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Biomedical subjects

D W Kaplan

Publications and source records attributed to D W Kaplan.

29 records · Page 2Linked to original sources
PubMed1989

Adolescent contraceptive use and parental notification.

Little research exists regarding the relationship between family communication and the sexual behavior and contraceptive use of adolescent females. A self-administered questionnaire was used to survey 196 adolescent females regarding communication with their parents about sexual issues and their reaction to proposed parental notification of the dispensing of prescription contraception. Parents of 80% of the subjects who were sexually experienced were aware of this activity. Parents of 80% of those subjects who had used contraception were aware of this use; 59% of these subjects informed their parents before their family planning visit. The majority of female adolescents (57%) were unwilling to communicate with their parents about sexual issues; 64% felt they should be able to receive prescription contraception without parental knowledge. Communication regarding sexual issues was related to lifetime contraceptive use. Eighteen percent of the sexually experienced subjects would not allow their parents to be notified of their family planning visit; 86% would use less effective contraception if family planning services were not sought. Our findings suggest that a parental notification policy will not compel all adolescents to inform parents about their contraceptive use; most adolescents will resort to less effective contraceptive methods.

Adolescent↗
PubMed1988

Physicians' values and experience during adolescence. Their effect on adolescent health care.

The values and experience of physicians as adolescents can effect their care of adolescent patients. Eighty residents were studied using extensive personal data gathered from a structured interview, a questionnaire of perceived clinical skills, and a videotape with a simulated patient. A "values" and "risk-taking during adolescence" score was constructed and related to the resident's perceived skills for and attitudes about adolescent health care. Residents with higher values scores (more conservative) were more likely to be pediatric than internal medicine residents and less likely to prescribe birth control pills to an adolescent. Residents with higher risk-taking scores considered themselves more skilled in dealing with substance abuse and sexually transmitted diseases and in recognizing psychologic problems. Values or risk-taking scores were not related to the resident's perceived skill in areas such as evaluating hypertension or performing Tanner staging. These data suggest that certain values and experiences may be influential in the physician's ability and approach to dealing with certain issues related to adolescent health care.

Adolescent↗
PubMed1987

Native American postneonatal mortality.

Although dramatic gains have been realized in lowering the incidence of neonatal deaths among native American infants to a level lower than the white race, postneonatal death rates for this population remain twice as high as in the white race. The limited data available reveal that excessive postneonatal deaths among native American infants largely result from preventable accidents and treatable acute medical conditions, such as pneumonia and gastroenteritis. This suggests that native American infants leave the hospital healthy but go to unsafe environments, which decrease their chances of survival past 1 year. In particular, the poorer socioeconomic conditions that native American families experience and the related problems of alcoholism, unemployment, and family disorganization contribute to the high rate of postneonatal mortality. Intervention programs to lower native American postneonatal mortality should focus on promoting prompt recognition of and health seeking for treatable medical conditions and prevention of accidents and other postneonatal health problems. The roots of the problem of native American postneonatal mortality lie in the socioeconomic conditions of many Indian communities and cannot be addressed without recognition of how these factors combine with the health care delivery system to diminish life expectancy for native American infants.

Child Abuse↗
PubMed1985

Breast masses in adolescent females.

Conservative management of breast masses in adolescents is generally advocated in consideration of the low incidence of breast cancer. A retrospective chart review of 130 female patients seen in a general adolescent clinic over a two-year period was performed. The mean age was 17.5 years (range 12-21). One hundred and seven (88% of available data) had self-discovered lesions. Fibrocystic disease was clinically diagnosed in 66 (51%) patients, while 19 (15%) had fibroadenomas and 17 (13%) had a normal breast examination. Of the remaining patients, six (5%) had mastalgia, five (4%) had mastitis/abscess, three (2%) has asymmetry, three (2%) had hypertrophy, two (1%) had breast changes of early pregnancy, two (1%) had hematoma, one (1%) had axillary lymphadenopathy, and six (5%) had unknown. Excisional biopsy was performed on eleven patients; it revealed fibroadenoma in eight, and one each had a hematoma, granular cell myoblastoma, and breast abscess. Improvement or complete resolution of breast masses was documented in 31 (47%) of the patients with fibrocystic disease.

Adenofibroma↗
PubMed1984

Evaluation of an enzyme immunoassay for detection of Neisseria gonorrhoeae in an adolescent population.

We compared a modified procedure of Gonozyme , an enzyme immunoassay for detection of gonococcal antigen in urogenital specimens, with bacterial culture for Neisseria gonorrhoeae in a hospital-based adolescent clinic. In 839 patients studied, prevalence of urogenital gonorrhea by culture was 14.3%. The sensitivity of the immunoassay was 90.0%, and the specificity was 98.1%; predictive values for a positive and a negative test result were 88.5% and 98.3%, respectively. Gonozyme was highly accurate in 57 males studied; sensitivity, specificity, and predictive values were 100%. In 782 females, sensitivity was 87.5%, specificity was 98.0%, positive predictive value was 85.7%, and negative predictive value was 98.2%. Patients with false-negative immunoassay results had lower colony counts on culture. Gonozyme is an acceptable substitute for culture in males and in females with intermediate or high prevalence of gonorrhea. Results can be available within three hours.

