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Biomedical subjects

I Grant

Publications and source records attributed to I Grant.

At least 253 records · Page 14Linked to original sources
PubMed1976

A neuropsychological study of polydrug users.

The long-term neuropsychological effects of persistent nonmedical drug use are still unknown. In this study, 22 young men, all extensive "polydrug" users, were examined while free from drugs for an average of 60 days by means of the Halstead-Reitan Neuropsychological Test Battery. Their performance was compared to that of age-education-sex-matched neurologically intact medical patients and a similarly matched group of neurologically impaired patients. Blind independent ratings of test protocols by two experienced clinicians judged 41% to 64% of the drug users, 11% to 26% of the medical patients, and 84% to 89% of the neurologic patients to be impaired. Interpretation of these results suggests that in some individuals, heavy "polydrug" use may be associated with neuropsychological dysfunction, which persists at least an average of two months beyond cessation of drug use.

Adult↗
PubMed1976

Evaluation of a sex education workshop.

Thirty-two first year medical students who attended a 1 day sex education workshop and seven of their classmates who did not attend the workshop were given the Sex Knowledge and Attitude Test (SKAT) both 1 month before and 3 months after the workshop. The workshop group on retest had scores significantly higher than their pretest scores in the areas of sexual knowledge, autoeroticism and sexual myths. The scores of the no-workshop group did not change significantly on any of the parameters.Evidently, knowledge can be increased and attitudes liberalized by means of an intensive day-long workshop and such changes may persist beyong the immediate period of the workshop.

Attitude of Health Personnel↗
PubMed1976

Neuropsychological and EEG disturbances in polydrug users.

EEG and neuropsychological evaluation of 66 polydrug users revealed that 43% had EEG abnormalities and 45% had neuropsychological impairment 3 weeks after admission to a polydrug study unit. At 5-month follow-up, 27% of 30 retested subjects were still impaired neuropsychologically. Impairment may be related to extensive involvement with sedatives, alcohol, or heavy polydrug use. The authors suggest that cerebral dysfunction in polydrug users might be the result of organicity of intermediate duration and that deficits may be experienced by some beyond 5 months of reduced use or abstinence. Organicity may dictate structured, reality-based intervention techniques, especially early in treatment.

Adolescent↗
PubMed1975

Chronic cerebral effects of alcohol and drug abuse.

A minority of alcohol abusers develop severe cerebral dysfunction in the form of Wernicke-Korsakoff syndrome. There is also evidence to suggest that cerebral dysfunction, particularly impaired abstracting ability, occurs in that larger population of heavy drinkers who do not go on to develop the Wernicke-Korsakoff syndrome. There is no consistent evidence that long-term marijuana, hallucinogen, or sedative use causes lasting neuropsychological disturbance. The deficits in abstract thinking reported by some LSD studies are similar to deficits others have reported among alcoholics. Since the LSD studies were not controlled for alcohol use, their interpretation is difficult. It appears that cerebrovascular accidents occur more frequently and at a younger age among amphetamine abusers. There is no reliable information about possible other long-term effects of stimulants on the brain per se (i.e., nonvascular complications). Abuse of intravenous narcotics has been associated with case reports of transverse myelitis and encephalitis. It is not known whether this pathology is a direct or hypersensitivity effect of narcotic drugs, of adulterants, or of infection.

Alcoholism↗
PubMedDate not supplied

Odor sensitivity is impaired in HIV-positive cognitively impaired patients.

An estimated 7-28% of patients infected by the human immunodeficiency virus (HIV) develop dementia and at least 50% develop mild neurocognitive impairment. Past studies have shown odor identification impairments in HIV + neurocognitively impaired patients. It is difficult, however, based on an odor identification test to state with certainty that individuals with cognitive impairment have sensory olfactory deficits, because odor identification tests are known to draw upon cognitive skills. In the present study odor detection sensitivity was evaluated using an ascending, forced-choice, two-alternative, odor threshold test for butanol. Subjects were divided into three groups, HIV seropositive (HIV+) neurocognitively impaired, HIV+ neurocognitively unimpaired, and HIV negative, based on neurological and psychological testing. An analysis of variance revealed significantly poorer odor sensitivity for the HIV+ neurocognitively impaired group than for the two control groups. A significant negative correlation between degree of cognitive impairment and olfactory sensitivity was also found. We suspect that the olfactory deficits found in the HIV+ neurocognitively impaired subjects are primarily due to damage to the central nervous system; however, nasal infection may be a contributing etiology.

