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Biomedical subjects

D B Louria

Publications and source records attributed to D B Louria.

At least 19 recordsLinked to original sources
PubMed1995

Gender differences in HIV-related psychological distress in heterosexual couples.

In order to determine the effect of family support on the psychological well-being of heterosexual couples with at least one HIV-seropositive, family support data were obtained from couples, who were separately interviewed. Two hundred heterosexuals were interviewed (97 males, 103 females). 182 were partners in HIV serodiscordant couples (18 members were in 10 couples concordant for HIV-seropositivity). Overall, there were 76 HIV+ males and 30 HIV+ females. The Brief Symptom Inventory (BSI) was used to measure psychological distress. Sixty-five per cent of the subjects had family members aware of partners' HIV infection, but only 50% of aware families were reported as supportive. Family support was not a significant predictor of distress. Gender was the most significant predictor of psychological distress as measured by the BSI subscales. Both HIV positive and HIV negative females had more distress than their male counterparts on several dimensions (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, phobic anxiety and paranoia), and on the General Severity Index (GSI) of the BSI (HIV-positives: p = 0.003; HIV-negatives: p = 0.01). Despite the general lack of association of family support with psychological distress, women in couples affected by HIV had more distress than men. The mental health needs of women clearly differ from men, and continued gender comparisons should be done to develop appropriate and effective interventions for these groups.

Adult↗
PubMed1994

Daily micronutrient supplements enhance delayed-hypersensitivity skin test responses in older people.

A placebo-controlled double-blind trial of the effects of daily micronutrient supplements on circulating vitamin and trace metal concentrations and delayed-hypersensitivity skin test (DHST) responses was conducted. Subjects, aged 59-85 y, were randomly assigned to placebo (n = 27) or micronutrient (n = 29) treatment groups. DHST and circulating concentrations of nine micronutrients were measured before and after 6 and 12 mo of micronutrient ingestion. For the micronutrient group, there were statistically significant increases at 6 and/or 12 mo in the mean serum concentrations of ascorbate, beta-carotene, folate, vitamin B-6, and alpha-tocopherol. There was a significant increase at 12 mo in the number of subjects in the placebo group with one or more low concentrations. DHST responses to a panel of seven recall antigens were significantly increased at 12 mo in the micronutrient group but not the placebo group. This study demonstrates that daily supplementation with low-to-moderate doses of micronutrients can prevent low concentrations of some micronutrients and can improve DHST responses in healthy, independently living older adults.

Aged↗
PubMed1994

Family support for heterosexual partners in HIV-serodiscordant couples.

OBJECTIVE: To ascertain the extent of family member support to heterosexual HIV-serodiscordant couples, and to identify associated sociodemographic and clinical characteristics. DESIGN: Discordant couples enrolled in a cohort study of heterosexual HIV transmission were interviewed with structured questionnaires to obtain sociodemographic data, family member awareness of HIV and perceived support from family members. Clinical characteristics were established by medical history, physical examination and laboratory tests. RESULTS: Awareness and support of family members were associated with sex of family member and HIV seropositivity, sex, education, and race of the partner. HIV-seropositive partners were more likely to have a sister aware than were HIV-negative partners (P = 0.01). More educated HIV-positive partners had fewer aware family members than less educated HIV-positive individuals (P = 0.02). Mothers of HIV-positive women were more often aware than mothers of all other partners (P = 0.04). Black HIV-negative partners had fewer aware family members than whites or Hispanics (P = 0.02). CONCLUSION: This research shows both encouraging and disturbing patterns of family awareness of HIV and support to serodiscordant partners.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Education initiatives in the health reform era.

Health care reform will change the way American physicians are trained. Medical students need to learn the importance of thinking like futurists and making a commitment to society. Hopefully, training physicians as futurists will be a part of the new health care system.

Comprehensive Health Care↗
PubMed1994

Quo vadis: perinatal AIDS issues--2004.

The HIV problem will inexorably increase over the next decade, with an increasing proportionate impact upon women and children over the next decade. HIV will become endemic, essentially worldwide. Some regions in the developed world may be relatively spared if current trends continue. This may reduce the willingness to expend necessary resources, particularly if trends toward increasing isolationism continue. There are already signs of a world becoming "bored" with AIDS and the chronicity of a difficult problem. This engenders an atmosphere ripe for increasing discrimination, with the development of loopholes in protective legislation. Already in the United States, some lawsuits concerning health care access among employees have been decided in the employer's favor, permitting them to restrict access to health insurance, despite other regulations which might have protected such workers. Similarly, some HIV-infected health care workers have been dismissed or lost their privileges in the 1990s, despite passage of the Americans with Disabilities Act as well as preceding legislation. It remains to be seen how society will cope with these complicated issues. The view of AIDS in 2004 presented above is pessimistic. There are some important rays of hope. Recent innovative vaccine work and new theoretical models may put us on the road to success, both with preventive and therapeutic vaccines. In particular, the first success in eliciting protection against vaginal HIV exposure, albeit partial, was reported in mid 1993. In a simian immunodeficiency virus (SIV) in vivo experimental model, cellular immunity to SIV was induced in macaques without their developing any signs of SIV infection. These macaques after rechallenge with low-dose SIV remained free of detectable SIV, so there may be an element of protection associated with specific cellular immune responses to immunodeficiency viruses. However, very high-dose SIV rechallenge experiments in similar macaques still led to acquisition of active SIV infection, suggesting that any such protection was only partial. It is also possible that cellular immune protection may be of varying efficacy against different types of exposure, particularly parenteral versus mucosal (such as sexual) exposures. There is also reason for specific optimism concerning interventions that might directly reduce the risk of perinatal transmission. Data from studies of twins suggest that a substantial proportion of perinatal transmission does not occur until after labor has commenced. Thus, caesarian sections may potentially reduce the risk of transmission to the fetus in some cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

Health promotion: the Health-Full-Life program.

