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At least 109 records · Page 6Linked to original sources
PubMed2003

Generalizability of STD screening in urban emergency departments: comparison of results from inner city and urban sites in Baltimore, Maryland.

BACKGROUND: A previous study in an inner city emergency department (ED) in Baltimore, Maryland, showed a high prevalence of gonorrhea and chlamydia infection among ED patients. GOAL: The goal was to compare results from an inner city ED to results from an urban ED in Baltimore, in terms of study population and setting, risks for infection, and factors associated with nonparticipation in the study. METHODS: This was a cross-sectional study of patients aged 14 to 44 years at two EDs. Outcomes for multivariate logistic regression analyses were (1). positive for gonorrhea or chlamydia by urine ligase chain reaction assay and (2). nonparticipation in the study. Comparative analyses were limited to patients aged 18 to 31 years. RESULTS: Patients differed significantly between EDs by participation rate, distribution of race/ethnicity, healthcare access, and behavioral risks, although the prevalence of infection did not differ. Risks for infection at the inner city ED were younger age, history of STD, and recent number of sex partners. Risks for infection at the urban ED were female gender and recent number of sex partners. At both EDs, being African American was associated with increased chance of participating, whereas lack of any genitourinary complaint was associated with nonparticipation. At the urban ED, women and patients approached for study enrollment during the day were also less likely to participate. CONCLUSION: ED-based screening for STDs can be an effective intervention for unrecognized infections. However, assessing population characteristics is necessary to develop targeted screening methods and clinical algorithms and to improve participation of patients and program sustainability.

Adolescent↗
PubMed1996

Glaucoma risk factors observed in the Baltimore Eye Survey.

The Baltimore Eye Survey identified race, intraocular pressure, systemic hypertension, perfusion pressure, family history, and quite possibly the structure and organization of the optic nerve head as potential etiologically significant risk factors in the development of glaucomatous optic nerve damage. These findings have been confirmed by subsequent, sometimes equally rigorous population-based studies in other communities and countries. The Baltimore Eye Survey failed to demonstrate a role for diabetes but revealed that estimates of the significance of diabetes, like that of family history, are subject to considerable selection bias.

Age Factors↗
PubMed2005

Proceedings of the Baltimore smooth muscle meeting: identifying research frontiers and priorities for the lower urinary tract.

PURPOSE: The myocyte is a major parenchymal cell of the lower urinary tract (LUT) in men and women. Significant phenotypic diversity ensures that myocytes subserve their important role in the physiologically distinct tissues and organs of the LUT, including the ureters, bladder, urethra, prostate, penis, vagina and myometrium. Coordinated contraction and relaxation of myocytes is required for normal organ function, while alterations in myocyte structure/function are implicated in the etiology of various LUT diseases/disorders. LUT diseases/disorders will continue to increase in an ever aging American population. The purpose of the Baltimore Smooth Muscle Meeting was to begin to identify some research frontiers and priorities. MATERIALS AND METHODS: A 1-day conference of some of the leading world experts in smooth muscle research was held at American Urological Association headquarters. These experts gave presentations in their areas of expertise and extensively discussed their work. This report details those interactions. RESULTS: There is astonishing diversity in the contribution of the myocyte to LUT physiology and dysfunction. Novel tools, technologies and ideas have produced increased understanding and identified new frontiers. CONCLUSIONS: An improved understanding of urogenital myocyte physiology, function and dysfunction is required better to elucidate disease mechanisms and develop novel therapeutics. The First Annual Baltimore Smooth Muscle Meeting provided the first step in this direction. More coordinated LUT myocyte funding initiatives, the further development of research resources, tools and technologies, and exploration of the urogenital system as a model system for studying systems biology and integrative physiology are among the highest research priorities.

Actin Cytoskeleton↗
PubMed2005

Hepatitis B vaccination rate of homeless children in Baltimore.

OBJECTIVE: To investigate the hepatitis B vaccination rate in homeless children 2 to 18 years old living in Baltimore City. METHODS: During a 21-month period, 250 children from homeless shelters were enrolled. RESULTS: The percent of children who had received 3 or more doses of hepatitis B vaccine was inversely related to age; 90% in 2- to 5-year-olds and 29% in 13- to 18-year-olds (P<0.0001). Seventy percent of 2- to 5-year-olds had at least some of their vaccine history recorded in the Baltimore Immunization Registry Program but the history was complete in only half. Forty-two percent of 13- to 18-year-olds had no hepatitis B vaccine doses recorded in any source; 49 per cent of 10- to 18-year-olds were either not immunized or had received only one hepatitis B vaccine dose. CONCLUSIONS: Hepatitis B vaccine coverage is high in homeless children up to 9 years of age, whereas the majority of homeless children 10 years of age and older are unprotected against hepatitis B virus infection. Tracking the vaccine records in homeless children is labor intensive. Better public health strategies to deliver hepatitis B vaccine to older homeless children are urgently needed.

