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Biomedical subjects

Frank M Biro

Publications and source records attributed to Frank M Biro.

At least 19 recordsLinked to original sources
PubMed2007

Childhood overweight and cardiovascular disease risk factors: the National Heart, Lung, and Blood Institute Growth and Health Study.

OBJECTIVE: To estimate the prevalence and incidence of overweight in African-American and Caucasian girls, and to examine associations between adolescent overweight and cardiovascular disease (CVD) risk factors. STUDY DESIGN: In the National Heart, Lung and Blood Institute Growth and Health Study (NGHS), annual measurements were obtained from girls followed longitudinally between age 9 or 10 and 18 years; self-reported measures were obtained at age 21 to 23 years. A total of 1166 Caucasian girls and 1213 African-American girls participated in the study. Childhood overweight as defined by the Centers for Disease Control and Prevention (CDC) was the independent variable of primary interest. Measured outcomes included blood pressure and lipid levels. RESULTS: Rates of overweight increased through adolescence from 7% to 10% in the Caucasian girls and from 17% to 24% in the African-American girls. The incidence of overweight was greater at age 9 to 12 than in later adolescence. Girls who were overweight during childhood were 11 to 30 times more likely to be obese in young adulthood. Overweight was significantly associated with increased percent body fat, sum of skinfolds and waist circumference measurements, and unhealthful systolic and diastolic blood pressure, high-density lipoprotein cholesterol, and triglyceride levels. CONCLUSION: A relationship between CVD risk factors and CDC-defined overweight is present at age 9.

Adolescent↗
PubMed2006

Self-esteem in adolescent females.

PURPOSE: Self-esteem is a major "predictor" of satisfaction with life. This longitudinal study examined mean and individual changes in self-esteem, and how self-esteem is affected by race and body mass. METHODS: Girls were recruited at ages 9 and 10 years, and followed to age 22 years. The Harter Self-Perception Profile was administered every other year, analyzing scores from the Global Self-Worth Scale, by age or developmental phase: ages 9-12 (I), 13-16 (II), and 17-22 (III). Regression modeling included main effects and interactions between age/phase, race, and body mass index (BMI). RESULTS: Self-worth was greater in black than white women, and greater with lower BMI in both races. In the model with age ("traditional model") (with race and BMI), significant variables included BMI (inverse relationship) and the interactions between age and race, race and BMI, and the triple interaction between age, race, and BMI. In the model with phase ("transitional model") (with race and BMI), BMI, and the interactions between BMI and race, and race and phase, were significant. For example, self-worth was generally lower in Phase II (middle adolescence) for white women. Self-esteem tracked significantly (correlation 0.22, p < .001). An individual's self-worth during any given phase of adolescence was correlated significantly with the other two phases. CONCLUSIONS: In this longitudinal analysis of self-esteem in adolescent girls, race and BMI are important predictors of self-esteem. Self-esteem is consistent across the phases of adolescence, and comparable with other personality traits. As noted by others, lower levels of self-esteem may increase the vulnerability of adolescents to risky behaviors.

Adolescent↗
PubMed2006

Pubertal correlates in black and white girls.

OBJECTIVES: Since pubertal maturation is an important covariate in studies that evaluate physical and social changes that occur during the teen years, we examined pubertal parameters in a group of US girls. STUDY DESIGN: Black and white girls recruited at age 9 were followed annually for 10 years. Preece-Baines model 1 was used to estimate tempo and growth parameters. The temporal trend between age of menarche and onset of puberty was calculated. RESULTS: The study included 615 (77.2% prepubertal) white and 541 (49.4% prepubertal) black participants. Mean onset of puberty was 10.2 and 9.6 years in white and black girls, respectively, menarche was 12.6 and 12.0, achievement of Tanner growth stage 5 was 14.3 and 13.6, and achievement of adult height was 17.1 and 16.5 years. The Pearson's correlation coefficient between menarche and onset of puberty was .37. CONCLUSIONS: Menarche is often used as a marker for onset of puberty and for timing of puberty. Data gathered over the past 20 years suggest only moderate correlation between menarche and onset of puberty (.37-.38), which has decreased significantly during the last 50 years. This suggests the existence of both similar and unique factors that impact the age at onset of puberty and age at menarche.

