Differential effects of sevoflurane and propofol anesthesia on left ventricular-arterial coupling in dogs.

Background: General anesthetics interfere with arterial and ventricular mechanical properties, often altering left ventricular-arterial (LVA) coupling. We hypothesized that sevoflurane and propofol alter LVA coupling by different effects on arterial and ventricular properties.

Methods: Experiments were conducted in six anesthetized open-chest dogs for the measurement of left ventricular pressure and aortic pressure and flow.

Prevalent herpes simplex virus type 2 infection is associated with altered vaginal flora and an increased susceptibility to multiple sexually transmitted infections.

Background: Prevalent herpes simplex virus type 2 (HSV-2) infection increases human immunodeficiency virus acquisition. We hypothesized that HSV-2 infection might also predispose individuals to acquire other common sexually transmitted infections (STIs).

Methods: We studied the association between prevalent HSV-2 infection and STI incidence in a prospective, randomized trial of periodic STI therapy among Kenyan female sex workers.

Clinical screening for HIV in a health centre setting in urban Kenya: an entry point for voluntary counselling, HIV testing and early diagnosis of HIV infection?

A study was conducted among patients attending a public health centre in Nairobi, Kenya in order to (a) verify the prevalence of HIV, (b) identify clinical risk factors associated with HIV and (c) determine clinical markers for clinical screening of HIV infection at the health centre level. Of 304 individuals involved in the study,107(35%) were HIV positive. A clinical screening algorithm based on four clinical markers, namely oral thrush, past or present TB, past or present herpes zoster and prurigo would pick out 61 (57%) of the 107 HIV-positive individuals.

Increased risk of HIV in women experiencing physical partner violence in Nairobi, Kenya.

As part of a study on etiology of sexually transmitted infections (STI) among 520 women presenting at the STI clinic in Nairobi, data on partner violence and its correlates were analyzed. Prevalence of lifetime physical violence was 26%, mainly by an intimate partner (74%). HIV seropositive women had an almost twofold increase in lifetime partner violence.

Associations of sexual risk taking among Kenyan female sex workers after enrollment in an HIV-1 prevention trial.

Background: Female sex workers (FSWs) often lack the ability to negotiate safer sex and are at high risk for HIV-1 infection and sexually transmitted infections (STIs).

Methods: Seronegative FSWs were enrolled in an STI/HIV-1 prevention trial in Nairobi, Kenya. Demographics and sexual risk taking were assessed every 3 months.

Comparison of cuff-pressure changes in LMA-Classic and the new Soft Seal laryngeal masks during nitrous oxide anaesthesia in spontaneous breathing patients.

Background And Objective: There are concerns over the intra-cuff pressure of the laryngeal mask and laryngopharyngeal morbidity. In a randomized study, the authors compared cuff-pressure changes in the LMA-Classic and the new disposable Soft Seal laryngeal mask during nitrous oxide anaesthesia.

Methods: Two-hundred adult patients were randomly assigned to a size 4 laryngeal mask in two equal-sized groups for airway management: (a) the re-usable LMA-Classic, or (b) the new disposable Soft Seal laryngeal mask.

Monthly antibiotic chemoprophylaxis and incidence of sexually transmitted infections and HIV-1 infection in Kenyan sex workers: a randomized controlled trial.

Context: Sexually transmitted infections (STIs) are common in female sex workers (FSWs) and may enhance susceptibility to infection with human immunodeficiency virus type 1 (HIV-1).

Objective: To examine regular antibiotic prophylaxis in FSWs as a strategy for reducing the incidence of bacterial STIs and HIV-1.

Design, Setting, And Participants: Randomized, double-blind, placebo-controlled trial conducted between 1998-2002 among FSWs in an urban slum area of Nairobi, Kenya.

Comparison of the LMA-classic with the new disposable soft seal laryngeal mask in spontaneously breathing adult patients.

