In order to determine the effect of family support on the psychological well-being of heterosexua... more In order to determine the effect of family support on the psychological well-being of heterosexual couples with at least one HIV-seropositive, family support data were obtained from couples, who were separately interviewed. Two hundred heterosexuals were interviewed (97 males, 103 females). 182 were partners in HIV serodiscordant couples (18 members were in 10 couples concordant for HIV-seropositivity). Overall, there were 76 HIV+ males and 30 HIV+ females. The Brief Symptom Inventory (BSI) was used to measure psychological distress. Sixty-five per cent of the subjects had family members aware of partners' HIV infection, but only 50% of aware families were reported as supportive. Family support was not a significant predictor of distress. Gender was the most significant predictor of psychological distress as measured by the BSI subscales. Both HIV positive and HIV negative females had more distress than their male counterparts on several dimensions (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, phobic anxiety and paranoia), and on the General Severity Index (GSI) of the BSI (HIV-positives: p = 0.003; HIV-negatives: p = 0.01). Despite the general lack of association of family support with psychological distress, women in couples affected by HIV had more distress than men. The mental health needs of women clearly differ from men, and continued gender comparisons should be done to develop appropriate and effective interventions for these groups.
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 1996
There is compelling evidence that micronutrients can profoundly affect immunity. We surveyed vita... more There is compelling evidence that micronutrients can profoundly affect immunity. We surveyed vitamin supplement use and circulating concentrations of 22 nutrients and glutathione in 64 HIV-1 seropositive men and women and 33 seronegative controls participating in a study of heterosexual HIV-1 transmission. We assayed antioxidants (vitamins A, C, and E; total carotenes), vitamins B6 and B12, folate, thiamin, niacin, biotin, riboflavin, pantothenic acid, free and total choline and carnitine, biopterin, inositol, copper, zinc, selenium, and magnesium. HIV-infected patients had lower mean circulating concentrations of magnesium (p < 0.0001), total carotenes (p = 0.009), total choline (p = 0.002), and glutathione (p = 0.045), and higher concentrations of niacin (p < 0.0001) than controls. Fifty-nine percent of HIV+ patients had low concentrations of magnesium, compared with 9% of controls (p < 0.0001). These abnormal concentrations were unrelated to stage of disease. Participants who took vitamin supplements had consistently fewer low concentrations of antioxidants, across HIV infection status and disease stage strata (p = 0.0006). Nevertheless, 29% of the HIV+ patients taking supplemental vitamins had subnormal levels of one or more antioxidants. The frequent occurrence of abnormal micronutrient nutriture, as found in these HIV+ subjects, may contribute to disease pathogenesis. The low magnesium concentrations may be particularly relevant to HIV-related symptoms of fatigue, lethargy, and impaired mentation.
P126 Cardiovascular risk increases with chronological age. Pulse pressure (PP) also increases wit... more P126 Cardiovascular risk increases with chronological age. Pulse pressure (PP) also increases with chronological age and is an independent indicator of cardiovascular risk. It is therefore possible that after age-adjustment, the biological age of persons with wide PP is more advanced than their chronological age would indicate. We explored whether an index of biological age, namely telomere length (measured by the mean length of the terminal restriction fragment, TRF), provides a better account than chronological age of about variation in PP. We studied 193 French men and women (age 56 ± 11 years) on no antihypertensive medications. Univariate analysis showed that in both genders, TRF length (in WBCs) was correlated inversely with age (p< 0.01). The rate of telomere attrition was 0.038 and 0.036 kb/year for men and women, respectively. Only in men, after adjustment for mean arterial pressure, TRF length accounted for 12% variability in PP (p<0.001), while chronological age acc...
Earlier investigations showed a positive correlation between basal cytosolic free calcium in huma... more Earlier investigations showed a positive correlation between basal cytosolic free calcium in human platelets and blood pressure; however, recent studies have failed to show this relation. We undertook the present work to examine which platelet cytosolic calcium parameters (namely, cytosolic calcium in resting or stimulated states in calcium-containing and calcium-free media) present the least variability and best correlation with blood pressure. We studied 17 healthy white men on three different occasions separated by 1- and 4-week intervals. Their manual and ambulatory automated 24-hour blood pressure measurements were correlated with cytosolic calcium in resting and stimulated (thrombin-treated) fura 2-loaded platelets. The following cytosolic calcium parameters were measured in 1 mmol/L calcium and calcium-free media: basal cytosolic calcium, peak thrombin-evoked cytosolic calcium, and post-transient cytosolic calcium 5 minutes after thrombin treatment. The highest and lowest coe...
