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COVID-19 - American Family Physician

Oct 15, 2021 - Advertisement AFP BY TOPIC COVID-19 Editors' Choice of Best Available Content COVID-19 is an infectious disease caused by an enveloped single-stranded RNA novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that was declared a pandemic by the World...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=117

Alcohol Withdrawal Syndrome: Outpatient Management - American Family Physician Restricted content. Login required.

Aug 1, 2021 - Approximately one-half of patients with alcohol use disorder who abruptly stop or reduce their alcohol use will develop signs or symptoms of alcohol withdrawal syndrome. The syndrome is due to overactivity of the central and autonomic nervous systems, leading to tremors, insomnia, ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0900/p253.html

Interventions to Improve Use of CPAP Machines in Adults with Obstructive Sleep Apnea - ... Restricted content. Login required.

Aug 1, 2021 - Behavioral interventions increase CPAP use compared with usual care. These interventions also increase CPAP adherence, measured by participants using their machine four or more hours per night, from 371 to 501 per 1,000 patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/1000/p356.html

Neonatal Resuscitation: Updated Guidelines from the American Heart Association - ... Restricted content. Login required.

Aug 1, 2021 - The American Heart Association released minor updates to neonatal resuscitation recommendations with only minor changes to the previous algorithm.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/1000/p425.html

Melatonin to Treat Insomnia in Older Adults - FPIN's Clinical Inquiries - American ... Restricted content. Login required.

Aug 1, 2021 - Melatonin preparations reduce sleep-onset latency, increase total sleep time, and slightly improve sleep efficiency. Prolonged-release melatonin reduces sleep-onset latency in older adults and has rates of adverse effects similar to those of placebo.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2021/0900/p297.html

Schizophrenia: Use of Antipsychotic Drugs for Maintenance Therapy - Cochrane for ... Restricted content. Login required.

Aug 1, 2021 - Compared with placebo, using antipsychotic drugs for maintenance therapy in patients with schizophrenia is associated with relapse prevention at seven to 12 months.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/1000/p355.html

Does Light Therapy Decrease Depression in Older Adults? - FPIN's Clinical Inquiries - ... Restricted content. Login required.

Aug 1, 2021 - Light therapy appears to be mildly effective in treating depression in older adults, but ideal wavelength, intensity, and length of treatment are unknown.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2021/1000/p417.html

Comparison of Treatment Regimens for Helicobacter pylori Infection - Medicine by the ... Restricted content. Login required.

Aug 1, 2021 - A network meta-analysis found that vonoprazan-based triple therapy and reverse hybrid therapy demonstrated the highest overall cure rates and SUCRA values; however, among Western countries, levofloxacin-based triple therapy had the highest cure rate and SUCRA value. Standard triple ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2021/0900/od1.html

Pelvic Floor Muscle Training to Prevent and Treat Urinary and Fecal Incontinence in ... Restricted content. Login required.

Aug 1, 2021 - Structured PFMT beginning early in pregnancy prevents the onset of urge incontinence later in pregnancy and in the postpartum period compared with no intervention. There is no evidence that PFMT improves urinary incontinence later in pregnancy or in the postpartum period in pregnant ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0900/p234.html

Remdesivir (Veklury) for the Treatment of COVID-19 in Hospitalized Patients - STEPS - ... Restricted content. Login required.

Aug 1, 2021 - Although remdesivir has been shown to be safe and well tolerated, there is a lack of consistency in clinical trial results and guideline recommendations.

American Family Physician : STEPS

https://www.aafp.org/afp/2021/0900/p311.html

For Patients with Type 2 Diabetes Mellitus Who Are Taking a GLP-1 Receptor Agonist, an ... Restricted content. Login required.

Aug 1, 2021 - This propensity score–matched analysis (not funded by industry) concluded that an SGLT2 inhibitor is preferred over a sulfonylurea for patients with type 2 diabetes who are already taking a GLP-1 receptor agonist, with favorable effects on the likelihood of hospitalization for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2021/1000/p424.html

Neonatal Abstinence Syndrome: A Call for Mother-Infant Dyad Treatment Approach - ...

Aug 1, 2021 - Neonatal abstinence syndrome (NAS) is a constellation of symptoms observed in newborns exposed to opioids during pregnancy. The incidence of NAS has steadily increased during the past decade as more infants have been born to mothers with opioid use disorder (OUD). Pregnancy and the ...

