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Type 2 Diabetes Therapies: A STEPS Approach - American Family Physician

Feb 15, 2019 - A concise way to evaluate pharmacotherapy options for type 2 diabetes mellitus is to use the five patient-oriented STEPS criteria: safety, tolerability, efficacy, price, and simplicity. The first-line treatment option, metformin, is safe and fairly well-tolerated, has excellent ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p237.html

Treatment of the Common Cold - American Family Physician

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

American Family Physician : Article

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

Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Ingrown Toenail Management - American Family Physician

Aug 1, 2019 - Ingrown toenails account for approximately 20% of foot problems in primary care. The great toe is most often affected. Ingrown toenails occur most commonly in young men, and nail care habits and footwear are most often contributory factors. No consensus has been reached for the best ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p158.html

Kidney Stones: Treatment and Prevention - American Family Physician

Apr 15, 2019 - Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults. During an episode of renal colic, the first priority is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p490.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.html

Opioid Use Disorder: Medical Treatment Options - American Family Physician

Oct 1, 2019 - Opioid use disorder is highly prevalent and can be fatal. At least 2.1 million Americans 12 years and older had opioid use disorder in 2016, and approximately 47,000 Americans died from opioid overdoses in 2017. Opioid use disorder is a chronic relapsing condition, the treatment of ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p416.html

Bartholin Duct Cyst and Gland Abscess: Office Management - American Family Physician

Jun 15, 2019 - The Bartholin glands, located in the base of the labia minora, have a role in vaginal lubrication. Because of the presence of other glands, removal of a Bartholin gland does not affect lubrication. Ductal blockage of these typically pea-sized structures can result in enlargement of the ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p760.html

Lice and Scabies: Treatment Update - American Family Physician

May 15, 2019 - Pediculosis and scabies are caused by ectoparasites. Pruritus is the most common presenting symptom. Head and pubic lice infestations are diagnosed with visualization of live lice. Nits (lice eggs or egg casings) alone are not sufficient to diagnose a current infestation. A no-nit ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p635.html

Acute Hand Infections - American Family Physician

Feb 15, 2019 - Acute hand infections are often caused by puncture wounds and are generally classified into superficial or deep infections. Superficial infections occur in the skin and subcutaneous tissues, whereas deep infections can involve the tendon sheaths, adjacent anatomic compartments, deep ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p228.html

Clinically Relevant Drug-Drug Interactions in Primary Care - American Family Physician

May 1, 2019 - Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p558.html

The Changing Climate: Managing Health Impacts - American Family Physician

Nov 15, 2019 - Concentrations of greenhouse gases continue to accumulate in the atmosphere at increasing rates, heating the Earth’s surface and destabilizing climate. Health impacts from climate change may include increased morbidity and mortality from worsening cardiopulmonary health, worsening ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p618.html

Stuttering: Understanding and Treating a Common Disability - American Family Physician

Nov 1, 2019 - Childhood-onset fluency disorder, the most common form of stuttering, is a neurologic disability resulting from an underlying brain abnormality that causes disfluent speech. Stuttering can lead to significant secondary effects, including negative self-perception and negative perception ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p556.html

Depression and Anxiety Disorders: Benefits of Exercise, Yoga, and Meditation - American...

May 15, 2019 - Many people with depression or anxiety turn to nonpharmacologic and nonconventional interventions, including exercise, yoga, meditation, tai chi, or qi gong. Meta-analyses and systematic reviews have shown that these interventions can improve symptoms of depression and anxiety ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0515/p620.html

Management of Chronic Tendon Injuries - American Family Physician

Aug 1, 2019 - Chronic tendon injuries are common athletic and occupational injuries that account for many physician visits. Tendons have a complex biology that provides a unique combination of strength, flexibility, and elasticity but also predisposes them to injury. The term tendinopathy is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p147.html

Manipulative Therapies: What Works - American Family Physician

Feb 15, 2019 - Manipulative therapies include osteopathic manipulative treatment and many other forms of manual therapies used to manage a variety of conditions in adults and children. Spinal manipulative therapy may provide short-term improvement in patients with acute or chronic low back pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p248.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.html

Interventional Radiology: Indications and Best Practices - American Family Physician

May 1, 2019 - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p547.html

Beers Criteria for Inappropriate Medication Use in Older Patients: An Update from the ...

