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Biomedical subjects

I Grant

Publications and source records attributed to I Grant.

At least 199 records · Page 11Linked to original sources
PubMed1989

Severely threatening events and marked life difficulties preceding onset or exacerbation of multiple sclerosis.

Information was obtained on stressful life circumstances, using the Life Events and Difficulties Schedule (LEDS) from 39 patients with early multiple sclerosis and 40 matched nonpatient volunteers. The proportion of multiple sclerosis patients who experienced marked life adversity in the year prior to onset of symptoms was significantly higher than for nonpatients in the year before interview (77% vs. 35%). The excess in marked life stress was most evident in the 6 months before onset. Such stressors might explain the timing of symptom exacerbation for some patients with multiple sclerosis, perhaps by perturbing an already unstable neuroimmunological system.

Adaptation, Psychological↗
PubMed1988

Amino acid infusion increases the sensitivity of muscle protein synthesis in vivo to insulin. Effect of branched-chain amino acids.

Rates of muscle protein synthesis were measured in vivo in tissues of post-absorptive young rats that were given intravenous infusions of various combinations of insulin and amino acids. In the absence of amino acid infusion, there was a steady rise in muscle protein synthesis with plasma insulin concentration up to 158 mu units/ml, but when a complete amino acids mixtures was included maximal rates were obtained at 20 mu units/ml. The effect of the complete mixture could be reproduced by a mixture of essential amino acids or of branched-chain amino acids, but not by a non-essential mixture, alanine, methionine or glutamine. It is concluded that amino acids, particularly the branched-chain ones, increase the sensitivity of muscle protein synthesis to insulin.

Amino Acids↗
PubMed1988

Prevalence of psychiatric disorders among men infected with human immunodeficiency virus. A controlled study.

We used structured diagnostic interviews and rating scales to assess lifetime prevalence of psychiatric disorders, by DSM-III criteria, among an unselected sample of 56 ambulatory homosexual men in four groups: men with acquired immunodeficiency syndrome (AIDS), men with AIDS-related complex (ARC), men asymptomatic or mildly symptomatic but seropositive for antibody to human immunodeficiency virus (HIV), and HIV-seronegative men. An age- and demographically matched comparison group of 22 healthy, heterosexual controls was also studied. The homosexual men had lifetime rates of alcohol or nonopiate drug abuse (22/56 [39.3%]), generalized anxiety disorder (22/56 [39.3%]), and major depression (17/56 [30.3%]) that often preceded diagnosed medical illness or knowledge of HIV status. The six-month point prevalence of these disorders in homosexual men was also high, especially alcohol abuse in patients with AIDS-related complex, and the occurrence of a DSM-III disorder within the previous six months significantly exceeded that in heterosexual controls. The data suggest that there may be a higher prevalence of anxiety disorder and major depressive illness in homosexual men when compared with sociodemographically matched heterosexual men and that the psychiatric morbidity may have preceded the onset of the AIDS epidemic. These findings indicate that awareness of psychiatric history is necessary to comprehensive medical care of men at high risk for AIDS, even among relatively healthy outpatients.

AIDS-Related Complex↗
PubMed1988

A Chinese version of the Mini-Mental State Examination; impact of illiteracy in a Shanghai dementia survey.

A dementia screening survey was carried out in Shanghai using a culturally adapted Chinese version of the Mini-Mental State Examination. A probability sample of 5055 community-dwelling elderly in Shanghai was surveyed, 1497 aged 55-64, 2187 aged 65-74, and 1371 aged 75 and over. In the 73.3% of the subjects who had gone to school, using the age and education adjustments suggested by Kittner et al. (1986), [Kittner et al. J Chron Dis 39: 163-170; 1986] suitable cutoff scores could readily be selected to identify the subjects who should be examined intensively for the presence of dementia. However, in the 26.7% who had not gone to school, there was a significant increase in low scores on the mental status test as well as a different error pattern, reflecting the lack of formal education. Methods for following cognitive changes in illiterate individuals need further development.

Aged↗
PubMed1988

Large granular lymphocytosis associated with rheumatoid arthritis.

A 74 year old woman with rheumatoid arthritis, hepatosplenomegaly, neutropenia, and peripheral blood lymphocytosis is described. The lymphocytes had a large granular morphology and expressed a CD3+ CD8+ Leu7+ surface antigen phenotype. They did not have natural killer cell function. Southern analysis of the lymphocyte DNA using two restriction enzymes showed a rearranged pattern for the T cell receptor beta chain gene, indicating a monoclonal lymphoproliferation. Large granular lymphocytosis is a rare and heterogeneous phenomenon, which has become more clearly characterised through the application of molecular biology techniques. Most cases appear to be forms of T cell leukaemia with a chronic benign course. The association between rheumatoid arthritis and large granular lymphocytosis is emphasised.

