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PubMed2003

Economic injury levels and sequential sampling plans for Mexican bean beetle (Coleoptera: Coccinellidae) on dry beans.

Field studies were conducted during the growing seasons of 1995 and 1996, in Scotts-bluff, Nebraska, to determine yield-loss relationships for Mexican bean beetle (Epilachna varivestis Mulsant) on dry bean (Phaseolus vulgaris L.). Results of those experiments were combined with data from other studies previously conducted to develop economic injury levels (EILs), economic thresholds (ETs), and a sequential sampling program for Mexican bean beetle. Yield loss was regressed against larvae/row-m, and the slope of the linear regression (113 kg/ha per larvae/row-m) was used as the DI (yield loss/insect density) variable in EIL calculations. The EILs calculated in larvae/row-m were converted to egg masses/row-m and adjusted to reflect average survivorship to the adult stage. An example EIL for esfenvalerate at 0.509 (formulation) liter/ha (0.0453 gal/a) and crop value of 0.44 dollars/kg (20 dollars/100 lbs) was 17.78 larvae/row-m. The corresponding ET is 1.04 egg masses/row-m, which reflects an average of 54.6 eggs/egg mass and 33% survival rate from egg to injurious stages. Sequential sampling plans were calculated based on a negative binomial distribution using parameter k estimated from previous research. Because sampling is based on egg masses, growers can make management decisions and take management actions before significant injury occurs. Also, ETs can be adjusted to include the occurrence of natural mortality in the egg and early instars. Analyses demonstrated that relatively minor variation in ETs has substantial impact on sequential sampling plans, including parameters such as average sample number. An interactive spreadsheet was developed that allows users to input economic and other data specific to their situation to calculate Mexican bean beetle EILs, ETs, and sequential sampling plans.

Animals↗
PubMed1989

Lyme disease in California: interrelationship of Ixodes pacificus (Acari: Ixodidae), the western fence lizard (Sceloporus occidentalis), and Borrelia burgdorferi.

The relationship of immature western black-legged ticks, Ixodes pacificus Cooley and Kohls, to the western fence lizard, Sceloporus occidentalis Baird and Girard, and to the Lyme disease spirochete, Borrelia burgdorferi, was investigated in chaparral and woodland-grass habitats in northern California from 1984 to 1986. Immature ticks were found on lizards in spring and summer, but the prevalence and abundance of ticks on this host were considerably greater in spring. The peak of larval abundance preceded that of nymphs by several weeks, but there was considerable seasonal overlap between these parasitic stages. Larvae and nymphs attached primarily to the lateral nuchal pockets of lizards in chaparral (99.5%) and woodland-grass (91.8%). The numbers of larvae infesting lizards in spring fit the negative binomial distribution in woodland-grass but not in chaparral; insufficient data precluded similar analyses for nymphs. Tick loads did not differ significantly with respect to age or gender of the lizard. Spirochetal infection rates (range, 0-3.7%) in I. pacificus immatures were comparable in both habitats and were similar to those reported previously for adults of this tick. Overall, 1 (0.9%) of 117 larvae and 10 (1.8%) of 552 nymphs were infected with spirochetes resembling B. burgdorferi. Spirochetes were not observed in blood smears prepared from 261 wild-caught lizards, including five lizards fed upon by infected ticks at the time of collection. These and other findings suggest that S. occidentalis, although an important host of I. pacificus immatures, may be less important as a source for infecting ticks with B. burgdorferi.

Animals↗
PubMed1990

Intraspecific variation in the reproductive capacity of Anopheles stephensi (Diptera: Culicidae).

Intraspecific variation in the reproductive capacity of Anopheles stephensi Liston females was studied under constant laboratory conditions. Of 421 engorged females examined individually throughout their lifetimes, 260 laid a total of 479 egg batches with a maximum of nine ovipositions per female. The number of eggs per oviposition varied from 5 to 247 (average 96.8). The number of ovipositions per female were correlated positively with the average number of eggs per batch and exhibited a negative binomial distribution among females, indicating that a small portion of the population exhibited a particularly high fecundity. Among the ovipositing females, the total fecundity and fertility ranged, respectively, from 5 to 1,084 eggs and from 0 to 1,036 larvae per female. The estimated maximal number of female progeny produced by a female in her lifetime was 317, and the estimates of net reproductive rate (Ro) and capacity for increase (rc) were 25.7 and 0.17, respectively. The number of eggs in the first oviposition was predictive of the total fecundity of a female. The wide range of individual variation in the reproductive capacity of An. stephensi emphasized the requirement for a large sample size for reliable estimation.

