Diagnosis and treatment of human seminal plasma hypersensitivity.

BACKGROUND: Human seminal plasma hypersensitivity is a rare disorder that is often misdiagnosed. While this disorder is well described in the allergy and immunology literature, few cases exist in the gynecologic literature. CASE: A young woman presented to our allergy clinic with recurrent vaginal burning, swelling, and itching occurring approximately 10 minutes postcoitally. Semen allergy was suspected. Using her partner's semen, intradermal testing produced 1.6-cm wheal and 6.0-cm flare. The patient underwent intravaginal desensitization, and she and her partner were instructed to have intercourse every 48 hours to maintain desensitization. At 5-month follow-up, they were practicing coitus interruptus with success. CONCLUSION: Human seminal plasma hypersensitivity may mimic chronic vaginitis. The intravaginal graded challenge, a form of immunotherapy used by allergists, remains a mainstay in treatment, but is only effective if maintained correctly.

The utilization of spirituality in occupational therapy: beliefs, practices, and perceived barriers.

Spirituality has become an increasingly important topic in healthcare and specifically in occupational therapy. This study utilized a survey design to examine occupational therapists' current beliefs and practices regarding spirituality, and to identify barriers to the use of spirituality in OT treatment. No statistically significant relationship was found between the use of spirituality and different practice settings or therapists' demographics However the participants' response indicated that the beliefs and practices regarding spirituality in occupational therapy may be changing Therapists reported discussing spiritual issues with clients more frequently than in previous studies. Lack of education or experience in taking a spiritual history was reported as the major barrier impeding the therapists' ability to incorporate spirituality into OT practice.