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At least 1,243 records · Page 69Linked to original sources
PubMed2002

High-dose rate brachytherapy of prostatic adenocarcinoma in combination with external beam radiotherapy a long-term follow-up of the first 50 patients at one center.

AIM: To report the long-term follow-up of 50 patients with prostatic adenocarcinoma (PAC) treated by high-dose rate brachytherapy in combination with external beam radiotherapy. PATIENTS AND METHODS: Between 1988 and 1995, 50 patients were treated with external beam radiotherapy delivered in 2 Gy fractions to a total dose of 50 Gy. Brachytherapy was delivered in two 10 Gy fractions. The mean follow-up time was 7.2 years. RESULTS: 42 patients are alive and four patients have deceased of prostatic adenocarcinoma. Of the remaining patients, 40 have a PSA < 1 ng/l. 41 patients were interviewed during the year 2000 and 91% of these were satisfied with the treatment. Four (8%) patients reported grade III/IV side effects. Ten of the 41 patients reported that they still had an erection allowing intercourse. Half of those who developed an erectile dysfunction did so in direct connection with the treatment. In the others erectile dysfunction developed gradually during the first 48 months after the treatment. CONCLUSION: The combined treatment gave an exceptionally good local control (86%). The method represents a promising curative treatment, but the effect can be double edged. The small number of patients in this study restricts a more conclusive statement concerning this treatment modality.

Adenocarcinoma↗
PubMed1998

Long-term results of total penile reconstruction with a prefabricated lateral arm free flap.

PURPOSE: We present 5-year followup results of patients who underwent total penile reconstruction with a prefabricated lateral arm free flap technique. MATERIALS AND METHODS: We treated 3 female-to-male transsexuals and a man with penile amputation with a 2-stage technique of total penile reconstruction. In the first stage the neourethra is constructed as a tubed skin graft incorporated in the territory of the lateral arm flap. Three to 6 months later the lateral arm flap with its well epithelialized conduit is fashioned into a penis, an inflatable prosthesis is incorporated and the construction is transferred to the pubis with vascular, urethral and nerve repairs. RESULTS: In addition to the 2 surgical procedures required to construct the penis, the patients have required an average of 3 revisions. There were no complications beyond the first year postoperatively. All 4 patients are able to void in the standing position and are free of fistulas or strictures. The inflatable prosthesis allows them to achieve penetration during sexual intercourse. All reconstructed penises have recovered erogenous and tactile sensibility. Patient satisfaction with the reconstructed penis is high. All transsexuals are married and fully integrated as men. CONCLUSIONS: With the prefabricated lateral arm free flap technique it is possible to achieve a fully functional penis with stable long-term results and excellent patient satisfaction. To our knowledge our series represents the first report of a technique for functional penile reconstruction with at least 5 years of followup.

Adult↗
PubMed2000

Sexuality and sexual activity in pregnancy.

OBJECTIVES: To evaluate women's sexual experience in pregnancy, and to describe their sources of information regarding sexuality during this period. DESIGN: Cross-sectional study. SETTING: The offices of obstetricians providing obstetric care in a tertiary care university hospital in St. John's, Newfoundland, Canada. POPULATION: One hundred and forty-one pregnant women. METHODS: Pregnant women anonymously completed self-administered questionnaires regarding sexuality and sexual activity during pregnancy. Responses were summarised using descriptive statistics, and comparisons were made between the trimesters of pregnancy. Multiple logistic regression was performed to assess the influences of a variety of factors on sexual activity. RESULTS: Vaginal intercourse and sexual activity overall decreased throughout pregnancy (P = 0.004 and 0.05, respectively) with the trimester of pregnancy being the only independent predictor. Most women reported a decrease in sexual desire (58%). Overall, 49% of women worried that sexual intercourse may harm the pregnancy. Concerns regarding sexual activity leading to preterm labour or premature rupture of membranes increased as the pregnancy progressed (P < 0-001 and P = 0-001, respectively). Only 29% of women discussed sexual activity in pregnancy with their doctor and 49% of these women raised the issue first, with 34% feeling uncomfortable in bringing up the topic themselves. Most women (76%) who had not discussed these issues with their doctor felt they should be discussed. CONCLUSIONS: A reduction in sexual activity, vaginal intercourse and sexual desire occurs in many women as pregnancy progresses. Both the woman and her partner have concerns regarding complications in the pregnancy as a result of sexual intercourse. The majority of women wish to discuss these issues with their doctor, but are not always comfortable raising the topic themselves.

