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Biomedical subjects

D G Ostrow

Publications and source records attributed to D G Ostrow.

At least 55 records · Page 3Linked to original sources
PubMed1987

The Multicenter AIDS Cohort Study: rationale, organization, and selected characteristics of the participants.

The Multicenter AIDS Cohort Study was designed to elucidate the natural history of the infection causing acquired immunodeficiency syndrome (AIDS), identify risk factors for occurrence and clinical expression of the infection, and establish a repository of biologic specimens for future study. A variety of recruitment techniques, including special assurance of confidentiality, were used to enroll participants. Nearly 5,000 homosexual men volunteered for semiannual interview, physical examination, and laboratory testing in four metropolitan areas. A significant majority of these men in each center (69-83%) reported having 50 or more lifetime sexual partners, and over 80% had engaged in receptive anal intercourse with at least some of their partners in the previous two years. By the time of the participants' initial evaluation (April 1984-April 1985), infection with the human immunodeficiency virus (HIV) had occurred in higher proportions of men in Los Angeles (51%) and Chicago (43%) than in Baltimore/Washington, DC (31%) and Pittsburgh (21%), presumably as a result of the higher number of partners and proportion with whom these men had engaged in high-risk practices (e.g., receptive anal intercourse). Follow-up evaluations are underway in this comprehensive longitudinal investigation of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Psychiatric consequences of AIDS: an overview.

As the AIDS epidemic has unfolded, a growing number of psychiatric consequences have been manifested. Based on his experiences as a researcher, clinician, and public health advisor, the author presents a number of conceptual models to assist in our understanding of the psychological, social and political consequences of AIDS, fear of AIDS, and infection with the Human Immunodeficiency Virus (HIV). These include a structural model for AIDS related behavioral change, a psychosocial model of the various types of social response, a biological model, and an integrated model for psychiatry's role in promoting positive social change which will control the spread of disease and fear. The author concludes that the magnitude of the psychiatric challenges of AIDS and the potential "holocaust" outcome if we fail to properly address that challenge necessitate the active mobilization of the mental health professions.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Long-term immunogenicity and efficacy of hepatitis B vaccine in homosexual men.

To study the duration of antibody persistence and protection provided by the hepatitis B vaccine, we followed 773 homosexual men for five years after completion of vaccination. Among the 635 participants in whom antibody levels above 9.9 sample ratio units (SRU) developed after vaccination, 15 percent lost antibody altogether, and in another 27 percent, antibody levels declined below 10 SRU within five years. The extent of the maximal antibody response strongly predicted the persistence of protective antibody. Hepatitis B infection occurred in 55 men; 8 of these infections were clinically important (characterized by the presence of the hepatitis B surface antigen and elevation of liver-enzyme levels), and two of the patients became hepatitis B virus carriers. The long-term risk of hepatitis B infection was inversely related to the maximal antibody response to vaccine. Most severe infections occurred among those who responded poorly or had no response to the vaccination. The risk of late infection with hepatitis B in those with an initially adequate vaccine response increased markedly when antibody levels decreased below 10 SRU, but only 1 of 34 late infections resulted in viremia and liver inflammation. A second series of vaccinations induced a moderate antibody response in 50 percent of the subjects who initially had no response or a poor response; however, the persistence of antibody was poor. Both antibody loss and the risk of severe disease should be considered when booster-dose strategies for the hepatitis B vaccine are being designed.

Carrier State↗
PubMed1986

Differentiating DST suppressors from nonsuppressors: a discriminant function analysis of clinical symptoms.

Ninety-seven patients who presented with depressive complaints were studied in an attempt to cross-validate a statistical model that uses items from the Hamilton Rating Scale for Depression (HRSD) to differentiate dexamethasone suppressors from nonsuppressors. Two split-sample discriminant function analyses (DFA) of data from this sample showed little agreement with either the original model or with each other. Accuracy of classification was acceptable for the derivation samples but was no better than chance for the validation samples. No single HRSD item was identified by all three DFAs as distinguishing between groups. The HRSD does not appear to be a reliable instrument for clinically distinguishing dexamethasone suppressors from nonsuppressors.

Adult↗
PubMed1986

Psychosocial and ethical issues of AIDS health care programs.

The psychiatric, psychosocial, and ethical considerations in the design and evaluation of health care programs for AIDS patients and others with HIV infection are described in this article. The responsibilities of health care providers are considered in the context of the history and epidemiology of AIDS, previous responses of the health care delivery system, and the concerns of the general public. General guidelines for program development are set forth; these guidelines embody ethical principles, the role of education in altering the behavior and attitudes of patients and health care workers, the optimal levels of and precautions for infection control, and the evaluation of a patient's competency and judgement. Several examples of the use of these guidelines to resolve difficult policy issues arising in the treatment of patients with AIDS or HIV infection are also provided.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Alcohol and drug use during sexual activity and compliance with safe sex guidelines for AIDS: the AIDS Behavioral Research Project.

This article describes the association between drug and alcohol use during sexual activity and high-risk sex for AIDS. Data to test this association are drawn from a prospective study of the behavioral changes made by gay men in San Francisco in response to the AIDS epidemic. Findings drawn from the May, 1984 and May 1985 waves of data collection are described. The cross-sectional analysis showed that use of particular drugs during sex, the number of drugs used during such activity, and the frequency of combining drugs and sex are all positively associated with risky sexual activity for AIDS. The retrospective data showed that men who currently abstained from combining drug use with sexual activity were likely to have been at no risk for AIDS over two measurement points during the previous year. The men who currently combined drug use with sex were most likely to have a history of high-risk sexual activity over the previous year. These findings show a strong relationship between drug and alcohol use during sex and non-compliance with safe sex techniques to prevent the spread of AIDS. Implications of this relationship for AIDS health education efforts are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The effect of alcoholism on membrane lithium transport.

