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Biomedical subjects

M Marmor

Publications and source records attributed to M Marmor.

At least 73 records · Page 4Linked to original sources
PubMed1989

The potential role of nutritional factors in the induction of immunologic abnormalities in HIV-positive homosexual men.

The literature is briefly summarized as to how several nutrients affect immune function, susceptibility to infection, and cancer susceptibility or progression. Nutritional deficiencies can impair immunity and so influence susceptibility to infectious agents, including ones that are common and relatively virulent in acquired immune deficiency syndrome (AIDS) patients. A variety of nutrients affect several of the immune functions that are defective in human immunodeficiency virus (HIV)-infected individuals. For example, beta-carotene increased the number of CD4+ cells; vitamin E decreased the number of CD8+ cells and increased the CD4+/CD8+ ratio; vitamin D decreased the CD4+/CD8+ ratio; and iron increased the number of peripheral lymphocytes in humans receiving supplementation. Furthermore, nutritional deficiencies can influence gastrointestinal function, while infectious diseases can influence nutrient requirements by altering the efficiency of absorption and the rate of tissue metabolism. Malnutrition, depressed serum zinc levels, and intestinal nutrient malabsorption have been found in AIDS patients. The above findings suggest that dietary manipulations might diminish the immune defects in HIV infection and enhance resistance to opportunistic infections. However, dietary alterations in immune defects are generally not well quantified and may be small relative to the magnitude of the defects observed in AIDS patients. Because conflicting or adverse effects have been reported for some nutrients, recommendations for dietary supplementation in HIV-infected individuals are premature and possibly hazardous. Further studies are much needed to relate dietary nutrient intakes to clinical outcomes.

HIV Seropositivity↗
PubMed1988

A larger spectrum of severe HIV-1--related disease in intravenous drug users in New York City.

Increasing mortality in intravenous (IV) drug users not reported to surveillance as acquired immunodeficiency syndrome (AIDS) has occurred in New York City coincident with the AIDS epidemic. From 1981 to 1986, narcotics-related deaths increased on average 32% per year from 492 in 1981 to 1996 in 1986. This increase included deaths from AIDS increasing from 0 to 905 and deaths from other causes, many of which were infectious diseases, increasing from 492 to 1091. Investigations of these deaths suggest a causal association with human immunodeficiency virus (HIV) infection. These deaths may represent a spectrum of HIV-related disease that has not been identified through AIDS surveillance and has resulted in a large underestimation of the impact of AIDS on IV drug users and blacks and Hispanics.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Mortality among bearing plant workers exposed to metalworking fluids and abrasives.

Epidemiologic studies have reported associations between gastrointestinal cancer mortality and exposure to cutting fluids and abrasives in metal machining and precision grinding operations. Two previous studies found excess stomach cancer among workers exposed to water-based cutting fluids in bearing plants. This study reports similar findings in a third and larger population. Cause of death and work histories were determined for 1,766 bearing plant workers who died between Jan 1, 1950 and June 30, 1982. Mortality odds ratios (SMOR) and proportional mortality ratios (PMR) revealed significant excesses of gastrointestinal malignancies. The proportional mortality excess for stomach cancer among white men was greatest among those with more than 10 years' exposure in the major grinding group (PMR = 13/3.8 = 3.39; P less than .001). The SMOR by logistic regression for stomach cancer among white men was 2.3 (P = .02) for 25 years' grinding experience. For cancer of the pancreas among white men, there were significant associations with both machining and grinding jobs in straight oil (SMOR = 9.9 and 3.2, respectively, for 25 years duration). These findings could not be explained by confounding due to the ethnic background of the decedents. This study confirms previous evidence that grinding operations using water-based cutting fluids increase the risk for stomach cancer and provides moderate evidence that exposures to straight oil-cutting fluids increase the risk for cancer of the pancreas. There were indications, meriting further investigation, that non-malignant liver disease is associated with cutting fluid exposures and that lung cancer is associated with oil smoke from operations such as forging or heat treating.

Aluminum↗
PubMed1987

Nonrandom development of immunologic abnormalities after infection with human immunodeficiency virus: implications for immunologic classification of the disease.

