Gynecomastia during indinavir antiretroviral therapy in HIV infection.
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Adult↗
Biomedical subjects
R Therrien
Publications and source records attributed to R Therrien.
Clindamycin with primaquine vs. Trimethoprim-sulfamethoxazole therapy for mild and moderately severe Pneumocystis carinii pneumonia in patients with AIDS: a multicenter, double-blind, randomized trial (CTN 004). CTN-PCP Study Group.
This double-blind, randomized, multicenter trial compared clindamycin/primaquine (Cm/Prq) with trimethoprim-sulfamethoxazole (TMP-SMZ) as therapy for AIDS-related Pneumocystis carinii pneumonia (PCP). Forty-five patients received clindamycin (450 mg four times daily [q.i.d.]) and primaquine (15 mg of base/d); 42 received TMP-SMZ (320 mg/1,600 mg q.i.d. if weight of > or = 60 kg or 240 mg/1,200 mg q.i.d. if weight of < 60 kg) plus placebo primaquine. Overall, the efficacy of Cm/Prq was similar to that of TMP-SMZ (success rate, 76% vs. 79%, respectively); Cm/Prq was associated with fewer adverse events (P = .04), less steroid use (P = .18), and more rashes (P = .07). These differences were even greater for patients with PaO2 of > 70 mm Hg (P = .02, P = .04, and P = .02, respectively). For patients with PaO2 of < or = 70 mm Hg (23 Cm/Prq recipients and 21 TMP-SMZ recipients), the efficacy of Cm/Prq was similar to that of TMP-SMZ (success rate, 74% vs. 76%, respectively); Cm/Prq was associated with similar adverse events (P = .57), steroid use (P = .74), and rashes (P = .78). This trial confirms that Cm/Prq is a reasonable alternative therapy for mild and moderately severe PCP.
AIDS-Related Opportunistic Infections↗
[Deinstitutionalization, the patients, the families and women: interests to reconcile].
Deinstitutionalization is very demanding for families. Forced to fill in the gaps of the system, their role is one of creating a therapeutic environment while receiving little support from government service organizations. Cohabitation often leads to difficult relations between a patient and his or her family. In such a context, a large proportion of families experience problems in their attempt to fill their parental role. Women are more affected by this situation seeing they provide a large part of the emotional support to chronically ill mental patients and maintain the contact with service organizations. Also, they must confront professionals who often judge them as overprotective or responsible if the patient is their own child. The authors definitely agree that collective responsibility must complement family responsibility to ensure the respect of patients', families', and women's rights.
Deinstitutionalization↗
The components of women's satisfaction with maternity care.
For a better understanding of how women's satisfaction with maternity care is affected, a representative sample of 1790 women from the Montreal area who had delivered four to seven months earlier were mailed a postal questionnaire; 938 (52.4%) completed and returned it. With factor analysis, we determined five dimensions to women's satisfaction: (a) the delivery itself, (b) medical care, (c) nursing care, (d) information received and participation in the decision-making process, and (e) physical aspects of the labor and delivery rooms. Multiple regression analysis was used to determine explicative factors for each of these dimensions of satisfaction. Items relative to the delivery process such as pain intensity, complications, and length of labor were the most important for the delivery experience itself. Participation in the decision-making process was the first component of satisfaction with medical care. Information received appeared to be the major component of their satisfaction with nursing care. The physical environment did not affect women's satisfaction with obstetric care.
Adolescent↗
[Reminder of important ideas on contact dermatitis].
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Dermatitis, Contact↗
Recruiting and retaining medical technologists.
Personnel recruitment and retention is one of the most challenging facets of management. Despite turnover rates, identifying and retaining good employees should be foremost on any managerial agenda. An effective employee recruiting/relations program enhances the overall productivity of an operation by addressing concerns at staff level, often considered the core of activity. In this issue, we asked our respondents: What methods do you use to recruit and retain medical technologists?
Laboratories, Hospital↗
Managed care.
Health-care reform has become a national mandate. Managed care and managed competition have been reinforced by the Clinton health-care reform plan. What type of health-care delivery system can laboratory managers expect to be part of in the near future? We asked laboratory managers who are currently involved in those types of systems. The result is a two-part As We See It. In part one, we will cover physician partnerships and the system laboratory as we ask: What can the laboratory community expect from a managed-care environment?
Administrative Personnel↗
Managed care.
Many say 1994 will be the year for health-care reform, but those in the thick of the current health delivery system know that 1993 has already brought many sweeping reforms. These reforms will be studied, refined, and tailored for the national plan. What types of reforms are laboratorians seeing now? What kinds of changes can we expect in the upcoming months and years? We asked laboratory managers those very questions. The result has been a two-part As We See It. In the last CLMR, we covered physician partnerships and the system laboratory. In this issue, we will cover alliances with hospitals and laboratory cost reductions as we ask: What can the laboratory community expect from a managed-care environment.
Contract Services↗
[Determinants of satisfaction with medical prenatal care in Quebec women].
This study aims at identifying determinants of satisfaction with medical care during pregnancy, a topic little explored until now. 937 women from the Montreal area answered a mailed questionnaire 4 to 7 months after giving birth. Results show a high level of satisfaction with prenatal care among respondents. Multiple regression analysis reveals that information variables emerge as the main determinants of satisfaction. In fact, not having received desired information appears as the strongest predictor; information pertaining to the delivery process is most often cited by women. The other predictors are events happening during the delivery process. Contrary to findings from other studies, sociodemographic data and characteristics of the physicians do not predict satisfaction. The discussion suggests some guidelines for the measurement of satisfaction with prenatal care as well as implications for practice.
Adolescent↗