Animals↗
PubMed2001

Orthogonal combinatorial mutagenesis: a codon-level combinatorial mutagenesis method useful for low multiplicity and amino acid-scanning protocols.

We describe here a method to generate combinatorial libraries of oligonucleotides mutated at the codon-level, with control of the mutagenesis rate so as to create predictable binomial distributions of mutants. The method allows enrichment of the libraries with single, double or larger multiplicity of amino acid replacements by appropriate choice of the mutagenesis rate, depending on the concentration of synthetic precursors. The method makes use of two sets of deoxynucleoside-phosphoramidites bearing orthogonal protecting groups [4,4'-dimethoxytrityl (DMT) and 9-fluorenylmethoxycarbonyl (Fmoc)] in the 5' hydroxyl. These phosphoramidites are divergently combined during automated synthesis in such a way that wild-type codons are assembled with commercial DMT-deoxynucleoside-methyl-phosphoramidites while mutant codons are assembled with Fmoc-deoxynucleoside-methyl-phosphoramidites in an NNG/C fashion in a single synthesis column. This method is easily automated and suitable for low mutagenesis rates and large windows, such as those required for directed evolution and alanine scanning. Through the assembly of three oligonucleotide libraries at different mutagenesis rates, followed by cloning at the polylinker region of plasmid pUC18 and sequencing of 129 clones, we concluded that the method performs essentially as intended.

Amino Acid Substitution↗
PubMed1989

Probability of introducing diseases because of false negative test results.

The use of diagnostic tests for the selection of healthy individual persons or animals for inclusion in certain groups carries with it an inherent risk of including those with infections because they falsely reacted negatively. The factors of sensitivity of the test, prevalence of the disease, and the size of the group all influence the degree of such risk. The probability of including an infected individual person or animal can be calculated combining conditional probability and the binomial distribution.

Animals↗
PubMed1991

Factors associated with transmission of bovine leukemia virus by contact in cows on a California dairy.

A prospective study was undertaken on a California dairy from 1984 to 1987 to examine factors associated with contact transmission of bovine leukemia virus in cows. Two approaches were used to model the probability of infection. First, the expected number of new infections per pen-month was assumed to follow a binomial distribution. The probability of infection was modeled, using logistic regression, as a function of prevalence of infection in pen, presence of lactating cows, proportion of pregnant cows, presence of an infected bull, and proportion of infected cows with a lymphocyte count above 10,000 cells/microliters of blood and/or with Mr 24,000 protein (p24) antibodies. The probability of infection was significantly associated with the prevalence of infection and at the limit of significance for presence of lactating cows in pen. Second, the Cox model with time-dependent covariates was used to analyze time from first parturition or from the beginning of the study to infection. Factors examined were age, breed, lactation number, whether the cow was pregnant and/or lactating, prevalence of infection, presence of an infected bull, and density of cattle in the pen holding the cow. Non-pregnant cows were 2.9 times more at risk of infection than were pregnant cows, and risk of infection significantly increased as prevalence of infection in a pen increased.

Animals↗
PubMed1992

Couples with exclusively female offspring have an increased probability of a male child after using male sex preselection.

The present study was undertaken to determine whether couples with one or more daughters and no sons had an increased probability of having a male child after using male sex preselection. The sex ratio of children born to couples after using 'protocol 3' (n = 70) or 'modified protocol 3' (n = 28) male sex preselection at one of 14 centres was determined. The normal approximation to the binomial distribution was used to determine significant differences between these sex ratios and the established sex ratio for children born to couples with one previous daughter and no sons. The sex ratios of both protocol 3 sex-preselected children (73.0%; P less than 0.0001) and modified protocol 3 sex-preselected children (86%; P less than 0.0001) were significantly different to the established sex ratio (control) for a current child born to parents with one previous daughter and no sons (50.1%). Couples with one or more daughters and no sons will have an increased probability of a male child after using male sex preselection.

Female↗
PubMed1996

Low diversity and biased substitution patterns in the mitochondrial DNA control region of sperm whales: implications for estimates of time since common ancestry.

