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Biomedical subjects

B Thom

Publications and source records attributed to B Thom.

At least 19 recordsLinked to original sources
PubMed1996

Changes in the binding characteristics of the mu, delta and kappa subtypes of the opioid receptor in the hypothalamus of the normal cyclic ewe and in the ovariectomised ewe following treatment with ovarian steroids.

The mu, delta and kappa opioid receptor subtypes were measured across the oestrous cycle of the ewe and in ovariectomised (OVX) ewes treated with oestrogen and/or progesterone. We have used a subtype-specific opioid receptor binding assay, in which [3H]diprenorphine non-preferentially labelled each receptor subtype in the presence of blocking concentrations of site-specific opioid analogues. The density and affinity of each receptor subtype was measured in the preoptic area (POA) of the hypothalamus and the mediobasal hypothalamus (MBH). Normally cycling ewes were killed during the luteal phase of the oestrous cycle and at various times after an injection of a synthetic prostaglandin (cloprostenol) to synchronise the onset of the follicular phase. OVX ewes were either untreated as controls (n = 4) or treated with oestrogen (n = 4), progesterone (n = 4) or oestrogen and progesterone combined (n = 4). The total number of opioid receptors did not alter across the oestrous cycle or with steroid hormone treatment. In the POA, the mean (+/- S.E.M.) number of delta receptors was significantly (P < 0.05) greater during the luteal phase than 24 h into the follicular phase (133 +/- 45 vs 35 +/- 8 fmol/mg protein). A significantly (P < 0.05) greater number of delta receptors was also found in the OVX progesterone-treated ewes compared with the control animals (172 +/- 9 vs 39 +/- 4 fmol/mg protein). In the MBH, the number of delta receptors was significantly (P < 0.01) greater in ewes killed 56 h after prostaglandin than luteal-phase ewes (184 +/- 40 vs 51 +/- 7 fmol/mg protein). The number of mu receptors in both the POA and the MBH was also significantly (P < 0.05) higher in the 56-h group than in the 12-h group. A similar trend was also observed in the steroid-treated animals, although differences did not reach statistical significance. The delta:mu ratio in the POA was significantly (P < 0.05) higher in the luteal-phase animals than any of the other groups killed after a cloprostenol injection that causes luteolysis. Similarly the ratio of delta receptor density to mu receptor density was greater (P < 0.05) in the OVX progesterone-treated ewes than in the OVX control ewes. No differences were found in the kappa receptor density across the cycle or with different steroid treatments. These data suggest that the relative proportions of the delta and mu subtypes of the opioid receptor in the hypothalamus change during the oestrous cycle. Regulation appears to be due to the feedback effects of ovarian steroids with progesterone altering the delta:mu ratio. In the MBH, there was a general increase in both delta and mu subtypes during the follicular phase of the oestrous cycle. This may explain, in part, how the responsiveness of the GnRH/LH axis to opioid peptides and antagonists changes across the cycle.

Animals↗
PubMed1995

Investigation of hepatitis B virus transmission in a health care setting: application of direct sequence analysis.

An epidemiologically linked cluster of hepatitis B virus (HBV) infections was investigated using HBV DNA amplification by a nested polymerase chain reaction with primers complementary to the region around the immunodominant a determinant of the surface gene, part of the X and core genes, and precore region and direct nucleotide sequence analysis. The cluster, in which 2 persons died of fulminant hepatitis, comprised 1 blood donor, 2 patients, and 2 health care workers. The Kimura two-parameter method was used to compare variance among the cluster with that in the control samples, which were collected from 7 patients infected with the same HBV subtype. Significantly less variation occurred within the cluster than in the control group (unpaired t test, P < .05). In an unrooted phylogenetic tree analysis, the 5 study samples formed a cluster distinct from the controls. This direct molecular approach of analyzing conserved regions of the HBV genome differentiated between viruses involved in HBV transmission events.

Aged↗
PubMed1992

Engaging patients with alcohol problems in treatment: the first consultation.

This paper considers the impact of the first consultation at a specialist alcohol clinic on patients' perceptions of their drink problem and on their expectations of help from three sources: an alcohol clinic, general practitioners and Alcoholics Anonymous. At intake, males had higher expectations than females of help from the alcohol clinic while people in manual occupations and those in the 'less heavy' drinking category had higher expectations of general practitioner help than other patients. Change was found to occur during the first clinic consultation so that by the end of the session patients had raised their rating of problem severity and their expectations of help from the three sources examined. Overall, patient perceptions of the clinic assessment session were positive. The study highlights the importance of obtaining a full understanding of the process of engagement in treatment and indicates the potential of a clinical assessment to effect change in patient attitudes.

Adult↗
PubMed1992

The use of services for alcohol problems: general practitioner and specialist alcohol clinic.

