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Biomedical subjects

P E Campos

Publications and source records attributed to P E Campos.

11 recordsLinked to original sources

Utility of the Determine Syphilis TP rapid test in commercial sex venues in Peru.

OBJECTIVES: This study sought to evaluate the utility of the Determine Syphilis TP test performed in Peruvian commercial sex venues for the detection of active syphilis; and determine the feasibility of integrating rapid syphilis testing for female sex workers (FSW) into existing health outreach services. METHODS: We tested 3586 female sex workers for syphilis by Determine in the field using whole blood fingerstick, and by rapid plasma reagin (RPR) and Treponema pallidum haemagglutination assay (TPHA) in a central laboratory in Lima using sera. RESULTS: 97.4% of the FSW offered rapid syphilis testing participated; and among those who tested positive, 87% visited the local health centre for treatment. More than twice as many specimens were RPR reactive using serum in Lima (5.7%) than tested positive by whole blood Determine in the field (2.8%), and although most were confirmed by TPHA, only a small proportion (0.7%) were RPR reactive at >or=1:8 dilutions, and likely indicating active syphilis. Sensitivity, specificity and positive predictive value of the Determine Syphilis TP test in whole blood when compared to serum RPR reactivity at any dilution confirmed by TPHA as the gold standard were 39.3%, 99.2% and 71.4%, respectively. Sensitivity improved to 64.0% when using serum RPR >or=1:8 confirmed by TPHA. Invalid tests were rare (0.3%). CONCLUSIONS: Rapid syphilis testing in sex work venues proved feasible, but Determine using whole blood obtained by fingerstick was substantially less sensitive than reported in previous laboratory-based studies using serum. Although easy to perform in outreach venues, the utility of this rapid syphilis test was relatively low in settings where a large proportion of the targeted population has been previously tested and treated.

Feasibility Studies↗

Introduction: perspectives on therapy with gay, lesbian, and bisexual clients.

The approach that mental health professionals have taken in working with gay, lesbian, and bisexual (GLB) clients has changed dramatically over the past 25 years. Once viewed as being pathological in nature-either a sociopathic personality disorder or a sexual deviation-homosexuality is no long conceptualized as a "disorder" and instead is viewed within the broader context of human diversity. Even with such changes, many mental health professionals nonetheless retain subtle biases against working with gay, lesbian, and bisexual clients, and often lack the necessary information for working with them effectively. This issue of In Session provides a series of articles designed to help practicing therapists to become better aware of those clinical issues if they are to work with GLB individuals-which they are likely to do.

Bisexuality↗

Endemic sporotrichosis.

Although first reported more than a century ago, sporotrichosis, caused by Sporothrix schenckii, still remains a poorly studied disease. Results from recently published studies on sporotrichosis in endemic areas are summarised and assembled with previous findings, providing a comprehensive review that highlights the needs for further research.

Adolescent↗

Situational factors associated with AIDS risk behavior lapses and coping strategies used by gay men who successfully avoid lapses.

While most gay men have reduced behavior practices at high risk for HIV infection, there is growing evidence that many also lapse to unsafe sex. This study examined situational factors related to risk behavior lapses as well as coping strategies used by men who successfully resist lapse urges. A convenience sample of 470 men patronizing gay bars or attending social organization meetings in four cities was surveyed. Forty-five percent of men were classified as "lapsers" (those who had had unprotected anal intercourse in the previous 6 months) and 24% were classified as "resisters" (those who successfully resisted urges to engage in this behavior). All provided information concerning the importance of factors related to the most recent occurrence of either unsafe sex or resisting unsafe urges. Most episodes of unsafe sex occurred outside monogamous relationships and with partners of unknown HIV serostatus, although simply inquiring about partner serostatus was relatively common. Lapsers rated affectionate feelings and wishing to please a partner as well as spontaneity of unsafe sex as the most important situational factors surrounding high-risk behavior. Resisters of unsafe sex urges reported active cognitive self-guidance, experience in safe sex, and recall of both AIDS fears and safety benefits as their most important coping strategies. Gay men who continue high-risk behavior may be overrelying on partner reports of negative serostatus. Lapse prevention approaches tailored to situations that create increased risk vulnerability must be developed. Teaching skills already used by men who successfully resist unsafe sex urges might be one approach.

