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Richard Guthmann

Publications and source records attributed to Richard Guthmann.

4 recordsLinked to original sources
PubMed2006

Clinical inquiries. How should we manage a patient with a positive PPD and prior BCG vaccination?

Prior bacille Calmette-Guerin (BCG) vaccination increases the likelihood of a positive tuberculosis (TB) 5TU purified protein derivative (PPD) skin test. The PPD response following BCG vaccine varies with age at vaccination, number of years since the BCG vaccination, number of times vaccinated, and number of PPDs performed. An induration of greater than 14 mm is unlikely to be due to prior BCG vaccination (strength of recommendation [SOR]: A, based on meta-analysis of validation cohort studies). The variable reaction after BCG vaccination, along with the desire to detect all cases of TB, has led to recommendations that all patients with a positive PPD test be treated as true positives. These patients should undergo chest radiography and appropriate treatment, regardless of history of BCG vaccine (SOR: B, extrapolation from level 1 study). A recently developed alternative is the interferon-gamma assay (QuantiFERON-TB Gold test), which may be used in place of, or in addition to, the PPD skin test for patients who are known to have received a BCG vaccine (SOR: B, extrapolation from a validation cohort study).

BCG Vaccine↗
PubMed2005

Visit frequency and hypertension.

The best return visit interval to achieve blood pressure control is currently unknown. This study investigates the relationship between return visit interval and percent change in blood pressure. We reviewed a cohort of hypertensive patient charts from two large, urban family practice offices. Four hundred twenty-nine patients with 7910 intervals showed a mean return visit interval of 79.5 days. Blood pressure control occurred during 34.5% of office visits. Pearson's r correlation coefficients between return visit interval and percent change in systolic and diastolic blood pressure demonstrated a small but statistically significant correlation. Shorter return visit intervals were associated with better percent changes in blood pressure. The return visit interval may be a simple and useful tool to improve management of hypertension.

Blood Pressure↗