Comment: Come fly with me
Paul Woolley
pp 4-6
Nearly two decades ago I remember a patient with AIDS wanting to fly home to his country of origin in the Caribbean to die. With no drugs available to extend his life, and no test of immune dysfunction to give an estimate of remaining life expectancy, this seemed a reasonable request. However, only under extreme pressure could an airline be found that would take him.
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Chaperones - essential, unnecessary or impossible?
Karen E Rogstad
pp 7-9
The issue of chaperones for patients undergoing intimate examinations has produced heated debate since the publication of the General Medical Council’s (GMC) guidance for doctors on this topic, which recommends offering chaperones to all. The GMC’s definition of an intimate examination includes examination of the breasts, genitalia or rectum and the recommendation is that all patients undergoing such an examination be offered a chaperone, which may be a friend or relative.
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Female incontinence part 1 – pharmacological treatments
Dudley Robinson and Linda D Cardozo
pp 11-14
Urinary incontinence, the ‘complaint of any involuntary leakage of urine’, is a common and distressing condition known to adversely affect quality of life. While the prevalence of urinary incontinence has been found to vary widely depending on the definition used, a recent large-scale epidemiological study found that 25% of women complain of urinary leakage and 7% had significant incontinence that was bothersome. In economic terms, the cost is also considerable, with over $26 billion being spent per annum on treatment in the USA alone.
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Colposcopy – from accident to screening programme
Tim R Moss
pp 16-18
In 2002, the number of deaths from invasive cervical cancer in England fell below 1,000 for the first time. This was the result of a successful screening programme that evolved from two completely divergent areas of scientific research in the early part of the 20th century. These later converged by coincidence, allowing population screening for cervical dysplasia.
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The 'one stop shop' service – a case study in patient care
Angela Ellis
pp 20-22
A young woman entered the bright, modern reception area. She was clearly distressed and kept repeating the phrase, ‘At 34, you would think one would know better’. The nurse called the patient by her first name, checked her details and introduced herself. The consultation at the nurse-led contraceptive clinic began with the nurse explaining the clinic remit and confidentiality process. The patient’s medical history was uneventful, although her sexual history revealed two sexual partners. The first was her ex-husband whom, she revealed later in the consultation, had been ‘playing the field’. The second partner had resulted from a casual holiday romance.
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Pearly penile papules – cause for confusion and concern
Mrinalini Mahto
pp 24-26
Pearly penile papules (PPPs) are normal skin coloured, white or red, smooth, dome-shaped or conical papules (between 1–3 mm in diameter and 1–4 mm in length) arranged in one or several orderly rows located circumferentially over the corona and/or the sulcus of the glans penis. They may also present on the under-surface near the frenulum. Clinically, they resemble the papular variant of genital condylomata. They commonly present to sexually transmitted infection (STI) clinics as one of the minor ‘rarities’, yet they are the source of much anxiety for worried adolescents.
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Discovering pleasure in pain
H Robert Johnston
pp 28-29
Sadism and salvation, torture and tenderness, martyrdom and mercy: these are the subjects of Pain: Passion, Compassion, Sensibility – the first major exhibition to explore the cultural and historical impact of pain, as well as its medical and scientific aspects. Pain is the most common presenting complaint at every general practice and dentist; pharmacies are stocked to their ceilings with analgesic drugs, devices and potions. Newspaper advertisements and complementary therapists promise pain relief by means of copper bracelets, magnets, homeopathic sugar pills, acupuncture, crystals, reflexology and ground-up beetles masquerading as herbal medicine.
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Clamping in progress
David Hicks
pp 31-31
As a genitourinary physician, a cornucopia of subjects related to human sexual behaviour (usually the price paid for it) is available in the post every morning. Thankfully, this variety persists, but in my other job as medical director, a different, some might think uninteresting, fare awaits. Some of the correspondence may sound dry and formal but closer reading can pay dividends. A recent Medical Device Alert published by the Medicines and Healthcare products Regulatory Agency (MHRA) concerned bath and shower seating equipment.
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