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Biomedical subjects

S Perry

Publications and source records attributed to S Perry.

At least 73 records · Page 4Linked to original sources
PubMed1995

Axis II diagnoses among volunteers for HIV testing and counseling.

OBJECTIVE: The authors' goal was to investigate the rate of personality disorders (axis II diagnoses in DSM-III-R) among adults at risk for AIDS. METHOD: The Personality Disorder Examination was administered to 260 volunteers for HIV testing and counseling. RESULTS: Thirty-seven percent of the subjects who subsequently tested seropositive for HIV and 20% of those who tested seronegative were given DSM-III-R axis II diagnoses on the Personality Disorder Examination. Thirty percent of the HIV-positive subjects who knew their serostatus before they were tested were given DSM-III-R axis II diagnoses. CONCLUSIONS: The meaningful rates of axis II diagnoses that preexisted determination of HIV status and the relation of these diagnoses to subsequently determined serostatus underscore the importance of adequately assessing the occurrence of personality disorder in individuals at risk for HIV infection.

AIDS Serodiagnosis↗
PubMed1995

HIV-related cases among 2,094 admissions to a psychiatric hospital.

OBJECTIVE: Admissions to an acute care psychiatric hospital were studied to determine what proportion of admissions were for HIV-related psychiatric disturbances, what evidence exists that the HIV-related admissions constitute a new population of psychiatric inpatients, and whether any psychiatric variables distinguish patients with HIV-related disorders from patients without such disorders. METHODS: Charts for 2,094 consecutive admissions to the hospital in a three-year period were reviewed. Chi square analyses and t tests were used to compare various groups of HIV-related admissions and non-HIV-related admissions on sociodemographic characteristics, length of stay, history of psychiatric hospitalization, and other clinical measures. RESULTS: One-hundred and sixty-three admissions (7.8 percent of the total admissions) were judged to be HIV related. The largest category of HIV-related admissions, nearly half, were patients experiencing functional or psychological complications of HIV infection or risk. AIDS-phobic patients, who expressed irrational concerns about infection, accounted for 20.2 percent, and patients with organic manifestations for 18.4 percent. If the AIDS-phobic, HIV-bereaved, and factitious HIV-positive admissions were excluded, the rate of HIV-related admissions was 5.2 percent. CONCLUSIONS: Psychiatric hospitals can expect a significant but not overwhelming number of HIV-related admissions.

Adolescent↗
PubMed1995

Diagnostic agreement between the SCID-II screening questionnaire and the Personality Disorder Examination.

Instruments to assess personality disorders offer reliability, but at the cost of large amounts of a skilled clinician's time to make assessments. The Structured Clinical Interview for DSM-III Axis II (SCID-II; Spitzer, Williams, Gibbon, & First, 1990), incorporates a self-report screening questionnaire, reducing the number of items needing evaluation by the interviewer. However, false negative responses may cause clinically important areas to be overlooked. To establish the rate of false negative responses, we compared participant self-report on the SCID-II with Axis II diagnostic assessment done by clinicians using the Personality Disorder Examination (Loranger, Susman, Oldham, & Russakoff, 1987). The false negative rate was low for every diagnosis, supporting validity of following up with clinician questioning only those diagnostic elements endorsed in the self-report. Avoidant and dependent personality disorders were accurately self-reported. This, an efficient assessment instrument for personality disorders might combine self-report of those disorders where self-report is reliable, with clinician assessment where needed.

Adult↗
PubMed1995

The effects of softwater acclimation on respiratory gas transfer in the rainbow trout Oncorhynchus mykiss

