ABSTRACT
An evaluation was performed to assess efficacy and resource utilisation of an elective inpatient alcohol detoxification service at a large inner-city teaching hospital. Abstinence rates at 3, 6 and 12 months post-detoxification were 68.1, 44.7 and 36.2%, respectively. Relapse was associated with referrals from acute hospital services, previous detoxifications, longer time between referral and admission for detoxification, presence of alcohol in the blood on the day of admission and requirement for benzodiazepines during withdrawal. The service operates within the national 18-week referral target and runs at a cost substantially lower than that of residential alcohol detoxification facilities but with similar sobriety rates. We demonstrate that elective detoxification with specialist follow-up provides an effective service both in terms of patient outcomes and resource use. Further investment in these services at both local and national level should be considered.
ABSTRACT
BACKGROUND: Although there is a range of different symptoms across neurodegenerative diseases, they have been noted to have common pathogenic features. An archetypal feature shared between these diseases is protein misfolding; however, the mechanism behind the proteins abnormalities is still under investigation. There is an emerging hypothesis in the literature that the mechanisms that lead to protein misfolding may be shared across neurodegenerative processes, suggesting a common underlying pathology. MAIN BODY: This review discusses the literature to date of the shared features of protein misfolding, failures in proteostasis, and potential propagation pathways across the main neurodegenerative disorders. CONCLUSION: The current data suggests, despite overarching processes being shared, that the molecular events implicated in protein pathology are distinct across common neurodegenerative disorders.
ABSTRACT
BACKGROUND: Previous work has shown that ethanol dampens cell growth signals and inhibits smooth muscle proliferation in a restenosis model. Catheter-based approaches to intrapericardial (IPC) delivery of therapeutic agents have been recently demonstrated to be feasible. This study tested the effect of IPC instillation of ethanol on the injury response of overstretched porcine coronary arteries. METHODS: Ethanol, 30%, (E, 10 mL, n = 6) or saline, 0.9%, (C, 10 mL, n = 6) was administered IPC after overstretch injury of porcine coronary arteries. Animals were sacrificed 28 days after balloon dilation. RESULTS: The neointimal and adventitial area were significantly reduced in the E group (0.36 +/- 0.05 mm2; 1.68 +/- 0.09 mm2) as compared to the C group (0.61 +/- 0.05 mm2; 2.61 +/- 0.14 mm2; p < 0.001). The maximal intimal and adventitial thicknesses of the treated vessels were also significantly smaller than those of untreated vessels (0.44 +/- 0.02, 0.38 +/- 0.08 mm vs 0.57 +/- 0.03, 0.54 +/- 0.03 mm, respectively; p < 0.005). The calculated luminal stenosis decreased in the treated group, 16.1%, versus the control group, 25.3%. CONCLUSION: Perivascular administration of a single-dose of ethanol significantly reduce neointimal proliferation in the porcine balloon-overstretch model. This data suggests that intrapericardial delivery of therapeutic agents may be useful and feasible in the coronary angioplasty setting for prevention of restenosis.