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Biomedical subjects

L S Neinstein

Publications and source records attributed to L S Neinstein.

At least 37 records · Page 2Linked to original sources
PubMed1987

Vaginal Chlamydia trachomatis prevalence in sexually abused prepurbertal girls.

The prevalence rate of Chlamydia trachomatis in the vagina of prepubertal sexually abused children was examined. Additionally, the culture technique was compared to direct immunofluorescence assay (DFA) for diagnosing chlamydial infections in the vaginas of prepubertal children. The study group included 50 consecutive prepubertal girls examined for sexual abuse in an urban pediatric hospital's emergency room. Vaginal swabs were obtained for culture and direct immunofluorescence assays of C trachomatis and for gonorrhea culture. Of these, 8/47 (17%) of the Chlamydia cultures, 4/43 (9.3%) of the direct immunofluorescence assay specimens, and 0/49 gonorrhea cultures were positive for Chlamydia. All patients with positive findings by direct immunofluorescence assay also had positive chlamydial cultures. Of the four other patients with positive cultures for Chlamydia, two had negative findings by direct immunofluorescence assay and two had inconclusive results reported. Twenty-nine patients had a syphilis serologic study performed, and all had negative results. There was no significant difference between the Chlamydia-positive and -negative groups with regards to age, race, nature of the abuse, frequency of abuse, and symptoms or findings on physical examination. Although not statistically significant, children with cultures positive for C trachomatis reported rectal penetration five times and vaginal penetration twice as often as those children with C trachomatis-negative results. This study demonstrates a significant prevalence of vaginal chlamydial infections in sexually abused children. Vaginal cultures for C trachomatis should be included in the medical evaluation of sexually abused girls. The culture technique was superior to the direct immunofluorescence assay in this group of patients.

Bacteriological Techniques↗
PubMed1986

Pediatrician's self-evaluation of adolescent health care training, skills, and interest.

The 1978 Task Force Report on pediatric education encouraged increased participation by pediatricians in the health care of adolescents. A survey of pediatricians in the Los Angeles County area was conducted to assess the pediatrician's self-evaluation regarding the medical and psychosocial problems of the adolescent, the problems of the sexually active teenager, and the pelvic examination. A questionnaire was used to assess competence, level of comfort, ability to counsel, prior training, and the importance and relevance of these areas to pediatricians' practice. Areas of least and greatest competence were examined. Our results support the conclusion of the 1978 Task Force Report on pediatric education that there is inadequate training in adolescent health care issues. This appears to be especially true for issues relating to the sexually active teen and the pelvic examination.

Adolescent↗
PubMed1986

Weight gain in adolescent and young adult oral contraceptive users.

This study analyzed weight gain as a side effect of oral contraceptive use in teens and young adults. A retrospective chart review from 1978 to 1983 was conducted at two family planning clinics. Weight gain over 12 months was compared between females starting oral contraceptive pills and a control group using an IUD or a barrier method. One-hundred thirty-eight charts were included in the oral contraceptive group and 35 in the control group. There was no significant difference between the oral contraceptive group and control group in initial weight and weight after one year of use. Distribution of weight was also similar. There were no significant blood pressure changes. In the oral contraceptive group only five (3.7%) users listed weight gain as a side effect. The results suggest that for many young women who use oral contraceptive pills there is no greater risk of weight gain than for other sexually active young females.

Adolescent↗
PubMed1986

Effect of an adolescent medicine rotation on medical students and pediatric residents.

This study evaluated the effects of an adolescent medicine rotation on the attitudes and skills in the care of adolescents of third-year pediatric residents and medical students. Competence, comfort, and prior training in four areas were assessed by a self-evaluation questionnaire. Ratings were made at the start of the year, prerotation, and post a four- to six-week rotation. Residents not taking the rotation were rated at the beginning and end of the year. In addition, pelvic-examination skills were assessed by the clinic nurse and by the patients during the first and last week of the rotation. There were no significant changes in those not taking the rotation. In those residents taking the rotation, there was no change from beginning of year to prerotation, but there were significant changes after the rotation. Only those residents taking the rotation indicated an increase in liking adolescents. Pelvic examination skills were rated significantly higher during the last week of the rotation by the nurse and patients. A one-year follow-up study continued to show significantly higher scores in those residents taking the rotation. An adolescent medicine elective may significantly improve medical students' and residents' self-assessed levels of competence, comfort, and training in adolescent health care and pelvic examination skills.

Adolescent↗
PubMed1985

Effect of physician dress style on patient-physician relationship.

This study evaluates the effect of physician dress and other variables (i.e., sex of physician and patient, age, and type and site of visit) on patient-physician rapport. Three hundred eighty-six teens filled out a questionnaire, at the end of an office visit, which evaluated their attitudes regarding their physician and their preference for physician dress. The physicians alternated between very informal, informal, formal-white coat, and formal-suit/dress styles. Dress style made no statistical difference in patients' attitudes toward their physician. When asked what they preferred their doctor to wear 43% responded "makes no difference," 26% said "white coat," 14% said "pants and shirt," 10% said "jeans and shirt," and 4% said "suit and tie." Female patients were significantly more comfortable (3.6 versus 3.3, p less than 0.01) with female physicians. Male patients did not show a preference for a same-sex physician.

Adolescent↗
PubMed1985

Menstrual dysfunction in pathophysiologic states.

The menstrual cycle is a complex entity involving many interactions of the central nervous system, hypothalamus, pituitary and ovaries. Normal menstrual function depends on a pulsatile gonadotropin-releasing hormone secretion leading to a pulsatile luteinizing hormone and follicle-stimulating hormone secretion that stimulates the ovaries. A cyclic burst of luteinizing hormone is also required for ovulation. Certain pathophysiologic states, such as those produced by stress, exercise and drugs, have the potential to affect the cycle at many levels. Chronic illness may have effects on beta-endorphins and hypothalamic functioning. Alternatively, the weight loss associated with chronic illness may alter estrogen metabolism, thus altering hypothalamic or pituitary function. Anorexia nervosa and simple weight loss may have effects at the hypothalamic level or through altering estrogen metabolism, as well.

Adolescent↗
PubMed1984

Coincident acute appendicitis and hemorrhagic corpus luteal cyst.

A case of coincident acute appendicitis and hemorrhagic corpus luteal cyst is presented. The difficulty of differentiating acute appendicits from gynecological problems is discussed. In addition, prior simultaneous occurrences of other abdominal emergencies with acute appendicitis are reviewed.

Acute Disease↗