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Biomedical subjects

G Jackson

Publications and source records attributed to G Jackson.

At least 307 records · Page 17Linked to original sources
PubMed1983

Is treatment for alcoholism effective in persons on methadone maintenance?

A randomized prospective study of 625 drug addicts on methadone maintenance revealed that 105 (17%) were active alcoholics, 47 (8%) were inactive alcoholics, and 473 (76%) were not alcoholics. The active alcoholics were randomly assigned to abstinence therapy, controlled drinking with behavior modification, or a control group receiving the usual clinic services. There were no differences between treatment and control groups at baseline and during follow-up of up to 2 1/2 years, and there was no relation between remission and treatment, suggesting that the effectiveness of currently employed specific interventions for alcoholism in active alcoholic addicts maintained on methadone cannot be demonstrated.

Alcohol Drinking↗
PubMed1983

Alcoholism among narcotic addicts and patients on methadone maintenance.

There was no difference in prevalence of current alcoholism between new admissions to a methadone-maintenance treatment program (MMTP) and patients already in MMTP at least one year, by previous treatment for drug misuse, or between MMTP patients and the population of the surrounding community.

Adolescent↗
PubMed1983

The pathophysiology of angina pectoris with normal coronary arteriograms. Histopathological and metabolic correlations with coronary vasospasm.

Angina pectoris may occur in the presence of normal major coronary vessels (NCA) in 10-20 per cent of patients investigated by coronary arteriography. Whilst hypertrophic cardiomyopathy, mitral valve prolapse and hyperthyroidism are excluded by routine investigation, in the remainder coronary vasospasm may be demonstrated. An organic basis for angina may not always be found. In order to document the pathophysiological basis for angina pectoris with NCA we have investigated patients using atrial pacing stress with measurement of coronary sinus blood flow and lactate metabolism, together with myocardial biopsy to determine biochemical and histopathological abnormalities. These have been correlated with localised coronary vasospasm induced by ergometrine (E). Thallium scintigraphy has also been used to detect the myocardial changes. Fifteen patients were investigated: 5 of 15 patients developed abnormal lactate metabolism on atrial pacing (change greater than 0.8 mg per cent in A/V lactate difference) and all had greater than 50 per cent coronary luman reduction after E. In 10 of 15 patients no lactate change occurred and in 7 no significant response to E was seen. However, significantly lower myocardial enzyme activities were found in the first group (lactate dehydrogenase p less than 0.01, malate dehydrogenase p less than 0.05, alpha hydroxy-butyrate dehydrogenase p less than 0.02). The change in myocardial enzyme activities in angina with NCA may indicate a metabolic basis for angina in those patients who develop both abnormal lactate metabolism on pacing and coronary vasospasm after ergometrine. The enzyme activities and histological changes in angina with NCA are similar to these in dilated cardiomyopathy.

Adult↗
PubMed1983

Angina with normal coronary arteriograms. Clinical status at one year.

Despite encouraging reports that patients with normal coronary arteries (NCA) have a benign prognosis in terms of progression of disease and mortality they suffer considerable functional disability following their arteriogram and continue to attend cardiac departments and general practitioners. Some may have coronary spasm and respond to calcium antagonists, others have abnormalities of lactate metabolism on atrial pacing and respond to beta blockade and nitrates. We have observed the psychosocial characteristics of 30 patients with NCA (17 women and 13 men). At one year only one patient was entirely free of chest pain, in 16 (54 p. 100) it had lessened, 10 (33 p. 100) noted no change and in 3 (10 p. 100) it was worse. 15 were initially unable to work at one year, 3 were still unemployed because of pain, 25 (84 p. 100) were reassured when told of NCA. At one year 16 (54 p. 100) were still attending clinics and 2 had sought further cardiac tests elsewhere. In spite of the NCA 7 (23 p. 100) attend casualty with pain and 2 (7 p. 100) were re-admitted. 7 (23 p. 100) had psychiatric morbidity and 6 (20 p. 100) were assigned a psychiatric diagnosis. 15 patients (50 p. 100) reported phobic symptoms at follow-up. 53 p. 100 reported symptoms of breathlessness that could not be explained on the basis of organic disease. This study shows that unexplained breathing disorders and psychiatric morbidity pursue a chronic course and can be detected in 53 p. 100 and 23 p. 100 of NCA patients one year post angiogram. These findings have implications for the management of patients with chest pain and NCA since breathing disorders and psychiatric morbidity are amenable to treatments already demonstrated to be effective.

Adult↗
PubMed1982

Early exercise testing and coronary angiography after uncomplicated myocardial infarction.

