Young people, alcohol, and designer drinks: quantitative and qualitative study

OBJECTIVE

To examine the appeal of "designer drinks" to young people.

DESIGN

Qualitative and quantitative research comprising group discussions and questionnaire led interviews with young people accompanied by a self completion questionnaire.

SETTINGS

Argyll and Clyde Health Board area, west Scotland.

SUBJECTS

Eight groups aged 12-17 years; 824 aged 12-17 recruited by multistage cluster probability sample from the community health index.

RESULTS

Young people were familiar with designer drinks, especially MD 20/20 and leading brands of strong white cider. Attitudes towards these drinks varied quite distinctly with age, clearly reflecting their attitudes towards and motivations for drinking in general. The brand imagery of designer drinks-in contrast with that of more mainstream drinks-matched many 14 and 15 year olds' perceptions and expectations of drinking. Popularity of designer drinks peaked between the ages of 13 and 16 while more conventional drinks showed a consistent increase in popularity with age. Consumption of designer drinks tended to be in less controlled circumstances and was associated with heavier alcohol intake and greater drunkenness.

CONCLUSIONS

Designer drinks are a cause for concern. They appeal to young people, often more so than conventional drinks, and are particularly attractive to 14-16 year olds. Consumption of designer drinks is also associated with drinking in less controlled environments, heavier drinking, and greater drunkenness. There is a need for policy debate to assess the desirability of these drinks and the extent to which further controls on their marketing are required.

Apoptosis through CD95 (Fas/APO-1), but not a CD40/CD95 chimeric receptor, is inhibited by phorbol-12-myristate-13-acetate

CD95 (Fas/APO-1)-mediated apoptosis appears to be regulated by positive and negative signaling molecules. A human CD40/CD95 chimeric receptor was stably transfected into CD95-expressing human Jurkat T cells, and signaling through native and chimeric CD95 was compared in the same cell type to assess contributions of the CD95 extracellular and intracellular domains. Apoptosis was induced in these transfectants by soluble CD40 ligand and also by the anti-CD40 monoclonal antibodies (mAb) M2 and M3. The M2 mAb was more effective than M3 in these transfectants. In contrast to apoptosis mediated through native CD95, CD40/CD95-mediated apoptosis was not inhibited by phorbol-12-myristate-13-acetate (PMA). The apoptotic response to the anti-CD40 mAb M3, but not M2, was enhanced by PMA and dibutyryl cyclic adenosine monophosphate (db-cAMP), which also increased mRNA levels and surface expression of CD40/CD95. The enhancing effects of PMA, but not those of db-cAMP, were sensitive to cycloheximide. The M2 and M3 mAbs appeared to have virtually identical binding affinities but, when added to cells together, M3 inhibited M2-induced apoptosis. These mAbs may bind neighboring epitopes, but M2 induces a more effective signaling-competent conformation upon the chimeric receptor. These data suggest that dimerization, however only in a signaling-competent conformation, was sufficient to induce apoptosis. When expressed as a chimera with the CD40 extracellular domain, the CD95 intracellular domain was not inhibited by protein kinase C (PKC)-dependent pathways, suggesting that the CD95 extracellular domain is required for association with a molecule that inhibits the apoptotic signal.

Protein expression of the epsilon subspecies of protein kinase C ceases as Swiss 3T6 fibroblasts increase in cell density even though message for the protein is still present

We have noted previously that growth of C6 glioma cells from low cell density to confluency and quiescence in serum is accompanied by changes in protein content of different protein kinase C (PKC) subspecies. Here we show that the same occurs as non-contact-inhibiting Swiss 3T6 fibroblasts grow to high density in the presence of serum. Protein expression of PKC subspecies alpha and delta increases as the cells increase in density while that of PKC-zeta remains the same. Unusually, protein expression of PKC-epsilon is completely down-regulated as cells grow beyond about 50% confluency and no PKC-epsilon protein can be detected in 3T6 fibroblasts at high density by Western blotting. However, mRNA for PKC-epsilon is expressed at all stages of fibroblast growth as revealed by RT-PCR. When high-density 3T6 fibroblasts are passaged to low density in fresh medium, re-expression of PKC-epsilon protein is observed within 15 min and becomes down-regulated again as cells become more dense. This very rapid synthesis of PKC-epsilon is not blocked by the transcription inhibitor actinomycin D but is inhibited by cycloheximide. PKC-epsilon has some characteristics of a novel 'early response' protein whose synthesis in newly passaged 3T6 cells is regulated at the translational level.