The mitochondrial DNA (mtDNA) control region was sequenced in 37 sperm whales from a large part of the global range of the species. Nucleotide diversity was several-fold lower than that reported for control regions of abundant and outbred mammals, but similar to that for populations known to have experienced bottlenecks. Relative neck tests did not suggest that the low diversity is due to a lower substitution rate in sperm whale mtDNA. Rather, it is more likely that demographic factors have reduced diversity. The pattern of nucleotide substitutions was examined by cladistic methods, facilitated by the apparent monophyly of lineages from the Southern Hemisphere, as defined by a single base pair deletion. Substitutions were nonrandom in nature, confined to a few "hot spots," and parallel substitutions constituted a majority of the inferred changes. The substitution pattern fitted a negative binomial distribution better than a Poisson distribution, and the bias in number of substitutions among sites was considerably higher than previously reported for the mtDNA control region of any species. A novel method of estimating time since common ancestry was developed, which utilizes the transition/transversion ratio R and the number of substitutions inferred from a parsimony analysis. Using this method, we estimated the age of sperm whale mtDNA diversity to be about 6,000-25,000 years, and when the uncertainty of R was accounted for, a range of about 1,000-100,000 years was obtained.

Animals↗
PubMed1998

Use of protein engineering to explore subunit interactions in an allosteric enzyme: construction of inter-subunit hybrids in Clostridium symbiosum glutamate dehydrogenase.

Hybrids of different forms of clostridial glutamate dehydrogenase (GDH) have been constructed in order to probe the basis of allosteric interaction in this hexameric enzyme. It was shown that the C320S mutant, which is fully active and shows allosteric behaviour similar to that of the wild-type enzyme, can also be renatured after unfolding in urea. Mixtures of unfolded wild-type and C320S subunits gave rise to hybrids upon refolding. A purely random reassembly would lead to a simple binomial distribution. However there was a slightly better overall recovery of wild-type subunits and there appears to be a tendency for rapidly formed structured wild-type subunits in a mixture to nucleate further refolding in a way that biases the final distribution against the formation of C320S hexamers. Only the wild-type subunits in such hybrid mixtures are able to react with Ellman's reagent, 5,5'-dithiobis-(2-nitrobenzoate) (DTNB). Accordingly, after modification of hybrid hexamers with DTNB only the mutant subunits can bind NAD+. This permits fractionation on an NAD+-agarose affinity column. The elution pattern in itself indicates cooperativity since DTNB modification of just one subunit in a 1:5 wild-type/C320S hybrid largely abolished binding to the column. Kinetic studies were carried out on a fractionated preparation in which hexamers containing only one C320S subunit and five wild-type subunits were the predominant active species. Measurements of activity were made both before and after treatment with an excess of beta-mercaptoethanol to remove the blocking thionitrobenzoate moieties. Before beta-mercaptoethanol treatment this sample, with only one active subunit per hexamer, gave strictly hyperbolic (Michaelis-Menten) kinetics with NAD+ at pH 7.0, whereas after beta-mercaptoethanol (all six subunits now active) the markedly kinked Eadie-Hofstee plot characteristic of wild-type enzyme was obtained. On the other hand the sigmoid response to glutamate at high pH persisted (Hill coefficient=3.6) even without beta-mercaptoethanol, reflecting the fact that the inactive subunits can still bind glutamate. Beta-mercaptoethanol treatment restored full positive cooperativity (Hill coefficient=5.2). These results prove beyond doubt that the non-classical kinetic behaviour of clostridial GDH is a direct result of interaction between NAD+ binding sites on the six (normally) identical subunits of a hexamer.

Allosteric Regulation↗
PubMed1994

Identification of sequence motifs from a set of proteins with related function.

The automatic identification of motifs associated with a given function is an important challenge for molecular sequence analysis. A method is presented for the extraction of such patterns from large sets of unaligned sequences with related but general function, for example, a set of heat shock proteins. In such a set of proteins there can often be several subfamilies each characterized by one or more distinct motifs. The aim is to develop computational tools to identify these motifs. The algorithm presented locates high frequency words of length k with a given number of positions, r, fixed. Statistics for a binomial distribution are used to assess the significance of the words. The high-frequency words are clustered and highly populated clusters retained. The composition of the clusters is displayed graphically. A set of motifs associated with the sequence family can automatically be extracted. The method is benchmarked on a set of 106 heat shock sequences and a set of 257 toxin sequences. It is shown to recover previously identified motifs.

Algorithms↗
PubMed2004

The number needed to treat needs an associated odds estimation.

