An audit on the management of pelvic inflammatory disease in the West Midlands, UK

2007 ◽  
Vol 18 (10) ◽  
pp. 717-719 ◽  
Author(s):  
M Walzman ◽  
A Tariq ◽  
S Bhaduri ◽  
J D C Ross
Keyword(s):  
Data Collection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
National Standards ◽  
National Standard ◽  
Standards Of Care ◽  
National Guidelines ◽  
The West ◽  
West Midlands

The potential complications of pelvic inflammatory disease (PID) make optimizing its management a high priority. A clinical audit of PID against current national management guidelines was conducted in 14 departments of genitourinary medicine in the West Midlands for women presenting with PID between January and December 2005. There were a total of 810 diagnoses of PID made from a total of 49,390 female attendees for that year, giving an incidence of 164 cases per 10,000 attendees. Of these 810 cases, data collection and analysis for this audit were performed on 139. An ofloxacin 400 mg twice daily (b.i.d.) based regimen was prescribed in 91 (65%, 95% confidence interval [CI] 57–73%) cases. Doxycycline 100 mg b. i. d. for 14 days plus metronidazole 400 mg b. i. d. for 5–14 days was prescribed in 44 (32%, 95% CI 25–40%) cases, but a third-generation cephalosporin was only given with this regimen in three cases. Partner notification was performed in 101 (73%, 95% CI 65–79%) cases. A total of 130 male contacts were recorded on the data collection forms, and of these 58 (45%) were traced and 51 (39%), treated. A follow-up appointment was given to 133 (96%, 95% CI 91–98%) women, although in most cases this was for seven days or more, and 104 (78%, 95% CI 67–81%) women attended for follow-up. Adherence to the national guidelines in this cohort of patients did not reach the national standard for choice of treatment regimen nor did it attain the target for proportion of male partners traced. Barriers preventing adherence to the national guidelines need to be explored and appropriate assistance given to physicians to help meet national standards of care.

scholarly journals Studying the pathophysiology of coronavirus disease 2019 – a protocol for the Berlin prospective COVID-19 patient cohort (Pa-COVID-19)

2020 ◽  
Author(s):  
Florian Kurth ◽  
Maria Roennefarth ◽  
Charlotte Thibeault ◽  
Victor M. Corman ◽  
Holger Müller-Redetzky ◽  
...  
Keyword(s):  
Data Collection ◽  
Medical Care ◽  
Clinical Course ◽  
National Standards ◽  
Ordinal Scale ◽  
Standards Of Care ◽  
Sample Collection ◽  
Comprehensive Data ◽  
Deep Phenotyping

AbstractPurposeSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide causing a global health emergency. Pa-COVID-19 aims to provide comprehensive data on clinical course, pathophysiology, immunology and outcome of COVID-19, in order to identify prognostic biomarkers, clinical scores, and therapeutic targets for improved clinical management and preventive interventions.MethodsPa-COVID-19 is a prospective observational cohort study of patients with confirmed SARS-CoV-2 infection treated at Charité - Universitätsmedizin Berlin. We collect data on epidemiology, demography, medical history, symptoms, clinical course, pathogen testing and treatment. Systematic, serial blood sampling will allow deep molecular and immunological phenotyping, transcriptomic profiling, and comprehensive biobanking. Longitudinal data and sample collection during hospitalization will be supplemented by long-term follow-up.ResultsOutcome measures include the WHO clinical ordinal scale on day 15 and clinical, functional and health-related quality of life assessments at discharge and during follow-up. We developed a scalable dataset to (i) suit national standards of care (ii) facilitate comprehensive data collection in medical care facilities with varying resources and (iii) allow for rapid implementation of interventional trials based on the standardized study design and data collection. We propose this scalable protocol as blueprint for harmonized data collection and deep phenotyping in COVID-19 in Germany.ConclusionWe established a basic platform for harmonized, scalable data collection, pathophysiological analysis, and deep phenotyping of COVID-19, which enables rapid generation of evidence for improved medical care and identification of candidate therapeutic and preventive strategies. The electronic database accredited for interventional trials allows fast trial implementation for candidate therapeutic agents.

