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Biomedical subjects

R A Feinstein

Publications and source records attributed to R A Feinstein.

23 records · Page 2Linked to original sources
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Sexual behavior and sexually transmitted diseases among male adolescents in detention.

BACKGROUND: Youth in detention represent a medically underserved population at risk for a variety of medical and emotional disorders. GOAL OF THE STUDY: To determine prevalence of STDs and high-risk sexual behaviors for HIV/STD among adolescent males admitted to a juvenile detention facility. STUDY DESIGN: Cross-sectional study of behavioral risk factors and STD prevalence among detained males, 11 to 18 years of age. Study subjects were interviewed for behavioral history and screened for STD. RESULTS: The median number of lifetime partners of the population was 8 (range 1-100), the number of partners in the preceding 4 months was 2 in median (range 0-30), 59% used a condom with their last sex, and consistent condom use in the past 4 months was reported by 37%. A history of sexual intercourse within the last one week was reported by 43%. Chlamydia trachomatis infection rate was 6.9% (66/957), Neisseria gonorrhoeae 4.5% (42/940) and syphilis 0.9% (8/930) including one who seroconverted while in detention. Overall, 12% (109/908) of subjects tested for all three infections were positive for at least one STD. Stepwise logistic regression analysis showed that greater than one partner in the previous 4 months (OR 1.53, 95% confidence interval [95% CI] 1.18-1.98), inconsistent or no condom use in the preceding 4 months (OR 1.77, 95%CI 1.37-2.28), a history of recent STD (OR 1.80, 95%CI 1.33-2.42) and greater than five lifetime partners (OR 2.03, 95% CI 1.41-2.92) were independent predictors of these STDs in this population. CONCLUSION: Detained juvenile males in our study were at a high-risk for STD/HIV infections and probably form a core group of STD transmitters. Vigorous attempt to reduce STD reservoir and change behavior of juveniles in detention, such as our study subjects, is urgently needed for the control of the STD/HIV infections.

Adolescent↗
PubMedDate not supplied

A simple "step-test" protocol for identifying suspected unrecognized exercise-induced asthma (EIA) in children.

The purpose of this study was to demonstrate that a simple submaximal "step-test" could be used as an exercise challenge to identify elementary school students with suspected but undiagnosed asthma. This article also describes a protocol for exercise testing that can be used in epidemiological evaluations. School age children grades 1-4 with suspected but undiagnosed asthma were identified by a 12-item questionnaire completed by a parent or guardian. Only students identified with suspected asthma by questionnaire were exercise challenged on a step-test it baseline spirometry was normal and there was no contraindication for intense aerobic activity. Possible asthma was defined as a 15% or greater decrease in FEV1 or a 25% or greater decrease in FEF25-75 from baseline at either 3 or 10 minutes. The exercise protocol included spirometry before and after stepping continuously for 5 minutes at an exercise intensity sufficient to maintain a heart rate between 150 and 200 beats per minute. Heart rate was continuously monitored throughout the exercise period. Testing was completed at school. No complications occurred during the exercise testing. Exercise testing was completed on 548 students with suspected undiagnosed asthma. Thirty students (6%) had exercise test changes in pulmonary function that met established criteria for suspecting asthma. A board-certified pediatric allergist/immunologist or private physician examined 26 of the 30 students with positive exercise testing. Asthma was diagnosed in 23 (88.89%) of these students. All students with impaired pulmonary function after exercise were able to return to class after a short period of observation. In conclusion, a simple, reproducible school-based exercise protocol can be used to identify students with suspected undiagnosed asthma.

Asthma, Exercise-Induced↗