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1.  Problems of drug abuse, HIV and AIDS: the burden of care in one general practice. 
Responsibility for many of the problems of intravenous drug abuse and human immunodeficiency virus (HIV) infection lies with community care agencies, such as general practitioners, community psychiatric and district nurses and drug agencies. It is in general practice that this burden is most clearly observed, given that general practitioners are in charge of the day-to-day care of patients. In an attempt to quantify this workload in an inner city practice with 11,200 patients, data were gathered from several sources relating to drug use and HIV infection. The study identified 432 patients who had consulted with problems of drug abuse and/or HIV infection over the period 1981-90. Among this group of patients 161 (37%) were HIV antibody positive. Among 191 drug abusers who were still registered with the practice in 1990 dihydrocodeine was the most commonly prescribed substitute treatment (130 patients) and only nine patients were prescribed methadone. Forty seven per cent of drug users continued to inject drugs occasionally. However, analysis of urine samples revealed that there was a shift away from injecting mainly heroin to multiple drug use, including benzodiazepines, usually originating from prescribed sources. Drug abusers who were HIV positive consulted their general practitioner significantly more often over one year than those who were not (mean 24.9 versus 15.8 consultations, P < 0.01). However, there was no significant difference between these two groups in terms of days spent in hospital. A total of 61 patients were referred to a community psychiatric nurse over an eight month period.(ABSTRACT TRUNCATED AT 250 WORDS)
PMCID: PMC1372058  PMID: 1419244
3.  Human immunodeficiency virus in drug misusers and increased consultation in general practice. 
The use of general practitioner services by a group of intravenous drug users was recorded over two two-year time periods 1984-85 and 1986-87. This was felt to represent the period of maximum change in awareness of human immunodeficiency virus (HIV) infection by patients and medical staff. Fifty patients were randomly selected: 25 who were HIV positive and 25 who were HIV negative. Between the two time periods a dramatic increase in consultation rate for both high risk and infected patients attending their general practitioner was recorded (318% and 172% increase, respectively). A small increase in attendance at the accident and emergency department (30% and 34% increase, respectively) was recorded for high risk and infected patients, and there was a large increase in attendance at the infectious diseases unit for infected patients but there was little effect on use of other hospital services. The implications for resource needs in the community are discussed.
PMCID: PMC1711873  PMID: 2558188
4.  Epidemic of AIDS related virus (HTLV-III/LAV) infection among intravenous drug abusers. 
Stored blood samples from 164 intravenous drug abusers who attended a Scottish general practice were tested for HTLV-III/LAV (human T cell lymphotropic virus type III/lymphadenopathy associated virus) infection. Of those tested, 83 (51%) were seropositive, which is well above the prevalence reported elsewhere in Britain and Europe and approaches that observed in New York City. The timing of taking samples of negative sera and continued drug use suggest that as many as 85% of this population might now be infected. The infection became epidemic in late 1983 and early 1984, thereafter becoming endemic. The practice of sharing needles and syringes correlated with seropositivity, which, combined with the almost exclusive intravenous use of heroin and other behavioural patterns, may explain the high prevalence of HTLV-III/LAV infection in the area. Rapid and aggressive intervention is needed to control the spread of infection.
PMCID: PMC1339512  PMID: 3081158
5.  Caffeine inhibits excision of 7-bromomethylbenz (a) anthracene-DNA adducts from exponentially growing but not from stationary phase Chinese hamster cells. 
Nucleic Acids Research  1978;5(12):4795-4803.
Excision of 7-bromomethylbenz(a)anthracene (7-BMBA)-DNA adducts from exponentially growing cultures of Chinese hamster V79-379A cells followed logarithmic kinetics with a half of approximately 20 hrs. Post-treatment incubation in the presence of a sub-toxic concentration of caffeine markedly reduced this loss. Caffeine brought about a concomitant increase in overall DNA synthetic rate in treated exponential cultures. Excision in stationary, non-DNA-replicating cultures, was slower and caffeine did not affect this reduced rate of excision. These findings lend support to a previous proposition that the caffeine-induced inhibition of elongation of nascent DNA on a template containing chemical lesions results in an interference with the excision repair mechanism that removes these lesions.
PMCID: PMC342789  PMID: 745993

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