Association of major depression with subtypes of nicotine dependence found among adult daily smokers: A latent class analysis

Nicotine dependence (ND) and major depression (MD) are highly prevalent disorders that frequently co-occur. Less is known about which aspects of ND are most strongly associated with MD. The present study was designed to determine if subtypes of smokers exist and differ in their risk of MD and lifetime MD symptoms. Latent class analysis was used to identify profiles of DSM-IV ND criteria for 8,842 daily smokers drawn from the larger 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). We found evidence for 4 distinct subtypes of smokers mainly characterized by increasing levels of ND severity, by number of criteria endorsed. We found a dose-response relationship between classes by increasing ND severity and odds of past-year MD and lifetime depression criteria. Class 2 was characterized by higher symptom endorsement probabilities (SEPs) for wider range of ND criteria and a higher odds of MD (OR = 3.66) compared to class 3, which was characterized by higher SEPs for physiological ND criteria, higher prevalence of ND (class 2, 71.50% vs. class 3, 81.57%), and a lower odds of MD (OR = 2.15). A post hoc contrast showed these two distinct classes of respondents with mild to moderate ND significantly differed in their likelihood of MD comorbidity (F = 12.25, 1 df, p = 0.0008). ND severity mainly characterized the classes, but unique differences may exist between smokers with mild to moderate ND. Individuals with symptom profiles not characterized by physiological dependence endorse wider range of ND criteria and have a higher likelihood of MD. (C) 2009 Elsevier Ireland Ltd. All rights reserved

The tof-guard neuromuscular transmission monitor and its use in horses O monitor da transmissão neuromuscular "tof-guard" e seu uso em eqüinos

It has been emphasized in the human medical literature, that when using a neuromuscular blocking agent, it is of vital importance the monitoring of the neuromuscular block and that these agents should never be used without it. The purpose of this study was to evaluate the use of the neuromuscular transmission monitor TOF-Guard in horses. Twelve horses were randomly assigned whether to receive pancuronium or atracurium as the neuromuscular blocking agent. All horses were pre-medicated with romifidine, anaesthesia induced with diazepam and ketamine and maintenance with halothane. Abolition of spontaneous ventilation was accomplished by the administration of atracurium or pancuronium. The time from injection of the muscle relaxant agent to the onset of maximum block (T1=0), recovery of T1 to 25% and the recovery of TOF ratio to 0.7 were recorded, as was the time for recovery of T1 from 25 to 75%. It was concluded that it is very important the neuromuscular transmission monitoring during the use of a nondepolarizing neuromuscular blocking agent, since it provides a safer anaesthetic and surgical procedure with the use of adequate dosages and due to the impossibility of a superficialization of the neuromuscular blockade during a surgical procedure. The TOF-Guard showed to be a good option for neuromuscular monitoring in horses.<br>Quando da utilização de bloqueadores neuromusculares, já foi enfatizado na literatura médica humana, que é de vital imporância a monitoração do bloqueio neuromuscular e que estes agentes nunca devem ser utilizados sem a mesma. O objetivo deste estudo foi o de avaliar o uso do monitor da transmissão neuromuscular TOF-Guard em eqüinos. Para tanto, doze eqüinos foram separados aleatoriamente para receberem como bloqueadores neuromusculares o pancurônio ou o atracúrio. Todos os eqüinos foram pré-medicados com romifidina, induzidos com diazepam e quetamina e mantidos com halotano. Foi administrado o atracúrio ou o pancurônio, seguindo-se a apnéia e início da ventilação mecânica controlada. O tempo entre a administração do relaxante muscular e a obtenção de um bloqueio máximo (T1=0), o retorno do T1 para 25% e da razão do TOF para 0,7 e o tempo do retorno do T1 de 25 para 75% foram mensurados. Concluiu-se que é de grande importância a monitoração do bloqueio neuromuscular quando da utilização de um bloqueador neuromuscular não-despolarizante, uma vez que ela torna o ato anestésico e cirúrgico mais seguro, com a utilização de doses adequadas que inviabilizam a superficialização do bloqueio durante o procedimento cirúrgico. O monitor TOF-Guard mostrou ser uma boa opção para a monitoração do bloqueio neuromuscular em eqüinos