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Enuresis in Children: A Case Based Approach - American Family Physician

Oct 15, 2014 - Enuresis is defined as intermittent urinary incontinence during sleep in a child at least five years of age. Approximately 5% to 10% of all seven-year-olds have enuresis, and an estimated 5 to 7 million children in the United States have enuresis. The pathophysiology of primary ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1015/p560.html

Health Literacy in Primary Care Practice - American Family Physician

Jul 15, 2015 - Health literacy includes a set of skills needed to make appropriate health decisions and successfully navigate the health care system. These skills include reading, writing, numeracy, communication, and, increasingly, the use of electronic technology. National data indicate that more ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0715/p118.html

Diagnosis and Treatment of Venous Ulcers - American Family Physician

Apr 15, 2010 - Venous ulcer, also known as stasis ulcer, is the most common etiology of lower extremity ulceration, affecting approximately 1 percent of the U.S. population. Possible causes of venous ulcers include inflammatory processes resulting in leukocyte activation, endothelial damage, platelet ...

American Family Physician : Article

https://www.aafp.org/afp/2010/0415/p989.html

Cardiac Rehabilitation: Improving Function and Reducing Risk - American Family Physician

Jul 1, 2016 - Cardiac rehabilitation is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. The overall goals focus on improving daily function and reducing cardiovascular risk factors. Cardiac rehabilitation includes interventions ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0701/p37.html

Diagnostic Approach to Chronic Constipation in Adults - American Family Physician

Aug 1, 2011 - Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0801/p299.html

Diagnosis and Treatment of Peripheral Arterial Disease - American Family Physician

Sep 1, 2013 - Peripheral arterial disease (PAD) is atherosclerosis leading to narrowing of the major arteries distal to the aortic arch. The most common presenting symptom is claudication; however, only 10% of patients have classic claudication. Approximately 8 to 12 million Americans have PAD, ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p306.html

Management of Mastitis in Breastfeeding Women - American Family Physician

Sep 15, 2008 - Mastitis occurs in approximately 10 percent of U.S. mothers who are breastfeeding, and it can lead to the cessation of breastfeeding. The risk of mastitis can be reduced by frequent, complete emptying of the breast and by optimizing breastfeeding technique. Sore nipples can precipitate ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0915/p727.html

Provision of Contraception: Key Recommendations from the CDC - American Family Physician

May 1, 2015 - The Centers for Disease Control and Prevention has released comprehensive recommendations for provision of family planning services. Contraceptive services may be addressed in five steps, and counseling may be provided in a tiered approach, whereby the most effective options are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0501/p625.html

Diagnostic Approach to Pleural Effusion - American Family Physician

Jul 15, 2014 - Pleural effusion affects more than 1.5 million people in the United States each year and often complicates the management of heart failure, pneumonia, and malignancy. Pleural effusion occurs when fluid collects between the parietal and visceral pleura. Processes causing a distortion in ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0715/p99.html

Weighing the Risks and Benefits of Chronic Opioid Therapy - American Family Physician

Jun 15, 2016 - Evidence supports the use of opioids for treating acute pain. However, the evidence is limited for the use of chronic opioid therapy for chronic pain. Furthermore, the risks of chronic therapy are significant and may outweigh any potential benefits. When considering chronic opioid ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0615/p982.html

Common Questions About Pressure Ulcers - American Family Physician

Nov 15, 2015 - Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1115/p888.html

Pharmacologic Therapy for Acute Pain - American Family Physician

Jun 1, 2013 - The approach to patients with acute pain begins by identifying the underlying cause and a disease-specific treatment. The first-line pharmacologic agent for the symptomatic treatment of mild to moderate pain is acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID). The choice ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0601/p766.html

Diagnosis and Treatment of Plantar Fasciitis - American Family Physician

Sep 15, 2011 - Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in adults. It affects more than 1 million persons per year, and two-thirds of patients with plantar fasciitis will seek care from their family physician. Plantar fasciitis affects sedentary and athletic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0915/p676.html

Lung Cancer: Diagnosis, Treatment Principles, and Screening - American Family Physician

Feb 15, 2015 - Lung cancer is classified histologically into small cell and non–small cell lung cancers. The most common symptoms of lung cancer are cough, dyspnea, hemoptysis, and systemic symptoms such as weight loss and anorexia. High-risk patients who present with symptoms should undergo chest ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0215/p250.html

Dyspareunia in Women - American Family Physician

Oct 1, 2014 - Dyspareunia is recurrent or persistent pain with sexual activity that causes marked distress or interpersonal conflict. It affects approximately 10% to 20% of U.S. women. Dyspareunia can have a significant impact on a woman’s mental and physical health, body image, relationships with ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1001/p465.html

Common Questions About the Diagnosis and Management of Benign Prostatic Hyperplasia - ...

