O3-S1.02 Deciphering the code of Treponema pallidum in the UK: implications for treatment and prevention

AbstractIn Japan, corticosteroid tapes and plasters have long served as a first-line therapy for keloids and hypertrophic scars. Pediatric patients are particularly responsive to this type of treatment. This may reflect the fact children have thinner skin than adults and the steroids are therefore more easily absorbed. The postoperative application of corticosteroid tapes/plasters also significantly prevents the development of keloids and hypertrophic scars after surgery. Steroid tape is available in the following three countries in different preparations. In the UK, the commercially available formulation comprises a fludroxycortide-impregnated tape (4 μg/cm2). Fludroxycortide tape is a Group III preparation. The USA has a steroid tape preparation that contains 4 μg/cm2 flurandrenolide, which is also a Group III preparation. In Japan, two steroid tape formulations are available, namely, the Group III preparation found in the UK (4 μg/cm2 fludroxycortide tape) and a 20 μg/cm2 deprodone propionate tape. Deprodone propionate tape is considered to be a Group I or II preparation. In our experience, deprodone propionate tape (Eclar® plaster) is the most effective tape for the treatment and prevention of keloids.

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Lessons from a publicly funded tier 2 healthy weight programme in Cornwall, UK

Journal of Public Health ◽

10.1093/pubmed/fdz037 ◽

2019 ◽

Author(s):

A J Williams ◽

T Barter ◽

R A Sharpe

Keyword(s):

Statistical Tests ◽

Evidence Base ◽

Lessons Learned ◽

Healthy Weight ◽

Anthropometric Measures ◽

Prevention Services ◽

Treatment And Prevention ◽

Weight Management Programme ◽

The Uk ◽

The Impact

Abstract Background The UK has one of the highest prevalence rates of obesity worldwide. Public health departments have a duty to provide some obesity treatment and prevention services. With evidence of effective programmes lacking, we investigate lessons learned from a healthy weight programme in Cornwall, UK. Methods Data from the 12-week multi-component adult healthy weight management programme were obtained for 2012–2016. Descriptive statistics and statistical tests were used to describe participants’ demographics, health status and anthropometric measures to explore the enrolment and retention of the programme as well as the impact. Results A total of 1872 adults were referred into the programme. Overall, 646 completed the programme and, 48.8% achieved the programme’s aim of a >3% reduction in weight. Those who completed and met the programme aim tended to have had healthier outcomes at baseline. Conclusions For those who engage with the programme the impact can be meaningful. However, <1% of the population of Cornwall with overweight or obesity enroled in the programme, and those who benefitted most might have been in least need. Providing services that meet the needs of the population is challenging when a variety of services is needed, and the evidence base is poor.

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Tuberculosis (TB)

Oxford Handbook of Respiratory Nursing ◽

10.1093/med/9780198831815.003.0022 ◽

2021 ◽

pp. 497-506

Author(s):

Terry Robinson ◽

Jane Scullion

Keyword(s):

Disease Risk ◽

Treatment Phase ◽

Signs And Symptoms ◽

Multidrug Resistant ◽

Contact Tracing ◽

Directly Observed Therapy ◽

Standard Drug ◽

Treatment And Prevention ◽

Increased Risk ◽

The Uk

This chapter covers the key facts about tuberculosis (TB), then goes on to describe the epidemiology and pathophysiology of the disease. Risk factors, and signs and symptoms, and investigations are all covered. The treatment phase and standard drug therapies are shown, and directly observed therapy for the patient with an increased risk of poor adherence is described. Mono-resistant, multidrug-resistant, and extensively drug-resistant types are included in this chapter, as well as contact tracing in line with NICE clinical guidelines. Mycobacterium Tuberculosis (MTB) is part of a family of mycobacterium which includes Mycobacterium bovis. M. bovis is uncommon in humans, although it frequently affects cattle and badgers. MTB can affect any organ in the body; this chapter will concentrate on the diagnosis, treatment, and prevention of pulmonary MTB in adults in the UK.

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Current and future management of non-tuberculous mycobacterial pulmonary disease (NTM-PD) in the UK

BMJ Open Respiratory Research ◽

10.1136/bmjresp-2020-000591 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000591

Author(s):

Marc Lipman ◽

Joanne Cleverley ◽

Tom Fardon ◽

Besma Musaddaq ◽

Daniel Peckham ◽

...

