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Neurobehavioral and systemic effects of longterm blood lead-elevation in rats. I. Discrimination learning and open field-behavior.

In order to assess neurobehavioral deficit subsequent to early low-level lead-exposure, Wistar-rats were prenatally Pb-exposed via their mothers, neonatally via their dams' milk, and later on via their diet containing lead acetate (745 mg Pb/kg diet). Blood-lead levels (PbB) of dams increased from 24.2-31.2 microgram-% during pregnancy and suckling-periods, those of offsprings were 26.6 microgram-% at about 16 days of age and 28.5 microgram-% at about 190 days of age. Between 100 and 200 days of age 40 male offsprings were subjected to behavioral testing, namely an open field-test and a visual discrimination-learning task. Two learning-tasks of different complexity, i.e. orientation- and size-discrimination, were used. Data of 20 lead-treated animals were compared with those of 20 age-matched controls. In the open-field test lead-fed animals were significantly more restless than controls; an increase of ambulation, rearing and grooming was observed. In the difficult learning-task, i.e. size discrimination, only the controls did learn the problem, whereas only one of the lead-group did; there was, however, no difference between lead- and control-animals for the easy task, i.e. orientation-discrimination. The observed effects, namely overreaction in the open field and a deficit of visual discrimination learning, may be interpreted in terms of lead-induced CNS-dysfunction. They clearly suggest that the "no-response level" for neurobehavioral damage in the rat, subsequent to early lead-exposure, must be assumed to be lower than 35 microgram/100 ml.

Animals↗

[Effects of longterm HCG administration on testicular function in hemodialysis patients (author's transl)].

Thirtheen male patients with chronic renal failure undergoing regular dialysis treatment (2 X 8-10 hours/week) were treated with gonadotropins (HCG, Primogonyl) primarily 2 X 2,000 IU/week and later 2,000 IU/week. Before HCG administration and during 4-months HCG-therapy testosterone, dihydrotestosterone, Androstandiol, LH and FSH levels were determined by RIA-methods in 7-14 days intervals. Before HCG-application plasma testosterone levels were low and did not increase in the course of regular dialysis treatment. Derivates from testosterone like dihydrotestosterone and Androstandiol were elevated in plasma, presumbably because of accumulation in renal failure. LH-levels were slightly elevated on the average. FSH-levels showed a high individual variation but also seemed to be elevated on the average. HCG stimulation by exogenous HCG administration for short time resulted in a insufficient rise of testosterone levels as compared to normals. During prolonged HCG administration plasma testosterone levels increased to normal but dropped immediatly after cessation of therapy or reduction to less than 2,000 IU HCG twice/week. Body weight, plasma proteins, haematocrite and fertility did not improve significantly. These results indicate that in chronic renal failure androgen synthesis by testicular tissue is seriously impaired and does not improve under usual dialysis treatment. Feedback regulation of testosterone levels by increase of LH levels seems not to be sufficient although pituitary response is found to be normal. This may be explained by elevated levels of testosterone derivates which exert negative feedback effects.

Adult↗

Psychosocial effects of longterm cannabis use in India. A study of fifty heavy users and controls.

Fifty cases of heavy cannabis users in India (25 smokers of charas and 25 drinkers of bhang) were studied for their physical and mental health and compared with 25 non-user controls. The average duration of cannabis use was more than 10 years with an estimated average consumption of about 150 mg of THC daily. Physical health and nutrition were relatively poor in users and there were more respiratory complaints. No case of definite psychosis related to the use of cannabis was found in the series, though minor neurotic complaints were present in all groups. In the social sphere cannabis users gave more often a history of poor work record, family maladjustment and episodes of violent behaviour.

Adolescent↗

The effect of longterm vs shortterm tutors on the quality of the tutorial process and student performance.

Small-group, problem- based learning can require a significant amount of individual faculty time when groups last as long as 10 weeks. One solution is to use two short-term (3-5 weeks) tutors instead of a single long-term (6-10 weeks) tutor. This study was performed to evaluate whether having short-term instead of a long-term tutors affected student performance and/or the quality of the tutorial process. The grade point averages for first and second year medical students in the classes of 2001 and 2002 were stratified by how many long-term tutors students had (2, 3, 4, 5, or 6) over a period of 17 months. In addition, students completed anonymously a 24-item tutor evaluation questionnaire utilizing a 5 point Likert scale (outstanding, good, satisfactory, marginal or unsatisfactory) at the mid-point and at the end of each tutorial. The evaluations were stratified by whether the tutor was short-term or long-term (to the mid-point or end of the tutorial, respectively). Statistical analysis was performed using analysis of variance. Grade point averages did not correlate with the number of long-term tutors that students had. Long-term tutors were rated significantly higher than short-term tutors in 17 of the 24 categories evaluated by the questionnaire, including development of students' critical thinking, information skills and self-learning skills; encouraging students to express themselves freely and to take responsibility for their own learning; helping students to balance basic science and clinical applications; and overall assessment. Short-term vs long-term tutors do not affect objective student performance as measured by grade point average. However, long-term tutors are ranked significantly higher by students in numerous areas related to the perceived quality of the tutorial process. Short-term tutoring may be less of a demand on an individual faculty's time, but may lessen the students' perceived quality of the tutorial process.

