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Screening for Abdominal Aortic Aneurysm - Putting Prevention into Practice - American ... Restricted content. Login required.

May 15, 2020 - A 65-year-old man with no significant medical history presents to your clinic for a wellness visit. His social history includes smoking periodically in his 20s, and his family history includes a father who died from an abdominal aortic aneurysm (AAA) in his 60s. The patient wants to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2020/0515/p621.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ... Restricted content. Login required.

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.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

IBSchek for Irritable Bowel Syndrome - Diagnostic Tests: What Physicians Need to Know -... Restricted content. Login required.

May 1, 2020 - IBSchek is a blood test marketed to assist in the diagnosis of irritable bowel syndrome with predominant diarrhea (IBS-D) or with mixed bowel habits (IBS-M) in adults.

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

https://www.aafp.org/afp/2020/0501/p564.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

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

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

Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis - POEMs - American Family ... Restricted content. Login required.

Jun 1, 2020 - Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p696.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

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

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

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

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

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

Screening for Asymptomatic Bacteriuria in Adults - Putting Prevention into Practice - ... Restricted content. Login required.

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

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

Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer - ... Restricted content. Login required.

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

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

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

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

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

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ... Restricted content. Login required.

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

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

Results of Fecal Immunochemical Tests for Colorectal Cancer Screening Not Affected by ... Restricted content. Login required.

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

Vitamin and Mineral Supplementation for Maintaining Cognitive Functioning in ... Restricted content. Login required.

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

Medication Use to Reduce Risk of Breast Cancer - Putting Prevention into Practice - ... Restricted content. Login required.

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

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

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

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

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

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

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

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

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ... Restricted content. Login required.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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