Jan 1, 2020 - The 2019 American Geriatrics Society update of the Beers Criteria uses the five criteria outlined in 2015; these include medications that should typically be avoided in most older patients, medications that should be avoided in older patients with certain conditions, medications that ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0101/p56.html

Positional Therapy for Obstructive Sleep Apnea - Cochrane for Clinicians - American ...

Jan 1, 2020 - Positional therapy for OSA reduces scores on the apnea-hypopnea index (AHI) and Epworth Sleepiness Scale compared with no treatment. Although continuous positive airway pressure (CPAP) improves AHI scores more than positional therapy, patients seem to better tolerate positional therapy ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0101/p16.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - Discussing with patients the pros and cons of medications for borderline glucose values could distract us from more important topics such as lifestyle changes, smoking cessation, and blood pressure control. Time is the most valuable resource in a physician-patient partnership, and there...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p136.html

Tapering Long-Term Opioid Therapy - Curbside Consultation - American Family Physician

Jan 1, 2020 - My patient is a 54-year-old construction worker who has been taking prescribed opioids for more than a decade for chronic knee and back pain.

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2020/0101/p49.html

Gabapentinoids for Pain: Potential Unintended Consequences - Editorials - American ...

Dec 1, 2019 - The widespread and often indiscriminate prescribing of gabapentinoids is not supported by robust evidence, and it carries known and unknown risks.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1201/p672.html

Cholesterol Management: ACC/AHA Updates Guideline - Practice Guidelines - American ...

May 1, 2019 - The American College of Cardiology/American Heart Association (ACC/AHA) task force on clinical practice guidelines has updated its 2013 cholesterol guideline.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0501/p589.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

C-Reactive Protein Guidance Safely Reduces Antibiotic Use in Patients with Acute ...

Jan 1, 2020 - CRP guidance, regarding the likelihood that antibiotics will be helpful for patients with acute exacerbation of COPD, safely reduces antibiotic use (number needed to treat = 5).

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p54.html

Overuse of Statins in Older Adults - Lown Right Care: Reducing Overuse and Underuse - ...

Dec 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/1215/p742.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Managing Chronic Hypertension in Pregnant Women: ACOG Releases Updated Practice ...

Dec 15, 2019 - The American College of Obstetricians and Gynecologists (ACOG) has released an updated practice bulletin to outline diagnosis, effects on pregnancy outcomes, and approaches for management based on new evidence.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1215/p782.html

Baloxavir Marboxil (Xofluza) for Influenza - STEPS - American Family Physician

Dec 15, 2019 - Single-dose baloxavir should be limited to ill patients who cannot tolerate or comply with a course of oseltamivir. For otherwise healthy adults with confirmed influenza or influenza-like illness, the high cost of baloxavir may not justify the one-day reduction in symptoms of a ...

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1215/p776.html

Hydrogen Peroxide 40% (Eskata) for Seborrheic Keratosis - STEPS - American Family ...

Nov 15, 2019 - Hydrogen peroxide 40% topical solution is not particularly effective for removing seborrheic keratosis lesions, and skin reactions are common.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1115/p643.html

Renin-Angiotensin System Inhibitors vs. Other Antihypertensive Drug Classes for ...

Nov 1, 2019 - RAS inhibitors, which include angiotensin receptor blockers, angiotensin-converting enzyme inhibitors, and renin inhibitors, should not be used as first-line agents.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1101/p540.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

Antibiotics for Acute Rhinosinusitis in Adults - Medicine by the Numbers - American ...

