A study of human papillomavirus on vaginally inserted sex toys, before and after cleaning, among women who have sex with women and men.

OBJECTIVES: The objective of the study was to determine the potential of human papillomavirus (HPV) transmission via shared sex toys, and determine whether cleaning practices implemented by the study participants were effective. METHODS: Vibrator 1 was composed of thermoplastic elastomer. Vibrator 2 was composed of silicone. Twelve women, recruited from a university, used each vibrator on separate occasions and provided self-collected vaginal and vibrator samples (obtained from the vibrator shaft and handle), collected immediately after use, immediately after cleaning with a commercially available cleaner, and 24 h after cleaning. Vaginal and vibrator samples were assessed for HPV DNA by the Roche Linear Array HPV Genotyping Test. RESULTS: HPV was detected in the vaginal samples of 9/12 (75%) women. Vibrator 1 shaft swabs were HPV positive before cleaning in 89% (8/9), immediately after cleaning in 56% (5/9), and 24 h after cleaning in 40% (2/5) of those that were HPV positive immediately after cleaning. Vibrator 2 shaft swabs were HPV positive before cleaning in 67% (6/9), immediately after cleaning in 44% (4/9), and 24 h after cleaning in none. CONCLUSIONS: HPV was detected on at least one vibrator immediately after use in the women with vaginal HPV. This supports the potential for HPV transmission via shared sex toy use, and is additionally supported by continued detection of HPV up to 24 h after standard cleaning. The data add to understanding of the range of sexual behaviours associated with HPV transmission, and the need for evidence-based recommendations for sex toy cleaning.

Embedding Physical Activity into Community-Based Peer Support Groups for those Severely Affected by Mental Illness.

Despite a growing evidence base on the effectiveness of community-based physical activity interventions for mental health, there is a lack of studies that focus on those affected by severe mental illness (SMI), who often experience poorer physical health, and are less physically active than the wider population. The use of peer support groups in this context is also understudied, despite benefits being documented in other contexts. This study examined the impact and process of a nationwide project to embed physical activity into peer support groups for those affected by SMI. Following the embedding of physical activity within peer support groups, interviews and focus groups were conducted to explore the experiences of those involved with the project and analysed using reflexive thematic analysis. The key findings related to: 1) the social aspects of embedding physical activity in the groups; 2) the focus on peer support and informal physical activity (rather than organised sport) being beneficial; 3) doing things differently and lessons to learn; and 4) the impact of the COVID-19 pandemic. Overall, we found that peer support is an important feature to include in projects encouraging those severely affected by mental illness to become more physically active.

Field collection of rectal samples for sexually transmitted infection diagnostics among men who have sex with men.

Rectal sexually transmitted infections (STIs) are common in men at risk for urethral infections with these pathogens, particularly men who have sex with men (MSM). However, for those individuals not regularly seen by a clinician, screening for rectal STI is not currently a widespread option. Qualitative data and samples (i.e. self-obtained rectal specimens) were collected from 75 MSM in a variety of venues. Upon completion of the rectal self-sampling, each participant completed a brief interview regarding their overall experience with the process. Participants reported an overall high level of acceptability and comfort-level involved with self-sampling for rectal STI. Of the majority of men who agreed to provide a rectal self-sample, all reported that they would provide a sample again in the future. However, many men also appreciated the interaction with a health-care provider that a clinical setting offered. In conclusion, self-sampling is a feasible and acceptable option when offered to MSM in a range of community-based venues. Further research is needed to determine which combinations of STI testing and treatment methods (including self-sampling) are most appropriate for diverse groups of men.

Penile dimensions and men's perceptions of condom fit and feel.

