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Asthma: Updated Diagnosis and Management Recommendations from GINA - Practice ... Restricted content. Login required.

Jun 15, 2020 - The latest update to the Global Initiative for Asthma (GINA) guidelines includes significant changes to treatment recommendations, especially a recommendation against using a short-acting beta2 agonists such as albuterol as sole therapy.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0615/p762.html

Ozenoxacin (Xepi) for the Treatment of Impetigo - STEPS - American Family Physician Restricted content. Login required.

Jun 15, 2020 - Ozenoxacin is an effective and safe topical quinolone treatment for bullous and nonbullous impetigo in patients as young as two months. However, it is expensive and some patients may have limited access because it is only available through a physician or hospital.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0615/p760.html

Newborn Circumcision Techniques - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Newborn male circumcision is a common elective surgical procedure for the removal of foreskin covering the glans penis. The American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the American Academy ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p680.html

Nerve Blocks: Part II. Lower Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Family physicians use anesthesia to provide diagnostic and procedural analgesia for conditions such as neuropathies, fracture reduction, foreign body removals, and complex wound management. Local infiltration of anesthetics is commonly used in this setting because of the ease of use, ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p669.html

Nerve Blocks: Part I. Upper Extremity - American Family Physician Restricted content. Login required.

Jun 1, 2020 - Procedural anesthesia is administered by family physicians for a variety of conditions, including neuropathies, fracture reduction, foreign body removals, and complex wound management. A nerve block may be preferred because it provides effective regional anesthesia with less anesthetic....

American Family Physician : Article

https://www.aafp.org/afp/2020/0601/p654.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 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

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

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

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

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

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

Tranexamic Acid for Postpartum Hemorrhage - Medicine by the Numbers - American Family ... Restricted content. Login required.

May 1, 2020 - Postpartum hemorrhage is the most common cause of maternal death worldwide. Tranexamic acid is an antifibrinolytic agent that has shown to decrease bleeding in surgical patients and all-cause death in trauma patients. Does early administration of tranexamic acid reduce the rate of death...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0501/od2.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

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

Outpatient Burn Care: Prevention and Treatment - American Family Physician Restricted content. Login required.

Apr 15, 2020 - Most patients with burn injuries are treated as outpatients. Two key determinants of the need for referral to a burn center are burn depth and percentage of total body surface area involved. All burn injuries are considered trauma, prompting immediate evaluation for concomitant ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0415/p463.html

Galcanezumab (Emgality) for Migraine and Cluster Headaches - STEPS - American Family ... Restricted content. Login required.

Apr 15, 2020 - In otherwise healthy adults with severe and frequent migraine or cluster headaches, galcanezumab may provide a modest reduction in debilitating headache frequency in the short term.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0415/p502.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

Ketorolac vs. Morphine for Pain Relief After Fractures - FPIN's Help Desk Answers - ... Restricted content. Login required.

Apr 15, 2020 - Parenteral ketorolac is as effective as parenteral morphine for short-term pain relief in patients with long bone fractures, and it results in fewer adverse effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2020/0415/p495.html

Acute Altitude Illness: Updated Prevention and Treatment Guidelines from the Wilderness... Restricted content. Login required.

Apr 15, 2020 - Acute altitude illness comprises acute mountain sickness, high altitude cerebral edema, and high altitude pulmonary edema. The Wilderness Medical Society has updated prevention and treatment guidelines on acute altitude illness.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0415/p505.html

Sepsis: Diagnosis and Management - American Family Physician Restricted content. Login required.

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

Cutaneous Cryosurgery for Common Skin Conditions - American Family Physician Restricted content. Login required.

Apr 1, 2020 - Cryosurgery is the application of freezing temperatures to achieve the destruction of tissue. Cutaneous cryosurgery has become a commonly performed outpatient procedure because of the combination of its safety, effectiveness, low cost, ease of use, lack of need for injectable ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0401/p399.html

Five Days of Penicillin for Strep Throat Is Equal to 10 Days - POEMs - American Family ... Restricted content. Login required.

