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2011 - Behavioural sources of repeat Chlamydia trachomati.pdf", "md5": "1256dc094a75db99bb922baf7c878bc4", "mtime": 1347989377646, "tags": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "SJH5TTCM", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/SJH5TTCM", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/SJH5TTCM", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Goyal et al.", "parsedDate": "2012", "numChildren": 2 }, "data": { "key": "SJH5TTCM", "version": 1, "itemType": "journalArticle", "title": "Racial Disparities in Testing for Sexually Transmitted Infections in the Emergency Department", "creators": [ { "creatorType": "author", "firstName": "Monika K.", "lastName": "Goyal" }, { "creatorType": "author", "firstName": "Katie L.", "lastName": "Hayes" }, { "creatorType": "author", "firstName": "Cynthia J.", "lastName": "Mollen" } ], "abstractNote": "ACADEMIC EMERGENCY MEDICINE 2012; 19: 604–607 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives: The objective of this study was to determine predictors of sexually transmitted infection (STI) testing among adolescent females presenting to an urban pediatric emergency department (ED) with symptoms potentially suggestive of an STI.Methods: This was a secondary analysis of data collected in a prospective prevalence study of STIs among a consecutive sample of symptomatic females aged 14 to 19 years presenting to a pediatric ED with lower abdominal or genitourinary complaints. The outcome of interest was performance of an STI test. Correlates of interest included patient age, race, insurance status, chief complaint, presence of comorbid conditions, and treating physician sex.Results: Of the 328 adolescent females who presented to the ED with STI-related complaints and met inclusion criteria, 15.6% did not undergo STI testing. Univariable analysis revealed that black or African American race (odds ratio [OR] = 4.98, 95% confidence interval [CI] = 2.67 to 9.30) and nonprivate insurance (OR = 3.47; 95% CI = 1.83 to 6.58) were significantly associated with the performance of STI testing. In a multivariable model, only black or African American race (OR = 3.94; 95% CI = 1.96 to 7.91) remained significantly associated with the performance of STI testing.Conclusions: A substantial number of adolescent females who presented with complaints suggestive of an STI did not undergo STI testing, and a racial disparity in STI testing was noted. The racial disparity in rates of STI testing among symptomatic adolescent girls presenting to the ED warrants further study to confirm validity, to determine if disparity reflects physicians’ biases, and to inform strategies for controlling the present epidemic of STIs in adolescents.", "publicationTitle": "Academic Emergency Medicine", "publisher": "", "place": "", "date": "2012", "volume": "19", "issue": "5", "section": "", "partNumber": "", "partTitle": "", "pages": "604–607", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1111/j.1553-2712.2012.01338.x", "citationKey": "", "url": "http://onlinelibrary.wiley.com/doi/10.1111/j.1553-2712.2012.01338.x/abstract", "accessDate": "2012-09-18T18:01:48Z", "PMID": "", "PMCID": "", "ISSN": "1553-2712", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "en", "libraryCatalog": "Wiley Online Library", "callNumber": "", "rights": "© 2012 by the Society for Academic Emergency Medicine", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "H9C7IK37", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/H9C7IK37", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/H9C7IK37", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Faricy et al.", "parsedDate": "2012-06", "numChildren": 0 }, "data": { "key": "H9C7IK37", "version": 1, "itemType": "journalArticle", "title": "Patterns of empiric treatment of Chlamydia trachomatis infections in an underserved population", "creators": [ { "creatorType": "author", "firstName": "Lauren", "lastName": "Faricy" }, { "creatorType": "author", "firstName": "Tanya", "lastName": "Page" }, { "creatorType": "author", "firstName": "Mischa", "lastName": "Ronick" }, { "creatorType": "author", "firstName": "Rebecca", "lastName": "Rdesinski" }, { "creatorType": "author", "firstName": "Jennifer", "lastName": "Devoe" } ], "abstractNote": "BACKGROUND AND OBJECTIVES\n\nAppropriate 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.