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Biomedical subjects

J B Williams

Publications and source records attributed to J B Williams.

At least 91 records · Page 5Linked to original sources
PubMed1994

Psychopathology in male and female intravenous drug users with and without HIV infection.

OBJECTIVE: The authors report on results of systematic clinical assessment of psychopathology among HIV-positive and HIV-negative intravenous drug users. METHOD: As part of a multidisciplinary baseline assessment, 147 male (85 HIV-positive and 62 HIV-negative) and 76 female (39 HIV-positive and 37 HIV-negative) intravenous drug users were evaluated with the Structural Clinical Interview for DSM-III-R and measures of psychiatric symptom severity, global functioning, and stress. RESULTS: Prevalence of a diagnosis of current depression (26%) and severity of depressive and anxiety symptoms in both HIV-positive and HIV-negative subjects were greater than in the general community, but not greater than in other studies of intravenous drug users. HIV-positive men had a higher prevalence of depressive disorders than HIV-negative men (33% and 16%, respectively), although this pattern was not found among women (26% and 30%). Diagnosis of depressive disorders and severity of depressive and anxiety symptoms were associated with a symptom-based measure of HIV illness stage, but not with indices of immune functioning (CD4+ cell count and CD4+ cell percent). CONCLUSIONS: Despite selective associations between HIV illness variables and depression, high rates of depression across HIV status in this cohort suggest that intravenous drug use and associated factors are more salient than HIV illness factors in understanding psychopathology in this population.

Anxiety Disorders↗
PubMed1993

Dynamic pay initiatives.

In the battle to manage change and deal successfully with health care reform, hospitals are looking to innovative methods to optimize compensation for their executives. Results of the 1993 Hay Hospital Compensation Survey indicate clearly that the pressures of managed care and the uncertainty--but inevitability--of reform are forcing organizations to use new tools and strategies for achieving productivity and quality goals. Another interesting survey finding: Two positions critical to the success of integrated health care systems--the head of medical affairs and the head of managed care--show significant compensation growth during the past two years.

Chief Executive Officers, Hospital↗
PubMed1993

Clinical determinants of dementia related to stroke.

Among 251 patients examined 3 months after the onset of acute ischemic stroke, we diagnosed dementia in 66 (26.3%) by using modified DSM-III-R criteria based on neuropsychological, neurological, functional, and psychiatric examinations. We used a logistic regression model to derive odds ratios (ORs) for clinical factors independently related to dementia in this cross-sectional sample. Dementia was significantly associated with age, education, and race. A history of prior stroke (OR = 2.7) and diabetes mellitus (OR = 2.6) was also independently related to dementia, but hypertension and cardiac disease were not. Stroke features associated with dementia included lacunar infarction compared with all other subtypes combined (OR = 2.7) and hemispheric laterality in relation to brainstem or cerebellar location. There was a predominance of dementia in patients with left-sided lesions (OR = 4.7), an effect not explained by aphasia. Dementia was especially common with infarctions in the left posterior cerebral and anterior cerebral artery territories. A major dominant hemispheral syndrome (reflecting size and laterality) was also independently associated with dementia (OR = 3.9). We suggest that dementia after ischemic stroke is a result of multiple independent factors, including both small subcortical and large cortical infarcts especially involving the left medial frontal and temporal regions, with additional contributions by demographic and vascular risk factors.

Age Factors↗
PubMed1993

Torsion of wandering spleen: the whorled appearance of the splenic pedicle on CT.

Congenital deficiency or acquired laxity of the suspensory ligaments of the spleen may result in extreme splenic mobility. This rare condition, which is termed wandering or ectopic spleen predisposes the elongated splenic pedicle to torsion. We present a case of splenic torsion with a new CT finding consisting of a whorled appearance of the splenic pedicle. To our knowledge this finding has not been described before.

Child, Preschool↗
PubMed1993

Responses to isolation in Japanese quail genetically selected for high or low sociality.

