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Biomedical subjects

C J Priestley

Publications and source records attributed to C J Priestley.

10 recordsLinked to original sources
PubMed1998

The management of Chlamydia trachomatis genital infection in genitourinary medicine clinics in the Wessex region.

The management of cases of Chlamydia trachomatis genital infection diagnosed in clinics in Wessex in the last quarter of 1996 was surveyed, and the results compared with those obtained in the national gonorrhoea audit. Treatment regimens were extremely varied both between and within clinics. Overall, 71% of patients saw a health adviser, 74% returned for follow-up, and 96% of these were cured. Compared with the national gonorrhoea audit, fewer contacts were reported (1.2 vs 1.5), but more contacts were seen per index case (0.7 vs 0.5), and a higher proportion of contacts were seen (59% vs 33%). The figures were higher in those who returned for a test of cure. Little data were available for contacts attending elsewhere for treatment; communication networks among genitourinary medicine (GUM) clinics are essential for effective contact tracing. Variations between clinics may reflect differences between the populations served as well as in diagnostic methods and management policies.

Ambulatory Care Facilities↗
PubMed1997

What is normal vaginal flora?

OBJECTIVE: To observe the composition of the vaginal flora of healthy women over time, and in relation to hormonal changes, sexual activity, and hygiene habits. DESIGN: A longitudinal surveillance of the vaginal flora over an eight week period. SUBJECTS: 26 female health care workers in local genitourinary medicine clinics. METHODS: The participants were anonymised. They filled in diary cards daily. Blind vaginal swabs were self-taken two-seven times weekly. A smear was air-dried for later Gram staining. The swabs were also cultured for Candida spp, Gardnerella vaginalis, anaerobes, Mycoplasma hominis and Ureaplasma urealyticum. RESULTS: Of 26 subjects, only four had normal vaginal microbiology throughout. One woman, who was not sexually active, had bacterial vaginosis (BV) throughout and nine (35%) had intermittent BV. Candidiasis was found intermittently in eight women (31%), and eight had normal microscopy. U urealyticum was isolated intermittently in 40% of women with BV, 25% with candida, and 50% with normal microscopy. Many women were symptomatic, but symptoms correlated poorly with microbiological findings. All but two women were sexually active; however, more women with BV were exposed to semen. BV seemed to be related to frequent use of scented soap, and there appeared to be an additive effect of clothing and hygiene factors. CONCLUSIONS: Our study raises doubts about what should be regarded as normal vaginal flora. It calls into question the significance of finding BV or U urealyticum on a single occasion in asymptomatic women, or of finding normal flora in symptomatic women. The effect of external factors on the vaginal flora deserve further study.

Adult↗
PubMed1996

A comparison of referral patterns and characteristics of patients with first episode symptomatic genital HSV-1 and HSV-2 infections in Sheffield.

OBJECTIVE: To ascertain factors associated with HSV-1 and HSV-2 isolates in patients attending a genitourinary medicine clinic with symptomatic first episode genital herpes (FEGH). DESIGN: Retrospective study. SUBJECTS: A total of 606 females and 333 males presenting with culture positive FEGH between 1990-94. SETTING: Department of Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield, UK. METHODS: Group comparison of referral patterns, demographic data, prior and concurrent episodes of STD, recent partner change. RESULTS: HSV-1 infected patients of either sex were more likely to be general practitioner (GP) referred, to be white, and less likely to have had preceding STD episodes. Recent sexual partner change had occurred significantly more often in HSV-2 infected females but there was no similar difference between HSV-1 and HSV-2 infected males. CONCLUSION: The relative HSV-1:HSV-2 isolate ratio in FEGH is influenced by the referral patterns. HSV-1 isolates predominate in patients presenting to GPs who refer the patients to GUM clinics for accurate diagnosis, counselling, follow up and screening for other STDs.

Adolescent↗
PubMed1996

Bacterial vaginosis.

Bacterial vaginosis (BV) is an alteration of the vaginal flora, where the normally predominant lactobacilli are replaced by a cocktail of organisms including Gardnerella vaginalis and anaerobes. It presents with a grey, homogenous, offensive vaginal discharge that has a raised pH. However, around half the women with this condition are asymptomatic. Diagnosis is best made by microscopic examination of a Gram-stained smear of vaginal secretions. Treatment is with metronidazole or clindamycin. The indications for treatment of asymptomatic BV are not clear, but women should probably be treated before any invasive gynaecological procedure, including intrauterine contraceptive device (IUCD) insertion. BV during pregnancy is associated with preterm labour, although a causal effect is not proven; studies are in progress to determine whether treatment of BV will improve the outcome of these pregnancies.

