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Biomedical subjects

D Ostrow

Publications and source records attributed to D Ostrow.

At least 19 recordsLinked to original sources
PubMed2003

Sexual sensation seeking, reduced concern about HIV and sexual risk behaviour among gay men in primary relationships.

Gay and bisexual men who indicated they were currently in a primary relationship with another man (N = 230) completed measures of HIV treatment attitudes, sexual risk behaviour and sexual sensation seeking. Results indicate non-primary partner sexual activity is common in many gay relationships and men in non-exclusive relationships possessed greater levels of sexual sensation seeking and treatment-related reduced concern about the dangerousness of HIV than men in exclusive relationships. Results also suggest that individuals who were members of HIV-seroconcordant relationships were more likely to engage in unprotected sexual activity with their primary sexual partners than gay men who were members of HIV-discordant couples. A series of regression analyses revealed that reduced concern about HIV mediated the relationship between sexual sensation seeking and sexual risk behaviour. The next generation of HIV prevention interventions must address the attitudinal shifts that have occurred among some gay men regarding the seriousness of HIV and should be sensitive to the dynamics of gay relationships.

Adult↗
PubMed2001

Risk of psychiatric disorders among individuals reporting same-sex sexual partners in the National Comorbidity Survey.

OBJECTIVES: This study examined the risk of psychiatric disorders among individuals with same-sex sexual partners. METHODS: Data are from the National Comorbidity Survey, a nationally representative household survey. Respondents were asked the number of women and men with whom they had sexual intercourse in the past 5 years. Psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria were assessed with a modified version of the Composite International Diagnostic Interview. RESULTS: A total of 2.1% of men and 1.5% of women reported 1 or more same-sex sexual partners in the past 5 years. These respondents had higher 12-month prevalences of anxiety, mood, and substance use disorders and of suicidal thoughts and plans than did respondents with opposite-sex partners only. Decomposition showed that the elevated same-sex 12-month prevalences were largely due to higher lifetime prevalences. Ages at onset and persistence of disorders did not differ between the same-sex and opposite-sex subsamples. CONCLUSIONS: Homosexual orientation, defined as having same-sex sexual partners, is associated with a general elevation of risk for anxiety, mood, and substance use disorders and for suicidal thoughts and plans. Further research is needed to replicate and explore the causal mechanisms underlying this association.

Adolescent↗
PubMed1992

The link between sexually transmitted disease clinics and HIV counseling and testing centers: who is not getting referred?

A total of 236 clients attending human immunodeficiency virus (HIV) counseling and testing (C&T) centers and sexually transmitted disease (STD) clinics were interviewed to evaluate who is being reached by C&T services and if STD clients are being referred to HIV C&T centers. Respondents receiving HIV C&T reported significantly more sexual risk based on characteristics of their partners, whereas STD clinics respondents more frequently reported previous STD diagnoses and sex with prostitutes. Over 50% of the high-risk individuals attending STD clinics were not referred to HIV C&T centers. The differences in perceived risk of current and future infection between STD and HIV C&T centers and the low referral rates of high-risk individuals for HIV C&T indicate a need for increased education efforts, more effective risk-assessment policies in STD clinics, and a tightening of the link between STD clinics and HIV C&T centers.

Adolescent↗
PubMed1991

Stressful life events and symptom onset in HIV infection.

OBJECTIVE: The authors' goal is to provide basic epidemiologic data on the issue of reactivity to stress and HIV symptom onset by studying the relationship between a broad set of naturally occurring stressor events and HIV natural history in a large longitudinal community sample of HIV-seropositive homosexual men. METHOD: Subjects were recruited from a cohort of 1,011 homosexual men enrolled in the Chicago site of the Multicenter AIDS Cohort Study who also participated in the Coping and Change Study. The men were given self-administered questionnaires assessing behavioral, psychological, and psychosocial variables. Relationships between reports of stressful life events and longitudinal biomedical data measuring illness progression were examined. Life events were assessed by reports on the numbers of lovers, friends, and acquaintances who were diagnosed with AIDS or had died of AIDS and by scores on a checklist of 24 more general serious stressor events. The variables indicating progression of illness among initially asymptomatic men were a drop in T-helper lymphocyte percent (CD4%) between pairs of examinations of at least 25% and onset between examinations of thrush and/or fever lasting a minimum of 2 weeks. RESULTS: The authors found no evidence that serious stressor events have any meaningful effect on symptom onset indicated by either a drop in CD4% or onset of fever or thrush. CONCLUSIONS: There is no need for asymptomatic people with HIV infection to restrict their lives in order to avoid exposure to stressful life experiences or to develop special skills for coping with stress to forestall the progression of HIV illness.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Hypertension and sodium transport in 390 healthy adults in Chicago.