BACKGROUND: The number needed to treat (NNT) is a practically useful indicator that represents how many patients must be treated to prevent one adverse event when provided with a new intervention instead of the standard one. The NNT associates the net-benefit of an experimental treatment with the number of patients, or the size of trials, expecting one outcome of success. The NNT, however, also suggests that we assume an implicit execution of independent Bernouilli trials--as it were, the hypothetical NNT trials--independently repeated the same number of times as the value of NNT and with the same occurrence-probability of success as the value of absolute risk reduction. These independent Bernouilli trials, of course, have some probabilities of failure. Most decision-makers in practice would be more interested in how much the hypothetical NNT trials can achieve 'success/failure' with 'how many' patients, or the 'odds' of success versus failure, rather than 'one' outcome of success as the mean value. METHODS: We investigated the properties of hypothetical NNT trials. A binomial distribution was employed to develop formulae for estimating the odds of success versus failure to gain net-benefit in the NNT-associated trials. RESULTS: Most of the estimates of odds expected by the new intervention are between three and 1.72, converging to e-1 as the NNT increases. CONCLUSION: When basing decisions on an NNT, clinicians and public health specialists should take account of the odds of achieving the theoretical NNT.

Data Interpretation, Statistical↗
PubMed1998

Hydroxyethyl starch antibodies in humans: incidence and clinical relevance.

UNLABELLED: Hydroxyethyl starch (HES) is a plasma expander used for perioperative i.v. fluid management, as well as for resuscitation from trauma and shock. HES is very well tolerated, and the incidence of anaphylactic reactions is lower than with dextran or gelatin. Dextran anaphylaxis is caused by circulating dextran-reactive antibodies (ABs) of the immunoglobin G (IgG) class found in most adults. Histamine release from mast cells induces adverse reactions after gelatin infusion. The cause of adverse reactions due to HES is not yet clear. To investigate AB formation due to HES, we collected sera of 1004 patients at least 14 days after starch administration. Using a highly sensitive enzyme-linked immunoabsorbent assay technique, we found one patient with a low 1:10 titer of HES-reactive ABs (immunoglobin M [IgM] class). Despite repeated HES infusions, no clinical reaction could be detected in this patient. On the basis of a binomial distribution, a one-tailed confidence interval (99%) was used to calculate the percentage of the occurrence of ABs in general with maximum of 33 in 10,000 persons (IgM) and 23 in 10,000 persons (IgG). We suggest that HES-reactive ABs are extremely rare and that they do not necessarily induce anaphylaxis. Other mechanisms may be responsible for adverse reactions due to HES. IMPLICATIONS: The frequency of antibody formation due to hydroxyethyl starch, a commonly used plasma expander, was prospectively investigated in 1004 patients. Only one patient showed transient antibody formation, which was not harmful to the patient. This low antigenicity could explain the excellent tolerance of hydroxyethyl starch compared with other plasma expanders.

Adolescent↗
PubMed1994

The orderly progression of melanoma nodal metastases.

OBJECTIVE: The aim of this study was to determine the order of melanoma nodal metastases. SUMMARY BACKGROUND DATA: Most solid tumors are thought to demonstrate a random nodal metastatic pattern. The incidence of skip nodal metastases precluded the use of sampling procedures of first station nodal basins to achieve adequate pathological staging. Malignant melanoma may be different from other malignancies in that the cutaneous lymphatic flow is better defined and can be mapped accurately. The concept of an orderly progression of nodal metastases is radically different than what is thought to occur in the natural history of metastases from most other solid malignancies. METHODS: The investigators performed preoperative and intraoperative mapping of the cutaneous lymphatics from the primary melanoma in an attempt to identify the "sentinel" lymph node in the regional basin. All patients had primary melanomas with tumor thicknesses > 0.76 mm and were considered candidates for elective lymph node dissection. The sentinel lymph node was harvested and submitted separately to pathology, followed by a complete node dissection. The null hypothesis tested was whether nodal metastases from malignant melanoma occurred in equal proportions among sentinel and nonsentinel nodes. RESULTS: Forty-two patients met the criteria of the protocol based on prognostic factors of their primary melanoma. Thirty-four patients had histologically negative sentinel nodes, with the rest of the nodes in the basin also being negative. Thus, there were no skip metastases documented. Eight patients had positive sentinel nodes, with seven of the eight having the sentinel node as the only site of disease. In these seven patients, the frequency of sentinel nodal metastases was 92%, whereas none of the higher nodes had documented metastatic disease. Nodal involvement was compared between the sentinel and nonsentinel nodal groups, based on the binomial distribution. Under the null hypothesis of equality in distribution of nodal metastases, the probability that all seven unpaired observations would demonstrate that involvement of the sentinel node is 0.008. CONCLUSIONS: The data presented demonstrate that nodal metastases from cutaneous melanoma are not random events. The sentinel lymph nodes in the lymphatic basins can be mapped and identified individually, and they have been shown to contain the first evidence of melanoma metastases. This information can be used to revolutionize melanoma care so that only those patients with evidence of nodal metastatic disease are subjected to the morbidity and expense of a complete node dissection. Because sentinel node histology accurately reflects the histology of the remainder of the lymphatic basin, information gained from the sentinel node biopsy can be used as a prognostic factor for melanoma. These findings demonstrate effective pathologic staging, no decrease in standards of care, and a reduction of morbidity with a less aggressive, rational surgical approach.