Adolescent↗
PubMed2005

Influence of obesity on timing of puberty.

Timing of normal pubertal maturation has received increased attention over the past several years. Age of menarche showed a dramatic decrease in the first half of the 20th century in Western nations; since 1960, the decrease in age of menarche has slowed and, in some societies, has actually increased. More recently, age of onset of pubertal maturation appears to have decreased, especially in girls. Multiple studies have demonstrated that childhood levels of obesity and ponderosity are associated with earlier menarche in girls. Earlier maturation in boys, however, is associated with lower adiposity and ponderosity. Secular changes in the United States as well as around the world have noted increases in prevalence as well as extent of overweight. Factors contributing to these changes include increases in calories and fast food consumption, decreases in physical activity, and increases in television viewing. There appear to have been selective advantages to lower metabolic rate (the 'thrifty' gene hypothesis), and earlier maturation. However, changes in caloric consumption, caloric density and physical activity, combined with greater lifespan, may allow expression of the adverse consequences of these adaptations, such as the metabolic syndrome or cancers.

Biological Evolution↗
PubMed2005

Genital herpes in adolescents.

Herpes simplex virus (HSV) infections occur commonly among adolescents. Most HSV-2 infections are genital, but genital herpes can be caused by either HSV-1 or HSV-2. Weighted means were calculated based on published seroprevalence data on adolescents from the United States and found HSV-1 rates of 53.1 percent for adolescent males and 49.4 percent for adolescent females. The weighted means for HSV-2 was 15 percent for adolescent females and 12 percent for adolescent males. Most individuals who are infected with HSV-2 are unaware of their infection. Healthcare providers of adolescents should consider genital herpes even when an adolescent presents with nonspecific genital symptoms. In this article, we review current recommendations for diagnosis and management and review the psychological sequelae that can be associated with having genital herpes. Finally, we discuss biomedical interventions that are being developed to help reduce the epidemic of HSV and the challenges that these interventions face with regard to implementation.

Adolescent↗
PubMed2005

Puberty and adolescent sexuality.

Teenagers undergo biological, cognitive, and social changes. Each of these changes interacts with the other developmental parameters and may affect outcomes in late adolescence and adulthood. Sequence, tempo, and timing of puberty all affect when changes in hormones, feelings, and behavior will emerge in children. The pediatrician should recognize stages of pubertal development and be able to provide counseling and information to patients and parents. Some suggested resources are listed in the Sidebar.

Adolescent↗
PubMed2004

Longitudinal risk of herpes simplex virus (HSV) type 1, HSV type 2, and cytomegalovirus infections among young adolescent girls.

BACKGROUND: Cross-sectional seroprevalence studies indicate that infections with herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2) and cytomegalovirus (CMV) are common. However, data on the rates of acquisition of these infections are limited. METHODS: A 3-year longitudinal study of HSV-1, HSV-2, and CMV seroprevalence was conducted in a cohort of 174 adolescent girls (age at enrollment, 12-15 years). RESULTS: At study entry, 41% of the girls reported a history of sexual activity, and by the end of the study, 73% reported a history of sexual activity. At enrollment, 71% of all participants were seropositive for CMV, 44% were seropositive for HSV-1, and 7% were seropositive for HSV-2. By the end of the study, 81% of the girls were seropositive for CMV, 49% were seropositive for HSV-1, and 14% were seropositive for HSV-2. Among girls with a history of sexual activity, 15.5% were HSV-2 seropositive at the beginning of the study, and 18.9% were HSV-2 seropositive at the end of the study. The attack rates, based on the number of cases per 100 person-years, were 13.8 for CMV infection and 3.2 for HSV-1 infection (among all girls) and 4.4 for HSV-2 infection (among girls with a history of sexual activity). Participants with preexisting HSV-1 antibodies were associated with a significantly lower attack rate for HSV-2 infection. A generalized estimating equation model indicated that participants with a longer history of sexual activity and those who had more sexually transmitted diseases during the 6-month periods before the study visits were more likely to be HSV-2 seropositive. CONCLUSIONS: This longitudinal study of adolescent girls found high baseline CMV and HSV-1 seroprevalence rates and substantial attack rates for all 3 pathogens.