Oct 1, 2019 - Because of the relatively high rate of reported adverse effects and the high likelihood of resolution of symptoms with supportive care and symptomatic management, the authors recommend selective antibiotic use in patients with acute sinusitis. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1001/od1.html

Combined Hormonal Contraceptives for Heavy Menstrual Bleeding - Cochrane for Clinicians...

Dec 1, 2019 - Combined oral contraceptives decrease the number of women reporting menorrhagia over six months compared with placebo (absolute risk reduction = 36.7%; number needed to treat = 2.7).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1201/p677.html

Revefenacin (Yupelri) for the Treatment of Chronic Obstructive Pulmonary Disease - ...

Jan 15, 2020 - Revefenacin is a once-daily nebulized alternative to metered dose long-acting muscarinic antagonists for patients with moderate to severe COPD. Given its expense, complicated administration process, and lack of evidence that it improves key patient-oriented outcomes, its use should be ...

American Family Physician : STEPS

https://www.aafp.org/afp/2020/0115/p121.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

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

Alpha Blockers for Nephrolithiasis - FPIN's Clinical Inquiries - American Family Physician

Dec 1, 2019 - The alpha blocker tamsulosin (Flomax) can be used to improve clearance of stones larger than 5 mm, shorten expulsion times, and reduce hospitalization.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1201/p710.html

Pharmacologic Therapy for Heart Failure - FPIN's Help Desk Answers - American Family ...

Jul 1, 2019 - Compared with monotherapy, the combination of an ACE inhibitor and an ARB has not been shown to improve cardiovascular or overall mortality in patients with symptomatic heart failure. The combination is associated with an increased number of adverse drug effects.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0701/p49.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

Community-Acquired Pneumonia: Determining Safe Treatment in the Outpatient Setting - ...

Jun 15, 2019 - When is it safe to treat a patient with community-acquired pneumonia a an outpatient?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0615/p768.html

Aromatase Inhibitors Such as Letrozole (Femara) vs. Clomiphene (Clomid) for Subfertile ...

May 1, 2019 - When treated with letrozole, subfertile women with PCOS who are trying to conceive have increased chances of pregnancy (number needed to treat [NNT] = 11) and live birth (NNT = 10) compared with those treated with clomiphene.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p545.html

Should Adults with Prediabetes Be Prescribed Metformin to Prevent Diabetes Mellitus? ...

Aug 1, 2019 - High-quality evidence supports metformin use for diabetes prevention among younger or more obese individuals or for women with a history of gestational diabetes. Clinicians should consider prescribing metformin, in addition to intensive lifestyle interventions, in accordance with ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2019/0801/p134.html

Medication Management for Chronic Heart Failure with Preserved Ejection Fraction - ...

Jul 1, 2019 - Mineralocorticoid receptor antagonists reduce hospitalizations for patients with HFpEF. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have not been shown to change the morbidity or mortality in patients with HFpEF.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p17.html

Oral H1 Antihistamines as Add-on Therapy to Topical Treatment for Eczema - Cochrane for...

Nov 1, 2019 - In children with eczema, there is no evidence to support the addition of oral H1 antihistamines to standard treatment regimens. In adults, the use of fexofenadine (Allegra), 120 mg per day, improves patient-assessed eczema symptoms compared with placebo (number needed to treat = 11; 95%...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1101/p541.html

Infantile Hemangioma: AAP Releases Guideline for Management - Practice Guidelines - ...

Aug 1, 2019 - Infantile hemangiomas are the most common benign tumors of childhood, occurring in up to approximately 5% of infants. These benign vascular tumors are small, self-resolving, and do not require treatment.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0801/p186.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

Treatment of Threatened Miscarriage with Progestogens - Cochrane for Clinicians - ...

