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Practice Guidelines

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Treatment of the Common Cold - American Family Physician

Sep 1, 2019 - Acute upper respiratory tract infections are extremely common in adults and children, but only a few safe and effective treatments are available. Patients typically present with nasal congestion, rhinorrhea, sore throat, cough, general malaise, and/or low-grade fever. Informing patients...

American Family Physician : Article

https://www.aafp.org/afp/2019/0901/p281.html

Hirsutism in Women - American Family Physician

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

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

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

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Crohn's Disease: Diagnosis and Management - American Family Physician

Dec 1, 2018 - Crohn’s disease is a chronic inflammatory condition that affects the gastrointestinal tract. It can cause lesions from mouth to anus and may result in extraintestinal complications. The prevalence of Crohn’s disease is increasing in adults and children. Genetic predispositions to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p661.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

General Parenting Strategies: Practical Suggestions for Common Child Behavior Issues - ...

May 15, 2018 - Parents often seek guidance from physicians on child behavior problems. Questions may range from general parenting strategies to managing specific child behaviors. Physicians and their staff can identify problematic parent-child interactions or behaviors within the office setting and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p642.html

Testicular Cancer: Diagnosis and Treatment - American Family Physician

Feb 15, 2018 - Testicular cancer is the most common solid tumor among males 15 to 34 years of age, with an estimated 8,850 new cases and 410 deaths during 2017 in the United States. With effective treatment, the overall five-year survival rate is 97%. Risk factors for testicular cancer include ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p261.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.html

Cardiomyopathy: An Overview - American Family Physician

Nov 15, 2017 - The definition and classification of cardiomyopathy have evolved considerably in recent years. Cardiomyopathy can be separated into primary (genetic, mixed, or acquired) and secondary categories, which result in varied phenotypes including dilated, hypertrophic, and restrictive ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p640.html

Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention - American ...

Sep 1, 2017 - The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p314.html

Preventing Falls in Older Persons - American Family Physician

Aug 15, 2017 - The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p240.html

Probiotics for Gastrointestinal Conditions: A Summary of the Evidence - American Family...

Aug 1, 2017 - Probiotics contain microorganisms, most of which are bacteria similar to the beneficial bacteria that occur naturally in the human gut. Probiotics have been widely studied in a variety of gastrointestinal diseases. The most-studied species include Lactobacillus, Bifidobacterium, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0801/p170.html

Chronic Obstructive Pulmonary Disease: Diagnosis and Management - American Family ...

Apr 1, 2017 - The diagnosis of chronic obstructive pulmonary disease (COPD) should be suspected in patients with risk factors (primarily a history of smoking) who report dyspnea at rest or with exertion, chronic cough with or without sputum production, or a history of wheezing. COPD may be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p433.html

Evaluation of Jaundice in Adults - American Family Physician

Feb 1, 2017 - Jaundice in adults can be an indicator of significant underlying disease. It is caused by elevated serum bilirubin levels in the unconjugated or conjugated form. The evaluation of jaundice relies on the history and physical examination. The initial laboratory evaluation should include ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p164.html

Respiratory Syncytial Virus Bronchiolitis in Children - American Family Physician

Jan 15, 2017 - Bronchiolitis is a common lower respiratory tract infection in infants and young children, and respiratory syncytial virus (RSV) is the most common cause of this infection. RSV is transmitted through contact with respiratory droplets either directly from an infected person or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p94.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Diagnosis and Treatment of Obstructive Sleep Apnea in Adults - American Family Physician

Sep 1, 2016 - Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p355.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Current Concepts in Adult Acute Rhinosinusitis - American Family Physician

Jul 15, 2016 - Acute rhinosinusitis is one of the most common conditions that physicians treat in ambulatory care. Most cases of acute rhinosinusitis are caused by viral upper respiratory infections. A meta-analysis based on individual patient data found that common clinical signs and symptoms were ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0715/p97.html

Common Questions About Streptococcal Pharyngitis - American Family Physician

Jul 1, 2016 - Group A beta-hemolytic streptococcal (GABHS) infection causes 15% to 30% of sore throats in children and 5% to 15% in adults, and is more common in the late winter and early spring. The strongest independent predictors of GABHS pharyngitis are patient age of five to 15 years, absence of...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p24.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Diagnosis and Management of Ovarian Cancer - American Family Physician

