The effect of steroids on Dupuytren's disease: role of programmed cell death

This study compared the rates of proliferation and apoptosis of cells within nodules of Dupuytren's disease and nodules from patients that had been injected preoperatively with steroid (Depo-Medrone). It also compared the effects of steroids in apoptosis in cultured Dupuytren's cells and control fibroblasts from palmar fascia and fascia lata. Steroids reduced the rate of fibroblast proliferation and increased the rate of apoptosis of both fibroblasts and inflammatory cells in Dupuytren's tissue. Steroids also produced apoptosis of cultured Dupuytren's cells but not of palmar fascia and fascia lata cells.     

Benefit-cost analysis of addiction treatment: methodological guidelines and empirical application using the DATCAP and ASI

OBJECTIVE: To provide detailed methodological guidelines for using the Drug Abuse Treatment Cost Analysis Program (DATCAP) and Addiction Severity Index (ASI) in a benefit-cost analysis of addiction treatment. DATA SOURCES/STUDY SETTING: A representative benefit-cost analysis of three outpatient programs was conducted to demonstrate the feasibility and value of the methodological guidelines. STUDY DESIGN: Procedures are outlined for using resource use and cost data collected with the DATCAP. Techniques are described for converting outcome measures from the ASI to economic (dollar) benefits of treatment. Finally, principles are advanced for conducting a benefit-cost analysis and a sensitivity analysis of the estimates. DATA COLLECTION/EXTRACTION METHODS: The DATCAP was administered at three outpatient drug-free programs in Philadelphia, PA, for 2 consecutive fiscal years (1996 and 1997). The ASI was administered to a sample of 178 treatment clients at treatment entry and at 7-months postadmission. PRINCIPAL FINDINGS: The DATCAP and ASI appear to have significant potential for contributing to an economic evaluation of addiction treatment. The benefit-cost analysis and subsequent sensitivity analysis all showed that total economic benefit was greater than total economic cost at the three outpatient programs, but this representative application is meant to stimulate future economic research rather than justifying treatment per se. CONCLUSIONS: This study used previously validated, research-proven instruments and methods to perform a practical benefit-cost analysis of real-world treatment programs. The study demonstrates one way to combine economic and clinical data and offers a methodological foundation for future economic evaluations of addiction treatment.     

Effect of ingesting caffeine and ephedrine on 10-km run performance

. BACKGROUND: The ingestion of either caffeine (C) or ephedrine (E) has been shown to improve performance during high-intensity aerobic activity lasting 10-20 min, with an additive effect being found when the combination (C + E) was ingested. It was the purpose of this study to determine if the addition of E to C would improve performance in activity lasting longer than 20 min. METHODS: One and one half hours after ingesting a placebo (P), C (4 mg/kg), E (0.8 mg/kg), or C + E, 12 subjects performed a 10-km run while wearing a helmet and backpack weighing 11 kg. The trials were performed in a climatic suite at 12-13 degrees C, on a treadmill where the speed was regulated by the subject. VO(2), VCO(2), V(E), heart rate (HR), and rating of perceived exertion (RPE) were measured during the run at 15 and 30 min, and again when the individual reached 9 km. Blood was sampled at 15 and 30 min and again at the end of the run and assayed for lactate, glucose, and catecholamines. RESULTS: Run times (mean +/- SD), in minutes, were for C (46.0 +/- 2.8), E (45.5 +/- 2.9), C + E (45.7 +/- 3.3), and P (46.8 +/- 3.2). The run times for the E trials (E and C + E) were significantly reduced compared with the non-E trials (C and P). Pace was increased for the E trials compared with the non-E trials over the last 5 km of the run. VO(2) was not affected by drug ingestion. HR was elevated for the ephedrine trials (E and C + E). RPE remained similar for all trails. Caffeine increased the epinephrine and norepinephrine response associated with exercise and also increased blood lactate, glucose, and glycerol levels. Ephedrine reduced the epinephrine response but increased dopamine and FFA levels. CONCLUSION: The previously seen additive nature of E and C was not evident in this study, with the primary ergogenic effect being attributed to E.