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1.
Pediatrics ; 153(Suppl 2)2024 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-38300009

RESUMEN

Adolescent medicine (AM) subspecialists provide primary, subspecialty, and consultative care to adolescents and young adults (AYAs). Given insufficient numbers of AM subspecialists to care for all AYAs, the workforce supports AYAs health care capacity through education, research, advocacy, and the development of policies and programs sensitive to their unique needs. A modeling project funded by the American Board of Pediatrics Foundation was developed to forecast the pediatric subspecialty workforce in the United States from 2020 to 2040 on the basis of current trends in each subspecialty. The model predicts workforce supply at baseline and across alternative scenarios, and reports results in headcount and headcount adjusted for percentage of time spent in clinical care, termed "clinical workforce equivalent." For the AM subspecialty, several scenarios were considered that modified the number of fellows and/or clinical time. The baseline model predicted low growth nationally (27% and 13% increase in total AM subspecialists and AM subspecialists per 100 000 children, respectively) and declines in AM workforce relative to population growth in census divisions with existing geographic workforce disparities. In the alternative scenarios, fellow number and clinical time changes did not significantly change predictions relative to the baseline model, but a 12.5% decrease in fellows predicted a 40% reduction in the workforce from baseline with a widening of geographic workforce disparities. On the basis of the expansive clinical and nonclinical roles of AM subspecialists and these forecasted workforce challenges, significant educational, practice, and policy changes will be necessary to bolster the supply of well-trained clinicians addressing the dynamic health care needs of AYAs.


Asunto(s)
Medicina del Adolescente , Adolescente , Adulto Joven , Humanos , Niño , Salud Infantil , Escolaridad , Derivación y Consulta , Recursos Humanos
3.
Urogynecology (Phila) ; 29(2): 104-112, 2023 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-36735421

RESUMEN

IMPORTANCE: There are limited data on the economic comparison between retropubic midurethral sling and autologous fascial sling. OBJECTIVE: This study aims to evaluate the cost-effectiveness of autologous rectus fascial sling compared with retropubic midurethral sling from both hospital and health care perspectives. STUDY DESIGN: A decision tree model was developed with 1 year of follow-up. We included variables such as objective success rate, complications and subsequent treatments, and retreatment for incontinence. The model included the index procedure and 1 retreatment for stress urinary incontinence. Cost estimates were calculated from both hospital and health care perspectives. The outcomes were expressed in incremental cost-effectiveness ratio (ICER) or cost per quality-adjusted life-year (QALY). An ICER <$50,000/QALY was considered cost-effective. RESULTS: From a hospital perspective, the overall cost of retropubic midurethral sling was higher than autologous rectus fascial sling ($2,348.94 vs $2,114.06), but was more effective (0.82 vs 0.80 QALYs). The ICER was $17,452/QALY. From a health care perspective, the overall cost of autologous rectus fascial sling was higher than retropubic midurethral sling ($4,656.63 vs $4,630.47) and was less effective. Retropubic midurethral sling was the dominant strategy, with ICER of -$1,943.32/QALY. If the success rate of autologous rectus fascial sling was ≥84.39%, or the cost of retropubic midurethral sling surgery was > $2,654.36, then autologous rectus fascial sling would become cost-effective. CONCLUSIONS: Retropubic midurethral sling is the cost-effective treatment from the hospital perspective and the dominant treatment from the health care perspective. However, changes in the costs and success rates of surgical procedures can alter the cost-effectiveness results.


Asunto(s)
Cabestrillo Suburetral , Incontinencia Urinaria de Esfuerzo , Incontinencia Urinaria , Femenino , Humanos , Incontinencia Urinaria de Esfuerzo/cirugía , Análisis Costo-Beneficio , Incontinencia Urinaria/cirugía , Resultado del Tratamiento
4.
Urogynecology (Phila) ; 28(8): 554-560, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35649241

