RESUMEN
Background: Although alcohol and nicotine are often used together, the biological consequences of these substances are not well understood. Identifying shared targets will inform cessation pharmacotherapies and provide a deeper understanding of how co-use of alcohol and nicotine impacts health, including biomarkers of stress and inflammation.Objective: We examined the effects of nicotine exposure and withdrawal on alcohol self-administration (SA), stress and inflammatory biomarkers, and a G-protein coupled receptor subunit (Gß) in brain areas associated with drug use.Methods: Male rats were trained to SA alcohol and then received a nicotine pump (n = 7-8 per group). We assessed alcohol intake for 12 days during nicotine exposure and then following pump removal to elicit withdrawal. After the behavioral studies, we assessed plasma leptin, corticosterone, and interleukin-1ß (IL-1ß), and Gß protein expression in the amygdala, nucleus accumbens (NAc), and prefrontal cortex (PFC).Results: Nicotine exposure or withdrawal did not alter alcohol intake (p > .05). Alcohol and nicotine withdrawal elevated corticosterone levels (p = .015) and decreased Gß levels in the PFC (p = .004). In the absence of nicotine, alcohol SA suppressed IL-1ß levels (p = .039). Chronic exposure to nicotine or withdrawal during alcohol SA did not alter leptin levels or Gß expression in the amygdala or NAc (p's > .05).Conclusions: The combination of alcohol SA and nicotine withdrawal produced a persistent increase in stress biomarkers and a suppression in Gß expression in the PFC, providing an important first step toward understanding the common biological mechanisms of alcohol/nicotine misuse.
Asunto(s)
Nicotina , Síndrome de Abstinencia a Sustancias , Ratas , Masculino , Animales , Nicotina/efectos adversos , Leptina/metabolismo , Leptina/farmacología , Leptina/uso terapéutico , Corticosterona/metabolismo , Corticosterona/farmacología , Corticosterona/uso terapéutico , Ratas Wistar , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Corteza Prefrontal , Etanol/efectos adversosRESUMEN
OBJECTIVE: Determine if racial/ethnic disparities exist for access to high-volume surgeons (HVS) for patients with ovarian cancer. METHODS: Retrospective study of ovarian cancer surgeries identified by the California Cancer Registry (CCR) linked to hospital discharge data (1991-2002). Surgeon volume was defined as HVS (>10 ovarian cancer surgeries/year), middle volume (MVS; 2-9/year), and low volume (LVS; =1/year). Multivariate ordered logistic regression predicting surgeon volume provided estimates of relative risk (RR) of surgeon volume by patient race/ethnicity. RESULTS: 13,186 women had ovarian cancer (mean age 57.8 years; 72% non-Hispanic White (NHW), 4% Black, 8% Hispanic). 25% of cases were treated by HVS, 31% by MVS, and 44% by LVS. Compared to NHW, Black (RR: 0.70, p<0.05) and Hispanic women (RR: 0.75, p<0.05) were less likely to have care by a HVS. Hispanic women were significant more likely to have surgery by LVS (RR: 1.1; p<0.05). CONCLUSIONS: Disparities in access to HVS for cancer care exist for minority women. Selective referral to high-volume providers should be considered to improve outcomes among minority women.