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Acne Vulgaris: Diagnosis and Treatment - American Family Physician

Oct 15, 2019 - Acne vulgaris is the most prevalent chronic skin disease in the United States, affecting nearly 50 million people per year, mostly adolescents and young adults. Potential sequelae of acne, such as scarring, dyspigmentation, and low self-esteem, may result in significant morbidity. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1015/p475.html

Acute and Chronic Urticaria: Evaluation and Treatment - American Family Physician

Jun 1, 2017 - Urticaria commonly presents with intensely pruritic wheals, sometimes with edema of the subcutaneous or interstitial tissue. It has a lifetime prevalence of about 20%. Although often self-limited and benign, it can cause significant discomfort, continue for months to years, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0601/p717.html

Acute Kidney Injury: Diagnosis and Management - American Family Physician

Dec 1, 2019 - Acute kidney injury is a clinical syndrome characterized by a rapid decline in glomerular filtration rate and resultant accumulation of metabolic waste products. Acute kidney injury is associated with an increased risk of mortality, cardiovascular events, and progression to chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p687.html

Acute Lower Gastrointestinal Bleeding: Evaluation and Management - American Family ...

Feb 15, 2020 - Evaluation and management of acute lower gastrointestinal bleeding focus on etiologies originating distally to the ligament of Treitz. Diverticular disease is the most common source, accounting for 40% of cases. Hemorrhoids, angiodysplasia, infectious colitis, and inflammatory bowel ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0215/p206.html

Adolescent Substance Use and Misuse: Recognition and Management - American Family ...

Jun 1, 2019 - Adolescent use of illicit substances imposes an enormous burden on individuals, families, and communities. The types of illicit substances adolescents are using have changed drastically over the past decade with decreases in alcohol use (including binge alcohol use) offset by increases ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p689.html

Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention - American ...

Sep 1, 2017 - The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p314.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

Bladder Cancer: Diagnosis and Treatment - American Family Physician

Oct 15, 2017 - Bladder cancer is the sixth most prevalent malignancy in the United States and causes more than 16,000 deaths annually. The most common clinical presentation is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1015/p507.html

Care of Incarcerated Patients - American Family Physician

Nov 15, 2018 - The United States has the highest incarceration rate of any nation in the world. Approximately 870 of every 100,000 U.S. citizens are currently in jails or prisons. U.S. inmates are disproportionately young males, racial and ethnic minorities, and persons of low socioeconomic status. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p577.html

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

Caregiver Care - American Family Physician

Jun 1, 2019 - Eighty percent of adults requiring long-term care currently live at home in the community, and unpaid family caregivers provide 90% of their care. Family caregivers serve as a critical extension of the U.S. health care system, and the demand for family caregivers is expected to increase...

American Family Physician : Article

https://www.aafp.org/afp/2019/0601/p699.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

Clostridioides difficile Infection: Update on Management - American Family Physician

Feb 1, 2020 - Guidelines for the diagnosis and treatment of Clostridioides difficile infection have recently been updated. Risk factors include recent exposure to health care facilities or antibiotics, especially clindamycin. C. difficile infection is characterized by a wide range of symptoms, from ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p168.html

Depression in Children and Adolescents: Evaluation and Treatment - American Family ...

Nov 15, 2019 - The prevalence of major unipolar depression in children and adolescents is increasing in the United States. In 2016, approximately 5% of 12-year-olds and 17% of 17-year-olds reported experiencing a major depressive episode in the previous 12 months. Screening for depression in ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p609.html

Developmental Delay: When and How to Screen - American Family Physician

Jul 1, 2017 - An estimated 15% of children in the United States have at least one developmental delay, yet less than one-fifth of those children receive early intervention services before three years of age. Many barriers exist to implementing initial screening and referral, but screening tools can ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0701/p36.html

Diagnosis of Urinary Tract Infections in Children - Point-of-Care Guides - American ...

Feb 15, 2018 - A recent observational study found that 2.2% of acutely ill children younger than five years met criteria for a UTI when their urine was cultured. However, in the same study, overall clinician impression that a UTI was present (fairly to very certain) identified only 28 out of 60 ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0215/p273.html

Epilepsy: Treatment Options - American Family Physician

Jul 15, 2017 - The occurrence of a single seizure does not always require initiation of antiepileptic drugs. Risk of recurrent seizures should guide their use. In adults, key risk factors for recurrence are two unprovoked seizures occurring more than 24 hours apart, epileptiform abnormalities on ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0715/p87.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

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

Functional Dyspepsia: Evaluation and Management - American Family Physician

Jan 15, 2020 - Functional dyspepsia is defined as at least one month of epigastric discomfort without evidence of organic disease found during an upper endoscopy, and it accounts for 70% of dyspepsia. Symptoms of functional dyspepsia include postprandial fullness, early satiety, and epigastric pain or...

American Family Physician : Article

https://www.aafp.org/afp/2020/0115/p84.html

Gastroenteritis in Children - American Family Physician

Feb 1, 2019 - Acute gastroenteritis is defined as a diarrheal disease of rapid onset, with or without nausea, vomiting, fever, or abdominal pain. In the United States, acute gastroenteritis accounts for 1.5 million office visits, 200,000 hospitalizations, and 300 deaths in children each year. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p159.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

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

Heat-Related Illnesses - American Family Physician

Apr 15, 2019 - Heat-related illnesses comprise a spectrum of syndromes resulting from disruption of thermoregulation in people exposed to high environmental heat. Symptoms range from heat edema and exercise-associated muscle cramps to exercise-associated collapse, heat exhaustion, and life-threatening...

