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Familial Childhood Sleep Apnea, Robert M. Wittig, Frank J. Zorick, Timothy A. Roehrs, Jeanne M. Sicklesteel, Thomas Roth

Henry Ford Hospital Medical Journal

We report four siblings who had polysomnographically documented sleep apnea. Two presented with the typical clinical picture of sleep apnea syndrome including daytime somnolence and snoring, had repetitive obstructive apneic episodes during sleep, and were effectively treated with upper airway surgery. The other two were asymptomatic and showed infrequent apneic episodes during sleep. This family illustrates the distinction between the sleep apnea syndrome and infrequent apneic episodes during sleep. The sleep apnea syndrome is associated with daytime symptomatology and requires treatment. The presence of apneic episodes during sleep in all four siblings has implications regarding the predisposing factors (eg, upper …

Clinical Manifestations Of Acute Pulmonary Embolism: Henry Ford Hospital Experience, A Five-Year Review, Kenneth V. Leeper Jr., John Popovich Jr., Deborah Adams, Paul D. Stein

Henry Ford Hospital Medical Journal

Clinical findings of 112 patients with angiographically proven pulmonary embolism over a five-year period were analyzed. Recent immobilization, chronic heart disease, deep venous thrombosis, malignancy, and recent surgery were the most frequent predisposing factors. Only 5% had no identifiable risk factors. Presenting syndromes were circulatory collapse (25%), pulmonary infarction (59%), and uncomplicated pulmonary embolism (18%). Dyspnea and pleuritic chest pain were the predominant symptoms. The combination of dyspnea, pleuritic chest pain, and hemoptysis occurred in 23% of the patients. The most frequent signs were tachypnea, tachycardia, and rales. Most of the patients demonstrated arterial oxygen tension (PaO2) between 50 and …

Disseminated Strongyloides Stercoralis And Aspergillus Fumigatus Presenting As Diffuse Interstitial Pneumonitis In A Steroid-Dependent Chronic Obstructive Pulmonary Disease Patient, Larry Tankanow, Michael S. Eichenhorn

Henry Ford Hospital Medical Journal

We describe a patient with long-standing steroid-dependent chronic obstructive pulmonary disease who was admitted with new diffuse interstitial pulmonary infiltrates. Strongyloides stercoralis was present in the sputum and stool and responded to treatment. However, complicating disseminating Aspergillus fumigatus infection eventuated in the patient's death. Strongyloides stercoralis infection should be considered in patients with relevant exposure history, and complicating fungal and gram-negative bacterial infections which such patients may develop should be suspected.

Radiation And Society, Rosalyn S. Yalow

Journal of the Minnesota Academy of Science

We live in a world in which the perception of reality is too often confused with reality and there are few fields in which more confusion exists than in the popular perception of the hazards of exposure to low-level radiation and low-level radioactive wastes. Much of the fear of radiation has been generated by the association of radiation and radioactivity with nuclear explosions and nuclear war. So phobic is the fear that, in the United States at least, the old dream of "Atoms for Peace," including the use of nuclear reactors for power production and even the use of radioactive …

The Aids Project Newsletter (January 1988), David Ketchum, The Aids Project

AIDS Project Newsletter (1987-1991)

No abstract provided.

Pms Or Perifollicular Phase Euphoria?, Mary Guinan

School of Public Health Faculty Research

Why is it that so little is known about PMS? First of all, there is no agreement on what PMS is. If investigators are referring to different sets of symptoms, how can studies be comparable? In fact, they are not. Not only are the symptoms different, but the timing of symptoms is different, Some studies describe symptoms that occur 7 to 10 days before the onset of menses, while others include symptoms that begin 14 days before the onset of menses and continue for 7 days after onset. This definition suggests that women may have PMS-related symptoms during 21 days …

Conduct Disorder And Cognitive Functioning: Testing Three Causal Hypotheses, Irvin Sam Schonfeld, David Shaffer, Patricia O'Connor, Stephanie Portnoy

Publications and Research

Studied the relation between cognitive functioning, as evidenced by IQ and achievement test performance, and Diagnostic and Statistical Manual of Mental Disorders (DSM-III) categories of conduct disturbance, using data from Black adolescents who were members of collaborative perinatal project from birth to age 7 yrs. At age 17 yrs, Ss and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM—III. Results suggest that the relation of cognitive …

Neuropsychiatric Complications Of Hiv Infection: Public Policy Implications, Alexandra Beckett, Theo Manschreck

New England Journal of Public Policy

The human immunodeficiency virus (HIV) infects the central nervous system (CNS), causing symptoms in most persons with AIDS-related complex (ARC) and AIDS, and in a significant proportion of those classified as asymptomatic seropositive. The most common clinical syndrome secondary to CNS infection is known as HIV encephalopathy. When sufficiently disabling, HIV encephalopathy is known as AIDS dementia, and must be reported to the Centers for Disease Control as a case of AIDS.

