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Biomedical subjects

H Joseph

Publications and source records attributed to H Joseph.

At least 37 records · Page 2Linked to original sources
PubMed1994

A study of the use of clonidine and naltrexone in the treatment of opioid addiction in the former USSR.

Sixty-eight opioid addicts in Moscow voluntarily entered a two phase study that employed the medications clonidine and naltrexone to withdraw addicts from narcotics and naltrexone for maintenance therapy. Of the 44 subjects entering the withdrawal phase, only 3 completed the procedure and entered naltrexone maintenance. All 27 subjects entering naltrexone maintenance left within 50 days against medical advice. Follow-up on about 75% of the subjects in both phases of the study showed they relapsed to opioid use after leaving treatment.

Adult↗
PubMed1991

Medical maintenance: the treatment of chronic opiate dependence in general medical practice.

Medical maintenance was created to treat rehabilitated methadone maintenance patients within the context of general medical practice. One hundred methadone patients who met screening criteria were transferred for continuing care from traditional methadone clinics either to the practices of hospital-based physicians or to a health maintenance organization. Patients see their physicians about once per month, submit urine samples at the time of the office visits, drink a dose of methadone in the presence of their doctor or nurse, and receive a 28-day supply of methadone in pill or tablet form. The methadone prescriptions are filled by the hospital pharmacies. Physicians are responsible for the patients' annual physicals and can treat patients for other conditions. In our initial analysis of medical maintenance, 82.5% of the patients remained in good standing and 5% left the program voluntarily in good standing; the remaining 12.5% who were unable to respond favorably were returned to clinic programs. For rehabilitated patients requiring long-term or life-long care, medical maintenance is a viable alternative to traditional clinic programs. With proper policies and procedures, medical maintenance can be implemented in many hospitals.

Aftercare↗
PubMed1990

Absence of antibody to human immunodeficiency virus in long-term, socially rehabilitated methadone maintenance patients.

Human immunodeficiency virus (HIV) infection has become widespread among parenteral drug abusers. We measured antibody to HIV and hepatitis B virus markers in 58 long-term, socially rehabilitated methadone-maintained former heroin addicts. None of the 58 had antibody to HIV, but one or more markers of hepatitis B virus infection were seen in 53 (91%). The duration of methadone maintenance was 16.9 +/- 0.5 years, and the median dose of methadone was 60 mg (range, 5 to 100 mg). Before methadone treatment, the patients had abused heroin parenterally for 10.3 +/- 1.7 years, and they had engaged in additional high-risk practices for HIV infection. We conclude that successful outcomes during methadone maintenance treatment are associated with sparing of parenteral drug abusers from HIV infection.

Female↗
PubMed1988

Methadone maintenance patients in general medical practice. A preliminary report.

Medical maintenance is the treatment by primary care physicians of rehabilitated methadone maintenance patients who are stable, employed, not abusing drugs, and not in need of supportive services. In this research project, physicians with experience in drug abuse treatment provided both the pharmacologic treatment of addiction as well as therapy for other medical problems, as needed. Decisions regarding treatment were based on the individual needs of the patient and on currently accepted medical practice rather than on explicit regulations. We studied the first 40 former heroin addicts who were transferred to this program from more conventional methadone clinics. At a follow-up visit at 12 to 55 months, 33 (82.5%) of 40 patients had remained in treatment; five (12.5%) had been discharged because of cocaine abuse and two (5%) had been voluntarily discharged. Personal benefits of medical maintenance include the dignity of a standard professional atmosphere and a more flexible reporting schedule. This program has the potential for improving treatment of selected methadone maintenance patients.

Counseling↗
PubMed1988

Cost effectiveness. How should it be determined?

The purpose of this article is to compare three commonly used indices of cost-effectiveness: the cost-effectiveness ratio, the cost-benefit ratio, and net benefit. We show that these indices can be interpreted to be consistent with one another and consistent with the traditional economic definition of cost-effectiveness. Further, we show that the relative cost-effectiveness of competing strategies cannot be determined by simply comparing their respective cost-benefit or cost-effectiveness ratios, but can be determined by comparing their respective net benefits. Finally, we show that cost-effectiveness ratios cannot be properly interpreted without consideration of the dollar value of health benefits.

Abstracting and Indexing↗
PubMed1988

[Studies on the biological function of the nucleotide base of vitamin B12].

Studies on the coenzyme activity of some nucleotide base analogues of adenosylcobalamine in the dioldehydratase and methyl-malonyl-CoA mutase systems resulted in fundamental differences: Contrary to dioldehydratase the coenzyme activity remains in the methyl-malonyl-CoA mutase system when adenosyl-cobamides with a strongly modified nucleotide base are studied. The analogues give a good growth response with Escherichia coli. In the growth test with Lactobacillus leichmanii only the cobamides that do not have substituted nucleotide bases in the positions 2 or 3 of their imidazole ring are active.

Escherichia coli↗
PubMed1985

Alcoholism and methadone treatment: consequences for the patient and program.

The data on alcoholism presented in this paper were extracted from a major follow-up study of active and discharged methadone patients conducted from 1974 through 1977 in New York City. Alcoholism is a factor in 26% of the terminations from methadone treatment. It is also the leading cause of death in treatment and the second leading cause of death, following complications with opiates, in the post-treatment Also, patients with episodes of excessive drinking have markedly lower survival rates over a 10-year period when compared to patients who are social or moderate drinkers.

Actuarial Analysis↗