A sample of 40 patients referred to a specialist alcohol clinic were given a full assessment by a clinician and then randomly allocated to one of two groups. The first group received continuing care from the clinic. The second group were returned to the management of their general practitioners who were offered specialist support in caring for their patients. Patients and general practitioners were followed-up 6 months after the clinic assessment. This paper reports on the uptake of clinic and general practice services by patients and examines the possible factors associated with continuing attendance, including patient attributes, service activity, patients' self-assessments of their drink problem and their expectations of help from services. Qualitative data is used to examine patients' perceptions and experiences of clinic and general practice-based care for drinking problems. The findings highlight some of the difficulties reported by patients in receiving help for their problems particularly from general practitioners.

Adult↗
PubMed1990

Specialist versus general practitioner treatment of problem drinkers.

The efficacy of specialist versus general practitioner (GP) treatment of problem drinkers was assessed in a randomised controlled trial. 40 problem drinkers referred consecutively to a specialist alcohol clinic by their GP were, after assessment, randomly allocated to either GP or specialist clinic treatment groups. All subjects received initial advice and counselling in the clinic about their drinking. The specialist clinic group received continued care from the clinic including, if necessary, admission to hospital. Patients in the GP group were returned to the care of the GP who was contacted and supported by the specialist. After 6 months of follow-up, there were significant reductions in alcohol consumption and alcohol-related problems in both groups. No significant difference was found between the two groups with respect to the main outcome measures. No differential treatment effect was found with the more severely dependent drinkers. The findings show that after an initial detailed assessment and advice session, the treatment provided by GPs is at least as effective as that from a specialist clinic with respect to improvements in drinking behaviour and alcohol-related problems. After initial assessment and advice, specialist clinics should encourage GPs to become more involved in the subsequent care of problem drinkers. Such a practice should be based on the individual patient's needs and the adequacy of support offered to GPs.

Adult↗
PubMed1987

Rethinking drug policies in the context of the acquired immunodeficiency syndrome.

This article presents a policy analysis of the needed responses to the problems associated with the acquired immunodeficiency syndrome and drug misuse that are now being experienced in the United Kingdom of Great Britain and Northern Ireland. Among the issues considered is the overall organizational and administrative capacity of a country to deal with a new acute demand and the probable need for more national centralization of planning and effort in the drug field. Policies must aim at small multiple gains rather than at master-strokes. International communication must be strengthened. The human immunodeficiency virus (HIV) epidemic requires re-examination of the penal handling of drug misusers. Treating more patients earlier may contribute significantly to prevention strategies, and methods for "harm reduction" deserve attention. Compulsory treatment or testing of HIV infection is not favoured. The importance of professional training and of research is stressed. Although the immediate focus is on one particular country's policy needs, the issues raised are of wider relevance.

Acquired Immunodeficiency Syndrome↗
PubMed1982

Health, smoking and doctor' advice.

One hundred and sixty-seven individuals with chronic conditions were interviewed about their smoking history and current habits as part of two larger studies on health care. The interviews were lengthy and permitted individuals to comment freely on reasons for stopping or continuing smoking and the role of doctors' advice in these decisions. Only 22 per cent had never smoked. The youngest and males were most likely to have smoked. At time of interview, 51 per cent of those who had ever smoked were still smoking. Those with circulatory disorders, in contrast to respiratory or musculoskeletal disorders, were most likely to have stopped. Perceptions of doctors' advice varied by both age and diagnosis, with the elderly claiming to have received little medical advice. Those with histories of circulatory disorders reported receiving advice more frequently. Doctors may have advised these individuals more frequently because there was threat to life, but it is also possible that individuals with life-threatening disorders are more likely to recall such advice.

Aged↗
PubMedDate not supplied

Exploring young men's drinking using the AUDIT questionnaire.

This paper reports the findings of an AUDIT questionnaire administered to a sample of young (16-24-year-old) white males. Of the sample, 65% were drinking at potentially harmful levels. Averaging 45 U/week, 18-21 years was the age of highest alcohol consumption. Compared with 16-17- and 22-24-year-olds, this group recorded the highest proportion of hazardous drinkers and most negative consequences of drinking.

Adolescent↗
PubMedDate not supplied

Identifying alcohol-related harm in young drinkers: the role of accident and emergency departments.

Data are presented from a screening study of ambulant attendees at two London Accident and Emergency (A&E) departments. Among young people (aged 16-24 years), 37.2% were drinking harmfully [an Alcohol-Use Disorders Identification Test (AUDIT) score of 8 or more]; 17.3% admitted to drinking alcohol in the 6 h prior to attendance; and 14.6% considered that their attendance was alcohol related. Young women were as likely as men to score 8 or over. This age group had nearly twice the odds of scoring highly on the AUDIT, compared to those over 25 years old, and were more likely to report that their attendance was alcohol related. Screening in A&E departments would identify considerable numbers of young people who might benefit from brief intervention, but the problems of doing so are acknowledged.

Adolescent↗