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J Jacobson

Publications and source records attributed to J Jacobson.

At least 19 recordsLinked to original sources
PubMed2025

A genome-wide association study of methamphetamine use among people with HIV.

BACKGROUND: Amphetamine-like stimulants are the most used psychostimulants in the world; methamphetamine use is the most prevalent in people with HIV. Prolonged methamphetamine use can cause lasting damage to the heart, gut, and brain, as well as auditory hallucinations and paranoid thinking. However, relatively little is known about methamphetamine use and its genetic contributors. METHODS: Using genetic information from the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort, we conducted a multi-ancestry genome-wide association study (GWAS) of methamphetamine use among people with HIV (n&#x2009;=&#x2009;1,196 reported ever use, n&#x2009;=&#x2009;4,750 reported never use). RESULTS: No single nucleotide polymorphism was statistically associated with methamphetamine use at the genome-wide level (p&#x2009;<&#x2009;5 * 10-8) in our study. Further, we did not replicate previously suggested genetic variants from other studies (all p&#x2009;>&#x2009;0.05 in our analysis). DISCUSSION: Our study suggests that there is no single strong genetic contributor to lifetime use of methamphetamine in people with HIV enrolled in CNICS. Larger studies with more refined outcome assessment are warranted to further understand the contribution of genetics to methamphetamine use and use disorder. Investigation into social and environmental contributors to methamphetamine use are similarly necessary.

Humans↗
PubMed1992

Neuropsychological and neurological manifestations of HIV-1 dementia in drug users.

The cognitive and motor deficits associated with human immunodeficiency virus-1 (HIV-1) infection have been studied using neurological examination and neuropsychological tests. However, drug users with HIV-1 infection generally have been excluded from such studies. Forty-four well-characterized drug users stratified by Centers for Disease Control staging were administered a standardized neurological examination and a battery of neuropsychological tests under single-blind conditions designed to minimize the acute effects of psychoactive substances. The results of the blind neurological examination were consistent with the previously ascertained clinical staging of HIV-1 infection. The pattern of neuropsychological deficits across HIV-1 states was similar to those found in cohorts of homosexual men.

AIDS Dementia Complex↗
PubMed1992

Auditory event-related potentials in HIV-1 infection: a study in the drug-user risk group.

Features of event-related potentials (ERPs) may be sensitive and clinically useful markers of central nervous system infection by the human immunodeficiency virus (HIV-1); however, this application has not been studied in the risk group of intravenous drug users. Auditory ERPs generated by an "oddball" paradigm were analyzed for 39 male drug abusers as part of a multimodal assessment. Stage of HIV-1 infection was associated with prolongations of P1, N1, and P3 components of the ERP waveform. Only patients with full acquired immunodeficiency syndrome showed statistically significant increases in waveform prolongations. Specific neuropsychological deficits were not related to waveform latency prolongations.

AIDS Dementia Complex↗
PubMed1992

Cost-effectiveness of alternative methods for diabetic retinopathy screening.

OBJECTIVE: To assess from the perspectives of a government delivery system and patients, the cost-effectiveness of the 45-degrees retinal camera compared to the standard ophthalmologist's exam and an ophthalmic exam by a physician's assistant or nurse practitioner technician, for detecting nonproliferative and proliferative diabetic retinopathy. RESEARCH DESIGN AND METHODS: Comparison of 45-degrees fundus photographs with and without pharmacological pupil dilation taken by technicians and interpreted by experts, direct and indirect ophthalmoscopy by ophthalmologists, and direct ophthalmoscopy by technicians with seven-field stereoscopic fundus photography (reference standard). Costs were estimated from market prices and actual resource use. The study included 352 patients attending outpatient diabetes and general-medicine clinics at VA and DOD facilities. RESULTS: Medical system costs per true positive were: 45-degrees photos with dilation, $295; 45-degrees photos without dilation, $378; ophthalmologist, $390; and technician, $794. Patient costs per true positive were: 45-degrees photos with dilation, $139; 45-degrees photos without dilation, $171; ophthalmologist, $306; and technician, $1009. Cost-effectiveness is sensitive to program size due to high fixed cost of the camera methods but not to prevalence. Cost-effectiveness of the technician exam is strongly affected by its sensitivity. CONCLUSIONS: Primary-care screening with retinal photographs through pharmacologically dilated pupils for diabetic retinopathy is an appropriate and cost-effective alternative to screening by an ophthalmologist in this setting. Ophthalmologists are scarce, primary-care physicians are extremely busy, and large clinics allow fixed equipment costs to be spread across many patients.

