中医疗效系统评价体系的研究

临床疗效是中医药学生存在和发展的基础。建立中医临床疗效系统评价体系。对于科学、客观、系统地开展中医临床疗效的评价具有重要意义。本文研究并探讨了建立中医临床疗效系统评价体系所需达到的目标和发展思路，提出了建立该系统的重点任务及关键技术。     

Consensus guidelines on pediatric acute rheumatic fever and rheumatic heart disease

JUSTIFICATION: Acute rheumatic fever and rheumatic chronic valvular heart disease is an important preventable cause of morbidity and mortality in suburban and rural India. Its diagnosis is based on clinical criteria. These criteria need verification and revision in the Indian context. Furthermore, there are glaring differences in management protocols available in literature. These facts prompted Indian Academy of Pediatrics to review the management of rheumatic fever. PROCESS: Management of Rheumatic fever was reviewed and recommendation was formulated at national consultative meeting on 20th May 2007 at New Delhi. OBJECTIVES: To formulate uniform guidelines on management of acute rheumatic fever and rheumatic heart disease in the Indian context. Guidelines were formulated for the management of streptococcal pharyngitis, acute rheumatic fever and its cardiac complication as well as secondary prophylaxis for recurrent episodes. RECOMMENDATIONS: (1) Streptococcal eradication with appropriate antibiotics (Benzathine penicillin single dose or penicillin V oral or azithromycin). (2) Diagnosis of rheumatic fever based on Jones criteria. (3) Control inflammatory process with aspirin with or without steroids (total duration of treatment of 12 weeks). (4) Treatment of chorea according to severity (therapy to continue for 2-3 weeks after clinical improvement). (5) Protocol for managing cardiac complication like valvular heart disease, congestive heart failure and atrial fibrillation. (6) Secondary prophylaxis with benzathine penicillin and management of anaphylaxis.     

Age-related fertility decline: a committee opinion

Age is a significant factor influencing a woman's ability to conceive. Social trends have led to deferred childbearing, and an increasing number of women are experiencing age-related infertility and pregnancy loss. Women older than 35 years should receive expedited evaluation and treatment after 6 months of failed attempts to conceive, or earlier if clinically indicated.     

ACOG Committee Opinion No. 421, November 2008: antibiotic prophylaxis for infective endocarditis

The recommendations for endocarditis prophylaxis from the American Heart Association have changed for three main reasons: 1) most cases of endocarditis are not attributable to an invasive procedure but rather are the result of randomly occurring bacteremia from routine daily activities; 2) prophylaxis may only prevent a small number of cases of infective endocarditis in women undergoing genitourinary procedures; and 3) the risk of antibiotic associated adverse events exceeds the benefit, if any, from prophylactic antibiotic therapy. The specific changes pertinent to the obstetrician-gynecologist are discussed.