Many UK patients with gonorrhea prescribed outdated antibiotics

Many UK patients with gonorrhea are being prescribed antibiotics that are no longer recommended for treating the infection by their family doctor, reveals research published in the online journal BMJ Open. 

This failure to keep abreast of national clinical guidance is of concern, given the global threat of antibiotic resistance, say the researchers.
They base their findings on an analysis of electronic health records entered anonymously into the Clinical Practice Research Datalink-- a large database containing the health records of around 5.5 million patients registered with 680 general practices around the UK--as well as information from anonymous monitoring of sexually transmitted infections in England.
They looked particularly at how doctors in general practice had treated the two most commonly diagnosed bacterial sexually transmitted infections in England, Chlamydia and gonorrhoea, between 2000 and 2011.
GPs diagnosed an estimated 193,000 people with Chlamydia and nearly 17,000 with gonorrhoea during this period, accounting for between 9% and16% of all Chlamydia cases and between 6% and 9% of all gonorrhoea cases in England.
The number of diagnoses GPs made for Chlamydia rose substantially from 22.8/100,000 of the population in 2000 to 29.3/100,000 of the population in 2011. And the proportion of patients treated for this infection rose from around six in every 10 (60%) to almost eight out of 10 (78%).
Most (90%) were prescribed an antibiotic recommended in national clinical guidance. But this was not the case for gonorrhoea.
The number of diagnoses fluctuated between 3.2 to 2.4/100,000 of the population, while the proportion treated ranged between a third (just under 33%) and just over half (54%).
Despite being discontinued as a recommended treatment for the infection in 2005, ciprofloxacin continued to be prescribed. This antibiotic accounted for more than four out of 10 prescriptions (42%) in 2007, and one in five in 2011.
The bacterium that causes gonorrhoea, Neisseria gonorrhoeae, is adept at developing resistance to the antibiotics used to treat it, and the evidence from other research shows that over a third of gonorrhoea infections treated at sexual health clinics were resistant to ciprofloxacin, for example, while up to one in five cases may be resistant to penicillin.
The researchers conclude that GPs make an important contribution to the diagnosis and treatment of bacterial sexually transmitted infections, but while most patients with Chlamydia are treated appropriately, "significant numbers" of those infected with gonorrhoea are not.
"Treatment of infections with reduced susceptibility or resistance to the prescribed therapy may inadvertently facilitate onward transmission and risks infection complications," they write.
"Antimicrobial resistance in gonorrhoea is a global problem and may become an issue for Chlamydia in future," they warn. "Practitioners should be alert to the likelihood of revisions to national treatment guidelines and of treatment failure in their patients."

This story is taken from Science Daily

Study findings linking ovulation, racial bias questioned

Is ovulation related to higher racial bias? Despite previous studies, researchers have been unable to find any evidence that there is an increase in racial bias related to conception risk. 

In four studies, documented in their paper "In Search of an Association Between Conception Risk and Prejudice," Carlee Beth Hawkins, a doctoral student, and her co-authors were unable to find any evidence that there is an increase in racial bias related to conception risk.
Hawkins, along with Cailey Fitzgerald of the University of Virginia and Brian Nosek of the University of Virginia and the Center for Open Science, closely followed the study procedures in "Race Bias Tracks Conception Risk Across the Menstrual Cycle," published in the journal Psychological Science, but were unable to come to the same conclusions. They also sought to expand beyond racial bias toward other social groups.
"The theoretical explanation for the findings was that women with higher conception risk and therefore at higher risk of unwanted pregnancy resulting from sexual coercion, are more negative toward racial outgroups because outgroup men are more threatening and therefore more likely to be sexually coercive," Hawkins says. "This logic shouldn't hold for outgroups that aren't likely to be sexually coercive, so we shouldn't see this pattern -- or it should be reduced -- when examining attitudes toward elderly men, physically disabled men, and gay men, for example."
Being unable to replicate the original findings, though halted further studies.
"Perhaps the effect is smaller than originally proposed, so small that we couldn't find it again," Hawkins says. "Or, perhaps the effect doesn't replicate in samples or contexts outside the ones originally tested. Either way, this is useful information for this area of research."
The hope is that researchers build off of both sets of research to better understand how physiological processes may shape psychological responses or processes, and improve the way they study this subject, either through larger samples, or more diverse samples.
 

