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gamma-Aminobutyric acid (GABA) is the major inhibitory neurotransmitter of the central nervous system and it acts at the GABA(A) and GABA(B) receptors. A possible role for the GABA(A) receptors in alcohol action has been derived from in vitro cell models, animal studies and human research. GABA(A) subunit mRNA expression in cell models has suggested that the long form of the gamma2 subunit is essential for ethanol enhanced potentiation of GABA(A) receptors, by phosphorylation of a serine contained within the extra eight amino acids. Several animal studies have demonstrated that alterations in drug and alcohol responses may be caused by amino-acid differences at the GABA(A)alpha6 and GABA(A)gamma2 subunits. An Arg(100)/Glu(100) change at the GABA(A)alpha6 subunit conferring altered binding efficacy of the benzodiazepine inverse agonist Ro 15-4513, was found between the AT (alcohol tolerance) and ANT (alcohol non-tolerance) rats. Several loci related to alcohol withdrawal on mouse chromosome 11 which corresponds to the region containing four GABA(A) subunit (beta2, alpha6, alpha1 and gamma2) genes on human chromosome 5q33-34, were also identified. Gene knockout studies of the role of GABA(A)alpha6 and GABA(A)gamma2 subunit genes in mice have demonstrated an essential role in the modulation of other GABA(A) subunit expression and the efficacy of benzodiazepine binding. Absence of the GABA(A)gamma2 subunit gene has more severe effects with many of the mice dying shortly after birth. Disappointingly few studies have examined the effects of response to alcohol in these gene knockout mice. Human genetic association studies have suggested that the GABA(A)beta2, alpha6, alpha1 and gamma2 subunit genes have a role in the development of alcohol dependence, although their contributions may vary between ethnic group and phenotype. In summary, in vitro cell, animal and human genetic association studies have suggested that the GABA(A)beta2, alpha6, alpha1 and gamma2 subunit genes have an important role in alcohol related phenotypes (300 words).

Plasma catecholamine concentrations in 40 patients shortly after accidental injury rose progressively with increasing severity of injury. Norepinephrine and epinephrine concentrations were unrelated other than by a common rise with severity; dopamine was closely related norepinephrine and not independently related to injury severity. Plasma glucose concentrations rose after injury; however, this was related only to the plasma epinephrine concentration and not independently to injury severity. Plasma lactate concentrations, in contrast, showed components related both to severity of injury and independently to norepinephrine and epinephrine concentrations. Plasma insulin concentrations were uniformly low, especially with respect to the hyperglycemia, in patients with high plasma epinephrine concentrations. Plasma concentrations of free fatty acids and of cortisol were unrelated to plasma catecholamine concentrations, as were pulse rate and blood pressure. These relationships confirm the expected role of the sympathoadrenal system in the metabolic changes following injury in man.

