This paper reports the results of a case control study of non-Hodgkin's lymphoma in the Yorkshire Health Region. In all, 437 cases and 724 controls were interviewed. Risk factors associated with past skin conditions, family history of cancer and infectious mononucleosis, aspects of social life and contact with wood dust and epoxy glues all emerge. A comparison of high and low grade morphological forms of disease reveal contrasting risks and suggest separate aetiologies for these conditions.

England↗

PubMed1988

Is inpatient medical alcohol detoxification justified: results of a randomized, controlled study.

The findings of this study revealed relatively few short-term outcome differences for patients meeting study criteria who were randomly assigned to either outpatient or inpatient medical detoxification. Given the higher costs of inpatient treatment, these findings suggest that outpatient detoxification be considered as a meaningful and cost-effective treatment for persons with mild to moderate alcohol withdrawal symptomatology.

Alcoholism↗

PubMed1988

Hormone secretion in methadone-dependent and abstinent patients.

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Adult↗

PubMed1988

Progress in understanding the conditioning aspects of drug dependence.

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Conditioning, Classical↗

PubMed1988

Conditioned craving and arousal in cocaine addiction: a preliminary report.

Though data collection is still in progress, several significant findings are already apparent from our study of cocaine 'reminders': 1) In the laboratory, detoxified cocaine abusers show a differential responsivity to drug-related cocaine 'reminders', responding with strong signs of physiological arousal (peripheral skin temperature reductions and decreases in skin resistance) and subjective cocaine craving. 2) In extinction sessions, repeated, non-reinforced exposure to cocaine 'reminders' led to a complete reduction in craving to these stimuli by the fifteenth hour-long session. High and 'crash' responses were virtually eliminated by the sixth hour of extinction. 3) Physiological arousal to cocaine 'reminders' was often still in evidence even after fifteen hours of extinction. 4) Even after completing the current extinction protocol cocaine abusers may crave--and use--cocaine when experiencing drug 'reminders' in the natural environment. Clearly, detoxified cocaine abusers can experience conditioned craving and arousal to cocaine 'reminder' stimuli. These responses can be both intense and persistent, meaning that the abstinent cocaine abuser may be vulnerable long after detoxification is complete. Though the program of extinction described here is effective in reducing craving to cocaine-related stimuli presented in the context of the laboratory or clinic, this effect may not generalize well to the natural environment. We are currently considering two approaches to this problem: 1) One approach would attempt to increase the generalization of extinction by the use of even more realistic stimuli (e.g., the sight of real cocaine) and stimulus contexts (e.g., in vivo repeated exposures).(ABSTRACT TRUNCATED AT 250 WORDS)

Cocaine↗

PubMed1988

Psychotherapy for substance abuse.

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Counseling↗

PubMed1988

Update on behavioral treatments for substance abuse.

In the past five years there has been an encouraging increase in the amount and quality of research on behavioral treatments for substance abuse. Some of the most promising approaches combine behavioral treatments with each other (e.g., relapse prevention and cue exposure) or with other forms of treatment (e.g., psychotherapy), attempting to maximize impact on the multiple determinants of drug use. We are fast approaching the time when a patient may be systematically evaluated to develop a profile of vulnerabilities (cue responsivity, psychiatric symptoms, etc.) to rationally determine the treatment or combination of treatments of greatest potential benefit.

Behavior Therapy↗

PubMed1987

Chronic lymphocytic leukaemia: case control epidemiological study in Yorkshire.

This is the second report of a large case control study of lymphoma/leukaemia occurring in Yorkshire during 1979-84, and deals with chronic lymphocytic leukaemia presenting either in its haematological (CLL) or more solid lymphomatous (malignant lymphoma-lymphocytic or MLL) forms. In all, 330 cases and 561 controls were interviewed. The results support the concept that CLL/MLL is a condition of multiple aetiologies with evidence for genetic predisposition through an excess of family cases, immune perturbation demonstrated by excessive previous skin diseases and phenylbutazone use, and viral involvement shown by links with infectious diseases and multiple sclerosis.

