Biomedical subjects

Stephanie K Brodine

Publications and source records attributed to Stephanie K Brodine.

13 recordsLinked to original sources

PubMed2006

Epidemiology of stress fracture and lower-extremity overuse injury in female recruits.

PURPOSE: The purpose of this prospective study was to examine rates and risk factors for overuse injuries among 824 women during Marine Corps Recruit Depot basic training at Parris Island, SC, in 1999. METHODS: Data collected included training day exposures (TDE), baseline performance on a standardized 1.5-mile timed run, and a pretraining questionnaire highlighting exercise and health habits. The women were followed during training for occurrence of stress fracture and other lower-extremity overuse injury. RESULTS: There were 868 lower-extremity overuse injuries for an overall injury rate of 12.6/1000 TDE. Rates for initial and subsequent injury were 8.7/1000 and 20.7/1000 TDE, respectively. There were 66 confirmed lower-extremity stress fractures among 56 (6.8%) women (1.0/1000 TDE). Logistic regression modeling indicated that low aerobic fitness (a slower time on the timed run (> 14.4 min)), no menses in six or more consecutive months during the past year, and less than 7 months of lower-extremity weight training were significantly associated with stress fracture incidence. Self-rated fair-poor fitness at baseline was the only variable significantly associated with other non-stress fracture overuse injury during basic training. CONCLUSIONS: Among this sample of women, the risk of lower-extremity overuse injury was high, with a twofold risk of subsequent injury. The results suggest that stress fracture injury might be decreased if women entered training with high aerobic fitness and participated frequently in lower-extremity strength training. Furthermore, women reporting a history of menstrual irregularity at their initial medical exam may require closer observation during basic training.

Adolescent↗

PubMed2005

Predictors of stress fracture susceptibility in young female recruits.

BACKGROUND: Stress fractures account for substantial morbidity for young women undergoing U.S. Marine Corps basic training. HYPOTHESIS: Certain pretraining characteristics identify women at increased risk of stress fractures during boot camp. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: Data collected included baseline performance on a timed run (a measure of aerobic fitness), anthropometric measurements, and a baseline questionnaire highlighting exercise and menstrual status among 2962 women undergoing basic training at the Marine Corps Recruit Depot, Parris Island, in 1995 and 1996. RESULTS: One hundred fifty-two recruits (5.1%) had 181 confirmed lower extremity stress fractures, with the most common sites being the tibia (25%), metatarsals (22%), pelvis (22%), and femur (20%). Logistic regression models revealed that having low aerobic fitness (a slower time on the timed run) and no menses during the past year were significantly associated with the occurrence of any stress fracture and with pelvic or femoral stress fracture during boot camp. CONCLUSION: These findings suggest that stress fractures may be reduced if women entering Marine Corps Recruit Depot training participated in pretraining activities designed to improve aerobic fitness. Furthermore, women reporting no menses during the previous year may need additional observation during training. CLINICAL RELEVANCE: Consistent with previous studies, we found that low aerobic fitness was the only modifiable risk factor associated with stress fractures during boot camp.

Adolescent↗

PubMed2005

Hepatitis A vaccine uptake in San Diego County: Hispanic children are better immunized.

BACKGROUND: Few studies have examined compliance with hepatitis A vaccination recommendations or factors likely to predict vaccination against hepatitis A virus. OBJECTIVES: To investigate hepatitis A coverage among 3- to 17.9-year-olds in San Diego County and examine predictors of child and adolescent hepatitis A immunization. DESIGN, SETTING, AND PARTICIPANTS: A total of 1455 participants completed a random-digit dial telephone survey that assessed hepatitis A immunization status of 3- to 17.9-year-old children from May 1 to June 24, 2003. Analysis was limited to the 983 respondents with available immunization records or verified immunization histories. MAIN OUTCOME MEASURES: Receipt of at least 1 hepatitis A vaccine administered on or after the child's second birthday and differences in the frequencies of vaccination based on vaccine availability, sex, ethnicity, type of health care provider, mother's highest level of education, and parental knowledge of the hepatitis A vaccine recommendation. RESULTS: Participant response rate was 77.1%. Among all respondents aged 3 to 17.9 years, 59% received at least 1 hepatitis A vaccine and 41% completed the 2-shot regimen. The adjusted odds that a child received at least 1 hepatitis A vaccine was 3.6 times greater among Hispanic children compared with non-Hispanic children. Other predictors of hepatitis A immunization included child's age, having a public health care provider, lower maternal education, and parental knowledge of the vaccine recommendation. CONCLUSIONS: Results challenge historical patterns of underimmunization among Hispanic children compared with white children. Public health education and community awareness should be sustained in Hispanic communities, but interventions are needed in non-Hispanic communities.