A total of 390 people undergoing routine examinations at the Portes Center, a screening center in Chicago, and at the Northwestern Memorial Hospital employee health service, underwent an in-depth battery of tests designed to explore the relationships of both intracellular erythrocyte sodium and sodium-lithium countertransport with age, race, gender, body mass index, pattern of alcohol intake, exogenous hormone use and the presence of hypertension. Erythrocyte sodium was significantly higher in blacks than in whites and in men than in women aged 20-39 years. Relationships of erythrocyte sodium with race and gender, as well as inverse associations with alcohol intake in men, and positive associations with age and the presence of hypertension in women were significant on multivariate analysis after control for other variables. Sodium-lithium countertransport was significantly higher in whites than in blacks and in men than in women aged 20-59 years. Associations of sodium-lithium countertransport with race and gender as well as positive associations of sodium-lithium countertransport with body mass index in men and women were significant on multivariate analysis after control for other variables. Age-related gender differences in both sodium-lithium countertransport and erythrocyte sodium, as well as the association of erythrocyte sodium with the presence of hypertension in women but not in men, suggest a hormonal interaction with sodium transport in the development of hypertension.

Adult↗
PubMed1988

Cerebrospinal fluid abnormalities in homosexual men with and without neuropsychiatric findings.

We have studied cerebrospinal fluid obtained from 38 homosexual or bisexual men participating in a prospective study of the neuropsychological disorders associated with human immunodeficiency virus (HIV) infection. Twenty-two subjects had neuropsychiatric findings and seropositivity, 11 asymptomatic subjects had seroconverted within 6 to 24 months, and 5 subjects were seronegative controls. Only 1 had acquired immunodeficiency syndrome-related complex, and none had the acquired immunodeficiency syndrome when initially studied. There was a high rate of cerebrospinal fluid abnormalities in men with neuropsychiatric findings, including pleocytosis (41%), elevated IgG and IgG index (47%), and oligoclonal bands (18%). Even in the absence of neuropsychiatric findings, the asymptomatic HIV-seropositive subjects frequently had spinal fluid abnormalities. Of those with neuropsychiatric findings, HIV p24 antigen was detectable in cerebrospinal fluid in only 1 individual, yet HIV was isolated in 11 of 16 (69%) compared to 2 of 7 (29%) of those without neuropsychiatric findings. The identification of cerebrospinal fluid abnormalities in individuals known to have become infected within 6 to 24 months supports the hypothesis that the nervous system is an early target for HIV.

Adolescent↗
PubMed1988

Validity of the Millon Clinical Multiaxial Inventory in the assessment of affective disorders.

The Millon Clinical Multiaxial Inventory (MCMI) was administered to 270 adult outpatients with major affective disorders at the same time that a semistructured, diagnostic interview was conducted by a clinician. The mood of the patient was then rated, and the clinician completed the Hamilton Depression Rating Scale and the Mania Rating Scale. A consensual diagnosis was arrived at by the team of investigators using DSM-III criteria. Significant correlations were found between four MCMI affective scales and the global mood state of the patient. Analysis of covariance indicated that the MCMI affective scales are significantly related to DSM-III affective disorders even after the effect of the current mood of the patient is partialled out. The clinical usefulness of each of the scales is discussed.

Adult↗
PubMed1988

Assessment and management of the AIDS patient with neuropsychiatric disturbances.

The studies reviewed here and ongoing work indicate a primary role for psychiatry in treating patients with the acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection. Those patients often have neuropsychiatric disorders concurrent with the complications of physical disease. It is important to understand the diagnostic criteria for patients with HIV-related disorders to distinguish CNS disturbances caused by infections from those psychiatric problems exacerbated by the social consequences of the syndrome. Although treatment is difficult in immunocompromised patients and treatments may cause serious side effects, many of the CNS symptoms of AIDS patients can be treated in the same way as other diseases of the CNS. Psychostimulants are the most promising therapeutic agents for AIDS patients. In the treatment of psychotic episodes, high-potency neuroleptics at low dosages have been used successfully. In all therapies, careful consideration must be given to possible adverse reactions, which may be more serious in HIV-related diseases.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Risk factors for seroconversion to human immunodeficiency virus among male homosexuals. Results from the Multicenter AIDS Cohort Study.