American Family Physician : Editorials

https://www.aafp.org/afp/2021/0900/p222.html

High-Dose Amoxicillin/Clavulanate No Better than Standard Dose for Acute Sinusitis in ... Restricted content. Login required.

Aug 1, 2021 - This study found no significant difference between the standard-dose and high-dose regimens of amoxicillin/clavulanate for treating acute sinusitis in adults. It is important to note that both doses are minimally superior to placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/1000/p423.html

Ultrasound Guidance for the Placement of Peripheral Intravenous Catheters - Medicine by... Restricted content. Login required.

Aug 1, 2021 - Learn more about ultrasound guidance for the placement of peripheral intravenous catheters.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2021/1000/od2.html

Epidural Corticosteroid Injections Provide Minimal, If Any, Benefit in Low Back Pain ... Restricted content. Login required.

Aug 1, 2021 - Epidural corticosteroid injections provide a small and probably clinically insignificant reduction in leg and back pain in the immediate term (less than two weeks), and a small to moderate reduction in disability in the short and intermediate terms.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0900/od2.html

Take-and-Hold Prescriptions for Children with Respiratory Tract Infections Decrease ... Restricted content. Login required.

Aug 1, 2021 - A strategy of providing education about the natural history of respiratory symptoms in children combined with giving a take-and-hold prescription (to be filled only if symptoms persisted) resulted in one in four of those children eventually receiving an antibiotic.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0900/od5.html

Breast Cancer Treatment - American Family Physician Restricted content. Login required.

Jul 1, 2021 - Breast cancer is the leading cause of death from cancer in women worldwide, and the second most common cause of death from cancer in women in the United States. Risk assessment tools can identify the risk of breast cancer, and patients at high risk may be candidates for risk-reducing ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0800/p171.html

Pharmacologic Therapy for Acute Pain - American Family Physician Restricted content. Login required.

Jul 1, 2021 - Pharmacologic management of acute pain should be tailored for each patient, including a review of treatment expectations and a plan for the time course of prescriptions. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line treatment options for most patients ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0700/p63.html

Inhaled Budesonide Reduces the Risk of Emergency Department Evaluation or ... Restricted content. Login required.

Jul 1, 2021 - Inhaled budesonide, 800 mcg twice daily, significantly reduces the likelihood that patients with early COVID-19 will require emergency department evaluation or hospitalization (number needed to treat = 7 to 8). This is a widely available, relatively inexpensive drug with the potential ...

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0800/p207.html

GeneSight Psychotropic Genetic Testing for Psychiatric Medication Selection - ... Restricted content. Login required.

Jul 1, 2021 - The GeneSight test may assist in drug selection and dosing for individuals having difficulty finding an effective option or who have had intolerable adverse effects after trials of several drugs. However, because only a small population of patients are expected to have genetic ...

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

https://www.aafp.org/afp/2021/0700/p89.html

Clascoterone (Winlevi) for the Treatment of Acne - STEPS - American Family Physician Restricted content. Login required.

Jul 1, 2021 - More comparative data are needed to justify the use of clascoterone over less expensive, currently available therapies for moderate to severe acne. However, systemic absorption of clascoterone is low, and it may serve as a safe alternative for patients 12 years and older who saw ...

American Family Physician : STEPS

https://www.aafp.org/afp/2021/0700/p93.html

Treatment of Chronic Obstructive Pulmonary Disease: Guidelines from the VA/DoD - ... Restricted content. Login required.

Jul 1, 2021 - The U.S. Department of Veterans Affairs and U.S. Department of Defense published guidelines for the primary care management of COPD.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/0700/p98.html

SGLT2 Inhibitors or GLP-1 Receptor Agonists Reduce Cardiovascular Outcomes in Patients ... Restricted content. Login required.

Jul 1, 2021 - SGLT2 inhibitors, the diabetes medications ending in -flozin, and GLP-1 receptor agonists, the -tide medications, decrease cardiovascular and renal outcomes to a greater extent than placebo or other treatments. They should be considered in addition to metformin and other ...

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0800/p206.html

Hydrochlorothiazide vs. Chlorthalidone for the Treatment of Hypertension - FPIN's Help ... Restricted content. Login required.

Jul 1, 2021 - Chlorthalidone reduces systolic blood pressure by 10 mm Hg more than hydrochlorothiazide at equal dosages in patients using monotherapy. Low-dose chlorthalidone and controlled-release hydrochlorothiazide reduce 24-hour ambulatory systolic blood pressure and diastolic blood pressure, ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2021/0800/p203.html

Treatment of Chronic Obstructive Pulmonary Disease: Guidelines from the American ... Restricted content. Login required.