Gill O2 uptake, CO2 excretion, ventilation and blood respiratory/acid&shy;base variables were evaluated in control and softwater-acclimated trout (Oncorhynchus mykiss) to test the hypothesis that gill chloride cell (CC) proliferation, elicited by 2 weeks of softwater exposure, impairs the diffusion of respiratory gases across the gill. The proliferation of CCs in softwater fish was verified using light microscopy, and its impact on respiratory gas transfer was assessed in vivo by continuous monitoring of arterial blood PO2 (PaO2), PCO2 (PaCO2) and pH (pHa) using an extracorporeal blood circulation under conditions of normoxia and graded hypoxia [water PO2 (PwO2) was lowered from 20.0 kPa to 5.3 kPa within 20 min]. During normoxia, ventilation frequency was significantly higher in the softwater trout (78&plusmn;4 versus 57&plusmn;4 breaths min-1; mean &plusmn; s.e.m.), while ventilation amplitude was similar in both groups (1.0&shy;1.1 cm opercular displacement). PaCO2 and plasma HCO3- concentration were significantly lower in the softwater fish and the blood acid&shy;base status was characterized by a mixed respiratory alkalosis and metabolic acidosis such that blood pH was not statistically different between the two groups. CO2 excretion (2.5&shy;2.8 mmol kg-1 h-1) and O2 uptake rates (2.3&shy;5.1 mmol kg-1 h-1), as measured during normoxia, were unaffected by acclimation to soft water. During hypoxia, ventilation frequency and amplitude increased in the control trout, whereas only ventilation amplitude increased in the softwater-acclimated fish. The rate of PaO2 reduction during hypoxia was significantly greater in the softwater fish (0.84&plusmn;0.06 versus 0.65&plusmn;0.06 kPa PaO2 kPa-1 PwO2) and, at the most severe level of hypoxia (PwO2=5.3 kPa), PaO2 was significantly lower in the softwater fish. The rate of PaCO2 reduction (caused by hyperventilation) was significantly lower in the softwater-acclimated fish (0.002&plusmn;0.001 versus 0.005&plusmn;0.001 kPa PaCO2 kPa-1 PwO2; mean &plusmn; s.e.m.; P<0.06) and, indeed, was not statistically different from zero. Blood pH did not change significantly during hypoxia in either group but, through much of the hypoxic period (7&shy;15 kPa PwO2), pHa was statistically lower in the softwater-acclimated fish. These results demonstrate that exposure of trout to soft water for 2 weeks is associated with proliferation of lamellar CCs and impaired branchial gas transfer. Hyperventilation was identified as a compensatory physiological adjustment.

Journal Article↗
PubMed1995

Immunolocalization of proton pumps (H+-ATPase) in pavement cells of rainbow trout gill

The expression of the V-type proton ATPase (H+-ATPase) was examined in the gill of the freshwater rainbow trout (Oncorhynchus mykiss) using immunocytochemistry in concert with laser scanning confocal or electron microscopy. A synthetic peptide consisting of the carboxy-terminal region of the 31 kDa subunit of the bovine renal H+-ATPase was used to generate an antiserum in rabbits, and its suitability for use in trout gill was confirmed by western blotting. Gill epithelial cells demonstrated specific immunoreactivity, the intensity of which was increased markedly after 18 h of exposure to hypercapnia (1 % CO2 in air). The increased intensity of H+-ATPase immunoreactivity was associated with elevated branchial net acid excretion. In the hypercapnic fish, the specific immunoreactivity was associated with both the apical membrane and cytoplasm. Electron microscopy revealed that specific immunoreactivity was localized to the pavement cells and was particularly associated with the apical membrane and subapical cytoplasmic vesicles. The increased H+-ATPase immunoreactivity in the epithelial cells of hypercapnic fish and the increased intensity of the immunoreactive bands in western blots from hypercapnic fish demonstrate an 'up-regulation' of this protein in response to respiratory acidosis. The results are discussed with reference to current models of acid&shy;base and ion regulation in the gill of freshwater fish.

Journal Article↗
PubMed1994

Estrogen mediates the pregnancy-enhanced cardiotoxicity of cocaine in the isolated perfused rat heart.

OBJECTIVE: To determine whether pregnancy enhances cocaine toxicity in the isolated perfused whole rat heart model and whether this enhanced toxicity can be simulated by pre-treatment with either estrogen or progesterone. METHODS: Hearts excised from 65 female Sprague-Dawley rats were attached to a Langendorff apparatus for measurement of left ventricular systolic pressure, heart rate, and contractility. Before excision, the animals were assigned to one of five groups: 1) nonpregnant, 2) pregnant, 3) nonpregnant pretreated with progesterone, 4) nonpregnant pretreated with estrogen, and 5) nonpregnant pretreated with estrogen and progesterone. Each group was exposed serially to the following cocaine concentrations: 5 x 10(-6), 1 x 10(-5), and 6 x 10(-5) mol/L. RESULTS: Heart rate declined at all doses of cocaine (9.2, 6.9, and 31.0%, respectively). The lowest dose of cocaine had positive inotropic effects, with a 23.2% increase in left ventricular pressure and a 15.3% increase in contractility. Exposure to the two higher doses resulted in negative inotropic effects (a 24.8% decrease in left ventricular pressure and a 39.7% decrease in contractility for the highest dose). Although pre-treatment with estrogen, alone or with progesterone, resulted in responses similar to those seen in pregnant animals, progesterone pre-treatment alone failed to do so. CONCLUSIONS: Cocaine displayed cardiotoxicity in isolated rat hearts similar to that in other animal models. This toxicity was enhanced by pregnancy. We were able to simulate changes by pretreating the animals with estrogen. Perhaps the enhanced cardiotoxicity of cocaine in pregnancy is partially mediated by estrogen.

