Medicine and Health Sciences Commons^™

The Quest For An Aids Vaccine, Robert T. Schooley

New England Journal of Public Policy

More than fifty thousand cases of AIDS have been reported in the United States since the disease wasfirst described in 1981. Many times this number of people are infected with human immunodeficiency virus (HIV), which has been identified as the agent responsible for the illness. The seriousness of the disease, coupled with the relatively rapid spread of HIV, has fueled the effort for development of an effective vaccine.

Much is now known about the life cycle of the virus, and about its structural components. This information, and information about methods of transmission of the virus, form the basis for a …

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 …

Hiv Antibody Screening: An Ethical Framework For Evaluating Proposed Programs, Ronald Bayer, Carol Levine, Susan M. Wolf

New England Journal of Public Policy

The acquired immunodeficiency syndrome (AIDS) poses a compelling ethical challenge to medicine, science, public health, the legal system, and our political democracy. This report focuses on one aspect of that challenge: the use of blood tests to identify individuals who have been infected with the retrovirus human immunodeficiency virus (HIV). In this article, we follow the terminology recently proposed by the International Committee on the Taxonomy of Viruses; that is, we use the term human immunodeficiency virus. This replaces the more cumbersome dual terminology of human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV).

The issue is urgent: the tests are …

Behavioral Change In Homosexual Men At Risk Of Aids: Intervention And Policy Implications, Suzanne B. Montgomery, Jill G. Joseph

New England Journal of Public Policy

With more than fifty thousand cases of acquired immunodeficiency syndrome (AIDS) diagnosed since its initial recognition in 1981 and no cure or vaccine in sight, experts agree that prevention is of the utmost importance. Yet very little research has investigated how existing social-psychological and health behavioral knowledge can be applied to the special circumstances of programmatic responses to AIDS. One of the central aims of our own research group has been to describe the psychosocial determinants of successful behavioral risk reduction among homosexual men, the largest affected group. This work is reviewed and its implications for the development of intervention …

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 …

The Role Of Education In Aids Prevention, George A. Lamb, Linette G. Liebling

New England Journal of Public Policy

The severity of the current AIDS epidemic, combined with the lack of successful biological interventions, necessitates an active educational program as the primary intervention strategy. Health education theories abound, but relatively little definitive application of these theories has been made to the issues involved with HIV transmission: sexual behavior and the sharing of intravenous drug apparatus. Significant behavior changes have occurred in some people, but the consistency of the behavior change may be difficult to sustain. Thus, the authors suggest that health education should be delivered repeatedly in culturally acceptable language and format, by community leaders, and through many different …

U.S. Women And Hiv Infection, P. Clay Stephens

New England Journal of Public Policy

Women are inadequately provided with HIV services and education and are differentially denied access to these. Divisions of race, ethnicity, economic class, and religion, among others, are compounded by sexual discrimination within each of these categories.

Review of current data on women with AIDS reveals that the reporting methods used convey a false impression that women are not at significant risk. Moreover, the persons indirectly affected by AIDS are predominantly women — mothers, sisters, partners, family members, teachers, and human service workers. Thus, AIDS is more of a women's issue than the statistics imply.

Women, as a gender-defined class, face …

Sensitivity To Ingested Sulfites, Steve L. Taylor, Julie A. Nordlee

Department of Food Science and Technology: Faculty Publications

Sulfiting agents, including sodium and potassium bisulfite, sodium and potassium metabisulfite, sodium sulfite, and sulfur dioxide, have enjoyed widespread use as food and drug ingredients. The oral ingestion of these sulfiting agents is now known to trigger asthma in a small subset of the asthmatic population. The best evidence suggests that perhaps 150,000 to 200,000 individuals in the United States may be sulfite sensitive. Although the mechanism of sulfite-induced asthma remains unknown, several possibilities have been considered, including inhalation of sulfur dioxide (SO₂) while swallowing, an IgE-mediated reaction, and a deficiency of sulfite oxidase leading to impaired sulfite …

Clinical Use Of A Standard Kit-Preparation Of Radiolabeled Monoclonal Antibody 96.5 In The Diagnostic Imaging Of Metastatic Melanoma., Mansoor Saleh, D M. Miller, L Peterson, C D. Russell, M W. Unger

