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Biomedical subjects

H J Aubin

Publications and source records attributed to H J Aubin.

13 recordsLinked to original sources

Sleep effects of a 24-h versus a 16-h nicotine patch: a polysomnographic study during smoking cessation.

BACKGROUND AND PURPOSE: Sleep disturbance is a common symptom of tobacco withdrawal and might contribute to early relapse vulnerability in abstinent smokers. This study was designed to compare the effects on sleep of nicotine patches applied either for 24 h (Nicopatch) or 16 h (Nicorette). PATIENTS AND METHODS: During a short smoking cessation period (48 h), this open-label, randomised, two-period crossover study compared the effects on sleep of the two nicotine patches in 20 heavy smokers (9 women, 11 men). During each period, polysomnographic recordings were performed from 12 pm to 7 am for two consecutive nights (baseline and treatment nights). Smoking cessation started from 8 pm the day of the baseline sleep recordings, and treatments were applied around 8 am the following morning. RESULTS: Compared to the 16-h nicotine patch, smokers who received the 24-h nicotine patch experienced significantly less microarousals, a greater proportion of slow wave sleep, a higher REM density and higher rapid eye movement (REM) beta activities. CONCLUSIONS: The results of this study suggest that a 24-h nicotine patch is more efficient than a 16-h nicotine patch to alleviate tobacco withdrawal-induced sleep disturbances.

Administration, Cutaneous↗

Efficacy of bupropion and predictors of successful outcome in a sample of French smokers: a randomized placebo-controlled trial.

BACKGROUND: Previous published studies assessed the efficacy of bupropion in smoking cessation only in North American populations of smokers. Results of therapeutic drug trials are not always directly applicable in other populations. AIMS: To confirm the efficacy of bupropion in smoking cessation in European smokers. DESIGN: A multi-centre, randomized, double-blind placebo-controlled trial. SETTING: Seventy-four smoking cessation out-patient clinics in France. PARTICIPANTS: The study included 509 smokers motivated to quit smoking. Intervention Subjects were randomized to either slow-release bupropion 150 mg b.i.d. (B) or to placebo (Pl) in a 2 : 1 ratio, treated for 7 weeks, and followed-up for 26 weeks. MEASUREMENTS MAIN OUTCOME MEASURE: 6 months' point prevalence abstinence, determined by self-report and expired air carbon monoxide measurement. SECONDARY OUTCOME MEASURES: weeks 4-7 and weeks 4-26 continuous abstinence rates, craving, withdrawal symptoms, weight and cigarette consumption in smokers unable to quit. Adverse events were recorded systematically. FINDINGS: Six months' point prevalence abstinence rates were 31% and 16%[odds ratio = 2.3, confidence interval (CI) 95%: 1.4-3.7] in the B and Pl groups, respectively. Continuous abstinence rates were 41% (B) and 21% (P) with OR = 2.5 (CI 95%: 1.6-3.9) for weeks 4-7, and 25% (B) and 13% (P) with OR = 2.2 (CI 95%: 1.3-3.6) for weeks 4-26, respectively. Craving decreased significantly more with B than with Pl during treatment period, but there was no difference for total withdrawal symptoms score. Abstinent subjects gained significantly less weight at week 7 with B than with Pl. Low level of nicotine dependence, high motivation, absence of smoking-related disease, long duration of previous quit attempts, male gender, low level of current alcohol problems and living as a couple were predictive of successful cessation. With the exception of marital status, no interaction was observed between any of these predictive factors and the efficacy of bupropion. More of those who continued smoking in the B group than the P group reduced their consumption by at least 50%. CONCLUSIONS: Sustained-release bupropion is efficacious as an aid to smoking cessation in European smokers. No outcome predictors were identified that might indicate that certain subgroups of smokers would benefit more than others from treatment with bupropion.

Adult↗

Changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics.

AIMS: To assess the changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics. DESIGN: Evaluation at admission and an average 16 days following discharge. SETTING: Alcohol detoxification inpatient programme. PARTICIPANTS: Seventy-three alcohol dependent (DSM-III-R) inpatients. MEASUREMENTS: Average number of cigarettes and of cups of coffee per day; urine cotinine level. Smokers were classified as moderate on the basis of consuming fewer than 30 cigarettes per day at the time of admission; heavy smokers were those who smoked 30 cigarettes per day or more. FINDINGS: As a group, the smokers (N = 58) did not significantly change their cigarette consumption and there was no change in urine cotinine level. Heavy smokers (N = 34), however, significantly decreased their cigarette consumption, but urine cotinine was unchanged. Moderate smokers (N = 24) significantly increased their cigarette consumption but urine cotinine was not significantly changed. All patients--non-smokers, moderate and heavy smokers--significantly increased their coffee intake. CONCLUSIONS: The results suggest that heavy smokers may react to alcohol cues and thus reduce smoking activity when sober. Moderate smokers may increase their smoking rate to cope with alcohol abstinence. These changes appear only to reflect a behavioural adjustment, without modification of patients' nicotine-seeking. Alcoholics may increase their coffee intake to cope with alcohol abstinence.

