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Biomedical subjects

L Strunin

Publications and source records attributed to L Strunin.

At least 55 records · Page 3Linked to original sources
PubMed1990

Beliefs about AIDS, use of alcohol and drugs, and unprotected sex among Massachusetts adolescents.

In August 1988, 1,773 Massachusetts 16-19-year-olds were surveyed by telephone using anonymous random digit dialing; response rate 82 percent. Logistic regression tested whether alcohol and drug use, perceived susceptibility to human immunodeficiency virus (HIV), severity of HIV if infected, effectiveness of condoms in preventing infection, barriers to condom use, and behavioral cues such as exposure to media or personal communication about acquired immunodeficiency syndrome (AIDS) were independently related to condom use. Among sexually active respondents, (61 percent of those interviewed) 31 percent reported always using condoms. Respondents who believed condoms are effective in preventing HIV transmission and worried they can get AIDS were 3.1 and 1.8 times, respectively, more likely to use condoms all the time. Respondents who carried condoms and who had discussed AIDS with a physician were 2.7 and 1.7 times, respectively, more likely to use them. Those who believed condoms do not reduce sexual pleasure and would not be embarrassed if asked to use them were 3.1 and 2.4 times, respectively, more likely to use condoms. Teens who averaged five or more drinks daily or used marijuana in the previous month were 2.8 and 1.9 times, respectively, less likely to use condoms. Among respondents who drink and use drugs, 16 percent used condoms less often after drinking and 25 percent after drug use. Those counseling adolescents about HIV should assess and discuss beliefs outlined in the Health Belief Model, as well as their alcohol and drug use.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Acquired immunodeficiency syndrome transmission: changes in knowledge and behaviors among teenagers, Massachusetts statewide surveys, 1986 to 1988.

Despite substantial progress, adolescents remain at high risk for human immunodeficiency virus (HIV) infection. Two independent random digit dial statewide Massachusetts surveys of 16- to 19-year-old persons conducted August through September 1986 and 1988 revealed that the proportion of teenagers who had discussed acquired immunodeficiency syndrome (AIDS) in schools increased from 52% to 82%. Knowledge about how AIDS is transmitted was also significantly higher in 1988. The proportion of teenagers using drugs other than alcohol and marijuana declined from 13% to 9%, and intravenous drug use declined from 1% to 0.1%. At the same time, among sexually active teenagers, the proportion who reported changes in sexual behavior to avoid AIDS increased from 16% to 34%. The proportion who adopted condom use to avoid AIDS increased from 2% to 19%. However, the overall proportion of teenagers who reported sexual intercourse in the past year increased significantly from 55% to 61%. In 1988, among sexually active teenagers, 37% never used condoms and 33% used them only some of the time. Of all respondents, 18% reported unprotected sex with more than one partner in the previous year, and 3% reported unprotected sex with intravenous drug users. Although mass media and school education may increase knowledge and stimulate some teenagers to change behavior, for others more personal forms of counseling may be needed. The effects of increasing physician counseling warrant special study. Teenagers who had spoken to physicians about AIDS were much more likely to have adopted condom use to avoid HIV exposure. However, although 80% of adolescents saw a physician in the past year, only 13% were counseled about AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Survey of AIDS knowledge and behavior changes among Massachusetts adults.