OBJECTIVES: Sexual health professionals continue to promote correct and consistent condom use among sexually active individuals yet research indicates that some men remain resistant to using condoms because of perceptions that they do not fit properly or feel comfortable. This study empirically assessed relations between men's penile dimensions and their perceptions of condom fit and feel. METHODS: Data related to demographics, a bivariate calculation of erect penile length and circumference, and perceptions of condom fit and feel were analysed from 1661 adult men from 50 US states RESULTS: While many men reported that condoms generally fit fine and feel comfortable, at clearly identifiable intersections of length and circumference relations between penile dimensions and perceptions of condom fit and feel existed, particularly for those men who felt that condoms were "too long" (p<0.004), "too short" (p<0.001), "too loose" (p<0.047) or "too tight" (p<0.001). CONCLUSIONS: These analyses provide empirical insights into the relations between bivariate penile dimensions (the intersection of length and circumference) and men's perceptions of the positive and negative aspects of condom fit and feel. Those men with the most negative perceptions of condom fit and feel may benefit from an assessment of their condom-related concerns as a component of community and clinic based STI prevention interventions in order to help them select from the variety of condoms in the marketplace that they may find to be better fitting or more comfortable.

Relations between sexually transmitted infection diagnosis and sexual compulsivity in a community-based sample of men who have sex with men.

OBJECTIVE: To assess relations between sexual compulsivity and a history of sexually transmitted infection (STI) diagnosis and testing among a community-based sample of men who have sex with men (MSM) in a mid-size urban area of the midwestern United States. METHODS: Sexual health data were collected from 504 MSM in the metropolitan area of Indianapolis, Indiana, using a community-based participatory research approach. Sexual compulsivity scores were assessed using the Sexual Compulsivity Scale (SCS). RESULTS: The reliability and construct validity of the SCS were determined to be high in the total study sample. Men who scored high on the SCS reported higher levels of sexual risk behaviour with both male and female partners and were significantly more likely to have been diagnosed with STI (including chlamydia, gonorrhoea, both hepatitis A and B, and syphilis) than other men. Men who scored high on the SCS were not more likely than other men to have been tested for STI, despite higher levels of sexual risk. CONCLUSIONS: The SCS may be useful as a supplemental instrument in public health programmes and healthcare settings that encourage men to assess their sexual behaviours and make decisions to pursue STI or HIV screening. For those already diagnosed with an STI, the SCS may help providers to identify the cognitive and affective components of sexual behaviours that increase the likelihood that an STI will be transmitted to a sexual partner.

A new eyedrop dispensing bottle.

PURPOSE: To report a new eyedrop dispensing container that allows administration of eyedrops while the head of the patient is in the usual upright position. METHODS: An eyedrop dispensing container with a dip tube extending to the bottom, an automatic venting mechanism, and an angulated dispensing tube was developed. RESULTS: The problem of unwanted efflux of fluid was solved by incorporating the automatic venting mechanism. The final design includes an adjustable, angulated dispensing tube and "single structure" construction incorporating the cap. A removable cheek rest is also provided. The design allows eyedrops to be instilled while the patient's head is in the upright position and even when spectacles are being worn. A prototype 15-ml bottle delivered an eyedrop volume of 19.7+/-1.2 microl (mean +/- SD) (n = 75). CONCLUSION: This new eyedrop bottle should allow precise self-administration of eyedrops by a patient in front of a mirror, without a need to change head position.

Herpes simplex virus type 2 serological testing at a community court: predictors of test acceptance and seropositivity among female defendants.

Despite the high prevalence of herpes simplex virus type 2 (HSV-2), testing for asymptomatic infections is uncommon. One population for whom targeted interventions may be prioritized include individuals involved with the correctional system. Here we describe the acceptability of a novel HSV-2 screening program, implemented in a court setting, as a possible intervention for corrections-involved women. Female defendants completed an interviewer administered survey assessing factors associated with uptake/refusal of free point-of-care HSV-2 serologic testing and HSV-2 seropositivity. Participants included 143 women, 18-62 years old (mean 32.85) with diverse ethnicities. The majority (65.7%) accepted testing and 62.4% tested HSV-2 seropositive. Factors independently associated with test acceptance included higher perceived susceptibility to genital herpes infection and not receiving a preventative health screen. Women who were seropositive tended to be older, Black, report having previous STI, and be arrested on a prostitution charge. Findings suggest point-of-care testing in a court setting is acceptable to women and can be implemented to improve case finding of STI.

Low acceptance of HSV-2 testing among high-risk women.

