Search PubMed⌕ Search

Biomedical subjects

J D Ross

Publications and source records attributed to J D Ross.

At least 37 records · Page 2Linked to original sources
PubMed1998

How are men with urethral discharge managed in general practice?

Chlamydia and gonorrhoea remain major causes of morbidity despite the availability of effective therapy. Because of the asymptomatic nature of many infections, particularly in women, active case finding is necessary to trace and offer screening and treatment to sexual contacts of those infected. Genitourinary medicine (GUM) clinics provide investigation and treatment for a variety of sexual health problems but the proportion of infections treated outside these clinics is unknown. A questionnaire survey of general practitioners (GPs) was used to examine the prevalence and management of male urethritis in Scotland. Responses were received from 277/347 (80%) of GPs. A median of one case/year of male urethritis was seen and screening for gonorrhoea and chlamydia was undertaken in 82% and 63% of cases not referred to a GUM clinic respectively. Six per cent of GPs attempted to trace sexual contacts. Twenty-nine per cent (60) of patients were not referred to a GUM clinic and increasing distance to the clinic was associated with non-referral. Eleven per cent (18) of patients objected to referral to a GUM clinic. There is scope to improve the management of male urethritis by providing greater support for GPs, encouraging clinic referral where possible and appropriate investigations and treatment when not.

Chlamydia Infections↗
PubMed1998

Thermosensory threshold: a sensitive test of HIV associated peripheral neuropathy?

The purpose of the study was to assess the prevalence of thermosensory abnormalities in patients infected with HIV infection. Using a Thermo Sensory Analyser, we assessed thermosensory threshold for warm sensation (WS) and cold sensation (CS) of the forearm and foot in 40 controls and 75 HIV positive patients, including five patients with clinically evident peripheral neuropathy, three with AIDS-related dementia and 20 with AIDS. We found that thermosensory threshold is a reproducible test. The 95th centile for normal WS of the forearm was 1.4 degrees C above and CS 0.9 degrees C below the baseline temperature of 32 degrees C, and for WS of the foot was 5.3 degrees C and CS 4.4 degrees C respectively. The median WS of the foot for controls was 1.4 (IQR 0.7-2.8) degrees C, for asymptomatic HIV positive patients was 1.9 (1.1-4.2) degrees C, for patients with AIDS was 3.5 (1.6-5.7) degrees C and for those with peripheral neuropathy was 5.4 (1.7-14.9) degrees C (P< 0.05 compared to controls). A higher threshold was also evident for CS in patients with advanced HIV disease. These findings suggest that thermosensory testing is a sensitive tool in detecting early, small nerve fibre disease before the onset of clinically evident peripheral neuropathy.

AIDS Dementia Complex↗
PubMed1997

Patterns of HIV testing in Scotland: a general practitioner perspective.

General practitioners are one of the largest groups who offer HIV testing but little is known about the patient group who present for HIV counselling and testing in primary care. This study describes the risk factors, positivity rate, temporal trends and demographic profile of patients presenting to their general practitioner for HIV testing in central Scotland. Of 8,466 tests taken 1% (84%) were positive with an independent association between a positive result and age group, history of drug misuse, homosexuality and region of testing. The majority of tests were performed in those who were at low risk and because of patient concern about HIV. No increase in the number of positive tests was apparent over the five-year study period. Variations between GP testing for HIV occurs in different regions and may reflect the underlying HIV positivity rate. General practitioners performing HIV tests are well placed to educate their patients about HIV and encourage low risk sexual behaviour patterns.

AIDS Serodiagnosis↗
PubMed1997

Rapid isolation of muscle and heart mitochondria, the lability of oxidative phosphorylation and attempts to stabilize the process in vitro by taurine, carnitine and other compounds.

We modified the isolation procedure of muscle and heart mitochondria. In human muscle, this resulted in a 3.4 fold higher yield of better coupled mitochondria in half the isolation time. In a preparation from rat muscle we studied factors that affected the stability of oxidative phosphorylation (oxphos) and found that it decreased by shaking the preparation on a Vortex machine, by exposure to light and by an increase in storage temperature. The decay was found to be different for each substrate tested. The oxidation of ascorbate was most stable and less sensitive to the treatments. When mitochondria were stored in the dark and the cold, the decrease in oxidative phosphorylation followed first order kinetics. In individual preparations of muscle and heart mitochondria, protection of oxidative phosphorylation was found by adding candidate stabilizers, such as desferrioxamine, lazaroids, taurine, carnitine, phosphocreatine, N-acetylcysteine. Trolox-C and ruthenium red, implying a role for reactive oxygen species and calcium-ions in the in vitro damage at low temperature to oxidative phosphorylation. In heart mitochondria oxphos with pyruvate and palmitoylcarnitine was most labile followed by glutamate, succinate and ascorbate. We studied the effect of taurine, hypotaurine, carnitine, and desferrioxamine on the decay of oxphos with these substrates. 1 mM taurine (n = 6) caused a significant protection of oxphos with pyruvate, glutamate and palmitoylcarnitine, but not with the other substrates. 5 mM L-carnitine (n = 6), 1 mM hypotaurine (n = 3) and 0.1 mM desferrioxamine (n = 3) did not protect oxphos with any of the substrates at a significant level. These experiments were undertaken in the hope that the in vitro stabilizers can be used in future treatment of patients with defects in oxidative phosphorylation.