RESUMEN

IMPORTANCE: There are limited studies evaluating the effect of preoperative interventions on postoperative bowel function after prolapse surgery. OBJECTIVE: The objective of this study was to evaluate if preoperative fiber intake reduces time to first bowel movement after surgery for pelvic organ prolapse. STUDY DESIGN: We performed a randomized controlled trial of women undergoing pelvic organ prolapse surgery between July 2019 and May 2021. Participants were recruited at their preoperative visit and randomized to receive either 3.4 g psyllium fiber supplementation twice a day for 1 week before surgery or no fiber supplementation before surgery. Postoperative bowel regimen was standardized for both groups. Participants completed a bowel diary for their first postoperative bowel movement after surgery characterized by the Bristol Stool Scale and any associated pain or urgency. The primary outcome was time to first bowel movement. Secondary outcomes included pain associated with first bowel movement. RESULTS: Eighty-four patients were enrolled in the study. Seventy-one patients had complete data for primary analysis, with 35 patients in the intervention group and 36 patients in the control group. Demographic and perioperative characteristics were similar between the groups. There was no difference found between the groups with respect to time to first bowel movement (control: 68.3 [SD, 25] hours vs intervention: 66.5 [SD, 23] hours, P = 0.749). There was no difference found with pain associated with first bowel movement (visual analog scale median [interquartile range] control: 2.0 [0.0-4.0] vs intervention: 2.0 [1.0-4.0]; P = 0.655). CONCLUSIONS: Preoperative fiber supplementation before prolapse surgery does not improve time to first bowel movement after surgery.


Asunto(s)
Prolapso de Órgano Pélvico , Procedimientos de Cirugía Plástica , Psyllium , Humanos , Femenino , Defecación , Prolapso de Órgano Pélvico/cirugía , Fibras de la Dieta , Dolor/cirugía
5.
JMIR Med Inform ; 10(6): e38482, 2022 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-35687381

RESUMEN

BACKGROUND: With the increased sharing of electronic health information as required by the US 21st Century Cures Act, there is an increased risk of breaching patient, parent, or guardian confidentiality. The prevalence of sensitive terms in clinical notes is not known. OBJECTIVE: The aim of this study is to define sensitive terms that represent the documentation of content that may be private and determine the prevalence and characteristics of provider notes that contain sensitive terms. METHODS: Using keyword expansion, we defined a list of 781 sensitive terms. We searched all provider history and physical, progress, consult, and discharge summary notes for patients aged 0-21 years written between January 1, 2019, and December 31, 2019, for a direct string match of sensitive terms. We calculated the prevalence of notes with sensitive terms and characterized clinical encounters and patient characteristics. RESULTS: Sensitive terms were present in notes from every clinical context in all pediatric ages. Terms related to the mental health category were most used overall (254,975/1,338,297, 19.5%), but terms related to substance abuse and reproductive health were most common in patients aged 0-3 years. History and physical notes (19,854/34,771, 57.1%) and ambulatory progress notes (265,302/563,273, 47.1%) were most likely to include sensitive terms. The highest prevalence of notes with sensitive terms was found in pain management (950/1112, 85.4%) and child abuse (1092/1282, 85.2%) clinics. CONCLUSIONS: Notes containing sensitive terms are not limited to adolescent patients, specific note types, or certain specialties. Recognition of sensitive terms across all ages and clinical settings complicates efforts to protect patient and caregiver privacy in the era of information-blocking regulations.

7.
J Pediatr Adolesc Gynecol ; 35(3): 267-269, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35031445

RESUMEN

The Centers for Disease Control and Prevention's Sexually Transmitted Infections Treatment Guidelines, 2021 contain new recommendations for the treatment of gonococcal, chlamydial, and trichomonas infections, as well as pelvic inflammatory disease. Providers are encouraged to broaden their screening practices by considering incorporating rectal and pharyngeal testing when indicated, as well as opt-out testing for adolescent females. The discussion of testing and counseling for genital herpes infections has been expanded.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Enfermedad Inflamatoria Pélvica , Enfermedades de Transmisión Sexual , Adolescente , Salud del Adolescente , Infecciones por Chlamydia/diagnóstico , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Humanos , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/prevención & control
8.
Female Pelvic Med Reconstr Surg ; 28(4): 220-224, 2022 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-34608033

