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Top POEMs of 2018 Consistent with the Principles of the Choosing Wisely Campaign - ... Restricted content. Login required.

Sep 1, 2019 - In this article, we discuss the POEMs (patient-oriented evidence that matters) of 2018 judged to be most consistent with the principles of the Choosing Wisely campaign. We selected these POEMs through a crowdsourcing strategy of the daily POEMs information service for Canadian Medical ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0901/p290.html

Patient-Centered Communication: Basic Skills - American Family Physician

Jan 1, 2017 - Communication skills needed for patient-centered care include eliciting the patient’s agenda with open-ended questions, especially early on; not interrupting the patient; and engaging in focused active listening. Understanding the patient’s perspective of the illness and expressing ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p29.html

Diagnosis and Initial Management of Dysmenorrhea - American Family Physician

Mar 1, 2014 - Dysmenorrhea is one of the most common causes of pelvic pain. It negatively affects patients’ quality of life and sometimes results in activity restriction. A history and physical examination, including a pelvic examination in patients who have had vaginal intercourse, may reveal the ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p341.html

Thyroid Disease in Pregnancy - American Family Physician

Feb 15, 2014 - Thyroid disease is the second most common endocrine disorder affecting women of reproductive age, and when untreated during pregnancy is associated with an increased risk of miscarriage, placental abruption, hypertensive disorders, and growth restriction. Current guidelines recommend ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0215/p273.html

Common Questions About Recurrent Urinary Tract Infections in Women - American Family ...

Apr 1, 2016 - Recurrent urinary tract infections (UTIs) are common in women, including healthy women with normal genitourinary anatomy. Recurrent UTI is typically defined as three or more UTIs within 12 months, or two or more occurrences within six months. The same species that caused previous ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0401/p560.html

Evaluation of Short and Tall Stature in Children - American Family Physician

Jul 1, 2015 - Short stature is defined as a height more than two standard deviations below the mean for age (less than the 3rd percentile). Tall stature is defined as a height more than two standard deviations above the mean for age (greater than the 97th percentile). The initial evaluation of short ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0701/p43.html

Hypothermia and Cold Weather Injuries - American Family Physician Restricted content. Login required.

Dec 1, 2019 - Hypothermia, frostbite, and nonfreezing cold injuries predominantly affect older adults, homeless or intoxicated people, adventurers, and military personnel. Prevention begins with clothing that is clean, layered, and loose to promote circulation. Base layers made of moisture-wicking ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1201/p680.html

Initial Evaluation, Diagnosis, and Treatment of Anorexia Nervosa and Bulimia Nervosa - ...

Jan 1, 2015 - Eating disorders are life-threatening conditions that are challenging to address; however, the primary care setting provides an important opportunity for critical medical and psychosocial intervention. The recently published Diagnostic and Statistical Manual of Mental Disorders, 5th ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0101/p46.html

Ear and Hearing Disorders - American Family Physician

Sep 15, 2019 - This collection features AFP content on ear and hearing disorders and related issues, including hearing loss, otitis externa, otitis media, and tinnitus. This collection features AFP content on ear and hearing disorders and related issues, including hearing loss, otitis ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=98

Influenza - American Family Physician

Dec 15, 2019 - This collection features AFP content on influenza and related issues, including influenza vaccination and avian influenza. This collection features AFP content on influenza and related issues, including influenza vaccination and avian influenza.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=14

Multiple Myeloma: Diagnosis and Treatment - American Family Physician

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

American Family Physician : Article

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

Dental Problems in Primary Care - American Family Physician

Dec 1, 2018 - Oral health directly affects overall health and quality of life. More Americans lack dental insurance than medical insurance. Patients with poor oral health are more likely to have respiratory and cardiovascular diseases, adverse pregnancy outcomes, and diabetes mellitus. Early ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p654.html

Care of the Military Veteran: Selected Health Issues - American Family Physician Restricted content. Login required.

Nov 1, 2019 - According to the U.S. Census Bureau, 18.2 million veterans were living in the United States in 2017, of whom 1.6 million were female. Less than one-half of all veterans receive care at a Veterans Health Administration or military treatment facility, leaving most to receive services from...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p544.html

Lower Extremity Abnormalities in Children - American Family Physician

Aug 15, 2017 - Leg and foot problems in childhood are common causes of parental concern. Rotational problems include intoeing and out-toeing. Intoeing is most common in infants and young children. Intoeing is caused by metatarsus adductus, internal tibial torsion, and femoral anteversion. Out-toeing ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0815/p226.html

The Pregnant Patient: Managing Common Acute Medical Problems - American Family Physician

Nov 1, 2018 - Women often see their primary care physicians for common acute conditions during pregnancy. These conditions may be caused by pregnancy (obstetric problems) or worsened by pregnancy (obstetrically aggravated problems), or they may require special consideration during pregnancy because ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1101/p595.html

Conduct Disorder: Recognition and Management - American Family Physician

Nov 15, 2018 - Conduct disorder is a psychiatric syndrome that most commonly occurs in childhood and adolescence. It is characterized by symptoms of aggression toward people or animals, destruction of property, deceitfulness or theft, and serious violations of rules. Risk factors include male sex, ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p584.html

Diagnosis and Management of Kawasaki Disease - American Family Physician

Mar 15, 2015 - Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0315/p365.html

Transfusion of Blood and Blood Products: Indications and Complications - American ...

