Changes concurrent with intiation of abstinence from cocaine abuse

In an exploration of changes that occur with initiation of cocaine abstinence, this study examined treatment outcomes in four domains—behavior (cocaine use), affect (depression), cognition (schematic self-representations), and psychophysiology (reactivity to drug cues). Nineteen patients initially entered this 8-week outpatient psychopharmacotherapy trial for the treatment of cocaine dependence. Thirteen completed treatment, and eleven maintained abstinence during the last four weeks of the study. In addition to a demonstrated change in their cocaine-using behavior, these “abstainers” reported reduced depression, increased congruency with “ideal” self-schemas, increased discrepancy with “addict” self-schemas, and generally more positive self-representations. In addition, “abstainers” reported reduced posttreatment craving in the presence of cocaine cues, but evidenced no change in physiological reactivity. Implications of these findings for research and treatment are discussed.     

脑血管病患者血清果糖胺水平测定及其临床意义

目的 通过血清果糖胺（FTM）检测,探讨脑血管病（CVD）患者高血糖状态时的FTM水平,客观评价糖尿病对CVD的影响,鉴别CVD的高血糖状态。方法 设立脑出血、脑梗塞、健康对照和疾病对照4组,对共137例研究对象采用比色法进行FTM分析,同时检测血糖水平以供比较。结果 两组CVD患者血清FTM水平、血糖检测值及异常率均高于两对照组,FTM异常者患CVD的相对危险度是健康及疾病对照者的4－19倍,脑出血组血糖异常率明显高于FTM异常率。表明FTM及血糖异常均是CVD的危险因素,而TM更能客观、准确地反映糖尿病与CVD的关系。结论 FTM既可作为进行CVD危险因素研究的可信指标,亦可作为鉴别CVD高血糖状态,判断、监测病情,估计预后及指导治疗的依据。其检测方法简便易行,快速可靠,适于推广。     

Demonstration of the existence of nitric oxide-independent as well as nitric oxide-dependent vasodilator mechanisms in the in situ renal circulation in near term pregnant rats

1. We have investigated the role of endogenous nitric oxide on renal vascular reactivity in late pregnancy in in situ blood perfused kidneys of α-chloralose anaesthetized Wistar-Kyoto rats. Nitric oxide synthesis inhibition was achieved by intravenous administration of N^G-nitro-L-arginine or N^G-nitro-L-arginine methyl ester.
2. Intra-arterial mean blood pressure was lower in pregnancy compared with nonpregnant controls. Following nitric oxide synthesis inhibition mean blood pressure increased in both pregnant and nonpregnant groups, but remained lower in pregnant animals.
3. Basal renal perfusion pressure was similar in pregnant and nonpregnant groups. Intravenous administration of N^G-nitro-L-arginine resulted in dose-dependent increases in renal perfusion pressure but responses were substantially depressed in pregnancy.
4. Renal vasoconstrictor responses to regional angiotensin II (AII) were decreased in pregnancy, whereas those to noradrenaline (NA) did not differ from nonpregnant controls. N^G-nitro-L-arginine (5 mg kg⁻¹) potentiated renal responses to regional AII and NA in both groups, but AII responses remained lower in pregnancy. Blunted renal AII responses in pregnancy were still evident following large doses of N^G-nitro-L-arginine methyl ester (100 mg kg⁻¹).
5. The results demonstrate that nitric oxide synthesis inhibition increases renal perfusion pressure to a lesser extent in pregnant compared with nonpregnant rats, and that reduced renal pressor responses to AII are still evident in pregnancy after nitric oxide synthesis inhibition.
6. These results suggest that although endogenous nitric oxide synthesis modulates renal vasoconstrictor responses in both pregnant and nonpregnant animals, this mechanism does not fully account for the blunted renal vasoconstrictor responses to regional AII or nitric oxide inhibitors in near term pregnant rats. The nature of this important physiological vasodilator mechanism in pregnancy remains to be elucidated.

