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Biomedical subjects

F M Biro

Publications and source records attributed to F M Biro.

At least 55 records · Page 3Linked to original sources
PubMed1995

Sexual histories of adolescent girls: comparison between interview and chart.

PURPOSE: The purpose of this study is to determine the reliability of sexual histories obtained from adolescents and the adequacy of chart documentation by providers of adolescent health care. METHODS: Responses to an interview by a female research assistant about sexual activity were compared to chart-documented sexual histories taken by physicians and nurse practitioners. The setting was an urban, hospital-based adolescent clinic. The subjects were 106 females, 15-18 years old; 82% were African-American and 18% Caucasian. RESULTS: Significant correlations between interview and chart were seen for information about menarche, age at first intercourse, number of sexually transmitted diseases (STDs), and number of sexual partners. Accuracy of reporting sexually transmitted infections varied according to the organism; HPV infection was underreported more than other infections. Chart documentation of sexual histories was inadequate. CONCLUSIONS: Adolescents generally provide reliable sexual histories, but health care providers may not be documenting these histories adequately.

Adolescent↗
PubMed1995

Hepatitis B vaccine acceptance among adolescents and their parents.

PURPOSE: To employ theoretic health decision models to determine strategies that may facilitate acceptance of hepatitis vaccination programs among adolescents and their parents/guardians. METHODS: The research was conducted in a hospital-based adolescent clinic between January and September 1994. Eighty adolescents and 65 parents participated in a survey that was administered to new patients. Two groups (those who accepted the vaccine and those who rejected it) were compared for each variable and potential predictor. RESULTS: The majority of adolescents and parents indicated that their clinic care provider was the initial contact to initiate discussion about the vaccine. Significant predictors for parents' acceptance of the vaccination were their perceptions of the vaccine's importance to the care provider and concern about the general risk of the disease. Predictors for adolescents' acceptance of the vaccine was their perception that their parents felt it was important and the extent to which they believed it was for "everyone" to be vaccinated. CONCLUSIONS: Providers should be aware that adolescents are influenced by their parent's opinions and that the care provider's endorsement of the vaccine may be a key factor in parental acceptance of the vaccine. Results of this study have potential implications for public health approaches to facilitate vaccine acceptance.

Adolescent↗
PubMed1995

Pubertal staging in boys.

To determine the earliest signs of pubertal maturation, we followed 515 boys, aged 10 to 15 years at intake, every 6 months for 3 years. Changes in age, height, weight, body mass index, and serum levels of sex steroid hormones were significantly related to pubertal stage (PS). The earliest clinical stage of pubertal maturation, designated PS2a, was represented by the absence of public hair and a testicular volume 3 cc or greater; 6 months later, further maturation had occurred in 82% of these boys. Inclusion of PS2a as the earliest stage of puberty may help allay concerns about boys with perceived delayed maturation, and may allow more precise definition of early puberty.

Adolescent↗
PubMed1995

Depo-Provera in adolescents: effects of early second injection or prior oral contraception.

PURPOSE: To examine the effects of an early second injection or prior use of oral contraceptive pills (OCP) on side effects of Depo-Provera during the early months of use in adolescents. METHODS: Thirty-six girls, gynecologic age 4.2 +/- 0.3 years, and body mass index (BMI) 23.2 +/- 0.8, received the currently recommended injection of 150 mg every three months. Twenty-seven girls (gynecologic age 3.9 +/- 0.5 years, BMI 24.0 +/- 0.8) received the second injection six weeks after the first injection. Fifteen girls (gynecologic age 5.0 +/- 0.5, BMI 25.4 +/- 1.3) switched directly from an OCP to Depo-Provera. The patients were periodically assessed by their care providers. RESULTS: Early administration of the second injection of Depo-Provera did not alter the bleeding episodes, onset of bleeding, or total days of bleeding (14.3 +/- 3.7 vs. 17.1 +/- 4.0, p = 0.62) during the three months interval following injection, compared with the standard second injection interval. Moreover, an excessive BMI gain (BMI increase 0.99 +/- 0.22 vs. 0.40 +/- 0.14, p = 0.03) was observed in these girls. Girls who switched directly from OCP showed no difference in the rate of BMI gain when compared to those not previously on OCP (BMI increase 0.38 +/- 0.3). Bleeding duration of these girls, however, was markedly reduced; the total number of days of bleeding was 5.7 +/- 1.9 (p = 0.0003) during the first three month interval, and 5.7 +/- 2.3 (p = 0.019) during the three month period following the second injection. This reduction did not persist beyond the first six months. CONCLUSIONS: Early second Depo-Provera injection does not alter the experience of menstrual abnormalities, and predisposes to greater weight gain; OCP use prior to Depo-Provera results in a decrease in the duration of bleeding with no change in the weight gain rate.