Haematology and Oncology, East Africa

We studied the efficiency of a standard-kit preparation using 1 mg 111In-labeled 96.5 monoclonal antibody in combination with 19 mg of unlabeled antibody in the diagnostic imaging of 27 patients with documented metastatic melanoma. Twenty-three of 26 patients (88%) demonstrated immunoscintigraphic localization of tumor. Of 104 metastatic sites previously documented by conventional studies, 62 (60%) were identified by immunoscintigraphy. A total of 77 sites demonstrated localization of radiolabeled antibody. Fifty-four (70%) corresponded to known sites of disease; eight sites (10%) were "discovered" by immunoscintigraphy and subsequently confirmed by conventional studies; 15 imaged sites (20%) could not be confirmed by conventional …

A Stereotaxic Atlas Of The Brain Of The Chick (Gallus Domesticus), Wayne J. Kuenzel, Manju Masson

Poultry Science Faculty Publications and Presentations

Nine brains taken from chicks two weeks of age were used for the development of this atlas. Each chick was first anesthetized with an intravenous (IV) injection of Chloropent2 (1.8 ml/kg). Chicks were then perfused via the heart with 90 ml physiological saline followed by 90 ml Heidenhain's3 solution. Each head was then positioned in a stereotaxic instrument as described in the previous section and three stainless steel (SS) insect pins (#2) were implanted in each brain at known coordinates. In the case of the brains used to construct the cross- sectional atlas plates, two pins were implanted horizontal to …

An Identified Histaminergic Neuron Can Modulate The Outputs Of Buccal-Cerebral Interneurons In Aplysia Via Presynaptic Inhibition, Hillel J. Chiel

Faculty Scholarship

We have identified 2 buccal-cerebral interneurons (BCIs), B17 and B18, that appear to be involved in the coordination of feeding behavior in Aplysia. The BCIs have their cell bodies in the buccal ganglion, but send axons to the cerebral ganglion via the cerebral-buccal connectives. The BCIs appear to make monosynaptic connections with neurons in the cerebral ganglion that modulate extrinsic muscles involved in feeding behavior. B17 and B18 are activated antiphasically during a motor program induced by stimulating the esophageal nerve and appear to 'read out' different phases of the buccal program to different cells in the cerebral ganglion. B17 …

Aspects Of Endocrinology, Michael Kleerekoper, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

No abstract provided.

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.

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 …

Pregnancy Following Sequential Bromocriptine Therapy In A Hyperprolactinemic Subject, Malachi J. Mckenna, M. Saeed-Uz-Zafar, Raymond C. Mellinger

Henry Ford Hospital Medical Journal

Regular menses were maintained in a 26-year-old woman with a prolactinoma by sequential bromocriptine therapy given for either five or 14 days of the menstrual cycle. She conceived promptly when desired.

Comparison Of Four High-Sensitivity Immunoradiometric Assays For Thyrotropin And Results Of Preliminary Clinical Studies, Malachi J. Mckenna, Earl Goad, Mohini Pimputkar, Carolyn S. Feldkamp

Henry Ford Hospital Medical Journal

New immunoradiometric assays (IRMAs) that detect low concentrations of thyroid-stimulating hormone (TSH) have recently become available for routine diagnostic use. These new assays have the putative advantage over conventional radioimmunoassay in that they can distinguish hyperthyroidism from euthyroidism by the finding of a serum TSH below the normal limit. In the present study we sought to evaluate four of these kits according to analytical performance characteristics and clinical utility. All IRM As could detect TSH at a concentration substantially below the lower limit of normal and thus effectively identify hyperthyroid samples. Although differences in the performance characteristics were found, all …

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 …

Back Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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.

End Matter, Vol. 11

Great Basin Naturalist Memoirs

No abstract provided.

Front Matter, Vol. 11

Great Basin Naturalist Memoirs

No abstract provided.

Front Matter

Henry Ford Hospital Medical Journal

No abstract provided.

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.