Jun 1, 2016 - Ovarian cancer is the most lethal gynecologic cancer. Less than one-half of patients survive for more than five years after diagnosis. Ovarian cancer affects women of all ages but is most commonly diagnosed after menopause. More than 75% of affected women are diagnosed at an advanced ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p937.html

Diagnosis and Management of Adnexal Masses - American Family Physician

Apr 15, 2016 - Adnexal masses can have gynecologic or nongynecologic etiologies, ranging from normal luteal cysts to ovarian cancer to bowel abscesses. Women who report abdominal or pelvic pain, increased abdominal size or bloating, difficulty eating, or rapid satiety that occurs more than 12 times ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p676.html

Aortic Stenosis: Diagnosis and Treatment - American Family Physician

Mar 1, 2016 - Aortic stenosis affects 3% of persons older than 65 years. Although survival in asymptomatic patients is comparable to that in age- and sex-matched control patients, it decreases rapidly after symptoms appear. During the asymptomatic latent period, left ventricular hypertrophy and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p371.html

Treatment of Adult Obesity with Bariatric Surgery - American Family Physician

Jan 1, 2016 - In 2013, approximately 179,000 bariatric surgery procedures were performed in the United States, including the laparoscopic sleeve gastrectomy (42.1%), Roux-en-Y gastric bypass (34.2%), and laparoscopic adjustable gastric banding (14.0%). Choice of procedure depends on the medical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p31.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.html

Diagnosis and Treatment of Gastroesophageal Reflux in Infants and Children - American ...

Oct 15, 2015 - Gastroesophageal reflux is defined as the passage of stomach contents into the esophagus with or without accompanied regurgitation (spitting up) and vomiting. It is a normal physiologic process that occurs throughout the day in infants and less often in children and adolescents. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p705.html

Diagnosis and Management of Kawasaki Disease - American Family Physician

Mar 15, 2015 - Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p365.html

Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection - American ...

Feb 15, 2015 - The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p236.html

Lung Cancer: Diagnosis, Treatment Principles, and Screening - American Family Physician

Feb 15, 2015 - Lung cancer is classified histologically into small cell and non–small cell lung cancers. The most common symptoms of lung cancer are cough, dyspnea, hemoptysis, and systemic symptoms such as weight loss and anorexia. High-risk patients who present with symptoms should undergo chest ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p250.html

Common Questions About the Initial Management of Hypertension - American Family Physician

Feb 1, 2015 - Hypertension is the most common chronic condition treated by family physicians. Elevated blood pressure is associated with an increased risk of heart failure, myocardial infarction, cerebrovascular disease, and death. Treatment of hypertension reduces the risk of these events. Several ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0201/p172.html

Common Questions About Developmental Dysplasia of the Hip - American Family Physician

Dec 15, 2014 - Developmental dysplasia of the hip is a common musculoskeletal condition in newborns. Infants with developmental dysplasia of the hip, whether treated or untreated, have a higher incidence of early-onset hip osteoarthritis in adulthood. Evidence to support universal screening by ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1215/p843.html

Delirium in Older Persons: Evaluation and Management - American Family Physician

Aug 1, 2014 - Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition. Assessment for and prevention of delirium should occur at ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0801/p150.html

Diagnostic Approach to Pleural Effusion - American Family Physician

Jul 15, 2014 - Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p99.html

Diagnosis and Management of Pancreatic Cancer - American Family Physician

Apr 15, 2014 - Pancreatic cancer remains the fourth leading cause of cancer-related deaths in the United States. Risk factors include family history, smoking, chronic pancreatitis, obesity, diabetes mellitus, heavy alcohol use, and possible dietary factors. Because more than two-thirds of ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0415/p626.html

Evaluation and Management of Neck Masses in Children - American Family Physician

Mar 1, 2014 - Neck masses in children usually fall into one of three categories: developmental, inflammatory/reactive, or neoplastic. Common congenital developmental masses in the neck include thyroglossal duct cysts, branchial cleft cysts, dermoid cysts, vascular malformations, and hemangiomas. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p353.html

Pituitary Adenomas: An Overview - American Family Physician

Sep 1, 2013 - Prolactinomas and nonfunctioning adenomas are the most common types of pituitary adenomas. Patients with pituitary adenomas may present initially with symptoms of endocrine dysfunction such as infertility, decreased libido, and galactorrhea, or with neurologic symptoms such as headache ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p319.html

Diabetic Foot Infections - American Family Physician

Aug 1, 2013 - Diabetic foot infection, defined as soft tissue or bone infection below the malleoli, is the most common complication of diabetes mellitus leading to hospitalization and the most frequent cause of nontraumatic lower extremity amputation. Diabetic foot infections are diagnosed clinically...

