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Biomedical subjects

A Spirito

Publications and source records attributed to A Spirito.

At least 37 records · Page 2Linked to original sources
PubMed1999

Acamprosate does not antagonise the discriminative stimulus properties of amphetamine and morphine in rats.

Acamprosate (calcium acetylhomotaurinate) is a GABA derivative that prevents drinking relapses in a significant number of alcoholics. Since little is known about the interaction of acamprosate with other addictive drugs, we studied the effects of this agent (as sodium salt) in two groups of rats trained to discriminate, respectively, morphine (1.7 mg kg(-1)i.p.) or amphetamine (0.5 mg kg(-1)i.p.) from solvent in a two-lever fixed ratio 30 operant behaviour reinforced by water access. Accordingly to the finding that acamprosate inhibits the action of excitatory aminoacids, its effects were compared with those of dizocilpine (MK-801), an NMDA antagonist. Results show that acamprosate (170 and 320 mg kg(-1)i.p. ) produced a slight, and not significant, shift to the left of generalization curves of both morphine and amphetamine without affecting response rates. In contrast, MK-801 potentiated response rate effects of both morphine and amphetamine without affecting their generalization curves. As far as discriminative stimuli participate in the relapsing process of addiction, our results do not predict a role of acamprosate in the prevention of amphetamine or morphine abuse relapsing.

Acamprosate↗
PubMed1999

Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department.

This study evaluated the use of a brief motivational interview (MI) to reduce alcohol-related consequences and use among adolescents treated in an emergency room (ER) following an alcohol-related event. Patients aged 18 to 19 years (N = 94) were randomly assigned to receive either MI or standard care (SC). Assessment and intervention were conducted in the ER during or after the patient's treatment. Follow-up assessments showed that patients who received the MI had a significantly lower incidence of drinking and driving, traffic violations, alcohol-related injuries, and alcohol-related problems than patients who received SC. Both conditions showed reduced alcohol consumption. The harm-reduction focus of the MI was evident in that MI reduced negative outcomes related to drinking, beyond what was produced by the precipitating event plus SC alone.

Adolescent↗
PubMed1998

Hypotaurine disproportionation reaction: identification of products.

Hypotaurine, concentrated under reduced pressure in HCl solution, partially (30-40%) degrades into taurine (about 30%), 2-aminoethyl-2-aminoethanethiolsulfonate (about 10%) and ethanolamine. The degradation products were identified using LC/APCI-MS, NMR, amino acid analysis and various chromatographies. The identities were confirmed by comparing the HPLS, MS and NMR characteristics of authentic compounds. One of the degradation processes during concentration of HCl solution of hypotaurine is therefore a disproportionation reaction which can interfere with the experimental results, when studying hypotaurine in biological systems.

Chromatography, High Pressure Liquid↗
PubMed1998

Brief motivational interviewing in a hospital setting for adolescent smoking: a preliminary study.

This study tested the feasibility and efficacy of a brief smoking intervention for adolescents in a hospital setting. Forty adolescent patients were randomized to receive either brief advice or a motivational interview, a nonconfrontational therapeutic intervention. Feasibility of brief smoking interventions with teen patients was supported by high rates of recruitment, retention, and quit attempts, and long periods of continuous abstinence. Although between-groups differences on smoking measures were not significant at 3-month follow-up, an effect size of h = .28 was noted. The sample showed significant decreases in smoking dependence and number of days smoked. Baseline stage of change, smoking rate, and depression were significant prospective predictors of smoking outcome. Implications for smoking intervention research with adolescents are discussed.

Adolescent↗
PubMed1998

Reasons for adolescent suicide attempts: associations with psychological functioning.

OBJECTIVE: To determine reasons for suicide attempts in adolescents and to examine the relationship between these reasons and psychological functioning. METHOD: Self-reported reasons for suicide attempts and psychological functioning were examined in 120 adolescent suicide attempters who presented to a pediatric general hospital. RESULTS: Consistent with prior research, the most frequently endorsed motives for self-harm were to die, to escape, and to obtain relief. More manipulative reasons for overdose (such as making people sorry) were endorsed less frequently. Adolescents who cited death as a reason for their suicide attempt reported more hopelessness, socially prescribed perfectionism, depression, and anger expression. Discriminant function analyses indicated that high levels of depression and anger expression predicted a self-reported wish to die, and high levels of depression and socially prescribed perfectionism predicted death as the primary reason reported for the suicide attempt. CONCLUSIONS: Systematic assessment of the reasons for a suicide attempt is a useful tool for clinicians in determining recommendations for follow-up treatment.

Adolescent↗
PubMed1998

Detection of alcohol use in adolescent patients in the emergency department.

OBJECTIVES: To examine 3 methods of detecting alcohol use among adolescent patients visiting a Level-1 regional trauma center. METHODS: Part 1 was a retrospective review of laboratory records and (13- to 19-year-old) patient medical records over the 1-year period from August 1993 to July 1994. Part 2 was a review of ICD-9 discharge diagnoses for the same age range during the same 1-year period. Part 3 involved prospective saliva alcohol testing of injured patients aged 13-17 years old. RESULTS: Part 1: A total of 522 blood tests were conducted and 160 (30.6%) were positive for alcohol. More than one-third of the alcohol-positive sample had alcohol ingestion as the only reason for their visits, i.e., they were uninjured. The alcohol-positive group was more likely to be male and older. Part 2: A total of 99 alcohol-related discharge diagnoses were given to adolescent patients. Alcohol abuse was the most common diagnosis. With the 2 methods of detection combined, 186 patients were identified. Part 3: A total of 119 saliva alcohol tests were conducted. One patient tested positive but had been identified while in triage as having used alcohol. CONCLUSION: In this study population, approximately one-third of adolescent patients tested for alcohol as part of routine clinical care were alcohol-positive but were not necessarily given an alcohol-related diagnosis. Thus, studies determining rates of alcohol-positive adolescents treated in EDs should use multiple methods of detection. Universal testing does not appear to be warranted for all injured adolescent patients.

