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Biomedical subjects

D Lamparski

Publications and source records attributed to D Lamparski.

13 recordsLinked to original sources

Substance abuse among subjects screened out from an alcoholism research program.

Three hundred and eight subjects were screened over the phone for admission to an inpatient alcohol treatment research unit. Using a structured interview, the prospective patients were asked questions regarding demographics, drinking history, previous treatments, physical health, family history, and a detailed history of past and present substance use. Drug use was studied as regular use versus no use or brief experimental use of five drug categories: cannabinoids, stimulants, sedatives, opiates, and hallucinogens. Fifty-one percent of the men and 48% of the women reported regular use of one or more of the drugs in addition to alcohol. For women, the amount of alcohol intake was positively correlated with use of stimulants (r = .32, p = .001), cannabinoids (r = .24, p = .019), sedatives (r = .30, p = .003), and hallucinogens (r = .30, p = .003). For men, correlations between the amount of alcohol intake and drug use were weaker but significant for stimulants (r = .21, p = .002), opiates (r = .15, p = .028), and hallucinogens (r = .15, p = .029). Women with alcoholic mothers displayed higher alcohol intake than women with nonalcoholic mothers (p = .02) and also showed more frequent use of most drugs. Although men with alcoholic fathers also showed greater alcohol intake compared to men with nonalcoholic fathers, the two groups did not differ in drug use. Younger subjects of both sexes were more likely to use cannabinoids, stimulants, opiates, and hallucinogens. Alcohol and sedative use was relatively constant across all age groups.

Adult↗

Mental disorders among alcoholics. Relationship to age of onset and cerebrospinal fluid neuropeptides.

Eighty-one percent of 339 alcoholics participating in a research program were found to have associated mental disorders. Alcoholics with onset of heavy drinking before 20 years of age had significantly more antisocial personality traits, drug abuse, bipolar disorder, panic disorder, suicide attempts, and paternal alcoholism than alcoholics with onset after age 20 years. Alcoholics with onset before and after 20 years of age also differed significantly from each other for cerebrospinal fluid concentrations of diazepam-binding inhibitor and somatostatin. These results support the notion that age of onset may delineate subgroups of alcoholics with significant clinical and neurochemical differences.

Adult↗

Depression among alcoholics. Relationship to clinical and cerebrospinal fluid variables.

Although depression is common among alcoholics, its determinants are poorly understood. Among 339 alcoholics, 111 (33%) had a history of major depression. Depressed, compared with never-depressed alcoholics, had a higher daily alcohol intake, more lifetime diagnoses of other anxiety and affective disorders and drug abuse, more had attempted suicide, and more reported alcoholism in both parents. Depressed alcoholics also had significantly lower cerebrospinal fluid levels of the dopamine metabolite homovanillic acid and of gamma-aminobutyric acid. Among subgroups of depressed alcoholics, secondary compared with primary depressives were more often divorced, of lower social status, with an earlier onset of alcoholism, and higher Michigan Alcohol Screening Test scores. Secondary depressives also had significantly lower cerebrospinal fluid concentrations of homovanillic acid than never depressed alcoholics. These results suggest that certain psychosocial variables, alcohol consumption, and neurochemical variables may be specifically associated with depression in alcoholics.

Adult↗

Personality and cerebrospinal fluid monoamine metabolites in alcoholics and controls.

Alcoholics as a group have been consistently reported to show differences from controls on various personality inventories. Moreover, neurobiologic substrates have been postulated to underlie personality dimensions. Therefore, we compared alcoholics with controls on measures of personality and investigated relationships between measures of personality and cerebrospinal fluid monoamine metabolite concentrations. The alcoholics were significantly different from controls on many personality measurements. There were significant, negative correlations between interview-derived lifetime aggression scores and cerebrospinal fluid concentrations of both the serotonin metabolite 5-hydroxyindoleacetic acid and the dopamine metabolite homovanillic acid. However, there were no significant correlations between any cerebrospinal fluid monoamine metabolite concentrations and scores on personality inventories.

3,4-Dihydroxyphenylacetic Acid↗

Long-term smoking status of cardiac patients following symptom-specific cessation advice.

Although physicians routinely advise postcardiac event patients to stop smoking, the effect of a modified advice format targeting specific health concerns has not been investigated. Also, no studies of cessation advice with cardiac patients have used biochemical verification of self-reported abstinence. The present study included 48 veterans with a history of smoking and cardiac problems; of these, 31 were smoking and 17 were abstinent at initial assessment. Alveolar carbon monoxide (COa) levels served to: (1) augment cessation advice by demonstrating smoking risks and cessation benefits specific to cardiac patients and (2) verify self-report. At 12 months followup, following cessation advice, 18% of the abstinent subjects had resumed smoking while none of the smokers had become abstinent. Those who maintained abstinence significantly increased their estimates of the contribution of smoking to their cardiac problems whereas those who continued to smoke showed no change.

