Biomedical subjects

Rebecca Flynn O'Brien

Publications and source records attributed to Rebecca Flynn O'Brien.

3 recordsLinked to original sources

PubMed2006

Medical conditions with psychiatric manifestations.

A variety of medical conditions can present, or be associated, with psychiatric symptoms. At times, these may be so prominent that they can overshadow the underlying pathophysiologic process that accounts for them. Thus, it is equally important for mental health providers to be alert to the possibility that adolescents whom they are treating may have symptoms related to a treatable medical condition as it is for primary care providers to conduct a targeted history and physical examination with their adolescent patients exhibiting psychiatric symptoms. Using the biopsychosocial approach, these two domains are not considered separately or hierarchically, but as highly interactive. In some cases (eg, adrenal insufficiency), appropriate and continued treatment of the underlying condition results in resolution of the psychiatric symptoms. In others (eg, SLE), treatment of the underlying condition may alleviate but may also exacerbate psychiatric symptoms. Therefore, comprehensive treatment of adolescents with psychiatric symptoms due to a medical condition may require the professional services of primary care, mental health, and specialty care providers, but their services should follow the collaborative model espoused throughout the other articles in this volume.

Adolescent↗

PubMed2006

Vaginal microbicides.

This article reviews the current status of microbicide development and challenges faced in developing safe and effective compounds. The ever growing HIV pandemic, lack of effective vaccines against HIV and other sexually transmitted infections, concern about the vulnerability of women, and difficulty in condom negotiation are factors that drive the development of topical microbicides as a prophylactic method for women. The ideal microbicide needs to be safe and highly effective and not increase viral resistance or cause disruption of host defenses. Advances in the understanding of HIV transmission and the role of other sexually transmitted infections have allowed progress in development of microbicide candidates as clinical trials of potential agents are awaited.

Anti-Infective Agents, Local↗

PubMed2005

Bacterial vaginosis: many questions--any answers?

PURPOSE OF REVIEW: Bacterial vaginosis, a common disorder among young women, is associated with adverse reproductive health outcomes. This review summarizes our current understanding of bacterial vaginosis and where future research should be focused. Recommendations for prevention, diagnosis, and treatment in both nonpregnant and pregnant populations are discussed. RECENT FINDINGS: Little progress has been made in understanding the causal factors. The results of several large prospective studies have shown that racial differences persist for rates of bacterial vaginosis even when other known risk factors are controlled for. Studies of the gene-environment interaction that examine the genetic aspects of immune response may explain racial differences and why some but not all women with bacterial vaginosis experience complications. Trials to prevent preterm birth by the treatment of bacterial vaginosis in pregnancy are disappointing. Resistance to clindamycin by bacterial vaginosis-associated anaerobic organisms has also been documented. New technology to provide rapid point-of-care diagnostic testing for bacterial vaginosis has emerged. SUMMARY: To understand the vaginal ecosystem and its role in reproductive health and disease, we will need to study not only the microflora but also the host-immune response. Currently recommended treatment options for bacterial vaginosis are associated with high rates of recurrence. A new concern is the development of macrolide resistance to vaginal anaerobic flora when clindamycin is used as treatment. Further studies are still needed to determine whether prevention or control of bacterial vaginosis, particularly approaches that rely not on antibiotic treatment but on the maintenance of a healthy vaginal ecosystem, can reduce adverse health outcomes.

Adolescent↗