Two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease undergoing hemodialysis

We report on two additional cases of metformin‐associated encephalopathy in patients with end‐stage renal disease (ESRD) undergoing hemodialysis. Two patients were seen at our hospital with abnormal neurological signs and symptoms. Magnetic resonance imaging (MRI) revealed the same pattern of high signal intensity in both basal ganglia in T2‐weighted images in the two patients. The two patients had started taking metformin 5 and 6 weeks earlier at the same dose of 1000 mg per day. Metformin was immediately stopped, and regular hemodialysis was conducted. Their signs and symptoms resolved completely after these measures. The high signal intensity in both ganglia in T2‐weighted MRI also disappeared. We should suspect metformin‐induced encephalopathy and withdraw the drug when presented with diabetic patients with chronic kidney disease and neurological signs and symptoms of unknown cause.     

Adaptation of performance during a week of simulated night work

This study aimed to provide a comparative index of the performance impairment associated with the fatigue levels frequently experienced in workplaces that require night work. To do this, we equated fatigue-related impairment with the impairment resulting from varying levels of alcohol intoxication. Fifteen young individuals participated in two counterbalanced conditions which required them to (1) ‘work’ seven consecutive 8-h night shifts, and (2) consume an alcoholic beverage at hourly intervals until their blood alcohol concentration (BAC) reached 0.10%. In each condition, performance was measured at hourly intervals using a 10-min psychomotor vigilance task (PVT). Analysis indicated that as BAC increased, performance impairment significantly increased. Similarly, response times significantly increased during the first six simulated night-shifts, and lapse frequency significantly increased during the first two shifts. Equating the two conditions indicated that the first simulated night shift was associated with the greatest degree of performance impairment. In general, the impairment at the end of this shift was greater than that observed at a BAC of 0.10%. During the second and third simulated night shifts, the performance impairment was less than on the first night, but greater than that observed at a BAC of 0.05%. For the final four nights, the performance decrements generally did not exceed those observed at a BAC of 0.05%. This suggests that during a week of consecutive night shifts, adaptation of performance occurs.     

Categorizing food-related illness: Have we got it right?

Since the 1950s food safety hazards have been categorized simply as (micro) biological, chemical or physical hazards with no clear differentiation between those that cause acute and chronic harm. Indeed international risk assessment methods, including hazard analysis critical control point (HACCP) use these criteria. However, the spectrum of food related illness continues to grow now encompassing food allergy and intolerance, obesity, type 2 diabetes, stroke, heart disease, cancer as well as food poisoning, foodborne illness and food contamination. Therefore over a half-century later is this the time to redefine the spectrum of what constitutes food related illness? This paper considers whether such “redefinition” of food related intoxicating and infectious agents would provide more targeted policy instruments and lead to better risk assessment and thus mitigation of such risk within the food supply chain.     

Salivary Glands after Prolonged Aluminum Exposure: Proteomic Approach Underlying Biochemical and Morphological Impairments in Rats

Aluminum (Al) is one of the most abundant elements on Earth, and its high extraction rate and industrial use make human exposure very common. As Al may be a human toxicant, it is important to investigate the effects of Al exposure, mainly at low doses and for prolonged periods, by simulating human exposure. This work aimed to study the effects of low-dose exposure to chloride aluminum (AlCl₃) on the oxidative biochemistry, proteomic profile, and morphology of the major salivary glands. Wistar male rats were exposed to 8.3 mg/kg/day of AlCl₃ via intragastric gavage for 60 days. Then, the parotid and submandibular glands were subjected to biochemical assays, proteomic evaluation, and histological analysis. Al caused oxidative imbalance in both salivary glands. Dysregulation of protein expression, mainly of those related to cytoarchitecture, energy metabolism and glandular function, was detected in both salivary glands. Al also promoted histological alterations, such as acinar atrophy and an increase in parenchymal tissue. Prolonged exposure to Al, even at low doses, was able to modulate molecular alterations associated with morphological impairments in the salivary glands of rats. From this perspective, prolonged Al exposure may be a risk to exposed populations and their oral health.     

