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C Sonnex

Publications and source records attributed to C Sonnex.

At least 37 records · Page 2Linked to original sources
PubMed1995

Candidal balano-posthitis: a study of diagnostic methods.

OBJECTIVES: To compare microscopy with culture for diagnosing candidal balanoposthitis and to document which diagnostic methods are used in genitourinary medicine clinics in Great Britain. DESIGN: (a) Penile material for microscopy and fungal culture were obtained from men with balano-posthitis. A "plain-slide" method of collecting material for microscopy was compared with a novel "adhesive-tape" method of sampling. (b) Questionnaires were sent to all genitourinary medicine clinics in Great Britain. SETTING: The Department of Genitourinary Medicine, Addenbrooke's Hospital, Cambridge, England. MAIN OUTCOME MEASURES: The sensitivity and specificity of microscopy using culture as the "gold standard" for diagnosis. RESULTS: Candida was isolated from 35% of 450 men with balano-posthitis attending the clinic over a three year period. The sensitivity of microscopy compared with culture was 12% ("plain-slide" method of material collection) and 65% ("adhesive-tape" method) (p < 0.0001). The respective specificities were 95% and 81%. The positive predictive values for the two methods of material collection were 50% ("plain-slide" method) and 75% ("adhesive-tape" method). The respective negative predictive values were 71% and 72%. 60% of 250 genitourinary medicine clinics returned questionnaires. 13% routinely diagnosed candidal balanoposthitis by appearance only and 34% sometimes relied only on clinical appearance. Culture was used by 78% and microscopy by 69% of clinics. Material for microscopy was most commonly collected by using a cotton-wool tipped swab and the Gram stain was the favoured method for microscopy. CONCLUSION: Candida is a common cause of balano-posthitis. Diagnosis by microscopy has a low sensitivity and varies with the method used for collecting material. Although up to one third of genitourinary medicine clinics may rely solely on clinical appearance for diagnosis most continue to use microscopy and culture.

Balanitis↗
PubMed1993

Cutaneous vasculitis presenting on the penis.

Cutaneous vasculitis is frequently located on the lower limbs. We describe a patient who developed palpable purpura affecting the penis as the presenting sign of more widespread lesions of Henoch-Schönlein purpura.

Adult↗
PubMed1993

Defective IgG2 response to Pneumovax in HIV seropositive patients.

OBJECTIVE: To determine whether HIV (Human Immunodeficiency Virus) antibody positive adults are capable of mounting an effective immune response when immunized with polyvalent pneumococcal vaccine. DESIGN: 28 patients (nine homosexual men, one bisexual man, three heterosexual females, 10 injecting drug abusers, five haemophiliacs) and 11 healthy volunteers, were immunised with Pneumovax II and titres of IgG1 and IgG2 specific antibody measured before and 1 month after immunisation. Magnitude of immune response was related to CD4 T-lymphocyte count at time of immunisation to establish whether responses are better in early disease. MAIN OUTCOME MEASURES: Based on our data in healthy volunteers we defined an adequate response to Pneumovax II as a post immunisation IgG2 antibody level at least 50% greater than the pre immunisation level. RESULTS: The magnitude of the response was significantly higher in the normal volunteers (U = 95; p = 0.0328). Adequate IgG2 responses were seen in 11/11 normals but in only 14/28 HIV seropositives (chi 2 = 8.58; p < 0.01). Poor responses were unrelated to the CD4 T-lymphocyte count at immunisation. Absolute IgG2 deficiency accounted for the poor response in only 1 HIV patient. CONCLUSION: 50% of HIV antibody seropositive individuals fail to mount adequate immune responses to polyvalent pneumococcal vaccine. Non responders are unlikely to be protected.

Adult↗
PubMed1991

Anal human papillomavirus infection: a comparative study of cytology, colposcopy and DNA hybridisation as methods of detection.

OBJECTIVE: To compare anal cytology, colposcopy and DNA hybridisation as methods of detecting anal HPV infection. SUBJECTS AND DESIGN: Patients attending: (1) a genitourinary medicine (GUM) clinic with ano-genital warts; (2) a surgical out-patient department with anal fissure or haemorrhoids were examined for evidence of anal HPV infection. RESULTS: Considering GUM clinic attenders, 17% (38/225) and 40% (90/225) had perianal or anal canal warts respectively. Colposcopic examination revealed anal acetowhite lesions without warts in 28% (63/225). Cytological evidence of HPV infection was found in 98%, 83%, and 90% of patients with anal canal warts, perianal warts and acetowhite lesions respectively. Anal intraepithelial neoplasia (AIN) was documented in 22% of patients with anal canal warts compared with 6% with perianal warts (p less than 0.01). HPV DNA was detected from the anal brushings of 71%, 50%, 32%, and 29% of patients with anal canal warts, perianal warts, acetowhite lesions and a normal anal examination respectively. HPV type 6/11 was detected in the majority of HPV positive samples. Considering surgical out-patient attenders with no history or signs of anal warts, 25% showed cytological evidence of anal HPV infection and HPV DNA was detected from anal brushings in 3% (2/71). CONCLUSION: Anal examination with the colposcope is a useful method for detecting subclinical HPV infection. Anal cytology may prove helpful for detecting AIN, however, since koilocytosis was rarely seen, the specificity of the cytological criteria for anal HPV infection in the absence of AIN is uncertain. DNA analysis of anal brushings proved only moderately sensitive.

