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Biomedical subjects

P Munday

Publications and source records attributed to P Munday.

14 recordsLinked to original sources

Plastic specula: can we ease the passage?

BACKGROUND: For many years, genitourinary physicians have taught that specula should be used without lubrication other than water, as it was assumed that gel would interfere with the processing of samples, but there seems little evidence to support this. Many clinics are now using plastic specula to avoid reusable instruments, and one of the commonest problems with such specula is increased friction. METHODS: We looked at the effect of Aquagel on the culture of different dilutions of Neisseria gonorrhoeae on three standard laboratory media. The effect of Aquagel on the chlamydial strand displacement assay (SDA) test was also assessed by mixing different amounts of Aquagel with the positive and negative control and processing in the usual way. RESULTS: There was found to be no inhibition of culture following emulsification of N gonorrhoeae in Aquagel at any concentration. All the results for the chlamydial SDA test were satisfactory following mixing with Aquagel. CONCLUSION: We think that the clinician should now be more confident that if a difficult examination requires the use of a lubricant, the test results will not be compromised.

Chlamydia Infections↗

Current treatments and perceptions of genital herpes: a European-wide view.

A European panel of physicians reviewed the current treatments and perceptions of recurrent genital herpes (GH) across the continent. The panel consisted of specialists in dermatology and venereology from France, Finland, Germany, Italy, Norway, Spain, Sweden and the UK. A wide variety of factors that influence GH management were considered, including different health delivery systems, funding and cultural differences. The poor awareness of GH among both the general public and physicians was highlighted. The effectiveness of GH management was then examined from a patient's viewpoint, including the confirmation of the diagnosis, information and counselling about GH, as well as prescriptions for treatment. It was agreed that both physicians and patients often feel uncomfortable about discussing the disease, and that a European-wide effort is needed to re-educate patients and physicians about GH. The panel identified clear and unmet needs to manage a patient with clinical recurrences and to attempt to reduce the risk of GH transmission. Finally, resiquimod, an immune response modifier, was considered as a potential treatment option for GH.

Attitude of Health Personnel↗

The development of a national oral health promotion programme for pre-school children in England.

Dental caries amongst pre-school children remains a significant dental public health problem in the UK. The well-developed and extensive treatment and preventive services in the UK have failed to effectively prevent dental caries in a significant proportion of pre-school children, especially within disadvantaged communities. This paper outlines the development of an innovative national oral health promotion programme in England which has targeted the carers of pre-school children attending day care facilities. Extensive background research informed the approach of the programme and the resource requirements. Particular emphasis in the programme has been on the development of policies and guidelines in day care settings that promote oral health. Key features of the programme have been the integration of oral health and nutrition, and joint working across sectors and professional disciplines. An evaluation framework, which outlines a range of outcome measures that can be used to assess the effects and impact of the programme, is also described.

Child Day Care Centers↗

Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis.

23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied. Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis. 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment. The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID. Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis. This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract. Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigation.

Anti-Bacterial Agents↗

Risk factors of female HIV-seropositive patients attending the clinic for sexually transmitted diseases at St Mary's Hospital, London.

Of 3450 women tested for antibodies to human immunodeficiency virus HIV-1 and HIV-2 between September 1985 and July 1989, 61 were positive (1.8%). Twenty-seven of these (44%) were presumed to have acquired their HIV infection by heterosexual contact and 23 (38%) were intravenous drug addicts. In geographical origin, 23 (38%) of the patients were from the UK and 19 (31%) from Africa. Amongst these 61 women, 2 (3%) have since died, one committed suicide and one was suspected of committing suicide.

Adolescent↗

Group B streptococci--gastrointestinal organisms?

Matched perianal swabs, rectal swabs, and faecal samples from a group of male homosexual patients attending a clinic for sexually transmitted disease were examined for the presence of group B streptococci (GBS). GBS recovery rates were as follows: perianal skin 31/115 (27%), rectal mucosa 18/72 (25%) and faeces 7/115 (6%). The recovery of GBS from faeces was similar to that obtained from faecal samples sent to the laboratory for routine investigation (5%). Although there was no difference in GBS recovery rates from rectal and perianal swabs, the latter did show heavier colonisation. These results suggest that gastrointestinal GBS carriage is mainly limited to the rectum and anal canal and that this may represent contamination from perianal skin.

Anal Canal↗

Recognition of meconium staining of the liquor aminii at amnioscopy.

The results of a prospective investigation into the reliability of amnioscopy in the detection of meconium staining of the liquor amnii is presented. Under the conditions which prevail in most obstetric units, amnioscopy was found to be an unreliable method of detecting meconium staining of the liquor amnii. False-positive findings are infrequent but false-negative findings are common.

Amnion↗