Correspondence about handling evidence in cases of acquired immune deficiency syndrome (AIDS)
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
J A Kaye
Publications and source records attributed to J A Kaye.
The role of L-dopa holiday in the long-term management of Parkinson's disease.
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Aged↗
The effect of 8-methoxypsoralen-plus ultraviolet light on cell-virus interaction: the transforming infection; effect of PUVA on the transformation of baby hamster kidney cells by polyoma virus.
Pre-treatment of baby hamster kidney (BHK) cells with 8-methoxypsoralen (8-MOP) plus ultraviolet (UV) light enhances the frequency of their transformation by polyoma (Py) virus. Of the doses tested, 0.5 microgram/ml 8-MOP plus 0.3 J/cm2 UV-light results in maximal (30-fold) stimulation of viral transformation. 8-MOP alone does not affect viral transformation and UV-light alone causes only a slight increase in the transformation frequency. Thus the drug and light act synergistically in promoting the effect. Treatment of BHK cells with drug plus light without Py infection does not lead to a transformed morphology. A drug-light combination (0.01 microgram/ml 8-MOP plus 1.2 J/cm2 UV) that inhibits cellular DNA synthesis to 75% of control at 28 hr after treatment results in a 6-fold stimulation of the transformation frequency.
Animals↗
Parkinson's disease: follow-up after "drug holiday".
Long-term management of patients with Parkinson's disease includes close monitoring and frequent dose adjustment. In a small selected group of patients, complete withdrawal of L-dopa (drug holiday) and slow reintroduction of lower doses of this drug assured continued benefit for six to 24 months. We studied 45 drug holidays in 45 patients with idiopathic Parkinson's disease. Average preholiday L-dopa dose was 2,970 mg/d; at 24 months, it was 263 mg/d. The drug holiday resulted in reduced adverse drug effects (dyskinesias, "on-off" phenomenon, hallucinations, and confusion), and improved functional ratings at one, six, 12, and 24 months after the drug holiday.
Aged↗
Sex differences in the corpus callosum with aging.
The present study examined sex differences in the area and age-related atrophy of the corpus callosum (CC) of 76 healthy elderly subjects using magnetic resonance imaging. The cerebellum and pons served as noncortical control structures. CC area and its subregions were also related to cognitive performance. Women had a slightly larger posterior sector of the CC than men. Women but not men showed age-related atrophy of the anterior and middle sectors of the CC but not the posterior sector. Cerebellum and pons size was similar in men and women, and neither showed age-related atrophy. CC area was related to visual memory in women but not men; no other significant cognitive to structure area relationships were found. These findings show that selective age related atrophy of the CC differs in men and women late in life.
Aged↗
Sex differences in prefrontal volume with aging and Alzheimer's disease.
We used volumetric magnetic resonance imaging to examine sex differences in prefrontal tissue volumes of healthy aged and patients with Alzheimer's disease (AD). Healthy subjects had greater total prefrontal volume than AD, and men had greater total prefrontal volume than women (ps < or = 0.02). This was true for both gray and white matter volumes. There were no interactions between group and sex for total prefrontal volume. An exploratory analysis of each group suggested that sex differences in both gray and white matter in healthy aging are not sustained in AD.
Aged↗
Age-related differences in visual search task performance: relative stability of parallel but not serial search.
The hypothesis that visual search tasks requiring effortful, serial processing are more sensitive to aging than those requiring relatively automatic, parallel processing was tested in 96 healthy adults who performed parallel and serial visual search tasks with fixed presentation times. Reaction times and error rates increased with age in both tasks, but there was no difference between young and old in the effect of increasing numbers of distractors on reaction times. However, the older subjects made significantly more errors with increasing numbers of distractors in the serial search task. Older subjects have disproportionately more difficulty performing serial compared to parallel visual search tasks than do younger subjects. Additionally, this difference is not caused solely by cautious response strategies in the elders.
Adult↗
Early noncognitive change in Alzheimer's disease and healthy aging.
