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Paget Disease of Bone for Primary Care - American Family Physician Restricted content. Login required.

Aug 15, 2020 - Paget disease of bone is a benign disorder characterized by focal areas of increased bone turnover in one or more skeletal sites. It usually affects older adults, and men are at a higher risk than women. Any bone may be affected, but the disease has a high preference for the pelvis, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0815/p224.html

Colorectal Cancer Screening: ACP Guidance Statements - Practice Guidelines - American ... Restricted content. Login required.

Aug 15, 2020 - The American College of Physicians developed a consensus statement for colorectal cancer screening of average-risk adults based on their review of six independent guidelines and supporting evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0815/p250.html

Colorectal Cancer Screening: BMJ Rapid Recommendation - Practice Guidelines - American ... Restricted content. Login required.

Aug 15, 2020 - Colorectal cancer (CRC) screening recommendations vary because the underlying evidence is low quality, with few screening methods evaluated by randomized trials. The BMJ/MAGIC Group performed a systematic review based on 15-year CRC risk models to compare screening options.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0815/p253.html

Daily Colchicine Post-MI Reduces Strokes and Recurrent Hospitalizations for Angina - ... Restricted content. Login required.

Aug 15, 2020 - Daily colchicine after MI reduces cardiovascular events, specifically strokes and hospitalizations for angina. It is inexpensive and well-tolerated and should be considered for patients with recent MIs who are already using guideline-directed therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p248.html

Small Reduction in Cardiovascular Outcome After Ischemic Stroke with Lower LDL Target, ... Restricted content. Login required.

Aug 15, 2020 - A lower LDL target slightly reduced the likelihood of a broad composite outcome (number needed to treat [NNT] = 43 over 3.5 years), largely by reducing nonfatal strokes (NNT = 77; statistical significance not reported).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0815/p247.html

Acute Pyelonephritis in Adults: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Aug 1, 2020 - Acute pyelonephritis is a bacterial infection of the kidney and renal pelvis and should be suspected in patients with flank pain and laboratory evidence of urinary tract infection. Urine culture with antimicrobial susceptibility testing should be performed in all patients and used to ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0801/p173.html

VTE in Patients with Cancer: Guidelines from the American Society of Clinical Oncology ... Restricted content. Login required.

Aug 1, 2020 - The American Society of Clinical Oncology has updated recommendations for the prevention and treatment of venous thromboembolism (VTE) in patients with cancer.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0801/p188.html

Smoking Cessation with Text Messaging and App-Based Interventions - Cochrane for ... Restricted content. Login required.

Aug 1, 2020 - Automated text messaging interventions are more effective than minimal smoking cessation support (absolute risk reduction [ARR] = 3%; 95% CI, 1% to 5%).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0801/p148.html

Acupuncture for Knee Osteoarthritis - FPIN's Clinical Inquiries - American Family ... Restricted content. Login required.

Aug 1, 2020 - Electroacupuncture can be used to improve pain and physical function in adults with knee osteoarthritis.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0801/p184.html

Heart Failure - American Family Physician

Jul 15, 2020 - This collection features AFP content on heart failure and related issues, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), cardiomyopathy, cardioverter-defibrillators, congestive heart failure, and diastolic and systolic heart failure. This...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=26

Dapagliflozin (Farxiga) for Preventing Hospitalization for Heart Failure - STEPS - ... Restricted content. Login required.

Jul 15, 2020 - Dapagliflozin can be added to existing treatment to reduce the risk of hospitalization for heart failure in patients with type 2 diabetes who have established CVD or are at high risk of CVD. It may also decrease the risk of renal disease progression and death from renal failure.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0715/p115.html

Acetaminophen for Pain Relief in Osteoarthritis - FPIN's Help Desk Answers - American ... Restricted content. Login required.

Jul 15, 2020 - Acetaminophen is no better than placebo for relief of hip or knee pain due to osteoarthritis. Although acetaminophen does provide some pain relief, the effect is small and not clinically significant.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0715/p113.html

Mailing gFOBT or FIT Directly to Patients Increases Uptake of Colorectal Cancer ... Restricted content. Login required.

Jul 15, 2020 - Mailed outreach significantly increases rates of colorectal cancer screening, with four tests needing to be mailed to screen one person.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0715/p117.html

Blood Product Transfusion in Adults: Indications, Adverse Reactions, and Modifications ... Restricted content. Login required.

Jul 1, 2020 - Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0701/p30.html

Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2020 - This collection features AFP content on chronic obstructive pulmonary disease (COPD) and related issues, including acute and chronic COPD, spirometry, pulmonary rehabilitation, oxygen therapy, corticosteriods, and pulmonary complications. This collection features AFP content on chronic ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=32

Vitamin D Supplementation and All-Cause Mortality - Medicine by the Numbers - American ... Restricted content. Login required.

