A word from WIPRO. Alzheimer's disease caregiver cooperative project.
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Aged↗
Biomedical subjects
J Gold
Publications and source records attributed to J Gold.
Influenza vaccinations do work, but only if health care professionals provide them.
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Humans↗
Physiological activation of a cortical network during performance of the Wisconsin Card Sorting Test: a positron emission tomography study.
To determine the neural circuitry engaged by performance of the Wisconsin Card Sorting Test (WCST), a neuropsychological test traditionally considered to be sensitive to prefrontal lesions, regional cerebral blood flow was measured with oxygen-15 water and positron emission tomography (PET) while young normal subjects performed the test as well as while they performed a specially designed sensorimotor control task. To consider which of the various cognitive operations and other experiential phenomena involved in the WCST PET scan are critical for the pattern of physiological activation and to focus on the working memory component of the test, repeat WCST scans were also performed on nine of the subjects after instruction on the test and practice to criteria. We confirmed that performance of the WCST engages the frontal cortex and also produces activation of a complex network of regions consistently including the inferior parietal lobule but also involving the visual association and inferior temporal cortices as well as portions of the cerebellum. The WCST activation in the dorsolateral prefrontal cortex (DLPFC) remained significant even after training and practice on the test, suggesting that working memory may be largely responsible for the physiological response in DLPFC during the WCST and, conversely, that the DLPFC plays a major role in modulating working memory.
Adolescent↗
HIV risk exposure of injecting drug users in Sydney.
One thousand two hundred and forty-five Sydney injecting drug users (IDUs) were interviewed by questionnaire in 1989 to determine demographic and behavioural characteristics. One-sixth (16.7%) were considered to be at low risk of HIV from either needle sharing or sexual transmission as they had either never shared injecting equipment, or had not shared for years, or cleaned their injecting equipment effectively on 100% of the occasions when they did share; and were either celibate or monogamous or, if they had multiple partners, had not had unsafe sex in the previous 6 months. Over half (50.7%) had either unsafe injecting or sexual behaviour with the remaining third (32.6%) engaging in both unsafe injecting and sexual practises. Women were more at risk from sharing injection equipment than men but men were more at risk from sexual transmission than women. Increasing age was associated with greater likelihood of safer sex but age had no effect on injecting practises. There was no relationship between unsafe injecting and sexual practises. Amphetamine use was associated with low risk injecting practises while heroin use was associated with low risk sexual transmission. These findings indicate appreciable residual risk behaviour sufficient to allow for at least a slow diffusion of HIV among injecting drug users.
Journal Article↗
Education opportunities in alternative/complementary medicine for nurses.
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Academies and Institutes↗
Wechsler adult intelligence scale-revised in the evaluation of anterior temporal lobectomy candidates.
We wished to (a) determine the ability of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) to discriminate between patients with epilepsy of left or right temporal lobe (LTLE, RTLE) origin and (b) examine the ability of Kaufman's (1990) WAIS-R short forms to estimate actual Full-Scale IQ (FSIQ). We administered the WAIS-R to 215 nonretarded, left hemisphere dominant patients with invasively verified epilepsy of unilateral TL origin without lesions demonstrated by magnetic resonance imaging (MRI) (excluding mesial temporal sclerosis, MTS). LTLE (n = 106) and RTLE (n = 109) groups were compared on the WAIS-R subtests and summary IQ scores. Verbal-Performance IQ (VIQ-PIQ) discrepancies of various magnitudes, and Verbal Comprehension (VC) and Perceptual Organization (PO) scores derived by factor analysis. The LTLE group scored significantly lower on the Vocabulary subtest, and none of the other indexes reliably distinguished LTLE from RTLE patients. The Kaufman 2, 3, and 4 subtest short forms were significant predictors of FSIQ, with the 4 subtest short form having the highest correlation and lowest error of estimate.
Adult↗
Reliability of interview responses of injecting drug users.
We compared 23 injecting drug users (IDUs) who were part of a larger study at retest periods of less than or greater than one month for test-retest reliability of their responses to a detailed questionnaire covering demographics, drug use, HIV risk behavior and attitudes and knowledge about HIV. Data indicated that there was high test-retest reliability for demographic characteristics, and for the social context of drug use for the shorter retest duration.
Acquired Immunodeficiency Syndrome↗
A short history of AIDS.
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Acquired Immunodeficiency Syndrome↗
Site-specific adhesion of Staphylococcus epidermidis (RP12) in Ti-Al-V metal systems.
