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A real-time PCR assay was developed to identify varicella-zoster virus (VZV) and herpes simplex virus (HSV) DNA in clinical specimens from subjects with suspected herpes zoster (HZ; shingles). Three sets of primers and probes were used in separate PCR reactions to detect and discriminate among wild-type VZV (VZV-WT), Oka vaccine strain VZV (VZV-Oka), and HSV DNA, and the reaction for each virus DNA was multiplexed with primers and probe specific for the human beta-globin gene to assess specimen adequacy. Discrimination of all VZV-WT strains, including Japanese isolates and the Oka parent strain, from VZV-Oka was based upon a single nucleotide polymorphism at position 106262 in ORF 62, resulting in preferential amplification by the homologous primer pair. The assay was highly sensitive and specific for the target virus DNA, and no cross-reactions were detected with any other infectious agent. With the PCR assay as the gold standard, the sensitivity of virus culture was 53% for VZV and 77% for HSV. There was 92% agreement between the clinical diagnosis of HZ by the Clinical Evaluation Committee and the PCR assay results., (Published 2009 Wiley-Liss, Inc.)

Two injections of tetravalent (Groups A, C, Y and W-135) meningococcal polysaccharide vaccine conjugated to diphtheria were given to 30 toddlers at dosages of 1, 4 and 10 microg/ml polysaccharide of each serogroup. Reactogenicity was acceptable at all dosages. The 4-microg/ml dose appears to be immunologically optimal.

Objectives: To assess pediatric residents' self-reported skills and satisfaction with providing sexuality-related health care to teenagers and to examine differences by resident and patient gender., Design: Cross-sectional survey., Participants: Forty second-year (PGY2) and 17 third-year (PGY3) pediatric residents at one training program who completed a self-administered questionnaire., Main Outcome Measures: Residents rated their skills with taking a history from, performing a physical examination on, developing a diagnosis for, and counseling both male and female teenagers. Skills with providing health care to male and female teenagers were assessed separately. Scales were constructed for skills with performing a physical examination and providing a diagnosis and counseling. Residents also rated their satisfaction with providing health care to male and female teenagers. Skills and satisfaction with providing health care to male vs female teenagers were analyzed., Results: Female residents rated their skills with providing health care to male teenagers significantly lower than their skills with providing health care to female teenagers as follows: taking a history of pubertal development (PGY2, P = .001; PGY3, P = .02), taking a sexual history (PGY2, P = .004), asking about sexual preference (PGY2, P = .02), examination and diagnosis scale (PGY2, P < .001; PGY3, P = .008), and counseling scale (PGY2, P = .003). For male residents, there were no significant differences in skills with providing health care to male vs female teenagers. Second-year, but not third-year, female residents reported significantly lower (P < .005) satisfaction with providing health care to male vs female teenagers., Conclusions: Among female residents, discrepancies were found when comparing self-assessed competencies and, for PGY2 residents, level of satisfaction with providing health care to male vs female patients. If other research confirms these findings, educational interventions related to sexuality-related health care for teenagers should be designed with consideration to gender-specific learner needs.