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In the era of the pandemic in which stressful work environment, social distancing, and self-isolation make it difficult to maintain interconnectedness and build relationships, despair can occur. Spiritual practices are examples of the resources that can be used effectively in times of stress to reduce the negativity that life stressors create in individuals.

Partner notification services (PS) are often used to control sexually transmitted infections, but their effectiveness is limited by patients' reluctance to name sex partners. We hypothesized that being notified of having antimicrobial resistant Neisseria gonorrhoeae (ARGC) would make patients more likely to provide named partner information.

We used King County, Washington STD surveillance and Strengthening the U.S. Response to Resistant Gonorrhea data to identify gonorrhea cases. Using log-binomial regression, we computed unadjusted and adjusted prevalence ratios for factors associated with naming any partners during routine PS interview vs. interview following ARGC diagnosis. Among those who completed a standard PS interview and later a reinterview after ARGC diagnosis, we compared mean numbers of reported and contactable partners at initial interview and reinterview using the Wilcoxon rank sum test.

From 7/2018 to 10/2020, 1,588 gonorrhea cases were interviewed; 103 (6%) had ARGC. After adjusting for sexual exposure, age, year, DIS, reinterview, and diagnosing clinic, being interviewed following ARGC diagnosis remained predictive of naming ≥1 partner relative to routine PS (PR 2.2, 95% CI 1.6-2.9). Among 40 cases who completed a standard PS interview and later a reinterview following ARGC diagnosis, there was a modest increase in mean partners named at initial vs. reinterview (1.4 vs. 1.9 per case, p = 0.09).

Cases interviewed after ARGC diagnosis named more contactable partners than those undergoing routine PS. Reinterviewing patients following ARGC diagnosis provides only a modest increase in contactable partners but may be useful to limit transmission of this potentially challenging infection.

Cases interviewed after ARGC diagnosis named more contactable partners than those undergoing routine PS. Reinterviewing patients following ARGC diagnosis provides only a modest increase in contactable partners but may be useful to limit transmission of this potentially challenging infection.

This national survey demonstrates age-disparate (≥5 years; AD-5) sexual partnerships remain common among males and females aged 20-29 years in the U.S. (2005-2016). Females reported more older AD-5 partners and males reported more younger AD-5 partners. Having AD-5 partners was associated with greater lifetime and recent number of sexual partners.

This national survey demonstrates age-disparate (≥5 years; AD-5) sexual partnerships remain common among males and females aged 20-29 years in the U.S. (2005-2016). Females reported more older AD-5 partners and males reported more younger AD-5 partners. Saracatinib Having AD-5 partners was associated with greater lifetime and recent number of sexual partners.

While most gonorrhea (GC) cases in the US are detected using nucleic acid amplification tests (NAATs), isolation of Neisseria gonorrhoeae (NG) using culture specimens is needed for antibiotic susceptibility testing (AST). We present data on NAATs and cultures collected before and during the CDC demonstration project (SURRG) to describe a process to define culture criteria for NG isolation for surveillance of NG with reduced susceptibility.

For STI clinics in New York City, NY, San Francisco, CA, and Milwaukee, WI, we calculated NAAT positivity by anatomic site in 2016 (pre-SURRG) across three groups 1) sex partners of persons with GC; 2) patients with symptoms (e.g., urethral or cervical discharge); 3) patients who had tested positive and were returning for GC treatment, and compared it with positivity among all other patients. We then examined SURRG-period NAAT positivity among patients from whom a culture was or was not collected, and culture positivity, by specimen site and jurisdiction.

Pre-SURRG, NAAT positivity across the three select groups was at least twice that of patients who did not meet any criteria. SURRG-period NAAT positivity was higher among patients from whom a culture was also collected. Overall culture positivity was relatively high (NYC34.8%, SF26.7%, Milwaukee24.8%); the proportion of specimens tested widely varied (range 5.7%-26.5%) by jurisdiction.

NAAT data evaluation can inform the establishment of criteria for culture collection for AST. Routine evaluation and quality improvement activities related to culture collection/isolation techniques could increase NG isolation for AST.

NAAT data evaluation can inform the establishment of criteria for culture collection for AST. Routine evaluation and quality improvement activities related to culture collection/isolation techniques could increase NG isolation for AST.

The CDC implemented Strengthening the U.S. Response to Resistant Gonorrhea (SURRG) to build local detection and response capacity and evaluate responses to antibiotic-resistant gonorrhea outbreaks, including partner services for gonorrhea. We evaluated outcomes of traditional partner services conducted under SURRG, which involved (1) counseling index patients and eliciting sexual partners, (2) interviewing, testing and treating partners, and (3) providing partner services to partners newly diagnosed with gonorrhea. We also evaluated outcomes of enhanced partner services, which additionally involved interviewing and testing partners of persons who tested negative, and social contacts of index patients and partners.

