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Biomedical subjects

P D Woolley

Publications and source records attributed to P D Woolley.

At least 19 recordsLinked to original sources
PubMed1997

Utilisation of genitourinary medicine services by general practitioners: effect of geographic location, fundholding status, and potential effect of total fundholding.

OBJECTIVES: To determine the current utilisation of genitourinary medicine (GUM) services by general practitioners (GPs) and any changes likely to occur with moves towards a primary care led NHS. METHODS: A questionnaire survey of practising GPs appearing in the Medical Directory in England and Wales to determine the effect of geographical location, fundholding status, and potential effect of total fundholding on referrals to GUM clinics. RESULTS: Referral patterns for STDs varied according to the genital infection concerned, being highest for gonorrhoea and lowest for Trichomonas vaginalis infection. Referral patterns were little affected by geographic location of the practice or fundholding status. The reported intention on becoming total fundholding was a modest shift towards more STDs being treated in the community which varied according to the genital infection concerned. CONCLUSIONS: Although some GPs elect to always treat some STDs in the community most refer patients to GUM clinics. There appears to be little enthusiasm among GPs, should they become total fundholders, to extend their range of services to include STD provision.

England↗
PubMed1997

Application of 'Clearview Chlamydia' for the rapid detection of cervical chlamydial antigen.

In a study to evaluate the Clearview chlamydia test in a genitourinary medicine clinic, the sensitivity and specificity were 76.4% and 99.4% respectively when compared with the DAKO IDEIA chlamydia test processed in a department of medical microbiology. The time taken to perform and read the Clearview chlamydia test 'on site' did not interfere with the normal routine functioning of the clinic and the nurses who performed it as part of their routine duties found it simple and easy to use.

Chlamydia Infections↗
PubMed1992

Acyclovir vs isoprinosine (immunovir) for suppression of recurrent genital herpes simplex infection.

OBJECTIVE: To compare the efficacy and safety of oral acyclovir (400 mg twice daily) with oral isoprinosine (500 mg twice daily) in the suppression of recurrent genital herpes. DESIGN: Double-blind, double-dummy, randomised, controlled, parallel group trial. SETTING: 13 centres in UK, Belgium and Germany. SUBJECTS: 127 immunocompetent patients with frequently recurring genital herpes. MAIN OUTCOME MEASURES: Proportions of patients reporting recurrences, recurrence frequency, and mean duration of lesions during breakthrough recurrences in each treatment group during a 6 month treatment period; time to first recurrence during treatment and follow-up after treatment cessation. RESULTS: During treatment, acyclovir recipients showed significant differences (p < 0.05) when compared with isoprinosine recipients in terms of a lower proportion reporting recurrences (31% vs 96%), a reduced mean number of reported recurrences per patient (0.6 vs 3.6), a shorter mean duration of breakthrough lesions (6.4 days vs 8.2 days), and a longer mean time (standard error) to first recurrence (143.7 (9.1) days vs 40.5 (5.4) days. The mean time to first recurrence after treatment cessation did not differ between the two groups. As compared with placebo recipients, isoprinosine treated patients had an increased recurrence frequency (3.6 vs 2.5) during treatment, and a shorter time to first recurrence after treatment cessation. All treatments were well tolerated without serious adverse events or toxicity. CONCLUSIONS: Acyclovir is very effective in suppressing recurrent genital herpes and is clearly superior to isoprinosine which is not clinically useful in the dosage studied.

Acyclovir↗
PubMed1991

Diabetic ketoacidosis precipitated by genital herpes infection.

Diabetic ketoacidosis is frequently precipitated by infections. We report three cases in which ketoacidosis was induced by genital herpes infection. There is good evidence that early treatment with systemic Acyclovir is effective in patients with a first attack of genital herpes. Therefore genital examination should be considered in patients with diabetic ketoacidosis particularly when there are symptoms of genital herpes. During episodes of recurrence, diabetic patients need to monitor their blood sugars more frequently and adjust insulin requirements accordingly. We believe that this is the first description of ketoacidosis being associated with this increasingly common and recurrent infection.

Acyclovir↗
PubMed1990

Isolation of Bacteroides ureolyticus from the genital tract of men with and without non-gonococcal urethritis.

Urethral specimens from 247 heterosexual men--118 patients with non-gonococcal urethritis and 129 controls with no evidence of urethritis--were examined for the presence of Bacteroides ureolyticus. Bacteroides ureolyticus was isolated from 45 (34.9%) of the controls and from 31 (26.3%) of the urethritis patients; there was no significant difference between these rates (p = 0.1). There was no association between the density of Bacteroides ureolyticus on primary isolation plates in either group.

