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1.
J Clin Med ; 13(11)2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38892778

RESUMEN

Background/Objectives: Recurrent shoulder instability following Bankart lesion repair often necessitates surgical revision. This systematic review aims to understand the failure rates of arthroscopic revision Bankart repair. Methods: Following the PRISMA guidelines and registered on PROSPERO, this systematic review examined twenty-five articles written between 2000 and 2024. Two independent reviewers assessed eligibility across three databases, focusing on recurrent instability as the primary endpoint, while also noting functional measures, adverse events, revision operations, and return-to-sport rates when available. Results: The key surgical techniques for recurrent instability post-Bankart repair were identified, with revision arthroscopic Bankart being the most common (685/1032). A comparative analysis revealed a significantly lower recurrence for open coracoid transfer compared to arthroscopic revision Bankart repair (9.67% vs. 17.14%; p < 0.001), while no significant difference was observed between remplissage plus Bankart repair and Bankart repair alone (23.75% vs. 17.14%; p = 0.24). The majority of studies did not include supracritical glenoid bone loss or engaging Hill-Sachs lesions, and neither subcritical nor non-engaging lesions significantly influenced recurrence rates (p = 0.85 and p = 0.80, respectively). Conclusions: Revision arthroscopic Bankart repair remains a viable option in the absence of bipolar bone loss; however, open coracoid transfer appears to have lower recurrence rates than arthroscopic Bankart repair, consistent with prior evidence. Further studies should define cutoffs and investigate the roles of critical glenoid bone loss and off-track Hill-Sachs lesions. Preoperative measurements of GBL on three-dimensional computed tomography and characterizing lesions based on glenoid track will help surgeons to choose ideal candidates for arthroscopic revision Bankart repair.

2.
Emerg Med Australas ; 36(4): 604-608, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38558322

RESUMEN

OBJECTIVES: In overdose, gamma-hydroxybutyrate (GHB) and its precursors can cause decreased levels of consciousness, coma and death. Here, we aim to describe reported exposure to GHB at four EDs in Sydney, New South Wales (NSW), Australia. METHODS: We searched the ED databases of four Sydney metropolitan hospitals for presentations relating to GHB exposure between 2012 and 2021. We calculated annual number of presentations stratified by hospital, age, sex, mode of arrival and triage category. RESULTS: A total of 3510 GHB-related presentations to ED were recorded across the four hospitals. Data for all hospitals were only available from 2015 onwards and between 2015 and 2021; there was a 114% increase in annual presentations (from 228 to 487). Males represented 68.7% of all presentations and the median age was 31 years (range 16-74 years). There was an increase in the proportion of female presentations between 2012 and 2021 (from 27.9% to 37.9%) along with the severity of presentation over the same period, with the proportion of presentations with a triage category 1 increasing from 19.7% to 34.5%. CONCLUSIONS: Increases in recorded absolute number and severity of GHB-related presentations to Sydney EDs are a major public health concern. There may also be shifts in the demographics of those with GHB-related presentations. Renewed efforts are required to understand the drivers of these increases to optimally target harm reduction approaches.


Asunto(s)
Servicio de Urgencia en Hospital , Oxibato de Sodio , Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Nueva Gales del Sur/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Servicio de Urgencia en Hospital/tendencias , Adolescente , Anciano , Sobredosis de Droga/epidemiología
3.
Artículo en Inglés | MEDLINE | ID: mdl-38589715

