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Biomedical subjects

L S Brown

Publications and source records attributed to L S Brown.

At least 73 records · Page 4Linked to original sources

Relationship of proton uptake on the cytoplasmic surface and reisomerization of the retinal in the bacteriorhodopsin photocycle: an attempt to understand the complex kinetics of the pH changes and the N and O intermediates.

In the bacteriorhodopsin photocycle the recovery of the initial BR state from the M intermediate occurs via the N and O intermediates. The molecular events in this process include reprotonation of the Schiff base and the subsequent uptake of a proton from the cytoplasmic side, as well as reisomerization of the retinal from 13-cis to all-trans. We have studied the kinetics of the intermediates and the proton uptake. At moderately low pH little of the N state accumulates, and the O state dominates in the reactions that lead from M to BR. The proton uptake lags behind the formation of O, suggesting the sequence N(0)<==>O(0) + H+ (from the bulk)-->O(+1)-->BR+H+ (to the bulk), where the superscripts indicate the net protonation state of the protein relative to BR. Together with a parallel study of ours at moderately high pH, these results suggest that the sequence of proton uptake and retinal reisomerization depends on pH: at low pH the isomerization occurs first and O accumulates, but at high pH the isomerization is delayed and therefore N accumulates. Although this model contains too many rate constants for rigorous testing, we find that it will generate most of the characteristic pH-dependent kinetic features of the photocycle with few assumptions other than pH dependency for protonation at the proton release and uptake steps.

Amino Acid Sequence↗

Photoreaction of the N intermediate of bacteriorhodopsin, and its relationship to the decay kinetics of the M intermediate.

Because the M photointermediate of recombinant T46V bacteriorhodopsin decays more rapidly and the N intermediate more slowly than in wild-type, the photoreaction of N could be examined without interference from M. We found that between pH 6 and 9 the photoproducts of N included both earlier suggested M-like intermediate and red-shifted R state. However, when the photoexcitation of N was at wavelengths below 500 nm the amount of M-like product decreased with increasing pH, and at pH 9 virtually only R was produced. In the dark, T46V contains an N-like conformer, in increasing amounts with increasing pH like wild-type but in 4-5 times greater concentrations. The photoreaction of this thermally produced state is much like that of the N intermediate. It is associated with the appearance of a slowly decaying M, but we calculate that under most conditions used to follow M in the wild-type photocycle the amount of N-like conformer, and therefore the amplitude of this slow component, will not be significant. The results confirm the suggestion [Fukuda & Kouyama (1992) Biochemistry 31, 11740-11747] that an M-like state is included among the photoproducts of N, but at the same time provide support to photocycle models in which the slow component of the biphasic M decay is attributed not to this secondary photoreaction or to a separate photocycle originating from a heterogeneous initial state, but to thermal equilibration between M and N in a single photocycle.

Bacteriorhodopsins↗

Addiction Severity Index scores of four racial/ethnic and gender groups of methadone maintenance patients.

This report compares the findings for four racial/ethnic and gender groups of methadone maintenance (MM) patients--African-American men (n = 153), African-American women (n = 107), Hispanic men (n = 138), and Hispanic women (n = 70)--administered the Addiction Severity Index (ASI). African-American men had a history of more arrests and incarcerations than Hispanic men. African-Americans had a longer history of drug and alcohol abuse problems than Hispanics and more current alcohol problems. Women reported more medical, psychiatric, family-social, and employment problems than men. Men reported more legal and alcohol-related problems than women. With several exceptions, the study findings were consistent with those based on other instruments. Given the relatively large sample sizes, the data may provide a characteristic ASI profile of the racial/ethnic and gender groups studied. The implications of differential group problem levels for substance abuse treatment efforts are discussed.

Adult↗

Conflicting measurements of depression in a substance abuse population.

Methadone maintenance patients (N = 217) were administered a computerized screening version of the National Institute for Mental Health (NIMH) Diagnostic Interview Schedule (DIS), the Beck Depression Inventory (BDI) and the Addiction Severity Index (ASI) 2-4 weeks after treatment entry. Few differences were found between African-American, Hispanic, and Caucasian subjects. Only 1.7% of the patients met a lifetime diagnosis of major depressive disorder, and 1.4% qualified for a current diagnosis major depressive disorder. In contrast, 35.8% of the patients reported moderate to serious depression on the BDI during the previous week, and 19.3% reported serious depression during the previous month on the ASI (38.7% lifetime depression). Because moderate correlations were found between the DIS, the BDI, and the ASI measures of depression, there is some indication that they were tapping a similar construct. Therefore the lower rates of depression found with the DIS are probably attributable to its more stringent definition of depression. The findings tend to confirm previous literature indicating that the DIS, as contrasted with other structured psychiatric interviews, underestimates depression.

