tailieunhanh - Current practice guidelines in primary care - part 5

Trong bệnh giang mai cuối, kết quả trước đây phản ứng trở lại nonreactive trong 25% bệnh nhân. 3. Đặc các bài kiểm tra nontreponemal là 75% -85% ở người có bệnh từ trước hoặc điều kiện (ví dụ, bệnh mạch máu collagen, tiêm chích ma túy sử dụng | Disease Screening Organization Date Population Recommendations Comments Source SYPHILIS Syphilis AAFP USPSTF 2007 2004 Pregnant women Strongly recommends screening all pregnant women. 1. All reactive nontreponemal tests should be confirmed with a more specific treponemal test eg FTA-ABS . 2. Sensitivity of nontreponemal tests varies with levels of antibodies 62 -76 in early primaiy syphilis 100 during secondary syphilis and 70 in untreated late syphilis. In late syphilis previously reactive results revert to nonreactive in 25 of patients. 3. Specificity of nontreponemal tests is 75 -85 in persons with preexisting diseases or conditions eg collagen vascular diseases injection drug use advanced malignancy pregnancy malaria tuberculosis viral and rickettsial diseases and 100 in persons without preexisting diseases or conditions. 4. Between 2000 and 2003 syphilis cases increased 60 in men and decreased 53 in women. About two-thirds of syphilis cases in 2003 were among men having sex with men. Am J Public Health 2007 97 1076 http exam http clinic uspstf AAFP USPSTF 2007 2004 Persons at increased riska-b Strongly recommends screening high-risk persons. http exam http clinic uspstf AAN 2001 Patients with dementia Do not screen unless clinical suspicion of neurosyphilis is present. Neurology 2001 56 1143 http professionals practice guidelines pda Dementia_ aHigh risk includes commercial sex workers persons who exchange sex for money or drugs persons with other STDs including HIV and sexual contacts of persons with active syphilis. bRecommends against screening asymptomatic persons not at increased risk for syphilis infection. 80 DISEASE SCREENING SYPHILIS Disease Screening Organization Date Population Recommendations Comments Source THYROID DISEASE Thyroid Disease AAFP USPSTF 2007 2004 Adults Insufficient evidence to recommend for or against routine screening for thyroid