Women Who are Older and Access to Medication Information

Concern regarding a lack of research into the experiences with medication of women who are older, led to the development of a three stage project to investigate this topic. Stage 1 (reported here) interviewed mobile, independently living women of 60 years and over in two community settings in Adelaide, in order to gain their stories regarding access to medication information, relationships with health professionals, self perceptions of well-being and social networks. Half of the 40 women interviewed had sought information regarding their medication from doctors or pharmacists and it was evident that some women made their own independent decisions regarding the taking of prescribed medication. Despite some fairly debilitating health conditions, all women referred very positively to both perceived well-being and active social networks. Some preliminary suggestions are made regarding improved access to information for these women.

Driving with an internal defibrillator: legal, ethical, and quality-of-life issues

Patients with internal cardioverter-defibrillators experience many issues after implantation. One issue is operating a motor vehicle. This issue has many ethical, legal and quality-of-life concerns that must be addressed by the patient, health care providers, and society. The legal and ethical issues surrounding patients with internal cardioverter-defibrillators will be explored using an ethically based theoretical framework.

Evaluation plan for a cardiological multi-media workstation (I4C project)

The goal of the I4C project (Integration and Communication for the Continuity of Cardiac Care) is to build a multi-media workstation for cardiac care and to assess its impact in the clinical setting. This paper describes the technical evaluation plan for the prototype.

The nurse's role in clinical trials

Parkinson's disease (PD) is a chronic and progressive degenerative disorder of the central nervous system characterized by tremor, rigidity, slowness of movement (bradykinesia) and postural abnormalities. The cause is unknown, but the pathology shows that dopamine is profoundly reduced in the basal ganglia of patients with PD. When dopamine is replenished by the administration of levodopa, most of the symptoms of parkinsonism are reduced significantly. Levodopa is considered to be the most reliable and effective symptomatic drug treatment for keeping patients autonomous and functionally independent for as long as possible.

Functional comparison of spleen dendritic cells and dendritic cells cultured in vitro from bone marrow precursors

We have compared dendritic cells (DC) isolated from mouse spleen, or generated in vitro from bone marrow (BM) precursors cultured in granulocyte macrophage-colony stimulating factor (GM-CSF) and interleukin-4 (IL-4), for the ability to process and present soluble antigen and stimulate major histocompatibility complex (MHC) Class II-restricted T cells. DC from spleen or BM cultures were equally able to stimulate the in vitro proliferation of allogeneic T cells or of antigen-specific T-cell receptor (TCR)-transgenic T cells. Both DC populations also induced comparable levels of IL-2 secretion by a T-cell hybridoma. Therefore, splenic and BM-derived DC express comparable levels of (Antigen + MHC Class II) ligands and/or costimulatory molecules and have comparable ability to stimulate T-cell responses. When presentation of a native protein antigen, rather than peptide, was evaluated, BM-derived DC were at least 50 times better than splenic DC at stimulating the proliferation of TCR-transgenic T cells. The antigen processing ability of the two populations was similar only when splenic DC were used immediately ex vivo. Therefore, unlike spleen DC, BM-derived DC maintain the capacity to process protein antigen for MHC Class II presentation during in vitro culture. Due to these characteristics, BM-derived DC may represent a useful tool in immunotherapy studies, as they combine high T-cell stimulatory properties with the capacity to process and present native antigen.

Ribavirin treatment for patients with chronic hepatitis C: results of a placebo-controlled study

BACKGROUND/AIMS

Small, uncontrolled studies of ribavirin for patients with chronic hepatitis C have reported efficacy in chronic hepatitis C. We have evaluated the efficacy and safety of a 24-week course of oral ribavirin in patients with chronic hepatitis C, compared to placebo.

METHODS

A total of 114 patients were randomised to ribavirin or placebo. Ribavirin was administered in doses of 1000 or 1200 mg/day for 24 weeks. Efficacy was determined in the intention-to-treat population: 76 received ribavirin and 38 placebo.

RESULTS

Ribavirin was significantly more effective than placebo in reducing and normalising serum ALT levels: 42/76 (55%) of ribavirin-treated patients vs 2/38 (5%) placebo recipients had either normalisation of the ALT levels or a reduction from baseline of at least 50% (p < 0.001). ALT levels were normal in 22/76 (29%) of ribavirin-treated patients vs 0/38 placebo recipients (p < 0.001). Twenty-four weeks after stopping ribavirin, the majority of patients had abnormal ALT levels. There was no difference between the treatment groups in reduction or disappearance of HCV-RNA levels. HCV RNA disappeared during treatment in 3% of ribavirin-treated patients and 3% of placebo recipients. More ribavirin than placebo patients showed improvement in total Knodell score (45% vs 31%), but these differences were not statistically significant. Analysis of each component of a histology activity index revealed no statistically significant differences between treatment groups. Ribavirin patients had fewer lymphoid aggregates than did placebo recipients at the post-treatment assessment (p = 0.05). Ribavirin was associated with reversible haemolytic anaemia: a fall in haemoglobin occurred in 3% of placebo- and 32% (25/78) of ribavirin-treated patients, respectively (p < 0.001).

