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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.

We sought to determine the prevalence, trends, and correlates of recent HIV testing (within the past year) among young Asian and Pacific Islander men who have sex with men (API MSM) in two U.S. cities. We conducted serial, cross-sectional, interviewer-administered surveys of 908 API MSM aged 15-25 years, sampled from randomly selected MSM-identified venues annually from 1999 to 2002. The prevalence of recent testing increased from 63% to 71% between the first and fourth year. Recent testing was most significantly associated with ethnicity and with knowledge of testing sites to which respondents felt comfortable going. Other correlates of recent testing included gay identity, comfort with sexual and API identity, having a main partner, social support, and recent unprotected anal intercourse. API MSM who had ever traded sex for material goods or shelter were as likely to have tested recently. HIV prevention campaigns should increase the awareness and availability of culturally appropriate testing sites and urge more frequent testing by young API MSM.

Neurodevelopmental outcomes among infants with total serum bilirubin levels of 25 mg per deciliter or more with those among randomly selected controls are compared. When treated with phototherapy or exchange transfusion, total serum bilirubin levels in the range included in the study were not associated with adverse neurodevelopmental outcomes in infants born at or near term.

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. (Am J Public Health. 1998;88:1208-1212)

HIV-related sexual risk and protective behaviors have no consistent causal relationship with the severity of alcohol and other drug addiction in heterosexuals undergoing alcoholism treatment. Severe addiction problems, high alcohol expectancies, and having sex under the influence of alcohol or drugs are associated with high-risk behaviors. Results suggest the importance of educating alcohol- and drug-dependents to practice safe sex, and addressing both anticipatory and general risk taking behaviors in treatment programs designed for them.

There appears to be little change in the risk factors for heterosexually transmitted HIV among U.S. adults. A group of 1062 adults between 18 and 49 years old in a national sample and 3728 similar adults living in 23 high-risk cities participated in two interviews spaced one year apart about HIV risk factors. In the national sample, the percentage of respondents at high risk showed little change. In the cities sample, the percentage of respondents reporting multiple sexual partners increased by 4%. While some respondents reduced their risk, they were replaced by an equal number of respondents who increased their risk. The annual turnover rate for those at risk from multiple partners is about 39%. Among respondents with multiple partners, slightly over one-third reported seeking HIV testing in both interviews, and condom use rates with the primary partner did not vary. However, condom use rates with secondary partners increased from one interview to the next.

A study reveals that heterosexuals with active sex life, gay or bisexual men in AIDS epicenter and drug addicts undergoing treatments need special attention against HIV infections in America. The alcoholic drinks have negative relationship with sexual risk factors. Prolonged association with the partner initiates sexual expectancies and long alcoholic sessions adversely affect the risk factors consciousness. The habit of socialization in bars enhances the HIV infection risks among homosexuals.

Heterosexuals who abuse alcohol appear to be at a higher risk of contracting HIV than previously thought. A total of 860 heterosexuals in alcohol treatment programs were interviewed and tested anonymously for HIV infection. Forty study participants (5%) tested positive for HIV infection. Sixty-two percent of those who were HIV positive had a history of injection drug use. Additionally, those who had a history of syphilis were more likely to be HIV positive than those who did not. No other sexually transmitted disease appeared to be associated with HIV infection. Almost 85% of participants reported heterosexual activity in the past year. Almost half had at least three sexual partners. Consistent condom use with all sexual partners was reported by 3% of participants. Few participants reported they always asked about a new partner's sexual history or HIV status., Objective.--To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment. Design.--Cross-sectional survey. Setting.--Five public alcohol treatment centers. Subjects.--Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%. Measurements.--Structured interview and serotesting for HIV antibodies. Results.--The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors. Conclusions.--There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs. (JAMA. 1994;271:515-518)

A strategy needs to be developed to increase HIV antibody testing among individuals with risk factors for infection. Researchers examined the rate of HIV testing among 2,673 individuals throughout the US and 8,263 individuals from 23 urban areas with a high incidence of AIDS. Twenty-one percent of the individuals from the US as a whole had been tested at some time. Only 23% of those from urban areas had ever had an HIV test. Frequency of HIV testing was highest among men who had engaged in homosexual activity during the previous five years. It was also high among both male and female intravenous drug users. A low number of individuals from other risk groups had ever been tested. The testing rate was 35% among heterosexuals who had unprotected sex with multiple partners. Public health efforts should emphasize the universal risk of infection and the availability of early treatment for HIV-positive individuals., Objective. - To determine the prevalence of testing for human immunodeficiency virus (HIV) antibody among adults with various risk factors for infection, particularly those residing in large metropolitan areas where the bulk of cases of acquired immunodeficiency syndrome (AIDS) have occurred. Design. - A nationwide, population-based telephone survey eliciting testing, sexual, and injection drug use histories. Participants. - A total of 2673 randomly chosen US residents and 8263 randomly chosen residents of 23 metropolitan areas containing 64% of reported cases of AIDS. Interventions. - None. Main Outcome Measure. - Testing for HIV antibody. Main Results. - Overall, rates of individuals ever tested were only slightly higher in the urban areas (23%) than in the nation as a whole (21 %). Testing frequencies were low among all risk groups (less than 40%), except men engaging in same-sex sexual activity (60%) and male and female injection drug users (46% and 73%, respectively). The low rate of testing (35%) among the largest risk group, heterosexual men and women engaging in unprotected sexual intercourse with multiple partners, was particularly worrisome. Conclusions. - To encourage antibody testing among the many at risk for infection who have not yet been tested, promotional campaigns should explain the universal susceptibility to infection among those at risk, and the availability of prophylactic medical therapies and social support services to persons who are HIV-seropositive. As there were comparable levels of risk-taking behavior among subjects in both samples, these campaigns must be designed to reach all segments of the population.

Objective: To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcoholism treatment, comparing two cross-sectional surveys completed 2 to 3 years apart. Method: Two groups of entrants to alcoholism treatment clinics were recruited, between October 1990 and December 1991 (n = 860; 639 men) and between January 1993 and March 1994 (n = 752; 520 men). Participants underwent a structured interview including an assessment of demographics, substance abuse characteristics and sexual behaviors, as well as serotesting for HIV antibodies. Associations were examined between HIV serostatus and several factors, including demographic variables, substance use and high-risk sexual behaviors. Results: The overall HIV seroprevalence in the first and second samples was 5% (95% CI: 3-6%) and 5% (95% CI: 3-7%). When the two samples were compared, there were no significant differences in prevalence of HIV infection by categories of gender, race, income and most other demographic characteristics with in either sample; history of injection drug use (IDU) was significantly related to HIV serostatus in both samples. Unsafe sexual practices were common in both samples. When samples were combined, those 30 years of age or older were more likely to be HIV infected, and men and women with no reported history of IDU still had an HIV prevalence of 3% and 2%, respectively. More than half of the respondents had two or more partners in the previous 6 months and reported a history of a sexually transmitted disease. Conclusions: There was no change in the substantial prevalence of HIV infection and high-risk behavior among heterosexual clients entering alcoholism treatment programs over the 3.5-year study period. The HIV prevalence among non-IDU clients remained several times higher than published estimates from similar community-based heterosexual samples. These data reinforce the concept that heterosexual noninjection drug users are at high risk for HIV and may benefit from intervention programs. (J. Stud. Alcohol 61: 262-266, 2000), THE AIDS EPIDEMIC in the United States has long been associated with injection drug use (IDU) (Turner et al., 1989). Later it became clear that alcohol and other noninjected drugs [...]

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.