A Novel Mouse Model of Peritoneal Dialysis: Combination of Uraemia and Long-Term Exposure to PD Fluid

Different animal models for peritoneal dialysis (PD) have been used in the past decades to develop PD fluids compatible with patient life and to identify markers of peritoneal fibrosis and inflammation. Only few of those studies have taken into account the importance of uraemia-induced alterations at both systemic and peritoneal levels. Moreover, some animal studies which have reported about PD in a uremic setting did not always entirely succeed in terms of uraemia establishment and animal survival. In the present study we induced uraemia in the recently established mouse PD exposure model in order to obtain a more clinically relevant mouse model for kidney patients. This new designed model reflected both the slight thickening of peritoneal membrane induced by uraemia and the significant extracellular matrix deposition due to daily PD fluid instillation. In addition the model offers the opportunity to perform long-term exposure to PD fluids, as it is observed in the clinical setting, and gives the advantage to knock out candidate markers for driving peritoneal inflammatory mechanisms.Marie Curie actionsPeer Reviewe

S100B and homocysteine in the acute alcohol withdrawal syndrome

Elevations of serum homocysteine levels are a consistent finding in alcohol addiction. Serum S100B levels are altered in different neuropsychiatric disorders but not well investigated in alcohol withdrawal syndromes. Because of the close connection of S100B to ACTH and glutamate secretion that both are involved in neurodegeneration and symptoms of alcoholism the relationship of S100B and homocysteine to acute withdrawal variables has been examined. A total of 22 male and 9 female inpatients (mean age 46.9 ± 9.7 years) with an ICD-10 diagnosis of alcohol addiction without relevant affective comorbidity were examined on admission and after 24, 48, and 120 h during withdrawal. S100B and homocysteine levels in serum were collected, and severity of withdrawal symptoms (AWS-scale), applied withdrawal medication, initial serum ethanol levels and duration of addiction were recorded. Serum S100B and homocysteine levels declined significantly (P < .05) over time. Both levels declined with withdrawal syndrome severity. Females showed a trend to a more intense decline in serum S100B levels compared to males at day 5 (P = .06). Homocysteine levels displayed a negative relationship to applied amount of clomethiazole (P < .05) and correlated with age of onset of addiction. No withdrawal seizures were recorded during the trial. As it is known for homocysteine, S100B revealed to decline rapidly over withdrawal treatment in alcoholism. This effect is more pronounced in female patients. S100B could be of relevance in the neurobiology of alcohol withdrawal syndromes. It may be indirectly related to the level of stress level or glutamatergic activity during alcohol withdrawal

Coping styles of alcohol-dependent individuals: Comparison with depressed patients and controls

The profile of coping mechanisms in a sample of 164 subjects (60 alcohol-dependent individuals, 47 depressed patients, 57 controls) was investigated. Data were collected over the period January-December 2004, at the Eginition Psychiatric Hospital of the Athens University Medical School in Athens, capital of Greece. The Albert Einstein College of Medicine Coping Styles Questionnaire (AECOM-CSQ; Plutchik &amp; Conte, 1989), and the Hamilton Depression and Anxiety Rating Scales (Hamilton, 1959, 1960) were used for the assessment. Post hoc analysis of variance for comparisons between groups and logistic regressions using coping styles as predictor variables for group classification were used for data analysis. The main findings were that alcohol-dependent individuals could be distinguished from either depressed or control subjects on the ground of their coping mechanisms with stress, and that men and women use different patterns of psychological adaptation. More specifically, group classification in terms of specific coping styles could be predicted with an overall accuracy of more than 84%; in men, classification related to the coping mechanism of substitution, and in women to blame, reversal, and substitution. These findings may have implications for individually tailored psychotherapeutic interventions in alcohol-dependent individuals. © Society for Personality Research (Inc.)

