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  • Elsevier (CrossRef)  (76)
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  • 1
    Language: English
    In: Microbial Pathogenesis, 2006, Vol.40(3), pp.110-115
    Description: express two porin proteins, termed OmpP2A and OmpP2B. To test whether expression of OmpP2A and OmpP2B was necessary for virulence in humans, eight volunteers were experimentally infected with the parent (35000HP) in one arm and a double OmpP2A OmpP2B mutant (35000HP::P2AB) in the other arm. The pustule formation rates were 58.3% (95% CI, 33.2–83.5%) for the parent and 41.7% (95% CI, 19.3–64.0%) for the mutant ( =0.25). Biopsy of 35000HP and 35000HP::P2AB-infected sites yielded similar amounts of bacteria in quantitative culture. These results indicate that expression of OmpP2A and OmpP2B is not necessary to initiate disease or to progress to pustule formation in humans.
    Keywords: Pustule Formation ; Haemophilus Ducreyi ; Porin Proteins ; Uirulence ; Human Challenge Model ; Biology ; Chemistry
    ISSN: 0882-4010
    E-ISSN: 1096-1208
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  • 2
    Language: English
    In: Patient Education and Counseling, October 2012, Vol.89(1), pp.184-190
    Description: To evaluate (PC), a program that employed lay health workers to motivate antiretroviral adherence among persons living with HIV with coverage from Indiana's high-risk insurance pool. Four hundred and forty nine participants living in the greater Indianapolis area were randomly allocated to treatment ( = 91) or control ( = 358) groups and followed for one year. Compared to control subjects, PC subjects were more likely to adhere to HIV medications (medication possession ratio adherence ≥0.95, OR = 1.83, = 0.046), and to achieve undetectable viral load (〈50 copies/mL, OR = 2.01, = 0.011) in the 12 months following introduction of PC. There were no significant differences observed between groups in any of self-reported health status indicators. Estimates suggest that PC clients were 16% more likely to have undetectable viral loads than clients in standard care. The incremental program cost was approximately $10,000 for each additional person who achieved an undetectable viral load. As persons living with HIV experience greater longevity and healthcare reform expands coverage to these high-risk populations, greater demands will be placed on the HIV-care workforce. Results suggest lay health workers may serve as effective adjuncts to professional care providers.
    Keywords: Lay Health Workers ; Medication Adherence ; HIV ; Medicine ; Public Health
    ISSN: 0738-3991
    E-ISSN: 1873-5134
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  • 3
    Language: English
    In: Journal of Adolescent Health, 2006, Vol.38(3), pp.275-281
    Description: Our objective was to describe familial, intrapersonal, and partner-related factors associated with time of day of sexual activity among adolescent women. Annual questionnaires and daily diaries were collected from 106 adolescents. Participants contributed up to 3 questionnaires and 5 12-week diary periods over 27 months. Predictor variables included type of day (weekend, school day, vacation day); partner variables (argument with partner, partner emotional support, time spent with partner); parent/family variables such as supervision, monitoring, and attitudes about adolescent sexual behavior; and mood and behavior variables such as negative mood, positive mood, and sexual interest. The outcome variable for each diary day was no coitus, coitus between noon and 6 , or coitus after 6 . Coitus occurred on 12.0% of the diary days. Coital events were more than twice as likely to occur after 6 (8.5% of days) than in the afternoon (3.5% of days). Afternoon sex was least likely to occur on school days whereas evening sex occurred most often on weekends. An argument with a partner, partner emotional support, time spent with partner, sexual interest, and coital frequency were associated with increased likelihood of afternoon sex, whereas parental supervision and negative mood were associated with decreased likelihood of afternoon sex. For school days, skipping school was associated with increased likelihood of afternoon sex. Evening/night sexual activity was not associated with any parent/family variables. Afternoon sex on school days is relatively uncommon. Direct parental supervision may decrease afternoon sexual activity but relationship and intrapersonal factors also are important factors in the timing of sexual activity on any given day.
