Biomedical subjects

F M Biro

Publications and source records attributed to F M Biro.

At least 37 records · Page 2Linked to original sources

PubMed1998

Changes in self-esteem in black and white girls between the ages of 9 and 14 years. The NHLBI Growth and Health Study.

PURPOSE: We examined changes in self-esteem and feelings of competence with physical appearance and social acceptance over approximately 5 years in 1166 white and 1213 black girls, aged 9 and 10 years at baseline. METHODS: Maturation stage and body mass index (BMI) were assessed annually. Biennially girls completed Harter's Self-Perception Profile for children. Changes were analyzed in the context of race, sexual maturation, BMI, and household income. Longitudinal regression models were used to compare trends with age in global self-worth, physical appearance, and social acceptance. RESULTS: Mean global self-worth showed little change over ages 9-14 years in blacks (p = 0.09) but decreased in whites (p < 0.001). Mean physical appearance scores for both races declined between ages 9 and 14 years (blacks, p < 0.001; whites, p < 0.001). Mean social acceptance scores increased for both races between ages 9 and 14 years (blacks, p < 0.001; whites, p < 0.001). For all three scores, these changes differed between blacks and whites (all three p values, < or = 0.002). Adjustment for maturation stage, BMI, and household income did not alter the significance or direction of racial differences in the changes with age in global self-worth and physical appearance scores. Self-worth, physical appearance, and social acceptance scores decreased with increasing BMI. Decreases in physical appearance and social acceptance scores with increasing BMI were smaller in blacks than in whites (p < 0.05). After adjustment for maturation stage and household income, racial differences in social acceptance scores depended on BMI (p < 0.05) but not on age (p = 0.008). CONCLUSIONS: This article reports the first data on self-esteem scores by age for a large population of black girls aged 9 and 14 years and concludes that self-esteem does not follow the same developmental pattern in black as in white girls. A reason for black girls' higher and more stable self-worth and their greater satisfaction with their physical appearance compared to white girls may be racial differences in attitudes toward physical appearance and obesity.

Adolescent↗

PubMed1998

Longitudinal correlates of change in blood pressure in adolescent girls.

The objective of this study was to assess the longitudinal changes in blood pressure in black and white adolescent girls and evaluate potential determinants of changes in blood pressure, including sexual maturation and body size. A total of 1213 black and 1166 white girls, ages 9 or 10 years at study entry, were followed up through age 14 with annual measurements of height, weight, skinfold thickness, stage of sexual maturation, systolic and diastolic blood pressures, and other cardiovascular risk factors. Average blood pressures in black girls were generally 1 to 2 mm Hg higher than in white girls of similar age over the course of the study. Age, race, stage of sexual maturation, height, and body mass index (kg/m2) were all significant univariate predictors of systolic and diastolic blood pressures in longitudinal regression analyses. Black girls had a significantly smaller increase in blood pressure for a given increase in body mass index compared with white girls. The predicted increases in blood pressure per unit increase in body mass index (mm Hg per kg/m2) were as follows: systolic, 0.65+/-0.04 in whites and 0.52+/-0.04 in blacks (P<.001); diastolic fourth Korotkoff phase, 0.31+/-0.04 in whites and 0.15+/-0.03 in blacks (P<.001); and diastolic fifth Korotkoff phase, 0.31+/-0.05 in whites and 0.16+/-0.04 in blacks (P<.001). Understanding of the determinants of the racial differences in blood pressure could provide the rationale for future interventions to reduce the excess cardiovascular mortality in black compared with white women.

