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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

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

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

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.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

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

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.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

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

Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

Cervical Cancer Screening - American Family Physician

Apr 1, 2018 - Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p441.html

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions ...

Feb 15, 2018 - Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p254.html

Preoperative Assessment in Older Adults: A Comprehensive Approach - American Family ...

Aug 15, 2018 - Surgical outcomes are significantly influenced by patients’ overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p214.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Tremor: Sorting Through the Differential Diagnosis - American Family Physician

Feb 1, 2018 - Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is the most common movement disorder encountered in primary care. The diagnosis of tremor is based on clinical information obtained from the history and physical examination. The most common tremors in patients ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0201/p180.html

Primary Care for Persons Who Inject Drugs - American Family Physician

Jan 15, 2019 - More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p109.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

Hoarseness in Adults - American Family Physician

Dec 1, 2017 - Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p720.html

Noninfectious Penile Lesions - American Family Physician

Jan 15, 2018 - Noninfectious penile lesions are classified by clinical presentation as papulosquamous (e.g., psoriasis), inflammatory (e.g., lichen sclerosus, lichen nitidus, lichen planus), vascular (e.g., angiokeratomas), or neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p102.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 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/2019/0915/p369.html

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

Feb 15, 2019 - The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus ...

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

https://www.aafp.org/afp/2019/0215/od1.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

Screening for Osteoporosis to Prevent Fractures: Recommendation Statement - U.S. ...

Nov 15, 2018 - The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.

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

https://www.aafp.org/afp/2018/1115/od1.html

Colorectal Cancer Screening: ACS Updates Guideline for Adults with Average Risk - ...

Jan 15, 2019 - To support early identification and treatment, the American Cancer Society (ACS) has updated its 2008 guidance on counseling and referring patients at average risk of colorectal cancer (CRC) based on new evidence regarding screening options and the ever-changing risk of CRC.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0115/p129.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

Prolaris Test for Prostate Cancer Risk Assessment - Diagnostic Tests: What Physicians ...

Sep 1, 2019 - The Prolaris test improves the accuracy of prognosis for patients with prostate cancer, especially those with low- or intermediate-grade disease who may be deciding between interventional and noninterventional treatment approaches.

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

https://www.aafp.org/afp/2019/0901/p311.html

Applying a Clinical Decision Rule for CAD in Primary Care to Select a Diagnostic Test ...

May 1, 2019 - Using the INTERCHEST chest pain decision rule to decide next steps when a patient presents to a primary care physician with chest pain.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0501/p584.html

Cancer Screening: ACS Releases Annual Summary of Recommendations - Practice Guidelines ...

Jun 1, 2019 - The American Cancer Society (ACS) provides a summary of recommendations for cancer screening each year, including any updates and recent data, and advice for when recommendations cannot be made.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0601/p719.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

Noninvasive Diagnostic Tests for Helicobacter pylori Infection - Cochrane for ...

Jul 1, 2019 - When compared with serology or stool antigen tests, the urea breath test has the highest diagnostic accuracy to identify H. pylori infection in patients without a history of gastrectomy or recent use of antibiotics or proton pump inhibitors.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0701/p16.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

Flexible Sigmoidoscopy or Fecal Occult Blood Testing for Colorectal Cancer Screening in...

Aug 1, 2019 - This meta-analysis provides high-quality evidence that flexible sigmoidoscopy and fecal occult blood testing both reduce the risk of death from colorectal cancer. The study did not provide a clear answer regarding a superior screening modality, so the decision to choose one test over ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0801/od1.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults: ...

May 15, 2019 - The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services.

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

https://www.aafp.org/afp/2019/0515/od1.html

mSEPT9 (Epi proColon) Blood Test for Colorectal Cancer Screening - Diagnostic Tests: ...

Jul 1, 2019 - Epi proColon is a blood test used for the detection of the methylated septin 9 (mSEPT9) gene. It is approved by the U.S. Food and Drug Administration for colorectal cancer screening in people at average risk who have declined first-line screening tests.

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

https://www.aafp.org/afp/2019/0701/p10.html

Screening for Cervical Cancer - Putting Prevention into Practice - American Family ...

Feb 15, 2019 - P.J., a 48-year-old woman, presents to your office for a well-woman examination. She has been married for eight years, has no history of sexually transmitted diseases, and has nothing remarkable in her medical history.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0215/p253.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

Screening for Peripheral Artery Disease and Cardiovascular Disease Risk Assessment with...

Dec 15, 2018 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for peripheral artery disease (PAD) and cardiovascular disease (CVD) risk with the ankle-brachial index (ABI) in asymptomatic adults.

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

https://www.aafp.org/afp/2018/1215/od1.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults - ...

May 15, 2019 - A.F., a 32-year-old woman, presents for a health maintenance visit. It has been more than a year since she was last seen. She has no significant medical history and has never used tobacco, alcohol, or any other substances.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0515/p649.html

Screening for Prostate Cancer - Putting Prevention into Practice - American Family ...

Oct 15, 2018 - A.E., a 57-year-old black man, comes to your office for an annual visit. He has a history of diabetes mellitus, has never smoked, and has no family history of prostate cancer. He is current with preventive services, including screening for colorectal cancer and counseling for a healthy ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1015/p537.html

Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients - Editorials - ...

Mar 15, 2019 - Despite the lack of outcomes evidence, the rise of wearable ECG sensors will cause many individuals to seek care for misdiagnosed AF. The best intervention for patients with correct diagnoses remains unclear. Primary care physicians must use their skills in discussing uncertainty and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0315/p354.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors: ...

Jan 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adding the ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, or coronary artery calcium score to traditional risk assessment for cardiovascular ...

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

https://www.aafp.org/afp/2019/0115/od1.html

Screening for Osteoporosis to Prevent Fractures - Putting Prevention into Practice - ...

Nov 15, 2018 - A 57-year-old postmenopausal woman comes to your clinic for a wellness visit. She has no significant medical problems. She broke her left forearm as a child by falling out of a tree but has had no other fractures. She currently smokes one pack of cigarettes per day, rarely drinks one ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/1115/p593.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

Counseling Patients About Prostate Cancer Screening - Editorials - American Family ...

Oct 15, 2018 - The AAFP finds that the net benefit of population screening for prostate cancer is small at best, and it does not recommend routinely discussing PSA-based screening if the patient does not request it.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1015/p478.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

Risk Assessment for Cardiovascular Disease with Nontraditional Risk Factors - Putting ...

Jan 15, 2019 - A 46-year-old Asian American woman with no significant medical history presents to your clinic for the first time for a pre-employment physical examination.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0115/p123.html

Screening for Atrial Fibrillation with Electrocardiography - Putting Prevention into ...

Mar 15, 2019 - M.T. is a 67-year-old woman who presents to your office requesting electrocardiography (ECG). Her brother was recently diagnosed with atrial fibrillation after screening with ECG, and she is concerned that she may have the same condition.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0315/p383.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

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