Search PubMed⌕ Search

Biomedical subjects

W Ling

Publications and source records attributed to W Ling.

At least 55 records · Page 3Linked to original sources
PubMed1997

Outpatient non-opioid detoxification for opioid withdrawal. Who is likely to benefit?

The authors examined characteristics of successful completers of an outpatient clonidine/oxazepam detoxification procedure for opioid dependence. Of 215 initial applicants, 167 received medication, and 65 successfully completed by taking a dose of naltrexone. Those who completed were more likely to have last used an opioid other than heroin, to be heroin smokers, rather than intravenous users, to have used benzodiazepines in the 30 days before treatment, and to have abstained from opioids for a longer time before presenting for treatment. New users (for less than 2 years) did no better than those using longer than 2 years. These findings may help in the continued refinement of patient placement criteria.

Adolescent↗
PubMed1997

Cocaine abuse counseling as HIV prevention.

The current study evaluated the efficacy of cocaine abuse counseling alone as a strategy to reduce HIV-related sexual risk behaviors. Participants were 232 cocaine-abusing or dependent individuals who received up to 26 weeks of Matrix counseling but no formal HIV-prevention interventions. One hundred fifty-seven (67.6%) participants completed assessments at admission, during treatment, and at 6 months following admission. Participants located for follow-up were significantly more likely to be Caucasian, to be better educated, and to complete longer treatment episodes than those not located. Main study findings indicated a statistically significant association between safer sex behavior and completion of a cocaine abuse counseling episode (chi 2 (2, n = 157) = 6.25, p < .05). Participants who completed counseling were more likely to change to safer sex or maintain safer sex over the 6-month period than participants who terminated counseling prematurely. The primary method for reducing sexual risk involved overall decreases in reported numbers of partners (Partners-baseline = 5.32, SD = 6.25; Partners6 Months = 2.47, SD = 2.62; F(1, 132) = 36.32, p < .001) among this group of mostly heterosexual (89.9%), Caucasian (69.0%), crack cocaine users (65.6%). We concluded that cocaine abuse counseling is a powerful intervention for reducing HIV-related sexual behaviors in this group at high risk for exposure to HIV. Study findings suggested that efforts to evaluate HIV prevention programs must also account for the effect of drug counseling.

Adult↗
PubMed1996

Addiction medicine.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed1996

A controlled trial comparing buprenorphine and methadone maintenance in opioid dependence.

BACKGROUND: Buprenorphine is a partial agonist at the mu-opioid receptor that has been proposed as an alternative to traditional full agonist maintenance therapy for the treatment of opioid addiction. We report on a clinical trial in which the relative safety and efficacy of long-term fixed-dose buprenorphine maintenance was examined in comparison to low- and high-dose methadone maintenance. METHODS: Two hundred twenty-five treatment-seeking opioid addicts (46 women, 179 men) were randomly assigned to receive, in a double-blind manner, either 8 mg/d of buprenorphine, 30 mg/d of methadone, or 80 mg/d of methadone maintenance over a 1-year period. Objective and subjective measures of efficacy (urine toxicology, retention, craving, and withdrawal symptoms) were examined at the study midpoint and at termination, and safety data were tabulated over the entire 52-week study period. RESULTS: Patients assigned to high-dose methadone maintenance performed significantly better on measures of retention, opioid use, and opioid craving than either the low-dose methadone or the buprenorphine group at both 26-week and 52-week time points. Performance on these measures was virtually identical between the latter two groups. No serious adverse health effects attributable to buprenorphine were noted. CONCLUSIONS: Buprenorphine maintenance at 8 mg/d appears to be less than optimally efficacious under the conditions of the present study. Continued research is needed to reconcile these findings with the more positive results reported by other investigative groups. There are no apparent health risks associated with long-term buprenorphine maintenance at this dosage.

Adult↗
PubMed1996

Lack of correlation of anorectal manometry with symptoms of chronic childhood constipation and encopresis.

UNLABELLED: Chronic constipation is an extremely common problem in children. Many authors have advocated using anorectal manometric examination during evaluation of chronic childhood constipation and encopresis as a means of developing individualized modes of treatment. PURPOSE: This study was designed to prospectively examine frequency and severity of symptoms of childhood constipation and encopresis and associate these symptoms with anorectal manometric findings. METHODS: Forty-four children with chronic constipation participated in the study. Before performing anorectal manometry, bowel-related symptoms were collected for two consecutive weeks with a computerized voice mail system. Anorectal manometry was performed using a triple lumen catheter attached to a hydraulic manometry infusion system. RESULTS: Frequency of voluntary bowel movements did not correlate with any manometric parameters. Frequency of fecal soiling, age at onset of symptoms, and duration of symptoms were all highly correlated with degree of sphincter spasm during attempted defecation; however, none of these variables correlated with any other manometric parameter. Amount of pain associated with bowel movements correlated with frequency of soiling and was inversely correlated with maximum squeeze pressure but was not correlated with any other manometric parameter. CONCLUSIONS: In children with chronic constipation and encopresis, sphincter spasm demonstrated with anorectal manometry is highly correlated with frequency of fecal soiling, age at onset, and duration of symptoms; however, none of the other commonly measured manometric parameters appear to correlate with symptoms of chronic childhood constipation and encopresis.

