Articles: treatment.
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Review
Self-monitoring of blood glucose in diabetes mellitus: arguments for an individualized approach.
The utility of glucose self-monitoring in different types and stages of diabetes is controversial, as there is only sparse relevant evidence from randomized controlled clinical trials. In this analysis, the authors aim to develop individualized recommendations based on clinical needs and the available literature. ⋯ The decision to use glucose self-monitoring, as well as the type and extent of self-monitoring that will be used, should be based on the individual patient's type of diabetes, treatment regimen, and clinical characteristics. Like any other type of therapeutic intervention, self-monitoring should have a well-documented, rational justification.
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Crohn's disease and ulcerative colitis are chronic inflammatory diseases resulting from an inappropriate immune response, in genetically susceptible individuals, to microbial antigens of commensal microorganisms. This inappropriate response is promoted by certain environmental factors. Both diseases manifest themselves primarily in the gastrointestinal tract yet can, in principle, affect all of the organ systems of the body. The purpose of this review article is to heighten awareness of these diseases among physicians whose primary clinical activities lie outside gastroenterology. ⋯ A cure is still not possible, yet the opportunities for diagnosis and treatment have improved significantly. Early diagnosis is important so that patients can be referred onward for further diagnostic evaluation and appropriate treatment without delay.
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Am. J. Obstet. Gynecol. · Aug 2000
ReviewAlternatives to mifepristone regimens for medical abortion.
Alternatives to regimens with mifepristone and a prostaglandin analog for medical abortion emerged because of the need for accessible, effective, and safe options in areas of the world where mifepristone was unavailable. Studies of oral or intramuscular methotrexate combined with misoprostol have demonstrated complete abortion rates in the same range as mifepristone regimens at =49 days' gestation. ⋯ Recent reports suggest that misoprostol alone may have similar efficacy, but with significantly higher rates of side effects. Randomized trials are needed to directly compare the clinical efficacies and acceptabilities of available medical abortion regimens.
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Obstet. Gynecol. Clin. North Am. · Dec 1997
ReviewGynecology and family planning care for the woman infected with HIV.
This article reviews the interactions between HIV infection and a variety of gynecologic conditions, including lower genital tract neoplasia, pelvic inflammatory disease, menstrual disorders, sexually transmitted diseases, and vaginitis. Important considerations in choosing a family planning method for women infected with HIV-infected women will respond to standard therapy, but require multiple courses of treatment or use of innovative treatment methods. All HIV-infected women deserve careful evaluation for and treatment of gynecologic diseases.
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To evaluate the research evidence on the efficacy and tolerability of mefloquine chemoprophylaxis. ⋯ One trial showed mefloquine to be effective in preventing malaria, but withdrawal rates, presumably from side effects, were high across most studies. This is likely to impair mefloquine's effectiveness in general travellers, and it may therefore not be useful for routine prophylaxis. Mefloquine may be useful in specific situations such as for groups travelling to regions with a high risk of chloroquine resistant malaria and only limited access to effective medical care.