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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

A Stepwise Approach to the Interpretation of Pulmonary Function Tests - American Family...

Mar 1, 2014 - Office-based pulmonary function testing, also known as spirometry, is a powerful tool for primary care physicians to diagnose and manage respiratory problems. An obstructive defect is indicated by a low forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio, which...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p359.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

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.html

Causes and Evaluation of Chronic Dyspnea - American Family Physician

Jul 15, 2012 - Chronic dyspnea is shortness of breath that lasts more than one month. The perception of dyspnea varies based on behavioral and physiologic responses. Dyspnea that is greater than expected with the degree of exertion is a symptom of disease. Most cases of dyspnea result from asthma, ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0715/p173.html

Diagnostic Approach to Pleural Effusion - American Family Physician

Jul 15, 2014 - Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p99.html

Evaluation of the Patient with Chronic Cough - American Family Physician

Oct 15, 2011 - Initial evaluation of the patient with chronic cough (i.e., of more than eight weeks’ duration) should include a focused history and physical examination, and in most patients, chest radiography. Patients who are taking an angiotensin-converting enzyme inhibitor should switch to a ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p887.html

Diagnosis of Deep Venous Thrombosis and Pulmonary Embolism - American Family Physician

Nov 15, 2012 - Venous thromboembolism manifests as deep venous thrombosis (DVT) or pulmonary embolism, and has a mortality rate of 6 to 12 percent. Well-validated clinical prediction rules are available to determine the pretest probability of DVT and pulmonary embolism. When the likelihood of DVT is ...

American Family Physician : Article

https://www.aafp.org/afp/2012/1115/p913.html

Diagnostic Approach to Pleural Effusion in Adults - American Family Physician

Apr 1, 2006 - The first step in the evaluation of patients with pleural effusion is to determine whether the effusion is a transudate or an exudate. An exudative effusion is diagnosed if the patient meets Light's criteria. The serum to pleural fluid protein or albumin gradients may help better ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1211.html

Overview of Changes to Asthma Guidelines: Diagnosis and Screening - American Family ...

May 1, 2009 - The Expert Panel Report 3 of the National Asthma Education and Prevention Program represents a major advance in the approach to asthma care by emphasizing the monitoring of clinically relevant aspects of care and the importance of planned primary care, and by providing patients ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0501/p761.html

An Approach to Interpreting Spirometry - American Family Physician

Mar 1, 2004 - Spirometry is a powerful tool that can be used to detect, follow, and manage patients with lung disorders. Technology advancements have made spirometry much more reliable and relatively simple to incorporate into a routine office visit. However, interpreting spirometry results can be ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0301/p1107.html

The Diagnosis of Wheezing in Children - American Family Physician

Apr 15, 2008 - Wheezing in children is a common problem encountered by family physicians. Approximately 25 to 30 percent of infants will have at least one wheezing episode, and nearly one half of children have a history of wheezing by six years of age. The most common causes of wheezing in children ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1109.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Oct 15, 2009 - Solitary pulmonary nodules are common radiologic findings, typically discovered incidentally through chest radiography or computed tomography of the neck, chest, and abdomen. Primary care physicians must decide how to pursue an evaluation of a nodule once it has been identified. The ...

American Family Physician : Article

https://www.aafp.org/afp/2009/1015/p827.html

Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia - Point-of-Care ...

Aug 15, 2019 - In patients with acute cough, is it possible to identify a subset with a very low likelihood of community-acquired pneumonia?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0815/p246.html

Tuberculosis: Guidelines for Diagnosis from the ATS, IDSA, and CDC - Practice ...

Jan 1, 2018 - Persons with Mycobacterium tuberculosis infection may have no clinical evidence of disease and present asymptomatically, known as latent tuberculosis infection (LTBI) or symptomatically, known as tuberculosis (TB). The American Thoracic Society (ATS), Infectious Diseases Society of ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0101/p56.html

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

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

American Family Physician : POEMs

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

Diagnosis of Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2008 - Chronic obstructive pulmonary disease affects more than 26 million adults in the United States. Family physicians provide care for most of these patients. Cigarette smoking is the leading risk factor for chronic obstructive pulmonary disease, although other risk factors, including ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p87.html

Chronic Cough After Acute Viral Bronchiolitis: Suggestions from the ACCP - Practice ...

May 15, 2019 - To address the high prevalence of bronchiolitis, the effects of chronic cough on patients' quality of life, and adverse effects from inappropriate use of medications, an expert panel from the American College of Chest Physicians performed systematic reviews to develop several ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0515/p654.html

Identification and Management of Latent Tuberculosis Infection - American Family Physician

May 15, 2009 - Latent tuberculosis infection (LTBI) is a condition in which a person is infected with Mycobacterium tuberculosis, but does not currently have active tuberculosis disease. An estimated 10 to 15 million persons in the United States have LTBI. Because 5 to 10 percent of persons with LTBI ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0515/p879.html

Lung Cancer Screening: Pros and Cons - Lown Right Care: Reducing Overuse and Underuse -...