Apr 1, 2020 - Five days of 800-mg penicillin four times a day produced noninferior results to 10 days of 1,000-mg penicillin three times a day, with shorter symptom duration. This is not the first study to show similar benefits with a shorter duration of oral antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434.html

Benzodiazepines for Panic Disorder in Adults - Medicine by the Numbers - American ... Restricted content. Login required.

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

Frostbite: Recommendations for Prevention and Treatment from the Wilderness Medical ... Restricted content. Login required.

Apr 1, 2020 - Recommendations for prevention and treatment of frostbite from the Wilderness Medical Society.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0401/p440.html

Probiotics to Augment Antifungal Treatment of Vulvovaginal Candidiasis - FPIN's ... Restricted content. Login required.

Apr 1, 2020 - Adding probiotics (typically Lactobacillus species) to antifungal therapy for vulvovaginal candidiasis improves short-term cure rates by 14% and reduces one-month relapse rates by 66%.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2020/0401/p432.html

Pelvic Floor Muscle Training vs. Control for Urinary Incontinence in Women - Cochrane ... Restricted content. Login required.

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

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ... Restricted content. Login required.

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

Esketamine (Spravato) for Treatment-Resistant Depression - STEPS - American Family ... Restricted content. Login required.

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

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

Mar 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/2020/0315/p370.html

Tai Chi for Fibromyalgia - FPIN's Clinical Inquiries - American Family Physician Restricted content. Login required.

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

Music Therapy for Depression - Cochrane for Clinicians - American Family Physician Restricted content. Login required.

Mar 1, 2020 - Moderate-quality evidence shows that music therapy added to standard care is more effective in the first three months than standard care alone for depressive symptoms based on clinician-rated outcomes and patient-reported outcomes.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0301/p273.html

Fewer Severe Exacerbations in Patients with Mild to Moderate Asthma Treated with ... Restricted content. Login required.

Mar 1, 2020 - Patients with mild to moderate asthma only need relief treatment. In this study, patients taking the combination of budesonide/formoterol (Symbicort) as needed had slightly fewer severe exacerbations than patients treated with twice daily budesonide (Pulmicort).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p310.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ... Restricted content. Login required.

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

Dupilumab (Dupixent) for Asthma - STEPS - American Family Physician Restricted content. Login required.

Feb 15, 2020 - Dupilumab is an effective injectable drug that decreases asthma exacerbations and the need for an oral glucocorticoid in patients with moderate to severe asthma, particularly those with high eosinophil counts.

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0215/p244.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ... Restricted content. Login required.

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

Do Not Change Antidepressant Treatment Early Based on a Lack of Response - POEMs - ... Restricted content. Login required.

Feb 15, 2020 - Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p250.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ... Restricted content. Login required.

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

Topical Interventions Improve Outcomes After Cryosurgery for Actinic Keratosis - POEMs ... Restricted content. Login required.

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

OnabotulinumtoxinA for Prevention of Migraine in Adults - Cochrane for Clinicians - ... Restricted content. Login required.

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 - ... Restricted content. Login required.

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

Antibiotics for Exacerbations of Chronic Obstructive Pulmonary Disease - Medicine by ... Restricted content. Login required.

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

Short-Term Systemic Corticosteroids: Appropriate Use in Primary Care - American Family ... Restricted content. Login required.

Jan 15, 2020 - Short-term systemic corticosteroids, also known as steroids, are frequently prescribed for adults in the outpatient setting by primary care physicians. There is a lack of supporting evidence for most diagnoses for which steroids are prescribed, and there is evidence against steroid use ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p89.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ... Restricted content. Login required.

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

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ... Restricted content. Login required.

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

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician Restricted content. Login required.

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

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ... Restricted content. Login required.

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ... Restricted content. Login required.

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

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