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Biomedical subjects

M Lally

Publications and source records attributed to M Lally.

15 recordsLinked to original sources
PubMed2001

HIV testing in the setting of inpatient acute substance abuse treatment.

We examined patients' attitudes toward HIV testing in the setting of acute substance abuse treatment and determined the prevalence of offering routine on-site testing for human immunodeficiency virus (HIV) in inpatient state-funded detoxification centers in New England. Voluntary questionnaires were administered to patients (N = 66 respondents) at the only two state-funded inpatient drug detoxification treatment centers in Rhode Island, and a telephone survey of all state-funded inpatient detoxification facilities across the New England area was conducted. In New England, 17/38 (44.7%) of all state-funded inpatient detoxification facilities didnot routinely offer on-site HIV testing to clients. Of participants, 97% responded positively to the question, "Do you think HIV testing should be available to patients in drug detoxification facilities such as this one?" There were 89% who reported that they would cope "about the same" or "better" with receiving a positive HIV test result while in detoxification treatment versus elsewhere. The greatest number of participants ranked the Orasure HIV test, an assay for HIV-1 transmucosal antibody, as the test they would most prefer while in drug treatment. However, 59% of patients responded that the type of test offered would not make a difference in whether they chose testing. Most patients indicated that they would want to see a physician within a few days of a positive diagnosis of HIV infection. Despite the controversy surrounding the provision of HIV testing to patients in inpatient acute substance abuse treatment, HIV testing is desired among these patients provided that HIV clinical care is readily available.

Acute Disease↗
PubMed2001

Risk factors for syphilis among incarcerated women in Rhode Island.

Syphilis remains a significant problem in the United States. The prison environment is an ideal location to identify and treat syphilis. We undertook this study to describe the correlates and risk factors for syphilis among incarcerated women in Rhode Island. The study design was a review of all cases of syphilis identified through routine screening in the state prison and a case control study. Between 1992 and 1998, among 6,249 incarcerated women, 86 were found to have syphilis; of these, 29 were primary and secondary cases representing 49% of infectious cases of syphilis in women in the state. The prison environment offers a unique opportunity for the diagnosis and treatment of syphilis.

Adult↗
PubMed2000

Laboratory testing for infection with the human immunodeficiency virus: established and novel approaches.

The enzyme-linked immunosorbent assay (ELISA) and the Western blot are the primary tests for the diagnosis and confirmation of human immunodeficiency virus (HIV) infection. The ELISA, an inexpensive screening test for antibodies to HIV-1, is both sensitive and specific. The HIV-1 Western blot is a reliable confirmatory test following a repeatedly reactive ELISA. False-positive HIV-1 results with this sequence of tests are extremely rare but can occur, and test results that are inconsistent with clinical or other laboratory information should be questioned, repeated, or supplemented. The US Food and Drug Administration has also approved rapid and more accessible testing methods. Oral mucosal transudate and urine testing are noninvasive testing methods; rapid and home sample collection kits offer easier access to testing.

Blotting, Western↗
PubMed1999

Hepatitis B and C in the context of HIV disease: implications for incarcerated populations.

HIV-infected inmates are often co-infected with hepatitis B and/or hepatitis C virus. To describe the burden of HIV in the incarcerated population today, one must consider the impact of co-infection. HIV may dramatically modify the course of viral hepatitis infection, especially chronic hepatitis C. The converse is uncertain: chronic hepatitis does not seem to accelerate HIV disease progression. In this article, we offer guidelines for selecting appropriate candidates for treatment among co-infected inmates.

Comorbidity↗
PubMed1998

Legionella bozemanii pneumonia in three patients with AIDS.

Legionella bozemanii is known to cause pneumonia often in immunocompromised hosts. To our knowledge, we describe the first three cases of L. bozemanii pneumonia in patients with AIDS. At the time of presentation, these patients had varied histories, physical findings, and radiological findings. All three patients had a uniformly excellent response to treatment despite receiving different antibiotic regimens. The cases illustrate the need for thorough diagnostic workups and prompt institution of antibiotic therapy when clinical suspicion for L. bozemanii infection is high.

AIDS-Related Opportunistic Infections↗
PubMed1997

Hypercalcemia in an AIDS patient treated with growth hormone.

METHOD: Recombinant human growth hormone (rhGH) is a newly approved treatment for weight loss and wasting in patients with AIDS. We report a male patient with advanced AIDS who developed hypercalcemia 2 weeks after institution of rhGH therapy. RESULTS: Parathyroid hormone, parathyroid hormone-related peptide and 1,25-dihydroxyvitamin D levels were suppressed, suggesting that hypercalcemia was mediated through alternative mechanisms. The hypercalcemia responded to discontinuation of rhGH and a single dose of intravenous pamidronate disodium and has not recurred in 8 months of follow-up. CONCLUSION: We believe this to be the first reported case of rhGH-induced hypercalcemia in an HIV-infected patient.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Abdominal aortic aneurysm resection in patients more than 80 years old.

