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Biomedical subjects

C R Philpot

Publications and source records attributed to C R Philpot.

At least 19 recordsLinked to original sources
PubMed1992

Cutaneous cryptococcosis: recurrence following oral fluconazole treatment.

A case of recurrent cutaneous cryptococcosis in an immunocompromised patient is described. The patient presented with a non-healing cutaneous ulcer due to infection with Cryptococcus neoformans. Extensive investigation failed to reveal any evidence of associated systemic cryptococcosis. Treatment with oral fluconazole resulted in complete resolution of the ulcer but after several months a second cutaneous cryptococcal lesion appeared, strongly suggesting dissemination from an underlying systemic focus. This case illustrates the hazards associated with making a diagnosis of isolated cutaneous cryptococcosis and the necessity for prolonged follow-up of patients who present in this way.

Administration, Oral↗
PubMed1991

A survey of female prostitutes at risk of HIV infection and other sexually transmissible diseases.

OBJECTIVE: To determine risk factors for the transmission of human immunodeficiency virus (HIV), including injecting drug use (IDU), sexual behaviour and other sexually transmissible diseases (STDs), in female prostitutes who attended the Sydney Sexual Health (previously STD) Centre. DESIGN: We surveyed by questionnaire 231 (47%) of 491 female prostitutes who visited the Centre over a 19 month period from 1986 to 1988. All were tested for HIV antibody. MAIN OUTCOME: All the women were seronegative for HIV but a number of major risk factors for infection were identified. RESULTS: Seventeen of 26 (65%) current injecting drug users had shared needles in the previous 6 months. Nineteen per cent of those surveyed had bisexual non-paying partners and 21% had partners who injected drugs. Sixty nine per cent always used condoms for vaginal intercourse with paying clients, but they were rarely used with non-paying partners. Condom use was also rare for anal intercourse with clients and/or partners by those (18%) who practised it. Seventeen per cent used condoms alone for contraception and 48% relied on oral contraceptives. We found a reduction in gonorrhoea, herpes and trichomoniasis when compared with a 1985 study conducted at the same Centre. However, there was an increase in reported abnormal cervical cytology. CONCLUSION: In spite of behaviour change by some, there are still many women working as prostitutes in Sydney who remain seriously at risk of HIV infection. We recommend more widespread use of barrier methods of contraception, intensified efforts to prevent the sharing of intravenous needles, closer monitoring of the health of prostitutes, and scientific study of their paying and non-paying sexual partners.

Adolescent↗
PubMed1990

Voluntary HIV antibody testing among STD clinic patients: a pilot study.

A pilot study was conducted with the aim of measuring the acceptability of voluntary testing for human immunodeficiency virus (HIV) antibody among patients attending sexually transmissible disease (STD) clinics. Three STD clinics, two public and one private, participated in the study which was conducted over a three-month period beginning in November 1988. For each patient attending the clinics, sex, date of birth, HIV transmission category and previous HIV test result were recorded. Patients who did not request the HIV antibody test were offered testing. Of the 2356 patients who were included in the analyses, 784 (34%) requested testing. For almost all patients (97%) who requested testing, a serum sample was collected and testing completed. Approximately half (55%) of those patients who were offered the test accepted testing. Overall, 70% of patients completed HIV antibody testing. Of the major transmission categories, the acceptance rate for those offered the test was lowest among homosexual men (45%), who also had the highest rate of HIV antibody seropositivity (11%) among those tested. Of patients who reported themselves to be HIV antibody seronegative prior to the pilot study, 78% were retested during the study and seven had a positive test for HIV antibody. We conclude that voluntary HIV antibody testing is acceptable in both public and private STD clinic settings, although a substantial amount of additional resources would need to be allocated to counselling if voluntary testing is to be introduced on a routine basis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Drug use by prostitutes in Sydney.

We report a comparative study of drug consumption by 277 female prostitutes and 95 women who had never worked as prostitutes, attending the Sydney STD Centre in 1985 and 1987. Marijuana was the drug most often used by prostitutes and non-prostitutes, followed by sleeping pills, amphetamines, cocaine and heroin. About 12% in both groups used intravenous drugs but prostitutes were significantly more likely to share needles and syringes. Prostitutes were also more likely to smoke cigarettes than non-prostitutes, and young prostitutes smoked significantly more heavily than other women in the study. Although fewer prostitutes than non-prostitutes drank alcohol, those who did drink were more likely to do so at a harmful level. We conclude that where differences in drug consumption exist between prostitutes and non-prostitutes, they are mainly work related.

