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Biomedical subjects

S Sorrell

Publications and source records attributed to S Sorrell.

11 recordsLinked to original sources
PubMed1999

Bridging gaps between mind, body, & spirit. Healing the whole person.

Fifty percent of visits of primary care providers are for psychiatric problems making it desirable to screen for mental, addictive, or behavioral disorders at the level of primary care. Psychiatric/mental health nurses prepared at the master's level to practice in the blended clinical specialist/nurse practitioner role are well placed to treat or collaborate in the treatment of people who present with symptoms of physical or psychological problems. The role of the clinical specialist/nurse practitioner is evolving in response to changes in health demographics, epidemiology, scientific and technological advances, and changes in managed care. Advanced practice nursing education must continue to anticipate and meet on-going changes and challenges.

Adult↗
PubMed1995

Risk of human immunodeficiency virus type 1-related neurologic disease in a cohort of intravenous drug users.

BACKGROUND: Although the proportion of cases of acquired immunodeficiency syndrome related to intravenous drug use has increased dramatically over the past decade, there has been no longitudinal examination of primary neurologic disease in this group. OBJECTIVE: To study the development of neurologic disease in human immunodeficiency virus (HIV)-negative and HIV-positive men and women who were intravenous drug users over a 3.5-year period. DESIGN: Prospective observational cohort study. SETTING: Subjects were recruited from an infectious disease clinic at a New York City Hospital or from a methadone maintenance program. PARTICIPANTS: Ninety-nine HIV-negative (62 men and 37 women) and 124 HIV-positive (85 men and 39 women) intravenous drug users volunteered. MAIN OUTCOME MEASURE: The development of clinically significant manifestations in six neurologic domains. RESULTS: With multivariate adjustment for current and past substance abuse, age, education, and head injury, we examined the odds of developing HIV-related neurologic disease. Extrapyramidal signs and reduced motor ability became increasingly apparent over time in HIV-infected men as their CD4 cell count declined and as the subjects developed the acquired immunodeficiency syndrome. Fewer neurologic signs were seen in the women. CONCLUSIONS: The impact of HIV infection among intravenous drug users parallels that in homosexual men and is independent of alcohol and other drug use.

Adult↗
PubMed1994

Psychopathology in male and female intravenous drug users with and without HIV infection.

OBJECTIVE: The authors report on results of systematic clinical assessment of psychopathology among HIV-positive and HIV-negative intravenous drug users. METHOD: As part of a multidisciplinary baseline assessment, 147 male (85 HIV-positive and 62 HIV-negative) and 76 female (39 HIV-positive and 37 HIV-negative) intravenous drug users were evaluated with the Structural Clinical Interview for DSM-III-R and measures of psychiatric symptom severity, global functioning, and stress. RESULTS: Prevalence of a diagnosis of current depression (26%) and severity of depressive and anxiety symptoms in both HIV-positive and HIV-negative subjects were greater than in the general community, but not greater than in other studies of intravenous drug users. HIV-positive men had a higher prevalence of depressive disorders than HIV-negative men (33% and 16%, respectively), although this pattern was not found among women (26% and 30%). Diagnosis of depressive disorders and severity of depressive and anxiety symptoms were associated with a symptom-based measure of HIV illness stage, but not with indices of immune functioning (CD4+ cell count and CD4+ cell percent). CONCLUSIONS: Despite selective associations between HIV illness variables and depression, high rates of depression across HIV status in this cohort suggest that intravenous drug use and associated factors are more salient than HIV illness factors in understanding psychopathology in this population.

Anxiety Disorders↗
PubMed1992

Clinical and laboratory correlates of human immunodeficiency virus infection in a cohort of intravenous drug users from New York, NY.

BACKGROUND: The human immunodeficiency virus (HIV) epidemic has increasingly involved intravenous drug users. Few studies have attempted to define its clinical and laboratory characteristics in this population. METHODS: We recruited 223 intravenous drug users from New York, NY, for a prospective study of the natural course of HIV infection. Medical history, physical examination, medical staging, and immunologic assessments were performed at 6-month intervals. We examined the baseline findings among this cohort. RESULTS: Of the total cohort, 65.9% were men and 34.1% were women, with 70.9% African American, 12.6% white, 11.7% white Latino, and 4.9% black Latino. At baseline, 44.4% were HIV negative and 55.6% were HIV positive. No significant association was noted between ethnicity, gender, and serologic status. Also no significant difference was noted for homelessness either across serologic status or gender. There was a trend toward an association between gender and use of drugs during the week before interview; the women showed higher drug use. A significant association was noted between HIV serologic status and reported history of pneumonia, oral candidiasis, cough, night sweats, fever, and lymphadenopathy on physical examination. In a regression model, white blood cell count, hematocrit, symptom/sign complex score, and CD4 cell number were significantly associated with HIV status. CONCLUSION: This study provided important historical, clinical, and immunologic characteristics that are useful in the identification and evaluation of the HIV-infected intravenous drug user.

