Nicotine pre-treatment reduces sensitivity to the interoceptive stimulus effects of commonly abused drugs as assessed with taste conditioning paradigms.

BACKGROUND: Drug pre-exposure attenuates sensitivity to the interoceptive stimulus properties of additional subsequently administered drugs in drug-induced conditioned taste avoidance (CTA) and conditioned place preference (CPP) paradigms. Specifically, nicotine, commonly used in conjunction with other addictive substances, attenuates acquisition of ethanol and caffeine CTAs and morphine-induced CPP. METHODS: Because nicotine use is comorbid with a number of substance use disorders, we systematically examined the effects of nicotine pre-exposure on two different conditioning paradigms involving integration of the interoceptive stimulus properties of multiple commonly abused drugs, in male and female rats, designed to examine both the aversive and reinforcing properties of these drugs. RESULTS: Nicotine dose-dependently interfered with acquisition of CTA to passively administered morphine, ethanol, and cocaine, but not lithium chloride, demonstrating that the effects of nicotine are not simply a matter of reduced orosensory processing or an inability to learn such associations. Moreover, nicotine-treated rats required higher doses of drug in order to develop CTA and did not show increased acceptance of the taste of self-administered ethanol compared with saline-treated rats. CONCLUSIONS: These data demonstrate that nicotine pre-exposure attenuates sensitivity to the stimulus effects of multiple drugs in two conditioning paradigms, in a manner which is consistent with a reduced ability to integrate the interoceptive properties of abused drugs. Through reducing these stimulus properties of drugs of abuse, concomitant nicotine use may result in a need to increase either the frequency or strength of doses during drug-taking, thus likely contributing to enhanced addiction liability in smokers.

Cdh13 and AdipoQ gene knockout alter instrumental and Pavlovian drug conditioning.

Genome-wide association studies in humans have suggested that variants of the cadherin-13 (CDH13) gene are associated with substance use disorder, subjective response to amphetamine, and attention deficit hyperactivity disorder. To examine the role of the Cdh13 and its peptide ligand adiponectin (AdipoQ) in addiction-related behaviors, we assessed Cdh13 knockout (KO) rats and AdipoQ KO mice using intravenous cocaine self-administration and conditioned place preference (CPP) paradigms. During intravenous cocaine self-administration, male Cdh13 heterozygous (+/-) and KO (-/-) rats showed increased cue-induced reinstatement compared with wild-type (WT) rats when presented with a cocaine-paired stimulus, whereas female Cdh13 rats showed no differences across genotype. Cdh13 -/- rats showed higher responding for a saccharin reinforcer and learned the choice reaction time (RT) task more slowly than WTs. However, we found no differences between Cdh13 -/- and +/+ rats in responding for sensory reinforcement, number of premature responses in the RT task, tendency to approach a Pavlovian food cue, CPP and locomotor activation to cocaine (10 or 20 mg/kg). In AdipoQ -/- mice, there was a significant increase in CPP to methamphetamine (1 mg/kg) but not to a range of d-amphetamine doses (0.5, 1, 2 and 4 mg/kg). Taken together, these data suggest that Cdh13 and AdipoQ regulate sensitivity to psychomotor stimulants and palatable rewards without producing major changes in other behaviors. In humans, these two genes may regulate sensitivity to natural and drug rewards, thus influencing susceptibility to the conditioned drug effects and relapse.

Behavioral sensitization to ethanol is modulated by environmental conditions, but is not associated with cross-sensitization to allopregnanolone or pentobarbital in DBA/2J mice.

RATIONALE: The ability of ethanol to facilitate GABA(A) receptor-mediated transmission may result in GABA(A) receptor alterations during repeated ethanol administration, and lead to dynamic behavioral changes, including sensitization to the locomotor stimulant effect of ethanol. Since alterations in GABA(A) receptors are likely to alter sensitivity to GABAergic drugs such as 3alpha-hydroxy-5alpha-pregnan-20-one (allopregnanolone) and pentobarbital, we determined whether enhanced sensitivity to ethanol was associated with enhanced sensitivity (cross-sensitization) to these drugs. Two procedures that produced differences in the magnitude of expression of ethanol-induced locomotor sensitization were used. METHODS: After habituation to testing procedures for 2 days, female DBA/2J mice were injected with ethanol or saline for 12 days. On the following day, locomotion was recorded after a challenge injection of ethanol (2 g/kg), allopregnanolone (10 or 17 mg/kg), or pentobarbital (10 or 20 mg/kg). Due to evidence that exposure to the test chambers influenced sensitization, in some experiments, mice were exposed to the test apparatus on the day prior to challenge. RESULTS: Exposure to the test apparatus prior to drug challenge attenuated the expression of ethanol sensitization, compared with mice without this pre-exposure. Cross-sensitization was not observed to either allopregnanolone or pentobarbital under any condition; however, some groups of repeated ethanol-treated mice displayed tolerance to the initial stimulant effects of allopregnanolone and pentobarbital. CONCLUSIONS: These studies indicate that behavioral sensitization to ethanol is not associated with cross-sensitization to pentobarbital or allopregnanolone, and that the expression of ethanol sensitization is influenced by the relative novelty of the test chamber. In addition, these results do not support a mechanism in which alterations in the neurosteroid or barbiturate modulatory sites of the GABA(A) receptor are responsible for the expression of sensitization to the locomotor stimulant effects of ethanol.