\n\n\nMETHODS\n\nWe 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). We manually reviewed charts to confirm patient demographics, CT testing, STI symptoms, known exposure, empiric treatment, test results, and follow-up. We then conducted univariate and multivariate analyses to study patterns of and characteristics associated with receiving empiric treatment. We also assessed follow-up for non-treated patients with positive tests.\n\n\nRESULTS\n\nAmong 488 patients who presented with STI symptoms and who were tested, 181 (37.1%) were empirically treated. In multivariate analyses, women with symptoms had significantly lower odds of receiving empiric treatment, as compared with men. Of the 1,222 patients tested, 75 had a positive CT laboratory test; seven (9.3%) of these patients did not receive empiric treatment and had no documented posttest treatment.\n\n\nCONCLUSIONS\n\nA minority of patients with STI symptoms were empirically treated. Outpatient clinicians should consider whether a patient meets guidelines for empiric STI treatment; this decision should take into account the feasibility of prompt follow-up. This may be especially important in women presenting with STI symptoms.", "publicationTitle": "Family medicine", "publisher": "", "place": "", "date": "Jun 2012", "volume": "44", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "408-415", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Fam Med", "DOI": "", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22733418", "accessDate": "2012-08-14T15:11:38Z", "PMID": "", "PMCID": "", "ISSN": "1938-3800", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22733418", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "NUUTCJU6", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/NUUTCJU6", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/NUUTCJU6", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Timm et al.", "parsedDate": "2011-11", "numChildren": 0 }, "data": { "key": "NUUTCJU6", "version": 1, "itemType": "journalArticle", "title": "Evaluation and management of sexually transmitted infections in adolescent males presenting to a pediatric emergency department: is the chief complaint diagnostic?", "creators": [ { "creatorType": "author", "firstName": "Nathan", "lastName": "Timm" }, { "creatorType": "author", "firstName": "Kamali", "lastName": "Bouvay" }, { "creatorType": "author", "firstName": "Beth", "lastName": "Scheid" }, { "creatorType": "author", "firstName": "W Robert, Jr", "lastName": "Defoor" } ], "abstractNote": "OBJECTIVES\n\nThe objectives of the study were to (1) describe evaluation and treatment patterns for adolescent males presenting with a concern for sexually transmitted infection (STI) in a pediatric emergency department, (2) assess the rates of STIs in symptomatic males, and (3) determine the utility of urinalysis alone in predicting STIs in adolescent males.\n\n\nMETHODS\n\nA retrospective cohort study was conducted of all patients presenting to our pediatric emergency department from January 1, 2007, to December 31, 2007. Inclusion criteria included males, aged 15 to 21 years, with an STI or urinary chief complaint. Exclusion criteria were referrals from pediatricians, a previous history of urinary tract infection or preexisting urologic condition, or primary complaint of scrotal and/or testicular pain.\n\n\nRESULTS\n\nA total of 270 patients were identified. Testing included urinalysis with microscopy (UA) (64%), urine culture (53%), Neisseria gonorrhoeae (GC), and Chlamydia trachomatis (CT) (93%), and Trichomonas vaginalis (5%). Sixty-four percent of males tested positive for either GC or CT, or both. Overall, 91% of patients were treated for CT and GC, 18% for T. vaginalis, and 5% for urinary tract infection. The sensitivity and specificity of a positive UA for presence of GC and/or CT were 86% and 82%, respectively, whereas the positive and negative predictive values were 89% and 77%, respectively. There were no positive urine cultures in the cohort.