Improvement in anesthetic and surgical techniques has prompted a more aggressive approach to repair of abdominal aortic aneurysms in patients more than 80 years old. In order to determine if surgical treatment is justified, all of the patients who were more than 80 years old admitted to the hospital during the ten year period from 1974 to 1983 with the diagnosis of abdominal aortic aneurysm were reviewed. A total of 90 patients were available for analysis. The mortality of the 18 patients treated conservatively for ruptured aortic aneurysms was 100 per cent. Ten of the 27 patients operated upon for a ruptured aneurysm died yielding a mortality of 37 per cent. Eleven patients with symptomatic aneurysms had urgent repair with a mortality of 27 per cent. Only one of the 34 patients undergoing elective aneurysm repair died. There was no difference in the size of aneurysms among the groups. Although the ruptured aneurysms required more blood (10.2 +/- 3.7 units), there was no difference between the other two groups (symptomatic 4.5 +/- 3.1 units, elective 4.6 +/- 2.8 units). There was significantly fewer myocardial and renal complications in the elective group, although the sole death in this group was from myocardial infarction. Based upon these observations, we recommend aggressive elective therapy for selected patients who are more than 80 years of age with asymptomatic abdominal aortic aneurysms. Although the mortality is higher in those patients with symptomatic or ruptured aneurysms, it is not formidable, and therefore, repair should not be ruled out on the basis of age alone.

Aged↗
PubMed1984

Limitations in the accuracy of peak frequency measurements in the diagnosis of carotid disease.

Peak Doppler frequency is an index of the severity of carotid stenosis. Variability in this measurement is examined through in vitro and clinical studies. In vitro studies, using a carotid flow model, show that observers locate a stenosis and interpret the peak frequency differently, and each observer uses a different probe-vessel angle. Clinical studies support these findings. Comparison of 304 carotid Doppler studies with arteriograms demonstrates 90% overall clinical accuracy. Each observer has a consistent range of peak frequency measurements, yet the description of a discrete percent stenosis is limited by observer variability.

Blood Flow Velocity↗
PubMed1982

Computer-assisted handwriting instruction and visual/kinaesthetic feedback processes.

An evaluation of computer-assisted handwriting exercises which offer significant advantages over more conventional teaching techniques is described. Handwriting is considered as a skill that must be regulated by processes which at first are externally controlled but which become internalized as the learner becomes more proficient at the skill. Handwriting samples of lower-case alphanumeric characters were obtained from nine mentally retarded school children. After a training program spread over a period of four weeks (approximately 5 hours in total), the greatest improvement in handwriting ability occurred where the constraints of the computer-assisted handwriting exercises encouraged students to gradually transfer control of letter formation from computer-mediated cues to more internal ones. These results are discussed in terms of control functions and the acquisition of skilled behavior.

Adolescent↗
PubMed1981

Computer-assisted teaching of sight-word recognition for mentally retarded school children.

A computer-assisted training program used to teach a sight vocabulary to mildly mentally retarded school children was described and evaluated. The training program was designed to supplement conventional methods of teaching by using aspects of computer technology to implement various learning principles that would otherwise be difficult to employ. Eight children were taught associations between the written and spoken versions of words by a "talking" computer. These children increased their sight vocabularies by an average of 128 percent; a comparison group had a 34 percent increase. Furthermore, this increase remained constant for over 23 weeks following the completion of the nonintensive 4-week training program.

Adolescent↗
PubMed1979

Age, intelligence, and inspection time.

Ten young males whose IQ scores ranged from 51 to 71 were compared on a simple discrimination task with 10 male university students of the same CA and 28 nonrelated male children. Estimates of inspection time (lambda) were obtained from the pattern of errors made by each subject; lambda is assumed to reflect the rate at which sensory input is accumulated and processed. Average estimates of lambda from four groups of children (7, 8, 9, and 10 years) were 147, 142, 137, and 139 msec, respectively. The mean for university students was 130 msec, whereas that for retarded adults was 256 msec. Mean reaction time (RT) of all nonretarded groups increased as stimulus-exposure duration decreased, children being slower than adults. Retarded subjects' RT was less influenced by stimulus-exposure duration and was faster than that of nonretarded groups at the shortest exposure. These results suggest that slower perceptual speed among retarded persons is a consequence of a permanent deficiency; differences in response strategy may explain the differences in RT.

Adolescent↗
PubMed1977

Intelligence, reaction time, and inspection time.

Forty-eight subjects with IQ scores ranging from 57 to 138 discriminated between two lines of markedly different length, exposed for varying periods of time. Estimates of inspection time, lambda, a measure assumed to reflect the rate at which sensory input is processed, were obtained from the pattern of errors made by each subject and, therefore, independently from the reaction time (RT) required to respond. lambda correlated negatively with IQ scores. RTs of nonretarded subjects increased as stimulus-exposure duration decreased, whereas for retarded subjects RTs remained constant. This is interpreted as indicating differences between the groups in response strategy under conditions of difficult discrimination. The rate of information processing was also estimated in a different choice RT situation, using as an index the reciprocal of the slope of the function relating RT to degree of stimulus choice. Retarded subjects had slower rates and longer RTs than nonretarded subjects. A second experiment controlling for response-selection factors confirmed that this slowness could not be attributed to gross-movement difficulties and that a slower rate of information transmission seemed to be involved.

Adolescent↗
PubMed1976

Inspection time and measured intelligence.

Ten subjects with WAIS Full Scale IQ scores ranging from 119 to 47 were required to discriminate between two lines of markedly different length, exposed in random order for ten different durations, by pressing one of two keys. Estimates of inspection time gamma, the rate at which sensory input is accumulated and passed to subsequent decision processes, were calculated directly from the psychometric functions obtained gamma was found to correlate negatively with subtests contributing to Performance IQ. There was a substantial degree of consistency between estimates of gamma on two different occasions and training did not appear to affect the index, although differences between the two estimates increased as the value of the first estimate increased. Mean overall response latency did not correlate significantly with intelligence and measures obtained from retarded subjects were very like those reported in similar experimental situations utilizing normal subjects. This unexpected finding is interpreted as suggesting that, in this situation, retarded subjects have been prepared to respond on the basis of less evidence than is usually required by intellectually normal subjects.

Adolescent↗