Jul 1, 2021 - The American Thoracic Society published guidelines for pharmacologic management of COPD and long-term oxygen therapy for COPD and interstitial lung disease based on systematic reviews.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/0700/p102.html

Treatment of Chronic Obstructive Pulmonary Disease Exacerbations: Guidelines from the ... Restricted content. Login required.

Jul 1, 2021 - Run by May 2022; run with ATS and VA/DoD PGs; conflicts:

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/0700/p100.html

Can Pioglitazone Prevent or Delay Type 2 Diabetes in Patients with Prediabetes? - ... Restricted content. Login required.

Jul 1, 2021 - Pioglitazone prevents or delays the incidence of type 2 diabetes in individuals with prediabetes when compared with placebo (absolute risk reduction [ARR] = 11.3%; 95% CI, 0.9% to 15.6%; number needed to treat [NNT] = 9) or no intervention (ARR = 13.3%; 95% CI, 11.6% to 14.9%; NNT = 7)....

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0800/p139.html

Pharmacologic Management of Agitation in Patients with Dementia - FPIN's Clinical ... Restricted content. Login required.

Jul 1, 2021 - Selective serotonin reuptake inhibitors and risperidone are moderately effective at decreasing agitation in all types of dementia. Olanzapine and risperidone reduce dementia-related agitation much longer than placebo. Dextromethorphan/quinidine may be effective at reducing agitation in ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2021/0700/p91.html

Once-Weekly Semaglutide Is an Effective Adjunct for Weight Loss in Adults without ... Restricted content. Login required.

Jul 1, 2021 - Once-weekly subcutaneous semaglutide used as an adjunct to intensive behavioral therapy significantly improves the likelihood that adults without diabetes who are overweight or obese will lose at least 5% of their baseline body weight compared with placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0700/p96.html

Acromioclavicular Joint Dislocation: Surgical vs. Conservative Interventions - Cochrane... Restricted content. Login required.

Jul 1, 2021 - Surgical treatment for AC joint dislocation of the shoulder does not appear to be superior to conservative management in adults. Surgical therapy increases the risk of hardware complications, infection, and continued discomfort.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0700/p28.html

Levonorgestrel-Releasing Intrauterine System for Reducing Heavy Menstrual Bleeding - ... Restricted content. Login required.

Jul 1, 2021 - The levonorgestrel-releasing intrauterine system is more effective than other medical therapies at reducing menstrual bleeding volume, with similar rates of adverse effects. The effectiveness of the levonorgestrel-releasing intrauterine system compared with endometrial ablation and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0800/p138.html

Pharmacogenetic Gene-Drug Associations: FDA Perspective on What Physicians Need to Know...

Jul 1, 2021 - To share its perspective on the state of the science, the FDA has published a table of pharmacogenetic associations related to genetic variants that can affect drug concentrations, therapeutic responses, or adverse events.

American Family Physician : Editorials

https://www.aafp.org/afp/2021/0700/p16.html

Tighter Blood Pressure Control Does Not Increase the Likelihood of Orthostatic ... Restricted content. Login required.

Jul 1, 2021 - Orthostatic hypotension, a drop of 20 mm Hg systolic or 10 mm Hg diastolic after moving from sitting to standing, was not associated with more intensive treatment of blood pressure and may be less likely to occur with intensive treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0800/p208.html

Levonorgestrel-Releasing Intrauterine System for Regression of Endometrial Hyperplasia ... Restricted content. Login required.

Jul 1, 2021 - A Cochrane review compared the levonorgestrel-releasing intrauterine system with progesterone for the treatment of endometrial hyperplasia.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2021/0700/p26.html

Low-Carb Diets May Produce Short-Term Diabetes Remission - POEMs - American Family ... Restricted content. Login required.

Jul 1, 2021 - Patients with type 2 diabetes can try cutting out bread and pasta, leaving the skin on chicken, or eating nuts and avocados to lower their blood glucose levels. Six months of a low-carbohydrate diet (less than 26% of calories from carbohydrates) was more likely than other diets or usual...

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0700/p95.html

Cryoablation Preferred as Initial Therapy for Paroxysmal Atrial Fibrillation - POEMs - ... Restricted content. Login required.

Jul 1, 2021 - Initial cryoablation for patients with paroxysmal AF is superior to initial antiarrhythmic drug therapy. Another study in the same issue of New England Journal of Medicine compared cryoablation with medical therapy and had similar findings.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0700/p97.html

Single-Dose Opioid Analgesics Offer No Benefit over Nonopioid Analgesia for ... Restricted content. Login required.