Cost-Benefit Analysis↗
PubMed1992

Hip pain caused by buttock claudication. Relief of symptoms by transluminal angioplasty.

Two patients with severe hip pain proved to have buttock claudication resulting from isolated stenosis of the hypogastric artery. This diagnosis may be elusive if distal pulses are palpable, directing the clinician's suspicion away from vascular pathology. Diagnosis requires angiography. The patients were successfully treated by transluminal angioplasty. Angioplasty is the initial treatment of choice for these patients because the hypogastric artery is usually readily and safely accessible from either the femoral or axillary artery.

Aged↗
PubMed1991

Neurotologic disease in four patients with normal audiometric findings.

Clinical suspicion remains an underlying diagnostic clue in the evaluation of patients with unconfirmed acoustic neuromas. This is particularly true when initial otologic and audiologic evaluations are equivocal. This paper summarizes a series of four patients each who demonstrated normal audiometric (pure-tone and conventional speech audiometry) and/or ABR findings in the presence of surgically confirmed intracanalicular or cerebellopontine angle tumors. Three of the patients presented with evidence of "classical" acoustic tumors, whereas the fourth patient revealed a benign internal auditory canal capillary hemangioma. Audiologic evaluation, ABR measures, and MRI scanning demonstrate the relationships observed in each of the four patients. Diagnostic strategies illustrate the importance of cross-check principles (audiologic, electrophysiologic, and imaging techniques) in the diagnosis of posterior fossa tumors. The presence of normal pure-tone thresholds should not discourage the pursuit of additional diagnostic measures if clinical suspicion remains a factor in comprehensive patient management.

Adult↗
PubMed1990

The effects of tartar-control toothpaste on the oral soft tissues.

Ninety-two dental and dental hygiene students completed a double-blind, controlled clinical trial. The purpose of the trial was to evaluate the effects of toothpastes, in varying concentrations of flavor and tartar-control agents. Four formulations of toothpastes were assessed: (A) control-low flavor with no tartar control; (B) medium flavoring with medium tartar control; (C) high flavoring with medium tartar control; and (D) medium flavoring with no tartar control. Soft tissue reactions were assessed objectively and independently by three examiners. Subjective perceptions about each toothpaste were gathered by a structured, open-ended questionnaire. The "tartar control" toothpastes, B and C, resulted in statistically significant (p less than 0.005) higher rates of mucosal reactions (e.g., ulceration, sloughing, erythema, migratory glossitis) than the "non-tartar control" toothpastes A and D. When the oral mucosal reaction rates were adjusted for multiple clinical observations within each subject at the same point in time there was no statistically significant (p greater than 0.05) difference between male (0.25) and female (0.28) subjects. In this study population, the order of preference was observed as toothpaste A greater than D greater than B greater than C. The major reasons for disfavor were burning sensation in toothpastes C (2.4%) and B (4%).

Adult↗
PubMed1990

A database review in C-L psychiatry: characteristics of hospitalized suicide attempters.

A computerized database was used to study the characteristics of psychiatric consultations in patients admitted to nonpsychiatric services. The authors reviewed a consultation practice with suicide attempters over a four-year period and compared the patients with a patient sample matched for gender and age also seen by the service. For suicide attempters, the time elapsed between admission to the service and the consultation, as well as the lengths of stay, were significantly shorter. Suicide attempters were significantly more likely to have mood disorders and Axis II disorders. The authors review the role of consultation psychiatrists with these patients and suggest that a triage model fits the services provided and the needs of nonpsychiatric physicians.

