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WashU Study Group: STIs in ED

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27 papers 0 to 25 followers
Catherine M Smith, Lynsey Emmett
No abstract text is available yet for this article.
August 2016: Sexually Transmitted Infections
Sara A Lolar, Robert L Sherwin, Duane M Robinson, Cheryl Courage, Robert D Welch
OBJECTIVES: There is a high incidence of asymptomatic sexually transmitted infections (STIs) in emergency department (ED) patients. There is no historical indication, physical examination finding, or rapidly available laboratory testing specific for detecting STIs in women. This study was conducted to describe the performance of an ED call-back system for STI screening and linkage to care for treatment. Success was defined as the ability to contact STI-positive women who were undertreated and confirm their return for definitive treatment...
May 2015: Southern Medical Journal
Kari Schneider, Michael FitzGerald, Terri Byczkowski, Jennifer Reed
BACKGROUND: Because adolescents rely heavily on emergency services for health care, a pediatric emergency department (PED) visit may be their only opportunity for sexually transmitted infection (STI) screening. The primary objectives of this study were to determine the proportion of Neisseria gonorrheae (GC) and Chlamydia trachomatis (CT) infections in asymptomatic PED adolescents and patient-perceived barriers to STI screening. METHODS: A convenience sample of patients aged 14 to 21 years presenting to an urban PED with nongenitourinary complaints was offered screening for GC and CT...
April 2016: Sexually Transmitted Diseases
Arlene C Seña, Katherine K Hsu, Nancy Kellogg, Rebecca Girardet, Cindy W Christian, Judith Linden, William Griffith, Anne Marchant, Carole Jenny, Margaret R Hammerschlag
Survivors of sexual assault are at risk for acquiring sexually transmitted infections (STIs). We conducted literature reviews and invited experts to assist in updating the sexual assault section for the 2015 Centers for Disease Control and Prevention sexually transmitted diseases (STD) treatment guidelines. New recommendations for STI management among adult and adolescent sexual assault survivors include use of nucleic acid amplification tests (NAATs) for detection of Trichomonas vaginalis by vaginal swabs; NAATs for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from pharyngeal and rectal specimens among patients with a history of exposure or suspected extragenital contact after sexual assault; empiric therapy for gonorrhea, chlamydia, and trichomoniasis based on updated treatment regimens; vaccinations for human papillomavirus (HPV) among previously unvaccinated patients aged 9-26 years; and consideration for human immunodeficiency virus (HIV) nonoccupational postexposure prophylaxis using an algorithm to assess the timing and characteristics of the exposure...
December 15, 2015: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Shwetha Sequeira, Jake R Morgan, Maura Fagan, Katherine K Hsu, Mari-Lynn Drainoni
BACKGROUND: We examined quality of care across different clinical settings within a large safety-net hospital in Massachusetts for patients presenting with penile discharge/dysuria or vaginal discharge. METHODS: Using a modified Delphi approach, a list of sex-specific sexually transmitted infection (STI) quality measures, covering 7 domains of clinical care (history, examination, laboratory testing, assessment, treatment, additional screening, counseling), was selected as standard of care by a panel of 5 STI experts representing emergency department (ED), obstetrics/gynecology (Ob/Gyn), family medicine (FM), primary care (PC), and infectious disease...
December 2015: Sexually Transmitted Diseases
Elissa M Schechter-Perkins, Dareema Jenkins, Laura F White, Patricia M Mitchell
BACKGROUND: The aim of this study was to determine the proportion of patients treated appropriately, both presumptively in the emergency department (ED), and at follow-up, among those patients who ultimately tested positive for either Neisseria gonorrhoeae (NG) or Chlamydia trachomatis (CT). Secondary aims were to characterize patients who received appropriate presumptive antibiotic treatment of both NG and CT at the time of ED visit and to compare them to patients who did not receive appropriate presumptive therapy...
