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1.
J Dent Educ ; 83(8): 924-934, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31010888

RESUMO

An educational institution's decision to test or not test its students for drug use is controversial and complex. Although negative consequences of substance use disorder are well known, the consumption of prohibited substances continues to increase in young adults. Given the awareness of increasing drug use on college campuses and the potential impact on future health care professionals, issues associated with mandatory drug testing of dental students warrant investigation. The purpose of this Point/Counterpoint article is to present opposing viewpoints on whether mandatory student drug testing (MSDT) should be implemented for dental students. Viewpoint 1 affirms that MSDT is legal, ensures public safety, is recognized as a need in health care education, promotes professional and ethical responsibility, and is cost-effective. Viewpoint 2 asserts that MSDT has not been proven to be an effective deterrent for student drug use and it poses risks and costs for both institutions and students, ranging from potential violation of students' civil liberties to the consequences of false positive tests. This article's presentation of the recent literature on both sides of this issue provides dental educators with pertinent information for considering implementation of MSDT in their institutions.


Assuntos
Testes Obrigatórios , Estudantes de Odontologia , Detecção do Abuso de Substâncias , Análise Custo-Benefício , Assistência à Saúde , Usuários de Drogas , Educação em Odontologia/normas , Análise Ética , Liberdade , Humanos , Faculdades de Odontologia/normas , Transtornos Relacionados ao Uso de Substâncias , Estados Unidos
2.
Oncol. (Guayaquil) ; 28(2): 84-92, Ago. 30, 2018.
Artigo em Espanhol | LILACS | ID: biblio-1000153

RESUMO

Las alteraciones morfológicas de la próstata, por las que se realiza cribado son la hiperplasia prostática benigna (HPB) y el cáncer de próstata (CaP). La HPB es el tumor benigno más frecuente en varones mayores de 50 años, se caracteriza por el aumento del volumen de la glándula y usualmente acompañado de síntomas urinarios. El CaP es la segunda causa de muerte relacionada con cáncer en Estados Unidos y Europa en mayores de 70 años, su incidencia por debajo de los 50 es rara. El cribado o pruebas de detección, tiene como meta el hallar el cáncer antes de la aparición de síntomas, el cribado no se realiza en pacientes por sospechar que tienen cáncer, sino como un método de pesquisa. El objetivo de este artículo, es efectuar una revisión a los referentes teóricos, y proponer un nuevo algoritmo diagnóstico de alteraciones morfológicas de la próstata, basado en la evidencia.


Morphological alterations of the prostate, for which screening is performed include benign prostatic hyperplasia (BPH) and prostate cancer (PCa). BPH is the most common in men over 50 years benign tumor, is characterized by the increase in the volume of the gland and usually accompanied by urinary symptoms. PCa is the second leading cause of cancer-related death in the United States and Europe in over 70 years, the incidence below 50 is rare. Screening or testing, aims the finding cancer before the onset of symptoms, screening is not performed in patients with suspected cancer, but as a method of investigation. The purpose of this article is to review the theoretical framework and propose a new diagnostic algorithm of morphological alterations of the prostate, based on evidence.


Assuntos
Humanos , Hiperplasia Prostática , Neoplasias da Próstata , Antígeno Prostático Específico , Testes Obrigatórios , Exame Retal Digital
3.
Workplace Health Saf ; 66(7): 348-355, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29927363

RESUMO

Obstructive sleep apnea (OSA) is a chronic condition characterized by occlusion of the upper airway during sleep resulting in daytime sleepiness. Drivers with OSA are at a two- to sevenfold increase in risk of motor vehicle crashes (MVCs). Approximately, 13% to 28% of commercial motor vehicle drivers (CMVDs) are thought to have OSA. Obstructive sleep apnea is a significant issue in the transportation industry. Currently, The Federal Motor Carrier Safety Association (FMCSA) does not mandate OSA screening. Federal regulations only specify that CMVDs be free of "respiratory dysfunction" that would impair driving. Untreated OSA is a public safety concern. The purpose of this article is to use Bardach's eightfold policy analysis approach to examine policy options related to OSA screening in the trucking industry.


