Medication management reviews for people from the former Yugoslavia now resident in Australia

AIM: The objective of this prospective study was to conduct medication management reviews (MMR) in people from a non-English speaking background (NESB) (Bosnian/Serbian/Croatian, from former Yugoslavia, currently residing in Australia) in their native language in order to identify medication-related problems (needs analysis) and implement appropriate therapeutic interventions, in collaboration with their general practitioners (GPs). METHODS: Twenty-five participants entered the study. Each was interviewed and medication-related issues were identified by the health care team. RESULTS: Various interventions (over 150 for the whole group, an average of 6 per participant), based on actual and potential medication-related problems, were designed to improve the use of medicines. The MMRs introduced effective changes into the participants' health care. Psychological (e.g., feeling depressed) and sociological factors (e.g., costs of medicines, not understanding labels written in English) were identified as having significant impacts on medication management. CONCLUSIONS: These data confirmed there are avoidable medication-related problems in people from a NESB. GPs and pharmacists working in health care teams with a trained interpreter could greatly improve medication use through regular review and a team approach to problem identification and solving.     

Nephrotic syndrome and unrecognized Plasmodium malariae infection in a US Navy sailor 14 years after departing Nigeria

A 34-year-old Nigerian man presented with nephrotic syndrome. Renal biopsy revealed chronic membranous glomerulopathy with focal segmental sclerosis. Blood Giemsa smear contained rare Plasmodium sp. trophozoites and small subunit ribosomal RNA polymerase chain reaction amplification confirmed the presence of Plasmodium malariae. This case highlights the importance of obtaining even remote travel histories from ill immigrants and considering occult quartan malaria in patients from endemic locations with nephrotic syndrome.     

A ten-year follow-up of older former problem drinkers: risk of relapse and implications of successfully sustained remission

OBJECTIVE: This study examines the risk, predictors of relapse and the effects of successfully sustained remission on the drinking behavior, functioning, life context, coping and help seeking of older adults who were problem drinkers earlier in life. METHOD: Older former problem drinkers (n = 447) were prospectively followed for 10 years and compared to lifetime nonproblem drinkers. RESULTS: Of former problem drinkers, 31% (n = 141) died over the 10-year interval, a rate 1.6 times higher than that of lifetime nonproblem drinkers. Among surviving former problem drinkers, although relapse was relatively uncommon (11%), a less severe drinking history, heavier baseline alcohol consumption, and lower baseline income were associated with relapse. The majority (63%) of former problem drinkers who successfully achieved sustained remission continued to drink alcohol, though at levels below those consumed by older lifetime nonproblem drinkers (n = 339). Stably remitted problem drinkers who were abstinent (SRAs) generally reported more severe drinking histories, greater functioning and life context deficits and more help seeking than did stably remitted problem drinkers who were nonabstinent (SRNs). Although SRAs and SRNs both experienced improvements in functioning over the 10-year interval, they continued to experience financial, health-related and life context deficits relative to older lifetime nonproblem drinkers. CONCLUSIONS: Results suggest there are long-term costs associated with earlier drinking problems, even when remission is maintained. Both current drinking behavior and drinking history are worth considering when making recommendations regarding older adults' alcohol consumption.     

Programme base for the prevention of drug abuse in Yugoslavia

The article summarizes policies and strategies of a drug abuse control programme adopted by the Commission on Narcotic Drugs of the Federal Executive Council (federal Government) of Yugoslavia. Because it is on the main road between the Middle East and western Europe, Yugoslavia is increasingly being used by drug traffickers for the transit of heroin, cannabis and other drugs from their sources of production to illicit international markets. A small amount of heroin and other drugs spills over into the illicit channels in Yugoslavia, creating domestic demand for such drugs. According to annual reports, approximately 2,000 drug addicts have been registered in medical treatment facilities in urban areas, but it is estimated that some 10,000 people abuse narcotic drugs. The programme identifies action to be taken by different sectors of society concerned with drug problems. Emphasis is placed on preventing drug abuse, primarily by involving health and social services, parents and other members of the family, the school, the community, the work place and various social and non-governmental organizations. The programme also emphasizes the need for healthy activities for youth, personality development during adolescence and the elimination of factors that are conducive to drug abuse. The Customs and the police are making efforts to intensify their action against illicit drugs in transit in Yugoslavia and, to this end, plan to improve co-operation within the country and with their counterparts abroad and to improve their technical capability to combat drug trafficking.     