Adolescent↗

PubMed2005

Evaluation of a cognitive-behavioral, group, randomized controlled intervention trial to prevent sexually transmitted infections and unintended pregnancies in young women.

BACKGROUND: Few cognitive-behavioral interventions have focused on preventing sexually transmitted infections (STIs) and unintended pregnancies (UPs) in young, sexually active women in a single study. Military recruit training provides a well-defined, national, nonclinic sample in which to evaluate such an intervention. METHODS: All female Marine recruits (N=2,288) in training were approached. Of these, 2,157 (94.3%) voluntarily agreed and were randomly assigned, by platoons, to participate in cognitive-behavioral interventions to prevent STIs or UPs or to prevent physical training injuries and cancer. Participants completed self-administered questionnaires and were screened for pregnancy, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis at baseline and, on average, 1 and 14 months postintervention. RESULTS: A higher proportion of the control group had a postintervention STI or UP [odds ratio (OR)=1.41, 95% confidence interval (CI)=1.01-1.98]. Among participants who had no history of STIs or pregnancy, but who engaged in risky sexual behaviors just before recruit training, the control group was more likely to acquire a postintervention STI (OR=3.24, CI=1.74-6.03). Among participants who were not sexually experienced at baseline, the control group was more likely to have casual (OR=2.05, 95% CI=1.04-4.08) and multiple (OR=1.87, 95% CI=1.01-3.47) sexual partners postintervention. CONCLUSIONS: This randomized controlled trial indicates that cognitive-behavioral interventions are effective for reducing behavioral risk and preventing STIs and UPs in young, sexually active women who are not seeking health care.

Adult↗

PubMed2005

Characterization of complete HIV type 1 genomes from non-B subtype infections in U.S. military personnel.

Infections with non-B HIV-1 subtypes are rare in the United States, but comprise a significant percentage of infections among U.S. military personnel. Risk behavior while on overseas deployment correlates with non-B infection in this population. Extensive genetic characterization will be required to define HIV-1 diversity, and to effectively evaluate requirements for HIV-1 vaccines and other prevention strategies in this group. From 1997 to 2000, 520 recent seroconverters, identified through routine HIV-1 testing in the U.S. active military force, volunteered for a prospective study. V3 loop serology or partial genome sequencing identified 28 non- B subtype infections; 14 were studied by full genome sequencing and phylogenetic analysis. Five strains were CRF01_AE. Four of these clustered with CM240 from Thailand, and one clustered with African CRF01_AE. Four strains were CRF02_AG, prevalent in West and West Central Africa. Two strains were subtype C. One strain was a unique recombinant between CRF01_AE and subtype B, and another was a complex unique recombinant between subtype A and D. The final strain was a member of a complex circulating recombinant first identified in Senegal, CRF09_cpx, incorporating subtypes A, F, G, and an unclassified genome. This diversity of non-B subtype HIV-1 strains, encompassing three globally prevalent non-B strains and including rare or even possibly unique strains, illustrates the breadth of U.S. military exposure while deployed and sets the bar higher for breadth of cross-subtype protection to be afforded by an HIV-1 vaccine.

Adult↗

PubMed2004

Decrease in measles virus-specific CD4 T cell memory in vaccinated subjects.

Since the licensure and generalization of an effective measles virus (MV) vaccine 41 years ago, antibody levels have been used as correlates of immunity. The long-lived MV-specific antibody response has been studied intensely, but the dynamics of MV-specific T cell immunity over time have not been well characterized. We thus characterized the profiles of MV vaccine-induced antigen-specific T cells over time since vaccination. In a cross-sectional study of healthy subjects with a history of MV vaccination, we found that MV-specific CD4 and CD8 T cells could be detected up to 34 years after vaccination. The levels of MV-specific CD8 T cells and MV-specific IgG remained stable, whereas the level of MV-specific CD4 T cells decreased significantly in subjects who had been vaccinated >21 years earlier. These results show that MV-specific T cell immunity after vaccination is long lasting and reveal different dynamics between CD4 and CD8 cells after vaccination.

Adolescent↗

PubMed2004

HIV type 1 circulating recombinant form CRF09_cpx from west Africa combines subtypes A, F, G, and may share ancestors with CRF02_AG and Z321.

