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1.
NPJ Microgravity ; 10(1): 52, 2024 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-38714711

RESUMO

Sessile water droplet evaporation in varied gravity and electric fields has been experimentally studied. Specifically, the influences of gravity and electric fields are investigated in the context of the heat flux distribution beneath the droplets, as well as the droplet mechanics and resulting shapes. Experimental testing was carried out during a European Space Agency (ESA) Parabolic Flight Campaign (PFC 66). The droplets tested evaporated with a pinned contact line, a single wettability condition, and varied droplet volume and substrate heat flux. The peak heat transfer was located at the contact line for all cases. The peak heat flux, average heat flux, and droplet evaporation rate were shown to vary strongly with gravity, with higher values noted for hypergravity conditions and lower values in microgravity conditions. The droplet thermal inertia was shown to play a significant role, with larger droplets taking more time to reach thermal equilibrium during the parabolic testing period. No significant impact of the electric field on the droplet evaporation was noted for these test conditions.

2.
Genet Med ; 21(9): 2163-2164, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31028354

RESUMO

This Article was originally published under Nature Research's License to Publish, but has now been made available under a [CC BY 4.0] license. The PDF and HTML versions of the Article have been modified accordingly.

3.
Ultrasound Obstet Gynecol ; 54(3): 367-375, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30338593

RESUMO

OBJECTIVE: Fetal growth restriction (FGR) is a major risk factor for stillbirth and most commonly arises from uteroplacental insufficiency. Despite clinical examination and third-trimester fetal biometry, cases of FGR often remain undetected antenatally. Placental insufficiency is known to be associated with altered blood flow resistance in maternal, placental and fetal vessels. The aim of this study was to evaluate the performance of individual and combined Doppler blood flow resistance measurements in the prediction of term small-for-gestational age and FGR. METHODS: This was a prospective study of 347 nulliparous women with a singleton pregnancy at 36 weeks' gestation in which fetal growth and Doppler measurements were obtained. Pulsatility indices (PI) of the uterine arteries (UtA), umbilical artery (UA) and fetal vessels were analyzed, individually and in combination, for prediction of birth weight < 10th , < 5th and < 3rd centiles. Doppler values were converted into centiles or multiples of the median (MoM) for gestational age. The sensitivities, positive and negative predictive values and odds ratios (OR) of the Doppler parameters for these birth weights at ∼ 90% specificity were assessed. Additionally, the correlations between Doppler measurements and other measures of placental insufficiency, namely fetal growth velocity and neonatal body fat measures, were analyzed. RESULTS: The Doppler combination most strongly associated with placental insufficiency was a newly generated parameter, which we have named the cerebral-placental-uterine ratio (CPUR). CPUR is the cerebroplacental ratio (CPR) (middle cerebral artery PI/UA-PI) divided by mean UtA-PI. CPUR MoM detected FGR better than did mean UtA-PI MoM or CPR MoM alone. At ∼ 90% specificity, low CPUR MoM had sensitivities of 50% for birth weight < 10th centile, 68% for < 5th centile and 89% for < 3rd centile. The respective sensitivities of low CPR MoM were 26%, 37% and 44% and those of high UtA-PI MoM were 34%, 47% and 67%. Low CPUR MoM was associated with birth weight < 10th centile with an OR of 9.1, < 5th centile with an OR of 17.3 and < 3rd centile with an OR of 57.0 (P < 0.0001 for all). CPUR MoM was also correlated most strongly with fetal growth velocity and neonatal body fat measures, as compared with CPR MoM or UtA-PI MoM alone. CONCLUSIONS: In this cohort, a novel Doppler variable combination, the CPUR (CPR/UtA-PI), had the strongest association with indicators of placental insufficiency. CPUR detected more cases of FGR than did any other Doppler parameter measured. If these results are replicated independently, this new parameter may lead to better identification of fetuses at increased risk of stillbirth that may benefit from obstetric intervention. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.