Adult↗
PubMed1990

Is it possible to prevent bone loss in young women treated with luteinizing hormone-releasing hormone agonists?

Recent studies have shown that treatment with the LHRH agonist nafarelin gives symptomatic and objective relief to women with endometriosis. Such a treatment, however, results in increased bone turnover and loss of bone mass. In the present study 17 women with endometriosis were treated with 400 mg nafarelin combined with 1.2 mg norethisterone (NET) for 6 months, followed by 6 months with only 1.2 mg NET. The data were compared to data from a previously published study of 9 women treated for 6 months with 400 mg nafarelin alone, followed by 6 months without treatment. In the group treated with nafarelin plus NET the biochemical parameter of bone resorption (fasting urinary hydroxyproline) remained virtually unchanged, compared to a highly significant increase in the nafarelin-treated group. Estimates of bone formation (serum alkaline phosphatase and plasma bone Gla protein) increased in the nafarelin plus NET group, but to only a minor extent compared to those in the nafarelin group. In addition, bone mineral in the forearm, the spine, and the total skeleton remained virtually unchanged in the group treated with nafarelin plus NET, compared to the bone loss of 2-6%/6 months in the nafarelin group. We conclude that addition of NET to nafarelin treatment of endometriosis seems to have a bone-sparing effect.

Adult↗
PubMed1990

No abortion-inducing effect of the ulcer-healing dose of the synthetic prostaglandin E2 analogue enprostil in first trimester.

Milligram-range doses of E2 prostaglandins have long been used to induce labor or abortion in the second and third trimesters of pregnancy. Enprostil, a synthetic dehydroprostaglandin E2 structural analogue, is administered in microgram doses for the treatment of acute duodenal ulcer and acute gastric ulcer. This study examined the effect of the ulcer-healing dose and twice the ulcer-healing dose upon women in the first trimester of pregnancy. Two hundred and seven women who had requested legal abortion in the first trimester participated in two randomized, double-blind, placebo-controlled, parallel studies. They received two doses of enprostil 35 micrograms (the recommended dose for the treatment of duodenal and gastric ulcer) (n = 51), 70 micrograms (twice the recommended dose) (n = 53), or placebo (n = 103) 12 h apart. No drug-induced abortions occurred in any of the first-trimester pregnancies. Vaginal bleeding occurred in 4% of volunteers receiving the lower dose and 4% receiving the higher dose of enprostil. Vaginal bleeding occurred in up to 2% of volunteers on placebo. Although not recommended for pregnant women, if enprostil is given inadvertently to pregnant women with ulcers, it is unlikely to endanger the pregnancy during the first trimester.

Abortifacient Agents↗
PubMed1990

Congenital hearing loss in Jervell and Lange-Nielsen syndrome.

Jervell and Lange-Nielsen syndrome is an autosomal recessive hereditary condition that presents with cardiac abnormalities characterized by a prolonged Q-T electrocardiographic pattern and congenital severe-to-profound auditory deficits. This paper describes the auditory history of twin boys born out of consanguinity and diagnosed with this syndrome. Both infants were products of the neonatal intensive care unit (NICU) and failed initial ABR screening. Diagnostic evaluation demonstrated profound hearing loss and developmental delays for each infant. Because sudden death is a consequence, audiologists are advised to recognize signs and symptoms associated with this syndrome.

Child, Preschool↗
PubMed1990

Hearing loss in Stickler's syndrome: a family case study.

Stickler's syndrome is an autosomal dominant hereditary condition that presents with pathognomonic facial features, dysplasia, myopia and auditory deficits. This paper describes the auditory history of a family with Stickler's syndrome. Given the expressive variability, a complete audiologic and otologic evaluation is encouraged when Stickler's syndrome is suspected.

