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Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

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

Five Days of Penicillin for Strep Throat Is Equal to 10 Days - POEMs - American Family ...

Apr 1, 2020 - Five days of 800-mg penicillin four times a day produced noninferior results to 10 days of 1,000-mg penicillin three times a day, with shorter symptom duration. This is not the first study to show similar benefits with a shorter duration of oral antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434.html

Results of Fecal Immunochemical Tests for Colorectal Cancer Screening Not Affected by ...

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

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ...

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

Guideline for Chronic Diarrhea: Screening for IBD and Celiac Disease Is In, Screening ...

Mar 1, 2020 - Although an algorithm to guide the workup is not offered, the American Gastroenterological Association suggests the following tests for patients with chronic diarrhea (i.e., watery diarrhea for at least four weeks): fecal calprotectin or fecal lactoferrin to screen for inflammatory ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p310a.html

Misoprostol Alone is Associated with High Rate of Successful First-Trimester Abortion -...

Jul 15, 2019 - Misoprostol alone was associated with a nearly 80% success rate in the first trimester of pregnancy on meta-analysis.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p119.html

Linagliptin and Glimepiride Equally Effective for Adults with Type 2 Diabetes Mellitus ...

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

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ...

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

Fewer Severe Exacerbations in Patients with Mild to Moderate Asthma Treated with ...

Mar 1, 2020 - Patients with mild to moderate asthma only need relief treatment. In this study, patients taking the combination of budesonide/formoterol (Symbicort) as needed had slightly fewer severe exacerbations than patients treated with twice daily budesonide (Pulmicort).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p310.html

Do Not Change Antidepressant Treatment Early Based on a Lack of Response - POEMs - ...

Feb 15, 2020 - Do not be in a hurry to change treatment in patients with severe depression who do not respond to treatment within the first two weeks. Early response to treatment predicts eventual response or remission, but a lack of early response does not predict treatment failure.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p250.html

No Benefit, Longer Hospital Stay with Treatment of Asymptomatic Bacteriuria - POEMs - ...

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

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

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

Addition of Steroids Improves Outcomes in Children and Adults with CAP - POEMs - ...

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

Baloxavir Reduces Symptom Duration Similar to Oseltamivir, Primarily Within 24 Hours of...

Dec 15, 2019 - Baloxavir has similar efficacy to oseltamivir (Tamiflu) (33-hour reduction in duration of symptoms compared with placebo) and, like oseltamivir, is most effective when given within 24 hours of the onset of symptoms.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od4.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ...

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

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ...

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

Ibuprofen Plus Acetaminophen Equals Opioid Plus Acetaminophen for Acute Severe ...

Mar 1, 2018 - In adults presenting to the emergency department with acute extremity pain severe enough to warrant radiologic investigation, ibuprofen plus acetaminophen was equally effective in reducing pain intensity at two hours compared with three different opioid and acetaminophen combination ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0301/p348.html

Augmentation of Antidepressant Treatment Offers Little Benefit - POEMs - American ...

Dec 15, 2019 - The available evidence that treatment-resistant depression (depression that is unresponsive to two different treatments of adequate dose and length) responds well to augmentation treatment (i.e., adding psychotherapy, lithium, or aripiprazole [Abilify] to current treatment) is weak.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od3.html

Platelet-Rich Plasma is Equal to Saline for Patients with Patellar Tendinopathy - POEMs...

Dec 15, 2019 - In this study, platelet-rich plasma injections were no better than saline injections in improving pain or activity in patients with patellar tendinopathy. It did not matter whether the plasma was leukocyte rich or leukocyte poor.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od2.html

Normal Vital Signs and Pulmonary Examination Results Rule Out CAP in Adults with Acute ...

Sep 15, 2019 - Community-dwelling adults who present to a primary care office with acute respiratory infection symptoms but normal vital signs and normal findings on a pulmonary examination have only a 0.4% likelihood of community-acquired pneumonia (CAP).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p375.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ...

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Oral Antibiotics Are Equal to IV Antibiotics for Serous Bone and Joint Infections - ...

Oct 1, 2019 - Oral antibiotics started within seven days of surgery for patients with a serious bone or joint infection are as safe and effective as six weeks of IV antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p441.html

Laboratory-Based Prediction Model Can Rule Out Serious Bacterial Infections in Febrile ...

Oct 1, 2019 - In febrile infants up to 60 days of age, the combination of a normal urinalysis result, an absolute neutrophil count of less than 4,090 per mL (4.1 × 109 per L), and a serum procalcitonin level of less than 1.71 ng per mL is accurate at ruling out serious bacterial infections.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440.html

5% Fluorouracil Is the Preferred Treatment for Actinic Keratoses - POEMs - American ...