We analyzed partner services investigation data from eight jurisdictions participating in SURRG from 2017 through 2019. We summed total index patients, partners from traditional partner services, and partners and contacts from enhanced partner services, and calculated partner services outcomes aing, notifying, and diagnosing a substantial number of additional people.

Literature suggests that adolescents may not accurately report sexual activity to their providers, impeding risk-based screening efforts for gonorrhea and chlamydia (GC/CT). We assessed the effect of a clinic-based universal GC/CT screening initiative on GC/CT screening frequency and detection of GC/CT infections among adolescents (males and females ≥13 years old) and the association between positive GC/CT and documented sexual activity.

We conducted a pre-post analysis of a primary care clinic affiliated with an academic institution. The electronic medical record was queried to extract all adolescent well and acute encounters for the 12 months pre- and post-implementation of universal GC/CT screening in January 2015.

856 encounters from 752 unique adolescents were included. Screening increased post-implementation (23.3% vs 61.4%, p < 0.001) of universal screening. Though there were similar rates of documented sexual activity pre- and post-implementation (14.6% vs 16.0%), a larger proportion of unknown sexual activity was documented (10.5% vs 23.7%, p < 0.001). Provider-level factors were the most frequent reasons for not screening. The absolute number of GC/CT cases increased, though the proportion of cases out of all eligible adolescents remained similar as more testing was completed (chlamydia 5/752 vs. 12/752, p = 0.09; gonorrhea 0/752 vs. 1/752, p = 0.32). Nearly half of positive chlamydia infections post-implementation appeared in adolescents who reported no sexual activity.

Universal screening in a primary care clinic increased screening and detection of cases of gonorrhea and chlamydia, including in adolescents who did not report sexual activity.

Universal screening in a primary care clinic increased screening and detection of cases of gonorrhea and chlamydia, including in adolescents who did not report sexual activity.

To estimate the impact of the Check It program, a novel community-based chlamydia seek, test and treat program for young Black men who have sex with women, on test positivity rates for chlamydia in young Black women.

We used a synthetic control model to compare chlamydia test positivity rates in Orleans Parish (intervention site) to other similar parishes (control sites) in Louisiana. We estimated a model that used all other parishes as potential contributors to a synthetic control for Louisiana as well as a sample limited to the 40 parishes in Louisiana with the largest Black populations.

The Check It program was associated with a 1.69 percentage point decline in chlamydia positivity in the first full year of operation and a 2.44 percentage point decline in chlamydia positivity in the second full year of operation compared to control sites with the largest Black populations (p = 0.05). Results were similar when the treatment site was compared to all other sites in Louisiana.

The Check It program was associated with a significant decline in chlamydia testing positivity rates among women in Orleans Parish compared to control sites. Screening of young Black men who have sex with women can decrease rates in women living in the same community. Future recommendations for chlamydia screening of young men should be considered.

The Check It program was associated with a significant decline in chlamydia testing positivity rates among women in Orleans Parish compared to control sites. Screening of young Black men who have sex with women can decrease rates in women living in the same community. Future recommendations for chlamydia screening of young men should be considered.

This study aimed to assess the prevalence of chest wall injuries due to cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) and to compare in-hospital outcomes in patients with versus without chest wall injuries.

A retrospective cohort study was performed of all Intensive Care Unit (ICU)-admitted patients who underwent CPR for OHCA between January 1, 2007 and December 2019. The primary outcome was the occurrence of chest wall injuries, as diagnosed on chest Computed Tomography (CT). Chest wall injury characteristics such as rib fracture location, type, and dislocation were collected. Secondary outcomes were in-hospital outcomes and subgroup analysis of patients with good neurological recovery to identify those who could possibly benefit from the surgical stabilization of rib fractures (SSRF).

Three hundred forty-four patients were included, of which 291 (85%) sustained chest wall injury. Patients with chest wall injury had a median of 8 fractured ribs (P25-P75 4-10 ribs) which c, Level IV.

Therapeutic, Level IV.

Chest computed tomography (CT) scans are important for the management of rib fracture patients, especially when determining indications for surgical stabilization of rib fractures (SSRF). Chest CTs describe the number, patterns, and severity of rib fracture displacement, driving patient management and SSRF indications. Literature is scarce comparing radiologist versus surgeon rib fracture description. We hypothesize there is significant discrepancy between how radiologists and surgeons describe rib fractures.

This was an IRB approved, retrospective study conducted at a Level I academic center from 12/2016 through 12/2017. Adult patients (≥ 18 years-of-age) suffering rib fractures with a CT chest where included. Basic demographics were obtained. Outcomes included the difference between radiologist versus surgeon description of rib fractures and differences in the number of fractures identified. Rib fracture description was based on current literature 1-Non-displaced; 2-Minimally displaced (< 50% rib width); 3-Severely displaced (≥ 50% rib width); 4-Bicortically displaced; 5-Other.