Search PubMed⌕ Search

Biomedical subjects

C K Fairley

Publications and source records attributed to C K Fairley.

At least 55 records · Page 3Linked to original sources
PubMed2002

Characteristics of adenovirus associated urethritis.

OBJECTIVES: To describe the characteristics of adenovirus urethritis in men. METHOD: Cases occurred over a 30 month period among men presenting with urethritis to Melbourne Sexual Health Clinic. All cases had a urethral Gram stain and underwent testing for chlamydia, gonorrhoea, herpes, and adenovirus. Cases were empirically treated with a macrolide or doxycycline. RESULTS: Eight cases of adenovirus associated urethritis were identified in whom no other causative organism was isolated. Cases were clustered in autumn and winter of each year and all reported recent insertive oral sex and seven reported recent insertive vaginal sex. All patients complained of dysuria, seven had meatitis and mucoid discharge, six had conjunctivitis, and four constitutional symptoms. Three sexual contacts were known to be symptomatic. CONCLUSION: Adenovirus is an uncommon cause of urethritis in men but it should be considered in all males presenting with dysuria, meatitis, and associated conjunctivitis or constitutional symptoms.

Adenovirus Infections, Human↗
PubMed2001

Time trends in HIV incidence among homosexually active men seen at sexual health clinics in Australia, 1993-1999.

BACKGROUND: Increases in sexual risk behaviour have recently been reported among homosexually active men in Australia and in other industrialised countries, potentially facilitating an increase in HIV incidence. OBJECTIVE: To monitor HIV incidence among homosexually active men seen through a network of sexual health clinics in Australia. STUDY DESIGN: Selected metropolitan public sexual health clinics provided counts of the number of people seen at the clinics during a calendar year, the number voluntarily tested for HIV antibody and the number newly diagnosed with HIV infection, broken down by sex, age group, HIV exposure category and HIV antibody testing history. HIV incidence was estimated among homosexually active men with a history of a negative test in the 12 months prior to last being seen in a calendar year. RESULTS: Of 23924 men seen at the clinics in 1993-1999 with a reported history of male homosexual contact, 7440 (31.1%) had a negative test in the 12 months prior to last being seen in a calendar year. The percentage of men with a recent negative test declined significantly over time, from more than 33% in 1994-1996 to 29% in 1999 (P=0.003), and with increasing age, from 34.3% among men aged 25-29 years to 27.4% among men aged 40 years or older (P<0.0005). A total of 5346 (71.9%) men were retested for HIV antibody within 12 months of the last negative test. The percentage of men retested declined significantly over time, from 77.8% in 1994 to 67.2% in 1999 (P=0.021) but did not change by age group (P=0.132). Overall, 56 men were newly diagnosed with HIV infection. Estimated HIV incidence was 2.1% in 1993-1999; incidence did not change significantly by year (P=0.498) or age group (P=0.757). CONCLUSION: HIV incidence has remained stable among homosexually active men seen through a network of sexual health clinics in Australia.

Adolescent↗
PubMed2001

Differences in length of stay for Hospital in the Home patients: comparing simple clinical coding with medical record review.

AIM: To determine whether the apparently longer length of stay (LOS) reported for patients with cellulitis managed in Hospital in the Home (HITH) compared with those managed as inpatients was correct. METHODS: Data, including LOS, from the Victorian In-patient Minimum Database (VIMD) of all patients with cellulitis managed between July 1998 and June 1999 at a large metropolitan teaching hospital were analysed and compared with a retrospective medical record review of the same patients. RESULTS: In the VIMD data, there were 266 episodes of cellulitis during the study period. However, the medical record review found that six episodes were not separate, but rather a continuation of treatment for the same episode of cellulitis, and that 18 were not episodes of cellulitis, but were pilonidal sinus infections. In the VIMD data set, the mean LOS for patients treated in HITH was generally longer than that for inpatients (7.2 days vs 5.1 days, respectively, P = 0.002). However, in the retrospective medical record review, the LOS for patients treated in HITH was similar to inpatients (7.3 days versus 7.0 days, respectively, P = 0.68). CONCLUSIONS: In contrast to the VIMD data, the medical record review demonstrated that, overall, patients with cellulitis had a similar LOS irrespective of whether they were managed at home or in hospital. This study confirms that caution is required in interpreting the VIMD data, highlights the importance of carefully monitoring the introduction of new treatment modalities and indicates areas for further research.

