The communication of a secondary care diagnosis of autoimmune hepatitis to primary care practitioners: a population-based study

Background Autoimmune Hepatitis is a chronic liver disease which affects young people and can result in liver failure leading to death or transplantation yet there is a lack of information on the incidence and prevalence of this disease and its natural history in the UK. A means of obtaining this information is via the use of clinical databases formed of electronic primary care records. How reliably the diagnosis is coded in such records is however unknown. The aim of this study therefore was to assess the proportion of consultant hepatologist diagnoses of Autoimmune Hepatitis which were accurately recorded in General Practice computerised records. Methods Our study population were patients with Autoimmune Hepatitis diagnosed by consultant hepatologists in the Queens Medical Centre, Nottingham University Hospitals (UK) between 2004 and 2009. We wrote to the general practitioners of these patients to obtain the percentage of patients who had a valid READ code specific for Autoimmune Hepatitis. Results We examined the electronic records of 51 patients who had biopsy evidence and a possible diagnosis of Autoimmune Hepatitis. Forty two of these patients had a confirmed clinical diagnosis of Autoimmune Hepatitis by a consultant hepatologist: we contacted the General Practitioners of these patients obtaining a response rate of 90.5% (39/42 GPs). 37/39 of these GPs responded with coding information and 89% of these patients (33/37) used Read code J638.00 (Autoimmune Hepatitis) to record a diagnosis. Conclusions The diagnosis of Autoimmune Hepatitis made by a Consultant Hepatologist is accurately communicated to and electronically recorded by primary care in the UK. As a large proportion of cases of Autoimmune Hepatitis are recorded in primary care, this minimises the risk of introducing selection bias and therefore selecting cases using these data will be a valid method of conducting population based studies on Autoimmune Hepatitis

Testicular volume and semen characteristics in the endangered southern muriqui ( Brachyteles arachnoides

Background The southern muriqui (Brachyteles arachnoides) is an endangered Neotropical primate. Semen collection and description of its traits, as well as testicular morphometry, have never been reported for this species. Methods Testicles from five healthy adult captive southern muriqui were measured, and semen was collected by rectal probe electrostimulation (RPE). Results and Conclusions A solid coagulum was identified in all ejaculates, and none of them liquefied, spontaneously or non-spontaneously. It was possible to collect semen using RPE, and although solids coagula did not liquefy, we managed to describe ejaculates characteristics and also confirmed that southern muriqui have relatively large testes size. Further investigations are needed to improve coagulum handling, to achieve a better spermatozoa recovery aiming its application in assisted reproductive technologies.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Univ Sao Paulo, Coll Vet Med & Anim Sci, Dept Anim Reprod, Av Prof Dr Orlando Marques de Paiva Ave 87, BR-05508270 Sao Paulo, SP, BrazilSao Paulo Zool Pk Fdn, Sao Paulo, SP, BrazilQuinzinho de Barros Municipal Zool Pk, Sorocaba, SP, BrazilSao Paulo State Univ, Grad Program Wild Anim, Botucatu, SP, BrazilUniv Paulista, Inst Hlth Sci, Sao Paulo, SP, BrazilBiopesca Inst, Praia Grande, SP, BrazilSao Paulo State Univ, Grad Program Wild Anim, Botucatu, SP, BrazilCAPES: 00