Adolescent↗
PubMed1995

Gonococcal and chlamydial genitourinary infections in symptomatic and asymptomatic adolescent women.

To determine the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae endocervical infections in a group of adolescent women, gynecologic histories and evaluations were done on symptomatic and asymptomatic adolescent women presenting for pelvic examinations in an urban, hospital-based, adolescent clinic. C. trachomatis and N. gonorrhoeae cultures and three nonculture diagnostic tests for chlamydia (two ELISA assays and one DNA-probe) were performed on each patient. Patients were 12 to 21 years of age (mean 17.0); 53% were African-American, and 47% were Caucasian. Two hundred twenty-eight women were asymptomatic and 249 women had symptoms. There were 64 cases of chlamydia and 19 cases of gonorrhea; an additional 11 patients had both chlamydia and gonorrhea. Approximately one third of patients with chlamydia, gonorrhea, or both had asymptomatic disease an important reservoir of infection.

Adolescent↗
PubMed1995

Strategies for coping with sexually transmitted diseases by adolescent females.

Coping strategies of adolescent girls in response to the acquisition of a sexually transmitted disease (STD) were evaluated. Perceptions of control over acquisition of an STD and emotional impact were assessed. The sample consisted of 177 adolescent girls recruited from their source of primary care (mean age = 16.8). There were no differences in the use of coping strategies by age group or STD history. Subjects used a wide variety of coping strategies; those who viewed the future acquisition of an STD more negatively used more strategies. Wishful thinking was used by most of the subjects, but was not felt to be helpful; despite this, adolescents with a previous STD were no less likely to use wishful thinking. It was concluded that adolescent health care providers must understand girls' responses to STD and help them develop effective coping skills to reduce the incidence of STD.

Adaptation, Psychological↗
PubMed1994

Acne vulgaris in premenarchal girls. An early sign of puberty associated with rising levels of dehydroepiandrosterone.

BACKGROUND: This study examined the relationships of pubertal maturation and sex steroid hormones to the development of acne in young girls. Black (n = 317) and white (n = 306) premenarchal girls with a mean age of 9.97 +/- 0.62 years were evaluated for acne prevalence and severity, pubic hair and areolar maturation, and sex steroid hormone levels. RESULTS: Overall, 77.8% of the girls had some acne; of the whole group, 48.3% had only comedonal acne, 2.2% had only inflammatory acne, and 27.3% had both types. Although black girls matured at an earlier age than white girls, racial differences in acne were minimal when adjusted for pubertal maturation. Acne increased with advancing maturation; at Tanner pubic hair stages 1, 2, and 3, the prevalence of acne rose from 73.1% to 84.0% and to 90.6%, respectively. Acne lesion counts at seven facial locations revealed a predominance of midfacial acne on the middle aspect of the forehead, nose, and chin. Sex steroid hormone levels measured in 365 of the girls were found to increase significantly during maturation from prepuberty to early puberty. Testosterone-estrogen-binding globulin and the ratio of testosterone to estradiol decreased. In 118 prepubertal girls, estradiol, total and free testosterone, progesterone, testosterone to estradiol ratio, and testosterone-estrogen-binding globulin levels were no different whether in subjects with acne or without acne. However, the level of dehydroepiandrosterone sulfate, an androgen of adrenal origin, was significantly higher in prepubertal girls with acne. CONCLUSION: Acne, especially the comedonal type, can be the first sign of pubertal maturation in girls, even preceding pubic hair and areolar development. Concentration of dehydroepiandrosterone sulfate is significantly and specifically associated with the initiation of acne in young girls.

