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  • 1999  (17)
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  • 1999  (17)
  • 1
    Language: English
    In: American Journal of Obstetrics and Gynecology, 1999, Vol.180(5), pp.1110-1114
    Description: Our goal was to determine the persistence of human papillomavirus infection of the cervix in a prospectively evaluated cohort of pregnant women observed from the first trimester until after delivery. A group of 232 women were enrolled in the first trimester of pregnancy and had cervico-vaginal lavage specimens collected for detection of the deoxyribonucleic acid of human papillomavirus. They underwent sampling again in the third trimester (146 patients available) and at 4 to 12 weeks after delivery (83 patients available). Human papillomavirus deoxyribonucleic acid was detected by means of the Hybrid Capture assay. In the first trimester of pregnancy, 31% of the patients had positive test results for human papillomavirus deoxyribonucleic acid, whereas 35.6% had positive results in the third trimester ( = 1.0). A comparison of first-trimester test results with postpartum results (paired data available from 83 patients) showed a decline from 39.8% positivity to 26.5% ( = .04). Comparing third-trimester results with postpartum results (paired data available from 74 patients) showed a decline from 35.1% to 25.7% positivity ( = .12). When specimens positive for human papillomavirus were divided between those containing “high cancer risk” types (9 virus types often associated with dysplasia or malignancy) and “low cancer risk” types (5 types usually found in benign lesions), similar trends were seen, although not all comparisons were statistically significant. The increased prevalence, during pregnancy, of detectable human papillomavirus deoxyribonucleic acid, which was previously reported (Fife et al, Am J Obstet Gynecol 1996;174:1487-93), persists at a similar level throughout pregnancy but declines in the postpartum period. This observation is most consistent with activation of the virus by the physiologic changes of pregnancy. (Am J Obstet Gynecol 1999;180:1110-4.)
    Keywords: Papillomavirus ; Pregnancy ; Cervical Dysplasia ; Detection of Deoxyribonucleic Acid ; Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
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  • 2
    Language: English
    In: Arthritis & Rheumatism, 06/1999, Vol.42(6), pp.1267-1273
    Description: To determine the extent to which the cost of an effective self-care intervention for primary care patients with knee osteoarthritis (OA) was offset by savings resulting from reduced utilization of ambulatory medical services. In an attention-controlled clinical trial, 211 patients with knee OA from the general medicine clinic of a municipal hospital were assigned arbitrarily to conditions of self-care education (group E) or attention control (group AC). Group E (n = 105) received individualized instruction and followup emphasizing nonpharmacologic management of joint pain. Group AC (n = 106) received a standard public education presentation and attention-controlling followup. A comprehensive clinical database provided data concerning utilization and cost of health services during the following year. Only 25 subjects (12%) were lost to followup. The 94 subjects remaining in group E made 528 primary care visits during the year following intervention, compared with 616 visits by the 92 patients remaining in group AC (median visits 5 versus 6, respectively; P 〈 0.05). Fewer visits translated directly into reduced clinic costs in group E, relative to controls (median costs [1996 dollars] $229 versus $305, respectively; P 〈 0.05). However, self-care education had no significant effects on utilization and costs of outpatient pharmacy, laboratory, or radiology services over the ensuing year. The cost per patient to deliver the self-care intervention was estimated to be $58.70. Eighty percent of the cost of delivering effective self-care education to the knee OA patients in this study was offset within 1 year by the reduced frequency and costs of primary care visits. For 〉50% of patients receiving the intervention, the savings associated with fewer primary care visits exceeded the cost of self-care education.