     

Cue-elicited cocaine craving and autogenic relaxation : Association with treatment outcome

Prior to entering a pharmacotheraphy trial for the treatment of cocaine dependence, 19 patients participated in a pretreatment cue-reactivity protocol that concluded with a relaxation exercise. Measures included self-reported craving and skin conductance level (SCL). Post hoc exploratory analyses suggest that neither craving nor change in SCL in response to cocaine cues differentiated patients who subsequently achieved abstinence from those who did not. Craving following the relaxation procedure did differentiate the two groups: patients who subsequently initiated abstinence in treatment reported a reduction in cue-elicited craving to below baseline levels; craving reported by patients who did not successfully complete treatment remained elevated.     

Emotional reactivity and sympatho-adrenal activity in the rat (author's transl)

Using the open-field test, differences in emotional reactivity were shown in male rats of several albino strains. These behavioural differences were then investigated in relation to physiological differences. It was found that, under resting conditions, sympatho-adrenomedullary activity as estimated by urinary catecholamine excretion and adrenal catecholamine content is lower in the more emotionally reactive rats. The resting heart rate is correspondingly slower in these animals though they show the same noradrenaline cardiac concentration as the nonreactive rats. These data suggest that high defecating rats in the open-field exhibit a lower sympathetic tonus, possibly linked, however, with a higher parasympathetic tonus.     

Behavioral evidence implicating dopamine in sensorimotor arousal and norepinephrine in the sedative effects of antidepressant drugs

The effects of acute and chronic antidepressant treatment on acoustic startle were evaluated in three experiments. Administration of 2.5–10.0 mg/kg desipramine, amitriptyline, and nortriptyline depressed acoustic startle responding after repeated sensory stimulation. In contrast to the tricyclic drugs, the serotonin reuptake inhibitor zimelidine increased acoustic startle, and inhibition of dopamine reuptake following acute nomifensine and bupropion administration did not influence startle reactivity in the doses examined. The response reducing effects of desipramine and amitriptyline persisted following chronic exposure to these drugs, and these findings were discussed in relation to the inhibitory actions of the tricyclics on locus coeruleus neurons. A second major finding in this study was that animals challenged withd-amphetamine during desipramine and amitriptyline withdrawal showed a facilitated startle response. Enhanced startle reactivity to amphetamine was also observed following long-term exposure to iprindole, and a withdrawal hyperactivity of acoustic startle was evident after chronic treatment with amoxapine, bupropion, and nomifensine. These results agree with evidence that repeated administration of antidepressants increases dopamine neurotransmission which modulates sensorimotor arousal.     

Cocaine decreases relative cerebral blood volume in humans: a dynamic susceptibility contrast magnetic resonance imaging study

Cocaine has substantial effects on cerebral hemodynamics which may partly underlie both its euphorigenic and toxic effects. Dynamic susceptibility contrast magnetic resonance imaging (DSC–MRI) was used to determine whether a dose-effect relationship could be detected between cocaine administration and cerebral blood volume reduction in human brain. Twenty-three healthy and neurologically normal adult males with a history of recreational cocaine use (3–40 lifetime exposures) participated. Subjects underwent DSC-MRI measurements of relative cerebral blood volume (rCBV) at baseline and 10min after IV double-blind placebo or cocaine (0.2 or 0.4 mg/kg) administration. Placebo administration resulted in superimposable rCBV curves with post-placebo CBV averaging 104 ± 4% (mean ± SE) of baseline, indicating no CBV change. Both cocaine doses induced CBV decreases which were statistically equivalent and post-cocaine CBV averaged 77 ± 4% of baseline (P < 0.002), when measured 10 min following drug administration. These data suggest that DSC-MRI can detect cocaine-induced CBV reductions indicative of vasoconstriction, and that it may be useful for evaluating treatments designed to reduce the cerebrovascular effects of cocaine. Received: 25 September 1997 / Final version: 30 December 1997     

青年脑卒中患者相关危险因素分析

目的探讨青年脑卒中患者的危险因素。方法选择2003年1月至2008年12月连续登记住院的年龄18—45岁脑卒中患者共178例,其中脑梗死106例,脑出血72例,对已知危险因素进行分析。结果高血压、吸烟、过量饮酒、家族史是主要危险因素。超重、高血脂症在青年脑卒中患者中所占的比例也较高。糖尿病、心脏病、TIA不是青年脑卒中患者的主要危险因素。结论降压治疗是青年脑卒中一级预防的重点工作。应重视提倡健康的生活方式,有针对性地加强卫生知识的宣传。