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Biomedical subjects

F Tennant

Publications and source records attributed to F Tennant.

At least 19 recordsLinked to original sources
PubMed2001

Hepatitis C, B, D, and A: contrasting features and liver function abnormalities in heroin addicts.

Over 90% of intravenous heroin addicts (IVHAs) carry the hepatitis C virus (HCV). The other hepatitis viruses, A, B, D, and G are relatively unimportant in IVHAs compared to HCV although active hepatitis B may demonstrate a chronic, degenerative course identical to that of HCV. The clinical course of HCV and active hepatitis B may span three or more decades. It is helpful to classify patients as in the active, cirrhosis, or liver failure stages. Only in the active, early stage are the liver enzymes, ALT and AST, likely to be elevated. It is this stage that will most likely respond to antiviral therapy. HCV has so many extra-hepatic manifestations including immune suppression, collagen diseases, and possibly lymphoma and leukemia that the disease is best termed HCV syndrome rather than simple hepatitis.

Carrier State↗
PubMed1995

Cocaine abuse in methadone maintenance patients is associated with low serum methadone concentrations.

Cocaine abuse in methadone maintenance patients has emerged as a significant clinical problem. To determine if raising the daily methadone dosage is an effective way to eliminate cocaine abuse, 74 methadone maintenance patients maintained at daily dosages between 30 and 80 mg and who chronically abused cocaine were studied by a standard protocol. A total of 21 (28.4%) subjects ceased cocaine abuse when their methadone dosage was progressively raised to a maximal daily dose of 160 mg. Cocaine abuse appeared to accelerate elimination of methadone, since inadequate methadone serum concentrations (below 100 ng/ml) were found in 48 of 67 (71.6%) subjects tested 24 hours after a 100 mg oral methadone dose. Although cocaine abuse in methadone maintenance patients may respond to raising the daily methadone dosage, alternative treatments for cocaine abuse in methadone maintenance patients must be identified since cocaine abuse may lower serum methadone concentrations.

Adult↗
PubMed1995

Seroprevalence of hepatitis A, B, C, and D markers and liver function abnormalities in intravenous heroin addicts.

To determine the most prevalent forms of hepatitis in intravenous heroin addicts, 389 addicts consecutively admitted to outpatient treatment clinics throughout California were tested for antibodies to hepatitis A (anti-HAV), B core (anti-HBc), B surface (anti-HBs), C (anti-HCV), D (anti-HDV), and B surface antigen (HBsAg). The majority were also tested for serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase, lactic dehydrogenase, total bilirubin, globulins, albumin, and platelet count. The seroprevalence of each marker was: anti-HAV (40.7%); anti-Hbc (73.6%); anti-HBs (46.7%); anti-HCV (93.6%); anti-HDV (9.6%), and HBsAg (3.5%). No single case was positive for IgM, anti-HAV, or for both HBsAg and anti-HDV, indicating the presence of recent hepatitis A or hepatitis D infection. Abnormal liver enzymes, serum proteins, total bilirubin, and platelet count were found to be normal in 5.3 to 44.8% of anti-HCV cases indicating persistent infection. Among anti-HCV cases, elevated total bilirubin or a low platelet count was invariably associated with one or more liver enzyme and protein abnormalities. We conclude that while acute hepatitis may be frequent and caused by various viral types, hepatitis C is the primary form of chronic hepatitis found in intravenous heroin addicts. Almost half of hepatitis C cases demonstrate liver function abnormalities indicating persistent infection that has the potential to be contagious and progress to cirrhosis, liver failure, and hepatocellular carcinoma.

Adult↗
PubMed1992

Early amniocentesis: outcome, risks, and technical problems at less than or equal to 12.8 weeks.

OBJECTIVE: It is the purpose of this report to evaluate our experience with amniocentesis at less than or equal to 12 weeks' gestation. STUDY DESIGN: Medical records of 936 patients at less than or equal to 12.8 weeks' gestation undergoing genetic amniocentesis between Oct. 1, 1986, and June 30, 1990, were evaluated for gestational age, indication, frequency of needle insertion, amniocentesis complications, and pregnancy outcome. RESULTS: There were seven miscarriages within 2 weeks of amniocentesis (0.7%), 21 miscarriages before 28 weeks (2.2%), and four stillbirths or neonatal deaths (0.4%), resulting in a total postprocedural loss rate of 3.4%. There were 26 chromosomally abnormal fetuses (2.8%). The spontaneous abortion rate in ultrasonographically normal pregnancies at less than 14 weeks, not undergoing amniocentesis, has been estimated at 2.1% to 3.2%. CONCLUSION: Amniocentesis at 12 weeks is a viable option for patients desiring earlier prenatal genetic diagnostic information.