Two HIV-1 intersubtype recombinant forms are circulating widely in populations and have become important strains in the pandemic: CRF01_AE in Southeast Asia and CRF02_AG in West and West Central Africa, respectively. Several other circulating recombinant forms (CRF) have also been identified, but with fewer numbers of infections and/or more limited geographic spread. Here we expand knowledge of HIV-1 CRF using clinical samples, principally from West Africa, that were difficult to classify by partial genome sequencing. DNA was extracted from primary patient peripheral blood mononuclear cells (PBMC). The virtually complete HIV-1 genome was amplified by polymerase chain reaction (PCR) and directly sequenced. Additional strains were characterized by partial envelope sequencing. Phylogenetic analysis was used to identify and map intersubtype recombination breakpoints. Four virtually complete genome sequences and two partial envelope sequences represent CRF09_cpx, a newly identified complex recombinant HIV-1 whose principal focus seems to be in West Africa. This recombinant includes segments of subtypes A, F, G, and unclassified genetic material. It shares unique unclassified regions with the early Zaire strain Z321. There are similarities in structure, but considerable genetic distances, between CRF09_cpx and CRF02_AG IbNG. In conclusion, it is possible that this CRF shared common ancestors with both Z321 and CRF02_AG in the course of the pandemic, perhaps arising by recombination between earlier forms of these strains. Although newly identified, at least one infection with CRF09_cpx has already occurred outside of Africa.

Adult↗

PubMed2004

Human immunodeficiency virus/acquired immunodeficiency syndrome knowledge and risk factors in Ethiopian military personnel.

Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related knowledge and behaviors were assessed in face-to-face structured interviews with 314 Ethiopian military personnel. A significant finding of this research was the association between HIV/AIDS knowledge and risky sexual behavior. That is, military personnel who had inaccurate knowledge about HIV/AIDS transmission and prevention were 3.4 times as likely to engage in combined sexual risk behaviors compared with personnel with accurate knowledge, after controlling for age, military rank, and marital status (odds ratio, 3.4; 95% confidence interval, 1.86-6.22). This finding highlights the potential value of educational programs in slowing the spread of HIV/AIDS in sub-Saharan Africa.

Adolescent↗

PubMed2003

Diverse HIV-1 subtypes and clinical, laboratory and behavioral factors in a recently infected US military cohort.

OBJECTIVE: To describe the demographics, risk behaviors, and HIV-1 subtypes in a large cohort of recently HIV-infected military personnel. DESIGN: Descriptive, cross-sectional study. METHODS: US military personnel with recent HIV seroconversion from six medical referral centers were enrolled with a self-administered questionnaire, CD4 cell counts, syphilis and hepatitis B serologies, plasma viral RNA levels, and HIV-1 subtype nucleic acid sequencing. RESULTS: Between February 1997 and May 2000, 520 patients were enrolled. Most [488 (94.3%)] were infected with HIV-1 subtype B. The most prevalent non-B subtype was a circulating recombinant form (CRF01_AE) [17 (61%)]; however, two pure subtypes (C and D), as well as CRF02_AG, CRF09_cpx and a BE recombinant were identified. The likely area of HIV-1 acquisition was the United States for 70% of the volunteers. At least three non-B subtype infections (two subtype C, one subtype CRF01_AE) were apparently acquired domestically. Risk behaviors and comorbid sexually transmitted diseases were reported during the seroconversion period. Volunteers with non-B subtype HIV infection were more likely to report heterosexual contacts [92% vs. 39%; odds ratio (OR), 10.0], including contacts with commercial sex workers (41% vs. 13%; OR, 4.9). The Roche Amplicor version 1.0 assay was less sensitive for non-B subtype infections than the Roche Amplicor version 1.5 assay. CONCLUSION: There is a high prevalence and diversity of non-B HIV subtypes in this large cohort. Efficient diagnosis of acute primary HIV-1 infection was identified as a goal for prevention programs. Modifiable risk behaviors and target populations for intervention were identified.

Adolescent↗

PubMed2003

Correlates of human herpesvirus-8 seropositivity among U.S. military members recently infected with human immunodeficiency virus.

