The influence of cannabis use expectancies on cannabis use and psychotic symptoms in psychosis

Introduction and Aims. Little is known about motives or expectancies for cannabis use in psychotic populations, despite these cognitive factors being a central focus of the treatment for substance misuse in psychosis. This study examined the relationship between cannabis use expectancies, cannabis use and psychotic symptoms among cannabis using psychotic inpatients. A secondary aim was to determine if there were significant differences in the cannabis use expectancies of psychotic patients with and without Diagnostic and Statistical Manual version IV (DSM‐IV) cannabis dependence. Design and Methods. Participants consisted of 101 in‐patients with psychosis who had used cannabis more than five times in the past year. Expectancies were assessed using the Cannabis Expectancy Questionnaire (CEQ). The frequency of cannabis use, severity of cannabis dependence, presence of DSM‐IV cannabis dependence and severity of psychotic symptoms were also assessed using standardised measures. Results and Conclusions. Results suggested that cannabis use expectancies were associated with cannabis use but not symptom variables. Expectances for cannabis use predicted recent cannabis use and the presence and severity of cannabis dependence. Psychotic patients with DSM‐IV cannabis dependence had significantly higher expectancies for negative effects from cannabis use. Prospective research examining the influence of motives and expectancies for cannabis use on cannabis use and psychotic symptoms is required to obtain a greater understanding of substance use in psychosis and assist with the development of innovative treatment interventions.[Hides L, Kavanagh DJ, Dawe S, Young RMcD. The influence of cannabis use expectancies on cannabis use and psychotic symptoms in psychosis. Drug Alcohol Rev 2009;28:250–256]     

Further development of raccoon poxvirus-vectored vaccines against plague (Yersinia pestis)

In previous studies, we demonstrated protection against plague in mice and prairie dogs using a raccoon pox (RCN) virus-vectored vaccine that expressed the F1 capsular antigen of Yersinia pestis. In order to improve vaccine efficacy, we have now constructed additional RCN-plague vaccines containing two different forms of the lcrV (V) gene, including full-length (Vfull) and a truncated form (V307). Mouse challenge studies with Y. pestis strain CO92 showed that vaccination with a combination of RCN-F1 and the truncated V construct (RCN-V307) provided the greatest improvement (P = 0.01) in protection against plague over vaccination with RCN-F1 alone. This effect was mediated primarily by anti-F1 and anti-V antibodies and both contributed independently to increased survival of vaccinated mice.     

Sustained use of insecticide-treated curtains is not associated with greater circulation of drug-resistant malaria parasites, or with higher risk of treatment failure among children with uncomplicated malaria in Burkina Faso

The impact of vector control measures on the evolution of antimalarial drug resistance is an important issue for malaria control programs. We investigated whether the in vivo efficacy of chloroquine (CQ) in children aged 6-59 months with uncomplicated malaria differed in 9 villages that had benefited from long-term use of insecticide-treated curtains (ITCs) and in 9 nearby non-ITC villages. We also compared the prevalence of genetic markers of resistance to CQ and sulfadoxine-pyrimethamine (SP) between the two groups of villages. The study enrolled 1,035 children with uncomplicated malaria and 231 infected but asymptomatic children. After taking account of re-infections, the proportions of children who experienced clinical failure after treatment with CQ were 14% and 19% in ITC and non-ITC villages, respectively (OR = 0.68; 95% CI: 0.39, 1.18). Parasitologic failure was observed in 49% of children in ITC villages and 58% of children in non-ITC villages (OR = 0.71 95%CI: 0.44, 1.13). The proportion of symptomatic children who harbored parasites carrying the pfcrt-76T allele was 43% in ITC villages and 40% in non-ITC villages (OR = 1.09; 95%CI: 0.80, 1.50). The pfmdr1-86Y allele was detected in 31% and 29% of children in the two groups of villages (OR = 1.14; 95%CI: 0.75, 1.72). Triple mutations in the dhfr gene were observed in 12% of children in both groups. No double mutations in the dhps gene were observed. Similar results were observed in asymptomatic children. In this setting, ITC use was not associated with increased circulation of parasites resistant to standard antimalarial drugs, or with a greater risk of treatment failure among children less than 5 years of age.     

Propranolol blocks chronic risperidone treatment-induced enhancement of spatial working memory performance of rats in a delayed matching-to-place water maze task

Rationale Atypical antipsychotics improve cognitive function, including working memory, in schizophrenia. Some atypical antipsychotics have been reported to activate the locus coeruleus and induce beta-adrenoceptor antagonist sensitive c-Fos-like immunoreactivity in the prefrontal cortex. Materials and methods The present study investigated the effects of chronic treatment of rats with risperidone (1 mg kg⁻¹ day⁻¹ s.c.), clozapine (10 mg kg⁻¹ day⁻¹ s.c.), or acidified saline vehicle control for 2, 4, or 8 weeks on spatial working memory performance in a delayed matching-to-place water maze task with a 60-s inter-trial retention interval with and without acute challenge with propranolol (10 mg/kg i.p.). Results Treatment with risperidone for 8 weeks, but not 2 or 4 weeks, significantly improved working memory performance. In contrast, treatment with clozapine for up to 8 weeks did not improve working memory. Acute challenge with propranolol blocked the improvement in working memory produced by chronic treatment with risperidone, but had no significant effect on performance in saline- or clozapine-treated animals. Conclusions The delayed matching-to-place water maze task may prove valuable in the investigation of the behavioural pharmacology of the cognitive effects of antipsychotic drugs. These data suggest that beta adrenoceptors may contribute to the cognitive effects of chronic treatment with atypical antipsychotics.     