Mar 15, 2011 - Red blood cell transfusions are used to treat hemorrhage and to improve oxygen delivery to tissues. Transfusion of red blood cells should be based on the patient’s clinical condition. Indications for transfusion include symptomatic anemia (causing shortness of breath, dizziness, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0315/p719.html

Lead Poisoning in Children - American Family Physician

Jul 1, 2019 - Asymptomatic lead poisoning has become more common in children. Blood lead levels of less than 5 µg per dL are associated with impairments in neurocognitive and behavioral development that are irreversible. Risk factors for lead poisoning include age younger than five years, low ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p24.html

Interventional Radiology: Indications and Best Practices - American Family Physician

May 1, 2019 - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial...

American Family Physician : Article

https://www.aafp.org/afp/2019/0501/p547.html

Specific Learning Disabilities: The Family Physician's Role - American Family Physician Restricted content. Login required.

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

American Family Physician : Article

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

Preoperative Assessment in Older Adults: A Comprehensive Approach - American Family ...

Aug 15, 2018 - Surgical outcomes are significantly influenced by patients’ overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p214.html

Epistaxis: Outpatient Management - American Family Physician

Aug 15, 2018 - Epistaxis is a common emergency encountered by primary care physicians. Up to 60% of the general population experience epistaxis, and 6% seek medical attention for it. More than 90% of cases arise from the anterior nasal circulation, and most treatments can be easily performed in the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p240.html

Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders - American Family Physician

Oct 15, 2017 - Fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) result from intrauterine exposure to alcohol and are the most common nonheritable causes of intellectual disability. The percentage of women who drink or binge drink during pregnancy has increased since 2012. FAS ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1015/p515.html

Cerumen Impaction: Diagnosis and Management - American Family Physician

Oct 15, 2018 - Cerumen production is a normal and protective process for the ear canal. However, cerumen should be removed when it causes symptoms (e.g., hearing loss, itching, pain, tinnitus) or prevents assessment of the external auditory canal, the tympanic membrane, or audiovestibular system. ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p525.html

Caregiver Care - American Family Physician

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

American Family Physician : Article

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

Stuttering: Understanding and Treating a Common Disability - American Family Physician Restricted content. Login required.

Nov 1, 2019 - Childhood-onset fluency disorder, the most common form of stuttering, is a neurologic disability resulting from an underlying brain abnormality that causes disfluent speech. Stuttering can lead to significant secondary effects, including negative self-perception and negative perception ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1101/p556.html

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

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

American Family Physician : Article

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

Diagnosis and Treatment of Acute Uncomplicated Cystitis - American Family Physician

Oct 1, 2011 - Urinary tract infections are the most common bacterial infections in women. Most urinary tract infections are acute uncomplicated cystitis. Identifiers of acute uncomplicated cystitis are frequency and dysuria in an immunocompetent woman of childbearing age who has no comorbidities or ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1001/p771.html

Heart Failure Due to Reduced Ejection Fraction: Medical Management - American Family ...

Jan 1, 2017 - Heart failure is an increasingly common condition resulting in high rates of morbidity and mortality. For patients who have heart failure and reduced ejection fraction, randomized clinical trials demonstrate consistent mortality benefit from angiotensin-converting enzyme inhibitors, ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0101/p13.html

Diets for Health: Goals and Guidelines - American Family Physician

Jun 1, 2018 - Diet is the single most significant risk factor for disability and premature death. Patients and physicians often have difficulty staying abreast of diet trends, many of which focus primarily on weight loss rather than nutrition and health. Recommending an eating style can help patients...

American Family Physician : Article

https://www.aafp.org/afp/2018/0601/p721.html

Renal Cell Carcinoma: Diagnosis and Management - American Family Physician

Feb 1, 2019 - Kidney cancer is one of the 10 most common cancers in the United States with 90% being attributed to renal cell carcinoma. Men, especially black men, are more likely to be affected than women. Renal masses, either cystic or solid, are best detected with contrast-enhanced, triple-phase ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p179.html

The Changing Climate: Managing Health Impacts - American Family Physician Restricted content. Login required.

Nov 15, 2019 - Concentrations of greenhouse gases continue to accumulate in the atmosphere at increasing rates, heating the Earth’s surface and destabilizing climate. Health impacts from climate change may include increased morbidity and mortality from worsening cardiopulmonary health, worsening ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1115/p618.html

Caring for Transgender and Gender-Diverse Persons: What Clinicians Should Know - ...