Adult↗

Joint influence of alcohol, tobacco, and coffee on biological markers of heavy drinking in alcoholics.

BACKGROUND: Recent reports suggest that gamma-glutamyl transferase (GGT) decreases with coffee intake. The aim of this study was to examine the joint influence of alcohol, tobacco, cotinine, coffee, and caffeine on biological markers of heavy drinking in an alcoholic population. METHODS: Subjects were 160 alcohol-dependent inpatients. Biological assessments, performed at admission, were plasma levels of GGT, apolipoprotein AI, aspartate aminotransferase, and mean corpuscular volume (MCV), and urine cotinine and caffeine indexes. Years of alcohol abuse and of smoking, alcohol and coffee intake, and smoking rate were estimated in a semistructured interview, and Fagerström Tolerance Questionnaire was completed by inpatients. RESULTS: Coffee intake, but not caffeine, correlated negatively with biological markers of heavy drinking, after controlling for alcohol and tobacco intake. Years of smoking correlated positively to MCV, after controlling for alcohol and coffee intake. CONCLUSIONS: Concerning the effect of coffee, the most likely hypothesis is that noncaffeine coffee fractions have a protective effect on liver cells. Concerning the effect of smoking, one can propose that the increase of MCV with smoking could be a consequence of carbon monoxide inhalation, leading to hypoxemia, or of folate deficiency.

Adult↗

Frontal dysfunction in neurologically normal chronic alcoholic subjects: metabolic and neuropsychological findings.

BACKGROUND: Neuropsychological and imaging studies suggest that frontal dysfunction may occur in apparently normal chronic alcoholic subjects. METHODS: To investigate this issue further, we performed neuropsychological and fluorodeoxy-glucose-PET studies in 17 chronic alcoholics without patent neurological and psychiatric complications. RESULTS: Metabolic abnormalities were found in the mediofrontal and in the left dorsolateral prefrontal cortex, but not in the orbitofrontal cortex. Neuropsychological testing revealed significantly reduced verbal fluency and impaired performance on the Stroop test. The mediofrontal hypometabolism correlated with the reduction in verbal fluency and the time necessary to perform the interference condition of the Stroop test. The left dorsolateral prefrontal hypometabolism correlated with the number of errors on the Stroop test. CONCLUSION: These data indicate that circumscribed frontal dysfunctions may occur in chronic alcoholic subjects before clinically obvious neurological complications, and may account for some of the alcohol-related neuropsychological and behavioural impairments.

Adult↗

Self-reported alcohol use patterns in a sample of male and female heavy smokers.

In an attempt to characterize differences among male and female smokers based on past and current alcohol use, we studied patterns of drinking, smoking, caffeine intake, and depression as a function of lifetime history of alcohol dependence and current drinking status in a community sample of current smokers. Subjects were 65 male and 152 female moderate-to-heavy smokers. The CAGE was used to screen for lifetime history of alcohol dependence; current drinking status was classified using self-reported number of alcoholic drinks/week. No significant differences were detected for smoking rate, scores on the Fagerstrom Test for Nicotine Dependence, or either coffee or total caffeine intake. Drinkers with a history of alcohol dependence drank significantly more per week than drinkers with no history, with significant gender differences and interaction effects emerging as well; the phenomenon was particularly pronounced in men. Drinkers of both genders with a history of alcohol dependence scored significantly higher on the Center for Epidemiological Studies-Depression scale, with means exceeding the cutoff of 16 associated with clinical depression. Since comorbidity of depression and alcohol dependence is known to exert a detrimental effect on ability to stop smoking, the number of individuals at risk for smoking cessation treatment failure may be much larger than might be inferred from data based on psychiatric assessments or collected in inpatient settings. Routine screening for depressive symptomatology combined with heavy alcohol use in primary care settings may therefore be helpful in identifying smokers in need of more intensive stop-smoking interventions.

Adult↗

[Alcohol withdrawal syndrome and delirium tremens. Their treatment].

The clinical picture of alcohol withdrawal syndrome lies somewhere on a continuum that ranges from slight morning tremor to genuine delirium tremens. The diagnosis, usually easy, may be beset with several traps: alcoholism may be unrecognized, or a diagnosis other than withdrawal syndrome may be wrongly made, or again a complication may be either overlooked or erroneously suspected. An acute withdrawal syndrome normally regresses in less than one week, but a subacute withdrawal syndrome, which presents as signs of residual hyperexcitability of the central nervous system, must be recognized, as it may persist for several months. Beside delirium tremens, with its mandatory and well-established treatment, prevention of alcohol withdrawal syndrome and treatment of its initial stages raise no problems, as it consists above all of psychotherapy combined by such tranquillizers as febarbamate or a benzodiazepine taken in well-specified dosage.

Alcohol Withdrawal Delirium↗

[Alcohol, sleep and biological rhythms].