July 2015: Sexually Transmitted Diseases
Colleen E Holley, Thuy Van Pham, Heather M Mezzadra, George C Willis, Michael D Witting
BACKGROUND: Infections with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the most commonly reported sexually transmitted diseases in the United States. OBJECTIVES: The primary objective of this study was to estimate the incidence of overtreatment of GC and CT infections in the emergency department (ED). The secondary objective was to determine if there are clinical variables that predict infection with GC and CT. METHODS: A retrospective medical record review was performed at 2 inner-city hospitals...
September 2015: American Journal of Emergency Medicine
Jennifer L Reed, Mohsin A Zaidi, Tiffany D Woods, Justin R Bates, Maria T Britto, Jill S Huppert
STUDY OBJECTIVES: To understand Emergency Department (ED) utilization patterns for women who received sexually transmitted infection (STI) testing and explore the impact of post-visit telephone contact on future ED visits. DESIGN, SETTING, PARTICIPANTS: We performed a secondary analysis on a prospectively collected dataset of ED patients ages 14-21 years at a children's hospital. INTERVENTIONS AND MAIN OUTCOME MEASURES: The dataset documented initial and return visits, STI results, race, age and post-visit contact success (telephone contact ≤7 days of visit)...
June 2015: Journal of Pediatric and Adolescent Gynecology
Jennifer L Reed, Jill S Huppert, Regina G Taylor, Gordon L Gillespie, Terri L Byczkowski, Jessica A Kahn, Evaline A Alessandrini
PURPOSE: To improve adolescent notification of positive sexually transmitted infection (STI) tests using mobile phone technology and STI information cards. METHODS: A randomized intervention among 14- to 21-year olds in a pediatric emergency department (PED). A 2 × 3 factorial design with replication was used to evaluate the effectiveness of six combinations of two factors on the proportion of STI-positive adolescents notified within 7 days of testing. Independent factors included method of notification (call, text message, or call + text message) and provision of an STI information card with or without a phone number to obtain results...
November 2014: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
Fahd A Ahmad, Donna B Jeffe, Katie Plax, Karen K Collins, Kenneth B Schechtman, Dwight E Doerhoff, Jane Garbutt, David M Jaffe
STUDY OBJECTIVE: National guidelines recommend annual Chlamydia trachomatis and Neisseria gonorrhoeae screening for sexually active youth at risk for infection. These infections have serious sequelae in women if untreated, and methods to improve testing are needed. We hypothesize that an electronic method of identifying at-risk youth will significantly increase testing for these sexually transmitted infections during emergency department (ED) visits. METHODS: We developed an audio-enhanced computer-assisted self-interview (ACASI) to obtain sexual histories from ED patients and an embedded decision tree to create a sexually transmitted infection testing recommendation...
October 2014: Annals of Emergency Medicine
Monika K Goyal, Cynthia J Mollen, Katie L Hayes, Jennifer Molnar, Cindy W Christian, Philip V Scribano, Jane Lavelle
OBJECTIVES: The objectives of this study were to describe the experience of a novel pediatric sexual assault response team (SART) program in the first 3 years of implementation and compare patient characteristics, evaluation, and treatment among subpopulations of patients. METHODS: This was a retrospective chart review of a consecutive sample of patients evaluated at a pediatric emergency department (ED) who met institutional criteria for a SART evaluation. Associations of evaluation and treatment with sex, menarchal status, and presence of injuries were measured using logistic regression...
September 2013: Pediatric Emergency Care
Jill S Huppert, Regina G Taylor, Sarah St Cyr, Elizabeth A Hesse, Jennifer L Reed
OBJECTIVES: We aimed to examine the impact of a point-of-care (POC) test on overtreatment and undertreatment of sexually transmitted infections (STIs) by comparing treatment patterns for gonorrhoea (detected with nucleic acid amplification testing (NAAT)) with trichomoniasis (detected by POC test) for young women seen in an emergency department (ED). METHODS: We reviewed the database of a quality improvement (QI) project that aims to improve follow-up care for STIs in the ED...
September 2013: Sexually Transmitted Infections
Roman Krivochenitser, Jeffrey S Jones, David Whalen, Cynthia Gardiner
STUDY OBJECTIVES: The purposes of this study were to (1) quantify the frequency of underrecognized Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) infections in pregnant women tested in the emergency department (ED), (2) describe the characteristics of those not treated during the initial visit, and (3) determine how many pregnant women with acute cervicitis were lost to follow-up. METHODS: This was a retrospective, cohort analysis of consecutive women seen in the ED of 3 academic medical centers during a 36-month study period, with positive results for GC/CT...
