Book Reviews

Books Reviewed in this Article: Clinical Guide to Alcohol Treatment. The Community Reinforcement Approach ROBERT J. MEYERS & JANE ELLEN SMITH Tobacco and Health KAREN SLAMA (Ed.) The Cigarette Papers STANTON A. GLANZ, JOHN SLADE, LISA A. BERO, PETER HANAUER & DEBORAH E. BARNES Snow Job? The War against International Cocaine Trafficking KEVIN JACK RILEY Substance and Shadow: Women and Addiction in the United States STEPHEN R. KANDALL     

Effects of Spascupreel versus hyoscine butylbromide for gastrointestinal cramps in children

BACKGROUND: Gastrointestinal spasms and cramps are common in children as well as in adults. Alternative medical practices such as chiropractice and homeopathy are becoming increasingly popular in Europe and the USA. The effectiveness and tolerability of the homeopathic preparation Spascupreel was compared with that of hyoscine butylbromide treatment in children <12 years of age. METHODS: An observational cohort study in 204 children <12 years was conducted over a 1 week treatment period. The efficacy of the respective therapies were evaluated on the effect on severity of spasms and clinical symptoms (pain/cramps, sleep disturbances, distress, eating or drinking difficulties and frequent crying). Compliance was evaluated on a four-point scale from 'very good' to 'low'. Evaluation was done by the practitioner based on information given by the patient or minder. RESULTS: The analysis showed comparative improvements with the homeopathic preparation and hyoscine butylbromide therapy on severity of spasms, pain/cramps, sleep disturbances, eating or drinking difficulties, and frequent crying, all as evaluated by the practitioner. Both treatments were very well tolerated. CONCLUSIONS: For patients opting for a homeopathic therapy, Spascupreel seems to be an effective and well tolerated alternative to conventional therapies in children suffering from gastrointestinal spasms.     

Individual differences in differentiation among alcohol expectancy domains

Prior research indicates that alcohol-related outcome expectancies represent important etiological factors in the understanding of alcohol use/abuse. Although current multidimensional measures assess several substantively different domains of alcohol-related outcome expectancies, there is growing evidence that they may not possess adequate levels of discriminant validity. Therefore, the present study sought to examine whether reliable between-person differences exist in the ability to differentiate among alcohol expectancy domains. The focus of the study was on three sets of intrapersonal characteristics: cognitive resources, cognitive constraints, and alcohol-related experience. Data were collected via household interviews with a random sample of 1125 adults. Multiple regression analysis revealed that higher levels of cognitive resources were associated with increasing levels of differentiation among alcohol expectancy domains. Results are discussed in terms of implications for the development of new or revised multidimensional alcohol expectancy questionnaires. Directions for future research are also discussed.     

Binding of cardiolipin to polystyrene beads: evidence for a lamellar phase orientation

Summary. The association of cardiolipin with polystyrene beads was studied using ³¹P-NMR and electron microscopy. In the presence and absence of fetal calf serum, cardiolipin appeared to bind to the polystyrene beads in lamellar phase as assessed by ³¹P-NMR imaging. Electron microscopic analysis revealed an even coating of phospholipid about the beads with extensive micelle binding. Cardiolipin-coated beads challenged with ACA-positive sera followed by immunogold indicated antibody bound to micelles associated with the bead. Studies conducted with ACA IgG purified from patient sera indicated that some ACA bound to CL beads in the absence of a source of ACA cofactor (i.e. gelatin-blocked beads), some ACA required β₂-GPI for binding (i.e. no binding in the presence of β₂-GPI-depleted plasma), whereas other ACA which showed negliglible binding with gelatin-blocked beads, showed enhanced binding in the presence of /?₂-GPI-depleted plasma. The data indicate that: (1) cardiolipin binds to polystyrene beads in lamellar phase, (2) ACA bind to phospholipid micelles bound directly to the polystyrene beads, and (3) ACA differ between individuals displaying varying phospholipid and phospholipid/cofactor substrate specificities.     

Nonadditive Developmental Toxicity in Mixtures of Trichloroethylene, Di(2-ethylhexyl) Phthalate, and Heptachlor in a 5x5x5 Design

In order to identify nonadditive effects on development, threecompounds were combined using five dosages of each agent (a5x5x5 full-factorial design). Trichloroethylene (TCE), di(2-ethylhexyl)phthalate (DEHP), and heptachlor (HEPT), in corn oil, were administeredby gavage to Fischer-344 rats on Gestation Days 6–15.Dose levels were 0, 10.1, 32, 101, and 320 mg/kg/day for TCE;0, 24.7, 78, 247, and 780 mg/kg/day for DEHP; and 0, 0.25, 0.8,2.5, and 8 mg/kg/day for HEPT. The dams were allowed to deliverand their pups were weighed and examined postnatally. Maternaldeath showed no main effects but DEHP and HEPT were synergistic.For maternal weight gain on Gestational Days 6–8, maineffects for all three agents were observed, as well as TCE-DEHPsynergism, and DEHP-HEPT antagonism. Maternal weight gain onGestational Days 6–20 adjusted for litter weight showedmain effects for TCE and HEPT, but no interactions. Main effectsfor all three agents were evident for full-litter resorptionsand prenatal loss. The HEPT main effects were unexpected andwere interpreted as reflecting potentiation by HEPT of the otheragents. For full-litter loss, the TCE-HEPT and DEHP-HEPT interactionswere antagonistic, perhaps due to a "ceiling" effect. For prenatalloss, the TCE-DEHP interaction was synergistic. Postnatal lossshowed DEHP and HEPT main effects but no interactions. Analysisof pup weights on Day 1 revealed TCE and DEHP main effects andDEHP-HEPT antagonism; on Day 6, DEHP and HEPT main effects,DEHP-HEPT antagonism, and TCE-DEHP synergism were evident. Microphthalmiaand anophthalmia incidences revealed TCE and DEHP main effectsbut no interactions. This extensive examination of a full-factorialdesign elucidates the complexities of studying and interpretingmixture toxicity. The data are available for further analysis.     