Sep 1, 2019 - Progestogens reduce the risk of miscarriage when compared with placebo in patients with threatened miscarriage (number needed to treat [NNT] = 10.) Use of progestogens poses no significant risks to mother or baby.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p279.html

Erenumab (Aimovig) for Migraine Prophylaxis in Adults - STEPS - American Family Physician

Jun 15, 2019 - Erenumab is a safe option for migraine prophylaxis in adults. However, it is expensive and should be reserved for patients who have experienced intolerable adverse effects while taking oral migraine prophylaxis medication or who have poor adherence to daily preventive treatment.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0615/p781.html

Use of Amphetamines for Attention Deficit/Hyperactivity Disorder in Adults - Cochrane ...

Sep 1, 2019 - Amphetamines provide a clinician-rated 30% or greater reduction in ADHD symptoms when compared with placebo (number needed to treat = 5).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0901/p278.html

Elagolix (Orilissa) for Endometriosis Pain - STEPS - American Family Physician

Oct 15, 2019 - Elagolix can decrease pain in women with endometriosis, but it is expensive and has adverse effects similar to those of other medications that decrease estrogen levels.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/1015/p502.html

Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary ...

Nov 1, 2019 - The authors determined there is no benefit from the use of ticagrelor in patients with acute coronary syndrome and stable coronary artery disease because of the uncertainty about benefits and evidence of potential harms.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/1101/od1.html

Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - Diagnostic Tests: What ...

Nov 1, 2019 - The allopurinol hypersensitivity assay, or HLA-B*58:01 test, is a blood test to detect the presence of a human leukocyte antigen B (HLA-B) genetic variant that increases the risk of life-threatening, severe cutaneous adverse reactions in patients taking allopurinol.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2019/1101/p530.html

Dual Antiplatelet Therapy for Patients with Cardiovascular Disease - FPIN's Clinical ...

Oct 15, 2019 - Patients with established cardiovascular disease or risk factors (e.g., ischemic cerebrovascular disease, peripheral arterial disease, high risk of atherothrombotic disease) should receive dual antiplatelet therapy with aspirin plus clopidogrel, which confers additional benefit over ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/1015/p463.html

Gabapentin for Treatment of Radicular Low Back Pain - FPIN's Clinical Inquiries - ...

Sep 1, 2019 - Gabapentin is not effective for the treatment of radicular low back pain and is associated with adverse effects.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0901/p309.html

Antihypertensive Drug Therapy for Mild to Moderate Hypertension During Pregnancy - ...

Oct 1, 2019 - Compared with placebo, antihypertensive drug therapy for mild to moderate hypertension (defined by the authors as a blood pressure of 140 to 169 mm Hg systolic or 90 to 109 mm Hg diastolic) caused by chronic hypertension, gestational hypertension, or preeclampsia during pregnancy does ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p403.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

Secnidazole (Solosec) for Bacterial Vaginosis - STEPS - American Family Physician

Aug 15, 2019 - Secnidazole is much more expensive than generic metronidazole and other available treatments. However, it is a safe option for women who desire a single-dose treatment or for patients in whom treatment compliance is a concern.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0815/p242.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

Tonsillectomy in Children: AAO-HNS Updates Guideline - Practice Guidelines - American ...

Sep 1, 2019 - The American Academy of Otolaryngology–Head and Neck Surgery (AAO–HNS) has updated its 2011 guideline on tonsillectomy indications and perioperative care in children one to 18 years of age.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0901/p316.html

Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation -...

Oct 1, 2019 - Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p405.html

Thickened Feedings for Infants with Gastroesophageal Reflux - FPIN's Help Desk Answers ...

Oct 1, 2019 - Bottle-fed infants with gastroesophageal reflux should be given thickened formula feedings.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/1001/p437.html

Chronic Neck Pain: Nonpharmacologic Treatment - Implementing AHRQ Effective Health Care...

Aug 1, 2019 - Which noninvasive nonpharmacologic treatments for chronic neck pain improve function or pain for at least one month?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0801/p180.html

Common Misperceptions About Buprenorphine Prescribing for Opioid Use Disorder - ...