Analysis of Variance↗
PubMed2001

Changes in the incidence of gastroenteritis and the implementation of public water treatment.

There are few data available on the incidence of endemic waterborne disease in the developed world. This study aims to determine if there was a measurable decline in gastroenteritis related faecal specimens following the introduction of water treatment. The rate of faecal specimens for gastroenteritis was obtained for 17 communities one year before and after the introduction of water treatment in two states of Australia between 1992 and 1996. Of these 17 systems, 10 had filtration added to existing disinfection, while seven had both disinfection and filtration or disinfection alone added to no existing treatment. The rate of faecal sampling varied from a reduction of 55% to an increase of 198%. Large changes in water quality parameters occurred following treatment but there was no significant correlation between these changes and changes in the rate of faecal specimens. In this study there was no consistent change in gastrointestinal related faecal specimens despite marked changes in water quality. This suggests that the reduction in endemic gastrointestinal disease as a result of the introduction of water treatment was small as a percentage of all gastroenteritis. However, water treatment remains essential to protecting public health.

Australia↗
PubMed2001

Water fluoridation, osteoporosis, fractures--recent developments.

BACKGROUND: Optimal (1ppm) water fluoridation is seen as the most socially equitable way to prevent dental caries, however concerns about the safety of fluoridation are periodically raised. METHODS: Research on effects on bone published since the 1991 National Health and Medical Research Council report on water fluoridation was reviewed. RESULTS: Thirty-three studies were identified. Adverse effects in animal feeding studies were only seen at doses much greater than those currently used in artificial water fluoridation. The majority of animal studies showed no effect or a beneficial effect of low fluoride doses. The results of ecological studies were conflicting. One of the two cohort studies showed an increase in fracture incidence at fluoride levels four times greater than optimal water fluoridation and the other showed no effect after 20 years' optimal fluoridation. The cross-sectional studies showed a favourable effect on bone mineral density. The clinical trials predominantly showed increased bone density in several sites associated with fluoride treatment of 9-22.6mg fluoride per day for one-four years. CONCLUSION: These studies provide a substantial body of evidence that fluoride at up to 1ppm does not have an adverse effect on bone strength, bone mineral density or fracture incidence.

Adult↗
PubMed2001

Methods used to maintain a high level of participant involvement in a clinical trial.

OBJECTIVES: To describe the strategies adopted to maintain high level participation throughout a community based clinical trial, and the reasons given by participants for why they participated in the study. DESIGN: Observational study. SETTING: Community based clinical trial in Melbourne, Australia that ran for 68 weeks and involved 2811 community based individuals from 600 families. A high level of commitment was required of the families; each participant completed a Health Diary each week of the 68 week study, as well as answering numerous other questionnaires, and providing faecal and blood samples. MAIN RESULTS: Only 41 of the 600 families withdrew from the study; the majority of these families withdrew because they sold their home and moved from the study area. The completion rate of Health Diaries averaged 90.7% over the 68 weeks of data collection. Of the 559 families who completed the study, 524 (93.7%) completed the Participation Questionnaire. The statement that received the highest rating for why families enrolled in the study was they thought the study was researching an important community issue. The statements that received the highest ratings for why families continued to participate in the study was the family being kept well informed about the study's progress and that the study was well run. CONCLUSIONS: The low numbers of withdrawals and the high level of participation throughout the study suggests the strategies of (a) having a non-aggressive recruitment method, (b) maintaining regular contact with the participants and (c) ensuring participants were kept well informed of the study's progress and constantly encouraged to continue participation were successful. The results also suggest people involve themselves in research because they perceive it to be of value to the community, not simply for personal gain. They indicated that they maintained their participation because it was a well run study and they were kept well informed throughout the study.

Adolescent↗
PubMed2001

Psychosocial factors are associated with prolonged hospitalization in a population with advanced HIV.