Adult↗
PubMed1988

The Sydney AIDS Project: development of acquired immunodeficiency syndrome in a group of HIV seropositive homosexual men.

The Sydney AIDS Project is a prospective immunoepidemiological study of 996 homosexual/bisexual men enrolled between February 1984 and January 1985. By January 1987, 32 of 386 homosexual men who were seropositive at enrollment in the study had developed AIDS, yielding a crude progression rate of between 2.8% and 4.2% per annum. Of these subjects, 23 (72%) developed AIDS within 12 months of enrollment. In univariate analysis, the only lifestyle differences between seropositive subjects who progressed to AIDS and those that did not progress were less frequent oral sex activity and more use of marijuana in the three months prior to enrollment. In multivariate analysis, seropositive subjects who progressed to AIDS were more likely to have a lower percentage of CD4+ cells, a higher percentage of CD8+ cells and to have used marijuana in the three months prior to enrollment than the seropositive subjects who did not progress. No HIV seropositive subject who was asymptomatic and had normal T-cell subsets at enrollment had developed AIDS by January 1987. Persistent generalised lymphadenopathy was not associated with progression to AIDS. Although there are a number of lifestyle factors that may be associated with HIV infection, this study did not implicate most of these in the progression of HIV seropositive subjects to end-stage AIDS. We conclude that antecedent changes in T-cell subsets are associated with progression to AIDS and we emphasise the prognostic value of enumeration of T-cell subsets in HIV seropositive persons.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Human immunodeficiency virus and female prostitutes, Sydney 1985.

One hundred and thirty two female prostitutes and 55 non-prostitutes who were tested for antibodies to human immunodeficiency virus (HIV) were surveyed by questionnaire at this centre. The two groups were well matched for age and were very similar in other except for numbers of their sexual partners. Questions were asked about drug taking, sexual practices, general health, and episodes of sexually transmitted diseases (STDs). None of the women in the survey was found to be seropositive, but both groups were found to be seriously at risk of HIV infection through using intravenous (IV) drugs, having unprotected sexual intercourse with men who used IV drugs, having unprotected sexual intercourse with bisexual men, or exposure to several STDs.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Single-dose antibiotic therapy for the treatment of uncomplicated anogenital gonorrhoea.

Appropriate single-dose therapy will cure in excess of 95% of cases of uncomplicated anogenital gonorrhoea. Changes in the susceptibility of local isolates of Neisseria gonorrhoeae, particularly the emergence of beta-lactamase producing (and therefore penicillin-resistant) strains, have necessitated the modification of standard treatment regimens. Different patterns of antibiotic resistance have been documented in different regions of Australia and therapeutic regimens that are appropriate for use in different regions are recommended.

Anti-Bacterial Agents↗
PubMed1983

Drug treatment of sexually transmittable diseases.

Sexually transmittable diseases are an important group of conditions which frequently confront the Australian family practitioner. Primary-care health workers need especially to know how to deal with acute urethritis, persistent vaginitis and recurrent genital herpes, and should be aware of the rapidly spreading world-wide epidemic of drug-resistant gonorrhoea. The drug treatment aspects of managing sexually transmitted diseases in Australia are summarised.

Anti-Infective Agents↗
PubMed1983

Plesiomonas shigelloides septic arthritis complicating rheumatoid arthritis.

A patient with severe seropositive rheumatoid arthritis and hepatic cirrhosis developed septic arthritis of his knees. Plesiomonas shigelloides was isolated from joint fluid, blood, and also from the gut. The patient's joint symptoms responded to treatment with oral trimethoprim-sulphamethoxazole, but he died of uncontrolled gastrointestinal bleeding five days later.

Aged↗
PubMed1983

A survey of sexually transmitted disease centres in Australia.

