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

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

American Family Physician : POEMs

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

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

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

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

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

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

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

American Family Physician : POEMs

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

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

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

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

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

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

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients...

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

Platelet-Rich Plasma Injection Not Beneficial for Nonoperative Treatment of Rotator ...

Nov 15, 2019 - The review found no evidence that supports any additional benefit of platelet-rich plasma injections compared with various control interventions, including saline placebo, in the non-operative treatment of rotator cuff disease in adults.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p647.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

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

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.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

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

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

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

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

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

American Family Physician : POEMs

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

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

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

American Family Physician : POEMs

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

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

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

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

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

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

American Family Physician : POEMs

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

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

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

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

American Family Physician : POEMs

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

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

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

Limited Data: Deprescribing is Safe, But at the Risk of Symptom Recurrence - POEMs - ...

May 15, 2019 - The limited rigorous data on deprescribing suggest that many patients can safely stop unnecessary medication, but symptom relapse is significant.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od2.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

No Difference Between Oxycodone/Acetaminophen and Hydrocodone/Acetaminophen for Acute ...

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

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

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.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

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

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

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

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

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

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

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

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

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

Incidental Findings Are Common with Chest CT and MRI of the Spine and Brain - POEMs - ...

Dec 1, 2018 - The risks of imaging, in addition to radiation exposure, include the identification of incidentalomas, which can lead to patient anxiety, further testing, and overtreatment. There is little research to guide what to do when they pop up on an imaging report (as the famous dodge clinical ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682.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

Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation ...

Dec 1, 2018 - The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683.html

Mifepristone Pretreatment Improves Success Rate of Misoprostol for Early Pregnancy Loss...

Dec 1, 2018 - In women with early pregnancy loss between five and 12 weeks' gestation, pretreatment with 200 mcg of oral mifepristone before 800 mcg of vaginal misoprostol increases the likelihood of successful expulsion of the gestational sac.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683a.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

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

As-Needed Use of Budesonide Plus Formoterol As Good As Daily Use of Steroid - POEMs - ...

Nov 15, 2018 - As-needed use of budesonide/formoterol is as effective as the daily use of maintenance budesonide plus as-needed terbutaline at preventing severe exacerbations, and results in a much lower cumulative steroid dose.

American Family Physician : POEMs

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

Ambulatory Blood Pressure Important for Decision-Making About Treatment - POEMs - ...

Oct 15, 2018 - This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the decision to...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od5.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

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

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not ...

Oct 15, 2018 - This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od3.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

HPV Testing Better Than Cytology for Women Vaccinated Against HPV - POEMs - American ...

Sep 15, 2018 - In women who had received the HPV vaccine, screening for HPV every five years, with cytology and colposcopy follow-up as needed, resulted in higher rates of identification of high-grade pre-cancerous disease than standard liquid-based cytology every 2.5 years with HPV follow-up ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p384.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

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

Pulmonary Embolism Rule-Out Criteria Reduces the Need for CT Pulmonary Angiography in ...

Aug 15, 2018 - Use of the PERC clinical decision rule significantly reduces the need for CT pulmonary angiography in adults with an initial low-risk clinical estimate of suspected PE.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p250.html

Aspirin No Different Than Rivaroxaban for Prevention of VTE After TKA or THA - POEMs - ...

Aug 15, 2018 - Extended prophylaxis with low-dose aspirin is similar in efficacy to rivaroxaban for the prevention of symptomatic VTE following TKA or THA. Aspirin is cheap, widely available, and effective, making it a good alternative to the more costly direct oral anticoagulants.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248.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

Systolic Blood Pressure of At Least 140 mm Hg Best Place to Begin Treatment - POEMs - ...

Aug 15, 2018 - Beginning antihypertensive treatment when the systolic blood pressure is greater than 140 mm Hg delays death and prevents major cardiovascular events in some persons without preexisting heart disease; in patients with existing heart disease, it prevents further events, but does not ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p249.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

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

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

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

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

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

One-Third of Patients with Anxiety Disorder Will Relapse When Antidepressant Treatment ...

May 1, 2018 - Discontinuing the antidepressant treatment in patients with anxiety disorders will cause a relapse in almost one-third of them. One in six patients previously treated successfully will also relapse despite continued treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605.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

Single-Dose Dexamethasone an Option for Acute Adult Asthma - POEMs - American Family ...

Mar 15, 2017 - A single dose of 12-mg dexamethasone, which has a longer duration of action than prednisone, is almost as effective as five days of 60-mg prednisone for the prevention of relapse in adults with acute asthma treated in an emergency department.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od1.html

Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye" - POEMs - ...

Apr 1, 2018 - For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474.html

Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious ...

May 1, 2018 - Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p606.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

Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant ...

May 1, 2018 - Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0501/p605a.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

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.html

Ibuprofen and Morphine Provide Similar Post-op Pain Relief in Kids; Ibuprofen Has Fewer...

Mar 15, 2018 - This carefully designed and adequately powered study found no difference in pain reduction between ibuprofen and oral morphine in children with postoperative pain. Adverse effects, however, were much more likely with morphine.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p408a.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

Light Therapy Improves Behavioral Disturbances, Sleep, Depression in Older Patients ...

Feb 15, 2018 - In this meta-analysis, older patients with cognitive impairment who were exposed to light therapy had moderate improvements in behavioral disturbances, small improvements in sleep quality, and moderate improvements in depression. The authors did not report data on responders vs. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od2.html

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI -...

Feb 15, 2018 - In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all subgroups,...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od3.html

Long-Term Use of Bisphosphonates Increases the Risk of Fractures in Older Women - POEMs...

Jan 1, 2018 - In this cohort study, older women at a high risk of fractures who used oral bisphosphonates for 10 to 13 years had a higher risk of fractures than women who used bisphosphonates for only two years.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53a.html

Delayed Antibiotic Prescription for New-Onset Cough Associated with Decreased ...

Jan 1, 2018 - Delayed antibiotic treatment (that is, giving a prescription with a suggestion to fill it only if symptoms are still present after three days) was associated with decreased revisits by adults with new-onset cough deemed to be infective.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53.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

Intensive Blood Pressure Control in Older Patients Can Decrease Renal Function - POEMs ...

Jan 1, 2018 - In this post-hoc analysis of the previously published SPRINT trial, lowering the systolic blood pressure of patients who are at increased risk of cardiovascular events (average age = 66 years) will decrease their risk of cardiovascular disease but increase their likelihood of developing...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p54.html

Home Glucose Monitoring Offers No Benefit to Patients Not Using Insulin - POEMs - ...

Dec 15, 2017 - Home glucose monitoring of patients in primary care does not improve A1C scores or quality of life over one year in patients who are not taking insulin.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od4.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

In Hospitalized Patients with Influenza and an Infiltrate, Adding Clarithromycin and ...

Dec 15, 2017 - Adding clarithromycin and naproxen to oseltamivir significantly lowered all-cause mortality at 30 days and at 90 days. This study was limited by its open-label design. The outcome of mortality would not be subject to observer bias, though, and the groups were balanced.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1215/od5.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

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

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