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stroke

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Stroke and TIA - American Family Physician

Sep 15, 2019 - This collection features AFP content on stroke and related issues, including acute ischemic stroke, statins, and transient ischemic attacks. This collection features AFP content on stroke and related issues, including acute ischemic stroke, statins, and transient ischemic attacks.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=24

Recurrent Ischemic Stroke: Strategies for Prevention - American Family Physician

Oct 1, 2017 - Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1001/p436.html

Diagnosis of Acute Stroke - American Family Physician

Apr 15, 2015 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of the diagnosis of ischemic stroke. The most common presenting symptoms of ischemic stroke ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0415/p528.html

Transient Ischemic Attack: Part I. Diagnosis and Evaluation - American Family Physician

Sep 15, 2012 - Transient ischemic attack is defined as transient neurologic symptoms without evidence of acute infarction. It is a common and important risk factor for future stroke, but is greatly underreported. Common symptoms are sudden and transient, and include unilateral paresis, speech ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p521.html

Subacute Management of Ischemic Stroke - American Family Physician

Dec 15, 2011 - Ischemic stroke is the third leading cause of death in the United States and a common reason for hospitalization. The subacute period after a stroke refers to the time when the decision to not employ thrombolytics is made up until two weeks after the stroke occurred. Family physicians ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1215/p1383.html

Transient Ischemic Attack: Part II. Risk Factor Modification and Treatment - American ...

Sep 15, 2012 - Interventions following a transient ischemic attack are aimed at preventing a future episode or stroke. Hypertension, current smoking, obesity, physical inactivity, diabetes mellitus, and dyslipidemia are all well-known risk factors, and controlling these factors can have dramatic ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p527.html

Dual Antiplatelet Therapy for High-Risk TIA and Minor Stroke: BMJ Rapid Recommendation ...

Sep 15, 2019 - Based on a recent randomized controlled trial followed by a systematic review, the BMJ and MAGIC group concluded that dual antiplatelet therapy use for a limited period after mild stroke is beneficial.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0915/p378.html

Acute Stroke Diagnosis - American Family Physician

Jul 1, 2009 - Stroke can be categorized as ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage. Awakening with or experiencing the abrupt onset of focal neurologic deficits is the hallmark of ischemic stroke diagnosis. The most common presenting symptoms for ischemic stroke are ...

American Family Physician : Article

https://www.aafp.org/afp/2009/0701/p33.html

Apixaban (Eliquis) for Stroke Prevention in Atrial Fibrillation - STEPS - American ...

Apr 15, 2014 - Apixaban is at least as effective as aspirin or warfarin for preventing strokes in high-risk patients with nonvalvular atrial fibrillation, especially those who cannot or will not take warfarin. It is slightly less likely to cause major bleeding and may have better compliance because it...

American Family Physician : STEPS

https://www.aafp.org/afp/2014/0415/p672.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

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

Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in ...

Apr 1, 2019 - Direct oral anticoagulants are as likely as warfarin to prevent all strokes and systemic embolic events in patients with atrial fibrillation and CKD stage 3. They do not increase the risk of major bleeding events. The evidence remains insufficient to make recommendations for the use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p422.html

Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Prevention of Recurrent Ischemic Stroke - American Family Physician

Aug 1, 2007 - Recurrent ischemic stroke and transient ischemic attack are common problems in primary care, with stroke survivors averaging 10 outpatient visits per year. Risk factors such as hypertension, diabetes, and hypercholesterolemia should be evaluated during each office visit. Attention ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0801/p382.html

Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes ...

Apr 15, 2018 - For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0415/p533.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

Physical Fitness Training for Patients with Stroke - Cochrane for Clinicians - American...

Jun 1, 2017 - There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p701.html

The Risk of MI and Ischemic Stroke with Combined Oral Contraceptives - Cochrane for ...

Nov 1, 2016 - The overall risk of MI and ischemic stroke is increased in women who use combined oral contraceptives. The relative risk of MI and ischemic stroke increases as estrogen dose rises, increasing by 60% with doses of 20 mcg and more than doubling when doses of 50 mcg or more are used.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p691.html

AHA and ASA Release Guideline for Prevention of Future Stroke in Patients with Stroke ...