BACKGROUND: Human herpesvirus 8 (HHV-8), the cause of Kaposi's sarcoma, is common among HIV-infected persons. The exact route of transmission of HHV-8 in various populations is still debated. GOAL: The goal was to define the correlates of HHV-8 infection among men recently infected with human immunodeficiency virus. STUDY DESIGN: Three hundred forty-two HIV-infected U.S. military men were evaluated using a questionnaire regarding potential risk factors and laboratory data, including HHV-8, herpes simplex virus 2 (HSV-2), syphilis, hepatitis B, and hepatitis C serologies. RESULTS: The seroprevalence of HHV-8 was 32%. HHV-8 was significantly associated with hepatitis B seropositivity (odds ratio [OR], 2.44; 95% confidence interval [CI], 1.5-4.1), and black ethnicity was negatively associated with HHV-8 (OR, 0.6; 95% CI, 0.3-0.9) in the multivariate analysis. HHV-8 was not associated with drug use or hepatitis C seropositivity. Among men who have sex with men (MSM), HHV-8 infection correlated with hepatitis B seropositivity (OR, 2.2; 95% CI, 1.1-4.3) and HSV-2 (OR, 2.6; 95% CI, 1.4-4.9). Among heterosexuals, the correlates of HHV-8 were different; blacks as compared with whites (OR, 0.3; 95% CI, 0.1-0.8) and married versus single status (OR, 0.4; 95% CI, 0.2-0.9) were associated with a lower rate of HHV-8 infection. Among heterosexuals, hepatitis B, HSV-2, and sexual behaviors were not associated with HHV-8. CONCLUSION: This study suggests that the seroprevalence of HHV-8 is increased in both MSM and heterosexual men with HIV infection, and that the route(s) of HHV-8 acquisition might be different between MSM and heterosexuals.

Adolescent↗

PubMed2002

A behavioral intervention to prevent sexually transmitted diseases/human immunodeficiency virus in a Marine Corps sample.

Research evaluating human immunodeficiency virus (HIV) behavioral interventions among U.S. military personnel has been lacking. In this study, a behavioral intervention to prevent HIV and sexually transmitted diseases (STDs) was implemented in a sample of Marine security guards. Participants were assessed before and after a three-session intervention on a measure of STDs/HIV knowledge and a number of psychosocial scales. The results indicated that STDs/HIV knowledge was significantly greater after the intervention. Significant pre-test vs. post-test differences were also found on the Social Norms, Behavioral Intentions, Attitudes toward Condoms, and Self-Efficacy/Impulse Control scales. On Social Norms and Behavioral Intentions, the differences were as expected: subjects perceived greater social norms supporting condom use and had stronger intentions to practice safe sex after the intervention than they had before. On Attitudes toward Condoms and Self-Efficacy/Impulse Control, the differences were not in the expected direction. Psychosocial factors associated with self-reported condom use were also identified.

Adult↗

PubMed2002

Effectiveness of two versions of a sexually transmitted diseases/human immunodeficiency virus prevention program.

Little is known about the comparative effectiveness of human immunodeficiency virus prevention interventions that differ in duration but contain similar content. The objective of this study was to evaluate and compare the effectiveness of two versions (6 hours vs. 3 hours) of a behavioral intervention called the STD/HIV Intervention Program (SHIP) in a sample of Marines. Marines were exposed to either a 6-hour or a 3-hour version of SHIP. Comparisons of pre-test and post-test knowledge, attitude, and behavioral intention scores revealed similar results for both versions. For both versions of the intervention, scores on sexually transmitted diseases/human immunodeficiency virus knowledge were significantly higher after the intervention. Both the 6-hour and the 3-hour versions of SHIP also led to significant increases on scales measuring social norms and behavioral intentions. The two versions of SHIP appeared to be of comparable effectiveness for producing short-term changes in knowledge, attitudes, and behavioral intentions.

Female↗

PubMed2002

Correlates of sexually transmitted diseases in a young male deployed military population.

OBJECTIVE: To examine risk factors of sexually transmitted diseases (STDs) in a non-clinic-based sample of young male military personnel. METHODS: A total of 1,028 enlisted U.S. Marines completed a self-report survey querying sexual behaviors in the previous 3 months and provided urine specimens for STD screening by nucleic acid amplification testing for Chlamydia trachomatis and Neisseria gonorrhoeae. Risk for STDs was assessed using a composite Sexual Risk Index. Recent STD infection was defined as a positive result on urine-based screening for chlamydial and/or gonococcal infection and/or a history of STDs in the past 3 months. RESULTS: Recent STDs were identified in 76 men (7.4%): 42 (4.1%) were diagnosed with a chlamydial infection with no gonorrhea found, and 34 (3.3%) reported a history of STDs. Men with the highest score on the Sexual Risk Index were 2.6 times more likely to have a current STD compared with those at lowest risk (odds ratio = 2.6, confidence interval = 1.01, 6.2). CONCLUSIONS: Use of a composite measure of risk can identify the most significant factors associated with recent STDs in young military men. Such an index may be useful to target STD screening for those at greatest risk for STDs.

Adolescent↗