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PubMed2002

New trend by states is to integrate HIV programs. Collaboration saves some resources.

Until recently, a typical model for providing HIV services has been to separate prevention and testing programs from treatment and care programs. While many states still adhere to this model, there's a new trend in which state health departments are encouraging the two groups to collaborate and even merge their boards. The goal is to increase efficiencies, save board members' time, and improve communication.

Cooperative Behavior↗
PubMedDate not supplied

[Program of integral general medicine].

This paper intends to present to all the medical profession, but more specifically to the Medican and Latin American medical workers and authorities, the main purposes that arm and give structure to a new concept of teaching and learning medicine called, "Integral General Medicine" (also known as "Plan A-36"). This plan in basically conceived for México and most of Latin American countries, but may be applied to any other. The main idea is to keep the students in close contact with the community in order to achieve the best of their knowledge, both theoretically and practically, since the very early stages of their entrance to the medical school. The whole scholarship curriculum is described with reference to every one of the four academic years that accomplish the program.

Community Medicine↗
PubMed1998

[The management of tuberculosis in the Republic of Cuba].

The essential aspects for the management of tuberculosis surveillance and control are described to propitiate their divulgation among to health professionals. Since 1970 there is an integrated program under way within the health services based on the localization of cases by the bacilloscopic examination and the sputum culture in symptomatic respiratory patients, the ambulatory controlled treatment, the investigation of the contacts of the notified cases, including the chemoprophylaxis with isoniacide, and the BCG vaccination to newborns. In 1995, the percentage of symptomatic patients detected at the general medicine offices was of 0.7%, whereas the percentage of the first bacilloscopy performed among the symptomatic individuals was of 78.6%, 99.5% of the detected contacts were investigated. 37.9% of the new cases were diagnosed at the primary health care level. After a decreasing trend maintained from 1979 to 1991, mortality has increased from 50 deaths (0.5 x 10(5)) in 1991 to 157 (1.4 x 10(5)) in 1995, and the incidence rose from 503 (4.7 x 10(5)) in 1991 to 1,574 (14.3 x 10(5)) in 1994, and to 1,553 (14.0 x 10(5)) in 1995, which suggests that the increase observed during the last 6 years begins to stop. The primary resistance to tuberculostatics was of 3.5% in 1992-1995, and of 11.5% in 1996. A priority integrated program of surveillance and control adjusted to the present socioeconomic conditions of the country is still going on.

Antitubercular Agents↗
PubMed1983

Partial cystectomy: can it be incorporated into integrated therapy program?

A retrospective study of 23 partial cystectomies for bladder cancer performed during a twelve-year period revealed no operative deaths and a low morbidity. Bladder capacity was little affected by the use of preoperative radiotherapy, and complications were minimal. The results suggest that protracted radiotherapy can be used preoperatively without adversely influencing operative complications.

Adult↗
PubMed2002

The European NEAT program: an integrated approach using acamprosate and psychosocial support for the prevention of relapse in alcohol-dependent patients with a statistical modeling of therapy success prediction.

BACKGROUND: A multicenter, prospective study was conducted in five European countries to observe outcome in alcohol misusers treated for 24 weeks with acamprosate and various psychosocial support techniques, within the setting of standard patient care. METHODS: Patients diagnosed as alcohol dependent using DSM-III-R criteria were treated, for 24 weeks, with acamprosate and appropriate psychosocial support. Potential predictor variables were recorded at inclusion. Drinking behavior was monitored throughout; the proportion of cumulative abstinence days was the principal outcome measure. The influence of baseline clinical and demographic variables on outcome was assessed using multiple regression analysis. Adverse events were recorded systematically. RESULTS: A total of 1289 patients were recruited; 1230 took at least one dose of the drug and provided at least one set of follow-up data; 543 (42.1%)patients were observed for the full 24-week period. The overall proportion of cumulative abstinence days was 0.48. Multiple physical and psychiatric comorbidities and a history of drug addiction were negatively correlated with outcome, as were, to a lesser extent, multiple previous episodes of detoxification, unemployment, and living alone. Older age and stable employment were positively associated with outcome. The difference in the unadjusted proportion of cumulative abstinence days between countries was significant ( < 0.001) but less so when adjusted for the predictive factors identified in the multivariate model ( < 0.019). Overall, outcome was not influenced by the nature of the psychosocial support provided. Adverse events were generally mild, with gastrointestinal disorders, which occurred in 21.5% of patients, being the most frequent. CONCLUSIONS: This open-label study confirms the efficacy and safety of acamprosate in the treatment of alcohol dependence in the setting of standard patient care. Treatment benefit was observed irrespective of the nature of the psychosocial support provided. Predictors of the response to treatment were identified; their heterogeneous distribution within the study population explained, at least in part, the differences in outcome between countries.

Acamprosate↗
PubMed1976

An integrated treatment program for psychogenic pain.

The family characteristics associated with the presence of recurrent abdominal pain are identified. The involvement on the pediatrician and the effects of this involvement on the patient, family, and perpetuation of the symptoms are described. A successful therapeutic program combining behavior modification and family therapy is elaborated. Changes in the structure and functioning of the family are vital to the outcome of therapy and the prevention of recurrence of symptoms.

Abdomen↗
PubMed2001

India's multidrug-resistant tuberculosis crisis.

India has the highest number of tuberculosis cases of any country in the world, and many of these cases are MDR TB. A combination of contributing factors has led to the current public health crisis: a failing National Tuberculosis Programme, denial and lack of compliance on the part of patients, lack of regulation of doctors in private practice, governmental policy failure and corruption, social and economic problems, and a growing HIV epidemic. This situation must be combatted on several fronts, including promoting social change; increasing government funding; seeking global aid; implementing DOTS, non-DOTS, and NGO programs; integrating TB and HIV programs; funding research; enacting regulatory legislation; and establishing continuing medical education programs among private practitioners.

Drug Resistance, Multiple↗