\n\n\nCONCLUSIONS\n\nSixty-four percent of patients were diagnosed with either GC or CT. Although UA is helpful in predicting STI, limited use is warranted, given the high prevalence of disease in this selected population. The urine culture does not appear to be a necessary adjunct in the management of these patients.", "publicationTitle": "Pediatric emergency care", "publisher": "", "place": "", "date": "Nov 2011", "volume": "27", "issue": "11", "section": "", "partNumber": "", "partTitle": "", "pages": "1042-1044", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Pediatr Emerg Care", "DOI": "10.1097/PEC.0b013e318235e950", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22068065", "accessDate": "2012-09-18T18:07:10Z", "PMID": "", "PMCID": "", "ISSN": "1535-1815", "archive": "", "archiveLocation": "", "shortTitle": "Evaluation and management of sexually transmitted infections in adolescent males presenting to a pediatric emergency department", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22068065", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Anti-Bacterial Agents", "type": 1 }, { "tag": "Chlamydia Infections", "type": 1 }, { "tag": "Chlamydia trachomatis", "type": 1 }, { "tag": "Emergency Service, Hospital", "type": 1 }, { "tag": "Gonorrhea", "type": 1 }, { "tag": "Hospitals, Pediatric", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Male", "type": 1 }, { "tag": "Predictive Value of Tests", "type": 1 }, { "tag": "Prevalence", "type": 1 }, { "tag": "Retrospective Studies", "type": 1 }, { "tag": "Sensitivity and Specificity", "type": 1 }, { "tag": "Sexually Transmitted Diseases, Bacterial", "type": 1 }, { "tag": "Trichomonas Infections", "type": 1 }, { "tag": "Trichomonas vaginalis", "type": 1 }, { "tag": "Urinalysis", "type": 1 }, { "tag": "Urinary Tract Infections", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "72EU32QC", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/72EU32QC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/72EU32QC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Pattishall et al.", "parsedDate": "2011-12-12", "numChildren": 0 }, "data": { "key": "72EU32QC", "version": 1, "itemType": "journalArticle", "title": "Empiric treatment of sexually transmitted infections in a pediatric Emergency Department: are we making the right decisions?", "creators": [ { "creatorType": "author", "firstName": "Amy E", "lastName": "Pattishall" }, { "creatorType": "author", "firstName": "Shahnaz Y", "lastName": "Rahman" }, { "creatorType": "author", "firstName": "Shabnam", "lastName": "Jain" }, { "creatorType": "author", "firstName": "Harold K", "lastName": "Simon" } ], "abstractNote": "OBJECTIVE: Limited recommendations address empiric versus delayed treatment of pediatric patients for sexually transmitted infections (STIs). This study investigates how frequently empiric STI treatment correlated with subsequent positive test results in an urban, high-risk pediatric emergency department (PED). METHODS: A retrospective chart review was performed on patients 18 years and younger who presented to an urban PED and had testing for Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT). RESULTS: The positivity rate for STI among the 198 patients who met inclusion criteria was 28%. In 130 patients (66%), providers' management decision regarding use of empiric antibiotics correlated with subsequent test results. 45 patients (23%) received unnecessary antibiotics. Of the 23 patients (12%) who were positive for STI, but did not receive treatment, 43% (10) had difficulties with followup. CONCLUSIONS: Providers in high-risk pediatric populations with unreliable patient follow-up should consider having a low threshold for empiric treatment. Development of clinical decision rules and/or strategies to improve patient follow-up may help optimize empiric STI treatment decisions in the PED.", "publicationTitle": "The American journal of emergency medicine", "publisher": "", "place": "", "date": "Dec 12, 2011", "volume": "", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1016/j.ajem.2011.09.028", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/22169584", "accessDate": "2012-08-17T16:40:28Z", "PMID": "", "PMCID": "", "ISSN": "1532-8171", "archive": "", "archiveLocation": "", "shortTitle": "Empiric treatment of sexually transmitted infections in a pediatric Emergency Department", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 22169584", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "JV2U2IUC", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/JV2U2IUC", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/JV2U2IUC", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Geisler", "parsedDate": "2011-11-10", "numChildren": 1 }, "data": { "key": "JV2U2IUC", "version": 1, "itemType": "journalArticle", "title": "Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: Summary of Evidence Reviewed for the 2010 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines", "creators": [ { "creatorType": "author", "firstName": "W. M.", "lastName": "Geisler" } ], "abstractNote": "", "publicationTitle": "Clinical Infectious Diseases", "publisher": "", "place": "", "date": "2011-11-10", "volume": "53", "issue": "suppl 3", "section": "", "partNumber": "", "partTitle": "", "pages": "S92-S98", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "", "DOI": "10.1093/cid/cir698", "citationKey": "", "url": "http://cid.oxfordjournals.org/content/53/suppl_3/S92.full.pdf+html?frame=sidebar", "accessDate": "2012-09-18T17:23:34Z", "PMID": "", "PMCID": "", "ISSN": "1058-4838, 1537-6591", "archive": "", "archiveLocation": "", "shortTitle": "Diagnosis and Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults", "language": "", "libraryCatalog": "CrossRef", "callNumber": "", "rights": "", "extra": "", "tags": [], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "KK8TVHFG", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/KK8TVHFG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/KK8TVHFG", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Niccolai et al.", "parsedDate": "2011-04-01", "numChildren": 2 }, "data": { "key": "KK8TVHFG", "version": 1, "itemType": "journalArticle", "title": "Behavioural sources of repeat Chlamydia trachomatis infections: importance of different sex partners", "creators": [ { "creatorType": "author", "firstName": "Linda M.", "lastName": "Niccolai" }, { "creatorType": "author", "firstName": "Kara A.", "lastName": "Livingston" }, { "creatorType": "author", "firstName": "Alison S.", "lastName": "Laufer" }, { "creatorType": "author", "firstName": "Melinda M.", "lastName": "Pettigrew" } ], "abstractNote": "Objective To examine sources of repeat Chlamydia trachomatis infections using behavioural and molecular methods.\nMethods Women with C trachomatis had baseline and 4-month follow-up visits consisting of behavioural surveys and genotyping of C trachomatis. Frequencies and population-attributable risk percentages (PAR%) were estimated for possible sources of repeat infections including sex partners not known to be treated, new sex partners, and sex partners not known to be monogamous. Women with different genotypes at baseline and follow-up were classified as different partner sources of infection.\nResults The cumulative incidence of repeat infections in the sample (n=183) was 13% (95% CI 8% to 18%). Predictors of repeat infections included younger age and continued sex with a partner not known to be treated. Frequencies of having partners not known to be treated, new partners, or partners not known to be monogamous at follow-up were 21% (95% CI 15% to 27%), 37% (95% CI 30% to 44%) and 33% (95% CI 28% to 41%), respectively. The PAR% for having a partner not known to be treated was 26% (95% CI 3% to 49%) and for having a new sex partner was 21% (95% CI 0% to 50%). Among eight patients with available genotypes at baseline and follow-up, five had different genotypes and were classified as having a different partner source of infection.\nConclusions Different sex partner sources of repeat C trachomatis infections other than untreated sex partners may contribute substantially to the burden of repeat infections.", "publicationTitle": "Sexually Transmitted Infections", "publisher": "", "place": "", "date": "04/01/2011", "volume": "87", "issue": "3", "section": "", "partNumber": "", "partTitle": "", "pages": "248-253", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Sex Transm Infect", "DOI": "10.1136/sti.2010.045484", "citationKey": "", "url": "http://sti.bmj.com/content/87/3/248", "accessDate": "2012-09-18T17:29:31Z", "PMID": "", "PMCID": "", "ISSN": ", 1472-3263", "archive": "", "archiveLocation": "", "shortTitle": "Behavioural sources of repeat Chlamydia trachomatis infections", "language": "en", "libraryCatalog": "bmj-sti.highwire.org", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Chlamydia", "type": 1 }, { "tag": "Ophthalmology", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } }, { "key": "768KFWFT", "version": 1, "library": { "type": "group", "id": 89588, "name": "GC