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Biomedical subjects

A Huber

Publications and source records attributed to A Huber.

340 records · Page 19Linked to original sources
PubMedDate not supplied

Sexual HIV risk among gay and bisexual male methamphetamine abusers.

The current report examined HIV-related high risk sexual behaviors among a small sample of gay and bisexual male methamphetamine abusers in Los Angeles. Participants were 16 methamphetamine-abusing or -dependent gay or bisexual males who participated in a treatment demonstration project between 1989 and 1993. All participants completed the NIDA/WAVE survey, a detailed inventory of HIV-related risk behaviors. Findings indicate a strong connection between methamphetamine abuse and high-risk sexual behavior. For the 12 months prior to treatment 62.5% of participants reported having anal insertive sex without a condom, and 56.3% reported having sex with someone who had HIV. Drug use before or during sex, measured on a 5-point Likert scale, was frequent (M = 4.27, SD = 0.7). Implications for treatment of gay and bisexual male methamphetamine abusers and prevention of HIV among this population are discussed.

Behavior Therapy↗
PubMedDate not supplied

[Clinical manifestation of Lyme borreliosis in childhood].

We report on 4 children with different clinical manifestations of Lyme-Borreliosis. One patient presented with a stage 2 typical aseptic meningitis and 2 others with symptoms of Schönlein-Henoch purpura and rheumatic disease respectively. A further case had bilateral palsy of abducens nerve and unilateral palsy of trochlearis nerve which are described for the first time in Lyme-Borreliosis. Diagnosis was established by detection of specific antibodies to Borrelia in all patients. Differential diagnosis of these symptoms should include Lyme-Borreliosis.

Adolescent↗
PubMedDate not supplied

[Treatment of an extraneural metastasized medulloblastoma].

We report a patient with a history of a previously treated medulloblastoma, now presenting with generalized osseous metastases. Currently there is a complete remission under continuous therapy with VP-16. Since the frequency of systemic metastases in patients with medulloblastoma is approximately 5%, we recommend a more extensive initial evaluation in these patients.

Adult↗
PubMedDate not supplied

[Toxic shock syndrome].

We report about a one year old girl with toxic shock syndrome (TSS), which was confirmed by a significant rise of TSST-1 titers. In addition to known manifestations of TSS, to our knowledge this is the first report about development of polyserositis in this disease. Tumor necrosis factor (TNF) was elevated at initial evaluation and fell under treatment with cortisone. This finding is in contrast to in-vitro observations. We believe that the use of cortisone in TSS warrants further investigation.

Enterotoxins↗
PubMedDate not supplied

[Recurrent staphylodermas in marked IgE elevation: the hyper-IgE syndrome].

This is a report of a 6-year-old boy with repeated staphylococcus infections especially in the hairy region of the head. Investigating the disease an extremely elevated IgE of 10,000 KU/l was found, specific IgE in RAST only at a low level. The immunologic investigations showed a reduction of the T-suppressor-cells and an increase of IgG levels. Defects of phagocytosis or chemotaxis could not be demonstrated.

Child↗
PubMedDate not supplied

The CSAT methamphetamine treatment program: research design accommodations for "real world" application.

The Methamphetamine Treatment Program (MTP), funded by the Center for Substance Abuse Treatment, has the objectives of implementing the Matrix outpatient model and evaluating that model in comparison to the existing community "treatments as usual." Seven organizations in three western states (California, Montana, and Hawaii) were selected to participate in this randomized, controlled, multisite project in what constitutes the largest trial to date of treatment for methamphetamine (MA) dependence. One hundred fifty MA-dependent patients recruited at each site are randomly assigned to receive either the Matrix model, a manualized program of intensive outpatient treatment, or the site's standard treatment, "treatment as usual." Participants are evaluated at admission, weekly during treatment, at the time of scheduled discharge, and at six and 12 months after admission. Dependent measures assess changes in drug use, HIV risk behaviors, quality of life, and patient satisfaction. Cost analyses to quantify treatment costs and determine the association between costs and clinical outcomes will be conducted. A number of adjustments in the original study design have been necessitated by the realities of community sites' strengths and limitations. Experiences from this multisite project will also provide a model for other efforts to transfer research-based treatments into community settings. This article describes the main aims of the project, the background and rationale for the study design, a brief description of the research plan, and methods implemented to protect the integrity of the science.

