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Vitamin B12 Deficiency: Recognition and Management - American Family Physician

Sep 15, 2017 - Vitamin B12 deficiency is a common cause of megaloblastic anemia, various neuropsychiatric symptoms, and other clinical manifestations. Screening average-risk adults for vitamin B12 deficiency is not recommended. Screening may be warranted in patients with one or more risk factors, such...

American Family Physician : Article

https://www.aafp.org/afp/2017/0915/p384.html

Evaluation of Patients with Leukocytosis - American Family Physician

Dec 1, 2015 - An elevated white blood cell count has many potential etiologies, including malignant and nonmalignant causes. It is important to use age- and pregnancy-specific normal ranges for the white blood cell count. A repeat complete blood count with peripheral smear may provide helpful ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1201/p1004.html

Clinical Evaluation of Bleeding and Bruising in Primary Care - American Family Physician

Feb 15, 2016 - Bleeding and bruising are common symptoms in the primary care setting. The patient history can help determine whether the bruising or bleeding is abnormal. The International Society on Thrombosis and Hemostasis has developed a bleeding assessment tool that can be used to indicate ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0215/p279.html

Updated Guidelines on Outpatient Anticoagulation - American Family Physician

Apr 15, 2013 - The American College of Chest Physicians provides recommendations for the use of anticoagulant medications for several indications that are important in the primary care setting. Warfarin, a vitamin K antagonist, is recommended for the treatment of venous thromboembolism and for the ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p556.html

Epistaxis: Outpatient Management - American Family Physician

Aug 15, 2018 - Epistaxis is a common emergency encountered by primary care physicians. Up to 60% of the general population experience epistaxis, and 6% seek medical attention for it. More than 90% of cases arise from the anterior nasal circulation, and most treatments can be easily performed in the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p240.html

Evaluation of Anemia in Children - American Family Physician

Jun 15, 2010 - Anemia is defined as a hemoglobin level of less than the 5th percentile for age. Causes vary by age. Most children with anemia are asymptomatic, and the condition is detected on screening laboratory evaluation. Screening is recommended only for high-risk children. Anemia is classified ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0615/p1462.html

Transfusion of Blood and Blood Products: Indications and Complications - American ...

Mar 15, 2011 - Red blood cell transfusions are used to treat hemorrhage and to improve oxygen delivery to tissues. Transfusion of red blood cells should be based on the patient’s clinical condition. Indications for transfusion include symptomatic anemia (causing shortness of breath, dizziness, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p719.html

Update on Vitamin B12 Deficiency - American Family Physician

Jun 15, 2011 - Vitamin B12 (cobalamin) deficiency is a common cause of megaloblastic anemia, a variety of neuropsychiatric symp- toms, and elevated serum homocysteine levels, especially in older persons. There are a number of risk factors for vitamin B12 deficiency, including prolonged use of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0615/p1425.html

Thrombocytopenia - American Family Physician

Mar 15, 2012 - Thrombocytopenia is defined as a platelet count of less than 150 × 103 per µL. It is often discovered incidentally when obtaining a complete blood count during an office visit. The etiology usually is not obvious, and additional investigation is required. Patients with platelet counts ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0315/p612.html

Diagnosis and Management of G6PD Deficiency - American Family Physician

Oct 1, 2005 - Glucose-6-phosphate dehydrogenase deficiency, the most common enzyme deficiency worldwide, causes a spectrum of disease including neonatal hyperbilirubinemia, acute hemolysis, and chronic hemolysis. Persons with this condition also may be asymptomatic. This X-linked inherited disorder ...

American Family Physician : Article

https://www.aafp.org/afp/2005/1001/p1277.html

Hemolytic Anemia - American Family Physician

Jun 1, 2004 - Hemolysis presents as acute or chronic anemia, reticulocytosis, or jaundice. The diagnosis is established by reticulocytosis, increased unconjugated bilirubin and lactate dehydrogenase, decreased haptoglobin, and peripheral blood smear findings. Premature destruction of erythrocytes ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0601/p2599.html

Iron Deficiency Anemia - American Family Physician

Mar 1, 2007 - The prevalence of iron deficiency anemia is 2 percent in adult men, 9 to 12 percent in non-Hispanic white women, and nearly 20 percent in black and Mexican-American women. Nine percent of patients older than 65 years with iron deficiency anemia have a gastrointestinal cancer when ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0301/p671.html

Bleeding and Bruising: A Diagnostic Work-up - American Family Physician

Apr 15, 2008 - Primary care physicians are often asked about easy bruising, excessive bleeding, or risk of bleeding before surgery. A thorough history, including a family history, will guide the appropriate work-up, and a physical examination may provide clues to diagnosis. A standardized bleeding ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0415/p1117.html

Outpatient Management of Anticoagulation Therapy - American Family Physician

Apr 1, 2007 - The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0401/p1031.html

Hereditary Hemorrhagic Telangiectasia: Diagnosis and Management - American Family ...

