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A A Long

Publications and source records attributed to A A Long.

27 records · Page 2Linked to original sources

Neuropsychological correlates of serum lymphocytotoxic antibodies in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by frequent neuropsychiatric (NP) manifestations. At least two different pathogenetic mechanisms have been proposed for NP-SLE, including vasculitis and antibodies against neuronal antigens, the latter as expressed by the presence of brain cross-reactive lymphocyte antibodies. We have previously reported a high prevalence of cognitive dysfunction in SLE which can remain subclinical and which cannot be accounted for on the basis of disease activity, general distress, or steroid medication. In the present study, we undertook the same extensive, standardized neuropsychological testing in 98 consecutive female SLE patients in order to evaluate central nervous system functioning in relation to serum lymphocyte antibodies which were measured at the time of neuropsychological testing by a microcytotoxicity test. A significant association was observed between the presence of serum lymphocytotoxic antibodies (LCA) and cognitive impairment in patients with SLE. The pattern of impairment which predominated in the LCA-positive patients involved deficits in anteriorly associated, primarily visuospatial functions. These findings support the hypothesis of localization of a particular antigen-antibody interaction in the brain in SLE, suggesting the existence of immunological control mechanisms for normal brain functioning.

Antilymphocyte Serum↗

Hypogammaglobulinemia: therapeutic rationale.

Hypogammaglobulinemia is a feature of several B-cell disorders and is manifested clinically by recurrent infection, most commonly chronic upper and lower respiratory tract disease. Immunoglobulin replacement therapy is available, with at least four different routes of administration. There are as yet no convincing data that allow comparison of the cost-effectiveness of these methods. However, by individualizing therapy for each patient, it is possible to prevent life-threatening acute infections, reduce the severity of chronic upper and lower respiratory tract disease, improve pulmonary function and achieve normal levels of IgG. These are the currently acceptable goals of therapy in patients with hypogammaglobulinemia.

Agammaglobulinemia↗

Occupational stress and hypertension.

The Department of Occupational and Environmental Health in the Commonwealth Institute of Health and the University of Sydney has since 1977 been conducting a study of possible occupational factors in hypertension and in other precursors of coronary heart disease. The study arose out of claims by public service employees that the stress of their work was inducing these diseases. The study has two additional aims: prospective observation of progression of hypertension and associated cardiovascular risk variables in relation to evolving occupational conditions; and a trial of non-pharmacological modification of mild hypertension and associated variables through intervention by occupational nurses. A total of 4607 subject drawn from telecommunications and taxation offices in Sydney underwent medical screening before allocation, according to risk, into intervention and reference groups. Data acquisition included self-administration of two questionnaires, on personal, social, occupational and medical history, and on reaction to potential work stresses and to recent life events. Response to questions related to the coronary prone behaviour pattern was tested in a sub-set of the population against rating of the pattern by Rosenman and Friedman's interview method. The paper reports on method and preliminary description of the population.

Adult↗

Mortality among Vietnam veterans compared with non-veterans and the Australian population.

A retrospective cohort study of mortality was conducted to assess whether the military service of young Australian men in Vietnam has influenced their overall death rates, or those from specific causes. The study was of all national servicemen who were conscripted during the conflict and served in the Army for at least 12 months. Of these, 19 205 served in Vietnam (veterans) while 25 677 served only in Australia (non-veterans). These men were traced from the end of their national service (between 1966 and 1973) until the beginning of 1982. For most causes of death, the observed number of deaths of veterans and of non-veterans was less than expected from Australian population death rates, and for no cause was there a statistically significant excess of deaths compared with that of the Australian population. Similarly, when veterans were compared with non-veterans, there was no statistically significant difference in deaths for all causes combined, for diseases of the circulatory system, for deaths in motor vehicle accidents, for suicide and for all external causes after adjustment for the different subsequent death rates of men who had served in different Army corps. All seven deaths from diseases of the digestive system were of veterans. There was no excess of deaths among veterans from cancer or from atypical causes of death in this group of young men. Three-quarters of deaths of both veterans and non-veterans were from external causes, often involving motor vehicle accidents.

Adult↗