Animals↗
PubMed1994

Characterization of infectious molecular clones of equine infectious anaemia virus.

We have recovered five infectious molecular clones of the lentivirus equine infectious anaemia virus (EIAV). The clones were recovered from fetal equine kidney (FEK) cells infected with a virulent, cell culture-adapted virus stock (designated PV) and have been characterized at a molecular level. Each clone has unique envelope and long terminal repeat (LTR) sequences. We further investigated LTR sequence variation in the PV stock using PCR amplification to obtain additional LTR clones from infected FEK cells and from peripheral blood mononuclear cells (PBMCs) from animals experimentally infected with PV. Sequence analysis of resulting clones indicates a selection for different LTR populations in pony PBMCs compared to FEK cells. Finally, we observed that the cloned EIAV proviruses did not remain infectious when maintained in a derivative of pBR322. However, two proviruses have been stably maintained in a low copy number vector (pLG338-SPORT).

Amino Acid Sequence↗
PubMed1994

Undetected HIV infection among patients admitted to an alcohol rehabilitation unit.

Of 300 patients admitted to an alcohol rehabilitation unit, serological testing of discarded admission blood samples revealed that 31 (10.3%) had HIV infection. Chart records indicated that four patients were known to be HIV infected on admission, and HIV infection was detected in another three patients during hospitalization; however, 24 (77.4%) of the HIV-positive patients were discharged with their HIV infection still undetected.

Adult↗
PubMed1994

THE EFFECTS OF ACCLIMATION TEMPERATURE ON THE DYNAMICS OF CATECHOLAMINE RELEASE DURING ACUTE HYPOXIA IN THE RAINBOW TROUT ONCORHYNCHUS MYKISS

The response of cannulated rainbow trout (Oncorhynchus mykiss) to acute hypoxia was studied in fish acclimated to two temperatures (5 and 15 &deg;C). Blood/water respiratory variables and plasma catecholamine levels were measured before and 15 min after exposure to hypoxic water varying between 4.0 and 10.7 kPa (30&shy;80 mmHg) oxygen partial pressure (PwO2). Arterial blood PO2 (PaO2) and oxygen content (CaO2) fell during hypoxia in a similar manner at both temperatures, although the changes in CaO2 were often more pronounced in the fish acclimated to 15 &deg;C. Regardless of acclimation temperature, plasma catecholamine levels were consistently elevated at PwO2 values below 8.0 kPa (60 mmHg); the largest increases in plasma catecholamine levels occurred below PwO2=5.3 kPa (40 mmHg). Adrenaline was the predominant catecholamine released into the circulation. Adrenaline was released at PwO2 values of 8.0 kPa or below, whereas noradrenaline was released at PwO2 values of 6.7 kPa or below. The construction of in vivo oxygen dissociation curves demonstrated an obvious effect of acclimation temperature on haemoglobin (Hb) oxygen-affinity; the P50 values at 15 &deg;C and 5 &deg;C were 3.6 kPa (26.7 mmHg) and 1.9 kPa (14.0 mmHg), respectively. At 15 &deg;C, catecholamines were released into the circulation abruptly at a PaO2 threshold of 4.6 kPa (34.5 mmHg) while at 5 &deg;C the catecholamine release threshold was lowered to 3.3 kPa (24.5 mmHg). The difference in the PaO2 catecholamine release thresholds was roughly equivalent to the difference in the P50 values at the two distinct temperatures. Catecholamine release thresholds, calculated on the basis of arterial blood oxygen-saturation (expressed as CaO2/[Hb]), were similar at both temperatures and were approximately equal to 53&shy;55 % Hb O2-saturation. The results support the contention that the lowering of blood oxygen content/saturation rather than PO2 per se is the proximate stimulus/signal causing catecholamine release in rainbow trout during acute hypoxia.