Keyword(s):

Pulmonary Disease ◽

Support Groups ◽

Professional Education ◽

Multidisciplinary Teams ◽

Reference Laboratory ◽

Hub And Spoke ◽

Treatment And Prevention ◽

Multidisciplinary Working ◽

Patients At Risk ◽

The Uk

A rising number of non-tuberculous mycobacterial (NTM) isolates are being identified in UK clinical practice. There are many uncertainties around the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD), including its epidemiology, diagnosis, treatment and prevention. Regional variations in how patients with NTM-PD are managed reflects the lack of standardised pathways in the UK. Service optimisation and multidisciplinary working can improve the quality of care for patients with NTM-PD, including (1) better identification of patients at risk of NTM-PD and modification of risk factors where applicable; (2) standardisation of reference laboratory testing to offer clinicians access to accurate and prompt information on NTM species and drug sensitivities; (3) development of recognised specialist NTM nursing care; (4) standardisation of NTM-PD imaging strategies for monitoring of treatment and disease progression; (5) establishment of a hub-and-spoke model of care, including clear referral and management pathways, dedicated NTM-PD multidisciplinary teams, and long-term patient follow-up; (6) formation of clinical networks to link experts who manage diseases associated with NTM; (7) enabling patients to access relevant support groups that can provide information and support for their condition; and (8) development of NTM research groups to allow patient participation in clinical trials and to facilitate professional education.

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Pregnancy and neonatal outcomes in COVID-19: study protocol for a global registry of women with suspected or confirmed SARS-CoV-2 infection in pregnancy and their neonates, understanding natural history to guide treatment and prevention

BMJ Open ◽

10.1136/bmjopen-2020-041247 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041247

Author(s):

Jayanta Banerjee ◽

Edward Mullins ◽

Julia Townson ◽

Rebecca Playle ◽

Caroline Shaw ◽

...

Keyword(s):

Preterm Delivery ◽

Neonatal Outcomes ◽

Data Set ◽

Link Type ◽

Treatment And Prevention ◽

Registration Number ◽

Scientific Meetings ◽

The Uk ◽

Media Channels ◽

In Pregnancy

IntroductionPrevious novel COVID-19 pandemics, SARS and middle east respiratory syndrome observed an association of infection in pregnancy with preterm delivery, stillbirth and increased maternal mortality. COVID-19, caused by SARS-CoV-2 infection, is the largest pandemic in living memory.Rapid accrual of robust case data on women in pregnancy and their babies affected by suspected COVID-19 or confirmed SARS-CoV-2 infection will inform clinical management and preventative strategies in the current pandemic and future outbreaks.Methods and analysisThe pregnancy and neonatal outcomes in COVID-19 (PAN-COVID) registry are an observational study collecting focused data on outcomes of pregnant mothers who have had suspected COVID-19 in pregnancy or confirmed SARS-CoV-2 infection and their neonates via a web-portal. Among the women recruited to the PAN-COVID registry, the study will evaluate the incidence of: (1) miscarriage and pregnancy loss, (2) fetal growth restriction and stillbirth, (3) preterm delivery, (4) vertical transmission (suspected or confirmed) and early onset neonatal SARS-CoV-2 infection.Data will be centre based and collected on individual women and their babies. Verbal consent will be obtained, to reduce face-to-face contact in the pandemic while allowing identifiable data collection for linkage. Statistical analysis of the data will be carried out on a pseudonymised data set by the study statistician. Regular reports will be distributed to collaborators on the study research questions.Ethics and disseminationThis study has received research ethics approval in the UK. For international centres, evidence of appropriate local approval will be required to participate, prior to entry of data to the database. The reports will be published regularly. The outputs of the study will be regularly disseminated to participants and collaborators on the study website (https://pan-covid.org) and social media channels as well as dissemination to scientific meetings and journals.Study registration numberISRCTN68026880.

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Topical issues of diagnostics, examination and treatment of patients with COVID-19-associated pneumonia in different countries and continents

Medical Council ◽

10.21518/2079-701x-2020-21-96-102 ◽

2021 ◽

pp. 96-102

Author(s):

V. V. Salukhov ◽

M. A. Kharitonov ◽

E. V. Kryukov ◽

T. V. Stepanova ◽

A. V. Nikolaev ◽

...

Keyword(s):

