The social ecology of drug use: a factor analysis of an urban environment

Drug use is related to the environment in which drug users live. Using 32 economic, housing, crime, and health variables for 1990 census tracts in Houston, Texas, this study found four identifiable factors: social disorganization, economic success, threat of violence, and chronic disease. Narcotic offenses loaded strongly on one and weakly on two of the factors; this variable did not load on the economic success factor. These results suggest that a textured look at drug use environments finds them to be multidimensional. Urban dwellers must deal with the independent effects of social disorganization, economic conditions, chronic disease, and violence.     

Cerebrospinal fluid findings in asymptomatic patients with reactive serum fluorescent treponemal antibody absorption tests

It is common to examine the cerebrospinal fluid in untreated or inadequately treated asymptomatic patients with a reactive serum fluorescent treponemal antibody absorption (FTA-ABS) test before initiating antibiotic therapy for syphilis. This prospective study evaluated the usefulness of such examination. Four hundred thirty-two patients over 40 years old, reporting for annual physical examination, had a serum FTA-ABS test. Thirty-seven (8.6%) patients and 2 of 4 spouses were reactive repeatedly. Of the 39 patients with reactive tests, 7 had a history of penicillin therapy for syphilis, 5 had received heavy metal therapy, and 27 had no history of syphilis. These 39 patients had a neurological examination, serum VDRL, Treponema pallidum immobilization (TPI), and repeat FTA-ABS tests by two other laboratories. The TPI test was reactive in 30 (77%). Four had nonspecific neurological signs. Routine CSF examination (cells, total protein, VDRL, glucose, IgG%) on 30 patients with a history of inadequate treatment had a low diagnostic yield. Two patients had an unexplained total protein elevation (57 and 61 mg/dl) and 1 had a mildly increased IgG% (15%). All cell counts, VDRL tests, and glucose levels were normal. Agarose electrophoresis demonstrated one or more CSF immunoglobulin bands in 10 (36%) of 28 patients, possibly representing an immunological marker of past or latent central nervous system infection.     

The effect of furosemide on serum prolactin levels in the postpartum period

Furosemide, in combination with breast binding and milk fluid restriction, seems to inhibit postpartum lactation effectively, but has no effect in reducing serum prolactin levels. Inhibition of milk secretion must therefore be mediated by other mechanisms.