CONCLUSIONS

These data indicate that ribavirin was no more effective than placebo in reducing or eliminating HCV-RNA levels, and was not significantly more effective than placebo in improving hepatic histology after 6 months of treatment. The role of a 6-month treatment of chronic hepatitis C with ribavirin alone, without a significant effect on HCV RNA, is therefore limited.

Two-Day Hydrophobic Grid Membrane Filter Method for Yeast and Mold Enumeration in Foods Using YM-11 Agar: Collaborative Study

Twenty laboratories participated in a collaborative study to validate a 2-day hydrophobic grid membrane filter method using YM-11 agar for enumeration of yeast and mold in foods. Six naturally contaminated food products were included in the study: garlic powder, raw ground beef, walnuts, flour/meal, orange juice, and yogurt. The test method produced significantly higher results than the 5-day pour plate reference method for orange juice and significantly lower, though numerically similar, results for walnuts and yogurt. Differences between the test and reference methods were not significant for garlic powder, raw ground beef, or flour/meal. Repeatability and reproducibility were similar for both the test and reference methods in all cases. The hydrophobic grid membrane filter method for enumeration of yeast and mold in foods has been adopted by AOAC INTERNATIONAL.

Broad spectrum antiemetic effects of CP-122,721, a tachykinin NK1 receptor antagonist, in ferrets

The potent, selective, tachykinin NK1 receptor antagonist, CP-122,721 ([(+)-(2S,3S)-3-(2-methoxy-5-trifluoromethoxybenzyl)amino-2- phenylpiperidine]), at 0.01-1 mg/kg, s.c. reduced retching and vomiting elicited by loperamide, copper sulfate, ipecac syrup and cisplatin in a dose-dependent manner. ID50 values after subcutaneous administration ranged from 0.02 mg/kg (loperamide) to 0.08 mg/kg (ipecac). Oral CP-122,721 reduced cisplatin-induced emesis with an ID50 of approximately 0.08 mg/kg. The less active (2R, 3R)-enantiomer, CP-132.687, did not significantly suppress retching or vomiting induced by any of the emetogens. These data support the hypothesis that CP-122,721 blocks emesis by a specific action at tachykinin NK1 receptors. Its broad spectrum of antiemetic activity suggests a central site of action.

Audit of the outcome of peptic ulcer disease diagnosed 10 to 20 years previously

METHODS/AIMS: During 1993-1994 an audit of the outcomes of a consecutive series of peptic ulcer patients, first diagnosed endoscopically between 1972-1983, was carried out. Three hundred and thirty six patients fitting the entry criteria were identified, 46 had died in the interval, and 44 were lost to follow up, leaving 246 available for evaluation. All patients completed questionnaires on their current symptomatic state, drug treatment, and details of any operations they had undergone since their original diagnosis. In addition they were asked to indicate, on an analogue scale, their overall assessment of how their ulcer problem was affecting them at the time of the review. Where available hospital records were obtained and analysed for any further admissions and the results of any further endoscopies.

RESULTS

Of the 246 patients, 158 were men and 88 female. Duodenal ulcers (DU) were present in 204 and gastric ulcers (GU) in 51 (nine had both a DU and GU). Since the diagnosis 65 patients had undergone surgical treatment: 44 for poor ulcer control, nine for pyloric stenosis, nine for a perforation, one for a major gastrointestinal bleed, and two for a gastric carcinoma developing within two years of the diagnosis of a GU. The overall incidence of ulcer complications during this follow up period (excluding the carcinomas) was 7.7%. Initial medical treatment was with histamine H2 blockade in 234 patients--87.4% cimetidine (C) and 11% ranitidine (R)--with other agents in the remainder. At follow up 176 patients were still receiving medical treatment (C, 71%: R, 22%, other, 7%) including 30 who had previously undergone a definitive surgical procedure. Dyspeptic symptoms were recorded in 50.4% of the patients, abdominal pain being the commonest complaint. There was a significant relation between abdominal pain and the analogue scores provided by the patients with significantly more (p = 0.02) of those who had undergone surgical treatment recording this as a continuing problem (44.6% v 36%).

CONCLUSION

There is no evidence provided by this study that, in these patients, their ulcer disease is undergoing spontaneous remission with time.

