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The article reports on the study of HIV testing trends and correlates among young Asian and Pacific Islander men who have sex with men in two U.S. cities. Although the predominance of HIV infection is comparatively lesser in young Asian and Pacific Islander (API) men who have sex with men (MSM) than it is in MSM of other minority groups in the United States, there are still evidences of increasing number of rectal gonorrhea and syphilis infection portend the possibility of a bigger epidemic. Moreover, young API MSM involve themselves in unprotected anal intercourse as often or more often than MSM from other racial/ethnic groups and show other obvious high-risk behaviors such as many sexual partnerships.

Assesses the relationship between ascorbic acid use and gallbladder disease in the United States. Effect of the nutrient in cholesterol catabolism; Percentage of survey subjects who reported the disease due to ascorbic acid deficiency.

This article estimates the extent of response bias in seven measures of HIV-related sexual behaviors. The lack of a gold standard for validating self-reports is particularly troubling with respect to HIV-related behavior. To the extent that self-reports are affected by response bias, the prevalence of high-risk practices will be underestimated, hindering efforts to slow the spread of HIV. In this study, the researchers estimated the extent of socially desirable response tendency in injecting drug users' self-reports of high-risk injection-related and sexual behaviors. Three measures of injection risk behavior were employed, along with four measures of sexual risk. The measures included composite measures of both injection-related and sexual risk behaviors that took account of contextual factors such as whether a risky behavior was performed with a regular sexual partner believed to HIV-negative. The central working hypothesis of this study was that socially desirable response tendency would downwardly bias the reporting of high-risk behavior.

Presents a report on the effects of orally administered ascorbic acid in animal studies. Examination of the relationship between serum ascorbic acid levels and prevalence of elevated blood lead levels; Design, setting and participants; Main outcome measures; Results; Suggestion that high serum levels of ascorbic acid are independently associated with decreased prevalence of elevated blood lead levels.

Examines the relationship of serum ascorbic acid level to serum vitamin B12, serum ferritin, and kidney stones in American adults. Baseline characteristics of study population; Association of serum ascorbic acid level with higher serum vitamin B12 levels among women in regression models that assumed a linear relationship.

Objectives. This study examined the correlates of clinical gallbladder disease among US adults and whether serum ascorbic acid levels are associated with a decreased prevalence of gallbladder disease. Methods. Cross-sectional analyses of data from the Second National Health and Nutrition Examination Survey were conducted. Results. A total of 384 women (8%) and 107 men (3%) reported a history of gallstone disease, and 347 women (7%) and 81 men (2%) reported a history of cholecystectomy. An inverted U-shaped relation was found between serum ascorbic acid level and clinical gallbladder disease among women but not among men. Conclusions. Ascorbic acid, which affects the catabolism of cholesterol to bile acids and, in turn, the development of gallbladder disease in experimental animals, may reduce the risk of clinical gallbladder disease in humans. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of resident and attending physician gender on the evaluation of residents in an internal medicine training program.Design: Cross-sectional study.Setting: Large urban academic internal medicine residency program.Participants: During their first 2 years of training, 132 residents (85 men, 47 women) received a total of 974 evaluations from 255 attending physicians (203 men, 52 women) from 1989 to 1995.Measurements: The primary measurements were the numerical portions of the American Board of Internal Medicine evaluation form. Separate analyses were performed for each of the nine evaluation dimensions graded on a scale of 1 to 9. The primary outcome was the difference in the average scores received by each resident from male versus female attending physicians.Results: Compared with female trainees, male residents received significantly higher scores from male attending physicians than from female attending physicians in six of the nine dimensions: clinical judgment, history, procedures, relationships, medical care, and overall. Similar trends, not reaching conventional levels of statistical significance, were observed in the other three categories: medical knowledge, physical exam, and attitude. These differences ranged from 0.24 to 0.60 points, and were primarily due to higher grading of male residents by male attending physicians than by female attending physicians.Conclusions: In one academic training program, we found a significant interaction in the grading process between the gender of internal medicine residents and the gender of their attending evaluators. This study raises the possibility that subtle aspects of gender bias may exist in medical training programs. [ABSTRACT FROM AUTHOR]

The article presents a study that the significance of providing home fecal occult blood test (FOBT) kits to eligible patients during influenza inoculation clinics on higher colorectal cancer screening rates in the U.S. The study was conducted to 514 patients aged 50-79 years. The results revealed that FOBT screening rates increased by 4.4 percent in the control group and by 29.8 percent in the intervention group.