Aug 15, 2019 - The use of topical 5% fluorouracil is most likely to result in successful elimination of actinic keratoses in a field on the head or face.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249a.html

Pneumatic Compression in Addition to Pharmacologic Thromboprophylaxis Does Not Further ...

Oct 1, 2019 - This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440a.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

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Weak Evidence Supports Augmentation Therapy for Treatment-Resistant Depression - POEMs ...

Sep 15, 2019 - There is weak research to guide treatment decisions for patients who have not responded to two adequate courses of antidepressant treatment. One study of cognitive behavior therapy showed benefit over placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p376.html

Single-Dose Oral Dexamethasone Decreases Sore Throat Pain - POEMs - American Family ...

Feb 15, 2018 - Sore throats are rarely fatal anymore, but there is really no such thing as just a sore throat. Whereas antibiotics have no analgesic activity, a single low dose of a corticosteroid such as oral dexamethasone—0.6 mg per kg for children at least five years of age and up to 10 mg for ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od1.html

More Evidence Against Antibiotics for Acute Asthma Exacerbations - POEMs - American ...

Aug 1, 2019 - Antibiotics do not benefit patients hospitalized with an asthma exacerbation. Evidence from this study suggests worse outcomes with antibiotic use, including a longer hospital stay, higher costs, and greater risk of diarrhea.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p185.html

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.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

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

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

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.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

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.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

Increased Water Intake Decreases UTI Recurrence in Women - POEMs - American Family ...

Mar 15, 2019 - Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od3.html

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half ...

Jan 1, 2019 - This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53a.html

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy - ...

Jan 1, 2019 - Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p55.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Digital Media Use Associated with ADHD Symptom Development Among Adolescents - POEMs - ...

Feb 1, 2019 - High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting rate).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p189.html

Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome...

Feb 1, 2019 - Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p190.html

LABA Plus Inhaled Corticosteroid Reduces Exacerbations, But Not Hospitalizations - ...

Jan 1, 2019 - Adding a LABA to an inhaled corticosteroid is safe but does not reduce the likelihood of a serious exacerbation requiring hospitalization. There is a small reduction in nonsevere asthma exacerbations, with one fewer exacerbation for every 53 patients treated for six months.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.html

Estrogen No Better Than Vaginal Lubricant for Postmenopausal Vaginal Symptoms - POEMs -...

Nov 15, 2018 - It is time to rethink the idea that vaginal atrophy caused by diminished estrogen is the cause of vaginal symptoms associated with menopause. Vaginal estradiol is no more effective than a non-prescription vaginal lubricant or placebo lubricant in the treatment of women with painful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od3.html

Five-Day Nitrofurantoin Superior to Single-Dose Fosfomycin for Women with Uncomplicated...

Oct 15, 2018 - A five-day course of nitrofurantoin is significantly more likely than single-dose fosfomycin to achieve both clinical and microbiologic resolution of uncomplicated lower UTI in otherwise healthy adult women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od4.html

Long-Acting Muscarinic Antagonists plus Inhaled Steroids is Equal to Long-Acting ...

Oct 15, 2018 - Long-acting muscarinic antagonists added to inhaled corticosteroids are a superior treatment to placebo for improving asthma control in adults and children 12 years or older. Long-acting muscarinic antagonist add-on therapy is not superior to long-acting beta agonist (LABA) add-on therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od2.html

Single Maintenance and Reliever Therapy More Effective Than Inhaled Corticosteroids and...

Sep 15, 2018 - When compared with standard therapy (inhaled corticosteroids with or without LABAs and SABAs as relief therapy), SMART is associated with a reduced risk of acute asthma exacerbations in patients 12 years or older.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p383.html

Short Courses of Antibiotics as Effective as Longer Courses for Outpatient Infections -...

Jul 1, 2018 - Just about every time someone asks, Can I get away with a shorter course of antibiotics, the answer is, Yes, you can. Shorter courses reduce cost and may reduce the likelihood of adverse events.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p56.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

FIT More Acceptable with Better Detection Rate Than gFOBT for Colorectal Cancer ...

Jun 15, 2018 - FIT is more sensitive and specific than the older guaiac-based fecal occult blood tests (gFOBTs) when screening for colorectal cancer. We now know that it is also more acceptable to patients and increases uptake in a centrally administered screening program.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p818.html

Drugs for Chronic Idiopathic Constipation Are Similarly Effective - POEMs - American ...

