Suchergebnisse

<B>Hintergrund:</B> Eine Alkoholismus- assoziierte Hyperhomocysteinämie kommt nicht nur im Alkoholentzug vor, sondern ist mit kontinuierlichem und chronischem Alkoholkonsum verknüpft. Bei einer unter Alkoholentzug verstärkten glutamatergen Exzitotoxizität und Stress-induzierten Permeabilisierung der Blut-Hirn-Schranke erlauben erhöhte Homocystein-Plasmakonzentrationen die Prädiktion von Alkoholentzugsanfällen, was dann die frühzeitige Einleitung einer medikamentösen antiepileptischen Prophylaxe ermöglicht. Die Alkoholismus-induzierte Hyperhomocysteinämie korreliert mit der hippokampalen Volumenreduktion bei Patienten mit Alkoholismus und könnte zur Pathogenese auch der Alkohol-bedingten Hirnatrophie beitragen. Eine Hyperhomocysteinämie-induzierte Dysregulation der epigenetischen Kontrolle wird aktuell untersucht. </P><P> <B>Schlussfolgerungen:</B> Prospektive Interventionsstudien werden klären, ob durch eine frühzeitige Senkung erhöhter Homocysteinspiegel die Inzidenz von Komplikationen des Alkoholentzuges oder Alkoholismus-induzierter chronischer Schäden reduziert werden kann.

Ein Sexualaufklärungsbuch für die 10- bis 15-Jährigen. Die Verfasser sind Ärzte und haben sich des Sachverstandes von Pro Familia versichert. Wenn auch nicht so lebendig aufgemacht mit Betroffenenberichten und "Geschichten aus dem Leben" wie in den meisten Vergleichstiteln (zuletzt S. Thor-Wiedemann: BA 4/04), imponiert hier der sachliche und zugleich empathische Ton, in dem die Mischung aus Info- und Ratgeberteilen über die körperlichen und emotionalen Vorgänge des Erwachsenwerdens bei Jungen und Mädchen sowie die Entstehung eines neuen Lebens und zu den Themen 1. Liebe, Liebe & Sex sowie Verhütung präsentiert wird. Getragen ist das Ganze von einer Haltung, die den jungen Leuten einen selbstbewussten Umgang mit ihrer Sexualität jenseits von Normierung und Wertung vermittelt. Aufgelockert ist das vergleichsweise umfangreiche Textmaterial, das zuweilen sehr differenziert in sexualmedizinische Gegebenheiten einsteigt, durch Randspalten mit Info-Kästen, Comics-Elemente, Farbfotos und etwas betulich wirkende anatomische Zeichnungen. - Zur eigenen Orientierung wie auch im schulischen Kontext gern empfohlen.. - Fragen zu Liebe und Sexualität - vor der Pubertät, Menstruation, Geschlechtsorganen, dem 1. Mal bis zu Schwangerschaft und Geburt, Verhütung. Abtreibung, sexuelle Gewalt, Aids und Homosexualität - werden offen und einfühlsam beantwortet; reich illustriert.

<i>Aims:</i> Alcohol withdrawal seizures (AWS) are among the most important possible complications during the detoxification treatment of alcohol-dependent patients. Pharmacological therapy is often used during detoxification, but can cause dangerous side effects [Eur Addict Res 2010;16:179–184]. In separate studies several biological markers have been described as being associated with AWS risk. We investigated the role of homocysteine (HCT), carbohydrate-deficient transferrin (CDT) and prolactin (PRL) as biological markers for the risk of developing AWS. <i>Methods:</i> The present study included 189 alcohol-dependent patients of whom 51 had a history of AWS. We investigated the HCT, CDT and PRL levels of all patients and calculated sensitivity and specificity. Bayes' theorem was used to calculate positive (PPV) and negative (NPV) predictive values. <i>Results:</i> The highest combined sensitivity and specificity for %CDT was reached at a plasma cutoff value of 3.75%. The combination of HCT at a cutoff value of 23.9 µmol/l and %CDT at a cutoff value of 3.75% showed the best predictive values (sensitivity 47.1%, specificity 88.4%, PPV 0.504, NPV 0.870). <i>Conclusion:</i> A combined assessment of HCT and CDT levels can be a useful method to identify patients at a higher risk of AWS, which may lead to a more individualized therapy.

