What physicians can do to reduce occupational and incidental pesticide exposure: a guide to best practices.

Residents of rural areas trust their physicians to provide them with accurate, unbiased information about pesticides and the effect they can have on health. Educating patients about using pesticides safely and avoiding contact with them need not be difficult or time-consuming and can be based on universal precautions that are already being practiced in the health care industry. This article discusses the prevalence of pesticide use in the United States, the ways people can be exposed, and several best practices for helping patients reduce their chance of exposure to pesticides that can cause illness.

Unrecognized torture affects the health of refugees.

Recognizing the symptoms and signs of torture and documenting their cause may be key to providing effective health care for refugees from countries where torture is known to have occurred. Generalist or primary care physicians are in a unique position to establish a trust relationship with patients, to identify potential signs and symptoms of torture, and encourage patients to talk about their experiences. With knowledge about, understanding of, and sensitivity toward torture survivors, physicians can help these patients regain their health and a sense of well-being.

The TEAM project: the effectiveness of smoking cessation intervention with hospital patients.

BACKGROUND: This study evaluated the effectiveness of three smoking cessation interventions for this population: (1) modified usual care (UC); (2) brief advice (A); and (3) brief advice plus more extended counseling during and after hospitalization (A + C). METHODS: Smokers (2,095) who were in-patients in four hospitals were randomly assigned to condition. Smoking status was ascertained via phone interview 7 days and 12 months post-discharge. At 12 months, reports of abstinence were validated by analysis of saliva cotinine. Intent to treat analyses were performed. RESULTS: At 7-day follow-up, 24.2% of participants reported abstinence in the previous 7 days. There were no differences between conditions. At 12-month follow-up, self-reported abstinence was significantly higher in the A + C condition (UC (15.0%) vs. A (15.2%) vs. A + C (19.8%)). There was no significant difference among conditions in cotinine-validated abstinence, however (UC (8.8%) vs. A (10.0%) vs. A + C (9.9%)). CONCLUSIONS: These interventions for hospital in-patients did not increase abstinence rates. Features of the study that might have contributed to this finding were the inclusiveness of the participation criteria, the fact that pharmacological aids were not provided, and a stage-matching approach that resulted in less intensive counseling for participants unwilling to set a quit date.

Giardiasis / Giardiasis

Una vez que los quistes de Giardia son expulsados del huesped mueren rapidamente si son deshidratados, pero pueden sobrevivir hasta dos meses en aguas frias con temperaturas de 8 C. Por tanto, las giardiasis se transmiten por la ingestion de heces o aguas contaminadas. Generalmente la infeccion produce diarrea, en las formas subaguda o cronica se pueden desarrollar signos y sintomas adicionales de malestar intestinal