Treadmill and cycle ergometry testing in 5- to 6-year-old children.

The primary purpose of this study was to determine the maximal cardiorespiratory responses of 48, 5- to 6-year-old children (24 girls and 24 boys), who were tested on a treadmill (TM) and an electronically braked cycle ergometer (CE). We also examined the percentage of boys and girls who were able to achieve the criteria for reaching maximal oxygen consumption (VO2max) on each testing mode. After an orientation period, each child was tested twice (once on the TM and once on the CE), with an interval of 1 week between tests. VO2max was measured during progressive, all out, continuous TM and CE tests using standardized procedures. A 2 x 2 analysis of variance test (genderxexercise mode) with Bonferroni adjustment revealed the following: (1) there were no gender differences in any of the measured dependent variables, (2) the children produced a significantly higher relative VO2max (ml x kg(-1) x min(-1) and a higher absolute VO2max (l x min(-1)) on the TM than on the CE (P < 0.001), (3) the children produced a higher heart rate on the TM than on the CE (P < 0.001), (4) the CE generated significantly higher values for respiratory exchange ratio (P < 0.001), (5) the criteria necessary to establish a maximal exercise effort were achieved on both the TM and the CE, and (6) all of the children reached two of the criteria associated with a maximal effort, while only 46% of the children reached three criterion measures. There were no significant differences in the attainment of criterion measures between the TM and the CE. The results of this study indicate a lack of gender differences in maximal exercise testing in 5- to 6-year-old children, and that both the CE and the TM are effective modes of maximal cardiorespiratory testing in this age group.

Treatment of uncomplicated gonorrhea with single-dose imipenem-cilastatin.

Single 500-mg intramuscular doses of imipenem-cilastatin cured 116 (95%) of 122 men and 9 of 9 women with uncomplicated gonorrhea due to beta-lactamase-negative Neisseria gonorrhoeae. Most co-existing Chlamydia trachomatis infections persisted. Imipenem-cilastatin is effective for uncomplicated gonorrhea in men but has no advantages over other available regimens.

Cost-yield of routine Papanicolaou smear screening in a clinic for sexually transmitted diseases.

Because women who attend sexually transmitted diseases clinics have a greater risk of developing cervical cancer than do nonattenders, the authors assessed the cost-yield of routine Papanicolaou screening at the Denver metro Health Clinic. From February 1, 1981 to October 31, 1983, the authors offered Papanicolaou screening to women 25 years of age or older who would sign an agreement accepting responsibility for follow-up. To enhance the cost-yield of identifying a population of women at high risk for a seriously abnormal result who might not otherwise obtain screening, the authors excluded women under 25 years and women with recent smears or conditions complicating interpretation of the smear. Follow-up efforts included a sequence of mailed reminders, telephone calls, certified letters, and home visits. Of 697 initial smears, 40 (5.7%) showed some evidence of atypia, and 12 (1.7%) of these showed dysplasia. Colposcopic or surgical biopsy confirmed dysplasia in three, carcinoma in situ in two, and invasive cervical carcinoma in one. Only 53 patients (7.6%) contacted the clinic for results, and the clinic was able to reach only 49 of 102 women with abnormal smears. The direct cost of the program was about $15,000. Although the rate of dysplasia was relatively low, adequate follow-up proved to be the main barrier to maximizing the cost-yield of Papanicolaou smear-screening in the clinic. It may be necessary for each large sexually transmitted diseases clinic to perform a pilot study to determine whether or not the costs of performing routine Papanicolaou smears are justified by the yields.

Comparative study of ceftriaxone and spectinomycin in the treatment of uncomplicated gonorrhea in women.

Single-dose ceftriaxone, 125 mg given intramuscularly, was compared with spectinomycin 2.0 g given intramuscularly in the treatment of women with uncomplicated gonorrhea. Cervical or anorectal gonococcal infection was eradicated in 54 (98 percent) of 55 women treated with ceftriaxone and 22 (96 percent) of 23 treated with spectinomycin. Cure rates for pharyngeal gonococcal infections were nine of 10 for ceftriaxone and four of eight for spectinomycin (p = 0.18). Neither agent eradicated concurrent Chlamydia trachomatis infection. The geometric mean minimal inhibitory concentration for ceftriaxone was 0.0038 microgram/ml for 65 pretreatment cervical isolates of beta-lactamase-negative Neisseria gonorrhoeae and all isolates were inhibited by 0.063 microgram/ml. Neither drug caused perceptible toxicity, but patient acceptance was better for ceftriaxone than for spectinomycin. A single 125 mg dose of ceftriaxone is an excellent regimen in the treatment of uncomplicated gonorrhea in women.

Comparative study of ceftriaxone and aqueous procaine penicillin G in the treatment of uncomplicated gonorrhea in women.

Uncomplicated gonorrhea of 122 mucosal sites in 51 women was successfully treated with either a single intramuscular dose of 250 mg of ceftriaxone (23 patients) or two intramuscular doses of 4.8 X 10(6) U of aqueous procaine penicillin G (28 patients). Women treated with ceftriaxone had 22 cervical, 12 urethral, 10 anal canal, and 5 pharyngeal infections. All 122 pretreatment isolates were inhibited by 0.0125 microgram or less of ceftriaxone per ml. The minimal concentration needed to inhibit 90% of isolates was 0.006 microgram/ml for ceftriaxone and 0.2 microgram/ml for penicillin G. Ceftriaxone was very well tolerated and caused no toxicity.