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Biomedical subjects

R Fox

Publications and source records attributed to R Fox.

At least 127 records · Page 7Linked to original sources
PubMed1992

Homosexual and bisexual men's perceptions of discrimination in health services.

Questionnaires were distributed to homosexual and bisexual male participants in the Multicenter AIDS Cohort Study and to homosexual and bisexual male patients with acquired immunodeficiency syndrome (AIDS) to determine whether the men believed they had been refused medical or dental treatment because of their sexual orientation or a condition related to the human immunodeficiency virus (HIV). Men with AIDS were significantly more likely (18%) to report being refused treatment by a doctor or dentist on the basis of a known or suspected HIV-related condition than were men who were seropositive (5%) or seronegative (1%). Significantly more respondents reported refusal of dental care than of medical care.

Baltimore↗
PubMed1992

Spurious elevation of follicle-stimulating hormone.

Serum concentrations of follicle-stimulating hormone (FSH) were measured in a 33-year-old eumenorrhoeic woman with primary infertility. Postmenopausal levels were obtained. Using an alternative assay, the patient was found to have normal levels of FSH. The probable cause of the misleading result is discussed.

Adult↗
PubMed1992

Basic fibroblast growth factor in Dupuytren's contracture.

Lesions excised from nine patients undergoing surgery for Dupuytren's contracture (DC) and three normal fascia were examined for the presence of the angiogenic protein basic fibroblast growth factor (basic FGF). Endothelial cell proliferation assays established basic FGF-like activity in extracts of DC. Western blotting confirmed the presence of an 18,000-dalton protein which was localized in the lesions by immunohistochemical staining. All of the cells implicated in the progression of the disease (endothelial cells, fibroblasts, and myofibroblasts) contain the growth factor. Endothelial cells within the narrowed or occluded vessels, as well as fibroblasts surrounding these vessels, stained intensely positive. In situ hybridization using an antisense probe for human basic FGF and its receptor's (FGFR-1) mRNA established the major difference between normal and DC tissues: their levels are significantly higher than in the normal tissues. Thus the cells in DC also express both basic FGF and FGFR-1, suggesting a potential autocrine/paracrine role for basic FGF in the pathogenesis of DC. This finding is thus the first description of a nontumoral proliferative disease that can be directly associated with increased basic FGF mRNA. The possibility that therapies can be developed on the basis that basic FGF and its receptor are expressed in DC is discussed.

Dupuytren Contracture↗
PubMed1992

Longitudinal study of homosexual couples discordant for HIV-1 antibodies in the Baltimore MACS Study.

Thirty-six sexually active couples serologically discordant for human immunodeficiency virus, type 1 (HIV-1), within the Baltimore Multicenter AIDS Cohort Study (MACS) were assessed to determine whether evidence of HIV-1 infection could be detected in the HIV-1-antibody-negative partners and whether factors associated with lack of transmission of HIV from the seropositive to the seronegative partner could be ascertained. Six HIV-1 seropositive couples and 18 seronegative couples were followed concurrently for comparison. None of the seropositive subjects had an AIDS-defining illness at entry into the study, and all subjects were followed for 1 year. A separate evaluation of unprotected anal receptive and insertive intercourse between discordant couples indicated high-risk activities for a median of 40 months, as reported by the HIV seropositive partner. Despite this finding, none of the HIV-1 seronegative men in discordant couples had evidence of HIV-1 infection by viral culture, p24 antigen testing, or polymerase chain reaction for HIV-1 DNA. Discordant seronegatives and seropositives did not differ from concordant seronegatives and seropositives in numbers of circulating CD4, CD8, and natural killer lymphocytes or in prevalence of antibodies to herpes simplex virus, type 1, Epstein-Barr virus, or cytomegalovirus, except that discordant seronegative men were less likely than their seropositive partners to have antibodies to herpes simplex virus, type 2. The reason for the apparent lack of HIV-1 infection in seronegative discordant individuals remains unexplained and did not appear to be associated with type of sexual activity, T-lymphocyte subsets or natural killer cells, or early stage of HIV-1 disease.

Adult↗
PubMed1991

Interpartner reliability of reporting of recent sexual behaviors.

Epidemiologic studies exploring risks for sexually transmitted diseases, including human immunodeficiency virus infection, typically rely on self-report of sexual behaviors. Estimates of the incidence and prevalence of sexual practices are important measures for assessment of behavioral interventions as well as for examining disease transmission. This study examined the degree of agreement within heterosexual couples reporting frequency and type of sexual behaviors, including condom use. Self-reports were obtained from 71 couples attending Baltimore sexually transmitted disease clinics in 1989-1990 regarding the number of days and number of episodes of three specific sexual practices (any type of sexual activity, vaginal sex, and vaginal sex with condom use) over a 30-day period. Paired t test analysis revealed both sexes to be very consistent in their reporting of recent sexual experiences. Multivariate analysis showed that agreement did not vary by socioeconomic status, by whether the partners were married to each other, or by age. These findings suggest that reliable information regarding sexual behaviors may be obtained from men or women.

Adult↗
PubMed1991

Specific HLA-DQA and HLA-DRB1 alleles confer susceptibility to Sjögren's syndrome and autoantibody production.

