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1.
Histopathology ; 72(2): 339-341, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28815752

RESUMO

We describe the clinical and post-mortem findings of a case of rapidly progressive, ultimately fatal primary effusion lymphoma (PEL) arising in an HIV-positive man 2 years after renal transplantation. Disseminated multi-organ involvement associated with a peculiar intravascular pattern of growth, as seen in this case, has only been reported once previously. This is also, to our knowledge, the first detailed description of a lymphoma arising post-transplant in an HIV-positive patient.


Assuntos
Infecções por HIV , Hospedeiro Imunocomprometido , Transplante de Rim , Linfoma de Efusão Primária/imunologia , Linfoma de Efusão Primária/patologia , Adulto , Evolução Fatal , Humanos , Masculino
2.
J Fam Plann Reprod Health Care ; 33(3): 208-10, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17609084

RESUMO

BACKGROUND AND METHODOLOGY: Sexually active women presenting to genitourinary medicine (GUM) clinics are at risk of both sexually transmitted infections and unwanted pregnancies. Emergency hormonal contraception is the only contraceptive service provided in our GUM clinic in Birmingham, UK. We wanted to assess whether contraception use was adequate in women attending our clinic and whether we were missing opportunities to provide more reliable contraception. All new female patients attending the clinic in January 2006 had their notes reviewed to determine current contraception, adequacy of use and contraceptive advice given. RESULTS: A total of 266 women were eligible for contraception. Overall, 148 (56%) of the women used reliable methods. Fifty-five (21%) women were using no contraception and not planning a pregnancy. The under-20s, over-30s and ethnic minorities were more likely to use inadequate or no contraception. DISCUSSION AND CONCLUSIONS: Almost half (43%) the women attending our GUM clinic had inadequate or no contraception, and in addition documentation of contraceptive advice and further information was poor (5%). Young people and ethnic minorities seem particularly vulnerable and at present we are not addressing their contraceptive needs. We plan to conduct a prospective survey to assess this issue further and address feasibility for an on-site contraceptive service.


Assuntos
Instituições de Assistência Ambulatorial , Anticoncepção , Doenças Urogenitais Femininas , Adolescente , Adulto , Anticoncepção/métodos , Aconselhamento , Inglaterra , Feminino , Ginecologia/métodos , Necessidades e Demandas de Serviços de Saúde , Humanos , Prontuários Médicos , Pessoa de Meia-Idade , Registros de Enfermagem , Estudos Retrospectivos
3.
BMJ ; 332(7532): 14-9, 2006 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-16356945

RESUMO

OBJECTIVE: To evaluate the effectiveness of a practice nurse led strategy to improve the notification and treatment of partners of people with chlamydia infection. DESIGN: Randomised controlled trial. SETTING: 27 general practices in the Bristol and Birmingham areas. PARTICIPANTS: 140 men and women with chlamydia (index cases) diagnosed by screening of a home collected urine sample or vulval swab specimen. INTERVENTIONS: Partner notification at the general practice immediately after diagnosis by trained practice nurses, with telephone follow up by a health adviser; or referral to a specialist health adviser at a genitourinary medicine clinic. MAIN OUTCOME MEASURES: Primary outcome was the proportion of index cases with at least one treated sexual partner. Specified secondary outcomes included the number of sexual contacts elicited during a sexual history, positive test result for chlamydia six weeks after treatment, and the cost of each strategy in 2003 sterling prices. RESULTS: 65.3% (47/72) of participants receiving practice nurse led partner notification had at least one partner treated compared with 52.9% (39/68) of those referred to a genitourinary medicine clinic (risk difference 12.4%, 95% confidence interval -1.8% to 26.5%). Of 68 participants referred to the clinic, 21 (31%) did not attend. The costs per index case were 32.55 pounds sterling for the practice nurse led strategy and 32.62 pounds sterling for the specialist referral strategy. CONCLUSION: Practice based partner notification by trained nurses with telephone follow up by health advisers is at least as effective as referral to a specialist health adviser at a genitourinary medicine clinic, and costs the same. Trial registration Clinical trials: NCT00112255.


