By Ralph Gonzales
This publication is the single pocket-sized compendium of the most up-tp-date medical perform directions in basic care. It contains the 60 such a lot common/important directions for fundamental care clinicians.
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Risk factors: aged > 60 years; low parity; personal history of endometrial, colon, or breast cancer; family history of ovarian cancer; and hereditary ovarian cancer syndrome. Use of oral contraceptives decreases risk of ovarian cancer. 2. 6%, when followed by abdominal ultrasound. htm] 3. b Comprehensive family history and annual rectovaginal pelvic exam Recommend physical examination every 3 years in women aged 20–39 years, and annually in women aged ≥ 40 years. cancernet. htm Source Lifetime risk of ovarian cancer in a woman with no affected relatives is 1 in 70.
2. Abstinence from alcohol is imperative in patients with chronic hepatitis C. 3. Although antiviral therapy can improve intermediate outcomes, such as viremia, there is limited evidence that such treatment improves long-term outcomes. 4. Potential harms of screening include unnecessary biopsies and labeling, as well as adverse effects of antiviral therapy. Comments MMWR 2003;52(RR-1) Pediatrics 1998;101(3):481 Source risk includes injection drug use, receipt of clotting factor concentrates before 1987, chronic hemodialysis, persistently abnormal alanine aminotransferase levels, receipt of blood from a donor who later tested positive for HCV, receipt of blood transfusion or blood components before July 1992, receipt of organ transplant before July 1992, health care workers after needle sticks or mucosal exposures to HCV-positive blood, and children born to HCV-positive women.
B Screen asymptomatic patients (? ahajournals. org/cgi/content/full/ 97/5/501 1. In the Asymptomatic Carotid Atherosclerosis Study (ACAS), the actuarial 5-year risk of ipsilateral stroke, operative stroke, and death was ≅ 5% with CEA vs. 11% in the control group. 3%. (JAMA 1995;273:1421) In ACAS, the benefit of surgery was greater for men than women (reduction in risk 66% vs. 17%). 2. The cumulative cost-effectiveness of targeted screening and surgery for high-grade carotid artery stenosis is ~$43,000 per QALY.
Current Practice Guidelines in Primary Care, 2005 by Ralph Gonzales