Articles: treatment.
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Baillieres Clin Neurol · Dec 1996
ReviewContraception, pregnancy and lactation in women with epilepsy.
Despite all of our advances women with epilepsy face obstacles when it comes to pregnancy and childbearing. Many of these obstacles are social, based on incorrect and inappropriate attitudes of the public towards persons with epilepsy. Unfortunately many of the uninformed public are health care providers. ⋯ The number of exposed women is so small that no pattern or estimates of risk can be determined at this time. Careful monitoring as is being performed by the Lamotrigine and North American Epilepsy and Pregnancy Registries will hopefully provide the necessary safety information in the near future. All of the risks aside, the majority of women with epilepsy can and will have healthy children.
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Results of a 1995 survey reveal that 1,437 local health departments-half of those in the country-provide sexually transmitted disease (STD) services and receive about two million client visits each year. Their clients are predominantly individuals with incomes of less than 250% of the poverty level (83%), women (60%) and non-Hispanic whites or blacks (55% and 35%, respectively); 36% of clients are younger than 20, and 30% are aged 20-24. On average, 23% of clients tested for STDs have chlamydia, 13% have gonorrhea, 3% have early-stage syphilis, 18% have some other STD and 43% have no STD. ⋯ Some 14% offer services only in sessions dedicated to STD care, 37% always integrate STD and other services, such as family planning, in the same clinic sessions, and 49% offer both separate and integrated sessions. STD programs that integrate services with other health care typically cover nonmetropolitan areas, have small caseloads, serve mainly women and provide a variety of contraceptives. In contrast, those that offer services only in dedicated sessions generally are in metropolitan areas and have large caseloads; most of their clients are men, and few provide contraceptive methods other than the male condom.
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There is a great need to expand current knowledge of the various functional capacity measurements used in the rehabilitation of chronic low back pain (CLBP) patients. The literature on these patients reports that mobility, endurance, trunk strength and lifting capacity decrease during the process of chronicity. Chronically disabled patients appear to have lower functional capacity than asymptomatic persons. ⋯ Study results showed that physical capacity in disabled patients with low back pain is substantially reduced in comparison to persons who do not suffer from back pain. The only exception was in trunk flexor strength and endurance, in which measurements did not differ between the patients and the control group. However, even CLBP- patients with long-term pain and severe physical illness can successfully improve their physical condition by participating in an active treatment program. Back extensor muscle training has to be included in physical therapy. Because of loss of condition during the time after treatment, regular monitoring of patients and their home training programs is necessary. Overall, treatment of CLBP has to include physical training and psychosocial treatment to achieve satisfactory results.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomised controlled trial of treatment of chronic suppurative otitis media in Kenyan schoolchildren.
The outcomes of treatment of chronic suppurative otitis media (CSOM) are disappointing and uncertain, especially in developing countries. Because CSOM is the commonest cause of hearing impairment in children in these countries, an effective method of management that can be implemented on a wide scale is needed. We report a randomised, controlled trial of treatment of CSOM among children in Kenya; unaffected schoolchildren were taught to administer the interventions. ⋯ Our finding that dry mopping plus topical and systemic antibiotics is superior to dry mopping alone contrasts with that of the only previous community-based trial in a developing country, though it accords with findings of most other trials in developed countries. The potential role of antibiotics needs further investigation. Further, similar trials are needed to identify the most cost-effective and appropriate treatment regimen for CSOM in children in developing countries.
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Journal of anesthesia · Sep 1996
Comparative hemodynamic effects of hypotension induced by CGRP and PGE1 in dogs.
Calcitonin gene-related peptide (CGRP) produces vasodilation, hypotension, and tachycardia. We compared the hemodynamic effects of CGRP-induced hypotension with the effects of prostaglandin E1 (PGE1), which is currently used as a hypotensive agent during anesthesia. Eighteen mongrel dogs were anesthetized with pentobarbital (25 mg·kg(-1)), and 0.87% halothane in oxygen (1MAC). ⋯ The different results for changes in CI and cardiac contractility during the CGRP- and PGE1-induced hypotension were probably due to differences in ventricular filling pressure. Hypotension induced by PGE1 was associated with a significant decrease in heart rate (HR), whereas CGRP did not affect HR. This study shows that both CGRP and PGE1 are effective in decreasing afterload and in inducing hypotension; the results suggest that CGRP is a useful vasodilator for inducing hypotension during halothane anesthesia.