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Chronic Diarrhea in Adults: Evaluation and Differential Diagnosis - American Family ...

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 - ...

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

Pelvic Floor Muscle Training vs. Control for Urinary Incontinence in Women - Cochrane ...

Apr 1, 2020 - Use of pelvic floor muscle training to treat women with all subtypes of urinary incontinence results in improvement or cure vs. no treatment (number needed to treat [NNT] = 2.5; 95% CI, 1.4 to 5.4). Treatment with pelvic floor muscle training also results in one fewer episode of leakage...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0401/p393.html

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ...

Apr 1, 2020 - Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435a.html

Results of Fecal Immunochemical Tests for Colorectal Cancer Screening Not Affected by ...

Apr 1, 2020 - The use of aspirin, NSAIDs, and oral anticoagulants has no clinically important effects on the positive predictive value of FIT in a screening population.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Office Spirometry: Indications and Interpretation - American Family Physician

Mar 15, 2020 - High-quality, office-based spirometry provides diagnostic information as useful and reliable as testing performed in a pulmonary function laboratory. Spirometry may be used to monitor progression of lung disease and response to therapy. A stepwise approach to spirometry allows for ease ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p362.html

Genital Ulcers: Differential Diagnosis and Management - American Family Physician

Mar 15, 2020 - Genital ulcers may be located on the vagina, penis, and anorectal or perineal areas and may be infectious or noninfectious. Herpes simplex virus is the most common cause of genital ulcers in the United States. A diagnosis of genital herpes simplex virus infection is made through ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0315/p355.html

Medication Use to Reduce Risk of Breast Cancer: Recommendation Statement - U.S. ...

Mar 15, 2020 - The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects.

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

https://www.aafp.org/afp/2020/0315/od1.html

Medication Use to Reduce Risk of Breast Cancer - Putting Prevention into Practice - ...

Mar 15, 2020 - E.F., a 40-year-old woman, comes to your office for a routine gynecologic visit. She is not taking any medications and is generally healthy. She is sexually active, and her last menstrual period started 10 days ago.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0315/p373.html

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ...

Mar 15, 2020 - Esketamine is an in-office treatment for patients with a severe major depressive disorder to be used in addition to oral antidepressant therapy.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0315/p339.html

Integrating Breast Cancer Risk Management into Primary Care - Editorials - American ...

Mar 15, 2020 - It is important that primary care physicians have the ability and resources to identify women eligible for genetic counseling and testing for breast cancer.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0315/p330.html

Upper Gastrointestinal Bleeding in Adults: Evaluation and Management - American Family ...

Mar 1, 2020 - Upper gastrointestinal (GI) bleeding is defined as hemorrhage from the mouth to the ligament of Treitz. Common risk factors for upper GI bleeding include prior upper GI bleeding, anticoagulant use, high-dose nonsteroidal anti-inflammatory drug use, and older age. Causes of upper GI ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0301/p294.html

IDx-DR for Diabetic Retinopathy Screening - Diagnostic Tests: What Physicians Need to ...

Mar 1, 2020 - IDx-DR is a reliable screening tool used to diagnose diabetic retinopathy in the primary care office and may reduce barriers to screening and improve gaps in eye care for those with diabetes.

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

https://www.aafp.org/afp/2020/0301/p307.html

Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in ...

Mar 1, 2020 - Vitamin and mineral supplementation has little to no beneficial effect on preserving cognitive functioning or preventing dementia in cognitively healthy adults 40 years and older.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p272.html

HIV Status, Preexposure Prophylaxis, Sexual Health, and the Critical Role of Family ...

Mar 1, 2020 - Family physicians play a key role in expanding HIV testing and treatment, as well as providing sexual health services in areas where specialty sexual health services are not readily available.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0301/p262.html

Tai Chi for Fibromyalgia - FPIN's Clinical Inquiries - American Family Physician

Mar 1, 2020 - The practice of Yang-style tai chi for one hour twice weekly for 12 to 24 weeks is moderately effective in improving quality of life in patients with fibromyalgia.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0301/od1.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ...

Mar 1, 2020 - This study found that linagliptin is noninferior to glimepiride for reducing the risk of cardiovascular death, myocardial infarction, and stroke in adults with type 2 diabetes at an increased risk of cardiovascular disease.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309a.html

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ...

Mar 1, 2020 - Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309.html

Cerebral Palsy: An Overview - American Family Physician

Feb 15, 2020 - Cerebral palsy, which occurs in two to three out of 1,000 live births, has multiple etiologies resulting in brain injury that affects movement, posture, and balance. The movement disorders associated with cerebral palsy are categorized as spasticity, dyskinesia, ataxia, or mixed/other. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p213.html

Acute Lower Gastrointestinal Bleeding: Evaluation and Management - American Family ...

Feb 15, 2020 - Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p206.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: ...

Feb 15, 2020 - The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk...

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

https://www.aafp.org/afp/2020/0215/p233.html

Diagnosis of Heart Failure with Reduced Ejection Fraction - Point-of-Care Guides - ...

Feb 15, 2020 - Can signs, symptoms, and simple tests be used to determine the likelihood of heart failure with reduced ejection fraction?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2020/0215/p230.html

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer - ...

Feb 15, 2020 - A 31-year-old woman presents to your office for a well-woman examination. She is sexually active in a monogamous relationship and has never been pregnant. She tells you that her mother was diagnosed with tubal cancer at age 40 and that her sister, who is 42 years of age, was recently ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0215/p239.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ...

