American Family Physician

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POEMs

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POEMs: Gluten Is Not the Culprit in Many Patients’ Symptoms - American Family Physician

May 1, 2016 - Gluten may not be the cause of gastrointestinal symptoms in many patients with nonceliac gluten sensitivity. Only one-third of patients on a gluten-free diet experienced symptoms and correctly identified when they were given gluten-containing flour. Almost one-half (49%) of patients ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0501/p788.html

POEMs: Tamsulosin Effective as Expulsion Therapy for 5- to 10-mm Distal Ureteric Stones...

May 1, 2016 - Tamsulosin promotes stone passage of ureteric stones that are 5 to 10 mm. Five patients would need to be treated with tamsulosin to cause the expulsion of one such stone. Stones smaller than 5 mm have a high rate of spontaneous passage without any intervention.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0501/p788a.html

POEMs: Hyaluronic Acid Equivalent to Sham Injections in Patients with Knee DJD - ...

Apr 15, 2016 - The highest quality studies, which are now fairly plentiful, show that hyaluronic acid injections are only minimally better than sham injections in improving pain and function in patients with knee DJD.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0415/p704.html

POEMs: Delayed Prescription for Respiratory Infections Produces Similar Results and ...

May 1, 2016 - In almost 400 Spanish primary care patients with mild to moderate symptoms of respiratory infection of less than one week's duration, both a take-and-hold prescription and a come back and pick up, if necessary prescription produced a similar clinical response—and similar patient ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0501/p789.html

POEMs: Long-Acting Nitrates No Good for Heart Failure with Preserved Ejection Fraction ...

May 1, 2016 - Patients who have heart failure with preserved ejection fraction had decreased levels of activity and more adverse events when they were receiving isosorbide mononitrate than when they were taking a placebo. Moreover, activity levels decreased with increases in the dose of the drug, ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0501/p790.html

POEMs: Low High-Sensitivity Troponin I Level Accurate in Identifying Patients at Low ...

Apr 15, 2016 - The high-sensitivity troponin I assay used in this study was fairly accurate in identifying patients with chest pain who are at low risk of cardiac events.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0415/p704a.html

POEMs: Best Approaches to Physical Diagnosis of Acute Red Eye - American Family Physician

Apr 1, 2016 - Eliciting photophobia via pupillary constriction and the presence of anisocoria (greater than 1 mm) in patients with an acute red eye are the best predictors of serious eye disease (e.g., uveitis, keratitis, corneal abrasion, scleritis) requiring prompt referral. Lack of morning eye ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0401/p594.html

POEMs: Useful Signs and Symptoms of Severe Intracranial Injury After Minor Head Trauma ...

Apr 1, 2016 - Specific individual risk factors, clinical signs, and symptoms are useful in identifying adults with minor head trauma who are at risk of severe intracranial injury. The absence of all features of the Canadian CT Head Rule and New Orleans Criteria is also highly accurate for identifying...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0401/p594a.html

POEMs: Systolic BP of 120 Instead of 140 in High-Risk Older Patients Without Diabetes ...

Mar 15, 2016 - In this group of older patients (mean age = 68 years) who do not have diabetes but are at high risk of cardiovascular disease, a more aggressive systolic BP target of 120 mm Hg instead of 140 mm Hg led to benefits (lower all-cause mortality, lower cardiovascular mortality, less heart ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0315/p520a.html

POEMs: Steroids Beneficial As Adjunctive Treatment for Community-Acquired Pneumonia - ...

Feb 1, 2016 - Moderate-quality to high-quality evidence suggests that steroids, when added to antibiotics and usual care, can improve outcomes in the treatment of CAP. Benefits include reduced hospital length of stay, decreased time to clinical stability, and lower rates of mechanical ventilation and...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0201/p227.html

POEMs: Preexposure Prophylaxis with Tenofovir/Emtricitabine Prevents HIV Infection in ...

Mar 15, 2016 - Preexposure prophylaxis in high-risk men who have unprotected anal intercourse reduces the likelihood of developing HIV (number needed to treat = 17 per year). Participants averaged 15 pills per month, which costs approximately $700 per month ($8,400 per year). Condoms would be a much ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0315/p520.html

POEMs: Naproxen Alone May Be Best for Acute Low Back Pain - American Family Physician

Feb 15, 2016 - Naproxen alone is as effective as naproxen plus oxycodone/acetaminophen or naproxen plus cyclobenzaprine (Flexeril) in reducing pain and improving function in adults with acute musculoskeletal LBP without radicular symptoms. Adverse events were significantly more common in patients ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0215/p316.html

POEMs: In Patients with Type 2 Diabetes and CV Disease, Empagliflozin Reduces CV and ...