The adrenocortical, behavioral, and leucocytic responses to isolation, for 1, 3, or 72 h, of 7-10-day-old Japanese quail chicks, of lines selected for high (HSR) or low (LSR) levels of social reinstatement (SR) behavior, were studied. Isolation had no effect on plasma corticosterone levels of heterophil/lymphocyte measures in LSR line chicks. Conversely, circulating corticosterone levels were increased after 1 h of isolation in the HSR line, although they fell to control levels thereafter. Heterophil/lymphocyte ratios of HSR line chicks were also increased after 3 h of isolation but decreased to control levels thereafter. Isolated HSR line chicks were consistently more active and showed more peeping and jumping than LSR line chicks in which sitting and lying were more frequent. However, no such behavioral divergence was observed when HSR and LSR line chicks were housed in same-line groups. These results indicate that selection for SR behavior has influenced both underlying social motivation and responses to short-term isolation. Social separation appeared to be more stressful for HSR than LSR line chicks.

Animals↗
PubMed1993

Effects of CRF on isolated Japanese quails selected for fearfulness and for sociality.

The effects of CRF on the behavior and plasma corticosterone levels of isolated Japanese quail chicks were determined. Doses of 15, 30, and 45 micrograms/kg of CRF reduced the number of distress vocalizations emitted during isolation in chicks of a control line. The behavioral responses to a 15 micrograms/kg dose of CRF in lines selected either for high (HSR) or low (LSR) level of sociality or for low (STI) or high (LTI) fearfulness were compared. CRF suppressed vocalizations and increased the number of pecks at food. In LTI and STI chicks, CRF decreased the number of distress calls. In HSR chicks, CRF increased the number of pecks at food and suppressed vocalizations. No effect of CRF was found in LSR chicks. Chicks of the HSR, LSR, LTI, STI, and control lines were injected with 15 micrograms/kg of CRF or saline solution and the level of corticosterone measured following a 15-min isolation period. CRF or isolation alone slightly activated the HPA axis, whereas CRF plus isolation greatly increased corticosterone levels except in the LSR line. These differential responses of LSR chicks and chicks of the other lines, indicate a possible role of CRF in the regulation of social reinstatement behavior.

Animals↗
PubMed1993

Nature, origin and fates of membranous lamellae in the lung of the neonate rat.

This study explores the basic nature and formation of lamellar accumulations in the vertebrate lung, and the problematical interrelationship of the lamellae with mitochondria. Autolysosomes are a constant feature of the type II alveolar pneumonocyte of the 2-day-old rat. They are characterized by a single boundary membrane, enclosing a heterogeneous collection of vesicles and membraneous lamellae. The autolysosomes result from repeated episodes of glycogen catabolism, and eventually transform into osmiophilic lamellated bodies. Membranous lamellae within autolysosomes and lamellated bodies represent isolating membranes of cellular autophagy, emptied of their digested contents. Proliferated isolating membranes themselves undergo lysis, providing recycled constituents for the differentiating or dividing cell. Mitochondria of the type II alveolar cell often display invaginations occupied by membranous masses; these masses are demonstrated by high magnification electron micrographs to be continuous with and derived from lamellated bodies, a new finding. Inner mitochondrial membranes lining the invaginations are thinned and crista-free. It is concluded that undergraded or partially lysed isolating membranes follow either of two cellular pathways: they may be eliminated from the cell into the alveolar cavity, or may fill mitochondrial indentations.

Animals↗
PubMed1993

Suicidality in AIDS long-term survivors: what is the evidence?

This study was designed to investigate suicidal ideation and attempts, thoughts about living and dying, and the maintenance, diminution and loss of hope in a sample of long-term AIDS survivors. The study sample consisted of 53 gay men enrolled as clients at Gay Mens Health Crisis in New York City who had had an AIDS-defining opportunistic infection at least 3 years prior to study entry. Despite the experience of protracted biological stress associated with life-threatening illness and the psychological stress of living with AIDS, we found low rates of current syndromal mood disorders (6%) or psychiatric distress. While thoughts about death and wishes to die were reported by a significant portion of men, they were context-specific, occurring almost exclusively during serious illness, often accompanied by severe pain or at times of bereavement. Only two men had made a suicide attempt after being diagnosed with AIDS and both had a history of prior (pre-AIDS) suicide attempts. While anger was a prominent affect, hopelessness was not. Overall, we found a high level of positive psychological health independent of HIV illness stage or degree of illness-induced physical limitation.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Cortisol levels, immune status, and mood in homosexual men with and without HIV infection.

