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Biomedical subjects

J D C Ross

Publications and source records attributed to J D C Ross.

13 recordsLinked to original sources
PubMed2006

Public involvement in modernising genitourinary medicine clinics: using general public and patient opinion to influence models of service delivery.

OBJECTIVES: To determine which of the options available to modernise genitourinary medicine (GUM) clinics in the UK are most acceptable to patients and potential patients; to assess whether the views of a general population sample differ from those of clinic attenders. . METHODS: A questionnaire was used to explore the acceptability of different ways of delivering sexual healthcare including the potential trade-off between convenience/range of services with cost/staffing constraints. Potential differences in responses by age, sex, ethnicity and current attendance at a GUM clinic were evaluated using multivariate analysis. RESULTS: 542 respondents in the community and 202 clinic attenders provided responses. Delivery of sexual healthcare by specialist nurses and general practitioners was acceptable to 81% and 72% of interviewees, respectively, assuming common protocols were adhered to. The proportion of individuals who would accept a consultation with a nurse increased to 91% if the waiting time for an appointment could be reduced as a result. Men were less likely to accept a consultation with a nurse (odds ratio (OR) 0.52, 95% confidence interval (CI) 0.35 to 0.79), and Asian (OR 0.38, 95% CI 0.23 to 0.64) and other black (OR 0.41, 95% CI 0.2 to 0.87) ethnic groups were less likely to accept a consultation with a general practitioner. 44% of patients preferred walk-in clinics even if waiting times for an appointment were reduced to 48 h. CONCLUSION: Delivery of sexual healthcare by nurses and general practitioners was generally found to be acceptable, although this varies by patient sex and ethnicity. Some differences exist between the preferences of a general population sample compared with clinic attenders, but overall there is a high level of concordance. Walk-in clinics remain a popular choice even when appointment waiting times are short.

Adolescent↗
PubMed2006

Moxifloxacin versus ofloxacin plus metronidazole in uncomplicated pelvic inflammatory disease: results of a multicentre, double blind, randomised trial.

OBJECTIVE: This multinational, multicentre, prospective, randomised, double blind, parallel group, non-inferiority study compared the efficacy and safety of moxifloxacin monotherapy with ofloxacin plus metronidazole in women with uncomplicated pelvic inflammatory disease. METHODS: Women from hospitals throughout 13 countries received a 14 day course of either oral moxifloxacin, 400 mg once daily (n = 384), or oral ofloxacin, 400 mg twice daily plus oral metronidazole, 500 mg twice daily (n = 365). RESULTS: Of the 741 patients in the intent to treat (ITT) population, 564 (74.2%) were valid for the per protocol (PP) analyses; 112 (19.9%) of these were included in the microbiologically valid population (MBV). Clinical resolution rates in the PP population at the test of cure visit (TOC, 5-24 days post-therapy, primary efficacy end point) were 90.2% (248/275) for moxifloxacin and 90.7% (262/289) for ofloxacin plus metronidazole (95% CI: -5.7% to 4.0%). At follow up (28-42 days post-therapy), resolution rates in the PP population were 85.8% (236/275) and 87.9% (254/289) for moxifloxacin and comparator, respectively (95% CI: -8.0% to 3.1%). Bacteriological success rates in the MBV population at TOC were 87.5% (49/56) for moxifloxacin and 82.1% (46/56) for comparator (95% CI: -8.3% to 18.8%). Against Chlamydia trachomatis and Neisseria gonorrhoeae, bacteriological success rates with moxifloxacin were 88.5% (23/26) and 100% (13/13) and for comparator 85.7% (18/21) and 81.8% (18/22), respectively. Drug related adverse events occurred less frequently with moxifloxacin (22.5% (85/378)) versus the comparator (30.9% (112/363)) (p = 0.01). CONCLUSION: In uncomplicated PID, once daily moxifloxacin monotherapy was clinically and bacteriologically as efficacious as twice daily ofloxacin plus metronidazole therapy and was associated with fewer drug related adverse events.

Administration, Oral↗
PubMed2006

Mycoplasma genitalium as a sexually transmitted infection: implications for screening, testing, and treatment.

The evidence that Mycoplasma genitalium is a sexually transmitted pathogen is virtually incontrovertible based on both the concordance rates among partners and on DNA typing showing the same sequence type among partners in contrast to unrelated M genitalium positive patients. The implications that this has for the screening, testing, and treatment of patients is less certain however. Which tests are the most sensitive and specific, what samples are most appropriate, who should be tested, what treatment is best and how should partners be managed?

Animals↗
PubMed2006

Why do those using illicit drugs have higher rates of sexually transmitted infection?