Adult↗
PubMed1997

Sex, thrush and bacterial vaginosis.

Bacterial vaginosis (BV) is the most common cause of vaginal discharge in women of childbearing age. In some women it shows a relapsing and remitting course with apparently spontaneous onset and resolution. There are intermediate patterns of vaginal flora in which lactobacilli and other species co-exist. We asked women with recurrent BV to prepare vaginal smears daily, and to record symptoms, time of menstruation, sexual activity and use of douches or medication. We Gram-stained the smears and assigned a Nugent score for BV, and noted the presence of candida, pus cells, sperm and blood. Eighteen women collected daily vaginal smears for up to 10 months. Forty months of slides were collected in total. Bacterial vaginosis arose spontaneously on 23 occasions. We saw candida arise 11 times. Bacterial vaginosis appeared after candida on 9 of these 11 episodes. We saw BV regress spontaneously 13 times. Nine of these resolutions occurred within 48 h of unprotected sexual intercourse: BV only arose on one occasion within 48 h of unprotected intercourse. The intermediate pattern was seen for up to 10 days, and occurred as BV began or resolved in some women, and sometimes resolved without developing into BV. Bacterial vaginosis arose most often in the first 7 days of a menstrual cycle, and resolved spontaneously most often in mid-cycle. In women with recurrent BV, BV arises most often around the time of menstruation and resolves spontaneously in mid-cycle. Recurrences often follow an episode of candidiasis, and BV often regresses after unprotected sexual intercourse.

Adult↗
PubMed1982

Basal body temperature, ovulation and the risk of conception, with special reference to the lifetimes of sperm and egg.

The risks of conception, due to sexual intercourse at various times before and after the periovulatory rise in the woman's basal body temperature, are evaluated. In general, the risk is small nine or more days before, and two or more days after, the first day of elevated temperature. The model for the conception probabilities assumes exponential survival distributions for sperm and egg and a specific probability that an egg is viable. Median survival times for sperm and egg are estimated at 1.0 days and 0.5 days, respectively. The Pearl indices for intercourse on the third and fourth day of elevated temperatures are 4.7 and 1.2 pregnancies per 100 woman-years, respectively.

Body Temperature↗
PubMed2005

HIV and sexual health knowledge and sexual experience among Australian-born and overseas-born students in Sydney.

PURPOSE: To examine differences between Australian-born and Asian-born first-year university students in Sydney in their sexual behavior and knowledge about the prevention and transmission of human immunodeficiency virus (HIV) and other sexually transmissible infections (STIs). METHODS: Students were recruited from a stall during the student Orientation Week in both 2002 and 2003 at the University of New South Wales. A short questionnaire was completed and returned anonymously. Data on age, gender, country of birth, sexual behavior, and sexual health knowledge were collected. A score was calculated based on the sum of the correct answers given to 12 HIV/STI transmission and prevention questions. The students were then divided into three groups according to their country of birth (Australia, Asia, and elsewhere) and their knowledge scores were compared. Students born in certain Asian countries were also asked their perception of the HIV epidemic in their home country compared with Australia. RESULTS: A total of 1185 first-year students completed the questionnaire. Although older on average, Asian-born students were less likely to have had sexual intercourse and had had fewer sexual partners. They also had consistently poorer HIV/STI knowledge scores than Australian-born students. Students born in China, Hong Kong, Indonesia, Malaysia, and Singapore but not Thailand underestimated the prevalence of HIV in their country of birth in comparison with Australia. CONCLUSION: The combination of poorer knowledge, apparent misconception of the extent of HIV epidemic in their home country (or Australia), and potential later frequent travel indicates a potential risk for later transmission of HIV/STIs. The university is an underused setting for prevention health education.

Adolescent↗
PubMedDate not supplied

Oestrogen treatment to reduce the adult height of tall girls: long-term effects on fertility.