CONTEXT: Having a boyfriend or girlfriend, especially an older one, is associated with increased sexual risk in early adolescence. The mechanisms underlying this association are unclear. METHODS: Middle school students in Northern California were surveyed annually from 1997 to 2000. For a sample of 1,214 males and 1,308 females who were sexually inexperienced in seventh grade, logistic and linear regression were used to explore associations between relationship status in seventh grade and sexual activity in ninth grade, controlling for sixth-grade and eighth-grade characteristics. RESULTS: Males who had had a girlfriend their age by seventh grade were more likely than those who had had no relationship to report sexual activity in ninth grade (odds ratio, 2.1). Similarly, for females, the odds of being sexually active in ninth grade were elevated among those who had had a boyfriend their age (2.9); however, they also were higher among those who had had an older boyfriend than among those who had had one their age (2.1). With sixth-grade risk factors controlled, relationship status in seventh grade remained significant only for females; the association was explained by early menarche and by participation in situations that could lead to sex and riskier peer norms in eighth grade. For males, eighth-grade situations that could lead to sex, Hispanic ethnicity and sixth-grade peer norms explained ninth-grade sexual behavior. CONCLUSIONS: To reduce the risk of adolescent sexual activity, parents and communities should encourage youth in middle school, especially females who experience early menarche, to delay serious romantic relationships. [ABSTRACT FROM AUTHOR]

: PurposeTo determine whether an intensive cognitive-behavioral intervention begun during hospitalization when combined with transdermal nicotine replacement therapy is more effective than a minimal counseling intervention combined with transdermal nicotine replacement therapy in helping inpatients to quit smoking.: MethodsA total of 223 patients who smoked were enrolled in a hospital-based randomized smoking cessation trial at the San Francisco Veterans Affairs Medical Center. One hundred and seven participants (48%) received intensive counseling and outpatient telephone follow-up; 116 participants (52%) received minimal counseling. All study participants received 2 months of transdermal nicotine replacement therapy. We determined 6-month quit rates by self-report and measured saliva cotinine levels or obtained proxy reports to confirm self-reported smoking cessation at 12 months. Analyses adjusted for baseline differences in the distribution of coronary disease.: ResultsAt 6 months, 35% (36/103) of the intensive intervention group reported quitting, compared with 21% (23/109) of the comparison group (relative risk [RR] = 1.7; 95% confidence interval [CI]: 1.1 to 2.7). At 12 months, the self-reported quit rate was 33% (33/99) in the intensive intervention group versus 20% (21/103) in the comparison group (RR = 1.7; 95% CI: 1.1 to 2.7). Based on biochemical or proxy confirmation, 29% (30/102) in the intensive intervention group versus 20% (21/107) in the comparison group quit smoking at 12 months (RR = 1.6; 95% CI: 0.96 to 2.5).: ConclusionHospital-initiated smoking cessation interventions that include transdermal nicotine replacement therapy can improve long-term quit rates. [Copyright &y& Elsevier]

Objectives. The effect of local workplace smoking laws in California was assessed to determine whether such laws increase smoking cessation. Methods. Workplace smoking ordinance data from 1990 were appended to 1990 California Tobacco Survey data from 4680 adult indoor workers who were current cigarette smokers or reported smoking in the 6 months before the survey. Ordinance effects on cigarette smoking and worksite policy were estimated by using multiple logistic regression controlling for sociodemographic variables. Results. Smokers who worked in localities with a strong workplace ordinance (compared with no workplace ordinance) were more likely to report the existence of a worksite smoking policy (odds ratio [OR]: 1.6; 95% confidence interval [CI] = 1.2, 2.2) and to report quitting smoking in the prior 6 months (OR = 1.5; 95% CI = 1.1, 1.7). In communities with strong ordinances, an estimated 26.4% of smokers quit smoking within 6 months of the survey and were abstinent at the time of the survey, compared with an estimated 19.1% in communities with no ordinance. Conclusions. Workplace smoking ordinances increased smoking cessation among employed smokers, indicating that these laws may benefit smokers as well as nonsmokers. (Am J Public Health. 2000; 90:757-761) [ABSTRACT FROM AUTHOR]

