Heroin use during methadone maintenance treatment: the importance of methadone dose and cocaine use.

Objectives: The purpose of this study was to examine factors associated with heroin use during methadone maintenance treatment.

Methods: Logistic regression statistical models were used to examine data obtained in a cross-sectional sample of 652 methadone patients.

Results: Heroin use during the 3 months prior to interview was shown to be greatest among (1) patients maintained on methadone dosages of less than 70 mg/day (adjusted odds ratio [OR] = 2.

Laboratory markers and the risk of developing HIV-1 disease among injecting drug users.

Objective: To characterize the progression to HIV-1 disease among injecting drug users (IDU) according to laboratory markers.

Design: Prospective study of cohort of HIV-1-seroprevalent IDU, with case-comparison component.

Methods: Different laboratory markers were examined as predictors of progression to HIV-1-associated diseases including AIDS in a cohort of 318 HIV-1-infected IDU.

Maturity of human immunodeficiency virus infection and incubation period of acquired immunodeficiency syndrome in injecting drug users.

This study was aimed at estimating the maturity of the human immunodeficiency virus (HIV) epidemic in cohorts of injecting drug users with existing HIV infection at the time of first observation, and using this information to estimate the incubation period of acquired immunodeficiency syndrome (AIDS) in this population group. The method imputed the "missing" time from seroconversion to first observation for seroprevalent subjects in a combined cohort including injecting drug users from New York (n = 246) and Baltimore (n = 621). Imputation relied on a probability model predicting time since seroconversion on the basis of two markers of maturity of HIV infection: percent of CD4+ lymphocytes and platelet count.

Association of baseline neuropsychological function and progression of illness over 4 years in HIV-seropositive individuals.

The authors conducted a study to examine the association between neuropsychological markers of central nervous system impairment and systemic human immunodeficiency virus (HIV) disease progression in a sample of 64 HIV-positive asymptomatic patients who were followed for a median of 45.6 months. Patients with poorer baseline scores on the Halstead-Reitan Trail-Making A neuropsychological test developed HIV-related systemic symptoms earlier over the study period than patients with the higher scores on the same test (P < 0.

A prospective four-year follow-up of neuropsychological function in HIV seropositive and seronegative methadone-maintained patients.

The evolution of central nervous system (CNS) impairments associated with human immunodeficiency virus (HIV) infection was assessed by a prospective, longitudinal study of patients in a methadone maintenance clinic. At a mean of 47 months after baseline testing, which included physical exams, HIV antibody testing and a neuropsychological (NP) screening battery, 121 subjects received a second NP assessment. Forty subjects (33%) who were seropositive at baseline showed statistically significant declines in NP function over the 4 years compared with 81 seronegatives, on the Finger Tapping and Trail Making B tests.

Effects of HIV infection on the serologic manifestations and response to treatment of syphilis in intravenous drug users.

Objective: To describe the effects of human immunodeficiency virus (HIV) infection on the serologic manifestations and response to treatment of syphilis in intravenous drug users.

Design: Cohort study of intravenous drug users.

Setting: Medical clinic in a hospital-based methadone maintenance treatment program in New York City.

Clinical manifestations and predictors of disease progression in drug users with human immunodeficiency virus infection.

Background And Methods: To examine the clinical course of human immunodeficiency virus (HIV) infection in injection-drug users, we conducted a prospective study of a cohort of patients in a methadone-treatment program in New York City from July 1985 through December 1990. The patients underwent standardized evaluations at base line and semiannually thereafter and received on-site primary medical care. Rates of progression to the acquired immunodeficiency syndrome (AIDS) and major outcomes before the development of AIDS were examined by univariate analyses; the risk of AIDS was also assessed by product-limit survival analysis and proportional-hazards regression.

The spectrum of HIV-1-related disease among outpatients in New York City.

Objectives: To define the spectrum of HIV-1-related disease in New York City (NYC) and to determine how the clinical spectrum of illness differs in various populations.

Design And Methods: The medical records of the 2983 HIV-infected individuals who had received care through 1989 at four hospital outpatient clinics and two private physicians' offices were reviewed retrospectively.

Results: Sixty-one per cent of the study patients and 48% of patients seen in 1989 had AIDS.