Archivo adicional 2: Películas que muestran vistas de cuatro cámaras con cuatro componentes de flujo del ventrículo derecho (VD) utilizando el trazado de partículas en un sujeto normal de 29 años, un sujeto normal de 36 años, un sujeto normal de 49 años, un sujeto normal de 55 años y un sujeto normal de 64 años. Los círculos amarillos denotan los contornos del VR de las pilas de vistas de ejes cortos. Leyenda de color: verde (flujo directo de VD), amarillo (flujo de entrada retenido de VD), azul (flujo de eyección retardado de VD), rojo (volumen residual de VD). Fichier supplémentaire 2 : Films montrant des vues à quatre chambres avec quatre composantes de flux du ventricule droit (VR) en utilisant le traçage des particules chez un sujet normal de 29 ans, un sujet normal de 36 ans, un sujet normal de 49 ans, un sujet normal de 55 ans et un sujet normal de 64 ans. Les cercles jaunes indiquent les contours du VR à partir de piles de vues à axe court. Légende des couleurs : vert (flux direct du VR), jaune (flux entrant retenu du VR), bleu (flux d'éjection retardé du VR), rouge (volume résiduel du VR). ملف إضافي 2: أفلام تعرض مناظر من أربع غرف مع البطين الأيمن (RV) أربعة مكونات تدفق باستخدام تتبع الجسيمات في شخص طبيعي يبلغ من العمر 29 عامًا، وشخص طبيعي يبلغ من العمر 36 عامًا، وشخص طبيعي يبلغ من العمر 49 عامًا، وشخص طبيعي يبلغ من العمر 55 عامًا وشخص طبيعي يبلغ من العمر 64 عامًا. تشير الدوائر الصفراء إلى محيط البطين الأيمن من أكوام المناظر ذات المحور القصير. مفتاح الألوان: أخضر (تدفق مباشر للبطين الأيمن)، أصفر (تدفق داخلي محتجز للبطين الأيمن)، أزرق (تدفق طرد متأخر للبطين الأيمن)، أحمر (الحجم المتبقي للبطين الأيمن). Additional file 2: Movies showing four-chamber views with right ventricle (RV) four flow components using particle tracing in a 29-year-old normal subject, a 36-year-old normal subject, a 49-year-old normal subject, a 55-year-old normal subject and a 64-year-old normal subject. Yellow circles denote the RV contours from stacks of short axis views. Color legend: green (RV direct flow), yellow (RV retained inflow), blue (RV delayed ejection flow), red (RV residual volume).

Epilepsy is the most common serious neurological disorder and is one of the world's most prevalent noncommunicable diseases. As the understanding of its physical and social burden has increased it has moved higher up the world health agenda. Over four-fifths of the 50 million people with epilepsy are thought to be in developing countries; much of this condition results from preventable causes. Around 90% of people with epilepsy in developing countries are not receiving appropriate treatment. Consequently, people with epilepsy continue to be stigmatized and have a lower quality of life than people with other chronic illnesses. However, bridging the treatment gap and reducing the burden of epilepsy is not straightforward and faces many constraints. Cultural attitudes, a lack of prioritization, poor health system infrastructure, and inadequate supplies of antiepileptic drugs all conspire to hinder appropriate treatment. Nevertheless, there have been successful attempts to provide treatment, which have shown the importance of community-based approaches and also indicate that provision for sustained intervention over the long term is necessary in any treatment programme. Approaches being adopted in the demonstration projects of the Global Campaign Against Epilepsy--implemented by the International League Against Epilepsy, the International Bureau for Epilepsy, and the World Health Organization--may provide further advances. Much remains to be done but it is hoped that current efforts will lead to better treatment of people with epilepsy in developing countries.

Increasing evidence suggests that Fatty acid ethyl esters (FAEE) play a central role in ethanol induced organ damage. In the current study we measured FAEE formation in rats after short-term oral administration of ethanol, in the presence and absence of pre-treatment with acetyl-L-carnitine. Ethanol treatment caused a significant increase in the levels of FAEE, particularly in the brain and heart, but also in the kidney and liver. Increases in FAEE were associated with a significant increase in FAEE synthase activity, GSH transferase activity, and lipid hydroperoxide levels. Pretreatment with acetyl-L-carnitine resulted in a significant reduction of FAEE accumulation, decrease in FAEE synthase and GSH transferase activities, and lipid hydroperoxide levels. Administration of acetyl-L-carnitine greatly reduced the metabolic abnormalities due to non-oxidative ethanol metabolism, through an increment in lipid metabolism/turnover and by the modulation of the activities of enzymes associated with FAEE synthesis. These results suggest a potentially important pharmacological role for acetyl-L-carnitine in the prevention of alcohol-induced cellular damage.