<b><i>Background:</i></b> Atrial natriuretic peptide (ANP) is well known in psychiatric disorders to modulate hypothalamic-pituitary-adrenal axis activity. Disturbances of ANP have been described in early abstinent alcohol-dependent patients. This is the first longitudinal investigation on cytosine-phosphatidyl-guanine (CpG)-island promoter methylation of the <i>ANP</i> gene in the blood of tobacco-dependent patients. <b><i>Methods:</i></b> In a longitudinal approach, we investigated whether changes in ANP serum levels correlated to CpG methylation of the respective gene promoters on days 1, 7, and 14 of tobacco withdrawal. <b><i>Results</i></b> <b><i>and Conclusion:</i></b> Compared to non-smokers, promoter-related deoxyribonucleic acid methylation of the ANP promoter was significantly elevated on days 7 and 14 of withdrawal in tobacco-dependent patients. Baseline methylation status of the ANP promoter was not significantly different from controls, arguing for an impaired regulation during withdrawal.

<b><i>Aims:</i></b> Childhood trauma is of importance for the manifestation of substance-related disorders and maintenance of hypothalamic-pituitary-adrenal (HPA)-axis disorders. Since stress plays a crucial role in opioid compliance and craving, we investigated the immediate effects of diacetylmorphine application on the HPA axis. In particular, adrenocorticotropic hormone (ACTH) and cortisol secretion, as well as satiety regulating proopiomelanocortin peptides α-melanocyte-stimulating hormone (MSH) and β-endorphin (END) in a cohort of opioid-dependent patients in diamorphine maintenance treatment concerning the clinical severity of their childhood trauma. <b><i>Methods:</i></b> We compared the serum levels of ACTH, cortisol, MSH, and END in 15 opioid-dependent patients. All participants received treatment with diamorphine and were observed at 5 timepoints before and after injection. We split the cohort into 2 subgroups concerning childhood trauma measured by the Childhood Trauma Questionnaire. <b><i>Results:</i></b> Splitting in 2 subgroups for mild (5) and severe trauma (10), we found that while both groups show a significant reduction of ACTH and cortisol levels over time, slopes display different progressions over time for cortisol (<i>F</i>[1.6] = 9.38, <i>p</i> = 0.02), while remaining identical for ACTH (<i>F</i>[1.6] = 1.69, <i>p</i> = 0.24). Also, levels of both MSH and END were significantly lower in severely traumatized patients. <b><i>Conclusions:</i></b> For the first time, we present a detailed representation of stress- and addiction-related proteins for the first 5 h after diamorphine application, demonstrating the interrelationship between stress hormones and childhood trauma as well as its potential effects on the progression of addictions such as opioid dependence.

Appetite-regulating peptides, such as leptin, are linked to craving and have been in the focus of alcohol dependence research for years. The objective of our study was to investigate the dynamics of leptin gene promoter methylation during alcohol withdrawal and specific treatment in a rodent (rat) model for alcohol dependence. DNA methylation was measured using direct bisulfite sequencing at 0 h, 24 h, and 6 days of alcohol withdrawal as well as after treatment with alpha-melanocyte-stimulating hormone (alpha-MSH), Beta-Endorphin, or saline. We found significantly lower methylation levels in alcohol-consuming animals compared to alcohol-naïve animals. During 6 days of alcohol deprivation, this difference in methylation vanished. Leptin methylation of the alpha-MSH-treated group and 6 days alcohol-deprived animals was significantly higher than that in saline-treated animals, possibly indicating compensatory effects of the treatment. Our results further expand on previous findings from human studies that explain leptin's role in bridging the gap between alcohol consumption and appetite regulation.

