Sex and gender: modifiers of health, disease, and medicine

The Lancet, Volume 396, Issue 10250, 22–28 August 2020, Pages 565-582
Mauvais-Jarvis, F., et al

Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men’s and women’s health.

 

Online training: Hepatitis C in Primary Care

ASHM, August 2020

This training aims to provide participants with the knowledge and confidence to pursue the management of HCV in their primary care setting.

Primary care providers can play a critical role in the elimination of hepatitis C in Australia by 2030.

This workshop will provide an overview of the management of HCV in primary care
settings, including case finding, testing, patient assessment and treatment.

Learning Objectives:

• Identify priority populations for HCV screening
• Order and interpret tests appropriately to diagnose chronic HCV infection
• Describe the recommended pre-treatment assessment
• Demonstrate understanding of antiviral therapy for treatment of HCV
• Communicate confidently with patients about HCV

Webinar Presenter: Dr Alireza Ahmavand, General Practitioner, Arafura Medical Clinics – Casuarina

Target Audience:
General Practitioners, Nurse Practitioners, nurses, primary care-based practitioners
and other health care workers.

When: Wednesday 19 August 2020 7.30pm – 9.00pm AEST  (7 – 9.30 pm ACST)

Delivered online, free

This activity is allocated 3 activity points in the RACGP QI&CPD Program for the
2020-2022 Triennium.

For further details or assistance contact: Molly Stannard

 

‘I’m over the moon!’: patient-perceived outcomes of hepatitis C treatment

I’m over the moon!’: patient-perceived outcomes of hepatitis C treatment

Davoud Pourmarzi, Andrew Smirnov, Lisa Hall, Gerard FitzGerald, and Tony Rahman

Australian Journal of Primary Health 26(4) 319-324 https://doi.org/10.1071/PY20013

Submitted: 22 January 2020  Accepted: 29 April 2020   Published: 25 June 2020

Abstract

Understanding patient-perceived outcomes is crucial for assessing the effectiveness and acceptability of hepatitis C virus (HCV) treatment. This study aimed to explore patient-perceived outcomes of receiving direct-acting antivirals (DAAs). This study was a part of a mixed-methods case study of the Prince Charles Hospital program for improving access to HCV treatment in community settings. Data were collected using semi-structured interviews with nine patients who were in different stages of their treatment for HCV. The participants were recruited using purposive sampling. All interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Patients emphasised ‘having more energy’ when reporting improvements in their physical health following treatment. They also reported a newly developed sense of freedom and hope. Improved physical and mental health empowered them to start a healthy lifestyle and to practise self-protection from the risk of re-infection. Patients highlighted their desire to help other patients to receive treatment, which was connected to their experience of the services that they received and their perceived health outcomes. Patients expect and experience various outcomes that are related to the physical, psychological and social aspects of living with, and being cured of HCV. Emphasis on the short-term outcomes of receiving HCV treatment may improve HCV treatment uptake and adherence rates.

Case report: HIV-associated neurocognitive disorder & myelopathy in patient with preserved CD4, but high viral load

HIV-associated neurocognitive disorder and HIV-associated myelopathy in a patient with a preserved CD4, but high viral load-a rarely reported phenomenon: a case report and literature review. 

Ayele, B.A., Amogne, W. & Gemechu, L.

BMC Infect Dis 20, 574 (2020). https://doi.org/10.1186/s12879-020-05297-9

This case supports the current understanding regarding the persistent occurrence of HIV-associated neurocognitive disorder and HIV-associated myelopathy even decades after introduction of cART. Therefore, it’s important to screen HIV+ patients for the HAND and HAM even if they have relatively preserved immunity.

Because patient can be easily shifted to ART drugs with better CNS penetrating potential to achieve acceptable virological suppression level, to observe sound clinical improvement.

Hormones are not the key to younger women’s sexual function

Monash University, 22 July 2020

A Monash University study into the causes of sexual dysfunction in young women has found social factors play just as important a role as hormone levels, and hormone therapy should not be prescribed as the only treatment.

The study uncovered that while hormones, including androgens like testosterone, play a role, the things that matter more are whether a woman has children (parity), being partnered or taking psychoactive medication for depression or other mental health issues.

Diagnosis and Management of Syphilis in Patients With HIV Co-infection

Khaw, C., Malden, C., Ratnayake, M. et al. Diagnosis and Management of Syphilis in Patients With HIV Co-infectionCurr Treat Options Infect Dis (2020). https://doi.org/10.1007/s40506-020-00225-6

Published

Purpose of review

Syphilis cases are on the increase especially in men who have sex with men (MSM) in urban areas of high-income countries.

There is a strong association between syphilis and HIV infections.

We review the more recent literature regarding the epidemiology, clinical manifestations, diagnostic investigations, treatment and follow-up of syphilis in HIV infection.

  • Read abstract here (For full text access you can purchase from the publisher or see your librarian)