Treatment of mild-to-moderate pelvic inflammatory disease with a short-course azithromycin-based regimen versus ofloxacin plus metronidazole: results of a multicentre, randomised controlled trial

2020 ◽  
pp. sextrans-2020-054468
Author(s):  
Gillian Dean ◽  
Suneeta Soni ◽  
Rachel Pitt ◽  
Jonathan Ross ◽  
Caroline Sabin ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Cure ◽  
Primary Outcome ◽  
Controlled Trial ◽  
High Rate ◽  
Resistance Testing ◽  
Short Course

ObjectiveA multicentre, randomised non-inferiority trial compared the efficacy and safety of 14 days of ofloxacin and metronidazole (standard-of-care (SoC)) versus a single dose of intramuscular ceftriaxone followed by 5 days of azithromycin and metronidazole (intervention arm (IA)) in women with mild-to-moderate pelvic inflammatory disease (PID).MethodsWomen with a clinical diagnosis of PID presenting at sexual health services were randomised to the SoC or IA arms. Treating clinicians and participants were not blinded to treatment allocation but the clinician performing the assessment of primary outcome was blinded. The primary outcome was clinical cure defined as ≥70% reduction in the modified McCormack pain score at day 14–21 after starting treatment. Secondary outcomes included adherence, tolerability and microbiological cure.ResultsOf the randomised population 72/153 (47.1%) reached the primary end point in the SoC arm, compared with 68/160 (42.5%) in the IA (difference in cure 4.6% (95% CI −15.6% to 6.5%). Following exclusion of 86 women who were lost to follow-up, attended outside the day 14–21 follow-up period, or withdrew consent, 72/107 (67.3%) had clinical cure in the SoC arm compared with 68/120 (56.7%) in the IA, giving a difference in cure rate of 10.6% (95% CI −23.2% to 1.9%). We were unable to demonstrate non-inferiority of the IA compared with SoC arm. Women in the IA took more treatment doses compared with the SoC group (113/124 (91%) vs 75/117 (64%), p=0.0001), but were more likely to experience diarrhoea (61% vs 24%, p<0.0001). Of 288 samples available for analysis, Mycoplasma genitalium was identified in 10% (28/288), 58% (11/19) of which had baseline antimicrobial resistance-associated mutations.ConclusionA short-course azithromycin-based regimen is likely to be less effective than the standard treatment with ofloxacin plus metronidazole. The high rate of baseline antimicrobial resistance supports resistance testing in those with M. genitalium infection to guide appropriate therapy.Trial registration number2010-023254-36.

A multidistrict audit of the management of chlamydial PID in genitourinary medicine clinics in Yorkshire

2002 ◽  
Vol 13 (4) ◽  
pp. 264-267 ◽  
Author(s):  
Usha Kuchimanchi ◽  
Hugo McClean
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Antibiotic Treatment ◽  
Inflammatory Disease ◽  
Partner Notification ◽  
Clinic Attendance ◽  
Referral Patterns ◽  
Genitourinary Medicine ◽  
Audit Reports ◽  
Partner Participation

In response to recent reviews of practice of pelvic inflammatory disease (PID) management, a multidistrict audit involving eight genitourinary clinics within the Yorkshire region was carried out. This audit reports the referral patterns of patients, physical signs and microscopy findings at the first genitourinary medicine (GUM) clinic attendance, antibiotic treatment and follow-up data as well as health adviser involvement and partner participation for 68 patients diagnosed with chlamydial PID. Twenty-eight (41.2%) patients presented with symptoms of less than or equal to four weeks duration, partner notification was recorded as being carried out for all patients and at least one partner was documented as having been treated in 57 (83.8%) patients. There is, however, a wide variation in the antibiotic regimens used for treatment and their duration.