This story is taken from Science Daily

Sexual orientation, gender identity linked to eating disorders

Transgender and non-transgender lesbian, gay and bisexual students are at greater risk for eating disorders, finds a new study. The study used data from the American College Health Association–National College Health Assessment, a survey of 289,024 students from 223 U.S. universities. Researchers found that the rates of self-reported eating disorders were highest in transgender people. Heterosexual men had the lowest rates. 

he study used data from the American College Health Association-National College Health Assessment (ACHA-NCHA), a survey of 289,024 students from 223 U.S. universities. Researchers found that the rates of self-reported eating disorders were highest in transgender people. Heterosexual men had the lowest rates.

"Transgender people were more likely to report a diagnosis of an eating disorder -- bulimia nervosa or anorexia nervosa -- in the past year," said senior author Alexis Duncan, PhD, assistant professor at the Brown School. "They also reported using vomiting, laxatives or diet pills more for weight control in the past 30 days than cisgender men and women, regardless of their sexual orientation."

The ACHA-NCHA survey, the authors wrote in the study, "includes the largest number of transgender participants ever to be surveyed about eating disorders and compensatory behaviors, thus enabling us to conduct statistically powerful analyses of the relationship between gender identity, sexual orientation and eating-related pathology."

The results were published in the Journal of Adolescent Health in April. Elizabeth W. Diemer, who graduated in 2014 with a bachelor's degree in psychology in Arts & Sciences, was first author on the study.

The students self-reported their mental health, substance use, sexual behavior and nutrition history on questionnaires distributed between 2008-2011.

Of the ACHA-NCHA survey data, 268,066 students self identified as heterosexual, 5,057 as unsure, 15,422 as bisexual, lesbian or gay, and 479 as transgender.

Transgender students were found to have significantly greater odds of past-year eating disorder diagnosis, past-month diet pill use and past-month vomiting or laxative use compared to cisgender heterosexual women.

Transgender participants also were significantly more likely than members of any other group, including cisgender sexual minorities, to report past-year eating disorder diagnosis and past-month compensatory behaviors.

"I don't think that this is particularly surprising to the LGBTQ community and/or to clinicians that work with members of this community," Duncan said. "There is a lot of anecdotal evidence of eating disorders among transgender people; however, there have been few previous studies that have compared transgender people to cisgender people, and to our knowledge, no single previous study has compared transgender people to both cisgender heterosexual and sexual minority individuals."

This story is taken from Science Daily

Female cystic fibrosis patients need more contraceptive guidance, study finds

Only half of women with cystic fibrosis report using contraception and frequently apt to become pregnant unintentionally, according to a new study. As recently as the 1960s, children with cystic fibrosis -- an inherited disease that causes thick, sticky mucus to form in the lungs, pancreas, and other organs -- often died before attending elementary school. Today many people with the disease live into their 30s, 40s and beyond. 

"As the median age of survival for women with cystic fibrosis rises, reproductive health is becoming increasingly important in this population," said lead author Andrea H. Roe, MD, an OB/GYN resident at the Hospital of the University of Pennsylvania. "While this once was not an issue, what we found is that participants in our study are sexually active, but contraceptive use is inadequate."
The researchers used a survey to assess reproductive health and quality of life in patients with cystic fibrosis. Female participants aged 18 to 45 years were recruited through the electronic mailing list of the Penn Adult Cystic Fibrosis Program. Among 53 women surveyed, 83 percent reported being sexually active and 27 percent said they had been pregnant. Twenty-two percent of reported pregnancies were terminated, due to either unplanned pregnancy or suboptimal health status. Forty-nine percent of participants said they use contraception, compared to 65 percent of women in the same general U.S. population. Furthermore, women with more severe CF disease were revealed to be less likely to use contraception. Condoms and oral contraceptive pills were the most commonly used methods.
"With less than half reporting that they use contraception, there is clearly a significant unmet need for contraception in this population," said senior author Courtney A. Schreiber, MD, MPH, an associate professor of Obstetrics and Gynecology at Penn. "Participants said they prioritize effectiveness and ease of use in their contraceptive method. They also want to avoid side effects and diminished sexual enjoyment. It's important that physicians working with this population discuss these matters with them so that women with CF can avoid unintended pregnancy, especially in the context of a heritable disease that may be exacerbated by pregnancy. Pregnancy planning is important in the population."
 

This story is taken from Science Daily