Oct 1, 2010 - Hereditary hemorrhagic telangiectasia is an uncommon autosomal dominant disease that occurs in approximately one in 5,000 to 8,000 persons. This multisystem disorder can affect the nose, skin, gastrointestinal tract, lungs, liver, and brain. Epistaxis is the most common presenting ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1001/p785.html

Evaluating Benefits and Harms of Anticoagulation in Patients with Atrial Fibrillation -...

Dec 15, 2018 - In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%. However, they also significantly increase the risk of a major bleeding event or intracranial hemorrhage.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/1215/p751.html

Normocytic Anemia - American Family Physician

Nov 15, 2000 - Anemia is a common problem that is often discovered on routine laboratory tests. Its prevalence increases with age, reaching 44 percent in men older than 85 years. Normocytic anemia is the most frequently encountered type of anemia. Anemia of chronic disease, the most common normocytic ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1115/p2255.html

Leukocytosis: Basics of Clinical Assessment - American Family Physician

Nov 1, 2000 - Leukocytosis, a common laboratory finding, is most often due to relatively benign conditions (infections or inflammatory processes). Much less common but more serious causes include primary bone marrow disorders. The normal reaction of bone marrow to infection or inflammation leads to ...

American Family Physician : Article

https://www.aafp.org/afp/2000/1101/p2053.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

Lymphadenopathy: Differential Diagnosis and Evaluation - American Family Physician

Oct 15, 1998 - Although the finding of lymphadenopathy sometimes raises fears about serious illness, it is, in patients seen in primary care settings, usually a result of benign infectious causes. Most patients can be diagnosed on the basis of a careful history and physical examination. Localized ...

American Family Physician : Article

https://www.aafp.org/afp/1998/1015/p1313.html

Polycythemia Vera - American Family Physician

May 1, 2004 - Polycythemia vera is a chronic myeloproliferative disorder characterized by increased red blood cell mass. The resultant hyperviscosity of the blood predisposes such patients to thrombosis. Polycythemia vera should be suspected in patients with elevated hemoglobin or hematocrit levels, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0501/p2139.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

Edoxaban (Savaysa) for the Prevention of Thromboembolic Events - STEPS - American ...

Apr 15, 2018 - Edoxaban is an alternative to warfarin and other oral anticoagulants for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of deep venous thrombosis and pulmonary embolism.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0415/p529.html

Hemolytic Uremic Syndrome: An Emerging Health Risk - American Family Physician

Sep 15, 2006 - Hemolytic uremic syndrome is caused primarily by Shiga toxin-producing Escherichia coli O157:H7. The most common cause of acute renal failure in children, hemolytic uremic syndrome also can occur in adults. Characteristic features of the syndrome are microangiopathic anemia, thrombotic ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0915/p991.html

High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients - FPIN's Help...

Jun 1, 2018 - In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od2.html

Opportunities to Improve Outcomes in Sickle Cell Disease - American Family Physician

Jul 15, 2006 - Sickle cell disease represents a spectrum of inherited hemoglobin disorders. The pathophysiology involves abnormalities not just in red blood cells but also vascular endothelium, white blood cell function, coagulation, and inflammatory response. Known sequelae of sickle cell disease ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p303.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Thrombolysis for DVT: Has the Time Arrived? - AFP Journal Club - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

Evaluating the Child with Purpura - American Family Physician

Aug 1, 2001 - Purpura is the result of hemorrhage into the skin or mucosal membrane. It may represent a relatively benign condition or herald the presence of a serious underlying disorder. Purpura may be secondary to thrombocytopenia, platelet dysfunction, coagulation factor deficiency or vascular ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0801/p419.html

Deep Venous Thrombosis: Home vs. Inpatient Treatment - Cochrane for Clinicians - ...

