Diagnosis at this stage may permit treatment before the occurrence of a devastating neurologic event. Clinical suspicion of subarachnoid hemorrhage should be confirmed by computed tomographic evaluation. This report presents a new strategy to improve the delivery of vaccination services to adolescents and to integrate recommendations for vaccination with other preventive services provided to adolescents. This new strategy emphasizes vaccination of adolescents 11 to 12 years of age by establishing a routine visit to their health care providers. The recommendations for vaccination of adolescents are based on new or current information for each vaccine.
Perinatal transmission can occur during pregnancy, delivery or breast feeding.
Because 90 percent of pediatric HIV infections are caused by perinatal transmission, the U.S. Public Health Service has recommended that all pregnant women be offered HIV counseling and testing. Factors that influence perinatal transmission include high maternal viral load, low maternal CD4 count, prolonged rupture of the membranes, premature delivery and symptomatic maternal HIV infection. The U.S. Public Health Service, in conjunction with the American Academy of Family Physicians, has strongly recommended expanding the current noncoercive, voluntary HIV testing to include routine testing of all pregnant women. California Patients with asthma who are treated according to published guidelines usually have good outcomes. However, when these patients fail to improve despite our best efforts, a systematic review focusing on eight key questions can usually spot where the management plan went wrong.