The study was designed to assess the association between drug use and gonorrhoea in a UK setting and determine whether any differences identified could be explained by variations in sexual behaviour. A case control analysis was undertaken in a population of men and women presenting to an inner city sexually transmitted diseases clinic. The results were analysed using a multivariate model incorporating demographic and behavioural factors potentially associated with acquiring gonorrhoea. Infection with gonorrhoea was found to be associated with illicit drug use (odds ratio 1.8, 1.2-2.8) and the association became non-significant after controlling for sexual behaviour factors. Moderate alcohol use (<5 units/week) was associated with acquiring gonorrhoea but heavier use was not. Patients who used illicit drugs had more casual partners and more foreign partners than those with no history of drug use, but an increased numbers of foreign partners were not associated with a higher prevalence of gonorrhoea. It was concluded that drug use is associated with gonorrhoea in a UK setting. Specific sexual behaviours reported by drug users may increase their risk of gonorrhoea and provide potential targets for behavioural interventions.

Adolescent↗
PubMed2004

Surveillance of sexually transmitted infections in the West Midlands using anonymised individual patient datasets from genitourinary medicine clinics.

Sexually transmitted infections (STIs) declined in the UK during the 1980s and early 1990s but have increased substantially since 1995. Within the overall increase there are important differences in the epidemiology of these infections. The current, aggregate system of STI data collection in the UK provides limited demographic information and is unable to fully explain these differences. More useful information can be obtained using an enhanced surveillance system that collects disaggregate, anonymised, individual patient data including ethnic group and truncated postcode of residence. Such a system has been set up in the West Midlands NHS region. The methodology of the project is described here along with the findings to date. These findings confirm that the burden of STIs disproportionately affects young persons, men who have sex with men, black ethnic minority groups and those living in urban areas. Identifying the groups at greatest risk in this way enables interventions to be more usefully targeted.

Adolescent↗
PubMed2003

Reducing the risk of gonorrhoea in black Caribbean men: can we identify risk factors?

OBJECTIVES: Grouping patients by self assigned ethnicity may hide intraethnic differences in disease associations and sexual behaviour patterns. The aim of the study was to detect associations between gonorrhoea with differences in ancestry, degree of acculturation, and religious belief in young black Caribbean men, which could subsequently be used to target health promotion interventions. METHODS: A questionnaire based case-control study of black Caribbean men with gonorrhoea and a community control group without gonorrhoea. RESULTS: A lesser degree of acculturation, attending a single sex school, increasing numbers of partners, lack of condom use, not being married, and a belief that sex before marriage was not wrong were associated with an increased risk of gonorrhoea. Country of birth and religious belief were not associated with gonorrhoea. CONCLUSIONS: A number of factors were identified which may be useful in designing healthcare interventions in young black Caribbean men and these differed little from those in other ethnic groups. The healthcare intervention should include advice on reducing the number of partners and increasing the use of condoms.

Adolescent↗
PubMed2002

An update on pelvic inflammatory disease.

A review of the publications on pelvic inflammatory disease (PID) over the past 18 months reveals a number of common themes. This brief article highlights some relevant papers which may be of interest and summarises their main messages.

Female↗
PubMed2002

Seroprevalence of hepatitis A immunity in male genitourinary medicine clinic attenders: a case control study of heterosexual and homosexual men.

OBJECTIVES: To compare the seroprevalence of hepatitis A in homosexual and heterosexual men to determine their susceptibility to infection and provide guidance for a policy on vaccination. METHODS: A case-control study design was utilised to compare the risk factors associated with hepatitis A in homosexual and heterosexual men attending a city centre genitourinary medicine clinic. Demographic and sexual behavioural characteristics were included in univariate and multivariate models. RESULTS: The overall seropositivity rate was 29% with no significant difference between homosexual and heterosexual men. Ethnicity and age were strongly associated with hepatitis A seropositivity in both homosexuals and heterosexuals. A history of sex in a sauna in homosexual men, and being born outside the United Kingdom for heterosexual men, was associated with hepatitis A seropositivity. CONCLUSIONS: Targeted hepatitis A screening and vaccination of homosexual men attending UK genitourinary medicine clinics is not supported by the results of this study.

Adolescent↗
PubMed2002

Audit of official STD returns from genitourinary medicine.

We audited the accuracy of KC 60 coding in our department over a two-week period in 1999. Case notes of 400 consecutive new and rebook patients who attended during each of the audit periods were reviewed, and their clinical diagnosis was compared with KC 60 returns entered into the computer and sent to the Department of Health. We concentrated on four KC 60 diagnoses of positive sexually transmitted infections: uncomplicated gonorrhoea (B1) and chlamydia (c4a), first episodes of anogenital warts (C 11 a) and herpes (C 10 a). At the end of the audit, specific recommendations were introduced, aiming at improving accuracy of KC 60 coding, and a re-audit was carried out in 2000, using identical methodology. In the first audit period there were 106 positive diagnoses, of which 41 (38.7%) were not recorded in the KC 60 returns. In the second audit period there were 149 positive diagnoses, of which 20 (13%) were not recorded, showing a significant improvement (Chi square P = 0.0005).

Allied Health Personnel↗