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Biomedical subjects

P D Woolley

Publications and source records attributed to P D Woolley.

52 records · Page 3Linked to original sources
PubMedDate not supplied

Blood-taking practices and needle-stick injuries in house officers.

The blood-taking practices and prevalence of needle-stick injuries were recorded for 46 house officers working at the two largest teaching hospitals in Sheffield and 38 house officers working at three hospitals in London. Wearing gloves when performing venesection or inserting an intravenous cannula was generally perceived as making the procedure more difficult and no house officer in either centre wore gloves when performing routine venesection. Twenty-five (54.3%) of the house officers from Sheffield resheathed needles by hand, while a further 14 (28.3%) placed the sheath onto a work surface before attempting to manoeuvre the needle back into its sheath. Only 7 (17.4%) house officers denied resheathing needles after performing venesection. Twenty-seven (58.7%) admitted to having had a needle-stick injury within 3 months of commencing their first house officer post. Twenty-seven (71.1%) of the house officers from London resheathed needles, the remainder disposing of the needle by placing it straight into an appropriate container. Twenty-five (66%) admitted to having had a needle-stick injury the first 6 months of being a house officer. Training in the correct techniques of venesection with emphasis on either avoiding resheathing needles or resheathing safely is essential early in the medical student curriculum and needs regular repetition.

Accidents, Occupational↗
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Screening pregnant women for genital herpes.

In a prospective study to identify the viral type isolated from women undergoing screening for herpes simplex virus (HSV) during pregnancy using fluoroscine-labelled monoclonal antibodies to HSV-1 and HSV-2, HSV-2 was more likely to be isolated during the third trimester and was the only viral type isolated at term. As the severity of neonatal central nervous system disease is greater with HSV-2 than HSV-1 we recommended that all women with a history of genital herpes should be screened during pregnancy.

Antibodies, Monoclonal↗
PubMedDate not supplied

Value of examining the sexual partners of women suffering from initial genital herpes.

In a retrospective clinical audit of patient records to determine the value of examining the sexual partners of women with initial genital herpes, it was evident that only the regular partners attended for screening. Twenty-six per cent of women with initial genital herpes and 19% of male partners had some form of other lower genital tract infection. Of 164 male partners of women with initial genital herpes, 30 (18.3%) also suffered from initial genital herpes at the same time, 22 (13.4%) gave a history of, or had signs consistent with, recurrent genital herpes, and 3 (1.8%) asymptomatic male partners without a previous history of genital ulceration had herpes simplex virus isolated from the urethra on routine screening.

Contact Tracing↗
PubMedDate not supplied

Significance of Bacteroides ureolyticus in the lower genital tract.

In a study to determine the significance of Bacteroides ureolyticus in the lower urogenital tract using a new selective and differential medium, this organism was isolated from 30.1% of asymptomatic men, 37.8% of men with genital warts, and 26.3% of men with non-gonococcal urethritis. Using the same selective medium B. ureolyticus was isolated from 49% of women attending the same genitourinary clinic with symptoms of vaginal discharge and/or pruritus vulvae, 44.1% of asymptomatic women, and 50% of asymptomatic women attending a local family planning clinic. Furthermore, this organism was isolated from 27.1% of women whose vaginal specimens isolated commensal organisms only, 43.2% with C. albicans, 59.4% with U. urealyticum, 74.4% with M. hominis, and 76.8% with G. vaginalis. On testing with the API ATB 32A test strips, 86% of the positive isolates of B. ureolyticus from the female genital tract were indistinguishable from those isolated from the male genital tract indicating that this organism is common to the lower genital tract of both sexes. These results indicate that B. ureolyticus is a commensal in the lower genital tract.

Adult↗
PubMedDate not supplied

Lifetime cost of treating a person with HIV infection.

A study was conducted to examine the inpatient, outpatient and drug therapy costs incurred from initial presentation with HIV infection or AIDS to death, where death occurred between 1990 and 1994. The average lifetime cost per patient was 18,729 pounds being made up of 8428 pounds for inpatient care, 2086 pounds for outpatient care and 8215 pounds for drug therapy. Sixty per cent of patients died at home. Active cytomegalovirus infection was the most common condition encountered in the high cost patients. Escalating drug costs may eventually lead to priority setting for the management of certain opportunistic infections.

AIDS-Related Opportunistic Infections↗
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Survey of the management of genital herpes in general practice.

In a questionnaire survey of the management and treatment of genital herpes in the community by general practitioners (GPs) in 16 UK cities considered to have good access to genitourinary services, the mean number of cases seen per GP in the previous 12 months was 1.37 for first episodes and 0.96 cases for recurrent episode genital herpes. First episode genital herpes was regularly managed solely in the community by 21% of responding GPs, while 45% of those referring directly to the genitourinary medicine clinic initiated treatment prior to referral; the vast majority prescribing acyclovir. Overall, three-quarters of GPs prescribed oral acyclovir for first episode genital herpes. Recurrent genital herpes was regularly treated solely in the community by 47% of responding GPs, while 53% of those referring directly to the genitourinary medicine clinic initiated treatment prior to referral. There was almost equal usage between acyclovir cream and tablets in the treatment of recurrent infections.

Acyclovir↗
PubMedDate not supplied

Patients with genital warts: how are they managed by general practitioners?

This study was carried out to assess the management by general practitioners of patients with genital warts. An anonymized postal questionnaire was sent to 2060 general practitioners in the north west of England; 1260 (61.2%) completed questionnaires were returned. A total of 76.69% of GPs saw one or more cases per quarter. Of 468 (37.1%) GPs who managed patients in-house, 393 (83.9%) used podophyllin of concentration between 0.5 and 50%; 169 (43%) did not specify the podophyllin concentration and 112(23.9%) used podophyllotoxin. Of 395 GPs (31.3%) prescribing patient self-treatment, 259 (65.6%) prescribed podophyllin, but 60.23% did not specify the concentration; 134(33.9%) prescribed podophyllotoxin. Screening for selected sexually transmitted infections (STIs) was performed by 258/618 (41.7%) GPs. Only 74 (11.97%) screened for Chlamydia trachomatis and Neisseria gonorrhoeae and Trichomonas vaginalis. Partner notification was advised by 1138 (90.3%) and condom use by 1027 (81.5%). Only 333 (26.4%) referred all patients to GUM departments. Many GPs manage patients in-house, most using podophyllin solutions which vary in concentration, are non-standardized and potentially hazardous. Most GPs who instigate patient self-treatment prescribe podophyllin which is not licensed for this usage. Podophyllotoxin 0.5% is a safe, effective alternative. Few non-referring GPs screened for the 3 common STIs, thus putting patients at risk of complications such as pelvic inflammatory disease. Non-referral of patients with genital warts to GUM departments may have costly medical and financial consequences.

Condylomata Acuminata↗
PubMedDate not supplied

Comparison of clotrimazole, fluconazole and itraconazole in vaginal candidiasis.

Women attending a genitourinary medicine clinic (n = 229) with mycologically confirmed acute vulvovaginal candidiasis were randomised to receive either clotrimazole (500 mg pessary and 1% cream), fluconazole (150 mg single oral dose) or itraconazole (200 mg bd oral dose for 1 day). Mycological cure rates were 96% in the itraconazole group, 95% in the clotrimazole group, and 83% in the fluconazole group (P = 0.008). The proportion of patients who were clinically cured showed a similar pattern (itraconazole 80%, clotrimazole 80%, fluconazole 62%). This suggests that itraconazole or clotrimazole are more effective than fluconazole in the treatment of acute vaginal candidiasis.

Administration, Oral↗