Abnormalities, Multiple↗
PubMed1990

Cardiopulmonary effects of butorphanol tartrate intravenously administered for placement of duodenal cannulae in isoflurane-anesthetized yearling steers.

Cardiopulmonary effects of IV administered butorphanol tartrate (BUT) were assessed in 7 yearling steers medicated with atropine and anesthetized with guaifenesin, thiamylal sodium, and isoflurane in O2 for surgical placement of duodenal cannulae. Heart rate, respiratory rate, arterial blood pressures, pHa, PaCO2, PaO2, arterial [HCO3-], esophageal temperature, and end-tidal isoflurane concentrations were measured before and after IV administration of BUT (10 mg). Mean respiratory rate increased significantly (P less than 0.05) only at 45 and 60 minutes after BUT administration. Mean respiratory rate was 26 +/- 6.3 breaths/min before BUT administration and 46 +/- 12.1 breaths/min 60 minutes after BUT administration. Arterial blood pressures were increased significantly (P less than 0.05) at all times, except 5 minutes after BUT administration. The mean value for mean arterial pressure was 76 +/- 9.6 mm of Hg before BUT injection and 117 +/- 12.6 mm of Hg 60 minutes after BUT injection. Mean values for pHa and arterial [HCO3-] were significantly (P less than 0.05) higher at 60 minutes after BUT administration (baseline, pH = 7.25 +/- 0.04 and [HCO3-] = 29.9 +/- 3.5 mEq/L; 60 minutes after BUT, pH = 7.28 +/- 0.03 and [HCO3-] = 33.0 +/- 1.8 mEq/L). Although some statistically significant changes were recorded, IV administration of BUT to these steers did not have a marked effect on the cardiopulmonary variables measured.

Anesthesia↗
PubMed1989

Cyclic Cushing's disease in association with a pituitary stone.

We have documented what we believe to be the first reported case of a pituitary stone in a patient with pituitary-dependent Cushing's disease. Pituitary stones have been reported exclusively in growth-hormone-producing or prolactin-producing pituitary adenomas. Our patient's ACTH and serum cortisol levels cycled for 15 months and then resolved spontaneously. A CT scan of the head showed calcification of pituitary tissue. Pituitary stones may occur in association with Cushing's disease. We hypothesize that the spontaneous resolution of the cyclic Cushing's disease was due to destruction and ultimate calcification of abnormal pituitary tissue.

Adenoma↗
PubMed1989

Results of surgical treatment for Menière's disease.

In 1985 the American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium established revised guidelines for reporting treatment results for Menière's disease. Since then little information regarding the newly adapted criteria and their effects on the evaluation process has appeared. Thus we compared the results of different surgical procedures for Menière's disease using both the 1985 and 1972 guidelines. One hundred nine surgical procedures from 1969 to 1985 were reviewed. Six different surgical procedures were evaluated: the Cody-Tack, cochleosacculotomy, endolymphatic mastoid shunt, endolymphatic subarachnoid shunt, translabyrinthine vestibular nerve section, and transcanal labyrinthectomy. Results show that 68% of patients who had a Cody-Tack procedure continued to have vertiginous episodes in the same frequency postoperatively. Hearing was worse in 17 of these 25 patients. Of the patients who had a cochleosacculotomy, most had significant control of their vertiginous symptoms, but 10 patients had greater than 10 dB hearing loss postoperatively. Patients who had an endolymphatic mastoid shunt performed had better results when the 1972 guidelines were applied. In this group, the 1985 guidelines indicate that only 35% of the patients had significant relief of their vertiginous symptoms and 47% had hearing loss greater than 10 dB postoperatively. Six of the seven patients who underwent an endolymphatic subarachnoid shunt obtained significant relief of their vertiginous episodes, but hearing loss was more than 10 dB in four patients. Those patients who had either a labyrinthectomy or a translabyrinthine vestibular nerve section had relief of their vertiginous episodes. We conclude that the new guidelines appear to be superior to the 1972 guidelines for reporting results for the treatment of Menière's disease.

Auditory Threshold↗