Clinical Briefs

Am Fam Physician. 2001 Nov 15;64(10):1766-1768.

AAP Statement on Condom Use in Adolescence

The Committee on Adolescence of the American Academy of Pediatrics (AAP) has issued a position statement on the use of condoms by adolescents to help prevent unintended pregnancies and sexually transmitted diseases (STDs). This statement is an update of a previous AAP statement published in 1995 and refers only to the male condom. The current AAP statement appears in the June 2001 issue of Pediatrics.

In this policy statement, the AAP committee reviews the current rates of pregnancy, STDs, and human immunodeficiency virus (HIV) infection; recent changes in condom use by adolescents and the factors that affect condom use; the types of condoms, their proper use, and breakage rates; the effectiveness of condoms in preventing pregnancy, STDs, and HIV; and the role of schools in condom education and availability.

Based on their findings, the AAP committee makes the following recommendations:

  • Physicians should encourage adolescents to abstain from intercourse to prevent STDs and pregnancy. Adolescents who have been sexually active should be encouraged to postpone future sexual relationships.

  • Physicians should actively support the correct and consistent use of reliable contraception and condoms by sexually active adolescents, emphasizing that both males and females have a responsibility to use contraception.

  • In the interest of public health, restrictions and barriers to the availability of condoms should be removed.

  • Physicians can help parents and communities to understand that making condoms available to adolescents does not increase the rate of sexual activity, but can decrease rates of unintended pregnancies and STDs.

Management of Coexisting Cataract and Glaucoma

According to the Agency for Health-care Research and Quality (AHRQ), performing surgery for coexisting glaucoma and cataract at the same time results in lower intraocular pressure than cataract surgery alone. If not controlled, this increased pressure can damage the optic nerve, resulting in vision loss. This information is included in a report from the AHRQ, titled “Treatment of Coexisting Cataract and Glaucoma.”

For the AHRQ report, the Johns Hopkins Evidence-Based Practice Center conducted research to identify the most important questions regarding surgical treatment of coexisting glaucoma and cataract, review the quality and content of existing evidence on surgical treatment and identify future areas of research.

Because the progression of glaucoma is slow, long-term studies are necessary to assess the effects of surgery on quality of life, according to the AHRQ report. Although blacks have a high prevalence of glaucoma, few studies include significant numbers of this population. Blacks may respond differently to glaucoma surgery and should be significantly represented in future studies.

According to the AHRQ, issues for future research should include development of cataract after a patient has glaucoma surgery; short- and long-term control of intraocular pressure after cataract surgery in patients with glaucoma; and determination of the optimal surgical technique.

For a free copy of “Treatment of Coexisting Cataract and Glaucoma” (Evidence Report/Technology Assessment no. 38), contact the AHRQ Publications Clearinghouse at ahrqpubs@ahrq.gov, call 800-358-9295 or visit the AHRQ Web site at http://www.ahrq.gov/clinic/catarsum.htm.

ACEP/ACS Guidelines for Equipping Ambulances

The American College of Emergency Physicians (ACEP) and the American College of Surgeons (ACS) have collaborated on a set of recommendations for equipping ambulances. For years, these organizations had separate guidelines, but they have worked together to develop a consensus to facilitate patient care activities in the out-of-hospital setting.

The ACEP/ACS guidelines list equipment for ventilation and airway monitoring, defibrillation, immobilization, bandages, communication, obstetrics, infection control, injury prevention, and additional equipment for advanced-level ambulance services and extrication equipment for heavy rescue vehicles.

The collaboration took two years while the organizations gathered information from various sources such as emergency medical services personnel, rural ambulance units, paramedics, emergency physicians, and trauma surgeons.

The ACEP/ACS guidelines are intended to become the standard in emergency ambulance service in the United States and Canada. The guidelines, “Equipment for Ambulances,” are available on the ACEP Web site at http://www.acep.org/library/index.cfm/id/2231.pdf.

Guide for Prevention of Underage Drinking

The Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA) has developed a new guide to assist community leaders in understanding and effectively dealing with the issue of underage drinking.

According to CSAP, more than 10 million drinkers in the United States are underage. Young persons who drink are more likely to be the victims of violent crime, have problems in school, have drinking-related vehicle crashes, and develop alcohol dependence.

The “Underage Drinking Prevention Action Guide and Planner” provides information on how to build effective programs and activities to prevent underage drinking and its consequences. The guide is a monthly planner that can be used to track and schedule alcohol abuse prevention activities. A suggested theme or issue is provided for each month and ideas for activities appropriate to each theme are included.

For free copies of the “Underage Drinking Prevention Action Guide and Planner” and other substance abuse resource guides, call CSAP at 800-729-6686 or visit the SAMHSA Web site at http://www.samhsa.gov and click on “CSAP.”

FDA Approves Breath Test for H. Pylori Infection

The U.S. Food and Drug Administration (FDA) has approved Breathtek UBT, a new breath test that detects active Helicobacter pylori infection, for the initial diagnosis and for confirmation that the infection has been cured after treatment.

According to the manufacturer, the Breathtek UBT is as accurate as an endoscopy with biopsy for the detection of active H. pylori, which is the primary cause of peptic ulcer disease.

The Breathtek UBT takes about 15 minutes and is administered in the physician's office. The test is covered by Medicare and most medical insurers. [corrected] For more information on the Breathtek UBT, call the manufacturer at 888-637-3835.


Copyright © 2001 by the American Academy of Family Physicians.
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