In October 1987, 1,323 Massachusetts residents were randomly interviewed by telephone to explore their exposure to AIDS educational efforts, levels of knowledge about AIDS, and whether that knowledge modified their behavior. Gay/bisexual males, iv drug users and heterosexual respondents were compared as were blacks, Hispanics, and whites. While 81% of respondents had read or heard mass media stories about AIDS, in the previous week, only 5% had ever been counseled about AIDS by a physician. Over 97% of black (N = 152) and white respondents (N = 1,057), as well as gay/bisexual males (N = 21) and iv drug users (N = 33) were aware that HIV can be transmitted by homosexual or heterosexual intercourse and by sharing needles when injecting drugs. However, 9% of the 55 Hispanics interviewed were unaware of male homosexual transmission, and 7% did not know about heterosexual transmission or the risks of needle sharing. Twenty percent of Hispanics, compared with 9% of other respondents, did not know HIV can be transmitted sexually by someone who appears healthy. Fifty-two percent of gay/bisexual males, 27% of iv drug users, and 21% of those who had multiple heterosexual partners in recent years reported adopting abstinence, monogamous relations, or condom use to avoid HIV exposure. Those who continued risky behavior were just as knowledgeable about HIV transmission, but they were less likely to report that they worry a great deal about getting AIDS, 14% vs 32%. The results indicate that new strategies and resources are needed to educate Hispanics. Physicians need to counsel more persons about HIV transmission and further efforts are needed to translate knowledge about HIV transmission into behavior change to avoid the virus.

Acquired Immunodeficiency Syndrome↗
PubMed1989

First year medical students' attitudes and knowledge about AIDS.

Medical students attitudes and resulting behaviors about treating HIV-infected patients are critical and will become increasingly so in the years ahead. An anonymous self-administered questionnaire of 135 first year medical students at Boston University School of Medicine conducted in May 1988 queried students' knowledge of HIV transmission; concerns about contracting HIV; ethical and legal responsibilities; attitudes about testing for HIV and treatment of HIV-infected patients; the effect the epidemic poses for their medical careers; changes in personal sexual and drug use practices. Results indicate that students' careers are being affected because they are worried about contracting HIV, that the epidemic will affect their final choice of specialty, and that they believe they should be allowed to refuse to treat AIDS patients during their medical school training. The findings raise serious questions concerning why medical students hold these beliefs and suggest that students' willingness to care for AIDS patients may be a function of their level of knowledge and understanding of HIV infection and the disease AIDS. The results have implications for curriculum reform to address the AIDS crisis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Pharmacokinetics of sufentanil in patients undergoing abdominal aortic surgery.

The authors determined the pharmacokinetics of sufentanil, 12.5 micrograms.kg-1 iv in patients undergoing elective abdominal aortic surgery. The mean age (+/- SD) of the ten patients was 68.4 +/- 7.9 yr; their mean weight was 74.4 +/- 19.1 kg. Six patients underwent aortobifemoral grafting and four had abdominal aortic aneurysm repair. Serum sufentanil concentrations were determined in samples drawn at increasing intervals over a 24-h period. A three-compartment pharmacokinetic model was fit to the concentration versus time data. Total drug clearance was 15.0 +/- 3.2 ml.min-1.kg-1. The volume of distribution at steady-state (Vdss) was 8.7 +/- 4.5 l.kg-1. The elimination half-time were positively correlated with patient age. There were no significant correlations between the pharmacokinetic variables and the duration of aortic cross-clamping, the duration of surgery, or the rate or total volume of iv fluids given intraoperatively. In general surgical patients, the mean elimination half-time of sufentanil has been reported to be 2.7 h. When sufentanil is used in large doses as the primary anesthetic agent for patients undergoing abdominal aortic surgery, the long elimination half-time observed implies that recovery will take much longer than would have been anticipated from previously published pharmacokinetic data.

Aged↗
PubMed1988

Regional anaesthesia for 12,000 cataract extraction and intraocular lens implantation procedures.

Twelve thousand regional anaesthetics for cataract extraction and intraocular lens implantation surgery were administered by one anaesthetist over a period of 52 months in a free-standing outpatient surgical facility. The ophthalmologist, who did all the operations, assessed the quality of the blocks using an objective scoring system which is described. The first 3,595 patients had retrobulbar and seventh nerve blocks. The following 1,640 patients had higher volume retrobulbar blocking alone. The next 3,478 had peribulbar blocks, followed by 2,226 who had a modified form of peribulbar blocking. A final group of 1,061 had a combination of peribulbar and periorbital blocks with added retrobulbar injection if indicated. As the method of blocking evolved, the more closely was the goal of safe, painless and effective regional anaesthesia approached. The requirements for effective anaesthesia of this type are presented, the complications described and the importance of familiarity with the anatomy of the orbit and its contents stressed.

