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Biomedical subjects

D Metzger

Publications and source records attributed to D Metzger.

96 records · Page 6Linked to original sources
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Naltrexone pharmacotherapy for opioid dependent federal probationers.

Federal probationers or parolees with a history of opioid addiction were referred by themselves or their probation/parole officer for a naltrexone treatment study. Participation was voluntary and subjects could drop out of the study at any time without adverse consequences. Following orientation and informed consent, 51 volunteers were randomly assigned in a 2:1 ratio to a 6-month program of probation plus naltrexone and brief drug counseling, or probation plus counseling alone. Naltrexone subjects received medication and counseling twice a week; controls received counseling at similar intervals. All therapy and medication were administered in an office located adjacent to the federal probation department. Fifty-two percent of subjects in the naltrexone group continued for 6 months and 33% remained in the control group. Opioid use was significantly lower in the naltrexone group. The overall mean percent of opioid positive urine tests among the naltrexone subjects was 8%, versus 30% for control subjects (p < .05). Fifty-six percent of the controls and 26% of the naltrexone group (p < .05) had their probation status revoked within the 6-month study period and returned to prison. Treatment with naltrexone and brief drug counseling can be integrated into the Federal Probation/Parole system with favorable results on both opioid use and re-arrest rates.

Adult↗
PubMedDate not supplied

High-risk behaviors for HIV: a comparison between crack-abusing and opioid-abusing African-American women.

High rates of unprotected sexual behaviors and the exchange of sex for crack have been reported among female crack cocaine users. This subpopulation of drug users is at significant risk for contracting and transmitting HIV and AIDS. To date, there has been no research comparing crack- and opioid-abusing women, particularly regarding their involvement in high-risk behaviors and other key background indicators for different subgroups of drug-abusing women. Sixty-one crack-abusing African-American women who recently entered an intensive outpatient treatment program were compared to 64 matched women whose primary drug of abuse was heroin. The opioid subgroup represented both those who were involved in methadone maintenance and those who were out of treatment. Higher rates of high-risk sexual behaviors were reported by the crack subgroup, including prostitution, number of sexual partners, and infrequency of condom use. As expected, i.v. drug use and high-risk behaviors associated with needle use were much higher among the opioid subgroup. Other significant differences were found between the two groups across key indicators. Individuals in the crack subgroup were younger, cared for more children, were less employable, were less likely to be married, and had more extensive lifetime substance abuse. Quantitative and qualitative background and clinical data are also presented. The nature of crack versus heroin abuse is also discussed, particularly in relation to high-risk sexual behaviors. Finally, the impact of the findings on developing appropriate treatment interventions for both groups is addressed.

Adolescent↗
PubMedDate not supplied

Prevalence of anti-neutrophil cytoplasmic antibodies (ANCA) in juvenile chronic arthritis.

OBJECTIVE: Sera from 66 children with active JCA of oligoarticular, polyarticular or systemic onset, 13 sera from patients in disease remission, 15 sera from patients with reactive arthritis, and 11 from Lyme arthritis patients were tested for the presence of anti-neutrophil cytoplasmic antibodies (ANCA) in order to evaluate their diagnostic significance in JCA. RESULTS: ANCA were found in 21% (14/66) of the active JCA sera, all showing an atypical pANCA staining pattern using indirect immunofluorescence on ethanol fixed granulocytes. 71% of these sera also showed antinuclear antibodies (ANA) on HEp-2 cells. By additional staining on paraformaldehyde fixed granulocytes to exclude staining artefacts due to ethanol fixation, 2 of the pANCA positive sera showed cytoplasmic staining. In no case did we find nuclear fluorescence suggesting a true cytoplasmic localization of the involved antigens. All ANCA positive sera were negative for anti-MPO and anti-LF antibodies. ANCA prevalence in our study group did not correlate with the disease subgroup, disease duration or other clinical characteristics. However, we found ANCA only in active disease. CONCLUSION: Our data suggest that the diagnostic importance of ANCA in JCA is restricted to only a few JCA patients. In these cases, however, ANCA positivity supports the diagnosis of JCA. Further studies are needed to substantiate this finding, as well as possible subgroup specificities. Standardized techniques of granulocyte fixation and antigen specific tests are needed to produce comparable results in different study groups.

Adolescent↗