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D Fine

Publications and source records attributed to D Fine.

33 records · Page 2Linked to original sources

Adherence and blood-pressure response to hypertension treatment.

2 years of experience in the first phase of a large cooperative national hypertension programme yielded data indicating that a good level of patient adherence can be achieved and that satisfactory blood-pressure control can be maintained long term. For 116 participants, all employed persons, dropout in the first year was 20% but only 3% dropped out in the second year. At the second annual examination, 82% of those still in the programme had diastolic pressures under 90 mm Hg, with an average reduction of 18 mm Hg. Thus, nearly two-thirds (64%) of all patients originally enrolled were both active and with normal levels of blood-pressure after two years. Only 18% of active programme-treated patients had diastolic pressure 90 mm Hg or higher at the second anniversary in contrast with 33% of patients referred to their own doctors. In programme-treated patients, standard medication was used; diuretics effectively lowered blood-pressure in a third of patients, and diuretics plus reserpine were effective for another 20%. Special features of the programme included assistance to physicians by health counsellor therapists. Methods for achieving a high adherence-rate and satisfactory blood-pressure control probably have wider applicability.

Adult

Effects of storage of granulocytes on their fate in vivo.

During storage of granulocytes, the chemotactic response deteriorates first and to the greatest extent. Because in vitro assays such as chemataxis may not adequately predict the fate of granulocytes in vivo, we determined the intravascular kinetics and migration into skin windows of indium-111 labeled granulocytes. Granulocytes stored for 24 hours at either 1 to 6 or 20 to 24 degrees C had significantly reduced intravascular recoveries and migration into skin windows. Granulocytes stored for only eight hours at 20 to 24 degrees C had normal intravascular recovery and migration into skin windows. In granulocytes stored for eight hours at 1 to 6 degrees C, the intravascular recovery and migration into skin windows were reduced. Because of the method of calculating migration, this observation suggests that granulocytes which do circulate after storage at 1 to 6 degrees C had decreased ability to migrate into the skin windows. Granulocytes can be stored for up to eight hours at 20 to 24 degrees C without reduction in their ability to circulate and migrate to a site of inflammation. However, since many practical issues in granulocyte storage are not resolved, granulocytes should be transfused as soon as possible after collection.

Adult

Sexual abuse as a factor in adolescent pregnancy and child maltreatment.

Two-thirds of a sample of 535 young women from the state of Washington who became pregnant as adolescents had been sexually abused: Fifty-five percent had been molested, 42 percent had been victims of attempted rape and 44 percent had been raped. Compared with adolescent women who became pregnant but had not been abused, sexually victimized teenagers began intercourse a year earlier, were more likely to have used drugs and alcohol and were less likely to practice contraception. The abused adolescents were also more likely to have been hit, slapped or beaten by a partner and to have exchanged sex for money, drugs or a place to stay. Young women in the abused group were also more likely to report that their own children had been abused or had been taken from them by Child Protective Services.

Adolescent

Selective screening for chlamydial infection in women: a comparison of three sets of criteria.

Selective screening has been associated with marked declines in the prevalence of chlamydial infection, the most common bacterial sexually transmitted disease (STD) in the United States. A comparison of the performance of different selective screening criteria in three groups of family planning and STD clinic clients shows that criteria recommended by the Centers for Disease Control and Prevention performed well overall, detecting 88-89% of infections by screening 58-74% of women. Criteria based on age alone performed best among low-risk clients with a low prevalence of chlamydial infection, particularly when all women younger than age 25 were screened (sensitivity, 84-92%); the age-based criteria still required screening only 59-71% of all women. Selective screening criteria should be based on age, risk profile and chlamydia prevalence in specific clinical settings, and should be reevaluated as chlamydia prevalence declines.

Adolescent