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Biomedical subjects

R S Gold

Publications and source records attributed to R S Gold.

At least 37 records · Page 2Linked to original sources
PubMed1997

Unprotected anal intercourse in gay men: the resolution to withdraw before ejaculating.

734 gay men who had recently engaged in unprotected anal intercourse reported self-justifications they used at the time. A common self-justification involved a resolution to withdraw before ejaculating. Compared with other self-justifications, this resolution was associated with a "last minute" rather than a "premeditated" decision to have unprotected anal intercourse, suggesting that the resolution derived just from "heat of the moment" thinking. Implications for AIDS education are discussed.

Adult↗
PubMed1996

Cloning and expression of the Zymomonas mobilis "production of ethanol" genes in Lactobacillus casei.

This study describes the expression of the Zymomonas mobilis genes coding for pyruvate decarboxylase (pdc) and alcohol dehydrogenase (adh) in Lactobacillus casei 686. To promote transcription, the promoter and ribosome binding site (RBS) from the Lactococcus lactis subsp. lactis-derived vector, pMGE36e, were inserted upstream of the pdc gene. The former sequences were positioned such that translation of pdc was coupled to translation of an 81-base pair open reading frame terminating within the pdc initiation site. The recombinant plasmid (pRSG02) was electroporated into L. casei, and transformants were obtained. Northern analysis confirmed the production of a 3. 1-kb transcript corresponding to the predicted size of the PET operon. Western blot analyses revealed that the recombinant strain expressed both enzymes. The recombinant produced more than twice the ethanol produced by the parental L. casei strain.

Alcohol Dehydrogenase↗
PubMed1995

Dynamics of prolactin secretion in patients with hypopituitarism and pituitary macroadenomas.

Mild hyperprolactinemia frequently accompanies the hypopituitarism seen in patients with pituitary macroadenomas that do not secrete PRL. We postulated that hypopituitarism in this setting, is primarily caused by compression of the portal vessels and/or pituitary stalk. If this were the case, the dynamics of PRL secretion in this instance would be similar to those in patients with stalk section, dopamine deficiency, or hypothalamic disease. Furthermore, as hypopituitarism in this setting is largely reversible, we postulate that PRL dynamics should also normalize after adenomectomy as a result of the resumption of hypothalamic regulation of pituitary hormone secretion. To test these hypotheses, we examined PRL responsiveness to TRH and the dopamine antagonist, perphenazine (PZ), in patients with pituitary macroadenomas who had hypopituitarism and others with intact pituitary function (controls). Dynamic studies were performed before and 2-3 months after total or subtotal adenomectomy, and the results were correlated with alterations in other pituitary function. In addition, plasma ACTH, cortisol, and PRL levels were measured hours to days after surgery to investigate immediate alterations in pituitary function following surgical decompression. Before surgery, hypopituitary patients had higher serum PRL level than controls (25.5 +/- 12 vs. 11 +/- 3 micrograms/L; P < 0.001). Preoperative dynamic testing of PRL secretion in hypopituitary patients demonstrated an increase in PRL levels after TRH, but not after PZ, administration. In contrast, PRL levels increased appropriately when either stimulus was given to controls. Hours after adenomectomy, PRL levels decreased by 50% in hypopituitary patients (P < 0.0001) and remained so until discharge. In contrast, controls had a transient increase in serum PRL levels after adenomectomy. After surgery, 25 of 43 previously hypopituitary patients recovered part or all pituitary function. Serum PRL levels in the latter subgroup became normal and increased appropriately after stimulation with either TRH or PZ. In contrast, patients who did not recover pituitary function had lower PRL levels that increased minimally after TRH or PZ. The mild increase in serum PRL levels in hypopituitary patients and the discordant responses to stimulation with TRH and PZ suggest dopamine deficiency as a cause of hyperprolactinemia. The drop in serum PRL levels immediately after surgery, at a time when other pituitary hormones (e.g. ACTH), were documented to rise suggests restoration of hypothalamic control over pituitary hormone secretion. The pattern of PRL responses to stimulation in patients recovering function postoperatively was similar to that in controls, although the incremental rise was subnormal.(ABSTRACT TRUNCATED AT 400 WORDS)

Adenoma↗
PubMed1994

Immediate recovery of pituitary function after transsphenoidal resection of pituitary macroadenomas.

Mild hyperprolactinemia frequently accompanies the hypopituitarism associated with pituitary macroadenomas not secreting PRL. Because of this association, hypopituitarism was postulated to be due to compression of portal vessels. We postulate that resumption of hypothalamic control over pituitary function occurs immediately after adenomectomy. To test this hypothesis, we examined pituitary function before and after transsphenoidal adenomectomy in 26 ACTH-deficient patients and 23 subjects with normal adrenal and thyroidal functions (control group). Glucocorticoids, given only to ACTH-deficient subjects, were withdrawn 36 h after surgery. ACTH, cortisol, and PRL levels were measured twice daily in all patients. Both ACTH and PRL levels increased hours after surgery in controls and returned to baseline over 4 days. In all hypopituitary subjects, PRL levels decreased by 50% within hours of adenomectomy and remained so until discharge. ACTH levels, measured simultaneously, increased within hours in 17 of 26 hypopituitary patients, all of whom recovered normal adrenal function before discharge. Nine additional patients had low ACTH levels and required cortisol replacement. The reciprocal changes in PRL and ACTH levels measured simultaneously, hours after surgery, support the hypothesis that hypopituitarism is reversible and largely caused by compression of the protal vessels and the resulting interruption of delivery of hypothalamic hormones. The persistence of hypopituitarism in some patients suggests that ischemic necrosis of the anterior pituitary could limit recovery.

