Changes in Sexual Practices Over 5 Years of Follow-Up Among Heterosexual Men in San Francisco

Background: Sporadic brain arteriovenous malformations (BAVM) are a major cause of hemorrhagic stroke in younger persons. Prior studies have reported contradictory results regarding the risk of hemorrhage during pregnancy, and there are no standard guidelines for the management of pregnant women who present with BAVM rupture. The purpose of this study is to describe maternal and fetal outcomes and treatment strategies in patients with BAVM hemorrhage during pregnancy. Methods: We performed a retrospective review of the University of California, San Francisco Brain AVM Project database for female patients who were pregnant at the time of BAVM hemorrhage between 2000 and 2017. Clinical and angiographic characteristics at presentation, BAVM treatment, and maternal outcomes using modified Rankin scale (mRS) score at presentation and 2-year follow-up were recorded. Fetal outcomes were abstracted from medical records and maternal reports. Results: Sixteen patients presented with BAVM hemorrhage during pregnancy, 81% (n = 13) of whom were in their second or third trimester. Three patients (19%) who were in their first trimester terminated or miscarried pregnancy prior to BAVM intervention. Of the remaining 13 patients, 77% (n = 10) received emergent BAVM treatment at time of hemorrhage prior to delivery, and 85% of patients achieved BAVM obliteration and good maternal outcomes (mRS 0–2) at 2-year follow-up. All patients had uncomplicated deliveries (69% cesarean and 23% vaginal) with no reports of postnatal cognitive or developmental delays in infants at 2-year follow-up. Conclusions: Our study shows good long-term maternal and fetal outcomes in ruptured BAVM patients presenting during pregnancy, the majority who received BAVM interventional treatment prior to delivery.

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Clinical outcomes of pediatric macular edema associated with non-infectious uveitis

Journal of Ophthalmic Inflammation and Infection ◽

10.1186/s12348-021-00236-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Anh Hong Nguyen ◽

Bethlehem Mekonnen ◽

Eric Kim ◽

Nisha R. Acharya

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

San Francisco ◽

Pediatric Patients ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Study Cohort ◽

Common Diagnosis ◽

Corticosteroid Injections

Abstract Background Macular edema (ME) is the most frequent cause of irreversible visual impairment in patients with uveitis. To date, little data exists about the clinical course of ME in pediatric patients. A retrospective, observational study was performed to examine the visual and macular thickness outcomes of ME associated with chronic, noninfectious uveitis in pediatric patients. Methods Pediatric patients with noninfectious uveitis complicated by ME seen in the University of California San Francisco Health System from 2012 to 2018 were identified using ICD-9 and ICD-10 codes. Data were collected from medical records including demographics, diagnoses, ocular history, OCT imaging findings, complications, and treatments at first encounter and at 3, 6, 9, and 12-month follow-up visits. Cox proportional hazards regression was used to investigate the association between different classes of treatment (steroid drops, steroid injections, oral steroids and other immunosuppressive therapies) and resolution of macular edema. Results The cohort comprised of 21 children (26 eyes) with a mean age of 10.5 years (SD 3.3). Undifferentiated uveitis was the most common diagnosis, affecting 19 eyes (73.1%). The majority of observed macular edema was unilateral (16 patients, 76.2%) and 5 patients had bilateral macular edema. The mean duration of follow-up at UCSF was 35.3 months (SD 25.7). By 12 months, 18 eyes (69.2%) had achieved resolution of ME. The median time to resolution was 3 months (IQR 3–6 months). Median best-corrected visual acuity (BCVA) at baseline was 0.54 logMAR (Snellen 20/69, IQR 20/40 to 20/200). Median BCVA at 12 months was 0.1 logMAR (Snellen 20/25, IQR 20/20 to 20/50) Corticosteroid injections were associated with a 4.0-fold higher rate of macular edema resolution (95% CI 1.3–12.2, P = 0.01). Conclusions Although only 15% of the pediatric patients with uveitis in the study cohort had ME, it is clinically important to conduct OCTs to detect ME in this population. Treatment resulted in 69% of eyes achieving resolution of ME by 12 months, accompanied with improvement in visual acuity. Corticosteroid injections were significantly associated with resolution of macular edema.

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SUMMIT (Serially Unified Multicenter Multiple Sclerosis Investigation): creating a repository of deeply phenotyped contemporary multiple sclerosis cohorts

Multiple Sclerosis Journal ◽

10.1177/1352458517726657 ◽

2017 ◽

Vol 24 (11) ◽

pp. 1485-1498 ◽

Cited By ~ 10

Author(s):

Riley Bove ◽

Tanuja Chitnis ◽

Bruce AC Cree ◽

Mar Tintoré ◽

Yvonne Naegelin ◽

...

