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CONTEXT Many clinicians have called for an increased emphasis on the patient's role in clinical decision making. However, little is known about the extent to which physicians foster patient involvement in decision making, particularly in routine office practice. OBJECTIVE To characterize the nature and completeness of informed decision making in routine(More)
To estimate the incidence of pertussis, a prospective study was done among members of a managed care organization in Minneapolis/St. Paul, Minnesota. Of 212 patients 10-49 years old enrolled from January 1995 through December 1996, 8 were found to be culture positive, 10 were found to be positive by polymerase chain reaction assay, 13 had a > or =2-fold(More)
During a study of pregnancy in a poor rural tropical area, a high prevalence of neonatal fever and umbilical cord infection was detected. Interim analysis showed that this was associated with subsequent development of neonatal sepsis. Therefore an intervention was introduced in two stages. In the first stage, acriflavine spirit and new razor blades were(More)
SUGGESTED CITATION Centers for Disease Control and Prevention. Control and prevention of meningo-coccal disease and Control and prevention of serogroup C meningococcal disease: evaluation and management of suspected outbreaks: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997; 46(No. RR-5):[inclusive page numbers].(More)
We report four cases of necrotizing fasciitis that occurred following varicella in children ranging in age from 2 to 8 years. The only organism isolated from each of these patients was Streptococcus pyogenes or group A beta-hemolytic Streptococcus (GABHS). Each child recovered; however, three required repeated surgical debridements in addition to therapy(More)
Ethics education aims to train physicians to identify and resolve ethical issues. To address ethical concerns, physicians may need to confront each other. We surveyed medical students to determine if their comfort challenging members of their ward teams about ethical issues varies by specialty and what attributes of students and their teams contributed to(More)
Powassan virus is a rarely diagnosed cause of encephalitis, and is associated with significant neurologic sequelae. Although symptomatic infections with Powassan virus occur primarily in adults, we report a case of confirmed Powassan neuroinvasive disease in a child presenting to a Tennessee hospital, with symptoms and imaging studies suggestive of acute(More)
Untoward effects of human vaccines suggest that recombinant hepatitis B vaccine may induce alopecia areata (AA) in some patients. Similar untoward immunological effects may also account for AA-like diseases in domestic species. In this study, the C3H/HeJ spontaneous adult onset AA mouse model was used to test the role, if any, of recombinant hepatitis B(More)
A survey of 325 national patients attending six private clinics in Port Moresby was carried out to determine the characteristics of those using private medical services. Most patients were employed in professional or clerical occupations. A sizeable proportion of private patients were from low and moderate income categories and over 40% of those interviewed(More)