Cocaine and regional brain monoamines in mice.

Cocaine HCl (0, 10, or 50 mg/kg) was injected into adult male ICR mice IP. Thirty minutes later, brains were removed and nine regions were isolated: olfactory bulbs (OB), olfactory tubercles (OT), prefrontal cortex (PC), septum (SP), striatum (ST), amygdala (AMY), hypothalamus (HT), hippocampus (HC), and thalamus (TH). Using high-performance liquid chromatography, concentrations of norepinephrine (NE), dopamine (DA), serotonin (5-HT), and their major metabolites were determined. At 10 mg/kg cocaine, NE levels were increased in the AMY and its metabolite, 3-methoxy-4-hydroxyphenylglycol (MHPG), was decreased in the PC, AMY, and HT. DA levels were also increased in the AMY, while its intracellular metabolite, dihydroxyphenylacetic acid (DOPAC), was decreased in the ST and its extracellular metabolite, homovanillic acid (HVA), was decreased in the PC. 3-Methoxytyramine (3-MT) levels were not altered in any tissue. 5-HT levels were increased in the AMY, HT, and TH, while its metabolite 5-hydroxyindoleacetic acid (5-HIAA) was decreased in the OB and ST. MHPG/NE ratios were decreased in the PC, AMY, and HT as were those for HVA/DA. DOPAC/DA ratios were decreased in the ST and AMY and increased in the SP while those for 3-MT/DA were decreased in the TH and increased in the PC. 5-HIAA/5-HT ratios were decreased in the AMY, HC and TH. At 50 mg/kg cocaine, there was an increase in DA in the TH. There was a decrease in DOPAC, HVA, and 3-MT, as well as the DOPAC/DA ratio in the ST. In the OT, there was a decrease in DOPAC, the DOPAC/DA ratio, 3-MT, and the 3-MT/DA ratio.(ABSTRACT TRUNCATED AT 250 WORDS)     

Health policy and the emerging tobacco reality

Public policy is part of and a creator of modern environments. By intent or neglect, it affects our socially-created and natural worlds. It sets the odds for what organizations and individuals are likely to produce and consume in the form of goods, services and information, and assures how equitably these options for choice-making--and thus for life styles--are dispersed among social and economic groups. Policy is also created by environments: it is influenced by the reality of changing conditions and by the perceptions of those changes by groups who are organized to influence policymakers' views of 'reality'. The direction, humaneness and healthfulness of societal changes--to the extent that they can be guided--depend on whether new and old things are seen by policymakers in new or old ways. Creating environments conducive to health thus requires a two-pronged effort. It means: (1) developing policies that provide incentives to producers and consumers to make more healthful choices than they do today; and (2) creating a social and political climate that will encourage policymakers to choose more healthful policy options. This view point is illustrated here through an analysis of the smoking and health issue, in which changing conditions can potentially be healthfully guided, or alternatively, left to the vagaries of political and economic events. This article outlines the changing economics of tobacco, mainly as seen in its largest form in the U.S.A., its policy implications, and a political strategy to move policy in more healthful directions. Economic data reveal the tobacco sector in affluent nations as one that has been slowly declining, but now at an accelerating rate. At the same time, the tobacco economy is a growing sector in less-industrialized nations. Policy issues involve how to deal with the economic changes in health-promoting ways. Strategically this requires two simultaneous efforts. One is education/informational: posing the smoking/health issue in light of changing conditions, and addressing policy-relevant data (both economic and value-oriented) to the gatekeepers of public action and information (e.g. policymakers and media). The second is environmental/organizational, to improve the feasibility of policy changes by establishing means for transition planning in the tobacco economy.     

The profitization of health promotion

In this article the author argues that not only is the marketplace an ineffective arena for health development, it is currently generating decision-making paths that obscure more effective perspectives and directions to promote Americans' health. To illustrate this premise, available evidence is presented that suggests that the use of "health promotion" by the proprietary sector, as well as the commercialization of health promotion, is creating decision-making processes that are not accountable to those whom they affect. This emerging infrastructure is characterized by organizations, programs, delivery channels, and evaluative criteria that do not give people's health priority over organizational interests. These developments require critical examination and work on alternatives if the promotion of health is to result in more health than hype.     

Keeping up with ... health policy and women's health

The author compares current data on women's health with men's, in the early and adult years, noting socioeconomic variations and similarly compares variations in their use of health services. Clues to changes in women's health are described and relevant areas of policy which can affect emerging health problems as women alter their position in society are sketched.     

Organizational and environmental factors affecting the utilization of telemedicine in rural home healthcare

In the last five years, home health agencies have become increasingly interested in telemedicine as a potential means to meet the future healthcare needs of their aged and chronically ill clientele. This case study examines the organizational and environmental conditions that affected the implementation of a telemedicine program in one rural home healthcare organization. Several factors restricted the utilization of telemedicine, including Medicare's Prospective Payment System and corresponding documentation (Outcome Assessment and Information Set), the organization controlling grant funding for the program, and several environmental factors. Findings suggest that in rural communities, older homecare patients may have less opportunity to benefit from telemedicine. The study demonstrates the importance of environmental and organizational factors when implementing a telemedicine program. Recommendations are offered for home healthcare organizations considering development of telemedicine programs.     

Efficacy of the treatment with prostaglandin E-1 in venous ulcers of the lower limbs

BACKGROUND: Venous ulcers represent an important medical problem because of their high prevalence and consequent sanitary costs. In this study, we evaluated the effect of prostaglandin E-1 (PGE-1), a drug that improves district ischemia, on the healing of venous ulcers. METHODS: We performed a randomized, placebo-controlled, single blind study in which 87 patients who had venous leg ulcers homogeneous for dimensions and characteristics were treated for 20 days with an infusion of prostaglandin E-1 or placebo, in association with topical therapy. The dimension and the number of the ulcers were determined at the beginning of the treatment and then every 20 days up to 4 months, or until total recovery. The main outcome of the study was the recovery percentage of the ulcers at the end of the 120-day period of observation and the referred healing time. The reduction in the extension of ulcers from the baseline measurement to the last observation was also evaluated. RESULTS: The baseline characteristics of the treatment and control groups were similar. The reduction in the size of the ulcers was faster in the patients treated with PGE-1. In this group, 100% of the ulcers healed < or = 100 days, whereas in the placebo group, only 84.2% did so by the end of the 120-day observation period (P < .05). The estimated healing times of 25%, 50%, and 75% of the patients treated with PGE-1 were 23, 49, and 72 days, respectively, compared with 52, 80, and 108 for the patients in the placebo group. Only one serious event occurred in the treated group. CONCLUSIONS: This study demonstrates the effectiveness of PGE-1 in reducing the healing time of venous ulcers, suggesting that venous ulcers should also be considered ischemic.