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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

Current Concepts in Adult Acute Rhinosinusitis - American Family Physician

Jul 15, 2016 - Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p97.html

Common Questions About Streptococcal Pharyngitis - American Family Physician

Jul 1, 2016 - Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p24.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Genital Herpes: A Review - American Family Physician

Jun 1, 2016 - Genital herpes is a common sexually transmitted disease, affecting more than 400 million persons worldwide. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. A visible outbreak consists of single or clustered vesicles on the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p928.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Identification and Management of Peripartum Depression - American Family Physician

May 15, 2016 - Peripartum depression affects up to one in seven women and is associated with significant maternal and neonatal morbidity if untreated. A history of depression is the strongest risk factor for developing peripartum depression. The U.S. Preventive Services Task Force recommends screening...

American Family Physician : Article

https://www.aafp.org/afp/2016/0515/p852.html

Nonoperative Management of Cervical Radiculopathy - American Family Physician

May 1, 2016 - Cervical radiculopathy describes pain in one or both of the upper extremities, often in the setting of neck pain, secondary to compression or irritation of nerve roots in the cervical spine. It can be accompanied by motor, sensory, or reflex deficits and is most prevalent in persons 50 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p746.html

Primary Care of the Prostate Cancer Survivor - American Family Physician

May 1, 2016 - This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p764.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

Common Questions About Recurrent Urinary Tract Infections in Women - American Family ...

Apr 1, 2016 - Recurrent urinary tract infections (UTIs) are common in women, including healthy women with normal genitourinary anatomy. Recurrent UTI is typically defined as three or more UTIs within 12 months, or two or more occurrences within six months. The same species that caused previous ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p560.html

Prevention and Treatment of Drowning - American Family Physician

Apr 1, 2016 - Nearly 4,000 drowning deaths occur annually in the United States, with drowning representing the most common injury-related cause of death in children one to four years of age. Drowning is a process that runs the spectrum from brief entry of liquid into the airways with subsequent ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p576.html

Diagnosis and Management of Nephrotic Syndrome in Adults - American Family Physician

Mar 15, 2016 - Nephrotic syndrome (NS) consists of peripheral edema, heavy proteinuria, and hypoalbuminemia, often with hyperlipidemia. Patients typically present with edema and fatigue, without evidence of heart failure or severe liver disease. The diagnosis of NS is based on typical clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p479.html

Medications for Alcohol Use Disorder - American Family Physician

Mar 15, 2016 - The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p457.html

Diagnosis and Management of Endometrial Cancer - American Family Physician

Mar 15, 2016 - Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p468.html

Hyperthyroidism: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Hyperthyroidism is an excessive concentration of thyroid hormones in tissues caused by increased synthesis of thyroid hormones, excessive release of preformed thyroid hormones, or an endogenous or exogenous extrathyroidal source. The most common causes of an excessive production of ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p363.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Clinical Evaluation of Bleeding and Bruising in Primary Care - American Family Physician

Feb 15, 2016 - Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The International Society on Thrombosis and Hemostasis has developed a bleeding assessment tool that can be used to indicate ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0215/p279.html

Primary Brain Tumors in Adults: Diagnosis and Treatment - American Family Physician

Feb 1, 2016 - Primary intracranial tumors of the brain structures, including meninges, are rare with an overall five-year survival rate of 33.4%; they are collectively called primary brain tumors. Proven risk factors for these tumors include certain genetic syndromes and exposure to high-dose ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/p211.html

Hypertensive Disorders of Pregnancy - American Family Physician

Jan 15, 2016 - Elevated blood pressure in pregnancy may represent chronic hypertension (occurring before 20 weeks’ gestation or persisting longer than 12 weeks after delivery), gestational hypertension (occurring after 20 weeks’ gestation), preeclampsia, or preeclampsia superimposed on chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p121.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

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.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

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

Dysuria: Evaluation and Differential Diagnosis in Adults - American Family Physician

Nov 1, 2015 - The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p778.html

Diagnosis and Management of Common Types of Supraventricular Tachycardia - American ...

Nov 1, 2015 - Supraventricular tachycardia refers to rapid rhythms that originate and are sustained in atrial or atrioventricular node tissue above the bundle of His. The condition is caused by reentry phenomena or automaticity at or above the atrioventricular node, and includes atrioventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p793.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

Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children - American ...