Assuntos
Retardo do Crescimento Fetal/diagnóstico por imagem , Artéria Cerebral Média/fisiopatologia , Insuficiência Placentária/fisiopatologia , Ultrassonografia Pré-Natal , Artéria Uterina/fisiopatologia , Adulto , Biometria , Feminino , Retardo do Crescimento Fetal/fisiopatologia , Idade Gestacional , Humanos , Artéria Cerebral Média/diagnóstico por imagem , Valor Preditivo dos Testes , Gravidez , Terceiro Trimestre da Gravidez , Estudos Prospectivos , Valores de Referência , Artéria Uterina/diagnóstico por imagem
4.
Biochim Biophys Acta Mol Basis Dis ; 1864(6 Pt A): 2131-2142, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29601977

RESUMO

Leigh syndrome (LS) associated with cytochrome c oxidase (COX) deficiency is an early onset, fatal mitochondrial encephalopathy, leading to multiple neurological failure and eventually death, usually in the first decade of life. Mutations in SURF1, a nuclear gene encoding a mitochondrial protein involved in COX assembly, are among the most common causes of LS. LSSURF1 patients display severe, isolated COX deficiency in all tissues, including cultured fibroblasts and skeletal muscle. Recombinant, constitutive SURF1-/- mice show diffuse COX deficiency, but fail to recapitulate the severity of the human clinical phenotype. Pigs are an attractive alternative model for human diseases, because of their size, as well as metabolic, physiological and genetic similarity to humans. Here, we determined the complete sequence of the swine SURF1 gene, disrupted it in pig primary fibroblast cell lines using both TALENs and CRISPR/Cas9 genome editing systems, before finally generating SURF1-/- and SURF1-/+ pigs by Somatic Cell Nuclear Transfer (SCNT). SURF1-/- pigs were characterized by failure to thrive, muscle weakness and highly reduced life span with elevated perinatal mortality, compared to heterozygous SURF1-/+ and wild type littermates. Surprisingly, no obvious COX deficiency was detected in SURF1-/- tissues, although histochemical analysis revealed the presence of COX deficiency in jejunum villi and total mRNA sequencing (RNAseq) showed that several COX subunit-encoding genes were significantly down-regulated in SURF1-/- skeletal muscles. In addition, neuropathological findings, indicated a delay in central nervous system development of newborn SURF1-/- piglets. Our results suggest a broader role of sSURF1 in mitochondrial bioenergetics.


Assuntos
Sistema Nervoso Central/crescimento & desenvolvimento , Modelos Animais de Doenças , Doença de Leigh/genética , Proteínas de Membrana/genética , Proteínas Mitocondriais/genética , Sus scrofa/genética , Animais , Animais Geneticamente Modificados , Animais Recém-Nascidos , Comportamento Animal , Sistemas CRISPR-Cas , Células Cultivadas , Regulação para Baixo , Complexo IV da Cadeia de Transporte de Elétrons/metabolismo , Feminino , Fibroblastos , Edição de Genes , Técnicas de Inativação de Genes , Humanos , Jejuno/patologia , Doença de Leigh/patologia , Masculino , Mitocôndrias/patologia , Músculo Esquelético/citologia , Músculo Esquelético/patologia , Técnicas de Transferência Nuclear , Cultura Primária de Células
7.
J Plast Surg Hand Surg ; 50(4): 249-50, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26934428

RESUMO

Sebaceous naevus are associated with malignant transformation. They commonly occur in the head and neck region and are associated with malignant transformation into basal cell and squamous cell carcinomas. This case report describes a case of a malignant melanoma arising from a longstanding sebaceous naevus.


Assuntos
Melanoma , Nevo Sebáceo de Jadassohn/patologia , Neoplasias das Glândulas Sebáceas , Idoso de 80 Anos ou mais , Transformação Celular Neoplásica , Diagnóstico Diferencial , Humanos , Masculino , Melanoma/diagnóstico , Neoplasias das Glândulas Sebáceas/diagnóstico
8.
Eur J Surg Oncol ; 41(1): 165-8, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25468457

