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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

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher ...

Feb 1, 2017 - This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p196.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

Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular Outcomes - ...

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

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

All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD - POEMs - ...

Oct 15, 2016 - In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p664.html

Amoxicillin/Clavulanate or Ibuprofen No Better Than Placebo for Acute Bronchitis - ...

Feb 1, 2014 - Treating acute bronchitis with amoxicillin/clavulanate or the nonsteroidal anti-inflammatory drug ibuprofen is no more effective than placebo in decreasing symptoms in general or duration of frequent cough. Treatment does, however, produce adverse effects in one in eight patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p225.html

Amoxiclav Causes Diarrhea in 1 of 8 Persons Who Take It - POEMs - American Family ...

Jun 15, 2015 - The risk of diarrhea is significantly higher with amoxicillin/clavulanate (amoxiclav; Augmentin) than placebo, with a number needed to treat to harm (NNTH) of 8, which is not dissimilar from the number needed to treat for conditions such as otitis media. Contrary to popular belief, the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p877.html

An Oral Appliance Does Not Improve Sleep in Patients with Less Severe Sleep Apnea - ...

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

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

Anastrozole Decreases Rate of Breast Cancer in High-Risk Postmenopausal Women - POEMs -...

Aug 15, 2014 - Postmenopausal women at high risk of developing breast cancer who take anastrozole for five years have a lower rate of developing invasive breast cancer during that time frame.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od7.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

Antidepressants and Psychological Therapies Are Effective for IBS - POEMs - American ...

Jan 15, 2015 - Antidepressants and psychological therapies are effective in treating the symptoms of IBS. This study, an update of a similar systematic review and meta-analysis completed five years ago, found the same level of effectiveness for both treatment approaches as the previous analysis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p134.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

Are Some Antidepressants Safer than Others Regarding Suicide Risk? - POEMs - American ...

Jul 1, 2015 - Mirtazapine (Remeron) and venlafaxine are associated with higher rates of completed suicide in primary care patients. Rates of suicide attempts and completion are similar with the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52a.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

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

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

Aspirin Is as Safe and Effective as LMWH for Extended Thromboprophylaxis After Total ...

Dec 1, 2013 - Aspirin is as effective as dalteparin for extended thromboprophylaxis in patients who had total hip arthroplasty and had initially received 10 days of dalteparin prophylaxis postoperatively. Because of its relative safety, low cost, and easy administration, aspirin is an attractive ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/p739.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

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

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

Behavioral Interventions Reduce Inappropriate Antibiotic Prescribing for Acute ...

Jun 15, 2016 - Requiring clinicians to justify antibiotic prescribing in the permanent electronic health record and to undergo periodic peer comparisons of prescribing rates are effective interventions for reducing inappropriate antibiotic prescribing for acute respiratory tract infections. Helpful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1037.html

Beta-Lactam Not as Effective as Beta-Lactam Plus Macrolide for Treating CAP in the ...

May 15, 2015 - In this noninferiority trial, monotherapy with a beta-lactam was not as effective as combination therapy with a beta-lactam and a macrolide for achieving clinical stability in seven days for hospitalized patients with moderately severe CAP.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0515/p720.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Breast Cancer Prevented in Some Women with Drug Treatment - POEMs - American Family ...

Nov 1, 2013 - In some postmenopausal women at higher-than-average risk of breast cancer, tamoxifen and, to a lesser extent, raloxifene (Evista) will prevent the development of breast cancer. For every 1,000 women who receive the prophylaxis, there will be seven to nine fewer cases of diagnosed breast...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/p608.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Brief Interventions for Weight Management in Kids Are Not Effective - POEMs - American ...

Feb 1, 2017 - Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194a.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

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

CBT Effective for Chronic Insomnia - POEMs - 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

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

CBT Effective in Adolescents with Depression Who Do Not Want Medication - POEMs - ...

Sep 1, 2016 - In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384.html

CEA vs. Stenting: Mixed Results, Mostly Bad - POEMs - American Family Physician

Jul 1, 2015 - These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.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

CIN Treatment May Increase Miscarriages but Does Not Affect Fertility - POEMs - ...

Apr 1, 2015 - In this analysis of 15 observational studies (it would be difficult and unethical to do randomized research on this topic), excision using any method for CIN did not affect fertility, although second trimester miscarriages were more likely. A study published at the same time found the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p490.html

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

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

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

Clopidogrel Plus 21 Days of Aspirin Is Superior to Aspirin Alone Within First 24 Hours ...

Jan 1, 2014 - Patients with minor stroke (National Institutes of Health [NIH] Stroke Scale score ≤ 3) or TIA have a decreased risk of recurrent stroke if given aspirin plus clopidogrel vs. aspirin alone if started within 24 hours of the onset of symptoms. There was no significant increase in the risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0101/p55.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

Colchicine Effective for First Episode of Acute Pericarditis - POEMs - American Family ...