Adenoma↗
PubMed1993

Balloon rupture during peripheral stent implantation: a new technique for balloon retrieval.

Balloon rupture is a known technical problem with implantation of vascular stents. In most cases, the ruptured balloon can be retrieved with simple maneuvers. In this case report, a peripheral balloon became trapped within an undeployed peripheral vascular stent and could not be removed by application of standard maneuvers. A novel approach to balloon retrieval was devised and undertaken with success.

Aorta, Abdominal↗
PubMed1993

Educational attainment and coronary heart disease risk: the Framingham Offspring Study.

BACKGROUND: Efforts to control the continuing epidemic of coronary heart disease in the United States have been successful according to certain criteria, such as mortality, but by others, such as morbidity, the picture is less clear. Documenting whether various subgroups of the population have adopted healthier lifestyles that are likely to reduce coronary heart disease risk is essential to understanding the status of the epidemic and, most importantly, to formulating prevention and health education strategies that will ameliorate its effects. METHODS: The Framingham Offspring Study cohort participated in extensive health screening protocols to determine their cardiovascular risk. The 2,846 men and women who were between the ages of 25 and 64 years and who reported their educational attainment level are the subject of this report. RESULTS: Both body mass index and cigarette smoking showed inverse relationships to educational attainment among both men and women, while reported vigorous leisure time physical activity showed a positive relationship to educational attainment. However, fitness levels as assessed by treadmill duration were directly related to educational attainment only the women. With the exception of total plasma cholesterol among women, all coronary heart disease risk factors had most adverse levels in the least educated study participants. CONCLUSIONS: This study indicates that most components of the coronary heart disease risk profile show adverse levels in individuals with low educational attainment.

Adult↗
PubMed1992

Situational factors and thought processes associated with unprotected intercourse in heterosexual students.

Heterosexual students were asked to recall two sexual encounters from the preceding six months: one in which they had unprotected intercourse ('unsafe' encounter) and one in which they resisted a strong temptation to have unprotected intercourse ('safe' encounter). The aims were to record justifications for unprotected intercourse that respondents had given themselves during the unsafe encounter and to identify factors that distinguished between the encounters. In respondents recalling an unsafe encounter (n = 284), the most common self-justification reported was that there was no need for concern since measures to avoid pregnancy had been taken. The first factor that emerged from a Factor Analysis of the self-justification data involved using perceptible characteristics to infer that the partner was unlikely to be infected. Among respondents recalling both encounters (n = 173), there was a trend for type of partner to distinguish between the encounters. With this variable controlled (n = 115), desires, knowledge of condom availability, communication about condom use, degree of boredom, and level of intoxication differentiated between the encounters. The results are discussed in relation to those obtained in our earlier study of gay men.

Adolescent↗
PubMed1992

Situational factors and thought processes associated with unprotected intercourse in young gay men.

OBJECTIVES: To investigate (1) the types of justifications, if any, that young gay men give themselves at the time they make the decision to have unprotected anal intercourse and (2) the types of occasion on which they are most at risk of having unprotected intercourse. DESIGN AND METHODS: In structured interviews, gay men aged 15-21 years were asked to recall two sexual encounters from the preceding 6 months: one in which they had had unprotected anal intercourse ('unsafe' encounter) and one in which they had resisted a strong temptation to have unprotected intercourse ('safe' encounter). We studied both types of encounter to enable identification of situational variables distinguishing between them. RESULTS: The first two factors that emerged from a Factor Analysis of the self-justification data ('unsafe' encounter, n = 219) involved, respectively, high-risk behaviour in response to a negative mood state and inferring from perceptible characteristics that the partner was unlikely to be infected. The most commonly reported self-justification was of this latter type. In respondents recalling both encounters (n = 115), sexual desires, mood, communication, and use of 'dirty talk' distinguished between the encounters. In contrast, type of partner, consumption of alcohol or drugs, desire for excitement, and use of pornography did not. CONCLUSIONS: Results are discussed in relation to those obtained in our earlier study of older gay men. Young gay men appear to be more single-minded about what they want to do sexually, and more likely to infer from perceptible characteristics that their partner is unlikely to be infected. In young gay men, a negative mood state is associated with unsafe sex, an opposite finding to that obtained with older gay men. The results also suggest the possible importance of failure to communicate about desires concerning safe sex and the use of 'dirty talk'; these may help to facilitate the occurrence of unsafe sex.

Adolescent↗
PubMed1992

Gender and ethnic differences in adolescents' attitudes toward condom use.

This secondary analysis from the National Adolescent Student Health Survey (NASHS) examined relationships between adolescents' personal and perceived peer attitudes toward condom use with gender and self-reported ethnic background. Descriptive results revealed general personal support and perceived peer support for condom use. Results from multivariate analysis of variance (MANOVAs) demonstrated significant interaction effects for the eighth grade sample [F = (4, 2383228) = 3530.01 p = .000], and the 10th grade sample [F = (4, 2636878) = 2594.41073, p = .000]. Contrasts revealed significant differences among all ethnic groups for both belief variables for the entire sample, eighth grade students, and 10th grade students. Though general support exists for condom use among U.S. eighth and 10th grade students, conviction varies among groups perhaps indicating a need for tailored messages about condom use, especially for Hispanic students. Implications for health education include the need for cultural-sensitive and gender-sensitive STD education.

Acquired Immunodeficiency Syndrome↗
PubMed1990

The World Health Organization: school health initiatives.

The United Nations and its family of operational agencies have existed for almost five decades. For school health personnel, to understand how these agencies operate--in particular, the World Health Organization (WHO)--is worthwhile. To understand how WHO influenced the practice of health education for school-aged youth, some critical events that have occurred during the past five decades are reviewed and several current and future activities are identified and described.

Child↗