A trial of relapse prevention with severely dependent male problem drinkers

Over the last two decades, relapse prevention has emerged as a major focus of the treatment of drug problems. Few studies have demonstrated any impact on generally high relapse rates. In this paper the outcome of a controlled trial of a relapse prevention programme with male problem drinkers (n=60) attending an Alcohol Treatment Unit is reported. Subjects who met the inclusion criteria were allocated to a relapse prevention (n=20) procedure or a discussion (n=20) or no-additional treatment (n=20) control procedure. Subjects were followed-up at 6 and 12 months by the first author. The relapse prevention programme was associated with significantly greater increases in pre- and post-treatment self-efficacy compared to the discussion control group and significantly greater probability of total abstinence than all controls over the first 6-month follow up. In addition, the relapse prevention programme was associated with significantly longer survival time to an initial lapse and relapse than the controls. At 12-month follow-up, treatment effects had been eroded. It was concluded that the relapse prevention programme was an effective treatment in the short term and that longer-term impact may require greater focus on maintenance factors, such as the individual's environment.     

Catheter Ablation of Recurrent Scar-Related Ventricular Tachycardia Using Electroanatomical Mapping and Irrigated Ablation Technology: Results of the Prospective Multicenter Euro-VT-Study

Catheter Ablation of Ventricular Tachycardia.   Introduction: Ventricular tachycardia (VT) late after myocardial infarction is an important contributor to morbidity and mortality. This prospective multicenter study assessed the efficacy and safety of electroanatomical mapping in combination with open-saline irrigated ablation technology for ablation of chronic recurrent mappable and unmappable VT in remote myocardial infarction.
Methods and Results: In 8 European institutions, 63 patients (89% males) were enrolled in the study. All patients had remote myocardial infarction and presented with a median number of 17 (range 1–380) VTs in the preceding 6 months. Incessant VT was present in 14 patients (22%). Left ventricular ejection fraction measured 30 ± 13%. A mean of 3 VTs were targeted per patient and 22% of all patients had only unmappable VT. The mean follow-up period was 12 ± 3 months. A total of 164 VTs were targeted during catheter ablation. Ablation was acutely successful in 51 patients (81%). One patient (1.5%) experienced a major complication with degeneration of VT into ventricular fibrillation necessitating cardiopulmonary resuscitation maneuvers. However, no death occurred acutely or within the first 30 days after catheter ablation. During the follow-up, 19 of the initially successful ablated patients (37%) and 31 of all ablated patients (49%) developed some type of VT recurrence.
Conclusions: The results of this multicenter study demonstrate the high acute success rate and a low complication rate of irrigated tip catheter ablation of all clinical relevant VTs in remote myocardial infarction. However, during the follow-up a relevant number of recurrences occurred. (J Cardiovasc Electrophysiol, Vol. 21, pp. 47–53, January 2010)     

ADH and ALDH genotype profiles in Caucasians with alcohol-related problems and controls

Eighty-two Caucasian patients receiving treatment for alcohol-related problems and eighty four controls were DNA typed for variants in the alcohol dehydrogenase (ADH₂ and ADH₃) and mitochondrial aldehyde dehydrogenase (ALDHJ gene loci. No association was observed between individual, or combined gene frequencies and the presence of alcohol-related problems.     

Natural Killer Cell Cytotoxicity and Antibody-Dependent Cellular Cytotoxicity to Herpes Simplex Virus-Infected Cells in Human Pregnancy

ABSTRACT: Natural killer cell (NKC) cytotoxicity and antibody-dependent cellular cytotoxicity (ADCC) represent the ability of human leukocyte effector cells to destroy target cells in the absence and presence of antibody, respectively. Since these immune systems play a pivotal role in the body's primary lines of defense against a variety of pathogens including herpes simplex virus (HSV), a study was undertaken to evaluate the influence of pregnancy on these systems. Eleven uncomplicated gravidas were followed serially through each trimester and compared to 11 nonpregnant female controls. Mononuclear cells were acquired by Ficoll-Hypaque centrifugation of heparinized blood. Chang liver cells infected with HSV-I were utilized as target cells in a ⁵¹Cr release assay. Mean NKC values in the pregnant patients were uniformly lower than in the controls. No similar decreases in ADCC activity were observed in a comparison between the two study populations. These data support previous observations suggesting that pregnancy represents a relatively immunocompromised state. Differences apparently exist between NKC and ADCC effector cell populations with regard to the influence of pregnancy. Although these physiologic alterations in immunoregulation may help support the fetoplacental allograph, detrimental conditions may exist regarding susceptibility to various pathogens such as HSV.     

Denitrification of the genotoxicant 2-nitropropane : relationship to its mechanism of toxicity

1. The stabilities of the industrial chemical and constituent of cigarette smoke 2- nitropropane (2-NP) and its aci tautomer propane 2-nitronate (P2N) towards hepatic enzymes and proteins such as serum proteins and oxyhaemoglobin were investigated in vitro in biological (hepatocytes and subcellular liver fractions) and model systems (serum proteins, oxyhaemoglobin, methylene blue). 2. Denitrification of 2-NP, P2N and 2-deutero 2-nitropropane (²H-NP) occurred in murine hepatocytes significantly faster than in rat cells.For 2-NP the rates were 1271 ± 167 versus 820 ± 125 pmol nitrite × min^?1 × 10⁶ cells^?1. 3. A similar observation was made in microsomes, where 2-NP denitrification was 1460 ± 110 (mouse) versus 480 ± 80 pmol nitrite × min^?1 ×?mg protein^?1 (rat). 4. The major NO₂^?-forming activity was found to be localized in the microsomal fraction. 5. Conversionof 2-NP into P2N, either chemically or enzymatically,was a prerequisite for rapid denitrification. 6. Serum proteins and oxyhaemoglobin proved to be capable of denitrifying P2N (198 ± 24 pmol nitrite × min^?1 ×?mg protein^?1 and 7·1 ± 1·0 nmol nitrite × min^?1 × nmol HbO₂^?1 respectively), but were much less active towards 2-NP (24 ± 2 pmol nitrite × min^?1 ×?mg protein^?1 and none respectively). 7. Methylene blue decomposed 2-NP and P2N at rates of 11 ± 3 and 192 ± 4 pmol nitrite × min^?1 × nmol methylene blue^?1 respectively. The dye also enhanced NO₂^? formation from P2N and 2-NP in the presence of hepatocytes or serum proteins, with a concomitant enhancement of both 2-NP and P2N toxicity. 8. The results presented report species differences in the denitrification rate of 2-NP and highlight the crucial nitro-aci tautomerism of 2-NP as a pivotal determinant of 2-NP toxicity.