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Biomedical subjects

N S Miller

Publications and source records attributed to N S Miller.

At least 55 records · Page 3Linked to original sources
PubMed1992

Stimulation of rat alveolar macrophage fibronectin release in a cadmium chloride model of lung injury and fibrosis.

Rats were exposed to saline or cadmium chloride (CdCl2) at 25, 100, or 400 micrograms/kg body weight by intratracheal instillation. At 3, 7, 14, and 28 days after exposure five animals/treatment were euthanized, the lungs were lavaged, and bronchoalveolar lavage fluid (BALF) was analyzed for lactate dehydrogenase (LDH), total protein, N-acetylglucosamindase (NAG), and cell number, type, and viability. Lung hydroxyproline concentration was characterized as a marker of lung collagen. Alveolar macrophages (AM) obtained in BALF were cultured and the release of fibronectin and TNF was determined. Lung tissue was examined microscopically at 28 and 90 days after exposure. Exposure to CdCl2 resulted in lung injury and inflammation demonstrated by increases in BALF LDH, total protein, NAG, and inflammatory cells. AM TNF release was not significantly changed by CdCl2 treatment. All doses of CdCl2 stimulated AM fibronectin secretion, a response which persisted throughout the 28-day postexposure period examined. Pulmonary fibrosis was demonstrated biochemically and/or histologically (trichrome staining tissue) at all CdCl2 dose levels. The association of CdCl2-induced AM fibronectin release with lung fibrosis confirms and extends previous observations relating AM-derived fibronectin to the development of interstitial lung disease and provides further evidence that the persistent increase in AM fibronectin release represents an early indicator of fibrosis.

Animals↗
PubMed1992

Treatment of khat addiction.

The authors present two cases of khat addiction that were successfully treated with bromocriptine. Khat is a bush cultivated in the Mid East because of its highly stimulant effects. Its leaves contain a variety of sympathomimetics. While khat is rarely found in the U.S., American soldiers stationed in the Arabian peninsula may be exposed to it. Because of an alcohol interdiction during the current Persian Gulf crisis, these troops may be tempted to use this plant as an alternative recreational drug.

Adult↗
PubMed1991

Benzodiazepines: a major problem. Introduction.

Benzodiazepine use is prevalent. Moreover, benzodiazepine abuse, addiction, tolerance, and dependence occur commonly with benzodiazepine use. Confusion arises in assessing the nature and magnitude of benzodiazepine use and its consequences. Abuse, addiction, tolerance, and dependence occur in medical and nonmedical populations, but the studies do not clearly differentiate the benzodiazepine use between these two populations. The nonmedical use in medical populations is underestimated and underdiagnosed. The nonmedical use is also misdiagnosed in nonmedical populations as medical use. Clearer definitions and usage of the terms of abuse, addiction, tolerance, and dependence would result in accurate diagnosis and proper treatment of the disorders associated with benzodiazepine use, that is, anxiety and depressive disorders, alcoholism, and other drug addictions.

Anti-Anxiety Agents↗
PubMed1991

Addiction to and dependence on benzodiazepines. Diagnostic confusion in clinical practice and research studies.

Considerable confusion continues to surround basic concepts for abuse, addiction, tolerance, and dependence. Clinicians may be making decisions about prescribing these medications without clear definitions and distinctions. The terms are not equivalent in meaning and should not be used interchangeably in clinical application. Moreover, they may occur together or independently and are not etiologically related. Abuse is improper use outside the standard norms. Abuse implies a violation component and a control over the use of the drug. Addiction is a preoccupation with the acquisition and compulsive use of and a pattern of relapse to drugs is spite of adverse consequences. Pervasive to the criteria is a loss of control over drug use and a lack of volitional component in the drug use. In spite of problems in definitions, studies have clearly shown that abuse, addiction, tolerance, and dependence develop commonly in benzodiazepine use.

Adult↗
PubMed1991

Suicide risk associated with drug and alcohol dependence.

