Relapses in Illicit Drug Use Among Probationers: Results in a Risk Group of Public Health Services in Bavaria.

Objective: We aimed to identify in this study time trends of relapses in the illicit consumption of narcotics in a special at-risk population of former drug users under a public health perspective. Methods: In a pooled dataset of 14 consecutive calendar years (2006-2019), the use of seven different narcotic substances was studied in 380 persons with a total of 2,928 urine samples which were analyzed using a valid marker system for narcotic residues. Results: During the entire observation period, the relapse rate for cannabinoids and opiates was the highest despite abstinence requirements. It was noticeable that the relapses across all narcotics groups occurred primarily during the first 3 years of the probation period (90%) with a decrease in illegal consumption during the following years of the observation period. Conclusion: Special attention should be paid to probationers at the beginning of the probation period to develop more effective prevention strategies for substance abstinence by all involved actors in public health services.

Detection of two SNPs of the LIPE gene in Holstein-Friesian cows with divergent milk production.

The LIPE gene (lipase E, hormone-sensitive type), also known as hormone-sensitive lipase, acts as a primary regulator of lipid metabolism during lactation in cows. We studied a total of two hundred Holstein-Friesian cows and performed sequencing analysis that revealed two synonymous nucleotide changes within the LIPE gene: a transition change, c.276 T > C in exon 2 (g.50631651 T > C; position 351 of GenBank: ON638900) and a transversion change, c.219C > A in exon 6 (g.50635369C > A; position 1070 of GenBank: ON638901). The observed genotypes were TC and CC for the c.276 T > C SNP and CC and CA for the c.219C > A SNP. Notably, the heterozygous TC genotype of the T351C SNP exhibited a significant association with high milk yield. Furthermore, the T351C SNP displayed significant associations with various milk parameters, including temperature, freezing point, density and the percentages of fat, protein, lactose, solids and solids-not-fat, with the homozygous CC genotype showing higher values. The c.219C > A SNP also demonstrated a significant association with milk composition, with heterozygous genotypes (CA) exhibiting higher percentages of fat, protein, and lactose compared to homozygous genotypes (CC). This effect was consistent among both high and low milk producers for fat and lactose percentages, while high milk producers exhibited a higher protein percentage than low milk producers. These findings highlight the importance of considering the detected SNPs in marker-assisted selection and breeding programs for the identification of high milk-producing Holstein-Friesian cows and potentially other breeds. Moreover, this study strongly supports the fundamental role of the LIPE gene in milk production and composition in lactating animals.

Efficacy of laparoscopically assisted high ligation of patent processus vaginalis in children.

INTRODUCTION: Laparoscopic hernia repairs have been proven to be efficient and safe for children, despite the slightly higher recurrence rate compared with the classic surgical repair. They have the advantage of easy and precise identification of the type of defect and its correction, both in ipsilateral and contralateral sides. OBJECTIVES: The objectives of this study were to evaluate the efficacy, safety and outcome of the laparoscopically assisted piecemeal high ligation of a patent processus vaginalis (PPV) in children. METHODS: A total of 40 children were enrolled into this prospective study; they were aged ≥ 6 months and had an inguinal hernia. The peritoneal cavity, including the contralateral side, was inspected for the possibility of bilateral hernias using a 3-mm 30° telescope. Another 3-mm port was introduced through the same infra-umbilical incision. The hernia was manually reduced or with the aid of a working infra-umbilical grasper. A prolene or vicryl 2/0 or 3/0 suture on a curved semicircle round-bodied taper-ended 25-30 mm needle was introduced through a very small inguinal skin-crease incision. It was passed through the abdominal wall layers to the peritoneum and was manipulated by the laparoscopic grasper to pick up the peritoneum in piecemeal all around the internal ring. The needle was then pushed to the outside near to the entrance site, thus forming a semicircle around the internal ring. The suture was then tied and the knot was subcutaneously buried. The primary outcome of the procedure was the incidence of intraoperative diagnosis and surgical repair of contralateral hernias in pre-operatively diagnosed unilateral cases. The secondary outcomes were defined as the incidence of complications and hernia recurrence. DISCUSSION: The exploratory laparoscopy found contralateral patent processus vaginalis (CPPV) with a detection rate of 28.1%. Chan et al., Esposito et al., Toufique et al. and Niyogi et al. reported similar figures for laparoscopic contralateral hernia detection rates of 28%, 39%, 39.7% and 29.2%, respectively. The limitations of this study were the small sample size, plus the risk factors and clinical significance for CPPV. CONCLUSION: Laparascopically assisted piecemeal closure of the internal inguinal ring in children is a safe and effective procedure. It helps in detecting a contralateral hernia without prolonging the operative time.

Buccal versus lingual mucosal graft urethroplasty for complex hypospadias repair.