Adolescent↗
PubMed2005

Sex with women as a risk factor for herpes simplex virus type 2 among young men who have sex with men in Baltimore.

BACKGROUND: Herpes simplex virus type 2 is common among MSM and is a risk factor for transmission of HIV. The findings of studies investigating the relationship between infection with HSV-2 and number of sex partners among MSM are inconsistent and rarely distinguish between male and female partners. GOAL: To determine the prevalence and risk factors for infection with HSV-2, including the number and gender of sex partners, in a group of MSM in Baltimore, MD. STUDY: This was a cross-sectional study among young MSM in Baltimore. RESULTS: Of the blood samples from 824 participants, 19.3% had HSV-2 antibodies. After adjusting for known HSV-2 correlates, independent predictors of HSV-2 seropositivity included HIV seropositivity, black race, older age, number of lifetime female sex partners, recent unprotected receptive anal intercourse with a man. CONCLUSIONS: This study suggests that female sex partners may be an important source of HSV-2 infection among young bisexual MSM. After adjusting for known HSV-2 correlates, the number of lifetime female but not male sex partners was independently associated with HSV-2. These results highlight the need for HSV-2 prevention and treatment efforts targeting MSM who also have sex with women. Future investigations of HSV-2 and sexual behavior among MSM need to distinguish between male and female sex partners.

Adult↗
PubMedDate not supplied

The syphilis elimination project: targeting the Hispanic community of Baltimore city.

OBJECTIVE: The objective of the Syphilis Elimination Project was to decrease the incidence of syphilis in the Hispanic community of Baltimore City through a culturally appropriate health initiative. DESIGN: Both qualitative and quantitative methods were used in the study design. Surveillance data were used to collect testing information. Comparisons at the start and end of the project measured change in individual knowledge about syphilis. Cross-sectional data from interviews with business owners and qualitative comments from outreach workers evaluated perception of program effectiveness. The local health department collected surveillance data. SAMPLE: A convenience sample of 63 Hispanic community members, 12 business owners/managers, and 8 outreach workers was utilized throughout the evaluation process. INTERVENTION: The project was a culturally appropriate approach to health promotion with street and business outreach. RESULTS: Post intervention there was a statistically significant increase in knowledge about syphilis within the Hispanic community and an increase in testing behaviors. CONCLUSIONS: The Syphilis Elimination Project was created in response to a marked increase in syphilis in Baltimore among the Hispanic population and a health disparity that existed within the city. It increased community members' knowledge of syphilis and positively influenced testing behaviors.

Baltimore↗
PubMed1989

Relationship between psychiatric distress and alcohol use: findings from the Eastern Baltimore Mental Health Survey.

This study examined the nature and strength of relationships between levels of alcohol use and concurrent psychiatric distress among adults in the community aged 18-64 years. Data for this project were gathered by standardized interview methods during the 1981-1982 Eastern Baltimore Mental Health Survey. The 2558 survey respondents were initially selected by means of multistage probability sampling of adult household residents in eastern Baltimore, Maryland. This project's findings indicated gender differences in the relationships under study. There was a moderate degree of association between heavy alcohol use and psychiatric distress among women; at moderate levels of alcohol use, a modest association was also noted. In contrast, for males, the results suggested a small positive association between heavy alcohol use and concurrent psychiatric distress, although these findings were not conclusive.

Adaptation, Psychological↗
PubMed2006

Isolation of Trichophyton violaceum and Trichophyton soudanense in Baltimore, Maryland.

Tinea capitis is of public health importance because of its transmissibility. Trichophyton violaceum and Trichophyton soudanense, which are common causes of tinea capitis in parts of Africa and West Asia, have only rarely been reported to cause dermatophytoses in the United States. We identified 24 patients with 25 positive cultures for T. violaceum or T. soudanense that were processed in a single hospital laboratory in Baltimore, Maryland, between 1 January 2000 and 30 June 2006. Most patients for whom clinical information was available had tinea capitis. There was a marked increase in the isolation of these organisms between the period from 2000 to 2002 and the period from 2003 to 2006, possibly associated with changes in immigration to the Baltimore metropolitan area. The changing epidemiology of this transmissible fungal infection not only is of public health interest as an example of the introduction of a "new" pathogen to an area where it traditionally was not endemic but also is of clinical and microbiological importance given reports suggesting an increasing incidence of tinea capitis in some areas and increasing clinical failure rates of current therapies.

