ABSTRACT
We have evaluated the validity of the clinical data, the clinical impression (CI) of the physician and a rapid antigenic technique (RAT) for the diagnosis of acute streptococcal pharyngitis and tonsillitis (SPT). We evaluated 126 patients aged 7-60 years (October 1988-March 1989). The incidence of SPT was 19%. SPTs had a significantly higher frequency of lack of cough and sudden onset as isolated findings, and of the associations fever greater than 38 degrees C + exudate + lack of cough, and sudden onset + fever greater than 38 degrees C + exudate + lack of cough. CI had a sensibility (S) of 56%, a specificity (Sp) of 72%, a positive predictive value (PPV) of 32%, a negative predictive value (NPV) of 88% and an overall valve (OV) of 69%. The RAT had a S of 79.2%, a Sp 93%, a PPV of 73%, a NPV of 95%, and an OV of 90.5%. Only some clinical data are useful to diagnose SPT. The CI of the physician has a low predictive value, whereas TestPack Strep A is useful and has a similar value as pharyngeal culture.
Subject(s)
Pharyngitis/microbiology , Streptococcal Infections/diagnosis , Streptococcus pyogenes/isolation & purification , Tonsillitis/microbiology , Acute Disease , Adolescent , Adult , Child , Diagnosis, Differential , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Pharyngitis/diagnosis , Tonsillitis/diagnosisABSTRACT
Hispanic adolescents are the fastest growing ethnic-minority age group in America. They are also at high risk for drug, alcohol, and tobacco use. In this paper, the authors discuss the etiology of Hispanic adolescents' substance abuse, as explained in part by psychological stress. Based on the authors' research and on other data, a model for preventing substance abuse among Hispanic youths is presented. The model draws from coping, acculturation, social learning, and informal network theories. Concluding with a research agenda, the paper calls for descriptive, correlative, and intervention outcome studies to scientifically understand and prevent substance use among Hispanic adolescents.
