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M Verdon

Publications and source records attributed to M Verdon.

8 recordsLinked to original sources
PubMed1995

Racial/ethnic differences in the likelihood of cesarean delivery, California.

OBJECTIVES: The purpose of this study was to determine whether women's sociodemographic characteristics are independently associated with cesarean delivery. METHODS: A retrospective review was conducted of hospital discharge data for singleton first births in California in 1991. RESULTS: After insurance and personal, community, medical, and hospital characteristics had been controlled, Blacks were 24% more likely to undergo cesarean delivery than Whites; only among low-birthweight and county hospital births were Blacks not at a significantly elevated risk. Among women who resided in substantially non-English-speaking communities, who delivered high-birthweight babies, or who gave birth at for-profit hospitals, cesarean delivery appeared to be more likely among non-Whites and was over 40% more likely among Blacks than among Whites. CONCLUSIONS: The findings cannot establish causation, but the significant racial/ethnic disparities in delivery mode, despite adjustment for social, economic, medical, and hospital factors, suggest inappropriate influences on clinical decision making that would not be addressed by changes in reimbursement. If practice variations among providers are involved, de facto racial differences in access to optimal care may be indicated. The role of provider and patient attitudes and expectations in the observed racial/ethnic differentials should also be explored.

Adult↗
PubMed1993

Clinical manifestations of trichomoniasis in men.

OBJECTIVE: To determine the prevalence and clinical manifestations of trichomoniasis among sexually active men. DESIGN: Survey of two groups of men attending a sexually transmitted disease clinic. Subjects had a comprehensive sexual history and clinical examination plus cultures for Trichomonas vaginalis, Neisseria gonorrhoeae, and Chlamydia trachomatis. PARTICIPANTS: The study included 147 sexual partners of women with trichomoniasis and 300 subjects selected randomly from heterosexual men coming to the same clinic for evaluation of new problems. MAIN OUTCOME MEASURES: Isolation of T. vaginalis was compared with urogenital signs and symptoms. RESULTS: The prevalence of T. vaginalis was 33 of 147 (22% [95% CI, 16% to 29%]) among sexual contacts of women with trichomoniasis and 17 of 300 (6% [CI, 3% to 9%]) among heterosexual men attending the same clinic. Men with trichomoniasis alone were more likely to complain of urethral discharge (P < 0.01), to have discharge on examination (P < 0.03), and to have inflammatory cells in their urethral secretions (P < 0.01) than were men who did not have T. vaginalis, N. gonorrhoeae, or C. trachomatis. Trichomonas vaginalis remained associated with nongonococcal nonchlamydial urethritis (adjusted odds ratio 3.8; CI, 1.1 to 11.2) after adjustment for race, age, number of sex partners in the previous 6 months, exposure to a partner with trichomoniasis, and history of trichomoniasis, urethritis, or gonorrhea. CONCLUSIONS: Trichomoniasis was common among men at risk for sexually transmitted diseases and was associated with symptoms and signs of urethritis.

Adolescent↗
PubMed1993

Natural history of urogenital trichomoniasis in men.

Although Trichomonas vaginalis is a common sexually transmitted pathogen, the significance and natural history of trichomoniasis remain undefined in the male patient. We conducted a longitudinal study to examine the relationship of T. vaginalis to nongonococcal urethritis in men and to increase our understanding of the natural history of this infection. As previously reported, T. vaginalis was isolated from 50 of 447 men attending a sexually transmitted disease clinic by culture of urethra, first-void urine or external genitalia. Semen cultures proved valuable for documentation in select cases, including 4 instances when concomitant cultures of the external genitalia, urethra and first-void urine sediment were all negative. Spontaneous resolution was documented in 36% of untreated men but 1 asymptomatic man had persistence of T. vaginalis throughout a 4-month period. Nongonococcal nonchlamydial urethritis was documented in 12 of 21 men (57%) at the visit before treatment or spontaneous resolution compared to only 2 (10%) after elimination of T. vaginalis (p < 0.001). These findings suggest that spontaneous resolution of trichomoniasis and prolonged asymptomatic carriage occur in men with trichomoniasis and that T. vaginalis is a treatable cause of urethritis among sexually active men.

Adult↗
PubMed1992

Risk assessment and laboratory diagnosis of trichomoniasis in men.

Control of Trichomonas vaginalis is assuming higher priority because recent studies have suggested that trichomoniasis enhances susceptibility to human immunodeficiency virus infection and the risk for delivery of low-birth weight infants. In a cross-sectional study, 50 cases were identified among 447 men attending a sexually transmitted disease clinic. As previously reported, trichomoniasis was associated with nonchlamydial nongonococcal urethritis. Other risk factors included sexual contact with an infected woman or prior treatment for trichomoniasis or nongonococcal urethritis. Urethral and first-void urine cultures were positive in 80% and 68% of positive cases, respectively. When combined, these two cultures diagnosed 49 (98%) of 50 cases. These data suggest that criteria for selection of men for culture should include presence of nonchlamydial nongonococcal urethritis, recent exposure to trichomoniasis, or a history of trichomoniasis or nongonococcal urethritis. In addition, combining urethral and urine sediment cultures may prove accurate for evaluating T. vaginalis infection.

Adolescent↗
PubMed1990

Cytomegalovirus infection in women attending a sexually transmitted disease clinic.

To evaluate prospectively the relationship between current and past sexual practices and seroprevalence of cytomegalovirus (CMV) in adult women, 1481 women (1101 white, 301 black, 79 other) attending a sexually transmitted disease clinic underwent a standardized interview and genital examination. CMV seroprevalence was higher in black (78%) than in white (59%) women. In logistic regression models that adjusted for age and years of education, CMV seropositivity in white women was associated with younger sexual debut (P = .001), more lifetime sex partners (P = .025), recent new partner(s) (P = .003), and parity (P = .002), and was inversely associated with use of barrier contraception (P = .006). In black women, after adjustment for demographic characteristics, CMV antibody was associated with greater numbers of recent sex partners (P = .007), new sex partners (P = .04), and with cervical infection with Chlamydia trachomatis (P = .05). This study confirms that sexual activity is an important determinant of CMV infection in both white and black women; however, the relative contributions of sexual and nonsexual transmission of CMV apparently vary and require further investigation.

Adolescent↗
PubMed1988

Immunoblot analysis of the humoral immune response in primary cytomegalovirus infection.

Cytomegalovirus is a common infection in immunologically normal adults. It may cause an asymptomatic infection or may manifest symptomatically as heterophilic-negative mononucleosis. Studies of CMV infection in immunocompromised patients indicate that humoral immune response plays a role in modulating disease severity; however, the effect of antibodies to CMV in modifying disease expression and transmission in immunologically normal individuals has not been well characterized. Using immunoblot technology, we have demonstrated that immune serum from normal adults contains antibodies to at least 15 CMV-associated proteins and that there is strain-to-strain variation in the expression of these immunogens. The kinetics of the immune response were evaluated by using serial sera collected from normal adults after primary CMV infection; analysis of immunoblots of these sera identified one group of antibodies to CMV proteins that arise early and are stable over time, a second group that appear late after infection, and a third group that are variable among patients and over time.

Adult↗