Length Of Hospital Stay ◽

World Health ◽

Duration Of Treatment ◽

Treatment And Prevention ◽

Appropriate Treatment ◽

Pathogenetic Therapy ◽

The Usa ◽

Coronavirus Infection ◽

Health Organization ◽

The Uk

The lack of effective etiotropic methods of treatment and prevention of the new coronavirus infection (COVID-19), which caused the pandemic in 2020, determines the relevance of the review of researches of medicines for etiotropic and pathogenetic therapy. Most patients are diagnosed with pneumonia, the disease is especially difficult in people with concomitant chronic diseases, since COVID-19 leads to their decompensation, which can lead to death. To assess risk factors for mortality, scientists are developing programs to transfer the patient to appropriate treatment in a timely manner. This article analyzes the clinical efficacy of various agents for etiotropic and pathogenetic treatment of a new coronavirus infection based on data from international researches. Etiotropic medicines used at the beginning of the pandemic did not show their effectiveness in reducing the duration of treatment, the development of death, and preventing the transition to the use of mechanical ventilation. There are described researches of vaccines against a new coronavirus infection, developed in the Russian Federation, the USA, Germany and the UK, which showed the greatest efficiency (more than 90%) in preventing COVID-19. The World Health Organization initiated the international clinical research SOLIDARITY, according to which all medicines participating in the trials have little or no effect on overall mortality, the onset of ventilation requirements and the length of hospital stay in hospitalized patients. Now, only systemic glucocorticosteroids have proven effective against severe and critical forms of COVID-19. Thus, effective etiotropic drugs for the treatment of COVID-19 have not been developing, however, an active search for these funds and the development of vaccines to prevent the incidence of coronavirus infection are underway.

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Unlocking the potential for digital mental health technologies in the UK: a Delphi exercise

BJPsych Open ◽

10.1192/bjo.2019.95 ◽

2020 ◽

Vol 6 (1) ◽

Cited By ~ 1

Author(s):

Clare Murphy ◽

Lucy Thorpe ◽

Harriet Trefusis ◽

Antonis Kousoulis

Keyword(s):

Mental Health ◽

Lived Experience ◽

Service Providers ◽

Systems Of Care ◽

Small And Medium Enterprises ◽

Mental Healthcare ◽

Health Technologies ◽

Treatment And Prevention ◽

Delphi Exercise ◽

The Uk

Background Digitally enabled services can contribute to the support, treatment and prevention of mental health difficulties; however, questions remain regarding how we can most usefully harness such technology in primary and secondary mental healthcare settings. Aims To identify barriers and facilitators to enable the potential of digital mental health in England, Scotland, Wales and Northern Ireland. Method A three-round Delphi exercise was carried out online with 16 participants from across the four nations of the UK representing the following stakeholder groups: service providers, health professionals, policymakers, lived experience, small and medium enterprises and academics. Qualitative data were collected in the first round (80 fragments) that were then coded to produce a 26-item round-two questionnaire for participant rating. Participants were given the opportunity to reconsider their scores in light of the group responses in round three. Results Eight statements under the following five themes reached consensus with median scores between 8 and 10 (i.e. important/very important): co-production; the human element; data security; funding; and regulation. Conclusions The Delphi process allowed consensus to be achieved regarding the factors that experts consider important for harnessing technology in primary and secondary mental healthcare. Knowledge of these factors can help users and providers of mental health services negotiate how best to move forward with digitally enabled systems of care.

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An eight-year retrospective analysis of antenatal screening results for syphilis: is it still cost effective?

The Journal of Infection in Developing Countries ◽

10.3855/jidc.6064 ◽

2015 ◽

Vol 9 (09) ◽

pp. 1011-1015 ◽

Cited By ~ 3

Author(s):

Tugba Ensari ◽

Ayse Kirbas ◽

Ayse Seval Ozgu-Erdinc ◽

Sibel Gokay Saygan ◽

Salim Erkaya ◽

...

Keyword(s):

Congenital Syphilis ◽

Venous Blood ◽

Treponema Pallidum ◽

Cost Effective ◽

Adverse Outcomes ◽

Seroprevalence Rate ◽

Antenatal Screening ◽

Tertiary Referral Hospital ◽

Serological Screening ◽

Treatment And Prevention

Introduction: This study aimed to document the prevalence of syphilis among pregnant women in Turkey. Methodology: In this retrospective cohort study, a total of 63,276 sera obtained between January 2007 and June 2014 from women who were routinely screened for syphilis as a part of antenatal care at a tertiary referral hospital in Turkey were analyzed. Serological screening was done with the rapid plasma reagin (RPR) test on venous blood samples. Treponema pallidum hemagglutination assay (TPHA) was the confirmation test for the diagnosis of syphilis in patients who had positive results in the screening test. Results: Between 2007 and the first six months of 2014, 41 RPR+ and only five confirmed syphilis-positive patients were determined. The syphilis seroprevalence rate was 0.0648%. Within these years, there was no case of congenital syphilis detected in the hospital. Conclusion: As there is evidence of effective screening of syphilis contributing to the effective treatment and prevention of adverse outcomes, routine antenatal screening of syphilis is recommended. The rationale depends on the consideration of the serious results of not treating the disease and the cost effectiveness of screening.

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Substantial underdiagnosis of lymphogranuloma venereum in men who have sex with men in Europe: preliminary findings from a multicentre surveillance pilot

Sexually Transmitted Infections ◽

10.1136/sextrans-2019-053972 ◽

2019 ◽

Vol 96 (2) ◽

pp. 137-142 ◽

Cited By ~ 4

Author(s):

Michelle Jayne Cole ◽

Nigel Field ◽

Rachel Pitt ◽

Andrew J Amato-Gauci ◽

Josip Begovac ◽

...