RESUMEN

OBJECTIVE: The aims of the study were to construct uroflowmetry nomograms, evaluate uroflowmetry flow rate patterns, and graphically illustrate overlaid uroflowmetry curves in nulliparous female adult volunteers. METHODS: We performed a prospective cross-sectional study evaluating uroflowmetry curve and flow rate patterns on a cohort of nulliparous female adult volunteers. Primary outcome was construction of uroflowmetry maximum and average flow rate nomograms. Secondary outcomes included evaluation of uroflowmetry flow rate patterns and graphical illustrations of overlaid uroflowmetry curves. Uroflowmetry printouts were overlaid and used to create a model of uroflow patterns, and nomogram curves were analyzed in 5 groups based on voided volumes. RESULTS: We enrolled 164 participants and 158 had voided volumes between 50 mL and 800 mL. Participants' mean age and body mass index were 25 years and 23, respectively. Maximum and average flow rate nomograms were created, and analysis of uroflow parameters was performed. Median voided volume was 241 mL (149-431 mL), the median maximum flow was 29 mL/s (20-38 mL/s), and the median average flow was 15 mL/s (10-19 mL/s). Participants were divided into 5 groups based on voided volumes. The nomogram patterns for each voided volume group were visually different from typical nomogram patterns. CONCLUSIONS: Uroflowmetry curves and flow rates vary significantly according to voided volume. Our study suggests that in normal healthy nulliparous female adults there is likely a broader range of normal flow rates and uroflowmetry curves than what has been previously reported. Further research is needed to investigate the accuracy of these finding.


Asunto(s)
Nomogramas , Urodinámica , Adulto , Estudios Transversales , Femenino , Humanos , Estudios Prospectivos , Micción
9.
Eat Disord ; 30(6): 587-601, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34184971

RESUMEN

The study aimed to describe the progression of state anxiety in adolescents with anorexia nervosa (AN) hospitalized on a high calorie refeeding (HCR) protocol. Participants, 12-21 years, admitted for malnutrition due to AN were placed on a HCR protocol in which calories were advanced by 300 kcal/day. The State-Trait Anxiety Inventory for Children (STAIC) was given to participants within 24 hours of hospitalization and the state anxiety component of the STAIC was administered daily immediately before and after breakfast until discharge. Of 22 patients enrolled, 86% were female, mean age was 14.9 ± 2.0 years, and 95% had AN-restrictive type. The median state and trait anxiety scores at time of admission were 37.0 (28-55) and 35.5 (23-51), respectively. There was no significant difference in median pre-meal state anxiety from hospital day 1 to 6 (34.0(26-55) vs. 38.5(25-55), p-value = 0.079) or in median post-meal state anxiety from hospital day 1 to 6 (35.5(29-56) vs. 37(24-56), p-value = 0.484). Similarly, we found minimal correlation between change in caloric intake and change in pre-meal S-anxiety (Spearman correlation coefficient = -0.032) or post-meal S-anxiety (Spearman correlation = 0.032). While this was a small sample observing anxiety over one week, we found no evidence that state anxiety increased with advancing calories, providing additional support for the use of more rapid refeeding protocols.


Asunto(s)
Anorexia Nerviosa , Síndrome de Realimentación , Niño , Adolescente , Humanos , Femenino , Masculino , Anorexia Nerviosa/complicaciones , Proyectos Piloto , Ingestión de Energía , Ansiedad
10.
Cureus ; 14(11): e32070, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36600869

RESUMEN

Background Testing for sexually transmitted infections (STIs) decreased during the early months of the coronavirus disease 2019 (COVID-19) pandemic. Less is known about the extent to which screening of asymptomatic adolescents for STIs was specifically affected. Our aim was to describe the impacts of early stages of the COVID-19 pandemic on asymptomatic STI screening and overall STI testing among adolescent females aged 13 to 19. We hypothesized that screening would decrease more than overall testing. Methods We evaluated claims data from a pediatric accountable care organization responsible for approximately 40,000 adolescent females. We assessed rates of asymptomatic screening and overall testing for chlamydia and gonorrhea in this population, comparing the early pandemic to pre-pandemic levels. Results Both STI screening and overall STI testing were found to be significantly decreased during the early period of the COVID-19 pandemic compared to pre-pandemic levels. The proportion of tests billed as screening was 70% of tests for April to August 2020 (early pandemic), compared to 67% for October 2019 to February 2020 and 64% for April to August 2019, contrary to our hypothesis. Conclusion Asymptomatic screening represented a similar proportion of STI testing among this population of adolescent females during the early COVID-19 pandemic compared to pre-pandemic testing. More work is needed to understand how asymptomatic screening was proportionally maintained despite COVID-19 pandemic restrictions.