BACKGROUND: Treatment with oestrogen to reduce the adult height of tall girls has been available since the 1950s. We undertook a retrospective cohort study to assess the long-term effects of this treatment on fertility. METHODS: Eligible participants were identified from the records of Australian paediatric endocrinologists who assessed tall girls from 1959 to 1993, and from self-referrals. Individuals included girls who had received oestrogen treatment (diethylstilboestrol or ethinyl oestradiol) (treated group) and those who were assessed but not treated (untreated group). Information about reproductive history was sought by telephone interview. FINDINGS: 1432 eligible individuals were identified, of whom 1243 (87%) could be traced. Of these, 780 (63%) completed interviews: 651 were identified from endocrinologists' records, 129 were self-referred. Treated (n=371) and untreated (n=409) women were similar in socioeconomic and other characteristics. After adjustment for age, treated women were more likely to have ever tried for 12 months or more to become pregnant without success (relative risk [RR] 1.80, 95% CI 1.40-2.30); more likely to have seen a doctor because they were having difficulty becoming pregnant (RR 1.80, 1.39-2.32); and more likely to have ever taken fertility drugs (RR 2.05, 1.39-3.04). Time to first pregnancy analysis showed that the treated group was 40% less likely to conceive in any given menstrual cycle of unprotected intercourse (age-adjusted fecundability ratio 0.59, 95% CI 0.46-0.76). These associations persisted when self-referred women were excluded. INTERPRETATION: High-dose oestrogen treatment in adolescence seems to reduce female fertility in later life. This finding has implications for current treatment practices and for our understanding of reproductive biology.

Adolescent↗
PubMed2003

Children and adolescents who sell sex: a community study.

Adolescents who reported to have given sexual favors for payment were investigated. The sample consisted of all adolescents in the public and private school systems in Oslo, the capital in Norway (age group 14-17, response rate 94.3%, N=10,828). Adolescents who had sold sex form 1.4%, three times as many boys as girls. Half the group had done it more than 10 times. Most were under the legal age of sex in Norway (16 years) when this first happened. We found no associations with sociodemographic variables or residential area in Oslo. However, sex sale was associated with low intercourse debut age, conduct problems, alcohol problems, use of drugs (including heroin) and violent victimization. The conclusion is that a small group in the general adolescent population sells sex, and many of the clients are assumed to be homosexual or bisexual men. Adolescents who take part in these activities are often heavily involved in delinquent behaviors and use of drugs, and many probably are in a risk zone for sexually transmitted diseases (including HIV), drug abuse and a delinquent and criminal development.

Adolescent↗
PubMed2005

Sudden cardiac death in a young woman: tumor of the atrioventricular (AV) node or citalopram intoxication?

Atrioventricular (AV) node tumor is a very rare lesion of the cardiac conduction system. Clinically, it is associated with complete AV block and sudden cardiac death, often in apparently healthy young people. We report a case of a 24-year-old woman who developed ventricular fibrillation during sexual intercourse and died before admittance to the hospital. The woman had a medical history of depression and was treated with citalopram.At first, no macroscopic or microscopic pathologic changes were found. Toxicologic analysis showed a toxic level of citalopram in the blood. Further microscopic examination of the cardiac conduction system disclosed a tumor of the AV node. Immunohistochemical staining confirmed endodermal origin in accordance with the latest hypothesis of the pathogenesis of this tumor. It was concluded that this young woman died of cardiac arrhythmia due to the AV tumor and not from citalopram intoxication, as first suspected. This case emphasizes the importance of a microscopic examination of the cardiac conduction system in cases of sudden unexpected death, even in cases with a plausible cause and manner of death at first glance.

Adult↗
PubMed2005

Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior.

