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Biomedical subjects

S M Berman

Publications and source records attributed to S M Berman.

At least 37 records · Page 2Linked to original sources
PubMed1994

The development of cytomegalovirus encephalitis in AIDS patients receiving ganciclovir.

PURPOSE: Cytomegalovirus (CMV) retinitis in patients with the acquired immunodeficiency syndrome (AIDS) requires lifelong therapy with either intravenous ganciclovir sodium or foscarnet sodium. From June 1989 through February 1992, seven patients with AIDS were diagnosed to have CMV retinitis, and all were treated with ganciclovir. Five of the seven developed abrupt preterminal mental status changes. All five with mental status changes received anti-CMV therapy until the time of death. Autopsies were performed in all cases to determine the cause of mental status changes. PATIENTS AND METHODS: Five patients with AIDS and newly diagnosed CMV retinitis. Retrospective case analyses with autopsies. All five patients were treated with gangciclovir immediately upon the diagnosis of CMV retinitis and received ganciclovir at standard dosages until death. RESULTS: Four patients had clinically stable retinitis throughout the entire course of ganciclovir therapy. In the fifth patient, because of fundoscopic deterioration, foscarnet therapy was initiated 1 month prior to death. Cerebrospinal fluid analysis and magnetic resonance imaging, although abnormal, were not diagnostically specific. Neuropathologic examination revealed fulminant diffuse CMV encephalitis in all patients, with prominent ependymal and periventricular necrosis. CONCLUSIONS: These results suggest that while ganciclovir therapy may clinically stabilize CMV retinitis in patients with AIDS, it does not appear to prevent the development of, or be effective in the treatment of, CMV encephalitis. Thus, clinicians should consider the diagnosis of CMV encephalitis in patients receiving ganciclovir who develop mental status changes and, if possible, alter therapy accordingly.

AIDS-Related Opportunistic Infections↗
PubMed1994

Concentrations of procaine and aqueous penicillin in the cerebrospinal fluid of infants treated for congenital syphilis.

Penicillin concentrations in cerebrospinal fluid (CSF) were measured at various hours and days of treatment in 163 infants undergoing therapy for congenital syphilis. The CSF levels were compared for three treatment regimens. Aqueous penicillin G (A-PEN), 100,000 U/kg per day, was used in 23 infant, and a dosage of 200,000 U/kg per day was used in 40 patients; procaine penicillin G (P-PEN), 50,000 U/kg per day, was used in 100 children. Mean CSF penicillin levels were 0.416, 0.493, and 0.077 microgram/ml, respectively, in the three treatment groups. The mean CSF penicillin concentration among the 63 infants treated with either of the A-PEN regimens (0.465 microgram/ml) was significantly greater than the mean concentration (0.077 microgram/ml) among those treated with P-PEN (p < 0.001). Among those who received A-PEN, the difference in dosage was not associated with a significant difference in mean CSF penicillin concentration (p = 0.68). All the specimens obtained from patients who received A-PEN, but only 82% of those from patients who received P-PEN, had treponemicidal concentrations (> or = 0.018 microgram/ml). However, 33.3% (9/27) of specimens from infants who received P-PEN, tested between 18 and 24 hours after a dose, had CSF penicillin concentrations < 0.018 microgram/ml. These data suggest that administration of A-PEN may be the preferred therapy if CSF levels > 0.018 microgram/ml are desired, especially for infants with severe disease or congenital neurosyphilis.

Humans↗
PubMed1994

Mycobacterium genavense infection presenting as a solitary brain mass in a patient with AIDS: case report and review.

Patients with AIDS are prone to developing infections with opportunistic pathogens. Recently, a new mycobacterium, Mycobacterium genavense, has been found to cause infection in patients with AIDS. Previously published reports indicate that patients who are infected with this organism present with the same clinical features as do patients with disseminated infection due to organisms of the Mycobacterium avium complex. We describe an unusual case of a patient with AIDS who presented with grand mal seizures and a mass lesion in his brain, which was found to be caused by infection with M. genavense. No evidence of disseminated infection could be found in this patient. We discuss the microbiology of this organism and review the literature on M. genavense infections. Clinicians should be aware of this organism so that efforts at culture and identification will be made.

AIDS-Related Opportunistic Infections↗
PubMed1994

Pulmonary function test outcomes in healthy Navajo Native American adolescents.

