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Oral therapy with 2.0 g of azithromycin as a single dose or as two doses 1 week apart is a promising alternative to therapy with benzathine penicillin G for syphilis and should be studied further.

Objective:To estimate the contributions of five risk factors to changes in US traffic crash mortality: (1) alcohol use by drivers and pedestrians, (2) not wearing a seat belt, (3) lack of an air bag, (4) not wearing a motorcycle helmet, and (5) not wearing a bicycle helmet.Design:Longitudinal study of deaths; attributable deaths were estimated using data from other studies.Setting:US traffic crashes in 1982–2001.Subjects:People who died in a crash.Main outcome measures:Counts of deaths attributed to each risk factor, change in rates of deaths, and counts of lives saved by changes in risk factor prevalence.Results:There were 858 741 traffic deaths during the 20 year period. Estimated deaths attributed to each factor were: (1) alcohol use, 366 606; (2) not wearing a seat belt, 259 239; (3) lack of an air bag, 31 377; (4) no motorcycle helmet, 12 095; (5) no bicycle helmet, 10 552. Over the 20 years, mortality rates attributed to each risk factor declined: alcohol by 53%; not wearing a seat belt by 49%; lack of an air bag by 17%; no motorcycle helmet by 74%; no bicycle helmet by 39%. There were 153 168 lives saved by decreased drinking and driving, 129 297 by increased use of seat belts, 4305 by increased air bag prevalence, 6475 by increased use of motorcycle helmets, and 239 by increased use of bicycle helmets.Conclusions:Decreased alcohol use and increased use of seat belts were associated with substantial reductions in crash mortality from 1982 through 2001. Increased presence of air bags, motorcycle helmets, and bicycle helmets were associated with smaller reductions.

Objectives: To determine the utility of urine-based ligase chain reaction assays for Neisseria gonorrhoeae and Chlamydia trachomatis in (1) the acceptability of such testing to adolescent detainees, (2) the potential use of these tests for identifying asymptomatic infections, and (3) the effectiveness of this approach for ensuring treatment of infected adolescents.Design: Cross-sectional screening and verification of treatment for infected cases.Subjects: Adolescents admitted to a short-term juvenile detention center.Main Outcome Measures: Neisseria gonorrhoeae and C trachomatis infection rates, and timing and location of treatment for infected patients.Results: Refusal rate was 1.5%. Of 263 participants, 46 (17.5%) were female subjects. Chlamydia trachomatis infections were identified in 28.3% of the female and 8.8% of the male subjects. Neisseria gonorrhoeae infections were present in 13.1% of the female and 2.8% of the male subjects. Overall, 37 participants (14%) were positive for N gonorrhoeae, C trachomatis, or both, only one of whom had symptoms. Almost 70% (25/36) of asymptomatic infected subjects were treated within 28 days of screening. A treatment was documented in 36 of the 37 infected youth, including 20 who were followed up and treated after release from the detention center, by 6 months after testing. Conclusion:Urine ligase chain reaction tests were effective for identifying and guiding treatment of unsuspected N gonorrhoeae and C trachomatis infections in teenagers admitted to a short-term detention center where traditional swab specimens may be difficult to obtain.