Central Nervous System Stimulants↗
PubMedDate not supplied

Moving research into community settings in the CSAT methamphetamine treatment project: the coordinating center perspective.

The CSAT Methamphetamine Treatment Project (MTP) has been established to conduct a ground-breaking exercise in bringing research into a closer relationship with community-based treatment service organizations. In this article, some of the opportunities and challenges faced by the MTP coordinating center as it has attempted to bring research into community treatment organizations are described. Initially, there has been an active, energetic effort to design the study protocol, focus the activities of the project, and prioritize the tasks to be accomplished. The methods for training the research staff and monitoring the conduct of the research in the community sites are described. A number of observations have been made about the different "cultures and values" of the researchers and the seven clinical organizations where the project has been conducted. The myriad mistakes made and lessons learned about how to conduct a rigorous randomized clinical trial in community treatment organizations may be important for future research-treatment efforts. There has been a wealth of experience gained in the first year of this project that may be of use as efforts move forward to reduce the gap between research and practice.

Central Nervous System Depressants↗
PubMedDate not supplied

A comparison of injecting and noninjecting methamphetamine users.

The injection of illicit drugs exposes the user to a variety of risks that are not associated with other routes of administration. Information regarding differences between injecting and noninjecting methamphetamine (MA) users is provided. The population studied included MA dependent men and women (n = 427) from the Matrix Institute on Addictions in San Bernardino County, California. The sample was divided into two groups according to their injecting status; 55 individuals (13%) reported injecting, and 372 (87%) reported no history of injecting MA. Differences were found in specific use patterns and in medical, criminal, and psychological histories between the two groups.

Central Nervous System Stimulants↗
PubMedDate not supplied

Methamphetamine and cocaine users: differences in characteristics and treatment retention.

The use of methamphetamine and cocaine have both produced significant public health problems during the past two decades. Although these powerful psychostimulants have many common acute and chronic effects, there are some important differences in who uses these drugs and the consequences of their use. This article reports on two large cohorts of treatment-seeking cocaine and methamphetamine users who entered treatment at the same facility over the same four-year period of time. Patterns of use differed significantly. Cocaine users have more episodic use patterns, spend more money on purchasing their drugs, and use alcohol more heavily. Methamphetamine users include a higher proportion of women, more frequently use on a daily basis, use marijuana more often, and experience more severe medical and psychiatric consequences. Despite the differences in the stimulant drug effects and consequences, the treatment response to a multicomponent, outpatient program is very similar.

Adolescent↗
PubMedDate not supplied

Navigator echo-based respiratory gating for three-dimensional MR coronary angiography: reduction of scan time using a slice interpolation technique.

PURPOSE: The aim of the study was to compare a conventional respiratory-gated 3D MR coronary angiographic technique (conventional MRCA) with a respiratory-gated 3D MR coronary angiographic technique that includes a slice interpolation technique (slice interpolation MRCA). Both MRCA techniques were compared based on the quality of visualization of the coronary arteries and the diagnostic accuracy in identifying hemodynamically significant coronary artery stenoses. METHOD: Forty patients with known proximal coronary artery stenosis after conventional CA were examined on a 1.5 T scanner, that is, 20 patients with each sequence. A 6 point grading system (0 = worst quality, 5 = best quality) was used to evaluate and compare the image quality. The length and proximal diameter of the depicted coronary arteries were measured. Detection of coronary artery stenoses was compared with that obtained by conventional CA by two blinded readers. RESULTS: With the slice interpolation technique, the average scan time of the entire heart was reduced by approximately 40%. With use of conventional MRCA, 69% of all proximal and middle coronary artery segments were visualized with a sufficient image quality; with the slice interpolation technique, 79% of these segments were depicted adequately. For the assessment of stenoses, sensitivity was 71% and specificity was 53% for conventional MRCA and 72 and 60% for slice interpolation MRCA, respectively. These differences in sensitivity and specificity were statistically not significant. CONCLUSION: The application of a slice interpolation technique reduces the scan time, maintains a comparable sensitivity and specificity for the assessment of coronary artery stenoses, and increases the number of completely identified coronary artery segments compared with the conventional technique.

