Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures

A mixture of codeine cough syrup with alcohol and/or a soft drink known as “purple drank” has gained media attention in recent years as a drug associated with professional athletes and southern rap music. The existing research on purple drank consumption has primarily utilized samples of African Americans residing in the Houston, Texas area. This is the first scholarly study of purple drank use outside of the Houston, Texas area among a general population of young adults, and indicates that purple drank use is not limited to African American males. The findings depict higher odds of the use of purple drank among other racial and ethnic groups, males, and homosexual, bisexual, and transgender college students from urban areas.     

上海市松江区治愈麻风病人畸残情况调查

[目的]了解上海市松江区治愈麻风病人畸残情况,为制定麻风病防治策略提供依据。[方法]采用问卷调查病人基本人口学信息,临床检查手、足、眼等畸残及功能障碍情况。首先采用最大值、最小值、中位数等指标描述年龄、发病年龄等,其次描述手部、足部、眼部等畸残及功能障碍情况,并采用χ2及fisher确切概率法检验其身体左右侧位分布有无差异。[结果]调查48例,畸残率为64.58,不同性别间发病年龄及畸残率差异无统计学意义(χ2发病年龄=1.524,P=0.217;χ2畸残率=2.231,P=0.135);尺神经感觉功能障碍12人,运动功能障碍23人;正中神经感觉功能障碍5人,运动功能障碍8人;桡神经运动功能障碍1人;胫神经感觉功能障碍13人,腓总神经运动功能障碍15人;6人面神经功能障碍。功能障碍身体左右两侧分布差别均无统计学意义(P﹥0.05)。[结论]上海市松江区麻风病人畸残率较高,手部畸残率较其他部位高,手部和足部受害主要表现为瘫痪,未发现病菌对身体左右侧位有选择性,政府和防治部门需要加强对麻风病预防和病人的治疗救助。     

WAY-318068: a novel, potent and selective noradrenaline re-uptake inhibitor with activity in rodent models of pain and depression

Background and purpose:

Antidepressants, which raise the CNS concentrations of 5-HT and noradrenaline, are frequently used in the treatment of chronic pain; however, it is not known if increasing CNS noradrenaline levels alone is sufficient for efficacy, in part resulting from a lack of small molecules with sufficient selectivity.

Experimental approach:

In this report, we present the in vitro pharmacological and in vivo pharmacokinetic and pharmacological properties of the novel, orally available and CNS penetrant inhibitor of the noradrenaline transporter (NET), WAY-318068 (1-[(1S,2R)-1-(3,5-difluorophenyl)-2-hydroxy-3-(methylamino)propyl]-7-fluoro-3,3-dimethyl-1,3-dihydro-2H-indol-2-one).

Key results:

WAY-318068 is a potent and effective inhibitor of the NET with a K_i of 8.7 nM in a binding assay, and an IC₅₀ of 6.8 nM in an assay of transporter function, without significant binding to the dopamine transporter. Furthermore, the compound has only weak activity at the 5-HT transporter, leading to a functional selectivity of greater than 2500-fold. It is orally bioavailable with substantial quantities of the compound found in the CNS after oral dosing. As measured by microdialysis in rats, the compound causes a robust and significant increase in cortical noradrenaline levels without affecting 5-HT. WAY-318068 was effective in models of acute, visceral, inflammatory, osteoarthritic, neuropathic, diabetic and bone cancer pain, as well as in traditional models of depression at doses that do not cause motor deficits.

Conclusions and implications:

Collectively, the present results support the conclusion that selectively increasing CNS levels of noradrenaline is sufficient for efficacy in models of depression and pain.     

A study of professional nurses' perceptions of patient education

BACKGROUND: The purpose of this study was to describe the professional nurses' perception of the role of patient educator and to determine factors inhibiting and enhancing patient teaching. METHOD: One hundred and twenty-four hospital-based, acute-care professional nurses were randomly selected from a State Board of Nursing list and surveyed by mail. RESULTS: Ninety-two percent of nurses reported that patient education was a priority in their nursing care. The top three factors inhibiting patient education were time, staffing, and receptiveness of the patient. The top three enhancers were providing more time to teach, providing inclusive teaching guidance sheets, and making resources more accessible. CONCLUSION: Patient education is a valuable part of professional nurses' practice, but many factors impede this nursing function. Key recommendations to enhance patient teaching were suggested, including improving efficiencies in patient care, supporting the staff nurse educational role, and providing essential resources based on survey results.     

Supportive Care in Older Adults with Cancer: Across the Continuum

Supportive care is an essential component of anticancer treatment regardless of age or treatment intent. As the number of older adults with cancer increases, and supportive care strategies enable more patients to undergo treatment, greater numbers of older patients will become cancer survivors. These patients may have lingering adverse effects from treatment and will need continued supportive care interventions. Older adults with cancer benefit from geriatric assessment (GA)-guided supportive care interventions. This can occur at any stage across the cancer treatment continuum. As a GA commonly uncovers issues potentially unrelated to anticancer treatment, it could be argued that the assessment is essentially a supportive care strategy. Key aspects of a GA include identification of comorbidities, assessing for polypharmacy, screening for cognitive impairment and delirium, assessing functional status, and screening for psychosocial issues. Treatment-related issues of particular importance in older adults include recognition of increased bone marrow toxicity, management of nausea and vomiting, identification of anemia, and prevention of neurotoxicity. The role of physical therapy and cancer rehabilitation as a supportive care strategy in older adults is important regardless of treatment stage or intent.     

The receptor specificity of alloreactive T cells. Distinction between stimulator K, I, and Dr Products and degeneracy of third-party H-2 recognition by low-affinity T cells

The specificity of binding of stimulator-derived H-2 antigens by mixed lymphocyte culture (MLC)-activated T blasts was investigated under conditions of antigen excess. We have shown that the detectable proportion of alloantigen-binding blasts from primary MLC is a function of antigen concentration, and can represent up to more than 90 percent of total blasts, when the antigen is presented in the appropriate form (on mitomycin-treated viable stimulator cells, or membrane vesicles prepared from lipopolysaccharide blasts), and at nonlimiting concentration. Thus stimulator alloantigen-binding directly parallels the proliferative response and is not restricted to a subpopulation of T blasts. However, the marked dependence of the binding on antigen concentration indicates that cells with a wide range of receptor affinities for the stimulating determinants are involved. In view of this possibility, the specificity of binding by these cells was studied. We have demonstrated that stimulator K, I, and D region products are bound by nonoverlapping subpopulations of blasts, the sum of which may represent 93 percent of total blasts. Thus, specific distinction by these cells between different H-2 region products is not affected by the putative heterogeneity in terms of receptor affinities. However, specificity with respect to unrelated H-2 haplotypes is strictly dependent on antigen concentration. A preferential binding of stimulator membrane vesicles occurs at limiting concentrations; whereas the majority of blasts bind stimulator and third- party vesicles equally well at high vesicle concentrations. The binding of both vesicle types is specific in that it can be inhibited with the relevant anti-H-2 sera. Furthermore, stimulator and third-party vesicles seem to compete for binding sites on the same cells, as shown by cold antigen inhibition. From these results, we propose that there is an imperfect distinction between stimulator and third-party H-2 antigens by the majority of primary MLC blasts. In contrast, highly selected long-term MLC blasts do not bind third-party H-2 antigens at any concentration, and seem to have high affinity for the stimulating antigens. We conclude that large numbers of clones with low-affinity (cross- reactive) receptors are generated in primary MLC, most of which become eliminated during long-term selection. This implies that the frequency of cells strictly specific for nonshared stimulating determinants must be minute.