RESUMO

INTRODUCTION: Basal Cell Carcinomas are a condition commonly managed by Plastic Surgeons. National guidelines for their management where published in 2008. As part of revalidation, nine surgical subspecialities will publish individual surgeon outcome data for morbidity and mortality. Basal Cell Carcinoma incomplete excision rates have been postulated as an outcome measure for Plastic Surgeons. METHODS: We conducted a retrospective study of all Basal Cell Carcinomas within our unit from the 1st January to 31st December 2011. All patients were identified from the regional histopathology database and each histopathology report was analysed. Incomplete excisions were further analysed using a standard proforma. RESULTS: A total of 392 lesions were excised from 347 patients. In total there where 19 incompletely excised lesions with an overall incomplete excision rate of 4.8%. The temple area and inner canthus areas had the highest incidence of incomplete excision. Trainees encompassed 68% of all incompletely excised lesions. Histopathological analysis of the incompletely excised lesions showed that 60% of Consultant's incomplete excisions were morphoeic. Whereas for trainees, 54% were nodular, 30% infiltrative and the remainder morphoeic. Residual tumour was found in 36% of cases that were re-excised. No incompletely excised lesion that was followed up clinically, recurred after one year. CONCLUSIONS: The incomplete excision rate was low and comparable with other published studies in the literature. Individual surgeon outcome data based on incomplete excision rates for Basal Cell Carcinoma is meaningless unless the location of the lesion and the histopathological subtype have been adjusted for.


Assuntos
Carcinoma Basocelular/cirurgia , Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias Cutâneas/cirurgia , Cirurgia Plástica/normas , Carcinoma Basocelular/patologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Auditoria Médica , Corpo Clínico Hospitalar/normas , Neoplasia Residual , Irlanda do Norte , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Neoplasias Cutâneas/patologia
9.
Br J Radiol ; 88(1046): 20140496, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25496509

RESUMO

OBJECTIVE: Foetal CT has recently been added to the foetal imaging armamentarium, but this carries with it the risks of ionizing radiation, both to the mother and the foetus. Foetal "black bone" MRI is a new technique that allows assessment of the foetal skeleton without the risk of exposure to ionizing radiation and is a potential new sequence in foetal MRI examination. METHODS: Retrospective review of all foetal MRI studies over the past 4- to 5-year period identified 36 cases where susceptibility weighted imaging was used. Cases were selected from this group to demonstrate the potential utility of this sequence. RESULTS: This sequence is most frequently useful not only in the assessment of spinal abnormalities, most commonly the bony abnormalities in myelomeningocele, but also in cases of scoliosis, segmentation anomalies and sacrococcygeal teratoma. CONCLUSION: Although the utility of this sequence is still being evaluated, it provides excellent contrast between the mineralized skeleton and surrounding soft tissues compared with standard half Fourier acquisition single-shot turbo-spin echo sequences. Further assessment is required to determine whether black bone MRI can more accurately evaluate the level of bony defect in spina bifida aperta, an important prognostic factor. Potential further uses include the assessment of skeletal dysplasias, evaluation of the skull base and craniofacial skeleton in certain congenital anomalies and the post-mortem evaluation of the foetal skeleton potentially obviating the need for necropsy. ADVANCES IN KNOWLEDGE: Foetal black bone MRI can be performed using susceptibility weighted imaging and allows better demonstration of the mineralized skeleton compared with standard sequences.


Assuntos
Doenças Fetais/diagnóstico , Imageamento por Ressonância Magnética/métodos , Coluna Vertebral/anormalidades , Autopsia , Feminino , Humanos , Masculino , Gravidez , Diagnóstico Pré-Natal , Estudos Retrospectivos , Coluna Vertebral/embriologia
10.
J Plast Reconstr Aesthet Surg ; 66(1): 120-5, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22877891

RESUMO

BACKGROUND: Very few studies on long term evaluation of functional outcome following hypospadias reconstruction are available. Results from the modified Bretteville method have shown excellent cosmesis with a low risk of fistula and stenosis. This study addresses the question; do flow rates, quality of urinary stream and cosmesis change over time? METHODS: A sample of 18 patients who had undergone the 2 stage modified Bretteville technique between 1998 and 2004 were reviewed. Following a mean interval of 10 years and 5 months from initial functional assessment, repeat evaluation was performed using the "HOSE" questionnaire, flowmetry, and spray analysis. RESULTS: Improvement in mean flow rate (15.3 vs 10.1 ml/s; p value = 0.0036), reduced spraying (3.2 g vs 4.4 g; p value = 0.2927), with a mean increase in the "HOSE" score (from 13.8 (maximum score 16) to 15.4 (maximum score 16); p value = 0.0440) was observed over the follow up time. CONCLUSION: Improvement in flow rates, flow quality, and cosmesis over a mean interval of 10 years 5 months has been demonstrated in a random cohort of patients undergoing the modified Bretteville method of hypospadias reconstruction.


