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Evolocumab (Repatha) for the Treatment of Hyperlipidemia - STEPS - American Family ...

Nov 15, 2016 - Evolocumab is generally safe and effective at lowering serum LDL cholesterol levels for select patients who need marked cholesterol reduction and can tolerate injections. However, it remains unknown whether evolocumab prevents premature death from cardiovascular events.

American Family Physician : STEPS

https://www.aafp.org/afp/2016/1115/p843.html

Erectile Dysfunction - American Family Physician

Nov 15, 2016 - ...to the nerves and blood vessels in the penis. This allows the penis to fill with blood. Some medical conditions block these signals, such as strokes, spine or pelvic injuries, Parkinson disease, and multiple sclerosis. Nerve damage from diabetes or prostate surgery can also cause...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/1115/p820-s1.html

Panel Highlights Team Approaches to Patient-centered Primary Care

Nov 14, 2016 - Panelists at the Patient-Centered Primary Care Collaborative Fall Conference discussed successful team-based tactics and what primary care might look like in the future.

AAFP News : Practice and Professional Issues

https://www.aafp.org/news/practice-professional-issues/20161114pcpccteams.html

Speakers Tout Population Health, Primary Care Integration Success

Nov 2, 2016 - Speakers at the recent 2016 AAFP State Legislative Conference highlighted initiatives that link primary care and population health to help vulnerable populations.

AAFP News : Health of the Public

https://www.aafp.org/news/health-of-the-public/20161102pophealthintegration.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

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

Primary Care for Patients with HIV Infection: It’s Not Who Should Provide It, It’s How ...

Nov 1, 2016 - The major challenge is not to address whether primary care clinicians without substantial HIV experience should provide HIV care, but to create a framework that allows all primary care clinicians to provide the best possible care for their patients living with HIV infection.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/1101/p687.html

High-Deductible Plans May Reduce Ambulatory Care Use - Graham Center Policy One-Pagers ...

Nov 1, 2016 - Although rates of uninsured Americans are declining because of the Affordable Care Act (ACA), there is growing concern about out-of-pocket expenditures associated with private high-deductible insurance plans.

American Family Physician : Graham Center Policy One-Pagers

https://www.aafp.org/afp/2016/1101/p727.html

Amiodarone for the Prevention of Sudden Cardiac Death - Cochrane for Clinicians - ...

Nov 1, 2016 - Although not a substitute for an implantable cardioverter-defibrillator (ICD), amiodarone is effective for the primary prevention of sudden cardiac death when compared with placebo (number needed to treat [NNT] = 47; 95% confidence interval [CI], 33 to 100), but it does not ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1101/p692.html

National STD Prevalence Hits All-time High -- Again

Oct 26, 2016 - A new CDC report finds that for the second consecutive year, newly diagnosed cases of syphilis, gonorrhea and chlamydia have risen, topping out at an unprecedented combined high.

AAFP News : Health of the Public

https://www.aafp.org/news/health-of-the-public/20161026stdreport.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

The Mental Status Examination - American Family Physician

Oct 15, 2016 - The mental status examination includes general observations made during the clinical encounter, as well as specific testing based on the needs of the patient and physician. Multiple cognitive functions may be tested, including attention, executive functioning, gnosia, language, memory, ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1015/p635.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer:...

Oct 15, 2016 - The USPSTF recommends initiating low-dose aspirin use for the primary prevention of cardiovascular disease (CVD) and colorectal cancer (CRC) in adults aged 50 to 59 years who have a 10% or greater 10-year CVD risk, are not at increased risk for bleeding, have a life expectancy of at ...

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

https://www.aafp.org/afp/2016/1015/od1.html

Aspirin Use for the Primary Prevention of Cardiovascular Disease and Colorectal Cancer ...

Oct 15, 2016 - S.L. is a 55-year-old man who presents to your office for a routine refill of his antihypertension medication. He also takes a statin and an antidepressant. Although he smokes, his blood pressure and cholesterol are well controlled. His history and physical examination are unremarkable.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/1015/p661.html

Procalcitonin Guidance Safely Decreases Antibiotic Use in Critically Ill Patients - ...

Oct 15, 2016 - For patients in the intensive care unit (ICU) who receive antibiotics for presumed or proven bacterial infections, the use of procalcitonin levels to determine when to stop antibiotic therapy results in decreased duration and consumption of antibiotics without increasing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p663a.html

Review for ABFM Board Exam with an AAFP Live Course -- CME

Oct 10, 2016 - Get everything you need to pass the ABFM Board exam when you attend this dynamic 3-1/2 day live course. Learn from case studies and 400-plus Board-style questions condensed into quick, 30- to 45-minute lectures by Board-certified physicians.

CME : CME by Topic

https://www.aafp.org/cme/cme-topic/all/board-review-express.html

It’s Time for ICD-10 Changes -- FPM

Oct 3, 2016 - The ICD-10 grace period has ended, so avoid using out-of-date and unspecified codes.