Blood specimens from 165 intravenous drug users who were seropositive for the human immunodeficiency virus (HIV), from 158 seropositive homosexual men with lymphadenopathy, and from 77 patients with acquired immunodeficiency syndrome (AIDS) were assessed immunologically. Immunologic parameters were analyzed by the Guttman scalogram technique to determine if immunologic abnormalities occurred in a nonrandom pattern. The following four patterns emerged: (i) seropositivity for HIV with no immunologic abnormalities; (ii) seropositivity for HIV with a depressed T4/T8 cell ratio; (iii) seropositivity with a depressed T4/T8 cell ratio and T4-cell depletion; and (iv) seropositivity with a depressed T4/T8 cell ratio, T4-cell depletion, and lymphopenia. Ninety-two to 100% of subjects in each of the three groups of patients were found "to scale" because the abnormalities occurred in the cumulative, ordered fashion described. This nonrandom occurrence of abnormalities indicates an ordered progression of immunologic abnormalities in individuals infected with HIV, a finding useful in the staging of both symptomatic and asymptomatic HIV-seropositive subjects.

AIDS-Related Complex↗
PubMed1987

Toxocara canis infection of children: epidemiologic and neuropsychologic findings.

Sera from 4,652 children whose blood was submitted to the New York City Department of Health for lead analysis were tested for antibodies to Toxocara canis using an enzyme-linked immunosorbent assay (ELISA). Standardized to the age distribution of the study population, T. canis seropositivity (inverse titers greater than or equal to 16) was 5.7 per cent in males and 5.1 per cent in females. T. canis antibody titers and lead exposures as measured by Centers for Disease Control lead classes were positively correlated. Children who were seropositive to T. canis (cases) were compared to seronegatives (controls) matched on age (+/- 6 months), sex, time-of-screening (+/- 3 months) and CDC lead class. Logistic regression analysis of 155 case-control pairs demonstrated elevated relative risks (RRs) for geophagia (RR = 3.14; 95% CI = 1.75, 5.64) and having had a litter of puppies in the home (RR = 5.22; 95% CI = 1.63, 16.71). Compared to controls, cases had increased eosinophil counts, serum immunoglobulin E concentrations, and anti-hemagglutinin-A titers. Small deficits in cases compared to controls were found in performance on several neuropsychological tests after adjustment for potential confounders including case-control differences in race, socioeconomic status, and current blood lead concentrations. The study thus confirmed that T. canis infection is common in urban children and suggested that infection may be associated with adverse neuropsychological effects.

Adolescent↗
PubMed1987

Development of AIDS, HIV seroconversion, and potential co-factors for T4 cell loss in a cohort of intravenous drug users.

A cohort of 334 intravenous (IV) drug users from New York City drug treatment programs were followed over a mean 9-month period. Among the 165 who were seropositive at enlistment, four developed clinical AIDS, for an annual rate of 3%. Elevated IgA was a significant predictor of developing AIDS. Among 72 subjects who were initially seronegative and who were re-interviewed, four were seropositive at follow-up, for a seroconversion rate of 7% per year among seronegatives. Among seropositive subjects who did not develop AIDS or fatal AIDS related complex (ARC), continued drug injection was associated with rate of T4 cell loss, and there was a non-significant trend for males to lose T4 cells more rapidly than females. While it was not possible to distinguish the mechanism underlying the relationship between continued drug injection and T4 cell loss, seropositive IV drug users should be warned that continued injection may lead to increased HIV-related immunosuppression as well as, if injection equipment is shared, risking viral transmission to others.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Risk factors for infection with human immunodeficiency virus among intravenous drug abusers in New York City.

We report here the results of a survey of 308 intravenous drug abusers recruited from hospital-based methadone maintenance or drug detoxification programmes located in Manhattan, New York City. Complete interviews and serological analyses for antibodies to human immunodeficiency virus (HIV) using both enzyme-linked immunosorbent and Western blot assays were obtained from 290 (94%) of the subjects. HIV antibodies were found by both assays in 147 (50.7%) of the tested subjects; conflicting results were found in three (1%) of the subjects; and negative results on both tests were found in 140 (48.3%) of the subjects. Logistic regression analysis identified significant relative risks for HIV infection associated with the frequency of drug injection and the proportion of injections in 'shooting galleries'. Additional risk among men was associated with a history of homosexual relations. Traditional efforts taken by subjects to clean syringes between uses, such as washing with water or alcohol, showed no evidence of being protective. Programmes aimed at prevention of HIV infection should focus on reducing use of shooting galleries and sharing of needles and syringes as well as reducing intravenous drug abuse generally.