Jul 1, 2020 - Observational studies have shown that those with low vitamin D levels have higher cancer and cardiovascular mortality. Read more to learn about the effect of vitamin D supplementation on all-cause mortality.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0701/od1.html

The Promise and Challenge of Home Health Services During the COVID-19 Pandemic - ...

Jul 1, 2020 - The COVID-19 pandemic presents family physicians with unique opportunities to work with home health providers to combat the pandemic, provide quality care, and ease the burden of fear among patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0701/p8.html

Nicotine Replacement Therapy for Smoking Cessation - Cochrane for Clinicians - American... Restricted content. Login required.

Jul 1, 2020 - Patients using a combination of nicotine patch and fast-acting NRT are more likely to quit smoking than those on any single therapy alone (number needed to treat [NNT] = 29; 95% CI, 20 to 47).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0701/p17.html

Role of Mucolytics in the Treatment of Chronic Bronchitis or COPD - Cochrane for ... Restricted content. Login required.

Jul 1, 2020 - Oral mucolytic agents may reduce the number of acute exacerbations in patients with chronic bronchitis or COPD (number needed to treat [NNT] = 8 over an average of nine months; 95% CI, 7 to 10).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0701/p16.html

PAULA’s Test for Lung Cancer Screening - Diagnostic Tests: What Physicians Need to Know... Restricted content. Login required.

Jul 1, 2020 - Because of insufficient evidence of benefit, no recommendations can be made regarding PAULA's test. Prospective cohort studies of a screening population and randomized controlled trials comparing cancer mortality outcomes using PAULA's test vs. low-dose CT and no screening are needed ...

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

https://www.aafp.org/afp/2020/0701/p53.html

Family Physicians Play Key Role in Bridging the Gap in Access to Opioid Use Disorder ...

Jul 1, 2020 - Buprenorphine prescribing in primary care is a key bottleneck in the access to medications for opioid use disorder (OUD). In a Medicare claims study including family medicine, internal medicine, general practice, and psychiatry, the largest share of buprenorphine prescribers were family...

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2020/0701/p10.html

Acute Respiratory Distress Syndrome: Diagnosis and Management - American Family Physician

Jun 15, 2020 - Acute respiratory distress syndrome (ARDS) is noncardiogenic pulmonary edema that manifests as rapidly progressive dyspnea, tachypnea, and hypoxemia. Diagnostic criteria include onset within one week of a known insult or new or worsening respiratory symptoms, profound hypoxemia, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0615/p730.html

Screening for Cognitive Impairment in Older Adults: Recommendation Statement - U.S. ...

Jun 15, 2020 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for cognitive impairment in older adults.

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

https://www.aafp.org/afp/2020/0615/od1.html

Screening for Cognitive Impairment in Older Adults - Putting Prevention into Practice -... Restricted content. Login required.

Jun 15, 2020 - L.C. is a 70-year-old Asian American woman who retired from teaching middle school five years ago. She lives independently and has a daughter and grandchildren who live within 30 miles of her. She presents for a follow-up visit to renew her hypertension medications. Her blood pressure ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0615/p753.html

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

Jun 15, 2020 - A collaboration between AFP and the Lown Institute promotes a vision of delivering health 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/2020/0615/p748.html

Continuous Glucose Monitoring in Type 2 Diabetes Is Not Ready for Widespread Adoption -...

Jun 1, 2020 - Although continuous glucose monitoring may benefit patients with type 1 diabetes mellitus, there is limited evidence that it offers similar benefits in patients with type 2 diabetes, regardless of whether they are taking insulin.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0601/p646.html

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs... Restricted content. Login required.

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low ... Restricted content. Login required.

Jun 1, 2020 - Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ... Restricted content. Login required.

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.html

Supplemental Oxygen Therapy for Nonhypoxemic Patients with Acute Coronary Syndrome - ... Restricted content. Login required.

Jun 1, 2020 - No conclusive evidence demonstrates that routine use of supplemental oxygen therapy is associated with clinical benefit or harm in nonhypoxemic patients with acute myocardial infarction (MI).

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0601/p687.html

Noninvasive Positive Pressure Ventilation for Exacerbation of Chronic Obstructive ... Restricted content. Login required.

Jun 1, 2020 - Chronic obstructive pulmonary disease (COPD) is a progressive lung disease characterized by hyperinflation of the lungs, including emphysema and chronic bronchitis. Learn more about the benefits and harms of using noninvasive positive pressure ventilation for exacerbation of COPD.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0601/od1.html

Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis - POEMs - American Family ... Restricted content. Login required.

Jun 1, 2020 - Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p696.html

Screening for Abdominal Aortic Aneurysm: Recommendation Statement - U.S. Preventive ...

May 15, 2020 - The USPSTF recommends 1-time screening for abdominal aortic aneurysm (AAA) with ultrasonography in men aged 65 to 75 years who have ever smoked.

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

https://www.aafp.org/afp/2020/0515/od1.html

Equivalent Pain Relief with Different Doses of Ibuprofen - POEMs - American Family ... Restricted content. Login required.