Aged↗
PubMedDate not supplied

Ductus venosus blood flow velocity waveforms as a predictor for fetal outcome in isolated congenital heart disease.

OBJECTIVE: To investigate whether pulsatility of ductus venosus (DV) flow velocity waveforms is of diagnostic value in predicting survival in fetuses with congenital heart disease (CHD). METHODS: In a cross-sectional study, Doppler investigation of DV and umbilical artery blood flow was performed in 58 fetuses with isolated structural CHD, without other sonographically detectable structural or chromosomal abnormalities or tachyarrhythmia. The pulsatility index for veins of DV (DV-PIV) waveforms was expressed as multiples of the 95th centile (Mo95th) of the reference ranges for gestational age. The PIV was related to intrauterine and neonatal mortality within the first 6 months of life. Terminations of pregnancies and neonates with additional abnormalities detected after birth were excluded from statistical analysis. For statistical analysis, the different types of heart defects were separated into atrial and/or ventricular (AV) septal defects, right or left ventricular in- and outflow tract abnormalities and others. RESULTS: After exclusion of 9 pregnancies (2 cases with failure of measurements of DV-PIV, 2 neonates with additional malformations, and 5 terminations of pregnancies), 49 cases were available for statistical analysis. The umbilical artery pulsatility index was within normal ranges in all but 1 case with AV canal and hydrops. In 7 pregnancies intrauterine fetal deaths occurred and 6 of them were hydropic. The median gestational age at birth for liveborn neonates was 39.0 weeks (range 27.8-41). There were 6 postnatal deaths, all but 1 within 28 days of delivery. The remaining fetuses survived for at least 6 months. The overall mortality rate was 27% (13/49). The DV-PIV was significantly higher in non-survivors than in survivors (median of Mo95th and interquartile ranges 1.48 (1.04-1.95) vs. 0.81 (0.70-1.15); p = 0.01). Analysis of subgroups showed significant differences for AV septal defects and abnormalities affecting predominantly the right ventricle (p = 0.046 and 0.043, respectively). Ten out of 13 non-survivors showed an abnormal DV-PIV (sensitivity 77%) as compared to 12 out of 36 survivors (specificity 67%). All hydropic fetuses (n = 6) showed an abnormal DV-PIV and ended in intrauterine deaths. CONCLUSIONS: Evaluation of the DV pulsatility is a useful additional variable for predicting the risk for mortality in fetuses with isolated structural CHD, in particular in fetuses with defects of the AV septum and with defects affecting predominantly right ventricular function. As there is no fetal hydrops without abnormal DV, this is another sign for the association of DV and cardiac failure.

Blood Flow Velocity↗
PubMedDate not supplied

Bilateral non-arteritic anterior ischemic optic neuropathy in a patient with autoimmune thrombocytopenia.

PURPOSE: To describe a patient with bilateral non-arteritic anterior ischemic optic neuropathy (NAION) and idiopathic autoimmune thrombocytopenia (ITP) with an extremely low platelet count. METHOD: Case report. RESULTS: Remarkably good recovery of visual acuity. CONCLUSIONS: Bilateral non-arteritic anterior ischemic optic neuropathy can develop in the presence of a very low platelet count.

Aged↗
PubMedDate not supplied

[Occurrence of contact allergies in atopic eczema. Relation to simultaneously detected atopic markers].

In a prospective study the risk of delayed-type hypersensitivity was investigated in 65 patients with atopic eczema (AE) and a noneczematous control group (n = 78) largely similar in age and occupational distribution. The diagnosis of AE was established according to the diagnostic criteria of Hanifin and Rajka. Patch tests were performed using the European standard series. There was no significant difference in the occurrence of contact sensitivity. Atopics showed a significantly higher incidence of reactions to nickel (atopics 28%/controls 6%/p less than 0.01), especially in females (females 29%/9%, p less than 0.05). Sensitivity to nickel could be regarded as a further minor atopic criteria. Patients with AE and simultaneously delayed type hypersensitivity showed significantly higher IgE levels (IgE means = 733 U/ml), than atopics without contact sensitivities (IgE means = 290 U/ml), but no differences in the occurrence of any major or minor criteria.

Adult↗