Assuntos
Estética , Hipospadia/cirurgia , Urodinâmica , Adulto , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reologia , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
11.
Ultrasound Obstet Gynecol ; 38(5): 598-602, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21370303

RESUMO

The characteristic imaging finding common to Joubert syndrome and related disorders is the 'molar tooth' sign. The prenatal diagnosis of Joubert syndrome using both ultrasound and fetal magnetic resonance imaging (MRI) in families with an affected child has been reported previously. We report two cases in which the molar tooth sign was identified by sonography at 26 + 4 weeks and at 20 + 6 weeks, respectively, prior to fetal MRI or genetic testing. In both cases the finding was subsequently confirmed on fetal MRI. As definitive prenatal genetic testing may not be conclusive in Joubert syndrome, the ability to identify the molar tooth sign sonographically before 24 weeks provides a valuable adjunct to prenatal diagnosis.


Assuntos
Anormalidades Múltiplas/diagnóstico por imagem , Encéfalo/patologia , Doenças Cerebelares/diagnóstico por imagem , Ecoencefalografia , Anormalidades do Olho/diagnóstico por imagem , Doenças Renais Císticas/diagnóstico por imagem , Ultrassonografia Pré-Natal , Anormalidades Múltiplas/patologia , Adulto , Encéfalo/anormalidades , Encéfalo/embriologia , Doenças Cerebelares/patologia , Cerebelo/anormalidades , Anormalidades do Olho/patologia , Feminino , Humanos , Doenças Renais Císticas/patologia , Imageamento por Ressonância Magnética , Gravidez , Resultado da Gravidez , Diagnóstico Pré-Natal , Retina/anormalidades , Retina/diagnóstico por imagem , Retina/patologia
12.
J Plast Reconstr Aesthet Surg ; 63(11): e788-91, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20638352

RESUMO

Most cases of carpal tunnel syndrome are idiopathic. One condition associated with carpal tunnel syndrome is a lipofibromatous hamartoma. We describe a case of a lipofibromatous hamartoma presenting as a soft tissue wrist swelling with associated symptoms and signs of carpal tunnel syndrome. We advocate that all soft tissue swellings of the wrist with associated neurological signs be investigated appropriately, avoiding unnecessary additional surgery.


Assuntos
Tecido Adiposo/patologia , Síndrome do Túnel Carpal/etiologia , Hamartoma/complicações , Neuropatia Mediana/complicações , Procedimentos de Cirurgia Plástica/métodos , Adulto , Biópsia , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/cirurgia , Diagnóstico Diferencial , Feminino , Seguimentos , Hamartoma/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Neuropatia Mediana/diagnóstico , Neuropatia Mediana/cirurgia
14.
J Plast Reconstr Aesthet Surg ; 63(7): e571-2, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19942490

RESUMO

Head and neck lumps are investigated with the aid of clinical examination, computed tomography and fine needle aspiration cytology. However, fine needle aspiration is theoretically associated with tumour seeding. We describe what we believe to be one of the first reported cases of fine needle aspiration associated tumour seeding of a malignant melanoma within the head and neck region.


Assuntos
Biópsia por Agulha Fina/efeitos adversos , Neoplasias de Cabeça e Pescoço/patologia , Linfonodos/patologia , Melanoma/patologia , Inoculação de Neoplasia , Neoplasias Cutâneas/patologia , Idoso de 80 Anos ou mais , Humanos , Masculino
15.
Rev Sci Instrum ; 80(9): 095111, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19791968