Naltrexone Does Not Affect Adrenal Steroidogenesis In Women With Hirsutism/Oligomenorrhea, Jeffrey A. Jackson, Thomas J. Wincek, Jose F. Pliego

Henry Ford Hospital Medical Journal

We studied the effects of the oral opiate receptor antagonist naltrexone on basal and ACTH-stimulated adrenal steroid levels in six women with hirsutism/oligomenorrhea and preexisting elevation of serum dehydroepiandrosterone sulfate. One of the six patients met the criteria for partial 3-β-hydroxysteroid dehydrogenase deficiency. No statistical differences were detected in steroid levels or ratios before and after 14 days of 50 mg/day of naltrexone. Thus, we find no support for the hypothesis that opioid peptides acting through opiate receptors (predominantly μ subtype) modulate the abnormal adrenal androgen secretion seen in these women with hirsutism/oligomenorrhea.

Hyperthyroidism Due To A Thyrotropin-Secreting Pituitary Microadenoma, Jeffrey A. Jackson, Mitchell Smigiel, John F. Green Jr.

Henry Ford Hospital Medical Journal

A 52-year-old man presented with elevated thyroid hormone levels and an inappropriately normal serum thyrotropin (TSH) (4.0 μU/mL: normal 0.5 to 6.0 μU/mL). Computed tomography suggested an intrasellar mass without radiographic sellar enlargement. Serum alpha-subunit was elevated with flat responses of both alpha-subunit and TSH to thyrotropin-releasing hormone. Transsphenoidal adenomectomy resulted in clinical and biochemical cure with subsequent development of hypothyroidism with otherwise preserved anterior pituitary function. Pathologic studies demonstrated an 8 mm typical thyrotroph cell adenoma. Early diagnosis of such tumors requires a high index of clinical suspicion and may be facilitated in the future by utilization of highly …

Primary Hyperparathyroidism And Associated Neoplasms, Angelos A. Kambouris, Mohammed R. Ansari, Gary B. Talpos

Henry Ford Hospital Medical Journal

No abstract provided.

Effects Of Weight Reduction, Exercise, And Diet Modification On Lipids And Apolipoproteins A-L And B In Severely Obese Persons, J. David Fachnie, Craig C. Foreback

Henry Ford Hospital Medical Journal

We assessed the lipid and apolipoprotein effects of hypocaloric dieting, increased physical activity, and dietary modification in severely overweight adults (body mass index [BMI] 43.05 kg/m-). The 34 women and four men enrolled in the ambulatory weight control program donated blood before, during, and after hypocaloric dieting (420 kcal/day). Mean values before dieting included cholesterol of 223 mg/dL, high-density lipoprotein (HDL) cholesterol of 43 mg/dL, and cholesterol/HDL cholesterol of 5.90. This placed our subjects at high risk for coronary artery disease. Other values included triglycerides of 138 mg/dL, apolipoprotein A-l of 152 mg/dL. and apolipoprotein B/apolipoprotein A-l of 0.64. Significant …

Renal Involvement In Type 2 Diabetes Mellitus: A Clinicopathologic Study Of The Henry Ford Hospital Experience, Francis Dumler, Vijay Kumar, Raymond N. Romanski, Pedro Cortes, Nathan W. Levin

Henry Ford Hospital Medical Journal

To better understand renal dysfunction in type 2 diabetes mellitus, we studied the clinical and autopsy findings in comparable cohorts of 108 diabetic and 77 nondiabetic patients. In the diabetic group, no differences were noted between black and white patients in blood glucose concentrations, mean blood pressure, or the prevalence of diabetic glomerulosclerosis. However, the prevalence of renal insufficiency was significantly greater (P = 0.002) in black diabetics (58%) than in white diabetics (35%). black controls (28%), and white controls (20%). Logistic regression analysis demonstrated a significant association of renal insufficiency with diabetes (P = 0.006) and race (P = …

Primary Aldosteronism At Henry Ford Hospital In The 1980s, Max Wisgerhof

Henry Ford Hospital Medical Journal

This report describes the experience with the diagnosis and treatment of primary aldosteronism at Henry Ford Hospital since 1980. Of the 28 patients who received the diagnosis. 13 had unilateral primary aldosteronism and 15 had idiopathic hyperaldosteronism. Individual cases are used to demonstrate clinical points. The clue to the presence of primary aldosteronism in a hypertensive patient is hypokalemia. The diagnosis is established by showing 1) high plasma aldosterone after intravenous saline or high urinary aldosterone after treatment with sodium chloride orally, and 2) low stimulated plasma renin activity. Treatment with potassium supplement should be given during the testing. Unilateral …