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Biomedical subjects

Keith B Holten

Publications and source records attributed to Keith B Holten.

17 recordsLinked to original sources
PubMed2006

Emergency contraception care.

This guideline targets women who have had unprotected or inadequately protected intercourse within the past 120 hours and do not desire pregnancy. Practitioners can make informed decisions about obstetric and gynecologic care, given the evidence in this guideline regarding safety, efficacy, risks and benefits of the use of emergency contraception including progestin-only and combined estrogen-progestin regimen. The major outcome considered was incidence of unintended pregnancy. The evidence rating is updated to comply with the SORT taxonomy.

Contraception, Postcoital↗
PubMed2003

Diagnosing the patient with abdominal pain and altered bowel habits: is it irritable bowel syndrome?

Diagnosing a patient who presents with abdominal pain and altered bowel habits can be challenging. Although serious organic illnesses can cause these symptoms, irritable bowel syndrome is commonly responsible. It can be difficult to properly evaluate these patients without overusing diagnostic tests and consultation. A practical approach for diagnosing irritable bowel syndrome is suggested, using the Rome II criteria and the presence of alarm symptoms such as weight loss, gastrointestinal bleeding, anemia, fever, or frequent nocturnal symptoms as starting points. If there are no alarm symptoms and the Rome II criteria are not met, it is acceptable to reevaluate the patient at a later date. If there are no alarm symptoms and the Rome II criteria are met, the patient should be categorized on the basis of age: patients 50 years or younger can be evaluated on the basis of predominant symptoms--constipation, diarrhea, or abdominal pain. Patients older than 50 years should be fully evaluated and considered for gastroenterology referral. If alarm symptoms are present, a full evaluation should be performed (and gastroenterology referral considered), regardless of the patient's age.

Abdominal Pain↗
PubMed2003

How should we manage an acute exacerbation of COPD?

Would you order a chest film to evaluate an acute exacerbation of chronic obstructive pulmonary disease (COPD)? Which medication would you first prescribe-a short-acting inhaled beta-2 agonist or an anticholinergic bronchodilator? These are important questions for family physicians who commonly manage acute exacerbations of COPD. The guideline summarized here was developed by a joint expert panel of the American College of Physicians-American Society of Internal Medicine and the American College of Chest Physicians. Three outcomes were considered: treatment efficacy, 6-month mortality, and relapse, as defined by return visit to the emergency department within 14 days of initial presentation. Systematic reviews with evidence tables were used to analyze data. The rationale for each recommendation is clear and well documented. We added strength-of-recommendation ratings, which are not in the original guideline.

Acute Disease↗