Aged↗
PubMed1988

Social supports in relation to physical health and symptoms of depression in the elderly.

The authors examined the relationship of social supports to physical and psychological well-being in 118 men and women 65 years old or older who were living independently in the community. Subjects with more symptoms of depression reported having fewer emotionally satisfying consistent supports from relatives, but those who had physical illnesses reported more supports from relatives. The authors conclude that although having fewer key supports may contribute to dysphoria, having a physical illness may mobilize meaningful support. They suggest that social supports and health outcomes be carefully defined so that possible differential relationships between them can be understood more specifically.

Aged↗
PubMed1988

Assessment and management of the AIDS patient with neuropsychiatric disturbances.

The studies reviewed here and ongoing work indicate a primary role for psychiatry in treating patients with the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection. Those patients often have neuropsychiatric disorders concurrent with the complications of physical disease. It is important to understand the diagnostic criteria for patients with HIV-related disorders to distinguish CNS disturbances caused by infections from those psychiatric problems exacerbated by the social consequences of the syndrome. Although treatment is difficult in immunocompromised patients and treatments may cause serious side effects, many of the CNS symptoms of AIDS patients can be treated in the same way as other diseases of the CNS. Psychostimulants are the most promising therapeutic agents for AIDS patients. In the treatment of psychotic episodes, high-potency neuroleptics at low dosages have been used successfully. In all therapies, careful consideration must be given to possible adverse reactions, which may be more serious in HIV-related diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Human immunodeficiency virus-associated neurobehavioural disorder.

AIDS, ARC, and other HIV-associated diseases were originally conceptualised exclusively in terms of defects in cell-mediated immunity and its consequences. But it is now becoming clear that HIV disease can also be a primary neuropsychiatric disorder, although the precise mechanism by which the retrovirus causes impairment in brain function and, ultimately, structural brain damage, remains obscure. The work presented here indicates another shift in our thinking concerning HIV infection. Until recently it was believed that neurological and neuropsychiatric phenomena tended to occur in the late stages of HIV disease. While that might be true for the more severe form of symptomatology that has been termed the AIDS dementia complex, we believe there is at least preliminary evidence that cognitive change can occur earlier in the course of illness, perhaps even in some medically asymptomatic HIV+ individuals. Other investigators have also noted increased neuropsychological abnormality in patients before they developed AIDS or ARC. For example, Janssen et al. found that about half their patients with lymphadenopathy syndrome (LAS) had some neuropsychological test deficits. Durara et al. recently reported on cerebral metabolic rates for glucose in seven HIV+ asymptomatic individuals, compared to 10 HIV- controls. Four of the HIV+ individuals had abnormal asymmetry in frontal and temporal regions suggesting focal reduction in cerebral glucose metabolism. Further indirect evidence that virus can enter the central nervous system early in the course of HIV disease comes from the work of McArthur and associates.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1987

Short-term effects of corticosterone treatment on muscle protein synthesis in relation to the response to feeding.

1. Rates of protein synthesis in liver and muscle of 100 g male rats were measured in vivo at 1 h or 4 h after injection of 2.5 mg of corticosterone and compared with those from animals given carrier medium alone. 2. In post-absorptive rats, corticosterone for 1 h had no effect on either muscle or liver protein synthesis. After 4 h there was a decrease in both tissues, but this was only statistically significant in muscle. 3. In fed rats, rates of protein synthesis were higher than those in post-absorptive animals, but the effects of corticosterone injection were similar. 4. Re-feeding of post-absorptive rats led to an increase in muscle protein synthesis after 1 h and 4 h. At 1 h this increase was not inhibited when plasma corticosterone concentrations were maintained high by injection of the hormone immediately before feeding commenced, but at 4 h there was a small inhibition. 5. It is concluded that the action of corticosterone in depressing muscle protein synthesis is time-dependent and requires longer than 1 h to develop. The failure of the hormone to alter the response to re-feeding for 1 h in post-absorptive rats suggest that corticosteroids are not important mediators of the acute stimulation of muscle protein synthesis by food intake.

Animals↗
PubMed1987

Progressive neuropsychologic impairment and hypoxemia. Relationship in chronic obstructive pulmonary disease.

In previous work we showed that patients with chronic obstructive pulmonary disease (COPD) suffered decrements in neuropsychologic functioning suggestive of organic mental disturbance. This study combined data from two multicenter clinical trials to explore the nature and possible determinants of such neuropsychologic change. Three groups of patients with COPD whose hypoxemia was mild (N = 86), moderate (N = 155), or severe (N = 61) were compared with age- and education-matched nonpatients (N = 99). The rate of neuropsychologic deficit rose from 27% in mild hypoxemia to 61% in severe hypoxemia. Various neuropsychologic abilities declined at different rates, suggesting differential vulnerability of neuropsychologic functions to progress of COPD. Multivariate analyses revealed a consistent significant relationship between degree of hypoxemia and neuropsychologic impairment, but the amount of shared variance was small (7%). Increasing age and lower education were also associated with impairment.

