M A Mendelson — Page 2

PubMedDate not supplied

Disease-based assessment of peripheral vascular disease in nursing facility patients.

OBJECTIVE: To determine the frequency of diagnosis of peripheral vascular disease (PVD) and selected related conditions in patients in a nursing facility, to determine the frequency of patients with risk factor(s) for or clinical evidence of PVD but without a diagnosis of PVD or a related condition, and to determine the frequency with which patients with and without a diagnosis of PVD or a related condition were treated with drug and nondrug therapies. DESIGN: A multicenter, disease-based, retrospective evaluation. SETTING: 41 nursing facilities in 6 regions of the US. PATIENTS: 4038 patients in a nursing facility: 827 patients with a PVD or related diagnosis; 2719 patients without a PVD or related diagnosis but with risk factor(s) for or clinical evidence of PVD; and 492 patients without a PVD or related diagnosis, risk factor(s), and clinical evidence. MAIN OUTCOME MEASURES: Evidence of disease and drug therapy for PVD. RESULTS: PVD was documented in 21% of patients; another 67% had risk factor(s) for or clinical evidence of PVD but no diagnosis of PVD or a related condition. Pentoxifylline was prescribed for 3% of the total sample and 12% of patients with PVD or a related condition. CONCLUSIONS: PVD appears to be inadequately evaluated in patients in a nursing facility. Disease treatment strategies should be developed and implemented to educate healthcare professionals and the general public about the need to acknowledge, assess, and treat PVD and related conditions.

Adult↗

PubMedDate not supplied

Contraception for women with congenital heart disease.

Barrier methods of birth control are less efficacious than other methods but pose significantly less risk of systemic complications for women with congenital heart disease. These methods require a motivated patient and a cooperative partner. Male contraception was not discussed in this article but certainly should be considered when counseling a couple. At present, essentially the only permanent option for male contraception is a vasectomy, but other methods are under investigation. Sterilization is not recommended uniformly in women with cardiovascular disease when pregnancy is feasible and not contraindicated. It may be considered an option for women with contraindications to pregnancy, but these patients may also be at increased risk from the sterilization procedure.

Contraception↗