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1.
BMJ ; 371: m3485, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028588

RESUMO

OBJECTIVE: To evaluate the effect of five years of supervised exercise training compared with recommendations for physical activity on mortality in older adults (70-77 years). DESIGN: Randomised controlled trial. SETTING: General population of older adults in Trondheim, Norway. PARTICIPANTS: 1567 of 6966 individuals born between 1936 and 1942. INTERVENTION: Participants were randomised to two sessions weekly of high intensity interval training at about 90% of peak heart rate (HIIT, n=400), moderate intensity continuous training at about 70% of peak heart rate (MICT, n=387), or to follow the national guidelines for physical activity (n=780; control group); all for five years. MAIN OUTCOME MEASURE: All cause mortality. An exploratory hypothesis was that HIIT lowers mortality more than MICT. RESULTS: Mean age of the 1567 participants (790 women) was 72.8 (SD 2.1) years. Overall, 87.5% of participants reported to have overall good health, with 80% reporting medium or high physical activity levels at baseline. All cause mortality did not differ between the control group and combined MICT and HIIT group. When MICT and HIIT were analysed separately, with the control group as reference (observed mortality of 4.7%), an absolute risk reduction of 1.7 percentage points was observed after HIIT (hazard ratio 0.63, 95% confidence interval 0.33 to 1.20) and an absolute increased risk of 1.2 percentage points after MICT (1.24, 0.73 to 2.10). When HIIT was compared with MICT as reference group an absolute risk reduction of 2.9 percentage points was observed (0.51, 0.25 to 1.02) for all cause mortality. Control participants chose to perform more of their physical activity as HIIT than the physical activity undertaken by participants in the MICT group. This meant that the controls achieved an exercise dose at an intensity between the MICT and HIIT groups. CONCLUSION: This study suggests that combined MICT and HIIT has no effect on all cause mortality compared with recommended physical activity levels. However, we observed a lower all cause mortality trend after HIIT compared with controls and MICT. TRIAL REGISTRATION: ClinicalTrials.gov NCT01666340.


Assuntos
Envelhecimento , Exercício Físico , Frequência Cardíaca/fisiologia , Treinamento Intervalado de Alta Intensidade/métodos , Desempenho Físico Funcional , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Causas de Morte , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Humanos , Masculino , Mortalidade , Avaliação de Resultados em Cuidados de Saúde , Aptidão Física , Comportamento de Redução do Risco
3.
J Foot Ankle Res ; 13(1): 63, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33059721

RESUMO

BACKGROUND: The arrival of the novel coronavirus (SARS-CoV-2) has impacted the many aspects of modern life, especially, in the immediate term, the delivery of healthcare. CONTEXT: This commentary examines the profession of podiatry and how it has adapted and responded to the emerging crisis. It focusses on but is not exclusive to the position in the United Kingdom (UK) and the edicts and direction from the UK Government. PODIATRY ROLES DURING THE PANDEMIC: It describes the role of podiatry in the pandemic and highlights the deployment of podiatry resources to fight the pandemic beyond traditional podiatric practice. It also looks at the shift from conventional consultation to digital solutions for managing patients in an effort to achieve the goals of maintenance of foot health whilst reducing the spread of the virus. The commentary summarises the emerging data related to a possible foot related presentation of the coronavirus. CONCLUSION: The podiatry profession proved its flexibility and adaptability during the pandemic, to adjust rapidly to ensure that patients were able to access treatment to reduce risk of infection, ulceration and amputation. Dermatological presentations on the feet have been associated with Covid-19 in adolescents as is often the case in viral infections. CPD webinars to support clinicians and manage and prevent the spread of Covid-19 have been widely disseminated along with algorithms to ensure that patients that need treatment are being treated appropriately. Podiatrists have embraced remote technology to ensure that patients are correctly and safely triaged and, signposted and given appropriate self-care advice. MSK podiatrists have the ability to play an intrinsic role within the post discharge rehabilitation pathway.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Podiatria/organização & administração , Idoso , Idoso de 80 Anos ou mais , Tecnologia Biomédica/métodos , Tecnologia Biomédica/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Assistência à Saúde/tendências , Doenças do Pé/prevenção & controle , Humanos , Pandemias/prevenção & controle , Maleabilidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Podiatria/estatística & dados numéricos , Comportamento de Redução do Risco , Reino Unido/epidemiologia
5.
BMJ Open ; 10(9): e040951, 2020 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-32912958