OBJECTIVE: Despite studies indicating that a significant proportion of adolescents are having oral sex, the focus of most empirical studies and intervention efforts concerning adolescent sexuality have focused on vaginal intercourse. This narrow focus has created a void in our understanding of adolescents' perceptions of oral sex. This study is the first to investigate adolescents' perceptions of the health, social, and emotional consequences associated with having oral sex as compared with vaginal sex, as well as whether adolescents view oral sex as more acceptable and more prevalent than vaginal sex. METHODS: Participants were 580 ethnically diverse ninth-grade adolescents (mean age: 14.54; 58% female) who participated in a longitudinal study on the relationship between risk and benefit perceptions and sexual activity. Participants completed a self-administered questionnaire that inquired about their sexual experiences and percent chance of experiencing outcomes from, attitudes toward, and perceived prevalence of oral versus vaginal sex among adolescents. RESULTS: More study participants reported having had oral sex (19.6%) than vaginal sex (13.5%), and more participants intended to have oral sex in the next 6 months (31.5%) than vaginal sex (26.3%). Adolescents evaluated oral sex as significantly less risky than vaginal sex on health, social, and emotional consequences. Adolescents also believed that oral sex is more acceptable than vaginal sex for adolescents their own age in both dating and nondating situations, oral sex is less of a threat to their values and beliefs, and more of their peers will have oral sex than vaginal sex in the near future. CONCLUSIONS: Given that adolescents perceive oral sex as less risky, more prevalent, and more acceptable than vaginal sex, it stands to reason that adolescents are more likely to engage in oral sex. It is important that health care providers and others who work with youths recognize adolescents' views about oral sex and broaden their clinical preventive services to include screening, counseling, and education about oral sex.

Adolescent↗
PubMed1992

Decreased fecundability in Hutterite couples sharing HLA-DR.

To study the effects of parental HLA sharing on pregnancy outcome, we initiated population-based studies in the Hutterites. We previously reported longer intervals from marriage to each birth among couples sharing HLA, particularly HLA-DR. In the present report, we present the results of a prospective, 5-year study of fecundability and fetal loss rates in this population. Between April 1986 and April 1991, 154 pregnancies were observed in 104 couples. The median number of months of unprotected intercourse to a positive pregnancy test was significantly longer among couples sharing HLA-DR who stopped nursing prior to the first menses as compared with couples not sharing HLA-DR who stopped nursing prior to the first menses (5.1 vs. 2.0 mo, respectively; P = .016). Fetal loss rates were increased among couples sharing HLA-B as compared with couples not sharing HLA-B (.23 vs. .12, respectively; P = .041, adjusted for age, gravidity, and kinship). These data suggest that our earlier observations of increased birth interval lengths among Hutterite couples sharing HLA were predominantly due to longer intervals until a clinical pregnancy among couples sharing HLA-DR and, to a lesser degree, were due to increased fetal loss rates among couples sharing HLA-B.

Abortion, Spontaneous↗
PubMed2004

Effects of a community-based sex education and reproductive health service program on contraceptive use of unmarried youths in Shanghai.

PURPOSE: To evaluate the effectiveness of a youth-friendly intervention in promoting one safe sex behavior-contraception and condom use among unmarried young people aged 15-24 years in Shanghai, China. METHODS: The study was conducted in two towns of a suburban area of Shanghai (one as the intervention and the other as the control), with comparable socio-cultural-economic and demographic characteristics. The intervention intended to build awareness and offer counseling and services related to sexuality and reproduction among unmarried youths, in addition to the routine program activities, which were exclusively provided in the control site. Baseline surveys were conducted in both sites before the implementation of the intervention, and similar surveys were conducted in both sites 20 months after the intervention had been initiated to test the feasibility and effectiveness of the intervention. In total, 1220 unmarried young people from the intervention site and 1007 from the control site, including 1304 out-of-school youths and 923 high school students, were recruited, and about 92% of them were successfully followed up. Four main measures were examined (i.e., ever contraceptive use, current regular contraceptive use, ever condom use, and contraceptive use at onset of sexual intercourse-if it occurred during the course of the intervention). The reasons for nonuse of contraceptives, the status of joint decision on contraception and the first method used were also assessed. Data were analyzed using Logistic regression models with dichotomous measures of contraceptive use and Generalized Estimating Equations (GEEs) with repeated measures. RESULTS: At baseline, there was no statistical difference in contraceptive use between the intervention and control groups. After intervention, the proportions reporting regular contraceptive use and condom use in the intervention group were much higher than that in the control group (p <.001). A group x time interaction effect (p <.0001) was found for regular contraceptive use and ever condom use. Logistic regression analysis with dichotomous measures of contraceptive use and GEEs with repeated measures showed similar results. The regular contraceptive use and ever condom use were correlated with subject's occupation and family economic status, respectively. After adjusting for demographic factors, the subjects from the intervention group were 14.58 (OR) times as likely to use contraceptives at onset of intercourse as those from the control group (95%CI: 8.55-24.87, p <.0001). Similar results were found for both females and males. CONCLUSIONS: A multifaceted intervention program that provided information and skills, as well as counseling and services, appears to have positive influences on contraceptive practice and condom use among unmarried young females and males in suburban Shanghai.

