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P A Brewer

Publications and source records attributed to P A Brewer.

5 recordsLinked to original sources
PubMed1998

Patients with alcohol problems in the emergency department, part 1: improving detection. SAEM Substance Abuse Task Force. Society for Academic Emergency Medicine.

Medical and social problems related to alcohol use are frequently seen in the ED. Often, the tempo of emergency medicine practice seems to preclude assessment beyond that required by the acute complaint. However, detection of ED patients with alcohol problems can occur using brief screening tools. This article was developed by members of the SAEM Substance Abuse Task Force, and describes screening tools that have been used successfully to identify at-risk and dependent drinkers. Their brevity, reproducibility, and accuracy vary somewhat, but screening can be realistically performed in the busy ED setting. The early detection of patients with alcohol problems would provide the opportunity for early intervention, and may reduce subsequent morbidity and mortality in this patient population.

Adult↗
PubMed1998

Patients with alcohol problems in the emergency department, part 2: intervention and referral. SAEM Substance Abuse Task Force. Society for Academic Emergency Medicine.

Early intervention and appropriate referral of patients with alcohol problems have the potential to reduce alcohol-related morbidity and mortality. Part 1 of this series introduced screening tools that can be applied in the ED to allow early detection of at-risk drinkers. This article was developed by members of the SAEM Substance Abuse Task Force and describes assessment and intervention techniques once the at-risk or dependent drinkers has been identified. Appropriate aftercare and referral of patients found to have alcohol problems are also discussed.

Alcoholism↗
PubMed1986

Stimulation-associated changes in frog neuromuscular junctions. A quantitative ultrastructural comparison of rapid-frozen and chemically fixed nerve terminals.

The ultrastructural effects of stimulation and subsequent rest were measured in frog neuromuscular junctions preserved by rapid-freezing and freeze-substitution, a method that minimizes fixation-associated membrane rearrangements. The effects were compared to those measured in junctions preserved by aldehyde fixation in order to identify artifacts attributable to the method of preservation. Effects of stimulation previously observed in tissue preserved by aldehyde fixation were evident in both the rapid-frozen and aldehyde-fixed neuromuscular junctions in the present study. Synaptic vesicles were reduced in number and cisternal profiles were increased. However, the sizes and shapes of the cisternae differed with the method of preservation. In addition, it was found that mitochondria underwent a change in shape with stimulation. This was accompanied by swelling in the fixed preparations, but not in the rapid-frozen ones. Fixation after stimulation also produced swelling of the nerve terminals, a stimulation-associated change not evident in preparations that were preserved by rapid-freezing. After stimulation and 60 min of rest, nerve terminals showed recovery towards control morphology, evidence that the effects of the stimulation parameters used in the study were reversible. This study, utilizing rapid-frozen material, confirms previous reports based on chemically fixed tissue that stimulation reduces the number of synaptic vesicles and increases the number of cisternae. The findings are in accord with the hypotheses of exocytotic neurotransmitter release and local recycling of synaptic membrane. In addition, the study emphasizes that accurate quantitative assessments of membrane redistribution in active secretory systems cannot depend on chemically fixed tissues. It also shows that mitochondria are susceptible to radical distortion by aldehyde fixatives, and that the degree of susceptibility differs with the physiological state of the tissue.

Animals↗