RESUMEN

In this study, γ-butyrolactone/water (GBL/H2O) was explored as a mild, efficient, and cost-effective binary solvent pretreatment to enhance hydrolyzability of corn stover (CS). Key pretreatment parameters-reaction time, temperature, and H2SO4 concentration-were systematically investigated for their effects on the physicochemical properties of CS. Specifically, increased temperature and acid concentration significantly decreased cellulose crystallinity (from 1.39 for untreated CS to 1.04 for CS pretreated by GBL/H2O with 100 mM H2SO4 at 120 °C for 1 h) and promoted lignin removal (47.3% for CS pretreated by GBL/H2O with 150 mM H2SO4 at 120 °C for 1 h). Acknowledging the cellulase's limited hydrolysis efficiency, a dual-enzyme scheme using a low cellulase dosage (10 FPU/g) supplemented with ß-glucosidase or xylanase was tested, enhancing hydrolysis of CS pretreated under low temperature-long duration and high temperature-short duration conditions, respectively. Optimum sugar release was obtained from CS pretreated with GBL/H2O and 150 mM H2SO4 at 120 °C for 1 h, achieving 98% glucan and 82.3% xylan conversion, compared with 53.9% and 17% of glucan and xylan conversion from untreated CS. GBL/H2O pretreatment outperformed other binary systems in literature, achieving the highest sugar conversions with lower enzyme loading. These results highlight the potential of GBL/H2O pretreatment for efficient biomass conversion, contributing to the goals of the green economy.

4.
Ann Jt ; 9: 8, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38529296

RESUMEN

Background and Objective: Crucial to the success of any total or reverse shoulder arthroplasty (RSA) is the stability of the glenoid component fixation. Instability can lead to early implant failure and unsatisfactory results. Patients often present with varying forms of glenoid bone loss (GBL) in both the primary and revision settings, which can be a challenge for the treating surgeon. Severe cases of GBL can increase the risk of potential complications and diminish implant longevity. The use of the reverse total shoulder replacement has been particularly helpful when addressing significant glenoid bony defects. Various approaches have been proposed to deal with GBL, all of which require an individualized assessment of the specifics of the defect in order to provide maximal fixation and thereby optimize the longevity of the shoulder arthroplasty. This article aims to review the recent literature on GBL in shoulder arthroplasty to provide guidance when considering treatment based on the best available evidence. Methods: PubMed, MEDLINE, EMBASE, AccessMedicine, ClinicalKey, DynaMed, and Micromedex were queried for publications utilizing the following keywords: "glenoid bone loss" AND "glenoid bone deficiency" AND "shoulder arthroplasty" AND "classification". The search was restricted to research published between 2004 and 2023. There were no restrictions on study type or language. Key Content and Findings: GBL should be critically evaluated prior to undertaking total shoulder arthroplasty (TSA). The treating surgeon should be aware of various methods of addressing bone defects. Conclusions: The use of TSA is increasing to address various shoulder pathologies. Addressing glenoid bone defects is of critical importance to maximize the longevity and outcome of TSA.

5.
J Homosex ; 71(6): 1392-1418, 2024 May 11.
Artículo en Inglés | MEDLINE | ID: mdl-36939142

RESUMEN

Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclusion, chemsex had to be the main focus, and studies had to specify GHB/GBL, stimulant (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine use with sex as a variable. From 7055 titles/abstracts, 108 studies were included, mostly cross-sectional, and from Western countries. About one-third of studies recruited exclusively from clinical settings. A majority of these recruited from sexually transmitted infection (STI) clinics. The included quantitative studies analyzed possible associations between chemsex and STI health (40%), mental health (15%), drug health (12%), sexological health (10%), and post-diagnostic HIV health (7%). Most studies included GHB/GBL and crystal meth in their operationalization of chemsex. Definitions and operationalizations of chemsex vary greatly in the literature, and researchers of chemsex among MSM should consider ways in which this variation impacts the validity of their results. More studies are needed among MSM in non-high income and non-Western countries, and examination of possible links between chemsex and post-diagnostic HIV health, sexological health, and mental health.