Antifungal Agents↗
PubMed2001

Depressive disorder, dysthymia, and risk of stroke: thirteen-year follow-up from the Baltimore epidemiologic catchment area study.

BACKGROUND AND PURPOSE: This study examined depressive disorder as a risk factor for incident stroke in a prospective, population-based design. METHODS: The Baltimore Epidemiologic Catchment Area Study is a prospective 13-year follow-up of a probability sample of household residents from Baltimore, Md. Depressive disorder was measured with the diagnostic interview schedule, and stroke was assessed by questions from the health interview survey or by documentation on a death certificate. RESULTS: During the 13-year follow-up of 1703 individuals, 66 strokes were reported and 29 strokes were identified by death certificate search. Individuals with a history of depressive disorder were 2.6 times more likely to report stroke than those without this disorder after controlling for heart disease, hypertension, diabetes, and current and previous use of tobacco. Medications used in the treatment of depressive disorder at baseline did not alter this finding. A history of dysthymia demonstrated a similar relationship to stroke, although the estimate was not statistically significant. CONCLUSIONS: Depressive disorder is a risk factor for stroke that appears to be independent of traditional cardiovascular risk factors. Further research on mechanisms for the association and the impact of treatment for depressive disorder on subsequent stroke is needed.

Adolescent↗
PubMed1999

Cognitive decline in adulthood: an 11.5-year follow-up of the Baltimore Epidemiologic Catchment Area study.

OBJECTIVE: The epidemiology of cognitive decline over 11.5 years was investigated in a large community-residing population, with a special emphasis on the relationship between education and cognitive decline. METHOD: The study was an 11.5-year follow-up of a probability sample of the adult household residents of east Baltimore. From the Baltimore cohort of the Epidemiologic Catchment Area study, 1,488 participants completed the Mini-Mental State during three study waves in 1981, 1982, and 1993-1996. For each study participant, the difference in scores on the Mini-Mental State between waves 2 and 3 was calculated. RESULTS: Over a median interval of 11.5 years, the study participants' scores on the Mini-Mental State declined a mean of 1.41 points, and the scores of 68% of the participants declined by at least 1 Mini-Mental State point. With and without adjustment for age, greater declines were associated with having 8 years or less of formal education and with being African American. CONCLUSIONS: Over a long time period, cognitive decline occurred in all age groups. Having more than 8 years of formal education was associated with less decline. However, beyond 9 years, additional education was not associated with a further reduction in cognitive decline. This suggests that a minimal amount of education during early critical periods might confer protection against cognitive decline later in life.

Adolescent↗
PubMed1998

An evaluation of the Baltimore Community Lead Education and Reduction Corps (CLEAR Corps) program.

This evaluation examines the effectiveness of the Baltimore Community Lead Education and Reduction Corps (CLEARCorps) program in reducing lead dust levels in low-income urban housing in Baltimore, Maryland, through minor lead-reduction activities and tenant lead-poisoning prevention education. Lead dust data collected before and after lead-reduction activities show statistically significant mean declines for floors, window sills, and window wells. Limited data using tests also show that follow-up lead dust levels collected 6 months after the CLEARCorps intervention were significantly lower than preintervention lead levels. Although there are many important of this analysis, the findings suggest that in-place management may be an effective method in reducing childhood lead poisoning in high-risk areas.

Baltimore↗
PubMed2004

Disparities in cognitive functioning by race/ethnicity in the Baltimore Memory Study.

The Baltimore Memory Study is a cohort study of the multilevel determinants of cognitive decline in 50-70-year-old randomly selected residents of specific city neighborhoods. Prior studies have demonstrated that cognitive function differs by race/ethnicity, with lower scores in minorities than in whites, but the underlying basis for these differences is not understood. Studies have differed in the rigor with which they evaluated and controlled for such important confounding variables as socioeconomic status (SES), health-related behaviors, comorbid illnesses, and factors in the physical environment. The goal of this study was to describe differences in neurobehavioral test scores by race/ethnicity, before and after control for a four-dimensional measure of SES and health-related behaviors and health conditions, in a cross-sectional analysis of first visit data. Random samples of households in the study area were selected until enrollment goals were reached. Among the 2,351 persons on whom eligibility was determined, 60.8% were scheduled for an enrollment visit; of these, 1,140 (81.3%) were enrolled and tested. These study participants were 34.3% male and 65.7% female and were from 65 Baltimore, Maryland, neighborhoods. After adjustment for age, sex, and testing technician, there were large and statistically significant differences in neurobehavioral test scores by race/ethnicity, with African-American scores lower than those for whites, for both men and women. After adjustment for individual SES (educational status, household income, household assets, and occupational status), the average difference declined by 25.8%. After additional adjustment for SES, health-related behaviors and health conditions, and blood lead, the average difference declined another 10%, but large differences persisted; African Americans had test scores that averaged 0.43 standard deviation lower than those for whites across all neurobehavioral tests. These differences were present in all cognitive domains, including tests that would not be characterized as susceptible to differential item functioning by race/ethnicity, suggesting that the results are not due to race/ethnicity-associated measurement error.

