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PubMedDate not supplied

Premature labor, Part I: Risk assessment, etiologic factors, and diagnosis.

BACKGROUND: This paper, the first of a two-part series on premature labor, reviews the recent literature on the causes of and risk factors for preterm labor and methods of diagnosis. METHODS: A review of the literature on risk determination and diagnosis of preterm labor was conducted by searching MEDLINE files from 1983 to the present, using the key terms "preterm labor," "premature labor," "preterm labor and infection," and "uterine monitoring." Additional references were accessed by cross-referencing the bibliographies of the articles obtained through this search. RESULTS AND CONCLUSIONS: Risk factors for preterm labor, which include items related to the pregnant woman's demographic characteristics, history, daily habits, and current pregnancy, have been combined into scoring systems commonly used by clinicians and researchers to single out women at risk for preterm delivery. When such systems are tested in obstetric populations, results show variable success in predicting preterm labor or birth. These inconsistent results could be due, in part, to important factors that have often been omitted from scoring systems, such as chemical abuse, poor nutrition, little social support, demanding work, multiple sexual partners, past or current sexually transmitted diseases, and other gynecologic infections. Women who are considered high risk for preterm labor can benefit from participating in preterm birth prevention programs that incorporate home monitoring, patient education regarding the signs and symptoms of preterm labor, frequent contacts with health professionals, and cervical examinations.

Biomarkers↗
PubMed2003

Overlooked role of African-American males' hypermasculinity in the epidemic of unintended pregnancies and HIV/AIDS cases with young African-American women.

This article looks at multiple lines of converging evidence relevant to the 72% unintended pregnancy rate, and recently emerged heterosexually-based HIV/AIDS epidemic with young African-American women. Evidence recently reveals a convergence of these epidemics, in a vulnerable subpopulation segment of African-American women. Overlooked, as a unique contributing factor in these epidemics is the hypermasculine behaviors of African-American males. Among the risky behaviors linked with this hypermasculinity are a greater tendency with African-American males to have more multiple sexual partners, and a stronger aversion to condom use than other male ethnic groups. As a contributing factor in these epidemics, African-American males' hypermasculinity has several implications for intervention strategies to reduce the epidemics, which are discussed.

Adolescent↗
PubMed1992

AIDS (HIV) risk assessment in an inner-city women's clinic.

Risk assessment and antibody testing are potential modalities through which interventions to reduce heterosexual and perinatal transmission of human immunodeficiency virus (HIV) can occur. More than 98% of women attending inner-city adult gynecology, adult contraception and teen family planning clinics successfully completed self-administered HIV (AIDS) risk assessment questionnaires and received individual counseling, risk-reduction education and referral for antibody testing. Fourteen percent of the women (671/4,802) reported at least one HIV risk factor. Multiple sexual partners and intravenous drug use were the most commonly reported HIV risk factors in this population.

AIDS Serodiagnosis↗
PubMedDate not supplied

A survey on risk factors associated with cervical cancer.

Carcinoma of the cervix is one of the leading malignancies in the developing countries including India. In view of this health care program might have to be redefined. Most of the data are available from the developed countries, which rely mainly on cytology screening on regular basis. This however may not be feasible in developing countries because of various constraints. Thus alternative approaches are needed based on risk reduction modalities. This article while dealing with the control approaches based on secondary prevention, reviews several risk factors associated with cervical cancer. The various articles were approached through Medline search including cross-references. The important life styles associated with cervical cancer and which are amenable to primary prevention strategies through health education, behavioral interventions, legislative approaches and modifying the health care seeking behavior were identified through the review process. These factors mainly pertain to early sexual debut, multiple sexual partners, menstrual hygiene and unprotected sex. Role of male partners has also been delineated in the process of cervical carcinogenesis. These factors are essentially conducive to the transmission of an etiological agent; the high-risk types human papillomaviruses, the more proximal cause in the web of causation. Barrier method of contraception and prophylactic vaccine in future could help to check the transmission of the virus. Role of smoking and oral contraceptives has also been discussed. Till the facilities for mass scale screening are developed in developing countries the primary prevention approaches could certainly help to check the incidence of the disease.

