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Biomedical subjects

S Schnoll

Publications and source records attributed to S Schnoll.

13 recordsLinked to original sources
PubMed2000

Cutaneous aspergillosis and acquired immunodeficiency syndrome.

BACKGROUND: Primary cutaneous aspergillosis is an uncommon finding in patients with acquired immunodeficiency syndrome (AIDS); only 13 cases have been reported in the literature. OBSERVATIONS: We describe 11 patients with primary cutaneous aspergillosis and AIDS. There does not seem to be an age, sex, race, or human immunodeficiency virus risk factor predisposition. This is a late manifestation of AIDS; patients typically have low CD4 counts (<0.050 x 10(9)/L [<50/microL]) and other AIDS-defining illnesses. The most frequent presentation is in patients with cytomegalovirus disease and neutropenia caused by ganciclovir therapy. Lesions developed at the site of occlusive dressings for an indwelling intravenous catheter site in 10 patients. Neutrophil counts may be normal at the time of diagnosis. A minor presentation is in the patient without neutropenia as a result of traumatic inoculation. Histological findings and/or culture results are required for diagnosis. Patients develop cutaneous lesions despite prophylactic therapy with fluconazole. Lesions can be treated with excision and lifelong therapy with itraconazole. CONCLUSION: Because of the potential morbidity and mortality of cutaneous aspergillosis, a high level of suspicion and prompt institution of therapy is required.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Postgraduate medical fellowship training in alcoholism and drug abuse: national consensus standards.

This paper describes the historical background of the Consensus Standards for Postgraduate Medical Fellowships in Alcoholism and Drug Abuse, developed for the American Academy of Psychiatrists in Alcoholism and Addictions and the Association for Medical Education and Research in Substance Abuse. These standards were prepared by a National Advisory Committee of the Center for Medical Fellowships in Alcoholism and Drug Abuse, which includes 23 leading figures in academic medical training in the addiction field. The standards define general information, facilities and resources, the educational program, and the specific knowledge and skills appropriate to fellowship training. The standards were designed to provide a model for optimal training for residency affiliated fellowships to be used by faculty, trainees, and organizations setting training standards.

Alcoholism↗
PubMed1991

Narcotic use in pregnancy.

Narcotic use in pregnancy remains a critical problem in 1990. Maternal and neonatal morbidity and mortality are increased significantly in pregnancies complicated by opioid addiction. Methadone maintenance is an important component of the management of many pregnant opioid addicts. The unavailability in most communities of specialized services dealing with perinatal addiction contributes to the dismal outcome frequently observed. The helpless fetus does not get the opportunity to just say no to drugs. As a society, we must just say no to continuing to ignore this problem.

Female↗
PubMed1991

Substance use and receipt of treatment by persons with long-term spinal cord injuries.

The purpose of this study was to assess the rate of self-reported substance use, consequent problems, perceived need for treatment, and receipt of treatment by persons with long-term spinal cord injury (SCI). Information was obtained from 86 persons with traumatic SCI who were between 13 and 58 years of age at injury, cognitively intact, injured more than two years earlier, English speaking, and recruited from two SCI organizations. The mean age of the sample was 39.5 years at recruitment: 69% were men. Participants reported substance use information across four periods covering six months before injury to an average of 13 years after injury. All participants reported use of substances with abuse potential at some time in their lives; the time of greatest use was injury to six months before first interview. The duration of this period ranged from 18 months to 43 years. Problems resulting from substance use were reported by 70%; more than half (52%) the sample reported problems during this postinjury period. Sixteen percent of the sample believed they needed treatment at some time; the time of greatest perceived need was in the period after injury. Treatment for substance abuse was received by 7%. Problems attributable to abuse of both prescription and nonprescription medication were reported, suggesting the importance of close monitoring of substance-use patterns in persons with SCI who are prescribed sedating or narcotic medications. Timely assessment of problems related to substance use and provision of treatment services to persons with traumatic injury are indicated to prevent a potential dual disability.

Adolescent↗
PubMed1989

Generation of hybrid human immunodeficiency virus by homologous recombination.

