Biomedical subjects
Publications and source records attributed to K E Rogstad.
Vaginal anaerobic infection is the most common cause of vaginal discharge in women. We present a case of recurrent vaginal anaerobic infection and cervical carcinoma and discuss the association of the two conditions. More frequent cytology/colposcopy may be indicated in women who give a history of recurrent or persistent vaginal anaerobic infection.
A 21 year old woman presented with painful groin lymphadenopathy and malaise. Lymph node biopsy, to exclude atypical infection and malignancy, suggested the diagnosis of lymphogranuloma venereum. This diagnosis was confirmed by serology and polymerase chain reaction, with the patient subsequently admitting to a casual sexual contact within the United Kingdom. Alternative methods of investigation of this disease are discussed.
OBJECTIVE: The objective of this study was to determine the availability of necropsy services to departments dealing with HIV positive patients, and to assess their satisfaction with, and utilisation of, these services. METHOD: Confidential questionnaires were sent to 187 consultants in genitourinary medicine and infectious diseases departments within the United Kingdom and Ireland. One hundred and forty four (77%) replies were suitable for analysis. RESULTS: Seventy five (52.1%) centres had a routine necropsy service, compared with 59 (41.0%) which did not, including 15 (10.4%) with no service provision. Sixty one (42.4%) centres were satisfied with their current service; however, 31 (21.5%) clinics were not satisfied. The majority of service users considered necropsies to be beneficial in the subsequent management of HIV positive patients. CONCLUSION: The provision of services for HIV necropsies varies considerably. We advocate that they should be uniformly available, and that the dissatisfaction with current services should be addressed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To determine the perceived value of attendance at an International AIDS Conference and attitudes towards the effect of patient attendance on the conference. DESIGN: A confidential, self-administered questionnaire. PARTICIPANTS: 102 physicians from the United Kingdom who attended the VIII International AIDS Conference in Amsterdam. RESULTS: There was an 84% response rate. 50% reported increased motivation for clinical work and 57% for research. Physicians with a lower HIV positive patient workload found the conference more valuable for finding out the latest information on HIV, compared with those with a higher workload (p = 0.04). Those with a higher patient workload found the conference more useful for increasing motivation for research than those with a lower HIV workload (p = 0.047). Conference attendance was felt to reduce burnout by 48% of respondents. The majority (55%) would prefer a more traditional meeting. Patient attendance was seen as improving the standard of discussion of ethical and political issues but not on medical or scientific issues. CONCLUSIONS: The International AIDS Conferences are perceived as useful by those UK physicians who attend, but most would prefer a more "traditional" scientific meeting. Whilst patient participation was not seen as useful for medical or scientific discussions, it was felt to improve discussion of ethical and political issues. A smaller more focused conference may be equally useful to UK physicians.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
There is no consensus amongst physicians about the need for analgesia when a woman undergoes ablative therapy of the cervix. Many doctors believe that the discomfort felt during such procedures is insubstantial. By means of a randomised double-blind placebo-controlled trial, we have shown that patients experience considerable pain during cold-coagulation treatment of the cervix. We found that intracervical lignocaine leads to a significant (p < 0.01) reduction in this pain.
Explore the source record for details and available documents.
OBJECTIVE: To assess whether cold coagulation to the cervix eliminates subclinical wart virus infection and to determine the effectiveness of treatment for CIN I and II, using cold coagulation, by genitourinary physicians. DESIGN: Prospective study. SETTING: Department of Genitourinary medicine in a large teaching hospital. PARTICIPANTS: All patients who received cold coagulation to the cervix in a 1 year period, who had not had previous treatment. RESULTS: 261 patients were enrolled into this study; of these, 138 (53%) patients attended for repeat colposcopy and cytology at one year. Cure rates for lesions were 66% for initial wart virus infection, 80% for CIN I and 94% for CIN II and III. Four (5%) cases in whom repeat cytology was normal had CIN which would have been missed if repeat colposcopy had not been performed at one year. CONCLUSIONS: Cold coagulation is inappropriate treatment for subclinical wart virus infection of the cervix but is useful for the management of patients with CIN. Repeat colposcopy following treatment to the cervix is not necessary if cervical cytology is normal.
Two hundred and forty-two patients aged 60 years or over attended genito-urinary clinics in Nottingham and Leicester (England) in a 2-year period. Sixty-nine per cent of men and 53% of women were sexually active and 58 were found to have sexually transmitted diseases.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
One thousand consecutive attenders at a Department of Genitourinary Medicine (GUM) completed an anonymous questionnaire to assess the GUM services and provide suggestions for improvement. The replies showed patient preferences to be for an appointment system (68%), separate waiting rooms (84% women, 57% men) and to see the same doctor at each visit (75%). Forty-six per cent of women and 33% of men preferred to be seen by a doctor of the same sex, 38% requested evening clinics and 20% of patients wished to be interviewed with their partner.
In order to determine knowledge of HIV transmission, sexual risk behaviour and perception of risk in African health care workers, 200 employees at the Aga Khan Hospital, Nairobi, Kenya, were asked to complete an anonymous self-administered questionnaire. There was a 75% response rate. Twenty-five per cent believed that condoms were not protective against HIV transmission. Eighty-nine per cent believed oral sex to be a risk factor, as did 70% for kissing, 41% for masturbation of a partner and 43% for nursing an AIDS patient. Younger people were more likely to think condoms were ineffective (P = 0.007) and that insect bites were a significant risk factor (P = 0.004). Twenty-seven per cent had changed their sexual behaviour as a result of the AIDS epidemic, but 48% did not use condoms with non-regular partners. Four had current or previous homosexual relationships. Seventy per cent believed they were at risk of being HIV positive but only 12% had been tested. We have shown that even in the educated group, misconceptions regarding HIV transmission were high and many continue to be at risk for their sexual behaviour. In addition, in-service training regarding HIV transmission should be considered for health care workers in Africa.
Explore the source record for details and available documents.
Explore the source record for details and available documents.