Primary Sjögren's syndrome (1. SS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the salivary glands and autoantibody production. In order to identify genetic factors that play a role in pathogenesis and predict extent of disease, we used Southern blot and polymerase chain reaction (PCR) methods to detect polymorphisms of the HLA-DRB1 (DR), HLA-DRB3 (DRw52), and HLA-DQA1 genes among 75 Caucasoid 1. SS patients and 150 Caucasoid controls living in the same geographic region of Southern California. We found significantly increased frequency of HLA-DR3 (P less than .001), HLA-DW52a (P less than .001), and HLA-DQA4 (P less than .05), in comparison to normal controls. Also, an increased frequency of heterozygosity for HLA-DQA1/DQA4 (P less than .05) was present among 1. SS patients. Autoantibodies to SS-A and to SS-B were significantly associated with DR3 (P less than .001), HLA-DQA4, (P less than .05), and DQA4/DQA1 heterozygotes (P less than .01). Among the 1. SS patients, clinical and laboratory features such as hypergammaglobulinemia, symmetric peripheral neuropathy, and hypothyroidism were significantly associated with HLA-DR3 (P less than .01) but not with HLA-DR2 (P greater than .10). In comparison, 1. SS patients with leukocytoclastic vasculitis were more frequently HLA-DR2 (P less than .05). These results using PCR methods confirm and extend prior studies that have used serologic methods.

Adolescent↗
PubMed1991

The diagnosis of polycystic ovaries in women with oligo-amenorrhoea: predictive power of endocrine tests.

The ability of several endocrine tests to distinguish between women with and without polycystic ovaries (PCO) has been studied prospectively in a series of 65 patients with functional oligo-amenorrhoea using ultrasonography as a reference test. In terms of overall diagnostic accuracy, the free androgen index (FAI) (94%) and the progestogen challenge (89%) gave similar results (Cl = -5 to 15%) but both were significantly better than all the other tests including measurement of serum LH (69%), total testosterone (71%) and androstenedione (74%) (minimum Cl = 6 to 23%). The FAI together with LH measurement was the most accurate of the combinations (97%) but this was not significantly better than the best of the combinations incorporating the progestogen challenge (92%; Cl = -3% to 13%). Given the limited availability of the assay for SHBG, these results show that assessment of oestrogen state is a useful method for categorizing patients with functional oligo-amenorrhoea.

Amenorrhea↗
PubMed1991

Oestrogen and androgen states in oligo-amenorrhoeic women with polycystic ovaries.

Oestrogen and androgen states have been studied in relation to ovarian morphology defined by ultrasonography in 65 women with oligo-amenorrhoea. Of the 48 women with polycystic ovaries (PCO), 44 (92%) had a withdrawal bleed following progestogen challenge (indicating oestrogenization) compared with just three (18%) of the 17 with non-PCO (P less than 0.001). Median serum concentrations of oestradiol and oestrone were statistically significantly higher in the PCO group but the ranges overlapped widely. Of the four women with PCO but oestrogen deficiency, two were hirsute and had evidence of a severe form of the disorder. The other two were not hirsute and appeared to have hypothalamic dysfunction associated with weight loss overriding the disorder due to pre-existing PCO. Compared with the non-PCO group, the PCO subgroup without hirsutism (n = 31) had statistically significantly higher median values of LH, testosterone, androstenedione, and dehydroepiandrosterone sulphate concentrations, and free androgen index. Concentrations of androgen, but not LH, were significantly higher still in the PCO subgroup with hirsutism (n = 17).

Amenorrhea↗
PubMed1991

Fitness to plead.

Explore the source record for details and available documents.

Accidents, Traffic↗
PubMed1991

[Relationship between HLA D region gene and primary Sjögren's syndrome].

Primary Sjögren's syndrome is characterized by lymphocytic infiltration of the salivary and lacrimal glands and by autoantibody production. In order to identify the genetic factors that play a role in the pathogenesis and to predict the progress of the disease we used the restriction fragment length polymorphism and polymerase chain reaction method to detect the polymorphism of HLA-DRB1, DRB3, DQA and DQB genes among 75 Caucasoid primary SS patients, and compared the results with normal controls living in the same area. We found (1) significant increased frequency of HLA-DR3 (54%) and DRw8 (13%) (P less than 0.001); (2) increased frequency of the HLA-DRB3 allele DRw52a and of the HLA-DQA allele DQA 4 (P less than 005); (3) increased frequency of heterozygosity for DQA 1/DQA 4 (P less than 005); (4) autoantibody SSA and SSB associated with DR3 (P less than 002 and P less than 0001 respectively).

Adolescent↗
PubMed1991

Loss of private health insurance among homosexual men with AIDS.

In this study we analyze information on self-reported health insurance coverage, HIV screening by insurers, and loss of health insurance. We distributed questionnaires to gay male participants in the Baltimore and Los Angeles sites of the Multicenter AIDS Cohort Study and to leukemia patients and gay AIDS patients seen at the Johns Hopkins Hospital. In this unusually well-educated and well-insured group, 90% of participants without AIDS had private health insurance coverage, compared with only 64% of participants with AIDS. Persons with AIDS (PWAs) were 33 times as likely to have Medicaid as persons without AIDS, and PWAs were 5 times as likely to have lost health coverage altogether as persons without AIDS.

AIDS Serodiagnosis↗