Alcohol reduces sleep latency but notably alters sleep structure: sleep is fragmented, particularly at the end of the night. Slow wave sleep duration is enhanced in the first part of the night and REM sleep duration and density are diminished. Alcohol withdrawal provokes inverse effects in alcoholic patients: sleep onset is delayed, slow wave sleep durations diminished and REM sleep duration is enhanced. REM sleep is associated with motor inhibition failure. Sleep remains disturbed in long term evaluations. Alcohol promotes the occurrence of sleep apneas and hypopneas. This effect persists in alcoholics after alcohol withdrawal. Sleep disturbances in alcoholism can be partly understood as the expression of amplitude diminution and phase advance of biological rhythms. Thus, the chronobiologic characteristics of alcoholics resemble those of depressives or the elderly.

Circadian Rhythm↗

Alcohol consumption and biological markers for alcoholism in idiopathic dilated cardiomyopathy: a case-controlled study.

The aim of this study was to compare alcohol consumption and biological markers for alcoholism in a population of 23 men (57 +/- 8 years) admitted to hospital with idiopathic dilated cardiomyopathy (DCM), and a control group of 46 men (54 +/- 8 years) with coronary artery disease, matched for age. The DCM group had a higher daily alcohol consumption (82 g/day vs. 30 g/day, P < 0.0002). This difference was greater for the consumption of wine (63 g/day in the DCM group vs. 24 g/day in the control group, P < 0.002). Duration of regular daily alcohol consumption was longer in DCM patients (34 years vs. 22 years, P < 0.01) as well as duration of heavy alcohol consumption (> 60 g/day) (25 years vs. 10 years, P < 0.001). Among the biological markers, only the serum levels of immunoglobulin A were significantly increased in the DCM group (3.7 g/l vs. 2.7 g/l, P < 0.03). In this French population, alcohol is strongly linked to DCM. Biological markers appear to be poor predictors of alcohol intoxication in this so-called 'idiopathic' myocardial disease.

Alcohol Drinking↗

Outcome of treatment in alcoholic women.

One hundred and seventy-eight females (mean age 40.6 +/- 10.2 years) were retrospectively studied by questionnaires for a mean duration of 46 (17-75) months. Sixty-two percent were married or living maritally. One third were working. The mean alcohol intake was 157 +/- 76 g/day and 57.3% had alcohol dependence for less than 5 years. Twenty-seven patients (15%) were lost to follow-up; out of the 151 remaining patients, 7 (4%) refused to answer and 18 (12%) died. Suicide and alcoholism complications were a frequent cause of death. One hundred and twenty-six questionnaires were obtained. Twenty-eight women (22%) were abstinent. A good outcome determined by the state of alcoholization (abstinence or moderate consumption) and the improvement of quality of life, was found in 44% of patients. Absence of marital life and greater alcohol intake were related to a poor outcome, whereas enrollment in a fellowship of recovering alcoholics was more frequent in abstinent patients. The mortality rate was important in alcoholic females. A number of factors were related to the outcome.

Adolescent↗

Behavioral effects induced by beta CCE in free or restrained rhesus monkeys (Macaca mulatta).

Behavioral effects of the IV injection of beta carboline carboxylic acid ethyl ester (beta CCE) were studied in chair-restrained rhesus monkeys and in rhesus monkeys freely moving in their cages. Observations made during the administration of increasing doses of beta CCE (0.5, 1 and 2 mg/kg) evidence behaviors reflecting a state of anxiety. The similarity of results obtained under the two experimental conditions excludes a potential effect of restraint on the behavioral expression of effects induced by the administered molecule. Convulsions observed in three subjects out of twelve should call for great caution when using this molecule.

Animals↗

[Depression and smoking].

Lifetime history of major depressive disorder is more than double in ever smokers than in never smokers. Conversely, adjusted odds ratios of nicotine dependence are significantly elevated for major depressive disorder alone (3,11) or associated with an anxiety disorder (4,38). There is also a significant relationship between depressive symptoms' severity (CES-D) and ever smoking. A history of major depressive disorder is associated with a lower chance to quit smoking. One of the reasons is that smokers who try to quit smoking experience more withdrawal symptoms--including a depressive mood--and relapse more frequently if they have a history of major depressive disorder. Few trials experimenting the usefulness of antidepressants in smoking cessation were published. Only a limited trial concerning doxepin showed a significant action on withdrawal symptoms and abstinence rate at 4 weeks. Other trials with fluoxetine and moclobemide failed to show clearly a significant effect on abstinence rate, perhaps because the medication was initiated too soon before quit day. The nature of the association between smoking and depression has been explored in recent studies, which used a cohort follow-up or the evaluation of a female twin population. The conclusions were that there is probably no causal relationship but rather that the association arises largely from common familial factors that are probably genetic, at least in women. Concurrently, tobacco smoke has monoamine oxidase inhibitory properties, and smokers have lower monoamine oxidase activity than no smokers. Hence, it is possible that smoking has antidepressant properties. While smoking prevalence regularly decreases, one can assume that the relative risk of depressive disorder will increase in smokers.

Antidepressive Agents↗