OBJECTIVE: Alteration in cortisol levels has been reported in HIV infection and may be related to levels of psychiatric distress and immune function. The goals of this study were to assess cortisol levels in subjects with HIV infection and to determine whether stress-related activation of the hypothalamic-pituitary-adrenal (HPA) axis results in compromised immune function. METHOD: As part of a longitudinal study, the authors assessed urinary free cortisol levels of HIV-positive and HIV-negative homosexual men at four time points during a period of 2 years. Subjects' scores on the Hamilton depression and anxiety rating scales, medical stage of HIV infection, and CD4+ and CD8+ cell counts were also assessed. Repeated measures analysis of variance was used to determine whether subjects' cortisol levels at the four time points differed according to their serological status. Pearson correlation coefficients were computed to examine the relationships among mood ratings, cortisol levels, medical stages, and cell counts. RESULTS: Cortisol levels did not differ significantly between the HIV-positive and the HIV-negative subjects and were not associated with stage of medical illness in HIV infection. An association between cortisol level and depressed and anxious mood was found only at the first assessment. Cortisol level was not associated with CD4+ cell count in either group of subjects. CONCLUSIONS: There were no significant elevations of cortisol levels in the HIV-infected subjects, nor was there consistent evidence for stress-related activation of the HPA axis in either the HIV-positive or the HIV-negative subjects.

Adult↗
PubMed1993

The effect of zidovudine on neuropsychiatric measures in HIV-infected men.

The authors examined the effects of zidovudine on neuropsychiatric measures, at three assessment points separated by 6 months, in 25 HIV-positive men who took zidovudine for at least 6 months and a comparison group of 25 HIV-positive men with similar CD4+ T cell counts who had never taken zidovudine. Zidovudine had no statistically significant effect except for a slight improvement in Global Assessment of Functioning scale score. In this small group of subjects there was little benefit but also little evidence of CNS toxicity from zidovudine.

CD4-Positive T-Lymphocytes↗
PubMed1993

Resilience in adversity among long-term survivors of AIDS.

OBJECTIVE: This study evaluated psychological and behavioral aspects of quality of life and medical care utilization in a population of gay men whose intake records at a New York City agency indicated the presence of an AIDS-defining opportunistic infection at least three years before entry into the study. METHODS: Fifty-three men participated in a standardized psychiatric assessment of current mood disorders, psychiatric distress, future outlook, quality of life, and physical functioning using several clinician- and self-rated scales and a semistructured interview. RESULTS: Almost all of the men had experienced more than one episode of life-threatening illness, and many had been led to believe that they had only months to live. Nevertheless, low rates of current syndromal mood disorders and psychiatric distress were found. Degree of physical impairment was unrelated to psychiatric distress or life satisfaction, although men with more limited physical function were less optimistic about the future. CONCLUSIONS: Nearly all study participants displayed an extraordinary psychological resiliency and shared the conviction that good times lay ahead and that life continued to be worthwhile.

Acquired Immunodeficiency Syndrome↗
PubMed1992

The rat's postero-orbital sinus hair: II. Normal morphology and the increase in peripheral innervation with adjacent nerve section.