    Keywords: Sexuality ; Parents ; Sexual Behavior ; Medicine ; Social Welfare & Social Work
    ISSN: 1054-139X
    E-ISSN: 1879-1972
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  • 4
    Language: English
    In: American Journal of Obstetrics and Gynecology, 1996, Vol.174(5), pp.1487-1493
    Description: Because of incomplete data in the current literature, we sought to determine whether pregnancy is an independent risk for the detection of human papillomavirus infection. Pregnant patients in their first trimester who are seen for routine care at an obstetrics clinic and nonpregnant patients receiving routine care at a sexually transmitted diseases clinic and a gynecology clinic were recruited. Cervical cells were collected by saline solution lavage, and deoxyribonucleic acid was extracted and tested for the presence of human papillomavirus deoxyribonucleic acid with the hybrid capture assay. This assay detects the deoxyribonucleic acid of five “low cancer risk” and nine “high cancer risk” human papillomavirus types with two separate pools of deoxyribonucleic acid probes. Results from 245 pregnant women, 248 patients from the sexually transmitted diseases clinics, and 246 gynecology clinic patients were analyzed. Human papillomavirus deoxyribonucleic acid was detected in samples from 31% of the pregnant patients compared with 17.7% and 18.6% of the sexually transmitted diseases clinic and gynecology clinic patients, respectively. There was no significant difference in positivity for the “low-risk” human papillomavirus types among the three groups (positivity rates from 8.9% to 12.7%), but the pregnant patients had a significantly higher positivity rate for the “high-risk” human papillomavirus types (24.9% compared with 13.3% and 11.4% for the sexually transmitted diseases and gynecology clinic patients, respectively; 〈 0.001). A multiple logistic regression analysis showed that pregnancy was an independent predictor of a positive test result for a “high-risk” human papillomavirus type (odds ratio 1.79, 95% confidence interval 1.11 to 2.89) but not a positive test result for a “low-risk” type. Because sexual activity was not greater among the pregnant patients, we propose that the increased detection of “high-risk” human papillomavirus types among the pregnant patients represents a selective activation of these viruses by hormonal or immunologic factors associated with pregnancy. (A J O G 1996;174:1487-93.)
    Keywords: Pregnancy Complications ; Infectious ; Human Papillomavirus ; Cervix Neoplasms ; Sexually Transmitted Diseases ; Viral ; Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
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  • 5
    Language: English
    In: The Journal of Pediatrics, 1996, Vol.128(2), pp.288-295
    Description: To determine whether condom use among high-risk female adolescents could be increased by a behavioral intervention, with the use of infection with as a biomarker of condom practices. Prospective, randomized, controlled intervention. Urban family planning and sexually transmitted disease clinics. Two hundred nine female adolescents, aged 15 through 19 years, who were treated for genitourinary infection, were randomly assigned to standard (control) or experimental (behavioral intervention) groups. One hundred twelve subjects returned for follow-up 5 to 7 months after enrollment and comprise the study subjects. Subjects completed a multiinstrument questionnaire measuring sexual behavior, condom practices, attitudes and beliefs, cognitive complexity, sociodemographics, and motivation at enrollment and follow-up. Endourethral and endocervical sites were sampled for . Among the 112 subjects who returned for repeated examination, those who had received the experimental intervention reported increased use of condoms by their sexual partners for protection against sexually transmitted diseases (odds ratio = 2.4; = 0.02) and for vaginal intercourse (odds ratio = 3.1; = 0.005) at the 6-month follow-up. Multivariable logistic regression analysis controlling for condom use at enrollment demonstrated that the experimental intervention (odds ratio = 2.8; = 0.03) and the higher cognitive complexity (odds ratio = 4.6; = 0.02) independently contributed to greater condom use at follow-up. Despite greater use of condoms among the group who had received the intervention, use remained inconsistent and rates of reinfection with were not significantly different (26% vs 17%; = 0.3). Although a brief behavioral intervention among high-risk female adolescents can increase condom use by their sexual partners, incident infection does not appear to be reduced, because condom use remained inconsistent. (J P 1996;128:288-95 )
    Keywords: Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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  • 6
    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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  • 7
    Language: English
    In: General Hospital Psychiatry, 2005, Vol.27(5), pp.338-343
    Description: Major depression is common in low-income and chronically ill persons and is a barrier for effective chronic disease care. We evaluated a Medicaid-sponsored strategy for detecting depressive symptoms in adults with diabetes or congestive heart failure. Using a two-item screening tool, 890 adults enrolled in the Indiana Chronic Disease Management Program were assessed by telephone for depressive symptoms between December 2003 and March 2004. A subset of 386 participants also completed the eight-item Patient Health Questionnaire (PHQ-8) depression measure. Antidepressant use was examined using pharmacy claims. Depressed mood or anhedonia was reported by 51% of participants. About one in four participants had a PHQ-8 score indicating a high risk for major depression (score ≥10). The two-item screen was 96% sensitive [95% confidence interval (CI), 89–99%] and 60% specific (95% CI, 54–65%) for identifying members at high risk for depression by the full PHQ-8 instrument. Only half of participants with high-risk PHQ-8 scores had a pharmacy claim indicating that an antidepressant medication was filled within 120 days of the depression screening. A two-stage, telephonic approach involving the PHQ-8 instrument for Medicaid members with either depressed mood or anhedonia could identify two clinically depressed persons for every nine members screened.