Mar 1, 2016 - In patients with established CV disease and type 2 diabetes, the addition of empagliflozin to standard therapy reduces all-cause mortality and CV mortality. This is notable because empagliflozin is the only drug other than metformin to demonstrate a mortality benefit, albeit for a ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0301/p410.html

POEMs: No Difference Between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for ...

Mar 1, 2016 - This study found no significant difference in the management of acute musculoskeletal extremity pain, including fractures, with oxycodone/acetaminophen vs. hydrocodone/acetaminophen. Adverse events, including nausea and dizziness, occurred significantly more often with ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0301/p411.html

POEMs: Treating Low Vitamin D Levels Is Ineffective in Postmenopausal Women - American ...

Feb 15, 2016 - You do not have to treat a low vitamin D level if your patient is a typical community-dwelling postmenopausal woman younger than 75 years. The usual dosage of vitamin D, 800 IU (20 mcg) daily, will not increase levels even after a year of therapy and has little effect on calcium ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0215/p315.html

POEMs: Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0215/p315a.html

POEMs: Perioperative Bridging Anticoagulation Unhelpful for Invasive Procedures - ...

Jan 15, 2016 - Bridging anticoagulation worsens outcomes for patients with atrial fibrillation who undergo an elective invasive procedure, resulting in more episodes of major bleeding and no difference in the rate of stroke or venous thromboembolism.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0115/p130.html

POEMs: More Nuanced Guidelines for Lipid Lowering to Prevent CVD - American Family ...

Jan 1, 2016 - The authors of this guideline give a more nuanced and less aggressive approach to lipid lowering than other groups. For the primary prevention of CVD, check blood pressure and lipids (nonfasting is fine) to calculate the 10-year CVD risk. If greater than 12%, treat; if 12% or less, ...

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0101/p59.html

POEMs: Routine CT Scans for Occult Malignancy Not Useful in Patients with Unprovoked ...

Jan 1, 2016 - There is no advantage to adding CT of the abdomen and pelvis to a basic screening protocol for occult malignancy in patients with unprovoked VTE.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0101/p59a.html

POEMs: CBT Effective for Chronic Insomnia - American Family Physician

Jan 1, 2016 - A five-component approach to changing patients' beliefs and behaviors surrounding sleep is effective, at least in the short term, in getting persons to fall asleep and stay asleep, although total sleep time is not increased.

American Family Physician : POEMs

http://www.aafp.org/afp/2016/0101/p60.html

POEMs: Some Benefit to Treating Mild Hypertension to Prevent Stroke, CV Deaths, and ...

Dec 1, 2015 - Treating mild hypertension over five years decreases the risk of stroke, cardiovascular (CV) death, and overall mortality in a small proportion of patients.

American Family Physician : POEMs

http://www.aafp.org/afp/2015/1201/p1020.html

POEMs: An Oral Appliance Does Not Improve Sleep in Patients with Less Severe Sleep ...

Dec 1, 2015 - An oral appliance does not improve daytime sleepiness or other measures of a good night's sleep. It does, however, decrease apnea scores, snoring, and restless legs. Although not studied, these improvements may be valuable for bed partners who sleep each night enduring patients' lower ...

American Family Physician : POEMs

http://www.aafp.org/afp/2015/1201/p1021.html

POEMs: CCTA and Radionuclide Stress Testing Similar for Evaluation of Chest Pain - ...

Dec 1, 2015 - For the evaluation of chest pain in intermediate-risk patients, CCTA is comparable with myocardial perfusion imaging in its ability to select patients for invasive management. Both modalities are also similar when it comes to downstream resource use and adverse cardiovascular events. ...

American Family Physician : POEMs

http://www.aafp.org/afp/2015/1201/p1022.html

POEMs: Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular ...

Dec 1, 2015 - The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, ...

American Family Physician : POEMs

http://www.aafp.org/afp/2015/1201/p1020a.html

POEMs: Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

http://www.aafp.org/afp/2015/1101/p820.html

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