Age of Onset↗
PubMed1996

The phosphotyrosine phosphatase inhibitor-phenylarsine oxide restores defective phosphoinositide hydrolysis response in anergic C3H-gld/gld lymphocytes.

Mice homozygous for the gld (generalized lymphoproliferative disease) mutation develop both lymphadenopathy and autoimmune disease. CD4-CD8- (double negative, DN) T cells comprise the major population of T cells in mature C3H-gld/gld peripheral lymphoid tissues. These DN T cells are unresponsive to many forms of stimuli and have previously been shown to exhibit abnormally elevated levels of membrane phosphotyrosine phosphatase (PTPase) activity. In the present study, we demonstrate that IP3 production in response to mitogenic stimulation with Con A or anti-CD3 mAb (145-2CII) is significantly diminished in C3H-gld/gld lymphocytes when compared to that in congenic C3H(-)+/+ cells. The capacity to produce this second-messenger can be restored by pretreating C3H-gld/gld cells with the PTPase inhibitor, phenylarsine oxide (PAO). Although the inhibition of PTPase activity by treatment with PAO did restore C3H-gld/gld cell ability to produce IP3, the signal did not lead to lymphocyte proliferation, but instead to cell death. Our results suggest that the altered phosphoinositide hydrolysis observed in the mutant cells is related to their elevated membrane PTPase activity and that the anergy in these cells is at least in part related to the abnormally high activity of endogenous PTPases.

Animals↗
PubMed1996

Additive benefits of laxative, toilet training, and biofeedback therapies in the treatment of pediatric encopresis.

Compared the additive benefits of laxative, behavior, and biofeedback treatments for encopresis, while attempting to identify treatment mechanisms and predictors of treatment outcome. 44 encopretic children, ages 6-15 years, were randomly assigned to either laxative therapy (LAX), LAX plus enhanced toilet training (ETT), or LAX + ETT + anal sphincter biofeedback (BF). Daily symptom diaries were completed 14 days before, upon initiation of and 3 months following treatment initiation. ETT and BF were superior to LAX in reducing encopresis. Outcome was significantly predicted by improvement during the initial 14 days of treatment. Reduction of soiling was associated with an increase in bowel movement frequency, and reductions in defecation pain and parental prompting to use the toilet. Because of its efficacy and minimal reliance on technology, ETT should be the initial treatment of choice.

Adolescent↗
PubMed1996

Urine toxicology as an outcome measure in drug abuse clinical trials: must every sample be analyzed?

Clinical trials designed to establish the effectiveness of a pharmacotherapy for the treatment of drug abuse typically call for the collection and analysis of three urine samples per week to detect changes in drug use patterns. Examination of over 16,500 urine samples collected from 225 subjects during a one year buprenorphine/methadone clinical trial indicates that analysis of one weekly urine sample from those collected on a three-times-per-week fixed schedule provides essentially the same outcome information as analysis of all three weekly urines. Further, the percent of opiate-positive samples is constant across weekday, indicating that a single urine, randomly selected from those collected each week, is a valid indicator of treatment performance.

Adult↗
PubMed1995

A multicenter trial of bupropion for cocaine dependence in methadone-maintained patients.

We conducted a multi-site, placebo-controlled, randomized double-blind clinical trial comparing bupropion HCL (300 mg/day) to placebo for the treatment of cocaine dependence in methadone-maintained subjects. A total of 149 subjects at three sites participated in a 12-week study. Outcome measures included cocaine use, level of depression, and psychosocial functioning. Results showed no significant differences between placebo and bupropion. Exploratory analyses suggested a medication effect for the subset of subjects depressed at study entry. The need to target subgroups of cocaine abusers in future pharmacotherapy trials and the possible role of treatment readiness are discussed.

Adult↗
PubMed1995

Hepatitis C virus core region: helper T cell epitopes recognized by BALB/c and C57BL/6 mice.