Oct 1, 2019 - The antidote to the opioid use disorder epidemic is the thoughtful use of evidence-based medicine and an honest understanding of what we know—and what we don't know—about caring for people with substance use disorders.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1001/p396.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

Branched-chain Amino Acids for Patients with Hepatic Encephalopathy - Medicine by the ...

Jan 1, 2020 - << Previous article Next article >> Jan 1, 2020 Issue Medicine by the Numbers A Collaboration of TheNNT.com and AFP Branched-chain Amino Acids for Patients with Hepatic Encephalopathy AHMED HAMED, MD; AMIRA HAMED, MD; and KARISSA LAMBERT, MD Am Fam Physician. 2020 Jan...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2020/0101/od1.html

Glycopyrronium (Qbrexza) Topical Wipes for Hyperhidrosis - STEPS - American Family ...

Sep 15, 2019 - Glycopyrronium wipes are a useful alternative for the topical treatment of hyperhidrosis of the axillae in patients nine years and older who do not respond to or tolerate nonprescription antiperspirants or topical aluminum chloride.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0915/p372.html

Different Durations of Corticosteroid Therapy for COPD Exacerbations - Cochrane for ...

Mar 1, 2019 - Treatment of acute exacerbations of COPD with a shorter course of systemic corticosteroids (seven or fewer days) is likely to be as effective and safe as treating with longer courses (more than seven days).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p295.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

Integrating Medical Acupuncture into Family Medicine Practice - Editorials - American ...

Jul 15, 2019 - Acupuncture is an evidence-based therapy to reduce pain that can meet patient demand for nonpharmacologic treatment. Now is the time to offer training in medical acupuncture to more family physicians.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0715/p76.html

Identification of and Treatment for Unhealthy Alcohol Use in Primary Care Settings - ...

Jun 15, 2019 - We have identified the ways in which family physicians can implement the USPSTF screening recommendation for unhealthy alcohol use and then intervene when a patient has a positive screen.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0615/p733.html

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality...

Apr 15, 2019 - The USPSTF recommends that clinicians offer or refer adults with a body mass index (BMI) of 30 or higher (calculated as weight in kilograms divided by height in meters squared) to intensive, multicomponent behavioral interventions.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0415/od1.html

Abaloparatide (Tymlos) for Osteoporosis - STEPS - American Family Physician

Feb 15, 2019 - Abaloparatide is a safe and effective medication used to reduce the likelihood of vertebral and nonvertebral fractures in women at high risk. However, it is expensive and requires daily injections. It has not been evaluated for its effect on decreasing hip fractures.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0215/p260.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

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

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.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

Psychological and Pharmacologic Treatments for Adults with PTSD - Implementing AHRQ ...

May 1, 2019 - What are the benefits and harms of psychotherapies and pharmacologic agents for the treatment of adults with posttraumatic stress disorder (PTSD)?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0501/p577.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

Semaglutide (Ozempic) for Type 2 Diabetes Mellitus - STEPS - American Family Physician

Jul 15, 2019 - Semaglutide can be added to existing treatment to improve glycemic control and induce weight loss. It may also protect against cardiovascular outcomes in patients with type 2 diabetes and established cardiovascular disease.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0715/p116.html

Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation - FPIN's ...

Apr 15, 2019 - A limited number of trials that examined the risk of temporary interruption of anticoagulation before a variety of procedures did not find a reduction in the risk of stroke, but they did show an increased risk of bleeding events and venous thromboembolism (VTE) in patients who were ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0415/p519.html

Behavioral Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality...

Apr 15, 2019 - A.C., a 32-year-old woman, presents for her annual wellness visit. She recently had blood work completed that showed normal glucose and lipid levels. Her blood pressure is 124/76 mm Hg, weight is 221.8 lb (100.6 kg), height is 5 feet 6 inches (172 cm), and body mass index (BMI) is 34 kg...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0415/p515.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

Denosumab for Reducing Risk of Fractures in Postmenopausal Women - Medicine by the ...