RESUMO

OBJECTIVES: To assess the experience of people with long-term respiratory conditions regarding the impact of measures to reduce risk of COVID-19. DESIGN: Analysis of data (n=9515) from the Asthma UK and British Lung Foundation partnership COVID-19 survey collected online between 1 and 8 April 2020. SETTING: Community. PARTICIPANTS: 9515 people with self-reported long-term respiratory conditions. 81% female, age ranges from ≤17 years to 80 years and above, from all nations of the UK. Long-term respiratory conditions reported included asthma (83%), chronic obstructive pulmonary disease (10%), bronchiectasis (4%), interstitial lung disease (2%) and 'other' (<1%) (eg, lung cancer and pulmonary endometriosis). OUTCOME MEASURES: Study responses related to impacts on key elements of healthcare, as well as practical, psychological and social consequences related to the COVID-19 pandemic and social distancing measures. RESULTS: 45% reported disruptions to care, including cancellations of appointments, investigations, pulmonary rehabilitation, treatment and monitoring. Other practical impacts such as difficulty accessing healthcare services for other issues and getting basic necessities such as food were also common. 36% did not use online prescriptions, and 54% had not accessed online inhaler technique videos. Psychosocial impacts including anxiety, loneliness and concerns about personal health and family were prevalent. 81% reported engaging in physical activity. Among the 11% who were smokers, 48% reported they were planning to quit smoking because of COVID-19. CONCLUSIONS: COVID-19 and related social distancing measures are having profound impacts on people with chronic respiratory conditions. Urgent adaptation and signposting of services is required to mitigate the negative health consequences of the COVID-19 response for this group.


Assuntos
Infecções por Coronavirus , Exercício Físico , Pandemias , Pneumonia Viral , Saúde Pública , Doenças Respiratórias , Autogestão , Isolamento Social/psicologia , Adolescente , Adulto , Idoso de 80 Anos ou mais , Ansiedade/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Estudos Transversais , Exercício Físico/fisiologia , Exercício Físico/psicologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Solidão/psicologia , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/fisiopatologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Saúde Pública/métodos , Saúde Pública/normas , Doenças Respiratórias/epidemiologia , Doenças Respiratórias/fisiopatologia , Doenças Respiratórias/psicologia , Comportamento de Redução do Risco , Autogestão/métodos , Autogestão/psicologia , Autogestão/tendências , Reino Unido
8.
Trials ; 21(1): 809, 2020 Sep 29.
Artigo em Inglês | MEDLINE | ID: mdl-32993779

RESUMO

BACKGROUND: Early reports indicate that COVID-19 may require intensive care unit (ICU) admission in 5-26% and overall mortality can rise to 11% of the recognised cases, particularly affecting the elderly. There is a lack of evidence-based targeted pharmacological therapy for its prevention and treatment. We aim to compare the effects of a World Health Organization recommendation-based education and a personalised complex preventive lifestyle intervention package (based on the same WHO recommendation) on the outcomes of the COVID-19. METHODS: PROACTIVE-19 is a pragmatic, randomised controlled clinical trial with adaptive "sample size re-estimation" design. Hungarian population over the age of 60 years without confirmed COVID-19 will be approached to participate in a telephone health assessment and lifestyle counselling voluntarily. Volunteers will be randomised into two groups: (A) general health education and (B) personalised health education. Participants will go through questioning and recommendation in 5 fields: (1) mental health, (2) smoking habits, (3) physical activity, (4) dietary habits, and (5) alcohol consumption. Both groups A and B will receive the same line of questioning to assess habits concerning these topics. Assessment will be done weekly during the first month, every second week in the second month, then monthly. The composite primary endpoint will include the rate of ICU admission, hospital admission (longer than 48 h), and mortality in COVID-19-positive cases. The estimated sample size is 3788 subjects per study arm. The planned duration of the follow-up is a minimum of 1 year. DISCUSSION: These interventions may boost the body's cardiovascular and pulmonary reserve capacities, leading to improved resistance against the damage caused by COVID-19. Consequently, lifestyle changes can reduce the incidence of life-threatening conditions and attenuate the detrimental effects of the pandemic seriously affecting the older population. TRIAL REGISTRATION: The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (IV/2428- 2 /2020/EKU) and has been registered at clinicaltrials.gov ( NCT04321928 ) on 25 March 2020.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comportamento de Redução do Risco , Ensaios Clínicos Adaptados como Assunto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/efeitos adversos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/virologia , Exercício Físico , Comportamento Alimentar , Feminino , Nível de Saúde , Interações Hospedeiro-Patógeno , Humanos , Hungria , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Pneumonia Viral/virologia , Ensaios Clínicos Pragmáticos como Assunto , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos
9.
J Am Dent Assoc ; 151(10): 726-734, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32979952

