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Care of the Military Veteran: Selected Health Issues - American Family Physician

Nov 1, 2019 - According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p544.html

Mildly Elevated Liver Transaminase Levels: Causes and Evaluation - American Family ...

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.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

Pleuritic Chest Pain: Sorting Through the Differential Diagnosis - American Family ...

Sep 1, 2017 - Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p306.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Community-Acquired Pneumonia in Adults: Diagnosis and Management - American Family ...

Nov 1, 2016 - Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1101/p698.html

Exercise Stress Testing: Indications and Common Questions - American Family Physician

Sep 1, 2017 - Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p293.html

Migraine Headache Prophylaxis - American Family Physician

Jan 1, 2019 - Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p17.html

Acute Bronchitis - American Family Physician

Oct 1, 2016 - Cough is the most common illness-related reason for ambulatory care visits in the United States. Acute bronchitis is a clinical diagnosis characterized by cough due to acute inflammation of the trachea and large airways without evidence of pneumonia. Pneumonia should be suspected in ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1001/p560.html

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.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

Evaluation of Neck Masses in Adults - American Family Physician

May 15, 2015 - Neck masses are often seen in clinical practice, and the family physician should be able to determine the etiology of a mass using organized, efficient diagnostic methods. The first goal is to determine if the mass is malignant or benign; malignancies are more common in adult smokers ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p698.html

Hemorrhoids: Diagnosis and Treatment Options - American Family Physician

Feb 1, 2018 - Many Americans between 45 and 65 years of age experience hemorrhoids. Hemorrhoidal size, thrombosis, and location (i.e., proximal or distal to the dentate line) determine the extent of pain or discomfort. The history and physical examination must assess for risk factors and clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p172.html

Diagnosis and Management of Sodium Disorders: Hyponatremia and Hypernatremia - American...

Mar 1, 2015 - Hyponatremia and hypernatremia are common findings in the inpatient and outpatient settings. Sodium disorders are associated with an increased risk of morbidity and mortality. Plasma osmolality plays a critical role in the pathophysiology and treatment of sodium disorders. Hyponatremia ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0301/p299.html

Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults -...

May 1, 2015 - Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient’s quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p617.html

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Otitis Media: Rapid Evidence Review - American Family Physician

Sep 15, 2019 - Acute otitis media (AOM) is the most common diagnosis in childhood acute sick visits. By three years of age, 50% to 85% of children will have at least one episode of AOM. Symptoms may include ear pain (rubbing, tugging, or holding the ear may be a sign of pain), fever, irritability, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p350.html

Subclinical Hyperthyroidism: When to Consider Treatment - American Family Physician

Jun 1, 2017 - Subclinical hyperthyroidism is defined by a low or undetectable serum thyroid-stimulating hormone level, with normal free thyroxine and total or free triiodothyronine levels. It can be caused by increased endogenous production of thyroid hormone (e.g., in Graves disease, toxic nodular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p710.html

Chronic Obstructive Pulmonary Disease: Diagnosis and Management - American Family ...

Apr 1, 2017 - The diagnosis of chronic obstructive pulmonary disease (COPD) should be suspected in patients with risk factors (primarily a history of smoking) who report dyspnea at rest or with exertion, chronic cough with or without sputum production, or a history of wheezing. COPD may be suspected ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p433.html

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

Severe Asymptomatic Hypertension: Evaluation and Treatment - American Family Physician

Apr 15, 2017 - Hypertension affects one-third of Americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Severe asymptomatic hypertension is defined as severely elevated blood pressure (180 mm Hg or more systolic, or 110 mm Hg or more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p492.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

Mechanical Low Back Pain - American Family Physician

Oct 1, 2018 - Low back pain is usually nonspecific or mechanical. Mechanical low back pain arises intrinsically from the spine, intervertebral disks, or surrounding soft tissues. Clinical clues, or red flags, may help identify cases of nonmechanical low back pain and prompt further evaluation or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p421.html

Urine Drug Tests: Ordering and Interpreting Results - American Family Physician

Jan 1, 2019 - Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p33.html

Knee Pain in Adults and Adolescents: The Initial Evaluation - American Family Physician

Nov 1, 2018 - Knee pain affects approximately 25% of adults, and its prevalence has increased almost 65% over the past 20 years, accounting for nearly 4 million primary care visits annually. Initial evaluation should emphasize excluding urgent causes while considering the need for referral. Key ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p576.html

Coronary Artery Disease/Coronary Heart Disease - American Family Physician

Nov 1, 2019 - This collection features AFP content on coronary artery disease (CAD), coronary heart disease (CHD) and related issues, including acute coronary syndrome, angina, cardiomyopathy, hypertension, and myocardial infarction. This collection features AFP content on coronary artery disease ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=4

Acute Bacterial Prostatitis: Diagnosis and Management - American Family Physician

Jan 15, 2016 - Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0115/p114.html

Heart Failure with Preserved Ejection Fraction: Diagnosis and Management - American ...

