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Biomedical subjects

J Catalan

Publications and source records attributed to J Catalan.

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

How should a positive HIV result be given? The patients' view.

The study aimed at obtaining information about the experience of how the diagnosis of HIV infection was given. Thirty asymptomatic HIV seropositive subjects completed a self-report questionnaire enquiring about their views of the process of communication of a positive test result. Subjects' current mood was assessed with the Hospital Anxiety and Depression Scale (HAD). Only about one-third of subjects were definitely satisfied with the way they were told the diagnosis. Satisfaction was associated with perceived reassurance and sympathy, and with the quality of the information given. The views of patients, as reported in this study, should be taken into account when training staff in the notification of HIV test results.

AIDS Serodiagnosis↗
PubMed1994

Whose health is it? Views about decision-making and information-seeking from people with HIV infection and their professional carers.

The views of people with HIV and their professional carers about patients' views on involvement in decision-making and information-seeking were studied, using a standardized self-report instrument. Patients and staff reported high levels of desire for patients' involvement in their care, but there were important differences between groups. Staff had higher preference for patients' involvement in decision-making than the patients themselves, while the opposite was the case for information-seeking. There were differences between professional groups and symptomatic and asymptomatic patients, social workers generally reporting higher preference for patients' autonomy, while doctors reported lower levels. Symptomatic patients tended to have lower preference for autonomy than asymptomatic ones. The significance and practical implications of the findings are discussed.

Adult↗
PubMed1994

Psychosexual problems in people with HIV infection: controlled study of gay men and men with haemophilia.

HIV infection can be associated with major psychological and social disturbance. Psychosexual problems would be expected to arise in the context of the infection, in view of the contribution that sexual behaviour can make to the acquisition and spread of HIV infection. Here the results of a study of the psychosexual consequences of HIV infection in gay men and men with haemophilia are presented, with the inclusion of data from control groups. Sixteen HIV-positive and 23 HIV-negative gay men, and 20 HIV-positive and 24 HIV-negative men with haemophilia with sexual partners were studied. HIV infection was found to be associated with the greater risk of development of sexual dysfunction in seropositives, in particular in relation to ejaculatory difficulties, both delayed ejaculation in the case of gay men and men with haemophilia, and premature ejaculation in the case of men with haemophilia. Possible aetiological mechanisms are considered, including the possibility of organic disease. The findings are of relevance to those involved in the care of people with HIV infection.

Adult↗
PubMed1993

Psychological morbidity in women referred for treatment of hirsutism.

Sixty-nine pre-menopausal hirsute women were studied to determine the prevalence of psychological morbidity, and to identify factors associated with psychiatric symptoms. Measures used included: GHQ and POMS to assess psychological morbidity; self-esteem; personality (EPQ); and social adjustment, amongst other. About a third of subjects were found to be GHQ cases, one third had never discussed their hirsutism before, and two thirds avoided some social situations. Psychological morbidity was associated with poor social adjustment, higher levels of neuroticism and introversion, and avoidance of some social situations, but not with the severity of hirsutism or testosterone levels. The results suggest that a proportion of women with hirsutism experiences psychological and social difficulties, and that factors other than their dermatological status play an important part in their psychological difficulties.

Adolescent↗
PubMed1993

The psychosocial impact of HIV infection in women.

The aim of the investigation was to study the prevalence of current and past psychiatric morbidity and psychosocial problems in HIV seropositive (HIV +ve) asymptomatic women. A cross-sectional controlled study including 57 HIV +ve women belonging to CDC group II and III (43 intravenous drug users and 14 non-IVDUs heterosexuals) and 23 HIV -ve women (15 intravenous drug users and 8 non-IVDUs heterosexuals) is reported. Outcome measures included, past psychiatric history, current psychological status (Zung Anxiety and Depression scales, Symptom Check List 90-Revised), Social Supports and Locus of Control Scales, and information on changes in work, social and sexual life after HIV testing. Results showed that HIV +ve women differed very little from HIV -ve controls regarding outcome measures and indeed for some variables HIV infected women had lower levels of psychological morbidity. Multiple regression analyses showed that alcohol misuse and a predominantly external locus of control accounted for the 29% of the variance of psychiatric distress (F = 9.23, p < 0.0006). The implications of the findings are discussed.

Adaptation, Psychological↗
PubMed1993

Neuropsychiatric aspects of HIV-1 infection in gay men: controlled investigation of psychiatric, neuropsychological and neurological status.