Background: The laryngeal mask airway LMA-Classic has been used widely in clinical practice. A new disposable supraglottic airway device, the Soft Seal LM, has been introduced recently. In a randomized study, the authors compared the LMA-Classic and the disposable Soft Seal LM in terms of their clinical performance, cuff pressures during nitrous oxide anesthesia, position of the laryngeal mask in situ by fiberoptic evaluation, and morbidity in a wide range of routine general surgery procedures.

Reduced HIV risk-taking and low HIV incidence after enrollment and risk-reduction counseling in a sexually transmitted disease prevention trial in Nairobi, Kenya.

There is an urgent need in sub-Saharan Africa to develop more effective methods of HIV prevention, including improved strategies of sexually transmitted infection (STI) prevention or an HIV vaccine. The efficacy of these strategies may be tested through clinical trials within cohorts at high risk for STI and HIV, such as female commercial sex workers. For ethical reasons, standard HIV prevention services, including access to free condoms, risk-reduction counseling, and STI therapy, will generally be offered to all study subjects.

Health-seeking and sexual behaviors among primary healthcare patients in Nairobi, Kenya.

Background: Health-seeking and sexual behaviors are important elements in the control of sexually transmitted infections (STIs).

Goal: To examine patterns of health-seeking behavior and related sexual behavior relevant to improved prevention and care among patients attending primary healthcare (PHC) clinics.

Study Design: A questionnaire covering social, demographic, and healthcare-seeking and sexual behavior information was administered to 555 patients attending three primary healthcare clinics in low socioeconomic areas of Nairobi, Kenya.

Sexually transmitted infections and vaginal douching in a population of female sex workers in Nairobi, Kenya.

Objective: To assess the association between vaginal douching and sexually transmitted infections (STI) among a group of female sex workers (FSWs) in Nairobi, Kenya.

Methods: This study was part of a randomised, placebo controlled trial of monthly prophylaxis with 1 g of azithromycin to prevent STIs and HIV infection in a cohort of Nairobi FSWs. Consenting women were administered a questionnaire and screened for STIs.

Sexually transmitted infections and reproductive health in Azerbaijan.

Background: Little is known about the prevalence of sexually transmitted infections (STIs) and about sexual and reproductive health in Central and Eastern Europe. However, it is clear that major epidemics of STIs currently exist.

Goal: To provide baseline information for the development of national guidelines on the management of STIs in Azerbaijan.

Healthcare-seeking behavior and sexual behavior of patients with sexually transmitted diseases in Nairobi, Kenya.

Background: Sexual and health-seeking behaviors are important components of sexually transmitted disease (STD) control.

Goals: To generate data for improved STD prevention and care, and to assess sexual behavior and relevant health-seeking behavior.

Study Design: A questionnaire to elicit social, demographic, healthcare-seeking, and sexual behavior information was administered to 471 patients attending the referral clinic for STDs in Nairobi, Kenya.

Syphilis control during pregnancy: effectiveness and sustainability of a decentralized program.

Objectives: This study sought to assess the performance, effectiveness, and costs of a decentralized antenatal syphilis screening program in Nairobi, Kenya.

Methods: Health clinic data, quality control data, and costs were analyzed.

Results: The rapid plasma reagin (RPR) seroprevalence was 3.

A randomized, placebo-controlled trial of monthly azithromycin prophylaxis to prevent sexually transmitted infections and HIV-1 in Kenyan sex workers: study design and baseline findings.

Our objectives were to describe the baseline findings of a trial of antibiotic prophylaxis to prevent sexually transmitted infections (STIs) and HIV-1 in a cohort of Nairobi female sex workers (FSWs). A questionnaire was administered and a medical examination was performed. HIV-negative women were randomly assigned to either one gram azithromycin or placebo monthly.

Pattern of sexually transmitted diseases and risk factors among women attending an STD referral clinic in Nairobi, Kenya.