Staphylococcus epidermidis (RP12) adhesion patterns were studied on the following titanium (Ti)-aluminium (Al)-vanadium (V) metal systems: (i) microfabricated samples consisting of Ti, Al and V islands deposited onto Ti or V substrata, (ii) pure Ti, Al and V metals, and (iii) medical grade Ti6Al4-V alloy. All of these surfaces were covered with their respective oxides formed upon exposure of the metals to air. Quantitative analysis of the number of cells bound per unit area indicates that S. epidermidis (RP12) exhibits greatest adhesion to pure V surfaces. When exposed to surfaces having controlled spatial variations in chemical composition on the 10 microns scale (microfabricated samples), the bacteria preferentially populate V islands versus Ti or Al substrata. In the case of the biphasic Ti6Al4V alloy, the bacteria tend to adhere to V-rich, mixed phase regions and phase boundaries. These findings demonstrate that enhanced and preferential adhesion of S. epidermidis (RP12) occurs on V surfaces in Ti-Al-V metal systems and suggest that bacterial interactions are influenced by surface oxide composition.
Alloys↗
Long-term prognosis after peri-operative cardiac complications.
UNLABELLED: The objective was to document the 5 year prognosis of patients who had cardiac complications after non-cardiac surgery. DESIGN: 5-year follow-up of 218 patients originally enrolled in a prospective study to identify risks factors for peri-operative complications. SETTING: an academic medical center. Participants were hypertensives and diabetics who underwent elective surgery between 1982 and 1985. In the original study, patients were evaluated pre-operatively, monitored intra-operatively by an independent observer, and followed daily for 7 days post-operatively according to a standard surveillance protocol. Outcomes were judged by assessors blinded to the pre-operative status and intra-operative course. Patients were interviewed at 3 and 5 years post-operatively. Patients with post-operative cardiac complications had significantly higher rates of overall mortality, mortality attributable to cardiac causes (MI, CHF, arrest), and mortality attributable to other cardiovascular causes (stroke, renal failure) than patients without cardiac complications. For example, at 5 years 11% of those patients without post-operative cardiac complications had cardiac deaths, in contrast to 45% of those patients with post-operative cardiac complications. Proportional hazards analysis demonstrated that post-operative cardiac complications remained a significant predictor of cardiac (p < 0.001) and cardiovascular (p < 0.0001) mortality controlling for pre-operative cardiac disease, other non-cardiovascular comorbid diseases, age, sex, diabetes, and pre-operative renal insufficiency or stroke. Similarly, patients with post-operative non-fatal cardiac complications had higher rates of cardiac or cardiovascular events during the 5 year follow-up period. We conclude that post-operative cardiac complications have a significant adverse long-term prognostic impact comparable to the prognostic impact of myocardial infarction, ischemia or congestive failure in the non-operative setting. Understanding these events could be an important factor in identifying patients at high risk for subsequent peri-operative complications.
Aged↗
Validation of a combined comorbidity index.
The basic objective of this paper is to evaluate an age-comorbidity index in a cohort of patients who were originally enrolled in a prospective study to identify risk factors for peri-operative complications. Two-hundred and twenty-six patients were enrolled in the study. The participants were patients with hypertension or diabetes who underwent elective surgery between 1982 and 1985 and who survived to discharge. Two-hundred and eighteen patients survived until discharge. These patients were followed for at least five years post-operatively. The estimated relative risk of death for each comorbidity rank was 1.4 and for each decade of age was 1.4. When age and comorbidity were modelled as a combined age-comorbidity score, the estimated relative risk for each combined age-comorbidity unit was 1.45. Thus, the estimated relative risk of death from an increase of one in the comorbidity score proved approximately equal to that from an additional decade of age. The combined age-comorbidity score may be useful in some longitudinal studies to estimate relative risk of death from prognostic clinical covariates.
Age Factors↗
Reasons for entry into and understanding of HIV/AIDS clinical trials: a preliminary study.
Thirty-two men who participated in a trial of Zidovudine (> 500 CD4 cells/10(6) L) were surveyed regarding their reasons for participation in clinical trials. The major source of influence to enter the trial was the clinic doctor, and importance for self in participation was rated as the least important reason. Medical science and medical researchers were seen as the major beneficiaries. Being seen to do something about one's illness was also seen as being important and probability of delaying AIDS was rated lowest. Chance of occurrence of risks of treatment were rated as slightly below 50%. Results of Flesch and Fry tests of informed consent documents suggested that they were written in the style of a scientific article, required the readability level of a university graduate and that recall was imperfect. Those who saw more benefits in their trial participation appeared to be most knowledgeable. These data suggest that participation in this clinical trial was based on altruistic, rather than personal reasons and that participants had realistic perceptions of outcomes.
Acquired Immunodeficiency Syndrome↗
Predictors of unsafe injecting drug use.