Prediction equations for estimating lung volumes have been determined for Caucasians, African-Americans, and Mexican-Americans. These separate equations were determined because of differences in thoracic morphology between people of various racial groups, making it impossible to use one prediction formula to accurately estimate lung volumes for all individuals. One hundred ninety-one adolescent Navajo children (males, n = 110; females, n = 81) between 11 and 18 yr of age volunteered for the study and underwent a series of pulmonary function tests (PFT). New pulmonary function prediction equations for Navajo youth were generated for estimating pulmonary volumes and capacities that more accurately predict expected PFT outcomes than formulas in common use for Caucasian, Mexican-American, or African-American youth.

Adolescent↗
PubMed1994

Prolonged P300 latency in children with the D2 dopamine receptor A1 allele.

Previous studies have indicated the presence of a hereditary component in the generation of the P300, or P3, a late positive component of the event-related potential. Moreover, the dopaminergic system has been implicated in the P3. In the present study, 98 healthy Caucasian boys, mean age of 12.5 years and of above-average intelligence, were studied. The sample was composed of 32 sons of active alcoholic (SAA) fathers, 36 sons of recovering alcoholic (SRA) fathers, and 30 sons of social drinker (SSD) fathers, with none of them having yet begun to consume alcohol or other drugs. TaqI A D2 dopamine receptor alleles (A1 and A2) were determined. A significant difference in the frequency of the A1 allele was found among these three groups of boys, with the SAA group having the highest A1 allele frequency (.313), followed by the SRA (.139) and the SSD (.133) groups. The relationship of the A1 and A2 alleles to P3 amplitude and latency was also determined. The results showed no significant difference in P3 amplitude between boys with the A1 and A2 allele. However, P3 latency was significantly longer in the total sample of boys with the A1 allele compared with those carrying the A2 allele. These findings suggest that polymorphism of the D2 dopamine receptor gene is an important determinant of P3 latency.

Adolescent↗
PubMed1993

Surveillance for gonorrhea and primary and secondary syphilis among adolescents, United States--1981-1991.

PROBLEM/CONDITION: During the 1980s, an increasing proportion of adolescent women reported having had premarital sexual intercourse, thus potentially placing an increasing number of young persons at higher risk of acquiring a sexually transmitted infection. REPORTING PERIOD COVERED: To determine rates and examine trends of sexually transmitted infections among adolescents, we analyzed data for reported cases of gonorrhea and primary and secondary syphilis among 10- to 19-year-olds for 1981 through 1991. DESCRIPTION OF SYSTEM: Summary data for cases of gonorrhea and primary and secondary syphilis that were identified and reported to state health departments were sent annually to CDC. These data included total number of cases by disease (gonorrhea, primary and secondary syphilis), sex, racial/ethnic group (white, not of Hispanic origin; black, not of Hispanic origin; Hispanic; Asian/Pacific Islander; or American Indian/Alaskan Native), 5-year age group, and source of report (public, private). RESULTS: From 1981 through 1991, 24%-30% of the reported morbidity from gonorrhea and 10%-12% of the reported morbidity from primary and secondary syphilis in the United States affected the adolescent age groups. Some of the highest rates of gonorrhea during that time period were among 15- to 19-year-olds. Gonorrhea rates among adolescents increased or remained unchanged from 1981 through 1991, while the rates among older age groups decreased. Although primary and secondary syphilis rates were lower among adolescents than older age groups, adolescents contributed to the epidemic of syphilis that occurred from 1987 through 1990. Differences in reported rates of both syphilis and gonorrhea among white, black, and Hispanic adolescents increased during the latter half of the 1980s. INTERPRETATION: Reporting biases could account for some the differences among rates for white, black, and Hispanic adolescents. However, if gonorrhea has been underreported for any racial group, the high rates of gonorrhea among 15- to 19-year-olds represented an underestimate of the true infection rate. Increases in sexual activity among adolescents and a lack of clinical services in settings convenient to adolescents could have contributed to the increasing rates of gonorrhea and syphilis among these young persons during this time period. ACTIONS TAKEN: If gonorrhea and other sexually transmitted infections are cofactors for facilitating the transmission of human immunodeficiency virus (HIV), the high incidence of gonorrhea in some locales among some populations of adolescents could result in dramatic increases in HIV acquisition, a situation that demands attention from public health organizations.

