The Andalusian trial on heroin‐assisted treatment: A 2 year follow‐up

Introduction and Aims. In 2003, a randomised controlled trial comparing injected diacetylmorphine and oral methadone was carried out in Andalusia, Spain. The subsequent follow‐up study evaluated the health and drug use status of participants, 2 years after the completion of the trial. Design and Methods. This follow‐up cohort study was carried out between March and August 2006. Data collected included information on socio‐demographics, drug use, health and health‐related quality of life. We compared data collected before randomisation and at 2 years for the following three groups: those currently on heroin‐assisted treatment (C‐HAT), those who have discontinued HAT (D‐HAT), and those who have never received HAT (N‐HAT). Results. From the total 62 randomised participants in 2003, 54 (87%) were interviewed for this study. Participants were distributed as follow: C‐HAT 44.4% (24), N‐HAT 22.2% (12) and D‐HAT 33.3% (18). Illicit heroin use had a statistically significant decrease in the three groups from baseline to 2 years post trial. Mean days of heroin use were 2.42 (SD = 3.02); 6.56 (SD = 9.48) and 13.92 (SD = 12.59) for the C‐HAT, D‐HAT and N‐HAT groups, respectively. Those currently on HAT were the only group that sustained at 2 years, their marked improvement in health after 9 months of treatment during the trial period. Discussion and Conclusions: Patients who received HAT showed better outcomes compared with those not on HAT. The results of this study strengthen the evidence showing that HAT can improve and stabilise the health of long‐term heroin users with severe comorbidities and high mortality.[Oviedo‐Joekes E, March JC, Romero M, Perea‐Milla E. The Andalusian trial on heroin assisted treatment: A 2 year follow‐up. Drug Alcohol Rev 2009]     

The Effects of a Triterpene Fraction Isolated from Crataegus monogyna Jacq. on Different Acute Inflammation Models in Rats and Mice. Leucocyte Migration and Phospholipase A2 Inhibition

The plant Crataegus monogyna has action against cardiac insufficiency, angina and arrhythmia. The antiinflammatory properties of the cycloartenol fraction from this plant have been investigated. Chromatographic fractionation of the hexane extract of Crataegus monogyna Jacq. (Rosaceae) furnished a triterpene fraction containing cycloartenol as the main component (80.87%). The anti-inflammatory activity of the fraction was tested against hind-paw oedema induced by carrageenan in rats. At the highest oral dose (40 mg kg^?1) inhibition was 61.5 and 52.5% at 3 and 5 h respectively. In the mouse carrageenan peritonitis test, the triterpene fraction given orally inhibited peritoneal leucocyte infiltration (41.9, 64.7 and 89.4% at 10, 20 and 40 mg kg^?1, respectively). The fraction also showed weak inhibition of phospholipase A₂ (PLA₂) in-vitro. These results suggest that the fraction containing cycloartenol as the main component exerts an important anti-inflammatory action in-vivo by reducing the oedema.     

Focus-group methods: effects on village-agency collaboration for child survival

In the West African nation of Togo an essential element of healtheducation in support of child survival is the training of mid-levelhealth workers to conduct focus-group interviews with caretakersof children under 5 years of age. The intent is to develop thecapability of the National Health Education Unit to establishqualitative data bases that complement survey data on maternalpractices related to child health. These data are used to designand evaluate the health education component for programmes ofchildhood immunization, the control of diarrhoeal diseases,and malaria. Following a five-day training programme in late 1986, healthworkers collected and prepared for analysis data from 81 focus-groupinterviews involving a total of 324 mothers living in nine ruralTogolese villages. In addition, two unanticipated effects wereobserved during and after training. First, the focus-group methoddemocratized data gathering by forcing health workers out oftheir perceived roles as experts and teachers, and mothers outof being helpless villagers and learners. Second, by stimulatingthis shift in roles, the focus-group process enhanced the developmentof community competence, thereby promoting collaborative programmeplanning by health workers and target villages. Dramatic increases in childhood immunization rates offer evidencethat focus-group interviews can play an important role in stimulatingthe needed interaction between clients and providers to planand carry out a community education ‘mini-campaign’in each village. It is from such group processes that collectiveawareness of needs, and actions to resolve them, can arise.Child survival projects should consider training mid-level healthworkers to gather focus-group data as an action-research approachto planning, implementing and evaluating their community healtheducation programmes.     

FURTHER OBSERVATIONS ON POSTPARTUM OVARIAN REFRACTORINESS: EFFECT OF GONADAL STIMULATION IN WOMEN RECEIVING BROMOCRYPTINE

It has been reported previously that the administration of human menopausal gonadotrophins (HMG) to lactating and non-lactating women from day 5 to day 9 postpartum elicited no significant elevation of urinary oestrogens or serum oestradiol within 15 days after delivery. In order to study further the role of prolactin on this ovarian refractoriness, five women receiving 7-5 mg of bromocryptine (CB-154) daily were given HMG at a dose of 300 iu per day, from day 5 to day 10 post-delivery. In all women serum oestradiol and urinary oestrogens showed no significant elevation within the 2 weeks after delivery. Serum prolactin was elevated in all cases and fell to normal nonpregnant levels immediately after CB-154 was administered. The suggestion that prolactin may possess antigonadotrophic activity at the ovarian level is not supported by the data presented here. The deficient ovarian response to gonadotrophin stimulation could be due to either the intraovarian effect of the high amounts of circulating steroids produced during gestation or to some unknown mechanism.     

Acute lymphoblastic leukaemia in childhood: cell proliferation without rest

The percentage of non-cycling blast cells in children with untreated acute lymphoblastic leukaemia (ALL) was investigated by staining smears for statin, a nuclear protein specifically present in non-growing resting cells. Results were compared with purified normal CD34-positive progenitors. A low fraction of ALL and CD34-positive cells expressed statin (2.0 ± 3.8% and 2.8 ±3.1%, respectively), the growth fraction assessed by staining for the nucleolar antigen p120 was 94% in both ALL and CD34-positive cell samples. From this analysis it can be concluded that the compartment of non-replicating cells in ALL as well as in normal CD34-positive precursor cells collected from peripheral blood is very small and that most cells are cycling.     

Circular dichroism studies on sequential polypeptides (Arg-X-Gly) when X = L-Ala,Val, Leu,Ile, Nva,Nle in amphiphilic environments

A series of (L-Arg-X-Gly)_n sequential polypeptides, where X represents the amino acid residues L-Ala, Val, Leu, Ile, Nva, and Nle, have been prepared and their conformational properties as well as their association with nucleic acids in various water fluoroalcohol mixtures have already been reported. In order to gain further insight into the conformational behavior of these polypeptides in amphiphilic environments, we now report their secondary structure, in the presence of increasing amounts of sodium dodecylsulfate and dodecylphosphorylcholine using CD spectroscopy. The CD spectral pattern of all the polypeptides studied is indicative of an equilibrium between α-helix, β-turn, and random coil. They are analyzed in relation to the nature of the X side-chain (length, branching, linearity). The results are explained on the basis of Lundahl's model for polypeptide-micelle interactions.