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Correct coding for laboratory procedures during assisted reproductive technology cycles.

New Current Procedural Terminology (CPT) codes for 2004 have been adopted for utilization with assisted reproductive technologies. It is important for professionals in the field of assisted reproductive technology (ART) to become familiar with them prior to their implementation. This document replaces the July 2002 American Society for Reproductive Medicine (ASRM) Practice Guideline Correct Coding for Laboratory Procedures During Assisted Reproductive Technology.

Clinical Laboratory Techniques↗

Melanoma: treatment guidelines for patients (Part 1).

The mutual goal of the National Comprehensive Cancer Network (NCCN) and the American Cancer Society partnership is to provide patients and the general public with state of the art cancer treatment information in understandable language. This treatment information is based on the professional guidelines developed by the NCCN. It is intended to assist patients in a discussion with their doctor about the treatment that is best for their specific situation. Part I of these guidelines addresses melanoma risk factors, prevention, diagnosis, stages, prevention, and clinical trials. Part II (June 2005) will describe decision trees for evaluation and treatment.

Clinical Trials as Topic↗

Guidelines for the use of topical tretinoin (Retin-A) for photoaged skin.

Topical tretinoin (Retin-A) enhances the appearance of photoaged skin by effacing fine wrinkles, bleaching pigmented "age spots," improving surface texture, and inducing a rosy glow. A media blitz about Retin-A has resulted in a rush of patients to physicians, many of whom have had little experience with this drug. As a result, many patients receive too little information and often improper instructions regarding the best way to apply tretinoin. Misuse and misconceptions are common. Tretinoin is not a cosmetic preparation to be applied according to individual whims. Patients require detailed instructions to obtain maximal benefits, as well as an appreciation of the time frame for these to appear. This article presents current guidelines for the proper use of Retin-A.

Aging↗

How much of a topical agent should be prescribed for children of different sizes?

BACKGROUND: Compared with guidelines for the quantity of topical corticosteroids to apply in adults, standards for the use of topical corticosteroids in children are not well described. OBJECTIVE: To devise simple-to-use guidelines for topical corticosteroid quantities needed in infants, children, pre-teens, and adults. METHODS: We determined body surface area (BSA) using mean heights and weights in order to calculate the appropriate quantities of medication to be prescribed. RESULTS: As a rough estimate, infants require one-fifth of adult doses, children two-fifths of adult doses, and adolescents two-thirds of adult doses. However, the assessment of BSA may vary considerably between clinicians. Patients may also vary in how thickly they apply topical medication. CONCLUSIONS: A simple guideline for how much topical corticosteroid to prescribe may facilitate the treatment of young children with skin disease.

Administration, Topical↗

Guideline for the management of pediatric idiopathic constipation and soiling. Multidisciplinary team from the University of Michigan Medical Center in Ann Arbor.

OBJECTIVE: To develop an evidence-based guideline for the primary pediatric care of children (birth to 18 years old) with idiopathic constipation and soiling. DATA SOURCES: References were identified through a MEDLINE search from January 1975 through January 1998 to address 3 focus questions: (1) the best path to early, accurate diagnosis; (2) best methods for adequate clean-out; and (3) best approaches to promote patient and family compliance with management. DATA SELECTION: Twenty-five references were identified. DATA EXTRACTION: References were reviewed by a multidisciplinary team and graded according to the following criteria: randomized controlled trial; controlled trial, no randomization; observational study; and expert opinion. Evidence tables were developed for each focus question. DATA SYNTHESIS: An algorithm and clinical care guideline were developed by consultation and consensus among team members. Emphasis was placed on methods to promote early identification of pediatric idiopathic constipation and soiling, to recognize points of referral, and to increase patient and family compliance with treatment through use of education, developmentally based interventions, and variables for tracking success of management. CONCLUSION: An algorithm and guideline for pediatric idiopathic constipation and soiling are presented for use by primary care physicians.

Child↗

Australian and New Zealand clinical practice guidelines for the treatment of bipolar disorder.

BACKGROUND: The Royal Australian and New Zealand College of Psychiatrists is co-ordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Health Funding Authority METHOD: For these guidelines, the CPG team reviewed the treatment outcome literature (including meta-analyses) and consulted with practitioners and consumers. TREATMENT RECOMMENDATIONS: This guideline provides evidence-based recommendations for the management of bipolar disorder by phase of illness, that is acute mania, mixed episodes and bipolar depression, and the prophylaxis of such episodes. It specifies the roles of various mood-stabilizing medications and of psychological treatments such as cognitive therapy and psycho-education.

Anticonvulsants↗

Using the Nursing Interventions Classification to implement Agency for Health Care Policy and Research guidelines.

The mandate for establishing guidelines for assessing effectiveness has been given to the Agency for Health Care Policy and Research (AHCPR). This agency has published 10 practice guidelines for practitioners to use. The present task for practitioners is to establish how effectively use these guidelines. Nurse researchers at the University of Iowa have provided a practical standardized language of nursing interventions that will help nurses demonstrate and communicate current nursing practice. This Nursing Interventions Classification (NIC) will allow nurses to implement the guidelines, demonstrate nursing input for patient care, and make nursing visible to consumers and other health care providers.

Clinical Nursing Research↗