Adolescent↗
PubMed1993

Conditioning a diffusion at first-passage and last-exit times, and a mirage arising in drug therapy for HIV.

Let X(t), t > or = 0, be a real-valued diffusion process, not necessarily time-homogeneous. For a fixed z, let Tz be the first-passage time to z; and, under the assumption that z is a transient state, let Vz be the last-exit time from z. The main results of this work are a description of the structure of X(t), t > or = 0, upon conditioning by the values of Tz and Vz, and some of the characteristics of the conditioned process. The results are illustrated by application to Brownian motion with constant drift and also to the Ornstein-Uhlenbeck process augmented by a linear term representing a constant drift (a nonhomogeneous diffusion). The problem was motivated by the need to explain a possible mathematical mirage in the testing of antiviral drugs for HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Familial alcoholism and ERPs: differences in probability sensitivity?

Event-related potentials (ERPs) were recorded from sons (age 11-14) of families that were positive (FH+) and negative (FH-) for alcoholism in response to circles, triangles and squares presented in four colors with a single central digit. A button was pressed for successive presentations of identical stimuli (target probability = 0.2). Reduced late positivity in FH+ boys has been previously reported. This positivity was shown to increase with the number of features that match target requirements. FH- boys responded more quickly, but no less accurately, than FH- boys, and were characterized by reduced ERP stimulus selectivity. That is, FH+ boys not only produced less P3 than FH- boys in response to targets, but generally produced more late positivity than FH- boys in response to nontargets. The pattern of group differences was most consistent with FH+ boys exhibiting both reduced ERP effects of target features in general, and a specific insensitivity to matching digits. It is hypothesized that these effects result from reduced sensitivity to information about the frequency with which categories of events occur, and that this may be characteristic of those at high risk for alcoholism.

Adolescent↗
PubMed1992

Spatial adaptation to text on a video display terminal.

We employed vertical sinusoidal test gratings to search for spatial adaptation to lower-case text presented on a standard video display terminal. The parameters of the contrast sensitivity test were selected on the basis of waveform analysis of horizontal spatial luminance profiles of the text. We found that subjects exhibited a small (4-5 dB), but significant, frequency-specific spatial adaptation consistent with the frequency spectrum of the stimulus. The theoretical and practical significance of this finding is discussed.

Adaptation, Ocular↗
PubMed1991

Human electroretinogram responses to video displays, fluorescent lighting, and other high frequency sources.

Time-averaged human electroretinogram (ERG) responses were determined for several workplace visual stimuli which are temporally modulated at rates exceeding the perceptual critical fusion frequency (CFF). A clearly identifiable synchronous response was in evidence for a video display terminal (VDT) stimulus operating with a refresh rate as high as 76 Hz. A directly viewed fluorescent luminaire with controllable driving frequency elicited a synchronous response at rates as high as 145 Hz. In addition, an intense stimulus created by modulating the light from a slide projector produced responses at least as high as 162 Hz. The implications of these high-frequency responses are representing a potential basis for visual symptoms are discussed.

Adult↗
PubMed1989

Channel probability and Nd: an event-related potential sign of attention strategies.

Event-related potentials were recorded in a two-channel selective attention paradigm designed to assess the effects of channel probability on processing negativity. For channel probabilities of 70% or greater, the subtraction Nd for standard tones was greatly reduced or absent. This change was due to apparent processing negativity in the waveform of the irrelevant standards at high channel probabilities. Deviant long tones showed similar early Nds to standard tones, and also developed late attention-related negativity commencing at about 500 ms from stimulus onset. It was concluded that there was no evidence that processing negativity to the relevant tones, defined as a negative component associated with selective attention, is affected by channel probability. Changes in Nd amplitude as the channel probabilities became more unequal were attributed to changes in strategies used by subjects, which primarily altered ERPs associated with the irrelevant tones.

Adult↗
PubMed1988

Urachal remnants in adults.

Urachal disorders are uncommon and present with varied appearances. Three cases of urachal disease, one congenital and two acquired, are reported. Each case is representative of the symptoms and findings of its respective category. A review of the literature is presented. A basic understanding of urachal development is necessary to suspect a diagnosis of urachal disease.

Adult↗