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Search Results: 1 - 10 of 12104 matches for " Stephen Shiboski "
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Sexual Seroadaptation: Lessons for Prevention and Sex Research from a Cohort of HIV-Positive Men Who Have Sex with Men
J. Jeff McConnell,Larry Bragg,Stephen Shiboski,Robert M. Grant
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0008831
Abstract: Surveillance data on sexually transmitted infections (STIs) and behavioral characteristics identified in studies of the risk of seroconversion are often used as to track sexual behaviors that spread HIV. However, such analyses can be confounded by “seroadaptation”—the restriction of unprotected anal intercourse (UAI), especially unprotected insertive UAI, to seroconcordant partnerships.
Evaluating change in health-related quality of life in adult rhinitis: Responsiveness of the Rhinosinusitis Disability Index
Hubert Chen, Patricia P Katz, Stephen Shiboski, Paul D Blanc
Health and Quality of Life Outcomes , 2005, DOI: 10.1186/1477-7525-3-68
Abstract: We studied adults with a self-reported physician diagnosis of rhinitis identified through a national telephone survey. HRQL was assessed at baseline and at 24 months using the RSDI. Symptom severity, physical health status (SF-12 PCS), psychological mood (CES-D), and perceived control of symptoms were also assessed at the time of each interview. In addition, we ascertained specific health outcomes attributed to rhinitis, including days of restricted activity, job effectiveness, number of physician visits, and medication costs.Of 109 subjects interviewed at baseline, 69 (63%) were re-interviewed 24 months later. RSDI scores improved by = 0.5 standardized response mean in 13 (19%) subjects and worsened in 17 (25%). Change in the RSDI over time correlated with changes in symptom severity (r = 0.38, p = 0.001), physical health (r = -0.39, p = 0.001), mood (r = 0.37, p = 0.002) and perceived control of symptoms (r = -0.37, p = 0.01). In multivariate analyses adjusted for baseline health status, improvement in RSDI was associated with less restricted activity (p = 0.01), increased job effectiveness (p = 0.03), and decreased medication costs (p = 0.05), but was not associated with change in the number of physician visits from baseline (p = 0.45).The RSDI is responsive to changes in health status and predicts rhinitis-specific health outcomes.Rhinitis is a common chronic condition and can be a significant source of impairment. To measure the impact of rhinitis on health-related quality of life (HRQL), several disease-specific measures have been developed [1,2]. These instruments vary in length and content. Certain instruments, such as the 28-item Juniper Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), were originally intended to focus on persons with allergic disease [3]. Other instruments, such as the 16-item Sino-Nasal Outcome Test (SNOT-16), focus more on conditions characterized by chronic nasal obstruction, typically sinusitis [4].The Rhinosinusitis Disabilit
Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity
Eisner Mark,Katz Patricia,Yelin Edward,Shiboski Stephen
Respiratory Research , 2001,
Abstract: Background The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial. Methods In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization. Results Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4). Conclusion In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.
Investigating Potential Associations between Cervical Procedures and HIV Acquisition
Khady Diouf,George F. Sawaya,Stephen Shiboski,Tsitsi Magure
ISRN Obstetrics and Gynecology , 2011, DOI: 10.5402/2011/789106
Abstract:
Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity
Mark D Eisner, Patricia P Katz, Edward H Yelin, Stephen C Shiboski, Paul D Blanc
Respiratory Research , 2000, DOI: 10.1186/rr37
Abstract: In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization.Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4).In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.Asthma is a common condition in general medical practice, accounting for about 1% of all ambulatory visits in the USA [1]. The mortality rate from asthma has risen sharply since the late 1970s, which may reflect increasing disease severity [2]. The hospitalization rate, another population-level marker of asthma severity, remains substantial [2], generating nearly one-half of all US health care costs for asthma [3]. Hospitalization rates for asthma have actually increased in some demographic subgroups, such as young adults [2] and the urban poor [4], desp
Chronic Maternal Depression Is Associated with Reduced Weight Gain in Latino Infants from Birth to 2 Years of Age
Janet M. Wojcicki,Katherine Holbrook,Robert H. Lustig,Elissa Epel,Aaron B. Caughey,Ricardo F. Mu?oz,Stephen C. Shiboski,Melvin B. Heyman
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0016737
Abstract: Latino children are at increased risk for mirconutrient deficiencies and problems of overweight and obesity. Exposures in pregnancy and early postpartum may impact future growth trajectories.
Association of Attitudes and Beliefs towards Antiretroviral Therapy with HIV-Seroprevalence in the General Population of Kisumu, Kenya
Craig R. Cohen, Michele Montandon, Adam W. Carrico, Stephen Shiboski, Alan Bostrom, Alfredo Obure, Zachary Kwena, Robert C. Bailey, Rosemary Nguti, Elizabeth A. Bukusi
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0004573
Abstract: Background Since antiretroviral therapy (ART) became available in the developed world, the prevalence of unprotected sex and the incidence of sexually transmitted infections (STIs) and HIV have increased. We hypothesized that a similar phenomenon may be occurring in sub-Saharan Africa concomitant with the scale-up of HIV treatment. Methods We conducted a general population-based survey in Kisumu, Kenya. Participants completed an interview that included demographics as well as ART-related attitudes and beliefs (AB) and then underwent HIV serological testing. Exploratory and confirmatory factor analyses of AB about ART indicated two factors: 1) ART-related risk compensation (increased sexual risk taking now that ART is available); and 2) a perception that HIV is more controllable now that ART is available. Logistic regression was used to determine associations of these factors with HIV-seroprevalence after controlling for age. Findings 1,655 (90%) of 1,844 people aged 15–49 contacted, including 749 men and 906 women, consented to participate in the study. Most participants (n = 1164; 71%) had heard of ART. Of those who had heard of ART, 23% believed ART was a cure for HIV. ART-related risk compensation (Adjusted (A)OR = 1.45, 95% CI 1.16–1.81), and a belief that ART cures HIV (AOR = 2.14, 95% CI 1.22–3.76) were associated with an increased HIV seroprevalence in men but not women after controlling for age. In particular, ART-related risk compensation was associated with an increased HIV-seroprevalence in young (aged 15–24 years) men (OR = 1.56; 95% CI 1.12–2.19). Conclusions ART-related risk compensation and a belief that ART cures HIV were associated with an increased HIV seroprevalence among men but not women. HIV prevention programs in sub-Saharan Africa that target the general population should include educational messages about ART and address the changing beliefs about HIV in the era of greater ART availability.
