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Biomedical subjects

R D Weiss

Publications and source records attributed to R D Weiss.

At least 55 records · Page 3Linked to original sources
PubMed1993

Enhanced secretion of immune-modulating cytokines by human lung fibroblasts during in vitro infection with Mycoplasma fermentans.

Fibroblasts may play an important role in the modulation of immune and inflammatory responses through elaboration of cytokines. To test this hypothesis, human lung fibroblasts were isolated from transbronchial biopsy specimens and assayed for production of interleukin-6 (IL-6) and granulocyte/macrophage colony-stimulating factor (GM-CSF). The sources of fibroblasts included lung allografts, recipient lungs obtained at time of transplant, and normal lung tissue removed during tumor resection. During the course of these studies, several early-passage fibroblasts from transplant recipients were observed to contain mycoplasma (MP)-like organisms as detected by extranuclear fluorescent staining with Hoechst 33258. Positive staining cultures were associated with isolation of Mycoplasma fermentans. IL-6 and GM-GSF as measured by ELISA were found to be elevated over 50-fold in conditioned medium from MP-infected fibroblasts as compared with noninfected lines. Treatment of cells with mycoplasma removal agent (MRA) eliminated extranuclear Hoechst fluorescence and significantly reduced the production of these cytokines. Tumor necrosis factor-beta (TNF-beta) induction of IL-6 and GM-CSF was amplified synergistically in infected cultures. No additional production of IL-6 or GM-CSF was observed in infected cultures treated with interferon-gamma (IFN-gamma) despite the ability of IFN-gamma to modestly induce IL-6 in uninfected cultures. Thus, in vitro infection of lung fibroblasts with MP represents a potent stimulus for the production of inflammatory cytokines and, therefore, necessitates rigorous control for these organisms in cell culture studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Cycle↗
PubMed1992

Methodological considerations in the diagnosis of coexisting psychiatric disorders in substance abusers.

The authors reviewed the diagnostic methodology in 14 studies that examined the prevalence of coexisting psychiatric disorders in substance abusers. There was widespread variation among the studies in the timing of patient interviews, the nature of the interviews themselves, and abstinence criteria required before another psychiatric disorder could be diagnosed. These differences were reflected in some of the study results. The authors describe how variations in methodology can affect the diagnoses patients receive. They also suggest more specific abstinence criteria, based on the substances of abuse and the specific disorders being diagnosed.

Combined Modality Therapy↗
PubMed1992

Severity of cocaine dependence as a predictor of relapse to cocaine use.

The severity of cocaine dependence of 39 hospitalized patients was assessed by administering the Structured Clinical Interview for DSM-III-R. No significant relationship was found between severity of cocaine dependence and cocaine use at 3-month follow-up. These findings suggest that severity of cocaine dependence may be a poor predictor of relapse to cocaine use.

Analysis of Variance↗
PubMed1992

Patients who use drugs during inpatient substance abuse treatment.

OBJECTIVE: Drug use by patients during inpatient substance abuse treatment is frequently a cause of premature hospital discharge. The authors examined the histories of patients who used drugs while in inpatient substance abuse treatment, the methods used to detect drug use, and the temporal relationship of drug use episodes. METHOD: The authors reviewed the charts of patients admitted consecutively to an inpatient substance abuse treatment unit between 1981 and 1988. Of 729 patients, 42 were found to have used drugs while receiving inpatient treatment. The diagnoses and clinical histories of these 42 patients were compared with those of all other patients. Methods of detection and circumstances of drug use were recorded, and drug use episodes were plotted on a time line that was examined for temporal clustering. RESULTS: Significantly more of the patients who used drugs during inpatient substance abuse treatment had primarily used heroin or methadone before treatment. Random urine screens, self-report, and staff observation together detected approximately 85% of the patients who used drugs during treatment. Episodes of drug use did cluster in time, but within clusters the hospital stays of the patients who used drugs did not necessarily overlap. CONCLUSIONS: Temporal clustering of drug use episodes may occur because drug use by one patient heralds drug availability and stimulates craving in other inpatients. Clinicians should be aware that one episode of drug use may be followed by others. Multiple detection methods, including random comprehensive urine screens, should be used to test for drug use on inpatient units.

Adult↗
PubMed1992

Drug abuse as self-medication for depression: an empirical study.

The authors empirically studied the self-medication hypothesis of drug abuse by examining drug effects and motivation for drug use in 494 hospitalized drug abusers. Most patients reported that they used drugs in response to depressive symptoms and experienced mood elevation, regardless of their drug of choice. Drug use to relieve depressive symptoms was far more likely in men if they had major depression, but was equally common in women with and without major depression. Information regarding a history of self-medication may thus be more helpful in diagnosing major depression in men than in women. Difficulties in diagnosing psychiatric disorders in substance abusers are discussed, as are the limitations of obtaining retrospective data on drug-using behavior. The implications of these limitations on the generalizability of the findings are reviewed.

Adolescent↗
PubMed1992

Eating disorders in hospitalized substance abusers.

Among 386 consecutive patients hospitalized for substance abuse, 15% of 143 women had a lifetime diagnosis of anorexia or bulimia nervosa, compared to only 1% of 243 men. Women with eating disorders had significantly higher rates of stimulant abuse and lower rates of opioid abuse than women without eating disorders.

Adult↗
PubMed1989

A comparison of male and female cocaine abusers.

