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The efficacy of a university drug education course on factors that influence alcohol use.

The purpose of this investigation was to assess the impact that a Drug Education course has on motives, consequences, attitudes, and perceptions regarding alcohol use in a sample of university students, and to discern if these parameters alter substance usage. There were a total of 121 respondents (32 male, 94 female). Following the course, students reported a slight elevation in the motivation to drink alcohol to facilitate studying. However, drinking because they enjoyed the taste, drinking to get drunk, and drinking to celebrate special occasions decreased significantly following the course. No significant differences were noted in patterns of drinking consequences or selected attitudes toward alcohol use. Students did, however, perceive alcohol to be a more dangerous substance in the post-test. No gender differences were observed.

Adolescent↗

Acceptability trials with ready to eat foods in a rural area.

Acceptability trials with three types of recipes was carried out on 184 young preschoolers (6 months to 35 months) residing in four nearby villages around Hyderabad. Results of this study indicated that among the 3 types of supplementary foods (Sweet Ready Mix, Sweet Ready Mix with Amylase and Therapeutic food tested here, the Therapeutic food was more acceptable (taste, smell and bulk) to the children. The criteria for acceptability of the food was defined as the ability of 75% of the children to consume 75% or more of the food supplement at one sitting for 70% of the days of the trial. The Therapeutic food, a calorie dense supplement, met the above criteria. The acceptability was poor for the Sweet Ready Mix and Sweet Ready Mix with Amylase (< 4%) mainly due to quantity rather than taste and smell as revealed by the mothers. The mothers of the children also liked the taste and smell of the therapeutic food better. Consumption of the therapeutic food caused minimal side effects like diarrhea and vomiting when compared to side effects after eating Sweet Ready Mix and Sweet Ready Mix with Amylase in children.

Child, Preschool↗

Sensitivity to acute methadone dose changes in maintenance patients.

This study assessed whether methadone patients can identify acute dose changes in their maintenance dose, and explored the relationships between self-reported drug effects and real or perceived dose changes. Four times each week patients (N = 10) unpredictably received either 80%, 90%, 100%, 110% or 120% of their usual daily dose (50-100 mg). Approximately 24 hr later they indicated which dose they had received on the previous day, and rated the previous day's dose in terms of good effects, bad effects, and change in medication taste. Correct estimation of the doses received was always at the levels expected by chance alone. Furthermore, this sample of patients could not detect dose-related changes in medication taste. However, self-reports of good effects were significantly higher when patients believed that they had received a dose increment, and ratings of bad effects were higher when patients believed that they had received a dose decrement.

Adult↗

Optimization of placebos for double-blind clinical trials. Experience with a phytopharmaceutical.

The maintenance of double-blind conditions in placebo-controlled trials depends on the quality of the placebo preparation. The placebo should match the active substance-containing preparation as closely as possible, but it must not contain any substances that might themselves be pharmacologically active. Active substances characterized by a particular colour, taste, smell or other easily perceptible properties constitute a challenge to researchers. The way of developing a placebo that matches a phytopharmaceutical to a satisfactory extent is described and discussed.

Aged↗

Impact of interpersonal and ego-related stress on restrained eaters.

OBJECTIVE: This study examined the impact of different types of stress, one interpersonal and two ego-related versus a control condition, on the eating behavior of individuals with varying degrees of dietary restraint. METHOD: Eighty-two females were randomly assigned to one of three manipulations or a control group, and then all groups completed an ice cream taste test. RESULTS: A significant interaction revealed that for participants with higher restraint, those in the stressful manipulations ate significantly more than participants in the control group. Further, the pattern of consumption based on restraint for the interpersonal group differed from the other three conditions. In the interpersonal group, the greater the restraint, the more participants ate, whereas in the other three conditions, the pattern was reversed although not significantly so. DISCUSSION: Findings are discussed in terms of the role that interpersonal stress plays in the eating behavior of dieters and potential implications regarding the development of eating disorders.

Adolescent↗

Assessment of binge eating in obese patients.

Obese patients entering a weight control program were classified as binge eaters if they reported uncontrolled consumption of what others would regard as an unusually large amount of food at least once a week for the previous month. Binge eaters differed significantly from nonbingers across a broad range of eating and weight-related characteristics assessed using a self-report version of the Eating Disorder Examination. Attitudinal differences were marked. The results provided no support for the view that obese binge eaters have a pattern of general "addictiveness" to psychoactive substances or other activities.