Jan 15, 2015 - The American Heart Association (AHA) and American Stroke Association (ASA) have updated their guideline on prevention of future stroke in patients with a history of stroke or transient ischemic attack (TIA). Currently, the average annual rate of future stroke in these patients is at a ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0115/p136.html

Third-Generation Oral Contraceptives Associated with Greater Risk of PE, Stroke, and MI...

Oct 15, 2016 - Although there is risk with any current oral contraceptive combination, those that contain lower doses of estrogen, and levonorgestrel instead of desogestrel or gestodene, are associated with the least risk of ischemic stroke, myocardial infarction (MI), or pulmonary embolism (PE). ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663.html

Transient Ischemic Attacks: Part I. Diagnosis and Evaluation - American Family Physician

Apr 1, 2004 - Transient ischemic attack is no longer considered a benign event but, rather, a critical harbinger of impending stroke. Failure to quickly recognize and evaluate this warning sign could mean missing an opportunity to prevent permanent disability or death. The 90-day risk of stroke after...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1665.html

Newer Sulfonylureas Not Associated with Increased Mortality, MIs, or Strokes - POEMs - ...

Sep 1, 2016 - In multiple randomized trials, the long-term use of second- or third-generation sulfonylureas in patients with type 2 diabetes is not associated with more deaths, myocardial infarctions (MIs), or strokes. The included trials tended not to report other safety data.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p386.html

Meta-Analysis: Intensive BP Control Decreases Major CV Events and Stroke, but Not MI, ...

Jun 15, 2016 - Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart failure,...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1036.html

AHA/ASA Guidelines on Prevention of Recurrent Stroke - Practice Guidelines - American ...

Apr 15, 2011 - Persons who survive a stroke or transient ischemic attack (TIA) are at increased risk of experiencing another stroke. The American Heart Association (AHA) and the American Stroke Association (ASA) have released updated guidelines on preventing recurrent stroke in patients who have had a...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2011/0415/p993.html

AHA/ASA Release Guideline on Stroke Prevention in Women - Practice Guidelines - ...

Mar 1, 2015 - The American Heart Association and American Stroke Association (AHA/ASA) have released a guideline to help physicians identify women with increased risk of stroke and initiate appropriate preventive measures. The guideline includes recommendations on pregnancy and stroke; cerebral ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2015/0301/p330.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

Some Benefit to Treating Mild Hypertension to Prevent Stroke, CV Deaths, and Overall ...

Dec 1, 2015 - Treating mild hypertension over five years decreases the risk of stroke, cardiovascular (CV) death, and overall mortality in a small proportion of patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

Clopidogrel Plus 21 Days of Aspirin Is Superior to Aspirin Alone Within First 24 Hours ...

Jan 1, 2014 - Patients with minor stroke (National Institutes of Health [NIH] Stroke Scale score ≤ 3) or TIA have a decreased risk of recurrent stroke if given aspirin plus clopidogrel vs. aspirin alone if started within 24 hours of the onset of symptoms. There was no significant increase in the risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0101/p55.html

Transient Ischemic Attacks: Part II. Treatment - American Family Physician

Apr 1, 2004 - Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0401/p1681.html

Stroke: Strategies for Primary Prevention - American Family Physician

Dec 15, 2003 - Stroke is a leading cause of morbidity and mortality in North America. Primary prevention of stroke includes lifestyle modifications and measures to control blood pressure, cholesterol levels, diabetes mellitus, and atrial fibrillation. Lowering blood pressure in patients with ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1215/p2379.html

Severe Asymptomatic Hypertension: Evaluation and Treatment - American Family Physician

Apr 15, 2017 - Hypertension affects one-third of Americans and is a significant modifiable risk factor for cardiovascular disease, stroke, renal disease, and death. Severe asymptomatic hypertension is defined as severely elevated blood pressure (180 mm Hg or more systolic, or 110 mm Hg or more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0415/p492.html

AHA/ASA Publish Advisory on Oral Antithrombotics for Stroke Prevention in Nonvalvular ...

May 15, 2013 - New antithrombotics provide alternatives to warfarin, and may lower the threshold for thromboembolic risk for initiating therapy in patients with atrial fibrillation. This advisory summarizes existing American Heart Association/American Stroke Association (AHA/ASA) recommendations on ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/0515/p732.html

Diagnosis and Treatment of Atrial Fibrillation - American Family Physician

Sep 15, 2016 - Atrial fibrillation is a supraventricular arrhythmia that adversely affects cardiac function and increases the risk of stroke. It is the most common arrhythmia and a major source of morbidity and mortality; its prevalence increases with age. Pulse rate is sensitive, but not specific, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0915/p442.html

Fewer Deaths/Strokes/Revascularizations with Metformin Than Glipizide - POEMs - ...

