Outcomes following treatment of veterans for substance and tobacco addiction.

Persons who use tobacco in addition to alcohol and other drugs have increased health risks and mortality rates. The purpose of this study was to evaluate the impact of participation in a tobacco cessation program on tobacco, alcohol, and other drug use in a population seeking treatment for substance use disorders (SUDs). Tobacco, alcohol, and other drug use were assessed by urine drug screens, breathalyzer readings, and self-report. Veterans (N=137) with a tobacco use disorder enrolled in inpatient program for the treatment of SUDs at the Salem Veterans Affairs Medical Center participated in tobacco cessation education as part of their treatment programming. Use of tobacco, drugs and/or alcohol was evaluated upon admission, 2 weeks following admission, at discharge and 1 month following graduation. The 1-month follow-up rate was 70.8%, with 97 veterans completing the follow-up assessment. Of those 97 veterans, 90.7% (n=88) reported abstinence from alcohol and 91.8% (n=89) reported abstinence from other drugs of abuse. Fourteen veterans (14.4%) reported abstinence from tobacco at the 1-month follow-up. The veterans reporting abstinence from tobacco use also reported abstinence from alcohol and other drugs at the 1-month follow-up.

Management of schizophrenia with medical disorders: cardiovascular, pulmonary, and gastrointestinal.

Medical illnesses are particularly common in patients who have schizophrenia and one of the major tasks for consultation-liaison psychiatrists, and others, is to determine which medications are safest in which co-morbid condition. The authors review the relative risks for various antipsychotics, especially focusing on cardiovascular, pulmonary, and gastrointestinal co-morbid illnesses. The authors further review the atypical antipsychotics' cardiovascular risks, especially for prolonging QT intervals, in trying to avoid the risk for torsades de pointes. The relative risk for anticholinergic actions for these medicines is also reviewed, as this is especially important in the medically ill or elderly. The authors also review the relative safety of antipsychotics in patients who have liver disease and pulmonary disease. Finally, the authors review specific drug interactions that may be problematic when treating the medically ill with atypical antipsychotics.

Synthesis and characterization of carboxylate complexes of Sn(IV) porphyrin monomers and oligomers.

Most of the porphyrin-recognition chemistry we have investigated previously has centred on kinetically labile metal-ligand interactions, such as Z-N and Ru-N. Our interest in the broader scope of molecular recognition required a metal with the ability to specifically recognise non-nitrogen-based ligands, with a significantly different binding interaction to distinguish it from nitrogen-based analogues. In this report we describe interactions of Sn(IV) porphyrins that bind oxygen-based ligands and for which the Sn(IV)bond;O bond is in slow exchange on the NMR timescale. A series of carboxylate complexes is employed to highlight the structural/geometric features of porphyrin monomers and cyclic oligomers. Where more than one porphyrin unit is present in a molecular scaffold, we report the effect of carboxylate binding on the complex when the two porphyrins contain different metals (typically Sn(IV) and Zn(II)). The unexpected spectroscopic and structural properties of the Sn(2)(9-anthroic acid)porphyrin dimer are also reported.