11.
Curr Probl Pediatr Adolesc Health Care ; 51(11): 101101, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34776370

RESUMEN

Patient portals are the primary means by which electronic health information (EHI) is shared with patients and families. The use of patient portals increased during the COVID-19 pandemic and may continue to rise with the implementation and enforcement of the 21st Century Cures Act that encourages facilitation of access to EHI and prohibits information blocking. Research on the use of patient portals by adolescents and their families is limited. Potential benefits of portal use to adolescents include increased engagement in their own health care, direct communication with their health care clinicians, and facilitation of transition of care to new clinicians in adulthood. Clinicians need to educate adolescents on the functions available through the portal, appropriate use and expectations for messaging through the portal, and the pros and cons of viewing EHI such as test results independently. Parental proxy access to the adolescent's portal should be carefully and thoughtfully implemented, because it poses a potential breach to confidential care via disclosure of sensitive or protected information. Adolescents who choose to deny their parents proxy access to the portal should be supported in that decision. It is important that all clinicians understand portal functionality and have strategies to optimize use within their practice. This paper provides the reader considerations and tips for portal use within this population.


Asunto(s)
COVID-19 , Portales del Paciente , Adolescente , Adulto , Comunicación , Humanos , Pandemias , SARS-CoV-2 , Adulto Joven
14.
Sex Transm Dis ; 48(11): 828-833, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-33833149

RESUMEN

BACKGROUND: Given the high risk of sexually transmitted infections (STIs) in adolescents and young adults (AYAs), this study evaluated expedited partner therapy (EPT) acceptance and STI reinfection rates in female AYA before and after availability of EPT. METHODS: The pre-EPT cohort was a 3-year (November 2012 to November 2015) retrospective chart review of female AYA positive for Chlamydia trachomatis (CT) and/or Trichomonas vaginalis (TV) before introduction of EPT. An EPT protocol for CT and TV infections was implemented after legalization in Ohio in 2016. The post-EPT cohort was a prospective review of patients positive for CT and TV for 2 years (5/2016-5/2018) after EPT introduction. We evaluated EPT acceptance and compared reinfection rates (positive test 1-6 months after initial infection) in the pre-EPT versus post-EPT cohorts and by EPT acceptance. RESULTS: Among patients offered EPT, 28% (67/237) with CT and 25% (24/97) with TV accepted EPT. There were no significant differences in the reinfection rates for CT or TV in the pre-EPT versus post-EPT cohorts (CT: 24% (57/240) vs 20% (38/192), P = 0.42; TV: 23% (22/97) versus 14% (12/87), P = 0.11). Although lower, reinfections rates were not significantly different among patients who accepted versus did not accept EPT (CT, 13% (6/48) vs 21% (23/110), P = 0.50 and TV, 6% (1/18) vs 18% (9/49), P = 0.69). CONCLUSIONS: Despite the implementation of an EPT protocol, STI reinfection rates among female AYA remained high, and many declined EPT. Further research is needed to identify barriers to the provision and acceptance of EPT and ways to address these factors.


Asunto(s)
Infecciones por Chlamydia , Gonorrea , Enfermedades de Transmisión Sexual , Adolescente , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/epidemiología , Chlamydia trachomatis , Trazado de Contacto , Femenino , Gonorrea/epidemiología , Humanos , Estudios Prospectivos , Reinfección , Estudios Retrospectivos , Parejas Sexuales , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/epidemiología , Adulto Joven
15.
Female Pelvic Med Reconstr Surg ; 27(2): 85-89, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-31033527