Impact of a Region-Wide Approach to Improving Systems for Heart Attack Care: The West Midlands Thrombolysis Project

2003 ◽  
Vol 2 (2) ◽  
pp. 131-139 ◽  
Author(s):  
Tom Quinn ◽  
Teresa F Allan ◽  
John Birkhead ◽  
Rod Griffiths ◽  
Sylvia Gyde ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Heart Attack ◽  
National Standard ◽  
Hospital Treatment ◽  
First Year ◽  
Discharge Diagnosis ◽  
The West ◽  
The Third ◽  
West Midlands

Objective: To describe changes in delay to administration of thrombolytic therapy associated with a region-wide audit. Design: Observational study of patients admitted with suspected myocardial infarction (MI) based on continuous audit. Subjects: 18877 patients admitted to 23 hospitals with suspected MI between April 1995 and March 1998. Results: Of 11232 patients with a discharge diagnosis of definite MI, 8802 (46.6%) received thrombolytic therapy during hospitalisation, with 5155 patients eligible for treatment on admission to hospital on the basis of established indications. Call-to-needle time for those eligible for treatment on admission fell from median 105 min in the first year of the project to 85 min in year 3 ( P<0.001), and door-to-needle time fell from 45 to 35 min ( P<0.001). Forty percent of eligible patients were treated within the then current national standard of 90 min from time of call for help, with nearly 49% in the final year and 20% being treated within the new national standard of 60 min, by the third year. Conclusion: The proportion of eligible patients receiving thrombolysis within 1 h of the call for help doubled during the 3-year project but the majority of patients still wait longer than 60-min ‘call-to-needle’. New systems to reduce delays to administration of thrombolysis to within 60 min of call for help are required, including consideration of pre-hospital treatment.

scholarly journals P054 Pelvic Inflammatory Disease (PID) – Is telephone follow-up feasible, safe and effective?

2016 ◽  
Vol 92 (Suppl 1) ◽  
pp. A37.2-A37
Author(s):  
Myat Lwin ◽  
Sophie Forsyth ◽  
Jessica Daniel ◽  
Laura Hill
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease

Offering the vaccine and accepting it: an audit of hepatitis B vaccination in West Midlands region

2003 ◽  
Vol 14 (9) ◽  
pp. 632-635 ◽  
Author(s):  
Henna Jaleel ◽  
P S Allan ◽  
Mia Huengsberg ◽  
D Natin ◽  
Keyword(s):  
Hepatitis B ◽  
Venereal Disease ◽  
Medical Society ◽  
Hepatitis B Vaccination ◽  
National Guidelines ◽  
The West ◽  
West Midlands ◽  
Genitourinary Medicine ◽  
Hepatitis B Screening

The practice of hepatitis B screening and vaccination in genitourinary medicine clinics in the West Midlands Region is audited against the standards set by 1999 Medical Society for the Study of Venereal Disease National Guidelines.

scholarly journals Pelvic Inflammatory Disease (PID) Management in Corona Virus Disease 2019 (COVID-19) Era

2021 ◽  
Vol 4 (1) ◽  
pp. 34-41
Author(s):  
I Gde Sastra Winata ◽  
◽  
Musa Taufiq
Keyword(s):  
Disease Management ◽  
Emergency Room ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Emergency Room Visit ◽  
Virus Disease ◽  
Google Scholar ◽  
Face To Face ◽  
Corona Virus

Objective: This article aims to review pelvic inflammatory disease management during the coronavirus disease 2019 pandemic Method: We conducted a search for scientific articles through PubMed and Google Scholar, using the terminologies of “PID AND COVID-19”, “Pelvic Inflammatory Disease”; “Pelvic Inflammatory Disease AND COVID-19”, “PID Management AND COVID-19”, “Pelvic Inflammatory Disease Management AND COVID-19”, and “PID AND Pandemic” in English and Indonesian from 2019-2020. Result: There were a total of 25 scientific articles from PubMed and Google Scholar within 2019-2020 that were included as the source of this review Conclusion: There is no difference between the management of pelvic inflammatory disease during and before the pandemic. The mode of medical services and follow up tends to be conducted virtually. Technology-based services for pelvic inflammatory disease during the corona virus disease 2019 pandemic are promising and have been proven to be an effective method, therefore virtual-based pelvic inflammatory disease services may be safely applied. However, if there is any indication of emergency found during the telemedicine services, a face-to-face consultation or emergency room visit should be recommended. Key words : COVID-19, Pelvic Inflammatory Disease, SARS-CoV-2

scholarly journals Massive blood loss protocol ‘Code Red’ at Papworth Hospital: A closed loop audit

