Evidence Handbook - American Family Physician

Jan 15, 2016 - What are the effects of surgery compared with antibiotics for acute appendicitis?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0115/p142.html

CDC Releases 2015 Guidelines on the Treatment of Sexually Transmitted Disease - ...

Jan 15, 2016 - The Centers for Disease Control and Prevention has updated its 2010 recommendations to help guide physicians in preventing and treating sexually transmitted diseases. This summary practice guideline will focus on the updates.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0115/p144.html

Dietary Supplements: How Family Physicians Can Address Safety Concerns by Working with ...

Jan 15, 2016 - Your patients are likely using some type of dietary supplement, whether they tell you or not. What can a physician do to support and protect patients from harm if they choose to use readily available dietary supplements?

American Family Physician : Editorials

https://www.aafp.org/afp/2016/0115/p97.html

Perioperative Bridging Anticoagulation Unhelpful for Invasive Procedures - POEMs - ...

Jan 15, 2016 - Bridging anticoagulation worsens outcomes for patients with atrial fibrillation who undergo an elective invasive procedure, resulting in more episodes of major bleeding and no difference in the rate of stroke or venous thromboembolism.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0115/p130.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Jan 1, 2016 - In 2013, approximately 179,000 bariatric surgery procedures were performed in the United States, including the laparoscopic sleeve gastrectomy (42.1%), Roux-en-Y gastric bypass (34.2%), and laparoscopic adjustable gastric banding (14.0%). Choice of procedure depends on the medical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p31.html

Therapist-Supported Online Cognitive Behavior Therapy for Adult Anxiety - Cochrane for ...

Jan 1, 2016 - Therapist-supported online CBT is more effective than no treatment and as effective as face-to-face CBT for reducing overall anxiety as well as symptoms, and improving quality of life in adults with anxiety disorders.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/0101/p19.html

CBT Effective for Chronic Insomnia - POEMs - American Family Physician

Jan 1, 2016 - A five-component approach to changing patients' beliefs and behaviors surrounding sleep is effective, at least in the short term, in getting persons to fall asleep and stay asleep, although total sleep time is not increased.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p60.html

More Nuanced Guidelines for Lipid Lowering to Prevent CVD - POEMs - American Family ...

Jan 1, 2016 - The authors of this guideline give a more nuanced and less aggressive approach to lipid lowering than other groups. For the primary prevention of CVD, check blood pressure and lipids (nonfasting is fine) to calculate the 10-year CVD risk. If greater than 12%, treat; if 12% or less, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p59.html

Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report - ...

Dec 15, 2015 - Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1069.html

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

Timothy Grass Pollen Allergen Extract (Grastek) for Allergic Rhinitis - STEPS - ...

Dec 15, 2015 - Timothy grass pollen allergen extract produces small improvements in allergic rhinitis symptoms and the use of allergy relief medications, with a high rate of adverse effects. It may, however, be an option for patients who desire an alternative to standard allergy symptom relief but who...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/1215/p1096.html

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

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

American Family Physician : Editorials

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

Treatment of Allergic Rhinitis - American Family Physician

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

American Family Physician : Article

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

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

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

American Family Physician : FPIN's Help Desk Answers

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

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

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

American Family Physician : Practice Guidelines

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

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

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

American Family Physician : Medicine by the Numbers

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

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

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

American Family Physician : Cochrane for Clinicians

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Cochrane for Clinicians

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

Nonsurgical Management of Knee Pain in Adults - American Family Physician

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

American Family Physician : Article

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

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

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

American Family Physician : Editorials

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

Scabies - Clinical Evidence Handbook - American Family Physician

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

American Family Physician : Clinical Evidence Handbook

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

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

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

American Family Physician : Article

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

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

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

American Family Physician : Medicine by the Numbers

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Curbside Consultation

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Cochrane for Clinicians

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Article

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

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

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

American Family Physician : STEPS

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

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

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

American Family Physician : Article

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

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

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

American Family Physician : FPIN's Clinical Inquiries

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

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

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

American Family Physician : Cochrane for Clinicians

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

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

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

American Family Physician : Cochrane for Clinicians

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : Practice Guidelines

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

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