Intoxicated behavioral disinhibition and the heart rate response to alcohol.

This study examined the association between the heart rate (HR) response to alcohol intoxication, which is thought to reflect sensitivity to alcohol-induced reward and alcohol-induced behavioral disinhibition. High- and low-HR responders to alcohol participated in a go/no-go task, under sober and intoxicated conditions. Errors of commission on this task have previously been related to behavioral disinhibition. High-HR responders made more intoxicated commission errors as compared with low-HR responders. High-HR responders also reported increased alcohol consumption, and controlling for the latter did not alter the significant association between high-HR responders and increased intoxicated errors of commission. These results are consistent with previous findings of an increased risk for addictive and disinhibited behavioral propensities in individuals with a high-HR response to alcohol intoxication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Modeling homophily over time with an actor-partner interdependence model.

Selection and socialization have been implicated in friendship homophily, but the relative contributions of each are difficult to measure simultaneously because of the nonindependent nature of the data. To address this problem, the authors applied a multiple-groups longitudinal actor-partner interdependence model (D. A. Kashy & D. A. Kenny, 2000) for distinguishable dyads to 3 consecutive years of intoxication frequency data from a large community-based sample of Swedish youth. Participants, ranging from 12 to 18 years old (M = 14.35, SD = 1.56) at the start of the study, included 902 adolescents (426 girls and 476 boys) with at least one reciprocated friend during at least one time point and 212 adolescents (84 girls and 128 boys) without reciprocated friends at any time. Similarity estimates indicated strong effects for selection and socialization in friends' intoxication frequency. Over time, younger members of these dyads had less stable patterns of intoxication than older members, largely because younger partners changed their drinking behavior to resemble that of older partners. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

急性酒精中毒患者对心电图的影响

目的探讨急性酒精中毒对心电图的变化以及其临床意义。方法通过对我院2010年7～10月收治的48例急性酒精中毒患者进行心电图动态观察,并检测血压和心率情况。结果急性酒精中毒病人中心电图变化表现为PR和Q-T间期延长,对血压和心率变化并无明显影响。结论急性酒精中毒患者可导致PR间期及Q-T间期延长。     

Psychostimulant users are sensitive to the stimulant properties of alcohol as indexed by alcohol-induced cardiac reactivity.

One indicator of increased sensitivity to alcohol-induced reward is a heightened heart rate (HR) increase following alcohol intoxication, a characteristic associated with increased alcohol-induced dopamine (DA) release. The goal of this study was to determine whether users of drugs known to induce DA release have higher HR increases after alcohol intoxication than never users have. Sixty-four men with known drug-use histories participated in an alcohol challenge in which HR was measured. Stimulant users had significantly higher ethanol-induced HR increases than never users had, although use of marijuana or hallucinogens was not associated with this marker. Stimulant users obtained superior Sensitivity to Reward scores (R. Torrubia, C. ávila, J. Moltó, & X. Caseras, 2001) compared with never users. Stimulant drug users may be more sensitive to the stimulating properties of alcohol, and this appears to be mediated by superior activity in the Behavioral Approach System (J. A. Gray, 1991). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tonic and phasic processes in the acute effects of alcohol.

This article presents a novel method for measuring the acute effects of alcohol. One hundred twenty nonproblem drinkers aged 21-28 participated in 3 alcohol administration sessions that produced peak blood alcohol concentrations (BACs) near .09 g%. Subjective intoxication ratings were taken at multiple points across rising and falling BACs. Mathematical modeling techniques decomposed intoxication ratings into a tonic component sensitive to BAC level and a phasic component sensitive to BAC rate of change. This model provided a good fit to observed data. Tonic and phasic gain parameters showed high repeatability across sessions. The average phasic gain parameter was about 4 times larger than the average tonic gain parameter, indicating that subjective intoxication is usually more affected by BAC change than by BAC level. The associations of drinking practices with tonic and phasic gain parameters varied by gender and family history of alcoholism. Tonic-phasic modeling allows individual and group differences in the acute effects of alcohol to be studied as time-dynamic processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)