Adolescent↗
PubMed1987

Infection potential of nondisposable pressure transducers prepared prior to use.

This study was designed to examine whether pressure transducer systems prepared hours or days before actual use represent an infection potential. Twenty-one nondisposable transducers assembled with sterile plastic disposable domes and extension tubing were utilized. The systems were prefilled with heparinized flush solution (2 U sodium heparin per ml normal saline). Flush solution samples were cultured from the distal end of the equipment immediately after set-up (time 0) and 24, 48, and 72 h after set-up in all 21 transducers. In 11 of 21 transducers, cultures were also taken at 168 h (1 wk) and 336 h (2 wk) after set-up. Out of the total 106 cultures, only two showed growth, both of which proved to be external skin or mouth contaminants. Binomial distribution testing indicated that if a .05 probability level was used, the chance was 1.3% that one or more transducers in 100 could become contaminated by 72 h. Using the same statistical analyses for the 66 cultures involving the 11 transducers cultured for 2 wk, the chance of contamination in 100 cultures is 2.7% at 2 wk. We conclude from these data that nondisposable transducer systems, when preassembled using standard aseptic precautions and sterile disposable plastics, show no evidence of significant contamination when allowed to stand in readiness after assembly but not connected to a patient. We feel it is safe to preassemble transducers for at least a 72-h period before use. Longer intervals from set-up to use may also be justified.

Equipment Contamination↗
PubMed1997

The Carhart Memorial Lecture, American Auditory Society, Salt Lake City, Utah 1996. Phoneme and word recognition for words in isolation and in sentences.

OBJECTIVE: To evaluate relations among scores for phonemes, words in isolation, and words in sentences for listeners with normal hearing and for listeners with sensorineural hearing loss. DESIGN: Ten-word lists of consonant-vowel-consonant monosyllables with each list utilizing the same 10 vowels and 20 consonants (Boothroyd, 1968) were devised and recorded. These words also were incorporated into contextually correct sentences and recorded by the same talker. The materials were presented in quiet to 36 listeners with normal hearing and to 876 listeners (1260 ears) with sensorineural hearing loss. Formulae derived by Boothroyd and Nittrouer (1988) to relate scores for phonemes, words, and sentences were applied to the data. RESULTS: Phoneme scoring yielded scores that were on the order of 20% higher than scores for whole words heard in isolation, and scores for words in sentences were about 20% higher than when the same words were heard singly. Relations among scores for phonemes, words in isolation, and words in sentences were very similar to those observed by Boothroyd and Nittrouer (1988). The constants derived from application of their formulae to our data were very similar to the constants Boothroyd and Nittrouer obtained for a different set of materials presented against a noise background to listeners with normal hearing. Further, the constants were similar for our group of listeners with normal hearing and our large sample of listeners with sensorineural hearing loss. CONCLUSIONS: 1) These findings support Bilger's (1984) unifying assumptions that speech recognition is a single construct; therefore, scores on all speech recognition tests must be related and scores on one speech recognition test should be predictive of scores on other tests. 2) Advantages of phoneme scoring include: A) It increases the sample size of scored items for a given list of words, thereby reducing variability in test results. B) Statistical equivalence of phoneme scores for the same 30 phonemes in each of two isophonemic word lists can be evaluated quickly and easily by applying the binomial distribution model to the scores (Thornton & Raffin, 1978). C) Phoneme scores are reasonably accurate predictors of recognition of words in the contextually correct but generally low probability sentences used in this study.

Adolescent↗
PubMed2006

Fetal pyelectasis: does fetal gender modify the risk of major trisomies?

