Designing a biocontainment unit to care for patients with serious communicable diseases: a consensus statement.

In spite of great advances in medicine, serious communicable diseases are a significant threat. Hospitals must be prepared to deal with patients who are infected with pathogens introduced by a bioterrorist act (e.g., smallpox), by a global emerging infectious disease (e.g., avian influenza, viral hemorrhagic fevers), or by a laboratory accident. One approach to hazardous infectious diseases in the hospital setting is a biocontainment patient care unit (BPCU). This article represents the consensus recommendations from a conference of civilian and military professionals involved in the various aspects of BPCUs. The role of these units in overall U.S. preparedness efforts is discussed. Technical issues, including medical care issues (e.g., diagnostic services, unit access); infection control issues (e.g., disinfection, personal protective equipment); facility design, structure, and construction features; and psychosocial and ethical issues, are summarized and addressed in detail in an appendix. The consensus recommendations are presented to standardize the planning, design, construction, and operation of BPCUs as one element of the U.S. preparedness effort.

What's best for your patient with BPH?

Watchful waiting is recommended for patients with benign prostatic hyperplasia (BPH) whose clinical symptoms do not affect their quality of life. Use a validated patient questionnaire, such as the American Urological Association's Symptom Index, to establish the severity of BPH symptoms and follow their progression. alpha-Adrenergic blockers (either selective or nonselective) or 5-alpha reductase inhibitors are appropriate first-line therapies for patients bothered by BPH symptoms. Consider surgery for patients with severe obstructive symptoms who have not benefited from medical therapy or who prefer surgery as first-line treatment.