Family Practice Management : FPM Home

https://www.aafp.org/journals/fpm/explore/online/icd-10-update.html

Rivaroxaban vs. Warfarin for Anticoagulation in Patients with Atrial Fibrillation ...

Oct 1, 2016 - Studies showed that 433 patients needed to be treated with rivaroxaban to prevent one stroke and 629 patients needed to be treated with rivaroxaban to prevent one thromboembolic event. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/1001/od1.html

Top POEMs of 2015 Consistent with the Principles of the Choosing Wisely Campaign - ...

Oct 1, 2016 - The authors applied a novel method to identify recent clinical studies that showed results consistent with the principles of the Choosing Wisely campaign. The method, based on crowdsourcing studies known as POEMs (patientoriented evidence that matters), involved analyzing POEM ratings ...

American Family Physician : Article

https://www.aafp.org/afp/2016/1001/p566.html

USPSTF: Screen Pregnant Women for Pre-eclampsia Using BP

Sep 30, 2016 - The U.S. Preventive Services Task Force posted a draft recommendation statement calling for pregnant women to be screened for pre-eclampsia with blood pressure measurements throughout pregnancy.

AAFP News : Health of the Public

https://www.aafp.org/news/health-of-the-public/20160930draftrecpreeclampsia.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

Clinical Diagnosis of Gout Without Joint Aspirate - Point-of-Care Guides - American ...

Sep 15, 2016 - Gout is ideally diagnosed through identification of characteristic negatively birefringent crystals under polarized light microscopy in fluid aspirated from end-organ deposits, typically from a joint. However, fewer than 10% of patients with gout see a rheumatologist, and most cases of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0915/p505.html

Atrial Fibrillation - American Family Physician

Sep 15, 2016 - ...of your heart to shake, and not pump blood well. Sometimes a clot can form in this chamber, and if that clot breaks free it can cause a stroke. What are the symptoms? Your heartbeat may feel fast and uneven. You may also feel weak, tired, or short of breath. You may find it hard to...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/0915/p442-s1.html

AAFP News - Sep 15, 2016 - American Family Physician

Sep 15, 2016 - Selected policy and health issues news briefs from AAFP News.

American Family Physician : AAFP News: AFP Edition

https://www.aafp.org/afp/2016/0915/p420.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

Perioperative Beta Blockers - Medicine by the Numbers - American Family Physician

Sep 1, 2016 - Studies show that 1 in 72 patients had a nonfatal myocardial infarction prevents while harm end points included nonfatal stroke, hypotension, and bradycardia. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2016/0901/od1.html

Diagnosis and Treatment of Obstructive Sleep Apnea in Adults - American Family Physician

Sep 1, 2016 - Obstructive sleep apnea is a common disorder that causes patients to temporarily stop or decrease their breathing repeatedly during sleep. This results in fragmented, nonrestful sleep that can lead to symptoms such as morning headache and daytime sleepiness. Obstructive sleep apnea ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p355.html

Update on Office-Based Strategies for the Management of Obesity - American Family ...

Sep 1, 2016 - Obesity is a common condition that is associated with numerous medical problems such as cardiovascular disease, pulmonary disease, and diabetes mellitus. Primary care physicians have an important role in helping patients develop a successful weight loss plan to improve their overall ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0901/p361.html

Inhaled Fluticasone-Salmeterol Better Than Fluticasone Alone for Moderate to Severe ...

Sep 1, 2016 - The combination of fluticasone and salmeterol (Advair), with the steroid dose adjusted for disease severity, reduces the number of severe asthma exacerbations more than fluticasone (Flovent) alone (number needed to treat [NNT] = 50 over 26 weeks), with no difference in terms of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p387.html

Flibanserin Ineffective for Hypoactive Sexual Desire Disorder in Women - POEMs - ...

Sep 1, 2016 - Flibanserin produces a minimal effect on sexual desire and minimally increases the number of satisfying sexual events in women (less than one-half an event per month increase). Many women will be unable to tolerate the adverse effects.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384a.html

How to Recognize OSA and What It Means for Your Health - American Family Physician

Sep 1, 2016 - ...Stroke Hypertension (not controlled with medicine) Depression Increased risk of motor vehicle crashes Overall increased risk of death Where can I get more information? Your doctor American Sleep Apnea Association http://www.sleepapnea.org/ National Heart, Lung, and Blood...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2016/0901/p355-s1.html

AAFP Calls for Revisions in Proposed 2017 Physician Fee Schedule

Aug 24, 2016 - The AAFP is commending the 2017 proposed Medicare physician fee schedule for valuing primary care but has also called for many revisions to the proposal.

