Effects of repeated-dose isradipine on the abuse liability of cocaine.

Despite preclinical studies suggesting that isradipine may antagonize the abuse liability of cocaine, pretreatment with sustained-release isradipine did not reduce euphoric mood in cocaine-using volunteers. This double-blind, within-subject, crossover laboratory study determined whether maximal dose-loading with isradipine could antagonize effects of cocaine in 12 cocaine-dependent research volunteers administered intravenous cocaine doses (0, 0.325, and 0.65 mg/kg) on different days after 5 days of treatment with isradipine or placebo. Isradipine dose was 30 mg sustained release nightly plus 15 mg immediate release 2 hr before cocaine infusion. Cocaine produced dose-related increases in cocaine's subjective effects and a behavioral measure of reinforcement. Isradipine enhanced, rather than antagonized, subjective effects, indicating that isradipine does not antagonize cocaine's abuse liability in dependent research volunteers.

Hormone replacement therapy, cancer, controversies, and women's health: historical, epidemiological, biological, clinical, and advocacy perspectives.

Routine acceptance of use of hormone replacement therapy (HRT) was shattered in 2002 when results of the largest HRT randomised clinical trial, the women's health initiative, indicated that long term use of oestrogen plus progestin HRT not only was associated with increased risk of cancer but, contrary to expectations, did not decrease, and may have increased, risk of cardiovascular disease. In June 2004 a group of historians, epidemiologists, biologists, clinicians, and women's health advocates met to discuss the scientific and social context of and response to these findings. It was found that understanding the evolving and contending knowledge on hormones and health requires: (1) considering its societal context, including the impact of the pharmaceutical industry, the biomedical emphasis on individualised risk and preventive medicine, and the gendering of hormones; and (2) asking why, for four decades, since the mid-1960s, were millions of women prescribed powerful pharmacological agents already demonstrated, three decades earlier, to be carcinogenic? Answering this question requires engaging with core issues of accountability, complexity, fear of mortality, and the conduct of socially responsible science.

Community readiness to prevent intimate partner violence in Bexar County, Texas.

The purpose of this article is to describe the Community Readiness Model implemented by the San Antonio Safe Family Coalition in Bexar County, Texas, a coordinated community response to prevent intimate partner violence. The project used a participatory action process to (a) determine the city's and county's stage of readiness to prevent intimate partner violence; (b) identify differences in the city and county by dividing the area into sectors for the assessment; (c) engage the community in determining the accuracy and usefulness of the results of the assessment; (d) develop targeted strategies to move the city and county to a higher stage of readiness for prevention of intimate partner violence; and (e) evaluate the results of the project.

Gene family phylogenetics: tracing protein evolution on trees.

How have proteins taken on the remarkable diversity of biochemical and physiological functions necessary to create and maintain complex organisms? The majority of proteins are organized hierarchically into families and superfamilies, reflecting an ancient and continuing process of gene duplication and divergence. The techniques of molecular phylogenetics, developed to recover the nested hierarchy of taxa from character information in their gene sequences, can also reconstruct the evolutionary relationships among genes and provide a conceptual foundation for comparative evolutionary analysis of proteins and their functions. In this review, I outline the application of phylogenetic approaches to issues in gene family studies, beginning with the inference of phylogeny and the assessment of the two types of homology by which genes in a family can be related: orthology (common descent from a cladogenetic event) and paralogy (common descent from a gene duplication event). I show how the phylogenetic approach makes possible novel kinds of comparative analysis, including detection of exon shuffling, reconstruction of the evolutionary diversification of gene families, tracing of evolutionary change in protein function at the amino acid level, and prediction of structure-function relationships. A marriage of the principles of phylogenetic systematics with the copious sequence data being generated by molecular biology and genomics promises unprecedented insights into the nature of biological organization and the historical processes that created it.

Increasing physician impact on the prevention of domestic violence.

Physicians in their professional organizations have recognized the tremendous toll of domestic violence on the safety and health of their patients. Effective integration of screening and referral into routine practice has encountered many significant barriers, primarily the syndrome of compassion fatigue. This article describes how physicians can enhance the safety of families. Universal education offers more opportunities for physicians to communicate with survivors and perpetrators of violence. Specific documentation by physicians will enhance patient care and public health surveillance efforts. Safety planning skills offer immediate benefits to patients facing acute dangers. The participation of physicians (individually and collectively) on adult intentional fatality review boards will make available more specific data and tools for the prevention of domestic violence.

Jugando con fuego; incineración de residuos peligrosos

Los datos disponibles indican que las incineradoras de residuos peligrosos emiten al medio ambiente residuos químicos sin quemar, metales y productos derivados de una combustión incompleta, tanto en sus emisiones gaseosas como en sus residuos sólidos y líquidos. Entre dichas sustancias se encuentran productos sumamente tóxicos, persistentes y bioacumulativos (p.ej. dioxinas cloradas, furanos y PCBs) que se consideran actualmente contaminantes globales del medio ambiente, la cadena alimenticia y los tejidos y fluídos humanos, incluyendo leche materna

Jugando con fuego; incineración de residuos peligrosos

Los datos disponibles indican que las incineradoras de residuos peligrosos emiten al medio ambiente residuos químicos sin quemar, metales y productos derivados de una combustión incompleta, tanto en sus emisiones gaseosas como en sus residuos sólidos y líquidos. Entre dichas sustancias se encuentran productos sumamente tóxicos, persistentes y bioacumulativos (p.ej. dioxinas cloradas, furanos y PCBs) que se consideran actualmente contaminantes globales del medio ambiente, la cadena alimenticia y los tejidos y fluídos humanos, incluyendo leche materna

A Retrospective Study of Maintenance Electroconvulsive Therapy in a University-Based Psychiatric Practice.

We reviewed the log book of our university-based electroconvulsive therapy (ECT) service for the years 1981 to 1987. We identified 10 patients treated with monthly maintenance electroconvulsive therapy (ECT-M). These 10 patients received 3% of the ECT treatments given in this 7 year period. The review of their charts suggests that ECT-M is generally reserved for patients who are older (i.e., over 60 years of age), suffering from delusional depression and/or depressive pseudodementia, and have a history of poor response or tolerance to medications but good response to ECT. The patients had fewer hospitalizations in the 18 months after initiating ECT-M than during the 18 months preceding ECT-M (mean of 3.1 vs. 0.3, respectively, p < 0.001). However, this apparent efficacy of ECT-M may be confounded by the concurrent use of medication. A review of the literature reveals only descriptive studies on ECT-M and shows that our data are congruent with these published studies. The relative value of maintenance ECT and its specificity remain unknown. Its apparent impact on hospitalization rates and safety warrant controlled trials.