Animal models to study plaque vulnerability.

The need to identify and characterize vulnerable atherosclerotic lesions in humans has lead to the development of various animal models of plaque vulnerability. In this review, current concepts of the vulnerable plaque as it leads to an acute coronary event are described, such as plaque rupture, erosion, intraplaque hemorrhage and neovascularization. Recently developed animal models that have attempted to reproduce these concepts are described and evaluated based on their suitability in the study of vulnerable plaques. Although certain features of plaque vulnerability have been reported in animal models, a model encompassing all aspects of the vulnerable plaque is lacking.

Relationship of suicide rates to social factors and availability of lethal methods: comparison of suicide in Newcastle upon Tyne 1961-1965 and 1985-1994.

BACKGROUND: The UK Government's White Paper Saving Lives: Our Healthier Nation included among its targets a reduction in suicide. AIMS: To study causes of change in suicide rate over a 30-year period in Newcastle upon Tyne. METHOD: Suicide rates and methods, based on coroners' inquest records, were compared over two periods (1961-1965 and 1985-1994) and differences were related to changes in exposure to poisions and prescribed drugs, and to socio-demographic changes. RESULTS: Demographic and social changes had taken place which would adversely affect suicide rates. However, a dramatic fall was found in the rate for women, and a modest decline in that for men. Reduced exposure to carbon monoxide and to barbiturates coincided with the fall in rates. CONCLUSIONS: Reduced exposure to lethal methods was responsible for the fall in rate in both genders, while the gender difference in favour of women may be related to their preference for non-violent methods or to their being less affected by the social changes.

Open verdict v. suicide - importance to research.

BACKGROUND: Open verdicts are often included in with suicides for research purposes and for setting health targets. AIMS: To examine similarities and differences in cases defined by the coroner as suicide and open verdicts and the implications of open verdicts for suicide research. METHOD: All cases of open and suicide verdicts recorded in the Newcastle Coroner's Court in the period 1985-1994 were compared on demographic and medical parameters. RESULTS: Open and suicide verdicts had many similarities, differing only in some respects, of which logistic regression identified the most significant to be a suicide note, method used and age. CONCLUSIONS: Open verdicts should be included in all suicide research after excluding cases in which suicide was unlikely. Objective criteria are needed to facilitate comparison between different studies.

The dexamethasone suppression test in bulimia nervosa.

In a study of the dexamethasone suppression test (DST) in patients with bulimia nervosa, a non-suppression rate of about 50% was found. The only clinical correlates of DST non-suppression were a previous history of weight loss and/or of anorexia nervosa. These results suggest that DST non-suppression in these subjects may be a trait rather than a state marker of anorexia nervosa.

A comparison of high- and low-dose lorazepam with amylobarbitone in patients with anxiety states.

A double-blind crossover trial comparing lorazepam at two dosage levels with amylobarbitone supported previous reports of the effective anxiolytic action of the drug. Evaluation of the patients' responses during each week of treatment was based on a physician's weekly rating and on daily self-rating by patients. The results were analyzed by sequential and nonsequential analyses. The main side effect of the drug was drowsiness, which occurred to a clinically significant degree among the high-dose group of patients. The authors emphasize the value of two dosage trials, particularly in devising subsequent flexible individual treatment regimens.