In a prospective study 61 patients aged 55 years or less with uncomplicated myocardial infarction underwent treadmill stress testing at two weeks and coronary angiography at six weeks after infarction. Of the 44 patients who had a positive stress test, 43 had additional severe coronary artery disease confirmed by coronary angiography. Of the 17 patients who had a negative stress test for additional disease, coronary angiography identified only single-vessel disease in the infarct area in 15. The sensitivity of the stress test was 95% and the specificity 94%, though the number of patients in the study was small. Thus, exercise testing has considerable potential for the early identification of multiple-vessel disease in patients with uncomplicated myocardial infarction.

Coronary Angiography↗
PubMed1982

Alcoholism as a risk factor in methadone maintenance. A randomized controlled trial.

A randomized controlled trial of 625 addicts on methadone maintenance identified 105 (17 percent) as active alcoholics, 47 (8 percent) as inactive alcoholics, and 473 (75 percent) as nonalcoholics. Subjects were followed for up to 29 months (mean 53.7 weeks) to assess the influence of alcoholism on the rehabilitative process. During the study, alcohol consumption significantly decreased (p less than 0.001) in active alcoholics. Indexes of productive activity on entry or during follow-up revealed no significant differences between active alcoholics and other patients with the exception of alcohol-related hospitalizations (p less than 0.001). Behavioral indexes consistently improved with treatment in all patients, being greatest among active alcoholics (p less than 0.01). During the study, 28 (7 percent) of 399 nonalcoholics were recategorized as active alcoholics, and remission from alcoholism was noted in 28 (27 percent) of patients who were initially classified as alcoholic. These findings suggest that alcoholism does not significantly affect rehabilitation from narcotic use and therefore should not be cause for detoxification from methadone maintenance.

Alcoholism↗
PubMed1982

The effect of alcoholism in methadone-maintained persons on productive activity: a randomized control trial.

The effect of alcoholism on indices of productive activity was determined in a prospective, randomized, and controlled study of alcoholism in narcotic addicts undergoing methadone maintenance (MM) therapy. Indices of productive activity included: percentage of persons engaged in productive activities; number of days worked per quarter; number of arrests per quarter; number of hospitalizations; and days of hospitalizations per quarter. Baseline as well as longitudinal data were obtained on operative alcoholics (OA), inactive alcoholics (IA), and nonalcoholics (NA). OA patients were subsequently randomized to a control group or groups receiving either abstinence-oriented insight group therapy or controlled drinking-oriented behavioral modification group therapy. The retention rate in MM of OA versus NA during the 29-month clinical phase of the study did not differ significantly. Similarly, no significance was reported with respect to any index of productive activity. Indices of productive activity in OA undergoing treatment as compared to those randomized to the control group also did not reveal any significant differences. The compliance of OA in seeking and maintaining therapy for their alcoholism, however, was sufficiently poor so that any conclusions concerning the effectiveness of therapy on indices of productive activity should be viewed cautiously.

Alcohol Drinking↗
PubMed1982

The ability of a Self-Administered Alcohol Screening Test (mSAAST) to detect future excessive alcohol consumption in persons on methadone maintenance.

A modified Self-Administered Alcoholism Screening Test (mSAAST) was prospectively administered to 625 narcotic addicts participating in a randomized clinical control trial to study its effectiveness in detecting future excessive alcohol consumption. At entry into the study, of 105 patients categorized as active alcoholics, 84 (80%) obtained a positive score on the mSAAST. Of 77 patients initially identified as being at risk for developing alcoholism (potential alcoholics) by mSAAST scores, 31 (40%) subsequently developed characteristics of excessive alcohol consumption. Of the 321 patients classified as nonalcoholic by history as well as mSAAST score, a significantly lesser proportion (15%) developed characteristics of excessive alcohol consumption (p less than 0.001). These findings suggest the mSAAST to be a useful adjunctive indicator of persons at risk of developing excessive consumption of alcohol. It is probable that the usefulness of the mSAAST extends beyond narcotic-dependent populations and may be of value in identifying the potential for excessive alcohol consumption in other populations.

Adolescent↗
PubMed1982

Quantitation of T-lymphocyte subsets in human bronchus mucosa.

Cells were isolated from human bronchus mucosa, and characterized according to a surface marker for sheep erythrocytes (T cells), to the presence of membrane associated immunoglobulin (B cells), and to the capacity to phagocytose latex particles (macrophages). The T lymphocytes were further characterized according to their capacity to bind to the Fc fragment of IgG, IgM, and IgA (T gamma, T mu, and T alpha cells, respectively). Less t alpha cells were found in acutely inflamed mucosa than in mucosa obtained from patients with chronic inflammatory, or neoplastic disease (p = less than 0.001).

Antibodies, Monoclonal↗
PubMed1982

Alcohol consumption in persons on methadone maintenance therapy.

