Cannabis use predicts shorter duration of untreated psychosis and lower levels of negative symptoms in first-episode psychosis: a South African study

Objective: Cannabis use/abuse is a common co-morbid problem in patients experiencing a first episode of psychotic illness (FEP). The relationship between the clinical presentation of FEP and cannabis abuse is complex and warrants further investigation; especially within the South African context. Method: We tested associations between recent/current cannabis use and duration of untreated psychosis (DUP); age of onset (AO); PANSS-rated (Positive and Negative Syndrome Scale) positive; negative and general psychopathology symptoms and depressive symptoms (Calgary Depression Scale for Schizophrenia) in a sample of 54 patients with FEP. Results: Mean DUP was 34.4 weeks; while mean AO was 24.7 years. Co-morbid cannabis use occurred in 35of the sample and was significantly associated with shorter DUP (Mann-Whitney U; p=0.026). While not significant; there was also a trend association between cannabis use and lower negative symptoms (Mann-Whitney U; p=0.051). Conclusion: Current/recent cannabis use was associated with clinical features of psychosis onset that previously have been associated with better outcome. Medium and long-term outcome for cannabis users however; is likely to depend on whether or not cannabis use is ongoing

Implementation of the Mental Health Care Act (2002) at District Hospitals in South Africa : Translating Principles into Practice

Legislation prior to 2002 tended to reinforce the alienation; stigmatisation and disempowerment of mentally ill patients in South Africa. In line with international develop- ments in mental health legislation; the Mental Health Care Act (2002) was promulgated in South Africa. Its core principles - human rights for users; decentralisation and integration of mental health care at primary; secondary and tertiary levels of care; and a focus on care; treatment and rehabilitation - are progressive and laudable. However; the task of implementing the requirements of the Act at community and district hospital levels is fraught with problems. Lack of infrastructure; inadequate skills and poor support and training undermine its successful implementation.Health workers already burdened with enormous workloads and inadequate resources struggle to manage mentally ill patients at district hospitals. The 72- hour observation is a particular area of difficulty throughout the country. This paper outlines the rationale and sense behind this legislation; discusses the problems encountered at the 'rock face'; and offers solutions to the problem of translating principles into practice

Antioxidant flavonols from fruits, vegetables and beverages: measurements and bioavailability

Flavonols are polyphenolic secondary plant metabolites that are present in varying levels in commonly consumed fruits, vegetables and beverages. Flavonols have long held an interest for nutritionists, which has increased following a Dutch study in the early 1990's showing that dietary intake of flavonols was inversely correlated with the incidence of coronary heart disease. The main factors that have hindered workers in the field of flavonol research are (i) the accurate measurement of these compounds in foods and biological samples, and (ii) a dearth of information on their absorption and metabolism. This review aims to highlight the work of the authors in attempting to clarify the situation. The sensitive and selective HPLC procedure to identify and quantify common flavonols and their sugar conjugates is described. In addition, the results of an on-going screening program into the flavonol content of common produce and beverages are presented. The bioavailability of dietary flavonols is discussed with reference to an intervention study with onions, as well as pilot studies with tea, red wine and cherry tomatoes. It is concluded that flavonols are absorbable and accumulate in plasma and that consuming high flavonol-containing varieties of fruits and vegetables and particular types of beverages could increase their circulatory levels.

Immunoperoxidase localization of fibronectin in small bowel mucosa.

An indirect immunoperoxidase technique was employed to demonstrate fibronectin in cryostat sections of small bowel mucosa. Prior exposure of the sections to a solution of pepsin (4 mg/ml) was not essential to localize antigenicity of fibronectin immunohistologically.