Jan 15, 2014 - Over five years, treatment with metformin for three years, with other hypoglycemics as needed, reduced the likelihood of death, nonfatal stroke, or the need for vascularization compared with treatment beginning with glipizide (Glucotrol). Cardiovascular events were not individually ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0115/p131.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

Insulin for Glycemic Control in Acute Ischemic Stroke - Cochrane for Clinicians - ...

Dec 1, 2012 - Administering insulin to maintain glycemic control does not improve the rates of mortality or dependency, or the final neurologic outcome after an acute ischemic stroke. Additionally, in randomized controlled trials, patients in the intervention groups (those under tight glycemic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2012/1201/p1008.html

Transient Ischemic Attack: The Rules Have Changed - AFP Journal Club - American Family ...

Jun 15, 2012 - This scientific guideline includes three game changers for physicians regarding TIA. The Journal Club authors discuss why physicians should be wary of clinical guidelines that are based on expert opinion.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0615/p1179.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

Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with Nonvalvular Atrial ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

Preventing Stroke in Patients with Transient Ischemic Attacks - American Family Physician

Nov 15, 1999 - Stroke is the third most common overall cause of death and the leading cause of adult disability in the United States. New therapeutic interventions instituted in the period immediately after a stroke have revolutionized the approach to ischemic cerebrovascular disease. Recognition of a...

American Family Physician : Article

https://www.aafp.org/afp/1999/1115/p2329.html

AAN Releases Guideline on Magnetic Resonance Imaging for Diagnosing Acute Ischemic ...

Feb 15, 2011 - Computed tomography (CT) is the diagnostic standard for acute stroke even though its accuracy has not been formally established. Its sensitivity for diagnosing ischemic stroke in the initial hours is limited; therefore, improved accuracy is needed to develop and provide optimal stroke ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2011/0215/p483.html

Dabigatran (Pradaxa) for Prevention of Stroke in Atrial Fibrillation - STEPS - American...

Dec 15, 2011 - Dabigatran is superior to warfarin for stroke prevention in patients with atrial fibrillation, with similar rates of major bleeding. Because it does not require laboratory monitoring, dabigatran therapy is less complicated than warfarin therapy, but it costs significantly more.

American Family Physician : STEPS

https://www.aafp.org/afp/2011/1215/p1397.html

Stroke: Part II. Management of Acute Ischemic Stroke - American Family Physician

May 15, 1999 - Optimal treatment of the patient who has sustained an acute ischemic stroke requires rapid assessment and early intervention. The leisurely approach to acute stroke management sometimes taken in the past should be replaced by an approach that treats stroke as a true medical emergency. ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0515/p2828.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

Practical Considerations in the Early Treatment of Ischemic Stroke - American Family ...

Jan 1, 1998 - Successful treatment of patients with ischemic stroke depends on the ability to treat within three hours of onset, because tissue plasminogen activator has not yet been proved effective beyond this time frame. The two major causes of delay in treatment are failure, on the part of the ...

American Family Physician : Article

https://www.aafp.org/afp/1998/0101/p73.html

Update on Vitamin Supplements for the Prevention of Coronary Disease and Stroke - ...

Sep 15, 2000 - Dietary antioxidants and folic acid may play a role in the pathophysiology of coronary disease and stroke. We review patient-oriented evidence on the effectiveness of supplementation with antioxidants and/or folic acid in the prevention of myocardial infarction and stroke. Observational...

American Family Physician : Article

https://www.aafp.org/afp/2000/0915/p1359.html

Stroke: Part I. A Clinical Update on Prevention - American Family Physician

May 1, 1999 - Clinical trials conducted during the past five years have yielded important results that have allowed us to refine our approach to stroke prevention. Treatment of isolated systolic hypertension prevents stroke and is generally well tolerated. New antiplatelet agents (clopidogrel and the...

American Family Physician : Article

https://www.aafp.org/afp/1999/0501/p2475.html

Aspirin in Patients with Actue Ischemic Stroke - FPIN's Clinical Inquiries - American ...

