Higher Incidence Of Positive Tests Research Articles

Embedding a Novel Screening Programme for Sexually Transmitted Infections Within an Ambulatory Emergency Surgical Admissions Unit: An Observational Cohort Study

Abstract Aims To establish a sexually transmitted infection (STI) screening programme for females presenting to an Emergency Ambulatory Surgical Clinic (ASC), and to analyse incidence and prevalence of STIs as an underlying cause for their abdominal pain. Methods Observational cohort study in ASC of a tertiary hospital. Between December 2021 to December 2022, females aged 18-44 years presenting with abdominal pain were offered self-collected vulvovaginal swabs for chlamydia and gonorrhoea as part of a new standardised diagnostic pathway. Positive results were referred to local sexual health services for treatment and contact tracing. Main outcome measures included number of patients consenting to the screening programme and number of positive swab results. Results The cohort comprised 297 eligible patients; 259 with 20 patients declining testing and 18 samples rejected. A total of 5.4% of swabs were positive (2 gonorrhoea, 12 chlamydia) with mean age of 24.5. All positive patients presented with lower abdominal pain and of these, only 25% had a documented sexual history during assessment. 7 had further imaging with 4 results diagnosing pelvic inflammatory disease (PID). 4 patients were treated for PID empirically. Remaining patients were treated for non-specific pain or unrelated pathology. Conclusions Undiagnosed STIs are prevalent, and have known fertility and public health risks. Young females with lower abdominal pain provide an opportunistic and arguably necessary screening cohort in ASC with good uptake of self-testing. Results demonstrate high incidence of positive tests, suggesting that inclusion of sexual history during assessment is vital to identify those with highest STI risk.

WTP7.7 A novel sexually transmitted infection (STI) testing and screening programme in an Ambulatory Surgical Clinic (ASC) for female patients presenting with abdominal pain

Abstract Aims Methods Women aged 18-44 years presenting to ASC were offered a voluntary self-collected high vulvovaginal swab for chlamydia and gonorrhoea at triage. Data was collected over one year (Dec 2021-Dec 2022). Testing was offered to 299 patients, 20 declined to participate and 18 samples were rejected. Positive results were referred to the Sexual Health service for treatment and contact tracing as agreed on a pre-planned referral pathway. Results 5.4% of swabs were positive (2 Gonorrhoea and 12 Chlamydia). The mean age of those testing positive was 24.5. All positive patients presented initially with lower abdominal pain. Of those testing positive 7 had further imaging (USS pelvis) and only 25% had a documented sexual history taken. 4 women had diagnostic imaging indicative of PID and 4 patients were treated for PID empirically. The remaining patients were treated for non-specific abdominal pain or unrelated pathology. Conclusions Undiagnosed sexually transmitted disease is prevalent and young females presenting with lower abdominal pain provide an excellent testing cohort. Given the high incidence of positive tests, further training of surgeons to consider and ask pertinent questions regarding an STI diagnosis is vital. The introduction of self-swab testing has been successful in assisting as a diagnostic tool and screening programme.

めまい患者におけるＳｃｈｅｌｌｏｎｇ ｔｅｓｔの再検討

We analyzed the results of Schellong tests of 192 patients seen in our out-patient clinic for complaints of dizziness or vertigo.The dizzy patients of indeterminate etiology had a significantly higher incidence of positive Schellong tests than did healthy controls. In contrast, patients with peripheral vestibular disorder had only a slightly higher incidence of positive tests than did normal subjects.These results suggest the following: 1) a substantial number of patients with orthostatic dysregulation or hypotension may be included in the group of patients with diz-ziness of indeterminate etiology; 2) since peripheral vestibular dysfunction generally causes intermittent symptoms, patients with this disorder tend to be asymptomatic or to have an entirely normal physical examination during their visits to the clinic, and test results similar to those of normal healthy individuals; 3) the main drawback of the Schellong test in clinical practice is that a number of healthy subjects show positive results (the false-positive rate was estimated from our previous data to be about 30% in normal subjects). This relatively poor specificity may prevent the obtaining of clear-cut data from the test results.