Nov 1, 2017 - Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p582.html

Diagnosis and Management of Osteoporosis - American Family Physician

Aug 15, 2015 - Osteoporosis-related fractures affect approximately one in two white women and one in five white men in their lifetime. The impact of fractures includes loss of function, significant costs, and increased mortality. The U.S. Preventive Services Task Force recommends using dual energy ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0815/p261.html

Heart Failure - American Family Physician

Jul 1, 2019 - This collection features AFP content on heart failure and related issues, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), cardiomyopathy, cardioverter-defibrillators, congestive heart failure, and diastolic and systolic heart failure. This...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=26

Dysuria: Evaluation and Differential Diagnosis in Adults - American Family Physician

Nov 1, 2015 - The most common cause of acute dysuria is infection, especially cystitis. Other infectious causes include urethritis, sexually transmitted infections, and vaginitis. Noninfectious inflammatory causes include a foreign body in the urinary tract and dermatologic conditions. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p778.html

Urinary Incontinence in Women: Evaluation and Management - American Family Physician

Sep 15, 2019 - Urinary incontinence is a common problem among women worldwide, resulting in a substantial economic burden and decreased quality of life. The Women’s Preventive Services Initiative is the only major organization that recommends annual screening for urinary incontinence in all women ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p339.html

Evaluation of Elbow Pain in Adults - American Family Physician

Apr 15, 2014 - The elbow is a complex joint designed to withstand a wide range of dynamic exertional forces. The location and quality of elbow pain can generally localize the injury to one of the four anatomic regions: anterior, medial, lateral, or posterior. The history should include questions about...

American Family Physician : Article

https://www.aafp.org/afp/2014/0415/p649.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.html

Diagnosis, Treatment, and Prevention of Gout - American Family Physician

Dec 15, 2014 - Gout is characterized by painful joint inflammation, most commonly in the first metatarsophalangeal joint, resulting from precipitation of monosodium urate crystals in a joint space. Gout is typically diagnosed using clinical criteria from the American College of Rheumatology. Diagnosis...

American Family Physician : Article

https://www.aafp.org/afp/2014/1215/p831.html

Insomnia: Pharmacologic Therapy - American Family Physician

Jul 1, 2017 - Insomnia accounts for more than 5.5 million visits to family physicians each year. Although behavioral interventions are the mainstay of treatment, pharmacologic therapy may be necessary for some patients. Understanding the risks and benefits of insomnia medications is critical. ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p29.html

Evaluating Medical Decision-Making Capacity in Practice - American Family Physician

Jul 1, 2018 - Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). Capacity is the basis of informed consent. Patients have medical decision-making capacity if they...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p40.html

Dementia - American Family Physician

Sep 15, 2019 - This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia with Lewy bodies. This collection features AFP content on dementia and related issues, including Alzheimer’s, Binswanger’s type, dementia, and dementia ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=5

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Deep Venous Thrombosis and Pulmonary Embolism: Current Therapy - American Family Physician

Mar 1, 2017 - Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p295.html

Chronic Cough: Evaluation and Management - American Family Physician

Nov 1, 2017 - Although chronic cough in adults (cough lasting longer than eight weeks) can be caused by many etiologies, four conditions account for most cases: upper airway cough syndrome, gastroesophageal reflux disease/laryngopharyngeal reflux disease, asthma, and nonasthmatic eosinophilic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1101/p575.html

Testosterone Therapy: Review of Clinical Applications - American Family Physician

Oct 1, 2017 - Testosterone therapy is increasingly common in the United States, and many of these prescriptions are written by primary care physicians. There is conflicting evidence on the benefit of male testosterone therapy for age-related declines in testosterone. Physicians should not measure ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p441.html

Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection - American ...

Feb 15, 2015 - The most common causes of peptic ulcer disease (PUD) are Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). The test-and-treat strategy for detecting H. pylori is appropriate in situations where the risk of gastric cancer is low based on age younger ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p236.html

Surgical and Nonsurgical Management of Gallstones - American Family Physician

May 15, 2014 - Cholelithiasis, or gallstones, is one of the most common and costly of all the gastrointestinal diseases. The incidence of gallstones increases with age. At-risk populations include persons with diabetes mellitus, persons who are obese, women, rapid weight cyclers, and patients on ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0515/p795.html

Colorectal Cancer Screening and Surveillance - American Family Physician

Jan 15, 2015 - Colorectal cancer is the third most common cancer in men and women. The incidence and mortality rate of the disease have been declining over the past two decades because of early detection and treatment. Screening in persons at average risk should begin at 50 years of age; the U.S. ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p93.html

The Adult Well-Male Examination - American Family Physician

Dec 15, 2018 - The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodeficiency virus and other sexually transmitted infections, and diet and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p729.html

Diagnosis and Management of Nephrotic Syndrome in Adults - American Family Physician

Mar 15, 2016 - Nephrotic syndrome (NS) consists of peripheral edema, heavy proteinuria, and hypoalbuminemia, often with hyperlipidemia. Patients typically present with edema and fatigue, without evidence of heart failure or severe liver disease. The diagnosis of NS is based on typical clinical ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0315/p479.html

Diabetic Kidney Disease: Diagnosis, Treatment, and Prevention - American Family Physician

Jun 15, 2019 - Globally, approximately 20% of the 400 million individuals with diabetes mellitus have diabetic kidney disease (DKD). DKD is associated with higher cardiovascular and all-cause morbidity and mortality, so timely diagnosis and treatment are critical. Screening for early DKD is best done ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0615/p751.html

Uterine Fibroids: Diagnosis and Treatment - American Family Physician

Jan 15, 2017 - Uterine fibroids are common benign neoplasms, with a higher prevalence in older women and in those of African descent. Many are discovered incidentally on clinical examination or imaging in asymptomatic women. Fibroids can cause abnormal uterine bleeding, pelvic pressure, bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0115/p100.html

Glucose Management in Hospitalized Patients - American Family Physician

Nov 15, 2017 - Glucose management in hospitalized patients poses challenges to physicians, including identifying blood glucose targets, judicious use of oral diabetes mellitus medications, and implementing appropriate insulin regimens. Uncontrolled blood glucose levels can lead to deleterious effects ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1115/p648.html

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