Feb 1, 2009 - Aspirin in a daily dose of 160 to 300 mg initiated within 48 hours of symptom onset results in a net decrease in morbidity and mortality caused by acute ischemic stroke, based on a systematic review), regardless of the availability of computed tomography (CT).

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2009/0201/p226.html

Choosing Wisely: Don’t order formal swallow evaluation in stroke patients unless they ...

Don’t order formal swallow evaluation in stroke patients unless they fail their initial swallow screen.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=325

Is Telmisartan Effective for Stroke Prevention? - AFP Journal Club - American Family ...

Nov 15, 2009 - Does telmisartan therapy after stroke prevent recurrence and adverse cardiovascular events? Despite lowering blood pressure, telmisartan did not provide preventative benefit. This study reflects problems with publication bias and that surrogate markers, such as blood pressure control, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/1115/p1042.html

Choosing Wisely: Don’t routinely use seizure prophylaxis in patients following ischemic...

Don’t routinely use seizure prophylaxis in patients following ischemic stroke.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=209

Choosing Wisely: Avoid transfusions of red blood cells for arbitrary hemoglobin or ...

Avoid transfusions of red blood cells for arbitrary hemoglobin or hematocrit thresholds and in the absence of symptoms or active coronary disease, heart failure, or stroke.

American Family Physician : Choosing Wisely Recommendations

https://www.aafp.org/afp/recommendations/viewRecommendation.htm?recommendationId=31

Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report - ...

Dec 15, 2015 - Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1069.html

Predicting Prognoses in Patients with Acute Stroke - Point-of-Care Guides - American ...

Jun 15, 2008 - A number of clinical decision models and scoring systems have been developed and validated to assist physicians in assessing the prognosis of patients with acute stroke.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2008/0615/p1719.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.html

Treatment of Acute Ischemic Stroke with t-PA - AFP Journal Club - American Family ...

Apr 1, 2008 - Does the widespread use of the thrombolytic tissue plasminogen activator (t-PA) more beneficial or harmful in patients with acute stroke? The benefits must be balanced against the harms. Informed consent is necessary when making the decision.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0401/p901.html

Predicting Short-term Risk of Stroke After TIA - Point-of-Care Guides - American Family...

Sep 15, 2006 - Five to 10 percent of patients presenting with TIA will have a stroke within the following week. Because guidelines do not mandate hospitalization for patients who have had a TIA or suspected TIA,4,5 validated clinical prediction rules may be used to identify patients who should ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2006/0915/p1001.html

Occupational Therapy Improves Activities of Daily Living After Stroke - Cochrane for ...

Jun 1, 2007 - Compared with standard rehabilitation, ADL-based occupational therapy significantly decreases death or institutionalization and deterioration in the ability to perform ADL after stroke. The optimal length and type of therapy is not well defined.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2007/0601/p1651.html

Warfarin for Prevention of Ischemic Stroke Recurrence? - FPIN's Clinical Inquiries - ...

Jun 1, 2006 - There is no evidence that anticoagulation with warfarin, initiated after a noncardioembolic ischemic stroke, significantly reduces stroke recurrence. Furthermore, anticoagulation significantly increases the risk of fatal and nonfatal hemorrhagic stroke and extracranial hemorrhage in ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2006/0601/p2011.html

Health Maintenance in Women - American Family Physician

Jan 1, 2013 - The health maintenance examination is an opportunity to focus on disease prevention and health promotion. The patient history should include screening for tobacco use, alcohol misuse, intimate partner violence, and depression. Premenopausal women should receive preconception counseling ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p30.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Nov 15, 2011 - Chronic kidney disease affects an estimated 27 million adults in the United States, and is associated with significantly increased risk of cardiovascular disease and stroke. Patients should be assessed annually to determine whether they are at increased risk of developing chronic kidney...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1138.html

Top 20 Research Studies of 2015 for Primary Care Physicians - American Family Physician

May 1, 2016 - In 2015, a group of primary care clinicians with expertise in evidence-based practice performed monthly surveillance of more than 110 English-language clinical research journals. They identified 251 studies that addressed a primary care question and had the potential to change practice ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p756.html

Atrial Fibrillation: Diagnosis and Treatment - American Family Physician

Jan 1, 2011 - Atrial fibrillation is the most common cardiac arrhythmia. It impairs cardiac function and increases the risk of stroke. The incidence of atrial fibrillation increases with age. Key treatment issues include deciding when to restore normal sinus rhythm, when to control rate only, and how...

