Specificity of personality relationships to particular forms of concurrent substance use among methadone maintenance therapy clients.

OBJECTIVE: A mainstay treatment for opioid addiction in North America is methadone maintenance therapy (MMT) - a form of opiate agonist therapy (OAT). While efficacious for treating opioid addiction, MMT fails to address the concurrent polysubstance use that is common among opioid dependent clients. Moreover, psychosocial approaches for addressing polysubstance use during MMT are lacking. Our study's goals were to validate the use of the four-factor personality model of substance use vulnerability in MMT clients, and to demonstrate theoretically-relevant relationships of personality to concurrent substance use while receiving MMT. METHOD: Respondents included 138 daily-witnessed MMT clients (65.9% male, 79.7% Caucasian), mean age (SD) 40.18 (11.56), recruited across four Canadian MMT clinics. Bayesian confirmatory factor analysis was used to establish the structural validity of the four-factor personality model of substance use vulnerability (operationalized with the Substance Use Risk Profile Scale [SURPS]) in MMT clients. SURPS personality scores were then used as predictors for specific forms of recent (past 30-day) substance use. RESULTS: Using a latent hierarchal model, hopelessness was associated with recent opioid use; anxiety sensitivity with recent tranquilizer use; and sensation seeking with recent alcohol, cannabis, and stimulant use. CONCLUSION: Personality is associated with substance use patterns and may be an appropriate target for intervention for those undergoing MMT to reduce opioid use, and potentially dangerous concurrent use of other drugs, while receiving methadone.

Evidence that cyclosporine causes both intracellular migration and inappropriate urinary excretion of magnesium in rats.

We determined the effects of cyclosporine on calcium, magnesium, and potassium metabolism in rats. Thirty Sprague-Dawley rats were randomized into three groups of ten animals each--control rats given olive oil, rats given cyclosporine at a dosage of 5 mg/kg daily, and rats given 15 mg/kg daily for four weeks. Urinary excretion of calcium, magnesium, and potassium was determined before and after 2 and 4 weeks of cyclosporine therapy. All rats were sacrificed after 4 weeks of therapy, and calcium, magnesium, and potassium concentrations in serum and tissues were determined. Serum magnesium levels were significantly lower in the cyclosporine-treated groups than in the control group, but there was no significant difference between the control and either of the cyclosporine-treated groups with regard to total urinary excretion of magnesium after four weeks of treatment. Magnesium content in the kidney, muscle, and liver was significantly higher in the 15 mg/kg group than in the control group. Calcium content in the kidney and liver was significantly higher as well. Potassium content in any type of tissue was similar in the three groups. We conclude that the intracellular migration of magnesium plays an important role--as does impaired renal conservation of magnesium--in the pathogenesis of cyclosporine-induced hypomagnesemia and that there is a discrepancy between magnesium and potassium metabolism in cyclosporine-treated rats.

Prospects for reform of hospital fees in sub-Saharan Africa: a case study of Niamey National Hospital in Niger.

Hospital finance in developing countries has attracted increasing attention in recent years as economists and health planners have examined whether financial reforms will make public hospitals more financially autonomous and consequently reduce (or limit the increase in) their share of government health budgets. This paper presents estimates of the effects of some reforms of hospital user fees on total hospital revenue and on the amount of fees paid by patients in various payor categories. The reforms include special fees for non-referred patients and changes in exemptions for some categories of patients and types of care. The estimates show that doubling fees for non-referred patients increases revenue more than charging them prices equal to operating costs, because current fees are not uniformly less than operating costs. Eliminating exemptions can be as important as changing fees. For example, eliminating exemptions for surgery and inpatient diagnostic exams increases the percentage of operating costs recovered by the same amount as doubling prices for non-referred patients in estimates with an elasticity of demand equal to zero.

[A case of hydatid cyst of the mediastinum in the Republic of Niger]. / A propos d'un cas de kyste hydatique du médiastin en République du Niger.

The authors report on an observation made at the Niamey hospital, because of the combined infrequency of both human hydatidosis in western Africa and mediastinal localization of the observed cases.

[Suppurative otitis media, bacteriologic study and therapeutic management]. / Gnoinoe vospalenie srednego ukha, bakteriologicheskie issledovaniia i terapevticheskie vozmozhnosti.

The patients of the ENT clinic at the Gabriel Ture hospital (Bomako, Mali) suffering from otitis media purulenta (96 patients under 70) were examined for pathogenetic agents in their purulent exudate. The infection was found in 96.9% of the samples. Monoflora dominated in 74%, mixed flora in 26% of the examinees. The patients received antibiotics. The antibioticograms proved high effectiveness of gentamycin, colistin, sisomicin and cefatoxin in the treatment of acute and chronic otitis media purulenta.

[Particularities of hearing disorders in inhabitants of Mali]. / Osobennosti narusheniia slukhovoi funktsii u zhitelei Mali.