Assuntos
Indústrias/organização & administração , Testes Obrigatórios , Veículos Automotores , Formulação de Políticas , Apneia Obstrutiva do Sono/diagnóstico , Acidentes de Trânsito/prevenção & controle , Feminino , Humanos , Masculino , Política Organizacional , Risco
4.
Rev. psicol. trab. organ. (1999) ; 34(1): 16-28, abr. 2018.
Artigo em Espanhol | IBECS | ID: ibc-174275

RESUMO

Esta investigación ha tenido como objetivo profundizar en el conocimiento sobre el funcionamiento de los procedimientos selectivos en el sector público. Para ello, a partir de los datos del concurso-oposición de 2010 para la selección de auxiliares administrativos en el Gobierno Vasco se estudiaron dos cuestiones: a) la validez predictiva de los predictores empleados y b) la justicia percibida por parte de los auxiliares con respecto al proceso selectivo y a las pruebas empleadas y su relación con el resultado en las mismas y el desempeño laboral. Los resultados muestran que la prueba de conocimientos es el mejor predictor del desempeño y que las reacciones de los candidatos presentan una correlación positiva con el desempeño laboral y con el resultado en el test de juicio situacional. Se comentan las limitaciones de la investigación así como las implicaciones prácticas de los resultados


The purpose of this research has been to deepen the knowledge about how selection procedures work in the public sector. To this aim two aspects were considered: a) the predictive validity of the predictors employed and b) the perceived justice of the hired workers regarding the selection process and the tests used and their relation with test performance and job performance. The results show that the job knowledge test is the best predictor of performance and that the reactions of the candidates present a positive correlation with job performance and with the situational judgment test results. The limitations of the research as well as the practical implications of the results are discussed


Assuntos
Humanos , Masculino , Feminino , Adulto , Seleção de Pessoal/organização & administração , Setor Público/organização & administração , Organização e Administração , Desempenho de Papéis , Conhecimento , Seleção de Pessoal/normas , Setor Público , Setor Público/estatística & dados numéricos , Testes Obrigatórios/métodos , Psicologia Industrial , Psicologia Industrial/organização & administração
6.
Medisan ; 21(10)oct.2017. ilus
Artigo em Espanhol | LILACS | ID: biblio-996150

RESUMO

En el presente artículo se expone lo relacionado con la labor preventiva, que constituye una vía pedagógica encaminada a potenciar la preparación del futuro médico general integral en la comunidad ante enfermedades trasmitidas por vectores; escenario propicio para adquirir las habilidades necesarias para su formación bajo la guía del profesor y del personal médico de cada área de salud y lograr un proceso consecuente con la excelencia académica, lo que a su vez genera un alto impacto social.


The preventive work which constitutes a pedagogic way aimed at potentiating the preparation of future comprehensive general doctors when facing diseases transmitted by vectors in the community is exposed in this work; favorable scenario to acquire the necessary skills for their training-under the professor's guide and medical staff of each health area-and to achieve a consistent process with the academic excellence, which in turn generates a high social impact.


Assuntos
Humanos , Masculino , Feminino , Adulto , Educação em Saúde/métodos , Vetores de Doenças , Mordeduras e Picadas de Insetos/complicações , Estudantes , Doenças Transmissíveis/epidemiologia , Testes Obrigatórios , Determinação de Necessidades de Cuidados de Saúde
7.
Medisan ; 21(10)oct. 2017. ilus
Artigo em Espanhol | CUMED | ID: cum-70141

RESUMO

En el presente artículo se expone lo relacionado con la labor preventiva, que constituye una vía pedagógica encaminada a potenciar la preparación del futuro médico general integral en la comunidad ante enfermedades trasmitidas por vectores; escenario propicio para adquirir las habilidades necesarias para su formación bajo la guía del profesor y del personal médico de cada área de salud y lograr un proceso consecuente con la excelencia académica, lo que a su vez genera un alto impacto social(AU)


