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  1. Article: Bacterial vaginosis: an update.

    Majeroni, B A

    American family physician

    1998  Volume 57, Issue 6, Page(s) 1285–9, 1291

    Abstract: Bacterial vaginosis is the most common cause of vaginal discharge. Recent studies have confirmed its association with pelvic inflammatory disease and adverse pregnancy outcomes. Bacterial vaginosis is treated with oral metronidazole (given either as a ... ...

    Abstract Bacterial vaginosis is the most common cause of vaginal discharge. Recent studies have confirmed its association with pelvic inflammatory disease and adverse pregnancy outcomes. Bacterial vaginosis is treated with oral metronidazole (given either as a single dose or a seven-day course) or clindamycin. Treatment with topical clindamycin or metronidazole is also effective in returning the vaginal flora to normal but may be less effective in preventing the increased incidence of adverse pregnancy outcomes.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents/therapeutic use ; Clindamycin/therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Metronidazole/therapeutic use ; Patient Education as Topic ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/drug therapy ; Teaching Materials ; Vaginosis, Bacterial/diagnosis ; Vaginosis, Bacterial/drug therapy
    Chemical Substances Anti-Bacterial Agents ; Anti-Infective Agents ; Metronidazole (140QMO216E) ; Clindamycin (3U02EL437C)
    Language English
    Publishing date 1998-03-15
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 412694-4
    ISSN 0002-838X ; 0572-3612
    ISSN 0002-838X ; 0572-3612
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Douching frequency.

    Majeroni, B A

    The Journal of family practice

    1997  Volume 45, Issue 2, Page(s) 168–169

    MeSH term(s) Adolescent ; Adult ; Female ; Humans ; Middle Aged ; Therapeutic Irrigation/utilization ; Vagina
    Language English
    Publishing date 1997-08
    Publishing country United States
    Document type Letter
    ZDB-ID 197883-4
    ISSN 0094-3509
    ISSN 0094-3509
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  3. Article: Treatment of bacterial vaginosis.

    Majeroni, B A

    The Journal of family practice

    1996  Volume 42, Issue 5, Page(s) 530–531

    MeSH term(s) Animals ; Female ; Giardia/isolation & purification ; Humans ; Recurrence ; Vaginosis, Bacterial/microbiology
    Language English
    Publishing date 1996-05
    Publishing country United States
    Document type Letter
    ZDB-ID 197883-4
    ISSN 0094-3509
    ISSN 0094-3509
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  4. Article: Screening and treatment for sexually transmitted infections in pregnancy.

    Majeroni, Barbara A / Ukkadam, Sreelatha

    American family physician

    2007  Volume 76, Issue 2, Page(s) 265–270

    Abstract: ... treatment for gonorrhea is ceftriaxone 125 mg intramuscularly or cefixime 400 mg orally. Hepatitis B ...

    Abstract Many sexually transmitted infections are associated with adverse pregnancy outcomes. The Centers for Disease Control and Prevention recommends screening all pregnant women for human immunodeficiency virus infection as early as possible. Treatment with highly active antiretroviral therapy can reduce transmission to the fetus. Chlamydia screening is recommended for all women at the onset of prenatal care, and again in the third trimester for women who are younger than 25 years or at increased risk. Azithromycin has been shown to be safe in pregnant women and is recommended as the treatment of choice for chlamydia during pregnancy. Screening for gonorrhea is recommended in early pregnancy for those who are at risk or who live in a high-prevalence area, and again in the third trimester for patients who continue to be at risk. The recommended treatment for gonorrhea is ceftriaxone 125 mg intramuscularly or cefixime 400 mg orally. Hepatitis B surface antigen and serology for syphilis should be checked at the first prenatal visit. Benzathine penicillin G remains the treatment for syphilis. Screening for genital herpes simplex virus infection is by history and examination for lesions, with diagnosis of new cases by culture or polymerase chain reaction assay from active lesions. Routine serology is not recommended for screening. The oral antivirals acyclovir and valacyclovir can be used in pregnancy. Suppressive therapy from 36 weeks' gestation reduces viral shedding at the time of delivery in patients at risk of active lesions. Screening for trichomoniasis or bacterial vaginosis is not recommended for asymptomatic women because current evidence indicates that treatment does not improve pregnancy outcomes.
    MeSH term(s) Anti-Infective Agents/therapeutic use ; Female ; Humans ; Mass Screening ; Practice Guidelines as Topic ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/epidemiology ; Pregnancy Complications, Infectious/prevention & control ; Prognosis ; Risk Factors ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; United States/epidemiology
    Chemical Substances Anti-Infective Agents
    Language English
    Publishing date 2007-07-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 412694-4
    ISSN 0002-838X ; 0572-3612
    ISSN 0002-838X ; 0572-3612
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  5. Article: Chlamydial cervicitis: complications and new treatment options.

