Triazolam was used to study the plasma concentration-effect relationship of a benzodiazepine because it has a very short plasma t½. A standard hypnotic dose of 0.25 mg was given by mouth to six healthy subjects, and blood samples were drawn when the subjects had to perform a battery of psychologic tests. Only the digit-symbol substitution test, the card-sorting test according to numbers, and the visual analog scale (energetic-lethargic) gave significant results. Analysis of the concentration-effect relationship in individuals indicated a wide scatter of the data. Mean values revealed a trend for a learning effect in the card-sorting test. The results are consistent with the hypothesis that triazolam is well suited for a study of concentration-effect relationships, but better psychologic tests would be desirable. Clinical Pharmacology and Therapeutics (1983) 34, 195–201; doi:10.1038/clpt.1983.152
Only about 15% of the subjects abusing ethanol will eventually develop cirrhosis of the liver, suggesting that other factors in addition to the consumption of large quantities of ethanol play a role in the pathogenesis of alcoholic cirrhosis. Important contributors may be infection with hepatitis viruses, in particular HCV, protein-calorie malnutrition and immunologic factors. Abstinence improves the prognosis of patients with alcoholic cirrhosis, provided that the liver disease is not too far advanced. No pharmacotherapeutic intervention has shown a convincing improvement of the prognosis of alcoholic liver disease, so that the therapeutic efforts should be mainly directed towards abstinence. The patient with alcoholic liver disease needs support and guidance by the treating physicians. Supportive treatment with Disulfiram, Acamprosate or Naltrexon can help with achieving durable abstinence.
Reliable assessment of cognitive dysfunction in the elderly is a prerequisite for the evaluation of treatment of age-related cognitive decline. Psychophysical thresholds are known to be more reliable than psychometric tests, as assessed by stability of performance in visual masking. A backward (Till & Franklin, 1981) and a forward masking study (Coyne, 1981) were replicated. Thereafter, the same volunteers carried out a backward and forward masking task adapted to minimize noncognitive age-related influences: target and mask duration were individually adjusted to control for reduced eye transmissiveness. Attention was assessed with the electrooculogram; a dependent variable insensitive to sporadic decreases of attention was selected. Test-retest stability in the elderly after 2–4 weeks was r = .97 in backward and r = .86 in forward masking. As Alzheimer's disease mainly affects the cortex, backward masking, which is primarily cortical, may be useful to assess aspects of cognitive dysfunction.
