Aminotetralins as narcotic antagonists. Synthesis and opiate-related activity of 1-phenyl-2-aminotetralin derivatives.

The synthesis and the opiate agonist and antagonist activities of three derivatives of cis-2-[methyl(cyclopropanemethyl)amino]-1-phenyltetralin are reported. The compounds were obtained by synthetic modification from 2-amino-1-tetralone. The 1-propionoxy derivative 4c shows analgetic activity (ED50 = 17.8 mg/kg) one-half that of codeine, and the 1-methoxy derivative 4b has weak antagonist activity (AD50 = 33.5 mg/kg). The compounds showed no other significant opiate-related activity.     

Differences in food intake and exercise by smoking status in adolescents

BACKGROUND: Smoking, diet, and lack of exercise are the top preventable causes of death in the United States. Some 23% of high school students currently smoke and many teens do not meet Healthy People 2010 standards for healthy eating or physical activity. This study examined the relationship between smoking and the consumption of fruit, vegetables, milk/dairy products and the frequency of exercise in 10,635 Virginia youth. METHODS: Survey data were collected from middle school (MS; n = 8022) and high school (HS; n = 2613) adolescents participating in youth tobacco prevention/cessation programs. Data were analyzed using chi-square bivariate tests and multivariate regression models. RESULTS: Smokers were significantly less likely than nonsmokers to exercise > or = 3x week and to consume > or = 1 serving/day of vegetables or milk/dairy products. This was more evident in high school than middle school students and in females compared to males. In both HS and MS, a dose-response relationship was detected with higher level smoking associated with lower frequency of eating specified food and exercise. CONCLUSIONS: Smoking is associated with compromised intake of healthy food and exercise. To decrease incident cases of chronic disease later in life, new tailored, innovative interventions are needed that address multiple health behaviors in youth.     

Randomized trial of a low-intensity dietary intervention in rural residents: the Rural Physician Cancer Prevention Project

BACKGROUND: Dietary behavior, specifically a low-fat, high-fiber diet, plays a role in the primary prevention of chronic diseases including cancer. DESIGN: A community-based randomized trial to assess the impact of a low-intensity, physician-endorsed, self-help dietary intervention that provided tailored dietary feedback, and was designed to promote improved fat and fiber behavior in a rural, low-education/low-literacy, partly minority population. The data were collected from 1999 to 2003. SETTING/PARTICIPANTS: A total of 754 patients from three physician practices in rural Virginia completed a baseline telephone survey assessing dietary and psychosocial information, and were then randomly assigned to the intervention or control condition. Follow-up telephone evaluation was based on 522 participants at 1 month, 470 at 6 months, and 516 participants at 12 months. INTERVENTION: A series of tailored feedback, followed by brief telephone counseling and theory-based nutritional education booklets, provided by staggered delivery to the home. MAIN OUTCOME MEASURES: Dietary fat and fiber behavior, dietary intentions to change, self-efficacy for dietary change, and fat and fiber knowledge. RESULTS: The intervention group demonstrated significant improvement in dietary fat and fiber behaviors and intentions to change fat and fiber intake (p <0.05) at 1, 6, and 12 months. CONCLUSIONS: The Rural Physician Cancer Prevention Project provides an effective model for achieving public health-level dietary health behavior changes among a rural, minority, and low-literacy/low-education population.     

