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PubMed1999

Genotypic and phenotypic characterization of "Streptococcus milleri" group isolates from a Veterans Administration hospital population.

Because identification of the species within the "Streptococcus milleri" group is difficult for the clinical laboratory as the species share overlapping phenotypic characteristics, we wished to confirm biochemical identification with identification by 16S rRNA gene sequence analysis. Ninety-four clinical isolates previously identified as the "Streptococcus milleri" group were reclassified as S. anginosus, S. constellatus, or S. intermedius with the API 20 Strep system (bioMerieux Vikek, Hazelton, Mo.) and the Fluo-card (Key Scientific, Round Rock, Tex.). In addition, we determined the Lancefield group, hemolysis, colony size, colony texture, repetitive extragenic palindromic PCR (rep-PCR) pattern, and cellular fatty acid (CFA) profile (MIDI, Newark, Del.). 16S rRNA gene sequence analysis with 40 selected representative strains showed three distinct groups, with S. constellatus and S. intermedius found to be more closely related to each other than to S. anginosus, and further distinguished a biochemically distinct group of urogenital isolates within the S. anginosus group of isolates. Except for strains unreactive with the Fluo-card (8%), all S. anginosus and S. intermedius strains identified by sequencing were similarly identified by biochemical testing. However, 23% of the selected S. constellatus isolates identified by sequencing (9% of all S. constellatus isolates) would have been identified as S. anginosus or S. intermedius by biochemical tests. Although most S. anginosus strains formed one unique cluster by CFA analysis and most S. constellatus strains showed similar rep-PCR patterns, neither method was sufficiently dependable for identification. Whereas Lancefield group or lactose fermentation did not correspond to sequence or biochemical type, S. constellatus was most likely to be beta-hemolytic and S. intermedius was most likely to have a dry colony type. The most frequent isolate in our population was S. constellatus, followed by S. anginosus. There was an association of S. anginosus with a gastrointestinal or urogenital source, and there was an association of S. constellatus and S. intermedius with both the respiratory tract and upper-body abscesses.

Adult↗
PubMed1976

Characteristics of drug abuse patients at a Veterans Administration Hospital.

A total of 308 patients were treated at the Wood VAC Drug Treatment Center during its first 2 years of operation (November 1, 1971-October 318 1973). They completed confidential questionnaires upon admission. Personal information and data concerning drug usage were obtained. Significant findings include the following: 1. A wide variety of opiate and nonopiate drugs were available in the military. 2. Although most patients had experienced illicit drugs prior to service, over 60% tried heroin for the first time while in the military; 83% of these men were subsequently treated for opiate dependence. 3. High rates of unemployment, marital instability, and convictions for illegal activities were revealed. A significant proportion of first convictions occurred prior to major drug usage. Data suggest that a flexible and multimodal approach to drug abuse therapy may have the best potential for success. Problems in evaluating and coordinating drug treatment programs are discussed briefly.

Adult↗
PubMed1980

Characteristics of inner city heroin addicts applying for treatment in a Veteran Administration Hospital Drug Program (Chicago).

Based on a total sample of 469 clients processed for admission to an inner city Veteran Drug Abuse Program, reliable information was obtained from a total of 322 heroin addicts. The following is a summary profile of the "average" narcotic addict prior to program entry: Black male, age 30, and unmarried. He has an 11th grade education, including 1/3 who completed the GED while in prison. He has been unemployed for over 1 year and receives $383 per month in legitimate benefits. He began to use heroin at 21 and did not perceive himself to have a drug problem until a year later. He has been addicted for over 8 years and has made five attempts to autonomously detox while ambulatory without the benefit of a treatment program. He has been treated on two other occasions for drug abuse in formal programs. He uses heroin from 2 to 3 times per day at an average daily cost of $68. He has spent 3 years in prison for committing crimes against property or narcotic crimes. He abuses alcohol and marijuana regularly, but has discontinued his use of amphetamines, barbiturates, and hallucinogens. These have been replaced with Talwin and Pyribenzamine. His personality tends to have traits associated with the Character Disorder or Schizoid Personalities. He has been refractory to past treatment efforts.

Adult↗