Fall in new HIV diagnoses among men who have sex with men (MSM) at selected London sexual health clinics since early 2015: testing or treatment or pre-exposure prophylaxis (PrEP)?

Since October 2015 up to September 2016, HIV diagnoses fell by 32% compared with October 2014-September 2015 among men who have sex with men (MSM) attending selected London sexual health clinics. This coincided with high HIV testing volumes and rapid initiation of treatment on diagnosis. The fall was most apparent in new HIV testers. Intensified testing of high-risk populations, combined with immediately received anti-retroviral therapy and a pre-exposure prophylaxis (PrEP) programme, may make elimination of HIV achievable.

Impact of being placed at risk of Creutzfeldt-Jakob disease: a qualitative study of blood donors to variant CJD cases and patients potentially surgically exposed to CJD.

BACKGROUND: The study objective was to describe the emotional and behavioural responses to Creutzfeldt-Jakob disease (CJD) risk notification. METHODS: A qualitative study using 11 participants' interviews, which were analysed thematically with Framework Analysis. PARTICIPANTS: Six participants purposively selected from people exposed to surgical instruments used previously on patients with or at risk of CJD (any type; n = 60), and 5 participants from a cohort of blood donors to patients who subsequently developed variant CJD (n = 110). RESULTS: Notification was initially a shocking event, but with no lasting emotional impact. Those notified were convinced they were at extremely low risk of CJD and coped by not thinking about the information. Disclosure outside the immediate family was limited by fears of stigma. All expressed concern about the possibility of onward transmission and agreed notification was appropriate. Individual adherence to public health precautions varied from those who did nothing, apart from not donating blood, to those who consistently followed all advice given. This variation was informed by an assumption that information was always shared among health professionals. CONCLUSIONS: Factors contributing to minimising emotional distress following notification of CJD risk were evident. We found little evidence of sustained emotional distress. However, implementation of behaviours to minimise onward transmission, particularly in health care settings, was variable - this requires further investigation.

Follow-up of markedly elevated serum potassium results in the ambulatory setting: implications for patient safety.

Failure to follow up outpatient test results in a timely manner is a growing patient safety concern. To investigate the follow-up of markedly elevated serum potassium levels in the ambulatory setting, the authors reviewed the medical records of all patients seen in a large primary care practice between September 1, 2003, and August 31, 2004, with potassium levels > or = 5.8 mEq/L. Of the 12,914 serum potassium tests performed, there were 109 cases of markedly elevated serum potassium levels in 86 patients. The median potassium level was 5.9 mEq/L (range, 5.8-7.3). More than half the patients were recalled to the clinic specifically for repeat testing; however, 25% of patients had no repeat tests until they were seen at routine follow-up visits. The median time to a repeat potassium level was 6 days (range, 0-445). Patients > or = 65 years old had a lower likelihood of having repeat testing within 1 week (odds ratio = 0.38, P = .03).