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Biomedical subjects

L Dunlap

Publications and source records attributed to L Dunlap.

6 recordsLinked to original sources
PubMed2004

Physicians practicing in methadone treatment programs: who are they and what do they do?

OBJECTIVE: This study examines the characteristics and roles of physicians practicing in methadone maintenance treatment programs (MTPs). METHODS: Physicians and clinic directors at 172 MTPs in the United States completed surveys. MTPs were selected for study participation based on their locations (large urban, urban, or nonurban area) ownership status (for profit and non-profit), and size (patient capacity of 1-100, 101-300, and 300+). Weighted data were analyzed with descriptive and multivariate methods. RESULTS. Physicians were primarily white males aged 45 or older; 44% had 10 or more years of experience working in methadone treatment. Physicians reported spending 26% of their time completing administrative tasks. Most reported that they determine dosing levels on an individual patient basis. Average maintenance dose was 69 mg/day. CONCLUSIONS: Physicians' treatment practices play a major role in overall treatment, treatment retention, and outcomes. Physicians at for-profit and large urban MTPs reported spending the most time in direct patient contact.

Accreditation↗
PubMed1993

Fibromyalgia. Part I. Review of the literature.

Fibromyalgia presents with generalized body pain, multiple tender points, and associated ancillary symptoms, including fatigue and nonrestorative sleep. The abnormal sleep pattern is the most common accepted etiology for this condition. The diagnosis may be made on the basis of a classic presentation of symptoms and clinical findings. The treatment of fibromyalgia includes aerobic exercise and the use of tricyclic antidepressants to modulate the sleep disorder with less than excellent results. In spite of the frustrations in treating this condition successfully, many patients are relieved to be provided with a diagnosis and to obtain sympathetic and supportive care from their physicians.

Combined Modality Therapy↗
PubMed1989

Extending the detection limit of the TDx fluorescence polarization immunoassay for benzoylecgonine in urine.

This modified calibration method decreases from 300 to 27 micrograms/L the limit of detection for the cocaine metabolite (hydrolysis product), benzoylecgonine, by the Abbott Laboratories TDx fluorescence polarization immunoassay. For this determination we used 30 controls prepared from a single urine pool known to be negative for cocaine metabolite. Assay of 80 controls prepared from 20 different patients' urine samples yielded a limit of detection of 44 micrograms/L. To test these limits of detection, we analyzed 90 patients' urine samples known to be negative for cocaine metabolite and 74 patients' samples known to be positive for cocaine metabolite, using the TDx with our revised calibration. Results for two of the known negative samples and 96% of the samples containing cocaine in the 50 to 100 micrograms/L range fell above the 44 micrograms/L limit. The TDx showed excellent calibration stability. For 28 days during the test, the instrument was not recalibrated. During this period the day-to-day analysis of 50 micrograms/L controls produced a mean TDx response of 0.485 (SD 0.007) with a coefficient of variation of 1.5%.

Autoanalysis↗
PubMedDate not supplied

Limit for qualitative detection of benzoylecgonine in urine using EMIT reagents and the Hitachi 705 automatic analyzer.

The limit of detection for the cocaine metabolite (hydrolysis product), benzoylecgonine, using Syva EMIT reagents and the Hitachi 705 automatic analyzer has been found to be 10 ng/mL at the 99% confidence level. For this determination 30 controls were prepared from a single urine pool known to be negative for cocaine metabolite. Urine samples of 90 patients were found to be drug-free when analyzed by selected ion monitoring gas chromatography/mass spectrometry for ecgonine methyl ester and benzoylecgonine at sensitivities of less than 0.4 ng/mL and 1.3 ng/mL, respectively. To test matrix effects on the limit of detection, these samples were screened with the Hitachi 705. Results for eight of the known negative samples fell above the 10-ng/mL limit of detection while only one presumptive positive resulted at an arbitrary 20-ng/mL cutoff. Detection limits were also determined using 20 different negative patients' urine samples fortified with benzoylecgonine. At the 99% confidence level using EMIT d.a.u. and 705 reagents the detection limits were found to be 44 ng/mL and 35 ng/mL, respectively. It was found that 62% of patients' samples positive for benzoylecgonine fell below the 300-ng/mL cutoff and above a cutoff at 50 ng/mL.

Cocaine↗