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Biol Psychiatry. 2005 Jul 15;58(2):158-64.

Vaccine pharmacotherapy for the treatment of cocaine dependence.

Martell BA , Mitchell E , Poling J , Gonsai K , Kosten TR .Section of General Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.bridget.martell@yale.edu

BACKGROUND: Cocaine abuse has no established pharmacotherapy, but active immunotherapy with a cocaine vaccine shows promise as a therapeutic intervention. METHODS: An open label, fourteen week, dose-escalation study evaluated the safety, immunogenicity, and clinical efficacy of a novel human cocaine vaccine (TA-CD) in eighteen cocaine dependent subjects. Ten subjects (400 microg total dose group) received four-100 microg injections over the course of eight weeks. Subsequently, eight subjects (2000 microg total dose group) received five-400 microg vaccinations over twelve weeks. Intent to treat analysis of thrice weekly urine toxicologies and cocaine antibody titers were compared. RESULTS: Sixteen of 18 subjects completed the study. There were no serious adverse reactions and the vaccine was well tolerated. The 2000 microg total dose group had a significantly higher mean antibody titer response (2000 units) as compared to the 400 microg total dose group (1000 units) (p = .05). The 2000 microg group was more likely to maintain cocaine free urines than those in the 400 microg group (Z = -3.12, p = .002). Despite relapse in both groups, most reported an attenuation of cocaine's usual euphoric effects at the six month follow-up time points (63% in the 400 microg and 100% in the 2000 microg groups). CONCLUSIONS: The conjugated cocaine vaccine was well tolerated and cocaine specific antibodies persisted at least six months. The likelihood of using cocaine decreased in subjects who received the more intense vaccination schedule.

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Soggetti con sintomi nell’infanzia di ansia e depressione sarebbero più inclini the use of ecstasy

Researchers Erasmus Medical Center / Sophia Children's Hospital in Rotterdam have evaluated whether the use of ecstasy (3,4-methylenedioxymethamphetamine, MDMA) is preceded by symptoms of behavioral problems and emotional childhood and early adolescence. The study, prospective, involved 1580 subjects followed for up to a period of 14 years, from pediatric to adulthood. The first evaluation was performed in 1983 before the onset of MDMA as a recreational substance in the Netherlands. E 'was observed that individuals with symptoms of anxiety and depression in childhood have a greater tendency to use MDMA in adolescence or young adulthood. MDMA promotes the feeling with other people, gives it produces euphoria and relaxation. Especially those with symptoms of anxiety and depression may be susceptible to these effects.

Huizink AC et al, BMJ 2006; 332: 825-828

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Sildenafil may be useful in Crohn's disease

according to researchers at 'University College London, the underlying cause of Crohn's disease would be opposed to that previously supported. At the base, there would be an alteration of innate immunity, rather than a hyperactive immune system. Crohn's disease is a chronic inflammatory bowel disease characterized by ulcers in the intestine. E 'and is considered an autoimmune disease currently treated with immunosuppressants. British researchers, led by Anthony Segal, have instead found that people with Crohn's disease have a weak immune system and non-responsive, unable to easily repair the damage in the intestine. The direction of blood flow in damaged cells is substantially reduced and the authors believe that a drug like sildenafil (Viagra, Revatio) could be useful in patients with Crohn's disease, because of its effect of stimulating blood flow. The researchers compared the immune system of patients with Crohn's disease with that of healthy individuals with minor damage (eg skin abrasions) and found differences in the number of neutrophils produced by the body to repair the damage in the intestine and skin. Healthy people have more neutrophils than patients with Crohn's disease, showing that the immune response in people with Crohn's is damaged. E 'was also evaluated the inflammatory response to bacteria (Escherichia coli). Patients with Crohn's disease were unable to destroy bacteria that penetrate the intestinal wall, because of the weakness of the immune system.

Source: The Lancet, 2006

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Europe, the CHMP recommended approval of Acomplia

The Advisory Panel (CHMP) (European Medicines Agency) gave a positive opinion for approval of Rimonabant (Acomplia) in the treatment of obesity (BMI greater than or equal to 30) or overweight (BMI greater than 27) with associated risk factors such as diabetes and dyslipidemia. Sanofi-Aventis said that rimonabant not only reduces body weight, but improves also glycosylated hemoglobin (HbA1c), raises levels of HDL cholesterol and reduces triglycerides. In the U.S., the FDA sent to Sanofi-Aventis an approvable letter for Acomplia, which includes additional documentation prior to approval.

Source: Sanofi-Aventis, 2006

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The effect of antidepressants in the homeostasis of glucose and insulin sensitivity

Researchers at Toronto University conducted a Medline search with the objective of evaluating the effect of antidepressant drugs glucose-insulin homeostasis. An analysis of the literature showed that serotonergic antidepressants such as fluoxetine, reduce hyperglycemia, normalize glucose homeostasis and increase insulin sensitivity, whereas some noradrenergic antidepressants such as desipramine, exert opposite effects. The dual mechanism of action of antidepressants such as duloxetine and venlafaxine do not appear to alter glucose homeostasis, whereas, for example, phenelzine, an MAOI, was associated with hypoglycemia and an increased rate of glucose disposal .

McIntyre RS et al, Export Opin Drug Saf 2006; 5: 157-168

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Agomelatine, an antidepressant melatonergico

Agomelatine (Valdoxan) is the first antidepressant melatonergic. The therapeutic efficacy of the drug was demonstrated in the treatment of major depressive disorder at a dose of 25mg/die. For its pharmacological profile, agomelatine does not induce side effects typical of other therapies, such as selective serotonin reuptake inhibitors (eg, gastrointestinal disorders, weight gain, serotonin syndrome and insomnia). A placebo-controlled study in patients with depressive disorder major, who compared the effects of agomelatine with those of venlafaxine (Efexor) on sexual dysfunction, have demonstrated a very favorable Agomelatine. In addition, the Agomelatine has proven to be as effective as venlafaxine. A placebo-controlled study evaluated the effect of abrupt cessation of treatment, highlighting the absence of withdrawal symptoms with agomelatine in contrast to that observed with paroxetine (Eutimil / Daparox / Sereupin / Seroxat). Agomelatine has also been shown to positively influence the abnormal circadian rhythms in depressed patients, significantly improving all phases of disturbed sleep and sleep quality, with a favorable impact Supervision throughout the day. The clinical trial data so far indicate that the Agomelatine represents a new approach to the treatment of depression, combining the effectiveness of a favorable safety profile and sleep regulation.
Rouillon F et al, Int Clin Psychopharmacol 2006; 21 Suppl 1: S31-S35