Alcohol withdrawal syndromes: clinical management with lofexidine

Sixty-three mainly male alcoholics were randomly assigned to placebo or lofexidine treatment for 48 hr shortly after admission to the hospital. Their starting points were similar regarding their semiquantitative estimates of alcohol withdrawal symptoms (AWS). Their demographics, histories of past alcohol use, physical findings, and laboratory abnormalities usually associated with alcoholism were similar. Starting 3 hr after 0.4 mg of oral lofexidine, which was given every 6 hr as eight doses, the AWS scores were significantly lower than those of the placebo group. Hypotension was the strongest finding. Six placebo recipients had to be prematurely interrupted due to increasing or intolerable alcohol withdrawal symptoms and switched to a benzodiazepine. Only one lofexidine recipient was prematurely interrupted, due to transient hallucinations. The study has a large placebo effect, as both groups of patients rated the treatment process very highly. Lofexidine, an alpha 2-adrenergic agonist, was superior to placebo in alcohol withdrawal. This drug, as with its analogue clonidine, may represent a new and important pharmacological treatment for alcohol withdrawal symptoms.

A comparison of accuracy and estimated cost of methods for home blood glucose monitoring

Venous serum glucose concentrations determined by a laboratory hexokinase technique were compared over a wide range of glucose concentrations with concentrations of capillary blood glucose determined by three reflectance meter techniques currently available in the United States (Eyetone and Dextrometer, Ames Company; StatTek, Bio-Dynamics BMC) and by visual interpretation of reagent strips (Chemstrip bG, Bio-Dynamics BMC). The Chemstrip bG reagent strip was read by patients, nurses, and a physician. In all cases, there was an excellent correlation between laboratory serum glucose concentrations and reflectance meter blood glucose determinations (r = 0.90-0.94, P less than 0.0001) or visual interpretation of Chemstrip bG (r = 0.85-0.92, P less than 0.0001). Chemstrip bG appears to be the least expensive method of glucose measurement. This method offers additional advantages in not requiring a reflectance meter, which needs frequent recalibration and other ancillary equipment for blood glucose determination.

A case-control study of hair dye use and breast cancer

A case-control study of the relationship between hair dye use and breast cancer included 129 breast cancer patients and 193 control women drawn from the records of a multiphasic screening clinic. Information was obtained by telephone interview on a number of risk factors for breast cancer and on variables pertaining to hair dye use: chronologic time, duration, frequency, type, and color. From this, quantitative measures of cumulative hair dye use at various intervals prior to breast cancer (or an equivalent for controls) were obtained. A multivariate risk factor score was used to control for confounding variables. The adjusted relative risks for breast cancer versus hair dye use were greater than unity but were not generally significant. However, integral measures of hair dye use (No. of yr times frequency per yr) were significantly related to breast cancer when confounding variables were controlled. The association between hair dye use and breast cancer was greatest among women over 50 years of age and among those at lower natural risk for breast cancer. An analysis of temporal patterns showed that breast cancer was related mainly to hair dye use 10 or more years before cancer diagnosis. Because of the retrospective nature of the hair dye data and the small sample size, these results require further validation.