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Extent of myocardial infarction and reverse remodeling assessed by cardiac magnetic resonance in patients with and without right bundle branch block following alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Related Articles Extent of myocardial infarction and reverse remodeling assessed by cardiac magnetic resonance in patients with and without right bundle branch block following alcohol septal ablation for obstructive hypertrophic cardiomyopathy. Am J Cardiol. 2007 Feb 15;99(4):563-7 Authors: McCann GP, Van Dockum WG, Beek AM, Nijveldt R, Ten Cate FJ, Ten Berg JM, Van Rossum AC Percutaneous alcohol septal ablation (ASA) is an established technique for the relief of refractory symptoms in patients with obstructive hypertrophic cardiomyopathy. Most subjects develop right bundle branch block (RBBB) after ASA, but it is not known whether these patients have similar infarct characteristics, which may influence left ventricular (LV) pressure gradient reduction and reverse remodeling, compared with those without RBBB. Twenty-seven consecutive patients (15 men, 12 women; mean age 62 +/- 16 years) were studied with electrocardiography and cardiac magnetic resonance imaging at baseline and 1 and 6 months (n = 25) after ASA. Infarct size and location were determined at 1 month by delayed contrast-enhanced cardiac magnetic resonance imaging. The 17 subjects who developed RBBB tended to have larger infarcts (creatine kinase-MB 251 +/- 92 vs 148 +/- 97 IU, p = 0.03; cardiac magnetic resonance imaging mass 22.5 +/- 9.3 vs 16.6 +/- 8.3 g, p = 0.1) and were more likely to have sustained anterior and inferior septal transmural infarctions (9 of 17 vs 1 of 10, p = 0.03) than those without RBBB. Those who developed RBBB had greater LV mass reductions at 6 months (46 +/- 26 vs 29 +/- 13 g, p = 0.04) despite similar reductions in LV pressure gradients (64 +/- 31 vs 56 +/- 32 mm Hg). In conclusion, patients who develop RBBB after ASA tend to have more extensive transmural septal infarctions and greater reverse remodeling than those without RBBB. PMID: 17293204 [PubMed - in process] (Source: The American Journal of Cardiology) Publ.Date : Thu, 15 Feb 2007 07:00:00 +0100 Disrupting brain's stress system intensifies opiate withdrawal Avoiding the severe pain, nausea, agitation, sweats and other symptoms of opiate withdrawal are among the many reasons addicts are motivated to continue taking drugs. Now, researchers have found that disrupting the brain's stress-response mechanism exacerbates behavioral withdrawal symptoms in mice, and that giving the mice the hormone corticosterone alleviates those symptoms. The researchers said their findings suggest new approaches to reduce withdrawal symptoms. [click link for full article] (Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today) Publ.Date : Wed, 21 Feb 2007 02:00:00 +0100 Alcohol redirects cck-mediated apical exocytosis to the acinar basolateral membrane in alcoholic pancreatitis Traffic Volume 0, Issue ja. (Source: Traffic) Publ.Date : Tue, 20 Feb 2007 13:38:15 +0100 Substance use disorder (sud) morbidity versus number of parents with sud. Related Articles Substance use disorder (SUD) morbidity versus number of parents with SUD. Addict Behav. 2007 Apr;32(4):661-74 Authors: Westermeyer J, Yoon G, Thuras P OBJECTIVES: To assess the association between numbers of parents (i.e., 0, 1 or 2) with Substance Use Disorder (SUD) and proband's SUD severity and morbidity. DESIGN: Descriptive, cross-sectional. SETTINGS: Alcohol-drug treatment programs in two university medical centers. SUBJECTS: 597 voluntary patients aged 18 and older with SUD; adoptees excluded. RESULTS: On univariate analysis, parental SUD was associated with ten characteristics. On logistic regression analysis, having any parental SUD was associated with lower socioeconomic status, younger age at using tobacco, more severity on M-SAPS, and lower psychosocial function in the last year (Axis 5) as threshold effects. Logistic regression analysis comparing 1 versus 2 parents with SUD showed that those with 2 SUD parents began using alcohol at an earlier age as compared with having 1 SUD parent; this was an additive effect. CONCLUSIONS: Parental SUD affects the proband's SUD severity in a threshold fashion. PMID: 16875788 [PubMed - in process] (Source: Addictive Behaviors) Publ.Date : Sun, 01 Apr 2007 06:00:00 +0100 A cautionary note regarding count models of alcohol consumption in randomized controlled trials Background: Alcohol consumption is commonly used as a primary outcome in randomized alcohol treatment studies. The distribution of alcohol consumption is highly skewed, particularly in subjects with alcohol dependence. Methods: In this paper, we will consider the use of count models for outcomes in a randomized clinical trial setting. These include the Poisson, overdispersed Poisson, negative binomial, zero-inflated Poisson and zero-inflated negative binomial. We compare the Type-I error rate of these methods in a series of simulation studies of a randomized clinical trial, and apply the methods to the ASAP (Addressing the Spectrum of Alcohol Problems) trial. Results: Standard Poisson models provide a poor fit for alcohol consumption data from our motivating example, and did not preserve Type-I error rates for the randomized group comparison when the true distribution was overdispersed Poisson. For the ASAP trial, where the distribution of alcohol consumption featured extensive overdispersion, there was little indication of significant randomization group differences, except when the Standard Poisson model was fit. Conclusions: As with any analysis, it is important to choose appropriate statistical models. In simulation studies and in the motivating example, the Standard Poisson was not robust when fit to overdispersed count data, and did not maintain the appropriate Type-I error rate. To appropriately model alcohol consumption, more flexible count models should be routinely employed. (Source: BMC Medical Research Methodology - Latest articles) Publ.Date : Thu, 15 Feb 2007 07:00:00 +0100 Traumatic experiences and posttraumatic stress disorders: differences between treatment-seeking early- and late-onset alcoholic patients. Related Articles Traumatic experiences and posttraumatic stress disorders: differences between treatment-seeking early- and late-onset alcoholic patients. Compr Psychiatry. 2007 Mar-Apr;48(2):178-85 Authors: Dom G, De Wilde B, Hulstijn W, Sabbe B Childhood traumatic experiences have been suggested to relate to early-onset alcoholism and to negatively influence the severity and course of alcohol use disorders. Early-onset alcoholic (n = 54) and late-onset alcoholic (n = 65) inpatients were compared as to the severity of their childhood traumatic experiences, prevalence of current and lifetime posttraumatic stress disorder (PTSD), and depressive symptoms. The early-onset alcoholic patients had a higher number and more severe childhood traumatic experiences compared with the late-onset alcoholic patients. More female than male alcohol-dependent patients had lifetime PTSD diagnosis. Finally, specifically within the female alcoholic patients the severity of early childhood experiences was positively associated with the severity of current substance use and related problems. Within early-onset alcoholic treatment-seeking populations, active screening for childhood traumatic experiences and current PTSD is advised in view of treatment planning. PMID: 17292709 [PubMed - in process] (Source: Comprehensive Psychiatry) Publ.Date : Thu, 01 Mar 2007 07:00:00 +0100