2507 homosexual men who were seronegative for human immunodeficiency virus (HIV) at enrollment were followed for six months to elucidate risk factors for seroconversion to HIV. 95 (3.8%) seroconverted. Of men who did not engage in receptive anal intercourse within six months before baseline and in the six-month follow-up period, only 0.5% (3/646) seroconverted to HIV. By contrast, of men who engaged in receptive anal intercourse with two or more partners during each of these successive six-month intervals, 10.6% (58/548) seroconverted. No HIV seroconversions occurred in 220 homosexual men who did not practise receptive or insertive anal intercourse within twelve months before the follow-up visit. On multivariate analysis receptive anal intercourse was the only significant risk factor for seroconversion to HIV, the risk ratio increasing from 3-fold for one partner to 18-fold for five or more partners. Furthermore, data for the two successive six-month periods show that men who reduced or stopped the practice of receptive anal intercourse significantly lowered their risk of seroconversion to 3.2% and 1.8%, respectively. Receptive anal intercourse accounted for nearly all new HIV infections among the homosexual men enrolled in this study, and the hazards of this practice need to be emphasised in community educational projects.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Usual interstitial pneumonia: correlation of CT with clinical, functional, and radiologic findings.

Correlation between disease extent on computed tomographic (CT) scans and severity of clinical and functional impairment was obtained in 23 patients with usual interstitial pneumonia (UIP) by review of the clinical data, pulmonary function tests, chest radiographs, and CT scans. The CT scans and chest radiographs were each read twice by two independent observers. Disease extent was assessed on CT scans by a visual score (0%-100% involvement of the lung parenchyma) and on the radiograph by the International Labour Office classification. There was good intraobserver and interobserver agreement for both CT and radiograph scores (all r greater than or equal to .71). CT scans gave a better estimate of disease extent and showed more extensive honeycombing than did the radiograph. A significant correlation was found between the extent of disease as assessed with CT and the severity of dyspnea (r = .62, P less than .001), as well as between CT and impairment in gas exchange as assessed by the diffusing capacity (r = .64, P less than .001). There was poor correlation between disease severity as assessed with chest radiography and the clinical and functional variables (all r less than or equal to .39).

Adult↗
PubMed1987

Epidemiological studies of sodium transport and hypertension.

Red blood cell membrane cation transport was measured in five population-based surveys and two randomized, controlled, dietary intervention studies to examine its associations with demographic, biological, and dietary variables in free-living individuals. A total of 508 individuals, 255 with high blood pressure, were studied. Both sexes, blacks and whites, and several age groups were represented. The intervention studies included short-term dietary sodium restriction in normotensive adolescents, and a 4-year multifactorial trial on weight, sodium, and alcohol in hypertensive adults. The findings from these surveys and intervention studies are summarized in this report. Sodium-stimulated lithium countertransport was significantly related to diastolic blood pressure in white adults (r = 0.28, p less than 0.001), and to systolic blood pressure in black children (r = 0.50, p less than 0.005) and white adolescents (r = 0.31, p less than 0.05). Lithium countertransport was related to sex and race, but not age. Body mass index had an independent relationship with lithium countertransport in some age groups. Lithium countertransport was lower in normotensive adults than in both younger and older hypertensive adults. Lithium countertransport did not differ significantly between subjects with hypertension treated with antihypertensive medications and those with untreated hypertension. Short-term dietary sodium restriction did not influence lithium countertransport in normotensive adolescents. Long-term dietary intervention was associated with low lithium countertransport in hypertensive adults able to maintain blood pressure control without medication. These findings indicate that lithium countertransport is related to blood pressure and hypertension among free-living individuals.

Adolescent↗
PubMed1987

Airway involvement in ulcerative colitis.

Two patients with ulcerative colitis developed progressive obstructive pulmonary disease. In one, the abnormality was a sclerosing peribronchiolitis confined to small airways, while the other demonstrated a large airway fibrotic obliterative bronchitis. A review of airway involvement in ulcerative colitis and a discussion of the possible similarity to another extraintestinal manifestation of ulcerative colitis, sclerosing cholangitis, are presented.