Insulin translocates PKC-epsilon and phorbol esters induce and persistently translocate PKC-beta 2 in BC3H-1 myocytes

Initial studies suggested that insulin increases diacylglycerol and activates protein kinase C (PKC) in BC3H-1 myocytes. In these earlier studies, insulin was found to translocate PKC-beta, but the presence of PKC-epsilon was not appreciated. More recently, the presence of PKC-epsilon was documented, but PKC-beta was not detected, and it was questioned whether insulin activates PKC in BC3H-1 myocytes [Stumpo, D.J., Haupt, D.M. and Blackshear, P.J. (1994) J. Biol. Chem. 269:21184-21190]. We questioned whether insulin translocates PKC-epsilon in BC3H-1 myocytes, and re-evaluated the question of whether myocytes truly contain a PKC-beta isoform whose existence can be verified by its response to phorbol ester treatment. We found that PKC-epsilon was acutely translocated by insulin and phorbol esters from the cytosol to the membrane fraction in BC3H-1 myocytes; in addition, PKC-epsilon, like PKC-alpha, was depleted by chronic phorbol ester treatment. We also found that BC3H-1 myocytes containing a 76,000 Mr PKC-beta isoform that is acutely translocated and subsequently depleted by phorbol esters. Moreover, chronic phorbol ester treatment induced an 84,000 Mr PKC-beta 2 isoform that appeared to be persistently translocated and activated, as suggested by studies of myristoylated arginic-rich C kinase substrate (MARCKS) phosphorylation. We conclude that: (1) insulin acutely translocates PKC-epsilon, as well as PKC-beta, in BC3H-1 myocytes; and (2) PKC-beta is not truly downregulated by phorbol esters in BC3H-1 myocytes.

Characterization of CP-122,721; a nonpeptide antagonist of the neurokinin NK1 receptor

CP-122,721 [(+)-(2S,3S)-3-(2-methoxy-5-trifluoromethoxybenzyl)amino-2 -phenylpiperidine] interacts with high affinity (pIC50 = 9.8) at the human NK1 receptor expressed in IM-9 cells. In the presence of CP-122,721, there was a reduction in Bmax of [125I]BH-SP binding with no change in affinity suggesting that CP-122,721 does not interact with the NK1 receptor in competitive manner. In an in vitro functional assay. CP-122,721 blocked SP-induced excitation of locus ceruleus cells in guinea pig brain slices with a IC50 value of 7 nM. In vivo, CP-122,721 potently blocked plasma extravasation in guinea pig lung elicited by aerosolized capsaicin (1 mM) with an ID50 = 0.01 mg/kg, p.o. Orally administered CP-122,721 antagonized Sar9, Met (O2)11-SP-induced locomotor activity in guinea pigs with an ID50 = 0.2 mg/kg suggesting good entry into the central nervous system. In addition, consistent with insurmountable blockade observed in vitro, CP-122,721 (0.01, 0.03 0.3 mg/kg, p.o.) produced a rightward shift in the dose response curve for SP-induced hypotension in the awake dog that was accompanied by a decrease in the maximal response. Thus, in vitro and in vivo CP-122,721 appears to behave functionally as a non-competitive antagonist producing an insurmountable blockade of the actions of SP.

Enteroaggregative Escherichia coli heat-stable enterotoxin is not restricted to enteroaggregative E. coli

Enteroaggregative Escherichia coli (EAggEC) have been implicated as diarrheal pathogens in several settings. Some EAggEC produce a distinct heat-stable enterotoxin named EAST1. The distribution and prevalence of the EAST1 gene in selected groups of bacterial enteropathogens were determined by colony hybridization. One hundred percent of 75 O157:H7 enterohemorrhagic E. coli (EHEC), 41% of 227 EAggEC, 41% of 149 enterotoxigenic E. coli, 22% of 65 enteropathogenic E. coli (EPEC), and 38% of 47 E. coli stool isolates from asymptomatic children hybridized with an EAST1 DNA probe. None of 55 enteroinvasive E. coli, 12 Yersinia enterocolitica, or 20 Vibrio cholerae non-O1 strains were EAST1 probe-positive. Concordance between EAST1 genotype and enterotoxicity was shown in examined strains of EAggEC, EHEC, and EPEC. The gene encoding EAST1 is more broadly distributed among diarrheogenic E. coli than previously known and may represent an additional determinant in the pathogenesis of E. coli diarrhea.

Effects of heat shock on gram negative bacteria: use of lysis by sodium dodecyl sulphate as a probe for the integrity of DNA

Rheograms of Alcaligenes eutrophus (NCIMB 40529) and Escherichia coli (C90 NCIMB 10616) cells lysed by sodium dodecyl sulphate were compared before and after a variety of heat shock regimes. It was found that unheated cells produced a very characteristic shear thickening rheogram which could be destroyed by DNase treatment. Cells which had been subjected to heat shock produced rheograms very similar to DNase digested material. We thus suggest that the rheogram is largely due to the presence of intact DNA molecules. The extent and nature of the heat shock affected the shape of the rheogram of the SDS lysed material. Heat shock of cells after SDS lysis did not appear to significantly damage the DNA. Storage of the cells at 10 degrees C before heat shock considerably reduced the shear thinning effect of subsequent heat shock at 90 degrees C. We attribute the shear thinning effect of the heat shock to the action of nucleases which are activated and then depolymerise the DNA molecules.