American Family Physician : Article

https://www.aafp.org/afp/2011/0101/p61.html

Asthma, Back and Neck Pain, Pain During Labor, TIA, CBT for Anxiety - AFP Clinical ...

Aug 15, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0815/p208.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

Postoperative Pain, Acute Stroke, Hormone Therapy, Diet to Improve Cardiovascular Risk,...

May 15, 2019 - Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians.

American Family Physician : AFP Clinical Answers

https://www.aafp.org/afp/2019/0515/p606.html

Emergency and Urgent Care Self-Study Package -- CME

Jul 12, 2019 - Refine your emergency care skills on topics that include pediatric emergencies, stroke and stroke mimics, vascular emergencies and more.

CME : CME by Topic

https://www.aafp.org/cme/cme-topic/all/er-urgent.html

Recognition and Evaluation of Nontraumatic Subarachnoid Hemorrhage and Ruptured ...

Oct 1, 2013 - Swift diagnosis and treatment are critical for good outcomes in patients with nontraumatic subarachnoid hemorrhage, which is usually caused by a ruptured aneurysm. This type of stroke often results in death or disability. Rates of misdiagnosis and treatment delays for subarachnoid ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1001/p451.html

Contraception Choices in Women with Underlying Medical Conditions - American Family ...

Sep 15, 2010 - Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0915/p621.html

JNC8 Guidelines for the Management of Hypertension in Adults - Practice Guidelines - ...

Oct 1, 2014 - Hypertension is one of the most important preventable contributors to disease and death in the United States, leading to myocardial infarction, stroke, and renal failure when it is not detected early and treated appropriately. The Eighth Joint National Committee (JNC 8) recently ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2014/1001/p503.html

Pain In the Quiet (Not Red) Eye - American Family Physician

Jul 1, 2010 - Although eye pain is often accompanied by redness or injection, pain can also occur with a quiet eye. Pain in a quiet eye can be the first sign of a vision-threatening condition, a more benign ophthalmologic condition, or a nonophthalmologic condition. Acute narrow-angle glaucoma is an ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0701/p69.html

Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation -...

Oct 1, 2019 - Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p405.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

Appropriate and Safe Use of Diagnostic Imaging - American Family Physician

Apr 1, 2013 - Risks of diagnostic imaging include cancer from radiation exposure and nephrogenic systemic fibrosis. The increase in volume of imaging between 1980 and 2006 has led to a sixfold increase in annual per capita radiation exposure. It is predicted that 2 percent of future cancers will be ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0401/p494.html

Outpatient Approach to Palpitations - American Family Physician

Jul 1, 2011 - Palpitations are a common problem seen in family medicine; most are of cardiac origin, although an underlying psychiatric disorder, such as anxiety, is also common. Even if a psychiatric comorbidity does exist, it should not be assumed that palpitations are of a noncardiac etiology. ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0701/p63.html

AAFP Chronic Diseases CME Course in San Diego (La Jolla), CA -- CME

Jul 15, 2019 - Learn the latest on AFib, hypertension, stroke prevention, and more at the AAFP Care of Chronic Conditions live, evidence-based CME course in San Diego (La Jolla), CA.

CME : CME by Topic

https://www.aafp.org/cme/cme-topic/all/chronic-conditions-live/san-diego1.html

Type 2 Diabetes Therapies: A STEPS Approach - American Family Physician

Feb 15, 2019 - A concise way to evaluate pharmacotherapy options for type 2 diabetes mellitus is to use the five patient-oriented STEPS criteria: safety, tolerability, efficacy, price, and simplicity. The first-line treatment option, metformin, is safe and fairly well-tolerated, has excellent ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0215/p237.html

Heat-Related Illness - American Family Physician

Jun 1, 2011 - Heat-related illness is a set of preventable conditions ranging from mild forms (e.g., heat exhaustion, heat cramps) to potentially fatal heat stroke. Hot and humid conditions challenge cardiovascular compensatory mechanisms. Once core temperature reaches 104°F (40°C), cellular damage ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1325.html

Rethinking Aspirin for the Primary Prevention of Cardiovascular Disease - Editorials - ...