Dec 1, 2018 - Patients treated at home with low-molecular-weight heparin (LMWH) have lower rates of recurrent VTE than those treated in a hospital.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p642.html

Approach to Vaso-occlussive Crisis in Adults with Sickle Cell Disease - American Family...

Mar 1, 2000 - The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. Acute episodes of severe pain (crises) are the primary reason that these patients seek medical care in hospital emergency departments. Frequently, ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1349.html

Recognition and Management of Hereditary Hemochromatosis - American Family Physician

Mar 1, 2002 - Hereditary hemochromatosis is the most common inherited single-gene disorder in people of northern European descent. It is characterized by increased intestinal absorption of iron, with deposition of the iron in multiple organs. Previously, the classic description was combined diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0301/p853.html

Warfarin Therapy: Evolving Strategies in Anticoagulation - American Family Physician

Feb 1, 1999 - Warfarin is the oral anticoagulant most frequently used to control and prevent thromboembolic disorders. Prescribing the dose that both avoids hemorrhagic complications and achieves sufficient suppression of thrombosis requires a thorough understanding of the drug's unique pharmacology....

American Family Physician : Article

https://www.aafp.org/afp/1999/0201/p635.html

Risk of GI Bleeding Highest with Rivaroxaban, Lower with Apixaban, and Lowest with PPI ...

May 15, 2019 - Among patients using oral anticoagulants alone, the risk of hospitalization for upper GI tract bleeding is highest with rivaroxaban (Xarelto) and lowest with apixaban (Eliquis).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od4.html

Is Rivaroxaban Noninferior to Standard Warfarin Therapy in Preventing Recurrent PE and ...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0615/p872.html

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.html

Low-Molecular Weight Heparin in Preventing and Treating DVT - American Family Physician

Mar 15, 1999 - Low-molecular-weight heparin is a relatively recent addition to the list of therapies for prophylaxis and treatment of deep venous thrombosis (DVT). As a prophylactic, low-molecular-weight heparin is as effective as standard heparin or warfarin and does not require monitoring of the ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1607.html

Controversies in Pulmonary Embolism and Deep Venous Thrombosis - American Family Physician

Nov 1, 1999 - The diagnosis of venous thromboembolic disease, and pulmonary embolism in particular, remains problematic. Physicians should strongly consider empiric anticoagulation if the best available diagnostic tests are inconclusive, because treatment is usually safe and successful. Twice-daily ...

American Family Physician : Article

https://www.aafp.org/afp/1999/1101/p1969.html

Evidence-Based Initiation of Warfarin (Coumadin) - Point-of-Care Guides - American ...

Feb 15, 2005 - Many physicians continue to use clinical judgment alone as the basis for initiating and adjusting warfarin dosages in patients who require oral anticoagulation. A number of studies have validated approaches to initiation of anticoagulation that provide more rapid anticoagulation with ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0215/p763.html

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

Jun 1, 2007 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for hemochromatosis and the supporting scientific evidence.

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

https://www.aafp.org/afp/2007/0601/p1696.html

Screening for Iron Deficiency Anemia, Including Iron Supplementations for Children and ...

Aug 1, 2006 - This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for iron deficiency anemia and the supporting scientific evidence.

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

https://www.aafp.org/afp/2006/0801/p461.html

Oral Anticoagulants vs. Antiplatelet Therapy - Cochrane for Clinicians - American ...

May 1, 2008 - Compared with antiplatelet therapy, oral anticoagulation significantly reduces stroke at an average follow-up of one to three years, but does not reduce mortality. Intracranial or extracranial hemorrhage is more common with anticoagulation and must be weighed against its therapeutic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0501/p1250.html

Is Unfractionated Heparin Equivalent to Low-Molecular-Weight Heparin for Venous ...

Jun 1, 2008 - Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0601/p1492.html

Treatment of Calf Deep Venous Thrombosis - FPIN's Clinical Inquiries - American Family ...

Jun 1, 2005 - Patients with a first episode of calf DVT with a transient risk factor should receive heparin therapy followed by oral anticoagulation for six to 12 weeks.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0601/p2157.html

Low-Molecular-Weight Heparin for Initial Treatment of Venous Thromboembolism - Cochrane...

Jul 1, 2005 - LMWH is safer and more effective than unfractionated heparin for initial treatment of venous thromboembolism.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0701/p75.html

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