RESUMO
Clinicians frequently use influenza rapid antigen tests for diagnostic testing. We tested nasal wash samples from 1 April to 7 June 2009 from 1538 patients using the QuickVue Influenza A+B (Quidel) rapid influenza antigen test and compared the results with real-time reverse transcription polymerase chain reaction (rRT-PCR) assay (gold standard). The prevalence of 2009 pandemic influenza A (pH1N1) was 1.98%, seasonal influenza type A .87%, and seasonal influenza type B 2.07%. The sensitivity and specificity of the rapid test for pH1N1 was 20% (95% CI, 8-39) and 99% (95% CI, 98-99), for seasonal influenza type A 15% (95% CI, 2-45) and 99% (95% CI, 98-99), and for influenza type B was 31% (95% CI, 9-61) and 99% (95% CI, 98-99.7). Rapid influenza antigen tests were of limited use at a time when the prevalence of pH1N1 and seasonal influenza in the United States was low. Clinicians should instead rely on clinical impression and laboratory diagnosis by rRT-PCR.
Assuntos
Antígenos Virais/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Vírus da Influenza A Subtipo H1N1/imunologia , Influenza Humana/diagnóstico , Virologia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Imunoensaio/métodos , Lactente , Recém-Nascido , Vírus da Influenza A Subtipo H1N1/genética , Vírus da Influenza A Subtipo H1N1/isolamento & purificação , Vírus da Influenza B/genética , Vírus da Influenza B/imunologia , Vírus da Influenza B/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Mucosa Nasal/virologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Sensibilidade e Especificidade , Texas , Adulto JovemRESUMO
OBJECTIVE: To measure indirectly standardized active duty Air Force (ADAF) suicide rates. METHODS: The study period was 1990-2004. ADAF suicide deaths were obtained from the Air Force Mortality Registry. ADAF population counts were obtained from the Defense Manpower and Data Center. Suicide rates for the U.S. general population were obtained from the National Center for Health Statistics. RESULTS: The standardized mortality ratios (SMRs), adjusted for age, gender, and race, were: all enlisted personnel, 0.64 (95% CI: 0.59-0.69) and all officers, 0.14 (95% CI: 0.10-0.20). Adjusted for age and race, the SMRs were: enlisted men, 0.63 (95% CI: 0.58-0.68); enlisted women, 0.95 (95% CI: 0.66-1.33); officer men, 0.12 (95% CI: 0.08-0.17); and officer women, 0.67 (95% CI: 0.27-1.36). CONCLUSIONS: There were significant deficits of suicides in overall enlisted personnel and in overall officers. When analyzed further by gender and rank, there were significant deficits only in enlisted men and officer men. Suicide mortality in enlisted and officer women was not significantly less compared to their general population counterparts.