Education, Medical↗

Disordered breathing and hypoxia during sleep in coronary artery disease.

The occurrence of breathing disorders and hypoxia during sleep was studied in 17 male patients with coronary artery disease, demonstrated by coronary angiography, who did not have symptomatic pulmonary disease. Thirteen patients (76 percent) experienced disordered breathing during sleep; of these, 11 had obstructive apnea and the other two had Cheyne-Stokes breathing. There was an average of 20 episodes of disordered breathing per hour during sleep among the 13 patients, with a mean duration of 24 seconds per episode; significant oxygen desaturation occurred in ten of these 13 patients. There was no episode of angina pectoris, myocardial infarction or sudden death. Although cardiac arrhythmias occurred in 12 patients, disordered breathing with hypoxia was not proven to be causative. Therefore, obstructive disordered breathing and nocturnal oxygen desaturation commonly occurred during sleep in patients with coronary artery disease. Although no immediate ill effects were noted, the longterm effects remain to be determined.

Adult↗

Longterm beneficial effect of chloroquine diphosphate on lipoprotein profile in lupus patients with and without steroid therapy.

OBJECTIVE: To investigate the influence of chloroquine diphosphate (CDP) alone and in combination with corticosteroids on systemic lupus erythematosus (SLE) lipoproteins. METHODS: Fasting lipid profiles were performed in 60 consecutive female patients with SLE and in 30 controls. All SLE patients had minor disease activity and were divided according to current therapy in 4 groups: No therapy; prednisone (Pred group; < 15 mg prednisone daily); CDP (250 mg daily); and Pred + CDP. RESULTS: There were no significant differences of age, race, and disease duration among SLE groups. All patients had SLEDAI scores < or = 4 and prednisone dose was similar in the 2 groups taking this drug. The CDP group had significantly higher levels of high density lipoprotein cholesterol (HDL-c) levels compared to No therapy group (p < 0.05), which were similar to those detected in healthy controls. In addition, higher levels of HDL-c and lower levels of triglycerides and very low density lipoprotein cholesterol levels (VLDL-c) were detected in Pred + CDP compared to Pred (p < 0.05). CONCLUSION: CDP alone or added to corticosteroid therapy has a beneficial effect in SLE dyslipoproteinemia, particularly in increasing HDL-c levels. Additionally, this drug seems to revert the increased hepatic synthesis of lipoproteins induced by corticosteroids as suggested by the concomitant decrease of triglycerides and VLDL-c levels in SLE patients taking the combined regimen.

Chloroquine↗

Gender and ethnic origin have no effect on longterm outcome of childhood-onset systemic lupus erythematosus.

OBJECTIVE: To investigate the associations of gender and ethnic origin with longterm outcome in childhood-onset systemic lupus erythematosus (SLE). METHODS: The study cohort consisted of 51 patients (13 males and 38 females) with childhood-onset SLE followed for > or = 5 years at the British Columbia Children's Hospital in Vancouver. Fifteen patients were Caucasian, 14 Chinese, 9 East Indian, and 13 patients were of other ethnic backgrounds: none was African-American or Hispanic. Outcome measures assessed retrospectively included Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score (SDI), SLE-related death, need for dialysis or renal transplantation, and use of intensive immunosuppressive therapy. A SDI > or = 2 was assigned as poor outcome. RESULTS: The median age at diagnosis was 10.8 years and the median duration of followup was 7.2 years. Five-year survival was 100%; 10-year survival was 85.7% (12/14 patients). The median SDI score at last followup was 2.0 (range 0-9); 2.0 for male, 1.5 for female; 2.0 for Caucasian and 2.03 for non-Caucasian patients. Twenty-six out of 51 patients (51%) had poor outcome (SDI score > 2). Three female patients required dialysis: 2 had subsequent renal transplants. Thirty patients received intensive immunosuppressive therapy. The SDI scores, mortality, and need for intensive immunosuppressive therapy were not influenced by either gender or ethnic origin. CONCLUSION: The median SDI score was high for this cohort with childhood-onset SLE. In contrast to other published data, no association of male gender and/or non-Caucasian ethnicity with poor outcome was found in our study cohort.

Age of Onset↗

The effect of longterm alcohol exposure on liver choline dehydrogenase activity.

Rats were exposed to an ethanol-containing drinking mixture for 54, 84 and 105 days. It was shown that a progressive increase in liver choline dehydrogenase activity occurred which became statistically significant at 105 days. This may be the mechanism by which ethanol increases choline requirement in mammals. Studies of this type might further our understanding of alcohol-related liver disease, and are particularly pertinent in countries such as Zambia in which alcohol consumption is high and dietary choline intake is likely to be low.

Alcohol Oxidoreductases↗