AAFP News : Government and Medicine

https://www.aafp.org/news/government-medicine/20160824feeschedule.html

CMS Fields New Pilot Program to Bolster Medicare Advantage

Aug 16, 2016 - The new Medicare Advantage Value-based Insurance Design Model initiative will permit health plans to be more flexible when designing incentives for enrollees.

AAFP News : Government and Medicine

https://www.aafp.org/news/government-medicine/20160816medicareadvantage.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

Behavioral Disorders in Dementia: Appropriate Nondrug Interventions and Antipsychotic ...

Aug 15, 2016 - Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient’s environment, and establishing daily routines. Family members ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0815/p276.html

AAP Updates Recommendations for Routine Preventive Pediatric Health Care - Practice ...

Aug 15, 2016 - The American Academy of Pediatrics (AAP) has updated recommendations for preventive pediatric health care services, including evidence-based screenings and assessments that should be addressed at well-child visits. The recommendations are organized by age: infancy, early childhood, ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2016/0815/p324.html

Alirocumab (Praluent) for Treatment of Hyperlipidemia - STEPS - American Family Physician

Aug 15, 2016 - Alirocumab is a novel lipid-lowering therapy that is highly effective at lowering LDL cholesterol when used in addition to statin therapy and diet. Its use should be limited to patients with either heterozygous familial hypercholesterolemia or clinical atherosclerotic cardiovascular ...

American Family Physician : STEPS

https://www.aafp.org/afp/2016/0815/p310.html

Stop Using Antipsychotics to Treat or Prevent Delirium—They Are No Better Than Placebo ...

Aug 15, 2016 - The available data indicate that antipsychotic medications are ineffective in preventing or treating delirium in hospitalized patients. Because there are concerns about falls and extrapyramidal effects with antipsychotics (not reported in this study), we should stop using them.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p318.html

Treating Painful Diabetic Peripheral Neuropathy: An Update - American Family Physician

Aug 1, 2016 - Painful diabetic peripheral neuropathy occurs in approximately 25% of patients with diabetes mellitus who are treated in the office setting and significantly affects quality of life. It typically causes burning pain, paresthesias, and numbness in a stocking-glove pattern that progresses...

American Family Physician : Article

https://www.aafp.org/afp/2016/0801/p227.html

Exercise to Improve Functioning in Patients with Dementia - FPIN's Help Desk Answers - ...

Aug 1, 2016 - Exercise programs lasting at least two months moderately increase the ability of patients with dementia to perform ADLs.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2016/0801/p242.html

CMS Announces Participants in Million Hearts CVD Risk Reduction Model

Jul 26, 2016 - On July 21, CMS announced the names of 516 practices -- including scores of family medicine offices -- that will participate in its Million Hearts Cardiovascular Disease Risk Reduction Model.

AAFP News : Health of the Public

https://www.aafp.org/news/health-of-the-public/20160726millionheartscvdmodel.html

Trigeminal Neuralgia - Clinical Evidence Handbook - American Family Physician

Jul 15, 2016 - What are the effects of ongoing treatments in persons with trigeminal neuralgia?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2016/0715/p133.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Stranded Patients, Lost Meds Are Just the Beginning of Flood Disaster

Jun 30, 2016 - Stranded Patients, Lost Meds Are Just the Beginning of Flood Disaster

AAFP News : Fresh Perspectives: New Docs in Practice | AAFP News Blog : Blogs

https://www.aafp.org/news/blogs/freshperspectives/entry/stranded_patients_lost_meds_are.html

USPSTF: More Research Needed on Screening for Obstructive Sleep Apnea

Jun 20, 2016 - The U.S Preventive Services Task Force posted its first-ever draft recommendation statement on screening for obstructive sleep apnea in asymptomatic adults in primary care settings.

AAFP News : Health of the Public

https://www.aafp.org/news/health-of-the-public/20160620sleepapnea.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

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Behavioral Interventions Reduce Inappropriate Antibiotic Prescribing for Acute ...

Jun 15, 2016 - Requiring clinicians to justify antibiotic prescribing in the permanent electronic health record and to undergo periodic peer comparisons of prescribing rates are effective interventions for reducing inappropriate antibiotic prescribing for acute respiratory tract infections. Helpful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1037.html

Report Highlights Need for Better Support for Primary Care

Jun 6, 2016 - Balancing care for complex patients with administrative demands is one of the toughest tasks for primary care physicians, according to a report by the Commonwealth Fund.

AAFP News : Practice and Professional Issues

https://www.aafp.org/news/practice-professional-issues/20160606jobsatisfaction.html

Diet and Physical Activity for Cardiovascular Disease Prevention - American Family ...

Jun 1, 2016 - Cardiovascular disease (CVD) is the leading cause of death in the United States. One-third of these deaths may be preventable through healthy lifestyle choices including diet and physical activity. The Mediterranean diet is associated with reduced cardiovascular mortality, whereas the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p919.html

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