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Biomedical subjects

A Wertheimer

Publications and source records attributed to A Wertheimer.

11 recordsLinked to original sources
PubMed1989

Chlamydia trachomatis cervical infection in women seeking routine gynecologic care: criteria for selective testing.

PURPOSE: Chlamydia trachomatis infection is one of the most common sexually transmitted diseases. Developing methods to identify patients who are at higher risk would enable clinicians to perform selective testing for C. trachomatis infection, which may reduce morbidity, sequelae, and overall costs. Risk factors for C. trachomatis infection of the cervix in women seen for routine gynecologic care were therefore analyzed. PATIENTS AND METHODS: Extensive clinical data and cervical cultures were obtained from 1,141 women between the ages of 18 and 50. Multivariate techniques were used to develop and prospectively test a model to predict infection. RESULTS: In the model development series of 530 patients seen in a hospital-based practice, 24 (4.5%) had a positive culture result. In the validation series of 611 patients seen in private practice, 17 (2.8%) had positive culture results. The majority of infected patients (61%) were asymptomatic. For sexually active women 18 to 35 years of age, the optimal predictive model was based on three factors: level of education (high school or less), a sex partner with other partners during the prior three months, and endocervical bleeding induced by the initial swab. In the validation series, the prevalence of infection for women with one or more of these factors was 5.8% (95% confidence interval, 4.0 to 8.6) compared with 0.9% in patients without these factors (p = 0.005). CONCLUSION: Clinical information can be used in a low-prevalence population to predict a patient's risk for C. trachomatis infection and to select patients for testing.

Adolescent↗
PubMed1988

Gonorrhea in women seen for routine gynecologic care: criteria for testing.

PURPOSE: This study was initiated to determine risk factors for Neisseria gonorrhoeae infection of the cervix in women seen for routine care in a hospital-based obstetrics and gynecology practice. PATIENTS AND METHODS: Extensive clinical data and cervical culture specimens for N. gonorrhoeae were obtained prospectively from 1,441 women between the ages of 18 and 50. Fifty clinical factors were evaluated by multivariate analysis. RESULTS: Of the 1,441 patients tested, 25 (1.7 percent) had a positive culture result. The majority of infected women were asymptomatic. The following five factors were found to be associated independently with gonococcal infection: (1) sex with a partner who may have had gonorrhea or a urethral discharge within the prior three months, (2) endocervical bleeding induced by the initial swab, (3) age at first intercourse less than or equal to 16, (4) method of payment (Medicaid), and (5) low abdominal or pelvic pain. Race, a univariate risk factor, was not associated with gonorrhea when these other factors were considered. The risk of infection for women with none, one, two, or three or more of these multivariate risk factors was 0.2, 0.8, 2.9, and 9.8 percent, respectively. CONCLUSION: Clinical data are helpful in identifying women at risk for gonorrhea. If resources are insufficient to evaluate all sexually active women, we suggest routine testing based on the presence of the multivariate risk factors identified.

Adolescent↗