The aim of this study was to determine whether HIV infection is associated with psychiatric morbidity or neuropsychological impairment in asymptomatic and early symptomatic stages of disease in gay men. The subjects were 100 gay men (68 HIV-ve, 32 HIV+ve, 6 being CDC IV). All subjects were recruited at the time of requesting their first HIV test and the assessment was double-blind to HIV serostatus. There were no differences in psychiatric status or neuropsychological performance between the HIV-ve and HIV+ve groups. Multiple regression analysis and logistic regression were used to identify factors associated with psychiatric morbidity, neuropsychological impairment and subjective reporting of memory problems and physical symptoms for all 100 subjects. Previous psychiatric history and current illegal (non-dependent) drug use were associated with psychiatric morbidity, poor education was associated with neuropsychological impairment and psychiatric status (score on HAD and PSE) was associated with subjective reporting of memory problems and physical symptoms.

AIDS Dementia Complex↗
PubMed1993

Sister-chromatid exchanges induced by chloramphenicol on bovine lymphocytes.

The induction of sister-chromatid exchanges (SCE) was studied in bovine lymphocyte cultures treated with chloramphenicol (CAP), an antibiotic agent in wide use in human and animal therapy. A total of six individuals, matched for sex, race, age and environmental conditions, were used for the analysis. Chloramphenicol was tested at four different concentrations (5, 10, 20 and 40 micrograms/ml) and acted for the last 24 h of the culture. Each experiment included two animals, each of which was exposed to all chloramphenicol doses, for a total of three repetitions. The results of the corresponding analysis of variance showed that this chemical had a small but statistically significant effect on the SCE frequency. In addition, the lymphocyte cultures responded strangely to this chemical: the highest SCE induction was produced by the lowest dose. However, the study of high frequency cells did not show the presence of this kind of cell which could explain this chloramphenicol response. In addition, chloramphenicol induced a high delay in the cell cycle.

Analysis of Variance↗
PubMed1993

Detection of subclinical motor dysfunctions in early symptomatic HIV infection with topographical EEG.

Motor dysfunctions are amongst the earliest and most common signs of brain impairment caused by human immunodeficiency virus (HIV) infection. Topographical EEG was recorded in patients both with asymptomatic and early symptomatic infection (without acquired immunodeficiency syndrome (AIDS) defining illness), as well as in seronegative controls under resting and motor activation conditions. While patients' motor performance did not differ from control values, the EEG showed a consistent increase in rhythmic activity in Theta, Alpha and Beta frequency bands in Symptomatics. This amplitude increase was evident in different topographical regions during resting states as compared with motor activation, findings which suggest concurrent involvement of several motor areas possibly due to a functional impairment in subcortical integratory mechanisms. Comparing motor task and baseline both patient groups showed less consistent patterns of task-related EEG amplitude reduction than found in the control group. Here topographical EEG in connection with motor activation procedures was found to be more sensitive than behavioral measures of motor performance and offers a technique to assess treatment effects before the development of motor abnormalities in patients with HIV infection.

Adult↗
PubMed1993

HIV antibody testing in the antenatal clinic.

With the increase in human immunodeficiency virus (HIV) seroprevalence amongst women attending the antenatal clinic in the UK it is essential that women are adequately prepared to make an informed decision about being tested for HIV and to receive the result of such testing. This paper discusses the purpose of testing, the necessity of pre-test counselling, its content and the practical implications of providing it. Guidelines for the content of a pre-test counselling session are outlined with particular reference to issues pertinent to the pregnant woman: vertical transmission, the effect of pregnancy on disease progression, the effect of HIV on pregnancy, the prognosis for an infected child and so on.

AIDS Serodiagnosis↗
PubMed1993

HIV antibody testing in the antenatal clinic: the views of the consumers.

OBJECTIVE: to investigate the attitudes of parturient women to HIV antibody testing in the antenatal clinic. DESIGN; anonymous self completion questionnaire. SUBJECTS: 318 women attending antenatal clinic for their first booking appointment. SETTINGS: a central London hospital, UK. RESULTS: 58% of the women felt that testing should not be compulsory, 33% that it should. Sixty per cent felt that results of the test should be given as routine but 38% felt that they should only be given if requested. Fifty five per cent felt the HIV test was as important as all the other routine tests and 60% felt that they personally did not need to be tested. Only 44% wanted to speak to a midwife about the test, with 23% saying that they did not want to speak to anyone at all. The main reason given for accepting testing was concern about passing the virus on to the baby, which was also the main concern if the test was found positive. Few women (23%) felt that those identified as positive should be encouraged to terminate their pregnancy. CONCLUSIONS: policy decisions around HIV testing should take into account the diversity of the needs and wants of this multicultural and multiracial group of consumers.

AIDS Serodiagnosis↗
PubMed1993

Suicide and HIV disease.

It has been suggested that HIV infection is associated with an increased risk of suicidal behaviour. This paper reviews the literature on suicide in patients with HIV disease and discusses methodological problems encountered in studying the incidence of suicide in this population. A snowballing method was used to identify cases of suicide in patients who were receiving treatment for HIV disease in a central London health district. The possible under detection of suicides among AIDS patients is considered. The six case reports are described to illustrate the clinical and psychosocial characteristics of suicides, and they are discussed in relation to other findings on suicide in patients with HIV disease and other physical illnesses.