This paper reports on the incidence of unsafe injecting and the factors which influence this practice in a sample of 1245 Sydney injecting drug users (IDUs). Using a needle and syringe after someone else at some time in the last six months was reported in 41.6% of the sample. Taking into account those who claimed always to clean used needles with virucidal methods, 32.9% had placed themselves at risk of HIV infection from shared needles in the six months prior to interview.Seven factors were predictive of unsafe behaviour. These were (a) the amount spent per week on drugs, (b) the number of times a single needle was used prior to disposal, (c) having shared with a person who is now HIV infected, (d) having a regular sexual partner, (e) the proportion of times high, stoned or drunk when injecting, (f) being part of a group that injects together and (g) having been in prison.
Journal Article↗
Explanations for sharing injection equipment in injecting drug users and barriers to safer drug use.
We examined the explanations given by a sample of 1245 injecting drug users in Sydney, Australia for accepting used injection equipment. Factor analysis of these reasons revealed three dimensions of sharing: not caring when withdrawing or intoxicated, unavailability of equipment, and not seeing it as high risk or ease of injecting. The most common reasons given were difficulty in obtaining sterile equipment (73% of cases), the dangers not seeming so important when in withdrawal (40%) and sharing being something done with friends or lovers (31%). Most common reasons for not sharing were related to health issues (91% citing AIDS and 67% hepatitis). These data suggest that interventions target provision of sterile equipment, and education which highlights risk situations such as intoxication and withdrawal.
Adult↗
Predictors of HIV status among injecting drug users and health promotion.
Two consecutive samples one year apart of injecting drug users (n = 754 and n = 345) were collected in Sydney, Australia and analysed for predictors of Human Immunodeficiency Virus (HIV) prevalence. Data indicated that similar variables were associated with HIV infection in both waves of the study. Risks for HIV infection included number of injections in last typical using month, acceptance of used injecting equipment from other injecting drug users (IDUs) who were known to be infected either before or after the sharing occurred, having sex with people known to be infected with HIV, and sexual orientation. It was not possible to determine whether sexual or equipment sharing with known HIV infected people preceded or followed HIV infection. These data confirm that predictors of HIV prevalence in Sydney are similar to those found in overseas studies and that sexual orientation appears to be the most powerful predictor. These data suggest both that sexual contact is an important route of infection in IDUs, and that sexual risks for HIV infection in IDUs need to be emphasised.
Acquired Immunodeficiency Syndrome↗
Predictors of intoxicated sex in injecting drug users.
Transmission of HIV by sexual contact as well as through sharing of contaminated injection equipment is a source of viral spread from injecting drug users (IDUs). We report on an analysis of data from 1,245 IDUs interviewed in Sydney, Australia in which half of the respondents reported being intoxicated during sex for more than half of their sexual encounters. The most common drugs on which people were intoxicated during sex were heroin, cannabis and alcohol. Predictors of having sex when intoxicated were a lower likelihood of having been in treatment, higher number of sexual partners, sharing injection equipment with more people and more recently, being intoxicated when injecting, and not being a sex worker. The data indicate that having sex while intoxicated is common in these IDUs and that sex under the influence of drugs is part of a more general lifestyle of spending a greater time intoxicated. Targeting of those IDUs who spend a significant amount of time intoxicated and their recruitment into treatment may thus reduce both risky sexual behaviour and risky injecting behaviour.
Adult↗
Acute reversible cardiomyopathy associated with the systemic inflammatory response syndrome.
In the absence of ischemic heart disease, severe acute reversible myocardial dysfunction is uncommon, with sepsis most often being implicated in the ICU. We report a 38-year-old woman who developed profound transient myocardial depression due to nonseptic systemic inflammatory response syndrome caused by a necrotic kidney. Hemodynamic parameters and echocardiographic findings improved dramatically following nephrectomy. Other causes of acute myocardial suppression, including electrolyte abnormalities, drugs, catecholamine excess, and endocrine disease were excluded.
Adult↗
A comparison of HIV risk between women and men who inject drugs.
Although there is growing evidence of differences between women and men who inject drugs (IDUs) in terms of level of risk for HIV infection, very little research has been conducted specifically addressing the risk practices of women IDUs. This study formed part of a national study of HIV infection risks in IDUs and the purpose of the present analysis was an exploration of gender differences in HIV risk practices, focusing on the HIV risk practices of IDU women. 1,245 IDUs from the inner city area of Sydney took part in this study. Of these, 908 were men and 331 were women. Notable results were that female respondents were more likely to report sharing needles, they injected heroin more times in a typical using month and were more likely to have shared with someone they later found out was HIV seropositive. Female respondents also reported more sexual partners than men, were more likely to engage in prostitution, and were more likely to have sexual partners who were themselves IDUs. The results provide support for the proposition that women who inject drugs may be at greater risk of HIV infection through both their drug taking and their sexual practices. Further research is needed to explore the reasons underlying the risk practices of women who inject drugs and an understanding of these factors needs to be incorporated into HIV risk-reduction and drug harm-reduction policies and programs.
Adolescent↗