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Biomedical subjects

P R Marques

Publications and source records attributed to P R Marques.

At least 19 recordsLinked to original sources

Anti-arthritic effect and subacute toxicological evaluation of Baccharis genistelloides aqueous extract.

This work studies the potential subacute toxicological effects of the aqueous extract of Baccharis genistelloides (AEBg) and demonstrates a new anti-arthritic therapeutic effect. The treatment of the collagen-induced arthritis (CIA) group with 4.2 mg/kg AEBg induced an important decrease (75%) in CIA severity in all animals, while the 42 mg/kg dose treated only 50% of animals. After AEBg treatment, no significant differences were observed in body weight, aspect, color and relative weight of liver, kidneys, thymus or lungs between CIA groups. CIA and healthy AEBg groups treated with both doses did not show genotoxic effects to liver and kidney cells by the Comet assay, compared to its own control group. The augmented AST in the CIA group, compared to healthy control one was regularized by the AEBg treatment with 4.2 mg/kg but not with 42 mg/kg. No other significant difference was found on serum biochemical parameters, as well as on spontaneous or stimulated lymphocyte proliferation between CIA groups. The treatment of healthy animals with AEBg 4.2 mg/kg did not change the aspect, color or relative weight of kidneys, liver or lungs but reduced the body weight, the thymus and popliteal lymph node (PLN) relative weight and serum glucose and triglyceride levels. Concluding, our results indicate an anti-arthritic effects of AEBg without liver and kidney subacute toxicity and hypoglycemic and hypotriglyceridemic actions on healthy animals.

Administration, Oral↗

Alcohol ignition interlock programs.

The alcohol ignition interlock is an in-vehicle DWI control device that prevents a car from starting until the operator provides a breath alcohol concentration (BAC) test below a set level, usually .02% (20 mg/dl) to .04% (40 mg/dl). The first interlock program was begun as a pilot test in California 18 years ago; today all but a few US states, and Canadian provinces have interlock enabling legislation. Sweden has recently implemented a nationwide interlock program. Other nations of the European Union and as well as several Australian states are testing it on a small scale or through pilot research. This article describes the interlock device and reviews the development and current status of interlock programs including their public safety benefit and the public practice impediments to more widespread adoption of these DWI control devices. Included in this review are (1) a discussion of the technological breakthroughs and certification standards that gave rise to the design features of equipment that is in widespread use today; (2) a commentary on the growing level of adoption of interlocks by governments despite the judicial and legislative practices that prevent more widespread use of them; (3) a brief overview of the extant literature documenting a high degree of interlock efficacy while installed, and the rapid loss of their preventative effect on repeat DWI once they are removed from the vehicles; (4) a discussion of the representativeness of subjects in the current research studies; (5) a discussion of research innovations, including motivational intervention efforts that may extend the controlling effect of the interlock, and data mining research that has uncovered ways to use the stored interlock data record of BAC tests in order to predict high risk drivers; and (6) a discussion of communication barriers and conceptual rigidities that may be preventing the alcohol ignition interlock from taking a more prominent role in the arsenal of tools used to control DWI. Whether interlock programs can help public policymakers achieve their expressed goals of substantially reducing the level of impaired driving will remain uncertain until procedural barriers and intransigent judiciary practices can be overcome that provide for more systematic routine use of interlock programs. Despite strong effectiveness evidence in all studies to date, the real potential of this technology to reduce the road toll cannot be estimated until they are more widely adopted.

Alcohol Drinking↗

The impact of mandatory versus voluntary participation in the Alberta ignition interlock program.

Research has demonstrated that participation in an interlock program significantly reduces the likelihood of subsequent driving while intoxicated (DWI) convictions at least so long as the interlock device is installed in the vehicle. Despite the growing number of jurisdictions that allow interlock programs and the demonstrated success of these programs, the proportion of DWI offenders who actually have the device installed is minimal. In an effort to increase the proportion of offenders using interlocks, some jurisdictions require offenders to install an interlock as a condition of license reinstatement whereas others merely offer offenders a reduction in the period of hard suspension if they voluntarily participate in an interlock program. The objective of the present study was to determine the extent to which voluntary interlock participants are more or less successful in terms of subsequent recidivism than those for whom interlock program participation has been mandated. The issue was addressed using data from the interlock program in Alberta, Canada, which provides for both mandatory and voluntary participation. The recidivism experience of voluntary and mandatory interlock participants was examined both during and after the period of interlock installation. Cox regression revealed that, after controlling for (or equating) the number of prior DWI offenses, the survival rates of DWI offenders who were ordered to participate in the interlock program did not differ from those of voluntary participants. These results suggest that further use of mandatory interlock programs should be just as successful as voluntary programs when offenders share characteristics with those studied in Alberta.