To study the effect of postponing hCG administration while continuing daily GnRH agonist therapy ... more To study the effect of postponing hCG administration while continuing daily GnRH agonist therapy (&quot;coasting&quot;) on highly responsive patients undergoing IVF-ET. Retrospective analysis. University-affiliated Center for Fertility and Reproductive Medicine. Patients undergoing IVF-ET from March 1995 to March 1997. Three groups of IVF-ET patients were compared to explore the effect of coasting on cycle outcome: a group of highly responsive coasted patients, a group of equally responsive noncoasted patients, and an age-matched normally responsive control group. Two groups of coasted patients were also compared to assess the effect of E2 levels at the time that they met the follicular criteria for hCG administration. Last, the effect of varying coast duration was examined by regression analysis. Patient characteristics, outcome parameters, and incidence of ovarian hyperstimulation syndrome (OHSS). Coasting had no detrimental effect on cycle outcome in the subset studied. Regression analysis, however, suggests an inverse relationship between coast duration and the number of mature oocytes retrieved as well as the clinical pregnancy rate. Coasting in the studied subset of IVF patients did not adversely affect cycle outcome parameters or the incidence of OHSS, but prolonged coasting intervals may impair IVF cycle outcome.
Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occu... more Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occurring infrequently. Because of the recent dramatic decrease in autopsy rates, the authors believe that current studies do not accurately represent the frequency of this catastrophic complication. Autopsy protocols and archived histologic slides of patients with AMI were retrospectively reviewed to determine whether the frequency of cardiac rupture, as a complication of AMI, is altered when a non–hospital-based patient cohort after autopsy is evaluated. This review yielded 153 cases of 41 women and 112 men, whose postmortem examinations revealed gross and histologic evidence of AMI. Cardiac rupture was present in 30.7% of these cases. Of the 47 patients with rupture, 35 had no relevant medical history. The remaining 12 patients had various medical conditions. None of the patients in the rupture group had previously treated symptoms related to coronary artery conditions. Whereas women cons...
Myocardial Blush Grade (MBG) is an angiographic method of assessing myocardial microcirculation a... more Myocardial Blush Grade (MBG) is an angiographic method of assessing myocardial microcirculation and provides independent risk stratification among patients with normal TIMI 3 flow. Although the beneficial effect of abciximab on microvascular perfusion is well established, the efficacy of eptifibatide in the prevention of platelet aggregation and distal microembolization is less proven. After a pharmacologic shift by our institution towards the use of eptifibatide in patients with unstable angina presenting for PCI, we sought to evaluate our experience by retrospectively comparing the effect on myocardial perfusion between abciximab and eptifibatide following PCI in stable angina or acute coronary syndrome. Microcirculatory perfusion was reviewed in 101 consecutive patients (23 stable angina, 61 unstable angina, 17 non-q MI) undergoing PTCA/stenting. This comparison was between the last group of 51 patients who routinely received standard bolus and infusion of abciximab and the first...
The present study was performed to investigate whether determination of serum relaxin concentrati... more The present study was performed to investigate whether determination of serum relaxin concentrations would allow assessment of the gestation further than that provided by determination of hCG. Serum relaxin concentrations were quantified in women with resorbing ectopic gestations (as documented by declining titers of beta-hCG). The control group consisted of individuals with intrauterine pregnancies. As an additional control, we studied pregnancies conceived through ovulation induction, which usually have an increased volume of relaxin-secreting luteal tissue. On days 39-70 of gestation, the mean serum relaxin concentrations were significantly lower in ten resorbing ectopic gestations (P less than .001, permutation test) than in the normal control group of 13 intrauterine pregnancies. The median serum relaxin concentrations in patients who had ovulation induction with Pergonal were substantially higher than the median for all normal controls; values in clomiphene citrate-treated pat...
In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school stude... more In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school students to survey their knowledge, attitudes, and behavior related to the acquisition of acquired immunodeficiency syndrome (AIDS). Knowledge about the disease was high, but exaggeration of risk from social contacts was common. Although fear was associated with misperceptions, it was not always dispelled by knowledge. Nearly half (49%) of all participants reported having used condoms, indicating that condom use is somewhat familiar and acceptable to them. Over 80% thought that condoms offer some protection against AIDS. However, knowledge did not always result in recognition or practice of risk-reduction behaviors. Student suggestions for slowing the spread of AIDS stressed personal responsibility and education. Follow-up assemblies that used survey results to address gaps in knowledge appeared necessary to counter misperceptions that might have arisen from the survey.