Female↗
PubMed2004

Racial differences in hepatitis B and hepatitis C and associated risk behaviors in veterans with severe mental illness.

Racial differences in the seroprevalence of and risks for hepatitis B (HBV) and hepatitis C (HCV) were examined in military veterans with severe mental illnesses (SMI). Participants (376; 155 Caucasian, 221 African American) were inpatients at a Veterans Affairs (VA) psychiatric unit in Durham, N.C., from 1998 to 2000. Prevalence rates of HBV and HCV were 21.3% and 18.9%, respectively. African Americans had a higher HBV seroprevalence than did Caucasians: 27.6% versus 12.3%; odds ratio (OR) 2.73; 95% confidence interval (CI)=1.55, 4.79. Although not statistically significant, HCV seroprevalence was also higher for African Americans than it was for Caucasians: 21.3% versus 15.5%; OR=1.47; 95% CI=0.86, 2.53. No racial difference was observed for injection drug use (IDU), the strongest risk indicator for both HBV and HCV. Multivariable analyses indicated that African-American race, IDU, and multiple sex partners in the past six months were related to an increased risk of HBV, whereas IDU and smoking crack cocaine were both independently related to an increased risk of HCV. Thus, veterans with SMI--particularly African-American veterans--have high rates of HBV and HCV infection. African-American veterans have significantly higher rates of HBV than do Caucasian veterans, which persist after controlling for prominent risk behaviors.

Adult↗
PubMed2003

Psychosocial factors associated with adolescent boys' reports of dating violence.

The prevalence of dating violence, as well as its association with psychosocial factors, was examined among a nationally representative sample of 9th- through 12th-grade U.S. boys (N = 7,434) who completed the 1999 Youth Risk Behavior Survey. The dependent variable was physical dating violence; the independent variables were violence, suicide, substance use, and sexual risk behavior. Unadjusted odds ratios (OR) and 95% confidence intervals (CI) were examined. Multivariate logistic regression was used to examine all significant independent variables from the univariate models. Adjusted OR and 95% CI were examined to assess the significance of these relationships. In terms of prevalence, 9.13% of the boys reported physical dating violence. Boys who reported sad/hopeless feelings (OR = 1.68), had attempted suicide (OR = 2.22), reported fighting (OR = 1.81), had multiple sex partners (OR = 3.53), and reported nonuse of condoms (OR = 1.66) were more likely to report physical dating violence. These findings indicate that physical dating violence among adolescent boys may be a more serious problem than has previously been recognized. It was concluded that intervention programs should include a focus on boys as not only perpetrators but also recipients of dating violence.

Adolescent↗
PubMed2001

Potassium channel subunits encoded by the KCNE gene family: physiology and pathophysiology of the MinK-related peptides (MiRPs).

Voltage-gated potassium channels provide tightly Controlled, ion-specific pathways across membranes and are key to the normal function of nerves muscles. They arise from the assembly of four pore-forming proteins called alpha-subunits. To attain the properties of native currents, alpha-subunits interact with additional molecules such as the mink-related peptides (MiRPs), single-transmembrane subunits encoded by the KCNE genes. Significantly, mutations in KCNE 1, 2 and 3 have been linked either to life-threatening cardiac arrhythmia or a disorder of skeletal muscle, familial periodic paralysis. The capacity of MiRPs to partner with multiple alpha-subunits in experimental cells appears to reflect still undiscovered roles for the KCNE-encoded peptides in vivo. Here, we consider these unique peptides in health disease and discuss future research directions.

Amino Acid Sequence↗
PubMed2004

Illicit drug use and risky sexual behavior among African American and Puerto Rican urban adolescents: the longitudinal links.