Dec 1, 2014 - Benign prostatic hyperplasia (BPH) is a common condition that increases in prevalence with age. A history should include onset, duration, and severity of lower urinary tract symptoms and medication use to rule out other causes of symptoms. Physical examination includes a digital rectal ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1201/p769.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

Urinary Retention in Adults: Diagnosis and Initial Management - American Family Physician

Mar 1, 2008 - Urinary retention is the inability to voluntarily void urine. This condition can be acute or chronic. Causes of urinary retention are numerous and can be classified as obstructive, infectious and inflammatory, pharmacologic, neurologic, or other. The most common cause of urinary ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0301/p643.html

Update on Prenatal Care - American Family Physician

Feb 1, 2014 - Many elements of routine prenatal care are based on tradition and lack a firm evidence base; however, some elements are supported by more rigorous studies. Correct dating of the pregnancy is critical to prevent unnecessary inductions and to allow for accurate treatment of preterm labor....

American Family Physician : Article

https://www.aafp.org/afp/2014/0201/p199.html

Management of Spontaneous Vaginal Delivery - American Family Physician

Aug 1, 2015 - Most of the nearly 4 million births in the United States annually are normal spontaneous vaginal deliveries. In the first stage of labor, normal birth outcomes can be improved by encouraging the patient to walk and stay in upright positions, waiting until at least 6 cm dilation to ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0801/p202.html

The Spiritual Assessment - American Family Physician

Sep 15, 2012 - More than 80 percent of Americans perceive religion as important. Issues of belief can affect the health care encounter, and patients may wish to discuss spirituality with their physician. Many physicians report barriers to broaching the subject of spirituality, including lack of time ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0915/p546.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

Urticaria: Evaluation and Treatment - American Family Physician

May 1, 2011 - Urticaria involves intensely pruritic, raised wheals, with or without edema of the deeper cutis. It is usually a self-limited, benign reaction, but can be chronic. Rarely, it may represent serious systemic disease or a life-threatening allergic reaction. Urticaria has a lifetime ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0501/p1078.html

Evaluation of Fever in Infants and Young Children - American Family Physician

Feb 15, 2013 - Febrile illness in children younger than 36 months is common and has potentially serious consequences. With the widespread use of immunizations against Streptococcus pneumoniae and Haemophilus influenzae type b, the epidemiology of bacterial infections causing fever has changed. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p254.html

Diagnosis and Management of Ectopic Pregnancy - American Family Physician

Jul 1, 2014 - Ectopic pregnancy affects 1% to 2% of all pregnancies and is responsible for 9% of pregnancy-related deaths in the United States. When a pregnant patient presents with first-trimester bleeding or abdominal pain, physicians should consider ectopic pregnancy as a possible cause. The ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0701/p34.html

Diagnosis and Evaluation of Heart Failure - American Family Physician

Jun 15, 2012 - Heart failure is a common clinical syndrome characterized by dyspnea, fatigue, and signs of volume overload, which may include peripheral edema and pulmonary rales. Heart failure has high morbidity and mortality rates, especially in older persons. Many conditions, such as coronary ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0615/p1161.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

Nonpharmacologic Management of Chronic Insomnia - American Family Physician

Dec 15, 2015 - Insomnia affects 10% to 30% of the population with a total cost of $92.5 to $107.5 billion annually. Short-term, chronic, and other types of insomnia are the three major categories according to the International Classification of Sleep Disorders, 3rd ed. The criteria for diagnosis are ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1058.html

The Adult Well Male Examination - American Family Physician

May 15, 2012 - The adult well male examination should incorporate evidence-based guidance toward the promotion of optimal health and well-being, including screening tests shown to improve health outcomes. Nearly one-third of men report not having a primary care physician. The medical history should ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0515/p964.html

Vaginitis: Diagnosis and Treatment - American Family Physician

Apr 1, 2011 - Bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis are the most common infectious causes of vaginitis. Bacterial vaginosis occurs when the normal lactobacilli of the vagina are replaced by mostly anaerobic bacteria. Diagnosis is commonly made using the Amsel criteria, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0401/p807.html

Pressure Ulcers: Prevention, Evaluation, and Management - American Family Physician

Nov 15, 2008 - A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure,...

American Family Physician : Article

https://www.aafp.org/afp/2008/1115/p1186.html

Common Questions About the Management of Gastroesophageal Reflux Disease - American ...

May 15, 2015 - Common questions that arise regarding treatment of gastroesophageal reflux disease (GERD) include which medications are most effective, when surgery may be indicated, which patients should be screened for Barrett esophagus and Helicobacter pylori infection, and which adverse effects ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p692.html

Outpatient Burns: Prevention and Care - American Family Physician

Jan 1, 2012 - Most burn injuries can be managed on an outpatient basis by primary care physicians. Prevention efforts can significantly lower the incidence of burns, especially in children. Burns should be managed in the same manner as any other trauma, including a primary and secondary survey. ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0101/p25.html

Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders - American ...