Dec 1, 2018 - Persons whose experienced or expressed gender differs from their sex assigned at birth may identify as transgender. Transgender and gender-diverse persons may have gender dysphoria (i.e., distress related to this incongruence) and often face substantial health care disparities and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1201/p645.html

Inguinal Hernias: Diagnosis and Management - American Family Physician

Jun 15, 2013 - Inguinal hernias are one of the most common reasons a primary care patient may need referral for surgical intervention. The history and physical examination are usually sufficient to make the diagnosis. Symptomatic patients often have groin pain, which can sometimes be severe. Inguinal ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0615/p844.html

Acupuncture for Pain - American Family Physician

Jul 15, 2019 - Acupuncture has been increasingly used as an integrative or complementary therapy for pain. It is well-tolerated with little risk of serious adverse effects. Traditional acupuncture and nontraditional techniques, such as electroacupuncture and dry needling, often result in reported pain...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p89.html

Common Sleep Disorders in Children - American Family Physician

Mar 1, 2014 - Up to 50% of children will experience a sleep problem. Early identification of sleep problems may prevent negative consequences, such as daytime sleepiness, irritability, behavioral problems, learning difficulties, motor vehicle crashes in teenagers, and poor academic performance. ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0301/p368.html

Somatic Symptom Disorder - American Family Physician

Jan 1, 2016 - With the release of the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., the diagnostic category previously known as somatoform disorders is now called somatic symptom and related disorders. The revisions were intended to increase their relevance in the primary care ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0101/p49.html

Osteoarthritis: Rapid Evidence Review - American Family Physician

Apr 15, 2018 - Osteoarthritis (OA) should be suspected in patients with pain in the fingers, shoulders, hips, knees, or ankles, especially if they are older than 40 years. Patients older than 50 years who have joint pain, minimal morning stiffness, and functional impairment likely have OA. Radiography...

American Family Physician : Article

https://www.aafp.org/afp/2018/0415/p523.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

Diagnosis of Heel Pain - American Family Physician

Oct 15, 2011 - Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, ...

American Family Physician : Article

https://www.aafp.org/afp/2011/1015/p909.html

Common Finger Fractures and Dislocations - American Family Physician

Apr 15, 2012 - Finger fractures and dislocations are common injuries that are often managed by family physicians. A systematic physical examination is imperative to avoid complications and poor outcomes following these injuries. Radiography (commonly anteroposterior, true lateral, and oblique views) ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0415/p805.html

Genital Herpes: A Review - American Family Physician

Jun 1, 2016 - Genital herpes is a common sexually transmitted disease, affecting more than 400 million persons worldwide. It is caused by herpes simplex virus (HSV) and characterized by lifelong infection and periodic reactivation. A visible outbreak consists of single or clustered vesicles on the ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0601/p928.html

Prostate Disorders - American Family Physician

Jun 1, 2019 - This collection features content on prostates disorders and related issues, including benign prostatic hyperplasia, hematospermia, and prostatitis. This collection features content on prostates disorders and related issues, including benign prostatic hyperplasia, hematospermia, and ...

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=97

Exercise Prescriptions in Older Adults - American Family Physician

Apr 1, 2017 - Regular physical activity and exercise are important for healthy aging and are beneficial for chronic disease management. Exercise prescriptions for older adults should account for the individual’s health status and functional capacity. Any amount of exercise is better than being ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0401/p425.html

Common Running Injuries: Evaluation and Management - American Family Physician

Apr 15, 2018 - Running is a common form of exercise but predisposes athletes to several running-related injuries. Most running injuries are due to overuse and respond to conservative treatment. Tendinopathies in the patellar, Achilles, and hamstring tendons are common, and are primarily treated with ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0415/p510.html

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

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

American Family Physician : Article

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

Delivering Bad or Life-Altering News - American Family Physician

Jul 15, 2018 - Delivering serious, bad, or life-altering news to a patient is one of the most difficult tasks physicians encounter. Broadly defined as information that may alter a patient’s view of his or her future, bad news may include information related to a chronic disease (e.g., diabetes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0715/p99.html

Diagnosis and Treatment of Urinary Tract Infections in Children - American Family ...

Feb 15, 2011 - Acute urinary tract infections are relatively common in children, with 8 percent of girls and 2 percent of boys having at least one episode by seven years of age. The most common pathogen is Escherichia coli, accounting for approximately 85 percent of urinary tract infections in ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0215/p409.html

Braces and Splints for Common Musculoskeletal Conditions - American Family Physician

Nov 15, 2018 - Braces and splints can immobilize and protect joints, reduce pain, decrease swelling, and facilitate healing of acute injuries. They are also used for injury prevention and chronic pain reduction, and to alter the function of a joint. The medial unloading (valgus) knee brace is an ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1115/p570.html

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