Analysis of Variance↗
PubMed1987

Expression of the multidrug-resistant gene in hepatocarcinogenesis and regenerating rat liver.

Preneoplastic and neoplastic liver nodules and hepatocytes isolated from regenerating rat liver have been shown to be resistant to a broad range of carcinogenic agents. This phenomenon was studied by measuring the expression of the multidrug-resistant (mdr) gene in normal liver cells and in preneoplastic and neoplastic nodules and regenerating liver. Levels of messenger RNA for the mdr gene, which encodes P-glycoprotein, were elevated in both preneoplastic and neoplastic lesions. Expression of the mdr gene also reached high levels in regenerating rat liver 24 to 72 hours after partial hepatectomy. These results show that the expression of the mdr gene can be regulated in liver and is likely to be responsible for part of the multidrug-resistance phenotype of carcinogen-initiated hepatocytes and regenerating liver cells.

Animals↗
PubMed1982

Mutations of glucocerebrosidase: discrimination of neurologic and non-neurologic phenotypes of Gaucher disease.

Multiple molecular forms of beta-glucocerebrosidase that permit discrimination between neurologic and non-neurologic phenotypes of Gaucher disease have been identified radioimmunologically in fibroblasts and human brain tissue. In normal human fibroblasts these forms have been shown by NaDodSO4/polyacrylamide gel electrophoresis to have apparent Mr of 63,000 (form A1), 61,000 (form A2), and 56,000 (form B). The Mr 63,000 form may be a precursor of the Mr 56,000 form. Non-neurologic Gaucher disease (type 1) fibroblasts and normal brain tissue are characteristic in that they contain only one major immunoreactive protein, the Mr 56,000 form. In contrast, fibroblast extracts and brain tissue from neurologic Gaucher disease phenotypes contain only the higher molecular weight forms A1 and A2. These data and the low residual activity of the enzyme in all the variants of Gaucher disease suggest that the mutations of beta-glucocerebrosidase are allelic and involve the active site.

Brain↗
PubMed1980

Estrogen dependence of a gonadotropin-induced steroidogenic lesion in rat testicular Leydig cells.

Leydig cells isolated from the testes of rats treated with intravenous exogenous gonadotropin (hCG) or subcutaneous gonadotropin-releasing hormone (GnRH) show markedly decreased luteinizing hormone (LH) receptors and a partial block in testicular 17,20 desmolase activity. In contrast, Leydig cells from animals with equivalent degrees of LH receptor loss induced by subcutaneous hCG treatment show no change in 17,20 desmolase activity. These findings indicated that the acuteness of gonadotrophic stimulation, rather than the extent of LH receptor loss, was responsible for the steroidogenic lesion. A role of estradiol in the enzymatic block produced in vivo by acute elevation of circulating gonadotropin (intravenous hCG or GnRH-stimulated endogenous LH) was suggested by rapid elevations of testicular 17beta-estradiol within 30 min after intravenous hCG, whereas more gradual increases in estradiol occurred 4-8 h after subcutaneous hCG. The inhibitory effect of endogenous estrogen on testicular steroidogenesis was confirmed by the ability of an estrogen antagonist (Tamoxifen) to prevent the reduction of testosterone responses caused by intravenous hCG and subcutaneous GnRH. In addition, Tamoxifen significantly increased the number of LH receptors in Leydig cells from both control and gonadotropin-desensitized animals. These findings indicate that the acute elevations of intratesticular estrogen produced by treatment with hCG or GnRH are responsible for the steroidogenic lesion seen in gonadotropin-desensitized Leydig cells. These results also suggest that locally produced estrogens contribute to the regulation of testicular LH receptors and 17,20 desmolase activity.

Aldehyde-Lyases↗
PubMed1974

Generality and side effects of overcorrection.

The effects and side effects of overcorrection for self-stimulatory behaviors of two children in a specialized day-care program were evaluated. For one child, a "hand" overcorrection procedure involving arm and hand exercises was introduced contingent upon inappropriate hand movements and later contingent upon inappropriate foot movements. After "hand" overcorrection was withdrawn for inappropriate foot movements, a "foot" overcorrection procedure involving foot and leg exercises was introduced contingent upon inappropriate foot movements. For a second child, the "hand" overcorrection procedure was introduced contingent upon inappropriate hand movements during a free-play period, and later contingent upon inappropriate vocalizations at naptime. "Hand" overcorrection was withdrawn and then re-introduced sequentially for both behaviors. Several concurrent behaviors were measured to assess multiple effects of treatment. Results for both children indicated the "hand" overcorrection procedure suppressed inappropriate hand movements and inappropriate behaviors that were topographically dissimilar. In addition, inverse relationships were observed between the second child's inappropriate hand movements and appropriate toy usage during free play and between his inappropriate vocalizations and inappropriate foot movements during naptime. Results suggest that overcorrection procedures that are effective for one behavior can be used to reduce the frequency of topographically different behaviors. This finding is discussed in terms of its practical implications for therapists.

Behavior Therapy↗