OBJECTIVE: Several studies have noted an increased prevalence of pyelectasis in male fetuses. It is speculated that pyelectasis represents a normal physiologic variant in males, whereas its presence in females indicates an increased risk of chromosomal abnormalities. Thus, we sought to investigate the association between fetal gender and the risk of major trisomies in fetuses with pyelectasis. METHODS: Retrospective analysis of a Genzyme Genetics amniocentesis database (1995 to 2004) was performed. Specimens obtained after an ultrasonographic finding of pyelectasis were eligible for analysis. The prevalence of major trisomies (trisomy 13, 18, or 21) in male and female fetuses with pyelectasis was compared using binomial distribution. RESULTS: A total of 760,495 amniocentesis specimens were analyzed. Fetal pyelectasis was reported in 671 cases. A male predominance, with a male-to-female ratio of 2.14:1 (457 compared with 214) was statistically significant (P < .001). A major trisomy was detected in 26 male fetuses (5.7%): 18 cases of trisomy 21, 2 cases of trisomy 18, and 6 cases of trisomy 13. Nine female fetuses had a major trisomy (4.2%): 6 cases of trisomy 21 and 3 cases of trisomy 13. There was no significant difference in the overall prevalence of trisomies between male and female fetuses (P = .14). CONCLUSION: We concur with previous studies documenting a higher prevalence of pyelectasis in male fetuses. In addition, our results indicate that the prevalence of major trisomies among fetuses with pyelectasis is unlikely to be dependent on fetal gender. Thus, counseling patients with regard to the genetic implications of fetal pyelectasis should be gender independent. LEVEL OF EVIDENCE: II-2.

Amniocentesis↗
PubMed2003

The fine specificity and cytokine profile of T-helper cells responsive to the alpha3 chain of type IV collagen in Goodpasture's disease.

Goodpasture's disease is a severe nephritis characterized by autoantibodies to the alpha3 chain of type IV collagen, alpha3(IV)NC1, in the glomerular basement membrane. The disease is very strongly associated with HLA-DR15, the affinities of alpha3(IV)NC1 peptides for DR15 are known, and elution experiments have identified major naturally processed sequences. Here, the fine specificity and cytokine profile of alpha3(IV)NC1-reactive T cells from patients with Goodpasture's disease is defined. Peripheral blood mononuclear cells from patients at diagnosis proliferated in response to significantly more peptides (chi(2) = 8.6, P = 0.004) from a panel spanning the sequence of alpha3(IV)NC1 than did those from control DR15-positive donors and were highly focused (P = 0.0002, binomial distribution) on two peptides, alpha3(71-90) and alpha3(131-150). Some peptides induced interferon-gamma, but none induced IL-4. Resolution of disease was accompanied by a striking deviation of the responses from proliferation to secretion of the T-regulatory cytokine IL-10, and addition of neutralizing antibody confirmed that such IL-10 production was suppressive. The affinity of the peptides for DR15 molecules was positively correlated (chi(2) = 14.6, P = 0.00067) with the ability to elicit proliferation. However, unlike foreign antigens, this hierarchy is not due to responses against the major naturally processed peptides, which rarely stimulated proliferation and which have only intermediate affinity for DR15 molecules. It is inferred that the helper response to alpha3(IV)NC1 in Goodpasture's disease is dominated by epitopes that are normally inefficiently presented because of processing constraints.

Aged↗
PubMed2007

No evidence for a sustained increase in sexually transmitted diseases among heterosexuals in Amsterdam, the Netherlands: a 12-year trend analysis at the sexually transmitted disease outpatient clinic, Amsterdam.

OBJECTIVES: Sexually transmitted diseases (STDs) are on the rise, mainly among men having sex with men (MSM). GOAL: The goal of this study was to evaluate whether STD increases as seen in MSM are also visible among heterosexuals. STUDY DESIGN: Attendees of the STD clinic in Amsterdam, The Netherlands, are routinely tested for chlamydia, gonorrhea, and syphilis. Additionally, all women are tested for trichomoniasis. STD time trends of heterosexual attendees between 1994 and 2005 were analyzed by logistic regression and generalized linear models with a negative binomial distribution. RESULTS: The number of consultations doubled since 1994. However, no long-term increase was seen in the number of syphilis and gonorrhea infections. Additionally, the trichomonas prevalence declined. However, the number of chlamydia infections increased over time. CONCLUSIONS: Although the number of attendees increased, no evidence for increasing STD incidence was found among heterosexuals. The increase in chlamydia infections can probably be explained by increased screening resulting from increased numbers of attendees.

Adult↗