Chlamydia", "links": { "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/89588/items/768KFWFT", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/gc_chlamydia/items/768KFWFT", "type": "text/html" } }, "meta": { "createdByUser": { "id": 1080714, "username": "rebeccamoore", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/rebeccamoore", "type": "text/html" } } }, "creatorSummary": "Prentiss et al.", "parsedDate": "2011-09", "numChildren": 0 }, "data": { "key": "768KFWFT", "version": 1, "itemType": "journalArticle", "title": "Adolescent female with urinary symptoms: a diagnostic challenge for the pediatrician", "creators": [ { "creatorType": "author", "firstName": "Kimball A", "lastName": "Prentiss" }, { "creatorType": "author", "firstName": "P K", "lastName": "Newby" }, { "creatorType": "author", "firstName": "Robert J", "lastName": "Vinci" } ], "abstractNote": "OBJECTIVES\n\nThe objective of this study was to determine the accuracy with which physicians diagnose sexually transmitted infections (STIs) and urinary tract infections (UTIs) in adolescent females with urinary symptoms. Secondary aims were to determine the prevalence of STIs and UTIs in this subset of patients and to identify variables associated with a physician diagnosis of STI or UTI.\n\n\nMETHODS\n\nWe performed a prospective cross-sectional study of females aged 13 to 21 years who presented to an urban pediatric emergency department with urinary symptoms. Pediatric emergency medicine physicians' diagnoses of STI or UTI were compared with the criterion standard of diagnosis.\n\n\nRESULTS\n\nOf the 233 patients enrolled, 211 had complete data sets and were included for analysis. Nineteen patients (9%) had STIs. Physicians predicted STIs in 35 patients (17%), of which 9 (25%) had true infections. Sexually transmitted infections in 10 patients (53%) were underdiagnosed, in 26 patients (74%) were overdiagnosed, and in 9 patients (26%) were correctly diagnosed. One hundred twenty patients (57%) had UTIs. Physicians predicted UTIs in 156 patients (74%), of which 107 (69%) had culture-confirmed UTIs. Urinary tract infections in 13 patients (11%) were underdiagnosed, in 49 patients (31%) were overdiagnosed, and in 107 patients (66%) were correctly diagnosed. Thirteen patients (6%) had a coinfection with both an STI and a UTI.\n\n\nCONCLUSIONS\n\nPediatric emergency medicine physicians both underdiagnose and overdiagnose STIs and UTIs in patients with urinary symptoms. This diagnostic challenge necessitates that all adolescent patients presenting with urinary symptoms should be tested for STIs and UTIs and have adequate follow-up means established to ensure timely treatment.", "publicationTitle": "Pediatric emergency care", "publisher": "", "place": "", "date": "Sep 2011", "volume": "27", "issue": "9", "section": "", "partNumber": "", "partTitle": "", "pages": "789-794", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Pediatr Emerg Care", "DOI": "10.1097/PEC.0b013e31822c10f6", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pubmed/21878833", "accessDate": "2012-09-18T18:12:00Z", "PMID": "", "PMCID": "", "ISSN": "1535-1815", "archive": "", "archiveLocation": "", "shortTitle": "Adolescent female with urinary symptoms", "language": "", "libraryCatalog": "NCBI PubMed", "callNumber": "", "rights": "", "extra": "PMID: 21878833", "tags": [ { "tag": "Adolescent", "type": 1 }, { "tag": "Anti-Bacterial Agents", "type": 1 }, { "tag": "Boston", "type": 1 }, { "tag": "Chlamydia Infections", "type": 1 }, { "tag": "Chlamydia trachomatis", "type": 1 }, { "tag": "Comorbidity", "type": 1 }, { "tag": "Cross-Sectional Studies", "type": 1 }, { "tag": "Diagnosis, Differential", "type": 1 }, { "tag": "Emergencies", "type": 1 }, { "tag": "Ethnic Groups", "type": 1 }, { "tag": "Female", "type": 1 }, { "tag": "Gonorrhea", "type": 1 }, { "tag": "Humans", "type": 1 }, { "tag": "Insurance Coverage", "type": 1 }, { "tag": "Neisseria gonorrhoeae", "type": 1 }, { "tag": "Prevalence", "type": 1 }, { "tag": "Prospective Studies", "type": 1 }, { "tag": "Reagent Strips", "type": 1 }, { "tag": "Sexually Transmitted Diseases", "type": 1 }, { "tag": "Urban Population", "type": 1 }, { "tag": "Urinary Tract Infections", "type": 1 }, { "tag": "Urine", "type": 1 }, { "tag": "Vaginitis", "type": 1 }, { "tag": "Young Adult", "type": 1 } ], "collections": [], "relations": {}, "dateAdded": "2012-09-18T19:42:58Z", "dateModified": "2012-09-18T19:42:58Z" } } ]