The preventive work which constitutes a pedagogic way aimed at potentiating the preparation of future comprehensive general doctors when facing diseases transmitted by vectors in the community is exposed in this work; favorable scenario to acquire the necessary skills for their training-under the professor's guide and medical staff of each health area-and to achieve a consistent process with the academic excellence, which in turn generates a high social impact(AU)


Assuntos
Humanos , Masculino , Feminino , Vetores de Doenças , Educação em Saúde , Testes Obrigatórios , Doenças Transmissíveis , Mordeduras e Picadas de Insetos/complicações , Determinação de Necessidades de Cuidados de Saúde
8.
Euro Surveill ; 22(34)2017 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-28857043

RESUMO

The largest measles outbreak in Berlin since 2001 occurred from October 2014 to August 2015. Overall, 1,344 cases were ascertained, 86% (with available information) unvaccinated, including 146 (12%) asylum seekers. Median age was 17 years (interquartile range: 4-29 years), 26% were hospitalised and a 1-year-old child died. Measles virus genotyping uniformly revealed the variant 'D8-Rostov-Don' and descendants. The virus was likely introduced by and initially spread among asylum seekers before affecting Berlin's resident population. Among Berlin residents, the highest incidence was in children aged < 2 years, yet most cases (52%) were adults. Post-exposure vaccinations in homes for asylum seekers, not always conducted, occurred later (median: 7.5 days) than the recommended 72 hours after onset of the first case and reached only half of potential contacts. Asylum seekers should not only have non-discriminatory, equitable access to vaccination, they also need to be offered measles vaccination in a timely fashion, i.e. immediately upon arrival in the receiving country. Supplementary immunisation activities targeting the resident population, particularly adults, are urgently needed in Berlin.


Assuntos
Controle de Doenças Transmissíveis , Surtos de Doenças/prevenção & controle , Vírus do Sarampo/genética , Refugiados/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Berlim/epidemiologia , Criança , Pré-Escolar , Surtos de Doenças/estatística & dados numéricos , Emigração e Imigração/estatística & dados numéricos , Feminino , Genótipo , Humanos , Incidência , Masculino , Testes Obrigatórios/estatística & dados numéricos , Sarampo/epidemiologia , Vírus do Sarampo/classificação , Vírus do Sarampo/isolamento & purificação , Adulto Jovem
10.
US Army Med Dep J ; (2-17): 18-24, 2017 Jul-Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28853115

RESUMO

OBJECTIVE: To determine whether mandatory psychiatric admission laboratory tests yield results that change the disposition of a patient with primary psychiatric complaint from admission to a psychiatric service to admission to a medical service. METHODS: This was a single center retrospective cohort chart review study approved by the facility Institutional Review Board in which we used a records database maintained by the emergency department's social workers to access the records of every patient that presented to our emergency department with a psychiatric chief complaint between the dates of December 1, 2011, and December 1, 2013. We focused on those that were admitted to either a psychiatric service or a medical service after a thorough evaluation by the department of social work and an emergency provider. We applied our inclusion and exclusion criteria and reviewed the results of the mandatory psychiatric laboratory tests (complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, acetaminophen, aspirin, blood alcohol level, urinalysis, urine pregnancy test, urine drug screen) required for admission. Our independent variables were the compulsory psychiatric admission laboratory tests and our dependent variable was the admission to a medical service. RESULTS: Of 5,606 laboratory tests that were ordered and produced results for the 682 patients enrolled in our study, 51 results were considered clinically significant abnormal results, or results requiring treatment prior to psychiatric service admission, by the 2 reviewing emergency physicians. Only one of 682 psychiatric patients received a final disposition to a medical service based upon abnormal laboratory studies. That patient presented without any medical complaints but a chief complaint of "suicidal ideation," and was found to have diabetic ketoacidosis. Based on our data, the probability that an abnormal laboratory test will result in a change in disposition is 1/682=0.1% (95% CI: 0.0% to 0.9%). CONCLUSION: Patients presenting to the emergency department with a psychiatric chief complaint and no physical complaints, abnormal vital signs, or abnormal physical exam findings have less than 1% probability that an abnormal laboratory study will change their disposition from a psychiatric admission to a medical admission.