Journal Article↗
PubMed1994

THE EFFECTS OF HYPOXIA, HYPEROXIA OR HYPERCAPNIA ON THE ACID-BASE DISEQUILIBRIUM IN THE ARTERIAL BLOOD OF RAINBOW TROUT

An extracorporeal circulation in combination with a stop&shy;flow technique was used to characterize the acid&shy;base disequilibrium in the arterial blood of rainbow trout Oncorhynchus mykiss during environmental hypoxia, hyperoxia or hypercapnia. Arterial blood was routed from the coeliac artery through an external circuit in which pH (pHa), partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were monitored continuously. The stop&shy;flow condition was imposed by turning off the pump which drove the external loop. Water PO2 or PCO2 was adjusted to give the experimental conditions by bubbling N2, O2 or CO2 through a water equilibration column supplying the fish. During normoxia, the arterial blood exhibited a positive acid&shy;base disequilibrium of approximately 0.04 pH units; that is, pH increased over the stop&shy;flow period by 0.04 units. The extent of the imbalance was increased significantly by hypoxia (final PaO2=2.7&shy;3.7 kPa; deltapH=0.05 units). In fish exposed to hyperoxia (final PaO2=47&shy;67 kPa), the direction of the disequilibrium was reversed; pHa declined by 0.03 units. During hyperoxia, CO2 excretion was impaired by 63 % and the PCO2 of postbranchial blood was higher than that of prebranchial blood. It is therefore conceivable that a reversal of the normal, outwardly directed, diffusion gradient for CO2 accounted for the negative disequilibrium; CO2 uptake at the gills would drive plasma CO2/HCO3-/H+ reactions towards CO2 hydration and H+ formation. During hypercapnia, fish exhibited a twofold increase in the positive pH disequilibrium (deltapH=0.06 units). The results of this study confirmed the existence of an acid&shy;base disequilibrium in the arterial blood of rainbow trout and clearly demonstrated that the extent and/or direction of the disequilibrium are influenced by the respiratory status of the fish.

Journal Article↗
PubMed1994

UREA TRANSPORT BY HEPATOCYTES AND RED BLOOD CELLS OF SELECTED ELASMOBRANCH AND TELEOST FISHES

Although urea transport is receiving increased attention in mammalian systems, very little is known about urea transport in fish tissues. This study examined mechanisms of urea transport in red blood cells and hepatocytes from the lesser spotted dogfish (Scyliorhinus canicula), Atlantic stingray (Dasyatis sabina), turbot (Scopthalmus maximus), redfish (Scianops ocellatus), gulf toadfish (Opsanus beta) and oyster toadfish (Opsanus tau). Urea appeared to be passively distributed in both tissues (i.e. there was no difference between plasma and tissue urea concentrations). Additionally, a number of in vitro experiments examining [14C]urea flux were performed. In red blood cells from all species except redfish, urea transport occurred via simple passive diffusion, but redfish red blood cells showed a small (25 %) phloretin-sensitive uptake component. In hepatocytes of the two elasmobranch species (dogfish and stingray), urea efflux was also by simple passive diffusion. However, urea efflux in toadfish (both O. beta and O. tau) hepatocytes exhibited a marked phloretin-sensitivity, and O. beta hepatocytes were used in further experiments with other inhibitors and treatments. Urea transport in O. beta had a relatively high specificity for urea compared with the urea analogues acetamide, thiourea and N-methylurea, was unaffected by phloridzin and extracellular Na+ removal, and was not inhibited by physiological levels of glucose (0.5&shy;10 mmol l-1). A phloretin-sensitive glucose transport, that was not inhibited by physiological levels of urea, was discovered in O. beta hepatocytes. The results are discussed in terms of patterns of species distribution and similarities between urea and glucose transport.

Journal Article↗
PubMed1994

THE EFFECTS OF BRANCHIAL CHLORIDE CELL PROLIFERATION ON RESPIRATORY FUNCTION IN THE RAINBOW TROUT ONCORHYNCHUS MYKISS

The objectives of this study were to induce chloride cell (CC) proliferation on the gill lamellae of rainbow trout Oncorhynchus mykiss and to evaluate the consequences for respiratory function. Chronic elevation of hormone levels was used to induce CC proliferation; fish were injected with a combination of cortisol (8 mg kg-1 intramuscularly every day for 10 days) and ovine growth hormone (2 mg kg-1 intraperitoneally every second day for 10 days). The extent of CC proliferation was quantified using scanning electron microscopy and a two-dimensional analysis. An extracorporeal preparation in combination with environmental hypoxia was used to assess the effects of CC proliferation on respiratory function. Arterial blood was routed from the coeliac artery through an external circuit in which pH (pHa), partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) were monitored continuously. Environmental hypoxia was imposed by gassing a water equilibration column supplying the experimental chamber with N2. The hormone treatment increased the average CC surface area by 2.7-fold and CC density by 2.2-fold; the combined effect was a fivefold increase in CC fractional area. While the PaO2 values of hormone-treated and control fish were similar at PwO2>12.0 kPa, the arterial O2 tensions of treated fish were significantly lower than those of the control group for PwO2&frac34;12.0 kPa. In comparison with control fish at all environmental O2 tensions, the hormone-treated fish exhibited elevated PaCO2 values and a significant acidosis. The effects of CC proliferation on blood gas variables in hormone-treated fish were accompanied by a significantly elevated ventilation amplitude and a lowered ventilation frequency. The results of this study demonstrated (i) that impairment of respiratory gas transfer coincides with CC proliferation, (ii) that O2 and CO2 transfer are influenced differently and (iii) that partial compensation is achieved through physiological adjustments.

