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Meet Singles On HIV Dating Sites

It is very important to be positive in life and always look forward to each new day with a smile on your face. When people are living with HIV and are dealing with this virus it is very important to keep a positive outlook. Many people are not looking at HIV dating options because they are depressed and will often keep to themselves. The word "HIV" has a black cloud that follows it and it isn't something that many people are comfortable discussing. Times are changing though, and as more information is revealed about the virus and advances in medicine unveil new treatment options that are working it has resulted in many people being slightly more open to discussing the topic without being overtaken by complete fear. As we become more educated as a whole, we begin to understand the disease more. As society becomes more supportive of the concept of someone being HIV positive, it has resulted in those people being more willing to try HIV dating options. Websites dedicated to providing those that are positive with a platform to find other singles with the same condition have become very popular and have helped many find individuals that share the same common factor. These dating sites aren't any different from the other mainstream online dating websites, as there is just one main different, and that is the fact that the users that register for these sites are HIV positive. Another good thing that these sites offer is information pertaining to the disease that is constantly updated. The are much more than just an online outlet for meeting other singles looking for HIV dating options. There is an actual educational element to these sites as well. Everyone wants to meet that special someone and nobody wants to live their life alone. When many people who have HIV would remain isolated and blocked off from society and dating, these sites give them a new outlook and ability to live a happy life with someone else. Users have the chance to meet friends, short term lovers, and long term relationships through these websites.

Many see this as an opportunity to be brought back into the normal world, as they will not be judged based just on the fact that they are infected with HIV. Now, when looking for an HIV dating website it is important that some research is done prior to joining to make sure that the correct one is picked. The first thing that we suggest is done is test the security of the website and read their privacy policy. You want to make sure that their site is secure and protected from hackers stealing the database information. Also, you want to make sure the site will not sell your email or other contact information to advertisers or other companies. While the other users on the site will be aware that the users are HIV positive, this isn't information that the participants would want leaked on the internet or shared with other companies. Once a site is picked, it is time to register! There are many sites that offer a limited free membership or a limited discounted membership that gives the users limited access to test the site and make sure that it is one that they will be happy with before they are charged the monthly fee. Some sites also give the option of signing up for a year in advance for a https://screencast.com/t/quQtoC8t lower rate, but we suggest that a monthly plan is selected. After all, what if you meet the person of your dreams after a month of HIV dating and the site isn't needed anymore.

http://www.selfgrowth.com/articles/meet-singles-on-hiv-dating-sites

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Online Dating - The Rules by Sonja Holbrook

- He loves and needs and wants and has to have you. Oh yeah, I bet he's falling for you and is half-way to *ahem* divine inspiration. - Limit the alcohol. It impairs your judgment. Period. STD-ridden sex ensues and we have yet one more generation of idiots, setting evolution back a few steps once and for all. Please, for the good of the species, do not send over your penis pics. Some may not believe that this is important, but when your desires are not reciprocated, there is a proper way to deal with it. If your mental SOS isn't immediately picked up by your date, let them down gently. - "Hey, so thanks for the coffee/drink/dinner. I had a great time, but I really should be going. I hope you have a great evening. Good Night. - Even if you're not interested, you still should spend 20-30 minutes with this person before escaping. Then you go home and draft an email: - This means you don't send a picture of your ripped, surfer 27 yr old son and call it an accident. - Use proper grammar & punctuation. It matters and if a person is too lazy to focus on what they're saying, then they'll be even less focused on what YOU'RE saying. Putting up a picture and a brief line: "just lookin' for a honey to spend some time wit" is not the best course of action. For best results, try to adhere to the following: http://www.articlecity.com/articles/relationships/article_3368.shtml - This means you don't list 20 shots of you in the same room, wearing the same shirt, shooting from the same 10 feet up angle, with 20 different facial expressions and calling it "random." - Stick with paid dating services. You get what you pay for and it's pretty safe to assume that if you have to pay for it, typically the low-life population gets weeded out. - This includes uploading pictures of you wearing your 10th grade cheerleader uniform when you graduated 15 years ago. Surefire way to sit on the back burner: "So, yeah. I'm interested. Tell me about yourself." - Picture-less profiles: married men don't want to be ID'd by their friends or *gasp* their wife. - "I didn't think you'd go out with me because of how I looked." You were right. Boob: oh you know it, baby, I gots to get me some of that! Acceptable: - "Whoops, look at that *checking cell phone*. I gotta run but it was great meeting you! We'll do this another time?" Yeah, I wouldn't hold my breath. - Don't brag about who you are. I'm sure you're very interesting and fascinating, but it will become very clear that you are already in a love affair: with yourself. - Don't wear self-pity like it's a warm, hand-knitted sweater. So you're divorced. So you just got dumped. So what? If you choose to put yourself out there, then you're stating that you're ready to date. Ergo, don't become the Swamps of Sadness that everyone has to steer clear of. Leave your drama where it belongs - at home, under the floorboards, bound and gagged. There's nothing noble about wallowing in self-pity. It only makes you look pathetic. - "I've got a bunch of errands to run after this." Doesn't work, no matter what the hour is. Cut straight to the chase: "When may I meet you?" - Don't type "You're only as old as you feel!" I have the energy of a 12 yr old. Still want to date me? - There are various unspoken rules in our society. Always bring flowers to Moms house, wash after you wipe, 2 parts to 1 makes perfect rice and you never lie about how you look. - Use a CURRENT picture. Not one that's 10 years old or even 5 years old. Because when you meet, they'll know who you REALLY are. Not Acceptable: - It IS acceptable to arrange a decoy phone call. It gives you an out and you don't have to lie. Just try not to go over the top with your dramatic exit. This isn't Highlander, there can be more than one. Only the ignorant and the arrogant believe they are the only ones playing the game. Given how dating sites are designed, you'll never know how many are in line before you. If the woman you are interested in is extremely attractive and you know for a fact that she's being pursued by every other tool on the totem, you need to do something that makes you stand out. Try speaking up and speaking out. - Use a free email account. When it progresses to private email transmissions, use a free anonymous account, so that your last name isn't readily available. - This means you don't pimp out your hotter, younger sister because, in reality, you're a 300lb shut-in who hasn't thought Herpes info past phase 1 and fails to realize that when you do meet face-to-face, the conversation will be short and sweet. 5. No Old Pictures - Look Like What You Look Like - Don't type "I'm 50 but I look 30!" Never, ever apologize for your age, unless you're 16. 1. Be Honest About Your Dating Status - Don't go back to their place. I don't care how safe you think they are. I don't care if you feel the need to screw right then and there. You don't know a person after a few hours, minutes or seconds of meeting. - He gives you detailed instructions which include not leaving voicemails, not calling at certain hours, failure to even disclose a phone number, a warning that he may disappear for a while, and a request for naughty pictures up front, given that he has to delete them quickly. Example: "I had a next-door neighbor with your name. She was 80 yrs old, grumpy and smelled suspiciously like rotten grapefruit. So I'm glad I found you on here. Even if we never speak to each other, you've erased a traumatic memory with a very classy, very tasteful, very beautiful visual. Thank you for that." 2. No Penis Pics - Don't be carrying 100 extra big ones, be pushing retirement and have no sense of humor and then declare you will only date girls if they come gift wrapped and carrying their own stuffed toys. Sicko. - Don't divulge the contents of your TRW. Your address, your work address, your bank and every other piece of confidential information can be used in a myriad of ways to compromise your safety. This is common sense, but you never know. 4. Know You Are Not the Only One 3. Be Safe - Have a Double Life

- Your profile is an extension of you and is the resume for your personal life. Make it good. - Don't parade the fact that you're financially successful. It makes you look like a snob and you'll only attract other snobs or gold-diggers. 7. Act Your Age - Do Not Lie - Cheating married men are slimy and hardly worth a single girl's time. Why take half of a half of a half of something, when you can have it all without the drama? It's funny and she won't be able to resist asking you for the story of your neighbor. 6. Be Gentle - "I just don't feel up to really DATING anyone right now." So why am I here? Penis: 'sup, baby? Wanna get some? Get at me! - "Crap, I forgot to feed my dog before I left!" You both know Rover isn't starving. - Married women are in the same category, but why repeat myself? - Harried and hurried emails, demanding to meet TONIGHT: he's got a 2 hour window while his wife is out with the girls and needs to fill it. My personal pet peeve: men who lie about being single. Nothing is more infuriating than a man desperate to break in a new kitten. Signs to look for include: Meet in a public place. Not his place. Not your place. A public, well-lit and moderately populated place. - Be HONEST about your circumstances. Be HONEST about your goals. Be HONEST about your agenda. Be honest about who the heck you are and what the heck you're looking for. Holy God this shouldn't even have to be mentioned. First of all, most of these pictures aren't even artfully taken. Second of all, these penises are often nothing to be proud of. I can attest that I've been visually raped more times than I can count and, adding insult to injury, the offending parties didn't even grace me with an erection. There is nothing pleasing about a flaccid unit. What, am I supposed to pet it and serve it dinner? Men, women do not want to see a picture of your penis or your "boys". Just because you don't have a job or a life, and spend hours online pleasuring yourself to equally aimless and spineless women who having nothing else to do than show off their pancake-like sweater puppies, doesn't mean the rest of us are panting to see your junk. It's like penis pics and boobs have replaced "Hi, how are you?" "Fine, thank you, and yourself?" Be Interesting and Funny, But Don't Write An Essay - "Thank you again for meeting me. I enjoyed hearing about _____ and ______. While I did enjoy meeting you, I didn't really feel that strong a connection with you. Please don't take offense to this." You've done nothing wrong. Good luck with the site and be safe! - Let someone else know where you're going to be. Make sure a friend knows where you're going and what time you'll be there. Provide them with all of the other persons information as well. That way the cops will have something to go on when your friend files a missing persons report. - Don't type "I'm 45 years young!" Why men do this is beyond me. You're still 45 and now, you're officially trying too hard. Asking someone to tell you something fascinating about them makes you look lazy and stuck-up. It says you think you're too good to volunteer any information and too lazy to ask an actual question. If you were truly interested, you wouldn't waste her time by asking her something so generic. She'll know you're sending that email to every other girl and you will be instantly dismissed from her court. Anyone can ask a boring question, but it takes true style to say something really cool. - The conversation ALWAYS leads to sex: it's all he's got on his mind and he doesn't care who it comes from.