Mirtazapine and venlafaxine in the management of collateral psychopathology during alcohol detoxification

Symptoms of anxiety and depression are common in a large proportion of alcohol-abusing/dependent individuals during alcohol detoxification. The aim of this study was to examine the impact of a combined psychotherapeutic-psychopharmacological (either with mirtazapine or venlafaxine) treatment of these symptoms during the earl), withdrawal phase of alcohol compared to a group treated only with psychotherapy. A total of 60 alcohol-dependent/abusing subjects randomly assigned to three groups (psychotherapy, psychotherapy plus mirtazapine, psychotherapy plus venlafaxine) were studied. Assessment of psychopathology and global functioning throughout a 4-5-week detoxification period was done by the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS). and the Global Assessment Scale (GAS). At baseline, high scores of anxiety and depression were recorded (HARS: controls: 33.1 +/- 7.8. mirtazapine: 33.2 +/- 12.6, venlafaxine: 36.6 +/- 5.4; HDRS: controls: 39.5 +/- 7.4, mirtazapine: 37.9 +/- 7.8. venlafaxine: 41.9 +/- 4.5). A marked improvement patients on mirtazapine improved significantly more (p&lt;0.000) was evidenced in all groups by the end of the detoxification period. However patients compared to the other two groups (HARS: controls: 9.6 +/- 7.6, mirtazapine: 4.3 +/- 4.4*. venlafaxine: 7.2 +/- 4.1. *p=0.011; HDRS: controls: 8.6 +/- 7.9, mirtazapine: 3.8 +/- 3.2*, venlafaxine: 8.2 +/- 3.5, *p=0.017; GAS: controls: 79.5 +/- 9.4. mirtazapine: 87.5 +/- 5.5**. venlafaxine: 83.0 +/- 8.0, **p=0.006). It is concluded that addition of mirtazapine, but not venlafaxine. to a standard psychotherapy-oriented alcohol detoxification treatment may facilitate the detoxification process by minimizing psychological discomfort. Consequently. it may prove to be a facilitator for the long-term abstinence from alcohol. (C) 2004 Elsevier Inc. All rights reserved

Alexander the Great&apos;s relationship with alcohol

Aims This study sought to clarify if Alexander the Great indulged pathologically in alcohol and whether it contributed to his death. Design The texts of the historians Diodorus of Sicily, Plutarch, Arrian, Curtius Rufus, Athenaeus, Aelian and Justin were studied, with their information concerning wine consumption by Macedonians, and especially Alexander, and were evaluated. The surviving historical texts, all later than Alexander’s epoch, are based on a series of contemporary histories and especially on the ‘Royal journals’, an official diary written in the imperial court. and conclusions Alexander consumed large quantities of undiluted wine periodically, reaching pathological intoxication. However, the existing data do not provide convincing evidence that Alexander the Great manifested abuse of or dependence on alcohol according to DSM-IV or ICD-10 criteria and it seems unlikely that alcohol was involved in his untimely death

Alcohol detoxification and social anxiety symptoms: a preliminary study of the impact of mirtazapine administration

Background: Social anxiety disorder is fairly prevalent among alcohol abusing/dependent subjects. The objective of the present study was to investigate: (a) the incidence of social anxiety symptoms in inpatient alcoholics, (b) the effect of alcohol detoxification on these symptoms, and (c) whether a combined psychotherapeutic/mirtazapine treatment during the post-detoxification phase of alcoholism has a greater impact on the aforementioned symptoms than a non-pharmacological approach. Method: Social anxiety symptoms were assessed through the Liebowitz Social Anxiety Scale (LSAS) following a 4-5-week detoxification period in two groups: group A (n = 21) that followed a detoxification protocol of cognitive-behavioral orientation and group B (n = 33) that was assigned to mirtazapine in addition to the standard protocol. Concomitant psychopathology was monitored through the HARS and HDRS, and level of functioning through the GAS. Results: A marked reduction of social anxiety symptoms was evidenced in both groups. However, patients on mirtazapine improved significantly more compared to controls. Limitations: A single measure of social anxiety, i.e., the LSAS was used. Also, a longer follow-up period is needed to ascertain remission of social anxiety symptoms. Conclusions: The present study found a rather high incidence of social anxiety symptoms in inpatient alcoholics which subsided following alcohol detoxification; moreover, it provides preliminary evidence that a combined psychotherapeutic/mirtazapine treatment (30-60 mg/daily) has a greater impact on the aforementioned symptoms than non-pharmacological treatment alone. (C) 2003 Elsevier B.V. All rights reserved