Keyword(s):

Preliminary Investigation ◽

Health Impact ◽

Lymphogranuloma Venereum ◽

European Countries ◽

Surveillance Systems ◽

Limited Data ◽

The Public ◽

Treatment And Prevention ◽

Sex With Men ◽

The Uk

ObjectivesUnderstanding the public health impact of lymphogranuloma venereum (LGV) in Europe is hampered by inadequate diagnostics and surveillance systems in many European countries. We developed and piloted LGV surveillance in three European countries without existing systems and performed a preliminary investigation of LGV epidemiology, where little evidence currently exists.MethodsWe recruited STI or dermatovenereology clinics and associated laboratories serving men who have sex with men (MSM) in Austria, Croatia and Slovenia, using the UK for comparison. We undertook centralised LGV testing of Chlamydia trachomatis (CT)-positive rectal swabs collected between October 2016 and May 2017 from MSM attending these clinics. Stored specimens from Austria (2015–2016) and Croatia (2014) were also tested. Clinical and sociodemographic data were collected using a standardised proforma. The ompA gene of LGV-positive specimens was sequenced.ResultsIn total, 500 specimens from CT-positive MSM were tested, and LGV positivity was 25.6% (128/500; 95% CI 22.0% to 29.6%) overall, and 47.6% (79/166; 40.1% to 55.2%) in Austria, 20.0% (3/15; 7.1% to 45.2%) in Croatia, 16.7% (1/6; 3.0% to 56.4%) in Slovenia and 14.4% (45/313; 10.9% to 18.7 %) in the UK. Proformas were completed for cases in Croatia, Slovenia and in the UK; proformas could not be completed for Austrian cases, but limited data were available from line listings. Where recorded, 83.9% (78/93) of LGV-CT cases were HIV-positive compared with 65.4% (149/228) of non-LGV-CT cases; MSM with LGV-CT were more likely to have proctitis (Austria, 91.8% vs 40.5%, p<0.001; Croatia, 100% vs 25%, p=0.04; UK, 52.4% vs 11.7%, p<0.001) than those with non-LGV-CT. Six different ompA sequences were identified, including three new variants; the L2 ompA sequence predominated (58.6%, 51/87).ConclusionsLGV is substantially underdiagnosed in MSM across Europe. Unified efforts are needed to overcome barriers to testing, establish effective surveillance, and optimise diagnosis, treatment and prevention.

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Genomic Influences on Self-Reported Childhood Maltreatment

10.1101/717314 ◽

2019 ◽

Author(s):

Shareefa Dalvie ◽

Adam X. Maihofer ◽

Jonathan R.I. Coleman ◽

Bekh Bradley ◽

Gerome Breen ◽

...

Keyword(s):

Physical Health ◽

Childhood Maltreatment ◽

Large Scale ◽

Genetic Relationships ◽

Genetic Correlations ◽

Discovery Sample ◽

Treatment And Prevention ◽

Genome Wide ◽

Physical Disorders ◽

The Uk

AbstractChildhood maltreatment is highly prevalent and serves as a risk factor for mental and physical disorders. Self-reported childhood maltreatment appears heritable, but the specific genetic influences on this phenotype are largely unknown. The aims of this study were to 1) identify genetic variation associated with reported childhood maltreatment, 2) calculate the relevant SNP-based heritability estimates, and 3) quantify the genetic overlap of reported childhood maltreatment with mental and physical health-related phenotypes. Genome-wide association analysis for childhood maltreatment was undertaken, using a discovery sample from the UK Biobank (UKBB) (n=124,000) and a replication sample from the Psychiatric Genomics Consortium–posttraumatic stress disorder working group (PGC-PTSD) (n=26,290). Heritability estimations for childhood maltreatment and genetic correlations with mental/physical health traits were calculated using linkage disequilibrium score regression (LDSR). Two genome-wide significant loci associated with childhood maltreatment, located on chromosomes 3p13 (rs142346759, beta=0.015, p=4.35×10−8, FOXP1) and 7q31.1 (rs10262462, beta=-0.016, p=3.24×10−8, FOXP2), were identified in the discovery dataset but were not replicated in the PGC-PTSD sample. SNP-based heritability for childhood maltreatment was estimated to be ∼6%. Childhood maltreatment was most significantly genetically correlated with depressive symptoms (rg=0.70, p=4.65×10−40). This is the first large-scale genetic study to identify specific variants associated with self-reported childhood maltreatment. FOXP genes could influence traits such as depression and thereby be relevant to childhood maltreatment. Alternatively, these variants may be associated with a greater likelihood of reporting maltreatment. A clearer understanding of the genetic relationships of childhood maltreatment, including particular abuse subtypes, with various psychiatric disorders, may ultimately be useful in in developing targeted treatment and prevention strategies.

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