New guidelines for prevention, detection, evaluation, and treatment of hypertension: Joint National Committee VI

We developed an immunochromatographic whole-blood test (WBT) which detects antibodies to human immunodeficiency virus types 1 and 2 (HIV-1 and HIV-2) from fingerstick blood. The sensitivity and specificity of the WBT were 99.41% (1,018 confirmed positive patients) and 99.89% (941 uninfected patients), respectively (enzyme immunoassay [EIA] on serum or plasma as a reference). WBT performance was comparable to those of licensed EIAs and Western blotting, using 18 HIV-2 sera, 23 HIV-1 seroconversion panels, and a low-titer performance panel (in lieu of whole blood).     

Misguided guidelines.

The proposed guidelines (see record 2001-17060-009) would require detailed, probing inquiry into motivation for choosing assisted suicide. This is an appropriate requirement in principle. In practice, it will be virtually impossible to carry out this inquiry within likely statutory time limits. Evaluators most likely will either reject the guidelines as impractical or give them merely perfunctory observance. There is, moreover, an inherent tension in the evaluator's relationship with the patient between empathy and impersonal distancing that the guidelines do not adequately acknowledge; this tension necessarily compromises the evaluator's ability to apply the guidelines in the probing, detailed manner they envision. The guidelines provide false comfort that physician-assisted suicide can be carried out with adequately sensitive monitoring of voluntariness and mental competence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bulk Metallic Glasses VI

Symposium: Bulk Metallic Glasses VI

Bulk Metallic Glasses VI Foreword     

Record keeping guidelines.

Provides ethical and procedural guidelines for the maintenance and use of client records, developed by the American Psychological Association's Committee on Professional Practice and Standards. Issues discussed include the underlying principles of record keeping; content, construction and control, and retention of records; outdated records; and the disclosure of record-keeping procedures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diabetes mellitus--current Swedish national guidelines

In 1996, national guidelines for the care and treatment of patients with diabetes mellitus were drawn up by specialists, in collaboration with representatives of the patient organisation, diabetes nurses, the professional associations of various medical specialties and central authorities. The national programme is divides into three parts: summarised information for decision-makers, clinical guidelines and complete information for patients. The guidelines are designed to provide a basis for treatment programmes at the local level. Among other things, the national guidelines stress the importance of the diabetes nurse both in primary and tertiary care, and emphasise the need of regional centers providing access to information and education and promoting the development of treatment. Another important aspect is fostering the influence of patient organisations at the local level, in order for the guidelines to have an impact on the quality of care for the individual patient.     

Current treatment guidelines for acromegaly

Acromegaly, an indolent disorder of growth hormone (GH) hypersecretion is most typically caused by a somatotroph cell adenoma and may be treated by several modalities. Transsphenoidal surgical resection of micro-adenomas by experienced neurosurgeons results in biochemical normalization (postglucose GH <2 ng/mL, assay-dependent, age- and sex-matched IGF-I levels) in 70% of patients. However, over 65% of GH-secreting adenomas are invasive or macroadenomas, and over 50% of these patients have persistent postoperative GH hypersecretion. Irradiation of adenomas results in attenuation of GH secretion to more than 5 ng/mL in 50% of subjects after 12 yr. However, the percent of parents who normalize IGF-I levels is less certain. Most of these patients develop associated pituitary failure and rarely develop other local adverse effects. About 60% of patients receiving somatostatin analogs achieve normalized IGF-I levels. Efficacy of medical management with somatostatin analogs may be improved by increasing injection frequency, changing delivery modes to depot preparations, and in the future, development of novel SRIF receptor subtype-specific analogs. An integrated approach to acromegaly management based upon relative risks and benefits of the currently available therapeutic modes is presented that allows for a national individualized strategy designed to achieve maximal biochemical control of GH hypersecretion and elevated IGF-I levels.