Jun 15, 2018 - If nondrug measures are unsuccessful for chronic idiopathic constipation, the choice of a pharmacologic agent should be based on cost, tolerability, and long-term adherence rather than efficacy, because the efficacy is similar among drugs and drug classes.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819a.html

PCI Equal to Sham PCI for Exercise Tolerance in Patients with Stable Angina Plus Severe...

Jul 1, 2018 - In patients with stable angina and severe coronary artery disease (CAD), PCI plus optimal medical treatment does not improve exercise tolerance or angina more than sham PCI plus optimal medical treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p55.html

Surgery Equal to No Surgery for Patients with Subacromial Shoulder Pain - POEMs - ...

Jul 1, 2018 - In patients with subacromial shoulder pain of at least three months' duration who receive physical therapy, surgical decompression is no better than arthroscopy without decompression in improving pain or function, and neither is much better than no invasive intervention at all.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54.html

Injectable Extended-Release Naltrexone Effective for Opioid Use Disorder - POEMs - ...

Jun 15, 2018 - Injectable extended-release naltrexone administered every four weeks is similar in efficacy to daily oral buprenorphine/naloxone for the treatment of opioid use disorder. Patients using extended-release naltrexone reported higher satisfaction with treatment and were more likely to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819.html

Lorazepam Added to Haloperidol Effective for Agitated Delirium in End-of-Life Cancer ...

Feb 15, 2018 - Using a single dose of lorazepam in combination with haloperidol decreases agitation in end-of-life patients with cancer who had persistent agitated delirium despite scheduled haloperidol. A recent POEM reported that haloperidol increases symptoms of distress in patients with cancer and...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od4.html

Ultrasound Is Reasonably Accurate in Detecting Synovitis in Patients with Rheumatoid ...

Jun 1, 2018 - In this systematic review of patients with rheumatoid arthritis, ultrasonography was reasonably accurate compared with magnetic resonance imaging (MRI) in detecting synovitis in fingers and wrists. The use of MRI as a reference standard is convenient, but problematic.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0601/p755.html

Single Question Is Useful for Identifying Acute Mountain Sickness in Travelers at High ...

May 1, 2018 - Three different diagnostic scoring tools have similar accuracy for identifying adults at risk of AMS. One tool, the clinical functional score, is the simplest to use and consists of asking a single question.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p607.html

Broad-Spectrum Antibiotics Increase Adverse Events in Children with Acute Respiratory ...

Apr 1, 2018 - Broad-spectrum antibiotics are no more effective than narrow-spectrum antibiotics for treating acute respiratory tract infections in infants and children, and adverse events are significantly more common in children treated with broad-spectrum antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474a.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Minimal Effect of ERT on Sexual Function in Menopausal Women - POEMs - American Family ...

Mar 15, 2018 - Transdermal, but not oral, estrogen produced a small improvement in sexual function scores in menopausal women. The increases were very small and may not be noticeable by most women.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408.html

Treatment of Subclinical Hypothyroidism Ineffective in Older Adults - POEMs - American ...

Oct 15, 2017 - Treatment of patients with a minimally elevated thyrotropin (thyroid-stimulating hormone) level did not result in any improvement in symptoms. If patients present with a thyrotropin level between 4.6 and 10 mIU per L, repeat the test because the levels often normalize (this occurred in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od3.html

Oral Steroids Not Helpful for Acute Lower Respiratory Tract Infection in Nonasthmatic ...

Jan 1, 2018 - This study found no clinically significant benefit of steroids for the treatment of acute LRTI in adults without asthma, including those presenting with wheezing or shortness of breath.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p55.html

Gabapentinoids for Chronic Low Back Pain: Limited Evidence, More Harm Than Benefit - ...

Dec 15, 2017 - The existing data on gabapentinoids for chronic low back pain are limited in number and quality. The amount of pain reduction is low to moderate, and the rate of adverse effects is high. The few studies that assessed function found no improvement.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od3.html

No Added Benefit with Higher Doses of Ketorolac for Treatment of Acute Pain in the ...

Aug 15, 2017 - A 10-mg dose of ketorolac is as effective as higher doses for the short-term treatment of acute pain for patients in the emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p262.html

Transdermal Estrogen and Progestogen Most Effective to Reduce Menopausal Vasomotor ...

Dec 1, 2017 - Transdermal estrogen plus progestogen, or oral estrogen plus progestogen, is the treatment most likely to effectively reduce the frequency of vasomotor symptoms among menopausal women. Isoflavones and black cohosh were found to be better than placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1201/p744.html

Use of Mindfulness or Self-Hypnosis Provides Immediate Pain Relief to Hospitalized ...

