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11881. What evidence is there for the effectiveness of self-help treatments for anxiety and depression?

: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection (...) therapies. The NICE guideline on anxiety notes, in a section on treatment in primary cares that, “ The recommended treatment options have an evidence base: psychological therapy, medication and self-help have all been shown to be effective. The choice of treatment will be a consequence of the assessment process and shared decision-making.” Within the section on self-help, NICE recommends: “ 26. Bibliotherapy based on CBT principles should be offered. (A) 27. Information about support groups, where

2006 TRIP Answers

11882. Is it known how much immunity a single MMR provides in a 3 year old whose parents wish to avoid a second MMR and can this checked serologically.

Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip (...) this checked serologically. The Green Book has separate chapters on mumps [1], measles [2] and rubella [3]. These supply the following: Mumps “In October 1996, a two-dose MMR schedule was introduced. A single dose of a mumps-containing vaccine used in the UK confers between 61% and 91% protection against mumps (Plotkin and Orenstein, 2004). Two doses are therefore needed for both individual and population protection.” Measles “To maintain the control of measles established after the MR campaign, in October

2006 TRIP Answers

11883. Are there special energy requirements for patients with prader willi syndrome? If so how do we calculate these?

Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen (...) we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Are there special energy requirements for patients with prader willi syndrome? If so how do we calculate these? An e-Medicine article on Prader Willi syndrome (PWS

2007 TRIP Answers

11884. What does it mean when a haematologist reports a on a blood film 'Neutrophils show a left shift'

: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection (...) band count or an elevated immature/total granulocyte (I/T) ratio.” The medical school at the Canadian University of Queen’s website reports [2]: “The term 'left shift' indicates that the neutrophils present in the blood are at a slightly earlier stage of maturation than usual.” A UK labs website reports [3]: “A left shift in the neutrophil series: This describes the appearance in the peripheral blood of immature neutrophilic granulocytes. Typically these are band neutrophils with a horseshoe shaped

2007 TRIP Answers

11885. We are reviewing our travel clinics and are querying whether we are able to charge for administration of TWINRIX vaccination?

abroad. However Hepatitis B is not routinely available free of charge and therefore GPs can charge patients for this vaccination when requested in connection with travel abroad.” A 2004 BMA document [2] has a section on private income and travel vaccines, reporting: “The situation with regard to travel vaccines and what can and cannot be charged for has not altered from the old to the new General Medical Service (GMS) contract. Under the Red Book a limited number of travel vaccines (see Appendix 1 (...) EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been

2008 TRIP Answers

11886. Is there any evidence linking high exercise levels, in fit young men, with a cardiothoracic ratio of >50%?

remains normal in the basal state in such individuals. We conclude that these individuals represent a selected subgroup of subjects who are variants of normal.” A book entitled the ABC of Sports and Exercise Medicine found by google has a chapter on the athlete’s heart and sudden cardiac death. This states: “A large heart and slow heart rate are features of athletes’ hearts and manifest as a displaced and forceful cardiac apical impulse on physical examination, large QRS complaexes, sinus bradycardia (...) considerably amongst athletes, even when allowances are made for these variables, suggesting that genetic, endocrine and biochemical factors also influence heart size. This review discusses the effects of age, sex, ethnicity and sporting discipline on cardiac dimensions in athletic individuals” A local medical library may be able to access the full paper. Another book found online in Google called Hurst ’s the Heart (4) states: “Chest roentogenograms may reveal cardiomegaly with a cardiothoracic ratio

2008 TRIP Answers

11887. Are there any nationally agreed guidelines on provision of Hep B vaccination for travellers going to high risk areas?

Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen (...) we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Are there any nationally agreed guidelines on provision of Hep B vaccination for travellers going to high risk areas? The Green Book has a chapter on Hepatitis B

2008 TRIP Answers

11888. Is there any evidence for the prescribing of an oral iron supplement called Spatone, which is a type of mineral water, in pregnant women?

Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip (...) contacted the manufacturer’s of Spatone to access any data they had on the product. They sent us one randomised controlled trial of Spatone as a prophylaxis against iron deficiency in pregnancy (2) The study examined Spatone (n=51) versus placebo (n=51) in 102 subjects with singleton pregnancy of known gestational age with a booking haemoglobin >10.4 g/100 ml who were not currently taking iron supplements. Primary outcome measures were compliance with treatments, modified Glasgow dyspepsia Severity

2008 TRIP Answers

11889. Are there any risk tables advising use of combined oral contraceptive relating to age, blood pressure and smoking?

-uterine devices or the levonorgestrel-releasing intra-uterine system." The World Health Organisation has published a book on medical eligibility criteria for Contraceptive Use. Tables from this book are available on the web; one on low-dose combined oral contraceptives is freely available at: http://www.prodigy.nhs.uk/guidance.asp?gt=Contraception Answered 28 January 2004 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK. (...) in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain

2004 TRIP Answers

11890. Do NSAID drugs affect the efficacy of the IUCD or the Mirena Coil?

in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection for a historical and research reasons. More results What is Trip (...) ) and separate guideline on the copper intrauterine device (2) in 2004. The LNG-IUS guideline has a section on whether there are any drugs that interact with the device. This states: “ Women using the LNG-IUS may be reassured that there is no evidence of reduced efficacy with liver enzyme-inducers or other drugs (Grade B). WHOMEC recommends that the benefits of LNG-IUS use by women using liver enzyme-inducers generally outweigh the risks (WHO 2). Data from an ongoing survey have not identified any reduction

2005 TRIP Answers

11891. Is there any evidence that progesterone only pills (POP) and cerazette in particular are associated with an increased risk of breast cancer?

study sample sizes. The Committee on Safety of Medicines has advised that the possible small increase in the risk of breast cancer should be weighed against the benefits. The most important risk factor seems to be the age at which the POP is stopped — the risk disappears gradually during the 10 years after stopping, and there is no excess risk by 10 years.” The Summary of product characteristics for Cerazette notes; “The risk for breast cancer increases in general with increasing age. During the use (...) Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip

2007 TRIP Answers

11892. What antibiotic prophylaxis is recommended for people who have had a splenectomy? What immunisations are recommended and how often are the boosters due?

immunisations are recommended and how often are the boosters due? The Department of Health Green Book (1) in chapter 7 notes: “Some medical conditions or treatments increase the risk of complications from specific infectious diseases. Individuals who have such conditions or receive such treatments require additional protection, as listed in the appropriate chapters, and so the following vaccines are recommended: Asplenia or splenic dysfunction · Hib vaccine · linfluenza vaccine · meningococcal C vaccine (...) phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years

2007 TRIP Answers

11893. Is there any association with recent influenza vaccination and acute pancreatitis?

by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection for a historical and research (...) types including images, videos, patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com Is there any association with recent influenza vaccination and acute pancreatitis? We searched Medline, TRIP and a number of SPCs but could find no association described in the literature. The Green Book reports

2008 TRIP Answers

11894. There seems to be differing views between surgeries as to whether we can charge our NHS patients for travel vaccinations. Is there any guidance on this?

not altered from the old to the new General Medical Service (GMS) contract. Under the Red Book a limited number of travel vaccines (see Appendix 1 for the list ) ** were provided on the NHS. This was for public health reasons. The public health agenda has not altered with the new contract and therefore those travel vaccines that were provided by practices on the NHS before the 31st March shall continue to be provided by them from 1st April. The only exception shall be for those practices that opt-out (...) : Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various

2007 TRIP Answers

11895. Could you please tell me what the current recommendations are for giving vitamin drops to breast fed babies? Also is any supplementation advised for breast feeding mothers ?

