Adequacy of testing, empiric treatment, and referral for adult male emergency department patients with possible chlamydia and/or gonorrhoea urethritis.

This study evaluated the adequacy of testing, empiric treatment and referral for further evaluation of adult male emergency department (ED) patients with possible chlamydia and/or gonorrhoea urethritis. Of 968 adult male ED patients, 84% were tested for chlamydia and gonorrhoea, 16% for HIV and 27% for syphilis; 92% received empiric treatment for chlamydia and gonorrhoea and 71% were referred for further evaluation; of those tested, 29% were infected with chlamydia, gonorrhoea or both; and 3% of those tested had a positive syphilis test. The results of logistic regression modelling indicated that testing, treatment and referral were not related to a history of sexual contact with someone known to have a sexually transmitted disease or to the patient's ultimate diagnosis of a laboratory-confirmed infection. Compliance with Centers for Disease Control and Prevention (CDC) recommendations for chlamydia and gonorrhoea testing and treatment regimens was high, but was poor for HIV testing. More explicit guidance from CDC regarding syphilis testing and referral for further evaluation is needed.

Effects of moderate dietary phosphorus restriction on intestinal absorption and external balances of phosphorus and calcium in growing female rabbits.

The effects of moderate dietary P restriction on intestinal net fluxes and external balances of P and Ca were studied in growing female albino rabbits that were fed a P-deficient diet for 10 consecutive days while they were housed in metabolism cages. Intestinal P secretion occurred during the first 24 h of P restriction and thereafter changed to absorption. During recovery, when the rabbits were consuming a normal diet, P absorption was significantly greater than either prerestriction control values or than in a separate group of time control rabbits. Phosphorus balance was negative during the 1st day of P restriction but thereafter became positive. This pattern occurred because intestinal P secretion changed to absorption and because urinary losses of P were negligible. Intestinal Ca absorption increased within 24 h of P restriction, reached maximal values by 4 days, and remained elevated for each of the remaining 6 days that dietary P was low. It also was elevated compared to P-sufficient time controls for 8 days after replenishment of dietary P. Despite increased intestinal absorption, Ca balance was significantly reduced during P restriction because of substantial hypercalciuria. Thus, selective dietary P restriction reduced the positive balances of both P and Ca that are characteristic of growth. We conclude that in growing rabbits moderate dietary P restriction induces both intestinal and renal adaptations that conserve this mineral; concomitantly, positive Ca balance is reduced. With dietary P replenishment, adaptations persist to restore the positive mineral balances that were lost because of dietary P restriction during growth.