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Biomedical subjects

D Goldmeier

Publications and source records attributed to D Goldmeier.

At least 37 records · Page 2Linked to original sources
PubMed1988

Psychosocial implications of recurrent genital herpes simplex virus infection.

Fifty seven patients experiencing first attacks of genital herpes simplex virus infection (HSVI) were compared with 50 patients who were concerned about frequently recurring attacks despite routine counselling and reassurance. Using the general health questionnaire this latter group was found to be more psychologically distressed and more socially naive than the first attack group, as measured by socioeconomic class and the lie score of the Eysenck personality questionnaire; otherwise the two groups were similar. Patients presenting to clinics with frequently recurring genital HSVI may therefore be especially psychologically distressed, socially naive, and disadvantaged. Managing these patients needs to include understanding these problems as well as giving advice and using antiviral agents.

Adolescent↗
PubMed1987

Psychosocial aspects of AIDS.

Bereavement after diagnosing AIDS or other HIV disease, psychological symptoms secondary to brain disease and the social consequences of having AIDS all interact to produce a devastating illness where the patient may be intensely grieving, demented and totally rejected by all of society.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Is Entamoeba histolytica in homosexual men a pathogen?

Entamoeba histolytica (EH) in homosexual men is generally considered to be pathogenic. To test this hypothesis, the generally accepted features of invasion (haematophagous trophozoites in faeces; high-titre serum antibody; moderate to severe acute inflammatory change; and presence of EH in the mucosa on rectal biopsy) and the zymodeme pattern of cultured trophozoites were assessed in twenty-three EH excretors and eleven control homosexual men. No trophozoites or antibody to EH were found in either group. When other pathogens were excluded, no patient in either group had severe, acute histopathological proctitis. Moderately severe change was seen in 38% of EH excretors and 18% of controls (not significant). All the zymodemes were non-pathogenic. Successful eradication of EH did not result in even a trend towards normalisation of the moderate inflammatory histopathology. There are, therefore, no data here to suggest that EH is a pathogen in homosexual men.

Adult↗
PubMed1986

Psychological aspects of recurrences of genital herpes.

Fifty-seven patients presenting with virologically confirmed first attacks of genital herpes were assessed for risk factors for time to the first recurrence. These factors included demographic details, personality traits, recent life events, herpes simplex biotype, frequency of orogenital intercourse and psychiatric illness as measured by the General Health Questionnaire (GHQ). This and our similar previous study (58 patients) were analysed separately and combined using a novel statistical technique (Cox's proportional hazards model). In the previous study there was a significant association only for GHQ score (p less than 0.02). For the present study age was the only statistical significant factor (the younger the patient the more likely a recurrence sooner (p less than 0.05), although there was a trend for high GHQ scorers to have recurrences sooner than low scorers. Data of the two studies combined showed that the only significant association with time to recurrence was the GHQ (p less than 0.02). These data support the notion that there is an association between psychiatric illness and recurrence of genital herpes.

Adaptation, Psychological↗
PubMed1986

Incidence of sexually transmitted diseases in rape victims during 1984.

During 1984, 46 women attended the sexually transmitted disease (STD) clinic at St Mary's Hospital alleging that they had been raped. At presentation, 31 (67%) were asymptomatic. Evidence of STD was found in 14 (30%) women, mixed infections occurring in four. Chlamydia trachomatis and Trichomonas vaginalis were each detected in six (13%) patients and Neisseria gonorrhoeae in three (6%). The source of the infection could not confidently be traced to the alleged rapist. Two patients were found to have cervical cytological abnormalities suggestive of cervical intraepithelial neoplasia of grades II or III. One woman became pregnant as a consequence of the sexual assault. Investigations may unveil infection or other abnormalities, which are incidental to the rape but nevertheless require further investigation and treatment.

Adolescent↗
PubMed1983

Topical acyclovir in the treatment of genital herpes: a comparison with systemic therapy.

Controlled trials of acyclovir cream were conducted in the treatment of initial and recurrent genital herpes. For 54 patients with the first episode of genital infection (initial disease) treated with acyclovir the duration of viral shedding, formation of new lesions, times to crusting and healing and duration of symptoms were significantly reduced compared with the results obtained in 47 placebo recipients. When applied early in the course of recurrent episodes in 44 patients, acyclovir cream significantly reduced viral shedding, a new lesion formation, time to healing and the duration of symptoms compared with the effects in 41 control patients. Topical therapy with acyclovir cream is well tolerated and compares quite favourably with systemic treatment, especially for recurrent genital herpes.

Acyclovir↗
PubMed1983

Immunocompromise syndrome in homosexual men. Prevalence of possible risk factors and screening for the prodrome using an accurate white cell count.