RESUMO

An apparatus has been designed and constructed to characterize thermal interface materials with unprecedented precision and sensitivity. The design of the apparatus is based upon a popular implementation of ASTM D5470 where well-characterized meter bars are used to extrapolate surface temperatures and measure heat flux through the sample under test. Measurements of thermal resistance, effective thermal conductivity, and electrical resistance can be made simultaneously as functions of pressure or sample thickness. This apparatus is unique in that it takes advantage of small, well-calibrated thermistors for precise temperature measurements (+/-0.001 K) and incorporates simultaneous measurement of electrical resistance of the sample. By employing precision thermometry, low heater powers and minimal temperature gradients are maintained through the meter bars, thereby reducing uncertainties due to heat leakage and changes in meter-bar thermal conductivity. Careful implementation of instrumentation to measure thickness and force also contributes to a low overall uncertainty. Finally, a robust error analysis provides uncertainties for all measured and calculated quantities. Baseline tests were performed to demonstrate the sensitivity and precision of the apparatus by measuring the contact resistance of the meter bars in contact with each other as representative low specific thermal resistance cases. A minimum specific thermal resistance of 4.68x10(-6) m(2) K/W was measured with an uncertainty of 2.7% using a heat transfer rate of 16.8 W. Additionally, example measurements performed on a commercially available graphite thermal interface material demonstrate the relationship between thermal and electrical contact resistance. These measurements further demonstrate repeatability in measured effective thermal conductivity of approximately 1%.

16.
Clin Exp Allergy ; 39(12): 1866-74, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19689459

RESUMO

BACKGROUND: Eosinophil accumulation in the lung is an important feature of airway inflammation in asthma. There is therefore much interest in developing novel therapies to prevent this process. Accumulating evidence suggests that statins have anti-inflammatory properties, including inhibition of leucocyte accumulation. We therefore assessed the ability of five statins to inhibit human eosinophil adhesion to recombinant human inter-cellular adhesion molecule (rhICAM)-1 under physiologically relevant flow conditions. METHODS: Purified eosinophils were pre-treated with a panel of statins before elucidation of the adhesion profiles of resting and granulocyte macrophage-colony stimulating factor (GM-CSF)-stimulated cells to rhICAM-1-coated microchannels at a flow rate of 0.5 dynes/cm(2). Images were recorded in real-time at 1 min intervals and analysed using Ducocell software. RESULTS: Fluvastatin and lovastatin (both 10 nm) significantly inhibited GM-CSF-stimulated eosinophil adhesion to rhICAM-1 after 2 min (34.4+/-3.0% inhibition and 37.8+/-12.6% inhibition, respectively, n=4, P<0.05) but had no significant inhibitory effect on unstimulated eosinophil adhesion. Mevastatin, simvastatin, and pravastatin (all 10 nm) had no significant effect on GM-CSF-stimulated eosinophil adhesion to rhICAM-1. A concentration range of fluvastatin and lovastatin inhibited GM-CSF stimulated eosinophil adhesion with significant (P<0.05) inhibition observed at low concentrations of 1 nm for both drugs. Mevalonate (100 nm) reversed fluvastatin-mediated but not lovastatin-mediated inhibition of eosinophil adhesion. CONCLUSIONS: Inhibition of eosinophil adhesion to ICAM-1 by fluvastatin and lovastatin under physiological shear stress represent novel actions by these drugs that may inform the development of anti-inflammatory therapy for allergic disease.


Assuntos
Adesão Celular/efeitos dos fármacos , Eosinófilos/citologia , Eosinófilos/efeitos dos fármacos , Ácidos Graxos Monoinsaturados/farmacologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Indóis/farmacologia , Molécula 1 de Adesão Intercelular/metabolismo , Lovastatina/farmacologia , Microfluídica , Anticorpos Monoclonais/imunologia , Anticorpos Monoclonais/farmacologia , Apoptose/efeitos dos fármacos , Forma Celular/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Eosinófilos/metabolismo , Fluvastatina , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Molécula 1 de Adesão Intercelular/genética , Lovastatina/análogos & derivados , Antígeno de Macrófago 1/imunologia , Antígeno de Macrófago 1/metabolismo , Ácido Mevalônico/farmacologia , Técnicas Analíticas Microfluídicas , Pravastatina/farmacologia , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Sinvastatina/farmacologia , Molécula 1 de Adesão de Célula Vascular/genética , Molécula 1 de Adesão de Célula Vascular/metabolismo
18.
Virology ; 384(1): 97-105, 2009 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-19049842

