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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

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

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

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

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

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

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

Predicting the Risk of Postoperative Pulmonary Complications - Point-of-Care Guides - ... Restricted content. Login required.

Oct 15, 2019 - What is the best approach to evaluate postoperative pulmonary risk?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/1015/p499.html

Dual Antiplatelet Therapy for Patients with Cardiovascular Disease - FPIN's Clinical ... Restricted content. Login required.

Oct 15, 2019 - Patients with established cardiovascular disease or risk factors (e.g., ischemic cerebrovascular disease, peripheral arterial disease, high risk of atherothrombotic disease) should receive dual antiplatelet therapy with aspirin plus clopidogrel, which confers additional benefit over ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1015/p463.html

Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician Restricted content. Login required.

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Opioid Use Disorder: Medical Treatment Options - American Family Physician Restricted content. Login required.

Oct 1, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p416.html

Antibiotics for Acute Rhinosinusitis in Adults - Medicine by the Numbers - American ... Restricted content. Login required.

Oct 1, 2019 - Because of the relatively high rate of reported adverse effects and the high likelihood of resolution of symptoms with supportive care and symptomatic management, the authors recommend selective antibiotic use in patients with acute sinusitis. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1001/od1.html

Common Misperceptions About Buprenorphine Prescribing for Opioid Use Disorder - ...

Oct 1, 2019 - The antidote to the opioid use disorder epidemic is the thoughtful use of evidence-based medicine and an honest understanding of what we know—and what we don't know—about caring for people with substance use disorders.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1001/p396.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ... Restricted content. Login required.

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation -... Restricted content. Login required.

Oct 1, 2019 - Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p405.html

Pneumatic Compression in Addition to Pharmacologic Thromboprophylaxis Does Not Further ... Restricted content. Login required.

Oct 1, 2019 - This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440a.html

Otitis Media: Rapid Evidence Review - American Family Physician Restricted content. Login required.

Sep 15, 2019 - Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p350.html

Urinary Incontinence in Women: Evaluation and Management - American Family Physician Restricted content. Login required.

Sep 15, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p339.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ... Restricted content. Login required.

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ... Restricted content. Login required.

Sep 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/2019/0915/p369.html

Normal Vital Signs and Pulmonary Examination Results Rule Out CAP in Adults with Acute ... Restricted content. Login required.

Sep 15, 2019 - Community-dwelling adults who present to a primary care office with acute respiratory infection symptoms but normal vital signs and normal findings on a pulmonary examination have only a 0.4% likelihood of community-acquired pneumonia (CAP).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p375.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ... Restricted content. Login required.

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ... Restricted content. Login required.

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Venous Ulcers: Diagnosis and Treatment - American Family Physician Restricted content. Login required.

Sep 1, 2019 - Venous ulcers are the most common type of chronic lower extremity ulcers, affecting 1% to 3% of the U.S. population. Venous hypertension as a result of venous reflux (incompetence) or obstruction is thought to be the primary underlying mechanism for venous ulcer formation. Risk factors ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0901/p298.html

Gabapentin for Treatment of Radicular Low Back Pain - FPIN's Clinical Inquiries - ... Restricted content. Login required.

Sep 1, 2019 - Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0901/p309.html

Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults - Cochrane ... Restricted content. Login required.

Sep 1, 2019 - Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p278.html

Prolaris Test for Prostate Cancer Risk Assessment - Diagnostic Tests: What Physicians ... Restricted content. Login required.

Sep 1, 2019 - The Prolaris test improves the accuracy of prognosis for patients with prostate cancer, especially those with low- or intermediate-grade disease who may be deciding between interventional and noninterventional treatment approaches.

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

https://www.aafp.org/afp/2019/0901/p311.html

Discussing Life Expectancy with Older Patients: Prediction and Patient Preferences - ...

Sep 1, 2019 - Evidence shows that physicians need more training in discussing life expectancy, and there are resources available to support this process for certain conditions.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0901/p265.html

5% Fluorouracil Is the Preferred Treatment for Actinic Keratoses - POEMs - American ... Restricted content. Login required.

Aug 15, 2019 - The use of topical 5% fluorouracil is most likely to result in successful elimination of actinic keratoses in a field on the head or face.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249a.html

Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia - Point-of-Care ... Restricted content. Login required.

Aug 15, 2019 - In patients with acute cough, is it possible to identify a subset with a very low likelihood of community-acquired pneumonia?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0815/p246.html

Omega-3 Fatty Acids and Cardiovascular Disease Prevention - Medicine by the Numbers - ... Restricted content. Login required.

Aug 15, 2019 - High-quality evidence suggests that long-chain omega-3 polyunsaturated fatty acids do not prevent mortality (all-cause or cardiovascular) or cardiovascular disease events when used as primary or secondary prevention. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0815/p209.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin... Restricted content. Login required.

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Hirsutism in Women - American Family Physician Restricted content. Login required.

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - Discussing with patients the pros and cons of medications for borderline glucose values could distract us from more important topics such as lifestyle changes, smoking cessation, and blood pressure control. Time is the most valuable resource in a physician-patient partnership, and there...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p136.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - High-quality evidence supports metformin use for diabetes prevention among younger or more obese individuals or for women with a history of gestational diabetes. Clinicians should consider prescribing metformin, in addition to intensive lifestyle interventions, in accordance with ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p134.html

Chronic Neck Pain: Nonpharmacologic Treatment - Implementing AHRQ Effective Health Care... Restricted content. Login required.

Aug 1, 2019 - Which noninvasive nonpharmacologic treatments for chronic neck pain improve function or pain for at least one month?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0801/p180.html

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