Asunto(s)
Infecciones por VIH , Metanfetamina , N-Metil-3,4-metilenodioxianfetamina , Minorías Sexuales y de Género , Enfermedades de Transmisión Sexual , Oxibato de Sodio , Trastornos Relacionados con Sustancias , Masculino , Humanos , Homosexualidad Masculina/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Estudios Transversales , Conducta Sexual
6.
Small ; 20(21): e2307945, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38098338

RESUMEN

The redox stabilities of different oxygen donor solvents (C═O, P═O and S═O) and lithium salt anions for supercapacitors (SCs) electrolytes have been compared by calculating the frontier molecular orbital energy. Among six lithium difluoro(oxalate)borate (LiDFOB)-based mono-solvent electrolytes, the dilute LiDFOB-1,4-butyrolactone (GBL) electrolyte exhibits the highest operating voltage but suffers from electrolyte breakdown at elevated temperatures. Trimethyl phosphate (TMP) exhibits the highest redox stability and a strongly negative electrostatic potential (ESP), making it suitable for promoting the dissolution of LiDFOB as expected. Therefore, TMP is selected as a co-solvent into LiDFOB-GBL electrolyte to regulate Li+ solvation structure and improve the operability of electrolytes at high temperatures. The electrochemical stable potential window (ESPW) of 0.5 m LiDFOB-G/T(5/5) hybrid electrolyte can reach 5.230 V. The activated carbon (AC)-based symmetric SC using 0.5 m LiDFOB-G/T(5/5) hybrid electrolyte achieves a high energy density of 54.2 Wh kg-1 at 1.35 kW kg-1 and the capacitance retention reaches 89.2% after 10 000 cycles. The operating voltage of SC can be maintained above 2 V when the temperature rises to 60 °C.

7.
Drug Alcohol Depend ; 252: 110951, 2023 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-37717308

RESUMEN

Γ-valerolactone (GVL), marketed online as "Tranquilli-G" and "excellent Valium", is used as a legal substitute for γ-hydroxybutyric acid (GHB); however, until now, GVL has only been connected to one Drug-Facilitated Sexual Assault (DFSA) case. Moreover, the pharmaco-toxicological effects of GVL are poorly studied. The aim of this study was to investigate the 1) in vivo effects of gavage administration of GVL (100-3000 mg/kg) on neurological (myoclonia, convulsions), sensorimotor (visual, acoustic, and overall tactile) responses, righting reflex, thermoregulation, motor activity (bar, drag, and accelerod test) and cardiorespiratory changes (heart rate, breath rate, oxygen saturation, and pulse distension) in CD-1 male mice and the 2) in silico ADMET profile of GVL in comparison to GHB and the open active form γ-hydroxyvaleric acid (GHV). The present study demonstrates that GVL inhibits, in a dose-dependent manner, sensorimotor and motor responses and induces cardiorespiratory depression (at a dose of 3000 mg/kg) in mice. The determination of the ED50 in sensorimotor and motor responses revealed that GVL is about 4-5 times less potent than GHB. In silico prediction of ADMET profiles revealed toxicokinetic similarities between GHB and GHV, and differences with GVL. These results suggest that GVL could be used as a substitute for GHB and should be added to forensic toxicology screenings.


Asunto(s)
Oxibato de Sodio , Masculino , Ratones , Animales , Hidroxibutiratos , Simulación por Computador
8.
Rev Med Liege ; 78(7-8): 451-455, 2023 Jul.
Artículo en Francés | MEDLINE | ID: mdl-37560960

RESUMEN

Chronic use of gamma-hydroxybutyric acid (GHB) and its precursors can rapidly lead to physical dependence with the emergence of a withdrawal syndrome. This complication is similar to the one linked to alcohol or benzodiazepines. The onset of symptoms and specially neuro-psychiatric symptoms is, however, more rapid in the case of the GHB and precursors. There is currently no consensus on the therapeutic management of GHB withdrawal syndrome. High-dose benzodiazepines are the most commonly used treatment. The use of GHB by titration and tapering could show fewer side effects and withdrawal symptoms. It appears necessary to reflect on and pursue research on the use of GHB and its precursors, which remains poorly understood, on the management of withdrawal syndrome due to the lack of protocol and on its probably underestimated impact on public health.