Audiologic examinations of the Mali people showed that neurosensory hypoacusis was the most common hearing problem, the incidence of which tended to increase. Altogether 147 patients (or 294 ears), aged 10 to 60 years, were examined, the duration of their hearing impairment varying from 1 month to 20 years. In terms of the pathological causes, all the patients were divided into 3 groups: 1) ototoxic antibiotics and quinine, 2) cerebrospinal meningitis, and 3) infectious disease. The patients underwent tonal threshold, suprathreshold and speech audiometry and showed impairment of primarily peripheral type. The prevalence of this type of pathology is indirect evidence that in this country the incidence of vascular pathologies is low and that prophylaxis of infectious diseases is necessary.

[Study of biologically active currents of the external ear in endaural pharmacophysical intervention]. / Issledovanie sostoianiia biologicheski aktivnykh tochek naruzhnogo ukha pri endaural'nom farmakofizicheskom vozdeistvii.

This study demonstrated that biologically active points (BAP) of external ear were sensitive to ultrasonic treatment. In order to identify their characteristics, specific conductivity of tissues in the BAP area was measured (in microamperes) by an Elita 4-PEP unit equipped with a silver probe. Conductivity was measured in five points. Such points as i-feng, er-meng, nei-er were shown to influence the cochleovestibular system and exhibit conductivity of approximately 150 microA. The risk of point hyperactivity increased drastically by the 4th and 13th exposure in response to unilateral endaural pharmacophysical treatment with 0.4 W/cm2 ultrasound. The use of ultrasound of lower intensity (0.05-0.2 W/cm2) helped to avoid this complication. These observations suggest that phonopuncture can constitute a component of endaural pharmacophysical treatment of internal ear.

Analysis of intragenic recombination at wx in rice: correlation between the molecular and genetic maps within the locus.

In plant genomes as well as other eukaryotic genomes, meiotic recombination does not occur uniformly. At the level of the gene, high recombination frequencies are often observed within genetic loci in maize, but this feature of intragenic recombination is not seen at the csr1 locus in Arabidopsis. These observations suggest that meiotic recombination in plant genomes varies considerably among species. In the present study we investigated meiotic recombination at the wx locus in rice. The mutation sites of wx mutants induced by ethyl methanesulfonate (EMS) treatment or gamma-ray irradiation and a spontaneous wx mutant were physically characterized, and the genetic distances between those wx mutation sites were estimated by pollen analysis. Based on these results, the recombination frequency at the wx locus in rice was estimated as 27.3 kb/cM, which was about 10 times higher than the average for the genome, suggesting that there was a radically different rate of meiotic recombination for intra- and intergenic regions in the rice genome.

Pathogenesis of cyclosporine-induced hypomagnesemia.

We studied the pathogenesis of cyclosporine-induced hypomagnesemia in five patients with nephrosis. Serum magnesium concentrations and urinary excretion of magnesium were reduced by the therapy. In contrast, the magnesium concentrations in mononuclear blood cells were increased. We conclude that short-term use of cyclosporine induces an intracellular shift of magnesium and causes hypomagnesemia.

Intracranial calcifications associated with nephrogenic diabetes insipidus.

A 6-year-old boy with nephrogenic diabetes insipidus (NDI) and intracranial calcification is reported. The calcifications were symmetrical and located in the basal ganglia and in the subcortical regions of the frontal, temporal, parietal and occipital lobes. Episodes of hyperosmolality during infancy are considered to be one of the causes of intracranial calcification in NDI. However, other unknown factors may be involved, because up to now there have been no reports of intracranial calcification in patients with central diabetes insipidus.

Magnesium status, serum HDL cholesterol, and apolipoprotein A-1 levels.

To determine the relationship between low magnesium status and lipids, we divided 27 patients with microscopic hematuria and normal renal function into two groups according to magnesium retention, as measured by a magnesium-loading test, and compared their serum lipid and apolipoproteins. Patients with low magnesium status (n = 7) had significantly lower levels of cholesterol, HDL cholesterol, and apolipoprotein A-1 than those with normal magnesium status (n = 20); however, there were no significant differences between the groups in serum concentrations of magnesium and apolipoprotein B. These data suggest that magnesium deficiencies are associated with low serum concentration of HDL cholesterol and apolipoprotein A-1.

Plasma endothelin-1 levels of children with cirrhosis.

We measured plasma concentration of endothelin-1 in three children with Byler's disease, five with biliary atresia after portoenterostomy, and nine controls. No patients had ascites or hepatorenal syndrome. Plasma endothelin-1 levels were significantly higher in patients with Byler's disease than in the controls (5.19 +/- 0.90 versus 1.81 +/- 0.19 pg/ml, respectively; p < 0.01), but were normal in operated biliary atresia. Urinary concentrations of N-acetyl-beta-D-glucosaminidase (NAG) were significantly higher in the patients with Byler's disease than in controls. Plasma endothelin-1 level correlated significantly with serum concentration of bile acid (r = 0.91; p < 0.01) and urinary concentration of NAG (r = 0.92; p < 0.01). We conclude that plasma endothelin-1 levels are high in patients with severe biliary cirrhosis and that endothelin-1 may partially contribute to development of renal injury in cirrhosis.

[2 cases of hydatidosis in the Republic of Niger]. / Deux cas d'hydatidose en République du Niger.

Two cases of hydatidosis have been observed at the hospital of Niamey, one involving the tibia and the other one the liver and the spleen. For unknown epidemiological factors, this helminthiasis is rare in man in western Africa.