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Biomedical subjects

C Brewer

Publications and source records attributed to C Brewer.

At least 55 records · Page 3Linked to original sources
PubMed1994

Identification of the MN antigen as a diagnostic biomarker of cervical intraepithelial squamous and glandular neoplasia and cervical carcinomas.

A new tumor-associated antigen, MN, has been identified whose expression correlates with the tumorigenic phenotype of HeLa x fibroblast somatic cell hybrids. Because HeLa is a cell line derived from a cervical carcinoma, we investigated the diagnostic utility of MN expression in cervical neoplasia. It was found that normal cervical tissue does not express the antigen, or does so in occasional focal areas of weakly staining reserve cells. In contrast, significant immunoreactivity (immunoperoxidase staining of paraffin-embedded sections) was observed in cervical intraepithelial neoplasias, adenocarcinoma in situ, and frank carcinomas, both squamous cell and adenocarcinoma. Varying patterns of immunoreactivity were observed and were characterized as diffuse, diffuse/focal, or focal. Greater than 90% of dysplastic or malignant tissues showed immunoreactivity. An interesting observation was that normal cervical tissue associated with cervical intraepithelial neoplasias, or adenocarcinoma in situ showed a staining pattern in the reserve cells and/or normal columnar cells that approximated the level of intensity exhibited by the dysplastic tissue. These results indicate that MN antigen expression has potential utility as a biomarker of cervical neoplasms.

Adenocarcinoma↗
PubMed1993

Hair analysis as a tool for monitoring and managing patients on methadone maintenance. A discussion.

Hair analysis for unprescribed drugs is not merely an effective, dignified, and time-saving alternative to urine testing. It is also more sensitive and more difficult to evade and minimises the risk of infection to clinic staff. Because of these characteristics, it can, when properly used, change the nature of the relationship between treatment personnel and patients on methadone maintenance. These changes can be beneficial and acceptable to both parties. In 263 patients, 41% of hair samples were negative for opiates, 22% had levels below 10 ng/10 mg, while in a further 7% the level was less than 20 ng/10 mg. The existing and potential advantages of this technique in managing both opiate abuse and other sorts of drug abuse are discussed.

Hair↗
PubMed1993

Long-term, high-dose disulfiram in the treatment of alcohol abuse.

A patient who had experienced most of the standard methods of managing alcohol abuse found that during 11 years of treatment, the most consistently effective intervention has been the taking of disulfiram under family supervision. He has received 600 mg daily almost continuously for over six years without side-effects. Smaller doses do not have an adequate deterrent effect.

Adult↗
PubMed1993

Treatment of cocaine abuse with monoamine oxidase inhibitors.

A cocaine-abusing patient was treated with phenelzine and tranylcypromine, under supervision, as deterrent drugs; other medical and psychological treatments had failed. When he eventually risked using cocaine there was no hypertensive reaction. Nevertheless, the deterrent effect seemed helpful in breaking his pattern of cocaine use, as confirmed by hair analysis for cocaine.

Adult↗
PubMed1993

Recent developments in disulfiram treatment.

This paper reviews the controlled studies which have led to the increasing recognition that supervised disulfiram is one of the few demonstrably effective interventions in alcoholism, both alone and as an adjunct to psychosocial methods. The specifically behavioural implications of disulfiram treatment are also noted. It examines techniques for maximising disulfiram's therapeutic effectiveness and reviews recent research into its pharmacokinetics, mode of action, toxicology and bioavailability. Finally, the prospects for an effective depot preparation are discussed.

Alcoholism↗
PubMed1992

The benefits of treating hyperlipidemia to prevent coronary heart disease. Estimating changes in life expectancy and morbidity.

OBJECTIVE: To evaluate the lifetime benefits of reducing total serum cholesterol levels to prevent coronary heart disease (CHD). DESIGN: We developed a CHD primary prevention computer model to estimate the benefits associated with lifelong risk factor modification. We validated the model by comparing the computer estimates with the observed results of three primary CHD prevention trials. PATIENTS: Men and women age 35 to 65 years who are free of CHD, with total serum cholesterol levels ranging from 5.2 to 7.8 mmol/L (200 to 300 mg/dL), with or without additional CHD risk factors. INTERVENTIONS: Serum cholesterol reduction through dietary modification or diet and medications. MAIN OUTCOME MEASURES: Changes in life expectancy and the delay of symptomatic CHD. RESULTS: The computer forecasts for CHD end points closely matched the observed results of the Lipid Research Clinics Trial, the Helsinki Heart Study, and MRFIT. We then applied the computer model to low-risk and high-risk men and women with total serum cholesterol levels between 5.2 and 7.8 mmol/L (200 and 300 mg/dL) and estimated that, after reducing serum cholesterol levels 5% to 33%, the average life expectancy would increase by 0.03 to 3.16 years. We also forecast that the average onset of symptomatic CHD would be delayed among these patient groups by 0.06 to 4.98 years. CONCLUSION: We conclude that this computer model accurately estimates the results of clinical trials and can be used to forecast the changes in life expectancy and morbidity (the development of CHD) associated with specific CHD risk reduction interventions. The wide variation surrounding these estimates underscores the need to better define which groups of individuals will gain the most from cholesterol reduction.

Adult↗
PubMed1992

Controlled trials of Antabuse in alcoholism: the importance of supervision and adequate dosage.

Methods of using Antabuse have changed since its introduction over 40 years ago. Several randomised controlled trials have shown that Antabuse can make a statistically and clinically significant contribution to treatment outcome in alcoholism but only if its administration is carefully supervised. The recent literature is reviewed. Adequate dosage is important and the recommended maximum in some countries is often insufficient. Both prescribers and supervisors of Antabuse need to be aware of the ways in which some patients try to evade medication.

Adult↗
PubMed1990

Combining pharmacological antagonists and behavioural psychotherapy in treating addictions. Why it is effective but unpopular.

Supervised administration of disulfiram is one of the very few treatments that can significantly reduce alcohol consumption, yet it is rarely used, despite being simple and cheap. Disulfiram is not 'aversion therapy', but a technique for facilitating exposure and response prevention, and it fits comfortably into a behavioural, social-learning model of addiction (or dependence) and its treatment. The availability of other effective antagonists, notably to opiates, suggests that an approach that is demonstrably effective in alcohol dependence may be helpful in treating other addictions. The reasons for the unpopularity of this approach appear to be largely ideological.

Alcoholism↗