In this study, we characterized the B cell and T cell responses to the hydrophilic portion of hepatitis C virus (HCV) core protein in two strains of mice and identified the respective antigen determinants. BALB/c (H-2d) and C57BL/6 (B6:H-2b) mice were immunized by a subcutaneous injection of recombinant HCV core protein together with Freund's complete adjuvant. The level of antibody production, as determined by ELISA, was consistently higher in BALB/c than in B6 mice. However, antibodies in sera from each strain bound to the N-terminal region of the core protein within amino acids 1 to 28 (MSTNPKPQRKIKRNTNRRPQDVKFPGGG), according to an experiment using non-overlapping peptides that covered the hydrophilic portion of HCV core protein. The T cell responses were also higher in BALB/c than in B6 mice with respect to the proliferative responses of the draining lymph node cells in vitro. By limiting dilution cultures of the draining lymph node cells in vitro repetitively stimulated with recombinant core protein, T cell clones were established from both strains of mice and characterized. The surface markers of these clones were Thy-1.2+, CD3+, TCR alpha beta+, CD4+ and CD8+. The proliferative responses were inhibited in the presence of anti-CD4 or anti-MHC class II monoclonal antibodies. The T cell lines in BALB/c mice recognized an epitope in HCV core at amino acids 72 to 91 (EGRAWAQPGYPWPLYGNEGL). The T cell lines in B6 mice recognized an epitope at amino acids 55 to 74 (RPQPRGRRQPIPKARQPEGR). Thus, mice with different MHC haplotypes recognized different non-overlapping T cell antigenic determinants of HCV core proteins.

Amino Acid Sequence↗
PubMed1995

Buprenorphine as a pharmacotherapy for cocaine abuse: a review of the evidence.

The partial mu-opiate agonist, buprenorphine, is the subject of recent evaluation as a potential pharmacotherapy for cocaine dependence. This paper reviews the extant preclinical and clinical evidence of buprenorphine effectiveness in treating cocaine abuse, including data from our large methadone comparison trial and a smaller buprenorphine dose ranging study. Although buprenorphine appears to reduce cocaine self-administration in studies of non-opiate dependent animals, clinical evidence for the same response in opiate addicts abusing cocaine has not been demonstrated. Further efficacy trials should await preclinical demonstrations of effectiveness in samples with opiate and cocaine exposure.

Analgesics, Opioid↗
PubMed1994

Inhibition of murine AIDS (MAIDS), development by the transplantation of bone marrow cells carrying the Fv-4 resistance gene to MAIDS virus-infected mice.

To examine whether the resistance allele of the Fv-4 gene (the Fv-4r gene) is a dominant inhibitory-product-encoding gene which an be used to prevent the development of murine AIDS (MAIDS), bone marrow cells from BALB/c-Fv-4wr mice were transplanted into BALB/c mice and C57BL/6 mice infected with MAIDS virus. Almost all of the virus-infected BALB/c and C57BL/6 mice developed MAIDS within 4 months and died 2 or 3 months later. However, when the virus-infected mice were subjected to cobalt irradiation and then given an intravenous injection of 10(7) BALB/c-Fv-4wr mouse bone marrow cells, the recipient mice survived much longer than the untreated mice, which suggests that the Fv-4 gene is a dominant inhibitory gene that is potentially useful in gene therapy of MAIDS.

Animals↗
PubMed1993

Prescription of opioids for treatment of pain in patients with addictive disease.

Addiction medicine specialists and pain specialists can provide better patient care by combining their expertise when treating patients who are addicted to alcohol, street drugs, or prescription medications. Addiction specialists--particularly those whose primary treatment philosophy is drug free--must accept that controlled opiate maintenance is appropriate for some patients, and pain specialists need to increase their sensitivity to the possibility of addiction among their patients. Both pain and addiction are treatable conditions, and optimal care of some patients requires the coordinated services of both an addiction medicine specialist and a pain specialist.

Humans↗
PubMed1993

Substrate induction and metabolite accumulation during anaerobic toluene utilization by the denitrifying strain T1.

The denitrifying strain T1 utilizes toluene anaerobically. We now report that anaerobic toluene degradation is inducible in strain T1. Fluoracetate treatment of cell suspensions inhibited both the rate of toluene metabolism and the formation of the toluene dead-end products benzylsuccinate and benzylfumarate, which is consistent with the pathway proposed by Evans et al. (Appl. Environ. Microbiol. 58:496-501, 1992). In addition, when either nitrate was limiting or fluoroacetate was added, benzoate was detected during toluene metabolism.

Bacteria, Anaerobic↗
PubMed1993

Neurobehavioral treatment for cocaine dependency: a preliminary evaluation.

The treatment of cocaine dependency in the 1980s has required the use of a broad range of strategies. Although there are some promising approaches for treating certain aspects of the cocaine withdrawal syndrome, there is no empirical evidence that provides a clear direction to the future development of a comprehensive treatment approach. The neurobehavioral model is an initial attempt to structure information, support, and encouragement across a series of stages that are experienced by cocaine abusers as they progress through the first 6 months of their recovery. This model attempts to sequence strategies in a way that will correspond to an expected timetable of problem emergence during recovery from cocaine dependency. Individual sessions with trained therapists are used extensively to move clients through the recovery process. Relapse prevention techniques have been used extensively within a relapse prevention group format and in a standardized relapse analysis procedure. This model has been standardized into a manual that allows for replication and evaluation. Current research efforts are under way to assess the usefulness of this model as an independent treatment approach and as a framework for evaluating other potentially useful cocaine dependency treatment strategies.

Behavior Therapy↗