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Biomedical subjects

R Golden

Publications and source records attributed to R Golden.

At least 19 recordsLinked to original sources

Rising risk of testicular cancer by birth cohort in the United States from 1973 to 1995.

PURPOSE: Recent epidemiological studies have demonstrated an increasing incidence of testicular cancer in white men which appears to be correlated with the period of birth. Because this birth cohort phenomenon can explain etiological factors in testicular cancer, we determine whether this trend is present throughout the United States based on an analysis of testicular cancer incidence by birth cohort. MATERIALS AND METHODS: Testicular cancer incidence was obtained from the National Cancer Institute Surveillance, Epidemiology and End Results database from 1973 to 1995. Numbers of cases were extracted and grouped by 5-year birth cohorts for all testicular germ cell neoplasms. Poisson regression analysis with variables of age, time of diagnosis and birth cohort were used to determine relative risk. Poisson models were compared using computer log linear model software. RESULTS: Between 1973 and 1995 the incidence of testicular cancer in the United States increased 51% (3.61 to 5.44/100,000). Analysis of Poisson models revealed that birth cohort was strongly associated with relative risk of testicular cancer (p = 0.001). In addition, peak age at diagnosis decreased for each successive birth cohort. CONCLUSIONS: The overall incidence of testicular cancer in white men and the relative risk of testicular cancer have been increasing in the United States. This trend is strongly associated with birth cohort in concordance with previously reported European data. Moreover, testicular cancer is being diagnosed at a younger age as evidenced by a shift to the left in the age of peak incidence. These unique epidemiological patterns offer a basis for analysis of potential etiological factors.

Child

The "equal environments assumption" in MZ-DZ twin comparisons: an untenable premise of psychiatric genetics?

The comparison of MZ-DZ twins in behavioral genetics has produced what seems like irrefutable evidence for the heritability of many psychiatric disorders. But such research depends on the validity of the EEA--the "equal environments assumption"--as an underlying premise. In this paper, several empirical studies which support the EEA are critically reviewed in terms of methodology and the way data has been processed in a mathematical model called "path analysis". It turns out that studies investigating the EEA appear to be largely inadequate in terms of technique, as well as biased in the inferences drawn. Further, the "heritability" estimate--often taken to mean the influence of trait-specific genes--is merely a statistical abstraction derived from a matrix of correlations; this estimate encompasses many buried environmental effects so that "heritability" does not correspond to any underlying DNA structure. In conclusion, many MZ-DZ pedigree studies have dubious scientific value, given the non-viable premise of the EEA, as well as the misleading operational definition of what has been called "heritability".

Humans

An unusual gastrointestinal presentation of leishmaniasis.

While visceral leishmaniasis (VL) generally occurs in immunocompetent subjects in endemic areas, it has been increasingly recognised as an important opportunistic infection in the immunocompromised including those infected with the human immunodeficiency virus. We report an unusual presentation of visceral leishmaniasis in a patient with the acquired immunodeficiency syndrome (AIDS) with disease which appeared to be limited to the gastrointestinal tract.

AIDS-Related Opportunistic Infections

Dementia and Alzheimer's disease. Indications, diagnosis, and treatment.

At least 6 million Americans suffer from some form of dementia. More than half of those patients are afflicted with Alzheimer's disease, a progressive, degenerative neurological disorder. Reaching the diagnosis of Alzheimer's, however, is often difficult since Alzheimer's can be accurately diagnosed only after all other options are ruled out. The process is painstaking, but it's also the crucial link in ensuring proper diagnosis and treatment. There's no cure yet for Alzheimer's, but researchers are narrowing in on possible causes of the disease and identifying patients who may be predisposed to developing it. Some of the most compelling research focuses on the presence of one or more of the apolipoprotein E4 genes. Researchers also continue to develop new drugs and physical therapies. In the Twin Cities, several drug studies are underway, and community resources are available to provide Alzheimer's patients and their families with information on everything from support groups to assisted-living arrangements.