Adult↗

Intravenous nicotine and caffeine: subjective and physiological effects in cocaine abusers.

The subjective and physiological effects of intravenously administered caffeine and nicotine were compared in nine subjects with histories of using caffeine, tobacco, and cocaine. Subjects abstained from tobacco cigarette smoking for at least 8 h before each session. Dietary caffeine was eliminated throughout the study; however, to maintain consistency with the nicotine intake, subjects were administered caffeine (150 mg/70 kg b.i.d.) in capsules, with the last dose administered 15 to 18 h before each session. Under double-blind conditions, subjects received placebo, caffeine (100, 200, and 400 mg/70 kg), and nicotine (0.75, 1.5, and 3.0 mg/70 kg) in mixed order. Physiological and subjective data were collected before and repeatedly after drug or placebo administration. Compared with the highest dose of caffeine, the highest dose of nicotine produced greater subjective ratings on a number of scales. At doses that produced comparable ratings of drug effect (1.5 mg/70 kg of nicotine and 400 mg/70 kg of caffeine), both drugs produced similar increases in ratings of good effect, liking, high, stimulated, and bad effect. Nicotine showed a somewhat faster time to peak subjective effects than caffeine (2 versus 4 min). Subjective ratings that differentiated caffeine and nicotine were ratings of rush, blurry vision, and stimulant identification (elevated by nicotine) and ratings of unusual smell and/or taste (elevated by caffeine). Both caffeine and nicotine decreased skin temperature and increased diastolic blood pressure; however, caffeine decreased whereas nicotine increased heart rate. The study documents both striking similarities and some notable differences between caffeine and nicotine, which are among the most widely used mood-altering drugs.

Adult↗

Zopiclone, the third generation hypnotic: a clinical overview.

Effective and safe hypnotics exist especially since the introduction of benzodiazepines (BZD) which appeared to bring major advantages over barbiturates. Ideally a new hypnotic should induce and maintain sleep without producing residual effect during the day and should be devoid of abuse and dependence potential. Zopiclone is a new hypnotic belonging to the cyclopyrrolone chemical class. Its elimination half-life is 5 to 6 h, no accumulation exists upon repeated administration, and its pharmacokinetic profile is not substantially modified in elderly and renal failure patients. Placebo-controlled studies have shown that zopiclone 7.5 mg is an effective hypnotic, and that it can improve all sleep variables in insomniacs. Its effects on sleep stages differ from those observed with BZD hypnotics: REM sleep is substantially unaffected by zopiclone and slow wave sleep is either unaffected or increased. Objective and subjective measurements during the day after bedtime administration of zopiclone, showed lack of residual effects and no residual impairment of cognitive functions. Zopiclone discontinuation is not accompanied by rebound effect and relevant withdrawal symptoms. Specific "craving effect" studies in alcoholics did not show an abuse potential for zopiclone. Side-effects are represented mainly by bitter taste and dry mouth with a minimal incidence of CNS depressant effects. Studies on the effects of zopiclone on respiratory functions failed to show detrimental effects. Efficacy and safety data on zopiclone suggest that this new drug can represent a useful alternative to existing hypnotics.

Azabicyclo Compounds↗

Intranasal sumatriptan for the acute treatment of migraine. International Intranasal Sumatriptan Study Group.

Two double-blind, placebo-controlled, randomised, multicentre, multinational, parallel-group studies were carried out to identify the optimum dose of intranasal sumatriptan for the acute treatment of migraine. Study medication was taken as a single dose through one nostril in the first study, and as a divided dose through two nostrils in the second study. Totals of 245 and 210 patients with a history of migraine were recruited into the one- and two-nostril studies, respectively. In both studies, headache severity had significantly improved at 120 min after doses of 10-40 mg sumatriptan compared to placebo (P < 0.05) and the greatest efficacy rates were obtained with 20 mg sumatriptan. With 20 mg sumatriptan 78% and 74% of patients experienced headache relief in one- and two-nostril studies respectively. Sumatriptan was generally well tolerated, the most frequently reported event being taste disturbance. The results of the two studies are similar and indicate that administering sumatriptan as a divided dose via two nostrils confers no significant advantage over single-nostril administration.