La consommation chronique d'acide gamma-hydroxybutyrique (GHB) et de ses précurseurs peut rapidement entraîner une dépendance physique avec l'émergence d'un syndrome de sevrage à l'arrêt des consommations. Ce syndrome de sevrage présente des similitudes avec celui lié à l'alcool ou aux benzodiazépines. On retrouvera, cependant, une apparition et une évolution plus brutales ainsi que l'émergence, plus précoce, de symptômes neuropsychiatriques. Il n'y a actuellement pas de consensus concernant la prise en charge thérapeutique de ce syndrome de sevrage. Dès lors, le recours aux benzodiazépines à hautes doses constitue le traitement le plus régulièrement utilisé. L'utilisation de GHB médical, titré et avec une posologie progressivement diminuée, pourrait démontrer moins d'effets secondaires et de symptômes de sevrage. Il apparaît nécessaire de réfléchir et de poursuivre les recherches sur la consommation du GHB et ses précurseurs, qui reste largement méconnue, ainsi que sur la prise en charge du sevrage, au vu de l'absence de protocole et de son impact en santé publique, probablement sous-estimé.


Asunto(s)
Oxibato de Sodio , Síndrome de Abstinencia a Sustancias , Humanos , Oxibato de Sodio/efectos adversos , Síndrome de Abstinencia a Sustancias/diagnóstico , Hidroxibutiratos/efectos adversos , Benzodiazepinas/uso terapéutico
9.
Psychopharmacology (Berl) ; 240(1): 127-135, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36508055

RESUMEN

RATIONALE: Regular consumption of gamma-hydroxybutyrate (GHB) may result in a dependence syndrome that can lead to withdrawal symptoms. There are limited data on medications to manage GHB withdrawal. OBJECTIVES: To examine characteristics associated with delirium and discharge against medical advice (DAMA), in the context of implementing a GHB withdrawal management protocol at an inner-city hospital in 2020. METHODS: We retrospectively reviewed records (01 January 2017-31 March 2021), and included admissions that were ≥ 18 years of age, admitted for GHB withdrawal, and with documented recent GHB use. Admissions were assessed for demographics, medications administered, features of delirium, ICU admission, and DAMA. Exploratory analyses were conducted to examine factors associated (p < 0.2) with features of delirium and DAMA. RESULTS: We identified 135 admissions amongst 91 patients. Medications administered included diazepam (133 admissions, 98.5%), antipsychotics (olanzapine [70 admissions, 51.9%]), baclofen (114 admissions, 84%), and phenobarbital (8 admissions, 5.9%). Features of delirium were diagnosed in 21 (16%) admissions. Delirium was associated with higher daily GHB consumption prior to admission, while duration of GHB use, time from presentation to first dose of diazepam, and concomitant methamphetamine use were inversely associated with delirium. DAMA occurred amongst 41 (30%) admissions, and was associated with a longer time from presentation to first dose of baclofen, while being female and receiving a loading dose of diazepam were inversely associated. CONCLUSIONS: This study adds to the literature in support of the safety and feasibility of diazepam and baclofen for the management of GHB withdrawal. Prospective, randomised trials are required.


Asunto(s)
Delirio , Oxibato de Sodio , Síndrome de Abstinencia a Sustancias , Humanos , Femenino , Masculino , Oxibato de Sodio/efectos adversos , Estudios Retrospectivos , Baclofeno/uso terapéutico , Pacientes Internos , Estudios Prospectivos , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico , Hospitales Urbanos , Diazepam , Delirio/tratamiento farmacológico , Delirio/epidemiología , Registros Médicos , 4-Butirolactona/uso terapéutico
10.
Ann Jt ; 8: 29, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38529218