AIDS dementia is a complex of cognitive, affective, behavioral, and motor symptoms which varies widely in its presentation. In some persons, cognitive impairment predominates, manifesting in a loss …

Understanding The Psychological Impact Of Aids: The Other Epidemic, Marshall Forstein

New England Journal of Public Policy

HIV has created two epidemics, one of disease, the other the consequence of the psychological response to that disease. Thus far, behavioral change is the only effective means of interrupting the transmission of HIV. The underlying psychological dimensions of the societal and individual responses to AIDS are discussed, with suggestions for how both rational thinking and irrational fears and anxiety contribute to the development of public policy. Examples are given of how short-term solutions to reduce anxiety may actually create long-term problems, potentially increasing the risk of transmission of HIV. Specific psychological mechanisms that contribute to the epidemic of fear …

Aids Public Policy: Implications For Families, Elaine A. Anderson

New England Journal of Public Policy

Much has been written about the AIDS crisis in the past few years. However, relatively little of this discussion has focused on AIDS as it may affect families. This report emerged from the 1987 Groves Conference on Marriage and the Family. It is a version of the chapter on public policy in AIDS and Families (ed. Eleanor Macklin, Hayworth Press, forthcoming, summer 1988), prepared by the conference's Task Force on AIDS and Families. The book details the probable impact of AIDS on individuals, families, and communities and delineates the implications for relevant professionals, organizations, and public policy. Those individuals who …

The Acquired Immunodeficiency Syndrome In New England: An Epidemiological Review Of The First Six Years, Laureen M. Kunches, Jeanne M. Day

New England Journal of Public Policy

Between 1981 and 1987 — the six-year period following initial recognition of the acquired immunodeficiency syndrome (AIDS) — 1,475 cases were reported among residents of the six New England states. Of nearly 40,000 cases nationwide, 3.8 percent occurred among New England residents, though the region 's population represents 5.5 percent ofthe total United States population. The groups most affected include homosexual or bisexual men (65 percent) and intravenous drug users (20 percent). However, in the two southernmost states — Rhode Island and Connecticut — 32 to 40 percent of all cases have used intravenous drugs. In these states, the male:female …

Motivational Strategies For Employee Participation In Corporate Health Promotion, Laura Eileen Cook

Dissertations and Theses @ UNI

This study was designed to describe the motivational strategies being used by corporations to encourage and/or maintain employee participation in health promotion programs. A questionnaire was designed and mailed to 170 members of the Association for Fitness in Business working in corporate health promotion facilities. Subjects were asked their subjective opinion concerning motivational strategy use and effectiveness, important considerations in motivational strategy development and which strategies had been objectively evaluated, and what were the outcomes of those evaluations. Data collection occurred over a four week period. The overall return rate was 48.2%. Seven strategies were identified to be currently in …

A Crisis In Insurance, Benjamin Lipson

New England Journal of Public Policy

As the life and health insurance industry evaluates its long-term financial goals, the cloud of Black Monday — October 19, 1987, the day the stock market collapsed — blurs its cherished investment income projections. With investment portfolios under siege, mutual life insurance companies and stock companies alike are wary of making policy-pricing miscalculations that could prove to be disastrous. As if that weren't enough, one single disease — acquired immunodeficiency syndrome — looms as the most serious threat to life and health insurers for the remainder of this century. The spread of the new disease has caused insurers to adjust …

The Clinical Spectrum Of Hiv Infections: Implications For Public Policy, Kenneth H. Mayer

New England Journal of Public Policy

The term acquired immunodeficiency syndrome (AIDS) is a definition developed by the Centers for Disease Control to explain the epidemic of immunosuppression first seen in the United States among gay and bisexual men and intravenous drug users in the early 1980s. It is now known that the human immunodeficiency virus (HIV) is the necessary agent for the compromise of the immune system which results in AIDS; however, there is a wide range of manifestations associated with HIV infection. Individuals with AIDS tend to have severe opportunistic infections or malignancies, and the vast majority ofindividuals die within two years after the …

