No sex please, we have angina
Paul Woolley
pp 3-3
There are not many things in this world that will stop people having sex. As a species we just seem to like it too much and, indeed, sexual functioning forms a critical part of our self-image. The one thing, however, that is generally acknowledged to put the brakes on someone’s sex life is a heart condition. Perhaps that is a result of reading too many tabloid news stories where people with weak hearts are found dead in undignified circumstances in the bedroom.
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Treatment options for vulvovaginal candiasis
Anna McKendry and David White
pp 4-6
Vulvovaginal candidiasis (VVC) is a common condition among women and can have significant impact on their physical and psychological wellbeing. Around 75% of women will experience at least one episode of VVC in their life, with 55% of these occurring by the age of 25. The clinical spectrum ranges from a one-off episode that is a minor nuisance and responds to treatment, to recurrent disease that has profound psychological and psychosexual effects.
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Will screening young people halt the chlamydia epidemic?
Alison Blume
pp 7-8
The National Chlamydia Screening Programme (NCSP) is being rolled out across England and Wales. Chlamydia trachomatis is the most common sexually transmitted infection in the UK: in 2005 109,958 diagnoses were made in genitourinary medicine (GUM) clinics alone. The highest prevalence of infection is in women aged 16–19 (1,359 per 100,000) and men aged 20–24 (1,070 per 100,000). Prevalence falls sharply in both sexes over the age of 25. The high prevalence can be explained in part by asymptomatic infection: up to 70% of women and 50% of men infected by chlamydia show no symptoms.
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Adherence and monitoring: the cornerstones of HAART
Orla McQuillan, Chitra Babu and Margaret Kingston
pp 9-12
The advent of highly active antiretroviral therapy (HAART) and its widespread use in those countries where resources are available has transformed HIV from a terminal disease to one that is lifelong and chronic, with an optimistic prognosis. However, this outlook is dependent on timely diagnosis, appropriate monitoring before starting therapy and excellent adherence once on HAART. HIV infects cells using the CD4 molecule. The most profoundly affected cells are the CD4-positive T-lymphocyte cells, which are progressively and severely depleted over time.
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How to spot and treat male genital dermatoses
Rakesh Patalay and Christopher Bunker
pp 13-14
Male genital dermatoses are seen by a variety of healthcare professionals, many of whom may be inexperienced in their diagnosis and treatment. In these instances, penile dermatoses are often not considered in the differential diagnosis. Delay in diagnosis can increase the morbidity and mortality of these conditions. Most penile dermatoses are encountered in uncircumcised men. Healthcare professionals treating male genital dermatoses should aim to: recognise manifestations that are within the normal range; exclude sexually transmitted infection (STI); minimise or abolish sexual and/or urinary dysfunction; minimise or abolish the risk of penile cancer; preserve the prepuce, if possible.
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Ameliorating the disfiguring side-effects of HIV therapies
Angelica Kavouni and Sharron Brown
pp 15-16
A well-recognised complication of the management of HIV/AIDS is the metabolic syndrome of lipodystrophy. Symptoms include dyslipidaemias, insulin resistance, fat loss (lipoatrophy) and fat accumulation (lipohypertrophy). Diabetes mellitus and lipid and glycaemic abnormalities (such as increased levels of triglycerides and total cholesterol or reduced levels of high density lipoprotein [HDL] cholesterol) greatly increase the risk of atherosclerosis and myocardial infarction among antiretroviral-treated patients.
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