Acquired Immunodeficiency Syndrome↗
PubMed1993

"I plan to have the HIV test"--predictors of testing intention in women attending a London antenatal clinic.

In order to identify which factors predict a parturient womans intention to take up voluntary HIV testing in the antenatal clinic, 318 women were surveyed by anonymous self-completion questionnaire. The strongest predictors of intention to be tested were the perceived benefit of the test to the woman herself, her partner, and the midwife, perceived risk of HIV infection, younger age and being single and having a poor knowledge of the sexual routes of HIV transmission. Health education strategies should therefore concentrate on: (a) increasing the parturient woman's knowledge of HIV transmission which will increase accuracy of perception of risk; and (b) stressing the potential benefits of HIV testing to all antenatal attenders, particularly to those who are older and in long term relationships.

AIDS Serodiagnosis↗
PubMed1993

Women's experience of HIV testing: the views of HIV positive and HIV negative women.

As part of a study of the psychosocial impact of HIV infection in women, 23 HIV seropositive and 23 seronegative women were asked about their experience of being tested for HIV. The majority of those who tested negative sought HIV testing because they felt at risk through unprotected sex, while most of the HIV positives were identified when they developed HIV-related symptoms. Pretest counselling was not universal, in particular in the case of HIV seropositives, some of whom were tested without consent. A substantial proportion of women, regardless of serostatus, had not communicated to anyone their intentions to have a test. There was some regret about knowing their HIV status, in particular in seropositives. The implications of the findings are discussed.

AIDS Serodiagnosis↗
PubMed1993

The reliability and validity of two HIV-specific health-related Quality-of-Life measures: a preliminary analysis.

OBJECTIVE: To evaluate the reliability and validity of two HIV-specific Quality-of-Life (QoL) questionnaires in a UK sample. METHOD: Subjects were 99 HIV-seropositive gay men (23 were asymptomatic, 41 were asymptomatic, 35 had AIDS). QoL was measured using two HIV-specific QoL questionnaires. MEASURES: An adaptation of the Medical Outcomes Study questionnaire and a self-completion version of the Health-Related Quality-of-Life Questions. Affect was measured using the Hospital Anxiety and Depression (HAD) Scale. Disease measures included Centers for Disease Control and Prevention (CDC) stage, and CD4 and CD8 cell count. RESULTS: Both QoL instruments showed good internal reliability on all scales used. Many of the scales, particularly those related to physical health and functional performance, showed significant correlations with CD4 cell count and other measures of disease progression. Measures of physical health showed a deterioration in QoL as disease progressed from asymptomatic disease to AIDS. In contrast, most subscales purporting to measure psychological aspects of QoL did not correlate significantly with measures of disease progression, nor was there any difference between CDC stages. Subjects' global ratings of QoL were most strongly correlated with the HAD depression scale, although there were also significant correlations with most other QoL scales. CONCLUSION: This study provides further evidence for the reliability and validity of two HIV-specific QoL questionnaires in a wider range of disease stages than hitherto reported and raises issues relevant to the practical use of QoL scales in HIV disease.

CD4 Antigens↗
PubMed1993

Management of genital herpes by genitourinary physicians: does experience or doctor's gender influence clinical management?

OBJECTIVE: To determine the variation in management of genital herpes by genitourinary physicians, and whether their duration of experience or gender influence their clinical management. METHODS: A postal questionnaire was sent to UK consultant genitourinary physicians with detailed questions about management of primary and recurrent herpes. The gender and duration of genitourinary medicine experience of the physicians were also recorded. RESULTS: One hundred and eighty two questionnaires were sent, 112 (62%) returned. Eighty-one (72%) physicians treat all patients with primary genital herpes, but physicians with more than 20 years experience were significantly (p < 0.05) more likely to treat only "severe" primary attacks. Most experienced physicians were also most likely (p < 0.05) to prescribe topical acyclovir. Prescription of suppressive acyclovir was also influenced by the experience of the physician, the least experienced physicians being more likely to prescribe to patients who were HIV antibody positive or to those entering new relationships, whereas the more experienced prescribed to those patients who were particularly anxious (p < 0.05 for each of these). Male physicians were significantly more likely to agree with the proposition that men cope better with genital herpes (54%) than female physicians (24%, p < 0.01). CONCLUSION: The response to the questionnaire illustrates that management of genital herpes is influenced by the duration of the physicians clinical experience. Gender of the physician may have an indirect role to play as we have shown that physicians differ in their perception of how the sexes cope with genital herpes.

Acyclovir↗
PubMed1993

Suicide notes.

Detailed case reports of incidents of suicide and attempted suicide on the London Underground railway system between 1985 and 1989 were examined for the presence of suicide notes. The incidence of note-leaving was 15%. Notes provided little insight into the causes of suicide as subjectively perceived, or strategies for suicide prevention.

Accidents, Traffic↗