RESUMEN
Windsor, Ascot, Maidenhead (WAM) primary care trust (PCT) currently has no specialist sexual health services. We researched the level of sexual health service provision in WAM compared with targets set out in the National Strategy for Sexual Health and HIV and assessed support for level 2 service expansion. We found practices were already providing much of level 1 and parts of level 2 services. Gaps centred on male and asymptomatic female screening and sexual health promotion. Ten out of 22 practices expressed interest for service development within the PCT, but obstacles cited included lack of resources, training and prioritization of the strategy. The study has identified strengths and weaknesses across the PCT that have guided recent initiatives. This model could be used by other PCTs to ascertain their needs and acknowledge their achievements.
Asunto(s)
Infecciones por VIH/prevención & control , Servicios de Salud/normas , Educación Sexual , Enfermedades de Transmisión Sexual/prevención & control , Estudios de Evaluación como Asunto , Gobierno Federal , Femenino , Infecciones por VIH/diagnóstico , Servicios de Salud/estadística & datos numéricos , Servicios de Salud/provisión & distribución , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Médicos de Familia , Atención Primaria de Salud , Evaluación de Programas y Proyectos de Salud , Enfermedades de Transmisión Sexual/diagnóstico , Encuestas y CuestionariosRESUMEN
A six-year retrospective review of concomitant HIV and mycobacterial infection in the Republic of Ireland is presented. A total of 42 culture proven mycobacterial infections were seen in 40 different HIV-infected patients. There were 24 infections with Mycobacterium tuberculosis (M.tb) and 18 infections with mycobacteria other than tuberculosis (MOTT), a significantly higher rate of MOTT infections in Ireland compared to a study from 1962-1981. The detection rate for all mycobacterial infections had an annual upward trend with a 4-fold increase between 1987 and 1992. In homosexuals, MOTT infections occurred more frequently than M.tb, while the reverse was true for IVDUs. Twenty per cent of the infections were seen in patients recently incarcerated. Relapse of tuberculosis occurred in 42.9% (3/7) of non-compliant patients, 2 of whom developed rifampin-resistant strains of M.tb. No patient compliant to their regimen had a relapse in disease. The overall survival of patients after diagnosis of M.tb was significantly better than those with MOTT infections, with respective one-year survival rate of 79% and 36% (log rank test, P = 0.006).
Asunto(s)
Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Tuberculosis/complicaciones , Tuberculosis/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Adulto , Femenino , Infecciones por VIH/mortalidad , Humanos , Irlanda/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológicoRESUMEN
Pancreatic tuberculosis is unusual occurring in only 2.7% of autopsy studies of persons with miliary disease. Reports of focal pancreatic tuberculosis are rare, even in patients with the acquired immunodeficiency syndrome (AIDS) in whom abdominal tuberculosis is a frequent feature. We describe two patients infected with the human immunodeficiency virus (HIV) who developed tuberculous pancreatic abscesses. In both this was their AIDS-defining illness.