Impact of new diagnostic criteria on the prevalence and incidence of pelvic inflammatory disease.

STUDY OBJECTIVE: The Centers for Disease Control and Prevention (CDC) recently changed the recommended criteria for the clinical diagnosis of pelvic inflammatory disease (PID). The purpose of this study was to assess the impact of this change on the frequency with which we made a diagnosis of PID. DESIGN: prospective cohort study. SETTING: juvenile detention center. PARTICIPANTS: adolescent females. INTERVENTIONS: We used the new diagnostic criteria to determine the prevalence and incidence of PID. We then compared these values to those in a previous study of a similar cohort of youth who were evaluated with the CDC's old, more stringent clinical criteria. MAIN OUTCOME MEASURES: Prevalence and incidence of PID. INCIDENCE MEASURES: Incidence density and cumulative incidence, using the Kaplan-Meier method. Results between studies were compared using prevalence and incidence ratios. RESULTS: In sexually active adolescents (N=315), the prevalence of PID (95% confidence interval) at admission was 8.6% (5.7-12.2%). During the first 31 days of incarceration, the cumulative incidence was 7.9% (5.0-12.3%) and the incidence density was 11.1 cases/100 person-months (6.5-16.4). Comparison of these results with those of our previous study that used old diagnostic criteria yielded a prevalence ratio of 2.0 (1.0-4.2), a risk ratio (comparing cumulative incidence) of 3.6, and a rate ratio (comparing incidence density) of 3.4 (1.2-11.2). All differences were statistically significant (P<0.05). CONCLUSION: The new diagnostic criteria for PID doubled the prevalence and more than tripled the incidence of this disease in this high risk population of incarcerated adolescents.

Ultrasonic vocalizations are elicited from rat pups in the home cage by pentylenetetrazol and U50,488, but not naltrexone.

Although isolated rat pups emit ultrasonic vocalizations (USVs), those kept warm and undisturbed in the home cage with their littermates seldom do. Drugs were administered to 10-day-old pups in the home cage to determine whether pharmacological agents can elicit USV in this familiar environment. Ten-day-old Wistar rats were injected with U50,488, a highly selective kappa opioid agonist; pentylenetetrazol (PTZ), an anxiogenic drug that binds at the GABA-benzodiazepine receptor complex; or naltrexone (NLX), an opiate receptor blocker, and then were returned to their littermates in the home cage. U50,488 increased USV and activity levels, lowered body temperature, and disrupted contact with littermates. PTZ raised activity levels but had a smaller effect on vocalization rates and did not alter temperature or contact with littermates. Behavioral measures and body temperature were unchanged by NLX.