AIDS Dementia Complex↗
PubMedDate not supplied

Sleep disorder and psychobiological symptomatology in male psychiatric outpatients and male nonpatients.

Sleep disturbance was studied in relation to psychiatric and physical symptoms for 214 male psychiatric outpatients and 248 male nonpatients. Our self-report instrument required that subjects describe the frequency of symptoms precisely on a five-point scale from "every day" to "not at all." Percentages are based on the numbers of subjects reporting a symptom as occurring "every day" or "several times a week." More patients reported sleep disturbance symptoms (75%) than nonpatients (25%) (P less than 0.001). Sleep loss symptoms were reported by 63% of patients and 20% of nonpatients. Twelve percent of patients and 6% of nonpatients reported trouble with excessive sleep problems. Sleep disturbance was not strongly related to specific diagnoses. Fewer schizophrenics (21%) than other patients (50%) reported trouble "falling asleep" (P less than 0.02). Finally, for both patients and controls, disturbed sleepers reported more psychiatric and physical symptoms than undisturbed sleepers (P less than 0.001). It is suggested that sleep disturbance might be a useful clinical clue to previously unsuspected psychiatric and physical illness.

Adult↗
PubMedDate not supplied

Neuropsychological impairment in human immunodeficiency virus-infection: implications for employment. HNRC Group. HIV Neurobehavioral Research Center.

Individuals infected with the human immunodeficiency virus-Type 1 (HIV-1), are at increased risk for neurobehavioral impairment, particularly in later stages of the disease. Even patients in the medically asymptomatic or minimally symptomatic stages of infection may show mild deficits on comprehensive neuropsychological (NP) test batteries, although the clinical significance of such deficits remains uncertain. The present study used vocational difficulties as markers of clinical significance of NP impairment. In a sample of 289 HIV-infected, nondemented men, those who evidenced NP impairment had a higher unemployment rate (p < .001) than did their unimpaired counterparts. In HIV-positive subjects who remained employed, NP impairment was strongly associated with subjective decreases in job-related abilities. Neither depression nor medical symptoms could explain the relationship between the NP impairment and employment problems. These results are consistent with previous studies investigating other neuropsychiatric disorders, which suggest that even mild NP impairment can interfere with employment status. From this standpoint, such impairment in HIV-infected persons may be described as "clinically significant."

AIDS Dementia Complex↗
PubMedDate not supplied

Somatization symptoms in chronic low back pain patients.

Chronic low back pain (CLBP) patients often are described as "somatizers", who report multiple somatic complaints beyond back pain itself, but the nature and clinical significance of this observation is poorly understood. To clarify the characteristics, correlates and severity of somatization in CLBP, we rigorously assessed somatization symptoms in a sample of patients not selected for psychiatric or pain clinic referral. Male CLBP patients (N = 97), attending a primary care orthopaedic clinic, and matched healthy controls (N = 49), were assessed using the Diagnostic Interview Schedule III-A (DIS), Beck Depression Inventory (BDI), Hamilton Rating Scale for Depression (HRSD), McGill Pain Questionnaire (MPQ), Sickness Impact Profile (SIP), and the Pain and Impairment Relationship Scale (PAIRS). Although none of the subjects met strict DSM-III criteria for a lifetime diagnosis of Somatization Disorder, 25.8% of CLBP patients reported a lifetime history of 12 or more somatic symptoms, as compared to only 4.1% of controls. In the less symptomatic ranges, patients still generally reported more symptoms than controls, with 51.5% of patients vs. 8.2% of controls reporting 7-11 symptoms, and 22.7% vs. 87.8% of controls reporting 0-6 symptoms (p < .001). Major depression and alcohol dependence were significantly associated with increased severity of somatization (p < .05). Lower mood and increased impairment, but not pain intensity, were related to greater number of somatic complaints. Symptoms of somatization are prevalent, but not universal, in CLBP and the pattern of these symptoms is reminiscent of the "spectrum of severity" reported in other medical populations. Recognizing this spectrum of somatization may lead to better patient-treatment matching and improved clinical outcomes.

Adaptation, Psychological↗
PubMedDate not supplied

Validity of the Quality of Well-Being Scale for persons with human immunodeficiency virus infection. HNRC Group. HIV Neurobehavioral Research Center.

