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Biomedical subjects

Paul Robertson

Publications and source records attributed to Paul Robertson.

7 recordsLinked to original sources
PubMed2006

Alcohol and drug treatment population profile: a comparison of 1998 and 2004 data in New Zealand.

AIMS: To describe the profile of clients attending dedicated alcohol and other drug (AOD) treatment services in New Zealand, and to compare this profile with data from a 1998 survey. METHODS: 288 randomly selected AOD treatment workers in New Zealand were interviewed by telephone regarding their most recent assessment and follow-up clients, yielding a randomly selected sample of 383 clients. Workers were asked to identify the age, gender, ethnicity, main substance use problem, and geographical location of clients. RESULTS: 65% of clients were male; 32% were Maori. The mean age was 34 years and the largest group of clients were seen for alcohol-related issues (47%), followed by cannabis (24%) and opioids (15%). Amphetamines had risen as the main substance used--from near zero (in 1998) to 10% of the sample (in 2004). In 2004, surveyed clients were older and less likely to be Caucasian (European ethnicity), and were more likely to be seen in district health board (DHB) and non-residential settings. Compared to clients attending assessment appointments, those attending for follow-up were older, less likely to be female or Maori, and more likely to use opioids. Overall, Maori clients were younger, used cannabis more, and were less likely to live in a large city. Amphetamine users were younger and almost exclusively living in the North Island. CONCLUSIONS: Several substantial changes have occurred in the profile of AOD clients over the 6 years (1998-2004). Although the traditional substances of alcohol, cannabis, and opioids continue to predominate, the rise in amphetamine use in the community is reflected in a corresponding rise in amphetamine presentations to AOD services, particularly amongst younger clients and those in the North Island. While other observed changes might have been predicted from broader demographic trends and service reconfiguration, the emergence of a substantial disparity in treatment follow-up rates between Maori and non-Maori is not so easily explained.

Adult↗
PubMed2006

CXCR4 and CCR5 mediate homing of primitive bone marrow-derived hematopoietic cells to the postnatal thymus.

Factors governing the entry of cells into the postnatal thymus are poorly understood. We aimed to define molecular mechanisms mediating the homing of bone marrow cells to the thymus using a sublethally irradiated in vivo murine model. Entry of unfractionated and lineage-depleted bone marrow cells to the thymus, but not bone marrow, was a Galphai-mediated phenomenon. Lineage-depleted cells that had homed to the thymus expressed abundant CXCR4 and CCR5 mRNA, alone of 17 chemokine receptors evaluated by QPCR. Thymic-homed cells were distinct from cells that had homed to bone marrow in expression of CXCR4 and CCR5 by mRNA quantification and cell-surface expression of protein. Abrogation of CXCR4 and CCR5 function by genetic, antibody, or pharmacologic means impaired homing of lineage-depleted cells to the thymus, although not in a synergistic manner, implying interdependency of these receptors in the homing process. Competitive repopulation experiments demonstrated that inhibiting CXCR4-mediated homing adversely affected the double-negative cell pool at 2 weeks, suggesting that cells with prothymocytic activity may in part home via CXCR4. Overall, our data demonstrate differential homing mechanisms governing entry of unfractionated and lineage-depleted cells to irradiated bone marrow or thymus, with thymic homing of immature cells being pertussis-sensitive and mediated by the chemokine receptors CXCR4 and CCR5.

Animals↗
PubMed2006

The linear cutting stapler for enteric anastomosis: a new technique in pancreas transplantation.

The drainage of pancreatic exocrine secretions following pancreas transplantation is an evolving area of surgical practice. We describe a new technique applying a 55 mm Linear Cutting Stapler (LCS) to create the duodenoenterostomy for enteric drainage of the pancreas transplant. Twenty simultaneous pancreas and kidney transplantations performed between April 2005 and March 2006 were reviewed. Using a prospective database and chart review, complications and outcome related to the new technique of exocrine drainage were described. During this 12 month period, 19 of 20 consecutive simultaneous pancreas and kidney transplantations have been performed using the linear cutting stapler techinque. No complications relating to the enteric anastomosis have been demonstrated. In our initial experience, use of the LCS is both safe and easy to perform.

Anastomosis, Surgical↗
PubMed2003

Immune reconstitution in HIV infection and its relationship to cancer.

HIV infection results in formidable immune dysfunction, widely affecting the immune system, but typified by T lymphopenia. This dysfunction includes a perturbed immune response to several persistent viruses that have a propensity to cause tumors. Effective control of HIV replication by highly active antiretroviral therapy (HAART) results in regeneration of the damaged immune system, and recent advances have allowed this immune reconstitution to be better defined. This article describes the immunodeficiency caused by HIV and the response of the immune system to HAART, with specific reference to the immune response to cancers associated with HIV infection.

HIV Infections↗
PubMed2002

Gambling in mild-moderate alcohol-dependent outpatients.

There is a growing interest in the comorbidity of "substance use disorder" and "problem gambling." although there has been little study specifically on people with "alcohol dependence" who are being treated in general alcohol- and drug-user outpatient settings. This study aimed to determine the nature and extent of gambling in a sample of 124 mild-moderate alcohol-dependent outpatients. Of these, 79.8% had gambled in the previous 6 months and 29.8% on at least a weekly basis. Although a wide range of gambling modes was used, by far the commonest was Lotto, a national weekly lottery, at 60.5%. Some 19.4% were found to manifest current "problem gambling" [i.e., scored at least 1 on the South Oaks Gambling Screen (SOGS) instrument], and a further 4.0% were found to manifest pathological gambling confirmed by Diagnostic and Statistical Manual of Mental Disorders Version IV (DSMIV) diagnosis. "Problem gamblers" were significantly more likely to be involved in all modes of gambling compared with non problem gamblers. However, the most differentiating modes, in order, were gambling machines, dogs, casino, and horses. Treatment implications of these findings are discussed. A two-arm model of intervention for problem gambling within the alcohol- and drug-user treatment setting is proposed.

Adolescent↗