The authors assessed whether (a) early illicit drug use predicted later risky sexual activity, (b) early risky sex predicted later illicit drug use, and (c) common factors affected both risky sexual behavior and illicit drug use. African American and Puerto Rican youth completed questionnaires in their classrooms at Time 1 (T1) and face-to-face interviews with the authors in their homes 5 years later at Time 2 (T2). Logistic regression analyses showed the association between T1 illicit drug use and T2 risky sexual activity and between T1 risky sexual behavior and T2 illicit drug use. With few exceptions, T1 illicit drug use was associated with all of the T2 risky sexual behaviors. After controlling for demographic factors, the authors found that multiple sex partners at T1 was not related to illicit drug use at T2. Condom use at T1 was related to illicit drug use at T2, whereas sexually transmitted diseases and adolescent pregnancy were not related to this drug use. The findings indicated that assessments of and treatments for substance use should focus on the risky sexual behaviors that seem to accompany illicit drug use.

Adolescent↗
PubMed2004

[Virology, diagnostic tests, epidemiology and transmission mechanisms of hepatitis C virus infection].

The hepatitis C virus is a human virus, classified within a third type (Hepacivirus) of the Flaviviridae family. It is a spherical virus, of approximately 50 nm in diameter, with a glycoprotein covering that contains lipids, and its genome is a simple chain RNA molecule. It is characterised by a high degree of genomic heterogeneity, whose evolutionary consequence in the long term is the appearance of genetically different viral groups, genotypes and quasispecies. There are different diagnostic techniques for detecting hepatitis C virus infection. Serological assays: the detection of specific IgG against HCV by means of enzyme immunoassays is the most practical method for diagnosing infection by this virus. Supplementary immunblot tests are employed to confirm the specificity of the results of the EIA test. Molecular assays: qualitative and quantitative techniques have been developed for detecting RNA-HCV, based on the direct detection of the virions. The pathogeny of hepatitis C is not well understood. Its world prevalence is estimated at some 3%, which is why routine screening for its detection is not recommended. HCV transmission basically occurs through percutaneous exposure to infected blood, with higher rates observed in imprisoned persons, vagabonds, intravenous drug addicts, haemophiliacs and patients on haemodialysis. Although it can be transmitted sexually, it seems that this path is not very efficient, with a greater prevalence observed in persons with multiple sexual partners. Vertical transmission is estimated at some 2%, reaching 20% in cases of maternal coinfection with HIV.

Hepacivirus↗
PubMed2004

"We have our own special language." Language, sexuality and HIV/AIDS: a case study of youth in an urban township in South Africa.

BACKGROUND: Despite the fact that most South African youth know about HIV/AIDS and how it can be prevented, there is a high prevalence of HIV/AIDS amongst youth in South Africa. Generally youth do not practice safe sex, and youth sexuality is characterised by multiple sexual partners, not using condoms and transactional sex. OBJECTIVES: To minimize the risk of HIV infection, it is necessary to understand youth sexuality. In this paper I explore youth sexuality with a specific focus on how language influences sexuality. METHODS: I use discourse analysis and qualitative research techniques. Purposive sampling, a form of non-probability sampling was used. I interviewed seventy youth individually or in groups and used in-depth semi-structured interviews. RESULTS: The use of language influences youth sexuality. Youth have developed a specialised language to talk about sex and sexuality and this language has become part of the daily discourse, so that unsafe sexual practices become norms and are justified. CONCLUSIONS: The realm of language can be a creative way for peer and HIV/AIDS educators to work with youth towards creating a healthier sexuality. However, as language always occurs in a material context, it is also necessary to work towards changing the material environment, such as poverty. This environment not only facilitates the development of a particular language but it also encourages unsafe sexual practices such as transactional sex.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Hepatitis C in obstetrics and gynecology.

Because of the risk of perinatal transmission and possible sexual transmission, it is important for obstetrician-gynecologists to keep abreast of the rapidly expanding literature on hepatitis C. Acute hepatitis C represents about 5% of all reported cases of hepatitis. Approximately 50% of acute infections progress to chronic liver disease. Risk factors for infection include intravenous (IV) drug use (21-42% of cases), previous blood transfusion (6-17%), and multiple sexual partners (6%); 40-50% of cases have no identified risk factors. The seroprevalence of anti-hepatitis C antibody is 70.8% in IV drug users, 11.6% in patients with human immunodeficiency virus, 8.8% in prostitutes, 1.2% in hospital personnel, and 0.5-1.4% in volunteer blood donors. The risk of transmission to the neonate depends on the trimester at exposure. No perinatal transmission has been shown after acute maternal infection in the second trimester. Based on the few reported cases, chronic maternal infection or acute infection in the third trimester may result in neonatal infection rates of 45-87.5%. Universal screening is probably not cost-effective because the prevalence is low and over 70% of screening tests can be falsely positive using the currently approved assay. Selective screening of high-risk patients is recommended.