Adult↗
PubMed1987

Serum IgD elevation is an early marker of B cell activation during infection with the human immunodeficiency viruses.

Serum IgD levels in individuals infected with the human immunodeficiency viruses (HIV) were studied as a means of monitoring the character and timing of B cell activation in individuals with this infection. Significantly increased levels of IgD were characteristic of homosexual men who were HIV seropositive but asymptomatic or mildly symptomatic. The hyper IgD globulinaemia became progressively more pronounced in patients with increasingly severe infection and reached its most marked level in patients with AIDS-related complex (ARC). In ARC patients, IgD levels were increased 8.8-fold above normal which was disproportionately greater than the 2.4-fold increase in IgG, the 1.8-fold increase in IgA and the 1.6-fold increase in IgM. IgD levels declined in AIDS patients (although remained elevated compared to controls). The data suggest that an unusual type of B cell activation is responsible for the unique pattern of hypergammaglobulinaemia seen in this disease and that the B cell activation occurs early in the pathogenesis of HIV infection, often before development of symptoms, and continues throughout the course of infection.

AIDS-Related Complex↗
PubMed1984

Quantitation of beta 2-microglobulin and other immune characteristics in a prospective study of men at risk for acquired immune deficiency syndrome.

Serum samples from 24 patients with acquired immune deficiency syndrome (AIDS) and from 15 patients with an early or milder form of this disease ("suspected AIDS") were found to contain elevated levels of beta 2-microglobulin (beta 2M). Therefore, prospective studies of 40 asymptomatic homosexual men from New York City were undertaken to determine whether quantitation of beta 2M and other immunologic variables was useful in recognizing those in populations at high risk for this disease who have a high probability for experiencing symptoms consistent with AIDS. After 20 to 26 months of follow-up, two of those persons now have AIDS and four have suspected AIDS. All six of these persons had elevated serum beta 2M levels and other immunologic abnormalities when they entered this study. Of those tested, only one other man had an increased level of beta 2M; neither he nor any of the remaining 33 persons in this group developed AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

The epidemic of acquired immunodeficiency syndrome (AIDS) and suggestions for its control in drug abusers.

Intravenous (IV) users of illicit drugs have accounted for 17% of AIDS cases seen in the United States. Previous research has shown that more than half of IV drug abusers entering a drug detoxification program in New York City had serologic evidence of exposure to the virus believed to cause AIDS. Spread of AIDS among drug abusers presumably occurs by transmission of the virus via shared needles, works, or drug-containing solutions. Secondary spread of AIDS from IV drug abusers to others may occur by venereal transmission or by perinatal transmission to infants. In this article, relevant characteristics of the AIDS epidemic are presented to assist the staff of drug treatment programs in their work with IV drug abusers. Suggestions regarding the education of drug treatment personnel and the dissemination of information about AIDS to drug abusers and their families are offered. Fact sheets on AIDS for drug treatment and prison staff, and for drug abusers with and without the disease are presented. Finally, possible approaches to the prevention of AIDS in drug users are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Kaposi's sarcoma in homosexual men. A seroepidemiologic case-control study.

The cases of 20 male homosexuals with Kaposi's sarcoma and the acquired immunodeficiency syndrome were compared with those of 40 age- and race-matched male homosexual controls. Patients with Kaposi's sarcoma had lower OKT4/OKT8 (T-helper/T-suppressor) ratios than controls, due to smaller numbers of OKT4 cells. Serum IgG concentrations and antibody titers to cytomegalovirus in patients exceeded those in controls, but patients had lower antibody titers to Epstein-Barr virus. Logistic regression analysis comparing patients with controls showed significant relative risks for Kaposi's sarcoma associated with the number of partners per month in receptive anal-genital intercourse, occasions per month of " fisting ," and cytomegalovirus antibody titers. Cytomegalovirus titers also were inversely correlated with OKT4 cell concentrations in the control group. Significantly greater OKT4 cell concentrations were found at diagnosis in HLA-DR5-positive patients than in HLA-DR5-negative patients. Patients who have HLA-DR5 may express disease at lesser degrees of immunodeficiency than HLA-DR5-negative patients.

Adult↗