American Family Physician : Article

https://www.aafp.org/afp/2013/0801/p177.html

Reducing the Risk of Adverse Drug Events in Older Adults - American Family Physician

Mar 1, 2013 - Adverse drug events occur in 15 percent or more of older patients presenting to offices, hospitals, and extended care facilities. These events are potentially preventable up to 50 percent of the time. Common serious manifestations include falls, orthostatic hypotension, heart failure, ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0301/p331.html

Subacute to Chronic Mild Traumatic Brain Injury - American Family Physician

Dec 1, 2012 - Although a universally accepted definition is lacking, mild traumatic brain injury and concussion are classified by transient loss of consciousness, amnesia, altered mental status, a Glasgow Coma Score of 13 to 15, and focal neurologic deficits following an acute closed head injury. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1045.html

Seasonal Affective Disorder - American Family Physician

Dec 1, 2012 - Seasonal affective disorder is a combination of biologic and mood disturbances with a seasonal pattern, typically occurring in the autumn and winter with remission in the spring or summer. In a given year, about 5 percent of the U.S. population experiences seasonal affective disorder, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1201/p1037.html

The Physician's Role in Managing Acute Stress Disorder - American Family Physician

Oct 1, 2012 - Acute stress disorder is a psychiatric diagnosis that may occur in patients within four weeks of a traumatic event. Features include anxiety, intense fear or helplessness, dissociative symptoms, reexperiencing the event, and avoidance behaviors. Persons with this disorder are at ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1001/p643.html

Transient Ischemic Attack: Part I. Diagnosis and Evaluation - American Family Physician

Sep 15, 2012 - Transient ischemic attack is defined as transient neurologic symptoms without evidence of acute infarction. It is a common and important risk factor for future stroke, but is greatly underreported. Common symptoms are sudden and transient, and include unilateral paresis, speech ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p521.html

Treatment of the Common Cold in Children and Adults - American Family Physician

Jul 15, 2012 - The common cold, or upper respiratory tract infection, is one of the leading reasons for physician visits. Generally caused by viruses, the common cold is treated symptomatically. Antibiotics are not effective in children or adults. In children, there is a potential for harm and no ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0715/p153.html

Diagnosis and Treatment of Basal Cell and Squamous Cell Carcinoma - American Family ...

Jul 15, 2012 - Family physicians are regularly faced with identifying, treating, and counseling patients with skin cancers. Nonmelanoma skin cancer, which encompasses basal cell and squamous cell carcinoma, is the most common cancer in the United States. Ultraviolet B exposure is a significant factor ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0715/p161.html

Reducing Adverse Effects of Proton Pump Inhibitors - American Family Physician

Jul 1, 2012 - Proton pump inhibitors effectively treat gastroesophageal reflux disease, erosive esophagitis, duodenal ulcers, and pathologic hypersecretory conditions. Proton pump inhibitors cause few adverse effects with short-term use; however, long-term use has been scrutinized for ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p66.html

Summary of the NIAID-Sponsored Food Allergy Guidelines - American Family Physician

Jul 1, 2012 - Patients with suspected food allergies are commonly seen in clinical practice. Although up to 15 percent of parents believe their children have food allergies, these allergies have been confirmed in only 1 to 3 percent of all Americans. Family physicians must be able to separate true ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0701/p43.html

End-Stage Renal Disease: Symptom Management and Advance Care Planning - American Family...

Apr 1, 2012 - The prevalence of end-stage renal disease continues to increase, and dialysis is offered to older and more medically complex patients. Pain is problematic in up to one-half of patients receiving dialysis and may result from renal and nonrenal etiologies. Opioids can be prescribed ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0401/p705.html

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