In order to determine the effect of family support on the psychological well-being of heterosexua... more In order to determine the effect of family support on the psychological well-being of heterosexual couples with at least one HIV-seropositive, family support data were obtained from couples, who were separately interviewed. Two hundred heterosexuals were interviewed (97 males, 103 females). 182 were partners in HIV serodiscordant couples (18 members were in 10 couples concordant for HIV-seropositivity). Overall, there were 76 HIV+ males and 30 HIV+ females. The Brief Symptom Inventory (BSI) was used to measure psychological distress. Sixty-five per cent of the subjects had family members aware of partners&#39; HIV infection, but only 50% of aware families were reported as supportive. Family support was not a significant predictor of distress. Gender was the most significant predictor of psychological distress as measured by the BSI subscales. Both HIV positive and HIV negative females had more distress than their male counterparts on several dimensions (somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, phobic anxiety and paranoia), and on the General Severity Index (GSI) of the BSI (HIV-positives: p = 0.003; HIV-negatives: p = 0.01). Despite the general lack of association of family support with psychological distress, women in couples affected by HIV had more distress than men. The mental health needs of women clearly differ from men, and continued gender comparisons should be done to develop appropriate and effective interventions for these groups.
Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 1996
There is compelling evidence that micronutrients can profoundly affect immunity. We surveyed vita... more There is compelling evidence that micronutrients can profoundly affect immunity. We surveyed vitamin supplement use and circulating concentrations of 22 nutrients and glutathione in 64 HIV-1 seropositive men and women and 33 seronegative controls participating in a study of heterosexual HIV-1 transmission. We assayed antioxidants (vitamins A, C, and E; total carotenes), vitamins B6 and B12, folate, thiamin, niacin, biotin, riboflavin, pantothenic acid, free and total choline and carnitine, biopterin, inositol, copper, zinc, selenium, and magnesium. HIV-infected patients had lower mean circulating concentrations of magnesium (p &amp;amp;lt; 0.0001), total carotenes (p = 0.009), total choline (p = 0.002), and glutathione (p = 0.045), and higher concentrations of niacin (p &amp;amp;lt; 0.0001) than controls. Fifty-nine percent of HIV+ patients had low concentrations of magnesium, compared with 9% of controls (p &amp;amp;lt; 0.0001). These abnormal concentrations were unrelated to stage of disease. Participants who took vitamin supplements had consistently fewer low concentrations of antioxidants, across HIV infection status and disease stage strata (p = 0.0006). Nevertheless, 29% of the HIV+ patients taking supplemental vitamins had subnormal levels of one or more antioxidants. The frequent occurrence of abnormal micronutrient nutriture, as found in these HIV+ subjects, may contribute to disease pathogenesis. The low magnesium concentrations may be particularly relevant to HIV-related symptoms of fatigue, lethargy, and impaired mentation.
P126 Cardiovascular risk increases with chronological age. Pulse pressure (PP) also increases wit... more P126 Cardiovascular risk increases with chronological age. Pulse pressure (PP) also increases with chronological age and is an independent indicator of cardiovascular risk. It is therefore possible that after age-adjustment, the biological age of persons with wide PP is more advanced than their chronological age would indicate. We explored whether an index of biological age, namely telomere length (measured by the mean length of the terminal restriction fragment, TRF), provides a better account than chronological age of about variation in PP. We studied 193 French men and women (age 56 ± 11 years) on no antihypertensive medications. Univariate analysis showed that in both genders, TRF length (in WBCs) was correlated inversely with age (p< 0.01). The rate of telomere attrition was 0.038 and 0.036 kb/year for men and women, respectively. Only in men, after adjustment for mean arterial pressure, TRF length accounted for 12% variability in PP (p<0.001), while chronological age acc...
Earlier investigations showed a positive correlation between basal cytosolic free calcium in huma... more Earlier investigations showed a positive correlation between basal cytosolic free calcium in human platelets and blood pressure; however, recent studies have failed to show this relation. We undertook the present work to examine which platelet cytosolic calcium parameters (namely, cytosolic calcium in resting or stimulated states in calcium-containing and calcium-free media) present the least variability and best correlation with blood pressure. We studied 17 healthy white men on three different occasions separated by 1- and 4-week intervals. Their manual and ambulatory automated 24-hour blood pressure measurements were correlated with cytosolic calcium in resting and stimulated (thrombin-treated) fura 2-loaded platelets. The following cytosolic calcium parameters were measured in 1 mmol/L calcium and calcium-free media: basal cytosolic calcium, peak thrombin-evoked cytosolic calcium, and post-transient cytosolic calcium 5 minutes after thrombin treatment. The highest and lowest coe...