Drug-Related Side Effects and Adverse Reactions↗

PubMed1987

Variation in lymphoma incidence within Yorkshire Health Region.

The spatial distribution of new cases of lymphoma occurring in Yorkshire between 1978 and 1982 has been studied. Administrative districts were used as the basis for analysis and differences in age standardised incidence rates between districts were determined. Excessive rates for NHL were found to occur in Scarborough, York and Leeds districts. In addition an analysis contrasting broadly urban and rural districts showed an excess of NHL in rural areas, particularly of the follicular subtypes.

Adolescent↗

PubMed1987

Spatial patterns in electoral wards with high lymphoma incidence in Yorkshire health region.

The possibilities of clustering between those electoral wards which display higher than expected incidences of cases of the lymphomas occurring between 1978 and 1982 are examined. Clusters are defined as being those wards with cases in excess (at a probability of less than 10%) which are geographically adjacent to each other. A separate analysis extends the definition of cluster to include high incidence wards that are adjacent or separated by one other ward. The results indicate that many high incidence lymphoma wards do occur close together and when computer simulations are used to compute expected results, many of the observed results are shown to be highly improbable both in the overall number of clustering wards and in the largest number of wards comprising a 'cluster'.

Computer Simulation↗

PubMed1987

Hodgkin's disease: case control epidemiological study in Yorkshire.

This is the first report of a case-control epidemiological study on lymphomas and leukaemias occurring in Yorkshire during 1979-84. This paper deals with the results of the Hodgkin's disease analysis comprising 248 cases and 489 controls. The results indicate support for previous work with respect to small family size and past history of infectious mononucleosis. Positive observations made in a previous pilot study are also confirmed and extended with respect to associations with certain chronic skin lesions, dental anaesthesia and familial factors. Negative associations are described with respect to X-ray exposures and cigarette smoking. It is proposed that these results fit into a general hypothesis that these conditions are the result of interaction between infectious agents and altered immunity in those persons genetically predisposed.

Adolescent↗

PubMed1987

A possible epidemiological association between multiple sclerosis and lymphoma/leukaemia.

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England↗

PubMed1986

Cooperative effect of thyroid and glucocorticoid hormones on the induction of hepatic phosphoenolpyruvate carboxykinase in vivo and in cultured hepatocytes.

The present study investigates the effect and interaction of glucocorticoid and thyroid hormones on the induction of phosphoenolpyruvate carboxykinase (PEPck) mRNA and enzyme protein under in vivo conditions and in serum-free cultured hepatocytes from hypothyroid rats. In hypothyroid/adrenalectomized rats T3 significantly enhanced the cAMP induced PEPck mRNA activity within 3-6 h. This effect was further enhanced by the presence of glucocorticoids. The half-life of PEPck mRNA, as determined after administration of cordycepin, was not affected by hypothyroidism or hyperthyroidism (t 1/2 approximately equal to 45 min), but considerably prolonged by the absence of glucocorticoid hormones (t 1/2 less than 80 min). In hepatocytes in culture Bt2cAMP (0.2 mM) provoked an increase in translatable PEPck mRNA within 2 h incubation time. Preincubation with either T3 (0.1 microM) or dexamethasone (0.1 microM) for 4 h significantly enhanced the cAMP response on PEPck mRNA. Addition of both, T3 plus dexamethasone further enhanced this Bt2cAMP-mediated effect. By measurement of PEPck synthesis corresponding findings were observed. It is concluded that glucocorticoid and thyroid hormones predominantly enhance the cAMP-provoked induction of hepatic PEPck mRNA and, consequently, of PEPck synthesis. Their effect is rapid, significant and additive, indicating an independent action. While glucocorticoids, in addition, accelerate PEPck mRNA degradation, the PEPck mRNA decay rate is similar in the presence and absence of thyroid hormones.

Animals↗