Accidents, Traffic↗

Predicting repeat DUI offenses with the alcohol interlock recorder.

The aim of this report has been to use information contained in the alcohol ignition interlock recorder to determine whether systematic analysis of it can be used to predict which DUI offenders will recidivate during the first 2 years after the interlock is removed. The interlock record was accumulated during a 4-year intervention study in Alberta, Canada. Data from more than 5.5 million breath tests collected during interlock use were analyzed retrospectively after allowing repeat DUI offenses to accumulate for up to 2 years post-interlock. The rate of interlock warns at low BAC (0.02-0.04%) and fails at higher BAC ( > 0.04%) were found to be predictive of later repeat DUI. The interlock record was used along with selected driver record variables and questionnaire data to identify predictor sets. CHAID segmentation analysis was used to identify combinations of predictor variables; these were joined with sensitivity analysis to compare different predictor combinations. Several variables, but primarily more prior DUIs and more interlock warns and fails logged during the first 5 months of interlock usage predict greater than 60% of repeat DUI with a false positive rate of less than 10%.

Adult↗

Subacute toxicity evaluation of a hydroalcoholic extract of Pterodon pubescens seeds in mice with collagen-induced arthritis.

When the immune system is stimulated there is a concomitant decrease in drug biotransformation and elimination that may results in unwanted drug response and toxic side effects. We investigated the subacute toxicity of a hydroalcoholic extract of Pterodon pubescens seeds (HEPp) to DBA1/J mice with collagen II-induced arthritis. The oral treatment with HEPp reduced the arthritic index without any concomitant alteration in their hematological examination, histopathological analysis and relative or absolute weight of several organs and in several clinical biochemical parameters when compared with the control group. We concluded that daily administration of anti-arthritic doses of HEPp did not induce any detectable subacute toxic side-effect in mice whose host defense mechanisms is active as we can observe in mice with CIA.

Animals↗

Financial risk, plan types, and authorizations for managed alcohol treatment services.

OBJECTIVE: To estimate the effects of a managed behavioral healthcare organization's (MBHO's) products/plans and financial risk on levels and amount of care authorized for patients with alcohol-related problems. STUDY DESIGN: Secondary analysis of 1995-1998 MBHO authorization files. PATIENTS: Individuals diagnosed as having an alcohol-related problem without comorbidities. METHODS: Episodes (n = 10,872) were constructed with 60-day clear zones. Multinomial regression equations were used to analyze the proportional distribution of care authorized within episodes at 5 levels: inpatient, residential, partial hospitalization, intensive outpatient, and traditional outpatient. Care equivalency hours were calculated to combine data across outpatient sessions and inpatient days. A linear regression equation analyzed quantity of care within episodes. Product/plan types, financial risk, state of residence, and participation in the MBHO's network were explanatory variables. Age, sex, diagnosis, and episode number were control variables. RESULTS: Most utilization management care hours authorized are inpatient and residential. Relative to other products/plans for managing care, utilization management leads to 50% more authorized hours. More financial risk does not predict fewer care units authorized but shifts hospitalizations toward residential treatment. Increasing age and higher-severity diagnoses predict more overnight care authorizations. Pennsylvania, which mandates minimum levels of care and follows American Society of Addiction Medicine criteria, has significantly more care authorized compared with 8 other states with data. CONCLUSIONS: Other than in utilization management, MBHO financial risk does not predict less care authorization. The MBHO authorizes higher-level care for older adults, for those with more severe diagnoses, and for those with episodes of care beyond the second. Authorization data do not necessarily reflect utilization but can provide a useful, partial view of management strategies.

Adult↗

Evaluation of a program to motivate impaired driving offenders to install ignition interlocks.

Approximately 30,000 alcohol ignition interlocks, which prevent a drinking driver from operating a vehicle, are in use in the United States and Canada. Currently available studies indicate that interlocks reduce impaired driving recidivism while on the vehicle. However, in the United States, the practical effectiveness of these devices is limited because few offenders are willing to install them in order to drive legally. This paper reports on a study of a court policy that created a strong incentive for impaired driving offenders to install interlocks by making penalties (e.g., jail or electronically monitored house arrest) the alternative to the interlock. Comparison of the recidivism rates of offenders subject to this policy with offenders in similar, nearby courts not using interlocks indicated that the policy was producing substantial reductions in DUI recidivism.