To study the effect of postponing hCG administration while continuing daily GnRH agonist therapy ... more To study the effect of postponing hCG administration while continuing daily GnRH agonist therapy (&quot;coasting&quot;) on highly responsive patients undergoing IVF-ET. Retrospective analysis. University-affiliated Center for Fertility and Reproductive Medicine. Patients undergoing IVF-ET from March 1995 to March 1997. Three groups of IVF-ET patients were compared to explore the effect of coasting on cycle outcome: a group of highly responsive coasted patients, a group of equally responsive noncoasted patients, and an age-matched normally responsive control group. Two groups of coasted patients were also compared to assess the effect of E2 levels at the time that they met the follicular criteria for hCG administration. Last, the effect of varying coast duration was examined by regression analysis. Patient characteristics, outcome parameters, and incidence of ovarian hyperstimulation syndrome (OHSS). Coasting had no detrimental effect on cycle outcome in the subset studied. Regression analysis, however, suggests an inverse relationship between coast duration and the number of mature oocytes retrieved as well as the clinical pregnancy rate. Coasting in the studied subset of IVF patients did not adversely affect cycle outcome parameters or the incidence of OHSS, but prolonged coasting intervals may impair IVF cycle outcome.
Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occu... more Cardiac rupture as a complication of acute myocardial infarction (AMI) has been described as occurring infrequently. Because of the recent dramatic decrease in autopsy rates, the authors believe that current studies do not accurately represent the frequency of this catastrophic complication. Autopsy protocols and archived histologic slides of patients with AMI were retrospectively reviewed to determine whether the frequency of cardiac rupture, as a complication of AMI, is altered when a non–hospital-based patient cohort after autopsy is evaluated. This review yielded 153 cases of 41 women and 112 men, whose postmortem examinations revealed gross and histologic evidence of AMI. Cardiac rupture was present in 30.7% of these cases. Of the 47 patients with rupture, 35 had no relevant medical history. The remaining 12 patients had various medical conditions. None of the patients in the rupture group had previously treated symptoms related to coronary artery conditions. Whereas women cons...
Myocardial Blush Grade (MBG) is an angiographic method of assessing myocardial microcirculation a... more Myocardial Blush Grade (MBG) is an angiographic method of assessing myocardial microcirculation and provides independent risk stratification among patients with normal TIMI 3 flow. Although the beneficial effect of abciximab on microvascular perfusion is well established, the efficacy of eptifibatide in the prevention of platelet aggregation and distal microembolization is less proven. After a pharmacologic shift by our institution towards the use of eptifibatide in patients with unstable angina presenting for PCI, we sought to evaluate our experience by retrospectively comparing the effect on myocardial perfusion between abciximab and eptifibatide following PCI in stable angina or acute coronary syndrome. Microcirculatory perfusion was reviewed in 101 consecutive patients (23 stable angina, 61 unstable angina, 17 non-q MI) undergoing PTCA/stenting. This comparison was between the last group of 51 patients who routinely received standard bolus and infusion of abciximab and the first...
The present study was performed to investigate whether determination of serum relaxin concentrati... more The present study was performed to investigate whether determination of serum relaxin concentrations would allow assessment of the gestation further than that provided by determination of hCG. Serum relaxin concentrations were quantified in women with resorbing ectopic gestations (as documented by declining titers of beta-hCG). The control group consisted of individuals with intrauterine pregnancies. As an additional control, we studied pregnancies conceived through ovulation induction, which usually have an increased volume of relaxin-secreting luteal tissue. On days 39-70 of gestation, the mean serum relaxin concentrations were significantly lower in ten resorbing ectopic gestations (P less than .001, permutation test) than in the normal control group of 13 intrauterine pregnancies. The median serum relaxin concentrations in patients who had ovulation induction with Pergonal were substantially higher than the median for all normal controls; values in clomiphene citrate-treated pat...
In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school stude... more In 1988 a questionnaire was administered to 1,793 urban and suburban New Jersey high school students to survey their knowledge, attitudes, and behavior related to the acquisition of acquired immunodeficiency syndrome (AIDS). Knowledge about the disease was high, but exaggeration of risk from social contacts was common. Although fear was associated with misperceptions, it was not always dispelled by knowledge. Nearly half (49%) of all participants reported having used condoms, indicating that condom use is somewhat familiar and acceptable to them. Over 80% thought that condoms offer some protection against AIDS. However, knowledge did not always result in recognition or practice of risk-reduction behaviors. Student suggestions for slowing the spread of AIDS stressed personal responsibility and education. Follow-up assemblies that used survey results to address gaps in knowledge appeared necessary to counter misperceptions that might have arisen from the survey.
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