Assuntos
Infecções por Chlamydia/prevenção & controle , Busca de Comunicante/métodos , Profissionais de Enfermagem/estatística & dados numéricos , Infecções por Chlamydia/epidemiologia , Infecções por Chlamydia/enfermagem , Busca de Comunicante/economia , Custos e Análise de Custo , Inglaterra/epidemiologia , Medicina de Família e Comunidade/economia , Medicina de Família e Comunidade/estatística & dados numéricos , Feminino , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Profissionais de Enfermagem/normas , Encaminhamento e Consulta/estatística & dados numéricos , Manejo de Espécimes/economia , Manejo de Espécimes/estatística & dados numéricos
4.
Int J STD AIDS ; 16(4): 284-6, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15899079

RESUMO

We have conducted a retrospective study of treatment failure of Trichomonas vaginalis (TV) infection in a busy, urban genitourinary medicine clinic in Birmingham, UK, between 1998 and 2002. The prevalence of non-response to standard doses of metronidazole without any history of reinfection or nonadherence was 1.7% (28/1603) overall, and has significantly increased from 0.38% in 1999 to 3.5% in 2002 (P = 0.001, chi2 test). There were no associated demographic factors. The majority of patients (53% or 15/28) responded to either a repeat of standard (10/26) or higher oral dose (5/7) of metronidazole. A standardized treatment algorithm using a high dose of metronidazole may be useful in the absence of any new, efficacious non-imidazole-based TV therapy in the clinical management of persistent TV infection.


Assuntos
Antiprotozoários/uso terapêutico , Resistência a Medicamentos , Metronidazol/uso terapêutico , Vaginite por Trichomonas/tratamento farmacológico , Administração Oral , Administração Tópica , Adolescente , Adulto , Algoritmos , Instituições de Assistência Ambulatorial , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Retratamento , Estudos Retrospectivos , Falha de Tratamento , Reino Unido
6.
Int J STD AIDS ; 15(8): 558-9, 2004 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15307968

RESUMO

We audited the practice of offering, and the uptake of, an HIV antibody test amongst genitourinary medicine clinic patients in the West Midlands region. There were wide variations in the offering (from 14 to 100%) and uptake (18 to 64%) of the test in the different clinics within the same region.


Assuntos
Testes Diagnósticos de Rotina/estatística & dados numéricos , Anticorpos Anti-HIV/sangue , Infecções por HIV/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Instituições de Assistência Ambulatorial , Inglaterra/epidemiologia , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Humanos , Masculino , Auditoria Médica , Comportamento Sexual/estatística & dados numéricos , Medicina Estatal/estatística & dados numéricos
7.
Int J STD AIDS ; 15(7): 484-5, 2004 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15228735

RESUMO

The victims of sexual assault may attend GUM clinic without any referral from any other agency. The management of these cases need special care. We audited the management of females who were known to us as victims of sexual assault. In 15 months, 68 females attended our clinic. All were screened for sexually transmitted infections (STI). Emergency contraception was offered to only 38.4% at risk cases, and formal counselling support was offered to only 25% cases. Further care is necessary to improve counselling support and offering emergency contraception to the victims of sexual assault.


Assuntos
Auditoria Médica , Estupro , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Criança , Anticoncepcionais Pós-Coito/administração & dosagem , Aconselhamento/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Feminino , Anticorpos Anti-HIV/sangue , Anticorpos Anti-Hepatite B/sangue , Vacinas contra Hepatite B/administração & dosagem , Anticorpos Anti-Hepatite C/sangue , Humanos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Infecções Sexualmente Transmissíveis/diagnóstico , Infecções Sexualmente Transmissíveis/prevenção & controle , Sorodiagnóstico da Sífilis/estatística & dados numéricos , Reino Unido/epidemiologia
8.
Int J STD AIDS ; 15(6): 422-3, 2004 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15186590

RESUMO

In the Sexual Health Strategy, the targets of HIV testing uptake in genitourinary medicine clinics (GUM) are set at 40% by year 2004 and 60% by 2007. We assessed the uptake of HIV test amongst GUM clinic attendees, more than six months after introducing an information leaflet in place of verbal pre-test counselling (PTC). The uptake rate was significantly higher than in a previous audit conducted in the same year, two weeks after introduction of the leaflets (62% vs 50%, P =0.001).


Assuntos
Infecções por HIV/diagnóstico , Folhetos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Educação de Pacientes como Assunto/métodos , Instituições de Assistência Ambulatorial , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Programas de Rastreamento , Auditoria Médica , Fatores de Risco , Fatores Sexuais , Reino Unido , População Branca
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