    Keywords: Health Services -- Statistics & Numerical Data ; Osteoarthritis, Knee -- Economics ; Outpatient Clinics, Hospital -- Economics ; Patient Education As Topic -- Economics ; Primary Health Care -- Economics ; Self Care -- Economics;
    ISSN: 0004-3591
    E-ISSN: 1529-0131
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  • 3
    Language: English
    In: The Journal of Infectious Diseases, 1 May 1999, Vol.179(5), pp.1283-1287
    Description: Two groups of human volunteers were inoculated with 2 doses of live Haemophilus ducreyi 35000HP. The reinfection group consisted of 7 subjects who previously had participated in experimental infection with 35000HP to the pustular stage of disease. The control group consisted of 7 naive subjects. Papules developed at 92.8% (95% confidence interval [CI], 66.1%-99.8%) of sites inoculated with live bacteria, in the reinfection group, and at 85.7% (95% CI, 57.2%-98.2%) of sites in the control group. Sixty-nine percent (95% CI, 36.8%-90.9%) of papules evolved into pustules in the reinfection group, compared with 41% (95% CI, 15.2%-72.3%) in the control group. The recovery rates of H. ducreyi from surface cultures and the histopathology of biopsies obtained from both groups were similar. Thus, experimental infection to the pustular stage of disease does not provide protective immunity against subsequent challenge.
    Keywords: Health sciences -- Medical conditions -- Infections -- Haemophilus ducreyi ; Health sciences -- Medical conditions -- Infections -- Haemophilus ducreyi ; Health sciences -- Medical sciences -- Medical research -- Haemophilus ducreyi ; Health sciences -- Medical conditions -- Infections -- Haemophilus ducreyi ; Health sciences -- Medical diagnosis -- Diagnostic methods -- Haemophilus ducreyi ; Health sciences -- Medical conditions -- Infections -- Haemophilus ducreyi ; Biological sciences -- Biology -- Microbiology -- Haemophilus ducreyi ; Behavioral sciences -- Anthropology -- Applied anthropology -- Haemophilus ducreyi ; Health sciences -- Medical conditions -- Physical trauma -- Haemophilus ducreyi ; Health sciences -- Medical conditions -- Physical trauma -- Haemophilus ducreyi
    ISSN: 00221899
    E-ISSN: 15376613
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  • 4
    In: Sexually Transmitted Diseases, 1999, Vol.26(1), pp.26-32
    Description: OBJECTIVE:: To identify factors associated with subsequent sexually transmitted infection (STI) (within 1 year of initial infection) due to Chlamydia trachomatis, Neisseria gonorrhoeae or Trichomonas vaginalis. DESIGN:: SETTING:: PARTICIPANTS:: MAIN OUTCOME MEASURES:: RESULTS:: CONCLUSIONS::
    Keywords: Chlamydia ; Demographic Aspects ; Trichomonas Vaginalis ; Gonorrhea ; Teenage Girls ; Sexual Behavior ; Sexually Transmitted Diseases ; Risk Factors ; Medicine;
    ISSN: 0148-5717
    E-ISSN: 15374521
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  • 5
    Language: English
    In: Journal of Hand Surgery, September 1999, Vol.24(5), pp.1109-1117
    Description: The endoscopic technique for the surgical treatment of carpal tunnel syndrome was developed to decrease postoperative morbidity and accelerate a patient's return to normal activities and work. We used the methods of decision analysis to compare the total cost of the open versus the endoscopic technique. We adopted a societal perspective and included estimates of the costs of medical procedures and complications, as well as lost wages. Our base case analysis showed that the 2 techniques have similar total costs, given the assumptions of our model. The endoscopic approach is more costly if the complication rate of endoscopic surgery exceeds 6.2% (base case estimate, 5.0%). The endoscopic technique is more costly if the risk of career ending injury exceeds 0.001 (base case estimate, 0.0004) and if the average work absence following a complication exceeds 15.5 months (base case estimate, 12 months). In addition, the endoscopic technique is more costly if the difference between the 2 techniques in mean time to return to work is less than 21 days (base case estimate, 26 days). These findings have different implications for recipients and nonrecipients of workers' compensation. If endoscopically treated patients return to work an average of 42 days faster than patients treated with the open technique (24 days vs 66 days), as was documented for nonrecipients of workers' compensation in one large study, the endoscopic strategy would be less costly ($5,599 for endoscopic release vs $7,340 for open surgery). If endoscopically treated patients return to work an average of just 10 days sooner (103 days vs 113 days), however, as was documented for workers' compensation recipients in the same study, the open technique would be less costly ($11,353 for open release vs $11,959 for the endoscopic technique). The relative costs are not sensitive to the direct medical costs of complications. These findings allow prediction of the costs of endoscopic and open surgery under a range of assumptions concerning key parameters. The analyses also emphasize the need for more precise data on risks and costs of surgical treatments for carpal tunnel syndrome. (J Hand Surg 1999;24A:1109–1117. Copyright © 1999 by the American Society for Surgery of the Hand.)
