ABSTRACT
OBJECTIVES: After studying this article, the reader should be able to: 1. Describe the relationship of sexual history taking and counseling to the safe prescription of teratogenic drugs. 2. Define the scope of the problem of unintended pregnancy and the importance of sexual history taking and counseling. 3. Review the skills of sexual counseling and taking a sexual health history. Although the need to take a sexual history and counsel patients about conception and contraception appears in several clinical situations, the process can be uncomfortable, and some physicians may avoid it or do it incompletely. When a patient is receiving a teratogenic agent, the need for proper history taking and counseling is critical. This article reviews ways to make the process more comfortable and rewarding for both the patient and physician.
Subject(s)
Medical History Taking , Sex Counseling/methods , Sexual Behavior , Teratogens , Adult , Contraceptive Agents, Female , Female , Humans , PregnancyABSTRACT
Kaiser Permanente Southern California and the Pacific Institute for Women's Health began a demonstration and evaluation project on emergency contraceptive pills (ECPs) in the summer of 1996 with the goal of evaluating the feasibility and acceptability of ECPs in a large health maintenance organization and developing institutional templates, provider training and patient education materials that could be used to replicate the project. The ECP program had six components: repackaging of oral contraceptives in an ECP "kit," development of provider education materials, development of patient education materials, in-service training, making ECPs kits available in convenient locations, and development of materials to support replication of the project inside and outside Kaiser Permanente. Although data are still being analyzed, preliminary results are promising. The success of the project within this relatively conservative, but well-established medical care organization provides a model for others. The development of a standard set of educational materials and approaches to implementation should facilitate dispensing ECPs in other settings.
Subject(s)
Contraceptives, Postcoital , Health Knowledge, Attitudes, Practice , Health Maintenance Organizations/organization & administration , Health Personnel/education , Health Personnel/psychology , Adult , California , Emergencies , Female , Humans , Inservice Training/organization & administration , Male , Middle Aged , Needs Assessment/organization & administration , Patient Education as Topic/methods , Pilot Projects , Program EvaluationSubject(s)
Electroconvulsive Therapy/standards , Mental Disorders/therapy , Adolescent , Child , England , Health Services Misuse , Humans , State MedicineABSTRACT
The results of this survey show that 0.5 mg of ethynodiol diacetate (Femulen) is a reliable oral contraceptive with a pregnancy rate calculated by the Pearl Index of 0.52 per 100 women years. This is superior to the failure rates for both 0.075 mg dl norgestrel and 0.35mg norethisterone and approximates more closely with the claimed failure rates for combined oestrogen/progestogen preparations. There is no evidence which suggests that side effects occur with prolonged use of Femulen therapy.
Subject(s)
Ethynodiol Diacetate , Pregnancy , Adult , Female , Humans , Middle AgedABSTRACT
In the results from this series ethynodiol diacetate ("Femulen") was found to be a reliable and acceptable oral contraceptive with a decreased risk of severe side-effects. A review of oral contraception (Jackson, 1973) supports the view that the progestogen-only pill has a useful part to play in modern oral contraception.
Subject(s)
Ethynodiol Diacetate , Adolescent , Adult , Clinical Trials as Topic , Drug Evaluation , Ethynodiol Diacetate/adverse effects , Female , Humans , Middle Aged , PregnancyABSTRACT
In a random crossover study in general practice, sixty patients with heart failure were given one week's maintenance treatment with the recommended dosage of Burinex K or Lasix+K. Burinex K appeared to be easier to swallow than the supplement tablets of Lasix+K although the differences were not significant. Patients showed a highly significant preference to take two tablets on one occasion (Burinex K) rather than two different types of tablet on three separate occasions (Lasix+K). Despite pharmacological arguments in favour of stimultaneous versus separate administration of potassium supplement and diuretic, patient acceptibility is of over-riding importance in the long-term.
Subject(s)
Bumetanide/administration & dosage , Diuretics/administration & dosage , Furosemide/administration & dosage , Patient Acceptance of Health Care , Potassium/administration & dosage , Aged , Bumetanide/therapeutic use , Clinical Trials as Topic , Deglutition , Delayed-Action Preparations , Drug Combinations , Drug Therapy, Combination , Female , Furosemide/therapeutic use , Heart Failure/drug therapy , Humans , Male , Middle Aged , Potassium/therapeutic use , Surveys and Questionnaires , TabletsABSTRACT
Three hundred and twelve patients suffering from painful conditions were admitted to a multicentre, double-blind controlled trial, conducted in general practice in which five analgesics--floctafenine (Idarac), paracetamol, aspirin, dihydrocodeine and pentazocine--were compared. Overall ratings of analgesic effect placed floctafenine first in rank order. Floctafenine was statistically significantly superior in effect to pentazocine but not to the other three agents as far as doctor ratings were concerned; and superior to both pentazocine and dihydrocodeine in the opinion of patients. Fewer patients experienced side-effects on floctafenine than on the other four analgesics and this difference between floctafenine and pentazocine, and floctafenine and dihydrocodeine was statistically significant.