Adolescent↗
PubMed1997

Drinking and sexual experience on first dates among adolescents.

Using Steele's inhibitory conflict model (C.M. Steele & R.A. Josephs, 1990) as a framework, the present study investigated the link between alcohol use and the probability that intercourse occurred on 2 different 1st date occasions in a random sample of adolescents and young adults interviewed twice approximately 4 1/2 years apart (Ns = 1,678 and 1,780, respectively). As expected, both between-subjects/within-occasion and within-subjects/across-occasion analyses indicated that the probability of intercourse was significantly higher when the male couple member, but not his female counterpart, drank alcohol. Also consistent with Steele's model, alcohol effects on intercourse probability were found primarily among males who were highly conflicted about having intercourse on the date. Inconsistent with Steele's model, however, a similar effect was not found among highly conflicted females. Results are discussed in terms of a more general variant of Steele's model that allows for both alcohol-related disinhibition and inhibition.

Adolescent↗
PubMed2005

Bacterial vaginosis in relation to menstrual cycle, menstrual protection method, and sexual intercourse in rural Gambian women.

OBJECTIVE: To examine the occurrence of bacterial vaginosis (BV) over the menstrual cycle and in relation to menstrual protection materials and sexual intercourse in a rural African setting. METHODS: Married, regularly menstruating female volunteers were asked to collect self administered swabs on alternate days through four menstrual cycles. BV was assessed using Nugent scores. Menstruation and reported sexual intercourse data were recorded contemporaneously. A crossover design comparing traditional and modern menstrual protection methods was incorporated. Multivariate logistic regression was used to examine associations with BV. RESULTS: 30 women completed four menstrual cycles in the study. Completeness and validity of data from the self administered swabs was high. Greater frequencies of BV were found for all women in the second week of the menstrual cycle relative to days 14+, and markedly higher frequencies of BV were found in the first week in women with infrequent BV. BV was (non-significantly) more frequent when modern pads were used compared with traditional cloths. No association was found between BV and intercourse reported in the previous 4 days; or between the frequency of reported intercourse in one menstrual cycle and BV in either the same menstrual cycle or the next. CONCLUSIONS: Similar transient fluctuations over the menstrual cycle were found to those in industrialised countries. We found no evidence that sexual intercourse was associated with increased frequency of BV. Our data do not support hypotheses that menstrual hygiene materials might explain the high prevalences of BV found in sub-Saharan Africa compared to industrialised countries.

Adult↗
PubMed2004

Screening for Chlamydia and gonorrhea by strand displacement amplification in homeless adolescents attending youth shelters in Korea.

We conducted the screening of sexually transmitted infections to define the prevalence of genital Chlamydia trachomatis and Neisseria gonorrhoeae infections and status of sexual risk behavior among homeless adolescents (10-19 yr old) in Korea. Adolescents who ran away from home and are under the care of youth shelters in ten cities in Korea served as the study population. Participants filled out a self-administered questionnaire related to sexuality. First-void urine was analyzed for chlamydial and gonococcal infection by strand displacement amplification (BDProbTec ET, BD Diagnostic Systems, MD, U.S.A.). A total of 175 adolescents from 15 youth shelters took part in the study. Their median age was 16 yr, and 54.9% of them reported having sexual intercourse at least once. The prevalence of C. trachomatis and N. gonorrhoeae among homeless adolescents was 12.6% and 15.4%, respectively. Factors significantly associated with the infections were number of sexual partners during the past year and lifetime. This is the first community-based sexually transmitted infection (STI) screening among adolescent in Korea. Screening programs targeting sexually active adolescents are important for detection of STIs. They should be considered an alternative population-based surveillance system in order to control STIs nationally.

