Search PubMed⌕ Search

Biomedical subjects

L Strunin

Publications and source records attributed to L Strunin.

At least 37 records · Page 2Linked to original sources
PubMed1993

A survey of attitudes, knowledge, and behavior related to HIV testing of adolescents and young adults enrolled in alcohol and drug treatment.

The objectives of this study were to assess attitudes, knowledge, and behavior related to human immunodeficiency virus (HIV) antibody testing of adolescents and young adults undergoing treatment for alcohol and drug problems. Setting and subjects were 101 adolescents and young adults enrolled in a New England substance abuse rehabilitation program. All subjects had heard about acquired immunodeficiency syndrome (AIDS) and 84% desired an HIV antibody test if it were anonymous and confidential. If found to be HIV positive, 83% stated that they would be less likely to continue substance-abuse treatment, 64% would be more likely to continue drug use, and 62% would be more likely to continue alcohol use. The likelihood of continuing school would decrease for 60%. Sixty percent would be more likely to increase use of condoms. Males were more likely than females to want to leave treatment and school, return to alcohol and drug use, and increase risk-taking behavior (p < 0.02). These findings suggest that teenagers undergoing treatment for substance-abuse problems require careful and comprehensive pre- and post-test counseling and follow-up when undergoing HIV antibody testing. Deciding when to test for HIV may impact on the success of substance-abuse treatment, as well as ability to control spread of HIV infection.

Adolescent↗
PubMed1992

Comparison of plain with pH-adjusted bupivacaine with hyaluronidase for peribulbar block.

Fifty patients scheduled for cataract surgery under peribulbar block were randomised to receive either plain (pH 5.4) or pH-adjusted (pH 6.8 range 6.7-6.9) 0.75% bupivacaine. Hyaluronidase was added to both solutions prior to peribulbar block. The time of onset of akinesia of the globe and the need for supplementary injections were recorded by an independent observer. Patients who returned for surgery to the second eye received the alternative local anaesthetic solution for the second peribulbar block. The relative efficacy of the different anaesthetic solutions was compared in patients who underwent unilateral surgery (Group A, n = 50). In 12 patients (Group B) who underwent bilateral surgery, direct comparisons between eyes in the same patient were possible. In both groups of patients, eyes receiving peribulbar block with the pH-adjusted solution showed a shorter time to partial akinesia of the globe (P less than 0.05). However, there was no difference between the solutions in the time to complete akinesia of the globe, but the number of supplementary injections required for an effective block with the pH-adjusted solution was increased. Onset time to akinesia of the lateral and superior rectus muscles was shortened in patients receiving the pH-adjusted solution but there were minimal effects on the medial and inferior recti.

Anesthesia, Local↗
PubMed1992

Alcohol, drugs, and adolescent sexual behavior.

In a 1990 Massachusetts-wide random digit-dial telephone survey of 16-19 year olds, 66% reported sexual intercourse of whom 64% had sex after drinking and 15% after other drug use. Thirty-seven percent always used condoms. Forty-nine percent were more likely to have sex if they and their partner had been drinking, and 17% used condoms less often after drinking. Fewer, 32%, said they would be more likely to have sex if they and their partner had used drugs, with 10% less likely to use condoms after drug use. Since so few adolescents consistently use condoms, the greatest risk for HIV, sexually transmitted diseases, and unwanted pregnancy is the increased likelihood of having sex after drinking or drug use, not the decreased likelihood of condom use after drinking and drug use.

Adolescent↗
PubMed1991

Adolescents' perceptions of risk for HIV infection: implications for future research.

Few studies have investigated adolescents' perceptions of their risk for HIV infection. Findings from two studies of adolescents in Massachusetts indicate that there are differences in the knowledge, beliefs, behaviors, and perceptions of risk among adolescents and suggest the need for understanding the differences among adolescents from different racial or ethnic backgrounds. In both studies, white students were the most knowledgeable about casual, sexual, and drug use transmission of HIV followed by black, Hispanic, and Asian students. In both studies more black adolescents than other racial or ethnic groups were sexually active, and black and Hispanic adolescents began having sexual intercourse at an earlier age than white or Asian adolescents. Asian and Hispanic adolescents were most worried about getting AIDS. Although more Hispanics than other groups reported changing their behavior because of AIDS, fewer of them who had changed their sexual or contraceptive behavior were using effective methods. Despite clear differences in the perceived risk of getting AIDS among these adolescents, the underlying reasons remain to be explicated, using, among other data collection methods, ethnographic techniques to probe adolescents' risk perceptions, their understandings of sickness, and their explanatory models of AIDS. Life events affect risk taking behaviors and also shape perceptions of risk. To understand what it is that adolescents consider 'risky' requires seeing their life options as they do in the larger context of their aspirations and worries about how 'to fit in'.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Knowledge about HIV and behavioral risks of foreign-born Boston public school students.