Adolescent↗

PubMed1997

Lipoprotein and apolipoprotein differences in black and white girls. The National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To define racial differences in lipoprotein and apolipoprotein levels in girls aged 9 to 10 years. DESIGN: Baseline analysis of a prospective cohort study. SETTING: Three clinical sites. SUBJECTS: A total of 1871 black and white girls, aged 9 to 10 years, with complete maturation data (pubic hair and areolar development and menarche) and an 8-hour fast before blood draw. MAIN OUTCOME MEASURES: Anthropometric measures and serum lipid, lipoprotein, and apolipoprotein levels. RESULTS: All analyses were adjusted for maturational differences between blacks and whites (areolar or pubic hair development and menarche). The mean body mass index was marginally higher in black girls than in white girls (18.9 vs 18.3 kg/m2; P = .002), while the sum of skinfolds (34.5 vs 34.8 mm; P = .77) was equivalent. However, both body mass measures were skewed higher at the upper percentiles in black girls. The low-density lipoprotein cholesterol level was similar between black and white girls. Mean triglyceride values were higher in white girls than in black girls (0.92 vs 0.79 mmol/L [81 vs 70 mg/dL]; P < .001); however, these differences were most pronounced in the upper percentiles. Conversely, mean high-density lipoprotein cholesterol and apolipoprotein A-I levels were higher in black girls than in white girls (1.44 vs 1.37 mmol/L [56 vs 39 mg/dL] and 147 vs 138 mg/dL, respectively; both P < .001); and again the differences were most evident at the upper end of the distributions. CONCLUSIONS: Racial differences in the mean levels of triglycerides, high-density lipoprotein cholesterol, and body mass in girls in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS) at age 9 to 10 years were predominantly the result of differences observed at the upper end of the distributions. The reported black-white differences for mean high-density and low-density lipoprotein cholesterol and triglyceride levels in adult women are comparable to NGHS results. Distributional characteristics of these risk factors as well as trends in lipids, lipoproteins, and apolipoproteins, will be evaluated in an ongoing longitudinal assessment that covers the full maturational period.

Apolipoproteins↗

PubMed1997

Predictors of severity of acne vulgaris in young adolescent girls: results of a five-year longitudinal study.

OBJECTIVES: The objectives of this study were to determine which factors in early pubertal girls might be predictive of later, severe facial acne. STUDY DESIGN: The study was a 5-year longitudinal cohort study, with yearly visits from 1987 through 1991, in a volunteer sample of 439 black and 432 white fourth- and fifth-grade girls with consent from their legal guardians. The subjects were recruited from public and parochial schools in Cincinnati, Ohio. The degree of facial acne was classified annually as mild, moderate, or severe. Blood samples were obtained at the first, third, and fifth years of the study. Using the acne status during the fifth year of the study as the outcome variable, we determined the contributions from the prior acne status and the serum levels of dehydroepiandrosterone sulfate (DHEAS), testosterone, free testosterone (FT), estradiol (E2), progesterone, and testosterone-estrogen binding globulin (TEBG) and compared the results at various ages and at times before and after menarche. RESULTS: No racial differences in acne or hormone levels were found. There was a progressive increase in the number of acne lesions with age and maturation. The girls exhibited many more comedonal than inflammatory acne lesions, regardless of age. The girls in whom severe acne developed by the fifth year of the study had significantly more comedones and inflammatory lesions than girls with mild or moderate acne, as early as age 10 years, approximately 2 h years before menarche, a time when their degree of acne was mild. Girls with mild comedonal acne had significantly later onset of menarche (12.5 compared with 12.2 years) than girls with severe comedonal acne. Girls in whom severe comedonal acne developed had significantly higher levels of serum DHEAS and, in a longitudinal analysis, somewhat higher levels of testosterone and FT in comparison with girls who had mild or moderate comedonal acne. Serum E2, testosterone/E2, progesterone, and TEBG values were no different in girls with severe compared with mild or moderate comedonal acne. CONCLUSIONS: The early development of comedonal acne may be one of the best predictors of later, more severe disease. The adrenal hormone DHEAS appears to play an important role in the initiation of acne. DHEAS, testosterone, and FT are associated with the perpetuation of severe comedonal acne. Early recognition of young girls at risk of having severe comedonal acne may enable the clinician to intervene and thus prevent unwanted sequelae.

Acne Vulgaris↗

PubMed1997

Heterosexual romantic relationships and sexual behaviors of young adolescent girls.