Assuntos
Medicina de Emergência/métodos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Testes Obrigatórios/métodos , Programas de Rastreamento/métodos , Transtornos Mentais/diagnóstico , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medicina Militar/métodos , Estudos Retrospectivos , Adulto Jovem
12.
J Minim Invasive Gynecol ; 24(6): 1014-1019, 2017 Sep - Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28648840

RESUMO

STUDY OBJECTIVE: To examine whether our new reporting system and mandatory fluid-balance form could improve the communication and awareness within the surgical team and therefore the safety of hysteroscopic operations. DESIGN: A case-control study (Canadian Task Force classification II-2). SETTING: An endoscopic gynecology unit at a tertiary-care university hospital. PATIENTS: Women aged 17 to 88 years (median, 43.9) who underwent operative hysteroscopy to treat uterine pathology. INTERVENTIONS: Operative hysteroscopy was performed using bipolar technology and normal saline as an irrigation media with the new fluid-balance form and a mandatory reporting system. The control group was composed of women who underwent the procedure using the same technology, with a previous protocol. MEASUREMENTS AND MAIN RESULTS: Data regarding intraoperative and postoperative short-term complications were prospectively collected during surgery and at the 2-week follow-up visit. About 2000 procedures were investigated (601 in the study group and 1396 in the control group). In the control group there were 20 incidents of fluid deficit over 2 L. In 4 of these cases the procedure was terminated, but in the other 16 cases the procedure was continued, with or without awareness of the surgeons to the deficit. Of these cases, 2 suffered from media-related complications, and in 3 others complications were avoided by diuretics. In contrast, in the study group there were 10 incidents of fluid deficit over 2 L, of which 5 cases were terminated on time and the other 5 continued under the informed decision of the surgeon. In this group, none of the women experienced a media-related complication. The difference between the number of procedures that were terminated on time between the control and study groups was not statistically significant (p = .115). There was a statistically significant reduction in the total complication rate between the study group (1.8%) and the control group (3.9%; p = .019). CONCLUSIONS: The fluid-balance form and mandatory reporting system have been shown to reduce the rate of total complications in hysteroscopic surgeries, in particular media-related complications. This result is achieved by an improvement of the awareness and communication among the operating team, leading to an improvement in procedure safety.


Assuntos
Histeroscopia/efeitos adversos , Notificação de Abuso , Complicações Pós-Operatórias/prevenção & controle , Registros/normas , Desequilíbrio Hidroeletrolítico/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Histeroscopia/métodos , Testes Obrigatórios , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Guias de Prática Clínica como Assunto , Gravidez , Útero/cirurgia , Equilíbrio Hidroeletrolítico , Desequilíbrio Hidroeletrolítico/diagnóstico , Desequilíbrio Hidroeletrolítico/etiologia , Adulto Jovem
13.
BMC Int Health Hum Rights ; 17(1): 12, 2017 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-28490382

RESUMO

BACKGROUND: HIV screening has existed in numerous methods as an important part of HIV prevention efforts over the years. Premarital HIV testing for couples who wish to marry has been implemented in a number of regions, which often operate in a mandatory rather than voluntary basis and is considered a contentious issue, with viewpoints held in favour and against. One such region is Malaysia which has a policy of mandatory premarital HIV testing of prospective Muslim married couples. The purpose of this study is to understand stakeholders' views on premarital HIV testing given the Malaysian Islamic context. METHODS: 35 in-depth face to face semi-structured interviews were undertaken with key stakeholder groups involved in HIV prevention policy in Malaysia, namely, officials from the Ministry of Health, religious leaders and people living with HIV. Participants were recruited from the Klang Valley area, from July to December 2013, using purposive sampling techniques. Inclusion criteria necessitated that participants were over the age of 18 and provided full consent. Interviews were audiotaped, followed a standardised topic guide, transcribed verbatim and analysed using a framework analysis. RESULTS: Participants identified pre-marital HIV testing as an effective HIV prevention policy implemented in Malaysia and was viewed, for the most part, as a positive initiative across all stakeholders. Religious leaders were supportive of testing as it provides a protective mechanism, in line with the teachings of the Shariah, while Ministry of Health officials considered it a normal part of their HIV prevention screening initiatives. However, there were concerns surrounding issues such as confidentiality, counselling and discrimination surrounding the test described by the PLHIV group. CONCLUSION: The findings of this study show that among the participants interviewed was strong support for mandatory premarital HIV testing, which could possibly expose the vulnerability to HIV, reluctance to test and other areas in the HIV response in Malaysia that need to be addressed. Furthermore, although international health organisations are vehemently against mandatory premarital HIV testing, the strong local support for such measures and the mismatch between these views is worth exploring in more detail, given the cultural, social and religious context.