Aids: An Overview, Loretta Mclaughlin

New England Journal of Public Policy

"We stand nakedly in front of a very serious pandemic, as mortal as any pandemic there ever has been," said Halfdan Mahler, director-general of the World Health Organization (WHO). "I don't know of any greater killer than AIDS, not to speak of its psychological, social and economic maiming. Everything is getting worse and worse with AIDS and all of us have been underestimating it, and I in particular. We're running scared. I cannot imagine a worse health problem in this century." When asked to compare AIDS to other epidemics, such as smallpox, that have infected and killed over the course …

Medical Care Of Aids In New England: Costs And Implications, Stewart J. Landers, George R. Seage Iii

New England Journal of Public Policy

This article presents an overview of cost issues related to AIDS. Data from the Massachusetts Cost of AIDS Study are combined with epidemiological projections to estimate the cost of treating people diagnosed with AIDS in New England. Aggregate inpatient, ambulatory, and home care costs are estimated to be $96.9 million and $524.8 million through 1987 and 1991, respectively. These estimates represent a relatively small percentage of total health care costs for all illnesses over the same time period.

The authors find that the cost of treating AIDS does not affect all health care providers uniformly and therefore argue that appropriate …

Introducing Aids Education In Connecticut Schools, William Sabella

New England Journal of Public Policy

Most of the nation 's schoolchildren are not infected with the AIDS virus (HIV). Since AIDS is a preventable disease, no one need become infected. In order to protect themselves, everyone, including children, must understand exactly how HIV is and is not contracted. The message of prevention, however, is controversial, since it must include advice on safer sex and drug use.

In 1984, Connecticut was forced to face the issue of a child with HIV infection entering school. The state responded by creating guidelines for prevention of disease transmission in schools and by subsequently developing an AIDS curriculum. Obstacles to …

Aids Initiatives In Massachusetts: Building A Continuum Of Care, Nancy Weiland Carpenter

New England Journal of Public Policy

The Health Resource Office was officially established within the Massachusetts Department of Public Health in August 1985 to coordinate policy, education, research, and service response to the AIDS epidemic, and to focus attention on the social and economic impact of the disease. The actual work of the office was begun earlier, in October 1983. This article reviews the activities of the Health Resource Office from October 1983 through June 1987 in allocating resources for AIDS and ARC programs and services. It then describes the conceptual model that evolved during this period for the continuum of services needed to reduce HIV …

Editor's Note, Padraig O'Malley

New England Journal of Public Policy

On occasion, the New England Journal of Public Policy will devote an entire issue to consideration of a public policy matter of major importance. The AIDS epidemic is such a matter, with a likely impact of overwhelming consequence well into the twenty-first century. The epidemic raises fundamental questions regarding the nature of individual freedom, our responsibilities to others, the always delicate balance between private rights and the public interest, and society's obligation to its "out" groups — whose members it has stigmatized, discriminated against, ridiculed, and treated as less than full and equal citizens. Indeed, it requires us to ask …

Hiv Antibody Testing: Performance And Counseling Issues, Michael Gross

New England Journal of Public Policy

This article assesses the performance of currently used tests for exposure to human immunodeficiency virus (HIV), the infectious agent associated with acquired immunodeficiency syndrome (AIDS); suggests, in view of that information, guidelines for counseling people seeking HIV antibody testing; and evaluates the claim that because antibody test results will effect behavior change in those who are infected, all members of high-risk groups should be tested.

HIV testing is likely to yield a high proportion of false-positive results in low-risk populations and infants born to infected mothers. A negative result may not establish freedom from infection in high-risk groups or the …

Aids And A-Bomb Disease: Facing A Special Death, Chris Glaser

New England Journal of Public Policy

In 1979 it was called "gay cancer," and it took the life of an acquaintance. Then "gay-related immune deficiency," or GRID, claimed neighbors, friends of friends, fellow activists. I began grief and death counseling with a segment of the population ordinarily concerned with life's ambitions and enjoyments: men in their twenties and thirties. Hospital visits and memorial services became more frequent.

By 1983, when it had come to be called AIDS, my own friends began to be affected. One was a man I dated in seminary, and I was devastated to learn of his illness only upon receiving a notice …

Analysis Of Body Composition With Use Of Body Impedance Analysis And Skinfold Calipers: A Correlation Study, Deborah J. Biver

Masters Theses

No abstract provided.