RESUMO

BACKGROUND: The National Commission on Radiation Protection and Measurements has reinforced its recommendation for the use of rectangular collimation for intraoral radiography in its Report No. 177 published in 2019. This study compared effective dose (E) using circular and rectangular collimator (RC) modalities. METHODS: The authors exposed 18 projections for adult and 12 projections for child full-mouth series using an original equipment 6 centimeter diameter circular collimator (circular), original equipment rectangular positioning indicator device (Focus-RC), and 5 universal RC modalities (JadRad-RC, Rinn-RC, Durr-RC, DEXshield-RC, and TruAlign-RC) for adult and child phantoms. The authors acquired dosimetry using optically stimulated luminescence dosimeters. Exposures were made with a Focus (Instrumentarium) intraoral source using 70 peak kilovoltage and total milliamperes of 5.34 (adult) and 2.7 (child). RESULTS: Adult E was lowest for Focus-RC (54 microsieverts), which also produced the greatest exposure area reduction (51%) compared with circular, followed by JadRad-RC (55 µSv), Durr-RC (58 µSv), Rinn-RC (62 µSv), DEXshield-RC (70 µSv), TruAlign-RC (85 µSv), and circular (86 µSv). Child E followed a similar trend: Focus-RC (44 µSv), JadRad-RC (44 µSv), Durr-RC (45 µSv), Rinn-RC (48 µSv), DEXshield-RC (53 µSv), TruAlign-RC (85 µSv), and circular (89 µSv). When used with thyroid shielding, circular collimation thyroid dose was reduced by as much as 59%. CONCLUSIONS: Focus-RC techniques yielded the greatest dose reduction compared with alternative RC and circular. In addition to shape, collimator dimensions should be considered as significant factors affecting patient E. RC alone yielded a greater reduction in thyroid dose than did circular with thyroid shielding. PRACTICAL IMPLICATIONS: This study's findings underscore the updated recommendations of the National Commission on Radiation Protection and Measurements Report No.177, which emphasized the benefits and important practical considerations of RC with intraoral imaging.


Assuntos
Proteção Radiológica , Glândula Tireoide , Adulto , Criança , Humanos , Doses de Radiação , Radiografia , Comportamento de Redução do Risco
11.
Crim Behav Ment Health ; 30(5): 221-227, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32830392

RESUMO

BACKGROUND: Women with histories of childhood trauma tend to score higher on recidivism risk/needs assessment tools, such as the Level of Service Inventory-Revised: Screening Version (LSI-R: SV). These may affect their chance of leaving custody, but risk scores may be inflated by reliance on additional items which reflect other fixed childhood events. AIMS: We hypothesised that adverse childhood experiences (ACEs) would be related to immutable risk measures according to the LSI-R: SV, such as juvenile arrest history, rather than more mutable factors, such as criminal attitudes. METHODS: Two interviewer-administered questionnaires-one about ACEs and one about criminogenic risk and needs-were given to a cohort of women just after release from jail. Phi coefficients were used to test for associations between ? ACE scale scores and scores on the risk tool-the LSI-R: SV. RESULTS: ACE scale items were related to static risk item scores from the LSI-R: SV, but not to any of the dynamic risk items except psychological health. CONCLUSIONS: Risk reduction is an important task in the criminal justice system, for which systematic risk assessment is an integral part of decision making. Self-reported experience of psychological health apart, only fixed historical variables were related to estimated recidivism risk. There was no relationship between the mutable constructs of attitudes towards crime or employment status and estimated risk. This raises the question of whether the risk of recidivism is increased when there is a background of childhood trauma. Implications for using risk reduction tools to inform the need for trauma-informed correctional care are discussed. Longitudinal research assessing recidivism is needed to test this further.


Assuntos
Experiências Adversas da Infância , Crime/psicologia , Criminosos/psicologia , Prisioneiros/psicologia , Reincidência , Comportamento de Redução do Risco , Adolescente , Adulto , Criança , Crime/prevenção & controle , Feminino , Humanos , Masculino , Saúde Mental , Prisões , Medição de Risco , Inquéritos e Questionários
12.
High Blood Press Cardiovasc Prev ; 27(5): 373-377, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32734561

RESUMO

In 2020, the Sars-Cov-2 pandemic is causing a huge and dramatic impact on healthcare systems worldwide. During this emergency, fragile patients suffering from other comorbidities, especially patients susceptible to or affected by cardiovascular disease, are the ones most exposed to the poorer outcomes. Therefore, it is still mandatory to continue to strictly adhere to the rules of cardiovascular prevention. This document aims to provide all doctors with simple and clear recommendations in order to spread useful messages to the widest number of subjects in order to continue the battle against cardiovascular diseases even in times of pandemic.