Bacteroides↗
PubMed1990

Efficacy of combined metronidazole and triple tetracycline therapy in the treatment of non-gonococcal urethritis.

In a double-blind placebo-controlled trial using triple tetracycline (Deteclo, Lederle) 300 mg twice daily for two weeks in conjunction with metronidazole (Flagyl, May & Baker) 400 mg or matching placebo twice daily for seven days, it was shown that the addition of anti-anaerobic therapy did not significantly affect the number of cases of persistent urethritis or the relapse of patients with non-gonococcal urethritis (NGU).

Double-Blind Method↗
PubMed1990

Experience in Sheffield: follow-up of abnormal cervical cytology.

Failure to re-attend for follow-up is a significant problem in patients attending genitourinary clinics. In this study, despite the efforts made to trac patients with cervical cytological abnormalities, adequate follow-up or further investigation was achieved in only 15.3% of women with inflammatory changes on initial cytology, 38.5% with herpes simplex virus changes, 34.5% with human papillomavirus changes, 60.8% with mild dyskaryosis, 79.9% with moderate dyskaryosis and 97% with severe dyskaryosis. Until the natural history of the minimal atypias is more fully understood, it may be that more vigorous surveillance in such women should be considered.

Colposcopy↗
PubMed1990

Microbiological flora in men with non-gonococcal urethritis with particular reference to anaerobic bacteria.

In a microbiological study of the urethral flora in men with non-gonococcal urethritis (NGU), Chlamydia trachomatis (isolated from 30% of men) was the only organism isolated significantly more often from men with NGU than controls (P less than 0.01). Bacteroids species, especially of the melaninogenicus-oralis group, were the predominant anaerobic bacterial isolate from both men with NGU (isolated from 24%) and controls (isolated from 30%). There was no evidence that aerobic bacteria, anaerobic bacteria or herpes simplex virus made a significant contribution as primary pathogens in non-chlamydial NGU. Gram-positive cocci were the only anaerobic organism isolated more often from chlamydia-positive men (29%) than chlamydia-negative men (16%) with NGU (P less than 0.01). The significance of this remains unclear.

Adult↗
PubMed1990

Asymptomatic herpes simplex virus shedding from the genital tract whilst on suppressive doses of oral acyclovir.

Forty-eight patients were recruited into a study of continuous oral acyclovir therapy for the suppression of recurrent genital herpes simplex virus (HSV) infection. Seven of these patients were shown to shed HSV in the absence of clinical signs or symptoms whilst on medication. The asymptomatic shedders did not differ significantly from the rest of the group in terms of age, interval from first attack to enrollment or number of recurrences prior to enrollment. Only one patient admitted to poor compliance as a trigger to asymptomatic HSV shedding. Failure to suppress asymptomatic shedding during prophylactic acyclovir therapy may have implications for sexual transmission to partners and vertical transmission to neonates and requires further study.

Acyclovir↗
PubMed1990

Incidence of herpes simplex virus type-1 and type-2 from patients with primary (first-attack) genital herpes in Sheffield.

In a study to determine the herpes simplex virus (HSV) type isolated from patients with primary (first-attack) genital herpes and to identify any clinical or epidemiological features that might influence the reported incidence of any particular viral type, there was almost an equal incidence of HSV-1 and HSV-2 isolated from women (48% versus 52%). In the case of women, the initial clinical diagnosis was correct in 97% with HSV-1 and 95% with HSV-2 infection. Amongst men, HSV-2 was isolated more frequently than HSV-1 (71% versus 29%). However, the initial clinical diagnosis in men was correct in only 53% with HSV-1 and 83% with HSV-2 infection. These results suggest that in primary genital herpes the incidence of HSV-1 and HSV-2 is probably equal, while in men the reported incidence of HSV-1 may be affected by underdiagnosis giving a falsely high incidence of HSV-2 infection.

Adult↗
PubMed1990

Comparative study of cefuroxime axetil and procaine penicillin in the treatment of uncomplicated gonorrhoea.

A total of 311 patients presenting with uncomplicated gonorrhoea were entered into a comparative randomized open-label study and given single-dose treatment with either oral cefuroxime axetil (CAE) or intramuscular procaine penicillin (PP). Neisseria gonorrhoeae was eliminated from 129 (98%) of 131 evaluable patients treated with CAE and 127 (98%) of 129 evaluable patients treated with PP. None of the 4 treatment failures (3 male and 1 female) were caused by beta-lactamase-producing isolates. Both treatments were well tolerated with minor adverse events reported in 3 (2%) of CAE treated patients. We conclude that CAE is an effective, well tolerated treatment for uncomplicated gonorrhoea which has the convenience and acceptability of single-dose oral therapy.

Administration, Oral↗