Feb 1, 2014 - When used in addition to conventional anti-inflammatory therapy, colchicine decreases the rate of incessant or recurrent pericarditis. You would need to treat four patients with colchicine to prevent one such episode.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p226.html

Cold Symptoms Unaffected by Regular Analgesic Dosing or Use of Steam - POEMs - American...

Sep 1, 2014 - Advice regarding the use of steam inhalation, ibuprofen alone or with acetaminophen, acetaminophen alone, and regular vs. as-needed use of analgesics did not show any improved effectiveness in treating symptoms of acute respiratory tract infections. Ibuprofen may be beneficial in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p335.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

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.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

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

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

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

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

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

Delayed Prescription Strategies Decrease Antibiotic Use - POEMs - American Family ...

Jul 15, 2014 - A delayed prescription approach in children and adults with acute respiratory tract infections, combined with explicit instructions for symptom control, is effective in decreasing antibiotic use, while not adversely affecting patient satisfaction or symptom duration or severity.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p110.html

Desmopressin Effective for Treating Nocturia in Adults - POEMs - American Family Physician

Dec 1, 2014 - Desmopressin is a safe and effective treatment to offer adults with clinically significant nocturia. The initial starting dose should be 50 to 100 mcg, with lower dosing for the advanced older patient. All patients should be monitored for hyponatremia.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p796a.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours - POEMs - American ...

Aug 15, 2017 - A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260a.html

Dextrose Prolotherapy Decreases Pain and Stiffness in Knee Degenerative Joint Disease -...

Nov 1, 2013 - Dextrose prolotherapy appears to be more effective in decreasing pain and stiffness, and improving function in patients with knee degenerative joint disease than saline injections and home exercise.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/od1.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

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

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

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

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

Epidural Steroid Injections Ineffective for Lumbar Spinal Stenosis - POEMs - American ...

Dec 1, 2014 - Epidural glucocorticoid injections are ineffective for lumbar spinal stenosis. Whether this will change practice for this lucrative procedure will be an interesting question.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p795a.html

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

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

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

Epley Maneuver Effective in the Long Term for Positional Vertigo - POEMs - American ...

Nov 1, 2014 - How often do patients walk into our offices with a problem and walk out cured? The Epley maneuver, which is not particularly difficult to do, results in the long-term (at least one year) resolution of posterior canal benign paroxysmal positional vertigo. A video of the maneuver can be ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p660.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

Evidence Does Not Show Benefit of Treating Mycoplasma Pneumonia in Children - POEMs - ...

Jan 15, 2015 - After all these years of knowing about Mycoplasma pneumoniae as a cause of lower respiratory tract infections and the effectiveness of various antibiotics against it in a Petri dish, we still do not know whether treating mycoplasma pneumonia in children is effective. This study does not...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p132.html

Exercise Effective for Depression in Older Patients - POEMs - American Family Physician

Dec 15, 2013 - An organized exercise program for older patients, which may include strength training, endurance training, or both, may be helpful for some patients with symptoms of depression. The results will not be striking, but exercise is an option for patients willing to participate.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/od2.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

Fewer Major Bleeds with Edoxaban Than with Warfarin, but Treatment Benefit Unclear - ...

May 15, 2014 - Edoxaban provides similar effectiveness and a somewhat lower rate of major gastrointestinal and intracranial bleeding than warfarin. It is worth reading the supplemental appendices to this report for a look at the subgroups. For almost all subgroups, low-dose edoxaban caused less major ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0515/p827.html

Finasteride Prevents Low-Grade Prostate Cancers, but Does Not Reduce Mortality - POEMs ...

Dec 1, 2013 - Although finasteride prevents low-grade prostate tumors, it does not affect overall survival or survival after prostate cancer diagnosis. Although high-grade cancers were more common among men taking finasteride, up to 18 years of follow-up failed to show increased mortality in this group.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/p744.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

Five-Day Steroid Treatment Effective for Acute COPD Exacerbation - POEMs - American ...

Dec 1, 2013 - A five-day course of systemic glucocorticoids is at least as effective as a 14-day course in the treatment of adults with acute exacerbations of COPD.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/od1.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

Focused Extracorporeal Shock Wave Therapy Better Than Placebo to Relieve Pain in ...

