Bariatric surgery: An HIV-positive patient's successful journey.

Bariatric surgery is becoming increasingly common in the UK. Little has been done to evaluate its place in HIV-positive patients. Here, we discuss a successful case and the complexities surrounding highly active antiretroviral therapy.

Factors associated with the anonymous reporting of lifetime domestic violence in a genitourinary medicine clinic: a patient self-reported questionnaire study.

Domestic violence (DV) occurs frequently within the UK, with one in four women and one in six men experiencing DV during their life. DV is the leading cause of morbidity for women aged 19-44 years and is associated with sexual health problems. However, few data exist on the prevalence of DV in UK genitourinary (GU) medicine settings. An anonymous questionnaire was self-completed by patients (n = 476/500) attending Bournemouth GU medicine clinic during July 2009 to explore associations between lifetime DV and sociodemographic, sexual and behavioural factors. Overall, 21% (98/472) reported that they had ever been abused by a partner (12% [27/229] of men and 29% [71/243] of women). Logistic regression highlighted that being female, having children/dependants and use of illicit drugs were the most important factors associated with lifetime DV. Regular staff training on DV is recommended to increase awareness and signposting to relevant services.

Genitourinary medicine clinic policies on domestic violence across England and Wales: a postal questionnaire survey.

Domestic violence (DV) is prevalent in the UK. There are no national recommendations for assessment of DV in genitourinary (GU) medicine clinics. Bournemouth GU medicine clinic has a referral pathway for victims of DV. A postal questionnaire survey was carried out to determine whether GU medicine clinics across England and Wales had local policies in place to assess DV and also to establish their views on routine assessment of DV within GU medicine. The response rate was 53%. Most clinics had access to patient literature. Only 20% of the clinics had a policy in place to assist victims of DV. Although over 50% agreed that routine assessment for DV should happen in GU medicine clinics, only 11% clinics routinely asked about DV.

Hoarseness of voice in an AIDS patient: a rare presenting feature of disseminated histoplasmosis.

Laryngeal histoplasmosis is very rare among patients with HIV and very few cases have so far been documented. We report a case of laryngeal histoplasmosis in a patient with no prior AIDS defining diagnosis, which mimicked epithelial neoplasia, and was treated successfully with oral fluconazole.

Do 'do not attends' at a genitourinary medicine service matter?

Patients who do not attend (DNA) clinic appointments are wasteful of resources and may also pose a potential public health risk through the onward transmission of untreated sexually transmitted infections (STIs). This service evaluation was performed to assess the demographics of DNAs, patient reasons for non-attendance and follows up data to determine the health outcomes of non-attendance. The genitourinary (GU) medicine clinic DNA rate between October 2008 and March 2009 was 6% (383/6961). Of the 383 patients who DNA'd their appointment successful telephone contact was made in 182 (48%) of them. Of these 40% of patients reported that they had forgotten they held an appointment; no patients reported that clinic opening hours prevented their attendance. Telephone contact increased GU medicine clinic attendance by 9% (35/383), but led to a greater number of subsequent DNAs; 43/75 (63%) of patients who accepted a further appointment DNA'd that appointment. Sending a SMS text message to patients who DNA notifying them of the time of walk-in services might be the most effective way of recapturing these patients without compromising future clinic appointment slots.

Patient-initiated delay at a genitourinary medicine clinic: are there public health consequences?

OBJECTIVES: To assess the public health consequence of patients electing not to be seen within 48 hours in a genitourinary medicine (GUM) clinic. METHODS: A 3-month retrospective case notes review was carried out for 310 new and re-book patients who chose to wait for more than 48 hours to be seen. RESULTS: Altogether, 10% (310/3110) of patients opted to be seen beyond 48 h. Their median wait was 6 days including weekends and 4 days excluding weekends. Demographic details did not vary except for the male to female ratio of 1:1.7 (1:1 in patients seen within 48 h). We found that no symptomatic patients or asymptomatic contacts of those with known sexually transmitted infections (STIs) reported sex with a new partner after booking their appointment. No patient reported sex with a recently treated partner who consequently required re-treatment and none suffered a complication of a STI. In addition, there were no cases of new HIV infection in this group and the rates of STIs were similar compared with patients seen within 48 hours of contacting the unit. CONCLUSIONS: Despite 10% of patients choosing to delay attendance beyond 48 h, no adverse public health outcomes were demonstrated.