Jul 1, 2021 - A single dose of opioid analgesics provides similar acute pain relief compared with a single dose of a combination of acetaminophen and ibuprofen in patients with acute musculoskeletal pain in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0700/p95a.html

Obstetric Lacerations: Prevention and Repair - American Family Physician Restricted content. Login required.

Jun 15, 2021 - Obstetric lacerations are a common complication of vaginal delivery. Lacerations can lead to chronic pain and urinary and fecal incontinence. Perineal lacerations are defined by the depth of musculature involved, with fourth-degree lacerations disrupting the anal sphincter and the ...

American Family Physician : Article

https://www.aafp.org/afp/2021/0615/p745.html

Hypertension: New Guidelines from the International Society of Hypertension - Practice ... Restricted content. Login required.

Jun 15, 2021 - The International Society of Hypertension has published summary guidelines based on major international guidelines published between 2017 and 2020 on the control of hypertension. These summary guidelines include essential recommendations and suggestions for optimal care.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/0615/p763.html

Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons: ...

Jun 15, 2021 - The USPSTF recommends that clinicians ask all adults about tobacco use, advise them to stop using tobacco, and provide behavioral interventions and U.S. Food and Drug Administration-approved pharmacotherapy for cessation to nonpregnant adults who use tobacco.

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

https://www.aafp.org/afp/2021/0615/od1.html

Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Persons - ... Restricted content. Login required.

Jun 15, 2021 - A 27-year-old patient, R.C., with a history of generalized anxiety disorder presents for a wellness examination. R.C. previously smoked a pack of cigarettes per day but has cut down to half a pack per day and started using electronic cigarettes (e-cigarettes) and is interested in ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2021/0615/p753.html

Poor Physician-Patient Communication and Medical Error - Lown Right Care: Reducing ... Restricted content. Login required.

Jun 15, 2021 - 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/2021/0615/p757.html

Lipid Lowering Is Beneficial for Secondary Prevention but Not Primary Prevention in ... Restricted content. Login required.

Jun 1, 2021 - Does lipid lowering reduce major vascular events in patients 75 years and older?

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0601/p695a.html

Preoperative A1C Threshold in Patients with Diabetes - FPIN's Clinical Inquiries - ... Restricted content. Login required.

Jun 1, 2021 - In patients with diabetes mellitus who are preparing for total joint replacement, what is the preoperative A1C goal to reduce postoperative periprosthetic joint infections?

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2021/0601/p693.html

Exercise Is the Only Intervention to Provide Long-Term Improvement in Patients with ... Restricted content. Login required.

Jun 1, 2021 - What interventions are effective in managing patients with chronic low back pain?

American Family Physician : POEMs

https://www.aafp.org/afp/2021/0601/p696.html

Pessaries for Managing Pelvic Organ Prolapse in Women - Cochrane for Clinicians - ... Restricted content. Login required.

Jun 1, 2021 - Pessaries combined with pelvic floor muscle training (PFMT) probably improve pelvic organ prolapse symptoms in women and prolapse-specific quality of life compared with PFMT alone.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0601/p660.html

Oxytocin as First-line Uterotonic Therapy for Postpartum Hemorrhage - Medicine by the ... Restricted content. Login required.

Jun 1, 2021 - Oxytocin decreases the chances of a blood transfusion and has fewer adverse effects compared with misoprostol.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2021/0601/p656.html

Psychological Therapies for Women Who Experience Intimate Partner Violence - Cochrane ... Restricted content. Login required.

Jun 1, 2021 - Are psychological therapies safe and effective for women who experience intimate partner violence?

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2021/0601/p661.html

Post-ICU Care in the Outpatient Setting - American Family Physician Restricted content. Login required.

May 15, 2021 - More than 5 million patients in the United States are admitted to intensive care units (ICUs) annually, and an increasing percentage of patients treated in the ICU survive to hospital discharge. Because these patients require follow-up in the outpatient setting, family physicians should...

American Family Physician : Article

https://www.aafp.org/afp/2021/0515/p590.html

Key Potentially Inappropriate Drugs in Pediatrics: The KIDs List - Practice Guidelines ... Restricted content. Login required.

May 15, 2021 - The Pediatric Pharmacy Association produced a list of key potentially inappropriate drugs in pediatrics, or the KIDs List, to guide physicians who treat children.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2021/0515/p633.html

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