RESUMEN
This study was designed to determine whether a better partner notification outcome could be achieved by giving female index patients with genital chlamydial infection a home sampling kit instead of contact slips only. Two hundred female patients attending a sexually transmitted infection clinic with a diagnosis of genital chlamydial infection were randomized to either the conventional partner notification arm using contact slips (swab testing arm) or the urine sampling kit for partner notification arm (urine testing arm). There were no differences in the number of partners treated per index case (0.67 in the swab testing group versus 0.62 in the urine testing group, P = 0.46), the median number of traceable partners and the number of index patients with at least one partner treated within 28 days. The addition of a urine testing kit to contact slips for male partners of women with genital chlamydial infection did not increase the partner notification rates for genital chlamydial infection.
Asunto(s)
Infecciones por Chlamydia/epidemiología , Trazado de Contacto/métodos , Urinálisis/métodos , Adolescente , Adulto , Infecciones por Chlamydia/orina , Femenino , Humanos , Masculino , Juego de Reactivos para Diagnóstico , Parejas Sexuales , Reino Unido/epidemiología , Adulto JovenRESUMEN
There have been very few studies focusing on what form of communication patients would find acceptable from a clinic. This study looks at the differences in preferences for various partner notification methods when the respondents were index patients compared with when they had to be contacted because a partner had a sexually transmitted infection (STI). There were 2544 respondents. When the clinic had to notify partners, respondents were more likely to report the method as good when a partner had an STI and they were being contacted compared with when the respondents had an infection and the partner was being contacted. The opposite was true for patient referral partner notification. Therefore, there are variations in the preferences of respondents for partner notification method, which depend on whether they see themselves as index patients or contacts.
Asunto(s)
Trazado de Contacto/métodos , Satisfacción del Paciente , Enfermedades de Transmisión Sexual/psicología , Enfermedades de Transmisión Sexual/transmisión , Instituciones de Atención Ambulatoria , Recolección de Datos , Inglaterra , Humanos , Relaciones Profesional-Paciente , Parejas Sexuales/psicologíaRESUMEN
A review of the randomized, controlled trials in the literature on the treatment of genital herpes infection with aciclovir, famciclovir and valaciclovir. Common clinical questions encountered by physicians, such as the effect of antivirals on symptoms, healing, aborting attacks and subsequent recurrences, are addressed. There is very little comparative data between the three licensed drugs but the little data that there is shows no difference in efficacy, tolerability and toxicity between aciclovir, valaciclovir or famciclovir when taken orally. Choice of therapy would then depend on convenience of dosing and cost.
Asunto(s)
2-Aminopurina/análogos & derivados , Aciclovir/análogos & derivados , Antivirales/uso terapéutico , Herpes Genital/tratamiento farmacológico , Valina/análogos & derivados , 2-Aminopurina/uso terapéutico , Aciclovir/uso terapéutico , Administración Oral , Famciclovir , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Prevención Secundaria , Valaciclovir , Valina/uso terapéuticoRESUMEN
A retrospective review of 400 cases of genital chlamydia managed with a traditional clinic follow-up was compared to 400 cases with a telephone follow-up appointment. We satisfactorily treated more patients with the telephone follow-up appointment than with a traditional clinic follow-up (204 [51%] vs 121 [30%]; P <0.0001). We also satisfactorily treated more partners with the telephone follow-up system than a traditional clinic appointment system (0.57 vs 0.45 contacts per case; P =0.0006). The introduction of the telephone follow-up appointment system in the clinic increased the number of patients and contacts of patients successfully managed for genital chlamydial infection. Our findings should lead to increased research and adoption of different methods of follow-up and help develop proper outcome standards.
Asunto(s)
Atención Ambulatoria/normas , Infecciones por Chlamydia/terapia , Adhesión a Directriz , Visita a Consultorio Médico , Guías de Práctica Clínica como Asunto , Teléfono , Adolescente , Adulto , Antibacterianos/uso terapéutico , Infecciones por Chlamydia/epidemiología , Trazado de Contacto , Eritromicina/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Parejas Sexuales , Factores de Tiempo , Reino Unido/epidemiología , Población BlancaAsunto(s)
Infecciones por VIH/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Pobreza , Enfermedades Bacterianas de Transmisión Sexual/epidemiología , Enfermedades Virales de Transmisión Sexual/epidemiología , Población Urbana , Adolescente , Adulto , Concienciación , Infecciones por VIH/psicología , Humanos , India/epidemiología , Masculino , Prevalencia , Enfermedades Bacterianas de Transmisión Sexual/psicología , Enfermedades Virales de Transmisión Sexual/psicologíaAsunto(s)
Conducta del Adolescente , Conducta Sexual , Enfermedades de Transmisión Sexual/epidemiología , Adolescente , Niño , Preescolar , Femenino , Enfermedades Urogenitales Femeninas/clasificación , Enfermedades Urogenitales Femeninas/diagnóstico , Enfermedades Urogenitales Femeninas/epidemiología , Humanos , Incidencia , Lactante , Masculino , Enfermedades Urogenitales Masculinas , Estudios Retrospectivos , Enfermedades de Transmisión Sexual/clasificación , Enfermedades de Transmisión Sexual/diagnóstico , Reino Unido/epidemiologíaAsunto(s)
Infecciones por VIH/complicaciones , Asignación de Recursos para la Atención de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Infertilidad/terapia , Medicina Reproductiva/organización & administración , Técnicas Reproductivas Asistidas , Femenino , Encuestas de Atención de la Salud , Humanos , Infertilidad/complicaciones , Infertilidad/diagnóstico , Masculino , Prejuicio , Negativa al Tratamiento , Encuestas y Cuestionarios , Reino UnidoRESUMEN
OBJECTIVE: To identify patient preferences for notification of sexual contacts when a sexually transmitted infection (STI) is diagnosed. METHODS: A questionnaire survey of 2544 patients attending three large genitourinary clinics at Derby, Birmingham, and Coventry in the United Kingdom. RESULTS: The median age of the respondents was 24 with 1474 (57.9%) women, 1835 (72.1%) white, 1826 (71.8%) single. The most favoured method of partner notification was patient referral, which was rated a "good" method by 65.8% when they had to be contacted because a sexual partner has an STI. Notifying contacts by letter as a method of provider partner notification is more acceptable than phoning, text messaging, or email. Respondents with access to mobile telephones, private emails, and private letters were more likely to rate a method of partner notification using that mode of communication as "good" compared to those without. With provider referral methods of partner notification respondents preferred to receive a letter, email, or text message asking them to contact the clinic rather than a letter, email or text message informing them that they may have an STI. CONCLUSION: Most respondents think that being informed directly by a partner is the best method of being notified of the risk of an STI. Some of the newer methods may not be acceptable to all but a significant minority of respondents prefer these methods of partner notification. The wording of letters, emails, or text messages when used for partner notification has an influence on the acceptability of the method and may influence success of the partner notification method. Services should be flexible enough to utilise the patients' preferred method of partner notification.
Asunto(s)
Trazado de Contacto , Satisfacción del Paciente , Parejas Sexuales , Enfermedades de Transmisión Sexual/psicología , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Factores de Riesgo , Enfermedades de Transmisión Sexual/prevención & controlRESUMEN
An HIV positive black African woman presented with widespread lymphadenopathy and pancytopenia that had been ascribed to tuberculosis. Lymph node biopsy showed both Kaposi's sarcoma and multicentric Castleman's disease. Despite antiretroviral therapy and chemotherapy the patient deteriorated, developing confusion and dysphasia. A cranial magnetic resonance scan showed central pontine myelinolysis. Despite supportive therapy the patient died.