The article estimates HIV incidence from first-time testers among voluntary counseling and testing clients in Uganda. It reveals a new phase of the HIV epidemic in the country: decreasing prevalence and increasing incidence, especially among middle-aged persons. The results support the need for intensified prevention interventions among middle-aged persons in Uganda.

Background: Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration.Methods: In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects.Results: There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, -0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, -0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups.Conclusions: In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00037154.). [ABSTRACT FROM AUTHOR]

Background: Bupropion hydrochloride is recommended for smoking cessation; however, there have been relatively few clinical trials examining its efficacy. Methods: A total of 244 current smokers were enrolled in an outpatient randomized blinded smoking cessation trial conducted at the San Francisco Veterans Affairs Medical Center, San Francisco, Calif. Of the 244 participants, 121 received a 7-week course of bupropion and 123 received placebo. All participants received 2 months of transdermal nicotine replacement therapy and 3 months of cognitive-behavioral counseling. We determined on-medication treatment, end-of-medication treatment, 3-month, 6-month, and 1-year quit rates. Results: During treatment with bupropion vs placebo, there was a trend toward increased quit rates among participants randomized to bupropion; the self-reported end- of-medication treatment quit rates were 64% for the bupropion group vs 57% for the placebo group (P=.23). The trend favoring bupropion persisted at 3 months of follow-up (P=.12) but was not apparent at 6 months and 1 year of follow-up (both P>.78). The 12-month quit rates, validated by either saliva cotinine or spousal proxy, were 22% in the bupropion group and 28% in the placebo group (P=.31). Based on biochemical validation, 19% of the bupropion group vs 24% of the placebo group had quit smoking by 1 year (P=.36). Conclusions: In this randomized blinded trial of mostly veteran participants, the addition of a brief 7-week bupropion trial to treatment with nicotine replacement therapy and counseling did not significantly increase smoking cessation rates. [ABSTRACT FROM AUTHOR]

Objectives. The National AIDS Behavioral Survey (1990-1992) of heterosexsual adults (18-49 years) measured human immunodeficiency virus (HIV) risk factors, condom use, and HIV antibody testing, with a focus on major "high-risk" cities. Methods. A longitudinal survey was conducted. Results. There was little reduction in the overall prevalence of HIV risk factors in the national or high-risk cities cohorts over time. Despite this picture of stability, approximately 36% of the population at risk for HIV because of multiple sexual partners turns over annually. There was little change in HIV test-seeking or in consistent condom use with primary sexual partners. Although the majority of at-risk respondents used condoms sporadically or not at all (65%), a significant increase in condom use was found among those reporting multiple sexual partners in both waves, particularly among Black heterosexuals. Data from other surveys and condom sales nationally support the findings. Conclusions. There is a need for a series of surveys in this area to assess the reliability of the present findings and to monitor the general US population's response to prevention programs. [ABSTRACT FROM AUTHOR]

In a study of risk behavior among heterosexuals, 9% of a national sample and 12% of a sample drawn from high-risk cities report having two or more sexual partners in the year before the survey. In both samples, sex with multiple partners is most common among men, younger people and the unmarried. Multivariate analyses show that racial and ethnic differences in the proportion of respondents with multiple partners vary by marital status. The results indicate that many heterosexuals are failing to protect themselves against sexually transmitted diseases: Among respondents with multiple partners, only 18% of men and 22% of women always use condoms with their primary partner, and 28% of men and 32% of women always use them with secondary partners. These proportions do not increase significantly with the number of partners; in general, almost half of men and women with multiple partners never use condoms. [ABSTRACT FROM AUTHOR]