    Keywords: Depression ; Disease Management ; Chronic Disease ; Medicaid ; Mass Screening
    ISSN: 0163-8343
    E-ISSN: 1873-7714
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  • 8
    Language: English
    In: The American Journal of Cardiology, 1983, Vol.52(1), pp.112-117
    Description: To determine whether altered baroreceptor function may contribute to systemic hypertension after coarctation of the aorta (C of A) repair, baroreceptor function was evaluated in 6 children with repaired C of A mild arm systolic hypertension. Data were compared with those from 7 normotensive control children with hemodynamically mild heart disease. Age at C of A repair averaged 9.9 +/- 3.1 years (mean +/- standard deviation [SD]). Arm systolic pressure was 143.8 +/- 2.9 mm Hg in the C of A repair group, compared with 118.3 +/- 9.9 for control subjects (p less than 0.001). At catheterization, steady-state sigmoidal baroreceptor function curves relating mean arterial pressure to R-R interval were derived by increasing and decreasing mean arterial pressure with small injections of phenylephrine and nitroprusside. Compared with control subjects, the baroreceptor function curves of children with repaired C of A (1) are reset about a higher baseline mean arterial pressure (108.8 +/- 6.6 versus 90.3 +/- 8.6 mm Hg, p less than 0.01), (2) have a decreased slope (7.9 +/- 3.7 versus 17.4 +/- 3.6 ms/mm Hg, p less than 0.001), and (3) have a diminished R-R interval range (246.7 +/- 81.5 versus 535.7 +/- 97.2 ms, p less than 0.001). Thus, in children with hypertension after C of A repair, the baroreflex is reset to an elevated mean arterial pressure level and has a diminished sensitivity to changes in arterial pressure.
    Keywords: Medicine
    ISSN: 0002-9149
    E-ISSN: 1879-1913
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  • 9
    Language: English
    In: American Heart Journal, 1996, Vol.132(4), pp.893-894
    Keywords: Medicine
    ISSN: 0002-8703
    E-ISSN: 1097-6744
    E-ISSN: 10975330
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  • 10
    Language: English
    In: The Journal of Pediatrics, 1992, Vol.121(3), pp.487-493
    Description: To determine the recurrence rate of chlamydial infections, we initially screened an urban population of 1308 sexually active female adolescents for chlamydial infection at the urethral and endocervical sites; these young women were followed and had additional examinations for infection. Chlamydial infection was documented by tissue culture in 31.1% (407) of them at some time during the study. After appropriate antibiotic treatment, 68.3% (278/407) returned for test-of-cure cultures within 3 months of their initial infection; of those 278, a total of 254 had sterile cultures. These patients were followed to determine the recurrence rate of chlamydial infections. Of these 254 patients, 177 (69.7%) had one or more follow-up visits; 38.4% (68/177) had a recurrent chlamydial infection. The majority of recurrent infections were documented within 9 months of the initial infection. Recurrent infections with the same serovar were frequent, suggesting reinfection by untreated partners or possible relapse of the initial chlamydial infection. This high rate of recurrent infection suggests that female adolescents should be rescreened frequently for genitourinary chlamydial infections.
    Keywords: Medicine
    ISSN: 0022-3476
    E-ISSN: 1097-6833
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