Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Más filtros












Base de datos
Intervalo de año de publicación
1.
J Pediatr Adolesc Gynecol ; 17(5): 331-9, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15581779

RESUMEN

STUDY OBJECTIVES: (1) To identify factors predictive for gonorrhea and chlamydia positivity by LCR testing based on history and physical findings encountered during the sexual abuse evaluations. (2) To compare Ligase Chain Reaction (LCR), Polymerase Chain Reaction (PCR), and culture methods in the detection of chlamydia and gonorrhea infection among prepubertal and adolescent girls referred for sexual abuse evaluations. DESIGN: Prevalence odds ratios and logistic regression analysis were used to identify factors among patients' physical symptoms and signs, history of sexual activity, and abuse characteristics that were associated with positive test results for gonorrhea and chlamydia. The Kappa statistic was used to perform pairwise comparisons of LCR, PCR, and culture identification of gonorrhea and chlamydia infection. SETTING: A specialized sexual abuse clinic in San Antonio, Texas. PARTICIPANTS: A consecutive sample of 229 girls between the ages of 6 and 20 who reported, or had indicators of, abusive genital-genital or genital-anal contact. MAIN OUTCOME MEASURES: Patients' history and physical findings predicting positive test results for gonorrhea and chlamydia infection; and relative sensitivity of testing sites (vaginal swab and urine) and methodologies (LCR, PCR, and culture) in identifying gonorrhea and chlamydia infection. RESULTS: (1) Gonorrhea infection: 3.2% of subjects were positive for gonorrhea by LCR at one or more sites; 2.4% had positive gonorrhea cultures. There was excellent agreement between vaginal swab LCR and PCR; agreement between urine samples was limited by the small number of positive tests. The sole factor that predicted gonorrhea positivity was increased number of white blood cells seen on wet mount. (2) Chlamydia infection: 11.1% of subjects were positive for chlamydia by at least one LCR test; only 0.8% had positive chlamydia cultures. Both urine and vaginal swab testing showed good agreement between PCR and LCR but not between culture and either of the newer methodologies. Factors that predicted chlamydia positivity were: patient history of consensual sexual contact, patient history of vaginal discharge, and the presence of concerning or definitive findings of genital trauma. CONCLUSIONS: While LCR, PCR, and culture techniques appeared comparable for detecting gonorrhea, LCR techniques detected significantly more patients with chlamydia infection when compared with the culture technique. PCR was comparable to LCR in detecting chlamydia infection. The LCR vaginal swab detected more patients with chlamydia and gonorrhea than the LCR urine sample. Risk factors for chlamydia and gonorrhea infection were present in most, but not all, of the children with positive LCR findings. LCR and PCR appear to detect more chlamydial and gonorrheal infections than do cultures.


Asunto(s)
Chlamydia trachomatis/aislamiento & purificación , Víctimas de Crimen , Neisseria gonorrhoeae/aislamiento & purificación , Técnicas de Amplificación de Ácido Nucleico/métodos , Adolescente , Adulto , Niño , Abuso Sexual Infantil , Preescolar , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/genética , Técnicas de Cultivo , Femenino , Gonorrea/diagnóstico , Humanos , Modelos Logísticos , Neisseria gonorrhoeae/genética , Técnicas de Amplificación de Ácido Nucleico/normas , Embarazo , Reproducibilidad de los Resultados , Texas
2.
Pediatrics ; 113(1 Pt 1): e67-9, 2004 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-14702498

RESUMEN

Many clinicians expect that a history of penile-vaginal penetration will be associated with examination findings of penetrating trauma. A retrospective case review of 36 pregnant adolescent girls who presented for sexual abuse evaluations was performed to determine the presence or absence of genital findings that indicate penetrating trauma. Historical information and photograph documentation were reviewed. Only 2 of the 36 subjects had definitive findings of penetration. This study may be helpful in assisting clinicians and juries to understand that vaginal penetration generally does not result in observable evidence of healed injury to perihymenal tissues.


Asunto(s)
Abuso Sexual Infantil/diagnóstico , Himen/anatomía & histología , Adolescente , Niño , Femenino , Humanos , Himen/lesiones , Violación/diagnóstico , Estudios Retrospectivos
3.
Child Abuse Negl ; 27(12): 1367-76, 2003 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-14644055

RESUMEN

OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate.


Asunto(s)
Maltrato a los Niños/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Familia/psicología , Adolescente , Adulto , Niño , Maltrato a los Niños/psicología , Abuso Sexual Infantil/psicología , Abuso Sexual Infantil/estadística & datos numéricos , Comorbilidad , Violencia Doméstica/psicología , Femenino , Humanos , Masculino , Prevalencia , Estudios Retrospectivos , Autorrevelación , Estados Unidos/epidemiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...