Associations between Childhood Abuse and Chronic Pain in Adults with Substance Use Disorders

Both childhood abuse and chronic pain are common in people with substance use disorders (SUDs). Studies have found that exposure to childhood abuse is associated with chronic pain in adulthood; however, few studies have examined this association in people with SUDs. Objectives: This study aimed to characterize the association between childhood abuse and chronic pain presence and severity in adults with SUDs. Methods: Data were obtained from 672 treatment-seeking participants with SUDs on an inpatient detoxification unit. Regression models evaluated whether childhood physical or sexual abuse was associated with the likelihood of chronic pain and severity of several pain-related characteristics: pain catastrophizing, pain severity, and pain interference. Results: Childhood physical and sexual abuse were significantly associated with a greater likelihood of chronic pain in adulthood. In the adjusted analyses, childhood physical abuse was associated with worse pain severity, whereas childhood sexual abuse was associated with greater pain catastrophizing and worse pain interference. Conclusions: Childhood physical and sexual abuse were associated with a greater likelihood of chronic pain in adults with SUDs. Among those with chronic pain, exposure to childhood abuse was associated with a more severe symptom profile, characterized by greater pain severity, more catastrophic interpretations of pain, and more pain-related interference with daily life. People with SUDs and a history of childhood abuse may benefit from screening for pain and interventions to reduce pain catastrophizing. These findings highlight the importance of longitudinal research to understand mechanisms linking childhood abuse exposure to later pain and substance misuse.

Sex differences in benzodiazepine misuse among adults with substance use disorders

Women are more likely than men to be diagnosed with anxiety disorders and to be prescribed benzodiazepines. People with substance use disorders are at a heightened risk for the misuse of benzodiazepines, yet little is known about sex differences in the prevalence, correlates or patterns of benzodiazepine misuse in this population. The aim of this study was to characterize sex differences in benzodiazepine misuse in a sample of adults receiving substance use disorder treatment (N = 352). Almost half of the sample had been prescribed a benzodiazepine and more than 40% had misused a benzodiazepine. Women were more likely to have a lifetime prescription than men, but were not more likely to report misuse or regular misuse. Consistent with data for other substances, women were more likely to report misusing benzodiazepines to cope and reported greater anxiety sensitivity. The vast majority (97%) of participants reported co-use of benzodiazepines with other substances and 65% of women reporting misusing benzodiazepines via a non-oral route of administration (e.g., intranasal). Although benzodiazepine misuse prevalence was not substantively different between men and women, several sex differences in clinical characteristics and patterns of use were identified. Further research on the nature of sex differences in benzodiazepine misuse is needed to inform targeted treatment for both men and women with substance use disorders.

Pregnancy outcomes in sickle cell disease: a retrospective cohort study from two tertiary centres in the UK

The objective of this retrospective cohort study from two tertiary centres in the UK was to describe the pregnancy outcomes of women with sickle cell disease (SCD) who booked at these centres between 2004 and 2008, and to compare this with historical data. The study population comprised 122 singleton pregnancies in women with SCD: homozygous sickle cell disease 64, sickle cell haemoglobin C disease 45, sickle b plus thalassaemia 11, sickle cell haemoglobin E disease 1 and sickle cell delta disease 1 from 2004 to 2008 managed in the joint haematology/obstetric antenatal clinics in two tertiary teaching hospitals. The main outcome measures were the frequency of sickle cell crises and obstetric complications. Age and gestation at booking were 18-43 years (mean 29.7) and 9-36 weeks gestation (mean 17.3), respectively. Complications of SCD occurred in 25% of pregnancies. Fifty-four percent of women had induction of labour and 39% were delivered by emergency caesarean section. Thirty-three percent had a postpartum haemorrhage. Nineteen percent of women delivered before 37 completed weeks. Birth weight below 2500 g occurred in 20% of singleton pregnancies. Three neonates developed transient complications related to maternal opiate exposure postnatally. Three intrauterine deaths occurred at 24, 29 and 34 weeks. Two of these had congenital defects, and the other severe intrauterine growth restriction. No maternal deaths occurred. Successful pregnancy outcomes can be achieved in SCD. There has been an improvement in fetal and maternal morbidity and mortality compared with historical data. Pregnancy in women with SCD remains high risk. Early access to antenatal care and to expertise in SCD is essential. A matched control population from the same time period and prospective data collection is needed to address confounders such as ethnicity and deprivation.

Ovarian sickling as a proposed mechanism for premature ovarian failure necessitating ovum donation

Iron overload in female patients with sickle cell disease (SCD) has been reported to result in gonadal dysfunction. To date there has been no report in the literature of ovarian sickling being a reason for gonadodysgenesis (premature ovarian failure [POF]) in women. This case report describes POF in a woman with SCD and suggests ovarian sickling as its cause. We propose that frequent episodes of intravascular sickling, vessel occlusion and infarction as well as tissue hypoxia associated with chronic anaemia could account for the ovarian dysgenesis and hence POF.