Amniocentesis↗
PubMed1990

Quantitative urine levels of abusable drugs for clinical purposes.

Urine screening by polarized fluorescent immunoassay (PFI), which can quantitate concentrations of drugs of abuse within specific ranges, has recently been developed. It is rapid and inexpensive, so it can be clinically used on a routine basis. Reported here are the urine concentrations of marijuana, cocaine, phencyclidine, and amphetamine metabolites in 790 clinical patients who either sought medical detoxification for a self-diagnosis of addiction, or a counseling and urine testing program with the self-perception that they were occasional, nonaddicted users. Mean urine concentrations of cocaine, phencyclidine, and amphetamine, but not marijuana, metabolites were significantly higher in addicted than nonaddicted patients. Sequential urine tests in addicts progressively demonstrate reduced urine concentrations for as long as several weeks if cessation of usage has occurred. Nonaddicted, occasional users usually produce a negative urine sample within 2 to 3 days. Despite some overlap in urine concentrations between addicted and nonaddicted users at the time of admission for treatment, quantitative urine testing is a valuable adjunct in the clinical diagnosis and treatment of drug abuse.

Humans↗
PubMed1989

Quantitative urine testing. A new tool for diagnosing and treating cocaine use.

The new quantitative urine tests for cocaine are an easy and inexpensive method of diagnosing and monitoring use of this drug and thus are practical for the primary care physician's office. They may help differentiate between occasional and addicted users, thus establishing the severity of the problem for the patient and family, employer, or school officials. Although the tests cannot be used for legal applications, they have great clinical value. The receptivity of patients and third parties to urine testing has been gratifying. Physicians are encouraged to consider use of these tests in office assessment.

Adolescent↗
PubMed1989

Alpha-fetoprotein levels in amniotic fluid between 11 and 15 weeks.

We have shown that alpha-fetoprotein levels in amniotic fluid peak at 13 weeks and then fall by about 10% a week until 20 weeks. Use of cutoff levels obtained by extrapolation backward from medians at later dates gives results that are too high and could cause diagnostic errors. The ability to monitor alpha-fetoprotein levels accurately provides an advantage to this method of early prenatal diagnosis.

Amniocentesis↗
PubMed1988

The rapid eye test to detect drug abuse.

Because the current epidemic of drug abuse has touched all levels of society, the primary care physician is increasingly called on to identify, monitor, and treat persons with drug abuse problems. All of the major drugs of abuse, including cocaine, marijuana, amphetamine, phencyclidine, heroin, and alcohol, may produce typical eye signs that can be easily detected by a rapid eye test. These signs include ptosis, abnormal pupil size, nonreactivity of the pupil to a light challenge, nystagmus, and non-convergence. When eye signs are detected, drug use should be confirmed by analysis of body fluids. The rapid eye test is suitable for routine use when screening adolescents, athletes, and employees with jobs where safety is essential.

Blinking↗
PubMed1988

Stepwise detoxification from cocaine. A promising regimen.

Cocaine dependence may not respond to behavioral and self-help treatment because of alterations in neurochemistry, particularly the catecholamine system. Thus, medical detoxification using a stepwise approach and several different therapeutic agents is often needed to assist the patient in achieving a cocaine-free state. An outpatient regimen includes regular clinic attendance, urine testing, education of patient and family, psychological evaluation, and a three- to four-week counseling program. Continued use of medication may be advisable for four to six months. Re-treatment is encouraged if relapse occurs.

Adolescent↗
PubMed1988

Chronic opioid treatment of intractable, non-malignant pain.

There is a sub-group of patients with non-malignant medical conditions who have severe, intractable pain and who require chronic opioid administration for adequate pain control. Reported here is a systematic clinical evaluation of 52 such patients who were referred after they had failed numerous, non-opioid pain treatments. Major causes of pain were irreversible degenerative and/or traumatic injuries to the musculoskeletal system. A variety of opioids in high daily dosages were required to achieve adequate pain control in these patients. Once pain relief was achieved, patients did not escalate their dosage, and they were able to maintain pain relief for long time periods. Although opioids produced dependence in all patients and complications of constipation and edema in about one third, high daily opioid dosage treatment appeared to be the only medical means to achieve adequate pain control in these subjects. We conclude that opioid maintenance should be utilized as a last resort treatment in patients who fail other pain treatments.

Adult↗