Alcohol use among methadone maintenance treatment program (MMTP) patients is substantial and a frequent impression is that addicts accelerate their consumption once in MMTP. This study reports an attempt to more clearly define alcohol consumption in opioid dependence as well as changes associated with methadone maintenance therapy. Two-day alcohol consumption (2-day EtOH) data were collected initially and quarterly on participants in a randomized controlled trial of intervention for alcoholism. Blood alcohol levels (BAL) were also determined. 17% of the participants were classified as active alcoholics (AA) and 8% as inactive alcoholics (IA). Two-day EtOH and BAL were significantly higher for AA than AI and nonalcoholics (NA, and AI higher than NA. Two-day EtOH decreased significantly over time for AA, AI, and NA. These findings indicate that AA among narcotic addicts and those on MMTP consume large quantities of EtOH but that consumption decreases with time on MMTP. The results, in confirmation of the work of others, suggest that entry and participation in MMTP has a broader effect than just on the use of narcotic drugs.

Alcohol Drinking↗
PubMed1982

The influence of hemodialysis fistulas on circulatory dynamics and left ventricular function.

This study was designed to examine the influence of arteriovenous (A-V) fistulas on cardiac output and left ventricular performance in 13 uremic patients on regular hemodialysis. M-mode echocardiography and systolic time intervals were used to derive indices of left ventricular function, and cardiac output was measured by thermodilution. Measurements were performed before and after acute digital occlusion of the A-V fistulas. Occlusion of a single fistula caused systemic vascular resistance and the systolic diameter of the left ventricle to increase from 9.6 +/- 1 to 13.5 +/- 2 units (p less than 0.001) and from 3.2 +/- .3 to 3.4 +/- .4 (p less than 0.05) respectively. The increase in afterload caused a reduction in cardiac output from 11.0 +/- 1 to 9.6 +/- 1 l/min (p less than 0.001) and probably accounted for the minor, though not significant, "deterioration" in the indices of left ventricular function. Bilateral fistula occlusion in 8 patients exaggerated these changes, and the reduction in fractional shortening from 43 +/- 4 to 37 +/- 4% was significant at the 5% level. In two patients with severe left ventricular failure, fistula occlusion caused a more pronounced deterioration in cardiac performance. These results show that acute A-V fistula occlusion effectively lowers cardiac output and is, therefore, likely to be beneficial in the management of high output failure. However, when intrinsic left ventricular disease is the primary etiological factor in heart failure, fistula occlusion is unlikely to be helpful, and may worsen the hemodynamic derangement.

Adult↗
PubMed1981

A survey of antibiotic resistance of Escherichia Coli isolated from farm animals in Great Britain from 1971 to 1977.

A total of 94,827 Escherichia coli strains isolated from cattle, sheep, pigs and poultry during the years 1971 to 1977 were tested for resistance to six antibiotics using a disc diffusion technique. The percentage of strains resistant to chloramphenicol (10 microgram), streptomycin (10 microgram), tetracycline (10 microgram), neomycin (10 Microgram) and furazolidone (15) were 16.8, 53.9, 42.7, 18 and 10.9 per cent, respectively; 52.2 per cent of strains (1971 and 1972) were resistant to 2 microgram ampicillin and 27.8 per cent of strains (1973 and 1977) were resistant to 10 microgram ampicillin. There was no evidence of an overall increase in antibiotic resistance during the seven year period. The animal species of origin was recorded for each of the 55,494 E coli strains examined during 1974 to 1977; 31,763 strains were isolated from cattle, 15,688 from pigs, 4582 from sheep and 3191 from poultry. Considerable variations in antibiotic resistance were recorded for strains isolated from different species.

Animals↗
PubMed1981

Prostacyclin: haemodynamic and metabolic effects in patients with coronary artery disease.

The therapeutic potential of prostacyclin was evaluated in 10 patients with angina pectoris and angiographically proved coronary artery disease. Platelet aggregation and coronary and systemic haemodynamic effects were examined before and after intravenous infusions of 2, 4, 6, and 8 ng/kg/min of prostacyclin and were dose related. At 8 ng/kg/min the ADP concentration required to induce 50% of maximum platelet aggregation increased from 1.8 to 4.5 mumol/l (p less than 0.001). Heart rate and cardiac index rose from 77 to 93 beats/min and 2.47 to 3.48 l/min/m2, respectively (p less than 0.01). Mean blood pressure and systemic and pulmonary resistances fell from 107 to 92 mm Hg and 1704 to 1048 and 80 to 45 dyn s cm-5, respectively (p less than 0.01). Coronary vascular resistance also fell from 0.95 to 0.73 units (p less than 0.01). Mean atrial pacing time to angina rose from 142 to 241 s (p less than 0.05), while lactate production during rapid atrial pacing was decreased, lactate extraction ratio rising from -25 to -9% (p less than 0.05). These coronary and systemic vasodilator effects and the prolongation of pacing time to angina indicate an acute beneficial effect of prostacyclin on angina. Since prostacyclin has been shown to prevent platelet accumulation and progression to total occlusion in animals with experimental coronary stenoses, the observed inhibition of platelet aggregation suggests that prostacyclin should be further evaluated in unstable angina.

Angina Pectoris↗