Outcomes and experiences of using oral voriconazole with or without concomitant topical agents to treat refractory vulvovaginal yeast infections.

Background: We describe 11 cases of refractory vulvovaginal yeast infections (RVVYI) treated using oral voriconazole with or without concomitant topical agents.

Methods: Retrospective case-note review of all women prescribed oral voriconazole to treat RVVYI in five Sexual Health Clinics from Jan 2010-March 2020. Demographic details, clinical features, diagnostic results and treatment outcomes were collected.

Successful treatment of high-grade vulval intra-epithelial neoplasia with imiquimod 5% in a renal transplant recipient.

Organ transplant recipients are at a higher risk of pre-malignant human papillomavirus-associated lesions due to immunosuppression. The efficacy of immunomodulants such as imiquimod 5% is not yet fully evaluated in this population. We describe a case of vulval intra-epithelial neoplasia in a renal transplant recipient which was successfully treated with topical imiquimod.

Making Sense of the Chest X-ray, a hands-on Dr Paul Jenkins, Hodder Arnold Press 2005.

The chest radiograph is one of the most challenging images to interpret reliably, yet accurate film reading can be very rewarding professionally and can significantly improve patient management. These skills are important for all professionals working in acute medicine and acquiring them requires a comprehensive book collection and a wide experience but above all a good teacher.