Oct 1, 2015 - In this study, unlike others, patients with chronic plantar fasciitis treated with extra-corporeal shock wave therapy had greater pain relief than those treated with placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p635.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

Gabapentin Equals Epidural Steroid for Radicular Pain - POEMs - American Family Physician

Nov 1, 2015 - After controlling for the placebo effect that may accompany an epidural steroid injection, treatment with gabapentin is as effective as the injection in reducing radicular leg pain in the short term (three months). A placebo bump in response, if present, is likely to be transient.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814a.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

Greater Benefit with Rivaroxaban Than Aspirin for Extended Treatment of VTE - POEMs - ...

Jul 15, 2017 - Compared with aspirin, the use of rivaroxaban (Xarelto) to extend anticoagulation beyond the initial six to 12 months to treat provoked or unprovoked VTE reduces the risk of recurrent symptomatic VTE without increasing the risk of bleeding. You would need to treat approximately 30 to 33...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p128.html

High-Potency Topical Corticosteroids Effective for Alopecia Areata in Children - POEMs ...

Jun 1, 2014 - Clobetasol propionate, 0.05%, applied in a thin layer for six weeks on, six weeks off, is a highly effective and safe treatment for alopecia areata in children; hydrocortisone, 1%, is not.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0601/p913.html

High-Risk Subgroups Have Little, if Any, Net Benefit from Antibiotics for Acute LRTI - ...

Oct 1, 2015 - Patients with acute LRTI and green sputum or cardiopulmonary comorbidities experience a slightly greater benefit with amoxicillin treatment. That outcome must be balanced against the harms of antibiotics on the individual and population level.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p640.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

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

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

https://www.aafp.org/afp/2016/0415/p704.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

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

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

Impact of Bracing in Adolescents with Idiopathic Scoliosis - POEMs - American Family ...

Mar 15, 2014 - When compared with observation, bracing significantly slows progression of high-risk curves to the surgery threshold (Cobb angle greater than 50 degrees), with a number needed to treat (NNT) of 4 in the randomized portion of the trial. This benefit is greater with more daily hours of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0315/p481.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

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

Increased GI Bleeding After Switch from Warfarin to Dabigatran - POEMs - American ...

May 1, 2015 - The risk of bleeding increases (though remains small) when patients with atrial fibrillation are switched from warfarin to dabigatran to prevent stroke or transient ischemic attack. This study, conducted almost exclusively in male veterans, found an increase in gastrointestinal (GI) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p648.html

Increasing HDL Level Ineffective at Decreasing Cardiovascular Events - POEMs - American...

Jan 15, 2015 - Being the good cholesterol is not the same as being the useful cholesterol. Drug therapy aimed at increasing HDL cholesterol levels, when added to statin treatment, does not decrease patients' likelihood of experiencing a cardiovascular event or of dying earlier.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p133.html

Individualizing Target Goals and Treatment in Patients with Type 2 Diabetes - POEMs - ...

Jun 1, 2015 - This statement from American and European diabetes societies suggests that tighter control of hyperglycemia be attempted only in patients with a recent diagnosis and a low risk of hypoglycemia; who have a long life expectancy with few or no comorbidities, including cardiovascular ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0601/p788.html

Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe ...

Sep 1, 2016 - The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p387.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

Injection Equals Physical Therapy for Shoulder Impingement - POEMs - American Family ...

Feb 15, 2015 - Both physical therapy and corticosteroid injection decrease pain and disability by about 50% within one month of beginning treatment. However, average scores will not improve beyond that over the course of the year, and the average person will have pain, disability, and an altered ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p260a.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

Intensive Lifestyle Intervention Fails to Improve Patient-Oriented Outcomes in Persons ...

Dec 15, 2013 - This large, well-designed trial failed to find a statistically significant improvement in patient-oriented outcomes in patients with diabetes, despite a fairly intensive lifestyle intervention and long-term follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1215/od1.html

JNC 8 Report on Prevention, Evaluation, and Treatment of Hypertension - POEMs - ...

Apr 1, 2014 - See the Synopsis section for a summary of the updated hypertension treatment recommendations from the Eighth Joint National Committee (JNC 8).

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0401/p574a.html

Knee Surgery Does Not Reduce Knee Catching or Locking in Patients with Meniscal Tear - ...

Aug 15, 2016 - Removing the torn bits of meniscus in middle-aged patients who have intermittent knee catches or locking does not decrease their likelihood of experiencing symptoms in the following year compared with diagnostic arthroscopy (i.e., looking but not touching). In general, meniscectomy does...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p317a.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

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

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

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

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

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

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

Long-Term Results of Drug Treatment for Obesity - POEMs - American Family Physician

Mar 1, 2014 - This review of commonly used weight-loss medications, including orlistat (Xenical), lorcaserin (Belviq), phentermine/topiramate (Qsymia), bupropion (Wellbutrin), metformin (Glucophage), and zonisamide (Zonegran), reported an average weight loss for participants of 2.5 to 8.0 kg (5.5 to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0301/p389a.html

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