PubMed Health⌕ Search

Biomedical subjects

John R Pfister

Publications and source records attributed to John R Pfister.

3 recordsLinked to original sources

Decision analysis: point-of-care Chlamydia testing vs. laboratory-based methods.

OBJECTIVE: To evaluate and compare the performance of several different methods available for detection of Chlamydia trachomatis (Ct) infection, and to explore possible testing and treatment strategies incorporating point-of-care testing versus laboratory-based tests. DESIGN: Prospective trial and decision analysis. SETTING: Large, urban, publicly funded sexually transmitted disease clinic. PARTICIPANTS: 1,384 female patients. METHODS: Each subject was tested for Ct infection by direct fluorescent antibody (DFA, Sanofi/Kallestad, Chaska, MN), optical immunoassay (OIA, Thermo Electron, Point of Care and Rapid Diagnostics, Louisville CO), McCoy cell culture (in-house method), and polymerase chain reaction (microwell PCR, microwell assay, Roche, Branchburg NJ). RESULTS: Performing a rapid in-clinic test on women who did not meet empiric treatment criteria would have increased the overall proportion of infected persons receiving same-day treatment from 48.6% to 79.1% using DFA or 78.4% using OIA. CONCLUSIONS: Use of empiric treatment criteria and same-day point-of-care testing for patients not meeting the empiric treatment threshold appears to be an appropriate, useful, and cost-effective strategy for increasing same-day treatment of Ct infections in this population.

Adolescent↗

Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students.

UNLABELLED: A retrospective review of genital herpes simplex virus (HSV) isolates collected in a university student health service over a 9-year period showed that an increasing proportion of isolates were HSV-1 rather than HSV-2. HSV-1 accounted for 78% of all genital isolates in this population by 2001, compared with 31% of isolates in 1993. BACKGROUND: Herpes simplex virus (HSV) type 1 is usually thought to cause less than 30% of genital herpes infections in the United States, but the proportion of infections resulting from HSV-1 is increasing in some populations. GOAL: The goal was to review the relative proportion of HSV-1 and HSV-2 as the cause of newly diagnosed genital herpes infections in a population of U.S. college students and to assess trends in the change of this proportion over time. STUDY DESIGN: Genital HSV isolates collected at a university student health service from 1993 to 2001 (n = 499) were reviewed retrospectively. Analyses included comparisons of isolates by HSV type, age group, and sex. RESULTS: The proportion of newly diagnosed genital herpes infections resulting from HSV-1 increased from 31% in 1993 to 78% in 2001 (P <0.001, linear trend P <0.001). HSV-1 was more common in females than males, but increases were noted for both sexes. HSV-1 was more common in persons aged 16 to 21 than in persons aged 22 or older. CONCLUSIONS: HSV-1 has become the most common cause of newly diagnosed genital herpes infections in this population of college students and reflects a reversal of the usual HSV-1/HSV-2 ratio.

Adolescent↗

Targeted laboratory screening for sexually transmitted and bloodborne infections in Wisconsin.

Public health laboratories play an important role in screening programs for asymptomatic diseases of public health importance in high-risk and underserved populations. The implementation of targeted screening strategies for communicable diseases requires thorough planning and evaluation. The Wisconsin State Laboratory of Hygiene (WSLH) systematically selects and evaluates laboratory tests used in communicable disease control programs coordinated by the Wisconsin Division of Public Health. To do this, the epidemiologic features of the disease in potential target populations are carefully assessed, with the choice of laboratory tests based on performance as well as practical and cost considerations. Laboratory testing at WSLH plays a crucial role in screening programs for sexually transmitted and bloodborne infections. Hallmarks of these programs are cross-sector collaboration, empirical selection of laboratory testing methods, and the use of epidemiologic data to develop and evaluate targeted screening strategies.

Blood-Borne Pathogens↗