The Financial Performance Of System Acquired Hospitals, Janet Lynch

Theses and Dissertations

This study investigated the financial performance of not-for-profit hospitals in 10 Southern states acquired by either the for-profit or not-for-profit multihospital systems between the years 1978 through 1982. The impact of system affiliation on acquired hospitals was investigated by looking at average financial performance from the two years before acquisition to 1984/1985. Differences between the performance of hospitals acquired by for-profit and not-for-profit multihospital systems were examined as well. with regard to the latter, major findings revealed both for-profit and not-for-profit multihospital systems increased debt in acquired hospitals and made improvements to plant and equipment. For-profit multihospital systems additionally increased …

A Civil Liberties Analysis Of Surrogacy Arrangements, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

In this essay the author comes to the following conclusions based upon a civil liberties analysis. First, surrogacy arrangements cannot be prohibited or criminalized. Second, the state cannot ban the exchange of money for surrogacy services, provided the money is paid for conception, gestation, and birth. Money, however, cannot be paid on condition that the gestational mother waive her parental rights over the child. Third, contractual provisions that require the gestational mother to waive her parental rights or her rights to privacy and autonomy are void and unenforceable. Fourth, when the child is born, both the gestational mother and the …

An Overview Of Magnetic Resonance Imaging Of The Appendicular Musculoskeletal System, Sharon C. Siegel, Allan M. Haggar, Jerry W. Froelich, Burton I. Ellis

Henry Ford Hospital Medical Journal

No abstract provided.

The Aids Project Newsletter (December 1987), David Ketchum, The Aids Project

AIDS Project Newsletter (1987-1991)

No abstract provided.

Pituitary Metastasis: Lung Cancer Presenting As Bitemporal Hemianopsia With Diabetes Insipidus And Anterior Pituitary Deficiency, A. Keith Cryar, Jay Morgan, Jack P. Rock, Max Wisgerhof

Henry Ford Hospital Medical Journal

Symptoms and signs of pituitary disease are rarely the first manifestations of malignancy originating in another organ. We present a case which exemplifies the key points that suggest a diagnosis of metastatic pituitary disease. Our patient's diagnosis was adenocarcinoma of the lung with a metastasis to the intrasellar and suprasellar regions, which caused diabetes insipidus, anterior pituitary deficiency, and visual field defects. The metastasis had a dumbbell appearance and extended from the sella turcica into the suprasellar region. Diabetes insipidus was the initial clinical manifestation of lung cancer in this patient. A metastasis to the pituitary should be suspected if …

Neurobehavioral Symptoms In Mild Primary Hyperparathyroidism: Related To Hypercalcemia But Not Improved By Parathyroidectomy, Gregory G. Brown, Richard C. Preisman, Michael Kleerekoper

Henry Ford Hospital Medical Journal

The neurobehavioral symptomatology of severe primary hyperparathyroidism (PHPT) has been thoroughly described. Less is known about more mild cases. We evaluated 34 patients with mild PHPT and followed 19 for an average of six months. Of those cases followed, ten had parathyroidectomy (PTX). Patients with no neurobehavioral abnormalities had the lowest serum calcium levels (10.9 ± 0.88 mg/dL), patients with signs of affective disorder had intermediate levels (11.25 ± 0.66 mg/dL), and patients with signs of cerebral dysfunction had the highest levels (12.17 ± 1.17 mg/dL). Serum calcium significantly correlated with motor speed, psychomotor speed, fluid intelligence, and short term …

Prolonged Remission Of Cushing's Disease Following Bromocriptine Therapy, Malachi J. Mckenna, Marc Linares, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

A 33-year-old woman developed hypercorticism of fulminant onset following delivery of a full-term, normal child. An ectopic hormone-producing neoplasm was excluded by extensive studies. Pituitary dependent hypercorticism of intermediate lobe origin was suggested on the basis of onset following pregnancy, failure of Cortisol suppression by high-dose dexamethasone, hyperresponsiveness of prolactin to thyrotropin-releasing hormone stimulation, and reduction in adrenocorticotropin titers following oral administration of bromocriptine. Initial remission of disease achieved with bromocriptine was followed by recurrence on discontinuation of the agent. However, complete remission which occurred following a prolonged course of bromocriptine has persisted for a total of 22 months.

Hypothalamic Hypogonadotropic Hypogonadism In An Adolescent Male: A Rare Manifestation Of Aqueductal Stenosis, Robert J. Wilson, Max Wisgerhof

Henry Ford Hospital Medical Journal

No abstract provided.