The morphology and innervation of the postero-orbital (PO) sinus hair has been studied in normal rats and in adult animals in which an adjacent nerve, the infraorbital nerve, was sectioned on postnatal day 0 or day 7. The normal morphology of the follicle was similar to that of mystacial sinus hairs. However, the normal innervation differed from mystacial follicles in three respects: (1) instead of a separate innervation, the deep vibrissal nerve (DVN) and dermal plexus were supplied by a common follicle and skin nerve, named here the postero-orbital cutaneous nerve, a branch of the zygomaticofacial nerve; (2) the entry of the DVN through the capsule was highly variable; in some cases fascicles entered in close proximity, but in others they were widely distributed around the capsule; and (3) two or three small nerves, called here anastomosing nerves, were found to leave the PO follicle. These arose from the DVN after it had passed through the capsule to the cavernous sinus. The anastomosing nerves passed back through the capsule and ascended on the outer surface of the follicle to join the dermal plexus. Each nerve contained 1-4 myelinated fibres and 11-35 unmyelinated fibres. Infraorbital (IO) nerve section on day 0 caused a 19% (P less than 0.001, n = 8) increase in numbers of fibers to the DVN on the lesioned side. Most of the increase was due to unmyelinated fibres with no significant change in myelinated axons. No change in axon numbers in the DVN occurred after day 7 lesions. Labelling of the mystacial pad and the PO follicle did not result in any double labelling of cells in the trigeminal ganglion, in either normal or lesioned animals, making it improbable that the increased numbers of unmyelinated axons arose from rerouting of infraorbital fibres. It is suggested that the increased innervation of the PO follicle may arise by the rescue of ganglion cells from developmentally programmed cell death.

Animals↗
PubMed1992

The Structured Clinical Interview for DSM-III-R (SCID). I: History, rationale, and description.

The history, rationale, and development of the Structured Clinical Interview for DSM-III-R (SCID) is described. The SCID is a semistructured interview for making the major Axis I DSM-III-R diagnoses. It is administered by a clinician and includes an introductory overview followed by nine modules, seven of which represent the major axis I diagnostic classes. Because of its modular construction, it can be adapted for use in studies in which particular diagnoses are not of interest. Using a decision tree approach, the SCID guides the clinician in testing diagnostic hypotheses as the interview is conducted. The output of the SCID is a record of the presence or absence of each of the disorders being considered, for current episode (past month) and for lifetime occurrence.

Decision Trees↗
PubMed1992

The Structured Clinical Interview for DSM-III-R (SCID). II. Multisite test-retest reliability.

A test-retest reliability study of the Structured Clinical Interview for DSM-III-R was conducted on 592 subjects in four patient and two nonpatient sites in this country as well as one patient site in Germany. For most of the major categories, kappa s for current and lifetime diagnoses in the patient samples were above .60, with an overall weighted kappa of .61 for current and .68 for lifetime diagnoses. For the nonpatients, however, agreement was considerably lower, with a mean kappa of .37 for current and .51 for lifetime diagnoses. These values for the patient and nonpatient samples are roughly comparable to those obtained with other structured diagnostic instruments. Sources of diagnostic disagreement, such as inadequate training of interviewers, information variance, and low base rates for many disorders, are discussed.

Diagnosis, Computer-Assisted↗
PubMed1992

Changes in endocrinological parameters and production performances in Turkey hens (Meleagris gallopavo) submitted to different broody management programs.

Occurrence of broodiness, egg production, feed consumption index and changes in the LH and prolactin levels were compared for turkey hens raised under 3 broody management programs. All hens (n=60 per group) were regularly ejected from the nest (basic treatment). Moreover, one group of hens was also rotated weekly (partial treatment), while in the third group (full treatment) hens showing broody symptoms were also identified daily and isolated for 24 hours. The percentage of hens which were identified as broody at least once was similar under the 3 programs (30%), although the use of the full and partial programs were more effective in inducing the disruption and/or preventing further expression of broody behavior. Plasma LH concentrations decreased progressively throughout the reproductive cycle under the 3 treatments. Maximum plasma concentrations of prolactin were measured between the 5th and the 10th weeks of production; higher concentrations of prolactin were maintained for a longer period under the full treatment, while a lower amplitude rise in plasma prolactin concentrations was observed in the hens submitted to the partial treatment. The egg production and feed consumption indices were lower and higher, respectively, under the full treatment than the basic treatment and partial treatments. We conclude that management programs need to be carefully evaluated under commercial conditions not only with respect to broodiness expression but also to egg production.

Journal Article↗