Partner treatment in HIV and STDs

November 26, 2008


Secondary syphilis

Secondary syphilis

New recommendations hot of the press at the CDC emphasize the importance of partner treatment.  Usually the most difficult task in this portion is identifying all the partners involved.  The recommendation is to test for all other STIs if one is positive.  So, in a patient who test positive for chlaymdia, she and her partner should be tested for HIV, syphillis, and gonorrhea as well. Intrestingly enough, the states hold legal authority for identifying and notifying partners of infected patients.  The situation can become sticky rather quickly, as it is the duty of the medical provider or the state to warn partners of possible exposure.


Understanding the evidence

November 25, 2008


The Annals of Internal Medicine tackle this tough task in their lead article.  I recommend listening to the pod cast summary of the article.  But here is the summary: make sure you are evaluating POEs (patient oriented outcomes) rather than DOEs (disease oriented outcomes).   It doesn’t matter if we can lower LDL but it may matter greatly if we can reduce death. What is the risk stratification? Well, you can find out now.  Listen here.

Ode to the colorectal surgeon…

November 24, 2008

Updated guidelines from the US Preventive Medicine Task Force on colonoscopy have emerged.  Annals of Internal Medicine 2008

All you folks age 77 who only expect to live to 84 can breath easier now.  Colonoscopy (every 10 years) or FOBT (fecal occalt blood testing yearly) is recommended for all persons aged 50-75.  Between 76 and 85 screening is only recommended if your life expectency is greater than 10 years.  And if your above 85 just forget screening.  Only pursue if there is a problem.  I always wondered when it was time to stop screening…I have to let my 95 year old great-grandfather Jake know that he got out of it this year.