    Majeroni, B A

    American family physician

    1994  Volume 49, Issue 8, Page(s) 1825–9, 1832

    Abstract: Chlamydial cervicitis has the potential for serious gynecologic complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. In the pregnant patient, this infection is associated with premature rupture of membranes and ... ...

    Abstract Chlamydial cervicitis has the potential for serious gynecologic complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. In the pregnant patient, this infection is associated with premature rupture of membranes and increased fetal morbidity and mortality. In addition, infants infected by passage through an infected cervix are at risk for respiratory complications and conjunctivitis. Chlamydial cervicitis may, however, be asymptomatic, and no single risk factor has been identified that reliably predicts infection. Current recommendations are to screen all pregnant women and patients in high-risk populations, such as those attending clinics for sexually transmitted diseases. Screening tests for chlamydial cervicitis are limited by expense and technical difficulties in obtaining and handling specimens. Chlamydial cervicitis can be treated effectively with several antibiotics, including doxycycline, ofloxacin and erythromycin. Newer antibiotics such as azithromycin offer the potential of effective single-dose treatment.
    MeSH term(s) Anti-Bacterial Agents/economics ; Anti-Bacterial Agents/therapeutic use ; Cells, Cultured/microbiology ; Chlamydia Infections/complications ; Chlamydia Infections/drug therapy ; Chlamydia Infections/transmission ; Chlamydia trachomatis ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications, Infectious/diagnosis ; Pregnancy Complications, Infectious/drug therapy ; Pregnancy Complications, Infectious/etiology ; Uterine Cervicitis/complications ; Uterine Cervicitis/diagnosis ; Uterine Cervicitis/drug therapy
    Chemical Substances Anti-Bacterial Agents
    Language English
    Publishing date 1994-06
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 412694-4
    ISSN 0002-838X ; 0572-3612
    ISSN 0002-838X ; 0572-3612
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  6. Article: New concepts in bacterial vaginosis.

    Majeroni, B A

    American family physician

    1991  Volume 44, Issue 4, Page(s) 1215–1218

    Abstract: Bacterial vaginosis is a polymicrobial, superficial infection caused by an increase in anaerobic bacteria and a concomitant decrease in lactobacilli. Diagnosis is based on the presence of three of the following findings: a homogeneous vaginal discharge; ... ...

    Abstract Bacterial vaginosis is a polymicrobial, superficial infection caused by an increase in anaerobic bacteria and a concomitant decrease in lactobacilli. Diagnosis is based on the presence of three of the following findings: a homogeneous vaginal discharge; an amine odor released by the addition of 10 percent potassium hydroxide; the presence of clue cells on wet mount; the absence of lactobacilli on wet mount, and an increase in the pH of vaginal secretions to more than 4.7. Oral metronidazole is the drug of choice for the treatment of bacterial vaginosis, but clindamycin is an effective alternative.
    MeSH term(s) Clindamycin/therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Metronidazole/therapeutic use ; Trichomonas Vaginitis/diagnosis ; Vaginosis, Bacterial/diagnosis ; Vaginosis, Bacterial/drug therapy
    Chemical Substances Metronidazole (140QMO216E) ; Clindamycin (3U02EL437C)
    Language English
    Publishing date 1991-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 412694-4
    ISSN 0002-838X ; 0572-3612
    ISSN 0002-838X ; 0572-3612
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  7. Article: The pharmacologic treatment of depression.

