Alterations of Homocysteine Serum Levels during Alcohol Withdrawal Are Influenced by Folate and Riboflavin: Results from the German Investigation on Neurobiology in Alcoholism (GINA)

Aims: Various studies have shown that plasma homocysteine (HCY) serum levels are elevated in actively drinking alcohol-dependent patients a during alcohol withdrawal, while rapidly declining during abstinence. Hyperhomocysteinemia has been associated not only with blood alcohol concentration (BAC), but also with deficiency of different B-vitamins, particularly folate, pyridoxine and cobalamin. Methods: Our study included 168 inpatients (110 men, 58 women) after admission for detoxification treatment. BAC, folate, cobalamin, pyridoxine, thiamine and riboflavin were obtained on admission (Day 1). HCY was assessed on Days 1, 7 and 11. Results: HCY levels significantly declined during withdrawal. General linear models and linear regression analysis showed an influence of BAC, folate and riboflavin on the HCY levels on admission as well as on HCY changes occurring during alcohol withdrawal. No significant influence was found for thiamine, cobalamin and pyridoxine. Conclusions: These findings show that not only BAC and plasma folate levels, but also plasma levels of riboflavin influence HCY plasma levels in alcohol-dependent patient

Implementing textural features on GPUs for improved real-time pavement distress detection

The condition of municipal roads has deteriorated considerably in recent years, leading to large scale pavement distress such as cracks or potholes. In order to enable road maintenance, pavement distress should be timely detected. However, manual investigation, which is still the most widely applied approach toward pavement assessment, puts maintenance personnel at risk and is time-consuming. During the last decade, several efforts have been made to automatically assess the condition of the municipal roads without any human intervention. Vehicles are equipped with sensors and cameras in order to collect data related to pavement distress and record videos of the pavement surface. Yet, this data are usually not processed while driving, but instead it is recorded and later analyzed off-line. As a result, a vast amount of memory is required to store the data and the available memory may not be sufficient. To reduce the amount of saved data, the authors have previously proposed a graphics processing units (GPU)-enabled pavement distress detection approach based on the wavelet transform of pavement images. The GPU implementation enables pavement distress detection in real time. Although the method used in the approach provides very good results, the method can still be improved by incorporating pavement surface texture characteristics. This paper presents an implementation of textural features on GPUs for pavement distress detection. Textural features are based on gray-tone spatial dependencies in an image and characterize the image texture. To evaluate the computational efficiency of the GPU implementation, performance tests are carried out. The results show that the speedup achieved by implementing the textural features on the GPU is sufficient to enable real-time detection of pavement distress. In addition, classification results obtained by applying the approach on 16,601 pavement images are compared to the results without integrating textural features. There results demonstrate that an improvement of 27% is achieved by incorporating pavement surface texture characteristics

Interoceptive Awareness, Tension Reduction Expectancies and Self-Reported Drinking Behavior

Aims: Recent accounts have suggested the involvement of interoceptive processes in consumption behavior for alcohol and other drugs. However, there is a paucity of empirical support for a direct association with physiologically assessed individual differences in interoceptive awareness (IA). The current research explored this postulated link and examined the interplay with positive outcome expectancies of alcohol consumption. Method: IA of alcohol-dependent adult in- and outpatients was measured with an objective electrocardiogram heart rate tracking task. Tension reduction expectancies (TRE) and drinking compulsions/obsessions were assessed with self-report questionnaires. Results: No direct associations of IA with drinking compulsions/obsessions were found. However, IA and TRE interacted as predictors of drinking compulsions and drinking obsessions. Conclusion: The results corroborate the suggestion that neglect of bodily feedback might be a maintaining factor for drinking behavior

Sind gemeinsame Therapieangebote für Partydrogen- und Cannabiskonsumenten sinnvoll? Ergebnisse zum stationären Behandlungsangebot des "Bonner Modells - Junge Sucht"

Fragestellung: Krankenhausabteilungen und psychiatrische Versorgungskliniken im Bereich der suchtmedizinischen Erwachsenenpsychiatrie werden, entsprechend dem allgemein steigenden Behandlungsbedarf, zunehmend auch mit dem Problem des exzessiven Konsums von Cannabis und Partydrogen konfrontiert. Gleichzeitig besteht ein Mangel an überprüften therapeutischen Konzepten. Es wurde daher ein speziell für junge Erwachsene mit Cannabis-/Partydrogenkonsum entwickeltes stationäres Behandlungsprogramm untersucht. Insbesondere wurde der Frage nach Gemeinsamkeiten und Unterschieden der Konsumentengruppe nachgegangen, sowie überprüft, ob ein gemeinsames Behandlungsangebot sinnvoll ist. Methodik: Untersucht wurden soziodemographische und klinische Merkmale von Pat. mit problematischen Partydrogen- und Cannabiskonsum (n1 = 27, n2 = 69), die im Zeitraum vom 01.06.2005 bis 01.06.2008 in unserer Einrichtung stationär behandelt wurden. Die Symptombelastungen wurden mittels Selbstbeurteilungsskalen sowie eines semistrukturierten Interviews zu Beginn und zum Ende der stationären Behandlung erfasst und über Gruppenvergleiche ausgewertet. Ergebnisse: Es ergeben sich zu beiden Messzeitpunkten keinerlei signifikante Gruppenunterschiede bei den substanzbezogenen und psychischen Merkmalen. Angst und interpersonale Probleme stellen die größten Belastungsfaktoren dar. Insgesamt ergeben sich für allgemeine psychische Faktoren höhere Belastungen als für substanzbezogene. Beide Gruppen profitieren in hohem Ausmaß von der stationären Behandlung. Es ergeben sich über alle untersuchten abhängigen Variablen hohe Effektstärken. Schlussfolgerungen: Gemeinsame Behandlungsangebote für Partydrogen- und Cannabiskonsumenten sind sinnvoll. Komorbide psychische Störungen, insbesondere Angststörungen und interpersonale Probleme sollten bei der Behandlungsplanung berücksichtigt werden