Black or African American↗

Estimated acid dissociation constants of the Schiff base, Asp-85, and Arg-82 during the bacteriorhodopsin photocycle.

The pK(a) values of D85 in the wild-type and R82Q, as well as R82A recombinant bacteriorhodopsins, and the Schiff base in the D85N, D85T, and D85N/R82Q proteins, have been determined by spectroscopic titrations in the dark. They are used to estimate the coulombic interaction energies and the pK(a) values of the Schiff base, D85, and R82 during proton transfer from the Schiff base to D85, and the subsequent proton release to the bulk in the initial part of the photocycle. The pK(a) of the Schiff base before photoexcitation is calculated to be in effect only 5.3-5.7 pH units higher than that of D85; overcoming this to allow proton transfer to D85 requires about two thirds of the estimated excess free energy retained after absorption of a photon. The proton release on the extracellular surface is from an unidentified residue whose pK(a) is lowered to about 6 after deprotonation of the Schiff base (Zimanyi, L., G. Varo, M. Chang, B. Ni, R. Needleman, and J.K. Lanyi, 1992. Biochemistry. 31:8535-8543). We calculate that the pK(a) of the R82 is 13.8 before photoexcitation, and it is lowered after proton exchange between the Schiff base and D85 only by 1.5-2.3 pH units. Therefore, coulombic interactions alone do not appear to change the pK(a) of R82 as much and D85 only by 1.5-2.3 pH units. Therefore, coulombic interactions alone do not appear to change the pK(a) of R82 as much as required if it were the proton release group.

Arginine↗

Medical disorders in a cohort of New York city drug abusers: much more than HIV disease.

We evaluated the medical histories, drug abuse patterns, sexual behaviors, serological studies for syphilis and hepatitis B infection and other laboratory studies in 1780 patients enrolled in New York City drug treatment clinics in 1987. HIV serology was available for 168 patients. Nearly seventy-five percent had at least one medical disorder and 57% one abnormal laboratory parameter. A history of gonorrhea, hepatitis B infection, pneumonia, and anemia was reported in 28%, 23%, 21%, and 20.7% of the patients, respectively. Fifty-seven percent of 168 patients tested HIV seropositive and 16% of 1,780 patients were tuberculin reaction positive. Given the considerable prevalence of medical disorders, in which early identification and intervention is possible, serious consideration should be given to extend the scope of drug abuse services to include primary medical care services targeted at the medical sequelae of drug abuse, and medical disorders not directly associated with either HIV disease or drug abuse.

Adult↗

Demographic, medical history and sexual correlates of HIV seropositive methadone maintained women.

Beginning in January 1989, consecutive female admissions to the ARTC MMTP Clinics in NYC were interviewed about their medical, drug, sexual and social experiences during 6 distinct historical years. Bloods were drawn and each sample tested for HIV via ELISA and Western Blot analysis. The data for 256 females was analyzed. The sample was predominantly Black (56%) and Hispanic (36%). Fifty-four percent (140) were between the ages of 31 and 40; 35% (91) were between the ages of 18 and 30; and 10% (27) were 41 or older. The majority, 179 (69%), had less than a high school education, while 79 (31%) had a high school education or greater. The seropositivity for this sample of females was 60.4%. Aside from the common types of illnesses often seen in gay men infected with the HIV virus (i.e., pneumonia, night sweats, sore throat and swollen glands) our sample of females presented with symptoms such as abnormal discharges from the vagina, infections or abscesses of the veins, kidney or bladder infections, bleeding from the bowels and hepatitis infections. The most commonly reported risk factors among our sample of HIV positive females were sharing injecting materials (38%); injecting drugs in the veins (37.2%); dividing an injection (24.3%); and blood transfusions (10.9%). Of our HIV positive females, 42 of 97 (43.3%) reported having sex with a man they shared needles with only one time so that having sex with a man who is potentially infected with the HIV virus only once may be enough for a female to seroconvert. One limitation of this data is that there is no knowledge of when the HIV positive women seroconverted. Some of the behaviors reported could be due to exposure to AIDS education, and not to the knowledge to their HIV serostatus.

Adolescent↗

Drug abuse treatment programs as centers for HIV-related research and treatment.

The Observational Data Base (ODB) is a multicenter, longitudinal effort of the Community Programs for Clinical Research in AIDS (CPCRA) designed to collect HIV-related data on a large number of HIV-infected patients receiving primary care from community based physicians and health care groups. Over 400 patients from the Addiction Research and Treatment Corporation have enrolled in the ODB. Compared to the remainder of the CPCRA, ARTC ODB enrollees are more likely to be female, African American or Hispanic and to have injectable drug use and heterosexual contact with an injectable drug user as risk factors. The ARTC ODB patient profile closely resembles the fastest growing segments of the AIDS epidemic.