Background: In Kenya, sexually transmitted disease (STD) clinics care for large numbers of patients with STD-related signs and symptoms. Yet, the etiologic fraction of the different STD pathogens remains to be determined, particularly in women.

Goal: The aim of the study was to determine the prevalence of STDs and of cervical dysplasia and their risk markers among women attending the STD clinic in Nairobi.

Effect of a syphilis control programme on pregnancy outcome in Nairobi, Kenya.

Objectives: To assess the impact of a syphilis control programme of pregnant women on pregnancy outcome in Kenya.

Method: Women who came to deliver to Pumwani Maternity Hospital (PMH) between April 1997 and March 1998 were tested for syphilis. Reactive rapid plasma reagin (RPR) tests were titrated and confirmed with treponema haemagglutination test (TPHA).

Validity of the vaginal discharge algorithm among pregnant and non-pregnant women in Nairobi, Kenya.

Objective: To evaluate the validity of different algorithms for the diagnosis of gonococcal and chlamydial infections among pregnant and non-pregnant women consulting health services for vaginal discharge in Nairobi, Kenya.

Methods: Cross sectional study among 621 women with complaints of vaginal discharge in three city council clinics between April and August 1997. Women were interviewed and examined for symptoms and signs of sexually transmitted infections (STIs).

Partner notification of pregnant women infected with syphilis in Nairobi, Kenya.

We examined partner notification among syphilitic pregnant women in Nairobi. At delivery, 377 women were found to be rapid plasma reagin (RPR) reactive. Data were available for 94% of the partners of women who were tested during pregnancy; over 67% of the partners had received syphilis treatment while 23% had not sought treatment mainly because they felt healthy.

Collisions involving mobile intensive care unit vehicles in Flanders, Belgium.

In order to evaluate the risk of collision during emergency responses of mobile intensive care units (MICUs) in Flanders, Belgium, a questionnaire was sent to 37 MICU services. The response rate was 84%. During the study period (1992-96) the incident rates for collision, collision with significant physical harm, and collision leading to a wrecked MICU vehicle were 1 per 52,000 km, 1 per 214,000 km and 1 per 250,000 km, respectively.

HIV/STD: the women to blame? Knowledge and attitudes among STD clinic attendees in the second decade of HIV/AIDS.

We aimed to determine the knowledge and attitudes towards HIV/STDs among women attending an STD clinic by interviewing 520 randomly selected women. Nearly all had heard of HIV/AIDS/STDs, with posters, pamphlets and the radio being the main source of their information. The years of schooling was the only predictive factor of knowing a preventive measure of HIV.

Knowledge, attitudes, and practices regarding emergency contraception among nurses and nursing students in two hospitals in Nairobi, Kenya.

A cross-sectional descriptive study on knowledge, attitudes, and practice about emergency contraception (EC) was conducted among nurses and nursing students using a self-administered questionnaire. One-hundred-sixty-seven qualified nurses and 63 nursing students completed the questionnaire. Over 95% listed at least one regular contraceptive method but only 2.

Declining syphilis prevalence in pregnant women in Nairobi since 1995: another success story in the STD field?

Untreated maternal syphilis during pregnancy will cause adverse pregnancy outcomes in more than 60% of the infected women. In Nairobi, Kenya, the prevalence of syphilis in pregnant women of 2.9% in 1989, showed a rise to 6.

Haemodynamic and electroencephalographic response to insertion of a cuffed oropharyngeal airway: comparison with the laryngeal mask airway.

We have compared the cuffed oropharyngeal airway (COPA), a modified Guedel airway device with a specially designed cuff at its distal end, with the laryngeal mask airway (LMA), on haemodynamic and electroencephalographic (EEG) responses to insertion. In addition, we examined the haemodynamic and EEG changes during initiation of the effect-compartment controlled infusion. We studied 35 female patients undergoing ambulatory gynaecological surgery allocated randomly to received an LMA or COPA to manage the airway.