    Majeroni, B A / Hess, A

    The Journal of the American Board of Family Practice

    1998  Volume 11, Issue 2, Page(s) 127–139

    Abstract: Background: Family physicians often provide the first line of treatment for patients with depression. Many effective drugs are now available for the pharmacologic treatment of depression.: Methods: We searched Medline from 1991-96 under the topics of ...

    Abstract Background: Family physicians often provide the first line of treatment for patients with depression. Many effective drugs are now available for the pharmacologic treatment of depression.
    Methods: We searched Medline from 1991-96 under the topics of depressive disorders/treatment and antidepressant medications. Other sources were found by back-referencing from these references and from pharmacology texts.
    Results: Although antidepressants appear to be equally effective, selective serotonin reuptake inhibitors are frequently the drugs of choice because of their safety profile the less troublesome side effects.
    Conclusions: When prescribing antidepressant medications, the clinician must educate patients about potential side effects and about the amount of time that must be allowed for therapeutic efficacy. Drug interactions and concurrent medical conditions are important factors in the choice of an antidepressant.
    MeSH term(s) Adolescent ; Adult ; Aged ; Antidepressive Agents/adverse effects ; Antidepressive Agents/therapeutic use ; Child ; Child, Preschool ; Depression/diagnosis ; Depression/drug therapy ; Depression/physiopathology ; Drug Interactions ; Drug Utilization/statistics & numerical data ; Family Practice ; Female ; Guidelines as Topic ; Humans ; Male ; Middle Aged ; Pregnancy ; Pregnancy Complications/drug therapy ; Prenatal Exposure Delayed Effects ; Referral and Consultation ; Serotonin Uptake Inhibitors/adverse effects ; Serotonin Uptake Inhibitors/therapeutic use ; United States
    Chemical Substances Antidepressive Agents ; Serotonin Uptake Inhibitors
    Language English
    Publishing date 1998-03
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1036289-7
    ISSN 0893-8652
    ISSN 0893-8652
    DOI 10.3122/15572625-11-2-127
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Family physicians' attitudes about and use of clinical practice guidelines.

    James, P A / Cowan, T M / Graham, R P / Majeroni, B A

    The Journal of family practice

    1997  Volume 45, Issue 4, Page(s) 341–347

    Abstract: Background: The use of clinical guidelines is one strategy intended to improve health care quality, rein in costs, and standardize medical practice. Clinical guideline development has been prodigious, while less effort has been expended on the ... ...

    Abstract Background: The use of clinical guidelines is one strategy intended to improve health care quality, rein in costs, and standardize medical practice. Clinical guideline development has been prodigious, while less effort has been expended on the guidelines' dissemination and implementation. This study examines family physician attitudes toward and perceived uses of clinical guidelines in practice.
    Methods: A survey questionnaire was sent to 978 family physicians in Upstate New York to assess their confidence in clinical guidelines developed or endorsed by organizations and the perceived usefulness of such guidelines in practice. Descriptive analyses, chi-square tests, and comparison of means (one-way ANOVA) were conducted.
    Results: After two mailings, the response rate was 43%. Most respondents perceived clinical guidelines as effective educational tools that should improve the quality of patient care, but were concerned about their potential regulatory intrusion into practice. Solo practitioners expressed more negative attitudes regarding clinical guidelines than physicians in non-solo practices. Respondents had greater confidence in clinical guidelines developed or endorsed by their professional society, the Centers for Disease Control and Prevention, the United States Preventive Services Task Force, and the National Institutes of Health, but less in those by insurance companies or state health departments. The reported adoption rate of clinical guidelines was low. The most preferred methods for adoption were continuing medical education and practice interventions.
    Conclusions: Family physicians found clinical guidelines to be valuable educational tools but were divided on their potential regulatory role. If clinical guidelines are to improve quality in practice, they must be more effectively disseminated and implemented. To broaden physicians' adoption of clinical guidelines, further research into dissemination and implementation methods is warranted, along with wider endorsement of guidelines by those whom family physicians trust.
    MeSH term(s) Attitude of Health Personnel ; Family Practice/standards ; Female ; Guideline Adherence ; Heart Failure/therapy ; Humans ; Male ; New York ; Physicians, Family/psychology ; Physicians, Family/statistics & numerical data ; Practice Guidelines as Topic ; Quality of Health Care ; United States ; United States Agency for Healthcare Research and Quality
    Language English
    Publishing date 1997-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 197883-4
    ISSN 0094-3509
    ISSN 0094-3509
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  9. Article: Body mass and weight as indicators for cholesterol screening.

