Canadian family physician Médecin de famille canadien
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Caring for and treating patients living with human immunodeficiency virus is challenging for busy family physicians. I present one strategy for managing patients with this complex infectious disease. Using averaged T4 blood cell counts as a marker of disease progression, I use antiretroviral treatment and preventive drug therapy against the complications of HIV infection.
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To assess the validity of a single stool or perianal swab specimen when screening for potentially pathogenic parasites, 88 residents of a centre for developmentally handicapped adults were screened by collecting on alternate days three stool samples and pinworm swabs. Both sensitivity and negative predictive values were so low that three samples were required for some parasites. The species being screened for and its underlying prevalence must be considered before collecting only one specimen to reduce laboratory costs.
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A survey of recent family medicine graduates showed that two thirds were doing no emergency work. Those who had originally planned to practise emergency medicine were more likely to be doing it than those who had not. More women than men dropped their plans to do emergency work. Two thirds of those who had dropped their plans thought their training had influenced the decision.