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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

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

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

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

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

Pharmacogenetic Testing—An Unfulfilled Promise - Editorials - American Family Physician

Oct 1, 2015 - Family physicians should not naively accept a new technology because it is the latest trend. We need to assess the clinical utility of potential applications of genetic information, adopting them when they improve patient-oriented outcomes and avoiding them when they simply add costs ...

American Family Physician : Editorials

https://www.aafp.org/afp/2015/1001/p558.html

High-Risk Subgroups Have Little, if Any, Net Benefit from Antibiotics for Acute LRTI - ...

Oct 1, 2015 - Patients with acute LRTI and green sputum or cardiopulmonary comorbidities experience a slightly greater benefit with amoxicillin treatment. That outcome must be balanced against the harms of antibiotics on the individual and population level.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p640.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Potassium Disorders: Hypokalemia and Hyperkalemia - American Family Physician

Sep 15, 2015 - Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p487.html

Management of Constipation in Older Adults - American Family Physician

Sep 15, 2015 - Chronic constipation is common in adults older than 60 years, and symptoms occur in up to 50% of nursing home residents. Primary constipation is also referred to as functional constipation. Secondary constipation is associated with chronic disease processes, medication use, and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p500.html

Skin and Soft Tissue Infections - American Family Physician

Sep 15, 2015 - Skin and soft tissue infections result from microbial invasion of the skin and its supporting structures. Management is determined by the severity and location of the infection and by patient comorbidities. Infections can be classified as simple (uncomplicated) or complicated ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0915/p474.html

Nausea and Vomiting in Early Pregnancy - Clinical Evidence Handbook - American Family ...

Sep 15, 2015 - What are the effects of treatment for hyperemesis gravidarum and nausea and vomiting in early pregnancy?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0915/p516.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

Spinal Stenosis: Physical Therapy Before Surgery - POEMs - American Family Physician

Sep 15, 2015 - Assigning patients to six weeks of physical therapy is as effective as initially sending them for decompression surgery, with fewer complications, even in patients who have a strong preference for surgery. A trial of six weeks of physical therapy makes sense for many patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528.html

Prednisone Speeds Recovery, Shortens Stay in Patients Hospitalized with CAP - POEMs - ...

Sep 15, 2015 - Among patients hospitalized with CAP, adjunctive prednisone speeds time to recovery by 1.5 days and shortens hospital length of stay by approximately one day, but produces no difference in pneumonia complications at 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p528a.html

Tricyclic Antidepressants for the Treatment of ADHD in Children and Adolescents - ...

Sep 1, 2015 - TCAs, specifically desipramine and nortriptyline (Pamelor), are superior to placebo at reducing ADHD symptoms in the short term (two to six weeks); however, the quality of evidence is low. Increased heart rate and diastolic blood pressure may be noted with treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0901/p352.html

Bronchodilators for Bronchiolitis - Medicine by the Numbers - American Family Physician

Sep 1, 2015 - Studies show that none were helped and the impact of harms such as decreased oxygen saturation and tachycardia was uncertain.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0901/od1.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Pharmacologic Therapy for Gastroesophageal Reflux Disease in Children - Cochrane for ...

Sep 1, 2015 - Among infants younger than 12 months diagnosed with GERD, weak evidence supports the use of proton pump inhibitors (PPIs) and histamine H2 antagonists. Among children 12 months and older, studies have shown moderate benefit from PPIs and weak benefit from H2 antagonists for providing ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0901/p351.html

Vorapaxar (Zontivity) for the Prevention of Thrombotic Cardiovascular Events - STEPS - ...

Aug 15, 2015 - Vorapaxar should be limited to select patients with a history of MI or peripheral arterial disease who desire additional treatment for the prevention of MI.

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0815/p304.html

Management of Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2015 - Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p202.html

Tap Water vs. Sterile Saline for Wound Irrigation - Medicine by the Numbers - American ...

Aug 1, 2015 - Studies show that there was no significant difference and none were harmed by using tap water. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0801/od1.html

Management of ACL Injuries: Clinical Practice Guideline from the AAOS - Practice ...

Aug 1, 2015 - Anterior cruciate ligament (ACL) injuries, which are usually related to sports, have an incidence of approximately 252,000 yearly. The American Academy of Orthopaedic Surgeons (AAOS) has provided guidance in determining the best options for treating an ACL injury.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0801/p232.html

The Epley Maneuver for Treatment of Benign Paroxysmal Positional Vertigo - Cochrane for...

Aug 1, 2015 - Treatment with the Epley maneuver resolves benign paroxysmal positional vertigo better than sham therapy or control. Minor adverse effects are uncommon.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0801/p184.html

Micronutrient Supplementation During Pregnancy - FPIN's Clinical Inquiries - American ...

Aug 1, 2015 - A multimicronutrient supplement is an oral tablet containing the recommended daily allowance of several vitamins and minerals. The World Health Organization does not recommend multimicronutrient supplementation because of the potential for increased neonatal mortality in some situations.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2015/0801/p222.html

Walking Program Effective for Chronic Low Back Pain - POEMs - American Family Physician

Aug 1, 2015 - Giving patients a pedometer, a walking diary, and instructions to walk at least four days per week, then gradually increase the walk's duration and intensity (see synopsis) results in improvement in pain and disability similar to usual physical therapy or a group exercise program.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p230.html

Common Questions About the Pharmacologic Management of Depression in Adults - American ...

Jul 15, 2015 - One in 11 U.S. adults currently meets diagnostic criteria for major depressive disorder, and a similar number report that they have taken an antidepressant medication in the past 30 days. In the primary care population, medications are modestly superior to placebo in achieving ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p94.html

Management of Non-ST Elevation Acute Coronary Syndrome: A Guideline from the AHA and ...

