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Abnormal Uterine Bleeding in Premenopausal Women - American Family Physician

Apr 1, 2019 - Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p435.html

Current Concepts in Concussion: Initial Evaluation and Management - American Family ...

Apr 1, 2019 - Mild traumatic brain injury, also known as concussion, is common in adults and youth and is a major health concern. Concussion is caused by direct or indirect external trauma to the head resulting in shear stress to brain tissue from rotational or angular forces. Concussion can affect a...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p426.html

Febrile Seizures: Risks, Evaluation, and Prognosis - American Family Physician

Apr 1, 2019 - A febrile seizure is a seizure occurring in a child six months to five years of age that is accompanied by a fever (100.4°F or greater) without central nervous system infection. Febrile seizures are classified as simple or complex. A complex seizure lasts 15 minutes or more, is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0401/p445.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Subcutaneous Nodules on the Chest, with Cough and Weight Loss - Photo Quiz - American ...

Apr 1, 2019 - A 60-year-old smoker presented with cough and hemoptysis. She had also developed several subcutaneous masses on her chest wall and left and right abdominal wall over the past several months.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0401/p451.html

Understanding the High Cost of Insulin: What Family Physicians Can Do to Help Our ...

Apr 1, 2019 - Through clinical and system-level interventions, family physicians can push back against the high cost of insulin and help patients with type 2 diabetes afford these essential medications.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0401/p416.html

Palliative Care in Advanced Dementia - Curbside Consultation - American Family Physician

Apr 1, 2019 - What is the best way for family physicians to determine prognosis and applicability of palliative care for patients with dementia?

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2019/0401/p456.html

Will a Feeding Tube Help? Deciding for a Father at the End of Life - Close-ups - ...

Apr 1, 2019 - Making caring, difficult choices on behalf of loved ones at the end of life.

American Family Physician : Close-ups

https://www.aafp.org/afp/2019/0401/p420.html

Mild TBI in Children: Guidance from the CDC for Diagnosis and Treatment - Practice ...

Apr 1, 2019 - Mild traumatic brain injury in children is a major problem in the United States. Based on a systematic literature review, the Centers for Disease Control and Prevention (CDC) released recommendations specific to children with Glasgow Coma Scale scores of 13 to 15.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0401/p462.html

HPV Vaccine for Prevention of High-Grade Precancerous Cervical Lesions - Medicine by ...

Apr 1, 2019 - Data suggest the benefits of HPV vaccination for reducing precancerous lesions outweigh the potential harms. Find out more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0401/od1.html

Maternal Pertussis Vaccination During Pregnancy - FPIN's Help Desk Answers - American ...

Apr 1, 2019 - Women should receive the Tdap vaccine during pregnancy regardless of previous immunization history. Infants whose mothers received prenatal immunization had 50% fewer cases of pertussis compared with those whose mothers received postpartum immunization.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0401/p454.html

Pulse Oximetry Screening for Critical Congenital Heart Defects in Newborns - Cochrane ...

Apr 1, 2019 - Pulse oximetry is an accurate screening test for critical congenital heart defects in newborns. Pulse oximetry is simple to use, widely available, and has moderate sensitivity (76.3%) and good specificity (99.9%). However, the prevalence of critical congenital heart defects is low, and ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p421.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.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

No Reduction in Delirium with the Use of Haloperidol or Ziprasidone in Critically Ill ...

Apr 1, 2019 - For patients with acute respiratory failure or shock who develop delirium in the intensive care unit (ICU), the use of haloperidol or ziprasidone (Geodon) does not reduce the duration of delirium. This trial was powered to detect at least a two-day difference in the duration of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p460.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

Testicular Cancer, Onset of Labor, Respiratory Tract Infection, Thyroid Cancer, Running...

Apr 1, 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/2019/0401/p424.html

Alternate Nasal Packing Technique for Patients Experiencing Epistaxis - Letters to the ...

Apr 1, 2019 - Advertisement << Previous article Next article >> Apr 1, 2019 Issue Letters to the Editor Alternate Nasal Packing Technique for Patients Experiencing Epistaxis Am Fam Physician. 2019 Apr 1;99(7):408. Original Article: Epistaxis: Outpatient Management Issue Date: August 15, 2018 See...

American Family Physician : Letter

https://www.aafp.org/afp/2019/0401/p408.html

Lower Extremity Peripheral Artery Disease: Diagnosis and Treatment - American Family ...