Adult↗

The Alberta Interlock Program: the evaluation of a province-wide program on DUI recidivism.

AIMS: This study was designed to determine the efficacy of alcohol safety interlocks in reducing recidivism among first and second driving-under-the-influence (DUI) offenders. It also evaluates the overall effectiveness of interlock programs where typically only a small portion of DUI offenders elect to install interlocks. DESIGN: The driving records of DUI offenders participating in interlock programs for 6 months for first offenders and 2 years for second offenders were compared with similar offenders who chose not to participate. SETTING: A province-wide program in Alberta, Canada. PARTICIPANTS: Records of 35,132 drivers convicted of DUI between 1 July 1998 and 30 September 1996 were analyzed MEASUREMENTS: Repeat DUI offenses during and after the interlock period. FINDINGS: While the offenders had interlocks on their vehicles, DUI recidivism was substantially reduced. Once the interlock had been removed and the participants had been reinstated, their DUI rate was the same as other offenders indicating that the interlock reduced recidivism while in place. Because only 8.9% of eligible drivers elected to participate in the interlock program, the program did not significantly increase the overall effectiveness of the province's management of DUI offenders. CONCLUSIONS: Interlocks are associated with a major reduction in DUI recidivism while on the vehicle of the offender. However, because few offenders elect to participate, the program produces only a small (5.9%) overall reduction in the recidivism rate of all DUI offenders.

Alberta↗

Behavioral monitoring of DUI offenders with the Alcohol Ignition Interlock Recorder.

AIMS: To evaluate patterns of blood alcohol concentration (BAC) and driving logged on the ignition interlock recorder and to assess whether this event record is a useful outcome measure for a behavioral intervention. DESIGN: Descriptive analyses of recorder data and multivariate analysis of the predictors of high BACs associated with a motivational intervention for driving-under-the-influence (DUI) offenders using an interlock. SETTING: Two interlock service centers in Alberta, Canada. PARTICIPANTS: 1309 first-time and multiple DUI offenders who agreed to participate during interlock installation. INTERVENTION: A human-services (supportive guidance) intervention based on motivational interviewing and pragmatic counseling was delivered to interlock users in Calgary, but not to interlock users in Edmonton, Canada. MEASUREMENTS: This report summarizes the patterns and predictors of BAC warnings (0.02-0.039%) (20-39 mg/dl) and failures (> or = 0.04) (> or = 40 mg/dl) from more than 3 million in-vehicle breath tests. Data come from three sources: driver records, questionnaires and the interlock. FINDINGS: From the beginning to the end of the interlock use period, there was a significant linear decline in the proportion of positive BAC driving to total driving. After controlling for prior offenses, demographics and reported drinking levels, offenders in the intervention site (Calgary) were less likely to have recorded fail BACs than were offenders in the control site (Edmonton). The temporal patterns of BAC fails with the interlock mimic the high-risk periods for DUI arrests and alcohol-involved fatal crashes. CONCLUSIONS: The interlock successfully blocks drinking and driving during high-risk periods. Preliminary recorder data suggest the services intervention may be affecting DUI behavior.

Alberta↗

Estimating blood alcohol level from observable signs.

Attempts to induce hosts and friends to prevent drinkers from reaching dangerous levels of alcohol impairment depend upon the ability to judge impairment from observable signs of physical appearance and behavior. In a study of this ability, researchers first observed and recorded signs of change in behavior and physical appearance among dosed drinkers in small social groups (n = 149). Signs were grouped into impairment levels corresponding to three broad categories of blood alcohol concentration (BAC): < 0.04% (no signs), 0.04%-0.08%, and > 0.08%. Next, drinkers were then classified into judged impairment level by guests observing small numbers in social groups (n = 333), hosts observing large numbers in social groups (n = 480), and servers observing patrons in public establishments (n = 436). A random half of the observers in each setting were given instructional guidance in the relationships of signs to impairment level. Results showed all observers to exceed chance in their classifications of drinker impairment, with observations in the small social groups being significantly more accurate than those in the other two groups. A beneficial instructional guidance effect was significant for the social groups, with the greatest benefit found in detecting those over 0.04% in the small groups. The authors conclude that, while people are fairly accurate in judging alcohol impairment, their accuracy is greatest and guidance most effective in detecting the presence rather than degree of impairment and when attention can be concentrated upon a few drinkers at a time.

Accidents, Traffic↗

Cocaine in the hair of mother-infant pairs: quantitative analysis and correlations with urine measures and self-report.