Keyword(s):

Multiple Sclerosis ◽

San Francisco ◽

Medical Center ◽

Clinically Isolated Syndrome ◽

American University ◽

American University Of Beirut ◽

Longitudinal Investigation ◽

American Academic

Background: There is a pressing need for robust longitudinal cohort studies in the modern treatment era of multiple sclerosis. Objective: Build a multiple sclerosis (MS) cohort repository to capture the variability of disability accumulation, as well as provide the depth of characterization (clinical, radiologic, genetic, biospecimens) required to adequately model and ultimately predict a patient’s course. Methods: Serially Unified Multicenter Multiple Sclerosis Investigation (SUMMIT) is an international multi-center, prospectively enrolled cohort with over a decade of comprehensive follow-up on more than 1000 patients from two large North American academic MS Centers (Brigham and Women’s Hospital (Comprehensive Longitudinal Investigation of Multiple Sclerosis at the Brigham and Women’s Hospital (CLIMB; BWH)) and University of California, San Francisco (Expression/genomics, Proteomics, Imaging, and Clinical (EPIC))). It is bringing online more than 2500 patients from additional international MS Centers (Basel (Universitätsspital Basel (UHB)), VU University Medical Center MS Center Amsterdam (MSCA), Multiple Sclerosis Center of Catalonia-Vall d’Hebron Hospital (Barcelona clinically isolated syndrome (CIS) cohort), and American University of Beirut Medical Center (AUBMC-Multiple Sclerosis Interdisciplinary Research (AMIR)). Results and conclusion: We provide evidence for harmonization of two of the initial cohorts in terms of the characterization of demographics, disease, and treatment-related variables; demonstrate several proof-of-principle analyses examining genetic and radiologic predictors of disease progression; and discuss the steps involved in expanding SUMMIT into a repository accessible to the broader scientific community.

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‘No expectations’: Straight men's sexual and moral identity-making in non-monogamous dating

Sexualities ◽

10.1177/1363460718779946 ◽

2018 ◽

Vol 22 (5-6) ◽

pp. 844-859

Author(s):

Katrien De Graeve

Keyword(s):

Sexual Identity ◽

Moral Identity ◽

Sexual Practices ◽

Heterosexual Men ◽

Discursive Strategies

This article juxtaposes the discursive strategies of two groups of heterosexual men in the context of non-monogamous internet-mediated dating in Belgium, notably men who are open about their extra-dyadic sexual practices and ‘cheating’ men. The analysis shows that regardless of the men's use of openness or discretion to construct narratives of sexual identity, morality and care, their accounts seem to be deeply intertwined with monogamist and gendered ideas on sex, care and commitment, which serves to define a largely uncaring and consumeristic dating culture. The article argues that attentiveness to power inequalities should be the main focus of ‘ethical’ non-monogamy.

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Report of a ten-year follow-up study of the San Francisco Longshoremen

Journal of Chronic Diseases ◽

10.1016/0021-9681(63)90067-5 ◽

1963 ◽

Vol 16 (12) ◽

pp. 1251-1266 ◽

Cited By ~ 38

Author(s):

Nemat O. Borhani ◽

Hyman H. Hechter ◽

Lester Breslow

Keyword(s):

San Francisco ◽

Follow Up Study

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African-American Adolescents Residing in High-risk Urban Environments Do Use Condoms: Correlates and Predictors of Condom Use Among Adolescents in Public Housing Developments

PEDIATRICS ◽

10.1542/peds.98.2.269 ◽

1996 ◽

Vol 98 (2) ◽

pp. 269-278 ◽

Cited By ~ 2

Author(s):

Ralph J. DiClemente ◽

Mark Lodico ◽

Olga A. Grinstead ◽

Gary Harper ◽

Richard L. Rickman ◽

...

Keyword(s):