Aged↗
PubMed1987

The pharmacokinetics of alfentanil in children.

The pharmacokinetics of alfentanil were studied in 18 children (3 months to 14 yr of age) undergoing surgery. Alfentanil was administered as a 30-s infusion of either 50 or 120 micrograms.kg-1. Pharmacokinetic values were independent of dose. There was no correlation between Vdss (Volume of distribution at a steady state, measured as l.kg-1) and age or weight, and there was a weak correlation between clearance and age (r = 0.51, P less than 0.05). Vdss and elimination t1/2 were not different in infants less than 1 yr of age when compared to older children. The mean value of Vdss was 0.419 (SE .028) l.kg-1) for the whole group, and elimination t1/2 was 76.3 (SE 6.5) min. The clearance rate [TBC = 7.9 (SE 0.41) ml.kg-1.min-1] was within the range of values previously determined in adult studies. From these data, it would appear that, although there may be differences in the disposition kinetics between children aged 3 months to 14 yr and those measured in adults in some studies by other investigators, age-related differences within this group were not demonstrable.

Adolescent↗
PubMed1987

Comparison of epidural fentanyl with sufentanil. Analgesia and side effects after a single bolus dose during elective caesarean section.

Duration of analgesia and side effects following single bolus doses of epidural fentanyl (100 micrograms) or sufentanil (10, 20, 30 or 50 micrograms) were studied in 50 patients who underwent Caesarean section under epidural anaesthesia. Fewer patients experienced pain peroperatively in the fentanyl group than in a joint group of those given sufentanil 20 or 30 micrograms (p less than 0.05). The combined fentanyl and sufentanil 50 micrograms groups had fewer patients in pain than the sufentanil 10 micrograms group at 3 hours after injection (p less than 0.05). Patients given fentanyl also had a longer pain-free interval than those who received sufentanil 10 micrograms (p less than 0.02). The sufentanil 50 micrograms group had more patients asleep than the 10 micrograms group and also had more patients with pruritus than the 10 micrograms or 30 micrograms groups (p less than 0.02). The patients given sufentanil 30 and 50 micrograms had more emetic sequelae than those who received sufentanil 10 and 20 micrograms or fentanyl 100 micrograms (p less than 0.05). There was no detectable excretion of drug into breast milk and no significant respiratory depression at the time of first postoperative analgesia in the patients who received fentanyl or 30 micrograms or less of sufentanil.

Analgesics↗
PubMed1987

Acquired immunodeficiency syndrome and adolescents: knowledge, beliefs, attitudes, and behaviors.

Adolescents are a group at high risk for exposure to acquired immunodeficiency syndrome (AIDS). Results of a random-sample survey of 860 adolescents 16 to 19 years of age, in Massachusetts indicate that many adolescents are still misinformed or confused about AIDS and AIDS transmission. Of the adolescent respondents, 70% said they were sexually active (having sexual intercourse or other sexual contact) but only 15% of them reported changing their sexual behavior because of concern about contracting AIDS, and only 20% of those who changed their behavior used effective methods. Of both sexually active and nonactive adolescents, 8% did not know that AIDS is transmitted by heterosexual sexual intercourse. Psychoactive drugs other than alcohol and marijuana had been used by 13% of those responding, and 1% reported injecting drugs. Of those psychoactive drug users, 8% did not know that AIDS can be transmitted by injecting drugs. There was no significant difference in knowledge between the sexually active and nonactive adolescents concerning sexual behavior and AIDS transmission or between the drug users and nonusers concerning drug use and AIDS transmission. The majority of respondents knew a relationship exists between AIDS and blood, and other body fluids, but knowledge of the mode of transmission was limited. Hence, many adolescents, including those in the highest risk subgroups of sexually active or psychoactive drug users, did not know what sexual and drug precautions are needed to prevent transmission of the virus. School systems and health care providers should systematically educate this population about AIDS to counter the current misinformation and confusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