May 1, 2019 - Denosumab appears to be effective in reducing the risk of vertebral and nonvertebral fractures in postmenopausal women with osteoporosis. Treatment with denosumab does not increase the risk of cancer or death but might increase the risk of infection. However, more studies are required.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0501/od1.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

H. pylori Screening Before Initiation of Long-term NSAIDs - FPIN's Clinical Inquiries -...

Jun 15, 2019 - Physicians should perform laboratory screening for and eradicate H. pylori before initiating long-term NSAID therapy in NSAID-naive patients to reduce the risk of peptic ulcer disease.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0615/p783.html

Metformin for Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis - ...

Feb 15, 2019 - Metformin does not seem to be an effective treatment for nonalcoholic steatohepatitis. There are no studies evaluating whether metformin improves long-term patient-oriented outcomes such as progression from NAFLD to nonalcoholic steatohepatitis, cirrhosis, hepatocellular carcinoma, or ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0215/p262.html

Alternative Interventions for Chronic Prostatitis/Chronic Pelvic Pain Syndrome in Men -...

Jun 1, 2019 - In men with chronic pelvic pain and urinary dysfunction who have not responded to standard medical management, extracorporeal shock wave therapy reduces symptoms and increases quality of life. Acupuncture may also provide benefit to some patients.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p677.html

Coaching Patients About Successful Blood Pressure Management - Lown Right Care: ...

Mar 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0315/p357.html

Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane ...

Jun 1, 2019 - Low-molecular-weight heparin (LMWH), vitamin K antagonists, and direct oral anticoagulants, when used to prevent recurrent VTE, have a similar impact on all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p676.html

Osteopathic Manipulative Treatment: A Primary Care Approach - Editorials - American ...

Feb 15, 2019 - Osteopathic manipulative treatment is a valuable modality that has the potential to decrease cost and improve pain/function in patients.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0215/p214.html

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

Antibiotic Prophylaxis in Patients with COPD - Medicine by the Numbers - American ...

Jun 1, 2019 - This research fails to determine whether the modest potential benefits of antibiotic prophylaxis in patients with chronic obstructive pulmonary disease outweigh the risk of resistance. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0601/od1.html

HIV Prevention and Treatment with ART: International Antiviral Society Updates ...

Mar 15, 2019 - Antiretroviral therapy is the key to preventing and managing human immunodeficiency virus infection. Based on the availability of new medications and treatment options, the USA Panel of the International Antiviral Society has updated its 2016 recommendations.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0315/p395.html

Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in ...

Apr 1, 2019 - Direct oral anticoagulants are as likely as warfarin to prevent all strokes and systemic embolic events in patients with atrial fibrillation and CKD stage 3. They do not increase the risk of major bleeding events. The evidence remains insufficient to make recommendations for the use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p422.html

Saline Irrigation for Allergic Rhinitis - Cochrane for Clinicians - American Family ...

May 1, 2019 - asal saline irrigation reduces the severity of allergy symptoms for up to eight weeks vs. no treatment. It is uncertain if adding nasal saline to pharmacologic treatment further improves symptoms over pharmacologic treatment alone.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0501/p544.html

Risks of Elective Labor Induction vs. Expectant Management - FPIN's Help Desk Answers -...

May 1, 2019 - Elective labor induction at 39 weeks’ gestation leads to a mean 145-g (5.1-oz) lower birth weight compared with expectant management, but there is conflicting evidence about the effects on rates of cesarean delivery, perinatal mortality, operative vaginal birth, and admission to the ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0501/p587.html

Management of Uterine Fibroids - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2019 - What are the comparative effectiveness and harms of treatments for uterine fibroids, and what is the risk of finding unexpected leiomyosarcoma in women with fibroids?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0301/p330.html

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