Assuntos
Infecções por HIV/prevenção & controle , Islamismo/psicologia , Testes Obrigatórios/métodos , Exames Pré-Nupciais/tendências , Adulto , Feminino , Direitos Humanos , Humanos , Entrevistas como Assunto , Liderança , Malásia , Masculino , Exames Pré-Nupciais/psicologia , Estudos Prospectivos , Saúde Pública , Pesquisa Qualitativa
14.
Medisan ; 21(4)abr.2017. graf
Artigo em Espanhol | CUMED | ID: cum-70024

RESUMO

Se realizó un estudio descriptivo y transversal de 568 pacientes de 15 años y más, que no estaban diagnosticados como hipertensos, pertenecientes al consultorio médico No. 17 del consejo popular Veguita de Galo, del Policlínico Ramón López Peña de Santiago de Cuba, con vistas a identificar la morbilidad oculta de hipertensión arterial en la citada población, desde diciembre de 2014 hasta enero de 2016. En la casuística se diagnosticaron 15 hipertensos, la mayoría de grado 1, entre los cuales predominaron el sexo femenino y los grupos etarios de 35-44 y de 55-64 años. Como principales factores de riesgo detectados primaron el color negro de la piel, la dieta inadecuada, el sedentarismo y la adicción tabáquica. Se concluye que la pesquisa activa resultó útil, pues permitió detectar casos no diagnosticados hasta ese momento(AU)


A cross-sectional descriptive study of 568 patients with 15 years and over that were not diagnosed with hypertension was carried out. They belonged to the doctor´s office 17 in Veguita de Galo, from Ramón López Peña polyclinic in Santiago de Cuba, with the purpose of identifying the hidden morbidity of hypertension in that population from December, 2014 to January, 2016. Fifteen patients with hypertension were diagnosed in the case material, most of them grade I, among which the female sex and 35-44 and 55-64 age groups prevailed. Black skin, inadequate diet, physical inactivity and nicotine addiction were the main risk factors detected. It was concluded that the active investigation was useful because it allowed to detect non diagnosed cases up to that moment.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Hipertensão , Fatores de Risco , Testes Obrigatórios , Atenção Primária à Saúde , Morbidade , Epidemiologia Descritiva , Estudos Transversais
15.
Medisan ; 21(4)abr. 2017. graf
Artigo em Espanhol | LILACS | ID: biblio-841684

RESUMO

Se realizó un estudio descriptivo y transversal de 568 pacientes de 15 años y más, que no estaban diagnosticados como hipertensos, pertenecientes al consultorio médico No. 17 del consejo popular Veguita de Galo, del Policlínico Ramón López Peña de Santiago de Cuba, con vistas a identificar la morbilidad oculta de hipertensión arterial en la citada población, desde diciembre de 2014 hasta enero de 2016. En la casuística se diagnosticaron 15 hipertensos, la mayoría de grado 1, entre los cuales predominaron el sexo femenino y los grupos etarios de 35-44 y de 55-64 años. Como principales factores de riesgo detectados primaron el color negro de la piel, la dieta inadecuada, el sedentarismo y la adicción tabáquica. Se concluye que la pesquisa activa resultó útil, pues permitió detectar casos no diagnosticados hasta ese momento