Adolescent↗
PubMedDate not supplied

Sexual and physical abuse history in gastroenterology practice: how types of abuse impact health status.

OBJECTIVE: There is an increasing amount of literature pointing to a relationship between sexual and/or physical abuse history and poor health status, although few studies provide evidence concerning which aspects of abuse may impact on health. In female patients with gastrointestinal (GI) disorders, the present study examined the effects on health status of: 1) history of sexual abuse and physical abuse, 2) invasiveness or seriousness of sexual abuse and physical abuse, and 3) age at first sexual and physical abuse. METHOD: The sample included 239 female patients from a referral gastroenterology clinic who were interviewed to assess sexual and physical abuse history. RESULTS: We found the following: 1) 66.5% of patients experienced some type of sexual and/or physical abuse; 2) women with sexual abuse history had more pain, non-GI somatic symptoms, bed disability days, lifetime surgeries, psychological distress, and functional disability compared to those without sexual abuse; 3) women with physical abuse also had worse health outcome on most health status indicators; 4) rape (intercourse) and life-threatening physical abuse seem to have worse health effects than less serious physical violence, and sexual abuse involving attempts and touch; and 5) those with first abuse in childhood did not appear to differ on health from those whose first abuse was as adults. CONCLUSIONS: The authors conclude that asking about abuse should be integrated into history taking within referral-based gastroenterology practices.

Adolescent↗
PubMed1983

High-risk group for benign prostatic hypertrophy.

A case control study was conducted on 100 patients with benign prostatic hypertrophy (BPH) and 100 controls matched by age and residence. Interviews were performed by well-trained urologists using an original questionnaire. Matched-pair analysis revealed the following characteristics and relative risks (RR) as being significantly (P less than 0.05) different among the BPH patients versus the controls: higher educational background (RR = 2.77); not engaged in farming, forestry, or fishing (RR = 4.82); no environmental pollution at work (RR = 2.90); a present annual income of more than 2,400,000 yen (RR = 3.84); a previous annual income of more than 2,400,000 yen (RR = 3.82); practice the highest standard of living (RR = 4.24); more than two children (RR = 2.67); experienced first nocturnal emission before reaching the age of 20 (RR = 3.11); expanding more than 10 min to complete one act of sexual intercourse (RR = 2.43); having no episode of sexual impotence that lasted more than 1 month (RR = 2.29); no family history of gastric ulcer (RR = 7.98); no family history of breast cancer (RR = 8.25); regular consumption of milk (RR = 2.25); irregular consumption of green and yellow vegetables (RR = 3.91); and pickles not consumed at every meal (RR = 1.99). Characteristics that did not achieve a high level of statistical significance (0.05 less than P less than 0.10) between cases and controls were as follows: past history of gonorrhea, urethritis, or prostatitis and syphilis (RR = 1.84, 2.76, and 4.26, respectively), and daily meat consumption (RR = 3.18). On the basis of interviews of the patients and cases reported in this study, we conclude that dietary and sexual habits may be important factors which place individuals at a higher risk for developing BPH.

Aged↗
PubMed1978

Cancer of the cervix--a sexually transmitted disease. Cytologic screening in a prostitute population.

The epidemiology of cervical cancer has been the subject of many articles centered around the question, "Is cancer of the cervix a sexually transmitted disease? A group of 750 Taiwan prostitutes had cervical cytology performed at the time of required gonorrhea screening. The prostitutes represented a unique group in which the variables of frequent intercourse with multiple partners and multiple infection can be separated from early coital experience. Cervical cytology was obtained and processed by the Pathology Department at Navy Medical Research Unit No. 2. A bilingual questionnaire was completed with the aid of a medical interpreter. The results included only eight of the 750 specimens in the "dysplasia plus" category for a rate of 10.7 per 1,000. The low yield of abnormal cytology suggests the factors of multiple partners, frequent intercourse, and high gonorrhea infection rate are not significant epidemiologically if they occur after the phase of active metaplasia, occurring during the first pregnancy or early adolescence.

Adolescent↗