PubMed HealthSearch

Biomedical subjects

J Stryker

Publications and source records attributed to J Stryker.

13 recordsLinked to original sources

Prevention of HIV infection. Looking back, looking ahead.

For some, the occurrence of as many as 40,000 new human immunodeficiency virus (HIV) infections in the United States each year is evidence that HIV education and prevention efforts have failed. To the contrary, more than a decade of experience with HIV has demonstrated that lasting changes in behavior needed to avoid infection can occur as a result of carefully tailored, targeted, credible, and persistent HIV risk-reduction efforts. Given experience in other health behavior change endeavors, no interventions are likely to reduce the incidence of HIV infection to zero; indeed, insisting on too high a standard for HIV risk-reduction programs may actually undermine their effectiveness. A number of social, cultural, and attitudinal barriers continue to thwart the implementation of promising HIV risk-reduction programs. The remote prospects for a successful prophylactic vaccine for HIV and the difficulty in finding effective drug treatments have underscored the importance of sustained attention to HIV prevention and education. A series of "correlates of immunity" are identified--precedents that must exist to establish effective HIV prevention programs. These include sound policies promoting HIV risk reduction; access to health and social services, condoms, needles, and syringes; interventions shown to motivate behavioral change; organizations capable of reaching those at risk; and development and diffusion of technologies to interrupt the spread of the virus.

Delivery of Health Care

Osteoradionecrosis of the hyoid induced by combined modality therapy for laryngeal carcinoma.

Contemporary management of laryngeal carcinoma often incorporates multiple modalities of therapy. We report a case of osteoradionecrosis of the hyoid bone in a patient treated with surgery, chemotherapy, and radiation therapy for a supraglottic squamous cell carcinoma. A discussion regarding pathophysiology, radiation dosimetry and treatment options is also presented.

Carcinoma

Condom availability in schools: the need for improved program evaluations.

OBJECTIVES: This article examines the impact of contentious local debates on the design and implementation of school-based condom availability programs. METHODS: Information about condom availability in schools was reviewed by 50 leading educators and health officials at a 1992 forum held in Menlo Park, Calif. RESULTS: Few existing condom availability programs were designed to yield definitive data on sexual risk-taking behavior or other measures of program effectiveness. CONCLUSIONS: In the debate over school-based condom availability programs, as in many aspects of human immunodeficiency virus (HIV) prevention programs, scientific, moral, and political concerns overlap. Behavioral research into the potential effectiveness of such programs can help inform debates about fundamental values concerning sexual decision making and privacy, family integrity and parental autonomy, and public health.

Adolescent

HLA antigens influence resistance to lung carcinoma.

The concept of genetic factors playing a role in the pathogenesis of lung cancer has gained increased attention. The present study was undertaken to reexamine the question of HLA antigen association with carcinoma of the lung. In a study of 90 patients, a significant association occurred between HLA-DR7 and resistance to lung cancer, after accounting for smoking status and sex. HLA class I antigens were also implicated. These results suggest that major histocompatibility complex loci affect carcinoma of the lung.

Carcinoma

Licit and illicit drug policies: a typology.

To foster comparison of policy interventions across the various categories of licit and illicit drugs, we develop a typology of policies intended to address drug abuse problems. The principal dimensions of the typology are policy type and intervention channel. While the typology has important limitations, as a mechanism to organize information and stimulate thought it holds the potential to improve understanding of commonalities and distinctions among policies applying to widely discrepant drug problems, both within and across cultures. As such, it could contribute to the development of more effective approaches to grappling with a diverse set of drug policy issues.

Alcoholism

The value of preoperative radiotherapy response to maximizing laryngeal conservation in early stage supraglottic carcinoma.

This study is a retrospective review between 1976 and 1986 of 12 patients with T1(1) and T2(11) NO supraglottic cancers which were managed by a method that utilized planned preoperative radiotherapy (45-51 Gy) to the primary and bilateral necks. If adequate tumor response (greater than 75% reduction in size) was noted by laryngoscopy, therapy was completed at levels of 65-70 Gy to the primary. If a lesser tumor response was noted, the patient underwent supraglottic laryngectomy. Six patients completed primary radiotherapy (RT-RT) and six patients underwent supraglottic laryngectomy (RT-SG). There was evidence of residual tumor in three of six RT-SG patients. No tumor recurred at any site. Laryngeal function was preserved in all patients. Absolute survival was 58% at 67 months. This approach is oncologically sound and permits maximal laryngeal conservation.

Adult

Multimodality approach to a massive carcinoma of the vulva.

The presentation, combination therapy and clinical course of a patient with a massive vulvar carcinoma are described. Therapeutic aspects in the treatment of such advanced malignancies are considered. A multimodality approach to locally advanced, unresectable vulvar carcinomas may benefit this group of patients.

Antineoplastic Combined Chemotherapy Protocols

Abnormal US appearance of the cerebellum (banana sign): indirect sign of spina bifida.

Certain fetal cranial abnormalities found on second-trimester sonograms can be signs of an open spina bifida. In particular, an abnormal configuration of the cerebellum, known as the banana sign, has been associated with neural tube defects. To further evaluate the usefulness of this sign, the authors compared images of the posterior fossa in 23 fetuses who had documented neural tube defects with those of 38 control fetuses who underwent sonography because of an elevated maternal serum alpha-fetoprotein level. Twenty-two of the 23 fetuses with neural tube defects had compression and anterior alignment of the cerebellar hemispheres (the banana sign), and follow-up confirmed the presence of an open neural tube defect. One fetus had a normal-appearing posterior fossa; however, the neural tube defect at birth was completely covered with skin. Four of the neural tube defects were difficult to see sonographically, and the abnormal configuration of the cerebellum, as well as the flattening of the frontal bone (lemon sign), was instrumental in suggesting the correct diagnosis. The 38 control fetuses had normal-appearing posterior fossae.

Cerebellum

I.v. drug use and AIDS: public policy and dirty needles.

Users of intravenous heroin, cocaine, and amphetamines risk the transmission of human immunodeficiency virus (HIV) through the sharing of contaminated injection equipment. Although most users are aware of this risk, the scarcity of sterile needles and syringes, combined with various social and cultural factors, fosters dangerous sharing practices. This paper examines the legal and political contexts of proposals to ease access to sterile needles and injection equipment. The author seeks an explanation for the continued reluctance to institute such programs in the United States, while similar programs have been instituted in other countries where intravenous drug use has also contributed to the spread of HIV infection and AIDS.

Acquired Immunodeficiency Syndrome