Annals of internal medicine
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Practice Guideline Guideline
General recommendations on immunization. Guidelines from the Immunization Practices Advisory Committee. Centers for Disease Control.
This revision of the "General Recommendations on Immunization" updates the 1983 statement. Changes or new sections include 1) listing of vaccines available in the United States by type and recommended routes, 2) updated schedules for immunizing infants and children, 3) clarification of the guidelines for spacing administration of immune globulin preparations and different vaccines, 4) an updated table of recommendations for routine immunization of children infected with human immunodeficiency virus, 5) listing of conditions that are often inappropriately considered contraindications to immunizations, and 6) addition of information on the National Childhood Vaccine Injury Act of 1986 and the National Vaccine Injury Compensation Program. These recommendations are not comprehensive for each vaccine: Immunization Practices Advisory Committee (ACIP) recommendations on each vaccine should be consulted for more details.
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Randomized Controlled Trial Clinical Trial
Targeted inspiratory muscle training improves respiratory muscle function and reduces dyspnea in patients with chronic obstructive pulmonary disease.
To examine the effects of targeted inspiratory muscle training on respiratory muscle function, clinical ratings of dyspnea, and perception of resistive loads in symptomatic patients with chronic obstructive pulmonary disease. ⋯ Targeted inspiratory muscle training may enhance respiratory muscle function and reduce dyspnea in symptomatic patients with moderate to severe chronic obstructive pulmonary disease.
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Review Practice Guideline Guideline
Clinical ecology. American College of Physicians.
Clinical ecologists propose the existence of a unique illness in which multiple environmental chemicals, foods, drugs, and endogenous C. albicans have a toxic effect on the immune system, thereby adversely affecting other bodily functions. The proposal uses some concepts that superficially resemble those that apply to clinical allergy and toxicology and others that are novel. Review of the clinical ecology literature provides inadequate support for the beliefs and practices of clinical ecology. ⋯ Enumeration of lymphocyte subsets and quantitation of serum immunoglobulin and complement levels in patients with "environmental illness" have not yielded clear-cut evidence of immunologic abnormality. Clinical ecologists use a treatment program that includes avoidance of environmental chemicals, rotation of foods in the diet, and neutralization of symptoms with injected or sublingual extracts. Except for small-dose oral nystatin, which is used for treatment of patients with the candida hypersensitivity syndrome, drug therapy is intentionally avoided, although some clinical ecologists recommend mineral salts, oxygen, vitamins, minerals, and antioxidants for relief of symptoms.(ABSTRACT TRUNCATED AT 400 WORDS)
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Case Reports Multicenter Study Clinical Trial
Anticytoplasmic autoantibodies: their immunodiagnostic value in Wegener granulomatosis.
To determine disease specificity and sensitivity of anticytoplasmic autoantibodies (ACPA) for Wegener granulomatosis, as well as their value as a marker of disease activity. ⋯ Testing for ACPA in serum of patients with Wegener granulomatosis is valuable for differential diagnosis; furthermore, APCA can be used as a marker to follow disease activity. A new type of ELISA yielded the same results as indirect immunofluorescence for the specificity, sensitivity, and correlation with disease activity of ACPA.