Our aim was to define a subgroup of patients with HIV at risk of adverse outcomes in terms of psychosocial factors in order to improve the targeting of hospital resources. The International Classification of Diseases, 9th Revision (ICD-9) coded discharges of all inpatients with HIV discharged from a tertiary hospital between July 1996 and March 1999 were matched against variables in the HIV/AIDS database. A 'prolonged hospitalization' subgroup was defined as those patients whose cumulative length of stay exceeded 90 days in the 33-month period. There were 2778 non-day stay discharges (n=757 patients) constituting 21,286 bed-days. The prolonged hospitalization group (n=62) accounted for 44.3% of the bed-days. Psychosocial co-diagnoses were associated with prolonged hospitalization in both crude and adjusted logistic analyses. These included psychiatric diagnoses such as mania, psychosis and anxiety, HIV dementia, housing issues and the need for social work interventions. In conclusion, a small group of individuals at risk of adverse outcomes has been defined by markers of psychosocial dysfunction. Increased understanding of this group should enable the development of programmes directed at morbidity and mortality.

Cross-Sectional Studies↗
PubMed2001

A randomized, blinded, controlled trial investigating the gastrointestinal health effects of drinking water quality.

A double-blinded, randomized, controlled trial was carried out in in Melbourne, Australia, to determine the contribution of drinking water to gastroenteritis. Melbourne is one of the few major cities in the world that draws drinking water from a protected forest catchment with minimal water treatment (chlorination only). Six hundred families were randomly allocated to receive either real or sham water treatment units (WTUs) installed in their kitchen. Real units were designed to remove viruses, bacteria, and protozoa. Study participants completed a weekly health diary reporting gastrointestinal symptoms during the 68-week observation period. There were 2,669 cases of highly credible gastroenteritis (HCG) during the study (0.80 cases/person/year). The ratio of HCG episode rates for the real WTU group compared to the sham WTU group was 0.99 (95% confidence interval, 0.85-1.15, p = 0.85). We collected 795 fecal specimens from participants with gastroenteritis, and pathogens were not more significantly common in the sham WTU group. We found no evidence of waterborne disease in Melbourne. The application of this methodology to other water supplies will provide a better understanding of the relationship between human health and water quality.

Adult↗
PubMed2000

Prevalence of enteric pathogens among community based asymptomatic individuals.

BACKGROUND AND AIMS: The objective of this study was to describe the prevalence of pathogenic microorganisms in asymptomatic individuals in a community study in Melbourne, Australia. METHODS: The study population was a subset of 2803 individuals participating in the Water Quality Study; a community based randomized trial. Faecal specimens (1091) were collected over a 3-month period from asymptomatic individuals. Specimens were tested for a range of bacteria including Salmonella, Shigella and Campylobacter species. Rotavirus and adenovirus were detected using a Rota-Adeno latex kit, and protozoa were detected using a permanent stain (modified iron-haemotoxylin). RESULTS: Twenty-eight known pathogens were identified from the 1091 faecal specimens, a total carriage rate of 2.6%. Giardia species were present in 18 specimens (1.6%), Salmonella in four (0.4%), Campylobacter in one (0.1%), Cryptosporidium in four (0.4%) and adenovirus in one (0.1%). Blastocystis hominis was found in 65 specimens. The median age of those without a pathogen was 12.5 years compared with 6.6 years for those with a pathogen (P=0.02). CONCLUSIONS: Except for Giardia, pathogens were rarely found in asymptomatic individuals in the community. The prevalence of pathogens was higher in children than adults.

Adolescent↗
PubMed2000

Evaluation of patient-administered tampon specimens for Chlamydia trachomatis and Neisseria gonorrhoeae.