Concomitant endocrine and immune alterations during alcohol intoxication and acute withdrawal in alcohol-dependent subjects

Although both alcohol intoxication and withdrawal have been demonstrated to produce significant endocrine alterations, no data exist on the effects of acute withdrawal on immune functions. Therefore, the current study investigated the effect of alcohol intoxication and acute withdrawal on plasma cortisol, prolactin and catecholamines, and blood leukocyte subset distribution in alcohol-dependent subjects. Nine male alcoholics admitted to the university clinic for alcohol dependence and 9 age-matched controls participated in the study. Blood was drawn from the alcohol-dependent subjects at 10:30 a.m. on day 0 (chronic alcohol intoxication), at the same time during acute alcohol withdrawal (day 1) and following the resolution of acute withdrawal (day 7). Blood was drawn from age- and gender-matched healthy control subjects at the corresponding time points. Plasma was then analyzed for hormone concentrations and blood examined for leukocyte subsets by flow cytometry. Alcohol-dependent patients displayed significantly elevated plasma cortisol during intoxication and withdrawal, which decreased to control levels following resolution of acute withdrawal. Small elevations of plasma prolactin and catecholamines were also observed during intoxication. Furthermore, alcohol-dependent subjects showed reduced absolute numbers of CD4(+) and CD8(+) T cells and natural killer cells compared with healthy controls across all time points. In contrast, although monocyte numbers were lower in alcohol-dependent patients during intoxication, acute alcohol withdrawal increased the number of monocytes in patients. Thus, alcohol dependence produces a general suppression of leukocyte subset populations in blood. However, resolution of acute alcohol withdrawal is associated with a return of plasma cortisol to control levels, and a concomitant increase in peripheral blood monocyte number

Fünf Minuten täglich: Kompass - eine stationäre Kurzintervention für junge Cannabis-/Partydrogenpatienten nach dem "Bonner Modell - Junge Sucht"

ragestellung: Zur stationären Behandlung von Cannabis-/Partydrogenkonsumenten wurde eine Kurzinterventionsmethode „Kompass“ mit einem Zeitaufwand von täglich fünf Minuten entwickelt und auf ihre Wirksamkeit insbesondere hinsichtlich der depressiven Symptomatik und den besonderen Bedürfnissen der Patientengruppe überprüft. Methodik: 104 Patienten im Alter von 23, davon 66 Cannabis- und 21 Partydrogenkonsumenten , die sich in der LVR-Klinik Bonn stationär in Behandlung befanden, wurden anhand standardisierter Fragebögen (BDI, Hautzinger, Bailer, Worrall & Keller, 1995; IIP-C, Horowitz, Strauß & Kordy, 2000; STAI, Laux, Glanzmann, Schaffner & Spielberger, 1981; SCL-90-R, Franke, 2005) und Interviews (EuropASI, Gsellhofer & Blanken, 1999) in einem quasi-experimentellem Design untersucht. Der Therapieerfolg (Symptomreduktion) wurde über die korrigierte Effektstärke erfasst. Ergebnisse: Die Kurzinterventionsmethode „Kompass“ ist ein in der stationären Behandlung wirksames Zusatztreatment. Im Vergleich zu einer „Treatment-as-usual“-Gruppe wurden mit dkorr = 0.70 für interpersonale Probleme, dkorr = 0.60 für Trait-Angst, dkorr = 0.56 für Depressivität und dkorr = 0.60 für psychische Belastung mittlere Effektstärken gefunden. Schlussfolgerung: Der „Kompass“ kann effektiv und effizient als Zusatzbehandlung in die stationäre Therapie für Cannabis-/Partydrogenkonsumentent integriert werden

Can reinforcement-based interventions to reduce drug use successfully be adapted to routine opioid maintenance treatment?

Introduction. Comorbid substance related disorders are a major health problem for patients in opioid maintenance treatment (OMT). It was investigated whether a reinforcement scheme adapted to the regulatory and financial restrictions of routine treatment reduces concomitant drug use.Methods. OMT patients from 7 clinics who were using cocaine, benzodiazepines, heroin or amphetamines were randomly allocated to either treatment as usual (n = 64) or treatment with an additional escalating reinforcement scheme (n = 72) in which a patient's number of weekly take-home dosages was increased after 1, 4, 8 and 12 consecutive weeks with drug-free urine specimens. Trial duration was 26 weeks. Results. Completion rates were 64% for controls and 62.5% in the experimental group. Mean number of drug-free weeks was 11.3 (SD 8.5) for the control group and 9.8 (8.9) for the experimental group (p = 0.30). Conclusion. The intervention was not effective compared to routine treatment. Additional features might be necessary to achieve an effect, e.g. a higher frequency of urine sampling or use of other reinforcers. It has to be further investigated how interventions which have been proven effective in experimental studies can successfully be adapted to routine care conditions.Peer reviewe