The use of naltrexone to treat ambulatory patients with alcohol dependence

The purpose of this study is to evaluate the efficacy of Naltrexone in decreasing craving symptoms among Puerto Rican male veterans with alcohol dependence. METHOD: This is a double blind placebo control study with a convenience sample of eleven patients divided in two groups (placebo and Naltrexone). Scales consisting of Zung Depression, Zung Anxiety, MMSE, OCD Screener, Craving, and Somatization were administered at baseline, and weekly for four weeks as follow up. RESULTS: There were no statistically significant differences between the two groups on any of the outcome variables at baseline or follow up measurements. A statistical trend was noted toward a decrease in somatization. A decrease in craving symptoms was observed in the experimental group. CONCLUSIONS: Even though our results did not show evidence of the efficacy of Naltrexone in decreasing craving symptoms, a small number of patients did benefit from the medication. The results could have been affected by the small sample size

Spontaneous granulomatous amebic encephalitis: report of four cases from Thailand.

Granulomatous amebic encephalitis (GAE), or meningoencephalitis caused by Acanthamoeba sp and leptomyxid amebae are uncommon CNS infections that usually occur in an immunocompromised host. From 1990 to 1992, 4 patients with GAE were treated at Siriraj Hospital, Bangkok. One case was diagnosed antemortem, from a brain biopsy. The other three cases were diagnosed as GAE postmortem. Pathological findings included acute and subacute granulomatous inflammation with extensive cerebral necrosis, angiitis, fibrinoid necrosis and fibrin thrombi. One patient had a chronic skin ulcer in which free-living amebic trophozoites were found. No visceral involvement was observed. All patients developed "spontaneous" GAE, but we suspect an undiagnosed abnormality in cell mediated immunity or a deficient humoral immune response.