PubMed Health⌕ Search

Biomedical subjects

C Hoff

Publications and source records attributed to C Hoff.

At least 37 records · Page 2Linked to original sources
PubMed1998

Methods used to diagnose premature rupture of membranes: a national survey of 812 obstetric nurses.

OBJECTIVE: To identify methods used to diagnose premature rupture of membranes (PROM). METHODS: A 14-item questionnaire was mailed to 1992 registered nurses certified in inpatient obstetrics to determine information on practice facility, obstetric services, procedures used to obtain vaginal fluids for testing, and methods used to diagnose PROM. RESULTS: A total of 812 (40.8%) surveys were available for analysis. Of tests used to confirm PROM, observation of pooling fluid in the posterior fornix and fern tests were much more likely to be used in teaching and military hospitals and in facilities with tertiary obstetric services than in private hospitals (all P values < .001). To obtain vaginal fluids for fern and nitrazine testing, the dry glove method (ie, insertion of a gloved hand or nitrazine strip into the vagina) was used significantly more often in private hospitals than in teaching or military facilities (P < .001). In addition, the dry glove method was used significantly more often (P < .001) and the speculum examination was used less often (P < .001) to collect vaginal fluids for testing when private physicians performed more than 75% of deliveries at a particular hospital. In contrast, vaginal fluid was obtained during a sterile speculum examination more often in facilities in which more than 75% of deliveries were performed by residents (P < .001), and/or when more than 75% of speculum examinations were performed by nursing personnel (P < .001). Multiple linear regression analyses indicated that observation of pooling fluid and use of the fern test were significantly associated with hospital type, percentage of deliveries by private physicians, and percentage of speculum examinations performed by nursing personnel (all P values < .001). CONCLUSION: A sterile speculum examination is used more often to obtain vaginal fluids for testing and to diagnose ruptured membranes in teaching or military facilities and when nursing personnel have been trained in speculum examinations.

Female↗
PubMed1998

Cerebrospinal fluid shunt infections in infants and children in Mobile, Alabama.

Cerebrospinal fluid shunt systems are used to treat hydrocephalus in infants and children; unfortunately, some shunt systems become infected. We sought to define the epidemiology of shunt infections and shunt survival prior to infection at our institution. We identified 268 shunt procedures performed from January 1990 to June 1996 in 145 patients. There were 29 episodes of shunt infection for an incidence of 10.8% per procedure and 13.1% per patient. Staphylococcus epidermidis was the most common isolate recovered. The probability of shunt infection was highest during the first 8 weeks after a shunt procedure and subsequent infection was less likely after 28 weeks.

Adolescent↗
PubMed1996

Decisions to get HIV tested and to accept antiretroviral therapies among gay/bisexual men: implications for secondary prevention efforts.

The objective of this study was to report prevalence rates of adherence by HIV-seropositive individuals to medical recommendations for the treatment of HIV infection, a behavioral pattern referred to as AIDS secondary prevention. We report cross-sectional data (n = 2,593) from two household-based and two bar-based samples of gay/bisexual men, gathered in 1992 in Tucson, Arizona, and Portland, Oregon. The main outcome variables were prevalence of HIV antibody testing and adherence to recommended secondary prevention behaviors to prevent onset of AIDS symptoms. Approximately one-third of the gay/bisexual men in these samples do not know their current HIV status. Of the gay/bisexual men who do know that they are HIV-seropositive, approximately three-fourths adhere to each of the secondary prevention recommendations, as appropriate to their stage of disease progression. In a multivariate logistic model, three variables distinguished between HIV-seropositive men who did and did not adhere: perceived antiviral treatment norms (OR = 1.4, CI = 1.1-1.7), perceived efficacy of secondary prevention treatments (OR = 1.4, CI = 1.1-1.7), and quality of the relationship with one's health-care provider (OR = 2.5, CI = 1.6-4.0). These findings indicate that efforts to support AIDS secondary prevention behaviors can occur not only through health education to change the perceptions of at-risk communities about the options available to delay the onset of opportunistic infections among HIV-seropositive individuals but also by enhancing effective doctor/patient communication.

