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Current practice guidelines in primary care - part 3

Khuyến cáo không nên 1. Cổ sự xem mạch cho nốt trong sử dụng siêu âm không có triệu chứng cá nhân màn hình ing trong không có triệu chứng mỗi độ nhạy 15% -38%; con trai đặc. 93% -100%. Chỉ có một tỷ lệ nhỏ của các tuyến tuyến giáp nốt ung thư, kết quả là một tỷ lệ dương tính giả cao. | Disease Screening Organization Date Population Recommendations Comments Source CANCER THYROID Cancer Thyroid AAFP 2007 Asymptomatic persons Recommends against the use of ultrasound screening in asymptomatic persons. 1. Neck palpation for nodules in asymptomatic individuals has sensitivity 15 -38 specificity 93 -100 . Only a small proportion of nodular thyroid glands are neoplastic resulting in a high false-positive rate. USPSTF http www.aafp.org online en home clinical exam.html 34 DISEASE SCREENING CANCER THYROID Disease Screening Organization Date Population Recommendations Comments Source CAROTID ARTERY STENOSIS Carotid Artery Stenosis asymptomatic ASN 2007 Asymptomatic adults Screening of the general population or a selected population based on age gender or any other variable alone is not recommended. 1. The prevalence of internal carotid arteiy stenosis ICAS of 70 is low in persons with only atherosclerosis risk factors 1.8 -2.3 intermediate in those with angina or MI 3.1 and highest in those with PAD 12.5 or AAA 8.8 . Advanced age 54 years and lower diastolic BP 83 mm Hg increased prevalence of ICAS. J Vasc Surg 2003 37 1226-1233 2. Asymptomatic Carotid Surgery Trial ACST Lancet 2004 363 1491 The absolute risk reduction for stroke or death at 5 years was 5.4 with significant benefit observed in women 4 absolute risk reduction as well as in men 8.2 risk reduction . 3. Severe CAS and coexisting conditions carotid stenting with use of emboli-protection device is not inferior to CEA. NEJM 2004 Oct 7 351 15 1493-1501 J Neuroimaging 2007 17 19-47 DISEASE SCREENING CAROTID ARTERY STENOSIS 35 Disease Screening Organization Date Population Recommendations Comments Source CHLAMYDIAL INFECTION Chlamydial Infection USPSTF 2007 Women aged 24 years who are sexually active and older nonpregnant women at increased riska Recommends at least annual screening optimal interval for screening is uncertain.b 1. Antigen detection tests nonamplified nucleic acid hybridization and .