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Biomedical subjects

J Gorman

Publications and source records attributed to J Gorman.

At least 19 recordsLinked to original sources
PubMed1992

A prospective controlled study of magnetic resonance imaging of the brain in gay men and parenteral drug users with human immunodeficiency virus infection.

To detect the earliest structural changes in the brain in human immunodeficiency virus (HIV) infection, 118 gay men and 115 parenteral drug users enrolled in a study of the natural history of HIV infection underwent magnetic resonance imaging evaluations. Routine T2-weighted and heavily T2-weighted scans for quantification of brain water were obtained, blinded to HIV serostatus. Atrophy and foci of increased signal did not correlate with any medical, immunologic, neurologic, or neuropsychologic parameters in the group as a whole, or in the gay men or parenteral drug user subgroups. Three subjects had progressive multifocal leukoencephalopathy and one had central nervous system lymphoma. In a subgroup in whom intracranial water percent was calculated, correlations were found with CD4 counts and CD4/CD8 ratios. We conclude that standard magnetic resonance imaging of the brain does not differentiate asymptomatic and mildly symptomatic HIV-positive individuals from HIV-negative individuals, regardless of risk group. However, intracranial water percent may distinguish HIV-positive from HIV-negative individuals because it correlates with raw CD4 counts and CD4/CD8 ratios.

Adolescent↗
PubMed1992

Neurologic and neuropsychological manifestations of human immunodeficiency virus infection in intravenous drug users without acquired immunodeficiency syndrome. Relationship to head injury.

We examined 99 human immunodeficiency virus (HIV)-negative and 122 HIV-positive intravenous drug users (IVDUs) without acquired immunodeficiency syndrome (AIDS) to determine whether HIV-positive IVDUs had more neurologic and neuropsychological impairment than their HIV-negative counterparts. Controlling for age, education, drug use, history of head injury, and interactions between head injury and HIV status and drug use, HIV-positive subjects had more extrapyramidal signs and frontal release signs. These findings persisted when asymptomatic HIV-positive subjects without systemic signs of infection and HIV-negative subjects were compared. Neurologic findings were more severe in those with more systemic illness. Among those reporting a history of head injury with loss of consciousness, neuropsychological performance was significantly worse in the HIV-positive subjects, and this increased with severity of illness. This was not true in the group without head injury, suggesting an interaction between history of head injury and the seropositive state. No relationship was noted between head injury and either drug use or HIV state. Therefore, subtle neurologic and neuropsychological abnormalities may precede clinical evidence of AIDS in IVDUs and may be more evident in those with head injury.

Adult↗
PubMed1992

Phenelzine vs atenolol in social phobia. A placebo-controlled comparison.

Seventy-four patients who met DSM-III criteria for social phobia completed 8 weeks of double-blind, randomly assigned treatment with the monoamine oxidase inhibitor phenelzine sulfate, the cardioselective beta-adrenergic blocker atenolol, or placebo. The overall response rates were 64% for phenelzine, 30% for atenolol, and 23% for placebo. Phenelzine was widely superior to both atenolol and placebo on independent rater analyses and, to a lesser extent, on self-report, with no significant differences between atenolol and placebo. At the end of 16 weeks, phenelzine was still significantly superior to placebo, while atenolol showed an intermediate response that did not differ significantly from either of the other treatments. Patients with generalized social phobia constituted 76% of the sample, and they were preferentially responsive to phenelzine. The small size of the discrete social phobic sample precluded separate outcome analyses for this subtype. Overall, the findings support the responsivity of social phobia to monoamine oxidase inhibitors.

Adolescent↗
PubMed1992

Theoretical and therapeutic considerations for the anxiety disorders.

Everyone is familiar with that paralyzing state of dread known as anxiety. Although it is unpleasant, the experience of anxiety has adaptive aspects: it can serve as an impetus to effect beneficial life change and can facilitate psychological development. Anxiety becomes of clinical concern, however, when it interferes with intellectual function, or arrests normal social or vocational pursuits. Anxiety disorders are chronic illnesses. Treatment can eliminate many of the disease's debilitating features, but the underlying disorder is not usually cured. Discontinuation of treatment-pharmacological, behavioral, or both-often results in the recurrence of symptoms. The focus of treatment, therefore, generally centers on striking a balance between the goal of alleviating the patient's symptoms, and the need to avoid the deleterious effects which result from long-term treatment (1). The intention of this paper is to review theoretical and therapeutic considerations for four types of anxiety disorder: panic disorder, generalized anxiety disorder, social phobia, and obsessive-compulsive disorder. In doing this, emphasis will be placed on the physiological concomitants and, when possible, neuropsychological bases of these illnesses. Furthermore, pharmacological treatment will be related to the underlying substrata of the disorder whenever possible.

Anti-Anxiety Agents↗
PubMed1992

VDJ recombination.

