Gynaecology and genitourinary medicine

2021 ◽  
pp. 17-34
Author(s):  
Kevin Hayes
Keyword(s):  
Primary Care ◽  
Surgical Management ◽  
Gynaecological Oncology ◽  
Genitourinary Medicine

Gynaecological practices are changing constantly, with more emphasis on management in primary care, conservative, rather than surgical, management of conditions, and an increase in sub-specialization such as gynaecological oncology and urogynaecology. This chapter contains 29 questions that encompass all of the important areas of this subject, with detailed explanations. Unique to this series, questions are rated by difficulty and are cross-referenced to the eleventh edition of Oxford Handbook of Clinical Specialties to track revision progress and revise effectively.

Combined Hemimandibular Hyperplasia and Elongation: the Orthodontic-Surgical Management

2020 ◽  
Vol 13 (3) ◽  
pp. 134-140
Author(s):  
Ciarán Devine ◽  
Anna Sayan ◽  
Velupillai Ilankovan
Keyword(s):  
Primary Care ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Clinical Relevance ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Techniques ◽  
Mandibular Asymmetry ◽  
Contemporary Management

Patients commonly present to orthodontists with complaints of facial and/or mandibular asymmetry. It is important that all asymmetry complaints are taken seriously and further investigated. Orthodontists play an important role in the diagnosis, management and follow-up of these conditions. For condylar hyperactivity, management is generally in a multidisciplinary setting. Clinicians who practice orthodontics in a primary care setting need to be aware of the correct terminology and the appropriate investigations required for diagnosis and the management of this condition. This paper aims to describe the contemporary management of condylar hyperactivity and presents a case of combined orthodontic-surgical treatment. CPD/Clinical Relevance: Condylar hyperactivity can lead to severe orofacial deformities and severe malocclusions. The orthodontist must understand the terminology, diagnostic techniques and treatment of this condition in order to offer the most appropriate management. The entire dental team may be involved in cases of condylar hyperactivity from diagnosis through to follow-up. Increased awareness may therefore improve diagnosis and ensure appropriate early referrals are made, thus potentially improving outcomes.

What do HIV-positive patients in Plymouth think about sharing details of their HIV status with other health-care workers?

2012 ◽  
Vol 23 (9) ◽  
pp. 647-648 ◽  
Author(s):  
Z Warwick ◽  
R Lillicrap
Keyword(s):  
Primary Care ◽  
Health Care Workers ◽  
Hospital Staff ◽  
Structured Interview ◽  
Hiv Care ◽  
Hiv Positive ◽  
Hiv Status ◽  
Opt Out ◽  
Care Workers ◽  
Genitourinary Medicine

We carried out a prospective structured interview with 71% of the HIV cohort in Plymouth to establish patients’ views on recording HIV status and details of HIV care in routine hospital and primary care notes. Forty-nine percent of patients did not want their HIV status routinely documented in hospital notes and 57% did not want hospital staff to have access to results of sexual health screens (SHSs). In light of these results, we plan to offer patients the option to opt out of using hospital notes for documentation of their HIV care and will be providing SHSs under a separate genitourinary medicine (GU) patient number.

Gynaecological Disorders and Human Immunodeficiency Virus Infection

1994 ◽  
Vol 5 (6) ◽  
pp. 383-386 ◽  
Author(s):  
P N Shah ◽  
P D Kell ◽  
S E Barton
Keyword(s):  
Primary Care ◽  
Human Immunodeficiency Virus ◽  
Virus Infection ◽  
Human Immunodeficiency Virus Infection ◽  
Hiv Infection ◽  
Direct Effect ◽  
Medicine Clinic ◽  
Immunodeficiency Virus ◽  
Genitourinary Medicine ◽  
Behavioural Factors

It is increasingly apparent that the differences in the prevalence and severity of various gynaecological conditions are a function of immunosuppression and differences in behavioural factors, rather than a direct effect of HIV itself. Women infected with HIV will present with their gynaecological disorders initially to their carers in both primary care and genitourinary medicine clinic settings. It is therefore essential that all those involved in the management of these women are aware of the interactions between HIV infection, immunosuppression and various gynaecological conditions so that they may be appropriately managed.

scholarly journals Cross-sectional study to evaluate Trichomonas vaginalis positivity in women tested for Neisseria gonorrhoeae and Chlamydia trachomatis, attending genitourinary medicine and primary care clinics in Bristol, South West England

2017 ◽  
Vol 94 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Jane E Nicholls ◽  
Katy M E Turner ◽  
Paul North ◽  
Ralph Ferguson ◽  
Margaret T May ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Trichomonas Vaginalis ◽  
Older Age ◽  
Nucleic Acid Amplification ◽  
Cross Sectional ◽  
South West ◽  
Genitourinary Medicine ◽  
Asymptomatic Women ◽  
South West England

BackgroundHighly sensitive, commercial nucleic acid amplification tests (NAAT) for Trichomonas vaginalis have only recently been recommended for use in the UK. While testing for T. vaginalis is routine in symptomatic women attending genitourinary medicine (GUM) clinics, it is rare in asymptomatic women or those attending primary care. The aim of this study was to evaluate the positivity of T. vaginalis using a commercial NAAT, in symptomatic and asymptomatic women undergoing testing for chlamydia and gonorrhoea in GUM and primary care settings.MethodsSamples from 9186 women undergoing chlamydia and gonorrhoea testing in South West England between May 2013 and Jan 2015 were also tested for T. vaginalis by NAAT alongside existing tests.ResultsT. vaginalis positivity using NAAT was as follows: in GUM 4.5% (24/530, symptomatic) and 1.7% (27/1584, asymptomatic); in primary care 2.7% (94/3499, symptomatic) and 1.2% (41/3573, asymptomatic). Multivariable regression found that in GUM older age, black ethnicity and deprivation were independent risk factors for T. vaginalis infection. Older age and deprivation were also risk factors in primary care. Testing women presenting with symptoms in GUM and primary care using TV NAATs is estimated to cost £260 per positive case diagnosed compared with £716 using current microbiological tests.ConclusionsAptima TV outperforms existing testing methods used to identify T. vaginalis infection in this population. An NAAT should be used when testing for T. vaginalis in women who present for testing with symptoms in primary care and GUM, based on test performance and cost.

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