Adult↗
PubMed1987

Life events do not predict symptoms: symptoms predict symptoms.

The effects of life events and previous symptoms on current symptom levels were examined in a model using data from a 3-year prospective study. Male psychiatric patients and nonpatients reported on life events and symptoms every 2 months on 18 occasions. Logistic regression analysis of these data revealed little dependence of psychiatric symptoms on preceding life events as measured by the Holmes and Rahe Schedule of Recent Experiences (SRE). The best predictor of the current symptom level was the level of previous symptoms. It is concluded that efforts to relate changes in the social environment to health must first consider the possible contribution of the antecedent symptom level to the variability in health outcome.

Adult↗
PubMed1987

Episodic and semantic memory: a comparison of amnesic and demented patients.

Episodic (recall of passages) and semantic (letter and category fluency) memory tasks were administered to Alzheimer's Disease (early stages), Huntington's Disease (HD), and alcoholic Korsakoff patients matched for overall severity of dementia. Although all three patient groups were severely (and equally) impaired on memory for passages, only the Alzheimer and Korsakoff patients emitted numerous intrusion errors. On the fluency tasks, the performance of the mild Alzheimer patients was distinguishable from that of the other two patient groups. On both fluency tasks, the HD and Korsakoff patients demonstrated severe and moderate deficits, respectively, whereas the mild Alzheimer patients were impaired only on the category fluency task. As with the episodic memory test, the Alzheimer and Korsakoff patients made more perseverative errors than did the HD patients on letter fluency. These findings suggest that Alzheimer and HD patients' impairments on episodic and semantic memory tasks reflect different underlying processes. The performance of Alzheimer patients is affected by their language dysfunction and an increased sensitivity to proactive interference; the deficits of the HD patients appear due to a general retrieval problem. Similarities in the error patterns (i.e., perseveration errors) of Alzheimer and Korsakoff patients are discussed with regard to recent neuropathological findings.

Adult↗
PubMed1987

Family history of alcoholism does not predict neuropsychological performance in alcoholics.

We examined the relationship of history of alcoholism in first-degree relatives to neuropsychological performance of alcoholics abstinent from several weeks to several years. Eighty-four men were assigned to four groups based on "strength" of family history of alcoholism. The groups were: (1) "strong history," a parent plus another first-degree relative positive; (2) "moderate," parent only positive; (3) "weak," nonparent first-degree relative only positive; and (4) "negative," no first-degree relative positive. There were no significant between-group differences in NP performance. In other analyses there were no NP differences between alcoholics classified positive or negative purely on basis of paternal alcoholism, and no differences between subjects who had multigenerational versus unigenerational versus negative familial histories of alcoholism. It is concluded that genetic loading for alcoholism does not significantly affect the NP status of abstinent alcoholic groups equated for education, drinking history, and medical risk.

Adult↗
PubMed1987

Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Studies with neuropsychologic testing and magnetic resonance imaging.

Although a high prevalence of central nervous system disease is seen in persons with the acquired immunodeficiency syndrome (AIDS), the natural history of brain involvement with human immunodeficiency virus (HIV) remains poorly understood. Neuropsychologic evaluations of 55 ambulatory homosexual men revealed abnormalities in 13 of 15 with AIDS, 7 of 13 [corrected] with AIDS-related complex, 7 of 16 [corrected] with HIV-seropositivity only, and 1 of 11 with HIV-seronegativity. Common neuropsychologic problems included impaired abstracting ability, learning difficulties, and slowed speed of information processing. Magnetic resonance imaging had abnormal findings in 9 of 13 patients with AIDS and 5 of 10 patients with AIDS-related complex who were available for scans. The commonest abnormalities were sulcal and ventricular enlargement and bilateral patchy areas of high signal intensity in the white matter. We postulate that central nervous system involvement by HIV may begin early in the course of AIDS and cause mild cognitive deficits in otherwise asymptomatic persons.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Diagnosis of intermediate-duration and subacute organic mental disorders in abstinent alcoholics.

In a longitudinal study of 136 male alcoholics and controls, the authors found evidence of slowly reversible, subtle organic mental disorders in relation to prolonged abstinence from drinking by alcoholics. They suggest criteria for two new nosologic categories to describe these alcohol-related neuropsychiatric phenomena: (1) intermediate-duration organic mental disorder associated with alcoholism and (2) subacute organic mental disorder associated with alcohol abuse or alcoholism.

Adult↗