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NAATs can be used to test vaginal and urine specimens from girls and urine in boys (see Sexual Assault or Abuse of Children). Data are lacking regarding use of NAATs for specimens from extragenital sites (rectum and pharynx) among boys and girls (553); other nonculture tests (e.g., DFA) are not recommended because of specificity concerns. Although data regarding NAATs for specimens from extragenital sites for children are more limited and performance is test dependent (553), no evidence supports that NAAT performance for detecting C. trachomatis for extragenital sites among children would differ from that among adults. Because of the implications of a diagnosis of C. trachomatis infection in a child, only CLIA-validated, FDA-cleared NAAT should be used for extragenital site specimens (837).

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Sexual abuse is the most frequent cause of gonococcal infection among infants and children (see Sexual Assault or Abuse of Children). For preadolescent girls, vaginitis is the most common manifestation of this infection; gonococcal-associated PID after vaginal infection can be less common among preadolescents than adults. Among sexually abused children, anorectal and pharyngeal infections with N. gonorrhoeae are frequently asymptomatic.

Culture can be used to test urogenital and extragenital sites for girls and boys. NAAT can be used to test for N. gonorrhoeae from vaginal and urine specimens from girls and urine for boys (see Sexual Assault or Abuse of Children). Although data regarding NAAT from extragenital sites (rectum and pharynx) among children are more limited, and performance is test dependent, no evidence supports that performance of NAAT for detection of N. gonorrhoeae among children differs from that among adults (553). Because of the implications of a N. gonorrhoeae diagnosis in a child, only validated FDA-cleared NAAT assays should be used with extragenital specimens. Consultation with an expert is necessary before using NAAT to minimize the possibility of cross-reaction with nongonococcal Neisseria species and other commensals (e.g., N. meningitidis, Neisseria sicca, Neisseria lactamica, Neisseria cinerea, or M. catarrhalis) and to ensure correct interpretation of results.

Evaluating children for sexual assault or abuse should be conducted in a manner designed to minimize pain and trauma to the child. Examinations and collection of vaginal specimens in prepubertal girls can be extremely uncomfortable and should be performed by an experienced clinician to avoid psychological and physical trauma to the child. The decision to obtain genital or other specimens from a child to evaluate for STIs should be made on an individual basis. However, children who received a diagnosis of one STI should be screened for other STIs. History and reported type of sexual contact might not be a reliable indicator, and urogenital, pharyngeal, and rectal testing should be considered for preverbal children and children who cannot verbalize details of the assault (1438,1449). Factors that should lead the physician to consider testing for STIs include the following (1449):

The risk for a child acquiring an STI as a result of sexual abuse or assault has not been well studied. Presumptive treatment for children who have been sexually assaulted or abused is not recommended because the incidence of most STIs among children is low after abuse or assault, prepubertal girls appear to be at lower risk for ascending infection than adolescent or adult women, and regular follow-up of children usually can be ensured. However, certain children or their parent or guardian might be concerned about the possibility of infection with an STI, even if the health care provider has perceived the risk to be low. Such concerns might be an indication for presumptive treatment in certain settings and might be considered after all relevant specimens for diagnostic tests have been collected.

In the movie Malevolent, brother and sister team Angela (Florence Pugh) and Jackson (Ben Lloyd-Hughes) seem like con artists who prey on grief-stricken people wanting to contact dead loved ones. Things are going well until Mrs. Green (Celia Imrie) hires the siblings and their team. They soon learn her home was once an orphanage where gruesome murders of young girls took place. But Angela starts to really see ghosts when she's confronted by the terrifying truth behind the orphanage murders.

MOVIES: Jennifer Hudson brings "Respect" Watch VideoOscar- and Grammy-winning actress Jennifer Hudson received "marching orders" from the legendary singer Aretha Franklin, who hand-picked the "Dreamgirls" star for her true dream role. Hudson talks with contributor Kelefa Sanneh about paying tribute to the Queen of Soul with her performance in the new biopic, "Respect."

An expansion card, also known as an expansion board, adapter card, or accessory board, is a printed circuit board that can be inserted into an expansion slot on the motherboard to add functionality to a computer system. [10] The three most common expansion cards are the audio card, graphics card, and network card. Each type of expansion card has a self-explanatory name and all serve the same purpose of adding functionality to the computer. The audio card is responsible for producing sound that is then transferred to speakers or headphones. Commonly audio cards are built onto the motherboard, however, they can be purchased separately. The graphics card turns the data produced by a CPU to an image that is able to be seen on a computer's display. Along with the audio card, graphics cards are commonly built onto the motherboard, yet graphics card that produce higher resolution images can be bought separately. Lastly, the network card is an expansion card that connects the computer to a computer network. This allows for a computer to exchange data with the computer network through a commonly used number of protocols called IEEE 802.11, popularly known as wireless LAN or Wi-Fi. [11]

Application Software is a single or group of programs that allow access for specific tasks to be performed. Users of a computer should familiarize themselves with the variety of applications that are available. The purpose of computer applications is that it can greatly simplify a task for a user. Ways applications can help are to create and modify word processing, spreadsheets, databases, presentations, along with graphics and multimedia.[1]

Alcala often posed as a friendly photographer, luring women and girls by approaching them on the street and offering to take their picture, before taking them to a secluded place and attacking them. He had been known to be violent and dangerous as early as when he was a young private in the Army.

KK Outlet is up for another opening this week. The -all too familiar- world where we are surrounded by inspiring quotes on life, but also have to fight the impossible beauty standards at the same time, is the main inspiration for these colourful paintings. Aspirational is about the dreams young people create, based on the perfect social media lives of others. We get taken into the lives of insecure girls, feeling their struggle and feeling uncomfortable, watching the cry for help in the intimate setting of the teenage bedroom. 350c69d7ab


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