    Majeroni, B A / Smallen, G / Crawford, M E

    The Journal of family practice

    1992  Volume 35, Issue 5, Page(s) 537–539

    Abstract: Background: Universal screening of serum cholesterol levels in adults has been recommended but not achieved. We were interested in factors that affected screening rates, and whether obese patients were more likely to have elevated cholesterol levels ... ...

    Abstract Background: Universal screening of serum cholesterol levels in adults has been recommended but not achieved. We were interested in factors that affected screening rates, and whether obese patients were more likely to have elevated cholesterol levels than other patients in our practice.
    Methods: A sequential sample of charts was reviewed for height, weight, race, sex, diagnosis of hypertension or diabetes, and evidence of cholesterol screening.
    Results: Of 604 adult patients, 32% had serum cholesterol measurements. No correlation was found between weight or body mass index and cholesterol levels. Patients with hypertension or diabetes were more frequently screened. Sex and race did not influence screening rates.
    Conclusions: In this population neither weight nor body mass index was associated with elevated serum cholesterol levels, suggesting that screening must be offered without regard to level of obesity in order to find those patients who will benefit from intervention.
    MeSH term(s) Adult ; Body Mass Index ; Body Weight ; Cholesterol/blood ; Female ; Humans ; Hypercholesterolemia/blood ; Hypercholesterolemia/prevention & control ; Male ; Mass Screening ; Obesity/blood ; Sampling Studies
    Chemical Substances Cholesterol (97C5T2UQ7J)
    Language English
    Publishing date 1992-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197883-4
    ISSN 0094-3509
    ISSN 0094-3509
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  10. Article: Use of wet mount to predict Chlamydia trachomatis and Neisseria gonorrhea cervicitis in primary care.

    Majeroni, B A / Schank, J N / Horwitz, M / Valenti, J

    Family medicine

    1996  Volume 28, Issue 8, Page(s) 580–583

    Abstract: Background and objectives: Cervicitis is associated with salpingitis, infertility, and complications of pregnancy. Universal screening has been recommended for high-prevalence populations but may not be appropriate in the family practice setting. ... ...

    Abstract Background and objectives: Cervicitis is associated with salpingitis, infertility, and complications of pregnancy. Universal screening has been recommended for high-prevalence populations but may not be appropriate in the family practice setting. Leukocytes on an endocervical gram stain have been associated with infectious cervicitis due to Chlamydia trachomatis and Neisseria gonorrhea. This study sought to determine whether the finding of leukocytes in a vaginal wet mount could be used to screen for infectious cervicitis in an urban family practice.
    Methods: A consecutive sample of 357 women had cultures for C trachomatis and N gonorrhea and a standardized wet mount.
    Results: All women with infectious cervicitis were under age 35. Thirty-six percent of infected women had more leukocytes than epithelial cells in the wet mount, compared with 23% of women without these organisms.
    Conclusions: Wet mount findings did not reliably predict infectious cervicitis. Study of a larger population is needed to confirm these findings.
    MeSH term(s) Adolescent ; Adult ; Age Distribution ; Aged ; Animals ; Chlamydia Infections/diagnosis ; Chlamydia Infections/epidemiology ; Chlamydia trachomatis/isolation & purification ; Female ; Humans ; Leukocyte Count ; Middle Aged ; Neisseria gonorrhoeae/isolation & purification ; Neisseriaceae Infections/diagnosis ; Neisseriaceae Infections/epidemiology ; New York/epidemiology ; Predictive Value of Tests ; Prevalence ; Primary Health Care ; Trichomonas vaginalis/isolation & purification ; Uterine Cervicitis/diagnosis ; Uterine Cervicitis/epidemiology ; Uterine Cervicitis/etiology ; Vaginal Smears/methods
    Language English
    Publishing date 1996-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 639374-3
    ISSN 0742-3225
    ISSN 0742-3225
    Database MEDical Literature Analysis and Retrieval System OnLINE

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