Jun 1, 2019 - Aspirin's routine use for primary prevention has been the subject of controversy because of questionable benefits and increased bleeding risk. Aspirin therapy may reduce the relative risk of a first heart attack or stroke, but this benefit could be outweighed by the risk of ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0601/p670.html

Clinical Vignettes in Geriatric Depression - American Family Physician

Nov 15, 2011 - The diagnosis of depression in older patients is often complicated by comorbid conditions, such as cerebrovascular disease or dementia. Tools specific for this age group, such as the Geriatric Depression Scale or the Cornell Scale for Depression in Dementia, may assist in making the ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1115/p1149.html

Dizziness: Approach to Evaluation and Management - American Family Physician

Feb 1, 2017 - Dizziness is a common yet imprecise symptom. It was traditionally divided into four categories based on the patient’s history: vertigo, presyncope, disequilibrium, and light-headedness. However, the distinction between these symptoms is of limited clinical usefulness. Patients have ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p154.html

Caregiver Care - American Family Physician

Jun 1, 2011 - In 2009, nearly 66 million Americans (three in 10 U.S. households) reported at least one person providing unpaid care as a family caregiver. More adults with chronic conditions and disabilities are living at home than ever before, and family caregivers have an even higher level of ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0601/p1309.html

Exercise Stress Testing: Indications and Common Questions - American Family Physician

Sep 1, 2017 - Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0901/p293.html

Community-Acquired Pneumonia in Adults: Diagnosis and Management - American Family ...

Nov 1, 2016 - Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1101/p698.html

Physical Activity Guidelines for Older Adults - American Family Physician

Jan 1, 2010 - Few older adults in the United States achieve the minimum recommended amount of physical activity. Lack of physical activity contributes to many chronic diseases that occur in older adults, including heart disease, stroke, diabetes mellitus, lung disease, Alzheimer disease, ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0101/p55.html

Hyperlipidemia - American Family Physician

May 1, 2019 - This collection features AFP content on hyperlipidemia and related issues, including dyslipidemia, hypercholesterolemia, hypertriglyceridemia, kidney disease, lipid disorders, metabolic syndrome, statins, and triglyceride levels. This collection features AFP content on hyperlipidemia ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=13

American Heart Association Scientific Statement on the Primary Prevention of Ischemic ...

Aug 1, 2001 - The American Heart Association (AHA) has issued a scientific statement on the primary prevention of ischemic stroke. The scientific statement includes an overview of established and potential risk factors and recommendations.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2001/0801/p513.html

Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: ...

Jan 15, 2017 - The USPSTF recommends that adults without a history of cardiovascular disease (CVD) (i.e., symptomatic coronary artery disease or ischemic stroke) use a low- to moderate-dose statin for the prevention of CVD events and mortality when all of the following criteria are met: (1) they are ...

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

https://www.aafp.org/afp/2017/0115/od1.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

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

Acute Coronary Syndrome: Current Treatment - American Family Physician

Feb 15, 2017 - Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0215/p232.html

Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults -...

May 1, 2015 - Generalized anxiety disorder (GAD) and panic disorder (PD) are among the most common mental disorders in the United States, and they can negatively impact a patient’s quality of life and disrupt important activities of daily living. Evidence suggests that the rates of missed diagnoses ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p617.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

Heart Failure - American Family Physician

Jul 1, 2019 - This collection features AFP content on heart failure and related issues, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers (ARBs), cardiomyopathy, cardioverter-defibrillators, congestive heart failure, and diastolic and systolic heart failure. This...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=26

AFP Podcast: Episode 94 - September 15, 2019 -- American Family Physician

Sep 21, 2019 - Episode 94 includes discussions on glycopyrronium topical wipes, urinary incontinence, augmentation for treatment-resistant depression, pelvic inflammatory disease, dual antiplatelet therapy for transient ischemic attack and minor stroke, ruling out community-acquired pneumonia.

American Family Physician : AFP Home

https://www.aafp.org/journals/afp/explore/podcast/94.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

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

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

Acute Migraine Headache: Treatment Strategies - American Family Physician

Feb 15, 2018 - Migraine is a primary headache disorder characterized by recurrent attacks. Acetaminophen, nonsteroidal anti-inflammatory drugs, triptans, antiemetics, ergot alkaloids, and combination analgesics have evidence supporting their effectiveness in the treatment of migraine. Acetaminophen ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p243.html

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