Non-organic psychiatric and psychosocial syndromes associated with HIV-1 infection and disease.
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Biomedical subjects
Publications and source records attributed to M Riccio.
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Six homosexual men with a diagnosis of acquired immunodeficiency syndrome (AIDS)-related complex (ARC- CDC IVA/C2) were assessed with a series of neuropsychological and psychiatric tests prior to commencing treatment with zidovudine and again after 5-6 months. Significant improvements were seen in cognitive functioning, mental state and physical health at the second assessment.
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Five cases of psychiatric illness, presenting as functional psychosis, occurring in male homosexuals with human immunodeficiency virus (HIV) infection are described and compared with similar cases in the literature. The association between psychosis and infection with HIV is discussed with particular emphasis on the significance of functional versus organic presentation.
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Auditory and visual event-related brain potentials (ERPs) were used to complement neuropsychological and medical assessment in neurologically healthy subjects with asymptomatic and symptomatic human immunodeficiency virus type 1 (HIV-1) infection. Auditory and visual ERPs, recorded using standard oddball paradigms, disclosed delays in late waves (N2 and P3) in symptomatic subjects (CDC stage IV) when compared with matched controls. Abnormally delayed P3 waves in at least one modality were recorded in 41% of symptomatics and this was associated with deficits in neuropsychological performance, particularly psychomotor slowing. However, no differences in late wave latencies between asymptomatic and control subjects were found, though asymptomatics showed delays in auditory N1 and P2 latencies. The number of morphological abnormalities, such as indiscernible late waves as well as topographical variability of the P3 wave, was increased in both HIV seropositive groups and possibly indicates a distinct mechanism of impairment, different from latency delay. Whilst P3 delay in symptomatics was not associated with changes in immune function (T4 cells) there was, however, a link with anaemia and subclinical hepatic dysfunction.
Recent studies suggest that antisense phosphorothioate oligonucleotides (APO) are useful tools not only to impair gene expression, but also to modify the splicing of pre-mRNA, as the classical view that they act by suppressing the translation of mature mRNA has been challenged by several examples showing their nuclear site of action. In this work we show that an APO directed against cytosolic phospholipase A2 (cPLA2) mRNA localises in the nucleus and interacts with a specific nuclear protein.
The aim of the study was to determine the reliability and validity of a self-report symptom checklist designed for use in HIV infection. One hundred and seventy-one gay men completed a 28-item symptom checklist which produces 3 dimensions: physical, cognitive and psychological. The validity of each dimension was examined by comparing scores on the checklist with indices of disease progression and previously validated psychological scales. People with more advanced HIV disease had higher scores on the physical and cognitive checklists, though the psychological scale was not related to disease stage. All the scales showed moderate correlations with measures of psychological health. Examination of individual item responses suggested that patients over-reported the presence of some symptoms. Although individual items should be interpreted with caution, the overall scores of the RSC are reliable and valid as measures of subjective health status in HIV infection. The importance of psychological factors in the reporting of symptoms suggests that symptom checklists should be interpreted in the light of adequate measures of psychological state.
Twenty HIV positive and 68 HIV negative subjects were assessed by the Hospital Anxiety and Depression Scale and by the Alcohol and Drugs Frequency Schedule immediately prior to notification of their HIV serostatus and 6 months after serodiagnosis. The 2 groups did not differ significantly in levels of anxiety or depression at baseline or follow-up. There were borderline levels of pathological anxiety prior to notification of HIV serostatus in both groups. The drop to normal levels of anxiety which had occurred by follow-up was significant in the HIV positive group. About a third of subjects in both groups were regularly making use of alcohol and/or drugs, both at baseline and follow-up. Mean levels of weekly alcohol intake for both groups ranged from about 20 to 30 units per week. The drugs most commonly used (in any frequency) were nitrates ('poppers') and cannabis.
We have investigated the intranuclear distribution of High-mobility group proteins I/Y by means of immunofluorescent staining employing a variety of cell lines. Confocal scanning laser microscopy analysis revealed that High-mobility group proteins I/Y are present in an intranuclear fibrogranular network and mitotic chromosomes. In Caski, C4I, Flow 2002, and K562 cell lines, High-mobility group proteins I/Y were absent from nucleoli, whereas in HeLa cells they were present in this nuclear domain. Double immunolabeling studies showed that High-mobility group proteins I/Y co-localize with other key nuclear components such as NuMA, SC-35, and TAF(II)70. Nuclear reactivity for High-mobility group proteins I/Y dramatically decreased in apoptotic nuclei of HL-60 human leukemia cells. Our morphological data correlate well with previous biochemical and functional findings obtained by other investigators, who have demonstrated multiple roles for this class of polypeptides. However, they point to the likelihood that High-mobility group proteins I/Y are involved in as yet unidentified functions, most likely in the speckle domains of the nucleus. They also show that conceivably these proteins are also involved in apoptosis.
The authors illustrate the advantage of vascularised as opposed to conventional edges in the reconstruction of the jaw, focusing in particular on the use of a fibular autologous transplant. After a rapid description of the surgical technique used to remove the graft, they report a case of mandibular reconstruction in a young patient who had been involved in a shooting accident which had led to the loss of the left of this jaw.
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