A 90-Day Chloroform Inhalation Study in F-344 Rats: Profile of Toxicity and Relevance to Cancer Studies

Composition of diet may influence growth, diseases, tumor rates,and responses to chemical treatment. Since 1980 the NIH–07open formula nonpurified diet has been the selected diet forthe National Toxicology Program (NTP) toxicity and carcinogenicitystudies in rodents. Studies with nonpurified experimental dietswith lower protein and higher fat and fiber than the NIH-07diet indicated that the diet for Fischer-344 (F344) rats inlong-term studies could be modified to decrease the severityof chronic diseases and to decrease/delay the development ofspontaneous tumors. Based on the results of these studies anew open formula nonpurified diet designated as NTP-2000 wasformulated to contain 14.5% protein, 8.5% fat, and 9.5% fiber.Corn, wheat, and wheat middlings contribute to about 60% ofthe ingredients; soybean meal, fish meal, and alfalfa meal arethe additional sources of protein; purified cellulose, oat hulls,and alfalfa meal are the major sources of fiber; and soy oiland corn oil are the major sources of fat in the NTP-2000 diet.The Ca:P ratio and mineral and vitamin concentrations were reformulatedbased on AIN-93 and NRC-95 recommendations. The NIH-07 and theNTP-2000 diets were fed to groups of 6-week-old F344 rats for13 weeks and evaluated for growth patterns, food and water consumptions,hematology and clinical chemistry parameters, and organ weightsand pathological changes. Growth patterns and body weights weresimilar for both diets. Food consumptions were slightly higherand water consumptions were slightly lower for the groups fedNTP-2000 diet. There were no differences in hematological parametersbetween the groups fed the above diets. Serum levels of cholesterol,alkaline phosphatase, and 5' nucleotidase were slightly higherin groups fed the NTP–2000 diet possibly due to higherfat content of this diet. However, the serum triglyceride levelswere slightly lower in groups fed the NTP–2000 diet andit may be related to higher fiber content of the NTP–2000diet. The liver and kidney weights of the groups fed NTP–2000diet were significantly lower possibly due to lower proteincontent of this diet and lower protein consumption associatedchanges in Phase I and Phase II drug metabolizing enzyme systems.The adrenal weights were also lower in groups fed the new diet.The NTP–2000 diet prevented nephrocalcinosis and decreasedthe severity of nephropathy and cardiomyopathy, the common lesionsof F344 rats in 13–week studies. These results indicatethat the NTP–2000 diet is adequate for growth and maintenance of rats and appears to prevent or decrease the severityof diet-associated lesions.     

The Effect of Saline Iontophoresis on Skin Integrity in Human Volunteers: I. Methodology and Reproducibility

This study, conducted in 36 human volunteers, was an evaluationof the effects of saline iontophoresis on skin temperature,irritation, and barrier function. The major objectives wereto assess the effects of low-level ionic currents, to validatethe proposed methodology of assessment, and to establish reproducibilityin repeated saline iontophoresis applications. This was thefirst of a multistage study designed to assess the safety of24-hr saline iontophoresis episodes at selected currents andcurrent densities. Since an iontophoresis patch challenges theskin harrier both by occluding the skin surface and by passingionic current through the skin, the experimental protocol wasdesigned to permit measurement of the contribution of each ofthese processes to the overall response. In this first stagewe investigated the effect of 10 min of current delivery, at0.1 mA/cm² on a 1-cm² area patch and 0.2 mA/cm² on a 6.5-cm²area patch compared to unpowered control patches. Twelve subjectswere tested under each condition on two separate occasions toexamine reproducibility of the response variable measurements.A further 12 subjects were tested once under the 0.2 mA/cm 6.5-cm2condition. Skin irritation was evaluated via repeated measurementsof transepidermal water loss, capacitance, skin temperature,skin color, and a visual scoring system, before the iontophoresisepisode and after patch removal. No damage to skin harrier functionin terms of skin-water loss or skin-water content was detected.Slight, subclinical, short-lasting erythema was observed forboth conditions. Assessment of correlation coefficients showedhighly statistically significant indications of reproducibilityfor all five response variables measured. The experimental design,in combination with a repeated measures analysis, provided clearseparation of the occlusion and ionic current components ofthe iontophoretic patch challenge. Further, the repeated measuresanalysis gave a highly sensitive assessment of skin irritationand resolution after patch removal. We conclude that the experimentalmethodology is appropriate for assessing possible changes inskin integrity resulting from saline iontophoresis under similaroperating conditions for longer durations and for other skinchallenges from which a subclinical response is expected.