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Biomedical subjects

J Gold

Publications and source records attributed to J Gold.

At least 19 recordsLinked to original sources
PubMed2002

Valaciclovir versus aciclovir for herpes simplex virus infection in HIV-infected individuals: two randomized trials.

Our objective was to evaluate valaciclovir for anogenital herpes in HIV-infected individuals using 2 controlled trials conducted before highly active antiretroviral therapy (HAART) was used. In Study 1, 1062 patients (CD4+ > or = 100 cells/mm(3)) received suppressive valaciclovir or aciclovir for one year and were assessed monthly. In Study 2, 467 patients were treated episodically for > or =5 days with valaciclovir or aciclovir and evaluated daily. Valaciclovir was as effective as aciclovir for suppression and episodic treatment of herpes. Hazard ratios [95% confidence interval (CI)] for time to recurrence for valaciclovir 500 mg twice daily and 1000 mg once daily vs aciclovir were 0.73[0.50, 1.06], P=0.10, and 1.31[0.94, 1.82], P=0.11. Valaciclovir 500 mg twice daily was superior to 1000 mg once daily, P=0.001. Valaciclovir 1000 mg twice daily was comparable to aciclovir on herpes episode duration (hazard ratio 0.92[0.75, 1.14]). Adverse events were similar among treatments. In conclusion, valaciclovir is a safe, effective, convenient alternative to aciclovir for HSV infection in HIV-infected individuals.

AIDS-Related Opportunistic Infections↗
PubMed2001

The importance of surface texture for bone integration of screw shaped implants: an in vivo study of implants patterned by photolithography.

The aim of the present study was to investigate the influence of different properties inherent in surface topography on the integration of an implant in bone. Using a photolithography technique, a specific surface pattern was produced on the screw flanks of threaded titanium oral implants. Surface topography was qualitatively assessed by scanning electron microscopy (SEM) and a confocal laser scanning profilometer. Quantitative analysis with the confocal laser profilometer derived parameters for surface roughness and surface roughness together with waviness. The chemical composition of the implant surfaces was analyzed by Auger electron spectroscopy. The patterned and control (turned) implants were inserted in New Zealand White rabbits with a healing period of 3 months. Bone fixation was evaluated with resonance frequency analysis (RFA), peak removal torque analysis (RTQ), and by histomorphometry. No statistically significant differences were seen in the fixation, with respect to bone-to-implant contact, between the patterned and control implants.

Animals↗
PubMed2001

A preliminary open label dose comparison using an antioxidant regimen to determine the effect on viral load and oxidative stress in men with HIV/AIDS.

OBJECTIVE: To investigate the effect of antioxidant supplementation on viral load and the antioxidant/reactive oxygen species system in people with HIV. DESIGN: Single centre, prospective, dose comparison study. SETTING: Outpatient clinic specializing in HIV care. SUBJECTS: Sixty-six participants were sequentially recruited by advertisement, and 48 subjects completed the study. INTERVENTIONS: A recommended dose antioxidant regimen (5,450 IU vitamin A as beta-carotene, 250 mg vitamin C, 100 IU vitamin E, 100 microg selenium, 50 mg coenzyme Q10) or a high-dose antioxidant regimen (21,800 IU vitamin A as beta-carotene, 1,000 mg vitamin C, 400 IU vitamin E, 200 microg selenium, 200 mg coenzyme Q10) for a 12 week period. RESULTS: Using repeated measures analysis of variance, the changes over treatment time were significant for selenium, glutathione, glutathione peroxidase and lipid peroxides (P < 0.03). Changes in allantoin, uric acid and viral load were not significant (P > 0.05). The main effects for group and the interaction effects were not significant for any of the parameters measured (P > or = 0.05). CONCLUSION: Antioxidant supplementation significantly improved some measures of oxidative defence. There was no benefit in using a high-dose supplement in this study.

Adult↗
PubMed2001

Evaluation of the use of tyrosinase-specific and melanA/MART-1-specific reverse transcriptase-coupled--polymerase chain reaction to detect melanoma cells in peripheral blood samples from 299 patients with malignant melanoma.