Adolescent↗

Alcohol abuse prevention in African-American communities.

Because of the devastating morbidity, mortality, and social dislocations associated with alcohol abuse in many African-American communities, the prevention of alcohol abuse represents a critical component of the public health agenda for African Americans. This article reviews African-American cultural issues pertinent to alcohol use and abuse and the information available regarding the excess medical and social complications experienced by African Americans secondary to alcohol abuse. Some recommendations are made for a specific research agenda for the prevention of alcohol abuse with relevance to African Americans.

Adolescent↗

Short-term declines in CD4 levels associated with cocaine use in HIV-1 seropositive, minority injecting drug users.

This study evaluates the association of cocaine use with short-term change in CD4 counts among human immunodeficiency virus type 1 (HIV-1) seropositive, minority injecting drug users prior to the introduction of zidovudine (AZT). Ninety-eight HIV-1 seropositive subjects were recruited from six inner-city, methadone maintenance clinics. A baseline assessment included a short questionnaire regarding drug behavior and quantitation of CD4 cell counts. These measures were repeated on all subjects 3 to 4 months later. Thirty-eight subjects reported using cocaine between baseline and 4-month follow-up evaluations. Males and African Americans were more likely to be cocaine users (P < .01). Cocaine users were more likely to engage in heroin and needle use (P < .001). Cocaine users experienced a significant decline in CD4 cells compared with nonusers (P = .013); no marked difference in CD4 decline was noted between heroin users and nonusers (P = .19). Multivariate analysis showed that a decline in CD4 counts was 2.82 times more likely to occur in cocaine users than in cocaine nonusers (90% two-sided confidence interval of 1.08, 7.37). These findings support the hypothesis of a possible link between cocaine use and short-term CD4 decline in HIV-1 seropositive injecting drug users.

Adult↗

A multicomponent model for substance abuse treatment. The Addiction Research and Treatment Corporation.

This paper reviews the activities of the Addiction Research and Treatment Corporation (ARTC), a substance abuse treatment agency, located in Brooklyn, New York, which services approximately 2,300 patients annually. ARTC's history, treatment, and research activities are first described. We then proceed to detail the ARTC's employee health maintenance and community relations programs. A multicomponent treatment model is then outlined, which emphasizes the interactive role of the above functions within an optimal treatment network.

Female↗

No seroconversions among steady sex partners of methadone-maintained HIV-1-seropositive injecting drug users in New York City.

OBJECTIVE: To assess the incidence of heterosexual HIV-1 transmission from seropositive methadone-maintained injecting drug users (IDU) to their seronegative, non-IDU steady sex partners. DESIGN: A prospective, longitudinal study. SETTING: HIV-1-seropositive IDU and their HIV-1-seronegative, non-IDU steady sex partners were recruited from six methadone-maintenance clinics in the New York City boroughs of Brooklyn and Manhattan. PATIENTS, PARTICIPANTS: Between December 1988 and October 1991, 60 research participants were recruited [30 methadone-maintained, HIV-1-seropositive IDU (index subjects) and their non-IDU HIV-1-seronegative steady partners]. Baseline and follow-up (every 3-4 months) data included a structured questionnaire and blood testing for HIV infection and CD4+ cell subsets. RESULTS: Demographic characteristics of the 30 steady sex partners were evaluated as follows: sex (22 women, eight men); age (mean, 32 years; range, 21-55 years) and race (African-American, 13; Hispanic, 13; other, 4). The average duration of relationship between index subject and partner at study entry was 7.5 years (range, 4 months to 19.4 years). At entry, 27 of the 30 partners reported no or intermittent use of condoms with the index subject during a typical 12-month period. Follow-up data (median follow-up, 298 days; range, 85-992 days) were available for 22 partners. Of these, 15 reported no or intermittent condom use. For a total study observation time of 23 person-years, there were no seroconversions. The upper 95% confidence interval for the observed seroconversion rate of 0% is 13%. CONCLUSIONS: These results suggest that the likelihood of heterosexual HIV-1 transmission from seropositive methadone-maintained IDU to their seronegative, non-IDU steady sex partners is low.

Adult↗

Sexual behaviors and HIV infection in intravenous drug users in New York City.