Three drinks containing 0 g (no alcohol, NA), 8 g (low alcohol, LA) and 24 g (high alcohol, HA) of alcohol were formulated which were found to be indistinguishable from one another in sip-and-swallow triangle tests. In a second study, conducted according to a within-subjects design, 14 healthy human volunteers consumed these drinks as part of a small lunchtime meal, in counterbalanced order on 3 different days. They also completed a battery of cognitive tasks, together with mood ratings, before lunch and during the 4 h following lunch. Compared with NA, LA (approximately 0.12 g/kg) significantly increased hit rate on a difficult rapid information processing vigilance task. In contrast, HA (approximately 0.35 g/kg) tended to impair performance of this task. There were no reliable effects of alcohol on performance on less demanding tasks. The low dose of alcohol also improved mood (for example, it significantly reduced tension and uncertainty), suggesting that the improvement in task performance was mediated by the calming or sedative effects of the alcohol. Volunteers did detect alcohol in the HA, but not the LA drink, when they consumed the full drink, confirming the difficulty of disguising the administration of alcohol.

Functional magnetic imaging (fMRI) studies showed that resting state activity in the healthy brain is organized into multiple large-scale networks encompassing distant regions. A key finding of resting state fMRI studies is the anti-correlation typically observed between the dorsal attention network (DAN) and the default mode network (DMN), which - during task performance - are activated and deactivated, respectively. Previous studies have suggested that alcohol administration modulates the balance of activation/deactivation in brain networks, as well as it induces significant changes in oscillatory activity measured by electroencephalography (EEG). However, our knowledge of alcohol-induced changes in band-limited EEG power and their potential link with the functional interactions between DAN and DMN is still very limited. Here we address this issue, examining the neuronal effects of alcohol administration during resting state by using simultaneous EEG-fMRI. Our findings show increased EEG power in the theta frequency band (4-8 Hz) after administration of alcohol compared to placebo, which was prominent over the frontal cortex. More interestingly, increased frontal tonic EEG activity in this band was associated with greater anti-correlation between the DAN and the frontal component of the DMN. Furthermore, EEG theta power and DAN-DMN anti-correlation were relatively greater in subjects who reported a feeling of euphoria after alcohol administration, which may result from a diminished inhibition exerted by the prefrontal cortex. Overall, our findings suggest that slow brain rhythms are responsible for dynamic functional interactions between brain networks. They also confirm the applicability and potential usefulness of EEG-fMRI for central nervous system drug research.

Cold spells and heatwaves increase mortality. However little is known about the effect of heatwaves or cold spells on cardiovascular morbidity. This study aims to assess the effect of cold spells and heatwaves on cardiovascular diseases in a Mediterranean region (Catalonia, Southern Europe). We conducted a population-based retrospective study. Data were obtained from the System for the Development of Research in Primary Care and from the Catalan Meteorological Service. The outcome was first emergency hospitalizations due to coronary heart disease, stroke, or heart failure. Exposures were: cold spells; cold spells and 3 or 7 subsequent days; and heatwaves. Incidence rate ratios (IRR) and 95% confidence intervals were calculated using the self-controlled case series method. We accounted for age, time trends, and air pollutants; results were shown by age groups, gender or cardiovascular event type. There were 22,611 cardiovascular hospitalizations in winter and 17,017 in summer between 2006 and 2013. The overall incidence of cardiovascular hospitalizations significantly increased during cold spells (IRR = 1.120; CI 95%: 1.10-1.30) and the effect was even stronger in the 7 days subsequent to the cold spell (IRR = 1.29; CI 95%: 1.22-1.36). Conversely, cardiovascular hospitalizations did not increase during heatwaves, neither in the overall nor in the stratified analysis. Cold spells but not heatwaves, increased the incidence of emergency cardiovascular hospitalizations in Catalonia. The effect of cold spells was greater when including the 7 subsequent days. Such knowledge might be useful to develop strategies to reduce the impact of extreme temperature episodes on human health. The online version of this article (doi:10.1186/s12940-017-0238-0) contains supplementary material, which is available to authorized users.

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