Mar 15, 2019 - Lower extremity peripheral artery disease (PAD) affects 12% to 20% of Americans 60 years and older. The most significant risk factors for PAD are hyperlipidemia, hypertension, diabetes mellitus, chronic kidney disease, and smoking; the presence of three or more factors confers a 10-fold...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p362.html

Primary Care of Breast Cancer Survivors - American Family Physician

Mar 15, 2019 - With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0315/p370.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

Peripheral Vascular Disease - American Family Physician

Mar 15, 2019 - Advertisement AFP BY TOPIC Peripheral Vascular Disease Editors' Choice of Best Available Content This collection features the best content from AFP, as identified by the AFP editors, on peripheral vascular disease and related issues, including atherosclerosis, critical limb...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=82

Gabapentin and Pregabalin Not Effective for Low Back Pain with or Without Radiculopathy...

Mar 15, 2019 - The use of anticonvulsants like gabapentin (Neurontin) for painful conditions has increased greatly in recent years. This review finds good evidence that these drugs are not an effective treatment for low back pain with or without radiculopathy, and are associated with an increased risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od2.html

Tongue Ulcer in a Young Child - Photo Quiz - American Family Physician

Mar 15, 2019 - A six-year-old boy presented with a painful ulcer on his tongue after receiving treatment at a dermatology clinic for foot lesions earlier in the day.

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0315/p385.html

Lofexidine (Lucemyra) for Treatment of Opioid Withdrawal Symptoms - STEPS - American ...

Mar 15, 2019 - Lofexidine has been shown to be as effective as clonidine at controlling some of the symptoms of withdrawal from opioid use. It may have a small additional benefit for maintaining abstinence in patients switched to buprenorphine or methadone for long-term maintenance.

American Family Physician : STEPS

https://www.aafp.org/afp/2019/0315/p392.html

Coaching Patients About Successful Blood Pressure Management - Lown Right Care: ...

Mar 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0315/p357.html

HIV Prevention and Treatment with ART: International Antiviral Society Updates ...

Mar 15, 2019 - Antiretroviral therapy is the key to preventing and managing human immunodeficiency virus infection. Based on the availability of new medications and treatment options, the USA Panel of the International Antiviral Society has updated its 2016 recommendations.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0315/p395.html

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

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

American Family Physician : Editorials

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

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

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

American Family Physician : Putting Prevention into Practice

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

Screening for Atrial Fibrillation with Electrocardiography: Recommendation Statement - ...

Mar 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography.

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

https://www.aafp.org/afp/2019/0315/od1.html

Increased Water Intake Decreases UTI Recurrence in Women - POEMs - American Family ...

Mar 15, 2019 - Drinking an additional 1.5 liters per day of water halved the recurrence of UTI in women with a history of at least three episodes per year.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od3.html

Lorcaserin Is Safe, But Only Modestly Effective for Weight Loss - POEMs - American ...

Mar 15, 2019 - Lorcaserin, 10 mg twice daily, helps some patients lose 10% or more of their body weight (number needed to treat [NNT] = 10) and appears to be safe in terms of cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od4.html

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.html

Osteoporosis, Childhood Bullying, Rheumatoid Arthritis, Diabetes Counseling, Inhaled ...

Mar 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/2019/0315/p356.html

Case Report: Efficient and Cost-Effective Diagnosis of Vaginitis - Letters to the ...

Mar 15, 2019 - Advertisement << Previous article Next article >> Mar 15, 2019 Issue Letters to the Editor Case Report: Efficient and Cost-Effective Diagnosis of Vaginitis Am Fam Physician. 2019 Mar 15;99(6):344. To the Editor: A 27-year-old woman presented with vaginal odor and increased discharge....

American Family Physician : Letter

https://www.aafp.org/afp/2019/0315/p344.html

Gas, Bloating, and Belching: Approach to Evaluation and Management - American Family ...

Mar 1, 2019 - Gas, bloating, and belching are associated with a variety of conditions but are most commonly caused by functional gastrointestinal disorders. These disorders are characterized by disordered motility and visceral hypersensitivity that are often worsened by psychological distress. An ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p301.html

Hepatitis B: Screening, Prevention, Diagnosis, and Treatment - American Family Physician

Mar 1, 2019 - Hepatitis B virus (HBV) is a partly double-stranded DNA virus that causes acute and chronic liver infection. Screening for hepatitis B is recommended in pregnant women at their first prenatal visit and in adolescents and adults at high risk of chronic infection. Hepatitis B vaccination ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p314.html

Adhesive Capsulitis: Diagnosis and Management - American Family Physician

Mar 1, 2019 - Adhesive capsulitis, also known as frozen shoulder, is a common shoulder condition characterized by pain and decreased range of motion, especially in external rotation. Adhesive capsulitis is predominantly an idiopathic condition and has an increased prevalence in patients with diabetes...

