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At least 181 records · Page 10Linked to original sources
PubMed1998

Meeting the challenge of early identification of HIV infection in primary care.

The authors review the role of human immunodeficiency virus (HIV) testing in primary care, including an overview of epidemiologic trends of the HIV epidemic; avenues for HIV counseling and testing; HIV testing assays; guidelines for HIV test counseling in primary care; special situations involving testing of pregnant women, infants, and young children; post-exposure prophylaxis; and related resources available to Wisconsin primary care clinicians. HIV disease is a major cause of premature death and disability in the United States. Advances in the understanding of the pathogenesis of HIV and developments of newer antiretroviral therapies have resulted in dramatic changes in the management of HIV disease. Combination antiretroviral drug therapy has resulted in prolonged and near complete suppression of detectable HIV replication in many HIV-infected persons. These clinical developments underscore the importance of early identification and intervention in HIV disease. Intervention during primary HIV infection, the time when the viral burden "set point" is achieved, may present a special window of opportunity to effectively intervene in limiting viral replication in an infected individual. This earliest intervention may have major benefits for infected persons and society at large. Decreasing viral load during primary HIV infection may decrease an individual's infectiousness and thereby decrease the overall rate of transmission of infection to others. Primary care clinicians play a critical role in diagnosing, managing, and preventing HIV infection. Because of the ongoing relationship between patient and health care provider, the primary health care clinician is in the best position to provide HIV risk assessment, testing, related prevention education, and coordination of needed health care. This article presents guidelines for conducting HIV counseling and testing in primary care for purposes of furthering the public health objective of early identification of HIV infection. Clinicians can achieve this objective by including HIV risk assessment during the initial history and physical exam of every patient.

AIDS Serodiagnosis↗
PubMed2001

[Japanese guideline for treatment and management of childhood asthma and its originality].

Japanese guideline for treatment and management of childhood asthma was published in April, 2000. This is the Japan original guideline. The general and practical asthma treatment in Japan is described. We compared with this guideline and GINA. There is not a difference in the diagnosis and concept of bronchial asthma. This guideline for several Japan original therapies are described. The originality of this guideline is the early use of theophylline. There is not the entry of the use of oral steroid. There are many Japan original therapies such as the isoproterenol continuous inhalation therapy. Also, as for this guideline the education, vaccination and exercise of the patient are written in detail. We hope that this guideline is translated to English and be published.

Adolescent↗
PubMed2005

How to prevent low back pain.

This chapter summarizes the European Guidelines for Prevention in Low Back Pain, which consider the evidence in respect of the general population, workers and children. There is limited scope for preventing the incidence (first-time onset) of back pain and, overall, there is limited robust evidence for numerous aspects of prevention in back pain. Nevertheless, there is evidence suggesting that prevention of various consequences of back pain is feasible. However, for those interventions where there is acceptable evidence, the effect sizes are rather modest. The most promising approaches seem to involve physical activity/exercise and appropriate (biopsychosocial) education, at least for adults. Owing to its multidimensional nature, no single intervention is likely to be effective at preventing the overall problem of back pain, although there is likely to be benefit from getting all the players onside. However, innovative studies are required to better understand the mechanisms and delivery of prevention in low back pain.

Exercise Therapy↗
PubMed2006

The content of prenatal care and its relationship to preterm birth in Alberta, Canada.

Prenatal care is universally acknowledged as the hallmark of preventive care for pregnant women, and it is commonly assumed to have a positive influence on birth outcomes. The results of studies that have examined the impact of prenatal care on adverse birth outcomes, however, have been equivocal. These investigations have focused primarily on initiation of prenatal care and its timing, and not on the content of care received. Using data obtained from maternal self-reports and an electronic perinatal database, we examined the relationship between selected components of prenatal care (i.e., medical management, health education, and health advice) and the birth of a preterm infant. We found that health care providers are meeting the clinical guidelines for the medical management of pregnancy, but they are not adequately meeting pregnant women's needs for health education and advice. We found no association between the content of prenatal care and the birth of a preterm infant. Prenatal care must focus more on providing health education and advice to pregnant women.

Adult↗
PubMed2006

Mood stabilizer prescribing in a Christchurch adolescent sample: does it comply with guidelines?

OBJECTIVE: To determine the level of compliance with official guidelines for prescribing mood stabilizers among adolescents in Christchurch, New Zealand. METHODS: A retrospective audit of clinical files of patients aged 13-19 years attending inpatient and outpatient services in the Child, Adolescent and Family Service in the Canterbury District catchment area was carried out against set criteria derived from the Ministry of Health Guidelines regarding the use of mood stabilizers (lithium and sodium valproate). A guideline compliance index was also created to measure overall compliance. RESULTS: Over a period of 3 years beginning from January 2000, we identified 68 episodes of initiation among 58 adolescents. Of those, 91.2% were for indications set in the guidelines. More than half appeared to have been given no information about the medication, and only 61.8% had documented consent. Two-thirds had a full laboratory work-up before initiation. More than one-third had no evidence of communication with general practitioners about being initiated on a mood stabilizer. Overall, only 13.2% were 100% compliant and only 50% were 80% compliant. CONCLUSION: In general, mood stabilizers were prescribed as indicated, but adherence to the guidelines beyond that appears to fall short of standards set by the guidelines.

Adolescent↗