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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

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

Flexible Sigmoidoscopy or Fecal Occult Blood Testing for Colorectal Cancer Screening in...

Aug 1, 2019 - This meta-analysis provides high-quality evidence that flexible sigmoidoscopy and fecal occult blood testing both reduce the risk of death from colorectal cancer. The study did not provide a clear answer regarding a superior screening modality, so the decision to choose one test over ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0801/od1.html

Vaccines for Preventing Influenza in Healthy Children, Healthy Adults, and Older Adults...

Aug 1, 2019 - Influenza vaccination reduces rates of laboratory-confirmed influenza and symptomatic influenza-like illness in healthy children, healthy adults, and older adults. There is no consistent evidence that influenza vaccination reduces school absenteeism in children, parental absenteeism ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0801/p143.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Interpregnancy Care: Guidelines from ACOG and SMFM - Practice Guidelines - American ...

Jul 15, 2019 - The American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have published guidelines focusing on interpregnancy care to improve outcomes of future pregnancies and the overall health of women, regardless of their future pregnancy plans.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0715/p121.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Vitamin D is Equal to Placebo for Preventing Cognitive Decline in African-American ...

Jul 15, 2019 - Is vitamin D more effective than placebo in preventing cognitive decline in African American women older than 65 years who have low serum vitamin D levels at baseline?

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.html

Medication Management for Chronic Heart Failure with Preserved Ejection Fraction - ...

Jul 1, 2019 - Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p17.html

Noninvasive Diagnostic Tests for Helicobacter pylori Infection - Cochrane for ...

Jul 1, 2019 - When compared with serology or stool antigen tests, the urea breath test has the highest diagnostic accuracy to identify H. pylori infection in patients without a history of gastrectomy or recent use of antibiotics or proton pump inhibitors.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p16.html

mSEPT9 (Epi proColon) Blood Test for Colorectal Cancer Screening - Diagnostic Tests: ...

Jul 1, 2019 - Epi proColon is a blood test used for the detection of the methylated septin 9 (mSEPT9) gene. It is approved by the U.S. Food and Drug Administration for colorectal cancer screening in people at average risk who have declined first-line screening tests.

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

https://www.aafp.org/afp/2019/0701/p10.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Lung Cancer Screening: Pros and Cons - Lown Right Care: Reducing Overuse and Underuse -...

Jun 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/2019/0615/p740.html

H. pylori Screening Before Initiation of Long-term NSAIDs - FPIN's Clinical Inquiries -...

Jun 15, 2019 - Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0615/p783.html

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

Varicose Veins: Diagnosis and Treatment - American Family Physician

Jun 1, 2019 - Varicose veins are twisted, dilated veins most commonly located on the lower extremities. The exact pathophysiology is debated, but it involves a genetic predisposition, incompetent valves, weakened vascular walls, and increased intravenous pressure. Risk factors include family history ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p682.html

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.html

Prostate Disorders - American Family Physician

Jun 1, 2019 - This collection features content on prostates disorders and related issues, including benign prostatic hyperplasia, hematospermia, and prostatitis. This collection features content on prostates disorders and related issues, including benign prostatic hyperplasia, hematospermia, and ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=97

Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease - Editorials - ...

Jun 1, 2019 - Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0601/p670.html

Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.html

Cancer Screening: ACS Releases Annual Summary of Recommendations - Practice Guidelines ...

Jun 1, 2019 - The American Cancer Society (ACS) provides a summary of recommendations for cancer screening each year, including any updates and recent data, and advice for when recommendations cannot be made.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0601/p719.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.html

An Unhappily Married Patient - Curbside Consultation - American Family Physician

Jun 1, 2019 - Overall, marriage enhances health. Men gain greater health benefits from marriage than their wives. Conversely, wives are more negatively affected by a bad marriage than their husbands. In general, the health benefit of marriage is maximized in a good marriage but negated in a bad ...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0601/p708.html

Antibiotic Prophylaxis in Patients with COPD - Medicine by the Numbers - American ...

Jun 1, 2019 - This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0601/od1.html

Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal ...

Jun 1, 2019 - After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: ...

May 15, 2019 - The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services.

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

https://www.aafp.org/afp/2019/0515/od1.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults - ...

May 15, 2019 - A.F., a 32-year-old woman, presents for a health maintenance visit. It has been more than a year since she was last seen. She has no significant medical history and has never used tobacco, alcohol, or any other substances.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0515/p649.html

Glycopyrrolate (Lonhala Magnair) for Treatment of Chronic Obstructive Pulmonary Disease...

May 15, 2019 - Glycopyrrolate is a safe alternative to long-acting muscarinic antagonists delivered by metered-dose inhaler for patients with moderate to severe COPD.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0515/p643.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Cholesterol Management: ACC/AHA Updates Guideline - Practice Guidelines - American ...

May 1, 2019 - The American College of Cardiology/American Heart Association (ACC/AHA) task force on clinical practice guidelines has updated its 2013 cholesterol guideline.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0501/p589.html

Psychological and Pharmacologic Treatments for Adults with PTSD - Implementing AHRQ ...

May 1, 2019 - What are the benefits and harms of psychotherapies and pharmacologic agents for the treatment of adults with posttraumatic stress disorder (PTSD)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0501/p577.html

Applying a Clinical Decision Rule for CAD in Primary Care to Select a Diagnostic Test ...

May 1, 2019 - Using the INTERCHEST chest pain decision rule to decide next steps when a patient presents to a primary care physician with chest pain.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0501/p584.html

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.html

Kidney Stones: Treatment and Prevention - American Family Physician

Apr 15, 2019 - Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. During an episode of renal colic, the first priority is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p490.html

Common Breast Problems - American Family Physician

Apr 15, 2019 - Palpable breast masses, mastalgia, and nipple discharge are commonly encountered symptoms in outpatient practice, causing significant patient anxiety and precipitating medical consultation. The initial workup includes a detailed clinical history and physical examination. Women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p505.html

Breast Disorders - American Family Physician

Apr 15, 2019 - This collection features content on breast disorders and related issues, including breast cyst aspiration, breast masses, breast pain, galactorrhea, gynecomastia, and mastitis. This collection features content on breast disorders and related issues, including breast cyst aspiration, ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=96

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality...

Apr 15, 2019 - The USPSTF recommends that clinicians offer or refer adults with a body mass index (BMI) of 30 or higher (calculated as weight in kilograms divided by height in meters squared) to intensive, multicomponent behavioral interventions.

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

https://www.aafp.org/afp/2019/0415/od1.html

Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation - FPIN's ...

Apr 15, 2019 - A limited number of trials that examined the risk of temporary interruption of anticoagulation before a variety of procedures did not find a reduction in the risk of stroke, but they did show an increased risk of bleeding events and venous thromboembolism (VTE) in patients who were ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0415/p519.html

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality...

Apr 15, 2019 - A.C., a 32-year-old woman, presents for her annual wellness visit. She recently had blood work completed that showed normal glucose and lipid levels. Her blood pressure is 124/76 mm Hg, weight is 221.8 lb (100.6 kg), height is 5 feet 6 inches (172 cm), and body mass index (BMI) is 34 kg...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0415/p515.html

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