Human immunodeficiency virus (HIV) type 1, isolated from diverse sources, exhibits genomic diversity. The mechanisms by which the genomic diversity takes place in individuals exposed to multiple virus isolates is yet to be elucidated. Genetic variation, in general, might result from mutagenic events such as point mutations, rearrangements (insertions and deletions), and recombination. In an attempt to evaluate the process of genetic diversity, we designed experiments to analyze recombination between HIV DNAs by using DNA transfection in cell cultures. Here we report the successful recombination between truncated HIV proviral DNAs with an overlap homology of 53 base pairs that leads to the formation of viable hybrid virus. Recombination was also seen between exogenous DNA introduced into cells and homologous HIV sequences resident in the cells. These results indicate that recombination among various HIV isolates may play a significant role in the generation of genetic diversity of HIV. Further, the method used here enables the construction of hybrid HIV genomes to identify the viral determinants responsible for tropism, replication, and cytopathic effects.

Base Sequence↗
PubMed1988

Toxicology screening in acute spinal cord injury.

The validity of self-reported intoxication at time of spinal cord injury (SCI) was examined for 88 cases at admission to an acute SCI center by comparing self-reports with serum and urine analyses. Serum ethanol greater than 50 mg/dl was the most frequently found substance (observed in 40% of the cases) followed by urine analysis evidence of cocaine (14%), cannabinoids (8%), benzodiazipines (5%), and opiates (4%). Evidence of substances with abuse potential was found in urine for 35% of the sample. While 62% of the sample had either serum ethanol greater than 50 mg/dl or a positive urine analysis, only 42% of the sample reported being under the influence of some substance at the time of SCI. Although the relationship between these two measures was statistically significant, self-report and toxicology analyses were discordant in 34% of the cases. These results suggest that routine drug testing at admission to an SCI center will produce both false-negative and false-positive results if substance presence alone is interpreted as evidence of intoxication.

Adolescent↗
PubMed1988

Alcohol use by persons with recent spinal cord injury.

Detailed drinking histories, prevalence of alcohol abuse, and consequences of alcohol use were studied in 103 persons with recent spinal cord injury. Ninety-five percent of the sample acknowledge prior alcohol use. The mean weekday quantity of alcohol consumed was 5.9 drinks (SD = 4.7), with a range of one to 24 drinks per drinking episode during the six months before disability onset. The median frequency of alcohol use was one to two times per week. The sample's mean Michigan Alcoholism Screening Test (MAST) score was 6.8 (SD = 8.0), above the usual cutoff of 5.0, which is interpreted as indicating problematic alcohol use. Forty-nine percent of the sample had scores equal to or exceeding this cutoff. These results suggest that a significant number of individuals with recent spinal cord injuries have heavy drinking histories and experience behavioral problems resulting from alcohol use. The MAST proved to be an efficient method of assessing alcohol-related problems among those with recent spinal cord injuries. Finally, treatment and hospital policy implications are discussed.

Adolescent↗
PubMed1984

Accelerated development of pulmonary complications due to illicit intravenous use of pentazocine and tripelennamine.

To gain information concerning the natural history and prevalence of pulmonary gas exchange abnormalities resulting from intravenous drug abuse, 45 intravenous drug users were studied. Twenty subjects used a mixture of the synthetic opiate pentazocine and the antihistamine tripelennamine, which, under the street name T's and B's, has become very popular in some urban areas as an available substitute for heroin. Compared with the 19 heroin addicts studied, the pentazocine and tripelennamine users had a significantly shorter mean duration of intravenous drug abuse (2.7 +/- 0.4 years versus 7.6 +/- 0.9 years, p less than 0.01), a greater frequency of respiratory symptoms (75 percent versus 36 percent, p less than 0.05), a significant reduction in the mean diffusing capacity of the lung for carbon monoxide (58.4 +/- 3.3 percent predicted versus 75.5 +/- 5.6 percent predicted, p less than 0.01), and abnormal responses to submaximal steady-state exercise testing. The intravenous use of pentazocine and tripelennamine and probably most other drug preparations intended for nonparenteral use represents a particularly noxious form of drug abuse that may lead to early respiratory complications in a large proportion of users.

Adult↗
PubMed1984

Pulmonary dysfunction in 'freebase' cocaine users.

Of 19 consecutive smokers of cocaine, "freebase" cocaine users, admitted to a chemical dependence program, 12 (63%) had respiratory symptoms and ten (58%) noted dyspnea. Abnormalities of carbon monoxide diffusing capacity were also seen in ten of the subjects, although responses to steady-state exercise testing were normal in subjects undergoing exercise. We believe that freebase cocaine use frequently produces pulmonary gas exchange abnormalities that appear after relatively brief periods of abuse. These abnormalities may persist after cessation of freebase cocaine use. A history of this form of drug abuse should be sought when evaluating patients with appropriate symptoms or abnormalities of diffusing capacity.

Adult↗
PubMed1975

Letter: Cocaine.

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Cocaine↗