ABSTRACT
AIMS: Our primary aim was to determine the rate of overseas travel in immunocompromised individuals attending appropriate clinics at an Australian tertiary care hospital. We also aimed to characterise health-seeking behaviour prior to travel and investigated sources of pre-travel advice, compared travel patterns and activities between three specific immunosuppressed groups, and examined pre-immunosuppression patient serology. METHODS: We implemented a cross-sectional survey of patients between February and August 2012. This survey was implemented among three outpatient populations at Monash Medical Centre, an Australian tertiary care hospital. RESULTS: We recruited 254 immunosuppressed adults from three patient populations: human immunodeficiency virus-positive individuals, renal transplant patients and rheumatology patients requiring immunosuppressive therapy. No clinical intervention was performed. In the 10 years preceding the survey, 153 (60.2%) participants reported international travel. Of these, 105 (68.6%) were immunosuppressed at the time of travel. These patients were 47.6% male and 60% Australian born. Forty per cent were visiting friends and relatives as part of their travel. Fifty-four per cent of those immunocompromised at the time of travel were going to high-risk destinations. Pathology files indicated that serological screening was frequently not performed prior to immunosuppression in the renal transplant and rheumatology groups. CONCLUSIONS: Immunocompromised patients often travel to high-risk destinations with limited or inadequate pre-travel preparations. Doctors caring for the immunocompromised should be aware of travel risks, suitable vaccination protocols and when to refer to specialist travel clinics.
Subject(s)
Communicable Disease Control/methods , Health Knowledge, Attitudes, Practice , Immunocompromised Host/immunology , Internationality , Travel , Communicable Diseases/epidemiology , Communicable Diseases/immunology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Patient Education as Topic/methods , Retrospective Studies , Risk Factors , Travel/psychologyABSTRACT
We report three cases of immigrants to Australia, living with HIV/AIDS, who, while travelling in countries of origin or migration, were unable to continue to take their antiretrovirals appropriately. We discuss the possible reasons for this and ways to reduce the possibility of it happening. Travel may be a significant risk factor for non-adherence; pre-travel advice and planning might help to prevent it occurring.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Infections/drug therapy , Medication Adherence/psychology , Travel , Adult , Australia , Emigrants and Immigrants , Family , Female , Friends , Humans , Male , Middle Aged , Risk AssessmentABSTRACT
We have observed one case of adenomyoepithelioma of the breast in a 65-years-old woman. Mammography was suspicious of malignancy. Morphological features were characteristic of this tumor. The origin of tumor cells was defined by immunohistochemical study using keratin and actin. The follow-up is not sufficient to predict the prognosis of our case.
Subject(s)
Adenomyoma/pathology , Breast Neoplasms/pathology , Carcinoma/pathology , Adenomyoma/surgery , Aged , Breast Neoplasms/surgery , Carcinoma/surgery , Female , Humans , Immunohistochemistry , MastectomyABSTRACT
191 patients with signs of threatened abortion were assessed by means of ultrasound (Kretz-Technik, Vidoson, Siemens) and semiquantitative assay of urinary HCG-excretion. Sonar examination was able to establish an accurate diagnosis of fetal life (heart action and/or movements) in all pregnancies showing a gestation sac suitable to the 11th week. The remainder cases required a repeated investigation including HCG-levels and growth rate of the gestational sac. Thus the diagnosis of blighted ovum could be made within one or occassionally two weeks.