Black or African American↗
PubMed2006

Associations between spirituality and substance abuse symptoms in the Baltimore Epidemiologic Catchment Area follow-up, 1993-1996.

Prior studies on substance abuse treatment programs have provided some evidence that participants who embrace some facet of spirituality during recovery may have greater success in maintaining sobriety. Several plausible associations exist between spirituality and sobriety; this paper posits that spirituality has consistently negative associations with substance abuse symptoms in models with 'substance abuse symptoms' as the outcome. The data come from the Baltimore Epidemiologic Catchment Area (ECA) study. In 1993, ECA researchers surveyed 1,920 of the original 3,841 participants, all household residents in East Baltimore. Multiple logistic regression analyses show that strong spiritual beliefs within this population are negatively associated with current substance abuse symptoms [OR = 0.53; 95%CI = 0.35-0.80, p = 0.002]. Homeownership is also negatively associated, while positively associated characteristics include suffering from income- related stress and having a history of substance abuse treatment. This population-based study confirms findings from clinical studies, and the results support continued emphases on spirituality in substance abuse recovery programs.

Adult↗
PubMed1992

Risk factors associated with antibodies to leptospires in inner-city residents of Baltimore: a protective role for cats.

Leptospiral antibody prevalence was 16% in residents of Baltimore. Seropositivity was associated with age, gender, race, and bird ownership, reduced the antibody risk associated with age and race from odds ratios (95% confidence interval) of 3.3 (2.0, 5.5) and 3.3 (1.1, 9.3), respectively, to the baseline level. These data establish the high prevalence of leptospiral antibody in Baltimore and suggest a protective role for cats in reducing the risk of human infection.

Adult↗
PubMed1995

Politics and practice: introducing Norplant into a school-based health center in Baltimore.

As one element of Baltimore's effort to combat its high rate of teenage pregnancy, the Baltimore City Health Department added the implantable contraceptive Norplant to the array of services offered at one of its school-based health centers in early 1993. The initial findings with the adolescents who received this contraceptive at the school were favorable, particularly regarding condom use, parental involvement, and patient acceptance of the contraceptive. This new policy garnered a significant amount of attention, both nationally and locally. It attempts to address problems that have complicated etiologies as well as diverse clinical, social, and ethical ramifications, all complicated by political realities. The Norplant experience offers useful lessons regarding controversial health initiatives that address problems facing public health practitioners today.

Adolescent↗
PubMed1989

Serologic evidence of hantaviral infections within small mammal communities of Baltimore, Maryland: spatial and temporal patterns and host range.

Serologic evidence was used to investigate the spatial and temporal distribution and host range of hantaviruses in small mammal communities in Baltimore, MD. Immunofluorescent antibody (IFA) reactive to a Baltimore rat isolate of Seoul virus was detected in 44% of 404 Norway rats captured at 4 park or residential locations; 21% of 121 meadow voles captured at 4 park locations possessed significant IFA titers to Prospect Hill virus. Evidence from plaque neutralization assay of rodent sera suggested that Seoul virus and Prospect Hill virus circulated concurrently in voles and rats, respectively, at 1 park. No cross infection of virus between these primary reservoir species was observed, as determined by higher specific neutralizing antibody titers to the characteristic virus for each host species. Only 4% of 449 house mice and 1% of 94 white-footed mice captured at the same sites as the primary host species were seropositive to hantaviruses, despite extensive demonstrated overlap in time and space with the primary host species.

Animals↗
PubMed2000

HIV-related tuberculosis in a transgender network--Baltimore, Maryland, and New York City area, 1998-2000.

During June-August 1998, the Tuberculosis (TB) Control Program of the Baltimore City Health Department (BCHD) identified four cases of TB among young black men. Three of these men also had human immunodeficiency virus (HIV) infection. The four reported belonging to a social network of transgender persons (i.e., persons who identify with or express a gender and/or sex different from their biologic sex) (1). By October 1998, test results on Mycobacterium tuberculosis isolates from the four men demonstrated a matching 11-band DNA fingerprint pattern (2), suggesting that these case-patients were epidemiologically linked. This report describes the public health investigation of these TB case-patients to identify contacts in Baltimore and the New York City area (NYC); the findings suggest that an interstate outbreak of TB has occurred within a social network that includes transgender persons.

AIDS-Related Opportunistic Infections↗