2020 ◽  
pp. 175045892094336
Author(s):  
M Tennyson ◽  
J Redlaff ◽  
G Biosse-Duplan ◽  
M Lewin ◽  
N Jones ◽  
...  
Keyword(s):  
Blood Loss ◽  
Patient Care ◽  
Closed Loop ◽  
National Standards ◽  
Standards Of Care ◽  
National Guidelines ◽  
Safe Patient Care ◽  
Massive Blood Loss ◽  
Care Systems ◽  
British Committee

Aim To investigate if the massive blood loss protocol ‘Code Red’ at a specialist cardiothoracic hospital was activated according to local and national guidelines by a closed loop audit. Methods Electronic and paper patient care systems were searched in 2015 and 2018 to access records for the ‘Code Red’ activations. Activation of the massive blood loss protocol was compared against the national standards set by The British Committee for Standards in Haematology. The percentage of cases meeting each of the ten standards in the specialist cardiac unit’s Protocol for the Management of Massive Blood Loss in Adults (adapted from the national standards) were evaluated. Results ‘Code Red’ protocol was activated on 18 occasions in 2015 and nine occasions in 2018, representing just 0.83 and 0.26% of emergency surgeries, respectively. Between 2015 and 2018, there was a 6% increase of ‘Code Red’ cases being appropriately activated, a 26% increase in the prompt notification of the haematology department upon activation, alongside a 30% increase in the timely delivery of blood products, and a 25% decrease in the average amount of blood transferred prior to ‘Code Red’ activation. Conclusion There has been an improvement in the standards of care and management of massive blood loss this specialist cardiac centre despite the target timeframe being reduced from 30 to 15min between 2015 and 2018. Preparation for and anticipation of massive blood loss has likely decreased the number of incidences requiring ‘Code Red’ activation, permitting delivery of safe patient care.

scholarly journals Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis

Eye ◽  
2020 ◽  
Author(s):  
George Moussa ◽  
◽  
Hetvi Bhatt ◽  
Ian Reekie ◽  
Gibran Butt ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Positive Culture ◽  
Clinical Effectiveness ◽  
Acute Onset ◽  
The West ◽  
Research And Innovation ◽  
West Midlands ◽  
Collaborative Working ◽  
Improving Patient Care

Abstract Background Whilst research and innovation is embedded within the UK’s National Health Service (NHS) constitution, Doctors-in-training have little opportunity to contribute to designing, leading and recruiting into clinical trials or cohort studies. We formed the West MidlandsCollaborativeOphthalmologyNetwork forClinicalEffectiveness &Research byTrainees (The West Midlands CONCERT) and undertook a characterisation of post cataract surgery endophthalmitis as a proof-of-concept study to test the feasibility of the CONCERT model. Methods Doctors-in-training formed a collaborative working group to test the concept of delivering a pan-regional clinical effectiveness study across multiple hospital sites by performing retrospective analyses of post cataract endophthalmitis over a 6-year period. Results Overall, 157,653 cataract surgeries were performed by participating centres accredited to deliver the Royal College of Ophthalmologists training curriculum. Thirty-eight cases of post cataract endophthalmitis were identified, giving an incidence of 2.41 per 10,000 cases (0.0241%). A further 15 endophthalmitis cases presented who had surgery in non-training centres, giving a total of 53 cases. The most common organisms were S. epidermidis (14 (51.9%)) and P. aeruginosa (5 (18.5%)). Anterior-chamber and vitreous sampling yielded positive culture in 33.3% (6/18) and 50.9% (27/53), respectively. At 6 months follow-up, 19 (51.4%) patients achieved visual acuities of ≤0.5 LogMAR. Repeat intravitreal injections (11 (20.8%)) and vitrectomy (n = 22 (41.5%)) were not associated with better outcomes. Conclusions Using post cataract endophthalmitis as a pilot cohort, this study highlights the feasibility of using the CONCERT model for studies across multiple sites. A UK-CONCERT could provide a powerful infrastructure enabling characterisation of patient cohorts and a platform for high-quality interventional studies, improving patient care.

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