Female↗
PubMedDate not supplied

Socio-demographic characteristics and risk factors among HIV/AIDS patients in Kano, Northern Nigeria.

BACKGROUND: There has been no description of the characteristics of HIV/AIDS patients that are referred to this antiretroviral treatment centre. The information could be useful in planning for prevention, care and support of people living with HIV/AIDS (PLWHA) and people affected by AIDS (PABA). OBJECTIVES: To describe the socio-demographic characteristics and identify risk factors among HIV/AIDS patients presenting to Aminu Kano Teaching Hospital. METHODS: Analysis of a prospectively collected data on 205 consecutive patients presenting to Aminu Kano Teaching Hospital from May 2002 to June 2003. RESULTS: Out of the 205 HIV positive patients seen, there were 112 (54.6%) males and 93 (45.4%) females giving a sex ratio of 1.2:1. The age range was 18 to 61 years with an overall mean S.D of 33.7 +/- [corrected] 8 years. The mean for males was 37.3 +/- [corrected] 7.8 years compared to 29.56 years for females. This difference was statistically significant (t = 8.1 DF = 201 P < 0.001). About 38.5% of the patients had secondary school education, 36.1% had tertiary education and 10.2% had primary education. Half of the patients were Hausas, 18.5% Igbos, 4.9% Idomas and 3.4% Igalas. Sixty percent were Muslims, the rest were Christians. About 64.0% were married, 23.0% were single and 11.0 % were divorced. Only 17.0% reported having multiple sexual partners. Eighteen percent claimed they use condoms always, 67.8% occasionally and 8.3% never. Twenty percent of the patients had previous blood transfusion. None reported intravenous drug abuse or homosexuality. CONCLUSION: The need for a sustained multi-sectoral preventive effort and the scaling up of treatment and community care initiatives were stressed.

Acquired Immunodeficiency Syndrome↗
PubMed2002

[Urethral discharge in Morocco: prevalence of microorganisms and susceptibility of gonococcos].

We studied 422 patients with urethral discharge recruited from 4 sentinel sites in Morocco to determine sociodemographic characteristics, history of STI infection, infecting organism and antibiotic susceptibility of Neisseria gonorrhoeae. The mean age of the sample was 28 years (range 16-67 years), and most were single, had multiple sex partners without taking protective measures and came from all social backgrounds; 59.9% had a history of a previous STI. The majority (87%) of the infections were the acute form. By polymerase chain reaction of urine samples of 399 patients, 41.6% had N. gonorrhoeae infection, 6.3% Chlamidia trachomatis and 10.8% both organisms; in 41.4% no organism was identified. N. gonorrhoeae was strongly susceptible to ciprofloxacin.

Acute Disease↗
PubMed2004

Acceptance rate of HIV testing among women seeking induced abortion in Benin City, Nigeria.

Although the campaign against HIV has been intensive, it has been focused mainly on the public health implications. Little or no attention is specifically directed at encouraging the public to know their HIV serostatus. The actual public health burden due to this infection is therefore not known. Accurate data on the health burden is critical for national planning on preventive and other interventional measures. Using a semi-structured self-administered questionnaire, we interviewed 1051 women seeking induced abortion in four randomly selected private clinics in Benin City between January and September 2002. The blood samples of those who accepted HIV testing were collected and screened at the University of Benin Teaching Hospital. The women were aged between 16 and 46 years (mean 31.1+/-6.7 years). One hundred and thirty seven women (13%) accepted HIV testing. Of the 1051 women, 1001 (95.2%) had multiple sexual partners and 722 (68.8%) regularly practiced unprotected sex. All were aware of HIV/AIDS. The older women were more likely to accept voluntary HIV testing than the younger ones. Acceptance rate for voluntary HIV testing was low in both the employed and unemployed and much lower among full time housewives (p = 0.01). We therefore recommend that HIV campaign programmes should include strategies aimed at arousing public interest in voluntary HIV testing.