Jun 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/2019/0615/p740.html

Lung Cancer Screening Recommendations from the ACCP - Practice Guidelines - American ...

Dec 1, 2018 - The American College of Chest Physicians (ACCP) recently published recommendations for lung cancer screening based on key questions developed using the PICO (population, intervention, comparator, and outcome) format.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/1201/p688.html

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

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

American Family Physician : POEMs

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

Ruling Out Pulmonary Embolism in the Primary Care Setting - Point-of-Care Guides - ...

Jun 1, 2018 - What is the best approach to evaluate patients with suspected pulmonary embolism in the outpatient, primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0601/p750.html

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

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

American Family Physician : POEMs

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

Identifying Patients with Newly Diagnosed Acute Pulmonary Embolism Who Are at Low Risk ...

Jun 15, 2018 - Standard management of acute PE includes five days of inpatient treatment with parenteral anticoagulation, followed by long-term oral anticoagulation as an outpatient. However, guidelines from the American College of Chest Physicians state that early discharge before five days can be ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0615/p811.html

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

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

American Family Physician : POEMs

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

Screening for Latent Tuberculosis Infection in Adults - Putting Prevention into ...

Nov 15, 2017 - G.R. is a 21-year-old nonpregnant woman who is new to the area and your office. She is applying to graduate school and wants to make sure her vaccinations are up to date. She reports she is doing well and has no concerns.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/1115/p675.html

Chronic Obstructive Pulmonary Disease: Diagnostic Considerations - American Family ...

Feb 15, 2006 - Chronic obstructive pulmonary disease is characterized by the gradual progression of irreversible airflow obstruction and increased inflammation in the airways and lung parenchyma that is generally distinguishable from the inflammation caused by asthma. Most chronic obstructive ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0215/p669.html

Screening for Obstructive Sleep Apnea in Adults: Recommendation Statement - U.S. ...

Jul 15, 2017 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for obstructive sleep apnea (OSA) in asymptomatic adults.

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

https://www.aafp.org/afp/2017/0715/od1.html

Home Sleep Testing for Diagnosing Obstructive Sleep Apnea - FPIN's Help Desk Answers - ...

Nov 15, 2017 - Home portable monitoring can be used as a substitute for in-laboratory polysomnography for the diagnosis of OSA in patients with a high pretest probability. Most patients prefer home monitoring, and clinical outcomes among patients diagnosed by either method are comparable regarding ...

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2017/1115/od1.html

YEARS Clinical Decision Tool Decreases CTA in Patients with Suspected Pulmonary ...

Nov 15, 2017 - In this study, using a simplified algorithm in patients with suspected pulmonary embolism can safely decrease the number of CTAs.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1115/od3.html

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

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

American Family Physician : POEMs

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

Screening for Latent Tuberculosis Infection in Adults: Recommendation Statement - U.S. ...

Mar 15, 2017 - The USPSTF recommends screening for latent tuberculosis infection (LTBI) in populations at increased risk.

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

https://www.aafp.org/afp/2017/0315/od4.html

Screening for Obstructive Sleep Apnea in Adults - Putting Prevention into Practice - ...

Jul 15, 2017 - R.K. is a 52-year-old white man who presents to your office for a preventive health visit. He is overweight and has a history of hypertension and hyperlipidemia, which are stable and well controlled with medication. One of his coworkers was recently diagnosed with obstructive sleep ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/0715/p123.html

Screening for Chronic Obstructive Pulmonary Disease: Recommendation Statement - U.S. ...

Jul 15, 2016 - The USPSTF recommends against screening for chronic obstructive pulmonary disease (COPD) in asymptomatic adults.

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

https://www.aafp.org/afp/2016/0715/od1.html

Evidence Poses a Challenge to Imaging Standards in the Diagnosis of Pneumonia - Letters...

Feb 1, 2018 - Advertisement << Previous article Next article >> Feb 1, 2018 Issue Letters to the Editor Evidence Poses a Challenge to Imaging Standards in the Diagnosis of Pneumonia Am Fam Physician. 2018 Feb 1;97(3):158-159. Original Article: Community-Acquired Pneumonia in Adults: Diagnosis and...

American Family Physician : Letter

https://www.aafp.org/afp/2018/0201/p158.html

Procalcitonin-Guided Antibiotic Therapy for Acute Respiratory Infections - FPIN's ...

