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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 - ... Restricted content. Login required.

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 ... Restricted content. Login required.

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

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

Muscle Weakness in Adults: Evaluation and Differential Diagnosis - American Family ... Restricted content. Login required.

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 Restricted content. Login required.

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 - ... 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

Acute Heart Failure in a 39-Year-Old Man - Photo Quiz - American Family Physician Restricted content. Login required.

Jan 15, 2020 - << 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 15;101(2):117-118. A...

American Family Physician : Photo Quiz

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

Benign Anorectal Conditions: Evaluation and Management - American Family Physician Restricted content. Login required.

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 ... 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

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

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 - ... Restricted content. Login required.

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 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

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

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

Addition of Steroids Improves Outcomes in Children and Adults with CAP - POEMs - ... Restricted content. Login required.

Jan 1, 2020 - Adding corticosteroid treatment to the management of CAP is beneficial for children and adults. Treatment decreases clinical failures, time in the hospital, and the risk of death in adults with severe pneumonia.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p55.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

Breast Implant—Associated Anaplastic Large Cell Lymphoma - Editorials - American Family...

Jan 1, 2020 - In October 2019, the FDA released draft guidance offering numerous recommendations to help ensure women have access to breast implant benefit and risk information, including that manufacturers incorporate a boxed warning and patient decision checklist in the device’s labeling, and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2020/0101/p8.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

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy - Medicine by the ... Restricted content. Login required.

Jan 1, 2020 - Hepatic encephalopathy is a brain dysfunction that can be mild with minimal confusion, or overt and severe with coma. Learn more about branched-chain amino acids for the treatment of hepatic encephalopathy.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0101/od1.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ... Restricted content. Login required.

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

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

Dec 15, 2019 - Cirrhosis is the 12th leading cause of death in the United States. Newer research has established that liver fibrosis is a dynamic process and that early cirrhosis may be reversible. Only one in three people with cirrhosis knows they have it. Most patients with cirrhosis remain ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1215/p759.html

The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk ...

Dec 15, 2019 - Although coronary artery calcium testing may slightly improve future risk prediction, this theoretical benefit is outweighed by its potential harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1215/p734.html

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

Dec 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath 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/2019/1215/p742.html

Diagnosing DVT in Nonpregnant Adults in the Primary Care Setting - Point-of-Care Guides... Restricted content. Login required.

Dec 15, 2019 - What is the best approach to the evaluation of nonpregnant adults with suspected first lower extremity deep venous thrombosis (DVT) in the outpatient primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/1215/p778.html

Screening for Pancreatic Cancer: Recommendation Statement - U.S. Preventive Services ...

Dec 15, 2019 - The USPSTF recommends against screening for pancreatic cancer in asymptomatic adults.

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

https://www.aafp.org/afp/2019/1215/od1.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ... Restricted content. Login required.

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Screening for Pancreatic Cancer - Putting Prevention into Practice - American Family ... Restricted content. Login required.

Dec 15, 2019 - A 71-year-old woman comes to your office for a regularly scheduled visit. She has type 2 diabetes mellitus and a 50-pack-year smoking history, and had non-ulcer dyspepsia two years ago. Her body mass index is 32 kg per m2, and her blood pressure is normal.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/1215/p771.html

Nonspecific Low Back Pain and Return To Work - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient’s symptoms, the family physician is charged with ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p697.html

Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Alpha Blockers for Nephrolithiasis - FPIN's Clinical Inquiries - American Family Physician Restricted content. Login required.

Dec 1, 2019 - The alpha blocker tamsulosin (Flomax) can be used to improve clearance of stones larger than 5 mm, shorten expulsion times, and reduce hospitalization.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1201/p710.html

Diagnosing VTE: Guidelines from the American Society of Hematology - Practice ... Restricted content. Login required.

Dec 1, 2019 - The American Society of Hematology has published recommendations for determining the optimal diagnostic strategy based on pretest risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1201/p716.html

General Health Checks in Adults for Reducing Disease-Related Morbidity and Mortality - ... Restricted content. Login required.

Dec 1, 2019 - General health check visits have no benefit on cardiovascular morbidity or on total, cardiovascular, or cancer-related mortality. There is also no evidence that they cause patient harm.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1201/p676.html

Pelvic Floor Muscle Training for Treatment of Urinary Incontinence in Women - Medicine ... Restricted content. Login required.

Dec 1, 2019 - Urinary incontinence is common in adult women, leading to health complications such as rash and urinary tract infections. This review discusses pelvic floor muscle training for the treatment of urinary incontinence in women.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1201/od1.html

Preexposure Prophylaxis for the Prevention of HIV Infection: Recommendation Statement -...

Nov 15, 2019 - The USPSTF recommends that clinicians offer preexposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of HIV acquisition.

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

https://www.aafp.org/afp/2019/1115/od1.html

Screening for HIV Infection: Recommendation Statement - U.S. Preventive Services Task ...

Nov 15, 2019 - The USPSTF recommends that clinicians screen for HIV infection in adolescents and adults aged 15 to 65 years. Younger adolescents and older adults who are at increased risk of infection should also be screened.

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

https://www.aafp.org/afp/2019/1115/od2.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ... Restricted content. Login required.

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Screening for HIV Infection and Preexposure Prophylaxis for the Prevention of HIV ... Restricted content. Login required.

Nov 15, 2019 - J.S., a 29-year-old transgender woman, presents for her first maintenance visit with a new family physician. It has been three years since her previous visit with a primary care physician. She has no chronic illnesses, stopped using tobacco products four years ago, and reports that she ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/1115/p637.html

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients... Restricted content. Login required.

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ... Restricted content. Login required.

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator ... Restricted content. Login required.

Nov 15, 2019 - The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p647.html

Care of the Military Veteran: Selected Health Issues - American Family Physician Restricted content. Login required.

Nov 1, 2019 - According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p544.html

Pilonidal Disease Management: Guidelines from the ASCRS - Practice Guidelines - ... Restricted content. Login required.

Nov 1, 2019 - The American Society of Colon and Rectal Surgeons (ASCRS) has released a clinical practice guideline to provide physicians with diagnosis and treatment options of pilonidal disease.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1101/p582.html

Aspirin for Colon Cancer Risk Prevention - FPIN's Clinical Inquiries - American Family ... Restricted content. Login required.

Nov 1, 2019 - Daily low-dose aspirin can be offered to patients older than 50 years for colon cancer prevention.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1101/od2.html

Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - Diagnostic Tests: What ... Restricted content. Login required.

Nov 1, 2019 - The allopurinol hypersensitivity assay, or HLA-B*58:01 test, is a blood test to detect the presence of a human leukocyte antigen B (HLA-B) genetic variant that increases the risk of life-threatening, severe cutaneous adverse reactions in patients taking allopurinol.

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

https://www.aafp.org/afp/2019/1101/p530.html

Renin-Angiotensin System Inhibitors vs. Other Antihypertensive Drug Classes for ... Restricted content. Login required.

Nov 1, 2019 - RAS inhibitors, which include angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and renin inhibitors, should not be used as first-line agents.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1101/p540.html

Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary ... Restricted content. Login required.

Nov 1, 2019 - The authors determined there is no benefit from the use of ticagrelor in patients with acute coronary syndrome and stable coronary artery disease because of the uncertainty about benefits and evidence of potential harms.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1101/od1.html

Military Health History: Resources for Use at the Point of Care - Editorials - American...

Nov 1, 2019 - Many clinicians outside of the VA or military are unaware of the importance of specific aspects of the military health history. The clinical expertise of health care professionals in the VA and military health systems can be leveraged to expand training opportunities.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1101/p523.html

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