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    11995 results match your criteria American family physician[Journal]

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    Top POEMs of 2016 Consistent with the Principles of the Choosing Wisely Campaign.
    Am Fam Physician 2017 Aug;96(4):234-239
    University of Georgia, Athens, GA, USA.
    A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. Read More

    Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.
    Am Fam Physician 2017 Sep;96(5):306-312
    Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
    Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Read More

    Exercise Stress Testing: Indications and Common Questions.
    Am Fam Physician 2017 Sep;96(5):293-299
    National Capital Consortium Family Medicine Residency, Fort Belvoir, VA, USA.
    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 adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. Read More

    Aseptic and Bacterial Meningitis: Evaluation, Treatment, and Prevention.
    Am Fam Physician 2017 Sep;96(5):314-322
    University of Cincinnati College of Medicine, Cincinnati, OH, USA.
    The etiologies of meningitis range in severity from benign and self-limited to life-threatening with potentially severe morbidity. Bacterial meningitis is a medical emergency that requires prompt recognition and treatment. Mortality remains high despite the introduction of vaccinations for common pathogens that have reduced the incidence of meningitis worldwide. Read More

    Vitamin B12 Deficiency: Recognition and Management.
    Am Fam Physician 2017 Sep;96(6):384-389
    St. Luke's Family Medicine Residency Program, Bethlehem, PA, USA.
    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 as gastric or small intestine resections, inflammatory bowel disease, use of metformin for more than four months, use of proton pump inhibitors or histamine H2 blockers for more than 12 months, vegans or strict vegetarians, and adults older than 75 years. Read More

    Hair Loss: Common Causes and Treatment.
    Am Fam Physician 2017 Sep;96(6):371-378
    Washington Health Systems Family Medicine Residency, Washington, PA, USA.
    Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Read More

    Diabetes Self-Management: Facilitating Lifestyle Change.
    Am Fam Physician 2017 Sep;96(6):362-370
    University of Buffalo Family Medicine Residency Program, Williamsville, NY, USA.
    Healthy eating and increased physical activity can prevent or delay the onset of diabetes mellitus and facilitate diabetes management. Current guidelines recommend long-term weight loss of 5% to 7% of body weight and 150 minutes of at least moderate-intensity physical activity per week for most patients with prediabetes and diabetes. Techniques to assess and facilitate adherence to these lifestyle changes can be practical in primary care. Read More

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