A sample of mothers who had used crack cocaine while pregnant was evaluated during the postpartum period before random assignment to drug treatment. Mean infant age was 74 days. Paired hair samples were acquired from 63 mothers and 63 infants. Maternal urine was screened for cocaine and benzoylecgonine; three different drug use self-report measures were also collected. Normalizing transformations of all hair and urine data preceded analyses. The initial correlation of mother and infant hair (r = .41, N = 62, P = .001) was strengthened (r = .62, N = 30, P < .0005) by removing from the dataset maternal hair independently judged to be damaged. Damage to hair is associated with certain types of "hair care" products. The damaged maternal hair bore no quantitative relationship to infant hair (r = -.04, N = 30, P = .41). Poor quality hair samples could have been partly anticipated because self-reported use of hair products had a significant contingent relationship to laboratory-judged damage to hair (Z kappa = 2.28, P = .01). Maternal urine benzoylecgonine correlated with maternal hair (r = .41, N = 60, P = .001) and, of course, with maternal urine cocaine (r = .63, N = 60, P < .0005). None of the three self-report measures (use in past 30 days, duration since first use, average regular use) significantly correlated with any of the hair or urine measures. Factor analysis of drug use variables identified three factors possibly representing long-term use, recent use, and some artifact of self-report. In summary, hair analysis may provide a quantitative index of exposure when the hair is not damaged. The amount of self-reported drug use could not be corroborated with analytic measures of hair or urine. Studies in which self-reported cocaine use is a scalar variable should be interpreted cautiously.

Adult↗

Drug abuse risk among pregnant adolescents attending public health clinics.

The drug abuse risk status and characteristics of pregnant adolescents (under 21 years) were evaluated at public maternal health clinics in Prince George's County, Maryland. During the project period (March 1988 to September 1989), 403 young women were interviewed. Based on those interviews, one of four risk judgments, scaled for increasing severity of risk, was assigned. Twenty percent of the sample was found to be either at high risk or current abusers of alcohol or other drugs. Risk was equally represented across both the age range (14-20 years) and marital status of the sample, but Whites were overall at significantly higher risk than Blacks (P less than .0001). Post-hoc examination of risk correlates identified drug use in the home and past or current cigarette smoking to be strongly predictive of risk (gamma = .92). While parental drug use was the most frequently reported social environment drug influence factor, as risk status of the young women increased in severity, the parental influence factor declined and the significant-other influence factor increased. A separate sample of adult women (21 years and older) was interviewed for comparison to the youth sample.

Adolescent↗

[Mitral valve prolapse as a probable cause of cerebral ischemia. A case report].

A 32 year old female patient, documented clinically and echocardiographically to have a competent prolapse of the mitral valve (MVP), developed a sudden ischemic cerebrovascular accident (CVA), suggestive of embolism. There were no predisposing factors to cerebrovascular disease, except for past use of contraceptive pills. Tomographic study disclosed an ischemic right-parietal "wedge-shaped" defect. The patients's recovery, with physiotherapy and AAS, was satisfactory. The authors discuss the association of MVP and CVA, considering physiopathogenic, prophylactic and therapeutic aspects, emphasizing the need to consider MVP as a cause of CVA in young adults.

Adult↗

Behavioral thermoregulation, core temperature, and motor activity: simultaneous quantitative assessment in rats after dopamine and prostaglandin E1.

These studies were designed to determine the dose-response autonomic and behavioral thermoregulatory effects and the motor effects of dopamine (DA) and prostaglandin E1 (PGE1) injected into the lateral cerebral ventricles of rats. These studies were made possible with a computer-controlled thermocline that permits freely moving rats to select preferred ambient temperatures ranging between 7 and 39 degrees C. All rats were studied with the thermocline gradient both on and off to control for nonspecific effects. PGE1 (0, 0.1, 0.2, 0.5, 1.0 micrograms) produced a dose-related increase in core temperature and produced a dose-related selection of warmer ambient temperatures. Dopamine (0, 50, 100, 200, 400 micrograms) produced a dose-related hypothermia and cold-seeking behavior. Without the gradient, DA-injected rats did not become as hypothermic as in the gradient-on condition. When the gradient was available, rats showed a significant rebound increase in core temperature 50-80 min after DA which did not occur when the gradient was off. Overall, DA induced increases in motor activity, but, during the first 10 min after injection while the gradient was on, the rats made stable selections of cool ambient temperatures and showed reduced activity. Conversely, the behavioral effect of PGE1 did not facilitate the autonomically mediated heat gain. These results emphasize the necessity of creating behavioral options for animals in order to fully evaluate drug effects on thermoregulation.

Alprostadil↗