PubMed Health⌕ Search

Biomedical subjects

D W Marshall

Publications and source records attributed to D W Marshall.

16 recordsLinked to original sources
PubMed1991

CSF changes in a longitudinal study of 124 neurologically normal HIV-1-infected U.S. Air Force personnel.

Over a 2 year period, 124 neurologically normal HIV-1-infected patients had three successive cerebrospinal fluid (CSF) examinations approximately 1 year apart. Immunological status as measured by absolute CD4 counts in the blood identified two groups of patients over time: (a) a group with progressive CD4 decline (66 patients), and (b) a group with stable CD4 counts (58 patients). These two study groups provided us the opportunity to compare CSF changes (cells, protein, albumin index, IgG, IgG index, and IgG synthesis rate) in neurologically normal individuals with respect to immunological status over time. We found significantly increased intrathecal cellular response and IgG production over time independent of CD4 group. We conclude that any clinical study comparing CSF findings in neurologically symptomatic HIV-infected individuals must recognize and control for these CSF changes in neurologically asymptomatic patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A bacteriological study of the effect on the environment of using a one- or two-trolley system in theatre.

In a survey of 53 hospitals, 62% still had a transfer zone in theatre, involving the use of two trolleys. Reluctance to use one trolley without patient transfer was probably because of concerns about excessive bacterial contamination of the theatre. In an attempt to see if these concerns were justified, air in the operating theatre was sampled for bacterial content, as were the surfaces and wheels of trolleys and the floor in the theatre, anaesthetic room and at the 'red line' in the transfer zone. Samples were taken during the first and second cases on the list of each session in one plenum-ventilated theatre over a four-week period, alternating each week between a one- and two-trolley system. Using one trolley did not significantly influence the bacterial counts in the theatre and anaesthetic room. There were significant differences between counts from the trolley wheels and from the floor of the transfer zone, with counts being higher for one trolley than two. These differences were greatly diminished after the trolleys were washed half way through the study. We conclude that there is no deleterious effect on the environment of the operating theatre, the most sensitive area, if only one trolley is used. If it is considered desirable to decrease the contamination of less important areas when using a one-trolley system, trolleys should be washed regularly, particularly the wheels.

Air Microbiology↗
PubMed1989

Neuropsychological and neurological function of human immunodeficiency virus seropositive asymptomatic individuals.

Although individuals with acquired immunodeficiency syndrome (AIDS) are often impaired on a variety of neuropsychological tasks, questions remain as to when neuropsychological decline can be reliably detected during the course of human immunodeficiency virus (HIV) infection. Detailed neuropsychological testing was accomplished on a cohort of 83 immunologically and neurologically intact asymptomatic HIV-infected individuals drawn from a larger pool of 649 US Air Force personnel with HIV antibodies. These asymptomatic subjects were compared with a group of HIV-negative subjects, and no significant differences in neuropsychological functioning were found. No significant neuropsychological differences were found as a function of cerebrospinal fluid abnormalities in these asymptomatic subjects. When data from 13 subjects with immune compromise were included in the analyses, those with abnormal cerebrospinal fluid values performed significantly poorer on a task of verbal memory, suggesting that cognitive dysfunction is antedated by immunological decline. Methodological problems that inhibit specification of the incidence, prevalence, and natural history of HIV-related cognitive impairment are discussed, as are data suggesting that previously published high estimates of the frequency of HIV-related dementia may not be representative of all HIV-infected populations.

Central Nervous System↗
PubMed1989

Lack of cerebrospinal fluid myelin basic protein in HIV-infected asymptomatic individuals with intrathecal synthesis of IgG.

We evaluated 130 consecutive HIV-infected neurologically asymptomatic individuals for intrathecal IgG production and myelin basic protein (MBP) levels. Although 56.7% of immunologically normal and 68.8% of immunocompromised patients had some CSF abnormality, no patient had an abnormal MBP level. The lack of MBP elevation in the CSF of these patients suggests that the production of intrathecal IgG is not related to active demyelination.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Focal and/or lateralized polymorphic delta activity. Association with either 'normal' or 'nonfocal' computed tomographic scans.

Focal continuous polymorphic delta activity (PDA) is classically taught to be associated with destructive lesions of cerebral white matter. One hundred patients with focal or lateralized continuous PDA recorded by an electroencephalogram who also had computed tomographic (CT) scans of the head performed at approximately the same time were studied. Thirty-three percent had normal or "nonfocal" abnormalities on their CT scans. Most of these had a history of either seizures (51%) or transient cerebral ischemia/stroke (27%); however, a wide variety of causes were possible. This high percentage of patients with focal continuous PDA without corresponding CT scan lesions supports the concept that the electroencephalogram is a physiologic study that is complementary to anatomic imaging techniques.

Adolescent↗
PubMed1988

Spectrum of cerebrospinal fluid findings in various stages of human immunodeficiency virus infection.

This report summarizes the results of neurologic and cerebrospinal fluid (CSF) study findings in over 400 of the 649 human immunodeficiency virus-infected US Air Force personnel, evaluated as of Dec 31, 1987. Eighty percent of these patients were entirely asymptomatic and immunologically normal, 13% had low T-helper lymphocyte counts and/or cutaneous anergy, and only 7% had opportunistic infection. Sixty-three percent of all patients had some CSF abnormality. Sixty percent of the asymptomatic group had at least one abnormal result, over 25% had three or four CSF abnormalities, and over 7% had five or six abnormal values. When patients with evidence of blood-brain barrier leak were excluded, significant differences were seen between disease groups with regard to CSF glucose, CSF IgG levels, and CSF IgG synthesis. No human immunodeficiency virus-related central nervous system abnormalities were found on neurologic examination in immunologically intact asymptomatic patients regardless of CSF findings. No clear-cut predictor of impending central nervous system complications has, as yet, been identified from the CSF parameters studied.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Cerebrospinal fluid abnormalities in patients without AIDS who are seropositive for the human immunodeficiency virus.

Lumbar punctures were done on 114 consecutive active duty patients referred for evaluation of positive tests for antibodies to the human immunodeficiency virus (HIV). Eighty-eight percent of these patients appeared to have early HIV infections, as evidenced by intact delayed hypersensitivity, T helper lymphocyte counts greater than 400/mm3, and lack of constitutional symptoms. Forty-four (38.6%) of the patients met our criteria for abnormal cerebrospinal fluid (CSF); another 13 (11.4%) had borderline elevations of nucleated cells or protein and could not be definitely classified as having normal or abnormal CSF. No significant differences existed between the patients with normal and abnormal CSF with regard to age; sex; race; serum FTA-Abs; clinical staging; absolute T helper lymphocyte counts; or cytomegalovirus, Toxoplasma, or Epstein-Barr virus serologies. Seventy-two percent of the patients with abnormal CSF had evidence of possible viral infection of the central nervous system (CNS), as evidenced by increased CSF IgG, increased IgG synthesis rates, or the presence of oligoclonal bands. We found that a significant percentage of asymptomatic patients with apparent early HIV infections have abnormal CSF that is possibly due to CNS involvement by HIV.

Central Nervous System Diseases↗
PubMed1988

Continuing education.

Explore the source record for details and available documents.

Education, Dental, Continuing↗