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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

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ...

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.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

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

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

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

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

Equivalent Pain Relief with Different Doses of Ibuprofen - POEMs - American Family ...

May 15, 2020 - Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631.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

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

For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs...

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ...

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

Increased Water Intake Decreases UTI Recurrence in Women - POEMs - American Family ...

Mar 15, 2019 - Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od3.html

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

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Medications Ineffective to Prevent Cognitive Decline or Dementia - POEMs - American ...

Aug 15, 2018 - None of the medications in this systematic review prevented or delayed cognitive decline, cognitive impairment, or dementia.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248a.html

No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in ...

Apr 1, 2020 - Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p435a.html

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low ...

Jun 1, 2020 - Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695.html

Nonopioids Equivalent to Opioids for Severe Chronic Back, Hip, or Knee Pain with Fewer ...

Sep 1, 2018 - Nonopioid medications were at least as effective as opioid medications for improving pain-related function over 12 months in adults with severe chronic back pain or knee or hip osteoarthritis pain. The evidence that opioids are not superior to nonopioid medications for chronic and acute...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0901/p316.html

Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and ...

May 15, 2020 - Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p631a.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

NPH Insulin: Fewer Episodes of Severe Hypoglycemia Than Analogs and Less Than One-Half ...

Jan 1, 2019 - This study found that compared with expensive long-acting insulin analogs costing two to 10 times as much, NPH insulin results in a similar number of episodes of severe hypoglycemia (if not fewer) that result in emergency department visits and hospitalizations.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p53a.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

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

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

American Family Physician : POEMs

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

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

Oral Contraceptives and Antiandrogens Most Effective for Hirsutism Pharmacotherapy - ...

Jan 1, 2019 - Combination oral contraceptive pills (OCPs) are an excellent treatment option for women desiring medical therapy for hirsutism. Based on this meta-analysis, an accompanying practice guideline recommends adding an antiandrogen, such as finasteride (Propecia), if there is an inadequate ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p55.html

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

Short-Term Clopidogrel Plus Aspirin Prevents Second Ischemic Stroke Better Than Aspirin...

Aug 15, 2019 - Combined treatment with clopidogrel and aspirin, started within 24 hours of the first event, will decrease the likelihood of a recurrent stroke in an additional 2% of patients compared with aspirin alone, with a slight increase in the risk of extra-cranial bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer ...

Jun 1, 2020 - Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p695a.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American...

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Thromboembolism Recurrence Likely; Consider It a Chronic Disease - POEMs - American ...

Mar 1, 2020 - Perhaps it is time to start thinking about VTE as a chronic disease. Approximately one in 10 patients that have a VTE will have a second VTE over the next 12 months and almost four in 10 will have a second VTE over 10 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0301/p309.html

Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis - POEMs - American Family ...

Jun 1, 2020 - Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p696.html

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

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

American Family Physician : POEMs

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

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

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