Acute Disease↗

A randomized, double-blind comparison of sumatriptan and Cafergot in the acute treatment of migraine. The Multinational Oral Sumatriptan and Cafergot Comparative Study Group.

The efficacy and safety of oral sumatriptan as a 100-mg dispersible tablet was compared with oral Cafergot (2 mg ergotamine tartrate, 200 mg caffeine) in a multicentre, randomized, double-blind, double-dummy, parallel-group trial. In the trial, 580 patients were treated from 47 investigating centres in nine European countries. Sumatriptan was significantly more effective than Cafergot at reducing the intensity of headache from severe or moderate to mild or none; 66% (145/220) of those treated with sumatriptan improved in this way by 2 h, compared with 48% (118/246) of those treated with Cafergot (p less than 0.001). The onset of headache resolution was more rapid with sumatriptan, whereas recurrence of migraine headache within 48 h was lower with Cafergot. Sumatriptan was also significantly more effective at reducing the incidence of nausea (p less than 0.001), vomiting (p less than 0.01) and photophobia/phonophobia (p less than 0.001) 2 h after treatment, and fewer patients on sumatriptan (24%) than on Cafergot (44%, p less than 0.001) required other medication after 2 h. The overall incidence of patients reporting adverse events was 45% after sumatriptan and 39% after Cafergot; the difference was not significant. The most commonly reported events in the sumatriptan-treated patients were malaise or fatigue and bad taste; these were generally mild and transient. Nausea and/or vomiting, abdominal discomfort, and dizziness or vertigo were reported by a greater proportion of Cafergot-treated patients. It is concluded that oral sumatriptan was well tolerated and is a more effective acute treatment for migraine than Cafergot.

Administration, Oral↗

Effects of nutrients (in food) on the structure and function of the nervous system: update on dietary requirements for brain. Part 1: micronutrients.

The objective of this update is to give an overview of the effects of dietary nutrients on the structure and certain functions of the brain. As any other organ, the brain is elaborated from substances present in the diet (sometimes exclusively, for vitamins, minerals, essential amino-acids and essential fatty acids, including omega- 3 polyunsaturated fatty acids). However, for long it was not fully accepted that food can have an influence on brain structure, and thus on its function, including cognitive and intellectuals. In fact, most micronutrients (vitamins and trace-elements) have been directly evaluated in the setting of cerebral functioning. For instance, to produce energy, the use of glucose by nervous tissue implies the presence of vitamin B1; this vitamin modulates cognitive performance, especially in the elderly. Vitamin B9 preserves brain during its development and memory during ageing. Vitamin B6 is likely to benefit in treating premenstrual depression. Vitamins B6 and B12, among others, are directly involved in the synthesis of some neurotransmitters. Vitamin B12 delays the onset of signs of dementia (and blood abnormalities), provided it is administered in a precise clinical timing window, before the onset of the first symptoms. Supplementation with cobalamin improves cerebral and cognitive functions in the elderly; it frequently improves the functioning of factors related to the frontal lobe, as well as the language function of those with cognitive disorders. Adolescents who have a borderline level of vitamin B12 develop signs of cognitive changes. In the brain, the nerve endings contain the highest concentrations of vitamin C in the human body (after the suprarenal glands). Vitamin D (or certain of its analogues) could be of interest in the prevention of various aspects of neurodegenerative or neuroimmune diseases. Among the various vitamin E components (tocopherols and tocotrienols), only alpha-tocopherol is actively uptaken by the brain and is directly involved in nervous membranes protection. Even vitamin K has been involved in nervous tissue biochemistry. Iron is necessary to ensure oxygenation and to produce energy in the cerebral parenchyma (via cytochrome oxidase), and for the synthesis of neurotransmitters and myelin; iron deficiency is found in children with attention-deficit/hyperactivity disorder. Iron concentrations in the umbilical artery are critical during the development of the foetus, and in relation with the IQ in the child; infantile anaemia with its associated iron deficiency is linked to perturbation of the development of cognitive functions. Iron deficiency anaemia is common, particularly in women, and is associated, for instance, with apathy, depression and rapid fatigue when exercising. Lithium importance, at least in psychiatry, is known for a long time. Magnesium plays important roles in all the major metabolisms: in oxidation-reduction and in ionic regulation, among others. Zinc participates among others in the perception of taste. An unbalanced copper metabolism homeostasis (due to dietary deficiency) could be linked to Alzheimer disease. The iodine provided by the thyroid hormone ensures the energy metabolism of the cerebral cells; the dietary reduction of iodine during pregnancy induces severe cerebral dysfunction, actually leading to cretinism. Among many mechanisms, manganese, copper, and zinc participate in enzymatic mechanisms that protect against free radicals, toxic derivatives of oxygen. More specifically, the full genetic potential of the child for physical growth ad mental development may be compromised due to deficiency (even subclinical) of micronutrients. Children and adolescents with poor nutritional status are exposed to alterations of mental and behavioural functions that can be corrected by dietary measures, but only to certain extend. Indeed, nutrient composition and meal pattern can exert either immediate or long-term effects, beneficial or adverse. Brain diseases during aging can also be due to failure for protective mechanism, due to dietary deficiencies, for instance in anti-oxidants and nutrients (trace elements, vitamins, non essential micronutrients such as polyphenols) related with protection against free radicals. Macronutrients are presented in the accompanying paper.

