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Biomedical subjects

S Perry

Publications and source records attributed to S Perry.

At least 127 records · Page 7Linked to original sources

Voluntarily informing others of positive HIV test results: patterns of notification by infected gay men.

Forty gay men who had recently learned that they were infected with human immunodeficiency virus (HIV) were interviewed to determine the frequency with which they voluntarily informed physicians, dentists, friends, family members, and current and past sexual partners of their positive test results. Ninety percent of the subjects informed a personal physician, and 48 percent of the subjects who sought dental care informed the dentist. Sixty-six percent of subjects with at least one current sexual partner notified every current sexual partner, although notification was not associated with a greater likelihood of safer sex practices. Ninety percent of the subjects who had past sexual partners made no attempt to inform them. Sixty-eight percent confided in at least one friend, but only 35 percent told a family member.

AIDS Serodiagnosis↗

Transcranial Doppler ultrasound studies of cerebral autoregulation and subarachnoid hemorrhage in the rabbit.

The authors describe a method for Doppler ultrasound recording of flow velocity in the basilar artery of normal rabbits and rabbits with experimental subarachnoid hemorrhage (SAH). With this transcranial Doppler (TCD) model, clinical assumptions regarding flow velocity/cerebral blood flow (CBF) relationships, autoregulatory responses, and Doppler spectral waveform analysis can be tested under controlled conditions and compared with established methods of CBF measurement (hydrogen clearance). The time course of changes in flow velocity following SAH (cerebral vasospasm) is successfully demonstrated using the experimental TCD method. There are significant differences in the flow velocity and CBF responses to hypercapnia, hypocapnia, and trimethaphan-induced hypotension which indicate that TCD cannot be considered a simple alternative to CBF measurement for the study of cerebrovascular reactivity and cerebral autoregulation.

Analysis of Variance↗

Orthotopic heart transplantation for complex congenital heart disease.

Orthotopic heart transplantation has become standard therapy for end-stage cardiomyopathy in children and adults, but there has been much less experience with transplantation for complex congenital heart disease. In this report experience with orthotopic transplantation in seven children with various forms of complex congenital heart disease is reviewed. Diagnoses included hypoplastic left heart syndrome in two (after stage I palliation), left ventricular diverticulum in one, single ventricle in two (dextrocardia, atrial situs inversus, and total anomalous pulmonary venous return in one patient and post-Fontan repair in the second), D-transposition of the great arteries and ventricular septal defect (post-Senning repair and ventricular septal defect closure) in one, and Ebstein's anomaly with biventricular dysplasia in one. Six of the seven were hospital survivors and there has been one late death at 2 1/3 years. Modifications of the standard operative technique to fit the anatomic variations in these defects are reviewed.

Adolescent↗

Combining antidepressants and psychotherapy: rationale and strategies.

Psychotherapy, in its broadest sense, is indicated for all depressed patients. General and specific research supports the potential additive effect of antidepressant medication for depressive syndromes, such as major affective or dysthymic disorders. Combined treatment is relatively less indicated for circumscribed depressive feelings, which occur in normal grief, personality disorders, and reactions to life stressors and acute medical illness. Specific strategies are described that potentiate the acceptance, compliance, and effectiveness of antidepressants.

Adult↗

Reporting consensus.

Explore the source record for details and available documents.

Consensus Statements as Topic↗

Interview assessment of critically Ill patients regarding resuscitation decisions. A case study in ethics research.

To examine how patients perceive and decide their resuscitation status, we monitored 113 admissions to a coronary care unit. We review the research process, including Institutional Review Board concerns, sampling bias and permission by physicians, informed consent, and the patient interview. In-depth psychiatric interviews on 16 patients demonstrated marked misperceptions about resuscitation procedures. Although standardized psychologic measures indicated distress in some of these critically ill patients, the interview itself induced no detected untoward physiologic or emotional reactions. This pilot study demonstrates the feasibility of assessing patients regarding resuscitation status and also identifies relevant methodologic problems to guide future research of resuscitation decision-making.