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Diagnostic tests for common STDs and HSV-2.

c. the cause of trachoma Sensitivity of serologic tests. The sensitivity of both nontreponemal and treponemal tests varies with stage of infection. The sensitivity of nontreponemal tests increases with duration of infection, and ranges from approximately 75% to 85% in the primary stage to virtually 100% in the secondary stage. (10) Humoral antibodies typically are detectable one to four weeks after chancre formation. Since the sensitivity of nontreponemal tests is lower in the primary stage, a negative nontreponemal test in an individual with a genital lesion cannot exclude primary syphilis. In such patients, direct laboratory examination of suspicious lesions should be sought. 2. Primary stage of infection with syphilis is a. most commonly reported STD Direct testing of clinical specimens. TP may be detected using specimens collected noninvasively from skin and mucosal lesions suspicious for P & S syphilis using dark-field microscopy, with sensitivity of 75% to 80%, depending on specimen adequacy. (7)

TP-specific staining of histologic specimens may also be performed, but sensitivity is diminished if concentration of treponemes is low. In clinical settings equipped with a dark-field microscope, the clinician may scrape the suspected syphilis lesion with a glass slide to prepare a wet mount for immediate examination. Identification of motile, corkscrew-shaped organisms appearing fluorescent green supports the diagnosis of syphilis. Specimens from oral lesions should not be examined using dark-field microscopy, as saprophytic, nonpathogenic treponemes may cause a false-positive result for TP. The FTA-Abs CSF test is also available for testing CSF specimens, though it lacks the specificity of the VDRL-CSF test. A nonreactive result, however, carries a high negative predictive value and is recommended by some experts to exclude neurosyphilis in VDRL-CSF-negative cases in which minimal abnormalities in WBCs and/or protein raise suspicion for active neurosyphilis. 18. HSV is c. endocervical specimens 4. Holmes KK, Sparling PF, Mardh P, et al. Sexually Transmitted Diseases. 3rd ed. 1999:1454. New York, NY: McGraw-Hill. Conclusion Neisseria gonorrhoeae (NG) is a Gram-negative diplococcus that commonly infects the mucosa of the urethra, cervix, rectum, and throat. It frequently presents as an uncomplicated, symptomatic infection at one or more of these sites. In women, untreated lower genital tract infection, which more often may be asymptomatic, may progress to pelvic inflammatory disease (PID). Repeated cases of PID increase the risk for chronic pelvic pain, ectopic pregnancy, and infertility. 3. Fleming DT, Wasserheit JN. From epidemiological synergy to public health policy and practice: the contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sex Transm Infect. 1999;75(1):3-17. c. an obsolete test The role of type-specific serologic testing for HSV. Clinical diagnosis of genital HSV is insensitive and nonspecific. (34) The diagnosis of HSV-2 infection has been aided by the availability of serologic tests for type-specific antibody to the virus, supplanting crude antigen testing. Use of these tests necessitates appropriate patient-centered counseling about transmission risk, prevention steps, and treatment, especially since herpes infection continues to carry significant stigma in the general population. The tests cannot differentiate recent infection from that acquired remotely. In many instances, patients diagnosed with HSV-2 can recall symptoms consistent with the infection. Diagnosis of HSV infection may facilitate interventions aimed at minimizing secondary transmission. For instance, a recent clinical trial showed daily antiviral therapy reduced the risk of HSV-2 transmission to uninfected partners. (35) 15. World Health Organization. Laboratory-based evaluation of rapid syphilis diagnostics. The Sexually Transmitted Diseases Diagnostics Initiative (SDI). Geneva, Switzerland. World Health Organization Special Programme for Research and Training in Tropical Diseases. 2003. Chlamydia trachomatis 10. NG can be detected by: a. True b. EIA 7. A multiplex polymerase chain reaction test detects a. urine Table 1: Performance of standard serologic tests for syphilis* Stage of untreated syphilis Specificity % sensitivity (range) % (range) Nontreponemal test Primary Secondary Latent Nonsyphilis RPR card 86 (77-99) 100 98 (95-100) 98 (93-99) VDRL slide 78 (74-87) 100 96 (88-100) 98 (96-99) Nontreponemal test FTA-Abs 84 (70-100) 100 100 87 (84-100) TPPA ** 90-100 50-100 * Modified from Larsen. S.A., V. Pope, R.E. Johnson, et al., A Manual of tests for syphilis. 9th ed. 1999. Washington, DC: American Public Health Association, except as indicated. Indicated percentage ranges based on CDC studies. (Citation 8 in references.) ** Fujirebio Diagnostics Inc., Serodia--TP-PA [package insert, p.4]. Malvern, PA, 2002, comparing TPPA with MHA-TP in population of patients suspected of syphilis by symptoms and history, as well as population of normal controls. (Not cited in references.) Table 2: Performance of selected tests for Neisseria gonorrhoeae* Sensitivity Specificity (%; range) (%; range) Culture 85-95 100 Nucleic acid amplification test ([double dagger]) Urine specimens, LCR 94.3-100 98.2-100 Nucleic acid hybridization (nonamplified) test ([dagger]) Endocervical swab specimens 85.4-100 93.5-99.6 Male urethral swab specimens 91.5-100 82.2-98.9 Performance of selected tests for Chlamydia trachomatis** Cell culture (male and female) 30-86 100 Nucleic acid amplification test ([double dagger]) Endocervical specimens PCR 85.0-100 99.0-100 SDA 92.8-100 98.2-99.3 TMA 82.5-100 99.4-100 Urine specimens PCR 86.7-100 97.0-100 SDA 92.8-100 93.8-99.3 TMA 82.5-100 98.7-100 Nucleic acid hybridization (nonamplified) test ([dagger]) Male and female swab specimens 75.3-91.7 99.0-100 * Koumans EH, Johnson RE, Knapp JS, St Louis ME. Laboratory testing for Neisseria gonorrhoeae by recently introduced nonculture tests: a performance review with clinical and public health considerations. Clin Infect Dis. 1998 Nov; 27(5): 1171-1180. (Not cited in references.) ** Evaluation of Diagnostic Tests for Detection of Genitourinary Chlamydia Infections, 2001 California Department of Health Services STD Control Branch and the Department of Epidemiology and Biostatistics: Berkeley, CA. (http://www.ucsf.edu/castd/std_publications.html) ([dagger]) Gen-Probe PACE 2, compared to culture as reference standard ([double dagger]) NAATs include polymerase chain reaction (PCR, e.g., Roche AMPLICOR), strand displacement amplification (SDA, e.g., BDProbeTec), and transcription-mediated amplification (TMA, e.g. Gen-Probe APTIMA) tests; ligase chain reaction (LCR, e.g., Abbott LCx NG Assay) no longer commercially available in the U.S. b. rashes on palms and soles Acknowledgement: The authors wish to thank Gail Bolan for her contributions in the preparation of this manuscript. c. 12 Herpes capsid images courtesy of Hong Zhou, Ph.D., University of Texas Health Science Center, Department of Pathology and Laboratory Medicine b. conventional serologic d. 6 a. direct examination of suspicious lesion material only Bacterial culture is the gold standard for diagnosis of gonorrhea. Growth of NG is selected using Thayer-Martin medium and 5% C[O.sub.2] incubation at 35[degrees]C to 36.5[degrees]C. Plates are examined at 24-hour intervals through 72 hours' incubation. A candle-extinction jar may be used at field sites where C[O.sub.2] incubation is unavailable. Self-contained transport systems, such as the GasPak C[O.sub.2] iPouch (BD, Franklin Lakes, NJ), are available to substitute for incubation. Presumptive diagnosis of culture isolates requires a Gram stain and oxidase test. Carbohydrate-degradation tests are used to differentiate nonNG species and related organisms. NG-specific tests, such as the nucleic acid probe test may be used to confirm isolates. In general, the sensitivity of culture is affected by a host of factors including specimen-collection technique, condition of medium prior to use, and handling issues (e.g., timing of plate inoculation, transit time, and storage of plates). (16) a. serology techniques A multiplex polymerase chain reaction (PCR) test for genital ulcer disease, or GUD, has been developed that simultaneously detects TP, Haemophilus ducreyi (the etiologic agent of chancroid), and herpes simplex virus (HSV) in ulcer material (Roche Diagnostics Corp., Basel, Switzerland). While its sensitivity for TP is excellent, approximating 95%, there are no plans to market this test in the United States. (9) c. both a and b a. uses a fluorescein isothiocyanate-labeled globulin Herpes simplex virus Gram stain and culture for NG. Gram staining of clinical specimens allows direct visualization of Gram-negative diplococci within polymorphonuclear leukocytes, supporting the diagnosis of gonorrhea. In symptomatic male urethritis, the sensitivity and specificity of Gram stain approximate that of culture; the utility of Gram stain in asymptomatic urethritis is not as well validated. Gram staining of endocervical smears should not be undertaken unless a skilled microscopist is available. Since saprophytic nonpathogenic Neisseria species colonize the pharynx and rectum, Gram staining of such specimens may lead to false-positive results and should not be done routinely. (16) 13. NG-specific NAAT test can be used for: a. TP only d. all of the above [ILLUSTRATION OMITTED] Infection with herpes simplex virus is among the most common STDs in the world, affecting more than one in five adults in the United States alone. (32) Most genital herpes is caused by HSV type 2. Initial, or primary, episodes may cause severely painful vesicles and ulcers, with or without lymph-node tenderness and enlargement. Less often, primary herpes involves systemic symptoms and causes "aseptic" meningitis. A chronic state of infection then ensues, in which recurrent symptoms vary in tempo and severity. Irrespective of symptoms, intermittent shedding of virus is ongoing, as is the risk of transmitting the virus to sex partners. (33) The infection cannot be cured. Use of nucleic acid amplification technology for testing of specimens from the oropharynx, rectum, and vagina is subject to limited FDA clearance. In January 2004, the FDA cleared the Gen-Probe APTIMA COMBO 2 for testing self-collected vaginal swabs. While research studies have validated the use of NAATs in certain anatomic sites (18-20), compliance with the Clinical Laboratory Improvement Amendments (CLIA) of 1988 requires clinical laboratories to conduct internal evaluations prior to testing specimens using collection methods not cleared by the FDA. Also, the assays are subject to factors that inhibit enzymatic amplification, which may be associated with false-negative results, although internal control procedures instituted by manufacturers have minimized this problem. Finally, a predictable rate of false-positive results using NAATs, as has been observed, may appreciably lower the positive predictive value of these tests when employed in populations with a low-prevalence of NG. (21) a. Gram stain 6. U.S. Department of Health and Human Services. Sexually transmitted diseases treatment guidelines:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2002. MMWR 2002;51(No. RR-6):1-82. Tertiary syphilis describes disease presenting with late manifestations, encompassing cardiovascular features such as aortitis with aneurysm formation, late neurologic sequelae, and formation of gummas (indolent, destructive lesions occurring in any organ but chiefly involving skin, bone, and liver). Late-stage manifestations may occur in one-third of untreated cases, and as long as 10 to 20 years after infection. Neurosyphilis, or central nervous system involvement by TP, is not a stage but rather a site of infection, where symptoms may manifest either earlier or later in the course of infection and may involve the visual and auditory systems prominently. a. a rare STD Nucleic acid amplification testing for CT. NAATs available for CT screening include the Roche AMPLICOR, BDProbeTec ET, and Gen-Probe APTIMA assays. A particular advantage of these tests is the ability to test urine samples, in addition to swabs of the endocervix and urethra. Since the sensitivity of these tests exceeds culture, the precise estimation of sensitivity and specificity is difficult and depends on the test used and the specimen tested, though most experts agree that sensitivity of NAATs exceeds that of other tests, especially rapid tests. (16) Use of NAATs identify up to 30% of CT infections that would be missed by other methods. (25) As mentioned previously, in January 2004, the FDA cleared the Gen-Probe APTIMA COMBO 2 for testing self-collected vaginal swab for CT. d. A and b 29. Miller GA, Klausner JD, Coates TJ, et al. Assessment of a rapid antigen detection system for Trichomonas vaginalis infection. Clin Diagn Lab Immunol. 