Aged↗

Pharmacological management of patients with peptic ulcer disease: prospects for the late 1980's.

Over the past ten years there have been major advances in the physician's ability to treat patients with peptic ulcer disease. Cimetidine continues to be the standard against which newer therapies are generally compared, although ranitidine is equally effective for short-term therapy, more effective for maintenance therapy, and has a superior safety profile. Famotidine is an even more potent H2 receptor antagonist, and initial clinical studies are promising. The initial concern for the development of gastric carcinoid lesions in rodents, maintained for long periods on high doses of omeprazole, defused the initial enthusiasm for this hydrogen-potassium ATPase "proton pump" inhibitor, but recent studies continue to show a marked efficacy of this agent for the short-term care of patients with gastric or duodenal ulcers and for the management of patients with the Zollinger-Ellison syndrome. Sulcrate continues to enjoy wide popularity for acute and chronic care of acid peptic disorders because of its local action and minimal adverse effects. Pirenzepine is effective in achieving and maintaining healing, but prevalence of anticholinergic side-effects has hampered enthusiasm for its widespread use. The 2 forerunners in the prostaglandin analogues arena, misoprostol and enprostil, are antisecretory agents when given in sufficiently high doses. These orally administered prostaglandins have a favourable safety profile, and their only adverse effect is that of the development of transient mild diarrhea. Finally, while antacids continue to be used in large amounts because of their over-the-counter availability, their clinical usefulness is limited by their unpalatable taste and the relatively large amounts usually required to achieve ulcer healing.

Alprostadil↗

Stress and consumption: inescapable shock, neophobia, and quinine finickiness in rats.

Exposure to inescapable shock has been shown to result in reduced consumption of quinine in water (the finickiness effect) in rats. In the present experiment, (a) a clear difference in finickiness occurred between male adult rats exposed to inescapable shock and those exposed to escapable shock (the first such demonstration), (b) finickiness was reinstated 20 days later, and (c) finickiness was eliminated by quinine exposure prior to treatment. The first 2 results support the role of uncontrollability and/or unpredictability in finickiness and extend its potential impact to long-term consequences. This allows greater potential for the modeling of long-term effects, such as eating disorders and depression in humans. The finding that preexposure to quinine eliminated finickiness is contrary to current accounts of the effect. Accounts of finickiness are proposed in terms of classically conditioned aversions, bitterness, and neuropeptide control of ingestion.

Animals↗

A comprehensive analysis of common copy-number variations in the human genome.

Segmental copy-number variations (CNVs) in the human genome are associated with developmental disorders and susceptibility to diseases. More importantly, CNVs may represent a major genetic component of our phenotypic diversity. In this study, using a whole-genome array comparative genomic hybridization assay, we identified 3,654 autosomal segmental CNVs, 800 of which appeared at a frequency of at least 3%. Of these frequent CNVs, 77% are novel. In the 95 individuals analyzed, the two most diverse genomes differed by at least 9 Mb in size or varied by at least 266 loci in content. Approximately 68% of the 800 polymorphic regions overlap with genes, which may reflect human diversity in senses (smell, hearing, taste, and sight), rhesus phenotype, metabolism, and disease susceptibility. Intriguingly, 14 polymorphic regions harbor 21 of the known human microRNAs, raising the possibility of the contribution of microRNAs to phenotypic diversity in humans. This in-depth survey of CNVs across the human genome provides a valuable baseline for studies involving human genetics.