To evaluate the validity of the Quality of Well-Being Scale (QWB) for studies of patients with human immunodeficiency virus (HIV) disease, 514 men were studied who were divided among four categories: Centers for Disease Control and Prevention (CDC) Group A (N = 272), CDC-B (N = 81), CDC-C (N = 47), and uninfected male controls (N = 114). The QWB and a variety of medical, neuropsychological, and biochemical measures were administered to all participants. When QWB scores were broken down by HIV group, the CDC-C group was significantly lower (.614) than the CDC-B (.679), CDC-A (.754), or control group (.801). The difference between Groups CDC-C and CDC-A was about .14 units of well-being, which suggests that individuals lose 1/7 equivalents of 1 well year of life for each year they are in Group CDC-C in comparison to the asymptomatic group (Group CDC-A). In comparison to the controls, this would equal a 1-year of life loss for each seven infected individuals. The QWB was shown to be significantly associated with CD4+ lymphocytes (p < .001), clinician ratings of neuropsychological impairment (p < .04), neurologists ratings of dysfunction (p < .001), and all subscales of the Profile of Mood States. Baseline QWB scores were significant prospective predictors of death over a median follow-up time of 30 months. Multivariate models demonstrated high covariation between predictors of QWB. It was concluded that the QWB is a significant correlate of biological, neuropsychological, neurological, psychiatric, and mortality outcomes for male HIV-infected patients.

AIDS Dementia Complex↗
PubMedDate not supplied

Plasma catecholamine and lymphocyte beta 2-adrenergic receptor alterations in elderly Alzheimer caregivers under stress.

OBJECTIVE: The purpose of this study was to determine the effects of chronic stress on beta-adrenergic physiology in elderly spousal caregivers to Alzheimer patients. METHODS: Thirty-seven elderly spousal caregivers and matched noncaregiver controls (mean age 73 years, SD = 6) were studied. Life stress categorization (presence of marked threat) covering the previous 6 months was determined using a semistructured interview based on the Psychiatric Epidemiological Research Inventory and the Life Events and Difficulties Schedule. beta 2-adrenergic receptor sensitivity (isoproterenol-stimulated cyclic AMP accumulation) and density were determined in lymphocytes. RESULTS: Caregivers with high life stress had higher plasma norepinephrine levels (p < .04) but no change in plasma cortisol. For beta-receptor sensitivity, 30% of the variance was accounted for by high life stress rating, increased age, being male, and lower norepinephrine (p = .018); 17% of the variance in beta-receptor density was accounted for by plasma norepinephrine (p = .03). CONCLUSIONS: The findings demonstrate that chronic high stress may be associated with changes in adrenergic physiology and may provide a mechanism through which chronic stress alters cellular immunity.

Adult↗
PubMedDate not supplied

Vulnerable caregivers of patients with Alzheimer's disease have a deficit in circulating CD62L- T lymphocytes.

OBJECTIVE: The cell adhesion molecule, L-selectin (CD62L), serves a crucial role in the migration of naive T lymphocytes and is typically shed on cell activation. The objective of this study was to determine the effects of chronic stress on L-selectin expression on peripheral lymphocytes in elderly spousal caregivers of patients with Alzheimer's disease. METHODS: Twenty caregivers (mean age, 73.5 years) had their lymphocytes and catecholamine levels sampled at rest and in response to an acute psychological stressor. Ten of the caregivers were classified as susceptible or "vulnerable" based on the large amount of care required by the patient relative to the amount of respite the caregiver received during the previous 6 months. RESULTS: At rest, vulnerable caregivers had 60% fewer L-selectin negative CD8+ T cells (CD8+CD62L-) (p=.01) but no difference in CD8+CD62L+ cells. Vulnerable caregivers also showed significantly fewer CD4+CD62L- T lymphocytes (p=.04) but no difference in CD4+CD62L+ lymphocytes. Resting plasma epinephrine levels were 44% higher in vulnerable caregivers as compared with nonvulnerable caregivers (p=.01). The acute stressor increased circulating levels of CD8+CD62L- and CD8+CD62L+ lymphocytes and catecholamines similarly in both groups. CONCLUSIONS: The findings suggest that caregivers who are more vulnerable to the chronic stress of caregiving show a decrement in circulating CD62L- T lymphocytes, possibly by adrenomedullary activation. The data also suggest the identity of lymphocyte subsets that may underlie prior observations of immunologic decrements associated with the chronic stress of caregiving.

Aged↗