Nov 15, 2017 - Compared with psychoeducation, a single 15-minute session of training in mindfulness or self-hypnosis leads to greater immediate pain relief for hospitalized patients with at least moderate pain at baseline.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od6.html

Mite-Impermeable Covers Decrease Hospital Visits in Kids with Asthma - POEMs - American...

Nov 15, 2017 - In children with house dust mite allergies and asthma, the use of mite-impermeable bedding decreases the frequency of asthma exacerbations.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od4.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

Newer Oral Hypoglycemics Do Not Increase or Decrease Mortality - POEMs - American ...

Oct 15, 2017 - This seems like a strange question considering that the goal is to decrease mortality with drug therapy. Nevertheless, this study showed that the new kids on the diabetes block—exenatide (Byetta), dulaglutide (Trulicity), sitagliptin (Januvia), saxagliptin (Onglyza), and others—do not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1015/od2.html

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

Steroid Treatment Adds No Benefit to Antihistamines for Acute Hives - POEMs - American ...

Sep 15, 2017 - The combination approach of steroids and antihista-mines offers no added benefit to antihistamines alone for the treatment of simple urticaria.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p399a.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

More Accurate Prediction of the Pretest Probability of Cardiovascular Disease with ...

May 15, 2017 - The European approach to determining the pretest likelihood of coronary artery disease (CAD) in patients with chest pain is superior to that of the Diamond-Forrester approach recommended by U.S. guidelines, and will result in less need for immediate invasive treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od1.html

High False-Positive Rate with Lung Cancer Screening - POEMs - American Family Physician

Jul 15, 2017 - If you are thinking about adding lung cancer screening to your delivery of preventive care, be sure to prepare patients. They are likely to receive a positive result, most of the positive results will not be lung cancer, and one in four patients will require additional tracking (i.e., ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128a.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Arthroscopic Meniscal Surgery Is Equivalent to Nonoperative Management - POEMs - ...

Jul 1, 2017 - The existing research base, with biases that typically make interventions look better, is unable to demonstrate that arthroscopy for meniscal injuries is any better than nonoperative approaches. Because this is a costly intervention and is being used more often, perhaps insurance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0701/p55.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Antibiotics May Equal Surgery for Children with Appendicitis - POEMs - American Family ...

Jun 1, 2017 - Antibiotic treatment appears to be effective for children with uncomplicated appendicitis without evidence of perforation or rupture, with 97% of children discharged without surgery. Approximately one in seven children will eventually have recurrence and require surgery. A couple of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p737.html

Bare Arm Best for Blood Pressure Measurement - POEMs - American Family Physician

Jun 1, 2017 - To get the most accurate measure, let patients sit for a few minutes, and then measure their blood pressure on a completely bare arm. Does a difference of 4 mm systolic and 6 to 7 mm diastolic matter?

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733.html

Testosterone Does Not Improve Cognition in Memory-Impaired Older Men with Low ...

Jun 1, 2017 - Testosterone supplementation for men 65 years or older with age-associated memory impairment and a low baseline testosterone level was not associated with significant improvements in memory or other cognitive functions.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733a.html

Topiramate and Amitriptyline Not Effective for Migraine in Children - POEMs - American ...

May 15, 2017 - Topiramate, amitriptyline, and placebo all led to a similar, substantial improvement in migraine frequency and disability. How to harness this strong placebo effect for our patients is an important, but unanswered, question.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od2.html

One-Third of Adults with Diagnosed Asthma Can Be Weaned Off All Asthma Medications - ...

May 1, 2017 - This study found that current asthma was ruled out after repeated testing in one-third of adults with physician-diagnosed asthma. Patients ruled out for current asthma were less likely to be using asthma medications or daily controlling medications and less likely to have undergone ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0501/p586.html

If You Give Amoxicillin/Clavulanate to Six- to 23-Month-Olds with AOM, 10 Days Is ...

Apr 1, 2017 - These authors begin with the assumption that we should treat children who have AOM with amoxicillin/clavulanate. The greatest benefit was in children one to two years of age who had more severe pain and fever. In children with less severe symptoms, observation should still be the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p457.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Getting an Infant to Sleep: Graduated Extinction and Sleep Fading are Effective - POEMs...

Nov 1, 2016 - This study found that graduated extinction (increasing intervals between comforting the infant) and sleep fading (putting the child to bed progressively later until the parent finds the sweet spot) are both effective at decreasing sleep latency and the number of awakenings and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1101/p750.html

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