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Olaf Drummer

Publications and source records attributed to Olaf Drummer.

4 recordsLinked to original sources
PubMed2005

Central sleep apnea in stable methadone maintenance treatment patients.

STUDY OBJECTIVES: Methadone, a long-acting mu-opioid agonist, is an effective treatment for heroin addiction. Our previous data show that 6 of 10 methadone maintenance treatment (MMT) patients had central sleep apnea (CSA). This study aims to confirm these results and to investigate the pathogenesis of the CSA. METHODS: Twenty-five male and 25 female MMT patients and 20 age-, sex-, and body mass index (BMI)-matched normal subjects were tested with polysomnography, blood toxicology, and ventilatory responses to hypoxia and hypercapnia. Resting cardiorespiratory tests were performed in the MMT group RESULTS: MMT patients and normal subjects were 35 +/- 9 years old (mean +/- SD), and BMI values were 27 +/- 6 kg/m2 and 27 +/- 5 kg/m2, respectively. Thirty percent of MMT patients had a central apnea index (CAI) > 5, and 20% had a CAI > 10. All normal subjects had a CAI < 1, and no difference was found in obstructive apnea-hypopnea index between the two groups. Methadone blood concentration was the only significant variable (t = 2.33, p = 0.025) associated with CAI and explains 12% of the variance. Awake Pa(CO2), antidepressant use, reduced ventilatory response to hypercapnia, and widened awake alveolar-arterial oxygen pressure gradient together explain a further 17% of the CAI variance. CONCLUSIONS: Thirty percent of stable MMT patients have CSA, a minority of which can be explained by blood methadone concentration. Other physiologic variables may also play a role in the pathogenesis of CSA in MMT patients, and further research is indicated in this area.

Adult↗
PubMed2002

Are 24-hour urine samples and creatinine adjustment required for analysis of inorganic arsenic in urine in population studies?

Compliance with 24-h urine samples can be low in population-based studies and first morning void urine samples are often collected for convenience. Interpretation of arsenic concentrations in urine is influenced by a range of factors unrelated to exposure. To reduce the influence of such factors, creatinine adjustment is routinely used. This study aimed to determine whether first morning void urinary inorganic arsenic concentrations approximate 24-h urinary arsenic concentrations and whether creatinine adjustment improved the correlation between environmental arsenic concentrations and urinary inorganic arsenic concentrations. One hundred sixty spot samples and corresponding 24-h urine samples were collected from people living in areas with a range of environmental arsenic concentrations and analyzed for inorganic arsenic using borohydride arsine generation followed by atomic absorption spectrophotometry. There were no significant differences between the urinary inorganic arsenic concentrations for the different sample types or whether creatinine adjusted or not. Significant correlations were observed between adjusted and unadjusted samples. The data set was highly skewed and when only detectable arsenic samples were considered, the relationship between sample types became nonsignificant. The results of this study suggest that spot samples may be adequate for measuring short-term exposure, using inorganic arsenic as the outcome variable; however, additional work on a larger data set is required. Creatinine adjustment of urinary inorganic arsenic concentrations may not be required in population studies investigating environmental exposure.

Arsenic↗
PubMedDate not supplied

Cardiorespiratory function in stable methadone maintenance treatment (MMT) patients.

Patients in methadone maintenance programmes (MMT) often smoke tobacco and cannabis and many have ongoing illicit drug use. There is therefore potential for these patients to have abnormal cardiorespiratory function; however, few studies address this in stable MMT patients. We assessed resting cardiorespiratory function on 50 stable MMT patients (25 males, 25 females). Forty-six MMT patients were current tobacco smokers, 19 were current cannabis users and none were currently using opioids other than prescribed methadone. We defined abnormalities of respiratory function as those results outside the 95% confidence interval of reference values for normal subjects adjusted for age, weight, height and sex. Thirty-one (62%) MMT patients had reduced carbon monoxide transfer factor (D(L)CO); 17 (34%) had elevated single breath alveolar volume (V(A)) and 43 (86%) had a reduced D(L)CO/V(A) ratio. Six patients (12%) had reduced FEV1; one (2%) had reduced FVC; and nine (18%) had an obstructive ventilatory defect. Ten (20%) patients had PaCO2 higher than 45 mmHg and 14 (28%) had alveolar to arterial oxygen gradient (A-aPO2) higher than 15 mmHg. CXR, Echocardiography and ECG showed no significant abnormalities. We conclude that stable MMT patients have abnormalities of resting respiratory function which may be due to ongoing tobacco cigarette and current or past cannabis smoking.

Adolescent↗