PURPOSE: To compare the heterosexual romantic relationships of a cohort sexually experienced and sexually inexperienced adolescent girls, to describe the perceptions of the appropriateness of the age of first intercourse, and to evaluate the reasons why sexually experienced girls chose to have sexual intercourse the first and the most recent times they had sexual intercourse. METHODS: Girls (n = 174) with a mean age of 14.5 years were recruited from an urban-based adolescent clinic to participate in a longitudinal study of psychosexual development. The subjects were interviewed regarding their views about relationships and sexual behaviors. For the purposes of this study, data were analyzed from the first wave of data collection. RESULTS AND CONCLUSIONS: The results of this study revealed that sexually experienced girls were more likely than sexually inexperienced ones to share unique information and spend time with their boyfriends, and to anticipate that their relationships would last longer. Regardless of sexual experience, 35% of their relationships were not mutually exclusive, which places the sexually experienced girls at risk for sexually transmitted infections. Most of the girls felt that they had been "too young" at the time of first intercourse. The reasons the adolescent girls gave for having intercourse the first time and the most recent time were correlated. It would be useful to incorporate the results of this study into subsequent research which identifies strategies to aid girls to postpone the initiation of intercourse, and maintain exclusive sexual relationships. Helping sexually experienced girls to consider why they have had intercourse in the past can aid future decision-making.

Adolescent↗

PubMed1997

Adolescent girls' understanding of Papanicolaou smear results.

STUDY OBJECTIVE: Human papillomavirus (HPV) urogenital infections are common in sexually active adolescents. Previous research has indicated that adolescent girls do not reliably report histories of HPV infection. This study examined whether asking an adolescent girl if she had ever had an abnormal Papanicolaou (PAP) smear was a good screening question for evidence of HPV urogenital infection. DESIGN: The responses to the question about abnormal PAP smears, were compared with their charts for documented abnormal PAP smear, HPV infection, and sexually transmitted infection. SETTING: An urban, hospital-based adolescent clinic. PARTICIPANTS: Fifty adolescent girls (mean age, 14.8 years). MAIN OUTCOME MEASURES: Degree of agreement (kappa statistic). RESULTS: Using a kappa statistic, reported history of an abnormal PAP smear had "fair" agreement with documented dysplasia on PAP smear and "moderate" agreement with documented HPV infection (i.e., either condyloma on PAP smear or genital warts noted on examination). This reported history of an abnormal PAP smear agreed better with documented HPV infection than with documented dysplasia on PAP smear. CONCLUSIONS: There appears to be considerable confusion among adolescent girls regarding their PAP smear results. Care providers need to be sensitive to this when they are collecting historical information and when they are diagnosing HPV infection or an abnormal PAP smear.

Adolescent↗

PubMed1997

Seroprevalence of herpes simplex virus types 1 and 2 and cytomegalovirus in adolescents.

We determined the prevalence of herpes simplex virus (HSV) and cytomegalovirus (CMV) antibodies in a cohort of adolescents 12 to 22 years of age in anticipation of the development of vaccines to control HSV and CMV infections. For the overall study population, we found that 62% were seropositive for HSV type 1 (HSV-1), 12% were seropositive for HSV type 2 (HSV-2), and 65% were seropositive for CMV. Race was not related to HSV-1 seropositivity, but African-American adolescents were more likely than Caucasian adolescents to be seropositive for HSV-2 and CMV. Girls also were more likely than boys to be seropositive for HSV-2 and CMV. For boys, history of a sexually transmitted disease was identified as a risk factor for HSV-2 seropositivity; for girls, a greater number of sexual partners increased the risk of being seropositive for HSV-2. Our data demonstrating a high prevalence of infection during adolescence suggest that immunization for HSV-1, HSV-2, and CMV may need to occur in childhood.

Adolescent↗

PubMed1997

Adolescent girls' perceived prevalence of sexually transmitted diseases and condom use.

Little is known concerning sexually experienced and inexperienced adolescent girls' perceptions of the prevalence of condom use and sexually transmitted diseases (STDs). Girls (n = 174; 41% sexually experienced) rated the prevalence of condom use among friends and STDs among male and female friends and adolescents in general. Girls perceive the prevalence of STDs similarly across both gender and level of familiarity. For the most part, however, the girls perceived the prevalence among boys and girls more similarly than among friends and adolescents in general. No significant differences were found between sexually experienced and inexperienced girls in perceptions of condom use prevalence, but girls with a history of STD perceived condoms as used less frequently. Girls with an STD history perceived STDs as the most prevalent, followed by sexually inexperienced girls and then sexually experienced girls without a history of an STD. After an adolescent girl initiates sexual intercourse, STD experience could be a key variable in affecting her perceptions. Prevention programs can incorporate an understanding of patients' perceptions of condom use and STDs.