RESUMEN

Posterior glenohumeral instability is an increasingly common and challenging orthopaedic problem. While an arthroscopic soft tissue stabilization procedure (i.e., reverse Bankart repair) is effective in treating most cases of posterior instability, this procedure may be inadequate in shoulders with critical posterior glenoid bone loss (GBL), or in cases of an engaging reverse Hill-Sachs lesion. Thus, the purpose of the present manuscript was to report contemporary surgical approaches, techniques, and outcomes for the open treatment of glenoid or humeral head bone loss in posterior instability to help guide clinical decision making. Open osteoarticular augmentation procedures have emerged as a popular option to treat posterior bone loss, with bony auto- and allografts utilized from a variety of donor sites including iliac crest, scapular spine, acromion, distal clavicle, and distal tibia. The combination of glenoid retroversion and bone loss can be addressed with a posterior glenoid opening wedge osteotomy. Bipolar bone loss may be treated with a combination of the aforementioned techniques, in addition to a reverse remplissage, a modified McLaughlin procedure, or various arthroplasty-related options. Although short and mid-term outcomes are dependable, studies reporting long-term outcomes are sparse. Moreover, there is no current consensus regarding the most effective treatment of posterior shoulder instability in the setting of bone loss, and open surgical techniques continue to evolve. Further research is necessary to determine long-term effectiveness of these surgical options.

12.
Fa Yi Xue Za Zhi ; 38(2): 212-216, 2022 Apr 25.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-35899509

RESUMEN

OBJECTIVES: To find a method to distinguish exogenous gamma-hydroxybutyrate (GHB) from endogenous GHB by establishing ultra-high performance liquid chromatography-mass spectrometry (UPLC-MS) based on exosome for quantitative detection of GHB in the rat blood. METHODS: Adult male SD rats were divided into 1 h, 5 h, 10 h administration group and control group. After 1 h, 5 h and 10 h of single precursor of GHB gamma-butyrolactone (GBL) intraperitoneal injection in administration groups, 5 mL blood was collected from the abdominal aorta. Meanwhile, the control group was given a same dose of normal saline, and 5 mL blood was collected at 1 h. Among the 5 mL blood, 0.5 mL was directly detected by HPLC-MS after pretreatment, and exosomes were extracted from the remaining blood by differential centrifugation and detected. RESULTS: The concentration of GHB in the control group was (87.36±33.48) ng/mL, and the concentration with administration at 1 h, 5 h and 10 h was (110 400.00±1 766.35) ng/mL, (1 479.00±687.01) ng/mL and (133.60±12.17) ng/mL, respectively. The results of exosome detection showed that no peak GHB signal was detected in the control group and the 10 h administration group, and the concentrations of GHB at 1 h and 5 h administration groups were (91.47±33.44) ng/mL and (49.43±7.05) ng/mL, respectively. CONCLUSIONS: GHB was detected in blood exosome by UPLC-MS, which indicated that exogenous GHB could be detected in plasma exosomes, while endogenous GHB could not be detected, suggesting that this method may be used as a basis to determine whether there is exogenous drug intake.


Asunto(s)
Exosomas , Oxibato de Sodio , 4-Butirolactona/análisis , 4-Butirolactona/química , Animales , Cromatografía Liquida , Exosomas/química , Hidroxibutiratos/química , Masculino , Ratas , Ratas Sprague-Dawley , Oxibato de Sodio/análisis , Espectrometría de Masas en Tándem/métodos
13.
Front Psychol ; 13: 856623, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35496196