Jul 15, 2015 - Acute coronary syndrome (ACS), a term that encompasses a range of conditions, is caused when blood flow to the heart is suddenly reduced. The American College of Cardiology (ACC), with the American Heart Association (AHA), has provided recommendations for managing non–ST elevation ACS.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0715/p151.html

Fungal Toenail Infections - Clinical Evidence Handbook - American Family Physician

Jul 15, 2015 - What are the effects of oral and topical treatments for fungal toenail infections in adults?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2015/0715/p132.html

Management of Blood Glucose with Noninsulin Therapies in Type 2 Diabetes - American ...

Jul 1, 2015 - A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p27.html

The Role of Levetiracetam in Treating Chronic Neuropathic Pain Symptoms - Cochrane for ...

Jul 1, 2015 - Based on low-quality evidence, levetiracetam was found to be ineffective for the treatment of chronic neuropathic pain symptoms. Moreover, patients who were taking levetiracetam experienced adverse effects at a significantly higher rate than those who were taking placebo.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0701/p23.html

AAO-HNSF Releases Guideline on Managing Tinnitus - Practice Guidelines - American ...

Jul 1, 2015 - Tinnitus, the perception of sound without an external source, can be caused by a variety of conditions. Prevalence in the United States is approximately 10% to 15%. It can be categorized as primary (idiopathic and accompanied by or not by sensorineural hearing loss) and secondary ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0701/p65.html

Are Some Antidepressants Safer than Others Regarding Suicide Risk? - POEMs - American ...

Jul 1, 2015 - Mirtazapine (Remeron) and venlafaxine are associated with higher rates of completed suicide in primary care patients. Rates of suicide attempts and completion are similar with the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52a.html

Nicotine Replacement Therapy for Smoking Cessation - Medicine by the Numbers - American...

Jul 1, 2015 - Studies show that 1 in 15 patients successfully quit smoking and 1 in 94 patients experienced chest pain or palpitations. Want to know more?

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0701/od1.html

Type 2 Diabetes: Updated Evidence Requires Updated Decision Making - Editorials - ...

Jul 1, 2015 - Clinicians need to consider the best available research findings, their own experience, and their patients' needs and values.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0701/p22.html

CEA vs. Stenting: Mixed Results, Mostly Bad - POEMs - American Family Physician

Jul 1, 2015 - These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52.html

Growth Hormone for Treatment of Idiopathic Short Stature in Children - FPIN's Help Desk...

Jul 1, 2015 - Advertisement << Previous article Next article >> Jul 1, 2015 Issue FPIN's Help Desk Answers Growth Hormone for Treatment of Idiopathic Short Stature in Children SUFIAN ZAYED, MD, and DIANE J. MADLON-KAY, MD, MS, University of Minnesota Medical Center, Smiley's Family Medicine...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2015/0701/p64.html

Dapagliflozin (Farxiga) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jun 15, 2015 - Dapagliflozin will lower A1C levels by an average of 0.7 percentage points when used alone or by an average of 0.5 percentage points when added to metformin therapy. Its effect on diabetes-associated morbidity and mortality has not been studied, and although it is well tolerated, there ...

American Family Physician : STEPS

https://www.aafp.org/afp/2015/0615/p828.html

Amoxiclav Causes Diarrhea in 1 of 8 Persons Who Take It - POEMs - American Family ...

Jun 15, 2015 - The risk of diarrhea is significantly higher with amoxicillin/clavulanate (amoxiclav; Augmentin) than placebo, with a number needed to treat to harm (NNTH) of 8, which is not dissimilar from the number needed to treat for conditions such as otitis media. Contrary to popular belief, the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p877.html

Patients with Initial Unprovoked DVT or PE Benefit from Long-Term Low-Dose Aspirin - ...

Jun 15, 2015 - Aspirin improves long-term cardiovascular and thrombotic outcomes in patients who have had an initial unprovoked episode of VTE. The risk of bleeding was no higher in the aspirin group, perhaps because those at risk of bleeding were uncovered during the initial period of anticoagulation.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p872.html

Sterile Gloves Not Necessary for Minor Skin Surgery - POEMs - American Family Physician

Jun 15, 2015 - Infection rates in patients undergoing uncomplicated minor skin surgery were not different when sterile gloves, rather than simply clean gloves, were worn. A previous study similarly found no difference in infection rates between sterile and nonsterile gloves in patients undergoing ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p872a.html

Role of the Family Physician in the Management of Cystic Fibrosis - Editorials - ...

Jun 15, 2015 - Advertisement << Previous article Next article >> Jun 15, 2015 Issue Editorials Role of the Family Physician in the Management of Cystic Fibrosis DOUGLAS LEWIS, MD, Via Christi Family Medicine Residency, Via Christi Adult Cystic Fibrosis Specialty Clinic, Wichita, Kansas Am Fam...

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0615/p822.html

Nonpharmacologic Management of Hypertension: What Works? - American Family Physician

Jun 1, 2015 - Hypertension is one of the most common conditions encountered in primary care. Nonpharmacologic strategies have been shown to help lower blood pressure. Lifestyle modifications are recommended for all patients with hypertension. The American Heart Association/American College of ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0601/p772.html

Colchicine for Acute Gout - Cochrane for Clinicians - American Family Physician

Jun 1, 2015 - Low-quality evidence shows that low-dose colchicine (up to 1.8 mg over one hour) is an effective therapy for acute gout.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2015/0601/p759.html

Tight Glycemic Control for Type 2 Diabetes Mellitus (Over Five Years) - Medicine by the...

Jun 1, 2015 - Studies show that none were helped and 1 in 6 patients were harmed. See why.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0601/od2.html

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