Adolescent↗
PubMed2004

Sexually transmitted disease testing: evaluation of diagnostic tests and methods.

Most STIs in adolescents are asymptomatic. Recent studies in adolescents have documented relatively short periods of time until reinfection occurs (median times 4.7-7.6 months), suggesting that sexually active adolescents should be screened for STI every 6 months. Evidence-based practice is exceedingly helpful in deciding when to test, whom to test, and which methodology to use. In a recent critical analysis regarding screening women for chlamydia, screening all women for chlamydia was more cost-effective than testing only symptomatic women. With the proliferation of highly sensitive and specific assays, and the usefulness of different specimen sources (such as urine or self-swabs), health care providers of adolescents should screen all patients at risk for STIs. Although these screening and diagnostic techniques provide greater accuracy than previously attainable, screening should be part of a comprehensive methodology designed to promote good health care decisions, such as encouraging abstinence, promoting safer sexual practices, and using the most appropriate methodology to detect and treat STIs.

Diagnostic Techniques and Procedures↗
PubMed2004

Adolescent girls perceptions of the timing of their sexual initiation: "too young" or "just right"?

PURPOSE: To examine variables associated with adolescent girls' perceptions of the timing of their first consensual intercourse. METHODS: One hundred seventy-four primarily African-American adolescent girls, aged 12 to 15 years participated in a 3-year longitudinal study of psychosexual development. Seventy-three percent reported being sexually experienced by the end of the study. They were asked whether they believed their age of initiation was "too young," "too old," or "just right." A generalized estimating equation (GEE) model was used to evaluate predictors of perception of timing of first consensual intercourse. RESULTS: Ninety-nine (78%) said that they were "too young" and 28 (22%) said that their age had been "just right." The results of the final GEE model indicated that variables associated with perceiving age of first consensual intercourse as "just right" included younger chronological age, an older age of first consensual intercourse, endorsement of being "in love" as a reason for first consensual intercourse, greater indirect parental monitoring (vs. "none" or "direct parental monitoring"), and a higher level of education for mothers. CONCLUSIONS: Most of these adolescents thought their age of initiation was too young. Factors associated with perceiving the timing of consensual intercourse as "just right" are similar to those reported in the literature to be associated with delaying the initiation of consensual intercourse.

Adolescent↗
PubMed2003

Evaluating adolescents in juvenile detention facilities for urogenital chlamydial infection: costs and effectiveness of alternative interventions.