RESUMEN

Learning grammar requires practice and practicing grammar can be boring. We examined whether an instructional game with intrinsically integrated game mechanics promotes this practice: compared to rote learning through a quiz. We did so "in the field." Tens of thousands children visited, in their leisure time, a public website with tens of attractive online games for children during a 6-week-long period. Of these children, 11,949 picked voluntarily our grammar training intervention. Thereafter, unbeknown to them, they were assigned either to the game or the quiz condition. By means of learning analytics, we examined variables related to participants' persistence and performance. The results showed large participant drop-out before completing the first level in both conditions (42.2%), confirming the boringness of the topic. More children completed at least one level in the game compared to the quiz (61.8 vs. 53.6%). However, more children completed the intervention (all six levels) with the quiz (6.0 vs. 4.3%). In the game, children answered fewer questions correctly (36.3 vs. 47.4) and made more errors compared to the quiz (16.1 vs. 13.1). These findings suggest that even if a game initially catches user attention, it may not hold it. Plus, even if it is a minimalistic game with intrinsic integration of learning and playing, it may be distractive. We conclude that persistence in practicing grammar may be driven by other means than by a game's shooting mechanics; for instance, by a desire to learn the topic and a feeling of achievement or by quizzing mechanics.

14.
Forensic Sci Int ; 329: 111093, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-34773817

RESUMEN

Over the last few years there has been a dramatic increase in the amount of "Fantasy" type drugs seized in New Zealand, with gamma-butyrolactone (GBL) being by far the most prevalent. In 2018, N-methyl-2-pyrrolidone (NMP) was detected in a liquid, along with GBL, for the first time in New Zealand. Since this seizure, the number of seizures containing mixtures of GBL and NMP that have been submitted for analysis by New Zealand authorities have significantly increased, with 82% of submitted samples containing GBL also containing NMP. Analysis of these liquids showed that the majority had GBL and NMP purities of approximately 60-70% and 30-40%, respectively. Subsequent investigations by New Zealand authorities revealed a potential source of these liquids being a diverted legitimate industrial product. The health and psychoactive effects of NMP, along with GBL and NMP mixtures, are unknown. Health statistics in New Zealand have indicated increased harm from GBL use over the last few years.

15.
J Forensic Sci ; 66(3): 846-853, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33400824

RESUMEN

Total Vaporization Solid-Phase Microextraction (TV-SPME) relies on the same technique as standard SPME but completely vaporizes a sample extract, and analytes are sorbed directly from the vapor phase. On-fiber derivatization may also be performed using TV-SPME, where the fiber is first exposed to the headspace of a vial containing the derivatization agent, then exposed to a new vial containing the sample. É£-Hydroxybutyric acid (GHB) and É£-butyrolactone (GBL) are drugs of concern in that they may be used in drug facilitated sexual assault by surreptitiously spiking them into a victim's beverage. These drugs cause sedation, memory loss, and are difficult to detect in biological samples. One challenge in their analysis is that they can interconvert in aqueous samples, which was demonstrated in samples allowed to stand at room temperature for long periods. A volume study of GBL in water was performed with volumes ranging from 1 to 10,000 µl to compare the efficacy of TV-SPME, headspace SPME, and immersion SPME. Lastly, water, beer, wine, liquor, and mixed drinks were spiked with either GHB or GBL with realistic concentrations (mg/ml) and microliter quantities were analyzed using a TV-SPME Gas Chromatography-Mass Spectrometry method. The GBL volume study demonstrated an increased sensitivity in GBL detection when TV-SPME was utilized. Additionally, GHB and GBL were identified in various beverages at realistic concentrations. Overall, TV-SPME is beneficial because it requires no sample preparation and uses smaller sample volumes than immersion and headspace SPME.


Asunto(s)
4-Butirolactona/análisis , Bebidas Alcohólicas/análisis , Hidroxibutiratos/análisis , Microextracción en Fase Sólida/métodos , Crimen , Toxicología Forense/métodos , Cromatografía de Gases y Espectrometría de Masas , Humanos , Intoxicación/diagnóstico , Volatilización
16.
Expert Opin Drug Metab Toxicol ; 17(12): 1445-1454, 2021 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35043730

