Biomedical subjects

D Melia

Publications and source records attributed to D Melia.

4 recordsLinked to original sources

PubMed1999

Methadone-maintained former heroin addicts, including those who are anti-HIV-1 seropositive, comply with and respond to hepatitis B vaccination.

AIMS: To study the efficacy of standard hepatitis B (HB) vaccination in methadone-maintained former intravenous drug users. DESIGN: HB vaccine was administered to subjects at 0, 1 and 6 months. SETTING: Two university-affiliated methadone maintenance clinics. PARTICIPANTS: Forty-three HB-unexposed former heroin addicts in methadone maintenance treatment for heroin addiction. MEASUREMENTS: HB surface antibody (anti-HBs) response to the vaccine was assessed at 0, 1, 6 and > or = 12 months; anti-HIV-1 status was also assessed. FINDINGS: Thirty-seven patients (86%) completed the 6-month vaccination series. Of the 30 anti-HIV-1 seronegative patients who then completed the entire 12-month protocol, 21 (70%) seroconverted (anti-HBs ratio > 2.1) and 19 (63%) were protected (anti-HBs ratio > 10). Two other subjects were anti-HIV-1 seropositive: one was HB-protected at 12 months but later lost immunity. Ten anti-hepatitis C antibody-positive patients completed the 12-month study and six were protected; thus, there was no significant relationship between hepatitis C status and HB vaccine response. CONCLUSIONS: Standard HB vaccination is both feasible and effective.

Adult↗

PubMed1998

Single-nucleotide polymorphism in the human mu opioid receptor gene alters beta-endorphin binding and activity: possible implications for opiate addiction.

Opioid drugs play important roles in the clinical management of pain, as well as in the development and treatment of drug abuse. The mu opioid receptor is the primary site of action for the most commonly used opioids, including morphine, heroin, fentanyl, and methadone. By sequencing DNA from 113 former heroin addicts in methadone maintenance and 39 individuals with no history of drug or alcohol abuse or dependence, we have identified five different single-nucleotide polymorphisms (SNPs) in the coding region of the mu opioid receptor gene. The most prevalent SNP is a nucleotide substitution at position 118 (A118G), predicting an amino acid change at a putative N-glycosylation site. This SNP displays an allelic frequency of approximately 10% in our study population. Significant differences in allele distribution were observed among ethnic groups studied. The variant receptor resulting from the A118G SNP did not show altered binding affinities for most opioid peptides and alkaloids tested. However, the A118G variant receptor binds beta-endorphin, an endogenous opioid that activates the mu opioid receptor, approximately three times more tightly than the most common allelic form of the receptor. Furthermore, beta-endorphin is approximately three times more potent at the A118G variant receptor than at the most common allelic form in agonist-induced activation of G protein-coupled potassium channels. These results show that SNPs in the mu opioid receptor gene can alter binding and signal transduction in the resulting receptor and may have implications for normal physiology, therapeutics, and vulnerability to develop or protection from diverse diseases including the addictive diseases.

Base Sequence↗

PubMed1998

Psychiatric comorbidity in methadone maintained patients.

Diagnosing comorbid psychiatric disorders in methadone maintained patients may help to identify subgroups with different outcomes and needs for treatment. In this study, 75 methadone maintenance clinic patients in treatment longer than 30 days were assessed with the Addiction Severity Index, Global Assessment Scale and Mini-Mental Status Exam, and were interviewed for DSM-III-R psychiatric diagnosis using the computerized Diagnostic Interview Schedule. Psychiatric diagnoses were prevalent in the sample with depression, phobic disorders, antisocial personality and generalized anxiety the most common. Both number of DSM-III-R diagnoses and severity of psychopathology were correlated with outcome measures such as concurrent drug abuse, family-social problems and employment status.

Adolescent↗

PubMed1998

Spasticity.

Spasticity affects people with a variety of conditions, including stroke, spinal cord injury and multiple sclerosis. Assessment, physical therapies and pharmacological and invasive treatments are discussed in this Update.

Humans↗