Breath Tests↗

Cerebrospinal fluid monoamine metabolites in alcoholic patients who attempt suicide.

Reduced cerebrospinal fluid (CSF) levels of the serotonin metabolite 5-hydroxyindoleacetic acid have been reported to be commonly associated with suicidal behaviour. Alcoholics are known to often manifest suicidal behaviour. Therefore, we compared cerebrospinal fluid levels of monoamine metabolites in alcoholics who had (n = 20) and had not (n = 108) attempted suicide and healthy volunteers (n = 30). There were no significant differences among the 3 groups for CSF levels of either 5-hydroxyindoleacetic acid, the dopamine metabolite homovanillic acid, norepinephrine, or the norepinephrine metabolite 3-methoxy-4-hydroxyphenylglycol.

Adult↗

Characteristics of alcoholics who attempt suicide.

Of 298 alcoholic subjects studied by the authors, 19% (N = 57) had attempted suicide. Compared with nonattempters, suicide attempters were significantly more likely to be female, to have a lower socioeconomic status, to be younger, to have begun heavy drinking and experienced the onset of alcohol-related problems at an earlier age, to consume a greater amount of alcohol when drinking, and to have additional lifetime psychiatric diagnoses of major depression, antisocial personality disorder, substance abuse, panic disorder, phobic disorder, or generalized anxiety disorder. Also, significantly more attempters had first- or second-degree relatives who abused alcohol.

Adult↗

Pathological gambling. A psychobiological study.

We investigated psychobiological substrates of pathological gambling by measuring levels of norepinephrine, monoamine metabolites, and peptides in cerebrospinal fluid, plasma, and urine. Pathological gamblers had a significantly higher centrally produced fraction of cerebrospinal fluid levels of 3-methoxy-4-hydroxyphenylglycol as well as significantly greater urinary outputs of norepinephrine than controls. These results suggest that pathological gamblers may have a functional disturbance of the noradrenergic system. This system has been postulated to underlie sensation-seeking behaviors, aspects of which are thought to be abnormal among pathological gamblers.

Adult↗

Variables related to long-term smoking status following cardiac events.

Abstinence rates for smokers following a myocardial infarction (MI) or coronary by-pass surgery (CABG) are far superior to those for persons attending formal cessation programs. However, only two studies have used any biochemical verification of self-report in this population, and it is unclear what variables are associated with successful cessation post-MI or -CABG. The present study used alveolar carbon monoxide levels to verify self-report of post-MI and -CABG veterans and obtained only a 29% abstinence rate. Most abstinent veterans quit immediately after their first cardiac event, and only the belief that smoking contributed to their cardiac problems predicted long-term smoking status.

Coronary Artery Bypass↗

Accuracy in estimating fasting blood glucose levels by patients with diabetes.

This study was designed to assess the accuracy with which diabetic patients can estimate their fasting blood sugars (FBS) and to determine whether experience with self-monitoring of blood glucose improves this ability. Twenty patients with type II diabetes who had no experience with self-monitoring of blood glucose were compared with 17 patients who had been monitoring blood sugar regularly for the previous 8 mo. All patients were asked to estimate FBS immediately before it was measured in the laboratory. Patients were very accurate in estimating their FBS; the average error in estimation was 2 mg/dl, and 65% of patients estimated FBS within 20% of actual FBS. However, there was no evidence that experience in self-monitoring of blood glucose improved the accuracy of estimation. Additional studies are needed to determine the types of cues that patients use in estimating blood sugar.

Adult↗

Behavioral skills in self-monitoring of blood glucose: relationship to accuracy.

Sixty-two children and adolescents with IDDM were observed while performing self-monitoring of blood glucose (SMBG) to determine which of the behaviors involved in SMBG were most likely to be performed incorrectly and which errors had the greatest effect on the accuracy of SMBG readings. Behaviors related to cleanliness and timing were performed most poorly; only 60% of the subjects correctly timed the first minute, and 30-33% correctly timed the second interval. The duration of SMBG and frequency of monitoring were not related to proper performance of the behaviors involved in SMBG. Accuracy of SMBG was assessed by comparing subjects' readings to laboratory values obtained immediately afterward. The behavior that had the greatest effect on the accuracy of SMBG readings was that concerning whether the blood was adequately wiped from the Chemstrip bG. This behavior should receive more emphasis in SMBG training programs. The systematic observation procedure used in this study may help to identify errors made by patients while performing SMBG and may serve as the basis for training programs to improve SMBG accuracy.

Adolescent↗