Adolescent↗
PubMed1998

Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders.

OBJECTIVE: The purpose of this study was: 1) to examine both bedtime sleep behaviors and daytime behaviors associated with daytime sleepiness in a group of children with a primary medical sleep disorder (obstructive sleep apnea syndrome [OSAS]) compared with a group of children with a primary behavioral sleep disorder (BSD) (limit setting sleep disorder or sleep onset association disorder); and 2) to investigate the impact of a comorbid BSD on sleep and daytime behavioral consequences of OSAS. METHODS: Children referred to a pediatric sleep disorders clinic during a 3-year period with a primary diagnosis of either polysomnographically-confirmed OSAS (n = 100) or a BSD (n = 52) were compared on several parent report measures assessing the following domains: symptoms of sleep disordered breathing, other sleep behaviors (primarily parasomnias), bedtime behaviors, and externalizing daytime behavior problems. The OSAS sample was then divided into a pure OSAS group (n = 78) and an OSAS plus a behavioral sleep diagnosis group (n = 22) based on the presence or absence of delayed sleep onset and/or prolonged nightwakings and compared on the parent-report symptom domains. RESULTS: Almost one-quarter of the OSAS group had clinically significant behavioral sleep problems, primarily bedtime resistance, in addition to OSAS. Bedtime resistance was associated with a significantly shortened sleep duration in both the BSD and OSAS-BSD groups. Although the OSAS-BSD group had less severe disease, as defined by polysomnographic variables, than the pure OSAS group, they were rated by their parents as having more daytime externalizing behavior problems associated with daytime sleepiness. CONCLUSIONS: The results of this study suggest that evaluation for comorbid BSD should be done in all children presenting with symptoms of OSAS. The coexistence of such BSDs may contribute significantly to sleep deprivation, and thus to behavioral manifestations of daytime sleepiness in these children.

Child↗
PubMed1997

Relationship between substance use and self-reported injuries among adolescents.

High school students (n = 1983), 14-18 years olds, were surveyed regarding the incidence of injury and substance use at the time of the injury in the prior 6 months. Alcohol or other drugs were reported particularly often for falls, cuts, and gun and assault injuries. Alcohol or other drugs were reported to be involved in a substantial proportion of injuries resulting in medical care, most notably for gunshots (70%), pedestrian injuries (42%) and physical fights (38%).

Adolescent↗
PubMed1997

A cross-cultural comparison of behavior disturbance and suicidal behavior among psychiatrically hospitalized adolescents in Israel and the United States.

American adolescent psychiatric patients had significantly higher levels of suicidal behavior (49% vs. 19%) and a higher percentage of depression diagnoses (78% vs. 24%) than Israeli psychiatric inpatients. After controlling for the diagnosis of depression, American male patients obtained significantly higher scores on the Obsessive-Compulsive, Aggression, and Hyperactive subscales of the Child Behavior Checklist (CBCL) than the Israeli males. American females scored higher on the Depression subscale than Israeli females. Differences may be attributed to less tolerance or differing perceptions of deviant behavior in America, clinical practice, and/or the CBCL's greater applicability to American inpatient samples.

Adolescent↗
PubMed1997

The use of scheduled awakenings to eliminate childhood sleepwalking.

Evaluated the use of scheduled awakenings to eliminate sleepwalking using a noncurrent multiple baseline design across three subjects with persistent sleep-walking. Treatment procedure involves having parents awaken children several hours after they go to sleep and just before the typical time of the sleepwalking episode. This intervention proved immediately successful in eliminating sleep-walking in all three children. Treatment effects were maintained at 3 and 6 months posttreatment. Implications for intervention and future research are discussed.

Behavior Therapy↗
PubMed1997

Risk taking, reported injury, and perception of future injury among adolescents.

Investigated the relationships among self-reported injury, risk taking, and perception of injury risk in a sample of 1,426 adolescents, 14 to 18 years old. Both risk taking and injury were higher in males than females across age groups. Having a friend injured the same way was the strongest predictor of injury, accounting for 28% of the variance. Risk taking accounted for 4% of the variance. Sociodemographic variables-gender, age, and race-accounted for only 1% of the variance. Findings underscore the potential role of pediatric psychologists in both understanding and reducing the incidence of adolescent injury.

Adolescent↗
PubMed1997

The pediatric psychologist's role in differential diagnosis: vocal-cord dysfunction presenting as asthma.

Presented the case of an 11-year-old boy with vocal-cord dysfunction (VCD) as an example of a rare clinical phenomenon that may result in clinical and systemic challenges for the pediatric psychologist. VCD presents as highly similar to asthma, yet is best treated with speech therapy and psychosocial intervention. The physical symptomatology of VCD and its conceptualization as a psychosomatic disorder are described. Difficulties inherent in integrating psychological factors into medical case formulation are discussed, and possible pitfalls and strategies are delineated.

Adaptation, Psychological↗