In 1990, 3049 Boston public middle and high school students were surveyed anonymously in English, Spanish, Vietnamese, Chinese, French, or Haitian Creole. Significantly fewer immigrant students, 35% of those surveyed, knew the principal modes of human immunodeficiency virus transmission. Fewer immigrants reported having sexual intercourse (31% vs 53% of nonimmigrants), but among the sexually active only 38% always used condoms, and more immigrants reported intercourse with intravenous drug users (4% vs 1% of non-immigrants). AIDS education should be taught to immigrant students in their native languages.

Adolescent↗
PubMed1990

A bolus dose of esmolol attenuates tachycardia and hypertension after tracheal intubation.

Forty-five patients of ASA physical status I and II undergoing a variety of non-cardiac surgical procedures were studied to determine the effect of bolus administration of esmolol, a new short-acting beta blocking drug, on heart rate and blood pressure responses to induction of anaesthesia and tracheal intubation. Subjects were allocated randomly to receive placebo, 100 mg or 200 mg of esmolol IV as part of an anaesthetic induction technique. The differences in heart rate between the placebo group and both the 100 mg and 200 mg groups were significant prior to intubation (95 +/- 7.9, 82 +/- 9.7, 80 +/- 7.3 beats per min respectively), and also at 0.5 min and 1.5 min following intubation for the 200 mg group. In the 200 mg group there was a significant decrease, compared with placebo, in systolic blood pressure at 0.5 min (144 +/- 32.1 vs 165 +/- 18.7 mmHg) and 1.5 min (154 +/- 25.0 vs 170 +/- 19.5 mmHg) after intubation. In this study, adequate haemodynamic control was obtained following administration of 200 mg of esmolol.

Adrenergic beta-Antagonists↗
PubMed1990

Analgesia and serum concentrations of extradural, subdural and intraperitoneal fentanyl in a rat model.

The effects of epidural, subdural and intraperitoneal fentanyl were determined on the tail flick response of the rat using the response latency as a measure of analgesia. Dose-time-response curves were generated for incremental doses of fentanyl administered at constant injection volumes. Serum concentrations at varying doses were determined using a radioimmunoassay technique. It was found that serum concentrations for extradural, subdural and intraperitoneal fentanyl were similar at the low doses, but differed significantly at higher doses suggesting that pharmacokinetic differences may be concentration dependent. Extradural administration of naloxone (0.004 mg) was able to antagonize extradural fentanyl (8.0 micrograms), a dose eight-fold greater than the lowest maximally effective dose. The relationship between serum fentanyl concentrations and administered doses suggest that the analgesic properties of extradural and subdural fentanyl are in part dependent on centrally mediated actions.

Analgesia↗
PubMed1990

Multicenter study of general anesthesia. I. Design and patient demography.

A prospective randomized clinical trial of enflurane, fentanyl, halothane, and isoflurane is described. The 17,201 patients were stratified into two groups (preanesthetic medication and no preanesthetic medication) and were randomized to one of four study agents: enflurane, fentanyl, halothane, and isoflurane. Fifteen university-affiliated hospitals in the United States and Canada participated. All patients were first assessed preoperatively. Data were collected during anesthesia, in the immediate recovery period, and for up to 7 days after anesthesia/surgery. The mean age of the patients was 43 yr, the mean height 167 cm, and the mean weight 68 kg. Sixty-five percent of patients were female. In this study 90.7% of patients were classified as ASA Physical Status 1 or 2, and 34.7% of patients smoked. It is concluded that pooling of data across institutions was valid and does allow determination of the efficacy and relative safety of the four study agents.

Adult↗
PubMed1990

Multicenter study of general anesthesia. II. Results.

A prospective, stratified, randomized clinical trial of the safety and efficacy of four general anesthetic agents (enflurane, fentanyl, halothane, and isoflurane) was conducted in 17,201 patients (study population). Patients were studied before, during, and after anesthesia for up to 7 days. Nineteen patients died (0.11%), and in seven of these (0.04%) the anesthetic may have been a contributing factor. The rates of death, myocardial infarction, and stroke in the study population were so low (less than 0.15%) that no conclusions regarding the relative rates of these outcomes among the four anesthetic agents could be reached. The rates of 16 of 66 types of adverse outcomes in the study population were significantly different among the four study agents. Most of these outcomes were minor. However, severe ventricular arrhythmia (P less than 10(-6)) was more common with halothane, severe hypertension (P less than 10(-6)) and severe bronchospasm (P = 0.028) were more common with fentanyl, and severe tachycardia (P = 0.001) was more common with isoflurane. Recovery from anesthesia during the first 30 min was slowest in those patients who received halothane (P less than or equal to 0.001). In addition, patients who received fentanyl experienced less pain during the first hour in the recovery room (P less than 10(-6)). In conclusion, clinically important differences do exist for some outcomes among the four study agents.

Adult↗