2003;10(6):1157-1158. Rapid point-of-care tests for CT. Rapid point-of-care tests for CT include QuickVue Chlamydia (Quidel Corp., San Diego, CA), Clearview Chlamydia (Unipath Limited, Bedford, U.K.), Biostar Chlamydia OIA (Thermo Electron Corp.), and Abbott Testpack (Abbott Laboratories, Abbott Park, IL). These tests offer rapid results, but entail higher cost and decreased sensitivity compared to other testing modalities, such as NAATs. Reliance on these rapid tests may slow adoption of NAATs, especially given logistical and practical considerations in some laboratories, such as lack of staff and loss of revenue from samples redirected to larger labs. In Seattle, for instance, a survey of laboratory directors revealed continued reliance on lower-sensitivity tests for CT six years after the advent of NAATs. (28) While use of rapid tests for CT may be justified in settings where follow-up is extremely unlikely, their utility must be weighed against the benefit of more accurate, less costly, laboratory-based NAATs now in wide use. 27. California STD/HIV Prevention Training Center and the California Chlamydia Action Coalition. Sexually Transmitted Chlamydial Infections: Continuing Education for Primary Care Clinicians. Berkeley, CA. 2002. b. must be transported to the lab within 48 hours Recent years have witnessed steady levels of most sexually transmitted diseases (STDs), along with a significant resurgence in syphilis cases. (1,2) At the same time, diagnostic tests for STDs have increased in number and diversity. This article summarizes the most important standard tests for common sexually transmitted infections in adults, highlighting newer tests designed to address challenges in management and control of these infections. 13. Joyanes P, Borobio MV, Arquez JM, et al. The association of false-positive rapid plasma reagin results and HIV infection. Sex Transm Dis. 1998;25(10):569-571. Cell/tissue culture for CT. A variety of methods is available to culture CT directly. Usually, a susceptible cell line is inoculated by a patient specimen, and within 72 hours of incubation, characteristic inclusions of CT elementary and reticulate bodies can be visualized using a CT-specific fluorescein-conjugated antibody. The process is labor intensive, costly, and subject to diminished sensitivity if specimens are handled improperly. Given interlaboratory variation in culture routines, performance of this method is variable. Since the advent of noninvasive nucleic acid tests, the role of CT culture has diminished. Yet given its absolute specificity, in most situations, culture remains the test of choice for legal purposes in sexual abuse cases. 17. The InPouch TV culture system 16. Johnson RE, Newhall WJ, Papp JR, et al. Screening tests to detect Chlamydia trachomatis and Neisseria gonorrhoeae infections:2002. MMWR Recomm Rep. 2002;51(RR-15):1-38; quiz CE1-4. 3. CDC defines early latent syphilis as infection in less than ______ months' duration. a. True d. by routine culture 15. In sexual abuse cases, the preferred test for CT is Infection caused by the spirochete Treponema pallidum (TP) is diagnosed by direct examination of suspicious lesion material and conventional serologic tests for syphilis. The organism cannot be cultured routinely, and the gold-standard rabbit infectivity test is impractical to perform. The selection and timing of serologic tests is integral to recognition and appropriate management of syphilis and necessitates an understanding of the natural history of the disease. The emergence of rapid tests for syphilis offers promise for timelier identification, treatment, and interrupted spread of this infection, which is a significant cofactor in human immunodeficiency virus (HIV) susceptibility and transmission. (3) Since infection with one STD is a marker of risk for contracting others, familiarity with the diagnostic modalities available for all such infections is important. Diagnostic testing is a critical tool for stemming spread of new infections. The invasiveness of diagnostic tests, their ease of use, ability to conduct them in alternative clinical and nonclinical settings, timing of results, and cost are important test factors that contribute to effective disease control. In some instances, newer diagnostic tests have replaced more labor-intensive and/or costlier techniques, such as bacterial culture and older assays necessitating daily preparation of reagents, nondisposable hardware, and intensively skilled staff for results interpretation. Increasingly, testing for STDs is conducted when and where the patient presents, such as in pre-natal and STD clinics. Such point-of-care testing minimizes mistreatment based on clinical diagnosis alone and addresses public health imperatives to recognize and treat STDs early, blunting further disease transmission. c. more severe in men than women Additional tests for TV. A variety of immunoassays, latex agglutination assays, and nucleic acid-based tests have been developed for use on serum and genital samples. Recently, the Xenostrip TV Trichomonas Test (Xenotope Diagnostics Inc., San Antonio, TX), a qualitative immunochromatographic assay, was FDA cleared for use on clinician-collected vaginal swab specimens. (29) The test provides results within 10 minutes and has a relative sensitivity compared to culture of 99% to 100% and specificity of > 98%. A PCR-based test has not been cleared for use in the United States, though local laboratories may develop and evaluate such assays. A recent evaluation of five PCR primers using self-collected vaginal swabs, with comparison to culture and/or EIA, demonstrated only 60% to 90% sensitivity of PCR. (30) Prior investigators reported sensitivity and specificity of TV PCR using vaginal swabs of 97 and 98%, respectively, compared to sensitivity of culture and wet prep of 70 and 36%. (31) [ILLUSTRATION OMITTED] Diagnosis of gonorrhea has undergone dramatic change with the advent and widespread use of NG-specific NAATs for urine, urethral, and endocervical specimens, first available in 1993. While different amplification techniques and nucleic acid targets underlie the variety of available NAATs, from a practical clinical perspective, the noninvasiveness and portability of test collection has increased the potential for more widespread screening. Furthermore, features translating into enhanced clinical practice and public health efforts include: comparable sensitivity to reference-standard tests, such as culture; noninvasiveness of specimen collection; ease of transport; the accurate performance of these tests with a variety of specimen sources; and the ability to detect nonviable organism. (17) b. bacterial culture d. all of the above b. asymptomic References Type-specific antibody tests. The Western blot assay is the gold standard technique for HSV antibody detection and can differentiate between type 1 and 2 antibodies. Limitations include high cost and labor intensity, such that tests have not been developed commercially. (36) Type-specific protein glycoprotein G2 antibody tests for HSV-2 include the HerpeSelect-2 ELISA IgG and HerpeSelect 2 Immunoblot IgG tests (Focus Technologies Inc., Herndon, VA). Sensitivities of these tests vary from 80% to 98%, with specificities [greater than or equal to]96%. (6,35) Since this is a serologic assay measuring IgG, the sensitivity relies on the time since infection, with median positivity occurring within two weeks. Rarely, HSV-2 can be gG2 deficient, resulting in a false-negative result. a. the gold-standard technique for HSV 1. Identify the most important standard test for common sexually transmitted infections. d. a and b 37. Turner KR, Wong EH, Kent CK, et al. Serologic herpes testing in the real world: validation of new type-specific serologic herpes simplex virus tests in a public health laboratory. Sex Transm Dis. 2002;29(7):422-425. 23. Morre, SA, Meijer CJ, Munk C, et al. Pooling of urine specimens for detection of asymptomatic Chlamydia trachomatis infections by PCR in a low-prevalence population: cost-saving strategy for epidemiological studies and screening programs. J Clin Microbiol. 2000;38(4):1679-1680. CE test on DIAGNOSTIC TESTS FOR COMMON STDs and HSV-2 a. NAAT All feature articles published in MLO are peer-reviewed. 16. Trichomoniasis is New rapid tests for syphilis. Given multiple incentives to accurately diagnose syphilis at the point of care, including the need to identify those infected and initiate treatment of the index case and partners early, numerous rapid treponemal tests have been developed for field-based use. None of these is yet cleared for use in the United States. A recent review of six such tests by the World Health Organization demonstrated a range of sensitivities from 84.5% to 97.7% and specificities from 92.8% to 98.0%. (15) A recent evaluation of three rapid tests by the San Francisco Department of Public Health showed that the Abbott Determine Syphilis TP test (Abbott Laboratories, South Pasadena, CA) had the highest sensitivity, 88% (95% CI 0.81 to 0.96), using whole-blood venipuncture samples, with both 100% sensitivity and specificity on 99 whole-blood fingerstick specimens. The test typically takes 15 minutes to perform, does not require sophisticated laboratory equipment, and costs approximately $2 per test. 3. Discuss the use of these tests to address management and control of these infections. Roughly one-third of individuals sexually exposed to a person with syphilis will become infected. (4) After exposure and incubation, the primary stage ensues with one or more typically painless ulcers (chancres) developing at the site of exposure, usually on the genitals or anus, with or without regional lymph-node enlargement. Such symptoms may appear within several days of exposure (mean, 21 days; range, 14 to 90 days). The chancre then resolves, even without treatment, in one to five weeks. (4,5) In the secondary stage, symptoms typically include mucosal lesions and rashes that may cover the palms and soles. Constitutional symptoms (e.g., sore throat, low-grade fever, malaise, muscle and joint aches, enlarged lymph nodes) also may be present. Less common symptoms and signs include oral mucous patches, condylomata lata (moist, wart-like papules occurring mostly in skin folds), and hair loss. In latent syphilis, serologic evidence of infection is found despite absence of symptoms and signs of the primary and secondary (P & S) stages. Early latent syphilis is defined by the Centers for Disease Control and Prevention (CDC) as infection less than 12 months in duration. (6) Without evidence of acquisition in the prior year, infection is referred to as syphilis of unknown duration. During the early latent phase, relapses with secondary stage symptoms may occur. 14. Rompalo AM, Cannon RO, Quinn TC, et al. Association of biologic false-positive reactions for syphilis with human immunodeficiency virus infection. J Infect Dis. 1992;165(6):1124-1126. Many clinics do not have dark-field microscopes and/or adequately trained staff to operate them. In these instances, smears from suspected syphilis lesions may be collected and submitted to the laboratory for fixation and immunostaining by the direct fluorescent antibody to TP (DFA-TP) method, which uses a fluorescein isothiocyanate-labeled globulin to detect TP antigen. Unlike direct dark-field examination, the DFA-TP employs a TP-specific conjugate; thus, specimens collected from oral lesions may be tested by this method. Sensitivity and specificity of DFA-TP approximate 100% using properly prepared specimens. (8) 34. Langenberg AG, Corey L, Ashley RL, et al. A prospective study of new infections with herpes simplex virus type 1 and type 2. Chiron HSV Vaccine Study Group. N Engl J Med. 1999;341(19):1432-1438. 36. Ashley RL, Wald A. Genital herpes: review of the epidemic and potential use of type-specific serology. Clin Microbiol Rev. 1999; 12(1):1-8. b. can differentiate between type 1 or 2 antibodies To earn CEUs, see test on page 22. c. can be used to test oral lesions [ILLUSTRATION OMITTED] 24. Morre SA, Van Dijk R, Meijer CJ, et al. Pooling cervical swabs for detection of Chlamydia trachomatis by PCR: sensitivity, dilution, inhibition, and cost-saving aspects. J Clin Microbiol. 2001;39(6):2375-2376. 17. Marrazzo JM. Impact of New Sexually Transmitted Disease Diagnostics on Clinical Practice and Public Health Policy. Curr Infect Dis Rep. 2001;3(2):147-151. c. painless ulcers (chancre) Detection of HSV in genital ulcer material. In addition to serologic testing, direct laboratory evaluation of suspicious genital lesions remains important to clinical management of genital ulcer disease. In the United States, HSV and TP cause most such ulcers. While direct laboratory evaluation of genital lesions to rule in syphilis is often most pressing, depending on clinical circumstances lesions suspicious for HSV should be evaluated by collecting a specimen for culture or DFA. Cell culture is the preferred test for laboratory evaluation of suspicious mucocutaneous lesions. The sensitivity of culture is higher for primary vs. recurrent lesions and declines as lesions heal, often several days after onset. HSV culture requires live virus, infected cells, special care in sampling and transport to a virology laboratory; it is time-consuming and expensive. Of note, the enzyme-linked virus-inducible ELVIS HSV system is a 24-hour culture system (Diagnostic Hybrids Inc., Athens, OH) that is commonly used but less sensitive than traditional culture. LEARNING OBJECTIVES