Allergic contact dermatitis in venous leg ulcer patients

Our aim was to determine the frequency and nature of contact sensitivity in venous leg ulcer patients in Lanarkshire. We performed patch testing with the European standard series, antimicrobials and medicaments on 200 patients referred to our leg ulcer clinics. Positive patch tests were found in 136 (68%) patients. Multiple allergies occurred in 102 (51%). The most frequent allergen groups were fragrances (30.5%), antimicrobials (19.5%), topical excipients (19.5%), rubber accelerators (13.5%) and topical corticosteroids (8%). We also found a high prevalence of positive patch tests to Intrasite gel (9.5%) and Hioxyl cream (8.5%), medicaments which are commonly used to treat leg ulcers in our area. Contact sensitivity is common in venous leg ulcer patients and has important implications for patient management. The allergens involved vary depending on local nursing practice. We suggest that all venous leg ulcer patients be patch tested with a locally relevant patch test series.     

Topical 5-aminolaevulinic acid photodynamic therapy for cutaneous lesions: outcome and comparison of light sources

BACKGROUND: Topical 5-aminolaevulinic acid (ALA) photodynamic therapy (PDT) is increasingly used for superficial non-melanoma skin cancers and their precursors. METHODS: We report our 3-year experience of topical ALA-PDT, with a preliminary comparison of the effects of broadband and laser light sources. RESULTS: We performed 688 treatments on 483 lesions in 207 patients. Complete clearance was achieved in 222/239 lesions of Bowen's disease (BD), superficial basal cell carcinoma (sBCC) and actinic keratosis (AK) (93%) - 117/129 BD (91%), 84/87 sBCC (97%) and 21/23 AK (91%), with a median follow up of 48 weeks. Broadband and laser light sources were of similar efficacy. Recurrences have occurred in 10.3% BD, 4.8% sBCC and 4.8% AK. Adverse effects from PDT were uncommon but included pigmentary change (2%) and minor scarring (2%). How-ever, severe pain was experienced in 16-21% of treatments using the high-output broadband and laser sources, but in only 2% with the low-output xenon arc source. CONCLUSION: Topical ALA-PDT is effective for BD, sBCC and AK and has been an invaluable addition to our dermatology service. Efficacy is similar for broadband and laser light sources, although treatment at higher surface irradiance may be painful, and excellent cosmetic results can be achieved.     

Therapeutic results and evolution of Black African patients with follicular lymphoma: Ivory Coast experience

We reported in this study a treatment results about 36 Africans patients with follicular lymphoma. The average age of patients was 18 to 73 years old with a median age at 50.83 years old and a sex ratio of 1. Clinical characteristics of patients are mainly represented by advance stage with 70% of stage III and IV of Ann Arbor classification. Histological, we mainly notified follicular lymphoma constituted of small cells 50%, followed by mixed follicular and large cells lymphomas with respectively 27.78 and 22.22%. Using varieties of therapeutics regiments, we obtained 41.67% of complete remission. There were significant correlations between complete remission and histology subtypes. Indeed, the follicular lymphomas constituted by large cells and mixed cells had higher rate of complete remission with respectively 46.67% and 40% in relation with those of small cells with a higher failure rate. Median follow-up was 24 months, the estimated 5-years overall survival and event-free survival were 22%. After a long period, 25 cases of death have been reported, 5 cases of losing sight and 6 patients are still alive and following treatment. Our results are lowers than the reported case in developing country. This none satisfying was in relation with the lower socio-economical level of the main part of the patients. The short survival delay time of our patients didn't permit time to observe transformation case in diffuse large cell lymphomas.     

Which tests are most useful in distinguishing between reactive thrombocytosis and the thrombocytosis of myeloproliferative disease?

In an attempt to distinguish between thrombocytosis in myeloproliferative disease (MPD) and reactive thrombocytosis (RT) the following aspects of platelet structure and function were evaluated: platelet size, platelet aggregation and adhesion, dense granule and alpha granule components. In addition plasma fibrinogen and von Willebrand factor antigen (vWFag) were measured. In all parameters measured there was a significant difference between normals and both categories of thrombocytosis, however there was considerable overlap between MPD and RT. Plasma fibrinogen emerged as the best single test to discriminate between MPD and RT, levels of less than 5.0 g/l indicating MPD and greater than 5.0 g/l indicating RT.     

A double‐blind,randomized assessment of the irritant potential of sunscreen chemical dilutions used in photopatch testing*

Background: The maximum concentration of organic sunscreen filters in current usage that does not lead to irritant reactions when performing photopatch testing is not known. Such irritant reactions can be misinterpreted as positive photoallergic contact dermatitis reactions. Objective: To determine the frequency of irritant reactions to 19 organic sunscreen filters in current use. Patients/Methods: Ninety‐four healthy volunteers were photopatch tested using the European consensus methodology to three different concentrations (2%, 5%, and 10%) of 19 organic sunscreen filters at the Photobiology Unit in Dundee, UK. Results: Of the 94 subjects recruited, 80 were analysed after withdrawals and exclusions. Of the 19 organic sunscreen filters studied, only 2 compounds led to irritant reactions in ≥5% subjects. Five per cent and 10% benzophenone‐4 led to irritant reactions in four and six subjects, respectively. Five per cent methylene bis‐benzotriazolyl tetramethylbutylphenol led to irritant reactions in six subjects, but unlike benzophenone‐4, this was not in a dose‐dependent fashion. Conclusions: When performing photopatch testing according to the European consensus methodology with these 19 organic sunscreen filters, a 10% concentration is suitable for all filters, except benzophenone‐4, which should be tested at a concentration of 2%.