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Biomedical subjects

V Egan

Publications and source records attributed to V Egan.

8 recordsLinked to original sources
PubMed1992

Neuropsychological aspects of HIV infection.

There is considerable consensus regarding the entity, aetiology, and assessment of HIV-1-caused cognitive impairment. Early fears that this would be very common, and early in onset, have not been realized. Research and clinical criteria should reflect current statistical standards. The large cohorts, broad test batteries and repeated testing of population samples provide a special opportunity to resolve perennial questions regarding the relationship between mood, health, and cognitive functions. It appears that AZT prevents mild cognitive impairment associated with HIV-1, though there is no strong evidence that it treats frank HIV-1 dementia complex. The management of patients with dementia requires proper consideration, as even if the incidence of HIV-1 dementia complex is only 5-10%, this is still a substantial number of patients for population centres with large numbers of people with HIV and AIDS. The distressing nature of this condition, combined with the specialized management required for HIV itself, make it advisable that more nurses with psychiatric training are employed in wards or units specializing in HIV.

AIDS Dementia Complex↗
PubMed1992

The Edinburgh cohort of HIV positive drug users: who are they and who cares for them?

Between 1983 and 1984, it is estimated that over 1,000 injection drug users in Edinburgh were infected with HIV. The social and demographic characteristics of 300 HIV positive drug users attending a medical clinical between 1987 and 1991 have been recorded. Nearly all were unemployed, poorly educated and living in council-owned accommodation; one third were female, 17% of whom were caring for a child. Half the cohort lived with a partner, and one fifth with parents; there were no differences between symptomatic and asymptomatic patients. During the study, 45 patients died, mostly from AIDS or an AIDS-related condition. HIV positive drug users are not socially isolated, but they are heavily dependent on family support in the community.

Adult↗
PubMed1992

The Edinburgh cohort of HIV-positive drug users: pattern of cognitive impairment in relation to progression of disease.

To examine the neuropsychiatric effects of infection with HIV, 220 drug users (27 HIV negative, 193 HIV positive) completed tests evaluating premorbid intelligence, memory, non-verbal performance, information processing speed, and mood. When these measures were compared cross-sectionally by the severity of HIV illness, symptomatic patients (in CDC stage IV) were impaired on Trails B, two-choice decision time, delayed recall of the Wechsler Logical Memory Test and most components of the Auditory Verbal Learning Test. These findings imply reduced capacity for concentration, speed of thought and memory. When 101 patients were retested a mean of 16 months after their initial assessment, performance on Trails A and B, Block Design and delayed recall of the Wechsler Logical Memory Test deteriorated more for patients at, or progressing within, CDC stage IV, than performance of patients at stage III. The results broadly correspond to the cross-sectional findings. However, there was a decline in all tests of memory function for the sample independent of clinical staging. This may be evidence of brain involvement before the appearance of other symptoms. Self-rated measures of mood did not change cross-sectionally, progressively, or interactively with time and stage of HIV illness, and cannot account for the changes in cognitive function observed. Change in drug use, similarly, does not account for the cognitive findings. Four (5%) of the retested subjects developed AIDS dementia complex, but most of the performance and memory impairments seen were subclinical despite the destructive neuropathology presumed to underlie intellectual decline in patients with HIV infection.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS Dementia Complex↗
PubMed1991

HIV-1 associated cognitive/motor complex in an injecting drug user.

The clinical and social consequences of AIDS dementia complex/HIV-1 associated cognitive/motor complex (ADC/HACC) in drug users have not been well documented. The value of prospective serial neuropsychological, neuroradiological and neurophysiological measurements to assist diagnosis of ADC/HACC in patients with premorbid personality disorder and intercurrent drug use is demonstrated. The psychosocial problems resulting from ADC/HACC with respect to community care and the location of hospitalization is considered. The relevance of the 1984 Mental Health Act (Scotland) with regard to drug users with ADC/HACC is discussed.

AIDS Dementia Complex↗
PubMed1990

The Edinburgh cohort of HIV-positive drug users: auditory event-related potentials show progressive slowing in patients with Centers for Disease Control stage IV disease.

A two-tone auditory event-related potential (AEP) task was used to examine brain function in 206 HIV-positive individuals (infected by intravenous drug use) approximately 6-7 years after initial infection. Multiple regression analysis of AEP latency and amplitude components showed only small effects of past medical and psychiatric history, current symptoms and drug use on electrophysiological responses. HIV-positive patients had longer latency and reduced amplitude of the P300 (P3) component of the AEP compared with a normal control group, but were electrophysiologically similar to a matched control group of HIV-seronegative drug users. However, a lower P3 amplitude was seen in patients in Centers for Disease Control stage IV. One-year follow-up of 103 patients (50%) found significant lengthening of P3 latency in patients with stage IV disease but not in those with stage II or stage III disease. The results suggest that brain involvement in HIV infection can be detected electrophysiologically after the clinical diagnosis of stage IV disease.

Adult↗