American Family Physician : Article

https://www.aafp.org/afp/2019/0415/p482.html

Hidradenitis Suppurativa: Rapid Evidence Review - American Family Physician

Nov 1, 2019 - Hidradenitis suppurativa is a chronic folliculitis affecting intertriginous areas. Onset generally occurs in young adulthood to middle adulthood (18 to 39 years of age). Females and blacks are more than twice as likely to be affected. Additional risk factors include family history, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p562.html

Hirsutism in Women - American Family Physician

Aug 1, 2019 - Hirsutism is the excessive growth of terminal hair in a typical male pattern in a female. It is often a sign of excessive androgen levels. Although many conditions can lead to hirsutism, polycystic ovary syndrome and idiopathic hyperandrogenism account for more than 85% of cases. Less ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0801/p168.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

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

Laceration Repair: A Practical Approach - American Family Physician

May 15, 2017 - The goals of laceration repair are to achieve hemostasis and optimal cosmetic results without increasing the risk of infection. Many aspects of laceration repair have not changed over the years, but there is evidence to support some updates to standard management. Studies have been ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p628.html

Localized Prostate Cancer: Treatment Options - American Family Physician

Jun 15, 2018 - In the United States, prostate cancer will be diagnosed in one out of seven men in his lifetime. Most cases are localized, and only one in 39 men will die from the disease. Prostate cancer is most often detected using serum prostate-specific antigen testing. The National Comprehensive ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p798.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

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

Multiple Myeloma: Diagnosis and Treatment - American Family Physician

Mar 15, 2017 - Multiple myeloma accounts for 1.6% of all cancer cases and approximately 10% of hematologic malignancies in the United States. In 2015, an estimated 28,850 new cases of multiple myeloma were diagnosed in the United States, and the disease caused more than 11,000 deaths. Patients older ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0315/p373.html

Nonspecific Low Back Pain and Return To Work - American Family Physician

Dec 1, 2019 - Nonspecific low back pain refers to a condition without a distinct etiology to explain its associated symptoms. This pain may become chronic and is a major cause of work loss around the world. Without a specific explanation for a patient’s symptoms, the family physician is charged with ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p697.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

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

Pelvic Inflammatory Disease: Diagnosis, Management, and Prevention - American Family ...

Sep 15, 2019 - Pelvic inflammatory disease (PID) is an infection of the upper genital tract occurring predominantly in sexually active young women. Chlamydia trachomatis and Neisseria gonorrhoeae are common causes; however, other cervical, enteric, bacterial vaginosis–associated, and respiratory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0915/p357.html

Perioperative Cardiovascular Medication Management in Noncardiac Surgery: Common ...

May 15, 2017 - Several medications have been used perioperatively in patients undergoing noncardiac surgery in an attempt to improve outcomes. Antiplatelet therapy for primary prevention of cardiovascular events should generally be discontinued seven to 10 days before surgery to avoid increasing the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0515/p645.html

Peritonsillar Abscess - American Family Physician

Apr 15, 2017 - Peritonsillar abscess is the most common deep infection of the head and neck, occurring primarily in young adults. Diagnosis is usually made on the basis of clinical presentation and examination. Symptoms and findings generally include fever, sore throat, dysphagia, trismus, and a hot ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p501.html

Polypharmacy: Evaluating Risks and Deprescribing - American Family Physician

Jul 1, 2019 - Polypharmacy, defined as regular use of at least five medications, is common in older adults and younger at-risk populations and increases the risk of adverse medical outcomes. There are several risk factors that can lead to polypharmacy. Patient-related factors include having multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p32.html

Postpartum Hemorrhage: Prevention and Treatment - American Family Physician

Apr 1, 2017 - Postpartum hemorrhage is common and can occur in patients without risk factors for hemorrhage. Active management of the third stage of labor should be used routinely to reduce its incidence. Use of oxytocin after delivery of the anterior shoulder is the most important and effective ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p442.html

Preventing Falls in Older Persons - American Family Physician

Aug 15, 2017 - The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p240.html

Right Care for Children: Top Five Do's and Don'ts - American Family Physician

Mar 15, 2019 - Underuse and overuse of medical interventions, failure to use interventions known to be effective, and provision of tests or interventions in which benefits do not exceed harms are types of low-value care. The Lown Institute’s Right Care Alliance Children’s Health Council identified ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p376.html

Screening and Counseling Adolescents and Young Adults: A Framework for Comprehensive ...

Feb 1, 2020 - Healthy development is likely to occur when an adolescent’s risk factors are limited and when protective factors are fostered. Healthy development is further encouraged when youth feel valued, empowered, and form healthy social connections. Threats to the well-being of adolescents ...

American Family Physician : Article

https://www.aafp.org/afp/2020/0201/p147.html

Specific Learning Disabilities: The Family Physician's Role - American Family Physician

Nov 15, 2019 - Academic underachievement, such as failing a class and the threat of being held back because of academic issues, is common. Family physicians can provide support and guidance for families as they approach their child’s unique academic challenges. Specific learning disabilities are a ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p628.html

Stable Coronary Artery Disease: Treatment - American Family Physician

Mar 15, 2018 - Stable coronary artery disease refers to a reversible supply/demand mismatch related to ischemia, a history of myocardial infarction, or the presence of plaque documented by catheterization or computed tomography angiography. Patients are considered stable if they are asymptomatic or ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p376.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

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

Type 2 Diabetes Mellitus: Outpatient Insulin Management - American Family Physician

Jan 1, 2018 - In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0101/p29.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

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

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

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