CONTEXT: Adolescents in juvenile detention facilities present a unique opportunity to diagnose and treat sexually transmitted diseases. OBJECTIVE: To evaluate the effectiveness and costs of different strategies for the diagnosis and treatment of chlamydial infection in adolescents in juvenile detention.Design, Setting, and Subjects For a cohort of adolescents in a juvenile detention facility, sex-specific decision models were developed comparing strategies for diagnosing and treating chlamydial infection. These strategies included not screening, treating everyone, and testing (with leukocyte esterase [LE], ligase chain reaction [LCR], or history and symptoms) followed by treatment for those with positive test results. Two different time horizons were considered: immediate and extended. In the immediate time horizon, we performed a cost-effectiveness analysis looking only at the outcomes associated with treating current infections; in the extended time horizon, we performed a cost-minimization analysis comparing the estimated total costs of diagnosing and treating Chlamydia as well as those associated with complications occurring up to 20 years in the future. RESULTS: In males, the immediate-time-horizon evaluation revealed that treating on the basis of urine LE results produced the lowest incremental cost-effectiveness ratio ($80 per infection treated). In the extended-time-horizon cost-minimization analysis, treating males on the basis of urine LE results was again found to be the least expensive strategy ($10.11 per person). Two other strategies, confirming urine LE results with LCR ($10.96 per person) and screening with urine LCR ($14.04 per person), were found to be less expensive than not screening ($16.66 per person). In females, the immediate-time-horizon evaluation found that treating on the basis of symptoms and history resulted in treating about half the cases of chlamydial infection and produced the lowest incremental cost-effectiveness ratio ($74 per infection treated). More infections were treated when treatment was based on urine LCR results with only a small increase in the incremental cost per case treated ($95 per infection treated). In the extended-time-horizon cost-minimization analysis, treating all females empirically and treating based on results of urine LCR testing were the least expensive strategies ($18.81 and $18.98 per person, respectively). The results were sensitive to several variables, including prevalence of chlamydial infection, in both males and females. CONCLUSIONS: For adolescent males in juvenile detention facilities, screening with urine LE minimizes the costs associated with diagnosis, treatment, and sequelae of urogenital chlamydial infection. For adolescent females in juvenile detention, empiric treatment and that based on urine LCR test results are the optimal strategies for managing urogenital chlamydial infection.

Adolescent↗
PubMed2003

Different shapes in different cultures: body dissatisfaction, overweight, and obesity in African-American and caucasian females.

OBJECTIVE: Body dissatisfaction and medical issues arising at both ends of the weight continuum are discussed from a cultural perspective. More specifically, a possible aesthetic preference and physical tolerance for increased adiposity among African-American females is discussed, as contrasted with that of Caucasian females. CONCLUSION: This mini-review of the existing literature suggests many avenues for future research in the cross-cultural aspects of body dissatisfaction, overweight, and obesity. Among these suggestions are (1) educating children and adolescents about excessive weight, (2) assessing cultural perceptions of overweight and obesity among African-Americans, (3) understanding the developmental trajectory of body dissatisfaction in females, and (4) placing more emphasis on the cross-cultural representation and psychological influence of the female body image in the media.

Black or African American↗
PubMed2003

Urinary tract infection and Chlamydia infection in adolescent females.

STUDY OBJECTIVE: To examine whether clinical or laboratory findings could distinguish Chlamydia trachomatis (CT) from urinary tract infection (UTI) among adolescent females in whom providers tested for both. DESIGN, SETTING, PARTICIPANTS: A laboratory database at an urban teen health center was reviewed to identify females who had both urine culture and ligase chain reaction (LCR) test for CT ordered at the same visit. History and physical findings were abstracted from the medical record. There were 81 visits with retrievable laboratory results and chart documentation. MAIN OUTCOME MEASURES: UTI was defined as >1000 colony-forming units on culture, and CT was defined as positive LCR test. Pearson's Chi-squared test was used to assess strength of the hypothesized associations. RESULTS: UTI was diagnosed in 20 (24%) and CT in 18 (22%) of 82 visits. Concurrent CT was diagnosed in 6 of 20 subjects with UTI. Symptoms and physical signs did not differentiate UTI from CT. Positive urinary nitrites were associated with UTI, but did not exclude CT. Similarly, wet prep evidence of trichomonas or white blood cells was associated with CT, but did not exclude UTI. Clinical diagnosis of CT or UTI was 50% sensitive and 70% specific. CONCLUSIONS: Adolescent females who are screened for both CT and UTI have high rates of concurrent disease. Urinary or vaginal symptoms do not differentiate well between these infections. Clinical diagnosis is imprecise, suggesting that adolescent females with vaginal or urinary symptoms should be tested for both CT and UTI.

Adolescent↗
PubMed2003

Pubertal maturation in girls and the relationship to anthropometric changes: pathways through puberty.