HIV antibodies in beggar blood donors in Rio de Janeiro, Brazil - II

The prevalence of HIV antibodies, as well as evidence of hepatitis B, syphilis, and Chagas' disease, was tested in 87 male and 13 female clients of a church-funded medical clinic in Rio de Janeiro who often donated blood to commercial blood banks. 5 individuals were seropositive for HIV, 2 homosexuals, 1 bisexual, and 2 heterosexuals. 21 had evidence of hepatitis B, including 2 with HBsag antibodies. 13 tested positive for syphilis, and 5 were positive for T. cruzi (Chagas' disease). The high incidence of positive tests for hepatitis B and Chagas' disease was possibly due to donation by plasmapheresis, which has been suspected to cause outbreaks of non-A, non-B hepatitis and malaria in this area. The practice of selling contaminated blood to unsuspecting recipients should be prevented no matter how high the cost.

HIV antibodies in beggar blood donors in Rio de Janeiro, Brazil.

The prevalence of HIV antibodies as well as evidence of hepatitis B syphilis and Chagas disease was tested in 87 male and 13 female clients of a church-funded medical clinic in Rio de Janeiro who often donated blood to commercial blood banks. 5 individuals were seropositive for HIV 2 homosexuals 1 bisexual and 2 heterosexuals. 21 had evidence of hepatitis B including 2 with HBsag antibodies. 13 tested positive for syphilis and 5 were positive for T. cruzi (Chagas disease). The high incidence of positive tests for hepatitis B and Chagas disease was possibly due to donation by plasmapheresis which has been suspected to cause outbreaks of non-A non-B hepatitis and malaria in this area. The practice of selling contaminated blood to unsuspecting recipients should be prevented no matter how high the cost.

Factors influencing the diagnostic sensitivity of the exercise test in coronary artery disease.

A continuous multistage bicycle ergometer test was performed on 50 patients with coronary artery disease. Selective cinecoronary angiography and left ventriculography were performed within a week of the test in all patients. Overall, 62% had a positive ischemic response, defined as 1 mm or greater depression of the ST segment. Patients with 75% or greater stenosis in any vessel and those with triple-vessel involvement had a higher incidence of positive tests. Those with low systolic ejection fractions and areas of asynergy had fewer positive tests than patients with normal ejection fractions and normal or minimal segmental wall motion abnormalities. The level of exercise, location of arterial disease and the presence of collateral blood supply to the diseased vessels did not appear to influence the sensitivity of the exercise stress test.

Increased incidence of positive tests for estrogen binding in mammary carcinoma specimens transported in liquid nitrogen.

Use of a liquid nitrogen container for convenient transport of frozen mammary carcinoma tissue for hormone-receptor assays is described. The container can be used in dry or wet mode and is appropriate for all types of transport, including air. Experience shows a significantly higher incidence of positive tests on specimens transported by this means than on specimens transported in dry ice.

Tests for so-called capillary fragility of the skin and the significance of positive tests in vascular disease

Positive capillary fragility or positive tourniquet tests are terms used loosely to describe intracutaneous hemorrhage produced by standardized doses of trauma (suction or venous compression). These tests for capillary fragility are crude and cannot be performed accurately by counting petechiae. Sources of error are numerous and can be overcome only by making numerous tests on different days. In the recorded results of this paper intracutaneous hemorrhage in the test is graded one to four plus. Inconstant and inconclusive results have been discarded. A higher incidence of positive tests is found in older patients. Patients with diabetes mellitus which coexisted with hypertension or other vascular disease showed an extremely high incidence of positive capillary fragility tests and this corresponds to the well known high incidence of spontaneous retinal and skin hemorrhages in such patients. All patients with hypertension and also those with arteriosclerotic disease without hypertension showed moderately high incidence of positive fragility tests.

Toxplasma Neutralizing Antibody in Human Beings and Morbid Conditions Associated With It

SummaryA standardized procedure for carrying out the toxoplasma neutralization test in rabbits was described. The sera of 59 of 151 selected individuals were positive. A very high incidence of positive tests was found in infants and children presenting psy-chomotor disturbances with or without hydro-cephalus or microcephaly only when these were associated with cerebral calcification or chorioretinitis in the macular region or both. The congenital character of the disease was confirmed by the regular presence of these antibodies in the mothers of the affected children. Chorioretinitis affecting predominantly the macular region, and resembling that seen in cases of proved congenital toxoplasmosis, but occurring in otherwise apparently normal children and adults was associated with neutralizing antibodies for toxoplasma in 9 of 10 individuals. Certain other morbid conditions associated with toxoplasma neutralizing antibodies were also briefly described.