Jul 1, 2016 - A procalcitonin-guided antibiotic therapy algorithm should be used to decrease antibiotic use in adults with acute respiratory infections. The use of a procalcitonin-guided therapy algorithm reduces antibiotic use by 3.47 days without increasing morbidity or mortality in adults with ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2016/0701/p53.html

Physician Assessment of COPD Does Not Match Spirometry Results - POEMs - American ...

Oct 1, 2015 - Using immediate, in-office spirometry results as the reference standard, seasoned physicians accurately identified COPD severity in approximately one in three patients, underestimating severity in 41% of patients and overestimating severity in 29% of patients. This mismatch seems to be ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p635a.html

Evaluation of Chronic Dyspnea - American Family Physician

Apr 15, 2005 - Chronic dyspnea is defined as dyspnea lasting more than one month. In approximately two thirds of patients presenting with dyspnea, the underlying cause is cardiopulmonary disease. Establishing an accurate diagnosis is essential because treatment differs depending on the underlying ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0415/p1529.html

Lung Cancer Screening Is Cost-Effective, but Only If Done Correctly - POEMs - American ...

Mar 1, 2015 - The U.S. Preventive Services Task Force (USPSTF) gave lung cancer screening a B recommendation on the basis of the reductions in disease-specific mortality and all-cause mortality seen in the National Lung Screening Trial (NLST). The NLST does not consider cost or cost-effectiveness in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0301/p328.html

DVT and Pulmonary Embolism: Part I. Diagnosis - American Family Physician

Jun 15, 2004 - The incidence of venous thromboembolic diseases is increasing as the U.S. population ages. At least one established risk factor is present in approximately 75 percent of patients who develop these diseases. Hospitalized patients and nursing home residents account for one half of all ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0615/p2829.html

Screening for Lung Cancer: Recommendation Statement - U.S. Preventive Services Task ...

Jul 15, 2014 - The U.S. Preventive Services Task Force (USPSTF) recommends annual screening for lung cancer with low-dose computed tomography (CT) in adults 55 to 80 years of age who have a 30 pack-year smoking history and currently smoke or quit within the past 15 years.

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

https://www.aafp.org/afp/2014/0715/od1.html

Asthma Update: Part I. Diagnosis, Monitoring, and Prevention of Disease Progression - ...

Sep 1, 2004 - Despite increased scientific knowledge about asthma and improved therapeutic options, the disease continues to cause significant morbidity and mortality. The National Asthma Education and Prevention Program Expert Panel has updated its clinical guidelines on asthma medications, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0901/p893.html

Screening for Lung Cancer - Putting Prevention into Practice - American Family Physician

Jul 15, 2014 - M.B., a woman with diabetes mellitus, presents to your office for an annual well visit. M.B. reports having smoked one and a half packs of cigarettes daily for 20 years. Her neighbor was recently diagnosed with lung cancer, and M.B. requests to be tested for lung cancer, too.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/0715/p117.html

Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? No:...

Jul 15, 2014 - There is still considerable uncertainty about the true magnitude of benefit from annual lung cancer screening, as well as the financial and psychological costs; therefore, the scope of the recommendation should be limited to one of individualized, shared decision making.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0715/od3.html

Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? ...

Jul 15, 2014 - When offered to the appropriate population in the appropriate context, CT-based lung cancer screening will reduce the number of deaths caused by this difficult disease.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0715/od2.html

One in Five Patients Overdiagnosed with Lung Cancer Screening - POEMs - American Family...

Jul 15, 2014 - In patients screened for lung cancer using low-dose computed tomography (LDCT), more than 18% of all lung cancers found are slow-growing and will not cause symptoms or harm during an average 6.4 years of follow-up. This risk of overdiagnosis should be part of the discussion regarding ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p112.html

Diagnostic Evaluation of Dyspnea - American Family Physician

Feb 15, 1998 - Dyspnea is a common symptom and, in most cases, can be effectively managed in the office by the family physician. The differential diagnosis is composed of four general categories: cardiac, pulmonary, mixed cardiac or pulmonary, and noncardiac or nonpulmonary. Most cases of dyspnea are ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0215/p711.html

Evaluation of the Patient with Chronic Cough - American Family Physician

May 1, 2004 - Patients with chronic cough should avoid exposure to irritants that can trigger cough, and those who smoke should stop smoking. Patients who develop chronic cough in association with angiotensin-converting enzyme inhibitor therapy should be switched to an agent from another drug class. ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2159.html

A Simple Cough Algorithm for Children with Chronic Cough - POEMs - American Family ...

Nov 15, 2013 - In children with chronic cough, a simple approach of ruling out specific indicators of cause, followed by treating a wet cough with antibiotics, results in a significant decrease in the duration of cough. Some of the causes of chronic cough were reactive airway disease, bronchiectasis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1115/od1.html

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