Journal Article↗
PubMed1994

Minimizing the risk of Q fever in the hospital setting.

Q fever is caused by a rickettsial microorganism (Coxiella burnetii) harboured in sheep. The highest concentration of organisms are found in birth products. It is a very contagious organism which humans can contract by inhaling aerosolized organisms. Most commonly it leads to an acute 'flu-like illness. Rarely, chronic disease with endocarditis is fatal. Infected patients should be treated with tetracyclines or chloramphenicol. A number of outbreaks have been reported in hospital and research settings. Because of the fear of patients and staff contracting Q fever, Hospital Research Review Boards have increasingly resisted the presence of sheep in medical facilities. The authors have reviewed the circumstances leading to these outbreaks and believe researchers can minimize the risk of Q fever. The most important precautions are to use sheep only from Q fever controlled flocks and, depending on the nature of the research, only male sheep.

Academies and Institutes↗
PubMed1994

Quality of sexually transmitted disease services in Jamaica: evaluation of a clinic-based approach. Collaborative Working Group on Indicators of STD Case Management.

As part of a larger strategy to develop global indicators of HIV (human immunodeficiency virus) infection prevention programmes, a clinic-based method for the assessment of sexually transmitted disease (STD) service quality was developed and field tested by trained observers who visited a random sample of public-sector clinics in Jamaica in October 1991. The assessment included an inventory of equipment and drugs, interviews with clinic staff, and observations of 27 health workers in 15 clinics as they provided services to 115 patients presenting for STD care. This observation-based method provided Jamaican programme managers with descriptive data on STD case management in public clinics within a one-month study period at an approximate local cost of US+ 5000. Based on weighted estimates, 91% of public-sector STD patients in Jamaica were seen in clinics whose staff had received some training in STD case management during the preceding 12 months. The correct treatment rate was estimated to be 82% for those diagnosed with gonorrhoea, and 70% for those diagnosed with syphilis. Based on 98 observed encounters for first-time-for-episode patients, counselling included sex partner referral (57%), partner reduction (48%), and condom use (59%). Although 61% of STD patients were seen in clinics with condoms in stock on the day of the assessment, only 23% were offered condoms during their visit. The clinic-based assessment method can be adapted to the programme management and reporting needs of countries at all stages of STD service development, and can provide data needed to improve programme operations and meet international reporting standards.

Adolescent↗
PubMed1993

Severity of psychiatric symptoms after HIV testing.

OBJECTIVE: The authors were interested in the psychiatric effects of serological testing for HIV and what information feasibly available at intake might predict more severe psychiatric symptoms 1 year later. METHOD: HIV testing in a private office setting was offered to adults at perceived risk for HIV infection but without AIDS. At entry, then 6 and 12 months later, subjects were counseled by psychiatric nurses and assessed by the Hamilton Rating Scale for Depression, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Brief Symptom Inventory. RESULTS: Mean scores on all measures of psychiatric symptoms were lower at follow-up among both 106 HIV-positive and 222 HIV-negative adults. One year after HIV testing, 121 (37%) of the 328 subjects had scores associated with psychopathology. These elevated scores were not predicted by serostatus but by initial psychopathological scores (N = 150), annual income less than +15,000 (N = 114), being female (N = 46), and history of injection drug use (N = 32) and heterosexual risk factors (N = 60) as compared to males having sex with males (N = 236). CONCLUSIONS: Before the development of more severe physical symptoms, on average, knowledge of HIV infection does not increase psychiatric morbidity; however, regardless of serostatus, a notable percentage of at-risk adults have sustained high levels of psychiatric symptoms. Counseling during the HIV testing process provides an opportunity to identify these individuals for closer study and indicated psychiatric treatment.

AIDS Serodiagnosis↗