A cross-sectional descriptive study of 568 patients with 15 years and over that were not diagnosed with hypertension was carried out. They belonged to the doctor´s office 17 in Veguita de Galo, from Ramón López Peña polyclinic in Santiago de Cuba, with the purpose of identifying the hidden morbidity of hypertension in that population from December, 2014 to January, 2016. Fifteen patients with hypertension were diagnosed in the case material, most of them grade I, among which the female sex and 35-44 and 55-64 age groups prevailed. Black skin, inadequate diet, physical inactivity and nicotine addiction were the main risk factors detected. It was concluded that the active investigation was useful because it allowed to detect non diagnosed cases up to that moment


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Atenção Primária à Saúde , Fatores de Risco , Testes Obrigatórios , Hipertensão/epidemiologia , Epidemiologia Descritiva , Estudos Transversais , Morbidade
16.
J Am Acad Psychiatry Law ; 45(1): 92-98, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28270467

RESUMO

We describe the application of a life-trajectory model of suicide to the prison setting and its implication for suicide risk detection. A model has been developed that describes two distinct trajectories culminating in suicide: one with large amounts of adversity early in life with a young age of suicide and another with chronic, gradually accumulating adversity with a later age of suicide. Support for applying the life-trajectory model to the prison population is found in prison-centric models of suicidal behavior and clinical profiles of individuals at high risk of suicide in prisons. We also describe how the life-trajectory model applies to two recent high-profile suicides within the Canadian prison system. Finally, we propose a screening tool based on the life-trajectory model to quantify an individual's adversity burden at intake and subsequently throughout incarceration. We describe how this proposed tool may improve detection of individuals with increased risk of suicide and describe the steps necessary for the development of this tool.


Assuntos
Acontecimentos que Mudam a Vida , Testes Obrigatórios/legislação & jurisprudência , Prisioneiros/estatística & dados numéricos , Medição de Risco/legislação & jurisprudência , Suicídio/legislação & jurisprudência , Suicídio/prevenção & controle , Adolescente , Idade de Início , Canadá , Estudos Transversais , Feminino , Humanos , Delinquência Juvenil/legislação & jurisprudência , Delinquência Juvenil/psicologia , Masculino , Prisioneiros/psicologia , Comportamento Autodestrutivo/psicologia , Isolamento Social , Suicídio/estatística & dados numéricos , Tentativa de Suicídio/legislação & jurisprudência , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Adulto Jovem
18.
Allergol. immunopatol ; 45(1): 33-39, ene.-feb. 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-158972

RESUMO

Background: The epidemiology and hospitalisation trends of primary immunodeficiency (PID) in Chile are unknown. We aimed to evaluate hospitalisation trends and demographic characteristics of PID admissions in Chile. Methods: PID admissions between 2001 and 2010 (ICD-10 codes D70.0, D70.4, D71, 72.0, D76.1, D80-D84, E70.3, G11.3) were reviewed using national hospital discharge databases. Results: During the study period, 5486 admissions due to PID were registered (0.03% of total). 58.5% of patients were male and 66.3% were under 18 years. Median length of stay was one day (range 1-403 days). The most frequent diagnoses were hypogammaglobulinaemia (27.6%), unspecified immunodeficiency (21.9%), haemophagocytic lymphohystiocytosis (18.3%) and common variable immunodeficiency (11.2%). There was a significant increase in PID admission rate and in one-day hospitalisations during this period (β = 0.2; P = 0.001 and β = 33; P ≤ 0.001, respectively), however no significant variation was found for longer admissions (β = 4.8; P = 0.175). The increasing trend in PID admission rate was significant in patients with private, but not public insurance (β = 0.53; P ≤ 0.001 vs. β = 0.08; P = 0.079, respectively). Conclusions: We report an increasing trend in admissions due to PID in Chile over a 10-year period. Increase is mainly due to short hospitalisations, possibly accounting for improvements in IVIG access. Higher admission rates in patients with private vs. public insurance suggest socioeconomic disparities in access to PID treatment. ICD-10 coded hospitalisation databases may be useful to determine hospitalisation trends and demographic characteristics of PID admissions worldwide (AU)