We evaluated the acceptability of a community-based herpes simplex virus type 2 (HSV-2) screening programme for at-risk women and assessed factors related to uptake of point of care HSV-2 testing. One hundred recently arrested women (median age 34 years) were recruited from a community court handling lower-level misdemeanour cases in Indianapolis, Indiana. Individuals completed a survey assessing factors related to HSV-2 screening intentions and were offered point of care HSV-2 testing. Rates of HSV-2 infection in this population are high; 61.1% of women tested were positive. The majority (81%) accepted a prescription for suppressive therapy. Women in this sample indicated that HSV-2 screening is an important component of health care but were unwilling to pay the US$10 it cost to be tested. To encourage this and other high-risk populations to be screened for HSV-2, public health resources will be needed to help individuals overcome cost-related barriers to care.

The computer in the consulting room. What can it do for the physician?

Helen Mawhinney, M.D., of McLure, Moynihan and Associates and the University of California-Los Angeles, and Brad Dodge of Health Communication Services Inc., write about the use of computer-based medical records and their effects on patient care, decision making and data generation.

A method for the differentiation of presynaptic inhibitors of adrenergic neurotransmitter release.

Injection of clonidine hydrochloride, 30 microgram/kg iv, or bretylium tosylate, 5 mg/kg iv, in pithed male spontaneously hypertensive rats inhibits the pressor responses to stimulation of the total sympathetic outflow, and enhances those to injected noradrenaline. The intravenous injection of d-amphetamine sulphate, 200 microgram/kg, reverses bretylium inhibition of the responses to sympathetic stimulation but not that of clonidine. Yohimbine, 10 microgram/kg/min iv on the other hand, reverses clonidine inhibition of the responses to sympathetic stimulation, but not that of bretylium. This pharmacological analysis provides a method for the differentiation of the mechanism of effect of two types of antihypertensive drug which act presynaptically to impair the release of the neurotransmitter from sympathetic nerves, viz., sympathetic neurone blocking agents (such as bretylium tosylate) and presynaptic alpha-adrenoceptor stimulants (such as clonidine hydrochloride).

Noncemented porous-coated anatomic total hip arthroplasty.

In 1984, as an alternate to the acrylic fixation of the components of total hip arthroplasty, the use of an uncemented porous-coated anatomic (PCA) hip system with a beaded porous coating to achieve biologic fixation was initiated. Since then, 44 patients with cementless acetabular components and 35 patients with cementless femoral components have been followed for a minimum of 24 months and an average of 37 months. Harris hip scores averaged 90.5 at most recent follow-up intervals. No reoperations were necessary for failures of fixation or change in position of the acetabular component. Ominous roentgenographic signs such as progressive bead shedding, progressive radiolucencies, or progressive component migration have not occurred. Two femoral component revisions have been necessary: one for intractable pain and one for pain and roentgenographic loosening. Although thigh pain has been prevalent (20%), all patients have been accommodated and have retained stable hip scores. Progressive radiolucencies and progressive implant subsidence have been rare occurrences. The authors continue to use the cementless acetabular component in all cases of total hip arthroplasty in which initial stability can be obtained. It is their preference to cement the femoral component in patients over 65 or when initial stability cannot be achieved.

Intravenous regional anesthesia: a safe and cost-effective outpatient anesthetic for upper extremity fracture treatment in children.

We reviewed our most recent 100 consecutive cases with respect to efficacy and safety of anesthesia in which Bier block anesthesia was used to reduce upper extremity fractures. Records were reviewed to document diagnosis, number of reduction attempts, efficacy of anesthesia, and incidence of complications and untoward effects. No adverse effects were noted from lidocaine injection or tourniquet release. The cost of Bier block anesthesia administered in the emergency room (ER) was significantly less than that of a general anesthetic in the operating room. We have found the Bier block to be a safe, reliable, and cost-effective anesthetic in treatment of children's upper extremity fractures in the ER.

Pediatric pelvic ring fractures.

Pelvic fractures are uncommon in children, yet they rank second to those of the skull in terms of complications. Thirty-six pediatric patients who sustained pelvic fractures were retrospectively studied, and a recent follow-up examination was conducted in 29 of the patients. All fractures were classified using Torode and Zieg's system, and the severity of injury was classified using the Modified Injury Severity Score (MISS). Associated injuries occurred in 67% of the patients, with long-term morbidity or mortality in 30%. The high probability of associated injuries must be appreciated, as even minimal bony injury may be associated with life-threatening visceral injuries and morbidity.

