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Biomedical subjects

J L Fahey

Publications and source records attributed to J L Fahey.

257 records · Page 15Linked to original sources
PubMedDate not supplied

Immune system changes after the death of a partner in HIV-positive gay men.

The objectives of this study were to determine 1) whether immune changes relevant to HIV progression occurred in HIV-seropositive men after the death of their intimate partner, and 2) whether depressed mood was associated with these immune changes. The bereaved group consisted of 39 gay men whose intimate partners had died of AIDS over the past year; the nonbereaved group consisted of 39 age- and HIV serostatus-matched nonbereaved men. Immunological parameters were assayed from blood samples drawn before and within 1 year after the death of the partner (bereaved group) or over an equivalent time period (nonbereaved group). In the HIV-seropositive bereaved men only, a significant increase in immune activation and a significant decrease in the proliferative response to phytohemagglutinin occurred after the death of the partner. These immunological changes were not explained by the use of recreational drugs, alcohol, cigarettes, or AZT. These data indicate that the death of an intimate partner in HIV-positive men is associated with immune changes that are relevant to HIV progression.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Accelerated course of human immunodeficiency virus infection in gay men who conceal their homosexual identity.

Research linking psychological inhibition to physical illness led us to examine whether human immunodeficiency virus (HIV) infection might progress more rapidly among gay men who conceal their homosexual identity than among those who do not. We also sought to determine whether any accelerated course of HIV infection among "closeted" gay men might be attributable to differences in health-relevant behavior (e.g., health practices, sexual behavior) or psychosocial characteristics (e.g., depression, anxiety, social support, repressive coping style). Data came from a longitudinal psychosocial study associated with the Los Angeles site of the Multicenter AIDS Cohort Study. Eighty gay men, HIV-seropositive but otherwise healthy at study entry (CD4 T lymphocytes = 30-60% of total lymphocytes), were examined at 6-month intervals for 9 years. Indicators of HIV progression included time to a critically low CD4 T lymphocyte level (15% of total peripheral blood lymphocytes), time to AIDS diagnosis, and time to AIDS mortality. On all measures, HIV infection advanced more rapidly in a dose-response relationship to the degree participants concealed their homosexual identity. Sample characteristics and statistical controls ruled out explanations based on demographic characteristics, health practices, sexual behavior, and antiretroviral therapy. Mediational analyses indicated that observed effects were not attributable to differences in depression, anxiety, social support, or repressive coping style. HIV infection appears to progress more rapidly in gay men who conceal their homosexual identity. These results are consistent with hypotheses about the health effects of psychological inhibition, but further research is required to definitively identify the psychosocial, behavioral, and physiological mechanisms underlying these findings.

Adaptation, Psychological↗
PubMedDate not supplied

Use of right atrial catheter for prolonged iv support in cancer patients.

A right atrial catheter has proven to be a well-tolerated technical advance for patients requiring prolonged vascular access. It is easily inserted and suited for ambulatory maintenance by the patient. Catheters are utilized for a wide spectrum of iv medications with an acceptably low complication rate. Most significantly, the infection rate is negligible, despite severely compromised hosts. Their use should be considered for any patient in whom problems with vascular access are anticipated. This report comprises our experience with the first 70 catheters in 66 patients in the Hematology/Oncology service.

Ambulatory Care↗
PubMedDate not supplied

Phenotypic properties and cytotoxic functions of human CD8+ cells expressing the CD57 antigen.

The CD8+CD57+ granular lymphocyte subset is significantly expanded in a number of clinical disorders. Because several studies have suggested that CD8+CD57+ cells might be in vivo primed, antigen-specific cytotoxic T lymphocytes, we have analyzed the phenotypic and functional properties of CD8+CD57+ cells. Using three-color flow cytometry, virtually all freshly isolated CD3+CD8+CD57+ cells were found to have phenotypic properties characteristic of 'naive' T lymphocytes; these cells coexpressed the CD45RA antigen, lacked expression of the CD45RO antigen, and expressed reduced levels of CD58 adhesion molecules. When purified CD45RA+ T cells were stimulated with alloantigens, approximately 50% of CD8+CD57- cells lost CD45RA antigen expression. In contrast, CD8+CD57+ cells (which were > 90% CD3+) remained CD45RA+. Although CD8+CD57+ cells could mediate lectin-dependent cytotoxicity, both before and after the mixed lymphocyte reaction cultures, CD8+CD57+ cells had no antigen-specific cytotoxic activity against allogeneic target cells; only the subset of CD8+CD57- cells which converted to the CD45RA- phenotype had specific cytotoxic activity. Interestingly, although CD8+CD57+ cells did not lyse allogeneic cells, 50-90% of these cells acquired HLA-DR antigen expression during the mixed lymphocyte reaction. This did not appear to be a passive effect produced solely by lymphokines, because soluble factors released by alloactivated T cells induced only modest HLA-DR expression on purified CD8+CD57+ cells. Thus, whereas CD8+CD57+ cells may become activated when in the milieu of an immunologically specific response, our data suggest that these cells do not develop into or appear to represent antigen-specific cytotoxic T cells.

Antigens↗