High risk of active tuberculosis in HIV-infected drug users with cutaneous anergy.

Objectives: To determine the incidence of active tuberculosis in human immunodeficiency virus (HIV)-seropositive and HIV-seronegative drug injectors with cutaneous anergy and to examine the effectiveness of isoniazid chemoprophylaxis in preventing tuberculosis among drug injectors with positive tuberculin test results.

Design And Setting: Prospective observational study linked to an ongoing study of HIV infection within a New York City (NY) methadone program; subjects also underwent routine intradermal tuberculin testing and multiple-antigen delayed-type hypersensitivity skin testing. The 31-month study period ended December 31, 1990.

Massive upper gastrointestinal hemorrhage with normal findings on arteriography: value of prophylactic embolization of the left gastric artery.

During a 5-year period, 13 patients who presented with massive upper gastrointestinal hemorrhage had normal findings on arteriography. Seven had prophylactic embolization of the left gastric artery, and six had conservative therapy. Normal angiographic findings were associated with clinical cessation of bleeding in 12 of 13 patients.

Functional abnormalities of the gastrointestinal tract in patients with spinal cord injuries: evaluation with imaging procedures.

One quarter of patients with spinal cord injuries eventually have severe chronic gastrointestinal symptoms. Because there are about 1.5 million such patients in the United States, major chronic gastrointestinal symptoms will develop in approximately 400,000 patients, all of whom are likely to need the services of radiologists.

Congenital anomalies of the inferior vena cava: embryogenesis and MR features.

This article describes the MR appearances of the six most common congenital anomalies of the inferior vena cava. As a basis for understanding those anomalies, it describes the embryology of the inferior vena cava, based on an actual study of embryos and fetuses. The article takes a fresh look at the original research in this area, discusses the possible embryogenesis of the relevant anomalies, and describes different opinions on that subject, where different opinions exist.

Pharmacokinetic interactions of zidovudine and methadone in intravenous drug-using patients with HIV infection.

Pharmacokinetic parameters for methadone and zidovudine (ZDV), alone and in combination, were determined in 14 HIV-infected individuals including nine former intravenous drug users (IVDU) who were receiving methadone maintenance therapy. The serum levels of methadone were measured prior to and after initiation of ZDV treatment, with each patient serving as his or her own control. Concurrent administration of ZDV did not alter either the peak methadone concentration or the area under the methadone concentration-time curve (AUC).

The role of imaging in prostate cancer.

For patients with prostate cancer, diagnostic imaging can play three roles: screening, staging, and monitoring. Bayesian analysis dictates that if the prior probability of cancer is relatively low or if the consequences of a false-positive result are unacceptable, the test must be optimally specific. If the prior probability of cancer is high or if the consequences of missing it are unacceptable, the test must be optimally sensitive.

Human T lymphotropic virus type II (HTLV-II) infection in a cohort of New York intravenous drug users: an old infection?

To identify risk factors for human T lymphotropic virus type II (HTLV-II) infection in intravenous drug users (IVDUs), participants in a longitudinal study of human immunodeficiency virus (HIV) infection in a New York methadone maintenance program were studied. Of 270 participants tested for HTLV-I/II, 21 (8%) were seropositive. Of those, 15 (71%) had HTLV-II-specific sequences by polymerase chain reaction (PCR) and 1 (5%) had both HTLV-I- and -II-specific sequences; 3 persons with indeterminate serologic results were also PCR-positive for HTLV-II.

Survival differences in patients with AIDS.

To define the clinical, demographic, and behavioral variables that may influence survival in patients with AIDS, we studied 526 patients with AIDS diagnosed through September 1987 who were cared for at a single medical center. A diversity of racial and ethnic backgrounds, ages, both men and women, and all risk behaviors except hemophilia were well represented. The initial AIDS defining diagnosis was the most powerful predictor of survival.

Demographic characteristics, drug use, and sexual behavior of i.v. drug user with AIDS in Bronx, New York.

Intravenous (i.v.) drug users are a key factor in the transmission of human immunodeficiency virus (HIV) infection, yet epidemiologic information about this population, especially those with acquired immunodeficiency syndrome, is scarce.