Feb 15, 2020 - Inappropriate treatment of asymptomatic bacteriuria is common in hospitalized patients. Older patients, those with dementia or acutely altered mental status, and those with abnormal urinalysis results are more likely to be treated with antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248.html

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ...

Feb 15, 2020 - Based on a review of low-quality evidence, adding a topical intervention after cryosurgery for actinic keratosis improves the likelihood of complete clearance from 46% to 79% (number needed to treat = 3).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p249.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

Chronic Wounds: Evaluation and Management - American Family Physician

Feb 1, 2020 - Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. They are common and are often incorrectly treated. The morbidity and associated costs of chronic wounds highlight the need to implement wound prevention and treatment guidelines. ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p159.html

Clostridioides difficile Infection: Update on Management - American Family Physician

Feb 1, 2020 - Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. difficile infection is characterized by a wide range of symptoms, from ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p168.html

Menopause - American Family Physician

Feb 1, 2020 - This collection features AFP content on menopause and related issues, including estrogen and progestogen therapy, hormone therapy, hot flashes, mood symptoms, sexual difficulties, and postmenopause. This collection features AFP content on menopause and related issues, including estrogen...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=59

Breast Cancer Screening: ACP Releases Guidance Statements - Practice Guidelines - ...

Feb 1, 2020 - The American College of Physicians reviewed guidelines from other organizations and developed four statements to provide advice to clinicians about breast cancer screening for women who are at average risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0201/p184.html

Shared Decision-Making for Administering PCV13 in Older Adults - Editorials - American ...

Feb 1, 2020 - In June 2019, the Advisory Committee on Immunization Practices approved a change from its age-based 13-valent pneumococcal conjugate vaccine recommendations to a shared clinical decision-making process.

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0201/p134.html

Treatments for Postmenopausal Hypoactive Sexual Desire Disorder - FPIN's Clinical ...

Feb 1, 2020 - Transdermal testosterone for the treatment of hypoactive sexual desire disorder in postmenopausal women results in an additional 0.92 sexually satisfying events per month, acne, and increased androgenic effects without major complications

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0201/p182.html

Antibiotics for Exacerbations of Chronic Obstructive Pulmonary Disease - Medicine by ...

Feb 1, 2020 - Prescription of antibiotics for the treatment of chronic obstructive pulmonary disease (COPD) is controversial due to the variety of etiologies. This review examined the use of antibiotics to treat COPD in outpatient, inpatient, and ICU settings. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0201/od1.html

OnabotulinumtoxinA for Prevention of Migraine in Adults - Cochrane for Clinicians - ...

Feb 1, 2020 - OnabotulinumtoxinA reduces the number of migraine days per month by two days compared with placebo in adults with chronic migraines.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0201/p144.html

Adverse Events of Pharmacologic Treatments of Major Depression in Older Adults - ...

Feb 1, 2020 - What are the adverse events of antidepressants prescribed to treat major depressive disorder in adults 65 years and older?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2020/0201/p179.html

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ...

Jan 15, 2020 - Although the prevalence of muscle weakness in the general population is uncertain, it occurs in about 5% of U.S. adults 60 years and older. Determining the cause of muscle weakness can be challenging. True muscle weakness must first be differentiated from subjective fatigue or ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p95.html

Functional Dyspepsia: Evaluation and Management - American Family Physician

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p84.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ...

Jan 15, 2020 - Revefenacin is a once-daily nebulized alternative to metered dose long-acting muscarinic antagonists for patients with moderate to severe COPD. Given its expense, complicated administration process, and lack of evidence that it improves key patient-oriented outcomes, its use should be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0115/p121.html

Acute Heart Failure in a 39-Year-Old Man - Photo Quiz - American Family Physician

Jan 15, 2020 - Advertisement << Previous article Next article >> Jan 15, 2020 Issue Photo Quiz Acute Heart Failure in a 39-Year-Old Man DREW ASHBY, MD; FRANKLIN NIBLOCK, MD, MPH; KENNETH HERRING, MD; and LOGAN MIMS, MD, University of Colorado, Denver, Colorado Am Fam Physician. 2020 Jan...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2020/0115/p117.html

Benign Anorectal Conditions: Evaluation and Management - American Family Physician

Jan 1, 2020 - Common anorectal conditions include hemorrhoids, perianal pruritus, anal fissures, functional rectal pain, perianal abscess, condyloma, rectal prolapse, and fecal incontinence. Although these are benign conditions, symptoms can be similar to those of cancer, so malignancy should be ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0101/p24.html

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ...

Jan 1, 2020 - The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions, medications that ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0101/p56.html

PLAC Test for Lp-PLA2 Activity to Predict Coronary Heart Disease - Diagnostic Tests: ...

Jan 1, 2020 - The PLAC test is a blood test used to measure serum activity of lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme that breaks down oxidized low-density lipoprotein in the vascular wall.

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

https://www.aafp.org/afp/2020/0101/p44.html

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk - ...

Jan 1, 2020 - Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was fasting or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Exercise to Reduce Falls in Older Adults - FPIN's Clinical Inquiries - American Family ...

Jan 1, 2020 - Exercise programs should be recommended for community-dwelling adults 60 years and older because they lead to fewer falls.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0101/p42.html

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