Assuntos
Betacoronavirus/patogenicidade , Cardiologia/normas , Fármacos Cardiovasculares/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Serviços Preventivos de Saúde/normas , Comportamento de Redução do Risco , Fármacos Cardiovasculares/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Medição de Risco , Fatores de Risco
13.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32839242

RESUMO

CONTEXT: Family-based lifestyle interventions are recommended for adolescent obesity treatment, yet the optimal role of parents in treatment is unclear. OBJECTIVE: To examine systematically the evidence from prospective randomized controlled and/or clinical trials (RCTs) to identify how parents have been involved in adolescent obesity treatment and to identify the optimal type of parental involvement to improve adolescent weight outcomes. DATA SOURCES: Data sources included PubMed, PsychINFO, and Medline (inception to July 2019). STUDY SELECTION: RCTs evaluating adolescent (12-18 years of age) obesity treatment interventions that included parents were reviewed. Studies had to include a weight-related primary outcome (BMI and BMI z score). DATA EXTRACTION: Eligible studies were identified and reviewed, following the Preferred Reporting for Systematic Review and Meta-Analyses guidelines. Study quality and risk of bias were evaluated by using the Cochrane Collaboration risk of bias tool. RESULTS: This search identified 32 studies, of which 23 were unique RCTs. Only 5 trials experimentally manipulated the role of parents. There was diversity in the treatment target (parent, adolescent, or both) and format (group sessions, separate sessions, or mixed) of the behavioral weight loss interventions. Many studies lacked detail and/or assessments of parent-related behavioral strategies. In ∼40% of unique trials, no parent-related outcomes were reported, whereas parent weight was reported in 26% and associations between parent and adolescent weight change were examined in 17%. LIMITATIONS: Only RCTs published in English in peer-reviewed journals were eligible for inclusion. CONCLUSIONS: Further research, with detailed reporting, is needed to inform clinical guidelines related to optimizing the role of parents in adolescent obesity treatment.


Assuntos
Relações Pais-Filho , Pais/psicologia , Obesidade Pediátrica/psicologia , Obesidade Pediátrica/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Comportamento de Redução do Risco , Adolescente , Humanos , Resultado do Tratamento
14.
Eur J Obstet Gynecol Reprod Biol ; 252: 622-623, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32778481

RESUMO

Covid-19 is not transmitted by sex but close proximity during the act could aide in spread of the disease. Health care workers by virtue of the nature of their work have higher chances of exposure to the virus and them indulging in sex needs risk reduction strategies.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pessoal de Saúde/psicologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comportamento Sexual , Coito , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pneumonia Viral/transmissão , Fatores de Risco , Comportamento de Redução do Risco , Doenças Virais Sexualmente Transmissíveis/transmissão
15.
Vasc Health Risk Manag ; 16: 299-305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764950

RESUMO

Objective: The main aim of this study was to investigate predictive factors of adherence to the hypertension control therapeutic and lifestyle recommendations in a sample of Iranian patients based on the constructs of Pender's health promotion model. Patients and Methods: The cross-sectional study was performed on the 380 hypertensive patients who were referred to the health centers, the emergency and internal diseases departments of the Bagheralolom Hospital, and the cardiologists' offices in the city of Ahar, North West of Iran. Data were collected using a researcher designed questionnaire based on the Pender's health promotion model. The Pearson correlation test, multivariate linear regression, and independent t-test were used for data analysis. Results: Mean age of the recruited patients was 52.94 (SD=12.8). Perceived benefits, perceived barriers, situational influences, and interpersonal influences (adjusted R2= 0.525) explained 52.5% of the observed variation in adherence to hypertension control recommendations. Conclusion: Successful hypertension control in patients with chronic morbidity need to be based on sound data about major determinants of the relevant health/illness behaviors. The study findings revealed that the Pender's health promotion model could be applicable as a theoretical framework to identify major determinants of adherence to hypertension control recommendations. Future cross-cultural validation of the study findings in more representative and larger sample sizes could add to the legitimacy of the evidence surrounding self-care practices in hypertensive patients.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea/efeitos dos fármacos , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Hipertensão/terapia , Adesão à Medicação , Modelos Teóricos , Comportamento de Redução do Risco , Adulto , Idoso , Anti-Hipertensivos/efeitos adversos , Estudos Transversais , Características Culturais , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Hipertensão/etnologia , Hipertensão/fisiopatologia , Hipertensão/psicologia , Irã (Geográfico)/epidemiologia , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Resultado do Tratamento
19.
JAMA ; 324(7): 682-699, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809007