32. Fleming DT, McQuillan GM, Johnson RE, et al. Herpes simplex virus type 2 in the United States, 1976 to 1994. N Engl J Med. 1997;337(16):1105-1111. b. False Improved methods for diagnosing neurosyphilis are needed. Use of PCR for identification of TP in CSF has been disappointing, due to inadequate sensitivity and the inability to distinguish between pathogenic and nonviable treponemes. 11. Carbohydrate-degradation tests are used to differentiate nonNG species and related organisms. MLO and Northern Illinois University (NIU), DeKalb, IL, are co-sponsors in offering continuing education units (CEUs) for this issue's article on DIAGNOSTIC TESTS FOR COMMON STDs and HSV-2. CEUs or contact hours are granted by the College of Health and Human Sciences at NIU, which has been approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E.[R] program (Provider No. 0001) and by the American Medical Technologists Institute for Education (Provider No. 121019; Registry No. 0061). Approval as a provider of continuing education programs has been granted by the state of Florida (Provider No. JP0000496), and for licensed clinical laboratory scientists and personnel in the state of California (Provider No. 351). Continuing education credits awarded for successful completion of this test are acceptable for the ASCP Board of Registry Continuing Competence Recognition Program. After reading the article on page 10, answer the following test questions and send your completed test form to NIU along with the nominal fee of $20. Readers who pass the test successfully (scoring 70 percent or higher) will receive a certificate for 1 contact hour of P.A.C.E.[R] credit. Participants should allow four to six weeks for receipt of certificates. c. labor intensive By Christopher S. Hall, MD, MS, and Jeffrey D. Klausner, MD, MPH 2. U.S. Department of Health and Human Services. Primary and Secondary Syphilis--United States:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2003. MMWR 2003;52:1117-1120. [ILLUSTRATION OMITTED] b. dependent upon concentration of treponema for accuracy results a. cardiolipin 4. Disease presenting with late manifestations, encompassing cardiovascular features and formation of gummas is defined as d. neurological syphilis Serologic testing for syphilis. Routinely employed to diagnose and monitor treated syphilis are nontreponemal assays that use cardiolipin-, lecithin-, and cholesterol-containing antigen to measure antilipoidal IgM and IgG antibodies. The two most common such tests are the rapid plasma reagin (RPR) card and venereal disease research laboratory (VDRL) slide tests. By contrast, treponemal tests utilize antigen from TP or its components and often are used to confirm the results of nontreponemal tests in a two-step, reflex process. Treponemal tests include the fluorescent treponemal antibody absorption (FTA-Abs) test, the Serodia TP particle agglutination (TP-PA) test (Fujirebio America Inc., Fairfield, NJ), and its manufacturer's predecessor test, the microhemagglutination assay for antibodies to TP, or MHA-TP. The FTA-Abs requires a fluorescent microscope to detect adherence of the patient's serum antibody to TP antigen fixed to a slide. By contrast, the TP-PA is an agglutination assay using colored gelatin particle carriers sensitized with TP antigen. Trichomonas vaginalis 8. Nontreponemal assays use b. False c. culture 18. Shafer MA, Moncada J, Boyer CB, et al. Comparing first-void urine specimens, self-collected vaginal swabs, and endocervical specimens to detect Chlamydia trachomatis and Neisseria gonorrhoeae by a nucleic acid amplification test. J Clin Microbiol. 2003;41(9):4395-4399. False-positive treponemal test results also occur in the general population, though at a lower rate than that seen with nontreponemal tests. In these instances, techniques are available to help resolve the treponemal test status, involving processing of patient serum and/or use of an investigational Western blot assay specific for TP antibodies. (8) Rarely, false-positive treponemal tests may be due to infection with other nonvenereal treponemal infections like yaws, bejel, or pinta, particularly in persons from endemic areas. d. all of the above The sensitivity of treponemal tests continues to approximate 100% in late syphilis, in contrast to nontreponemal tests, which are more practical and cost-effective for initial screening but have diminished sensitivity in late syphilis. Despite the higher sensitivity of treponemal tests, data supporting their use for initial screening are limited. Nonetheless, it may be useful to employ both a nontreponemal and (nonreflexed) treponemal test to identify newly infected persons with suspicious lesions. For instance, in a recent evaluation of 39 dark-field confirmed syphilis cases, VDRL was reactive in 30 (77%) whereas TP-PA was positive in 37 (95%). Using a strategy of initially obtaining both VDRL and TP-PA would have identified 100% of cases, compared to only 72% of cases using a conventional reflex strategy. (11) 31. Madico G, Quinn TC, Rompalo A, et al. Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. J Clin Microbiol. 1998;36(11):3205-3210. c. tertiary syphilis d. None of the above d. none of the above b. urethral specimens The most prevalent nonviral sexually transmitted infection worldwide, trichomoniasis is caused by the protozoan Trichomonas vaginalis (TV). Infection is often asymptomatic, especially in men. In women, trichomoniasis may cause a malodorous yellow-green discharge, along with vulvo-vaginal irritation. Since infection is often asymptomatic or mild in men, affected women are often re-exposed to TV from untreated male partners. Trichomoniasis is a risk marker for other STDs, inflammation from the infection may potentiate HIV transmission, and infection during pregnancy may contribute to poor birth outcomes. (3,4) The fee for each continuing education test will be $20. d. DFA a. a highly sensitive test d. highly recommended b. primary syphilis [ILLUSTRATION OMITTED] 20. Richardson E, Sellors JW, Mackinnon S, et al. Prevalence of Chlamydia trachomatis infections and specimen collection preference among women, using self-collected vaginal swabs in community settings. Sex Transm Dis. 2003;30(12):880-885. d. not a risk marker for other STDs a. mucosal lesions d. all of the above 28. Battle TJ, Golden MR, Suchland KL, et al. Evaluation of laboratory testing methods for Chlamydia trachomatis infection in the era of nucleic acid amplification. J Clin Microbiol. 2001;39(8):2924-2927. 2. Identify new tests for common sexually transmitted infections. c. an STD that can be cured Infection with Chlamydia trachomatis (CT) is the most commonly reported STD in the United States. It is an obligate intracellular bacterium with a complex life cycle that infects mucosa of the lower genital tract, rectum, and throat. It is also the cause of trachoma and lymphogranuloma venereum, rarely seen in this country. Most infection with CT is asymptomatic, more so in women, in whom untreated infection can lead to PID, ectopic pregnancy, and infertility. b. hybridization technology Nucleic acid amplification testing for NG. Available nucleic acid tests are based on probe hybridization technology, as well as amplification methods. Two such hybridization assays are FDA cleared, including the PACE 2 (Gen-Probe) and Hybrid Capture II (Digene Corp., Gaithersburg, MD) tests, both of which detect NG and C. trachomatis in the same specimen. A version of these two tests identifies the presence of either bacterium and, when positive, must be followed up by the more specific test. A particular advantage of these tests is the ability to store and transport specimens for one week. Sensitivity of these tests is somewhat lower than that of NAATs. b. False The mainstays of NG detection have been direct visualization by Gram-stain using light microscopy, as well as bacterial culture. In recent years, testing for NG has been reshaped by the emergence of widely available nucleic acid amplification tests (NAATs), often supplanting the need for invasive and uncomfortable collection of genital specimens. Nucleic acid probe hybridization assays remain available. Serologic tests for NG are not available, and although enzyme immunoassay (EIA) tests are available, their test performance is inferior to standard methods. A 20-minute rapid assay, based on an optical immunoassay (OIA) technology (Thermo Electron Corp., Waltham, MA), was recently cleared by the Food and Drug Administration (FDA) for testing of endocervical and male urine specimens in symptomatic persons. Its role in clinical care remains to be determined. a. True In general, serologic tests for HSV-2 should be available to those who request them, especially those who are partners to HSV-2-infected persons. Most authorities, however, recommend use of such tests for screening only in high-risk populations, such as persons with other STDs and those with or at risk for HIV infection. Screening the general population, including pregnant women, is not recommended. (33) In particular, serologic tests may be most useful for diagnosing genital herpes on the first presentation of genital symptoms when culture and antigen detection tests are not available, when a recurrent lesion is repeatedly culture-negative, or when a patient's history of symptoms is consistent with genital herpes. A "window period" of six to 12 weeks, during which time antibodies have yet to form after primary infection, however, complicates the use of HSV serology in these instances. (32) This test was prepared by Shirley A. Richmond, PhD, Dean, College of Health and Human Sciences, MT, ASCP, CLS, NCA, Northern Illinois University, DeKalb, IL. 35. Corey L, Wald A, Patel R, et al. Once-daily valacyclovir to reduce the risk of transmission of genital herpes. N Engl J Med. 2004;350(1):11-20. Despite the advantages of NAATs for NG, a significant benefit of culture is the capacity to determine antibiotic susceptibility of derived isolates. Such monitoring has become increasingly important given the recent emergence of drug-resistant gonococcal species, such as fluoroquinolone-resistant NG. (25) http://www.thefreelibrary.com/DiagnostictestsforcommonSTDsandHSV-2.-a0114339159 b. 18 Upon completion of this article the reader will be able to: The laboratory plays a crucial role in providing the tools necessary to effectively diagnose and control the spread of sexually transmitted infections. Numerous well-established assays continue to be used in the diagnosis of some STDs. Newer tests, however--some based on advances in molecular diagnostics--have radically improved the efficiency and accuracy of STD diagnosis. Rapid tests, point-of-care testing, and nucleic acid amplification technology represent advances addressing long-standing barriers in STD diagnosis, while meeting with patient acceptance given noninvasiveness, ease of collection, and quick turnaround of many such tests. By working closely with laboratorians, clinicians and public health officials are realizing new opportunities for the early recognition, treatment, and control of STDs. c. serology test 25. Fluoroquinolone-resistance in Neisseria gonorrhoeae, Hawaii, 1999, and decreased susceptibility to azithromycin in N. gonorrhoeae, Missouri: 1999. MMWR Morb Mortal Wkly Rep. 2000;49(37):833-837. c. IgM antigen d. b and c 6. The DFA-TP The availability of such technology also allows testing of pooled patient specimens. Pooling permits substantial cost savings of reagents and technicians' time, especially when testing in low-prevalence populations. Numerous published studies have demonstrated pooling does not significantly compromise sensitivity or specificity. (21-23) Pooled testing, however, is not cleared by the FDA. Local laboratories must perform validation studies to comply with regulations under CLIA. Turnaround time is increased if positive specimens are not retested the same day, and care in specimen processing is required to avoid laboratory error. Laboratories planning to implement pooling protocols should review CDC recommendations. (16) Christopher S. Hall, MD, MS, and is Fellow at California STD/HIV Prevention Training Center, and the Division of Infectious Diseases, Department of Medicine, University of California, San Francisco. Jeffrey D. Klausner, MD, MPH, is director, STD Services, San Francisco Department of Public Health, and assistant professor of Medicine, Divisions of Infectious Diseases and AIDS & Oncology, Department of Medicine, University of California, San Francisco. [GRAPHIC OMITTED] 33. Guerry S, Allen B, Branagan B, et al. Guidelines for the Use of Herpes Simplex Virus Type 2 Serologies: Recommendations from the California Sexually Transmitted Diseases (STD) Controllers Association and the California Department of Health Services (CA DHS). Sacramento, CA. California Sexually Transmitted Diseases (STD) Controllers Association and the California Department of Health Services (CA DHS). 2003. a. 24 b. detects TP antigen CONTINUING EDUCATION 26. Schachter J. DFA, EIA, PCR, LCR and other technologies: what tests should be used for diagnosis of chlamydia infections? Immunol Invest. 1997;26(1-2):157-161. 12. Nucleic acid test are based on: Neisseria gonorrhoeae Specificity of serologic tests. Syphilis test specificity is a function of the test used and the population tested. False-positive nontreponemal results are known to occur in the setting of coexisting infection, autoimmune disease, and drug use, among other conditions. In the general population, false-positive results may occur at a rate of 1% to 2%. (8) In HIV-infected persons, nonspecific polyclonal B-cell activation may lead to false-positive nontreponemal results or higher test titers than in those uninfected with HIV. (13,14) While many have observed that biologic false-positive nontreponemal test titers typically are less than 1:8, such low titers may also occur in latent syphilis. From a public health perspective, positive nontreponemal tests, particularly with titers greater than 1:8, should be interpreted as indicating active infection, with interval testing to assess delayed seroreactivity of the confirmatory test. a. early latent syphilis 7. Romanowski B, Forsey E, Prasad E, et al. Detection of Treponema pallidum by a fluorescent monoclonal antibody test. Sex Transm Dis. 1987;14(3):156-159. b. lecithin 30. Crucitti T, Van Dyck E, Tehe A, et al. Comparison of culture and different PCR assays for detection of Trichomonas vaginalis in self collected vaginal swab specimens. Sex Transm Infect. 2003;79(5):393-398. d. all of the above 14. Chlamydia trachomatis is Wet mount and culture for TV. Using light microscopy, examination of saline wet-mount specimens obtained from pelvic examinations allows direct visualization of motile trichomonads, though sensitivity is operator-dependent and rarely exceeds 70%. (6) Sensitivity of TV detection is increased by culture under microaerophilic conditions. A variety of culture media is commercially available for diagnosis of TV. Also available is the InPouch TV Culture System (Biomed Inc., San Jose, CA). The test involves simultaneous performance of wet mount and can detect presence of a single organism. Viable organisms are required, and inoculated pouches must be transported to the lab within 48 hours, incubated at 37[degrees]C, and read over five to seven days. Nontreponemal tests may be performed qualitatively or quantitatively, the latter enabling the clinician to follow serologic response to treatment. For quantitative tests, serum is diluted in a serial twofold fashion, and the last dilution in which the specimen is fully reactive is reported. Of significance to the laboratorian, the VDRL test requires daily preparation of an antigen suspension and use of reusable slides, whereas the RPR card test utilizes disposable plastic-coated cards. (8) Given variation in antigen preparation among the commonly available nontreponemal tests, reactivity level is variable and, therefore, the tests cannot be interchanged in monitoring response to treatment. 22. Clark AM, Steece R, Crouse K, et al. Multisite pooling study using ligase chain reaction in screening for genital Chlamydia trachomatis infections. Sex Transm Dis. 2001;28(10):565-568. b. always symptomatic Testing for CT has undergone dramatic change with the widespread use of NAATs. Compared to NG testing, alternatives to nucleic acid tests for CT diagnosis are more numerous and include cell culture, EIA- and DFA-based tests, and rapid tests. Serologic testing for acute CT is neither sensitive nor specific and should not be used. Despite a broad array of test alternatives, as well as statistical challenges in comparing accuracy of competing modalities, growing evidence supports use of NAATs for routine CT diagnosis, utilizing a variety of specimen types. 20. Cell culture is the preferred test for laboratory evaluation of suspicious mucocutaneous lesions caused by HSV. a. caused by a protozoan 9. The FTA-Abs requires a fluorescent microscope to detect adherence of the patient's serum antibody to TP antigen fixed to a slide. b. an obligate intracellular bacterium 9. Liu H, Rodes B, Chen CY, et al. New tests for syphilis: rational design of a PCR method for detection of Treponema pallidum in clinical specimens using unique regions of the DNA polymerase I gene. J Clin Microbiol. 2001;39(5):1941-1946. a. requires viable organisms d. temperature Laboratory diagnosis of neurosyphilis. Laboratory diagnosis of neurosyphilis is based primarily on a reactive VDRL-CSF. When the VDRL is negative, the diagnosis is suggested by elevated white blood cells (WBC), with or without elevated protein concentration, in the absence of other known causes of these abnormalities. Use of secondary criteria is problematic, since CSF WBCs and/or protein may be elevated in the natural history of HIV infection and other diseases. Syphilis Other techniques for direct examination are available. DFA tests, such as the Light Diagnostics HSV 1/2 Typing DFA Kit (Chemicon International Inc., Temecula, CA) and MicroTrak DFA test (Wampole Laboratories, Princeton, NJ), approximate the sensitivity of culture and can distinguish HSV-2 from HSV-1. Compared to other available techniques, cytologic detection of HSV infection, such as by Tzanck prep, is insensitive and nonspecific and thus not recommended. PCR assays for HSV, including multiplex assays, are highly sensitive but are not FDA cleared and thus not readily available. If herpes dating info culture and antigen detection tests are not available or if a recurrent lesion is repeatedly culture-negative, a serologic test for HSV-2 should be considered. Of special significance in the laboratory, the prozone phenomenon may lead to false-negative serologic test results, more often during the secondary stage. This reaction occurs when a high concentration of treponemal antigen does not permit detectable antigen-antibody complex formation. It may be overcome by dilution of the specimen. Clinicians should be reminded of the need to request specimen dilution in highly suspicious cases in which serologic tests are nonreactive. Finally, temperature of the laboratory (<73[degrees]F) may also contribute to false-negative nontreponemal test results. (12) 12. El-Zaatari MM, Martens MG. False-negative syphilis screening due to change in temperature. Sex Transm Dis. 1994;21(5):243-246. 10. Larsen SA, Steiner BM, Rudolph AH. Laboratory diagnosis and interpretation of tests for syphilis. Clin Microbiol Rev. 1995;8(1):1-21. 21. Katz, AR, Effler, PV, Ohye, RG, et al., False-positive gonorrhea test results with a nucleic acid amplification test: the impact of low prevalence on positive predictive value. Clin Infect Dis. In press. 1. U.S. Department of Health and Human Services. Sexually Transmitted Disease Surveillance:2002. Atlanta, GA: Centers for Disease Control and Prevention; 2003. 19. Western blot assay is 1. Infection caused by the spirochete Treponema pallidum is diagnosed by Available NAATs include: the PCR-based Roche AMPLICOR; the BDProbeTec ET, using strand displacement amplification; and the Gen-Probe APTIMA and APTIMA COMBO 2, using transcription-mediated amplification of ribosomal RNA targets. Institutional and laboratory selection among candidate assays requires a review of clinical service goals, population characteristics, and laboratory issues--such as physical space constraints, including segregation of sample processing and amplification areas, technician resources, and other economic and logistical factors. 5. Golden MR, Marra CM, Holmes KK. Update on syphilis: resurgence of an old problem. JAMA. 2003;290(11):1510-1514. c. Herpes simplex virus only 19. Schachter J, McCormack WM, Chernesky MA, et al. Vaginal swabs are appropriate specimens for diagnosis of genital tract infection with Chlamydia trachomatis. J Clin Microbiol. 2003;41(8):3784-3789. c. is incubated at 37[degrees]C 8. Larsen SA, Pope V, Johnson RE, et al. A manual of tests for syphilis. 9th ed. Washington, DC. American Public Health Association. 1999. [ILLUSTRATION OMITTED] 5. TP-specific staining of histologic specimens is c. amplification methods b. Haemophilus ducreyi only 11. Creegan L, Bauer HM, Klausner JD, et al. An evaluation of the relative sensitivities of VDRL and TP-PA among patients with darkfield-confirmed primary syphilis [Abstract 0641]. In: 15th Biennial Congress of the International Society for Sexually Transmitted Diseases Research. 2003. Ottawa, Canada. Other testing methods. Nucleic acid tests utilizing probe hybridization technology also are available. As discussed earlier, these tests facilitate testing for both CT and GC, simultaneously, are automated and cheap, and do not require refrigeration of transported specimen containers. They cannot be used, however, to test urine and are not as sensitive as NAATs. EIA- and DFA-based tests for CT antigen detection have similar disadvantages and are more technically difficult to perform. (27)