    Keywords: Carpal Tunnel Syndrome ; Carpal Tunnel Release ; Endoscopic Surgery ; Workers' Compensation ; Decision Analysis ; Cost Analysis
    ISSN: 0363-5023
    E-ISSN: 1531-6564
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  • 6
    Language: English
    In: Adolescence, 1999, Vol.34(135), p.621
    Description: Examines gender differences in eating attitudes and behaviors in undergraduate college students (N=471). Anorexic symptomatology was found for 20% of the females and 10% of the males. In general, students without symptomatic attitudes and behaviors had a more positive self-concept and reported...
    Keywords: Anorexia Nervosa ; College Students ; Eating Disorders ; Higher Education ; Sex Differences ; Student Attitudes ; Student Behavior ; Education ; Social Welfare & Social Work ; Psychology
    ISSN: 0001-8449
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  • 7
    Article
    Article
    In: I.D., Jan-Feb, 1999, Vol.46(1), p.79(1)
    Description: Good engineering is only one component of good design and this philosophy represents Hewlett-Packard's new design awareness. Noticing that the company lacked visual and functional consistency in its products, reformers within the company set common guidelines to guide people into one direction. The aim was to make component products coherent with the systems sold by HP. This new awareness extends to the company's facilities. Interactive design stations and tools that will revitalize the design process have been made to match the firm's commitment to excellence.
    Keywords: Office Equipment Industry -- Production Management ; Office Automation Systems -- Design And Construction ; Hewlett-packard Co.
    ISSN: 0894-5373
    Source: Cengage Learning, Inc.
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  • 8
    In: I.D., 1999, Vol.46(1), p.86(1)
    Description: Jet Propulsion Laboratory (JPL) in Pasadena, CA, is tasked with developing products for use in the unmanned exploration of the solar system. Its designers and engineers were responsible for the creation of the Sojourner microrover used for the Pathfinder mission to Mars. The design of the Pathfinder took into account NASA's limited financial resources. JPL was able to stick to NASA's budget by combining off-the-shelf technology and proprietary engineering.
    Keywords: Robotics Laboratories – Product Development ; Spacecraft – Design and Construction ; Space Probes – Design and Construction ; Jet Propulsion Laboratory
    ISSN: 0894-5373
    Source: Cengage Learning, Inc.
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  • 9
    Language: English
    In: Tetrahedron Letters, 1999, Vol.40(8), pp.1479-1482
    Description: A novel epoxycyclooctadiene-delta-lactone, mycoepoxydiene, was isolated from a fungal culture (OS-F66617). Its structure and relative stererochemistry were established using spectroscopic studies, including single-crystal X-ray diffraction analysis. ; Includes references ; p. 1479-1482.
    Keywords: Chemistry
    ISSN: 0040-4039
    E-ISSN: 1873-3581
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  • 10
    Language: English
    In: Social Behavior and Personality: an international journal, 01/01/1999, Vol.27(2), pp.109-128
    Description: Undergraduates (N = 248) at a private, midsize, Midwestern university provided self-reports of their psychological problems; stress; demographic variables; and people to whom they talked when they had problems. Help sources ranged from natural to formal support. Three patterns of psychological problems emerged: internalized distress; alcohol abuse; and dysfunctional eating. Demographic variables included, but were not limited to; gender, age, class, international student status, ethnicity, major, religion, residence, and parental income. Neither levels of psychological problems nor stress had much relation to self-reported talking, although internalized distress predicted talking to a counselor. Many demographic variables, particularly gender, international student status, ethnicity, full-time versus part-time status, and major, predicted talking to help sources. Females acknowledged talking more frequently, but genders showed the same preferences for help sources. Results raise issues of helping students, particularly those with alcohol abuse or eating problems, through either arenas or personnel which are nontraditional.
    Keywords: Subjective Taste Preference;
    ISSN: 03012212
    E-ISSN: 11796391
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