Aged

Dialysis adequacy versus metabolic factors in the clinical assessment of CAPD.

We performed a cross sectional study of our continuous ambulatory peritoneal dialysis (CAPD) patients (n = 98) to examine the relation between parameters of adequacy of dialysis [KT/V, weekly creatinine clearance (Ccr)], urea kinetics (PCR), biochemical parameters (serum albumin), and clinical status of these patients. We also investigated the predictive value of these parameters in the determination of clinical outcomes. The clinical status of each patient was assessed by patient self-assessment and objectively by physicians and nurses. On this basis a total clinical assessment score was assigned. Individuals with a score of 3 or less were judged to be clinically stable (group 1, n = 61), while a score of 4 or more was considered "not doing well" (group 2, n = 37). A good correlation (r = 0.7) between subjective and objective assessments was observed. No correlation between total clinical assessment score and KT/V, PCRN (normalized protein catabolic rate), or Ccr was obtained, while serum albumin levels correlated inversely (r = -0.30; p < 0.003), suggesting that parameters of dialysis adequacy (weekly KT/V, Ccr) and urea kinetics (PCRN) are not predictive of clinical outcome in CAPD patients, in contrast with hemodialysis (HD) patients. Serum albumin levels were observed to be correlated with clinical outcome in CAPD patients. Hypoalbuminemia was observed in group 2 patients, despite statistically insignificant different values of KT/V, Ccr, and PCRN in the two groups. Therefore, clinical assessment and parameters such as serum albumin must be considered when determining the total well-being of CAPD patients.

Creatinine

Visceral leishmaniasis in HIV infection and AIDS: clinical features and response to therapy.

The development of visceral leishmaniasis with atypical features in an AIDS patient, and the recent flurry of reports of visceral leishmaniasis in HIV-infected individuals prompted the review of its manifestations in the 47 reported cases. Splenomegaly, which is almost always a feature of visceral leishmaniasis in the immunocompetent host, was absent in eight. Antibodies to Leishmania donovani, which are present in approximately 95 per cent of immunocompetent patients with visceral leishmaniasis, were absent in 29 of 45 (66 per cent) of HIV-infected patients tested. Nine HIV-positive patients with visceral leishmaniasis did not exhibit a primary clinical response to therapy with antimonials and of those who did show a response, relapse occurred in 13, at a mean 4.5 months after stopping therapy. Seventeen patients are known to have died often in association with respiratory disease; Leishmania was seen in one bronchial lavage specimen and in lung tissue in one post-mortem performed. In order to improve the prognosis of visceral leishmaniasis in HIV-infected patients diagnosis will have to be made earlier, taking account of the atypical features, and treatment will need to be improved, both initially and perhaps also by the use of long-term maintenance therapy.

Acquired Immunodeficiency Syndrome

Alzheimer's disease: a correlational analysis of the Blessed Information-Memory-Concentration Test and the Mini-Mental State Exam.

We carried out a correlational analysis of the scores on the Blessed Information-Memory-Concentration Test and the Mini-Mental State Exam in 40 subjects with Alzheimer's disease. The average product moment correlation coefficient between the two tests on repeated administration over 6 weeks ranged from -0.73 to -0.83. Both tests demonstrated test-retest reliability coefficients of 0.75 and above. A formula was developed to convert one test score to the other.

Adult

Amyloidosis secondary to drug abuse and chronic skin suppuration.

Amyloidosis has not been included in the wide spectrum of medical complications associated with drug abuse. Chronic visceral infection is a recognized cause of amyloidosis, but chronic suppuration of the skin is not a well-appreciated cause of this condition. Furthermore, to our knowledge, chronic skin suppuration secondary to parenteral drug abuse has not been reported as a cause for systemic amyloidosis. We report a case in which subcutaneous injections of narcotic tablets led to chronic skin suppuration and systemic amyloidosis.

Abscess