Naltrexone alteration of acute smoking response in nicotine-dependent subjects.

There are mixed results on the effects of opioid antagonists on acute nicotine response in humans. The present study examined the effects of a single dose of 50 mg oral naltrexone relative to placebo on smoking response in 22 chronic smokers during short-term nicotine abstinence, after acute smoking and subsequent smoking deprivation, and on smoking behavior in a choice paradigm. The results showed that naltrexone significantly reduced immediate postcigarette ratings of smoking craving and desire to smoke and increased light-headedness, dizziness, and head rush (ps < 0.05). Reductions in craving and smoking desire persisted during a subsequent 1 h nonsmoking interval. Naltrexone also was found to significantly reduce the total number of cigarettes smoked in the choice interval, which was supported by objective measures of both reduced CO and plasma nicotine levels (ps < 0.01). Exploratory analyses on potential individual difference factors revealed that smokers with the highest levels of craving during abstinence showed the most pronounced naltrexone attenuation of smoking response. The results support the continued exploration of naltrexone as an adjunct to smoking cessation, especially in identified smoker subgroups most sensitive to the effects of opioid antagonism.

The role of the clinical nurse specialist and the nurse manager in case management.

Nursing case management was introduced into the acute care hospital as an approach to counteract the numerous changes occurring in the healthcare environment negatively affecting patient care. The authors address the development of case management at Bergan Mercy Medical Center, Omaha, Nebraska, and the integration of the nurse manager and clinical nurse specialist into this model.

Plastics from household waste as a source of heavy metal pollution. An inventory study using INAA as the analytical technique.

An inventory study to the levels of cadmium in the plastic component of household waste was carried out utilizing INAA as the analytical technique. In a 2-h irradiation, 2-d decay, and 1-h measurement, protocol adequate sensitivities could be obtained for Cd, but also for a group of other metals: Cr, Co, Ni, Cu, Sr, Zn, As, Se, Mo, Sn, Sb, Ba, and Hg. Red-, orange-, and yellow-colored plastics either contain Cd at high levels (over 1000 mg/kg) or have relatively low Cd concentrations (less than 50 mg/kg). High concentrations were also occasionally found for Sr, Se, Ba, Sb, and Hg. INAA appeared very well to be routinely usable for such analysis because of the absence of a destruction step, adequate sensitivity, high accuracy, and multielement results.

Efficacy of tests used to monitor rheumatoid arthritis.

The relative efficacy of clinical and laboratory tests used to monitor disease activity in rheumatoid arthritis was determined by consensus analysis in a study of 21 patients treated for 6 months. Erythrocyte sedimentation rate (ESR), which is influenced by the anaemia of chronic disease and by variation in the blood concentration of acute-phase proteins, was the most effective single test. ESR was a better guide to disease severity than measurement of plasma viscosity, serum C-reactive protein, and serum orosomucoid--tests that reflect the blood concentration of acute-phase proteins only. Clinical tests performed poorly unless combined with laboratory data in a numerical index. Consensus analysis can be used to assess the efficacy of clinical and laboratory tests and to identify redundant tests.

Evaluation of sealed vacuum extraction method (Seditainer) for measurement of erythrocyte sedimentation rate.

A sealed vacuum extraction method (Seditainer) for determining the erythrocyte sedimentation rate (ESR) was compared with the standard Westergren ESR technique. The Seditainer method was particularly easy to use, showed acceptable precision, reduced the biohazard risk to laboratory staff and, on storage of sealed blood specimens for 24 hours at 4 degrees C, gave ESR values that had decreased by a mean of only 1.9% (95% CI + 0.2 to -4.0%). Seditainer tubes are shorter (100 mm) than Westergren tubes (200 mm) and this reduced test sensitivity at ESR values above 55 mm/first hour. After application of the manufacturer's correction formula to adjust for tube length there was improved correlation (n = 150, r = 0.936, p less than 0.001), but still considerable scatter, between the Seditainer and Westergren results. Seditainer ESR values above 55 mm/first hour should therefore be regarded as semiquantitative. This vacuum extraction method offers a simple and safe technique for measuring the ESR and specimens can be stored overnight at 4 degrees C.