&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection for a historical and research reasons. More results What is Trip? Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care. Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto (...) recommendations are for giving vitamin drops to breast fed babies? Also is any supplementation advised for breast feeding mothers ? We searched the NLH Library, the TRIP and Medline databases and the Department of Health website but found little guidance on vitamin supplementation for breastfed babies and their mothers. NICE issued draft guidance on maternal and child nutrition in July 2007. This states: “ The Department of Health and the Chief Medical Officer (CMO) (DH 2005) state that pregnant

2007 TRIP Answers

11896. What is the current guidance on administering flu vaccines during pregnancy?

in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection for a historical and research reasons. More results What is Trip (...) , patient information leaflets, educational courses and news. For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via jon.brassey@tripdatabase.com What is the current guidance on administering flu vaccines during pregnancy? The Green Book has a chapter on the influenza vaccine [1] and this reports on pregnancy, stating: “Pregnant women in the risk groups listed in Table 19.2 above should

2007 TRIP Answers

11897. What are the survival rates for treated non-hodgkins lymphoma in patients with HIV?

to four months, regardless of CD4 cell count. However, recent research has shown that people with NHL who were treated with HAART had a median survival time of two years.” The free, online book HIV Medicine discuss prognosis [2]. Unfortunately, this does not give a ‘headline’ figure but discusses various aspects of survival. References 1) 2) Answered 13 November 2007 Follow us: © 2019 Trip Database Ltd. company number 04316414. Trip is proud to be made in the UK. (...) by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain this collection for a historical and research

2007 TRIP Answers

11898. Antenatal guidelines recommend iron + folic acid for anaemia in pregnancy with a normal MCV. What is the recommended dose of folic acid in this situation?

This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over (...) MCV. What is the recommended dose of folic acid in this situation? The PatientPlus website contains an article on anaemia in pregnancy and in which it states: “ The Royal College of Obstetricians and Gynaecologists advise that women should be offered screening for anaemia at booking and at 28 weeks gestation.1 Hb ≤10.5g/dl and serum ferritin and mean cell volume low indicate iron deficiency anaemia and this accounts for 85% of all cases of anaemia that are identified. Uncommon causes: • Folic acid

2008 TRIP Answers

11899. Can one give meitorix same time as prevenar to a 2 yr old who has missed her prevenar vacc when it was due?

guidelines based on a range of medical and scientific data and consider the epidemiology of pneumococcal disease as well as controlled trials on methods for its prevention (i.e. vaccination) [DH, 2006b]. The 'Green Book' chapter on pneumococcal disease can be accessed from the Department of Health website, at . • Children aged over 2 years are not eligible for standard pneumococcal vaccination, regardless of their vaccination status, as they have passed the age of highest risk of pneumococcal disease (...) in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Clinical Q&As This question and answer form part of a large corpus of over 7,000 clinical Q&As that have been generated over the years by various services Trip Database have run or been involved in. Trip are keen to retain

2008 TRIP Answers

11900. In a woman with a past history of ectopic pregnancy is the use of progesterone only pills (POP) an absolute or a relative contraindication?

or a relative contraindication? BNF lists past ectopic pregnancy as a caution rather than contraindication for the use of progesterone only pills (POP) (1). The World Health Organization (WHO) medical eligibility criteria for progesterone only pills (2) states that past ectopic pregnancy is considered as WHO 2 for this type of contraception. Their document adds: “POPs have a higher absolute rate of ectopic pregnancy compared with other POCs, but still less that using no method.” John Guillebaud’s book (...) , Contraception: Your questions answered, discusses the issue of ectopic pregnancy and POP use (3). The following extracts are reproduced from the book: “Pregnancies in POP users are more likely to be ectopic than pregnancies occurring in the general population. As for the IUD, it is not thought that the POP actually increases the risk of ectopics in a population of pop users; indeed the reverse is true.” It is stated that the likelihood of any rare breakthrough pregnancy that happens being ectopic

2006 TRIP Answers

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