AIDS Serodiagnosis↗
PubMed1996

Metabolism of [ring-U-14C] agaritine by precision-cut rat, mouse and human liver and lung slices.

Agaritine [(beta-N-[gamma-L(+)glutamyl]-4-hydroxymethylphenylhydrazine] is present in the common cultivated mushroom Agaricus bisporus and several agaritine derivatives have been shown to produce tumours in experimental animals. In this investigation the metabolism of [ring-U-14C]agaritine has been studied in precision-cut rat, mouse and human liver slices and in precision-cut rat and mouse lung slices. To confirm the functional viability of the tissue slice preparations, the metabolism of 7-ethoxycoumarin was also studied. Liver and lung slices from all species metabolized 50 microM 7-ethoxycoumarin to 7-hydroxycoumarin, which was conjugated with D-glucuronic acid and sulfate. Incubation of rat, mouse and human liver slices, and rat and mouse lung slices with 25 microM [14C]agaritine resulted in a time-dependent formation of metabolite(s), which bound covalently to tissue slice proteins. Agaritine metabolite covalent binding was greater in mouse liver than in rat and human liver slices and was greater in mouse lung than in rat lung slices. No correlation was observed between agaritine metabolite covalent binding and tissue slice gamma-glutamyltransferase activity. Additional studies with mouse liver slices showed that [14C]agaritine was also metabolized to a number of unknown polar metabolites. These results demonstrate that agaritine can be metabolized by enzymes present in mammalian liver and lung.

Animals↗
PubMed1996

HIV risk among Latino gay men in the Southwestern United States.

Using two different methods-bar and community household sampling-159 Latino gay men were recruited in the city of Tucson, Arizona. In addition to demographics, the study questionnaire assessed participants' sexual activity during the last 30 days with primary and nonprimary partners, condom use in the last year, and eight psychosocial constructs that have been predictive of HIV risk in different studies of (mostly white) gay/bisexual men. Questionnaires were available only in English; this Latino sample is thus likely to overrepresent highly acculturated, English-speaking men. Results show that 22% of the sample engaged in unprotected anal intercourse with nonmonogamous partners during the last 30 days; 51% of the sample reported at least one instance of unprotected anal intercourse during the last year. Of those men who practiced any anal intercourse during the last 30 days, 67% practiced unprotected anal intercourse with primary partners and 44% practiced unprotected intercourse with casual partners. Thus, the majority of Latino gay men who practiced anal intercourse in the month prior to the interview were not using condoms. Men who practiced unprotected intercourse with nonmonogamous partners reported lower annual incomes and were less educated. Two cognitive variables (behavioral intentions and perceptions of self-efficacy and self-control) and two behavioral variables (sex under the influence of alcohol and/or drugs and sex in public environments) emerged as the most important correlates of HIV risk.

Adult↗
PubMed1995

Comparisons of risk factors for HIV-1 infection in Jefferson and Mobile County, Alabama.

A study of the Alabama state AIDS database was conducted to determine whether differences exist in demographic and risk characteristics between patients with HIV-1 in Jefferson and Mobile County. The authors found that the age distribution of patients with HIV-1, the percent of those having AIDS, and the percent of those surviving were very similar. However, significant differences existed in patient-reported risk factors in the two counties. Homosexuality was reported as the major risk factor in both counties. However, there was proportionately more homosexuality reported in Jefferson County and, conversely, more heterosexuality reported in Mobile. There also were significant differences in race and gender distributions in the two counties. This was due in part to the proportionately higher prevalence of African American females of reproductive age with HIV-1 in Mobile County. This may pose a significantly greater risk for pediatric AIDS among African American females in Mobile County.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Predictors of repeat HIV testing among gay and bisexual men.