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href="http://www.petsmart.com/dog/food/cat-36-catid-100004">http://www.petsmart.com/dog/food/cat-36-catid-100004 href=''>

[nigogura-blog]

Why Dry Dog Food Is Bad For Dogs

Perhaps more importantly, when moldy corn is harvested along with healthy corn, some of it can get into the dog food processing system. Moldy corn produces toxins in the liver, which can lead to liver failure and other serious illnesses. Owners might believe there are enough safeguards in place to prevent this from happening, but in 2012 the hot-dry summer resulted in moldy corn getting into the dog food manufacturing process. The contamination resulted in metabolized aflatoxins being produced. Alfatoxins are one of the most dangerous poisons known and cause acute lethal cancers and fatal disease of the liver. Recalls of dry foods were undertaken, but undoubtedly some got through to the consumer. One of the worst features of many dry dog foods is the alarmingly high corn content. Pet food manufacturers make exaggerated and unqualified claims about the value of corn. In fact, it sometimes makes up to 70% of the entire product - and it has little if any nutritional value. It is, in reality, little more than a bulking agent, making it seem that an owner is getting more for their money. In terms of dog food ingredients, owners are best advised to look for a high meat content. Meat has essential proteins in it and a range of other good nutrients, such as fats. Corn is fat-free. It is a carbohydrate. Carbohydrates give very little energy to a dog, whereas fats supply about three times more per portion.

Dogs are our loyal and loving friends and companions. In some cases, they are our only family. They deserve nothing less than the very best we can do to keep them happy and healthy ... so throw out that cupboard full of kibble and start feeding them something less risky and of higher quality today.

Credit: Tony Booth

Solid Gold Green CowTripe Canned Dog Food 12 Pack I am a great advocate of green tripe. Human owners may hate the smell of it - but I have yet to find a dog that doesn't absolutely love it ... and it is safe and nutritional too. http://www.infobarrel.com/Why_Dry_Dog_Food_Is_Bad_For_Dogs Dr Becker of Healthy Pets.com suggests: '... I recommend you transition your pet away from all dry food. Replace it with a high quality canned food, a commercially prepared raw diet, dehydrated raw, a balanced home cooked diet, or a combination. If you want to continue to offer dry food to your dog, I recommend you study the ingredients carefully and avoid products containing corn in any form, including corn gluten meal, whole grain corn, corn flour, etc. Corn is not only highly susceptible to aflatoxin contamination, it is also allergenic and http://dogfoodchat.com/ difficult for most pets to digest.' When one of my dogs, called BB, died prematurely of kidney failure, I had little knowledge about the condition. It was at that time that I decided to research the subject fully and hopefully prevent the same scenario occurring with other pet dogs that shared my life. Some of the information I acquired completely stunned me - including aspects that directly related to dry dog food. There is a problem in getting adequate scientific and authorised research on this subject, partly because the pet food industry itself conducts most of the research in this field ... and they are very unlikely to publish unwanted facts about the products they are selling. Vets are also not entirely reliable, because (believe it or not) pet food manufacturers fund their training at some universities. Lectures on dog nutrition in some vet schools for both vets and veterinary nurses are also paid for - and in some cases taught by - pet food companies, which means the industry is telling those that should know all the facts only what the industry want them to know and not much else. ADDITIVES In comparison to good quality tinned food, pet food analysts say that dry food has about a third less nutritional value. The loss of nutritional value occurs entirely due to the drying and manufacturing process (depending on how much real meat is in the mixture before being dried). To offset this, some manufacturers add other chemicals, vitamins and ingredients - but these additives don't just enhance the quality, they can also exacerbate the harm dry food inflicts on dogs that have an existing susceptibility to chronic illness and allergies. Another popular brand is Bakers Complete by Nestle Purina, which scored a meagre 0.5 out of 5 by Whichdogfood.co.uk, despite it being hailed as the UK's most popular dry dog food product. Its awarded low score is because it has a low meat content, artificial additives, unclear labelling and by-products and derivatives. The analyst reviewer says of this product: 'The ingredients list reads like a 'who's who' of terms we recommend avoiding.' I will be blunt at the outset ... I believe dry food is dangerous to the good health of a dog when it is given as the only main source of nutrition during its lifetime. There are reasons for my opinion, which I will try to explain as fully as possible in this article. We all know how confusing it is to read and assess the safety of a list of ingredients on a product label, particularly when it has a plethora of E numbers. The first task is to spend hours and sometimes weeks trying to find out exactly what the E number represents - and then sift through a hundred pages of scientific jargon-filled journals trying to work out whether that particular chemical is okay or really not okay at all. In the end, many of us just rely on the food safety laws and pet manufacturers to do this work on our behalf. We assume (quite reasonably) they would not try to sell products that could harm us or our pets. We can all become blind to the fact that pet food manufacturers will get away with whatever they can, within the law (and occasionally on the fringe of it), so they can realise a bigger, easier and faster profit. According to the lawsuit, some Purina Beneful pet foods contain harmful ingredients that are toxic and poisonous to dogs. Allegations includethe product has Propylene Glycol in its ingredients, which is one of the toxic substances ofanti-freeze. It also allegedly has dangerous levels of Mycotoxins, which the plaintiff claims have been found during testing of Purina Beneful Original. The manufacturer (Nestle) has yet to issue any recalls of the affected products, despite thousands of consumer complaints. One example is ethoxyquin, which has been under investigation by the Food and Drug Administration in the U.S. as a possible cause for certain liver and blood problems. Perhaps this is no great surprise, as ethoxyquin is also used as a pesticide and as a hardening agent in the manufacture of artificial rubber. Other artificial preservatives to look out for are butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT), which the World Health Organisation has named as potential cancer-causing compounds. If you find any of these listed under the ingredients of a dry food you feed to your dog on a regular basis, you should undertake further research to learn more about the risks. Mars are the United Kingdom's biggest selling manufacturer of dog food (2012 Euromonitor report), representing a 29% share in a market of sales worth 451 million - which is a rise of 6% on the year before, realised mainly through its Pedigree and Caesar brands. Pedigree Complete Nutrition Small Crunchy Bites Original Beef Flavour is one of their dry dog foods that typically contain more than thirty different ingredients such as colorants, preservatives, vitamins and minerals on top of wheat, corn, salt, meat and bone meal. Putting just this one dog food from one manufacturer under the microscope, we find additives in overabundance ... these are mostly good, but there are some also not so good. It includes some risky things I have already mentioned, such as animal fat preserved with BHA/BHT, but it also has more corn than meat to fill the bulk, making it cheaper to produce. Corn is not good for dogs, particularly when used to replace animal origin tissues (meat) in a regular food. Despite that, this is perhaps one of the best dry foods there is on the market - which just makes others even worse by comparison. Other than to appease the human dog owner, there is no reason whatsoever to put colorants in a product intended for dogs. Dogs are largely colour blind, so the rainbow mixture of greens and reds often seen in dry food are only put there to help us humans think they represent meat and vegetables. Although many of the colorants used are natural ingredients, it just goes to show what manufacturers will do to entice and hoodwink owners into buying their products. KIDNEY FAILURE The pet food industry advertises dry dog food products showing happy, healthy and enthusiastic dogs enjoying their mealtime. Owners buy these products because they see the headline packaged ingredients and imagine the food is full of plump fresh chicken and choice cuts of beef. Once told that a lot of dry food is little more than reconstituted slaughterhouse offal sometimes considered unfit for human consumption, bulked out with grains that most vets would consider unsuitable for canine digestive systems, they might think again. Waste products often put into dry dog food manufactured in some countries include intestines, hooves, heads and udders, which are not exactly the mouth-watering delights shown on packaging.