RESUMEN

OBJECTIVES: The objective of our study was to determine if phenazopyridine reduces void trial (VT) failure rates after prolapse surgery. METHODS: A single-institution randomized controlled trial was conducted comparing a second dose of phenazopyridine 200 mg on postoperative day 1 versus no additional phenazopyridine in women undergoing prolapse surgery. All subjects (including controls) received 200 mg of phenazopyridine preoperatively for ureteral patency verification. The intervention group received a second dose of phenazopyridine 200 mg the morning of postoperative day 1. The primary outcome was assessed using a standardized VT. Secondary outcomes included pain, opioid usage, urinary tract infections, and prolonged or recurrent urinary retention. An intent-to-treat analysis was performed with a χ2 test to compare failure rates between the intervention and control groups. RESULTS: We enrolled 152 women, and 76 were randomized to each group. There was no difference in VT failures between the 2 groups-34% failed without phenazopyridine on postoperative day 1, and 42% failed with phenazopyridine on postoperative day 1 (P = 0.326). Subject characteristics were similar across both groups. Pain scores immediately before the VT were 3 out of 10 in both groups (P = 0.206), with no difference in opioid consumption (P = 0.750). There were no differences in the rate of urinary tract infections or prolonged or recurrent urinary retention between the groups (P = 0.304 and P = 0.745). CONCLUSIONS: While previous studies suggested an improvement in immediate postoperative voiding with phenazopyridine, our randomized controlled trial does not support this.


Asunto(s)
Anestésicos/administración & dosificación , Prolapso de Órgano Pélvico/cirugía , Fenazopiridina/administración & dosificación , Complicaciones Posoperatorias/prevención & control , Retención Urinaria/prevención & control , Femenino , Humanos , Persona de Mediana Edad , Cuidados Posoperatorios , Premedicación
16.
Female Pelvic Med Reconstr Surg ; 27(2): e465-e468, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33009265

RESUMEN

OBJECTIVES: To evaluate the effect of bilateral pudendal nerve blockade on immediate postoperative bladder emptying after midurethral sling. METHODS: We performed a double-blinded, randomized, placebo-controlled trial of women undergoing a midurethral sling procedure between October 2017 and February of 2019. Women older than 18 years were eligible if they were undergoing a midurethral sling with no concomitant procedures and had no preoperative urinary retention. Participant demographics and medical conditions that may affect bladder emptying were recorded preoperatively. Participants were randomized to a bilateral pudendal injection of either bupivacaine or normal saline. After induction of anesthesia, the pudendal injection was administered before any incisions. No other local anesthesia was used. The primary outcome was the rate of passing a standardized void trial. Secondary outcomes included perioperative pain scores, analgesia use, and complications. RESULTS: Ninety-one participants were enrolled in the study. One patient had a delayed void trial on postoperative day 1, leaving 90 participants for the final analysis. Demographic and perioperative characteristics were similar between the groups. Adjusted logistic regression showed that the administration of a bupivacaine pudendal block led to a higher rate of void trial failure (43% vs 20%, odds ratio = 0.32, P = 0.02 adjusted for age, body mass index, and comorbidities). Postoperative pain scores and analgesia use were similar between the groups. Postoperative complications, including urinary tract infection, mesh erosion, pelvic hematoma, or urinary retention within 6 weeks were similar between the groups. CONCLUSIONS: Our prospective trial demonstrates that a bilateral pudendal blockade before midurethral sling procedure worsens postoperative bladder emptying.


Asunto(s)
Bloqueo Nervioso/efectos adversos , Nervio Pudendo , Cabestrillo Suburetral , Retención Urinaria/etiología , Adulto , Anestésicos Locales/administración & dosificación , Bupivacaína/administración & dosificación , Método Doble Ciego , Femenino , Humanos , Persona de Mediana Edad
17.
Female Pelvic Med Reconstr Surg ; 27(6): 388-392, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-32649326