AIDS Serodiagnosis↗
PubMedDate not supplied

[Behavior of vaginal trichomoniasis in a group of adolescents].

275 adolescents aged 10-19 receiving attention at the infantojuvenile department of pregnancy interruption and of sexually transmitted infections of "Ramón Gonzalez Coro" and "Eusebio Hernández" Gynecoobstetric Teaching Hospitals, both in Havana City, were studied from August, 1999, to September, 2000, aimed at knowing the behavior of the infection caused by Trichomonas vaginalis in this population group. The results yielded 18.1 % of positivity to parasitosis. It was proved by the calculation of relative risk that the adolescents that had an active or past infection due to Trichomonas vaginalis have more possibilities of getting an infection produced by human Papilomavirus than those without this condition. It was demonstrated that 78 (28.3 %) of the total of patients examined had some type of lesion in the uterine cervix. Some risk factors as non using condon, having multiple sexual partners and the early beginning of sexual relations, which may facilitate the adquisition of this parasitosis in a population so vulnerable as the adolescents, were made known.

Adolescent↗
PubMed2005

Sexual behaviors and condom use of HIV-infected men and women of color attending a treatment and care clinic.

INTRODUCTION: Limited data are available regarding high-risk sexual behaviors among HIV-infected African Americans and Latinos who receive ongoing care in clinical settings. OBJECTIVES: To identify high-risk sexual behaviors and risk factors for consistent condom use and Chlamydia trachomatis (CT) infection. METHODS: Cross-sectional study data from interviewer-administered surveys and CT tests. RESULTS: Of 179 sexually active adults in the study, 35% had multiple sex partners, 37% had a partner with unknown HIV status and 49% used condoms consistently. Compared with men, women had fewer partners and were less likely to use condoms with partners of unknown HIV status. Men who have sex with men (MSM) had more partners and more partners with unknown HIV status compared with non-MSM. On multivariate analysis, drug use and having an HIV-infected partner were associated with less consistent condom use. CT prevalence was low (2%). CONCLUSION: This study identified ongoing high-risk sexual behaviors among a clinic-based group of African-American and Latino HIV-infected men and women. The clinical setting may be an ideal place for implementation of secondary prevention interventions.

Adult↗
PubMed2004

Vaginal discharge: perceptions and health seeking behavior among Nepalese women.

OBJECTIVES: To understand women's perceptions and health seeking behavior and the association between vaginal discharge, clinical signs and laboratory findings as a presentation of sexually transmitted diseases (STD). METHODS: We conducted five focus group discussions with women attending the outpatient department in a large public hospital in Katmandu, Nepal, during May-June 1997. We also interviewed seventy women presenting with vaginal discharge to the same hospital, through structured questionnaire. Women presenting with discharge were also examined and investigated for six common sexually transmitted diseases and reproductive tract infections. RESULTS: In the focus groups vaginal discharge was identified as a common disease distinct from STDs, for which women can seek treatment. STDs were considered as social diseases transmitted to women through multiple sexual partners and not from husband. Patients with vaginal discharge preferred traditional healers and pharmacist. Clinical signs were inconclusive for type of infection. Simple laboratory tests identified etiologic agent in 64 (91%) patients and the three commonest infections were Moniliasis (78%), Bacterial Vaginosis (25%) and Trichomoniasis (17%). CONCLUSION: Vaginal discharge may be used as a risk marker for identification of STDs by Primary Health Workers. Low cost investigations should be made available at the secondary care level for identification of most common Reproductive Tract Infections. Communication campaigns should target the misconceptions that exist in the communities local context related to the prevention, treatment and control of vaginal discharge and STDs.

Adult↗