Little has been written about the differences between male and female cocaine abusers. We therefore compared sociodemographic characteristics, reasons for cocaine use, drug effects, depressive symptoms, and psychiatric diagnoses in 95 men and 34 women hospitalized for cocaine abuse. Men were more likely to be employed, to hold higher status jobs, and to be self-supporting. Women were more likely to cite specific reasons for drug use, while men tended to use cocaine as part of a larger pattern of antisocial behavior. Women were diagnosed more often as having major depression, and their depressive symptoms improved much more slowly than men's when drug free. These findings suggest that women cocaine abusers may initially experience more residual problems, eg, depression and job dissatisfaction, than men after becoming drug free. Drug treatment centers should be alert to possible differences based on gender.

Adolescent↗
PubMed1989

Diagnosing major depression in cocaine abusers: the use of depression rating scales.

This study compared the sensitivity and specificity of three rating scales in detecting major depression in 149 hospitalized cocaine abusers. Patients were administered the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Depression, and the Symptom Checklist-90 at admission and at 2 weeks and 4 weeks of hospitalization. The admission BDI score offered the best combination of sensitivity and specificity. However, the low specificity of all the scales and the low prevalence rate of major depression in this population made the positive predictive power of the instruments weak. The results support some limited use of the BDI as an initial screening instrument in cocaine abusers.

Adult↗
PubMed1989

What is therapeutic about inpatient alcoholism treatment?

Empirical studies supporting the efficacy of specific techniques and practices in the inpatient treatment of alcoholism are reviewed. The studies confirm the value of an intensive, group-oriented, multimodal treatment approach. Specific features that have been found to be helpful include a responsive intake procedure, patient participation in treatment planning, a professional staff with good interpersonal skills, interdisciplinary assessment and treatment, judicious use of appropriate medication, and a strong aftercare program. These findings may be useful in efforts to assess and compare different treatment programs and to design treatment outcome studies.

Alcoholism↗
PubMed1989

Tricyclic antidepressants in the treatment of alcoholism and drug abuse.

Although the frequent coexistence of substance abuse and depression is widely recognized, studies assessing the efficacy of tricyclic antidepressants in patients who abuse alcohol and/or drugs have been problematic because of controversies about how to diagnose depression in this population, failure to measure plasma antidepressant levels, and inconsistent treatment outcome measures. Some studies have, however, demonstrated the effective use of specific tricyclic antidepressants in selected subgroups of substance abusers; for example, desipramine may facilitate initiation of cocaine abstinence, and doxepin may benefit certain opioid addicts. Although imipramine has shown only equivocal success in the treatment of alcoholics, preliminary studies of serotonin uptake inhibitors show some promise in this population. As research design in this field becomes more consistent, future studies may more clearly identify subgroups of chemically dependent patients who respond to specific antidepressant drugs.

Alcoholism↗
PubMed1988

Relapse to cocaine abuse after initiating desipramine treatment.

Three cocaine abusers who had been abstinent for one to six months relapsed to cocaine use soon after beginning desipramine hydrochloride therapy. The antidepressant treatment was begun for different reasons in each case. All three patients developed what has been termed the early tricyclic jitteriness syndrome. This reaction may have stimulated conditioned craving for cocaine because of the similarity between this syndrome and cocaine intoxication. Since desipramine is being used to reduce cocaine craving, it is important to recognize this paradoxical increase in craving as a potential adverse effect of desipramine.

Adult↗
PubMed1988

Psychopathology in cocaine abusers. Changing trends.

The authors studied a group of 149 hospitalized cocaine abusers as a follow-up to previous research performed in 1980-82, which had revealed a high prevalence of affective disorder in cocaine abusers. The authors hypothesized that the changing epidemiology of cocaine abuse since that time may have been accompanied by changes in the characteristics of patients seeking treatment for dependence on the drug. The cocaine abusers were compared with 293 other drug abusers to see whether clinical changes over time were specific to individuals abusing cocaine. The authors found slightly more affective disorder in the cocaine abusers when compared with the other patients (26.8% vs. 20.1%), with a significantly higher rate of cyclothymic disorder (11.4% vs. 2.7%, p less than .001). Affective illness was significantly more prevalent in the first-degree relatives of the cocaine abusers when compared with the sex-matched relatives of the other patients (p less than .05). Diagnostic trends changed a great deal, however, between the original 1980-82 study sample and the follow-up 1982-86 sample. The rate of affective disorder decreased over time from 50.0% to 21.0% (p less than .01), and the rate of affective illness in the families also declined, from 31.0% to 11.5% in females (p less than .001) and from 14.3% to 2.2% in males (p less than .001). No such change occurred in the comparison group of opioid and central nervous system depressant abusers. The authors conclude that although a substantial number of cocaine abusers suffer from concurrent affective disorder, this form of premorbid psychopathology has become a less important risk factor for the development of chronic cocaine abuse as cocaine use has become more widespread.

Adult↗
PubMed1988

A comparison of alcoholic and nonalcoholic drug abusers.

A group of 329 hospitalized drug abusers were evaluated for a current or past diagnosis of alcoholism. The alcoholic drug-dependent patients (n = 169, 51.4%) were then compared with the nonalcoholic patients (n = 160, 48.6%) with regard to sociodemographic, clinical and family history characteristics. The alcoholics were significantly more likely to receive a DSM-III diagnosis of major depression, with melancholia; other Axis I diagnoses were equally distributed between the two groups. Antisocial personality disorder was also significantly more prevalent among the alcoholic patients. The alcoholics had somewhat longer drug histories and more vivid memories of their first drinking experiences; polydrug abuse, however, was no more common in this group. Finally, the first-degree relatives of the alcoholics had significantly more alcoholism than the first-degree relatives of the nonalcoholic patients. Implications regarding the relationship of alcoholism and other forms of substance abuse are discussed.

Adult↗