Preventive health screening in adolescent patients.

This article describes an approach to health screening and promotion in adolescents. Key concepts in interviewing adolescents are presented along with practical suggestions for health education. Emphasis is given to psychosocial topics that contribute to morbidity in adolescents that is potentially preventable.

Comparison of three new nonculture tests in the diagnosis of Chlamydia genital infections.

This study compares three new rapid nonculture tests to cell culture with passage for the diagnosis of Chlamydia genital infections in sexually active adolescent and young adult females. Two hundred consecutive patients having a pelvic examination had cervical samples taken for the following: Papanicolaou smear, gonorrhea culture, Chlamydia cell culture, direct fluorescent antibody (DFA; Difco), isotopic DNA probe (Gen-Probe), and enzyme immunoassay (EIA; IDEIA III, Novo BioLabs). After resolution of discrepant results, 25 of the specimens were judged to be positive. The DFA identified 17 of the 25, with 3 false-positive results; the DNA probe identified 20 of the 25, with no false positive results; and the EIA identified 22 of the 25, with one false-positive result. The sensitivities, specificities, and positive and negative predictive values, respectively, were DFA, 68%, 98.2%, 85%, 95.5%; DNA probe, 80%, 100%, 100%, 97.2%; and EIA, 88%, 99.4%, 95.6%, 98.3%. These new rapid nonculture tests are comparable and relatively reliable, with trends favoring the EIA and the DNA probe. Further studies with larger samples are needed to determine their clinical utility.

Single dose enoxacin for the treatment of uncomplicated urogenital gonorrhea.

Enoxacin, a new broad spectrum azaquinolone, has demonstrated in-vitro activity against Neisseria gonorrhoeae including penicillinase producing strains. We evaluated the safety and efficacy or oral enoxacin 400 mg versus intramuscular ceftriaxone 250 mg for the treatment of uncomplicated genital N. gonorrhoeae infections. Of the 57 patients enrolled, 48 patients (26 men, 22 women) were culture positive and returned for the follow up visit. Six patients (12.5%) had penicillinase producing strains of N. gonorrhoeae, and eleven patients (23%) had concomitant Chlamydia trachomatis infections. Genital gonorrhea was eradicated in 98% of the patients, with a cure rate of 22/23 (96%) in the enoxacin group and 25/25 (100%) in the ceftriaxone group. There were no consequential side effects noted for either agent. Oral enoxacin is a safe and efficacious alternative for the treatment of uncomplicated N. gonorrhoeae infections.

Evaluation of two rapid tests for the diagnosis of Chlamydia trachomatis genital infections.

The performance of two new enzyme immunoassays (EIA) for the detection of Chlamydia trachomatis in a practice setting was compared. A consecutive series of 207 female patients seen at an inner-city sexually transmitted disease clinic were tested by cell culture, the Kodak SureCell (SC) and Abbott TestPack Chlamydia (TP) EIAs. In addition 210 male patients, selected by physicians on the basis of the fact that multiple urethral samples could be obtained, were tested by cell culture and SC. The prevalence of infection was 19% in the females and 12.5% in males. The sensitivity, specificity, positive predictive value and negative predictive value for the SC and TP were 88%, 95%, 81%, 97% and 59%, 99%, 95%, 91%, respectively, in the female population. The sensitivity of the SC was significantly greater than that of the TP (p less than or equal to 0.002). The performance values of the SC in men (in the same order) were 64%, 96%, 71% and 95%, respectively. The SC in male patients and the TP in female patients had low sensitivity. The sensitivity of the SC in female patients was significantly higher than that of the TP. However, the SC yielded more false positive results. To determine the utility of these tests in a practice setting further studies are required.