The association of alcohol and drugs with suicidal thinking and behavior is both causal and conductive. The subjective state of hopelessness is key to the disposition to actual suicides. Alcohol and drugs are influential in providing a feeling of hopelessness by their toxic effects, by possible manipulating of neurotransmitters responsible for the mood and judgement and by disruption of interpersonal relationships and social supports. The identification of alcohol and drug use and dependence is critical to the proper assessment of suicide. According to studies, over fifty percent of all suicides are associated with alcohol and drug dependence and at least 25% of alcoholics and drug addicts commit suicide. Over 70% of adolescent suicides may be complicated by drug and alcohol use and dependence. Because alcoholism and drug addiction are leading risk factors for suicidal behavior and suicide, any alcoholic or drug addict should be assessed for suicide, especially if actively using alcohol or drugs.

Alcoholism↗
PubMed1991

Nicotine dependence: diagnosis, pharmacology and treatment.

Nicotine dependence has been clearly documented as an addiction to nicotine. The development of tolerance and dependence to nicotine has been documented as well in studies in animals and humans. The morbidity and mortality from nicotine dependence continues to be widespread and significant in spite of some reduction in the prevalence of use. Various modalities of pharmacological and nonpharmacological treatments have been developed in recent years. These treatment methods may be used singularly or in combination. Although some success has been claimed with each form of treatment, more studies are needed to confirm their full efficacy.

Behavior Therapy↗
PubMed1991

Drug misuse in alcoholics.

Concurrent drug misuse is an increasing trend among alcoholics. It is occurring in an age-dependent manner so that the younger the age, the higher the incidence of concurrent misuse. Drugs concurrently misused by alcoholics, in decreasing order of frequency, are marijuana, cocaine and other sympathomimetics, phencyclidine, benzodiazepines, barbiturates, and psychedelics. Because of increasing prevalence of concurrent misuse, evaluation for alcohol detoxification should always include consideration of other drugs. Concurrent alcohol/drug addiction in alcoholics as well as increased incidence in alcoholism in families of drug addicts suggest a common genetic vulnerability to alcoholism and drug addiction.

Adult↗
PubMed1991

Violent behaviors associated with cocaine use: possible pharmacological mechanisms.

Violent behaviors are increasingly noted in clinical practice to be associated with cocaine use; however, few studies actually characterize these behaviors. Cocaine addicts who made self-inquiries for themselves to obtain information about the effects, diagnosis, and treatment of cocaine dependence were interviewed. The study examined in a structured telephone interview their violent behaviors associated with cocaine use. The types of violent behavior reported by these cocaine addicts ranged from minor psychological aggressions to major physical acts that included murder and rape. The pharmacological mechanisms underlying the induction of cocaine-associated violence may involve known neurotransmitter systems affected by cocaine. A possible explanation may be that cocaine acts in those areas of the brain, particularly the limbic system, that subserve aggressive and violent behaviors.

Adult↗
PubMed1991

Dual diagnoses: psychiatric syndromes in alcoholism and drug addiction.

Concomitant psychiatric illness and alcohol or drug addiction are difficult to diagnose and treat. Alcohol and drug problems are significantly underdiagnosed in medical and psychiatric populations, while psychiatric disorders may be underdiagnosed in alcohol- and drug-addicted patients. An understanding of addiction and psychiatric disorders is essential for successful treatment of the comorbidity of these disorders. Alcohol or drug addiction frequently produces significant psychiatric syndromes, which may resolve during periods of sobriety. The combination of addiction and established psychiatric disorders is less common.

Alcoholism↗
PubMed1991

Organic solvent and aerosol abuse.

Volatile organic solvents and aerosols are available in a wide variety of household and commercial products. Inhalation of these substances produces euphoria, excitement, sedation, delusions, and visual and auditory hallucinations. With acute and chronic use, organic solvents and aerosols cause slurred speech, ataxia, frank intoxication, and poor insight and judgment. Both acute and chronic toxic effects can occur, and addiction can develop with chronic use.

Aerosols↗
PubMed1990

Drug testing: medical, legal, and ethical issues.

Laboratory testing for drugs is a controversial issue in America. The authors present arguments for mandatory use under specific circumstances. Physical limitations of each test are discussed in terms of applicability as well as protection of the person being tested.

Ethics, Medical↗
PubMed1990

Cannabis diagnosis of patients receiving treatment for cocaine dependence.

In three separate samples using DSM-III-R criteria for substance dependence in 232 inpatients and 51 outpatients, we confirm the clinical suspicion that many cocaine dependents qualify for the diagnosis of cannabis dependence. As many as 53% of cocaine dependents diagnosed by DSM-III-R criteria have the concurrent diagnosis of cannabis dependence. The reports regarding cannabis dependence among cocaine dependents are few and inconclusive. The diagnosis of cannabis dependence in cocaine dependents has important consequences on etiology, prognosis, and treatment.

