Patient use of secure electronic messaging within a shared medical record: a cross-sectional study.

Background: Most patients would like to be able to exchange electronic messages with personal physicians. Few patients and providers are exchanging electronic communications.

Objective: To evaluate patient characteristics associated with the use of secure electronic messaging between patients and health care providers.

Risks of congenital malformations and perinatal events among infants exposed to antidepressant medications during pregnancy.

Purpose: To evaluate risks for perinatal complications and congenital defects among infants exposed in utero to antidepressants.

Methods: We identified 2201 women who were prescribed an antidepressant during pregnancy and who delivered an infant within one of five large managed care organizations (HMO). Prescription drug dispensings and inpatient and outpatient diagnoses were obtained from automated databases at each HMO.

Medical care utilization patterns in women with diagnosed domestic violence.

Background: Information on women with domestic violence (DV) suggests increased healthcare utilization across all levels of care and many diagnoses. In the present ancillary study (1997-2002), derived from a large, group-randomized intervention trial we conducted in a staff-model health maintenance organization (HMO) (1995-1998), we examined total and incremental utilization rates, costs, and patterns for women aged >/=18 years with DV identified through the record reviews conducted for the trial. By the choice of comparison groups used, our present aim was to "bracket" any associated increase in utilization.

Diphtheria antitoxin levels among children primed with a diphtheria and tetanus toxoids and acellular pertussis vaccine lot with a subpotent diphtheria toxoid component.

One lot of a nationally distributed diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine was recalled in January 1999 because of a subpotent diphtheria toxoid component. To evaluate vaccine immunogenicity, children who had received the recalled lot for at least 2 of the 3 doses of their primary series were identified. Diphtheria antitoxin (DAT) levels were then prospectively assessed before and after dose 4 of (fully potent) DTaP vaccine.

Identification and management of domestic violence: a randomized trial.

Background: Diagnosis of domestic violence (DV) in primary care is low compared to its prevalence. Care for patients is deficient. Over a 1-year period, we tested the effectiveness of an intensive intervention to improve asking about DV, case finding, and management in primary care.