Objectives. This paper measured the extent to which human immunodeficiency virus (HIV) infection has spread among the male working-class population of Santos, Brazil. Methods. Questionnaires on risk behaviors and blood tests were administered to a random sample (n = 395) of male port workers employed by the Santos Port Authority. Results. Although the rate of HIV infection among these men--the working-class male population of Santos--remains low (1.1%), self-reported behavioral risks for HIV infection are common. Conclusions. There is still time to prevent a widespread outbreak of HIV infection among the heterosexual population of Santos and of the transportation corridors emanating from that city. [ABSTRACT FROM AUTHOR]

Background: The neurodevelopmental risks associated with high total serum bilirubin levels in newborns are not well defined. Methods: We identified 140 infants with neonatal total serum bilirubin levels of at least 25 mg per deciliter (428 μmol per liter) and 419 randomly selected controls from a cohort of 106,627 term and near-term infants born from 1995 through 1998 in Kaiser Permanente hospitals in northern California. Data on outcomes were obtained from electronic records, interviews, responses to questionnaires, and neurodevelopmental evaluations that had been performed in a blinded fashion. Results: Peak bilirubin levels were between 25 and 29.9 mg per deciliter (511 μmol per liter) in 130 of the newborns with hyperbilirubinemia and 30 mg per deciliter (513 μmol per liter) or more in 10 newborns; treatment involved phototherapy in 136 cases and exchange transfusion in 5. Follow-up data to the age of at least two years were available for 132 of 140 children with a history of hyperbilirubinemia (94 percent) and 372 of 419 controls (89 percent) and included formal evaluation at a mean (±SD) age of 5.1±0.12 years for 82 children (59 percent) and 168 children (40 percent), respectively. There were no cases of kernicterus. Neither crude nor adjusted scores on cognitive tests differed significantly between the two groups; on most tests, 95 percent confidence intervals excluded a 3-point (0.2 SD) decrease in adjusted scores in the hyperbilirubinemia group. There was no significant difference between groups in the proportion of children with abnormal neurologic findings on physical examination or with documented diagnoses of neurologic abnormalities. Fourteen of the children with hyperbilirubinemia (17 percent) had “questionable” or abnormal findings on neurologic examination, as compared with 48 controls (29 percent; P=0.05; adjusted odds ratio, 0.47; 95 percent confidence interval, 0.23 to 0.98; P=0.04). The frequencies of parental concern and reported behavioral problems also were not significantly different between the two groups. Within the hyperbilirubinemia group, those with positive direct antiglobulin tests had lower scores on cognitive testing but not more neurologic or behavioral problems. Conclusions: When treated with phototherapy or exchange transfusion, total serum bilirubin levels in the range included in this study were not associated with adverse neurodevelopmental outcomes in infants born at or near term. N Engl J Med 2006;354:1889-900. [ABSTRACT FROM AUTHOR]

Background: Saw palmetto is used by over 2 million men in the United States for the treatment of benign prostatic hyperplasia and is commonly recommended as an alternative to drugs approved by the Food and Drug Administration. Methods: In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The primary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal urinary flow rate. Secondary outcome measures included changes in prostate size, residual urinary volume after voiding, quality of life, laboratory values, and the rate of reported adverse effects. Results: There was no significant difference between the saw palmetto and placebo groups in the change in AUASI scores (mean difference, 0.04 point; 95 percent confidence interval, –0.93 to 1.01), maximal urinary flow rate (mean difference, 0.43 ml per minute; 95 percent confidence interval, –0.52 to 1.38), prostate size, residual volume after voiding, quality of life, or serum prostate-specific antigen levels during the one-year study. The incidence of side effects was similar in the two groups. Conclusions: In this study, saw palmetto did not improve symptoms or objective measures of benign prostatic hyperplasia. (ClinicalTrials.gov number, NCT00037154.) N Engl J Med 2006;354:557-66. [ABSTRACT FROM AUTHOR]