The immunocompromise syndrome in homosexual men in the USA is thought to be associated with cytomegalovirus (CMV) infection and nitrite intake. Such men often have a lymphopenia. In a clinic in London 76% of 46 unselected homosexual men and 50% of 76 heterosexual controls had serum CMV IgG antibody at a titre of 1/16 or more (p less than 0.01). No case of excretion of CMV in the urine was found. Thirty per cent of the homosexual men admitted to using nitrites. These figures suggest that this population of homosexual men uses nitrites less often than their counterparts in the USA and is less likely to have evidence of active or past CMV infection. In addition, these male homosexual patients seem to be less promiscuous than those reported from the USA. Mean accurate total and differential white blood cell counts, using the Haemalog D automatic white cell counter, were no different in homosexual men (and various at risk subgroups of them) than heterosexuals, suggesting that the prodrome to the immunocompromise syndrome was not present in the London clinic population.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Entamoeba histolytica in male homosexuals.

The mobility patterns of four enzymes using cultured trophozoites of Entamoeba histolytica were examined by electrophoresis. By this means the stocks of amoebae isolated from male homosexuals were characterised into zymodemes. No amoebic stock isolated corresponded to a pathogenic zymodeme.

Animals↗
PubMed1982

Does psychiatric illness affect the recurrence rate of genital herpes?

The progress of 58 patients with first attacks of genital herpes was monitored for up to 30 weeks. The effects of sex (gender), age, social class, and non-psychotic psychiatric illness (as measured by the "general health questionnaire," GHQ) on the recurrence rate of herpes was studied. The recurrence rates, measured by the actuarial percentage recurrence-free curves, showed that the 29 patients with GHQ scores above 11 had a significantly higher recurrence rate than those who scored less than 11 (P = 0.002). There were no important differences between recurrence rates according according to sex, age, or social class. These findings suggest that non-psychotic states, such as anxiety or obsessionality resulting in GHQ scores above 12, may possibly cause an excess production of adrenergic substances which encourages reactivation of latent genital herpes. Thus, to lessen the recurrence rate in such patients, a psychological or chemical approach to treatment could be used to modify the autonomic sympathetic response.

Adolescent↗
PubMed1981

Gonococcal septicaemia presenting as a subcutaneous abscess.

In a case of disseminated gonococcal infection the diagnosis was delayed until Neisseria gonorrhoeae was grown from pus from a discharging abscess of the biceps muscle. This unusual skin manifestation appears not to have been reported before.

Abscess↗
PubMed1981

Penetration of penicillin into the cerebrospinal fluid of patients with latent syphilis.

Eighteen patients with latent syphilis were treated with 360 mg, 720 mg, 1080 mg or 1440 mg intramuscular procaine penicillin daily for 14 days. Penicillin was assayed in serum and cerebrospinal fluid collected 3 hours after the second injection in each patient. Penicillin was present in all sera in concentrations greater than the generally accepted fully treponemacidal level, but none was detected in cerebrospinal fluid from 11 patients. The significance of these results is discussed, particularly with a view to changes in standard treatment regimens for latent syphilis.

Adolescent↗
PubMed1980

Proctitis and herpes simplex virus in homosexual men.

In a study of the prevalence of rectal infection with herpes simplex virus (HSV) in a group of homosexual men the magnified appearance of the rectal mucosa correlated with isolation of the virus. HSV was isolated from rectal material from five of 77 men with proctitis of unknown cause but from none of 44 control patients without proctitis; two of four men with HSV proctitis were asymptomatic. Thus, the magnified rectal mucosal image, showing severe congestion, haemorrhage, and pus, appears to be a sensitive indicator of the presence of HSV proctitis.

Adult↗
PubMed1979

Relatives and friends group in a psychiatric ward.

To enable relatives and friends of psychiatric patients in a 30-bed acute admission ward to meet the staff team together a relatives and friends group was initiated. The group was intended to provide a forum for questions about the patients' illness and treatment; allow feelings, such as anger and anxiety, about the patient's illness to be expressed; and enable relatives and friends to share their experiences and offer advice and support to each other. A study was designed to assess the feasibility of the group scheme. Relatives and friends were invited to the day room of the admission ward each Wednesday evening for one hour. The visitors chose their own topics for discussion and the staff team tried to answer questions and to facilitate a free exchange of views. An account of each meeting was documented, including details of attenders, the nature of the topics raised, and a simple measurement of some of the emotions expressed by the visitors. Overall, the effect of the meetings seemed positive and productive, for they allowed relatives and friends to ask questions about many topics, to express pent-up emotions, and to gain a better understanding and tolerance of the patient's illness. The relatives and friends group has become an integral part of treatment on the wards. Now that the feasibility of such a group is established, further studies are required to evaluate its efficacy.

Communication↗