African American ◽

High Risk ◽

Condom Use ◽

Public Housing ◽

San Francisco ◽

African American Adolescents ◽

Consistent Condom ◽

Consistent Condom Use ◽

Housing Developments

Objective. African-American adolescents living in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases. Understanding the factors that influence the use of condoms by adolescents is critical for developing effective behavioral interventions. The present study examined the demographic, psychosocial, and behavioral correlates of condom use among African-American adolescents residing in public housing developements in an HIV epicenter (San Francisco) and prospectively evaluated the stability of these significant cross-sectional variables to predict consistent condom use. Design. A prospective study. Setting. Two public housing developments in San Francisco. Participants. African-American adolescents and young adults between 12 and 21 years of age were recruited though street outreach and completed a theoretically derived research interview assessing HIV-related knowledge, attitudes, and behaviors. After a 6-month period, adolescents completed a follow-up interview similar to the baseline measure. Among adolescents reporting sexual activity in the 6 months before completing the baseline interview (n = 116), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on consistent condom use. Results. Adolescents who had high assertive self-efficacy to demand condom use (adjusted odds ratio [OR], 11), perceived peer norms as supporting condom use (OR, 4.2), had greater impulse control (OR, 3.7), were male (OR, 4.7), and were younger (OR, 2.9) were more likely to report consistent condom use. Frequency of sexual intercourse was inversely related to condom use; adolescents with higher numbers of sexual episodes were less likely to use condoms consistently. Prospective analyses identified the baseline level of condom use as the best predictor of condom use at the 6-month followup Adolescents who were consistent condom users at baseline were 7.4 times as likely to be consistent condom users during the follow-up period. Of those adolescents changing their frequency of condom use during the follow-up interval, significantly more engaged in risky behavior; 33.3% changed from consistent to inconsistent condom use, whereas 20.6% changed from inconsistent to consistent use (OR, 1.6). Conclusions. The findings suggest that HIV prevention programs need to be implemented early, before high-risk behaviors are established and may be more difficult to modify.

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Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia

Sexual Health ◽

10.1071/sh19230 ◽

2020 ◽

Vol 17 (3) ◽

pp. 279

Author(s):

Finley J. Charleson ◽

Christopher K. Fairley ◽

Jane S. Hocking ◽

Lenka A. Vodstrcil ◽

Catriona S. Bradshaw ◽

...

Keyword(s):

Negative Binomial ◽

Health Centre ◽

Significant Risk ◽

Significant Risk Factor ◽

Sexual Practices ◽

Transmission Risk ◽

Heterosexual Men ◽

Sex Partners ◽

Cross Sectional Survey ◽

Cross Sectional

Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men. Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016–2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics. Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31–1.80) than local men. Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk.

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Early Adopters of Event-driven Human Immunodeficiency Virus Pre-exposure Prophylaxis in a Large Healthcare System in San Francisco

Clinical Infectious Diseases ◽

10.1093/cid/ciaa474 ◽

2020 ◽

Vol 71 (10) ◽

pp. 2710-2712 ◽

Cited By ~ 1

Author(s):

J Carlo Hojilla ◽

Julia L Marcus ◽

Michael J Silverberg ◽

C Bradley Hare ◽

Rachel Herbers ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Side Effects ◽

Healthcare System ◽

San Francisco ◽

Hiv Infections ◽

Early Adopters ◽

Immunodeficiency Virus ◽

Event Driven ◽

Exposure Prophylaxis

Abstract Among 279 patients within a large healthcare system in San Francisco, event-driven HIV pre-exposure prophylaxis using a 2–1–1 regimen was a desirable alternative to daily dosing. Problems with adherence, planning sex in advance, or side effects were infrequent (13.9%). We found no new HIV infections over 136 person-years of follow-up.

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Telemedicine in a pediatric headache clinic

Neurology ◽

10.1212/wnl.0000000000005482 ◽

2018 ◽

Vol 90 (19) ◽

pp. e1702-e1705 ◽

Cited By ~ 12

Author(s):

William Qubty ◽

Irene Patniyot ◽

Amy Gelfand

Keyword(s):

San Francisco ◽

Cost Effective ◽

Family Satisfaction ◽

Clinic Visit ◽

Survey Study ◽

Daily Routine ◽

Patient Centered ◽

Pediatric Headache ◽

Headache Clinic

ObjectiveThe aim of this prospective study was to survey our patients about their experience with our clinic's telemedicine program to better understand telemedicine's utility for families, and to improve patient satisfaction and ultimately patient care.MethodsThis was a prospective survey study of patients and their families who had a routine telemedicine follow-up visit with the University of California San Francisco Pediatric Headache Program. The survey was administered to patients and a parent(s) following their telemedicine visit.ResultsFifty-one of 69 surveys (74%) were completed. All (51/51) patients and families thought that (1) telemedicine was more convenient compared to a clinic visit, (2) telemedicine caused less disruption of their daily routine, and (3) they would choose to do telemedicine again. The mean round-trip travel time from home to clinic was 6.8 hours (SD ± 8.6 hours). All participants thought telemedicine was more cost-effective than a clinic visit. Parents estimated that participating in a telemedicine visit instead of a clinic appointment saved them on average $486.ConclusionThis prospective, pediatric headache telemedicine study shows that telemedicine is convenient, perceived to be cost-effective, and patient-centered. Providing the option of telemedicine for routine pediatric headache follow-up visits results in high patient and family satisfaction.

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