Acne Vulgaris↗
PubMed1994

Sexual maturation and obesity in 9- and 10-year-old black and white girls: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To assess the relationship between pubertal maturation and obesity in 9- and 10-year-old black and white girls. METHOD: Cross-sectional analysis of cohort baseline data. SUBJECTS: A cohort of 2379 girls recruited from selected schools in Richmond, Calif., and greater Cincinnati, Ohio, and from the membership rolls of a prepaid group practice in greater Washington, D.C. RESULTS: Sixty-four percent of black girls had begun pubertal maturation compared with 33% of white girls. In prepubertal girls, racial differences in height, weight, body mass index (kilograms per square meter) and skin-fold thickness were not significant. Within each race, onset of pubertal maturation was associated with greater height, weight, body mass index, and skin-fold measurements. Within 9-year-old girls who had begun pubertal maturation but not reached menarche, black girls were taller and heavier than white girls. Among pubertal but premenarcheal 10-year-old subjects, black girls were taller and heavier and had greater body mass index and subscapular skin-fold values. After analyses were adjusted for pubertal maturation stage by means of pubic hair development, 10-year-old pubertal black girls remained taller and heavier, but racial differences in body mass index and the sum of skin-fold measurements ceased to be significant. CONCLUSIONS: These findings suggest that the initiation of racial differences in obesity are related, at least temporally, to pubertal maturation.

Black People↗
PubMed1994

Knowledge of gonorrhea in adolescent females with a history of STD.

The purpose of this study is to examine how a previous infection with gonorrhea or another sexually transmitted disease (STD) will impact on patients' knowledge of gonorrhea. Adolescent girls were recruited from a primary-care adolescent clinic. Those with a history of an STD were overrecruited. Participants were given a standardized questionnaire regarding several symptoms and sequelae of STD. The results of this study revealed that girls (N = 248, mean age = 16.9 years) with a personal history of gonorrhea had more correct responses than those with no history of an STD, but they were not statistically different from those with a nongonococcal STD. No group had a mean correct score greater than 6.66 out of 13. Nearly two out of three participants reported that an individual had to always have one of four symptoms (discharge, pain on urination, rash, or sores) when there is a gonococcal infection. Overall, adolescents have an inaccurate foundation of knowledge regarding symptoms and sequelae of gonorrhea. Although those with a previous history of gonorrhea had higher mean scores than those with no history of an STD, they still identified the correct responses only half the time. Additionally, adolescents with a history of gonorrhea or another STD were no more likely to have identified the possibility of asymptomatic infection, despite several having only a history of asymptomatic infection.

Adolescent↗
PubMed1994

Reasons for condom utilization among high-risk adolescent girls.

Two hundred forty-eight adolescent girls responded to a list of 30 statements describing reasons for using and not using condoms. For 24 of the statements, most adolescents (> 70%) gave the same response regarding why they did or did not use condoms. Therefore, only the six remaining statements were used in further analyses. The relationship between the six statements and psychosexual history, condom use, and sexually transmitted disease (STD) history was examined. Those adolescent girls who had been sexually active longer were more likely to report lack of enjoyment as a reason that they did not use condoms (P < .03), and those adolescents who had been sexually active less time were more likely to report personal (P < .005) and partner (P < .0006) enjoyment of sex with condoms as a reason for using condoms. Longer relationships before intercourse were associated with having condoms available (P < .01) and partner insistence on their use (P < .02). Partner insistence on condom use was related to fewer episodes of sexually transmitted diseases (P = .03). These findings indicate the importance of relationship and partner variables in adolescent girls' perceptions of condom use.

Adolescent↗
PubMed1994

A comparison of diagnostic methods in adolescent girls with and without symptoms of Chlamydia urogenital infection.

OBJECTIVE: To evaluate the clinical utility of various diagnostic tests, two enzyme immunoassays and a chemiluminescent DNA probe were compared with cell culture (with monoclonal antibody confirmation) for the diagnosis of endocervical Chlamydia trachomatis infection. DESIGN: The clinical performance of four diagnostic methods for Chlamydia trachomatis urogenital infections were compared, using specimens generated from consecutive pelvic examinations. SETTING: Subjects were recruited from an urban adolescent clinic that provides primary and referral care. PARTICIPANTS: A total of 479 adolescent female subjects were enrolled. The order of sample collection was randomized. Subjects were stratified according to whether they were asymptomatic (n = 228) or symptomatic (n = 251). MEASUREMENTS AND RESULTS: Discrepant analysis was performed when culture was negative and nonculture technique was positive. The subject was considered to have chlamydia if culture was positive, or if one or more nonculture techniques, with that test's confirmatory assay, were positive (consensus-positive). Prevalence of chlamydia was 11.0% in the asymptomatic, and 20.7% in the symptomatic, group. Overall, 32.5% of the infected subjects were asymptomatic. Sensitivity of diagnostic methods varied from 52% to 80% in the asymptomatic subjects, compared with 65% to 81% in symptomatic subjects. Culture sensitivity was 75% to 80%. The specificities of all tests were 96% or greater. Accuracy of nonculture methods varied from 89.5% (DNA probe, symptomatic subjects) to 96.9% (enzyme immunoassay asymptomatic subjects). CONCLUSIONS: There are significant differences in symptomatic subjects when evaluating accuracy of test outcome, using a consensus-positive criterion. Asymptomatic infections account for nearly one third of adolescent females infected with chlamydia. The prevalence of chlamydia urogenital infections are underestimated by any single diagnostic test, particularly in the asymptomatic patient.