The ability of lymphocyte receptor V, D and J gene segments to rearrange generates much of the receptor diversity that is the hallmark of the immune system. Naturally, the mechanisms of immunoglobulin and T-cell receptor gene recombination are of enormous interest. Here, Fred Alt and colleagues review current understanding of the process and speculate on future findings.

Animals↗
PubMed1992

Effect of high-flux hemodialysis on quality of life and neuropsychological function in chronic hemodialysis patients.

The objective was to evaluate the effect of high-flux hemodialysis on quality of life, intra- and interdialytic symptoms and neuropsychological function. The study was double-blind single cross-over with random allocation to order of treatment. The patients were stable adult hospital hemodialysis patients. Both the conventional and high-flux membranes were cellulose acetate, the dialysate was bicarbonate, and dialysate sodium was held constant. The high-flux membrane had an ultrafiltration rate of 15 ml/h/mm Hg transmembrane pressure, a B12 clearance of 88 ml/min and a beta 2-microglobulin clearance of 11.4 ml/min. The values of the conventional membrane were 3.5-5.0, 34-45 and negligible. Each treatment period was 4 months. Twenty-two patients completed both phases of the cross-over. The KT/V value was higher during high-flux than conventional treatment; 1.42 versus 1.27(p < 0.05). There were no differences between high-flux and conventional treatment with respect to quality of life. Symptoms during dialysis were less severe during high-flux than conventional treatment for 12/14 items. Only 3 items reached statistical significance (0.05 > p > 0.01) and none were clinically significant. Symptoms between dialyses were less severe during high-flux than conventional treatment for 18/20 items. No single item had a statistically significant improvement but 3 had clinically important improvement. Among the 23 neuropsychological variables, none demonstrated statistically significant changes.

Adolescent↗
PubMed1991

Vulnerability to sodium lactate in panic disorder patients given cognitive-behavioral therapy.

Six patients with panic disorder who had panicked during sodium lactate infusion were given cognitive-behavioral treatment for 12-24 weeks. After treatment they underwent another lactate infusion, and four patients were rates as having no panic, suggesting that reduced vulnerability to lactate accompanies remission of panic. Controlled trials of cognitive-behavioral therapy and use of lactate infusion as a measure of remission are recommended.

Adolescent↗
PubMed1991

A lighting evaluation of a facility for the elderly.

A residential facility for the aged was evaluated for their illumination needs. Only the shared facility and grounds immediately surrounding it were considered. The facility evaluated is one of the most modern and the lighting design is considered its best feature. The age of residents occupying the facility ranges from 60 to 85 years. The lighting evaluation included administering a lighting adequacy/inadequacy questionnaire and measurement of actual light levels in the various parts of the facility during the day and after dark hours. The results indicated that lighting in approximately half the areas surveyed was substandard. An attempt to develop recommendations for the lighting needs of the elderly was unsuccessful. It was concluded that realistic illumination level recommendations need to be developed for the elderly.

Aged↗
PubMed1990

Phenelzine and atenolol in social phobia.

Seventy-four patients meeting DSM-III criteria for social phobia completed 4 or more weeks of double-blind, randomized treatment with the monoamine oxidase inhibitor phenelzine, the cardioselective beta-adrenergic blocker atenolol, or placebo. Sixty-four percent of the patients on phenelzine demonstrated moderate or marked improvement, compared to 30 percent on atenolol and 23 percent on placebo. Phenelzine was significantly more effective than atenolol or placebo, whereas the efficacy of atenolol and placebo did not differ significantly. Patients were also prospectively divided into generalized and discrete subtypes of social phobia. Phenelzine appeared to be a particularly effective treatment for the generalized form of social phobia. Atenolol may be useful for discrete forms of social phobia such as performance anxiety.

Adolescent↗
PubMed1989

Reliability of anxiety assessment. I. Diagnostic agreement.

Test-retest reliability of lifetime anxiety disorder diagnoses was determined using the Schedule for Affective Disorders and Schizophrenia-Lifetime Anxiety version. The subjects were 104 patients at an anxiety research clinic. Reliability ranged from good to excellent (kappa = +.60 to +.90) for generalized anxiety, social phobic, panic, agoraphobic, and obsessive-compulsive disorders. Simple phobia showed poor agreement. Current episodes showed better agreement than past episodes, particularly for social phobia and obsessive-compulsive disorder. Major sources of disagreement (variance in subject report, rate error, criterion ambiguity) were reviewed for each diagnosis and implications for DSM-IV are proposed.

Adult↗
PubMed1988

An eight-year experience with a very-low-calorie formula diet for control of major obesity.

