BACKGROUND AND PURPOSE Literature suggests a small increased risk of ischemic stroke with oral contraception (OC) use. We evaluated the association of stroke and OC use in women on the basis of whether they recalled being advised by a physician not to use OC or to discontinue OC use because of the presence of stroke risk modifiers, and whether such advice resulted in behavioral change. METHOD...

QUESTION One of my patients gave birth to a baby later diagnosed with HIV infection. I did not offer this patient HIV screening, as I thought she was at low risk. What are the recommendations for HIV testing and what might be the implications of not screening for HIV? ANSWER Although screening is currently recommended by all relevant authorities in Canada, more than 10% of women are not scree...

Clinical genetics is one of the most rapidly advancing fields in medicine. Spectacular progress has been achieved in this century with unraveling of the entire draft sequence of the human genome and identification of greater than 14,000 single gene disorders. A major contribution of these advances has been in diagnosis, management and prenatal diagnosis of genetic disorders, as the treatment in...

health workforce shortages in sub-saharan africa are widely recognized, particularly of physicians, leading the training and deployment of non-physician clinicians (npcs). the paper by eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of npcss in sub-saharan africa. certainly, in short or mid-term, npcs will continue to be a...

BACKGROUND This study assess knowledge, attitudes, and practices regarding Human Immunodeficiency Virus (HIV) testing and counseling services and the predictor characteristics of these outcomes among individuals who presented for the first time to Voluntary Counseling and Testing (VCT) public services. METHODS A sample of 244 subjects in the geographic area of Naples (Italy) received a self-a...

OBJECTIVE To investigate family physicians' and pediatricians' practice of and perceived barriers to smoking cessation counseling among patients 18 years and younger. DESIGN Cross-sectional mail survey conducted between November 1, 1997, and January 31, 1998. PARTICIPANTS A stratified random sample selected from the 1997 American Medical Association Physician Masterfile of 1000 family physi...

CONTEXT Almost 20% of children aged 2 to 5 years have untreated dental caries. Physician interventions to prevent and manage dental caries in preschool children could help address this common problem. OBJECTIVE To review the evidence for effectiveness of five possible physician interventions- (1) screening and risk assessment, (2) referral, (3) provision of dietary supplemental fluoride, (4) ...

BACKGROUND There is a need for primary care providers to have brief effective methods to intervene with high-risk drinkers during a regular outpatient visit. OBJECTIVE To determine whether brief physician- and nurse practitioner-delivered counseling intervention is efficacious as part of routine primary care in reducing alcohol consumption by high-risk drinkers. METHODS Academic medical cen...

OBJECTIVE Primary care physicians are in a unique position to perform skin cancer examinations and provide prevention counseling, given that approximately 40% of office visits to physicians in the United States are to a family practitioner or internist. Compared with family or self-detection, physician detection is associated with an increased probability of detecting thinner melanomas. However...

BACKGROUND AND OBJECTIVES The United States is experiencing an epidemic of opioid-related deaths. Naloxone, the drug of choice for reversing acute opioid overdose, is not routinely prescribed for outpatient use. The aims of this project were to improve naloxone awareness, increase naloxone prescribing, and prevent opioid overdoses. METHODS A naloxone counseling intervention was implemented in...