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Biomedical subjects

D Blackledge

Publications and source records attributed to D Blackledge.

7 recordsLinked to original sources
PubMed1998

"HPV effect" in the female lower genital tract. A community study.

OBJECTIVE: To determine the distribution of "human papillomavirus (HPV) effect" and intraepithelial neoplasia in the lower female genital tract in one community with a prospective study. STUDY DESIGN: In a family practice setting, colposcopy was offered to all women presenting for a routine cervical cytologic smear. Directed biopsies were taken from areas staining abnormally with acetic acid or iodine. RESULTS: This study of 224 women showed a high incidence of HPV effect in the lower genital tract (68%), including 18% on the vulva. The age distribution suggests a coital influence. A five-year review showed persistence of HPV effect on the vulva or vagina in only one patient. One other woman developed cervical intraepithelial neoplasia (CIN) 1. CONCLUSION: HPV effect is common in the lower genital tract of women under the age of 30 years. Colposcopic study suggested that HPV effect on the vulva and vagina is transient. The relatively high incidence of HPV effect on the vulva may explain why cervical HPV and CIN generally appear only after coitarche, as a consequence of physical transfer. This may help explain why women with a single lifetime sexual partner are not exempt from the risk of cervical cancer or its precursors.

Adolescent↗
PubMed1996

Colposcopy in general practice.

Primary care physicians are in an excellent position to identify women most at risk for cancer precursors. They can use a variety of modalities, including colposcopy thus reducing patient anxiety and waiting time. This article describes a training program for such a service, which includes at least 100 colposcopy examinations under supervision. It is applicable outside a hospital clinic setting. Subsequent practice must have a referral base sufficient to maintain competence as well as economic viability. All GP colposcopists in the Perth area attend regular quality assurance meetings. An audit has shown that properly trained GPs can achieve a level of competence equivalent to that expected of their specialist colleagues (89% concordance between colposcopic impression and histology). The format of the audit was based on that of the Royal Australian College of Obstetricians and Gynaecologists (RACOG). Treatment must be performed by experts. General practice is the appropriate location for community screening studies using colposcopy.

Clinical Competence↗
PubMed1979

A simple operation for postcoital urethrotrigonitis in women.

Definitive treatment of postcoital urethrotrigonitis, or "honeymoon cystitis", as it is commonly called, has only been paid serious attention since 1967. It has been suggested (O'Donnell, 1959) that the introduction of bacteria into the urethra is more likely when the urethra assumes a relatively hypospadiac position during coitus. This is commonly associated with incomplete rupture of the hymen. Division of the anterior bridge of the hymen on either side of the external urethral meatus appears to be as effective as more complicated procedures in preventing ascending infection associated with coitus.

Adult↗