American Family Physician : Article

https://www.aafp.org/afp/2019/0301/p297.html

Pharmacologic Treatment of Borderline Personality Disorder - FPIN's Help Desk Answers -...

Mar 1, 2019 - There is no pharmacotherapy regimen that improves the overall symptoms of borderline personality disorder. When used for six months or less, antipsychotics can improve paranoia, dissociation, mood lability, anger, and global functioning.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0301/od2.html

Preparing for Serious Illness: A Model for Better Conversations over the Continuum of ...

Mar 1, 2019 - How can we ensure that our seriously ill patients routinely get the right care without relying on individual sacrifice and luck?

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0301/p281.html

Management of Uterine Fibroids - Implementing AHRQ Effective Health Care Reviews - ...

Mar 1, 2019 - What are the comparative effectiveness and harms of treatments for uterine fibroids, and what is the risk of finding unexpected leiomyosarcoma in women with fibroids?

American Family Physician : Implementing AHRQ Effective Health Care Reviews

https://www.aafp.org/afp/2019/0301/p330.html

Different Durations of Corticosteroid Therapy for COPD Exacerbations - Cochrane for ...

Mar 1, 2019 - Treatment of acute exacerbations of COPD with a shorter course of systemic corticosteroids (seven or fewer days) is likely to be as effective and safe as treating with longer courses (more than seven days).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p295.html

Lesions on the Roof of the Mouth - Photo Quiz - American Family Physician

Mar 1, 2019 - Advertisement << Previous article Next article >> Mar 1, 2019 Issue Photo Quiz Lesions on the Roof of the Mouth SINDHUJA TEKUMALLA, MBBS; ANURADHA BISHNOI, MD; and KESHAVAMURTHY VINAY, MD, DNB, MNAMS, MRCP (SCE), Postgraduate Institute of Medical Education and Research, Chandigarh,...

American Family Physician : Photo Quiz

https://www.aafp.org/afp/2019/0301/p327.html

Myocardial Infarction: Expert Consensus Group Provides Updated Definition - Practice ...

Mar 1, 2019 - An expert consensus group of the European Society of Cardiology, American College of Cardiology Foundation, American Heart Association, and World Heart Federation has provided an updated universal definition of myocardial infarction.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0301/p334.html

Hemorrhoids, Tremor, C. difficile Infection, Migraine, Vitamin D Screening - AFP ...

Mar 1, 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/2019/0301/p285.html

To Prepare Patients Better: Reimagining Advance Care Planning - Editorials - American ...

Mar 1, 2019 - Forty-five million Americans live with one or more serious illnesses, many of which are life-limiting and marked by functional decline. Family physicians play a pivotal role in the care of these patients through their deep, longitudinal relationships.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0301/p278.html

Smectite for Acute Infectious Diarrhea in Children - Cochrane for Clinicians - American...

Mar 1, 2019 - When compared with placebo, smectite decreases the duration of diarrhea by about a day, with a mean difference of 24.4 fewer hours of diarrhea (95% confidence interval [CI], 17.9 to 30.9 hours). Smectite also decreases stool output by 11.4 g per kg (95% CI, 0.8 to 22 g per kg).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0301/p294.html

Metformin for Improving Maternal and Infant Outcomes in Pregnant Women Who Are Obese - ...

Mar 1, 2019 - This meta-analysis showed no clear benefit for metformin in reducing the risk of large for gestational age infants. Additionally, there was no difference in important secondary outcomes such as gestational diabetes, hypertensive disease in pregnancy, shoulder dystocia, advanced perineal...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0301/od1.html

Gas, Bloating, and Belching - American Family Physician

Mar 1, 2019 - Advertisement << Previous article Next article >> Mar 1, 2019 Issue Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2019/0301/p301-s1.html

Hepatitis B - American Family Physician

Mar 1, 2019 - Advertisement << Previous article Next article >> Mar 1, 2019 Issue Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of...

American Family Physician : Patient Handout

https://www.aafp.org/afp/2019/0301/p314-s1.html

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