Behavioral Research↗

Power frequency magnetic field; depressive illness and myocardial infarction.

Surveys were made to determine whether susceptibility to depressive illness and to myocardial infarction of people living in Wolverhampton was related to the intensity of 50 Hz magnetic field outside their homes. Comparing case with control addresses it was found that the field strength was significantly higher for depressive illness (P = 0.033) but not for myocardial infarction.

Depressive Disorder↗

Early neuropsychological dysfunction caused by human immunodeficiency virus.

The human immunodeficiency virus (HIV), the etiological agent of acquired immunodeficiency syndrome (AIDS), directly affects the central nervous system (CNS) and often causes cognitive, motor, and behavioral changes and eventually a dementia prior to death. Suggestive evidence for the early onset of HIV-induced mental changes is derived from numerous case reports, the nature of subcortical CNS postmortem findings, and early abnormalities seen in cerebrospinal fluid, on brain computed tomography, magnetic resonance imaging, and electroencephalography, and on neuropsychological tests administered to patients with AIDS and AIDS-related complex. However, whether clinically significant cerebral impairment can precede symptoms of immunosuppression is unclear. A few studies have shown poorer performance on neuropsychological tests by asymptomatic HIV-infected subjects compared with uninfected controls, but several studies have not found this difference. To address this controversy, the current literature is reviewed, methodological problems are discussed, and recommendations are made for evaluation and treatment when early HIV-induced mental changes are suspected.

AIDS Dementia Complex↗

Neuropsychological function in physically asymptomatic, HIV-seropositive men.

Twenty asymptomatic, HIV-seropositive homosexual men and a control group of 20 seronegative homosexual men were evaluated for evidence of neuropsychological impairment. Two-tailed paired t-tests of group differences revealed that the seropositive patients had significantly lower scores on two of 20 neuropsychological measures. Ten seropositive patients had scores two standard deviations below the sample, compared with three seronegative patients, a significantly different distribution (p = .04). The HIV-infected group exhibited lower mean scores on 17 of 20 variables (binomial probability, p less than .005). The 10 seropositive patients with scores that fell below the cut-off had significantly lower mean T4/T8 ratios than the 10 seropositive patients with scores above the cut-off (p = .02). The data suggest that a subpopulation of HIV-infected adults may exhibit subtle neuropsychological impairment before they develop clinical signs of cognitive deficit or immunosuppression.

AIDS Dementia Complex↗

Warning third parties at risk of AIDS: APA's policy is a barrier to treatment.

The American Psychiatric Association has adopted a policy stating that psychiatrists may warn third parties who are placed at risk by the behavior of a patient infected with human immunodeficiency virus (HIV). The author argues that although the policy appears reasonable and has well-established precedent, the public will ultimately be better served if HIV-infected patients are assured absolute confidentiality. He contends that the Tarasoff decision is not directly applicable to most HIV-infected patients, that education alone will not be sufficient to deter some infected patients from placing others at risk, that additional psychiatric interventions will be necessary to reduce the high-risk behaviors of those individuals, and that APA's policy will prevent many from seeking treatment.

Acquired Immunodeficiency Syndrome↗

Color vision defects in ocular hypertension and glaucoma. Quantification with a computer-driven color television system.

In order to detect early defects of color vision caused by increased intraocular pressure, a computer graphics device and color monitor system were used to measure color contrast sensitivity. The system determines the threshold chrominance of a colored grating in which there is no change in luminance. The study included 13 control subjects aged 10 to 57 years and 19 patients with ocular hypertension or glaucoma aged 20 to 58 years. In the 13 eyes with visual field loss, color contrast sensitivity was profoundly reduced when the grating colors fell on a tritan color confusion line. In the eyes without visual field loss, tritan color contrast sensitivity was reduced to an average level considerably below the extreme limits of the control group. These results were compared with those of other color vision tests and diagnostic criteria for glaucoma. The findings suggest that among the tests used, color contrast sensitivity testing was able to discriminate most effectively between patients who had retinal damage and the normal population.

Color Perception Tests↗