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Biomedical subjects

R Alcorn

Publications and source records attributed to R Alcorn.

8 recordsLinked to original sources
PubMed2001

Two methods of community detoxification from opiates: an open-label comparison of lofexidine and buprenorphine.

There is currently no consensus on the best approach to the management of opiate detoxification. In the current open-label study, 69 opiate-dependent individuals requesting outpatient detoxification were allocated to two different medication regimes: lofexidine and buprenorphine. Allocation was dependent on the timing of their presentation. Lofexifidine is a structural analogue of clonidine, and used widely in the UK. Buprenorphine is a partial opiate agonist with unusual pharmacological properties. Outcomes were better for the buprenorphine-receiving group (n=38). Clients receiving buprenorphine had a less severe withdrawal syndrome, and were more likely to complete their detoxification. In addition, for the buprenorphine-receiving group it was found that the withdrawal syndrome was least in those prescribed an initial dose of 4 mg. The findings and their implications are discussed. The design of the study precludes definitive conclusions regarding relative efficacy.

Adult↗
PubMed2000

Validation of the Christo Inventory for Substance-misuse Services (CISS): a simple outcome evaluation tool.

The Christo Inventory for Substance-misuse Services (CISS) was developed as a single page outcome evaluation tool completed by drug/alcohol service workers either from direct client interviews or from personal experience of their client supplemented by existing assessment notes. Its 0-20 unidimensional scale consists of 10 items reflecting clients' problems with social functioning, general health, sexual/injecting risk behaviour, psychological functioning, occupation, criminal involvement, drug/alcohol use, ongoing support, compliance, and working relationships. Comparison scores indicating low, average or high problem severity were produced by 243 drug users attending a harm minimisation out patient service and 102 alcohol users at an outpatient alcohol service. Means and cut-off scores for abstinence oriented treatments were derived from a 6-month follow-up of 90 treated drug users. Sub sets of the harm minimisation sample were used to derive item alpha, test-retest and inter-rater reliability coefficients of 0.74, 0.82 and 0.82, respectively. The inter-rater coefficient increased to 0.91 when retests were conducted the same day. Among the abstinence oriented treatment sample the CISS produced correlations ranging from 0.43 to 0.99 with the Opiate Treatment Index and measures of trait anxiety, unpleasant life events, poor quality of life and low self-esteem. The simplicity, flexibility and brevity of the CISS make it a useful tool allowing comparison of clients within and between many different service settings.

Adult↗
PubMed2000

Involvement of community pharmacists in the care of drug misusers: pharmacy-based supervision of methadone consumption.

This article examines the feasibility and acceptability of a supervised consumption of methadone service from local community pharmacies. It builds upon the British Department of Health's recommendations to increase the involvement of community pharmacists in the care of addicted drug users and to expand the range of services they offer to drug users. The article also takes up the ongoing debate on regulating the structure of prescribing and dispensing of methadone and the Department of Health's suggestion to consider methods to reduce the diversion of methadone, for example via supervised consumption of methadone. The pharmacy-based supervised self-administration of methadone scheme (SSA) at the Camden and Islington Community Health Services Trust Substance Misuse Services (CTDS) in London has been found to be valuable by clients, pharmacists and keyworkers. All pharmacists involved regarded the project as workable and expressed their willingness to continue with the provision of supervised dispensing of methadone in the future. Clients stated as main advantages: local access, which saved them time and travelling, and the longer opening hours enabled them flexibility in managing their time. The main negative comments were related to lack of privacy when drinking their methadone within the pharmacy. Most keyworkers welcomed the SSA scheme as another dispensing option available. The fact that another responsible and accountable health professional was involved was positively perceived by the key workers. The Camden and Islington pilot project of providing a supervised consumption of methadone service from local community pharmacies has successfully put into practice the Department of Health's recommendations to increase the involvement of community pharmacists in the care of addicted drug users and to expand the involved health range of services they offer to drug users. This suggests a positive future for the practice and implementation of pharmacy-based self-administered provision of methadone.

Journal Article↗
PubMed1986

Liquid chromatography used in diagnosis of a rare hemoglobin combination: hemoglobin S/LeporeBoston.

"High-performance" liquid chromatography (HPLC), applied to hemoglobin analysis, is decidely more sensitive and gives better resolution than do routine electrophoretic methods. Here we present a case with a rare double heterozygote hemoglobin S/LeporeBoston, originally diagnosed as homozygous hemoglobin S by routine electrophoretic methods. Using a gradient elution weak cation-exchange HPLC technique, we could separate hemoglobin S and hemoglobin LeporeBoston and make the correct diagnosis. This case demonstrates how HPLC can be a useful adjunct to routine electrophoresis.

Adult↗
PubMed1984

Fluidotherapy and exercise in the management of sickle cell anemia. A clinical report.

Children hospitalized during sickle cell anemia crises suffer restricted range of motion secondary to vasoocclusive-induced pain and are almost always nonambulatory. Texas Children's Hospital, Houston, TX, now refers most of these children to the Physical Therapy Department at St. Luke's Episcopal Hospital, Houston, TX, for Fluidotherapy and general strengthening and increased endurance programs. The Fluidotherapy treatment and the exercise program have resulted in a marked reduction in the length of hospitalization (compared with length of hospitalization by the same patients during previous episodes) and have permitted a major reduction in the dosage of analgesics previously administered. Spine, trunk, and extremity range of motion and gait improved markedly with treatment.

Adolescent↗
PubMed1983

Trivalent, inactivated influenza virus vaccine in children with sickle cell disease.

School-aged children with sickle cell disease who were administered a single dose of trivalent, inactivated influenza virus vaccine had serum antibody titers comparable to titers achieved in the two-dose trials carried out in 1978. The proportion exhibiting titers of 1:32 or greater ranged from 84% to 68% for the three antigens. Preschool children with sickle cell disease received two doses of the same vaccine four weeks apart and their postimmunization titers to each of the antigens were slightly lower. The vaccine, which contained 15 micrograms of hemagglutinin to each of three influenza viruses, A (H1N1), A (H3N2), and B, in a volume of 0.5 mL, was adequately immunogenic for schoolchildren who probably had been primed by previous natural infection. Younger children who received the same quantity in two divided doses four weeks apart had slightly lower but acceptable titers and tolerated the injections with few side reactions.

Anemia, Sickle Cell↗
PubMedDate not supplied

Experience with donors matched for minor blood group antigens in patients with sickle cell anemia who are receiving chronic transfusion therapy.

Clinically significant alloimmunization to red cell antigens occurred in 28 percent of transfused patients in a sickle cell clinic. Therefore, a prospective study was undertaken to determine whether matching donors carefully for 17 blood group antigens would diminish the risk of further alloimmunization in patients on a chronic transfusion program. Alloantibodies had developed previously in 8 of the 12 patients. After chronic transfusion with selected donors, four new antibodies developed in three patients. Three antibodies were due to errors in phenotyping or matching, and one was due to an antigen that was not tested for in the protocol. The incidence of developing antibodies per unit transfused was diminished tenfold when selected donors were used. Autoantibodies developed in five patients (42%), but these did not seriously interfere with the transfusion therapy. It was concluded that matching for red cell antigens may diminish the incidence of alloimmunization in patients with sickle cell anemia requiring transfusion.

Anemia, Sickle Cell↗