Adult↗
PubMed1991

Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance?

OBJECTIVE: To determine whether women who have a history of genital warts or whose sexual partners have such a history were more likely to have borderline or dyskaryotic cervical smears than other women. DESIGN: Prospective study conducted over a five month period. SETTING: A genitourinary medicine clinic in Cambridge, UK. PATIENTS: One hundred and eighty five women who attended the clinic during the study period, on whom cervical cytology was performed. Ninety-seven had a history of genital warts and twenty had partners with genital warts. METHODS: Cervical cytology taken by standard methods. Demographic data and sexual history obtained by questionnaire. Colposcopy was performed on patients with a history of warts or wart contact. OUTCOME MEASURED: Relative incidence of cytological abnormalities in the various groups of patients. RESULTS: "Borderline" nuclear change was the most frequent abnormality reported in the wart contact group (six cases) whereas mild dyskaryosis was the most frequent abnormal finding in those women with a history of warts (21 cases). CONCLUSIONS: Women with warts or contact with genital warts were more likely to have borderline or dyskaryotic cervical smears than women without such a history. Recommendations for follow-up of these patients are made.

Adult↗
PubMed1989

Anal and cervical intraepithelial neoplasia: possible parallel.

This study evaluated prospectively the use of an endoscope in examination of the anal canal for the detection of premalignant lesions. All patients underwent endoscopy and anal epithelial biopsy; the biopsy samples were examined histologically and human papillomavirus (HPV) DNA hybridisation was done. No evidence of anal intraepithelial neoplasia (AIN) was found in 20 control patients with anal fissure or fistula. Of 82 patients with anal HPV infection, 23 had evidence of AIN. The prevalence of AIN was significantly higher among homosexual than among heterosexual men (17 of 28 vs 1 of 26) with anal HPV infection. Of 28 women with anal HPV infection, 10 had cervical intraepithelial neoplasia (CIN); 5 of the 10 also had AIN, whereas no woman had AIN in the absence of CIN. The study shows that AIN occurs and can be diagnosed endoscopically in a manner similar to CIN. Further detailed prospective studies on the natural history of AIN and of groups at risk are required.

Adolescent↗
PubMed1989

Risk behaviours for HIV infection among injecting drug users attending a drug dependency clinic.

To study a range of possible risk factors for HIV among injecting drug user patients attending a clinic in London were interviewed from November 1986 to November 1987. Serum samples were tested for viral markers. Of 116 patients, 101 had shared injecting equipment, 75 on the first occasion of injecting and 76 during the past year. Seventy said that sharing was because equipment was not available. In the past year 102 had been sexually active, a third having two to 20 partners; a quarter of the women had exchanged sexual intercourse for money. The four patients who were positive for antibody to HIV antigen had shared equipment or had intercourse with drug users from areas with a high prevalence of HIV. Eleven patients had injected drugs while in prison. Despite a low prevalence of HIV infection this infection remains a threat to drug users in London; strenuous efforts are still needed to prevent its further transmission.

Acquired Immunodeficiency Syndrome↗
PubMed1989

An appraisal of HIV antibody test counselling of injecting drug users.

One-hundred and nine injecting drug users entering a methadone detoxification programme underwent HIV antibody test counselling. Approximately 80% of men and women were concerned because of sharing injection equipment ('works') in the previous year, although other reasons for considering an HIV antibody test, such as sexual contact with drug users and concern for sexual partners, was also given. Two-thirds of both men and women decided to be tested. Reasons for declining or deferring an HIV antibody test included an inability to cope with a positive result, recent sharing of 'works', and intoxication with drugs or alcohol at the time of counselling. Of the 74 clients tested, two were HIV antibody positive. Only 55% of clients reattended for results. Testing drug users for evidence of HIV infection requires careful pre-test counselling and adequate support should be readily available when results are given.

AIDS Serodiagnosis↗
PubMed1989

Transmission of HIV to heterosexual partners of infected men and women.

Future heterosexual spread of HIV will in part depend on the efficiency of transmission from men to women and from women to men. We studied seventy-eight female sexual partners of men infected with HIV and 18 male sexual partners of infected women. Participants were interviewed concerning sexual practices, use of contraception and other risk factors for HIV infection. Fifteen out of 78 (19.2%) female partners and one out of eighteen (5.5%) male partners were seropositive for HIV antibody. All couples had practised vaginal intercourse. Seropositive female partners did not differ significantly from seronegative partners with regard to length of relationship, number of acts of vaginal intercourse, other sexual practices, stage of clinical disease in the index case, or numbers of other sexual partners in the last five years. In two women, seroconversion was documented after one act of unprotected sexual intercourse. The majority of infected female partners (eight out of 15) had sexual relationships with men who were asymptomatic and did not practice anal intercourse. Biological factors such as variability in infectivity of the index case and susceptibility of the contact, as well as behavioural variables may be important in determining transmission.

Adolescent↗