Adult↗

PubMed1997

Impact of demographics, sexual history, and psychological functioning on the acquisition of STDS in adolescents.

Sexually transmitted diseases (STDs) are associated with significant morbidities for adolescents. This study sought to determine the relationship of demographic characteristics, sexual history, and psychological characteristics to actual acquisition of STD. Adolescents were recruited from their source of primary care: 44 males and 88 females matched on age and race. A series of logistic regression analyses were used to determine which of the independent variables were significantly associated with self-reported STD occurrences. When age, race, and gender were pretested, older age and being female were found to be associated with more episodes. The final model consisted of older age, female gender, greater number of lifetime partners, perceived greater frequency of STDs among adolescents in general, less negative feelings about STD acquisition, and being less likely to believe your friends would think you were bad. The findings indicate that acquisition of an STD is related to the demographic characteristics of age and gender, as well as to the number of lifetime partners and attitudes about STD acquisition. This information can be used to develop intervention programs.

Adolescent↗

PubMed1996

Differential classification of blood pressure by fourth and fifth Korotkoff phases in school-aged girls. The National Heart, Lung, and Blood Institute Growth and Health Study.

The use of the onset of the fourth (K4) or fifth (K5) Korotkoff phase to determine diastolic blood pressure in children has been controversial; most recently, the Second Task Force recommended the use of K4 for children up to age 13 years and K5 for children age 13 and above. We performed a cross-sectional analysis of 1,155 nine-year old (53% white and 47% black) and 1,224 ten-year old girls (45% white and 55% black) in the National Heart, Lung, and Blood Institute Growth and Health Study (NGHS). The mean blood pressures for the first, fourth, and fifth Korotkoff phases were 100.1 (+/- 8.9) mm Hg, 66.6 (+/- 9.8) mm Hg, and 56.8 (+/- 11.8) mm Hg for nine-year-olds and 102.8 (+/- 9.0) mm Hg, 68.1 (+/- 10.1) mm Hg, and 58.1 (+/- 11.9) mm Hg for ten-year-olds. The mean difference between K4 and K5 was 9.9 (+/- 6.4) mm Hg. The correlation between K1 and K4 was 0.45, between K1 and K5 was 0.34, and between K4 and K5 was 0.84. Elevation of blood pressure was defined at or above the 95th percentile based on the NGHS distribution for K1, K4, or K5; the relative risk of having an elevated K1 was 10.1 if K4 was elevated and 5.9 if K5 was elevated. Of the 159 subjects potentially classified with elevated diastolic pressure, 95 subjects (60%) would be classified differently depending on whether K4 or K5 was used to define elevated diastolic blood pressure. The choice of the onset of the fourth or fifth Korotkoff phase for determining diastolic blood pressure in children may have important implications for which individuals are classified as having hypertension.

Blood Pressure↗

PubMed1996

Adolescents' reasons for and experience after discontinuation of the long-acting contraceptives Depo-Provera and Norplant.