The Diaphragm and Lubricant Gel for Prevention of Cervical Sexually Transmitted Infections: Results of a Randomized Controlled Trial
Gita Ramjee, Ariane van der Straten, Tsungai Chipato, Guy de Bruyn, Kelly Blanchard, Stephen Shiboski, Helen Cheng, Elizabeth Montgomery, Nancy Padian, for the MIRA team
PLOS ONE , 2008, DOI: 10.1371/journal.pone.0003488
Abstract: Background We evaluated the effectiveness of the Ortho All-Flex Diaphragm, lubricant gel (Replens?) and condoms compared to condoms alone on the incidence of chlamydial and gonococcal infections in an open-label randomized controlled trial among women at risk of HIV/STI infections. Methods We randomized 5045 sexually-active women at three sites in Southern Africa. Participants who tested positive for curable STIs were treated prior to enrollment as per local guidelines. Women were followed quarterly and tested for Chlamydia trachomatis (CT) or Neisseria gonorrhoeae (GC) infection by nucleic-acid amplification testing (Roche Amplicor?) using first-catch urine specimens. STIs detected at follow-up visits were treated. We compared the incidence of first infection after randomization between study arms in both intent-to-treat (ITT) and per-protocol populations. Findings Baseline demographic, behavioral and clinical characteristics were balanced across study arms. Nearly 80% of participants were under 35 years of age. Median follow-up time was 21 months and the retention rate was over 93%. There were 471 first chlamydia infections, 247 in the intervention arm and 224 in the control arm with an overall incidence of 6.2/100 woman-years (wy) (relative hazard (RH) 1.11, 95% Confidence Interval (CI): 0.93–1.33; p = 0.25) and 192 first gonococcal infections, 95 in the intervention arm and 97 in the control arm with an overall incidence of 2.4/100wy (RH 0.98, 95%CI: 0.74–1.30; p = 0.90). Per protocol results indicated that when diaphragm adherence was defined as “always use” since the last visit, there was a significant reduction in the incidence of GC infection among women randomized to the intervention arm (RH 0.61, 95%CI: 0.41–0.91, P = 0.02). Interpretation There was no difference by study arm in the rate of acquisition of CT or GC. However, our per-protocol results suggest that consistent use of the diaphragm may reduce acquisition of GC. Trial Registration ClinicalTrials.gov NCT00121459 [NCT00121459]
A Phase I Randomized Placebo Controlled Trial of the Safety of 3% SPL7013 Gel (VivaGel?) in Healthy Young Women Administered Twice Daily for 14 Days
Craig R. Cohen,Joelle Brown,Anna-Barbara Moscicki,Elizabeth A. Bukusi,Jeremy R. A. Paull,Clare F. Price,Stephen Shiboski
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0016258
Abstract: To assess the safety of VivaGel? used vaginally twice daily for 14 days among healthy, sexually-abstinent women, aged 18–24 years in the USA and Kenya.
miR-19, miR-345, miR-519c-5p Serum Levels Predict Adverse Pathology in Prostate Cancer Patients Eligible for Active Surveillance
Siao-Yi Wang, Stephen Shiboski, Cassandra D. Belair, Matthew R. Cooperberg, Jeffrey P. Simko, Hubert Stoppler, Janet Cowan, Peter R. Carroll, Robert Blelloch
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098597
Abstract: Serum microRNAs hold great promise as easily accessible and measurable biomarkers of disease. In prostate cancer, serum miRNA signatures have been associated with the presence of disease as well as correlated with previously validated risk models. However, it is unclear whether miRNAs can provide independent prognostic information beyond current risk models. Here, we focus on a group of low-risk prostate cancer patients who were eligible for active surveillance, but chose surgery. A major criteria for the low risk category is a Gleason score of 6 or lower based on pre-surgical biopsy. However, a third of these patients are upgraded to Gleason 7 on post surgical pathological analysis. Both in a discovery and a validation cohort, we find that pre-surgical serum levels of miR-19, miR-345 and miR-519c-5p can help identify these patients independent of their pre-surgical age, PSA, stage, and percent biopsy involvement. A combination of the three miRNAs increased the area under a receiver operator characteristics curve from 0.77 to 0.94 (p<0.01). Also, when combined with the CAPRA risk model the miRNA signature significantly enhanced prediction of patients with Gleason 7 disease. In-situ hybridizations of matching tumors showed miR-19 upregulation in transformed versus normal-appearing tumor epithelial, but independent of tumor grade suggesting an alternative source for the increase in serum miR-19a/b levels or the release of pre-existing intracellular miR-19a/b upon progression. Together, these data show that serum miRNAs can predict relatively small steps in tumor progression improving the capacity to predict disease risk and, therefore, potentially drive clinical decisions in prostate cancer patients. It will be important to validate these findings in a larger multi-institutional study as well as with independent methodologies.
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