RESUMEN

INTRODUCTION: GHB is a small molecule and is present in the human CNS. Exogenously, GHB is administered orally in the form of sodium oxybate to treat cataplexy and excessive daytime sleepiness in patients with narcolepsy, and to manage alcohol withdrawal and detoxification in alcoholics. GHB shows a biphasic effect and dose-dependent pharmacokinetics and may interact with neuronal systems different from GABAergic one. The compound is also highly abused among bodybuilders and is associated with drugs of abuse. AREAS COVERED: This article provides an overview of the risks associated with the recreational consumption of GHB and its analogues, including pharmaceuticals mostly encountered in GHB-related emergency department admissions and postmortem investigations. A literature search was performed using PubMed, Scopus, Google Scholar, and Web of Science databases to identify scientific reports concerning the recreational use of GHB and analogs with prescribed drugs. Further articles were retrieved after consulting international health and regulatory authorities' reports. EXPERT OPINION: Due to its dual nature, interpreting and distinguishing GHB concentrations in biological fluid represents a challenge in forensic toxicology. To demonstrate recent exposure, a quick collection of samples is necessary to maximize the chance of detecting an exogenous GHB intake, especially in cases of GHB-facilitated sexual assaults.


Asunto(s)
Alcoholismo , Oxibato de Sodio , Síndrome de Abstinencia a Sustancias , Alcoholismo/tratamiento farmacológico , Interacciones Farmacológicas , Humanos , Oxibato de Sodio/efectos adversos , Oxibato de Sodio/farmacocinética , Síndrome de Abstinencia a Sustancias/tratamiento farmacológico
17.
Front Neurosci ; 14: 548704, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33328844

RESUMEN

Chemsex is described as the use of specific psychoactive substances (PS) during sexual activity to sustain, enhance, disinhibit or facilitate the sexual experience. It preferentially concerns men who have sex with men (MSM). They use new synthetic substances like cathinones, methamphetamines, gamma-butyrolactone/gamma-hydroxybutyrate (GBL/GHB), ketamine, and cocaine. The prevalence of chemsex varies from 3 to 31% during lifetime. The Internet has participated significantly in the evolution of sexual behaviors, both in terms of sexual dating and the availability of new synthetic substances. The advent of geolocation applications contributed to the development of chemsex. The literature describes many complications linked to these sexual practices; the main clinical effects related to cathinones consumption were psychiatric symptoms; agitation, hallucinations, anxiety, suicidal ideation, paranoia, and confusion. Regular GBL/GHB consumption alter cognitive functions, particularly memory and emotion management. Use of these drugs in party and play is dramatically associated with high-risk sexual behaviors. The prevalence of hepatitis B, hepatitis C syphilis, and HIV is higher in men who use methamphetamine and Viagra and/or who declared they practiced slamming, chemsex, and fisting. Other sexually transmitted infections (STIs) such as gonorrhea have increased with methamphetamine and GHB/GBL use. Actually, the care of individuals who practice Chemsex in a problematic way is currently not codified, but the use of integrative and specific interventions is necessary.

18.
AORN J ; 112(5): 447-456, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33113184

RESUMEN

Nurse educators may experience challenges (eg, distracted learners, inability to provide immediate feedback) when teaching in a classroom setting. Further, the perioperative workforce is multigenerational-younger staff members may have started using technology on a daily basis at a young age, so they may become distracted during traditional lectures and not retain important information. Online game-based learning (GBL) platforms are one technological solution that perioperative educators can use to maintain student engagement and foster learning. Educators at an academic medical center used an online GBL platform to develop presentations on instrument sterilization and surgical attire with sterile technique. At the conclusion of the sessions, the participants submitted surveys evaluating the teaching method. The survey results showed that the respondents found the GBL program to be a fun and positive interactive learning experience. Nurse educators should consider using this type of technology to improve participation and knowledge retention when developing educational programs.