Leuprolide Acetate Suppresses Pedophilic Urges and Arousability

Cognitive–behavioral psychotherapy was compared with cognitive–behavioral psychotherapy augmented by leuprolide acetate (LA) for suppression of pedophilic behavior. Five male pedophiles (M age, 50 years; range, 36–58) were administered LA by Depo injection for 12 months, followed by saline placebo for 12 months. Testosterone levels, sexual interest preference by visual reaction time (Abel Assessment), penile tumescence (Monarch Penile Plethysmography, PPG), as well as strong sexual urges toward children and masturbatory frequency involving thoughts of children (polygraph), were measured every 3 months. On LA, testosterone decreased to castrate levels. Penile tumescence was significantly suppressed compared with baseline, but sufficient response remained to detect pedophilic interest. Pedophilic interest was also detected by visual reaction times. When asked about having pedophilic urges and masturbating to thoughts of children, all subjects self-reported a decrease. Polygraph responses indicated subjects were not deceptive. On placebo, testosterone and physiologic arousal eventually rose to baseline. As noted by polygraph, at baseline and on placebo, subjects were deceptive regarding increased pedophilic urges and masturbatory frequency. Interest preference, as measured by Abel Assessment and Monarch PPG, was generally unchanged throughout the study. Cognitive–behavioral psychotherapy augmented with LA significantly reduced pedophilic fantasies, urges, and masturbation; however, pedophilic interest did not change during 1 year of therapy. Deceptive responses by polygraph suggested that self-report was unreliable. Follow-up utilizing objective measures is essential for monitoring efficacy of treatment in pedophilia. Our study supports the premise that suppression of pedophilic behavior is possible. LA may augment cognitive–behavioral psychotherapy and help break the sequence leading to a re-offense.     

Dependency of magnetocardiographically determined fetal cardiac time intervals on gestational age,gender and postnatal biometrics in healthy pregnancies

Background  

Magnetocardiography enables the precise determination of fetal cardiac time intervals (CTI) as early as the second trimester of pregnancy. It has been shown that fetal CTI change in course of gestation. The aim of this work was to investigate the dependency of fetal CTI on gestational age, gender and postnatal biometric data in a substantial sample of subjects during normal pregnancy.     

Magnetresonanztomographie in der Urologie

Due to low costs and common availability, ultrasonography and computed tomography still represent the most common diagnostic tools in uroradiology. However, magnetic resonance imaging (MRI) is gaining more and more importance since this imaging modality allows for a comprehensive examination of almost the complete spectrum of urologic diseases, including congenital malformations. The most important advantages of MRI are the free choice of slice orientation, high soft tissue contrast and high resolution as well as the lack of radiation. Technical progresses in hard and software components have led to a reduction in acquisition time, allowing for real-time imaging as well as MR angiography and MR urography with a significant reduction in motion artifacts. In addition, contrast enhanced MRI represents the imaging modality of choice in patients with reduced renal function or known allergy against iodinated contrast agent.     

Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions

OBJECTIVE: The objective of this study was to test the effectiveness of a mail-delivered, tailored self-management intervention (SMART) and to compare it with the classic Arthritis Self-Management Program (ASMP). METHODS: We performed 2 randomized controlled trials: 1) a study of 1090 participants randomized to SMART or USUAL CARE, and 2) a study of 341 participants randomized to SMART or ASMP. Dependent variables included disability, pain, depression, role function, global severity, doctor visits, and self-efficacy. SMART interventions were provided in months 0-18 and not reinforced. Results were assessed at 1, 2, and 3 years using analyses of covariance (ANCOVA). RESULTS: Compared with USUAL CARE, SMART participants at 1 year had decreased disability, improved role function, and increased self-efficacy (all P <0.01). At 2 years, decreases in global severity, doctor visits, and increases in self-efficacy (all P <0.01) were noted. At 3 years without reinforcement, no statistically significant effects remained. Compared with ASMP, SMART at 1 year had greater decreases in disability (P = 0.02) and increases in self-efficacy (P = 0.01). There were no differences at 2 years. At 3 years, role function (P = 0.04) and doctor visit (P = 0.03) were improved in ASMP as compared with SMART. Improvements from baseline were seen for nearly all variables in both groups. CONCLUSIONS: A mail-delivered arthritis self-management program, SMART, was similarly effective to the classic ASMP, with slightly better results in the first year and a slightly more rapid attenuation over the next 2 years. Results suggest that both programs are effective, and that the addition of a mail-delivered program could improve accessibility to arthritis self-management treatment.