Adolescent↗
PubMed1984

Epidemiology of sudden infant death syndrome in American Indians.

A 7-year retrospective study of sudden infant death syndrome in Oklahoma Indians failed to support previous observations of a markedly elevated rate among the American Indians compared with the white population. The rate of sudden infant death syndrome in Oklahoma Indians was 2.32/1,000 live births. The rates of sudden infant death syndrome among white infants (1.8/1,000) and black infants (3.11/1,000) were similar to those reported in previous studies. Males had consistently higher rates of sudden infant death syndrome regardless of race.

Black or African American↗
PubMed1983

Prevalence of cervical Chlamydia trachomatis and Neisseria gonorrhoeae in female adolescents.

The prevalence of cervical infection with Chlamydia trachomatis and Neisseria gonorrhoeae was examined in 125 girls receiving primary gynecologic care in a general adolescent clinic. C trachomatis was isolated in 8% of the patients using a microtiter tissue-culture method, and N gonorrhoeae was found in 12%. A significant association was found between the use of oral contraceptives and positive chlamydial cultures. Patients with Chlamydia-positive cultures were frequently asymptomatic and exhibited no positive findings on physical examination. Three of ten women with cervical chlamydial infection developed pelvic inflammatory disease. These results support the use of cervical screening for both of these pathogens in sexually active adolescents.

Adolescent↗
PubMed1981

Specific memory deficits associated with prolonged alcohol abuse.

The relationship between age, education, length and amount of heavy drinking, and performance on five memory tasks was investigated in 54 chronic alcoholics and 18 age-matched controls. Alcoholics with less than 12 yr of heavy drinking differed reliably from long-term (13-22 yr) and extended long-term drinkers (greater than 23 yr) in recognition memory for visual patterns when scores were corrected for age. Compared with controls, both groups of long-term drinkers were deficient on the visual, auditory, and Faces recognition tests. Age and education of alcoholics accounted for part of performance differences; length of alcohol abuse, however, predicted reliably the decline in memory scores on all but the tactual test. The profile of memory performances seemed to decrease linearly with increasing age and length of alcohol abuse.

Adult↗
PubMedDate not supplied

Spectrum of genital human papillomavirus infection in a female adolescent population.

BACKGROUND: Human papillomavirus infection is a sexually transmitted disease associated with cervical dysplasia and carcinoma. GOAL OF THIS STUDY: To determine prevalence rates of cervical human papillomavirus infection compared with other sexually transmitted diseases and risk factors associated with human papillomavirus infection among adolescent women, we evaluated 634 patients attending three urban adolescent clinics. STUDY DESIGN: Patient evaluation included Pap smears; screening for chlamydia, gonorrhea, and trichomoniasis; and testing of cervical swab samples for human papillomavirus DNA. RESULTS: Cervical human papillomavirus was the most common STD in our population (15.6%), followed by infection with Chlamydia trachomatis (11.0%), Neisseria gonorrhoeae (7.1%), and Trichomonas vaginalis (5.4%). The most prevalent human papillomavirus types were 16/18 (7.3%), followed by 31/33/35 (4.7%) and 6/11 (3.5%). When genital warts on exam, low-grade squamous intraepithelial lesions on cytology, or cervical human papillomavirus DNA were considered as indicators of genital human papillomavirus infection, 24% of patients had any manifestation of infection, including 15% with clinically apparent infection (genital warts), 36% with cytologically apparent infection without warts, and 49% with subclinical infection only (cervical human papillomavirus DNA without low-grade squamous intraepithelial lesions or warts). Factors associated with detection of cervical human papillomavirus DNA by multivariate analysis included number of lifetime sexual partners and genital warts on exam. CONCLUSION: Cervical human papillomavirus infection was the most prevalent sexually transmitted disease among an ethnically diverse group of urban adolescent females, with a large proportion of infections neither clinically nor cytologically apparent. The strong association with lifetime sexual partners substantiates that cervical human papillomavirus is acquired predominantly by sexual contact and often soon after the onset of sexual activity.

Adolescent↗
PubMedDate not supplied

A comparison of parent and adolescent responses from independent health histories.

This study compared agreement of written responses between parent and adolescent concerning medical and psychosocial information from independent health histories during an initial medical visit. Records with two health histories completed separately by 268 parent/adolescent pairs were studied. The following medical questions were coded and compared: chief complaint, infectious diseases, review of systems, hospitalizations, accidents, allergies, and medications. Psychosocial questions included recreational drug use, sexual behavior, body image, home life, and mental health. Using three-factor repeated measures ANOVA, significant differences (P less than or equal to 0.05) were obtained for gender and age when comparing the mean scores for medical and psychosocial questions. These differences were found primarily in the psychosocial category and chief complaint question. Findings suggest that many adolescents are reliable informants about their medical histories, but private interviewing of the teenager may be necessary to determine high-risk behaviors.

Adolescent↗