April 2013: American Journal of Emergency Medicine
Gordon Lee Gillespie, Jennifer Reed, Carolyn K Holland, Jennifer Knopf Munafo, Rachael Ekstrand, Maria T Britto, Jill Huppert
The purpose of this study was to describe the perceptions of pediatric emergency care providers in relation to implementing a universal sexually transmitted infection screening process for adolescent female patients in a pediatric emergency department. A descriptive qualitative design was used with a convenience sample of pediatric emergency physicians and nurses working in a large urban, pediatric teaching hospital. Participants were individually interviewed using a standard interview guide. Verbatim transcripts were analyzed using a modified constant comparative analysis method...
January 2013: Advanced Emergency Nursing Journal
Monika Goyal, Katie Hayes, Cynthia Mollen
OBJECTIVES: This study aimed to determine the prevalence of sexually transmitted infections (STIs) in symptomatic adolescent female patients presenting to a pediatric emergency department (ED). Secondary objectives included determining correlates of infection. METHODS: This was a prospective prevalence study of a consecutive sample of female patients aged 14 to 19 years presenting to a pediatric ED with lower-abdominal or genitourinary complaints between August 2009 and January 2010...
December 2012: Pediatric Emergency Care
Sabreen Akhter, Marc Gorelick, Kathleen Beckmann
OBJECTIVE: Human immunodeficiency virus (HIV) continues to be a significant public health concern for adolescents and young adults. Since 2006, the Centers for Disease Control and Prevention has recommended more aggressive routine screening for HIV for patients presenting to the emergency department (ED). Our objectives were to design and validate a survey of physician barriers toward the use of rapid HIV testing in the pediatric ED and then to use this validated tool to conduct a national survey of pediatric emergency practitioners' attitudes toward rapid HIV testing in the ED...
December 2012: Pediatric Emergency Care
Wiley D Jenkins, Whitney Zahnd, Regina Kovach, Patricia Kissinger
BACKGROUND: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) are the most commonly reported notifiable diseases in the United States, with annual reported cases exceeding 1.2 million and estimated costs exceeding $1.2 billion. Reported Emergency Department (ED) prevalence rates for CT and GC for adolescents and young adults range from 0.9% to 8.1%. OBJECTIVE: Our aim was to evaluate the burden of CT/GC infection in ED patients, assess the extent of associated under- and overtreatment, and investigate mechanisms whereby ED screening can be feasible...
February 2013: Journal of Emergency Medicine
Jill S Huppert, Jennifer L Reed, Jennifer Knopf Munafo, Rachel Ekstrand, Gordon Gillespie, Carolyn Holland, Maria T Britto
BACKGROUND AND OBJECTIVE: Inadequate follow-up of positive sexually transmitted infection (STI) test results is a gap in health care quality that contributes to the epidemic of STIs in adolescent women. The goal of this study was to improve our ability to contact adolescent women with positive STI test results after an emergency department visit. METHODS: We conducted an interventional quality improvement project at a pediatric emergency department. Phase 1 included plan-do-study-act cycles to test interventions such as provider education and system changes...
August 2012: Pediatrics
Lauren Faricy, Tanya Page, Mischa Ronick, Rebecca Rdesinski, Jennifer DeVoe
BACKGROUND AND OBJECTIVES: Appropriate treatment of chlamydia trachomatis (CT) sexually transmitted infections (STIs) is important. Much of this treatment is empiric, and most research on treatment patterns has been conducted in emergency department settings. Few studies have focused on CT treatment in outpatient primary care settings, especially among underserved populations. We aimed to study patterns of empiric CT treatment in an urban safety net clinic. METHODS: We examined electronic health records from all patients in whom a CT lab test was completed between January 1 and December 31, 2007 (n=1,222)...
June 2012: Family Medicine
2016-02-23 17:58:47
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