BACKGROUND: There is a current need for a reliable prognostic marker for melanoma patients, particularly those with stage 2 and stage 3 disease, so that adjuvant therapies can be directed appropriately. OBJECTIVES: To establish whether or not the use of tyrosinase-specific or melanA/MART-1-specific reverse transcriptase-coupled-polymerase chain reaction (RT--PCR) of peripheral blood cells detects preclinical disease progression in patients with malignant melanoma. METHODS: Two hundred and ninety-nine patients with melanoma in clinical stages 1--4 were observed in this study. Samples were obtained sequentially from 153 of these patients at 4-week intervals over a period of up to 2 years and correlated with clinical evidence of disease activity. Tyrosinase and melanA/MART-1 amplicons were analysed by agarose gel electrophoresis and Southern blot hybridization subsequent to a single round of amplification. RESULTS: We demonstrated a statistically significant increase in tyrosinase RT--PCR positivity with advancing stage of melanoma progression. The percentage tyrosinase positivity in 910 samples tested was: stage 1, 135 samples, 34% positive; stage 2, 196 samples, 51% positive; stage 3, 423 samples, 50% positive; and stage 4, 156 samples, 65% positive. The positivity rate for individual patients tested sequentially was higher if only one positive test was required to label a patient positive, at 42%, 65%, 82% and 81% for patients in stages 1--4, respectively. However, we did not find a clear pattern of conversion from negativity to positivity in patients who progressed during the study from stage 2 to stage 3 or stage 3 to stage 4, and found no clear evidence of increased positivity rates in the 6-week period following melanoma-related surgery in patients with stage 3 and 4 disease. The positivity rate for melanA/MART-1 was lower for both patients and samples, and no melanA/MART-1-positive sample was negative for tyrosinase. CONCLUSIONS: We conclude that the presence of circulating tyrosinase-positive cells as detected by this method appears to be a discontinuous rather than a continuous phenomenon, even in patients with stage 4 disease. For this reason the assay cannot be recommended as a method of sequentially monitoring individual patients in a clinical setting.

Antigens, Neoplasm↗
PubMed2001

Administrative relationships between medical schools and community preceptors.

PURPOSE: To determine the current administrative relationships between medical schools and community preceptors, with special emphasis on arrangements for academic appointment, review, and promotion. METHOD: In 1999, administrative contacts at all 126 U.S. allopathic medical schools were mailed a ten-item questionnaire to elicit information concerning the current practices of the schools regarding community preceptors, who were defined as volunteer or part-time physician faculty, primarily practicing at non-university-owned facilities, who contribute to medical students' and/or residents' education in various specified ways. RESULTS: Responses were received from 71 (56%) of the schools; they were in general a representative sample of U.S. medical schools. The numbers of preceptors per school ranged from 40 to 3,500. Sixty-seven percent of reporting schools identified clinical departments as the main administrative interface with preceptors. Only three schools used a central office; none exclusively used a regionalized system. Forty-four schools (63.8%) reported using formal written criteria for all preceptor appointments. Sixty-six schools (93%) used consistent academic titling systems, with 83.3% using titles including the word "clinical." Thirty-three schools (47.8%) reported that their departments conducted regular preceptor reviews; an additional 28 reported reviews by some departments. Preceptors were eligible for promotion at 94.4% of the responding schools. At 46.8%, specific promotion criteria exist; four schools were developing such criteria. Preceptors' interest in academic promotion was perceived to be moderate or low. CONCLUSION: A substantial proportion of U.S. medical schools have taken action to recognize preceptors as a unique faculty group. The comments received indicate that this is an active area of development in faculty affairs policy.

Personnel Management↗
PubMed2001

Effects of sustained-release bupropion and supportive group therapy on cigarette consumption in patients with schizophrenia.

OBJECTIVE: The study examined the efficacy, tolerability, and safety of supportive group psychotherapy and adjunctive sustained-release bupropion for nicotine addiction in patients with schizophrenia. METHOD: Eight patients participated in a 14-week open-label trial. End expired breath carbon monoxide level, symptom levels, neuropsychological performance, and suppression of the P50 event-related potential were measured before and after the 14-week trial. RESULTS: Patients showed a decrease in carbon monoxide levels that was not associated with any worsening in symptom, neuropsychological, or P50 suppression measures. CONCLUSIONS: Use of sustained-release bupropion in combination with supportive group therapy may help patients with schizophrenia decrease their cigarette consumption.

Antidepressive Agents, Second-Generation↗
PubMed2001

Functional deterioration in individuals with schizophrenia spectrum personality symptoms.

Although previous studies have noted functional deterioration in patients with severe schizotypal symptoms who meet criteria for schizotypal personality disorder, we are not aware of any study which examines level of functioning in nonpatients who experience mild schizophrenia spectrum personality (SSP) symptoms. With this issue in mind, occupational functioning was examined in non-patient subjects with mild SSP symptoms. Patients were recruited from the community by newspaper advertisements or from the first-degree relatives of patients with schizophrenia. Individuals with no DSM-IIIR Axis I diagnosis and with SSP symptoms (n = 60) and without symptoms (n = 75) participated in the study. The two groups had similar mean age and years of education. Occupational function was evaluated using the Level of Function Scale. The SSP patients with mild symptoms had significantly lower occupational scores (5.62 + 2.50) than the non-SSP patients (7.76 + 0.69; p < 0.001). A total of 39% of SSP patients, compared with 3% of non-SSP patients showed poor occupational functioning (chi 2 = 31, df = 1, p < 0.001). There was a significant deterioration in the socioeconomic status in SSP patients compared with their parents' status. Patients with mild SSP symptoms who were otherwise healthy showed severe difficulties with occupational function. Further research is needed to identify subtle deficits underlying functional deterioration and to develop targets for treatment strategies.