Reliable operant apparatus for fish: audio stimulus generator, response button, and pellet-dispensing nipple

As part of ongoing research into the ability of koi to categorize complex auditory stimuli, we have had to develop novel apparatus. The stimulus generator presents sound from two CD drives under computer control through a new underwater speaker. The operant manipulandum is a horizontal button that eliminates spurious triggering by water turbulence and problematic response topographies. The button's design has also been adapted for use by tilapia in an aquacultural food-preference study. The feeder uses a nipple to dispense food pellets reliably under water. In this paper, the apparatus is described in detail. Also discussed are methodological issues related to its design, as well as its usage in a pilot study in which koi learned to discriminate music from silence by using a single manipulandum with food reinforcement.

Heterogeneity of Xanthomonas campestris pv. hederae Strains from Araliaceous Hosts

ABSTRACT Xanthomonas campestris pv. hederae (synonym X. hortorum pv. hederae) strains (59 total) were collected from plants in the araliaceae family. Strains were isolated from Hedera helix, Schefflera arboricola, Brassaia actinophylla, and Polyscias spp. from Florida, California, Hawaii, and New Zealand. All strains produced yellow mucoid growth; hydrolyzed esculin, starch, casein and gelatin; were pectolytic; produced urease; and grew on minimal media containing asparagine. All bacterial strains were pathogenic on H. helix (English ivy), B. actinophylla (dwarf schefflera), and Polyscias fruticosa (ming aralia). No differences in symptomatology were detected among strains; however, severity of symptoms usually was greatest on the host of origin. In planta growth rates of representative strains isolated from H. helix, B. actinophylla, and Polyscias spp. also were compared among these three hosts. In all cases, populations grew more rapidly when strains were inoculated to their original host species. All 59 bacterial strains were compared by 95-carbon source GN microplate, fatty acid methyl ester (FAME), and restriction fragment-length polymorphisms (RFLP), with the pulse-field gel electrophoresis method, analyses. All three analyses grouped strains into two distinct groups that correlated with the host of origin. Using metabolic profiles, 75% of the H. helix strains were separated from strains isolated from Brassaia and Schefflera and 95% of the Polyscias strains. FAME analysis separated strains into two distinct groups, with 96% of the H. helix strains placed in one group. RFLP analysis placed all of the H. helix and Schefflera strains in one group, as well as 33% of the Brassaia strains, whereas the other group contained all of the Polyscias strains and the remainder of the Brassaia strains. It is apparent that the pathovar hederae is made up of heterogeneous populations that can be separated by biochemical, pathological, genetic, and physiological analyses into two groups that are closely associated with the host of origin.

beta-adrenergic receptor sensitivity in cultured vascular smooth muscle cells: effect of age and of dietary restriction

The effect of age and of dietary restriction on vascular beta-receptor sensitivity was investigated using cultured smooth muscle cells from rat aortas. The growth rate was slower in cells obtained from 36-month-old rats than in cells obtained from 24-month-old rats and the cells from older animals achieved lower densities. The dietary restriction did not affect growth of cells from 24-month-old rats but increased cell numbers in 36-month-old rats. The elevation of the cyclic AMP level in response to epinephrine was decreased with age. Cells from dietary restricted animals responded more to epinephrine than cells from animals of the same age fed ad libitum.

Quantitation of cannabinoids in biological fluids by radioimmunoassay

A tritium based radioimmunoassay for delta9THC and its metabolites has been developed for the use of investigators studying the epidemiological, medical, clinical, and research aspects of cannabis use. The assay is sufficiently sensitive to detect cannabinoids in the urine of marijuana smokers for several days after their last exposure to the drug. The results obtained from a 28 day study indicate that the assay reflects the administration and removal of oral doses of THC. The specificity of the antisera, as determined in cross reactivity studies, allows not only the assay of metabolites in biological samples without interference from other drugs, but also the evaluation of extracts of other kinds of samples which may contain unmetabolized delta9THC. The technique of radioimmunoassay has many advantages over other methods of analysis. It is simple to perform and can be readily applied to the rapid analysis of large numbers of samples. It can be used in the direct analysis of physiological fluids and other biological samples which ordinarily have to be processed before other techniques can be applied. The method is non-destructive abd obviates the need to use radiolabelled drugs in man during metabolic and other studies. This radioimmunoassay has been designed with particular emphasis on ease of use by other investigators. We anticipate that it will prove useful to investigators and scientists for determining the absence, or presence and amount, of THC metabolite in a biological specimen, for epidemiologists in determining the full extent of cannabis use and to the medical/clinical community for establishing the minimum effective dose of delta9THC for each patient. The widespread application of a single method of analysis should also remove a great deal of the controversy surrounding marijuana studies performed to date.