Acquired Immunodeficiency Syndrome↗

Marijuana sensitivity and panic anxiety.

The authors explore the relationship between marijuana smoking and panic anxiety by examining the effects of marijuana smoking on patients with panic anxiety compared with marijuana's effects on both patient and nonpatient controls. Patients with panic anxiety were found to be particularly likely to experience increased anxiety while smoking marijuana. The majority of panic anxiety patients spontaneously stopped using marijuana because of increased anxiety; continued marijuana smoking in these individuals was found to be infrequent. The results suggest that current marijuana use is atypical of panic anxiety patients.

Adult↗

The effects of timolol maleate on subjective and physiological components of air travel phobia.

Twenty-one monophobic patients with moderately severe fear of flying were exposed to two 40 minute challenge flights after taking either Timolol 20 mg/day or placebo. Heart rate, blood pressure, subjective ratings of anxiety, fear and palpitation and Hamilton Anxiety Scale ratings were made at the predetermined assessment intervals. Post-treatment global ratings of improvement were provided by patients and the attending psychiatrist. Results showed that heart rate significantly increased from baseline with placebo while Timolol successfully inhibited tachycardia during the challenge flights. Subjective ratings of anxiety, fear and palpitations did not show any drug group differences. These variables, however, showed a non-significant decrease from outgoing to return flight assessments after an initial significant increase from baseline scores. Hamilton Anxiety Scale ratings showed a significant decrease from baseline to post-treatment assessments, irrespective of drug group. Global improvement ratings revealed no significant differences between drug groups. Overall ratings by the psychiatrist were generally more positive than patients' ratings, with the difference between the two sources of assessment reaching significance only in the placebo group. Disregarding group membership, heart rate was positively and significantly correlated with subjective ratings of fear, but not with palpitations or ratings of overall anxiety.

Adolescent↗

Ineffective dental and surgical treatment associated with atypical facial pain.

Patients with atypical facial pain (AFP) are subject to ineffective dental and surgical procedures for their pain complaints. Twenty-one of fifty-eight patients (36.2 percent) with AFP had sixty-five dental and surgical treatments, with only one patient showing less pain as a result of the treatment. While the majority of patients (69 percent) with AFP suffered from a psychiatric illness, fourteen (24 percent) of the patients referred for AFP had a specific medical or dental disorder that was causal in their pain complaints. There is a trend for the AFP patient with a psychiatric diagnosis to receive more ineffective treatments than those AFP patients for whom a specific medical or dental diagnosis was made. Patients with AFP should receive conservative dental and medical treatment and a psychiatric assessment before dental and surgical procedures are contemplated.

Adult↗

Psychiatric disorders associated with atypical facial pain.

Atypical facial pain (AFP) patients classically present with a chronic discomfort that is neither anatomic nor dermatomal in distribution. Neuropsychiatric assessment of 68 patients with AFP indicated that 46 (68%) had a specific psychiatric disorder by DSM-III criteria. A wide spectrum of psychiatric disorders was present. The authors emphasize that psychiatric assessment of patients with AFP should be an integral part in early assessments of this disorder, rather than relying on psychiatric opinions after extensive dental and other invasive procedures have been tried in vain and often to the detriment of the patient. Comments on the excellent prognosis in treating the psychiatric syndromes associated with AFP are made.

Chronic Disease↗

A comparison of the safety and efficacy of bupropion HCL and amitriptyline hcl in depressed outpatients.

1. Thirty adult outpatients diagnosed with depressive illness were treated with either bupropion HCL or amitriptyline HCL. 2. Weekly ratings of efficacy and safety were undertaken using the Hamilton Depression, Hamilton Anxiety, Clinical Global Improvement, and Treatment Emergent Symptom Scales. Periodic physical investigations were also performed. 3. After 4 weeks of active treatment patients in both drug groups showed significant improvement on all rating scales. 4. The side effect profile of each drug was clinically different from one another with a notable absence of anticholinergic side effects characteristic of the bupropion group. 5. No significant laboratory or physical changes were found although slight changes in weight were noted with bupropion patients having a slight weight loss and amitriptyline patients a slight weight gain. There were no withdrawal effects from discontinuing either drug.

Adult↗

Postictal bulimia.

Explore the source record for details and available documents.

Feeding and Eating Disorders↗