RESUMO

Importance: Increasing rates of preventable sexually transmitted infections (STIs) in the US pose substantial burdens to health and well-being. Objective: To update evidence for the US Preventive Services Task Force (USPSTF) on effectiveness of behavioral counseling interventions for preventing STIs. Data Sources: Studies from the previous USPSTF review (2014); literature published January 2013 through May 31, 2019, in MEDLINE, PubMed (for publisher-supplied records only), PsycINFO, and Cochrane Central Register of Controlled Trials. Ongoing surveillance through May 22, 2020. Study Selection: Good- and fair-quality randomized and nonrandomized controlled intervention studies of behavioral counseling interventions for adolescents and adults conducted in primary care settings were included. Studies with active comparators only or limited to individuals requiring specialist care for STI risk-related comorbidities were excluded. Data Extraction and Synthesis: Dual risk of bias assessment, with inconsistent ratings adjudicated by a third team member. Study data were abstracted into prespecified forms. Pooled odds ratios (ORs) were estimated using the DerSimonian and Laird method or the restricted maximum likelihood method with Knapp-Hartung adjustment. Main Outcomes and Measures: Differences in STI diagnoses, self-reported condom use, and self-reported unprotected sex at 3 months or more after baseline. Results: The review included 37 randomized trials and 2 nonrandomized controlled intervention studies (N = 65 888; 13 good-quality, 26 fair-quality) recruited from primary care settings in the US. Study populations were composed predominantly of heterosexual adolescents and young adults (12 to 25 years), females, and racial and ethnic minorities at increased risk for STIs. Nineteen trials (n = 52 072) reported STI diagnoses as outcomes (3 to 17 months' follow-up); intervention was associated with reduced STI incidence (OR, 0.66 [95% CI, 0.54-0.81; I2 = 74%]). Absolute differences in STI acquisition between groups varied widely depending on baseline population STI risk and intervention effectiveness, ranging from 19% fewer to 4% more people acquiring STI. Thirty-four trials (n = 21 417) reported behavioral change outcomes. Interventions were associated with self-reported behavioral change (eg, increased condom use) that reduce STI risk (OR, 1.31 [95% CI, 1.10-1.56; I2 = 40%, n = 5253). There was limited evidence on persistence of intervention effects beyond 1 year. No harms were identified in 7 studies (n = 3458) reporting adverse outcomes. Conclusions and Relevance: Behavioral counseling interventions for individuals seeking primary health care were associated with reduced incidence of STIs. Group or individual counseling sessions lasting more than 2 hours were associated with larger reductions in STI incidence, and interventions of shorter duration also were associated with STI prevention, although evidence was limited on whether the STI reductions associated with these interventions persisted beyond 1 year.


Assuntos
Terapia Comportamental , Aconselhamento , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Fatores Etários , Terapia Comportamental/métodos , Aconselhamento/métodos , Feminino , Humanos , Masculino , Razão de Chances , Guias de Prática Clínica como Assunto , Gravidez , Atenção Primária à Saúde , Comportamento de Redução do Risco , Adulto Jovem
20.
JAMA ; 324(7): 674-681, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32809008

RESUMO

Importance: Approximately 20 million new cases of bacterial or viral sexually transmitted infections (STIs) occur each year in the US, and about one-half of these cases occur in persons aged 15 to 24 years. Rates of chlamydial, gonococcal, and syphilis infection continue to increase in all regions. Sexually transmitted infections are frequently asymptomatic, which may delay diagnosis and treatment and lead persons to unknowingly transmit STIs to others. Serious consequences of STIs include pelvic inflammatory disease, infertility, cancer, and AIDS. Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the benefits and harms of behavioral counseling interventions for preventing STI acquisition. Population: This recommendation statement applies to all sexually active adolescents and to adults at increased risk for STIs. Evidence Assessment: The USPSTF concludes with moderate certainty that behavioral counseling interventions reduce the likelihood of acquiring STIs in sexually active adolescents and in adults at increased risk, including for example, those who have a current STI, do not use condoms, or have multiple partners, resulting in a moderate net benefit. Recommendation: The USPSTF recommends behavioral counseling for all sexually active adolescents and for adults at increased risk for STIs. (B recommendation).


Assuntos
Terapia Comportamental , Aconselhamento , Comportamento Sexual , Doenças Sexualmente Transmissíveis/prevenção & controle , Adolescente , Adulto , Terapia Comportamental/métodos , Aconselhamento/métodos , Feminino , Humanos , Masculino , Atenção Primária à Saúde , Comportamento de Redução do Risco
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