Nov 1, 2015 - Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1101/p807.html

Treatment of Acute Migraine Headache - American Family Physician

Feb 1, 2011 - Migraine headache is a common and potentially debilitating disorder often treated by family physicians. Before diagnosing migraine, serious intracranial pathology must be ruled out. Treating acute migraine is challenging because of substantial rates of nonresponse to medications and ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0201/p271.html

Schizophrenia - American Family Physician

Dec 1, 2014 - Schizophrenia is the most common psychotic disease, with a global prevalence of less than 1%. It affects all ethnicities and is slightly more common in men. Patients with schizophrenia commonly experience debilitating social and occupational impairments, but some are able to function ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1201/p775.html

Signs and Symptoms of Childhood Cancer: A Guide for Early Recognition - American Family...

Aug 1, 2013 - Although cancer in children is rare, it is the second most common cause of childhood mortality in developed countries. It often presents with nonspecific symptoms similar to those of benign conditions, leading to delays in the diagnosis and initiation of appropriate treatment. Primary ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0801/p185.html

Common Questions About the Diagnosis and Management of Fibromyalgia - American Family ...

Apr 1, 2015 - Fibromyalgia has a distinct pathophysiology involving central amplification of peripheral sensory signals. Core symptoms are chronic widespread pain, fatigue, and sleep disturbance. Most patients with fibromyalgia have muscle pain and tenderness, forgetfulness or problems concentrating,...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p472.html

Primary Care of the Prostate Cancer Survivor - American Family Physician

May 1, 2016 - This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0501/p764.html

Urinalysis: Case Presentations for the Primary Care Physician - American Family Physician

Oct 15, 2014 - Urinalysis is useful in diagnosing systemic and genitourinary conditions. In patients with suspected microscopic hematuria, urine dipstick testing may suggest the presence of blood, but results should be confirmed with a microscopic examination. In the absence of obvious causes, the ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1015/p542.html

Diagnosis of Urinary Incontinence - American Family Physician

Apr 15, 2013 - Urinary incontinence is common, increases in prevalence with age, and affects quality of life for men and women. The initial evaluation occurs in the family physician’s office and generally does not require urologic or gynecologic evaluation. The basic workup is aimed at identifying ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p543.html

Common Questions About Chronic Low Back Pain - American Family Physician

May 15, 2015 - More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back...

American Family Physician : Article

https://www.aafp.org/afp/2015/0515/p708.html

Antiobiotic Prophylaxis to Prevent Surgical Site Infections - American Family Physician

Mar 1, 2011 - Surgical site infections are the most common nosocomial infections in surgical patients, accounting for approximately 500,000 infections annually. Surgical site infections also account for nearly 4 million excess hospital days annually, and nearly $2 billion in increased health care ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0301/p585.html

Cat-scratch Disease - American Family Physician

Jan 15, 2011 - Cat-scratch disease is a common infection that usually presents as tender lymphadenopathy. It should be included in the differential diagnosis of fever of unknown origin and any lymphadenopathy syndrome. Asymptomatic, bactere- mic cats with Bartonella henselae in their saliva serve as ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0115/p152.html

Responses to Medical Students' Frequently Asked Questions About Family Medicine - ...

Feb 1, 2016 - This article provides answers to many of the common questions that medical students ask about the specialty of family medicine. It describes the crucial role that family physicians have in the evolving health care environment, the scope of practice, the diverse career opportunities ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/od1.html

Pharmacogenetics: Using Genetic Information to Guide Drug Therapy - American Family ...

Oct 1, 2015 - Clinical pharmacogenetics, the use of genetic data to guide drug therapy decisions, is beginning to be used for medications commonly prescribed by family physicians. However, clinicians are largely unfamiliar with principles supporting clinical use of this type of data. For example, ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1001/p588.html

Oral Manifestations of Systemic Disease - American Family Physician

Dec 1, 2010 - Careful examination of the oral cavity may reveal findings indicative of an underlying systemic condition, and allow for early diagnosis and treatment. Examination should include evaluation for mucosal changes, periodontal inflammation and bleeding, and general condition of the teeth. ...

American Family Physician : Article

https://www.aafp.org/afp/2010/1201/p1381.html

Arthropod Bites - American Family Physician

Dec 15, 2013 - The phylum Arthropoda includes arachnids and insects. Although their bites typically cause only local reactions, some species are venomous or transmit disease. The two medically important spiders in the United States are widow spiders (Latrodectus), the bite of which causes intense ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1215/p841.html

Incidentalomas: Initial Management - American Family Physician

Dec 1, 2014 - Incidentalomas are increasingly common findings on radiologic studies, causing worry for physicians and patients. Physicians should consider the risk of discovering incidentalomas when contemplating imaging. Patients may assume that incidentalomas are cancer, and may not be aware of the...

American Family Physician : Article

https://www.aafp.org/afp/2014/1201/p784.html

Primary Care of the Solid Organ Transplant Recipient - American Family Physician

Feb 1, 2016 - The advancing science of transplantation has led to more transplants and longer survival. As a result, primary care physicians are more involved in the care of transplant recipients. Immunosuppressive therapy has significantly decreased rates of transplant rejection but accounts for ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0201/p203.html

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