RESUMO
The Ministry of Health (MOH) has updated the clinical practice guidelines on hypertension to provide doctors and patients in Singapore with evidence-based treatment for hypertension. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on hypertension, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html. The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.
Assuntos
Hipertensão/diagnóstico , Hipertensão/terapia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Medicina Baseada em Evidências , Promoção da Saúde , Humanos , Estilo de Vida , Fatores de Risco , SingapuraRESUMO
The Ministry of Health (MOH) has updated the Clinical Practice Guidelines on Lipids to provide doctors and patients in Singapore with evidence-based treatment for lipids. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH Clinical Practice Guidelines on Lipids, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh.gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.
Assuntos
Lipídeos/sangue , Guias de Prática Clínica como Assunto , Adulto , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/terapia , Criança , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/terapia , Sistemas de Apoio a Decisões Clínicas , Dislipidemias/sangue , Dislipidemias/complicações , Dislipidemias/terapia , Medicina Baseada em Evidências , Feminino , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/terapia , Estilo de Vida , Lipoproteínas LDL/sangue , Masculino , Gravidez , Complicações na Gravidez , Medição de Risco , Fatores de Risco , SingapuraRESUMO
INTRODUCTION: The delay in HIV diagnosis has been identified as a significant reason for late presentation to medical care. This research aims to elucidate the significant determinants of late-stage HIV infection in Singapore between 1996 and 2009, after the advent of highly active anti-retroviral therapies. MATERIALS AND METHODS: We included 3735 patients infected via sexual mode of transmission from the National HIV Registry diagnosed between 1996 and 2009. Late-stage HIV infection is defined as CD4 count less than 200 mm(3) or AIDS-defining opportunistic infections at fi rst diagnosis or within one year of HIV diagnosis. We determined independent epidemiological risk factors for late-stage HIV infection at first diagnosis using multivariate logistic regression. RESULTS: Multivariate analysis showed that older age corresponded significantly with increasing odds of late-stage HIV infection. Compared to persons diagnosed at 15 to 24 years of age, those diagnosed at age 55 years and above were associated with 5-fold increased likelihood of late-stage infection (adjusted odds ratio (AOR): 5.17; 95% CI, 3.21 to 8.33). Chinese ethnicity, singlehood, and non-professional occupations were also significantly associated with late-stage HIV infection. Persons detected in the course of medical care had over 3.5 times the odds of late-stage infection (AOR: 3.55; 95% CI, 2.71 to 4.65). Heterosexual mode of transmission and having sex workers and social escorts as sexual partners, were the other epidemiological risk factors with significant associations. CONCLUSION: The findings of this study emphasises the need to increase HIV awareness and to encourage early and regular HIV testing among at-risk persons.