Credit: Tony Booth E numbers are the hidden additives meant to enhance, colour, flavour and preserve the product. The best way of finding out about E numbers is to Google 'Artificial Additives E***', inserting the right number in the spaces. Check the label of your regular dog food now and see what comes up ... I think it will surprise and disturb you. Unfortunately, manufacturers also mix in flavourings, colorants and other artificial additives to make the end-product attractive to both dogs and to the owners buying it. It is some of these additives that make dry food controversial and sometimes downright harmful to our pets. The extrusion method used to manufacture about 95% of dry pet food means ingredients need heating to the higher temperature of 400 degrees. Unfortunately, this process causes vitamin loss and certain types of protein denaturation, which can make once healthy protein content in meat and poultry become indigestible and more difficult to assimilate. Some dogs develop food allergies as a direct result, because the immune system does not recognise the altered protein and acts on it as if it were a foreign body. In the USA, lawyers at Morgan & Morgan (specialists in nationwide mass tort litigation) have filed a class lawsuit against Purina on behalf of dog owners whose pets became ill after being fed Purina Beneful dry dog food. At the time of writing, this lawsuit is ongoing, but it transpires that canine kidney disease is one of the conditions allegedly complained about by some of the 3,000+ dog owners who say their dogs became ill after eating the product. In the end, it comes down to simple common sense. Chronic dehydration is something that can lead to all kinds of urinary tract problems, including kidney failure. This is a well-documented, long-established and scientifically upheld fact. Dogs fed on dry dog food as their main source of nutrition must take in a sufficient supply of water daily to keep up the necessary evacuation of toxins and stay adequately hydrated. Those that don't do this will become dehydrated - and the longer their diet consists of nothing more than dry food, the more dehydrated they will become. Owners may also imagine that the more expensive varieties of dry dog food might have better quality contents, but this is not necessarily the case. In the U.S., the pet food industry is worth some $16 billion a year with just eight manufacturers making up 85% of sales. So while the bag may seem different - the content will likely be much the same, regardless of who is selling it. All processed dog foods affect canine organs adversely to some extent, but I believe dry dog food adds to the long-term stress the kidneys particularly have to endure. This is because dry food is a million miles away from anything a dog would naturally eat and it all too often has things a dog should ideally not eat at all. Kidney disease can occur for many reasons, particularly in older dogs - just like humans, something has to fail eventually - but the kind of food we give certainly impacts on the health and longevity of our dogs. It strikes me that one of the main roles of a good owner is to offer the best diet they can and not one that is primarily convenient, cheap and potentially harmful to their family pet surviving into old age. Dry dog food has been an extraordinarily successful product in recent years, even though it was actually first launched on to the market by the pet food industry in the 1930s. Sales today are 85% more than they were 10 years ago. But despite its obvious convenience and cost advantage over other manufactured pet foods, it remains a controversial diet for dogs according to some veterinarians, pet food analysts, nutrition experts and enlightened pet owners. The manufacturing process destroys some of the nutritional value of these products. In 2011, studies conducted by Wageningen University in the Netherlands concluded that heating pet food to 200 degrees during the drying process lowered concentrations of essential amino acids and omega-3 and omega-6 fatty acids. While these merely cut the levels of nutrition, the process also creates an increased concentration of oleic acid, which in turn can lead to small-size kibble food becoming contaminated with toxic compounds through a conversion known as lipid oxidation. Amazon Price: $32.99 Buy Now (price as of Oct 13, 2015) The problem of identifying what some canine nutritionists consider as toxic additives is enormous, because EC permitted additives for pet food include a list of about 4,000 different chemicals, some of which different nutritionists suggest are at best only controversially considered safe for dogs. There is good reason dry pet food manufacturers always ask owners to make sure their best friend has an ample supply of fresh drinking water available. Tinned dog food has about 80% water, but dry food has none at all. Not all dogs are good or frequent water drinkers, so those fed on tinned foods tend to get much of the water intake they need from their daily meals. Dogs fed on dry food must rely on taking water separately, and as not all will do this, many become dehydrated. Many believe that some dogs fed only on dry food are chronically dehydrated for most of their lives - and this leads to a higher than expected incidence of early onset and fatal kidney failure. GDV is a commonly fatal condition where the stomach becomes bloated with gas, fluid and ingesta. This is an emergency situation and dogs that do not receive treatment in superfast time can deteriorate rapidly. Distention occurs because the stomach becomes blocked at both ends. Distention of the stomach eventually compromises blood flow and once it affects the heart, blood flow becomes restricted throughout the body. A state of hypovolemic shock and other problems occur and the dog's survival is in extreme danger. According to vet, Jason Nicholas (thepreventativevet.com), feeding only dry food to a dog is one of the many risk factors that collectively or in isolation may help cause GDV. NUTRITIONAL VALUE

Credit: Copyright of iStockphoto. All rights reserved. GASTRIC DILATION AND VOLVULUS (GDV) CLASS LAWSUIT IN THE USA A dog needs a certain amount of vitamins, minerals, fatty acids and protein to sustain a healthy disposition. Some of these naturally occurring elements are partly destroyed during the dry food manufacturing process, so they need putting back in to bring products up to a satisfactory nutritional level. IN CONCLUSION For now, I would ask you to remember that dry dog food was almost entirely designed for the benefit of humans and not dogs, because it is more convenient than home-cooked or high quality tinned pet food and it is usually cheaper to buy in comparison. The nutritional value is generally poor and packs often contain ingredients that are suspect, to say the least. And those are just some of the derisive physical characteristics of this product. Combine these with the psychological ordeal of eating something akin to dry cheese biscuits for the rest of your life, and some owners might have a twinge of guilt and reconsider just how compassionately they are caring for their best friend - albeit in most cases, without insight and mostly encouraged by emotive and not entirely factual advertising. The American Veterinary Medical Association (AVMA) lists almost 400 different dog food products that were recalled due to potential salmonella and toxin contamination or because antibiotic residues and foreign bodies were found, as well as various other assorted problems, in just the last 12 months (2012-2013). It is little wonder then that owners are increasingly questioning dog food quality. Dry dog food has an even worse pedigree than frozen and tinned varieties, because producers consider the convenience for owners and market sales potential first, rather than the good health of dogs as a priority. The very manufacturing process partly destroys what natural good there may once have been in the organic content, and artificial additives cause problematic health concerns on top of the inevitable risk of chronic dehydration and consequential kidney failure in some dogs. One of the prime advantages of dry dog food over a fresh product is the length of time an owner can keep it stored ready for use. The shelf-life is considerably longer, but only due to removal of moisture and preservation of ingredients. Manufacturers use natural preservatives, such as an anti-oxidant (more commonly called either vitamin C or E on packaging or as a form of ascorbate or tocopherol), and these are generally considered safe. However, some products incorporate artificial preservatives - and they can introduce a risk of toxicity when used long-term to feed a dog. There are alternatives. Good quality tinned dog food is available for those with busy lives who want convenient easy-to-store pre-prepared products, but even these are not ideal and are still subject to undesirable and unhealthy additives. Perhaps the best food for our pets is a home cooked variety that has every ingredient sourced, checked and known by you, the person putting it together. There are lots of resources, websites, books and companies that can help guide you to a better understanding of this subject, if this is something you wish to pursue further.

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CORRECTING and REPLACING Nickelodeon and Sid & Marty Krofft Unleash Playful Puppies for Preschoolers in Mutt & Stuff--New Series Premiering Friday, July 10, at 10 a.m. (ET/PT)

Cesar Millan is a best-selling author, a much-in-demand public speaker, a branded pet care product designer/entrepreneur, international star of Nat Geo WILD's Cesar 911 and original host of the Dog Whisperer. Cesar has co-authored several books as well as generated numerous instructional DVDs and CDs. In 2007, Cesar officially launched The Cesar Millan Foundation, a national nonprofit organization designed to champion worldwide animal advocacy for animals through the support http://www.dogfoodscoop.com/10-best-dog-food.html of community education and awareness programs. The series follows Calvin Millan and his best friend Stuff, a larger-than-life dog with a personality to match, as they take preschoolers inside the doors of Mutt & Stuff, a school for dogs, to explore the daily lives of these canine companions. Each episode features incredible tricks, training lessons and high-spirited humor. With the help of 15 playful puppies and charismatic puppets, Calvin educates preschoolers on how to train and guide their dogs, as well as showcase the friendship and loyalty that puppies can provide. Mutt & Stuff airs regularly Fridays at 10 a.m. (ET/PT) on Nickelodeon. http://www.businesswire.com/news/home/20150615005420/en/CORRECTINGand-REPLACING-Nickelodeon-Sid-Marty-Krofft-Unleash In Mutt & Stuff's series premiere, "Hip Hop Dogs," Calvin helps one of his canine students cope with missing his owner. In addition to helping his pup pal, Calvin helps the dog's owner when she needs back-up dancers for her dance performance. Cue the Mutt & Stuff hip hop dog dancers! Nickelodeon's award-winning NickJr.com and the Nick Jr. App will feature Mutt & Stuff content including episodic clips, series trailer and theme song. The series premiere of Mutt & Stuff will be available on NickJr.com, the Nick Jr. App, Nick VOD and DTO beginning July 11. Created by Sid and Marty Krofft, and Bradley Zweig *High-res art available at www.nickpress.com The corrected release reads: Mutt & Stuff will premiere Friday, July 10, at 10 a.m. (ET/PT), joining Nick's number-one lineup of preschool content that features the top-rated PAW Patrol and Blaze and the Monster Machines. Mutt & Stuff is created and executive produced by Sid and Marty Krofft (H.R. Pufnstuf, Land Of The Lost), along with Bradley Zweig. Cesar Millan also serves as executive producer. NEW YORK--(BUSINESS WIRE)--Please replace the release with the following corrected version due to multiple revisions. Calvin Millan and Cesar Millan Star in Live-Action Series Added Marty Krofft, "From the moment we met with the Millans it was clear that partnering with them was going to lead to something extraordinary. Mixing their dynamic talent with the unmatched appeal of puppies and the quirkiness of puppets, we knew that Mutt & Stuff would be a one-of-a-kind show that would pique the interest of preschoolers and enable us to connect with a new generation of kids."