Influence of catalase and superoxide dismutase on ozone inactivation of Listeria monocytogenes.

The effects of ozone at 0.25, 0.40, and 1.00 ppm on Listeria monocytogenes were evaluated in distilled water and phosphate-buffered saline. Differences in sensitivity to ozone were found to exist among the six strains examined. Greater cell death was found following exposure at lower temperatures. Early stationary-phase cells were less sensitive to ozone than mid-exponential- and late stationary-phase cells. Ozonation at 1.00 ppm of cabbage inoculated with L. monocytogenes effectively inactivated all cells after 5 min. The abilities of in vivo catalase and superoxide dismutase to protect the cells from ozone were also examined. Three listerial test strains were inactivated rapidly upon exposure to ozone. Both catalase and superoxide dismutase were found to protect listerial cells from ozone attack, with superoxide dismutase being more important than catalase in this protection.

Biologic properties of romazarit (Ro 31-3948), a potential disease-modifying antirheumatic drug.

The biologic effects of a new potential disease-modifying antirheumatic drug, romazarit (Ro 31-3948, 2-[[2-(4-chlorophenyl)-4-methyl-5-oxazolyl]methoxy]-2-methylpropio nic acid), have been investigated. In a 5-day adjuvant arthritis model, romazarit inhibited the development of hindpaw inflammation with a minimum effective dose of 30 mg kg-1. Plasma levels of the acute phase reactants seromucoid and haptoglobulin were also significantly reduced. Romazarit was equally effective in adrenalectomized animals, indicating that the compound is not acting via stimulation of the pituitary/adrenal axis. When the developing adjuvant arthritis was extended to 15 days romazarit showed dose-related improvements of all the symptoms of arthritis with a minimum effective dose of 25 mg kg-1. Romazarit caused a dose-dependent (range 20-250 mg kg-1) reduction in both the inflammatory and bony changes occurring during collagen arthritis in the rat, without any significant effect on anticollagen antibody titers except at the highest dose. Collagenase and prostaglandin E2 production in cultures of talus bones taken from rats with collagen arthritis were reduced by romazarit. In vitro romazarit was an extremely weak inhibitor of prostaglandin synthetase activity in both sheep seminal vesicle (IC50 6500 microM) and rat renal medulla (IC50 greater than 300 microM) cell-free preparations. Romazarit showed little or no activity in models of acute inflammation such as rabbit skin edema, carrageenan pleurisy or UV-induced erythema. In both acute and chronic tests romazarit displayed no ulcerogenic potential. In comparison with the structurally similar compound clobuzarit, hepatic changes such as increases in catalase and peroxisome proliferation-associated 80,000 mol.wt. protein were markedly less with romazarit. Clinical studies with romazarit are currently in progress.

Intricacies and inter-relationships between HIV disclosure and HAART: a qualitative study.

This study aimed to understand whether and how highly active antiretroviral treatment (HAART) affects views and patterns of disclosure and how disclosure interacts with treatment decisions. One hundred and fifty-two HIV-positive adults (52 MSM, 56 women and 44 IDU men) from four US cities participated in two to three-hour, semi-structured interviews in 1998-99. Results indicate that HAART interacts with and shapes HIV disclosure issues in several ways. Medications may 'out' people living with HIV. Thus, in different settings (e.g. work, prisons, drug rehabs and public situations), some try to hide medications or modify dosing schedules, which can contribute to non-adherence, and affect sexual behaviours. Disclosure of HIV and/or HAART may also result in antagonism from others who hold negative attitudes and beliefs about HAART, potentially impeding adherence. Observable side effects of medications can also 'out' individuals. Conversely, medications may improve appearance, delaying or impeding disclosure. Some wait until they are on HAART and look 'well' before disclosing; some who look healthy as a result of medication deny being HIV-positive. Alternatively, HIV disclosure can lead to support that facilitates initiation of, and adherence to, treatment. HIV disclosure and adherence can shape one another in critical ways. Yet these interactions have been under-studied and need to be further examined. Interventions and studies concerning each of these domains have generally been separate, but need to be integrated, and the importance of relationships between these two areas needs to be recognized.