PURPOSE: The objectives of this study were to examine the reasons for discontinuation of the long-acting contraceptives Depo-Provera and Norplant in adolescents, and to assess the adolescents' experience after discontinuation of the methods. METHODS: A total of 35 adolescents [gynecologic age 4.7 +/- 0.3 years, and body mass index (BMI) 24.2 +/- 0.6] who discontinued Depo-Provera, and 31 adolescents (gynecologic age 3.4 +/- 0.3 years, BMI 24.1 +/- 0.9) who discontinued Norplant were periodically assessed during use of the methods and up to 12 months after discontinuation. RESULTS: The most common reasons for discontinuation of both Norplant (after 21.8 +/- 1.6 months of use) and Depo-Provera (9.2 + 0.9 months of use) were irregular menstrual bleeding (64%), weight gain (41%), and increased headaches (30%). Resumption of menstrual regularity and dysmenorrhea was noted sooner after discontinuation of Norplant, compared with Depo-Provera. The increase in BMI noted at discontinuation of Depo-Provera (1.1, P = .0005) and Norplant (1.3, P = .03) persisted up to 6 months after discontinuation of either method (0.6, P = .01 post-Depo-Provera discontinuation; and 0.9, P = 0.02 post-Norplant discontinuation). Only 62% of the adolescents reported no break in contraceptive practice. The condom was the most popular method (37%) after discontinuation of Depo-Provera, and oral contraceptive (39%) after discontinuation of Norplant. The cumulative conception proportion reached 0.93 at 12 months after discontinuation of Norplant, and was significantly higher (P = .01) compared with the cumulative proportion of conception after discontinuation of Depo-Provera (P = .50). CONCLUSIONS: Health care providers should aggressively manage physical problems associated with Depo-Provera and Norplant use, and expedite the transition to a new contraceptive method to minimize the high pregnancy rate observed after discontinuation of these methods in adolescents.

Adolescent↗

PubMed1996

Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents.

OBJECTIVES: The purpose of the study was to examine whether dietary supplementation with omega-3 fatty acids can relieve symptoms of dysmenorrhea in adolescents. STUDY DESIGN: Forty-two adolescents with dysmenorrhea were randomly allocated to two groups. In the first group 21 girls received fish oil (1080 mg icosapentaenoic acid, 720 mg docosahexaenoic acid, and 1.5 mg vitamin E) daily for 2 months followed by a placebo for an additional 2 months. In the second group 21 girls received placebo for the first 2 months, followed by fish oil for 2 more months. The Cox Menstrual Symptom Scale was used to assess response to treatment. RESULTS: There were no significant differences in the Cox Menstrual Symptom Scale between the two groups at baseline after 2 months of placebo administration. After 2 months of treatment with fish oil there was a marked reduction in the Cox Menstrual Symptom Scale from a baseline mean value of 69.9 to 44.0 (p < 0.0004). CONCLUSIONS: This study suggests that dietary supplementation with omega-3 fatty acids has a beneficial effect on symptoms of dysmenorrhea in adolescents.

Adolescent↗

PubMed1996

Cost-effectiveness decision analysis of intramuscular ceftriaxone versus oral cefixime in adolescents with gonococcal cervicitis.

STUDY OBJECTIVE: We compared the cost-effectiveness of two single-dose treatment strategies for adolescents with uncomplicated Neisseria gonorrhoeae cervicitis. METHODS: We used a cost-effectiveness decision- analysis model to compare the two methods: the standard, ceftriaxone 125 mg given by IM injection; and an alternative, cefixime 400 mg given orally. The effect of the costs associated with the risk of accidental needlestick during IM administration was also evaluated. Key baseline assumptions (with ranges, when tested) were from the literature or costs to our hospital. These included ceftriaxone, $8.60 per dose; cefixime, $4.67 per dose; ceftriaxone efficacy, 98% (range, 94.9% to 100%); cefixime efficacy, 97% (94.1% to 100%); and a 15% probability of pelvic inflammatory disease (PID) related to failed treatment. We included costs for PID necessitating hospitalization, disseminated gonococcal infection, infertility, and ectopic pregnancy. Assumptions related to accidental needlestick included the rate of needlesticks with the disposable syringe, 6.9 per 100,000 injections (range, 0 to 69); cost of accidental needlestick to hospital; risk of HIV seroconversion after needlestick exposure to HIV-infected blood, .36% (range, 0% to .86%); rate of HIV infection in 15- to 19-year-olds attending sexually transmitted diseases clinics, .4% (range, 0 to 5); and lifetime treatment costs for a person with HIV. RESULTS: At baseline values the model favored ceftriaxone ($45 per patient) or cefixime ($59 per patient). However, over the range of efficacy of both drugs, two-way sensitivity analysis revealed no consistent cost advantage for either drug. The model was also insensitive to the economic effects associated with the risk of accidental needlestick during IM injection. CONCLUSION: over the range of efficacy by the 95% confidence intervals of both drugs, our analysis demonstrated no clear cost advantage for either. The economic effects of accidental needlestick do not change this conclusion. Compared with the IM alternative, oral cefixime is painless to the patient and simpler for the practitioner to administer. Oral cefixime also eliminates the psychologic effects associated with needlesticks in health care workers. For these reasons, we favor the use of oral cefixime for uncomplicated gonococcal cervicitis in adolescents.

