Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Chang DC[original query] |
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Increased gonorrhea screening and case finding after implementation of expanded screening criteria—urban Indian Health Service facility in Phoenix, Arizona, 2011–2013
Patton ME , Kirkcaldy RD , Chang DC , Markman S , Yellowman M , Petrosky E , Adams L , Robinson C , Gupta A , Taylor MM . Sex Transm Dis 2016 43 (6) 396-401 BACKGROUND: Gonorrhea screening is recommended for women at risk and men who have sex with men; expanded screening is encouraged based on local epidemiology. In response to a substantial increase in gonorrhea cases at an urban medical center serving American Indians, gonorrhea screening of all sexually active patients aged 14 to 45 years was initiated in March 2013. We describe gonorrhea screening coverage and case finding before and after implementation of expanded screening. METHODS: In March 2013, provider training, electronic health record prompts, and bundled laboratory orders were implemented to facilitate gonorrhea screening of all sexually active patients aged 14 to 45 years. We assessed the proportions of patients screened and testing positive for gonorrhea in the 2 years before (March 2011–February 2012 [indicated as 2011], March 2012–February 2013 [2012]) and 1 year after (March 2013–February 2014 [2013]) expanded screening measures. RESULTS: Gonorrhea screening coverage increased from 22% (2012) to 38% (2013); coverage increased 50% among females and 202% among males. Screening coverage increased in nearly all clinics. Gonorrhea case finding increased 68% among females in 2013 (n = 104) compared with 2012 (n = 62), primarily among women aged 25 to 29 years. No corresponding increase in gonorrhea case finding occurred among males. Most increased case finding occurred in the emergency department. CONCLUSIONS: After introduction of expanded gonorrhea screening, there was a significant increase in gonorrhea screening coverage and a subsequent increase in gonorrhea case finding among females. Despite increased screening in all clinics, increased case finding only occurred in the emergency department. |
National outbreak of Acanthamoeba keratitis associated with use of a contact lens solution, United States
Verani JR , Lorick SA , Yoder JS , Beach MJ , Braden CR , Roberts JM , Conover CS , Chen S , McConnell KA , Chang DC , Park BJ , Jones DB , Visvesvara GS , Roy SL , AcanthamoebaKeratitis Investigation Team . Emerg Infect Dis 2009 15 (8) 1236-42 An outbreak of Acanthamoeba keratitis, a rare, potentially blinding, corneal infection, was detected in the United States in 2007; cases had been increasing since 2004. A case-control study was conducted to investigate the outbreak. We interviewed 105 case-patients from 30 states and 184 controls matched geographically and by contact lens use. Available contact lenses, cases, solutions, and corneal specimens from case-patients were cultured and tested by molecular methods. In multivariate analyses, case-patients had significantly greater odds of having used Advanced Medical Optics Complete Moisture Plus (AMOCMP) solution (odds ratio 16.9, 95% confidence interval 4.8-59.5). AMOCMP manufacturing lot information was available for 22 case-patients, but none of the lots were identical. Three unopened bottles of AMOCMP tested negative for Acanthamoeba spp. Our findings suggest that the solution was not intrinsically contaminated and that its anti-Acanthamoeba efficacy was likely insufficient. Premarket standardized testing of contact lens solutions for activity against Acanthamoeba spp. is warranted. |
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