Nickelodeon is expanding its hit preschool roster with the launch of the inventive Mutt & Stuff, a live-action preschool series created by TV legends Sid and Marty Krofft, and Bradley Zweig. Set in a unique school for dogs, the series stars Calvin Millan and his dad, Cesar, star of Cesar 911 and former star of Dog Whisperer with Cesar Millan, interacting with a cast of both real dogs and puppets at a canine school called Mutt & Stuff. In addition to adorable puppies and unbelievable dog tricks, the series balances moments of heart and comedy with a social-emotional curriculum that helps preschoolers with identifying and managing emotions, building interpersonal awareness and developing social skills. The show also carries a message of pet adoption and responsible pet care based on Cesar Millan's philosophies. Bradley Zweig is an Emmy-nominated executive producer and writer who has worked on numerouslive-action and animated preschool shows forNickelodeon including Yo Gabba Gabba, Wallykazam!, Zack and Quack and The Fresh Beat Band. He has alsowritten and produced projectsfor The Jim Henson Companyand Cirque Du Soleil. In addition to his television work, Zweig has written several live touring shows including Ringling Brothers and Barnum & Bailey Circus, and multiple touring musical productions for Disney Jr. Many of the most colorful and fondly remembered children's series of the 1970s and 1980s sprang from the imaginations of Sid and Marty Krofft. The Kroffts made their television debut in 1969 with NBC's H.R. Pufnstuf and introduced the brothers' innovative mix of live-action and puppetry. For the next two decades, the Kroffts developed several hit shows including The Bugaloo, Lidsville, Sigmund and the Sea Monsters and Land Of The Lost. The Kroffts also found success as producers of popular primetime variety series such as The Donny and Marie Show, The Brady Bunch Variety Hour and the top-rated Barbara Mandrell & the Mandrell Sisters. In 2009, the Kroffts produced a feature film version of their classic TV program Land of the Lost, which was distributed by Universal Pictures.The Kroffts recently signed a development deal with Amazon Studios to develop a reimagined pilot based on Sigmund and the Sea Monsters. They are also producing a reboot of Electra Woman & Dyna Girl, consisting of a series of eight 11-minute episodes that can also be released as an 88-minute movie, at Legendary Entertainment. Nickelodeon, now in its 36th year, is the number-one entertainment brand for kids. It has built a diverse, global business by putting kids first in everything it does. The company includes television programming and production in the United States and around the world, plus consumer products, online, recreation, books and feature films. Nickelodeon's U.S. television network is seen in almost 100million households and has been the number-one-rated basic cable network for 20 consecutive years. For more information or artwork, visit http://www.nickpress.com. Nickelodeon and all related titles, characters and logos are trademarks of Viacom Inc. (NASDAQ: VIA, VIAB). Calvin Millan, 16, is the son of Cesar Millan, star of Nat Geo WILD's Cesar 911 and former host of the Dog Whisperer with Cesar Millan. Calvin began his acting career at the age of eight when he appeared as a guest on the Dog Whisperer helping to train small dogs. In 2012, he traveled with his father appearing in CESAR MILLAN LIVE touring shows in Asia and Canada. Calvin has one dog named Coco and actively works with the Cesar Millan Foundation in support of the Mutt-i-grees elementary school program that teaches children empathy and compassion for animals. The program has been taught in over 1,200 school districts in the United States and Canada. NICKELODEON AND SID & MARTY KROFFT UNLEASH PLAYFUL PUPPIES FOR PRESCHOOLERS IN MUTT & STUFF--NEW SERIES PREMIERING FRIDAY, JULY 10, AT 10 A.M. (ET/PT) "Mutt & Stuff will capture the hearts and imaginations of preschoolers everywhere with its upbeat energy, heartwarming friendships and valuable lessons," said Russell Hicks, President, Content Development and Production, Nickelodeon Group. "Sid and Marty Krofft have been entertaining kids for decades with shows that expertly blend fantasy and reality, and Mutt & Stuff truly embodies their colorful signature style."

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The Latest on AXS

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http://www.examiner.com/slideshow/doggies-and-stuff

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Inventors of Greenies -- Nation's #1 Dog Treat -- Receive `Small Business Exporter of the Year' Award from National District Export Council

Companies competing for the "Small Business Exporter of the Year Award" were nominated by private sector DEC members and U.S. Commercial Service offices. The DEC judging panel looked at criteria such as domestic product content, growth in the number of export markets; increased employment in the U.S., and share of exports contributing to company sales. The U.S. Commercial Service is a U.S. Commerce Department agency that helps small and midsize U.S. businesses sell their products and services globally. The Commercial Service's worldwide network includes 108 U.S. Export Assistance Centers and nearly 150 international posts. For more information on the Commercial Service, please call 816-426-6285 or visit www.export.gov. To learn more about S&M NuTec and Greenies(R) visit www.greenies.com. "My wife and I invented Greenies(R) to cure our own dog of his doggie-breath and now we've sold more than 260 million Greenies(R) all over the world," said Joe Roetheli, founder, S&M NuTec. "We'd like to thank the U.S. Commercial Service for its assistance in spreading Greenies(R) around the globe." From its modest start in 1996, the North Kansas City, Missouri, company has grown to 56 employees, with more than 300 local outsourced jobs. S&M NuTec exports Greenies(R) to 44 countries -- with exports accounting for about 12 percent of the firm's total sales. Among the firm's key markets are Japan, Canada, Australia, and Taiwan. The company has benefited from export counseling, market research, trade events, and other assistance from the Commercial Service's Kansas City U.S. Export Assistance Center. Greenies(R) are the first and only dental treat that decrease tartar and plaque, freshen breath, enhance nutrition, improve digestion, and taste great to dogs. Recently, Greenies(R) received the Veterinary Oral Health Council (VOHC) seal. Greenies(R) is the only treat to be awarded this prestigious seal for its success in removing tartar and plaque.

District Export Councils (DECs) are organizations of http://www.dogfoodadvisor.com/ leaders from the local business communities across the United States, and are appointed by successive Secretaries of Commerce. With their expert knowledge of international business, DEC members are a key source of professional advice for local firms. For more than 25 years, DECs have served the United States by assisting companies in their local communities export, thus promoting our country's economic growth and creating new and higher-paying jobs for their communities. http://www.businesswire.com/news/home/20041020006076/en/Inventors-Greenies----Nations-1-Dog-Treat S & M NuTec Jody Hanson, 913-341-1966 or Tennessee Export Council Jim Frierson, 423-505-6888 or Commercial Service Curt Cultice, 202-482-2253 MEMPHIS, Tenn.--(BUSINESS WIRE)--Oct. 20, 2004--Every dog has his day, and today a company that cleans dogs' teeth and freshens their breath is having theirs. The National District Export Council today presented its inaugural "Small Business Exporter of the Year Award" to S&M NuTec, LLC of North Kansas City, Missouri. The company makes Greenies(R), the country's number-one retailing dog treat. U.S. Department of Commerce Undersecretary for International Trade Grant Aldonas presented the award. Jim Frierson, Vice-Chair of the Tennessee Export Council, said this year's judges were "extraordinarily impressed" with S&M NuTec's use of scientific research and market strategies that include a tight network of nearby regional suppliers. "The S&M NuTec story is one of rapid export market introduction and acceptance by veterinarians and pet owners," he said. "Even more impressive is that new pet product lines are in the pipeline. This is a company that refuses to rest on its hind feet. There are good lessons in this story for American businesses that choose to compete globally."

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Selecting A Dog Crate by Kevin Gawricki

Wire Dog Crates First decide which crate will suit your needs. Soft Crates Do you need your crate to be portable? Offers great visibility and ventilation. Available in folding models and many offer divider panels. Mainly used for house breaking, crate training, a everyday crate. Is crate for home use only? Ask yourself some simple questions before selecting your crate. Wire- designed to safely confine your dog. These crates are not designed to be picked up and moved around with your pet inside.

href='http://www.articlecity.com/articles/pets_and_animals/article_1076.shtml'>http://www.articlecity.com/articles/pets_and_animals/article_1076.shtml Is this crate for a puppy? Consider these basic features before purchasing a crate or carrier. Hard Plastic- These are designed for your pet to be carried safely inside. Selecting A Dog Crate Primarily used for transport of small dogs. Work well in the car. Many are approved for airline travel. Hard Plastic Used to transport pets. Many are approved for airline travel. Will help to contain your pet while a vehicle. Article written by Kevin Gawricki With this in mind you will be able to select the proper crate. Main advantages are they are light weight, easy to transport, and easy to set up. They can be used as a everyday crate. These crates are not http://www.dogchannel.com/dog-food/ recommended for chewers or diggers. Do I plan to take my pet in the car? Soft Pet Carriers

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502 Bad Gateway

502 Bad Gateway The proxy server received an invalid response from an upstream server. Sorry for the inconvenience. Please https://www.dog.com/ report this message and include the following information to us. Thank you very much! URL: http://gather.com:1562/

Server: pc007.thor.asgard Date: 2016/07/19 21:41:48 Powered by Tengine/2.0.0 http://gather.com/

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Dogs :: How To Deal With Warts In Dogs

1. Surgery: cryosurgery, electrocautery are the two main surgical procedure implemented for removal. The former involves destruction of the damaged tissue by liquid nitrogen, while the later is the use of laser to kill the papilloma. In general, warts are harmless if few in number. They tend to stay on the skin of older dogs, while disappear in younger dogs on their own as the immune system can fight the virus properly. In some dogs, warts can create havoc with pet health and lead to problems in breathing and eating. 1. Halitosis (bad breath) 2. Excessive drooling/ salivating 3. Oral bleeding Medically warts are known as Canine viral papilloma. Spread by physical contact with other dogs, your dog can contract this infection rather easily. Small and shaped like cauliflowers these warts populate the muzzle, tongue, eyelids, and lips in dogs, but they can also invade the skin around the rectum or vulva in some others. Warts take about 1-2 months to grow from the time of the contact. Treatment of Warts in Dogs Warts don't require any particular treatment as the viral papillomas disappear on their own. However, in come cases, especially when the warts are located in an area that causes discomfort, or when pet owners demand removal of the warts to restore pet health, treatments can be initiated. 2. Another treatment involves crushing the papilloma physically to stimulate an immune response from the body of the pet as this helps restore pet health and expedites the disappearance of the warts. 3. If the dog has failed to relapse after more than 5-6 months, then systemic chemotherapy can help in varying degrees to successfully restore pet health. http://www.articlebiz.com/article/302683-1-how-to-deal-with-warts-in-dogs/ Symptoms of Warts in Dogs Warts in dogs are infectious in nature and can spread to other dogs through physical contact. Warts in dogs are epidermis tumors that are caused by many different types of viral infections. Asking pet health questions form an important part of dealing with warts in dogs. Warts in dogs come in two broad categories. Warts infecting older dogs are the most common ones. By nature, warts are benign and only threaten pet health if they get infected or become larger in size. However, warts can damage pet health in younger dogs as they are infectious in nature. F A complete blood count or CBC test, urinalysis, and biochemical profile is necessary for dogs that have lost appetite and have poor pet health as well as prolonged discomfort due to difficultly in food intake. F In some cases, the dog may be subjected to surgical biopsy for a proper confirmation. However, it may be required in most cases. These treatments include:

Diagnosis of Warts in Dogs Since papillomas are distinct and pathognomonic in nature, they don't require diagnostic testing. Nevertheless, in some cases, diagnosis may be necessary to ascertain the extent and depth of the infection as it would reveal the damage done to pet health. Two of the more important diagnostic tests that require to be http://www.petsmart.com/dog/dry-food/cat-36-catid-100032 done are:

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Homemade Dog Treats - Today's Creative Life

My sweet girl Maybelline loves to snack just as much as the next dog, but she is picky! In fact she will not eat the red colored dog biscuits at the pet store. The checkout gal is learning and will dig around in the box looking for a plain one just for her. To make her look even more like a princess, she very very gently takes a treat, then takes her sweet time eating her treats. It can take her at least 1 minute or more to eat a http://www.dogchannel.com/dog-food/ simple dog treat. She's picky...... In fact, she will NOT drink out of the dog fountain at the dog park or another dogs bowl. I don't blame her. Have you seen how some of those dogs drool? Not very lady like at all. http://todayscreativelife.com/homemade-dog-treats/

See that google+ button below? Click it.....go ahead. Thank you! I found the cutest dog themed cookie cutters, made by Martha of course. Here's another brand I found with all the shapes. Mini Dog Bone 5-Piece Cookie Cutter set

. Click HERE to Pin This Recipe

Since 2007, Kim has been sharing tips and tutorials on how to live a creative life. Owner/Founder of Today's Creative Blog and InspirationDIY.com where inspiration happens everyday! From the Pacific Northwest, Kim is a busy mom who adores her teen son, her middle aged husband and is constantly wiping the muddy paws of her adorable Labradoodle Maybelline. In her spare time, she teaches fitness classes and loves to decorate with thrift store bargains. You can also find Kim once a month on Portland's AMNW Morning show as their "creative expert". Life is more fun when it's creative!

