CORE--CLINICAL ASSESSMENT

核心——临床评估

• 批准号: 6302603
• 负责人: J A MCCUTCHAN
• 金额: $ 17.13万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2000-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6302603
• 关键词: AIDS; AIDS dementia complex; AIDS therapy; HIV infections; antiAIDS agent; biomarker; biomedical facility; case history; clinical research; cognition disorders; cytomegalovirus; disease /disorder proneness /risk; health care referral /consultation; histopathology; human subject; human therapy evaluation; human tissue; infectious encephalitis; longitudinal human study; medical outreach /case finding; patient /disease registry; postmortem; prognosis; psychoneuroimmunology; stavudine

Neurobehavioral problems in HNRC subjects must be interpreted in the context of their medical, neurologic and immunologic status. The CAC provides other HNRC cores and projects with quantitative, longitudinal assessment of medical history, physical signs and symptoms, immunologic status, quantitative medication histories, non-medical drug exposure, cerebrospinal fluid, and staging of HIV infection. The CAC plays a leading role in conceiving, organizing, and facilitating multidisciplinary review of each visit to integrate and provide quality control of findings from each core. To help maintain continuing subject participation in the HNRC, the CAC provides to participants l)individual feedback of multidisciplinary findings and (with written consent) to their health care providers, 2) short term medical crisis management and referral, and 3) updates of treatment and research findings. The CAC assists with long term cohort maintenance by establishing frequent monitoring of subjects with advanced AIDS. This personalized attention along with bedside assessment of subjects who are critically ill assures that subjects are studied preterminally and complete autopsy studies, thus supporting the neuropathological studies of HNRC. Data from the CAC support major scientific aims of every other core and project. Furthermore, the CAC itself has scientific aims which include: 1) We will complete a series of at least two, controlled, Phase II, treatment trials of Stavudine (D4T) and other antiretroviral, antitoxic, and anticytokine drugs for patients with Minor Cognitive Motor Disorder (MCMD) to determine: a) is the cognitive component of MCMD reversible? b) do changes in virologic markers (CSF and plasma HIV-RNA) predict the response to antiretrovirals? c) is response sustained for at least 24 weeks? 2) We will extend our current clinicopathologic correlations of neuropsychologic performance to determine: a) how frequently is MCMD associated with CMV-encephalitis, HIV-encephalitis, both or neither at post mortem neuropathologic examination? b) how often does CMV-E occur in the absence of clinically recognized CMV-R or other CMV syndromes?

HNRC受试者中的神经行为问题必须在 他们的医学，神经和免疫学位的背景。 CAC 提供其他HNRC核心和项目，以定量，纵向 评估病史，身体体征和症状，免疫学 状态，定量药物史，非医学药物暴露， 脑脊液和HIV感染的分期。 CAC扮演领先 在构想，组织和促进多学科审查中的作用 每次访问以整合并提供对发现的质量控制 每个核心。 为了帮助维持持续的主题参与HNRC，CAC 向参与者提供l）多学科的个人反馈 调查结果和（书面同意）给他们的医疗保健提供者，2） 短期医疗危机管理和推荐，以及3）更新 治疗和研究结果。 CAC协助长期队列 通过频繁监控高级受试者来维护 艾滋病。这种个性化的关注以及床头评估 严重不适的受试者确保对受试者进行研究 自虐和完成尸检研究，从而支持 HNRC的神经病理学研究。 CAC的数据支持其他每个核心的主要科学目标 项目。此外，CAC本身具有科学目的，其中包括： 1）我们将完成一系列至少两个受控的，II期， Stavudine（D4T）和其他抗逆转录病毒的治疗试验，抗毒性， 和针对较小认知疾病患者的抗细节药物 （MCMD）确定：a）MCMD可逆的认知成分？ b） 病毒学标记（CSF和等离子体HIV-RNA）的变化预测 对抗逆转录病毒的反应？ c）至少24 几周？ 2）我们将扩展当前的临床病理关系 神经心理学表现以确定：a）MCMD多久一次 与CMV-脑膜炎，HIV-脑膜炎有关，无论是在 验尸神经病理学检查？ b）CMV-E发生多久 缺乏临床认可的CMV-R或其他CMV综合征？