No disponible


Assuntos
Humanos , Síndromes de Imunodeficiência/diagnóstico , Procedimentos Clínicos/organização & administração , Classificação Internacional de Doenças , Encaminhamento e Consulta/organização & administração , Estudos Retrospectivos , Distribuição por Idade e Sexo , Chile/epidemiologia , Testes Obrigatórios/normas , Síndromes de Imunodeficiência/epidemiologia
19.
Mil Med ; 182(1): e1558-e1561, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-28051973

RESUMO

OBJECTIVE: To retrospectively analyze multiple years of legal blood alcohol test (LBAT) results as part of a laboratory process improvement plan. METHODS: We analyzed the LBAT requests received by the Brooke Army Medical Center during calendar years 2013 and 2014. RESULTS: We received 365 samples from 11 installations; 351 were tested and 14 were rejected. Nearly one-third of the tested samples had negligible ethanol levels. One installation was responsible for submitting 10 rejected samples which prompted laboratory intervention. CONCLUSION: The ability to perform timely LBATs is invaluable to the Department of Defense as the results are more readily accepted in a court of law than routine clinical ethanol test results.


Assuntos
Concentração Alcoólica no Sangue , Técnicas de Laboratório Clínico/normas , Testes Obrigatórios/legislação & jurisprudência , Militares/estatística & dados numéricos , Cromatografia Gasosa/métodos , Técnicas de Laboratório Clínico/métodos , Ionização de Chama/métodos , Humanos , Testes Obrigatórios/métodos , Estudos Retrospectivos , Texas
20.
AIDS Care ; 29(6): 724-728, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-27892711

RESUMO

Mandatory HIV screening of United States Air Force (USAF) personnel every two years effectively identifies incident cases, however testing frequency limits the ability to detect early HIV infection. Identifying clinical indicators of HIV in the USAF population is necessary to develop a supplemental provider-based targeted testing strategy. We conducted a matched case-control study of male active duty USAF personnel with a new HIV diagnosis (n = 452) between 1996 and 2011 matched to five randomly selected controls (n = 2176). The relationship between clinical diagnoses, determined by ICD-9 codes, and HIV infection was assessed using conditional logistic regression. In unadjusted analyses of ICD-9 codes ever and within the last two years before HIV diagnosis, the conditional odds of HIV infection were greater in those with clinical signs and symptoms of HIV (cOR 5.05, 95% CI 4.00-6.39), mental health diagnoses (cOR 2.61, 95% CI 1.86-3.67), and STI diagnoses (cOR 2.33, 95% CI 1.50-3.60). Compared to those with ≤10 medical encounters in the two years prior to HIV diagnosis, individuals with 11-35 medical encounters (cOR 2.19, 95% CI 1.73-2.79) and >35 medical encounters (cOR 4.15, 95% CI 2.69-6.39) had a higher odds of HIV acquisition. In multivariate analyses, clinical signs and symptoms of HIV within the last two years of HIV diagnosis (cOR 4.10, 95% CI 3.22-5.22) and ever having a mental health diagnosis (cOR 1.97, 95% CI 1.44-2.70) remained significant (p < .01). Clinical encounters, particularly those featuring clinical signs and symptoms of HIV or a history of mental health complaints, provide an opportunity for targeted testing as a supplement to mandated testing at two-year intervals. Provider education to increase HIV testing in persons at risk would enhance early HIV diagnosis and potentially reduce forward transmission in the USAF population.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/transmissão , Militares/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Comorbidade , Feminino , Humanos , Classificação Internacional de Doenças , Modelos Logísticos , Masculino , Testes Obrigatórios , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Medição de Risco , Doenças Sexualmente Transmissíveis/epidemiologia , Doenças Sexualmente Transmissíveis/transmissão , Estados Unidos , Adulto Jovem
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