A 17-point program of disease prevention-health promotion is offered as a paradigm for ostensibly healthy adults. The author stresses the necessity for keeping the program inexpensive and adequately documented; such a program will be state-of-the-art prevention.

Adult↗
PubMed1992

An unusual case of false-positive serology for the human immunodeficiency virus: report from the heterosexual HIV transmission study.

A man was found to have a repeatedly positive enzyme immunoassay (EIA) that was confirmed by a western blot with six positive bands. He was told that he was seropositive for the human immunodeficiency virus (HIV), but subsequent EIAs were negative and western blots were either negative or indeterminant. All other HIV-related studies were unrevealing, and no explanation for the false-positive result was found. We have not absolutely eliminated the possibility of mislabeled specimens, but we believe this to be unlikely. The possibility, albeit infrequent, of concomitant false-positive EIAs and western blots should be kept in mind when formulating public policy with regard to HIV testing.

AIDS Serodiagnosis↗
PubMed1991

New Jersey high school students' knowledge, attitudes, and behavior regarding AIDS.

In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school students to survey their knowledge, attitudes, and behavior related to the acquisition of acquired immunodeficiency syndrome (AIDS). Knowledge about the disease was high, but exaggeration of risk from social contacts was common. Although fear was associated with misperceptions, it was not always dispelled by knowledge. Nearly half (49%) of all participants reported having used condoms, indicating that condom use is somewhat familiar and acceptable to them. Over 80% thought that condoms offer some protection against AIDS. However, knowledge did not always result in recognition or practice of risk-reduction behaviors. Student suggestions for slowing the spread of AIDS stressed personal responsibility and education. Follow-up assemblies that used survey results to address gaps in knowledge appeared necessary to counter misperceptions that might have arisen from the survey.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Garlic (Allium sativum) in the treatment of experimental cryptococcosis.

An extract of garlic was studied for its efficacy in treatment experimental cryptococcosis in mice. The garlic, given by mouth, appeared to reduce brain cryptococcal populations, although the results obtained were generally inconsistent. Complete eradication of the cryptococci was not achieved and the early beneficial results observed diminished over time.

Animals↗
PubMed1989

The perceptions of one department of preventive medicine about its obligations to the larger community.

We believe that Department of Preventive Medicine must be actively involved in important societal issues. We have attempted to meet our commitments by: (I) developing position papers for distribution to our state legislators and Congressional delegation; (2) a focus on problems plaguing the community (cancer care, drug abuse, lead poisoning); (3) developing and implementing a health promotion program that is inexpensive, adequately documented, and effective; (4) being involved in various international medicine activities; and (5) starting a chapter of the World Future Society as part of an attempt to introduce futurism into universities, colleges and high schools in New Jersey.

Community-Institutional Relations↗
PubMed1988

Adolescents and nuclear arms issues.

Concerned about adolescents' reactions to the ever present nuclear threat, we surveyed 10,720 high school students in New Jersey, U.S.A. Half felt anxious about an accidental war and expected a major nuclear blast. One-quarter expected a nuclear war involving the United States, and one-fifth expected to die in a nuclear blast. Most expected the United States to be destroyed if a major nuclear war occurred, did not believe that long term survival after the initial exchanges is possible, or that civil defense preparations can be effective. Responses were similar across economic background, time period and type of high school.

Adolescent↗
PubMed1988

In situ/invasive cervical cancer ratios: impact of cancer education and screening.

A study of cancer incidence rates in Newark, NJ showed an increase in invasive cervical cancer among black women between 1970 and 1976. The incidence was substantially higher than that found in the Third National Cancer Survey and the Surveillance Epidemiology End Results Program. The ratio of in situ/invasive cervical cancer incidence among black women was 1:1, far below the national ratio of about 3:1. It seemed that the high-risk population in Newark might not be having regular Papanicolaou smears. From 1976 through 1981, intensive educational and cervical cancer screening programs were carried out in the city of Newark. A review was made of cervical cancer cases (1976-1981) reported to the tumor registries or recorded on discharge diagnoses in hospitals where Newark residents are known to have sought care. The findings showed that the ratio of in situ to invasive cervical cancer had increased dramatically: the overwhelming majority of cancers were found to be in situ carcinomas. The improvement was far more impressive among black women than among white women. Since the intervention campaign had been directed primarily toward the black female population, a group at extremely high risk, this suggested that efficacy of the intervention program.

Adolescent↗
PubMed1988

Comparison of ticarcillin plus clavulanic acid with clindamycin and gentamicin in the treatment of postcesarean endomyometritis.

The efficacy of a single antibiotic--Timentin (ticarcillin with clavulanic acid)--was compared with a standard two antibiotic regimen (clindamycin and gentamicin) for the treatment of endomyometritis after cesarean delivery. The regimens were 3 grams of ticarcillin plus 100 milligrams of clavulanic acid given intravenously every four hours, or 600 milligrams of clindamycin given intravenously every six hours plus 3 to 5 milligrams per kilogram per day of gentamicin given intramuscularly. The diagnosis of endomyometritis was based upon an oral temperature of 100.4 degrees F. or higher on any two occasions, excluding the first 24 hours post partum, uterine tenderness and the absence of another focus of infection. Ninety-one patients were treated. Treatment failure rates were three of 49 in the clindamycin and gentamicin group and four of 42 of the ticarcillin plus clavulanic acid group. Treatment failures did not appear to be different from successes demographically or in risk factors for endomyometritis. The results of this study suggest that ticarcillin with clavulanic acid is as effective in the treatment of postcesarean endomyometritis as the standard regimen of clindamycin and gentamicin.

Adult↗