RESUMO

Rabbit Haemorrhagic Disease Virus (RHDV) is widely used in Australia to control feral rabbit populations. Before RHDV was released on the Australian continent in 1996, antibodies cross-reacting in RHDV specific ELISAs were found in Australian wild rabbits, leading to the hypothesis that a non-pathogenic calicivirus had been circulating in rabbit populations in Australia, potentially providing some level of cross-immunoprotection to RHDV infection. For the detection of this putative virus, a universal lagovirus PCR test was developed to screen a variety of different tissues of wild caught rabbits. We identified a new lagovirus in the intestinal tissues of three apparently healthy young wild rabbits. Quantitative Real Time PCR analysis revealed high concentrations of viral RNA in intestinal tissues and suggests a faecal-oral mode of transmission. Genome organisation and phylogenetic analysis following the sequencing of the entire viral genome revealed a new member of the genus Lagovirus within the family Caliciviridae.


Assuntos
Lagovirus/classificação , Lagovirus/genética , Coelhos/virologia , Animais , Animais Selvagens/virologia , Austrália , Sequência de Bases , Western Blotting , Infecções por Bunyaviridae/veterinária , Sequência Conservada , Primers do DNA , DNA Viral/genética , Indústria Alimentícia , Genoma Viral , Lagovirus/isolamento & purificação , Carne/virologia , Dados de Sequência Molecular , Reação em Cadeia da Polimerase , Alinhamento de Sequência
19.
Int J STD AIDS ; 19(8): 550-2, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18663043

RESUMO

While most genitourinary (GU) medicine clinics achieve a high uptake for testing HIV in new patients, they may still miss testing those at highest risk. Point-of-care testing (POCT) and salivary samples are acceptable and feasible but have not yet been shown to increase uptake among high-risk patients (HRP). This study aimed to describe reasons why HRP decline HIV testing and whether offering POCT along with standard testing would increase the uptake of testing HIV in two London GU medicine clinics. Anonymous self-administered questionnaires were offered to all new and rebooked patients. Eight hundred and ninety-nine questionnaires were analysed of which 598 were HRP. Uptake of HIV testing was 77.1% among HRP and 65.8% among the rest. A total of 51.1% of HRP who declined HIV testing said they would be more likely to accept a POCT and 32.8% a salivary test. Introduction of rapid POCT for HIV would increase patient's choice and may increase the likelihood of HRP accepting an HIV test.


Assuntos
Sorodiagnóstico da AIDS , Infecções por HIV/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Sistemas Automatizados de Assistência Junto ao Leito , Inquéritos e Questionários , Instituições de Assistência Ambulatorial , Feminino , Heterossexualidade , Homossexualidade , Humanos , Londres , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Risco , Fatores de Tempo , Sistema Urogenital
20.
Sex Transm Infect ; 84(4): 265-70, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18096649

RESUMO

OBJECTIVES: To determine what proportion of men who have sex with men (MSM) attending genitourinary medicine (GUM) clinics are offered and accept an HIV test and to examine clinic and patient characteristics associated with offer and uptake. METHODS: A cross-sectional study of all GUM clinics in the United Kingdom, involving a case note review of up to 30 patient records per clinic and the completion of a clinic policy form. RESULTS: Overall, 86% of MSM were offered a test and of those 82% accepted a test. Attending with symptoms of a sexually transmitted infection (STI), fewer numbers of partners in the past three months and having tested previously were all independently associated with a decreased likelihood of being offered a test. Attending with symptoms of an STI, increasing age, never having had a risk from unprotected anal intercourse or a previous HIV test and increasing time to wait for results were all independently associated with a decreased likelihood of a patient accepting a test. Only a quarter of clinics reported a written policy for HIV testing intervals among MSM; however, all clinics reported offering testing to all new MSM patients at first screening. The testing policy for re-attending patients was less clear. CONCLUSIONS: Testing must reach those at most risk and those less likely to test in order to reduce further the proportion of undiagnosed HIV infection. This study suggests that opportunities to detect infection may be being missed and a move towards universal testing of all MSM attending with a new episode, as well as testing within the window period, is recommended.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Infecções por HIV/diagnóstico , Homossexualidade Masculina , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Idoso , Estudos Transversais , Política de Saúde , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Política Organizacional , Reino Unido
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