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Biomedical subjects

S L Montauk

Publications and source records attributed to S L Montauk.

7 recordsLinked to original sources

Home health care.

Home health care is the fastest-growing expense in the Medicare program because of the aging population, the increasing prevalence of chronic disease and increasing hospital costs. Patients and families are choosing the option of home care more frequently. Medicare's regulations are often considered the standard of care for all home health agency interactions, even when a patient does not have Medicare insurance. These regulations require patients who receive home health care services to be under the care of a physician and to be homebound. The patient must have a documented need for skilled nursing care or physical, occupational or speech therapy. The care must be part time (28 hours or less per week, eight hours or less per day) and occur at least every 60 days except in special cases. A detailed referral and specific care plan maximize the care to the patient and the reimbursement received by the physician.

Continuity of Patient Care↗

Treating chronic pain.

Quantifiable and measurable methods accurately assess pain severity and successfully guide physicians in determining which medications and modalities are appropriate and necessary for the treatment of chronic pain. A variety of pain assessment scales and the World Health Organization's three-step analgesic ladder can be the starting point for successful pain management.

Analgesics↗

Opportunistic infections and psychosocial stress in HIV.

Persons infected with the human immunodeficiency virus (HIV) are susceptible to both opportunistic infections and psychosocial crises at varying stages of their disease. Many interventions, including lifestyle changes and chemoprophylaxis, may help prevent, delay or lessen the extent of the morbidities associated with immunodeficiency. In appropriate patients, prophylaxis for infections with Pneumocystis carinii, Mycobacterium avium complex and Toxoplasma helps to reduce morbidity.

AIDS-Related Opportunistic Infections↗

Update on drug therapy for HIV and related infections in adults.

Antiretroviral therapy with zidovudine is indicated in patients with CD4 cell counts below 500 per mm3 (500 x 10(6) per L). Patients intolerant of zidovudine and those with advanced human immunodeficiency virus infection may benefit from newer antiretroviral agents, such as didanosine (ddl) or zalcitabine (ddC). Prophylactic therapy for Pneumocystis carinii pneumonia is indicated in patients with CD4 cell counts below 200 per mm3 (200 x 10(6) per L), in patients with CD4 cell counts less than 20 percent of the total lymphocytes and in patients with a prior history of P. carinii infection. In addition, prophylaxis is often initiated if thrush is present, even when CD4 cell counts are above 200. Trimethoprim-sulfamethoxazole is the drug of choice for Pneumocystis prophylaxis; aerosolized pentamidine is reserved for patients unable to tolerate trimethoprim-sulfamethoxazole. Oral candidiasis is treated with nystatin suspension, clotrimazole troches, ketoconazole or fluconazole, with fluconazole used for resistant or more invasive infection. Finally, acyclovir is used to treat herpes zoster or herpes simplex virus infection.

AIDS-Related Opportunistic Infections↗

AIDS: questions from fifth and sixth grade students.

Family Medicine resident physicians gave a slide show of information on AIDS to fifth and sixth grade students and their teachers. Throughout the program, students were encouraged to ask questions, which were recorded and categorized. Information on the presentation process, program content, and nature of the questions asked is presented. Through this pilot program, physicians in residency were trained and placed in a setting which allowed them to discuss AIDS with young people. Teachers were exposed to knowledge and techniques useful to their future role as educators concerning AIDS. The use of residents as co-educators in public school classrooms was shown to be an asset in the sometimes difficult, but necessary task of educating this age group about AIDS. More importantly, a unique insight into student perceptions was gained through the careful examination of 400 student questions about AIDS and other sexuality related issues.

Acquired Immunodeficiency Syndrome↗