ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Reported increases in the incidence of human papillomavirus infection have generated speculation that cervical cytological abnormalities may also be increasing. A 10-year retrospective study of cervical cytology in 2,919 college women demonstrated a significant increase in the frequency and severity of cervical-cytological abnormalities (p=0.0001). The peak year for abnormal cervical cytology coincided with the peak year for overt human papillomavirus infection. Women with human papillomavirus, women with genital herpes and those who smoked had mean cervical-cytology severity scores significantly worse than women with none of these risk factors (p=0.00001). A stepwise regression analysis of abnormal cytology from recorded risk factors accounted for only 10 percent of the variance, with human papillomavirus accounting for 8 percent of the total. If human papillomavirus is indeed responsible for the majority of abnormalities, this infection is not detected reliably through routine examination and cervical-cytology screening.

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Significant levels of older-adult mortality and morbidity are associated with vaccine-preventable diseases, specifically influenza and pneumococcal disease. Even though current guidelines for this age group recommend a single vaccination against pneumococcal pneumonia, an annual influenza vaccination and a combined tetanus-diptheria toxoid booster every 10 years after completion of a primary series, immunization levels remain extremely low. This article presents information regarding usage, efficacy and cost-effectiveness of these vaccines. Physician non-compliance and misinformation, negative patient attitudes and a shortage of effective programs for vaccine delivery account for vaccine underutilization. Recommendations from health care providers significantly affect whether a person will be immunized. Increased vaccine usage was noted in clinic-based programs that initiated organizational or administrative interventions, such as patient and physician reminders, physician-performance feedback, medical-record checklists and the use of non-physician health care staff to monitor patient vaccination status and to dispense vaccines. Providing organized education and vaccination programs in institutional and public settings may also help target the older-adult population. The future success of adult immunization will depend not only on increased professional and public awareness but also on the development of new approaches to vaccine delivery.

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Little is known about the pros and cons of circumcision in older men. While the American Academy of Pediatrics suggests there are potential medical benefits of circumcision, early and mid-life concerns guide this reasoning. This article's study was devised to investigate the impact of non-circumcision on elderly, institutionalized males. Caregivers from two nursing homes were asked their opinions about and experiences with caring for uncircumcised males. Survey results indicate that these caregivers strongly support routine neonatal circumcision. Even though nursing-home caregivers are prepared to provide personal hygiene for their male patients, they believe circumcision prevents infection and makes hygiene easier. The caregivers preferred neonatal circumcision over adult circumcision because they believed circumcision to be less painful for a neonate. Included in this article are recommendations for future research.

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Because health law is changing continually, clinicians must be updated periodically. This article discusses two significant legal developments: the defeat of court-ordered cesarean sections and the new Patient Self-Determination Act. A decision reached by the Court of Appeals for the District of Columbia asserted that medical decisions on behalf of a woman and her fetus should be made by the pregnant woman if she is conscious and alert. Although this decision does not supply all the answers, it reiterates judicial support for the primacy of a woman's rights when her welfare is endangered by a procedure designed to safeguard a fetus. The Patient Self-Determination Act, effective December 1991, requires health care providers at hospitals and other sites to supply all adult patients with written information advising them of their rights, to explain the provider's policy for implementing those rights and to document any advance directives supplied by patients.

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0361-1817    

出版商:OVID    

年代:1992

数据来源: OVID