OBJECTIVES: To compare surgical outcomes and donor site complications of buccal and lingual mucosa used as ventral onlay graft for complex hypospadias cases. PATIENTS & METHODS: Forty four cases with complex hypospadias after failed previous surgery were prospectively included. All had severely scarred penile skin with reasonable residual urethral plate. Cases were categorized into two groups: Group I (23) where buccal mucosal graft [BMG] was used and group II (21) where lingual mucosal graft [LMG] was used. Donor site complications as well as functional and esthetic outcomes were recorded for each group. RESULTS: Mean follow up was 20.8 months (range 12-24). Average graft harvesting time was 24 min for BMG and 19 min for LMG. Donor site pain was reported with both techniques but recovery was earlier with LMG. Slurred speech and difficult tongue protrusion were reported with lingual but not buccal grafts; however mouth tightness, peri-oral numbness and persistent oral discomfort were reported only with buccal grafts. Successful urethroplasty was obtained in 78.2% of BMG compared to 76.1% of LMG. CONCLUSION: Surgical outcomes of LMG urethroplasty were comparable to those of BMG in complex hypospadias cases. Compared to buccal mucosa, LMG is easy to harvest, with minimal donor site complications.

Characterization of wet granulation process parameters using response surface methodology. 1. Top-spray fluidized bed.

Randomized full-factorial designs (3(2)) were used to investigate the effects of processing conditions in the top-spray fluidized bed (TSFB) on the granulation of acetaminophen powder (USP) using 5% polyvinylpyrrolidone (w/w) as the binder. Measured granule properties included the following: mean size and size distribution, specific surface area, bulk density, tapped density, flow rate through an orifice, angle of repose, residual moisture content, and percent overs (> 2 mm). The granules were then compressed (500, 1000, 1500 lbs) into tablets (9-mm shallow concave) using an instrumented rotary press and analyzed for both physical properties and drug-release characteristics. All experimental batches were run in triplicate to reduce the possibility of erroneous results and to increase the confidence in the resulting empirical relationships derived using response-surface methodology. Measured responses were then related to process parameters using two-factor and three-factor linear, interactions, and quadratic regression models. These models were used to generate three-dimensional response surfaces for use in the final analyses. Coefficients of determination (R2) ranging from 0.08 to 0.81 were obtained, indicating that only a portion of the variation in the data could be explained by the changes in process parameter settings during granulation and tableting. The best overall model fits were observed for mean granule size, size distribution, bulk density, tapped density, percent drug dissolution, tablet disintegration time, and tablet friability.

Studies on the effect of histamine in isolated human pulmonary arteries and veins.

The effect of histamine (0.01-200 microM) was studied in isolated human pulmonary vessels. Histamine induced concentration dependent contractions in both arteries and veins. In veins the maximal response to histamine was lower than in arteries. Histamine and 2-methyl-histamine had a dual action in both arteries and veins clearly demonstrated in vessels precontracted with potassium. In these vessels histamine and 2-methyl-histamine induced relaxation at low concentrations and contractions at high concentrations. Veins were more sensitive to the relaxant effect of histamine than arteries. Mepyramine eliminated the dual action of 2-methyl-histamine and histamine and unveiled a mepyramine resistant relaxation at the highest histamine concentrations used which was resistant to the effect of cimetidine and metiamide. The H2 receptor agonist dimaprit (10-400 microM) induced a slight relaxation in both arteries and veins that could be eliminated by metiamide (100 microM). The results show that histamine has a dual action in human pulmonary vessels which includes a contractile effect mediated via H1 receptors and a relaxant response partly mediated through H1 receptors and partly via unspecific mechanisms. However, an H2 mediated relaxant effect cannot be excluded.

Effects of nifedipine on contractile responses to potassium, histamine, and 5-hydroxytryptamine in isolated human pulmonary vessels.

Isolated human pulmonary arteries and veins cut to ring preparations responded with maximum contractions to potassium (127 mM; K), histamine (90 microM), and 5-hydroxytryptamine (47 microM; 5-HT). Nifedipine (0.003-3 microM) had a concentration-dependent relaxant effect on contractions induced by K, histamine, or 5-HT. The magnitudes of the relaxant effect of nifedipine were equal in arteries and veins, except in the highest concentrations used, in which case the effect was more pronounced on K-induced contractions in veins than in arteries. The effect of nifedipine was less pronounced on contractions induced by histamine or 5-HT than on K-induced contractions, and was more pronounced on histamine- than on 5-HT-induced contractions. In Ca-free medium, the response to K was nearly abolished in both arteries and veins. When the Ca concentration was increased from 0 to 4 mM without nifedipine, the contractile response to K was completely restored, while in the presence of nifedipine the response to extracellular Ca was nearly abolished in both types of vessel. The results indicate that active tone induced by K in pulmonary vessels is dependent on Ca entry from the extracellular medium. Nifedipine has a relaxant effect on both arteries and veins. In both types of vessel contractions induced by histamine or 5-HT are more resistant to the effect of nifedipine than contractions mediated by depolarization.

Effect of guar gum on the dissolution rate of ephedrine hydrochloride and sulphadimidine tablets.

The effect of guar gum as a binder was studied in comparison with other commonly used binders namely: gun acacia, Carbopol 934, sodium carboxymethyl cellulose and Explotab on the disintegration time and the dissolution rate of tablets containing ephedrine hydrochloride and sulphadimidine. The results revealed that the solubility of the drug as well as the concentration and the type of binder affect both the disintegration time and the dissolution rate of the tablet.