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Biomedical subjects

Michael G Spigarelli

Publications and source records attributed to Michael G Spigarelli.

4 recordsLinked to original sources
PubMed2006

Urine gonococcal/Chlamydia testing in adolescents.

PURPOSE OF REVIEW: This review will highlight the recent literature findings regarding urine-based Chlamydia and gonorrhea testing in adolescents. RECENT FINDINGS: Rates of Chlamydia trachomatis are increasing, likely due to increased detection efficiency, but have not yet begun to decrease. Neisseria gonorrhoeae is at an all-time low. Urine-based testing for sexually transmitted infections is readily available and convenient but underutilized. Interesting approaches to a more universal screening program, including self-collected, mail-in urine samples, have been shown to be effective. SUMMARY: In spite of recommendations urging universal screening for C. trachomatis and N. gonorrhoeae and the availability of highly accurate and convenient tests, screening rates for adolescents and young adults remain below the universal recommendations. Strategies to improve screening rates should take advantage of urine-based screening methodologies for sexually transmitted infections because of their cost-effectiveness as well as the convenience for patient and provider.

Adolescent↗
PubMed2004

Sexually transmitted disease testing: evaluation of diagnostic tests and methods.

Most STIs in adolescents are asymptomatic. Recent studies in adolescents have documented relatively short periods of time until reinfection occurs (median times 4.7-7.6 months), suggesting that sexually active adolescents should be screened for STI every 6 months. Evidence-based practice is exceedingly helpful in deciding when to test, whom to test, and which methodology to use. In a recent critical analysis regarding screening women for chlamydia, screening all women for chlamydia was more cost-effective than testing only symptomatic women. With the proliferation of highly sensitive and specific assays, and the usefulness of different specimen sources (such as urine or self-swabs), health care providers of adolescents should screen all patients at risk for STIs. Although these screening and diagnostic techniques provide greater accuracy than previously attainable, screening should be part of a comprehensive methodology designed to promote good health care decisions, such as encouraging abstinence, promoting safer sexual practices, and using the most appropriate methodology to detect and treat STIs.

Diagnostic Techniques and Procedures↗
PubMed2002

Hypersensitivity to inhaled TOBI following reaction to gentamicin.

Cystic fibrosis (CF) is the most common autosomal-recessive disease in Caucasians. Colonization with Pseudomonas aeruginosa (P. aeruginosa) of the CF airways causes deterioration of pulmonary status. TOBI (Tobramycin solution for inhalation) is an inhaled antibiotic that can improve the pulmonary disease. We report on a 9-year old boy with CF who developed a rash following a course of IV gentamicin. The rash resolved after its discontinuation. However, the rash returned all over his body, with the start of inhalation of TOBI therapy. We desensitized the patient using escalating doses of inhaled TOBI. He tolerated the procedure well, and continues to be on TOBI 9 months after desensitization on a once-a-day regimen.

Administration, Inhalation↗