A Descriptive Analysis of Men Diagnosed With Epididymitis, Orchitis, or Both in the Emergency Department

Bonner, Mason; Sheele, Johnathan M.; Cantillo-Campos, Santiago; Elkins, Justin M.

doi:10.7759/cureus.15800

Cited by 7 publications

(13 citation statements)

References 24 publications

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“…Through this model, we can better reflect recent trends in chlamydia incidence in the U.S., at least relative to traditional compartmental models, while also projecting a greater health benefit from the upscaling of STI screening interventions. By integrating the capacity to evaluate disease interventions and inform on the time periods critical to the durations of chlamydia infection, our model uniquely contributes to the wealth of knowledge needed by health officials to make informed decisions, and thereby may aid in reversing the increasing rates of STIs in the U.S. 𝜔 𝐷 Disability weight of severe pelvic inflammatory disease 0.324 [39] 𝜔 𝐸 Disability weight of epididymo-orchitis 0.128 [39] 𝜌 𝐼 Proportion of symptomatic incidence with no complications 0.23 [37] 𝜌 𝐴 Proportion of asymptomatic incidence with no complications 0.60 [37] 𝜌 𝑀 Proportion of incidence leading to PID 0.09 [38] 𝜌 𝐸 Proportion of incidence with epididymo-orchitis 0.0415 [40] 𝜌 𝐷…”

Section: Discussionmentioning

confidence: 99%

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The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection

Farrell,

Spolyar,

Greenhalgh

2023

Preprint

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Sexually transmitted diseases are detrimental to the health and economic well-being of society. Consequently, predicting impending outbreaks and identifying effective disease interventions through the use of epidemiological tools, such as compartmental models, is of the utmost importance. Unfortunately, traditional compartmental models, specifically the differential equation models attributed to the work of Kermack and McKendrick, require either a duration of infection that follows the exponential or Erlang distribution, despite the biological invalidity of such assumptions. As these assumptions negatively impact the quality of model predictions, alternative approaches are required that capture the variability in the duration of infection, along with its associated effects on the trajectory of disease, and in the evaluation of disease interventions. So, we apply an entirely new family of differential equation compartmental models based on the quantity, "person-days of infection," to predict the trajectory of a disease. Importantly, this new family of models can alternative duration of infection distributions. As proof of concept, we calibrate our model to recent trends of chlamydia incidence in the United States and utilize a general statistical distribution that features periodic hazard rates. We then evaluate how increasing sexually transmitted disease screening rates alter predictions of incidence and saves disability adjusted life-years over a 5-year horizon. Our findings illustrate that increasing the annual screening rate of chlamydia from 35% to 40%-70% would annually avert 6.1-40.3 incidence and 1.68-11.14 disability adjusted life-years per 1000 people. This suggests increasing the screening rate of sexually transmitted diseases in the United States would greatly aid in ongoing public health efforts to curtail the rising trends in preventable sexually transmitted diseases.

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Section: Discussionmentioning

confidence: 99%

“…Chlamydia incidence averted and DALYS saved for screening rates that achieve 35%, 40%, 50%, and 70% coverage of the population per year. .319 3.318 3.157 3.131 3.124 3.033 3.034 3.037 3.03 40. 10.18 10.90 10.86 11.01 11.09 11.10 11.14…”

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confidence: 99%

The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection

Farrell,

Spolyar,

Greenhalgh

2023

Preprint

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“…As cited in literature, epididymitis and orchitis or epididymo-orchitis often present as gradual onset of scrotal pain and swelling, these conditions affect males of any age and are found to be the most common cause of scrotal pain in the emergency department ( 15 , 16 , 25 , 26 ). In the scans reported to be negative for TT, epididymitis was the most prevalent abnormality, accounting for 57% of the cases, followed by 30% with epididymo-orchitis.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of radionuclide scintigraphy in confirming testicular torsion at delayed presentation

Zondi,

Pilloy,

Ntuli

et al. 2023

Transl Androl Urol

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Background Testicular torsion (TT) is a urological emergency that needs early diagnosis and intervention to prevent testicular death and necrosis. This study aimed to determine the efficacy of testicular scintigraphy (TS) in confirming the clinical diagnosis of TT and how this imaging method correlates with the surgical findings. Methods A retrospective cohort review of clinical data was performed for 68 patients referred for TS from January 2016 to December 2021 to rule out possible TT. The final diagnosis was confirmed at surgery for all those with TS positive for TT. Results The median age of the patients was 18.5 years, interquartile range of 15–31 years. Commonly presenting symptoms were pain (99%) and swelling (68%). Only 6% had history of trauma. TT was diagnosed by technetium-99m ( 99m Tc)-pertechnetate in 35 (51%) patients all of whom underwent surgical exploration. Of this group, 7 (20%) had manual detorsion intraoperatively (intermittent torsion), in 20 (57%) missed (complete) torsion was confirmed and 8 (23%) had a necrotic testis. Of the remaining 33 patients with results negative for torsion, 10 were normal and 23 were diagnosed with either epididymitis 13/23 (57%), orchitis 3/23 (13%) or 7/23 (30%) with epididymo-orchitis. TT was more common in patients under 15 and 15–19 years (P<0.05). The mean presentation time was 5 days with a range of 1–30 days. Conclusions The 99m Tc-pertechnetate scan remains an effective investigation in the diagnosis of TT and may serve as a gate-keeper for surgery even in patients who present late for treatment.

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“…Data has previously been published from this dataset. 2,[15][16][17][18][19][20][21] The Mayo Clinic institutional review board provided an exemption from full review.…”

Section: Methodsmentioning

confidence: 99%

Clue Cells on Vaginal Wet Preparation Are Not Associated with Urinary Tract Infections or Positive Urine Cultures

Sheele

Mead-Harvey

Hodgson

2022

WestJEM

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Introduction: Clue cells result from aberrant vaginal microflora and are associated with an increased vaginal pH, which can allow colonization of uropathogens in the vaginal introitus, increasing the risk for urinary tract infections (UTI). We sought to determine whether clue cells on vaginal wet preparation in the emergency department (ED) are associated with emergency physician diagnoses of UTIs and positive urine cultures. Methods: We conducted a retrospective analysis examining a dataset of women (≥18 years of age) who received both a genital wet preparation and urine testing in the ED. Both chi-square and multivariable regression analysis were performed. Results: We analyzed 14,952 encounters. On both univariable and multivariable analyses, emergency physicians diagnosed significantly fewer clue cell-positive women with a UTI (10.9% diagnosed with UTI vs 13.1% without UTI) (P <.001). Women with clue cells on vaginal wet preparation were not more likely to have a positive urine culture or have a urine culture growing Escherichia coli. Pregnant women with clue cells on vaginal wet preparation were not more likely to have a UTI or have a positive urine culture. Conclusion: Emergency physicians diagnosed significantly fewer women with UTIs when they found clue cells on vaginal wet preparation. Clue cells on vaginal wet preparation were not associated with an increased likelihood of a positive urine culture or having E. coli growing in the urine.

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A Descriptive Analysis of Men Diagnosed With Epididymitis, Orchitis, or Both in the Emergency Department

Abstract: Bonner et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 7 publications

References 24 publications

The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection

The effect of screening on the health burden of chlamydia: An evaluation of compartmental models based on person-days of infection

The effectiveness of radionuclide scintigraphy in confirming testicular torsion at delayed presentation

Clue Cells on Vaginal Wet Preparation Are Not Associated with Urinary Tract Infections or Positive Urine Cultures

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