May 15, 2020 - Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631.html

Screening for Abdominal Aortic Aneurysm - Putting Prevention into Practice - American ... Restricted content. Login required.

May 15, 2020 - A 65-year-old man with no significant medical history presents to your clinic for a wellness visit. His social history includes smoking periodically in his 20s, and his family history includes a father who died from an abdominal aortic aneurysm (AAA) in his 60s. The patient wants to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0515/p621.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ... Restricted content. Login required.

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American... Restricted content. Login required.

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Chronic Dyspnea: Diagnosis and Evaluation - American Family Physician Restricted content. Login required.

May 1, 2020 - Dyspnea is a symptom arising from a complex interplay of diseases and physiologic states and is commonly encountered in primary care. It is considered chronic if present for more than one month. As a symptom, dyspnea is a predictor for all-cause mortality. The likeliest causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p542.html

Endometrial Biopsy: Tips and Pitfalls - American Family Physician Restricted content. Login required.

May 1, 2020 - Endometrial biopsy is a safe and efficient method to evaluate the endometrium for a variety of indications, most commonly abnormal uterine bleeding and postmenopausal bleeding. Endometrial biopsy is highly specific for diagnosing atypical hyperplasia and endometrial cancer in ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0501/p551.html

Therapies for COPD Exacerbations in Adults - Implementing AHRQ Effective Health Care ... Restricted content. Login required.

May 1, 2020 - What are the benefits and harms of pharmacologic and nonpharmacologic treatments for exacerbations of chronic obstructive pulmonary disease (COPD) in adults?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0501/p557.html

Antidepressants Plus Benzodiazepines for Adults with Major Depression - Cochrane for ... Restricted content. Login required.

May 1, 2020 - A combination of tricyclic antidepressants and benzodiazepines is more effective for major depression in adults than tricyclic antidepressants alone in the first four weeks of treatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p527.html

Lithium for Acute Mania - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

May 1, 2020 - Lithium is more effective at inducing a reduction of at least 50% on the validated Young Mania Rating Scale compared with placebo (number needed to treat [NNT] = 6; 95% CI, 5 to 8; six studies; n = 1,707).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0501/p528.html

IBSchek for Irritable Bowel Syndrome - Diagnostic Tests: What Physicians Need to Know -... Restricted content. Login required.

May 1, 2020 - IBSchek is a blood test marketed to assist in the diagnosis of irritable bowel syndrome with predominant diarrhea (IBS-D) or with mixed bowel habits (IBS-M) in adults.

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

https://www.aafp.org/afp/2020/0501/p564.html

Megestrol for Palliative Care in Patients with Cancer - FPIN's Clinical Inquiries - ... Restricted content. Login required.

May 1, 2020 - Megestrol may be considered as a component of palliative care nutritional support in patients with cancer.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0501/od1.html

Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

Apr 15, 2020 - Chronic diarrhea is defined as a predominantly loose stool lasting longer than four weeks. A patient history and physical examination with a complete blood count, C-reactive protein, anti-tissue transglutaminase immunoglobulin A (IgA), total IgA, and a basic metabolic panel are useful ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p472.html

Prescribing Opioids for Chronic Pain: Unintended Consequences of the 2016 CDC Guideline...

Apr 15, 2020 - Since the 2016 CDC guideline for the use of opioid pain relievers was released, there has been a significant reduction in opioid prescribing, and the guideline has been adopted by state Medicaid agencies, insurers, and others. Widespread implementation of the guideline has had ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0415/p458.html

Screening for Asymptomatic Bacteriuria in Adults: Recommendation Statement - U.S. ...

Apr 15, 2020 - The USPSTF recommends screening for asymptomatic bacteriuria using urine culture in pregnant persons. The USPSTF recommends against screening for asymptomatic bacteriuria in nonpregnant adults.

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

https://www.aafp.org/afp/2020/0415/p489.html

Screening for Asymptomatic Bacteriuria in Adults - Putting Prevention into Practice - ... Restricted content. Login required.

Apr 15, 2020 - A 33-year-old woman presents to your clinic for a first prenatal visit at 8 weeks' gestation. She reported morning nausea and breast tenderness. Review of systems and physical examination were consistent with early pregnancy but were otherwise unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0415/p493.html

Sepsis: Diagnosis and Management - American Family Physician

Apr 1, 2020 - Guidelines published in 2016 provide a revised definition of sepsis: life-threatening organ dysfunction caused by a dysregulated host response to infection. The guidelines define septic shock as sepsis with circulatory, cellular, and metabolic dysfunction that is associated with a ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p409.html

Benzodiazepines for Panic Disorder in Adults - Medicine by the Numbers - American ...

Apr 1, 2020 - Should benzodiazepeines continue to be prescribed during the initiation phase of selective serotonin reuptake inhibitors for acute relief of panic attacks? Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0401/od1.html

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