Heterosexual transmission of HIV infection is closely linked with intravenous drug use. This study investigated the sexual behaviors of intravenous drug users (IVDUs) in New York City. In 1986, 284 IVDUs were recruited from newly enrolled patients in methadone treatment clinics. A questionnaire asking for information on sexual behaviors was administered and sera were collected and tested by ELISA and Western Blot techniques. Associations between behavioral data and HIV serology were evaluated using univariate methods of analysis. HIV infection was significantly associated with age (p = 0.01). Subjects not claiming prostitution were also significantly more likely to be infected (p = 0.01). Subjects reporting condom use and oral sex had lower infectivity rates. Higher infection rates were observed in subjects reporting anal sex and homosexual or bisexual sexual behavior. The findings of this study suggest that greater efforts to isolate those sexual behaviors that are predictors or correlates of heterosexual transmission of HIV infection is much needed in order to design behavioral interventions that will effectively curtail the spread of this virus.

Adult↗

Effect of psychological factors on risk behavior of human immunodeficiency virus (HIV) infection among intravenous drug users (IVDUs).

The effect of psychological factors on drug and sexual behaviors in relation to HIV infection was investigated among 262 IVDUs in methadone clinics in New York City. Among female IVDUs, the HIV positive subjects reported larger numbers of sex partners than those subjects who were HIV negative, and those who had larger numbers of sex partners were more likely to be depressed. The IVDUs who had larger numbers of needle-sharing partners at shooting galleries were more likely to be HIV positive. Intervention programs should focus on IVDUs who are sexually active females, sharing needles at galleries, still using heroin and cocaine, and who began using heroin at an early age.

Adolescent↗

AIDS-related behavioral research and nursing.

As efforts targeted at producing an effective vaccine or a definitive cure are still in early stages of development, health education and prevention continue to be this country's major line of defense against acquired immunodeficiency syndrome (AIDS). This defense is dependent on knowledge of behaviors that place individuals at risk of human immunodeficiency virus (HIV) exposure and disease progression. This article reviews the critical points in our state of knowledge and offers additional areas of need. Research is needed to determine a database of persons who use psychoactive substances and to understand the HIV-associated behaviors linked to drug use. Epidemiologic studies are necessary to appreciate the sexual, contraceptive, and childbearing practices of users of any psychoactive substance. Greater emphasis also is needed to investigate the inherent effects of various psychoactive substances on the immune, neurologic, and endocrine systems. While biomedical research continues, it is apparent that research from behavioral studies are crucial to education and prevention efforts. Nurse investigators are well-positioned to play an important role in accumulating this information. Given the critical role of drug abuse in the HIV epidemic, the public health significance cannot be overestimated.

Acquired Immunodeficiency Syndrome↗

Endocrine complications of AIDS and drug addiction.

The endocrine and metabolic consequences of illicit drug use and HIV disease are extensive and profound. Both narcotic drug use and AIDS have the capacity to cause clinically significant multiglandular derangements. Admittedly, we were not able to focus as much attention on the less frequently occurring disturbances of calcium, phosphorus, or folate metabolism in HIV disease. Similarly, we reported very little information about the endocrinologic significance of the use of classes of narcotics other than opiates and to a far lesser extent cocaine. Even with these limitations, the spectrum of drug abuse and HIV-related endocrine manifestations discussed previously is quite diverse. Given the pervasive effects of drug abuse on other organ systems, it is not surprising to find expanding interest in the endocrine consequences of narcotic drug use. In fact, the use of these drugs is responsible, in part, for the past and continuing interest in identifying receptors for these agents and similarly structured endogenous ligands. As these investigations proceed, we must appreciate the limitations in translating basic and clinical scientific findings to the clinical setting. Much of the current research does not study street-relevant narcotic doses, does not use research designs involving polydrug use, and does not involve the processes or routes of drug administration used by active narcotic addicts. There is a critical need for more research methods with animal models and clinical study settings that more adequately mimic drug use outside of the laboratory. Our ability to develop appropriate psychopharmaceutical agents to respond to the different faces of drug abuse in the United States will depend on continued progress in the area of neuroendocrinology. With respect to the consequences of HIV disease, the clinical findings of elevated hormonal levels in some endocrine systems are amazing given what one would expect if one postulated direct or indirect destruction by HIV or the opportunistic complications that accompany AIDS. In unraveling this puzzle, careful attention must be given to evaluating the degree to which the clinical or biochemical consequences are due to a direct HIV effect, to an effect of a complicating infection or neoplasm, or to an AIDS-related therapeutic intervention. More work is needed also in obtaining histopathologic information to correlate with the biochemical and clinical derangement. In summary, there is a wealth of information demonstrating a wide spectrum of endocrine/metabolic consequences of drug abuse and AIDS. Still, just as many questions remain unanswered. While the exact biologic mechanisms are unclear, many of the biochemical aberrations have clinical relevance.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