Administration, Oral↗

PubMed1996

Hepatitis B vaccine completion among adolescents.

This study examined hepatitis B vaccination completion among 51 adolescents recruited from a primary care clinic. Seventy-one percent completed the series. Completion was not related to demographic characteristics or attitudinal measures at the first shot. Few opportunities for vaccination were missed. Inconvenience appears to be a factor in failure to complete the series.

Adolescent↗

PubMed1996

Developmental sophistication among adolescents of negotiation strategies for condom use.

Condoms are an important method of reducing the risk of sexually transmitted disease among sexually active adolescents. This study used a developmental approach to examine the negotiation of condom use. The Interpersonal Negotiation Strategy Interview was administered to adolescents using two vignettes that were focused on the negotiation of "safer sex" behaviors. The sample consisted of 196 girls and 92 boys recruited from their primary care clinic or Job Corps. The mean scores for each problem-solving step were at the subjective, unilateral stage, which indicates that problems are resolved through one-way methods. Current educational strategies and the lack of mutuality in adolescents' sexual relationships influence the level of negotiation skills. Interventions need to be at the appropriate developmental level but also need to encourage progress toward collaborative relationships.

Adolescent↗

PubMed1995

Experience with side effects and health risks associated with Norplant implant use in adolescents.

Levonorgestrel implants (Norplant) have been recommended as a contraceptive method for teenage women. Our experience suggests that the use of Norplant implants in adolescents is associated with bleeding irregularities and modest weight gain. There is no effect on condom use or STD acquisition. Despite the bleeding irregularities, we documented high continuation rates, suggesting that with appropriate pre-insertion counseling, Norplant implants can be a successful contraceptive method for adolescent women.

Adolescent↗

PubMed1995

Parents, peers, and the acquisition of an STD. Developmental changes in girls.

PURPOSE: The purpose of this study was to examine the relationship between age and number of sexually transmitted diseases (STD) episodes in sexually active girls with their perceptions of the interpersonal implications of STD acquisition. METHODS: The sample consisted of 248 girls (mean age = 16.9 years); 74% had an STD history. Adolescents responded to statements using a five-point Likert scale regarding their interpersonal expectations, and rated the perceived prevalence of STD among their friends and among all adolescents. RESULTS: The results of logistic regression analyses indicated that older girls were less likely to tell their parents but did not perceive parental support differently than younger girls. Older girls were more likely to tell their partners and to be more embarrassed by the acquisition. Those with a greater number of STD episodes perceived the acquisition as a less negative event. Girls with a greater number of STD episodes perceived the prevalence of STD to be significantly greater among their friends and among all adolescents than those girls with fewer episodes. Overall, the perceived prevalence among friends (40%) was significantly lower than the perceived prevalence among teens in general (74%). CONCLUSIONS: Future research and practice in aiding adolescent girls to manage STD acquisition must incorporate developmental theory, and, when appropriate, methods to involve families while preserving privacy.

Adolescent↗

PubMed1995

Effects of long term treatment with sertraline (Zoloft) simulating hypothyroidism in an adolescent.

A 16-year-old depressed adolescent, who had received sertraline treatment for the previous 18 months, developed insomnia, daytime somnolence and lack of energy. His thyroid function tests revealed low levels of total T4 with normal levels of free T4 and TSH, and a normal thyrotropin-releasing hormone (TRH) stimulation test. Discontinuing sertraline resulted in improved sleep and disappearance of daytime somnolence. Although daytime somnolence and low levels of total T4 can mimic hypothyroidism, in this case sertraline only displaced the bound-fraction of total T4 and was not associated with true hypothyroidism.

1-Naphthylamine↗