BACKGROUND: The patient-administered tampon specimen has proven to be an easy and sensitive method for the diagnosis of genital Chlamydia trachomatis and Neisseria gonorrhoeae infections in women by polymerase chain reaction (PCR). This method avoids the need for endocervical sampling and stringent criteria for transport. GOAL: To evaluate two commercial amplification systems for the detection of C trachomatis and N gonorrhoeae from tampon specimens. STUDY DESIGN: A group of 400 positive and negative tampon specimens tested by an in-house PCR method were selected from a pool of more than 2,000 previously collected tampons. Overall, 93 C trachomatis-positive and 77 N gonorrhoeae-positive specimens were evaluated. Each specimen was tested by Roche Cobas Amplicor and Abbott LCx (LCR), and results were compared to the in-house PCR method. RESULTS: Detection of C trachomatis by both assays was not significantly different from the in-house PCR assay. Fewer tampons were positive for N gonorrhoeae by LCR than either the in-house assay (P = 0.0001) or by Roche Amplicor (P = 0.01). However, tampon specimens tested by Roche Amplicor required DNA extraction to achieve comparative sensitivity. CONCLUSION: Both commercial assays can be applied to tampon-collected specimens for automated detection of sexually transmitted diseases. The detection of C trachomatis was similar to the in-house PCR test for both assays (P = 0.73, 0.68). Detection of N gonorrhoeae resulted in fewer positive tampon specimens when tested by ligase chain reaction than both Roche Amplicor and in-house PCR.

Chlamydia Infections↗
PubMed2000

How well does a telephone questionnaire measure drinking water intake?

BACKGROUND: Few studies have assessed the validity or reliability of drinking water intake estimations. In studies investigating potential waterborne disease, this is very important. METHODS: We carried out a validity and reliability study to evaluate water intake estimations. The validity part of the study compared a telephone questionnaire to a diary. The reliability part of the study compared two telephone questionnaires. RESULTS: 253 participants were recruited. The most commonly consumed water intake categories were plain and boiled tap water. For persons aged less than 12 years, the median volume of plain water consumption was 2.9 glasses/day according to the diary. For persons aged 12 years and over, the median volume of plain water consumption was 3.0 glasses/day and for boiled water 3.0 glasses/day according to the diary. There was negligible systematic over or under reporting by participants for the telephone questionnaire in comparison to the diary and for the comparison of both telephone questionnaires. Water intake estimates were converted to categorical variables and the per cent agreement and weighted kappa statistics were calculated. For both the validity and reliability parts of the study the per cent agreement was 57-78% and the weighted kappa was 0.57-0.81. CONCLUSION: Water intake estimates show only moderate levels of validity and reliability when using a telephone questionnaire in comparison to a diary. IMPLICATIONS: Investigators of potential waterborne disease or nutritional research should exercise some caution in drawing conclusions from minor differences in drinking water intake that are obtained from a telephone questionnaire.

Adolescent↗
PubMed2000

An outbreak of cryptosporidiosis in an urban swimming pool: why are such outbreaks difficult to detect?

OBJECTIVE: To describe an outbreak of Cryptosporidium gastroenteritis in a swimming pool in Melbourne in early 1998 that was not detected through routine surveillance, and discuss difficulties in identifying such outbreaks. METHODS: The Water Quality Study (WQS) was a large community-based study of gastroenteritis. Following suspicion of an outbreak of cryptosporidiosis within the study group, due to pool "X", a nested case control study was performed. Each case of Cryptosporidium gastroenteritis was matched with six controls and data from weekly Health Diaries from the WQS were reviewed. The Department of Human Services also instigated active surveillance among patrons at pool "X" using a systematic sample of 50 people from the pool's swim-school enrollment list. RESULTS: There were seven cases of Cryptosporidium gastroenteritis in the case control study. Five cases and eight controls swam at pool "X" during the outbreak period. The adjusted odds of developing cryptosporidial diarrhoea if an individual swam at pool "X" was 34.5 (CI 2.3-2548). DHS identified another 11 laboratory confirmed cases associated with pool "X" as well as cases not linked to pool "X". 125 cases were identified throughout Melbourne with the suspected involvement of seven swimming pools. CONCLUSIONS: Despite a high odds ratio of developing cryptosporidiosis this outbreak was not detected by routine surveillance methods. Current outbreak detection methods lack sensitivity, specificity or timeliness. IMPLICATIONS: Improved surveillance systems are required if outbreaks of gastroenteritis are to be detected early so an intervention can be instigated to reduce the amount of subsequent illness.

Animals↗