Animals↗
PubMed1996

Is oral contraceptive associated with genital warts?

OBJECTIVE: To measure the association between oral contraceptive use and the prevalence of genital warts in women. METHODS: Cross sectional case control study comparing oral contraceptive use in women with and without genital warts attending a city centre genitourinary medicine clinic controlling for recent sexual activity, the presence of other sexually transmitted infections, socio-economic class and history of pregnancy using a multivariate logistic regression model. RESULTS: After controlling for potential confounding variables women with genital warts were significantly more likely to be current users of the oral contraceptive pill (OR 1.7, 95% CI 1.3-2.2). CONCLUSION: The study suggests that women taking the oral contraceptive may be at increased risk of presenting with genital warts. Previously published papers provide some support for this hypothesis and potential biological mechanisms are discussed.

Adolescent↗
PubMed1995

Serovar specific immunity to Neisseria gonorrhoeae: does it exist?

OBJECTIVE: To determine whether the host immune response to gonorrhoea provides limited serovar specific protection from reinfection. SUBJECTS: 508 episodes of gonorrhoea diagnosed at a city centre genitourinary medicine clinic including 22 patients with multiple infections over a 4 year period. METHODS: Patients with recurrent gonococcal infection were analysed with respect to the initial and subsequent serovars isolated. RESULTS: No significant difference was seen in the prevalence of serovars isolated following a repeat infection compared with those without repeat infections. The site of the initial infection did not appear to influence the subsequent serovar isolated. CONCLUSION: We found no evidence of serovar specific immunity in our population. It remains possible that populations with a higher prevalence of gonorrhoea and more frequent infections may have a quantitatively greater immune response.

Adolescent↗
PubMed1995

Why do patients default from follow-up at a genitourinary clinic?: a multivariate analysis.

OBJECTIVE: Firstly to compare the proportion of patients defaulting from follow up at a genitourinary medicine clinic with those attending other hospital based clinics. Secondly to determine which factors are associated with non attendance at a city centre genitourinary medicine clinic. METHODOLOGY: The proportion of patients who defaulted at a genitourinary medicine clinic, a general medical clinic, a general surgical clinic and a dermatology clinic during March 1995 were compared. A multivariate logistic regression analysis was performed comparing attenders and non attenders at the genitourinary medicine clinic with respect to time of appointment, diagnosis, previous contacts with clinic staff, potential domestic commitments and patient demographics in a prospective case control study. RESULTS: The default rate at the genitourinary medicine clinic was 15% compared with 13%, 15% and 14% for medical, surgical and dermatology clinics respectively. Patients who defaulted from the genitourinary medicine clinic (167) were compared with 172 attenders and significant differences found for timing of appointments, area of residence, frequency of counselling by the health advisor and age of the patient. Other factors such as the diagnosis, whether a woman had children, sexual orientation, whether negative results had been given over the phone, source of referral, sex of patient, employment status and the weather were not found to be significantly associated with defaulting from an appointment. CONCLUSIONS: The time of the appointment and being seen by a health advisor were the only variables identified over which the clinic has control and therefore could potentially reduce non attendance rates.

Adult↗
PubMed1995

Gonococcal serovar patterns in Glasgow: 1990-1992.

Using monoclonal antibodies directed against protein 1 (major outer membrane protein) in the cell wall of Neisseria gonorrhoeae it is possible to serotype the gonococcus into different sub-groups. This study was designed to analyse the distribution of such serovars in Glasgow, Scotland, and report associations between serovars and clinical features of infection. N. gonorrhoeae isolated from all patients with a diagnosis of gonorrhoea attending genitourinary medicine clinics in Glasgow were serotyped between January 1990 and December 1992. The results were then correlated with sexual orientation of patients, penicillin sensitivity, site of infection, location of acquisition of infection and presence of symptoms. Six hundred and four episodes of gonococcal infection were analysed and an association between certain serovars with sexual orientation, penicillin sensitivity and asymptomatic infection was found. No association between serovar type and locality of acquisition of infection was apparent. Although there was a decreasing trend in the incidence of gonorrhoea overall, infections in homosexual men increased over the three-year study period. The associations between serovars and other features of gonococcal infection are discussed. The observed increase in homosexually-acquired infection has implications with regard to the spread of human immunodeficiency virus infection in this area, and suggests that attempts to promote safer sex in this group are failing.

Adolescent↗