Asunto(s)
Docentes de Enfermería , Aprendizaje , Humanos , Enseñanza
19.
Appl Environ Microbiol ; 86(18)2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32631864

RESUMEN

Streptomyces γ-butyrolactones (GBLs) are quorum sensing communication signals triggering antibiotic production. The GBL system of Streptomyces filipinensis, the producer of the antifungal agent filipin, has been investigated. Inactivation of sfbR (for S. filipinensis γ-butyrolactone receptor), a GBL receptor, resulted in a strong decrease in production of filipin, and deletion of sfbR2, a pseudo-receptor, boosted it, in agreement with lower and higher levels of transcription of filipin biosynthetic genes, respectively. It is noteworthy that none of the mutations affected growth or morphological development. While no ARE (autoregulatory element)-like sequences were found in the promoters of filipin genes, suggesting indirect control of production, five ARE sequences were found in five genes of the GBL cluster, whose transcription has been shown to be controlled by both S. filipinensis SfbR and SfbR2. In vitro binding of recombinant SfbR and SfbR2 to such sequences indicated that such control is direct. Transcription start points were identified by 5' rapid amplification of cDNA ends, and precise binding regions were investigated by the use of DNase I protection studies. Binding of both regulators took place in the promoter of target genes and at the same sites. Information content analysis of protected sequences in target promoters yielded an 18-nucleotide consensus ARE sequence. Quantitative transcriptional analyses revealed that both regulators are self-regulated and that each represses the transcription of the other as well as that of the remaining target genes. Unlike other GBL receptor homologues, SfbR activates its own transcription whereas SfbR2 has a canonical autorepression profile. Additionally, SfbR2 was found here to bind the antifungal antimycin A as a way to modulate its DNA-binding activity.IMPORTANCEStreptomyces GBLs are important signaling molecules that trigger antibiotic production in a quorum sensing-dependent manner. We have characterized the GBL system from S. filipinensis, finding that two key players of this system, the GBL receptor and the pseudo-receptor, each counteracts the transcription of the other for the modulation of filipin production and that such control over antifungal production involves an indirect effect on the transcription of filipin biosynthetic genes. Additionally, the two regulators bind the same sites, are self-regulated, and repress the transcription of three other genes of the GBL cluster, including that encoding the GBL synthase. In contrast to all the GBL receptors known, SfbR activates its own synthesis. Moreover, the pseudo-receptor was identified as the receptor of antimycin A, thus extending the range of examples supporting the idea of signaling effects of antibiotics in Streptomyces The intricate regulatory network depicted here should provide important clues for understanding the regulatory mechanism governing secondary metabolism.


Asunto(s)
4-Butirolactona/metabolismo , Filipina/metabolismo , Metabolismo Secundario , Streptomyces/metabolismo , Antifúngicos/química , Percepción de Quorum
20.
J Vet Med Educ ; 47(4): 523-531, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32412372

RESUMEN

A growing interest in the use of digital game-based learning has been identified in veterinary education. Projects in the development of veterinary game-based environments and scenarios are mostly initiated by veterinary institutions, faculties, or instructors; however, the process of development is complex and often involves expertise from a variety of disciplines. In the collaboration between professionals, discussions often arise about content, and how specific elements should be implemented or edited. As discussions are based on the individual experts' varied disciplines, it can be difficult to achieve a common language, and this leads to blockage and frustration in the development process. In 2012, the University of Copenhagen launched a project on digital game-based learning aimed at veterinary and agriculture students. The overall goal was to develop learning games for herd health management in pig production. The project was carried out in a collaboration between professional game developers, educational/didactic experts, and veterinarians. From early in the process, we identified a need to communicate across disciplines. Therefore, the framework of the Serious Game Development Triangle (SDT) was developed as a tool to facilitate a common language for solving complex issues. The SDT consists of three orientations: games, school, and professionalism. These three orientations are topics that are required considerations when developing a serious game that seeks to teach skills for a specific profession. The SDT contributed to improved understanding across disciplines and made the development process more progressive.


Asunto(s)
Educación en Veterinaria , Animales , Aprendizaje , Motivación , Porcinos
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