Adult↗
PubMed1990

The diagnosis of alcohol and cannabis dependence in cocaine dependence.

In two separate studies using DSM-III-R criteria for substance dependence in two hundred sixty-three (263) inpatients we confirm the clinical experience that cocaine addicts use other drugs including alcohol. As many as 89% of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence qualify for other substance dependence diagnoses. Previous reports regarding alcohol and other drug use among cocaine addicts are few and inconclusive. The diagnoses of other substance use and dependence in cocaine dependence has important impact on etiology, prognosis and treatment. Our study finds a high prevalence of alcohol dependence and cannabis dependence in patients with cocaine dependence.

Adult↗
PubMed1990

Benzodiazepines: reconsidered.

The benzodiazepines were first introduced in 1960. Chlordiazepoxide (Librium) was the first of the class of drugs called benzodiazepines, in a deliberate attempt to synthesize a tranquilizer without the sedative properties and abuse, addiction, tolerance, and dependence potential of the barbiturates, and other sedative/hypnotic drugs. The popularity of the benzodiazepines rose steadily to a peak period in the mid 1970s when diazepam (Valium) was the most commonly prescribed drug of any kind, including antihypertensive, analgesic and other psychotropic medications. The current evaluations of benzodiazepines use and abuse demonstrate clearly that they produce tolerance and dependence in short and long-term administration. The development of abuse and addiction is also strongly substantiated although they are not as easily appreciated and identified because of confusion in diagnosis and treatment of abuse and addiction. Significant problems in definitions, diagnosis, interpretations and conclusions exist in general practice regarding abuse and addiction, and their relationship to use of and symptoms produced by benzodiazepines. The lack of clarity in defining abuse and addiction and tolerance and dependence in clinical practice leads to institution and perpetuation of the toxicity and untoward effects of the benzodiazepines.

Anti-Anxiety Agents↗
PubMed1990

Increased membrane order of erythrocytes in alcoholics as measured by fluorescence polarization: a possible marker for tolerance in alcoholics.

The erythrocyte membranes from 9 healthy non-alcoholic controls and 8 alcoholic patients (fulfilled DSM-III-R criteria for alcohol dependence) were compared for changes in membrane order as measured by fluorescence polarization. The mean amount of change in fluorescence polarization in response to in vitro exposure to ethanol was significantly less in the alcoholics than controls. This increased membrane order of the peripheral blood erythrocytes suggests the presence of pharmacodynamic tolerance to ethanol in the alcoholic patients.

Adult↗
PubMed1990

Outcome at six and twelve months post inpatient treatment for cocaine and alcohol dependence.

This study presents outcome rates for inpatient treatment for alcohol, cocaine and other drug dependence. The abstinence rates at six and twelve months post discharge and other demographic information are compiled on 1,627 patients admitted to an inpatient treatment unit for the rehabilitation of cocaine, alcohol and other drug dependence. The percent of the 1,627 patients with the diagnosis of alcohol dependence only was 42%, cocaine, alcohol and other drug dependence 25%, and alcohol and other drugs, 28%. The abstinence rate at six months for patients with alcohol dependence only was 75%, alcohol and other drug dependence 82%, cocaine dependence 76%; at twelve months, the abstinence rates were 71%, 66%, and 62% respectively.

Adult↗
PubMed1990

The diagnosis of alcohol and cannabis dependence (addiction) in cocaine dependence (addiction).

In two separate studies in 263 inpatients using DSM-III-R criteria for alcohol and drug dependence (addiction) we confirm the clinical experience that cocaine addicts are dependent on other drugs including alcohol. Our study finds a high prevalence of alcohol dependence and cannabis dependence in patients with cocaine dependence. As many as 89% of cocaine addicts diagnosed by DSM-III-R criteria for cocaine dependence (addiction) qualify for other alcohol and drug dependence diagnoses. Previous reports regarding alcohol and other drug use among cocaine addicts are few and inconclusive. The diagnosis of other alcohol and drug dependence in cocaine dependence has important impact on etiology, prognosis, and treatment.

Adult↗