Dependence on the nicotine gum in former smokers

We conducted an Internet survey in 2004–2007 in 526 daily users of the nicotine gum, to assess use of, and dependence on the nicotine gum in former smokers. We used modified versions of the Nicotine Dependence Syndrome Scale (NDSS-G), the Cigarette Dependence Scale (CDS-G) and the Fagerström Test (FTND-G). After 30 days, 155 participants (29%) indicated their gum use. Higher dependence on the gum predicted a lower chance of stopping using it at follow-up (odds ratio = 0.36 for each standard deviation unit on CDS-G, p = 0.001). More long-term (> 3 months) than short-term (< = 3 months) users of the gum agreed with: “I use the nicotine gum because I am addicted to it” (83% vs. 7%, p < .001), and fewer long-term users reported that they used the gum to avoid relapsing to smoking (42% vs. 92%, p < .001). Long-term users had higher ratings of dependence on the gum than short-term users, as assessed with NDSS-Gum, CDS-Gum and FTND-Gum (all p < .001). Most long-term users reported symptoms of dependence on the nicotine gum. Lower levels of dependence on the gum predicted cessation of gum use. However, long term use of the nicotine gum has no known serious adverse consequence, and may be beneficial if it prevents late relapse.     

药物依赖者复吸的遗传学研究进展

药物依赖是一种以强制性寻求和使用成瘾性药物为特征的慢性复发性脑病[1].大量研究证实,遗传因素在药物依赖中起着重要作用(遗传度在30%-60%之间),但其遗传方式不符合孟德尔单基因遗传规律[2],而是符合多因素疾病的模式[3].     

Butyl-meta-cycloheptylprodiginine--a revision of the structure of the former ortho-isomer

A red pigment produced by the actinomycete strain B 4358 was identified as butyl-meta-cycloheptylprodiginine (4) by 1H, 13C and correlation via long range coupling NMR spectra. It shows striking spectroscopic similarities to butyl-ortho-cycloheptylprodiginine (1), the structure of which needs to be revised.     

Alcohol relapse as a function of relapse definition in a clinical sample of adolescents

Relapse is an important clinical and research problem in the addictions, but one that has no consensus on an operational definition. How relapse is measured could make substantial differences in clinical practice and in conclusions drawn from empirical studies. The aim of this study was to compare and contrast four different operational definitions of alcohol relapse in a clinical sample of adolescents. The participants were 75 males and females ages 14-18 who presented for outpatient treatment of alcohol use disorder (AUD). They completed an extensive in-person initial assessment, as well as 12 subsequent monthly telephone interviews that concerned their daily alcohol and other drug use and related events. The four alcohol relapse definitions evaluated included: at least 1 day of drinking any amount after at least 4 consecutive days of abstinence; at least 1 heavy (five standard drinks for boys, four for girls) drinking day after 4 abstinent days; at least 1 day of drinking any amount with associated problems after 4 abstinent days; and at least 1 heavy drinking day with associated problems following 4 abstinent days. Relapse events were identified during the first 6 months following the initial interview. The results showed that the time period until relapse varied across the four definitions of relapse ranging from 26 to 90 days. Additional analyses investigated the utility of each of the definitions in predicting functioning during months 7-12 using multiple regression. The results of these analyses showed that the two "heavy drinking" definitions contributed significantly independent variance to predicting average number of drinking days/month and drinks/drinking day and that the two "any drinking" definitions significantly predicted the presence of a current AUD diagnosis. The results suggest that relapse definitions make a difference in estimates of rates and times to first relapse. Furthermore, the occurrence of at least one relapse is predictive of later functioning in a clinical sample of adolescents, which is of practical and theoretical importance. Suggestions for the extensions of this investigation in future research are provided.