Finally, it is important to be aware of health initiatives aimed at older individuals in the general population (undertaken in

general practice). selleck products Men and women should be offered faecal occult blood screening for bowel cancer every 2 years between the ages of 60 and 70 years. Currently, all women aged 50–70 years in the UK are offered a routine breast-screening test every 3 years by their GP. There are plans to extend the age range for routine breast screening to include women from age 47 to 73 years. For women under the age of 50 years, screening should also be considered if there is: a history of breast cancer in the past; a first-degree relative (mother or sister) who has had breast cancer at a young age. Enquiries regarding other health interventions/new diagnoses and co-prescribed medications should be made at all routine visits (III). Consider a lower threshold for TDM (IV). In patients with symptoms of cognitive decline, consider and investigate HIV-related as well as alternative causes (IV). Routine bone density scanning in women over 65 years and in men over 70 years of age (III). Although needle

and syringe sharing selleck has declined within the UK in recent years, around one-quarter of injecting drug users (IDUs) continue to share needles and syringes. Injection of crack cocaine is now more common and this is associated with risky injection practice. In 2006, injecting drug use was the attributed risk factor for HIV acquisition in 176 individuals newly diagnosed as HIV positive [3]. In those continuing to inject, risk reduction by evaluation of injection technique should be considered. Discussion about the use of clean needles,

syringes and mixing equipment is important not only to influence the risk of acquisition of other infections but also to reduce the risk of onward transmission of HIV to injecting 6-phosphogluconolactonase partners. Easy access to needle exchange programmes should also be facilitated for those actively injecting. Knowing which drugs are being taken is important particularly in relation to interactions with ART (e.g. between opiates such as methadone and NNRTIs/PIs). IDUs as a group are more at risk of ART failure secondary to poor adherence. Specialist assessment prior to initiation of ART and additional adherence monitoring and support in IDUs, particularly those actively injecting and with chaotic lifestyles, should be considered [4-6]. Injecting site infections are common, with around one-third of IDUs reporting having had an abscess, sore or open wound at an injecting site in the last year [3]. Staphylococcus aureus can cause disease ranging from localized soft tissue infections to severe invasive disease including septicaemia and endocarditis. Injecting drug use accounted for 1-in-5 reports of serious Group A streptococcal infections reported to the Health Protection Agency (HPA) in 2007.