Homemade Dog Treats If you don't want to roll it out, just roll small pieces into a ball and press with a fork like peanut butter cookies. Your dog could care less if it's shaped like a bone or not. I added a couple of tablespoons of wet dog food just for extra flavor. Completely optional. Just don't tell people they're for human consumption. :) Ingredients 2 cups whole wheat flour 1 tablespoon baking powder 1 cup peanut butter 1 cup milk 3 tablespoons coconut oil Instructions Preheat oven to 375F Combine all ingredients into your mixing bowl, I used my kitchen-aid mixer, but a hand mixer works great too. Mix on Medium until well blended. Placing your dough on a floured surface, and knead. Roll it out. Mine kept looking like it would crumble apart, so I didn't roll it out too thin. Cut out your shapes and place on a greased cookie sheet. I poked holes with a fork in case they wanted to bubble, but mostly because it looked like I knew what I was doing. :) Bake for 10 minutes. Notes Please pin this post, but please do not copy and paste the full recipe details onto FB or Pinterest. 3.5.3208 September 17, 2013 By Kim I was asked to do a post for Alpo later this week and it got me thinking about making some homemade dog treats! So I guess she's really a germaphobe princess. (I kinda like that trait)

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Maltese Stuffed Animals

For Everyone: http://www.articlesnatch.com/blog/Maltese-Stuffed-Animals/1748545 Maltese's are an affectionate and lively little dog which provides its owner with loyal companionship. The same can be said about Maltese stuffed animals, though the 'lively' characteristic will have to remain within its owners vivid imagination. For a child that can only dream about having a Maltese, Maltese stuffed animals will provide years of endless entertainment and friendship. It's hard to ask for anything more from a plush toy. Article Published On:

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Site Navigation: ArticleSnatch Authors: The Maltese's fur coat is white, straight, and long and silky. Ideally, its long coat needs to be groomed carefully everyday and washed frequently. Maltese stuffed animals sport the same white, long coat which can also be brushed on a daily basis if its owner chooses to do so. A small amount of exercise is also required for the Maltese breed although he or she should not be taken out in severe cold or heavy rain. Extreme cold for Maltese stuffed animals won't be a problem, but allowing its beautiful silky coat to get wet would not be recommended, even at the best of times. You should do whatever it takes to keep a Maltese stuffed animals coat as dry as possible. And last but not least, like with the Maltese breed, Maltese stuffed animals require loads of love and attention the more you give, the more you will get back in return. For Publishers: About the Author: Angeline Hope is a collector of big stuffed animal toys. You can view a selection of big stuffed animal toys including big stuffed dog toys such as the Maltese at MyBigPlush. Just about every child wishes for a puppy at some point in their young lives. Some are lucky enough to have their wish come true while others never get to experience what it's like to have a dog while growing up. For those that don't get to have a puppy, there are any number of plush dog toys on the market to satisfy a child's burning desire for the real thing. Maltese stuffed animals are one of the many plush dog breeds that a child can choose from. Some Maltese stuffed animals, like those found in online stores, are so lifelike, you may not be able to tell the difference between it and the real breed. There are conflicting accounts of the Maltese's precise place of origin. Most believe that a pure-breeding line was first established on the island of Malta, while others think of Sicily as its home. All are agreed, however, that the breed type is centuries old, and royal portraits which include lap-dogs suggest that its appearance has not changed much over the years. The Maltese has never had to work for its living, but was kept as a companion dog by the European nobility. The first specimens arrived in Britain during the rein of Henry VIII, and it enjoyed consistent popularity until the introduction of the Eastern toy breeds at the end of the 19th century. Although eclipsed by these, the Maltese has never been in danger of disappearing and today it is well known in American and Britain. What Do We Do On Our Wedding Anniversary? By: Donald Geary - Are you about to celebrate a unique anniversary with the one you love? Often, as much as you want to bless the one you adore in a special http://www.petmd.com/dog/slideshows/nutrition-center/choosing-best-dog-food method, it is tough to come up with great anniversary ideas.Tags: wedding, relationships, anniversary ideas, home and garden, familyAnniversary Ideas For Everybody By: Elisa Dean - Are you about to celebrate a special anniversary with the one you love? In some cases, as much as you desire to bless the one you like in a special method, it is hard to come up with fantastic anniversary co ... Tags: home and garden, anniversary ideasLearning About The House And Land Packages Aspire Has To Offer By: smartweb - At Nostra Homes, we can create a home and land package to suit your lifestyle in Merrifield, Mickleham, Plumpton, Australia. Call us at 03-8331-3500. Whether you are building one of our conventional homes, a ... Tags: House and Land PackagesKingston Rental Apartments: A Luxury Dream House City By: smartweb - Find queens properties for rent at the best price. We have a large selection of Kingston apartment rentals near Queens Campus. We are a locally managed organization who specialize in the administration of ... Tags: Kingston Apartment RentalsQualities Of An Efficient Laundry In Los Angeles By: Robert Paul - Most people who are very busy look for reliable laundry services so they'll do their daily laundry task. There are such a lot of laundry providers who offer laundry services wash your garments.Tags: Los Angeles Fluff n Fold, Wash Dry Fold, Linen ServiceWhat Can We Do On Our Wedding Anniversary? By: Audrey L. Langley - Are you about to enjoy a special anniversary with the one you love? In some cases, as much as you desire to bless the one you like in a distinct method, it is hard to come up with fantastic anniversary ideas ... Tags: wedding, relationships, home and garden, family, anniversary ideasHouse Selling Tips For Winter By: Maria A Williams - For those who are willing to sell their house during the winter months, they will be faced with a bit of a challenge. Experienced buyers agents are already familiar with this challenge, but they still know h ... Tags: buyers agents, Buyers Agent SydneyForensic Testing In Rape And Incest Cases By: rossbrian - These samples must maintain a sterile chain of custody and documentation must be accurate throughout the testing.Tags: Legal Paternity Tests, Immigration DNA TestingExhibit Display Solutions: Influential Aspect Of Market By: smartweb - DTouchExhibit experts and designers believe in creating exhibition stand display and exhibition stand design and build that reflects the identity of your brand in the Dubai, UAE. Tags: Exhibition Stand DisplayChoosing A Good Mattress For Your Child By: Maria A Williams - When the time comes for your children to graduate from a cot to a bed, it is very important that they sleep on supportable mattress for their spines. Providing a comfortable base that will support your child ... Tags: Latex Mattresses, Kids Mattresses, Custom made mattresses By: Angeline Hope

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Serena Williams tries dog's food ... and pays the price

"Let's fast forward two hours," she continued. "I just ran to the toilet. I thought I was going to pass out. It did taste weird. Later looking distraught, Williams added: "I really don't feel so good." However she appeared in better spirits not long after and joked: "I need a life." The incident didn't stop Williams taking to the court for her next match and defeating fellow American Christina McHale 7-6 (9-7) 6-1 to reach the quarterfinals, where Svetlana Kuznetsova -- a two-time grand slam winner who upset her in Miami in March -- awaits Friday. Rome is only Williams' fourth official event of 2016 after she skipped three tournaments because of the flu. In less than two weeks at the French Open, Williams begins her quest for a 22nd major. If successful at Roland Garros this spring she would tie Steffi Graf's Open Era grand slam record. It wasn't Serena Williams but the world No. 1 is regretting eating some of her beloved canine's food. Williams ordered the meal for three-year-old Chip -- a Yorkshire Terrier -- at the hotel she was staying at during the Italian Open in Rome. The salmon and rice mix -- which cost $17 -- looked so good, she said, that the 21-time grand slam champion decided to give it a try. Wrong move as she quickly became ill and had to run to the bathroom. "Before you judge me, look at it," Williams said on Snapchat in a video that was later posted on YouTube, panning to the salmon and rice. "Come on. It looks good. In fact when I take the food to go, they give me the same food package. "It http://www.petmd.com/dog/slideshows/nutrition-center/choosing-best-dog-food comes with the expensive looking spoon. I'm like, 'What the heck? I'm going to try a piece.'" "I force swallowed it. It tasted a little bit like a house cleaner kind of thing. But Chip liked it and it looked good."

She took a spoonful. http://edition.cnn.com/2016/05/13/tennis/serena-williams-dog-food-tennis-italian-open/index.html

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Dog Food | Best Dog Food Brands on Sale

http://www.petco.com/shop/en/petcostore/dog/dog-food

The best dog food brands for your dog will provide them with the nutritional balance they need to keep their tail wagging for many years to come. So consult with your vet, sample a few varieties, and then browse through all the premium formulas and carefully-selected recipes your dog could ever wish for available in Petco's one stop shop. Look through our wide selection of the best dog food brands available online, including those which feature wet or dry varieties in natural, limited ingredient and raw recipes. Although some pet parents prefer one https://dogfood.com.au/ over the other, wet and dry recipes each have a wide variety of nutrient packed formulas, so you can provide a balanced meal for your pup either way. If you can't pick, you can always mix them together to give your dog the best of the both worlds in an irresistible mix that carries all the nutrients and yummy benefits that the best dog food can provide. The Petco exclusive brands can also give your dog the delicious, beneficial, and special recipes your dog craves. That's because our commitment to complete pet care begins with what's in your dog's bowl. We have the largest selection of Natural Nutrition of any national pet retailer and offer other dog parent favorites like the Blue Buffalo, Purina, and Merrick dog food brands. Many of the best dog food brands cater to a specific age, size, life stage, nutritional need and more. If you're looking for limited ingredient recipes, Petco has many dog foods formulated to help you avoid allergens, fillers, and other ingredients your dog can do without. Regardless of what variety you decide to switch to, remember to slowly transition the new variety in, so you don't upset your dog's tummy. And once you find your dog's perfect match, sign up for Petco's Repeat Delivery to get a discounted price.

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Dogs :: Different Collars For English Bulldogs

Choosing the perfect collar for Fido can be confusing due to the fact that there are various types of it for you to choose from. Types of dog collars include: Slip Collars Also called choke chains, chokers or slip chains, this type of collar is used for training purposes only. It could be made of nylon rope, cotton or leather with "O" rings at the end so that the collar can be formed into a loop (making a "P" shape) around the top of the dog's neck. The rings at the end of the collar are either dead ring (floating ring) or live ring. If a leash is attached to the live ring, the chain will tighten else the collar will not tighten if the leash is attached to the dead ring. This type of collar http://www.food.com/recipe/homemade-dog-food-250094 should be used properly during english bulldogs training to prevent injury or death due to choking. Prong Collars Just like slip collars, this type of collar is ideal for training purposes also. Prong collars, also called pinch collars are series of chain links with blunted open ends turned towards the dog's neck but can also be turned inside out in such a way that the prong is facing away from the dog's skin. Despite it's harsh appearance, study shows that there is no neck, back or trachea injuries found provided the collar is used properly. Other collars include martingale collar, flea collar (to repel fleas), break-away collars and stud collars. http://www.articlebiz.com/article/364093-1-different-collars-for-english-bulldogs/ Buckle Collars As the name implies, this type of collar is fastened with a buckle. Either flat or rolled, buckle collars are usually made of nylon webbing or leather although materials such as cotton, hemp or metal can also be used. The good thing about buckle collars is that they do not tighten on the dog's neck once fastened. Identification is often attached in this type of collar.

If you are considering of getting new pets such as english bulldogs, you are probably aware of the necessary stuff these four-legged creatures need. One of the things that must be included in the list of must-haves for pets is collar - a piece of material placed around the neck of a dog. While some use collars for fashion purposes, a lot are using it for identification and control. Tags containing identification and medical information are often placed on dog collars. A collar is especially beneficial when it comes to english bulldogs training since this this helps in controlling a dog by providing a handle for grabbing.