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Purpose: To review the evidence and provide clinical recommendations for the management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Methods: This guideline is based on a systematic review of randomized controlled trials from database inception to January 2, 2019. The target audience for the guideline includes all primary care clinicians, and the target patient population includes adults who are experiencing acute exacerbations of COPD. This guideline was developed using a modified version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, a transparent approach to evaluating the certainty of the evidence and determining the strength of recommendations. Recommendation 1: The American Academy of Family Physicians (AAFP) recommends that clinicians prescribe systemic antibiotics for adults with acute exacerbations of COPD to improve clinical cure and reduce clinical failure (weak recommendation, moderate quality of evidence). Choice of antibiotic should be based on local resistance patterns, affordability, and patient history and preferences because there is insufficient evidence to support a preferential recommendation. Recommendation 2: The AAFP recommends that clinicians prescribe corticosteroids for adults with acute exacerbations of COPD to reduce clinical failure (weak recommendation, low quality of evidence). There is insufficient evidence to guide the dose, route of administration, or duration of treatment. [ABSTRACT FROM AUTHOR]

Purpose: To review the evidence and provide clinical recommendations for the screening and treatment of depression in patients who have had a recent acute coronary syndrome event. Methods: This guideline is based on a systematic review of randomized controlled trials and observational studies from January 1, 2003, to August 15, 2017. It is an update to a previous systematic review published in May 2005, which included studies up to March 2004. The target audience for the guideline includes all primary care clinicians, and the target patient population includes adults who are within the three months following an acute coronary syndrome event (unstable angina or myocardial infarction). This guideline was developed using a modified version of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, a transparent approach to evaluating the certainty of the evidence and determining the strength of recommendations. Recommendation 1: The American Academy of Family Physicians recommends that clinicians screen for depression, using a standardized depression screening tool, in patients who have recently experienced an acute coronary syndrome event (weak recommendation, low-quality evidence). Individuals should undergo further assessment to confirm the diagnosis of depression (good practice point). Recommendation 2: The American Academy of Family Physicians strongly recommends that clinicians prescribe antidepressant medication, preferably selective serotonin reuptake inhibitors or serotonin-norepinephrine reuptake inhibitors, and/or cognitive behavior therapy to improve symptoms of depression in patients who have a history of acute coronary syndrome and have been diagnosed with depression (strong recommendation, moderate-quality evidence). [ABSTRACT FROM AUTHOR]

The article comments on the U.S. Preventive Services Task Force's (USPSTF) recently updated recommendation statement, lowering the starting age for colorectal cancer screening. It notes that the American Academy of Family Physicians (AAFP) disagrees with USPSTF for lack of evidence to assess its benefits and harms. Also discussed is the potential cost to patients and the health care system of lowering the screening age to 45.

The article comments on the U.S. Preventive Services Task Force's (USPSTF) updated recommendation statement, lowering the starting age for colorectal cancer screening. It notes that the American Academy of Family Physicians (AAFP) disagrees with USPSTF for lack of evidence to assess its benefits and harms. Also discussed is the potential cost to patients and the health care system of lowering the screening age to 45.

Purpose: To review the evidence and provide clinical recommendations for appropriate blood pressure treatment targets for adults with hypertension. [ABSTRACT FROM AUTHOR]

An editorial is presented on the management of acute pain from musculoskeletal injuries has guidance for family physicians. Topics include the family physicians commonly encounter patients with pain from acute musculoskeletal injuries that do not involve the lower back, and the management of chronic pain and the appropriate prescribing of opioids with less emphasis on the treatment of acute pain.