Outpatient cognitive behavioural therapy programme for alcohol dependence impact of naltrexone use on outcome

Objective: Cognitive-behavioural therapy (CBT) has been effectively used in the treatment of alcohol dependence. Clinical studies report that the anticraving drug naltrexone, is a useful adjunct to treatment. Currently, few data are available on the impact of adding this medication to programmes in more typical, outpatient, and rehabilitation settings. The objective of this study was to examine the impact on outcome of adding naltrexone to an established outpatient alcohol rehabilitation program which employed CBT. Method: Fifty patients participated in an established 12-week, outpatient, 'contract'-based alcohol abstinence programme which employed CBT. They also received naltrexone 50 mg orally daily (CBT + naltrexone). Outcomes were compared with 50 historical, matched controls, all of whom participated in the same programme without an anticraving medication (CBT alone). All patients met DSM-IV criteria for alcohol dependence. Results: Programme attendance across the eight treatment sessions was lower in the CBT alone group (p < 0.001). Relapse to alcohol use occurred sooner and more frequently in the CBT alone group (p < 0.001). Rehabilitation programme completion at 12 weeks was 88% (CBT + naltrexone) compared with 36% for (CBT alone) (p < 0.001). Alcohol abstinence at 12 weeks was 76% (CBT + naltrexone) compared with 18% (CBT alone) (p < 0.001). Conclusion: When employing the same outpatient rehabilitation programme and comparing outcomes using matched historical controls, the addition of naltrexone substantially improves programme attendance, programme completion and reported alcohol abstinence. In a typical outpatient programme, naltrexone addition was associated with significantly improved programme participation, better outcomes and was well tolerated.

In situ electron paramagnetic resonance (EPR) study of surface oxygen species on Au/ZnO catalyst for low-temperature carbon monoxide oxidation

Some paramagnetic superoxide ions detectable by electron paramagnetic resonance (EPR) can be generated on Au/ZnO catalyst by oxygen adsorption at room temperature as well as at 553 K. In both the cases, the O-2(-) ions are present on the catalyst surface. The disappearance of the O-2(-) signal by the introduction of carbon monoxide over the catalyst surface implies that the O-2(-) ions are either the active oxygen species or the precursors of the active oxygen species. The CO3- species produced are also detected by EPR. (C) 2001 Elsevier Science B.V. All rights reserved.

Single-electron measurements with a micromechanical resonator

A mechanical electroscope based on a change in the resonant frequency of a cantilever one micron in size in the presence of charge has recently been fabricated. We derive the decoherence rate of a charge superposition during measurement with such a device using a master equation theory adapted from quantum optics. We also investigate the information produced by such a measurement, using a quantum trajectory approach. Such instruments could be used in mesoscopic electronic systems, and future solid-state quantum computers, so it is useful to know how they behave when used to measure quantum superpositions of charge.

Eutectic solidification in hypoeutectic Al-Si alloys: electron backscatter diffraction analysis

Nucleation and growth of the eutectic, in hypoeutectic Al-Si foundry alloys has been investigated by the electron backscatter diffraction (EBSD) mapping technique using a scanning electron microscope (SEM). Sample preparation procedures for optimizing mapping have been developed. To obtain a sufficiently smooth surface from a cast Al-Si eutectic microstructure for EBSD mapping, an appropriate preparation technique by ion milling was developed and applied instead of conventional electropolishing. By comparing the orientation of the aluminum in the eutectic to that of the surrounding primary aluminum dendrites, the growth mechanism of the eutectic can be determined. Two different results were found, in isolation or sometimes together, but distinct for different strontium contents: (1) crystallographic orientations of aluminum in eutectic and surrounding primary dendrites are identical, and (2) wide variation in orientations of the aluminum in the eutectic. (C) 2001 Elsevier Science Inc. All rights reserved.

A practical method for identifying intermetallic phase particles in aluminium alloys by electron probe microanalysis

Aluminium alloys that contain Si, Mg, Fe, Mn and/or Cu usually contain one or more types of intermetallic phases that are not readily distinguishable in the microstructure by conventional microscopy methods. It has thus been a challenge to develop a method that will unambiguously identify them. A practical approach has been developed that is based on an inherent linear relationship revealed for the overall distribution of any two elements in a precipitate/matrix geometry and the first-order approximation of electron probe microanalysis (EPMA) results. Application of this approach to a direct chill cast 6082 alloy is demonstrated, and its major limitations are discussed.

Peritoneal cytology: impact on disease-free survival in clinical stage I endometrioid adenocarcinoma of the uterus

The prognostic significance of positive peritoneal cytology in endometrial carcinoma has led to the incorporation of peritoneal cytology into the current FIGO staging system, While cytology was shown to be prognostically relevant in patients with stage II and III disease, conflicting data exists about its significance in patients who would have been stage I but were classified as stage III solely and exclusively on the basis of positive peritoneal cytology (clinical stage I). Analysis was based on the data of 369 consecutive patients with clinical stage I endometrioid adenocarcinoma of the endometrium. Standard treatment consisted of an abdominal total hysterectomy, bilateral salpingo-oophorectomy with or without pelvic lymph node dissection. Peritoneal cytology was obtained at laparotomy by peritoneal washing of the pouch of Douglas and was considered positive if malignant cells could be detected regardless of the number of malignant cells present. Disease-free survival (DFS) was considered the primary statistical endpoint. In 13/369 (3.5%) patients, positive peritoneal cytology was found. The median follow-up was 29 months and 15 recurrences occurred. Peritoneal cytology was independent of the depth of myometrial invasion and the grade of tumour differentiation, Patients with negative washings had a DFS of 96'7e at 36 months compared with 67% for patients with positive washings (log-rank P < 0.001). The presence of positive peritoneal cytology in patients with clinically stage I endometrioid adenocarcinoma of the endometrium is considered an adverse prognostic factor. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

The impact of nutrition support on body composition in cancer outpatients receiving radiotherapy

This study investigated the change in body composition in 36 cancer outpatients receiving radiotherapy to the head and neck area (mean age: 63 ± 15 years) randomised to receive either nutrition intervention (NI; n=15) or usual care (UC; n=21). Body weight and composition were measured at the commencement of radiotherapy and 3 months later. The UC group lost significantly more weight; mean decrease = 4.3 kg, than the NI group: mean decrease = 1.1 kg (t(30)=-2.5, p=0.019). Fat-free mass loss was significantly higher in the UC group with a mean loss of 2.2 kg versus 0.3 kg in the NI group (t(30)=- 2.3, p=0.029). Body composition as measured by foot-to-foot bioelectrical impedance analysis provides more information than weight alone and can allow for tailoring of NI.