Abstract
Objectives. Cocaine is the second most used illegal drug in Europe. The transition from use to dependence involves both genetic and environmental factors. Genetic variation in ...neurotransmitter systems is involved in the susceptibility to cocaine dependence. We examined the possible contribution to cocaine dependence of 16 genes involved in the cellular machinery that controls neurotransmitter release: genes encoding proteins of the SNARE complex (STX1A, SNAP25, VAMP1 and VAMP2), fusion control elements (SYT1, SYT2, CPLX1, CPLX2, CPLX3 and CPLX4) and regulatory elements (STXBP1, SYP, SNPH, NSF, NAPA and RAB3A). Methods. We genotyped 121 SNPs, selected according to genetic coverage criteria, in 360 cocaine-dependent patients and 360 controls from Spain. Results. Single and multiple-marker analyses revealed a strong association between cocaine dependence and the NSF gene, encoding the N-ethylmaleimide-sensitive factor (P = 5.1e-04, OR = 2.44 (1.45-4.00) and P = 0.001, OR = 1.82 (1.28-2.59), respectively). The presence and absence of psychotic symptoms were also studied. Interestingly, when we considered the time between initial consumption and the onset of cocaine dependence, we observed that the association was mainly restricted to the group of patients that rapidly developed drug dependence (≤2 years; P = 2.98e-06, OR = 1.33 (1.20-1.47)). Conclusions. Our data show preliminary evidence that NSF may predispose not only to cocaine dependence, but also to an early onset of the dependence.
El presente trabajo pretende comparar las caracteristicas entre los pacientes que recaen en el consumo y los que se mantienen abstinentes, a los seis meses de seguimiento ambulatorio tras terminar ...una desintoxicacion hospitalaria. Se realizo un estudio observacional y prospectivo en pacientes con trastorno por dependencia de sustancias que ingresaron en la Unidad Hospitalaria de Desintoxicacion del Hospital Universitario de Vall d'Hebron desde junio 2009 hasta octubre 2010. Durante el ingreso se recogieron variables demograficas, clinicas, diagnosticas y terapeuticas, y se realizo la entrevista SCID. Se considero recaida el reinicio del consumo de la sustancia que fue motivo de ingreso y se evaluo por anamnesis y alcohotest y/o urinoanalisis. Las variables de estudio se compararon entre los pacientes que recayeron y los que no. De 165 pacientes incluidos, 108 finalizaron el estudio (75% varones, edad 37,7 + o - 9,5 anos). 72,2% recayeron a los 6 meses. El perfil de pacientes que recayeron fue: pacientes que ingresaban para desintoxicacion de heroina (91,7% vs 8,3%, p = .038), policonsumidores (71,4% vs 32%, p = .05), pacientes que consumian horas previas al ingreso a modo de despedida (61,5% vs 39,5%, p = .04), aquellos con comorbilidad medica (44,9% vs 23,3%, p = .04), y con trastornos afectivos comorbidos (19,5% vs 3,2%, p = .005). La desintoxicacion de opiaceos y el consumo en horas previas se asociaron de forma independiente con la recaida a los 6 meses. Existe un alto porcentaje de recaidas tras desintoxicacion hospitalaria. Ingresar para desintoxicacion de opiaceos y/o consumir de forma compulsiva antes del ingreso, estan relacionados con el mayor riesgo de recaida. Palabras clave: adiccion, recaidas, factores de riesgo, desintoxicacion hospitalaria, seguimiento ambulatorio. This work describes the profile of patients with relapse after hospital detoxification at six months of outpatient follow-up. An observational and prospective study was carried out in patients with substance-dependence disorder who were in the Detoxification Unit of the Vall d'Hebron University Hospital (Barcelona) between June 2009 and October 2010. Demographic, clinical, diagnostic and therapeutic variables were assessed. The criterion for relapse was a return to use of the substance that had led to hospitalization, and relapse was assessed by means of anamnesis, breathalyzer and/or urine analysis. Study variables were compared between patients who relapsed and those who did not. Of the 165 patients included, 108 patients finished the study (75% males, age 37.7 + or - 9.5 years). A total of 72.2% had relapsed at the 6-month follow-up. Profile of patients who relapsed was: hospitalized for heroin detoxification (91.7% vs 8.3%, p = .038), polyconsumers (71.4% vs 32%, p = .05), high substance use in the hours prior to admission as a "farewell" (61.5% vs 39.5%, p = .04), patients with comorbidity (44.9% vs 23.3%, p = .04) and patients with affective disorders (19.5% vs 3.2%, p = .005). Detoxification from opiates and use in the hours prior to admission were associated independently with relapse at 6 months. There is a high percentage of relapses after hospital detoxification. Patients most likely to relapse are those dependent on opiates and those with compulsive use immediately prior to hospitalization. Key words: addiction, relapses, risk factors, in-patient unit, follow-up.
A synthetic hydromagnesite obtained from an industrial by‐product rich in magnesium oxide was employed and evaluated as a non‐halogenated flame retardant for poly(ethylene‐co‐vinyl acetate).
The ...filler was characterized with different techniques (such as specific surface area, TGA, particle morphology and size measurements, WAXS). Significant differences were found between the synthetic hydromagnesite and the natural one.
Synthetic hydromagnesite was coated with stearic acid and the effectiveness of the coating process was studied by the dye adsorption method and sedimentation volume measurements. The amount of coating agent ranged from 1 to 4.5%. This factor was found to have a significant effect on the thermal decomposition behaviour of the filler.
A poly(ethylene‐co‐vinyl acetate) (27% of VA) was filled with the coated synthetic grades of hydromagnesite as well as with two commercial flame retardants and different physicochemical properties were evaluated, including their flame retardant effect.
Objective. To study the incidence, type and prognostic significance of clonal chromosomal abnormalities following SCT in patients with AML.
Patients and methods. From February 2000 to March 2008, 74 ...patients were studied. Karyotypes were analysed by G-banded chromosomes obtained from 24 hours bone marrow cultures, and were described according to ISCN 2005.
Results. Clonal abnormalities were observed in 17/74 patients (23%). Median follow-up was 11 months (range 5–47). Initial diagnosis: AML2 (6 cases), AML5a (3), AML6 (3), AML with inv(16)(p13;q22) (1), AML with multilineage dysplasia (1), AML5b (1), AML1 (1) and AML0 (1). Treatment before SCT: idarubicin, cytarabine and etoposide (16), FLAG-ida (1). All patients presented a normal karyotype at the time of SCT. SCT type: autologous (12 patients), allogeneic (3), allogeneic of reduced intensity (2). Conditioning regimen: TBI and cyclophosphamide (14 cases), busulfan and cyclophosphamide (1), fludarabine and busulfan (2). The median time between SCT and the appearance of clonal abnormalities was 8 months (range 3–36). At the time of clonal abnormality detection, 16 patients were in cytological and/or clinical relapse and 1 in complete remission. In 4 cases the initial clone reappeared, 1 showed the initial abnormalities with an acquired abnormality and 12 presented de novo clonal abnormalities. The median survival from the appearance of clonal abnormalities was 2 months (range 1–40). At the time of the analysis all patients had died.
Conclusions.
The appearance of clonal abnormalities following SCT in patients with AML is frequent.Time between SCT and the appearance of clonal abnormalities is short.The majority of patients presented de novo clonal abnormalities with cytological and/or clinical relapse and poor prognosis.
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