The objective of the study was to assess what differences exist between individuals who are dependent on opiates and benzodiazepines and compare to those who are dependent on opiates. A questionnaire was compiled and administered to patients who had been consecutively admitted to an inpatient drug treatment unit. The prevalence of benzodiazepine dependency was 54 per cent [n = 34]. Patients dependent on benzodiazepines and opiates were significantly older, had been admitted for methadone stabilisation and were more likely to have been prescribed a methadone maintenance programme prior to admission. They had used heroin longer, benzodiazepines more frequently, at larger doses for a longer duration of time and tended to use more drugs in general. They were found to be more psychologically vulnerable than those not dependent on benzodiazepines as they were significantly more likely to have described a past experience of depression and a past episode of deliberate self harm.

Adolescent↗

PubMedDate not supplied

Irish students and medical education.

The attitudes of a final year of medical students in University College Dublin and their level of satisfaction to their medical training was assessed. Medical students were significantly more dissatisfied with their pre-clinical teaching than clinical teaching and training. The majority of students felt inadequately trained in dealing with specific issues relating to patient care and communication. The most popular suggestions for improving the undergraduate teaching programme included increasing the use of patient case vignettes, small group tutorials and presenting patients' cases.

Attitude of Health Personnel↗

PubMedDate not supplied

Emission-based attenuation correction of myocardial perfusion studies.

BACKGROUND: Nonuniform attenuation in the thorax can generate artifacts in single-photon emission computed tomographic myocardial perfusion studies that mimic coronary artery disease. In this article we present both phantom and simulation data, as well as clinical data, in support of an emission-based method that provides reliable correction for attenuation effects without the need for a transmission measurement. METHODS AND RESULTS: The attenuation map is derived from the measured distribution of 99mTc-labeled macroaggregated albumin in the lungs and a radioactive binder wrapped about the thorax. This information is acquired as part of a dual-isotope acquisition during the rest 201Tl study. Segmentation is used to define the interiors of lung and body compartments, which are assigned a single attenuation coefficient for each of the two tissue types. The appropriateness of this approach was investigated by examining the measured attenuation coefficients in a group of 80 individuals (40 male, 40 female) from positron emission tomographic transmission studies. The correction technique was evaluated with computer simulations, a physical phantom, and clinical data acquired from 20 patients. Analysis of the positron emission tomographic data found a small SD in the mean attenuation coefficients for the body (<5%) and lungs (<15%). The application of emission-based attenuation-correction technique produced a substantial reduction in the magnitude of the attenuation artifact in images obtained from both the phantom and the simulation studies. The emission-based attenuation-correction technique was easily applied to myocardial perfusion studies, where it had a significant effect, resulting in changes in interpretation for nine of 20 patients. CONCLUSIONS: The results of this study provide strong support for the concept that an attenuation map can be generated with fixed attenuation values in place of those that are directly measured. Thus the emission-based attenuation-correction technique can be considered an inexpensive alternative to transmission-based correction methods. Because the emission-based correction technique does not require any additional hardware, it has the major advantage of being applicable to all single-photon emission computed tomographic systems.

Adult↗

PubMedDate not supplied

Disappearing carotid defects.

Large intraluminal cervical carotid artery filling defects consistent with mural thrombi were angiographically demonstrated during acute hemispheric neurologic episodes. These thrombi disappeared benignly as shown by serial angiography in 2 patients treated with intravenous heparin and spontaneously in 1 patient treated surgically. Thus, partially obstructing cervical carotid artery thrombi may lyse either with the use of anticoagulant therapy or else spontaneously. The etiology of the thrombi may partly be related to underlying atheromatous disease.

Aged↗

PubMedDate not supplied

Concomitant HIV and mycobacterial infection in Ireland, 1987-92.

A six-year retrospective review of concomitant HIV and mycobacterial infection in the Republic of Ireland is presented. A total of 42 culture proven mycobacterial infections were seen in 40 different HIV-infected patients. There were 24 infections with Mycobacterium tuberculosis (M.tb) and 18 infections with mycobacteria other than tuberculosis (MOTT), a significantly higher rate of MOTT infections in Ireland compared to a study from 1962-1981. The detection rate for all mycobacterial infections had an annual upward trend with a 4-fold increase between 1987 and 1992. In homosexuals, MOTT infections occurred more frequently than M.tb, while the reverse was true for IVDUs. Twenty per cent of the infections were seen in patients recently incarcerated. Relapse of tuberculosis occurred in 42.9% (3/7) of non-compliant patients, 2 of whom developed rifampin-resistant strains of M.tb. No patient compliant to their regimen had a relapse in disease. The overall survival of patients after diagnosis of M.tb was significantly better than those with MOTT infections, with respective one-year survival rate of 79% and 36% (log rank test, P = 0.006).

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Clinical parameters associated with recalcitrant oral candidosis in HIV infection: a preliminary study.

Clinical resistance in oropharyngeal candidosis is an increasingly significant management problem in HIV-seropositive patients. This study was undertaken to identify predisposing risk factors including the isolation of particular species of Candida which may be associated with the development of clinical resistance. The effect of particular antifungal prescribing regimens was also assessed. Data were compiled by chart review of 2 groups, each of 10 HIV-seropositive CDC stage IV patients with recurrent oropharyngeal candidosis. All patients had swabs taken at intervals during treatment and all candida isolates were species typed. The patients in group 1 exhibited candida infections which did not respond clinically to standard therapeutic regimens. The second patient group did respond to standard oral antifungal therapies. An association was found between the frequent utilization of azoles, particularly fluconazole and the development of clinically resistant oral candidosis. The number of candida isolates grown from the initial swab was also significantly related to the development of resistance.

Adult↗

PubMedDate not supplied

Prevalence of Salmonella serotypes on pig carcasses from high- and low-risk herds slaughtered in three abattoirs.

The aim of this study was to compare the prevalence of Salmonella serotypes at two different sites on pig carcasses from herds classified as high-risk or low-risk and to elucidate the relationship between carcass contamination levels and serological status. Caecal samples and carcass surface swabs were cultured for Salmonella from a total of 210 pigs from low risk herds (< 19% of pigs in herd Salmonella seropositive) and 209 pigs from high risk herds (> 32% of pigs in herd Salmonella seropositive) in three abattoirs. Meat juice samples were collected for analysis by ELISA. The prevalence of Salmonella in the caecal contents of "low-risk" pigs was 10%, which was significantly lower than the 19% prevalence in "high-risk" pigs (p < 0.01). The corresponding figures for skin samples collected immediately post-evisceration were 2% and 12%. The predominant Salmonella serotype in the caecal contents of both the low-risk and high-risk pigs was Salmonella Typhimurium. Salmonella Kentucky and Salmonella Derby were the most frequent isolates from the carcass surface swabs of low- and high-risk pigs respectively. There was a positive association between seropositivity of pigs from high-risk herds and caecal carriage (p < 0.05). Results showed that herd categorisation based on serological results was useful in predicting Salmonella isolation rates from caecal samples and surface swabs of slaughtered pigs.

Abattoirs↗

PubMedDate not supplied

A self-care approach.

Explore the source record for details and available documents.

Aged↗