Adolescent↗
PubMed1993

A comparison of self-perceived clinical competencies in primary care residency graduates.

One hundred seventy-eight graduates from four primary care residency training programs with common hospital sites (medicine/pediatrics, 72; family medicine, 29; pediatrics, 35; and internal medicine, 42) responded to a mailed survey questionnaire regarding distribution of professional time and self-perceived clinical competencies. Most of the internists, family physicians, and internist/pediatricians (MED/PED) were in primary care, and 57% of the pediatricians were subspecialists. Respondents rated each of 24 clinical vignettes as to their level of comfort in managing the patient problems presented. MED/PED and pediatricians responded similarly to all the infant, child, and adolescent cases. Family physicians were less comfortable in managing the complicated neonatal situations but more comfortable with adolescent health care than the MED/PED or pediatricians. MED/PED reported greater comfort than family physicians in complex internal medicine issues, but less than internists in intensive care and geriatric consultation. Significant differences in reported competency existed among these primary care practitioners despite substantially overlapping training backgrounds.

Adolescent↗
PubMed1992

Psychological sequelae of sexually transmitted diseases in adolescents.

Sexually active adolescents are the highest risk group for many of the sexually transmitted diseases. Although clinical presentations, diagnostic methods, and medical sequelae are understood increasingly, psychological sequelae are often neither recognized nor understood. Insight into these issues may prevent repeat episodes of sexually transmitted diseases and limit their spread. This article summarizes the literature regarding psychological issues and sequelae and emphasizes the need for further study.

Adolescent↗
PubMed1991

Medical needs of performing arts students.

A questionnaire was administered to 71 college students enrolled in dance, drama, and musical theater programs to assess health care problems, injuries, risk-taking behaviors, and sources of care. Many desired help with depression, fatigue, and chronic bone or joint pain, although 37% identified no regular physician. Thirty-nine students reported 87 injuries involving the back, foot, ankle, and knee; 12% sustained injuries at least monthly; and 72% of injuries occurred in class. The incidence of eating disorders appears to be low, as assessed by indirect measures such as body weight, oligomenorrhea, diet pill or laxative use, and scores on a body image index. The 30-day prevalence of tobacco use was 26%; marijuana, 11%; and alcohol, 71%. This survey suggests that performing arts students have important unmet health care needs.

Adolescent↗
PubMed1991

Urinary leukocyte esterase screening for asymptomatic sexually transmitted disease in adolescent males.

The objective of this study was to evaluate the effectiveness of urinary leukocyte esterase on random urine specimens as a screening test for chlamydial and gonococcal urethral infections in asymptomatic males. Random urine specimens were obtained on 106 consecutive asymptomatic adolescent males during intake physical examination at a residential vocational training program. Results of urinary leukocyte esterase were compared to those of urethral cultures for Chlamydia trachomatis and Neisseria gonorrhoeae. Five subjects had positive chlamydia cultures, three subjects had positive gonococcal cultures, and one patient had positive cultures for both organisms. Sixteen subjects had leukocyte esterase tests reported as "trace" or greater. When compare to positive culture results for either Chlamydia or gonorrhea, urinary leukocyte esterase activity had a sensitivity of 78%, specificity of 91%, and positive predictive value of 44%. A random urine specimen for urinary leukocyte esterase activity is a cost-effective screening method for chlamydial and gonococcal urethral infections in asymptomatic adolescent males.

Adolescent↗
PubMed1991

Self-reported health concerns and sexual behaviors in adolescents with cervical dysplasia. A pilot study.

A group of 46 women attending an adolescent dysplasia clinic were surveyed regarding the reported impact of cervical dysplasia on sexual beliefs and behaviors. The adolescents reported being concerned about their future health and having changed their sexual practices. There were no clear relationships between demographic variables or sexual attitudes and changes. The adolescents' self-reports of their behavior were not consistent; those adolescents who reported safer sex practices did not have lower rates of sexually transmitted diseases postbiopsy. The results of this study indicate the important but complex impact of sexually transmitted disease on adolescents and suggests that this impact on adolescents may be different from that on adults.

Adolescent↗