Oct 15, 2015 - Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p705.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

Diagnosis and Management of Foodborne Illness - American Family Physician

Sep 1, 2015 - The Centers for Disease Control and Prevention estimates that each year, one in six Americans will experience a foodborne illness. The most common causes in the United States are viruses, such as norovirus; bacteria, such as Salmonella, Escherichia coli, Campylobacter, and Listeria; and...

American Family Physician : Article

https://www.aafp.org/afp/2015/0901/p358.html

Rosacea: Diagnosis and Treatment - American Family Physician

Aug 1, 2015 - Rosacea is a chronic facial skin condition of unknown cause. It is characterized by marked involvement of the central face with transient or persistent erythema, telangiectasia, inflammatory papules and pustules, or hyperplasia of the connective tissue. Transient erythema, or flushing, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p187.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

Diagnosis and Management of Hepatitis C - American Family Physician

Jun 15, 2015 - Hepatitis C virus (HCV) infection, a major cause of chronic liver disease and cirrhosis, is predominantly transmitted by exposure to blood or body fluids. The infection progresses to a chronic state in 80% of patients, whereas the virus clears completely after the acute infection in 20%...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p835.html

Preventive Health Care for Men Who Have Sex with Men - American Family Physician

Jun 15, 2015 - Men who have sex with men (MSM) comprise at least 4% of males in the United States. MSM may describe themselves as gay, bisexual, or heterosexual. Because current medical practice does not always facilitate discussion of sexual behaviors, this group of men may face barriers to receiving...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p844.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

Sudden Infant Death Syndrome - American Family Physician

Jun 1, 2015 - Sudden infant death syndrome (SIDS) is the sudden unexpected death of a child younger than one year during sleep that cannot be explained after a postmortem evaluation including autopsy, a thorough history, and scene evaluation. The incidence of SIDS has decreased more than 50% in the ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0601/p778.html

Common Questions About the Management of Gastroesophageal Reflux Disease - American ...

May 15, 2015 - Common questions that arise regarding treatment of gastroesophageal reflux disease (GERD) include which medications are most effective, when surgery may be indicated, which patients should be screened for Barrett esophagus and Helicobacter pylori infection, and which adverse effects ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p692.html

Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults -...

May 1, 2015 - Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient’s quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p617.html

Provision of Contraception: Key Recommendations from the CDC - American Family Physician

May 1, 2015 - The Centers for Disease Control and Prevention has released comprehensive recommendations for provision of family planning services. Contraceptive services may be addressed in five steps, and counseling may be provided in a tiered approach, whereby the most effective options are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p625.html

Diagnosis of Acute Stroke - American Family Physician

Apr 15, 2015 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p528.html

Options for Women with Unintended Pregnancy - American Family Physician

Apr 15, 2015 - Unintended pregnancy refers to unwanted, unplanned, or mistimed pregnancies. One-half of all pregnancies in the United States are unintended, and family physicians are often asked to provide counseling, support, and resources for women with unintended pregnancies. Options include ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p544.html

Diagnosis and Treatment of Temporomandibular Disorders - American Family Physician

Mar 15, 2015 - Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint complex, and surrounding musculature and osseous components. TMD affects up to 15% of adults, with a peak incidence at 20 to 40 years of age....

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p378.html

Evaluation and Treatment of Infertility - American Family Physician

Mar 1, 2015 - Infertility is defined as the inability to achieve pregnancy after one year of regular, unprotected intercourse. Evaluation may be initiated sooner in patients who have risk factors for infertility or if the female partner is older than 35 years. Causes of infertility include male ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0301/p308.html

Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection - American ...

Feb 15, 2015 - The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p236.html

Lung Cancer: Diagnosis, Treatment Principles, and Screening - American Family Physician

Feb 15, 2015 - Lung cancer is classified histologically into small cell and non–small cell lung cancers. The most common symptoms of lung cancer are cough, dyspnea, hemoptysis, and systemic symptoms such as weight loss and anorexia. High-risk patients who present with symptoms should undergo chest ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p250.html

Common Questions About the Initial Management of Hypertension - American Family Physician

Feb 1, 2015 - Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0201/p172.html

Colorectal Cancer Screening and Surveillance - American Family Physician

Jan 15, 2015 - Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p93.html

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