OBJECTIVE: To examine the prevalence and predictors of repeat HIV testing. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional data from two random household-based and bar-based samples of gay/bisexual men in two medium-size cities (Tucson, Arizona and Portland, Oregon) with substantial numbers of AIDS cases, in 1992 (n = 2602). MAIN OUTCOME MEASURE: The prevalence and predictors of repeat testing among men who reported being HIV-tested at least once but not being HIV-positive (n = 1583). RESULTS: In total, 51% of the sample had been tested three or more times, and 15% were tested more than once every 6 months. Men with higher risk were more likely to be repeatedly tested, although oral but not anal risk was a significant predictor of repeat testing in regression analyses. Men who did not know the HIV status of their primary partner were less likely to be repeatedly tested. Men who perceived that social norms favored secondary prevention, specifically adherence to medical recommendations for the treatment of HIV infection, and who communicated more often about testing were more likely to be repeatedly tested. CONCLUSIONS: Policy and clinical recommendations for repeat testing must be based on consideration of the complexity and multi-faceted nature of repeat testing. For some individuals, repeat testing may play a legitimate role in HIV prevention by reinforcing safe behavior and providing confirmation of HIV-negative status. However, for others repeat testing may indicate a need for different or more intensive interventions to encourage safe sex.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The effects of antenatal steroid use in premature rupture of membranes.

We sought to determine if antepartum steroid treatment offers any clinical benefits to patients with premature rupture of membranes. One hundred and forty-five maternal-neonatal pairs were studied. Forty-five maternal-neonatal pairs with premature, preterm rupture of membranes received steroids during 24-35 weeks' gestation. One hundred maternal-neonatal pairs received no antenatal steroids. The 2 groups were identical with regard to gestational age at rupture of membranes, gravity, parity, race, fetal gender, socioeconomic status, smoking, and preterm labour risk factors. Study of the data revealed that maternal chorioamnionitis was less frequent in the steroid group (p < 0.001). Bronchopulmonary dysplasia (oxygen dependent at discharge at term gestational age) was less frequent in the steroid group (p < 0.05). The remainder of the data revealed no statistically significant differences in preterm delivery rate, necrotizing enterocolitis, respiratory distress syndrome, intraventricular haemorrhage rate or severity of haemorrhage, hospital days, latency to delivery, or ventilator days. Antepartum steroid use in preterm rupture of membranes appears to offer clinical benefit in premature infants by lessening the rate of bronchopulmonary dysplasia in those infants receiving antepartum steroids.

Betamethasone↗
PubMed1994

Intraoperative duplex monitoring of the carotid bifurcation for the detection of technical defects.

OBJECTIVES: Intraoperative Duplex examination can be used to identify technical imperfections during carotid endarterectomy. The objectives of this study were: (1) to evaluate the technical feasibility of intraoperative Duplex; (2) to compare Duplex findings with contrast arteriography; (3) to correlate intraoperative Duplex findings with postoperative complications and with Duplex data obtained during follow-up. DESIGN: Prospective clinical study. SETTING: Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands. MATERIALS: 44 patients underwent Duplex scanning at the completion of carotid endarterectomy. In addition intraoperative arteriography was performed in the first 16 consecutive patients. Follow-up included a Duplex examination at three monthly intervals during the first postoperative year. OUTCOME MEASURES: Technical defects and flow disturbance at the time of surgery, and postoperative restenosis. RESULTS: At contrast arteriography a distal intimal ridge with 15-20% diameter reduction was observed in two, an occlusion of the external carotid artery in three and moderate kinking in one patient. All abnormalities were identified at Duplex imaging. In none of the cases were the Duplex findings considered an indication to re-explore the endarterectomised internal carotid artery. Postoperative complications occurred in six patients: three strokes, two transient ischaemic attacks and two internal carotid occlusions (in one patient combined with a stroke). Severe spectral broadening (spectral class D) correlated significantly with early postoperative complications (p = 0.027). In contrast, moderate defects on Duplex imaging did not correlate significantly with early complications. Duplex examination during the first year of follow-up demonstrated recurrent stenosis in four patients. Intraoperative spectral broadening did not correlate significantly with the development of common or internal carotid restenosis. However, external carotid recurrent stenosis was positively related to intraoperative flow disturbance (p = 0.0003). CONCLUSION: Duplex scanning is easy to use after completion of carotid endarterectomy. There is good agreement between intraoperative Duplex scanning and contrast arteriography. Extensive spectral broadening of the Doppler velocity signal is associated with an increased prevalence of early postoperative complications. Restenosis at follow-up appears to be related to severe flow disturbance as was demonstrated for the external carotid artery.

Blood Flow Velocity↗