Anti-Bacterial Agents↗
PubMed1992

Failure to prevent nicotine addition in young people with diabetes.

The habit of smoking is usually acquired at a young age and it is particularly undesirable in individuals with diabetes. A study was carried out to assess objectively the prevalence of smoking in young patients with diabetes and whether younger age at onset of diabetes (implying exposure to health education) reduced the incidence of smoking. Ninety nine young adults with diabetes attending the routine clinic were studied using a structured interview and assay of a urinary nicotine metabolite (cotinine). Forty eight percent of the cohort were smoking (raised urinary cotinine), although only 31% admitted to smoking. Thirty eight percent of the patients with childhood onset diabetes, 56% of the adolescent onset, and 47% of the young adult onset patients were smoking. Smoking was not related to glycaemic control or body mass index. In conclusion, smoking is common in young patients with diabetes and is often denied. Conventional health education does not appear to prevent children and adolescents with diabetes from starting to smoke. Anti-smoking policies and health education must therefore be reinforced and improved.

Adolescent↗
PubMed1989

Patterns of pesticide usage by cereal crop farmers in Western Australia.

In Western Australia there has been an increase in the use of herbicides in recent years due to a change in farming practices. This change, together with more general public concern over exposure to chemicals, has resulted in farmers expressing concern over the possible long term health effects from exposure to herbicides. As part of a long term study of the possible health effects from such exposure, a survey was carried out to establish the extent of pesticide use within the cereal farming community of Western Australia. Of the 9,408 properties surveyed, 2,921 responses were received which represents a 32.2% response rate. The results indicate that a wide range of chemicals are used as insecticides, fumigants, seed dressings, seed pickles, herbicides, and rodent poisons. At the time of the survey in 1985, products containing prespruf and 1,1,1-trichloro-2,2-bis (p-chlorophenyl)ethane (DDT) were the most popular insecticide, and products containing diquat, diclofop-methyl, chlorsulfuron and glyphosate as active ingredients represented the four most popular herbicides.

Agriculture↗
PubMedDate not supplied

Hospital service utilization by HIV/AIDS patients and their management cost in a provincial genitourinary medicine department.

The hospital management of 108 HIV/AIDS patients cared for by the genitourinary medicine department, Sheffield, UK between 1984-93 was retrospectively studied to quantify the services utilized by these patients and to detail the management costs (1993 price) of outpatient (OP) services, inpatient (IP) care, investigational services and therapeutic provisions. The services utilized and cost are presented separately for the different clinical stages of the infection and as per patient year. Of the 108 patients, 95 (88%) were males and 13 (12%) females; most males (76.8%) acquired the infection through homosexual exposure, while 46% of females acquired it heterosexually. The mean number of OP consultation per asymptomatic, symptomatic non-AIDS and AIDS patient years were 11.6, 16.4 and 32.8 respectively; the mean number of IP episodes for each of these clinical groups were 0.15, 0.83 and 3.88 with IP stays 0.7, 3.5 and 40.6 days per patient year respectively. The annual costs of OP care (45.26 pounds per consultation), drugs and investigations were, respectively 525 pounds, 213 pounds and 153 pounds per asymptomatic patient year, 742 pounds, 2097 pounds and 224 pounds per symptomatic non-AIDS patient year and 1485 pounds, 2928 pounds and 382 pounds per AIDS patient year. The average annual OP drug cost per patient year showed little change since 1988. However, in the AIDS group, contributions from differing drug classes showed significant changes; while the contribution of antiretroviral drugs fell from 80.2% of the drug cost per AIDS patient year in 1990 to 31.3% in 1993, that from antibiotics rose from 0.3% in 1990 to 26.4% in 1993 and other antivirals from 9.4% in 1988 to 22.6% in 1993. These changes were related to lower recommended daily dosage of zidovudine and to wider prescription of antibiotics for atypical mycobacterial infections and domiciliary gancyclovir for CMV infection. The costs of annual mean IP care, IP drugs, IP investigations and IP procedures per AIDS patient year were 5926 pounds (146 pounds per IP stay), 2983 pounds, 282 pounds and 145 pounds respectively. The overall management cost of one AIDS patient year was 14,131 pounds and lifetime AIDS management cost, based on a mean survival of 17 months, a little more than 20,000 pounds. The annual management cost of an asymptomatic and symptomatic non-AIDS patient year is approximately 1/14th and 1/4th of the cost of an AIDS patient year.

Adult↗