OBJECTIVE: Patterns of pubertal maturation may have an impact on several risk factors associated with adult morbidity and mortality, such as obesity. We examined the relationship of the initial manifestation of puberty in girls with anthropometric measures, as well as age at menarche. METHODS: White females (n = 1166, ages 9 and 10 at intake) were followed with annual visits for 10 years. Physical examinations included height, weight, skinfold thicknesses, and pubertal maturation assessment. RESULTS: During the course of the study, 443 of 859 eligible females (51.6%) were observed to have asynchronous maturation in the development of puberty, that is, initial areolar/breast (thelarche pathway) or pubic hair (adrenarche pathway) development, without development of the other characteristic. Using a longitudinal regression model, significant interactions were noted between initial pubertal manifestation and years since onset of puberty on the following outcomes: sum of skinfolds thickness, percent body fat, waist-to-hip ratio, and body mass index (BMI). However, age of onset of pubertal maturation was the same in the 2 groups (10.7 years). Females in the thelarche pathway had earlier menarche (12.6 vs 13.1 years) as well as greater skinfolds, body fat, and BMI at the time of menarche. Females in the thelarche pathway also had greater body fat and BMI 1 year before puberty and throughout puberty compared with those in the adrenarche pathway. CONCLUSIONS: Females who enter puberty through the thelarche pathway, as compared with the adrenarche pathway, had greater sum of skinfold thicknesses, BMI, and percent body fat 1 year before the onset, as well as throughout, puberty. Because larger body composition and earlier age of menarche of females in the thelarche pathway parallel the epidemiologic profiles of women who are obese or at risk for obesity, these females may be at greater risk for adult obesity.

Anthropometry↗
PubMed2003

Sex hormones and the changes in adolescent male lipids: longitudinal studies in a biracial cohort.

OBJECTIVE: To determine the role of increasing free testosterone and estradiol in pubertal changes in male lipids. METHODS: We conducted a 3-year, longitudinal, observation study with biannual visits of 251 black and 285 white boys who were 10 to 15 years of age at enrollment. Sex hormones, lipid parameters, and body composition measures were obtained according to a standard protocol. The body mass index (kg/m(2)) was used to characterize obesity. RESULTS: White boys had higher triglycerides, lower high-density lipoprotein cholesterol (HDL-C), lower apolipoprotein (apo)AI, and higher apoB than black boys. In boys of both races, increased body mass index was associated with increases in triglycerides, low-density lipoprotein cholesterol, apoB and decreases in HDL-C and apoAII. Within this framework, increased free testosterone was associated with increased apoB and decreased HDL-C and apoAI, whereas increased estradiol was associated with increased HDL-C and decreased triglycerides, low-density lipoprotein cholesterol, and apoB. CONCLUSION: Changes in sex steroid hormones have significant effects on changes in lipid parameters-increasing free testosterone levels has atherogenic effects and increasing estradiol has antiatherogenic effects.

Adolescent↗
PubMed2003

Body morphology and its impact on adolescent and pediatric gynecology, with a special emphasis on polycystic ovary syndrome.

PURPOSE OF REVIEW: To provide the reader with a timely review of studies investigating the impact of body morphology and weight on pubertal maturation, impact of pubertal maturation on adult body morphology, and recent developments in the diagnosis and management of polycystic ovary syndrome. RECENT FINDINGS: The temporal trends in age of onset of puberty and menarche, and prevalence of obesity, are presented. Timing of pubertal maturation and initial manifestations of puberty may impact adult adiposity and ponderosity, as well as predispose to conditions associated with adult morbidity. The polycystic ovary syndrome is the most common endocrinologic disorder, occurring in up to 10% of women. It is associated with insulin resistance, and substantial proportions of women with polycystic ovary syndrome, regardless of age or obesity status, have impaired glucose tolerance. Clinical and biochemical abnormalities seen in polycystic ovary syndrome may improve through utilization of insulin-sensitizing agents, although lifestyle changes provide more profound clinical improvements. SUMMARY: We now understand better those factors associated with initiation of puberty, and pathophysiology of polycystic ovary syndrome. However, further longitudinal studies are needed.

Adolescent↗