Adult↗
PubMed2001

Motion to strike claim dismissed in HIV defamation suit.

On 23 April 2001, the Ontario Superior Court of Justice issued the first Canadian ruling on the issue of whether words inputing that a person is HIV-positive or has AIDS can be the basis of a defamation action per se, in the case of Serdar v Metroland Printing, Publishing and Distributing Ltd.

Bites, Human↗
PubMed2001

Alberta law confining child prostitutes upheld.

The Alberta Court of Queen's Bench has determined that the Alberta Protection of Children Involved in Prostitution Act is not in violation of the Constitution. This decision overturns the ruling of the Provincial Court, which held that the Act infringes the rights articulated in sections 7, 8, and 9 of the Charter.

Adolescent↗
PubMed2001

Supreme Court finds red cross negligent in screening blood donors.

On 19 April 2001, the Supreme Court of Canada released its first judgments in litigation alleging the Canadian Red Cross Society was negligent for inadequately screening blood donors in the early 1980s. It upheld an order that damages in the amount of over $2.5 million be paid to three individuals who contracted HIV between 1983 and 1985 from contaminated blood.

AIDS Serodiagnosis↗
PubMed2000

Retention of bacteria on a substratum surface with micro-patterned hydrophobicity.

Bacteria adhere to almost any surface, despite continuing arguments about the importance of physico-chemical properties of substratum surfaces, such as hydrophobicity and charge in biofilm formation. Nevertheless, in vivo biofilm formation on teeth and also on voice prostheses in laryngectomized patients is less on hydrophobic than on hydrophilic surfaces. With the aid of micro-patterned surfaces consisting of 10-microm wide hydrophobic lines separated by 20-microm wide hydrophilic spacings, we demonstrate here, for the first time in one and the same experiment, that bacteria do not have a strong preference for adhesion to hydrophobic or hydrophilic surfaces. Upon challenging the adhering bacteria, after deposition in a parallel plate flow chamber, with a high detachment force, however, bacteria were easily wiped-off hydrophobic lines, most notably when these lines were oriented parallel to the direction of flow. Adhering bacteria detached slightly less from the hydrophilic spacings in between, but preferentially accumulated adhering on the hydrophilic regions close to the interface between the hydrophilic spacings and hydrophobic lines. It is concluded that substratum hydrophobicity is a major determinant of bacterial retention while it hardly influences bacterial adhesion.

Bacterial Adhesion↗
PubMed2000

Vasopressin in the treatment of milrinone-induced hypotension in severe heart failure.

The use of phosphodiesterase inhibitors such as milrinone in the treatment of severe heart failure is frequently restricted because they cause vasodilation and hypotension. In patients with decompensated heart failure with hypotension after treatment with milrinone, low doses of vasopressin restored blood pressure without inhibiting the inotropic effect of milrinone.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed2000

B-cell stimulation and prolonged immune deficiency are risk factors for non-Hodgkin's lymphoma in people with AIDS.

OBJECTIVES: To identify risk factors for non-Hodgkin's lymphoma (NHL) in people with HIV infection. DESIGN AND SETTING: Case-control study in Sydney, Australia. PARTICIPANTS AND METHODS: Two hundred and nineteen patients with AIDS-related NHL were compared with 219 HIV-infected controls without NHL, matched for CD4 positive cell count and date of specimen collection. Data on demographic, infectious, treatment-related and immunological factors were abstracted by medical record review. The association between demographic factors, sexually transmissible diseases, HIV-related opportunistic infections, anti-viral therapy, duration of immune deficiency and indices of immune stimulation and risk of NHL were derived for these groups. RESULTS: In a multivariate model, there were two independent groups of predictors of NHL risk. The first was duration of immunodeficiency, as measured by longer time since seroconversion (P for trend 0.008), and lower CD4 positive cell count 1 year prior to the time of NHL diagnosis (P for trend 0.009). The second predictor was B-cell stimulation, as indicated by higher serum globulin (a surrogate marker for serum immunoglobulin, P for trend 0.044) and HIV p24 antigenaemia [odds ratio (OR) for p24 positivity, 1.82; 95% confidence interval (CI), 1.15-2.88]. Indices of B-cell stimulation preceded the diagnosis of NHL by several years. Factors not related to NHL risk included clinical indices of Epstein-Barr virus infection and receipt of individual nucleoside analogue antiretroviral agents. Combination therapy with these agents was associated with a non-significant reduction in NHL risk (OR, 0.68; 95% CI, 0.39-1.18). CONCLUSIONS: Markers of long-standing immune deficiency and B-cell stimulation were associated with an increased risk of developing NHL. Unless the strongest risk factor for NHL, immune deficiency, can be reversed, NHL is likely to become proportionately more important as a cause of morbidity and mortality in people with HIV infection.

Adult↗