Chromosome Mapping↗

Nasal sumatriptan is effective in treatment of migraine attacks in children: A randomized trial.

OBJECTIVE: To investigate the efficacy of nasal sumatriptan in migraine attacks of children and adolescents. METHODS: A double-blind, placebo-controlled, two-way crossover trial was conducted in three hospital outpatient departments, with 8 to 17 year olds diagnosed with migraine serving as subjects (International Headache Society 1988). A single dose of sumatriptan nasal spray and a matching placebo were administered at home during two attacks. The sumatriptan dose was 10 mg for a body weight of 20 to 39 kg and 20 mg for those with a body weight of >/==" BORDER="0">40 kg. The primary efficacy endpoint was headache relief by two grades on a 5-grade face scale at 2 hours. RESULTS: Eighty-three patients used both treatments and 11 only the first. At 2 hours, the primary endpoint was reached nearly twice as often after sumatriptan (n = 53/83; 64%) as after placebo (n = 32/83; 39%) (p = 0.003). Already at 1 hour, headache relief was seen more often after sumatriptan (n = 42/83; 51%) than after placebo (n = 24/83; 29%) (p = 0.014). The difference was even more obvious in patients who received the 20-mg dose as well as in the intention-to-treat analyses (n = 94). Other endpoints, including child's preference and using rescue medication, also favored sumatriptan. The most common adverse effect was a bad taste after sumatriptan, reported in 29% (n = 26/90) of the attacks. No serious adverse effects were observed. CONCLUSION: Nasal sumatriptan is an effective and well-tolerated treatment for migraine attacks in children over 8 years of age.

Administration, Intranasal↗

[Clinical analysis of trigeminal neuropathy as initial manifestations--an etiological study].

The differential diagnosis of trigeminal neuropathy is quite challenging because there is a significant variety of causes for the disorder. We reviewed our cases of trigeminal neuropathy by studying first the initial manifestations in order to evaluate their underlying disorders. Sixty-four patients with trigeminal neuropathy came to our Out-Patients clinic. We have excluded from our analysis any patients with atypical pain, facial migraine, nasal sinusitis, pain from inflammation of dental pulp or facial bones, and pretrigeminal neuralgia. In 53 cases (83%) we identified the causes; 35 of them were cases of symptomatic trigeminal neuritis and 18 were trigeminal neuralgia while, in the remaining 11 cases, no definitive causative disorder was identified. Among the 35 patients with symptomatic neuritis, 10 cases were found to have malignant neoplasms including 5 cases of squamous cell carcinoma, 6 had a virus infection, 5 had traumatic origin, 4 had multiple sclerosis, 2 exhibited Tolosa-Hunt syndrome, 2 had MCTD, and there were single cases of sarcoidosis, serpentine aneurysm, cavernous sinus thrombosis, maxillary cyst and trigeminal neurinoma. The remaining 11 cases of neuritis whose causes were undetermined showed clinical features similar to trigeminal sensory neuropathy, an analogue of Bell's palsy, a benign self-limiting condition. Since the cases shared symptoms of impairment of taste, and, occasionally, of facial palsy, vestibular insufficiency, hearing disturbance, hypoglossal palsy or signs of cerebellar lesion, we strongly suspected a virus origin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Frequency of self-reported 'anxiolytic withdrawal' symptoms in a group of female students experiencing anxiety.

This study describes the occurrence of self-reported perceptual phenomena in students experiencing anxiety. Phenomena like hypersensitivity to touch, hyposensitivity to taste and smell, and unusual tastes and smells appear to be non-specific and to be closely related to the level of anxiety. They emphasize the need for the development of techniques to elicit perceptual phenomena, and to investigate their occurrence and the intensity of their phenomena in variously defined groups. These also have implications for the assessment of benzodiazepine withdrawal syndromes.

Adult↗

Nutrition problems among home-living elderly people may lead to disease and hospitalization.

Undernutrition is a major problem among hospitalized elderly patients, increasing their morbidity and mortality. Various factors can contribute to the development of reduced nutrition status. In this study, reduced appetite and taste, dental problems, and difficulties in shopping and cooking were common in an elderly population during their last month before hospital admission compared to a reference group of home-living elderly. It is likely that these nutrition habits and disabilities may contribute to reduced nutrition status and increase the need for hospitalization in old people.

Aged↗