Zusammenfassung. Ziel der Studie: Untersucht wurden die Einstellungen gegenüber Menschen mit Alkoholabhängigkeit und die Akzeptanz neurobiologischer sowie sozialer Krankheitsursachen. Methodik: Mit einem 75-Item Fragebogen wurden die Ansichten von 254 Teilnehmern erfragt und die Einstellungen gegenüber alkoholabhängigen Patienten von Betroffenen und gesunden Menschen verglichen. Die betroffenen alkoholabhängigen Patienten (n = 122) wurden während einer stationären qualifizierten Entzugsbehandlung befragt, nachdem der körperliche Entzug vorüber war. In den Vergleichsgruppen wurden medizinisches Personal (n = 70) sowie Studierende (n = 62) ohne medizinisches Hintergrundwissen befragt. Ergebnisse: Zwischen den Betroffenen und dem medizinischen Personal fanden wir keine Unterschiede bezüglich der Zuschreibung neurobiologischer Faktoren als Ursachen der Alkoholabhängigkeit. Studierende hielten neurobiologische Faktoren für weniger ursächlich für Alkoholabhängigkeit als Betroffenen und als medizinisches Personal. Bezüglich der sozialen Faktoren als Ursachen der Alkoholabhängigkeit ergaben sich keine signifikanten Unterschiede zwischen den drei Gruppen. Die Betroffenen bewerteten die Charaktereigenschaften alkoholabhängiger Patienten insgesamt positiver als das medizinische Personal und die Studierenden.Schlussfolgerung: Betroffene berichten positivere Einstellungen gegenüber Menschen die an einer Alkoholabhängigkeit leiden, als medizinisches Personal und als Studierende.

Disturbances of volume-regulating peptides like vasopressin (AVP) and atrial natriuretic peptide (ANP) have been described in early abstinent alcohol-dependent patients. In a longitudinal approach, we investigated whether changes in AVP and ANP serum levels correlated to cytosine-phosphatidyl-guanine (CpG) methylation of the respective gene promoters on days 1, 7 and 14 of alcohol withdrawal. We analyzed the blood samples of 99 patients suffering from alcohol dependence alongside age- and BMI-matched controls. Concerning AVP promoter methylation, we observed an interaction between time of measurement and CpG loci with CpG 2 showing a significant increase in methylation from day 1 to 14. Serum levels of AVP were significantly decreased in the patient group. Compared to healthy controls, promoter-related DNA methylation of the ANP promoter was significantly reduced on days 7 and 14. Moreover, we detected a significant interaction between CpG position and group. In both cases the difference was mainly observed at CpG 1. The present study shows significant changes in the methylation status of individual CpG sites of AVP and ANP. Observing respective alterations of AVP serum protein levels in alcohol-dependent patients during detoxification treatment, we consider methylation as a possible mode of regulation for these proteins during alcohol detoxification.

Preclinical study results suggest that neurotrophic peptides like nerve growth factor (NGF) and vascular endothelial growth factor A (VEGF-A) may be associated with symptoms of addictive behavior like withdrawal symptoms and rewarding effects. We investigated alterations in NGF and VEGF-A serum levels in opiate-dependent patients (25 male patients), who received diamorphine (DAM, heroin) treatment within a structured opiate maintenance program, and compared the results with the NGF and VEGF-A serum levels of healthy controls (23 male controls). NGF and VEGF-A serum levels were assessed before and after DAM administration twice a day (in the morning (16 h after last application – t1) and in the afternoon (7 h after last application – t3)) in order to detect a possible immediate or summative (in the afternoon) heroin effect on these two neuropeptides. Moreover, we investigated possible associations between the serum levels of these neurotrophic growth factors and psychometric dimensions of addictive behavior, e.g. craving, withdrawal, depression. Whereas there was no direct effect of DAM application on the serum levels of both neurotrophic growth factors neither in the morning nor in the afternoon, the NGF serum levels of the patient group were found to be significantly increased at all four time points of investigation compared with the healthy controls. In contrast, VEGF-A serum levels did not differ significantly in the patient and control groups. We found a significant positive association between the NGF serum levels and several items of the short opiate withdrawal scale as well as a negative association between self-reported mood (measured by visual analogue scale) and mood before heroin application (in the morning as in the afternoon). Moreover, we found a significant positive association between the NGF serum levels (t1 and t3) and the self-reported craving for methadone. In contrast, we found a negative association between the VEGF-A serum levels and avoidance, anxiety, suicide intentions of the SCL-90 as well as a positive association between the VEGF-A serum levels and the subscales of the heroin craving questionnaire measuring the rewarding effects of heroin. In conclusion, the results of this pilot study show that there might be an association between symptoms of opiate dependence and withdrawal and serum levels of VEGF-A and NGF.