Genetic and metabolic factors are associated with increased hepatic iron stores in a selected population of p.Cys282Tyr heterozygotes.

Heterozygosity for p.Cys282YTyr is not ordinarily associated with a hemochromatosis phenotype, unless associated in the compound heterozygous state with other HFE mutations. The aims of the study were to identify factors responsible for iron overload in patients who were only heterozygous for p.Cys282Tyr at first genetic testing. Since 2001, twelve p.Cys282Tyr heterozygous patients with iron overload, defined by increased transferrin saturation, serum ferritin and hepatic iron stores, were identified. Four patients showed rare nonsense or missense HFE mutations in the compound heterozygous state with p.Cys282Tyr. One mutation (p.Gln233X) was never described before. The other 8 patients did not carry any other causal mutations in iron-related genes, but showed a very high prevalence of hepatic steatosis and steato-hepatitis, and metabolic alterations. Serum ferritin levels did not differ between the two groups, but transferrin saturation, hepatic iron amount and distribution significantly did. These last indices should be then strongly considered to decide for additional genetic characterization in p.Cys282Tyr heterozygotes. Our results also highlights the influence of metabolic alterations on serum iron indices and pattern of hepatic iron accumulation.

Changes in personality characteristics in women treated in a therapeutic community.

We examined changes in mood and personality characteristics in a sample of cocaine-dependent women being treated in a therapeutic community (TC). Forty-six women completed the Beck Depression Inventory (BDI), the Hamilton Anxiety Scale (HAM-A), and the Millon Clinical Multiaxial Inventory-II (MCMI-II) on admission and 12 months after discharge from the TC. On admission, the group was characterized by clinically significant scores on the BDI, HAM-A, and the MCMI-II Avoidant, Dependent, Antisocial, Passive-aggressive, Self-defeating, and Borderline scales. On follow-up, significant improvement in functioning was suggested by decreases in scale scores on the BDI, HAM-A, and MCMI-II Avoidant, Dependent, Self-Defeating, and Borderline Scales, but not for the MCMI-II Antisocial and Passive-Aggressive scales. These results suggest substantial positive effects of TC treatment on personality characteristics and functioning, but also indicate that TC treatment may not habilitate all critical personality deficits.

Retaining cocaine-abusing women in a therapeutic community: the effect of a child live-in program.

A clinical trial examined whether retention of cocaine-abusing women in a therapeutic community can be improved by permitting their children to live with them during treatment. Fifty-three women were randomly assigned to either the standard community condition (n = 22), in which children were placed with the best available caretaker, or the demonstration condition (n = 31), in which one or two of the children lived with their mother in the community. Survival analysis distributions indicated that demonstration women remained in treatment significantly longer than standard treatment women. (Mean length of stay was 300.4 days vs 101.9 days, respectively.)

PAR Village for chemically dependent women. Philosophy and program elements.

The authors present a description of PAR Village, a demonstration project designed to examine the question of whether mothers in residential treatment accompanied by their children have better outcomes than those who enter treatment without their children. Issues related to the treatment of women in substance abuse programs are discussed as an introduction to the structure and purposes of the program. Details of the setting, client selection process, and program philosophy are provided. The workings of program services and treatment elements are described and illustrated by a case example.

Benefit-cost analysis of drug abuse prevention programs: a macroscopic approach.

To date, benefit-cost analysis has rarely been used to justify the drug abuse prevention field. However, there is an increasing demand for this type of analysis as the field of substance abuse prevention enters a new phase--a phase characterized by a competitive marketplace, an increased demand for accountability, and the desire to measure return on the money invested in prevention. In response, an effort is made to stimulate discussion and further research on the topic. This article first determines the overall strategy for initiating benefit-cost analysis (BCA), followed by definitions of BCA and cost-effectiveness analysis (CEA). This is followed by the determination of some of the major variables used in BCA along with the algorithm for determining the benefit-cost efficiency ratio (R) as it applies to the macro level analysis. In estimating a value for the R, a decision has been made to incorporate uncertainty into the BCA. In a macroscopic approach to BCA, four independent variables are identified for computing R. These independent and dependent variables are assumed to be random variables with normal distributions. The population means and standard deviations pertaining to these independent variables are estimated from the existing literature. In order to incorporate uncertainty into the computation of R, ten measurements have been randomly selected for each of the four independent variables. Following this procedure, fifteen benefit-cost efficiency ratios are calculated by selecting one of the ten values at random per variable used in the R equation. In this way, we were able to determine the most likely population benefit-cost efficiency ratio of 15:1, indicating that there is a $15 savings on every dollar spent on drug abuse prevention. The 95 percent confidence level pertaining to the R has an interval from $13.7 to $16.1. This indicates that the population R resides within the range 95 percent of the time.

PAR village. Specialized intervention for cocaine abusing women and their children.

Operation PAR in St. Petersburg received National Institute on Drug Abuse support in 1989 and state and local appropriations to establish PAR Village, a research demonstration program for treatment of cocaine abusing women with young children. Adjacent to PAR's residential therapeutic community, it includes 14 housing units and a day-care center for infants and children. Women live with their children while receiving long-term residential care. The program is being systematically evaluated by researchers from the University of South Florida Department of Psychiatry and Behavioral Medicine. Retention in treatment and post-discharge outcomes of the women are compared with those involved in the standard program where children remain in the community with relatives or are placed in foster care. Preliminary results suggest the demonstration program increases retention in treatment.

Ocular dominance stripe formation by regenerated isogenic double temporal retina in Xenopus laevis.

In lower vertebrates such as frogs and fish, long ocular dominance stripes with anterior-posterior (A-P) orientation can be produced by causing both eyes to innervate one optic tectum during the course of development. Similar experiments on adult animals usually produce patches rather than stripes. During development, new retinal fibers from the nasal retina segregate into appropriate stripes at the growing edge of the posterior (P) tectum while new temporal fibers segregate at the non-growing anterior (A) tectal edge. Fiber segregation into long A-P oriented stripes might depend upon a template produced by new nasal fibers initiating stripe orientation in the vicinity of new tectal cells; new nasal fibers would orient to the nascent (posterior) edge of the template while temporal fibers would orient to the anterior (non-growing) end of the template. To test the dependence of stripe formation on the matching of nascent retinal cells with nascent tectal cells, we compared stripe orientation in animals with isogenic double nasal innervation and isogenic double temporal innervation of the tectum. In double nasal innervation, the oldest retinal cells innervate the anterior tectum; new fibers from the entire retinal periphery always innervate the newest tectal cells at the posterior tectum. Stripes are oriented A-P, consistent with a maturation front model. In contrast, the oldest retinal cells innervate the newest (posterior) tectal cells in double temporal innervation of the tectum; the growing retinal periphery innervates the non-growing anterior tectum. Stripes are also oriented A-P, indicating that the production of long stripes does not depend upon maturation front matching of nascent retinal fibers and nascent tectal cells.