Red cell lithium efflux rates in major affective disorder and alcoholic patient groups were studied. Current alcoholism was associated with significant elevation of lithium transport in white but not black subjects. This effect of alcoholism on the characteristics of membrane ion transport was independent of the blood pressure elevating effects of alcoholism and the diagnosis of major affective disorder. A model to explain the mechanism of this race-specific membrane effect of alcoholism is proposed and discussed.

Alcoholism↗
PubMed1984

The spectrum of immunologic abnormalities and clinical findings in homosexually active men.

Clinical and laboratory evaluations of 181 men were performed; the population studied included 131 homosexual or bisexual men (who were stratified into one of three groups on the basis of symptomatology and abnormal findings on physical examination), 39 heterosexual men (who served as controls), and 11 men with acquired immunodeficiency syndrome (AIDS). The presence of specific symptoms and/or lymphadenopathy in homosexual men was associated with perturbation of immunoregulation. A large percentage of asymptomatic, homosexually active men had abnormalities in lymphocyte numbers, subpopulations, and subclasses. Symptomatic individuals had clinical findings, immunologic alterations, and abnormalities of hematopoiesis similar to those found in patients with AIDS. These data suggest that clinical evaluation in conjunction with laboratory studies may serve to identify individuals at increased risk of developing AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Mixture distributions in psychiatric research.

This paper describes the application of Gaussian mixture distributions to biological marker research in psychiatry. Mixtures of univariate and multivariate normal distributions can be used to determine if diagnostically similar psychiatric patients belong to biologically distinct subpopulations. The resulting biological subtypes may be important in understanding the etiology of psychiatric disorders. The general model and estimation procedure are described (EM algorithm; Dempster, Laird and Rubin 1977). The method is illustrated using two examples of biological data: (1) red cell membranes and monoamine oxidase activity data in normal individuals having no family history of psychiatric illness, the first-degree relatives of bipolar depressed patients and a heterogeneous patient population; and (2) smooth pursuit eye movements that classify relatives of schizophrenics, nonschizophrenics and normal controls into biologically distinct populations.

Bipolar Disorder↗
PubMed1983

Preservation of human erythrocytes for sodium-dependent lithium efflux rate measurements.

Measurement of red blood cell ion transport levels have become increasingly important as biological markers in psychiatric research. A major drawback to large-scale collaborative studies of red blood cell lithium transport rates has been the requirements of fresh cells and a transport research laboratory for performance of the assays. We have developed a method for the preservation of human red blood cells for up to five days with retention of lithium efflux characteristics. This method should find wide-scale application in collaborative studies of this marker in major affective disorders, in genetic studies of families living in diverse geographic locales, and in collaborative studies utilizing a centralized transport assay laboratory.

Biological Transport↗
PubMed1983

Biologic markers and antidepressant response.

The use of biologic markers to predict antidepressant treatment response may lead to more rational selection of specific drugs for individual patients. Several biologic markers being developed as potential predictors of antidepressant treatment response are reviewed. Although research in this area is primarily concerned with predicting response to drug treatment, it may also prove useful in predicting which depressed patients may respond best to psychological treatments or combinations of biologic and psychologic treatments.

Antidepressive Agents↗
PubMed1982

The prevention of hepatitis B with vaccine. Report of the centers for disease control multi-center efficacy trial among homosexual men.

A randomized, double-blind, vaccine/placebo trial of the Merck 20-micrograms hepatitis B virus (HBV) vaccine was done among 1402 homosexual men attending venereal disease clinics in five American cities. Vaccination was followed by only minimal side effects. Two doses of vaccine induced antibody in 80% of vaccine recipients. A booster dose 6 months after the first dose induced antibody in 85% of recipients and markedly increased the proportion of recipients who produced high antibody titers. The incidence of HBV events was markedly less in the vaccine recipients compared to that in the placebo recipients (p = 0.0004). Between month 3 and 15 after the first dose, 56 more significant HBV events (hepatitis, or hepatitis B surface antigen positive, or both) occurred in the placebo group while only 11 occurred in the vaccine group. Ten of the 11 HBV events in the vaccine recipients occurred in hypo- or nonresponders to the vaccine. This vaccine appears to be safe, immunogenic, and efficacious in preventing infection with hepatitis B virus.

Adult↗
PubMed1982

Ion transport and adrenergic function in major affective disorder.

Altered functional levels of norepinephrine (NE) have been implicated in the etiology of affective disorders. Abnormalities of membrane ion transport have been postulated to underlie such neurotransmitter imbalances. To evaluate the role of these systems in the pathophysiology of specific affective syndromes, we have examined the NE metabolite MHPG and ion transport function in a cross-section of affective patients in different mood states. Analysis of those data reveals that plasma MHPG levels are dependent on mood state, with bipolar patients in the manic phase having significant elevations of this metabolite. In contrast, the red cell: plasma lithium ratio (LR) was independent of mood state and significantly elevated in a group of bipolar patients.

Affective Disorders, Psychotic↗