RESUMEN

OBJECTIVE: The objective of this study was to determine if in-person interpreters improve patient satisfaction scores compared with phone interpreters for urogynecology office visits in limited English proficient (LEP) patients. METHODS: Portuguese and Spanish LEP subjects were randomized to phone or in-person interpreter, and a 14-item questionnaire was administered with 3 subscales assessing the primary outcome of patient satisfaction with the interpreter, physician, and nursing. Subject demographics, English proficiency, overall health status, and yearly household income were recorded. Sample size calculations indicated that a mean difference of 12 in satisfaction scores could be detected with 44 subjects per arm. Analysis was conducted using descriptive statistics, and comparisons between the intervention versus control group were analyzed using Fisher exact test, Wilcoxon rank sum test, and linear regression. RESULTS: We enrolled and randomized 106 subjects, and 82 subjects completed the study. There was a statistically significant difference in subject satisfaction between randomization groups, favoring in-person interpreters. In the as-treated analysis, the median satisfaction score for the phone interpreter group was 92.9 and 100 for in-person interpreter group (P < 0.001). Linear regression adjusted for English proficiency showed that there was a difference between median scores of 7.14 (P = 0.002). CONCLUSIONS: Portuguese and Spanish LEP patients experienced higher satisfaction scores for urogynecology office visits when in-person interpreters are used compared with a phone interpreter. Although we found a statistically significant difference between these groups, the clinical significance of our finding is less clear. This topic should continue to be investigated for the field of urogynecology and further studies are needed.


Asunto(s)
Ginecología , Dominio Limitado del Inglés , Satisfacción del Paciente , Teléfono , Traducción , Urología , Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad
18.
Lancet Child Adolesc Health ; 4(9): 699-708, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32827491

RESUMEN

Sexual and reproductive health is an important aspect of human development, but discussions with adolescents and young adults on this topic are often challenging for health-care providers. As a result, many adolescents and young adults do not receive appropriate, comprehensive sexual education, despite recognition from WHO and the UN that access to this education is a human right. Adolescents and young adults with mild to moderate intellectual or developmental disability, or both, are just as likely to be sexually active as are their peers without disability; however, these individuals are less likely to receive comprehensive sexual education. To ensure adequate comprehensive sexual education for adolescents and young adults with intellectual and developmental disabilities, sexual health educators should facilitate conversations about sexual and reproductive health that are non-judgmental and sexually inclusive. Such initiatives should use an educational framework grounded in universal design for learning, including use of multiple media types with clear, concise language and images.


Asunto(s)
Educación Sexual/métodos , Conducta Sexual , Salud Sexual/educación , Adolescente , Discapacidades del Desarrollo/psicología , Discapacidades del Desarrollo/terapia , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Discapacidad Intelectual/psicología , Discapacidad Intelectual/terapia , Masculino , Medición de Riesgo , Adulto Joven
19.
Prev Chronic Dis ; 17: E74, 2020 07 30.
Artículo en Inglés | MEDLINE | ID: mdl-32730199

RESUMEN

Medically underserved patients in rural areas are more vulnerable to poor health outcomes, including the risks associated with coronavirus disease 2019 (COVID-19). Pharmacists, student pharmacists, and other health care professionals are working together to implement new, innovative ways to deliver the same standard of care during the COVID-19 pandemic to these vulnerable patients. These services include telehealth with virtual and telephone medication therapy management sessions led by ambulatory care pharmacists and student pharmacists. Pharmacists, student pharmacists, and other health care professionals should continue to adapt to these new technologies to improve health outcomes for their patients during the pandemic.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Área sin Atención Médica , Pandemias/prevención & control , Farmacéuticos/organización & administración , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Población Rural , COVID-19 , Enfermedad Crónica , Servicios Comunitarios de Farmacia , Florida , Humanos , Administración del Tratamiento Farmacológico/organización & administración , Rol Profesional , SARS-CoV-2 , Telemedicina
20.
Ther Adv Infect Dis ; 7: 2049936120960664, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33598210

RESUMEN

Adolescents and young adults are at high risk for sexually transmitted infections (STIs). Providers have the responsibility to accurately manage these infections to prevent medical complications and the spread of STIs. This article will review the epidemiology, screening recommendations, diagnostic tests, and treatment guidelines for STIs most commonly encountered in this population: Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus, and Trichomonas vaginalis, as well as the sexually associated infection bacterial vaginosis. This review will discuss ongoing research that explores ways to improve the management of STIs in adolescents and young adults.

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