In a nationwide survey carried out in 1981 centres offering free treatment for sexually transmitted diseases (STD) were located and the facilities available to the public were assessed. At least one special centre was located in each of the eight states and territories of Australia, but not in all cases did the clinics meet the basic requirements recommended by the Australian National Health and Medical Research Council. The STD clinics were almost exclusively found in capital cities, leaving large populations with no locally available specialist advice. The major centres, with one or two notable exceptions, were open only during routine office hours. In several centres staffing levels were barely adequate to cope with patient loads let alone deal with other important work required of reference centres--the training of health care workers, education of high risk groups, and institution of STD control programmes. In several respects the sexually transmitted diseases services in Australia were found to be inadequate to meet the needs of the population.

Ambulatory Care Facilities↗
PubMed1981

Absorption and bioavailability of oral erythromycin.

1 Extent and rate of absorption of erythromycin were studied in 24 healthy volunteers whose disposition kinetics after i.v. injections had been previously documented. 2 Two clinically attractive oral dosage regimens were administered: erythromycin stearate tablets 1 h before meals (Regimen A), and erythromycin base capsules 30 min after start of meals (Regimen B), each equivalent to erythromycin 250 mg, 6 h apart for 9 doses. 3 Serum concentrations of erythromycin measured during the 1st and 9th (steady-state) dosing intervals resulted in higher maximum serum concentrations for Regimen A (median 1.1, range 0-3.3 and 2.7, 0.6-7.3 mg/l for Doses 1 and 9, respectively) compared with Regimen B (0.4, 0-2.2 and 1.4, 0.2-4.9 mg/l). 4 Absorption occurred earlier with Regimen A with times to maximum concentrations (median, range) being 128, 60-greater than 360 and 118, 75-210 min for doses 1 and 9 respectively, (lag times 75, 15- greater than 360 and 73, 10-110 min) compared with 303, 130-greater than 360 and 173, 45-greater than 360 min (lag times 183, 70-greater than 360 and 190, 20-330 min) for Regimen B. 5 Where it could be assessed, absolute bioavailability for Regimen A was approximately 30% (Dose 1) and 65% (Dose 9) and 40% for both doses of Regimen B. 6 Whereas individual serum concentration-time curves were accurately predicted by the mean for Regimen A, predictability for Regimen B was impossible due to prolonged and variable lag time. 7 The large intersubject variability in erythromycin serum concentration after oral administration, has been shown conclusively to be related to variability in absorption kinetics and absolute bioavailability rather than to variability in disposition kinetics.

Administration, Oral↗
PubMed1980

Relapse of antibiotic-associated colitis after vancomycin therapy.

Antibiotic-associated colitis, although occasionally fatal, is a disease which is considered to be self-limiting and non-recurring. Recently, specific treatment with oral vancomycin directed at the trigger organism, Clostridium difficile, has been shown to be effective. A case in which antibiotic-associated colitis was treated with vancomycin and subsequently recurred is described. The fact that such relapse can occur indicates that further evaluation of the efficacy of vancomycin is required.

Aged↗
PubMed1980

Significance of enteric gram-negative bacilli in the throat.

Pharyngeal micro-organisms of 131 Australian and Malaysian children and adults were compared by analysis of aerobic culture of throat swab specimens. Enteric Gram-negative bacilli were commonly isolated in small numbers from Malaysian adults whether they had sore throats (28%) or not (36%), but were detected in only 9% of Australian adults without sore throats and in only 12% and 4% of Malaysian children with and without sore throats respectively. In other respects microbiological findings were similar in the different groups of subjects studied. It is concluded that the pharyngeal carriage rate of enteric Gram-negative bacilli may differ substantially between different groups of normal individuals. Our findings also suggest that these micro-organisms do not have a pathogenic role in pharyngitis.

Adult↗
PubMed1980

Intersubject and dose-related variability after intravenous administration of erythromycin.

1 It is well-known that considerable variability and unpredictability in serum concentrations results from orally administered erythromycin. 2 Disposition kinetics and their variability were studies in 24 healthy subjects after a single dose of erythromycin lactobionate and four doses were studied to evaluate dose-related variability in five other subjects. 3 Erythromycin kinetics were adequately described by a classical two compartment open model with little intersubject variability. 4 Dose-related variability occurred. Clearance was independent of dose but T1/2 beta and Vdss increased with dose. 5 Data are presented to show that non-invasive sampling of urine and saliva are of limited value in studying erythromycin pharmacokinetics.

Adolescent↗