Adult↗
PubMed1985

Bronchiolitis obliterans complicating bone marrow transplantation.

A 19-year-old woman with extensive, persistent chronic graft versus host disease (GVHD), following an HLA-identical bone marrow graft for acute leukemia, developed rapidly progressive airflow obstruction 140 days post-transplantation (PT) and presented clinically with persistent cough, inspiratory rales, bronchospasm and exertional dyspnea. Pulmonary function tests (PFT) showed rapidly evolving severe airflow obstruction and hypoxemia without restrictive ventilatory defect. Open lung biopsy on the 204th day PT confirmed focal bronchiolitis obliterans. On the 381st day PT, she remained clinically stable. Chest x-ray film showed mild overinflation, but was otherwise unremarkable. PFT's continued to show very severe airflow obstruction without restrictive ventilatory defect. The etiology of the obliterative bronchiolitis might be explained on the basis of a direct immunologic reaction mediated by GVHD or possibly a joint viral-GVHD interaction. Awareness and further detailed documentation and analysis of this unusual respiratory syndrome associated with marrow transplant recipients may help clarify the role of GVHD in the development of lung disease in recipients of marrow grafts.

Adult↗
PubMed1985

The new generation antidepressants: promising innovations or disappointments?

"New generation" antidepressants are generally considered to include all agents introduced in recent years which are neither tricyclic in structure nor monoamine oxidase inhibitors. They include the tetracyclics (mianserin and maprotiline), the bicyclic serotonergic compounds (fluoxetine and citalopram), and the unicyclics (bupropion), as well as the triazolobenzodiazepine derivatives (alprazolam), the triazolopyridines (trazodone) and the tetrahydroisoquinolines (nomifensine). Methodologic and economic considerations have hampered attempts to develop agents with significantly greater specificity or safety than traditional agents. Traditional agents, while lacking specificity, do have extensive records of efficacy and long-term safety and are usually less expensive than new agents. Patients not responding to traditional agents often have medical or characterologic problems that exclude them from participating in controlled studies of new agents. These problems are discussed and potential approaches to the development of new agents are presented.

Alprazolam↗
PubMed1985

Evolution of acute hepatitis B in homosexual men to chronic hepatitis B. Prospective study of placebo recipients in a hepatitis B vaccine trial.

To determine whether the frequency of chronic hepatitis B in homosexual men reflects the high rate of acute hepatitis B or an altered response to hepatitis B, 236 homosexual men were prospectively followed up after entry into the placebo group of a hepatitis B vaccine trial. Sixty-six participants (28.0%) developed hepatitis B ten to 18 months after entering the study. Only four (6.1%) of the 66 had persistence of hepatitis B beyond six months, similar to reports in nonhomosexual subjects. This study suggests that the high rate of acute hepatitis B is the major factor contributing to the high prevalence of chronic hepatitis B in homosexual men, rather than an altered host response. Clinical features of the acute illness could not be used to identify patients who developed chronic hepatitis B.

Acute Disease↗
PubMed1984

Sex and race differences in sodium-lithium countertransport and red cell sodium concentration.

A total of 417 individuals from all four major sex-race groups were examined for the rate of sodium flux via the countertransport pathway and the sodium concentration within red cells. The age span was from early adolescence to retirement. Males of both races had sizable higher countertransport rates than did women (p less than 0.01), and a slight increase in sodium concentration (p greater than 0.05). Contrariwise, while whites or both sexes had higher countertransport than their black counterparts, sodium concentration was higher in blacks than whites (p less than 0.01). This pattern is not consistent with a direct relationship between both countertransport or sodium concentration and blood pressure which applies across both racial groups. Sex-race differences must be taken into account in any group comparisons of these variables.

Adolescent↗
PubMed1984

Blood pressure and sodium-lithium countertransport: findings in population-based surveys.

A total of 448 individuals ranging in age from 11 to 72 years were studied in a series of seven population-based surveys. Although the relationship was positive in all surveys, a significant correlation was noted between sodium-lithium countertransport and blood pressure in only three of the seven. Hypertensives as a group had significantly higher levels of countertransport than did those with a normal blood pressure. In stepwise regression analysis, however, entering weight into the equation eliminated a significant predictive effect of countertransport. Red cell sodium concentration and membrane leak did not bear any significant relationship to blood pressure. The association between countertransport and blood pressure appears to be weaker in the general population than previously reported for case-control studies.

Adolescent↗