Recent studies in Alzheimer's disease have focused on behavioral disturbances in the more advanced stages of the illness rather than behavioral and personality changes occurring early in the disease course. We present a new instrument, the Oregon Noncognitive Inventory for Dementia (ONID), that was developed specifically for patients in the early stages of dementia, to identify subtle behavioral alterations that may precede the more severe cognitive changes of Alzheimer's disease. Mildly demented Alzheimer's patients were compared with age-matched healthy subjects on the ONID. Caregivers of these patients reported significantly more of the behaviors addressed by the ONID than did relatives of the healthy elderly. The results indicate that changes in behavior and personality can be reliably reported by family caregivers of patients with mild dementia. Future clinical applications of the ONID might include measuring change in drug trials, longitudinal studies of the progression of change, and differentiating Alzheimer's disease from other dementias based on a characteristics pattern of change.
Activities of Daily Living↗
Screening program for colorectal cancer: participation and follow up.
The benefit of screening for colorectal cancer with the fecal occult blood test (FOBT) remains controversial. In 1985, an annual FOBT screening program for colorectal cancer was begun at Harvard Community Health Plan (HCHP). We subsequently reviewed 409 randomly selected medical records of members over age 50 to determine whether screening had been performed, how members with positive test results were evaluated by their physicians, and what gastrointestinal lesions were found as a result of positive screening tests. One hundred and ninety seven of 409 members (48%) were screened at least once during the two-year study period. One hundred and eight of 180 members (60%) who had one periodic health review (PHR) and 72 of 88 members (82%) who had two or more PHRs during the study period were screened at least once. Sixteen of 197 members who were screened at least once (8%) had positive tests. Eleven of the 16 members with positive tests were adequately evaluated by their physicians. Four had colorectal polyps and five had some other benign gastrointestinal lesion. The conclusion drawn is that FOBT screening for colorectal cancer is practical in the HMO setting. Members who have periodic health reviews are more likely to participate in screening. Physicians and members must be better educated to ensure adequate evaluation of positive tests.
Colorectal Neoplasms↗
Interuncal distance: marker of aging and Alzheimer disease.
PURPOSE: To evaluate the utility of a recently reported simple measure of brain atrophy on MR imaging, the interuncal distance (IUD). METHODS: Measurements of the IUD were made over a 12-month interval in 10 patients with probable early Alzheimer disease and in a comparison group of age-matched healthy control subjects. The measurements were made in both the transaxial and coronal planes. RESULTS: Significant group differences for the coronal measurement of IUD were found in both the absolute value of the measurement and the IUD corrected for head size. There was overlap in IUD between the disease and the control groups. These differences were not found for the transaxial IUD. Significant positive correlations of the IUD with Mini-Mental State Examination score and Clinical Dementia Rating Scale stage were observed. Over the age range tested, age was not significantly correlated with IUD in the sample. CONCLUSIONS: The interuncal distance (IUD) is not a useful screening measurement for Alzheimer disease.
Aged↗
Neocortical temporal lobe sclerosis masquerading as Alzheimer dementia: does herpes virus encephalopathy protect against Alzheimer's disease?
Semi-quantitative neuropathological analysis and morphometric evaluations of the brains of 5 elderly people (63-85 years old) dying following a 5-27-year history of dementia reveal that, despite exhaustive survey of all major brain regions, 4 of these cases show virtually no histopathological lesions of Alzheimer's disease. Instead their CNS manifests a severe, bilateral, neuronal depletion, and astrogliosis afflicting the lateral temporal neocortex, highly compatible with a previous herpetic viral encephalitis. In the fifth case unilateral neocortical temporal lobe sclerosis is accompanied by Alzheimer's disease, but with much more dense Alzheimer lesions throughout the contralateral cerebral hemisphere. Three of these 5 individuals had a history either of herpes zoster of the skin or of a single episode of viral meningoencephalitis, roughly concomitant with the onset of memory loss. This clinical and pathological evidence that a remote herpes virus encephalopathy (when bilateral) "protects" that brain against Alzheimer's disease strengthens our growing suspicion that incomplete replication cycles of herpes simplex or zoster virus, following repeated reactivation within neurons of the trigeminal ganglia, may link these viruses to the pathogenetic cascade underlying dementia of the Alzheimer type.
Aged↗