We have utilized a very-low-calorie formula diet (VLCD) along with multidisciplinary group counselling in an attempt to achieve and maintain major weight loss in 4026 morbidity obese patients. Using a 420-cal protein supplement (Optifast), men lost weight, at an average of 4.6 +/- 0.9 lb/week and women, 3.1 +/- 1.1 lb/week. Men remained on the VLCD an average of 13.2 weeks, resulting in a mean weight loss of 66.0 +/- 8.1 lb; women remained on the fast an average of 14.1 weeks, with an average loss of 47.3 +/- 4.2 lb. Outcome analysis revealed that 25 percent of patients were unable to adapt to this approach, dropping out within the first 3 weeks. Of the patients remaining in the program, 68 percent lost considerable weight, but did not reach their goal; of this group, recidivism was extremely high, with only 5-10 percent maintaining weight loss after 18 months. Thirty-two percent of the patients successfully attained goal weight; the holding rate of this group has been considerably greater, with 30 percent of women and 58 percent of men maintaining weight loss (within 10 lbs) for a minimum of 18 months. Complications of obesity i.e. hypertension, type II diabetes mellitus, and hyperlipidemias were remarkably improved after weight loss. Complications of the VLCD including cardiac abnormalities, were minimal. Our 8-year experience strongly suggests that the VLCD approach using high quality protein supplement and multi-disciplinary counselling provides a reasonable success rate for achieving and maintaining weight loss in the morbidity obese population.

Adult↗
PubMed1987

CO2 challenge of patients with panic disorder.

In an open trial, five of eight panic disorder patients and none of five control subjects panicked after inhalation of two breaths of 35% CO2 and 65% O2; none panicked after placebo. Using 35% CO2 to induce panic is safe, simple, and well tolerated and may provide a valuable laboratory model of panic.

Administration, Inhalation↗
PubMed1987

Hematopoetic precursors respond to a unique B lymphocyte-derived factor in vivo.

In this study we detected a factor that stimulates the proliferation of bone marrow-derived hematopoietic precursors in diffusion chambers implanted in mice. This factor, called diffusible colony-stimulating factor (D-CSF), was found in medium conditioned in the presence of spleen and peripheral blood cells from mice with B cell leukemia (BCL1). After the administration of D-CSF, the number of colonies formed in the plasma clot inside the chamber (CFU-DG) was increased, as were the number of hematopoietic precursors (CFU-MIX, CFU-S, CFU-C, and BFU-E) as judged by a subculture of diffusion chamber contents. Depletion of macrophages and T cells from the spleen cell suspension did not decrease the production of D-CSF, thereby indicating that it was derived from B cells. Neoplastic BCL1 cells appear to be the source because D-CSF could not be detected in medium conditioned with normal B cells. BCL1-conditioned medium (CM) did not enhance CFU-MIX, BFU-E, and CFU-C colony formation in vitro, which suggested that D-CSF is different from multi-CSF, EPA, or CSF. The addition of BCL1 CM to multi-CSF-, erythroid potentiating activity (EPA), and CSF (EL-4CM)-containing cultures had no effect on CFU-MIX, BFU-E, and CFU-C colony formation, thus indicating the absence of a synergistic or inhibitory activity. On the other hand, EL-4 CM, which stimulates CFU-MIX, BFU-E, and CFU-C in vitro, had no effect on CFU-DG in vivo. Biochemical characterization of BCL1 CM revealed that D-CSF is relatively heat stable and loses its bioactivity with protease treatments. It binds to lentil-lectin, according to gel-filtration chromatography has a relative molecular weight of approximately 43,000, and on reverse-phase high-performance liquid chromatography elutes with acetonitrile. These data also indicate that transformed B cells may serve as a source for hematopoietic regulators that act on hematopoietic precursors in vivo.

Adrenocorticotropic Hormone↗
PubMed1986

Research and application of current topics in sports nutrition.

The increased focus on fitness and subsequent research in the exercise field has expanded the role of nutrition as it relates to sports medicine. A literature review and application are presented for the anatomical, physiological, and biochemical mechanisms of caffeine in endurance events; iron status and physical performance; regulation of fluid and electrolyte balance during exercise; and stress fractures, calcium, and diet. The goal is to provide dietitians with information that is needed to formulate and rationalize recommendations regarding sports nutrition. An expanded role is offered to dietitians who wish to communicate sports medicine information to other health professionals and to consumers who engage in exercise. Nutrition and sports medicine information could benefit consumers and other health professionals in employee wellness programs in medical centers and organizations, fitness centers, sports medicine clinics, schools, and athletic teams.

Caffeine↗
PubMed1985

Platelet monoamine oxidase activity in patients with panic disorder.

Preliminary reports have indicated that platelet monoamine oxidase (MAO) activity is elevated in patients with anxiety disorder. We compared MAO activity in 20 drug-free patients with panic disorder with 20 age- and sex-matched normal controls. MAO activity in patients was significantly higher than in normals. MAO activity was not correlated with age or plasma catecholamine levels. The authors speculate about the possible significance of elevated MAO activity in patients with panic disorder.

Adult↗