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1.
Med Clin North Am ; 106(1): 81-97, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34823736

RESUMO

Extending from the triple wave epidemic of opioid-related overdose deaths, a fourth wave of high mortality involving methamphetamine and cocaine use has been gathering force. This article provides a review of the published literature on stimulants including epidemiology, pharmacology, neurobiology, medical and psychiatric consequences, withdrawal management, and medical and behavioral treatments.


Assuntos
Estimulantes do Sistema Nervoso Central/efeitos adversos , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Metanfetamina/efeitos adversos , Overdose de Opiáceos/epidemiologia , Síndrome de Abstinência a Substâncias/terapia , Antagonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Adulto , Anticonvulsivantes/uso terapêutico , Terapia Comportamental/métodos , Bupropiona/uso terapêutico , Estimulantes do Sistema Nervoso Central/farmacologia , Transtornos Relacionados ao Uso de Cocaína/tratamento farmacológico , Transtornos Relacionados ao Uso de Cocaína/mortalidade , Disfunção Cognitiva/induzido quimicamente , Disfunção Cognitiva/epidemiologia , Comorbidade , Inibidores da Captação de Dopamina/uso terapêutico , Feminino , Humanos , Drogas Ilícitas/efeitos adversos , Drogas Ilícitas/farmacologia , Masculino , Transtornos Mentais/induzido quimicamente , Transtornos Mentais/epidemiologia , Metanfetamina/farmacologia , Mirtazapina/uso terapêutico , Neurobiologia , Doenças Neurodegenerativas/induzido quimicamente , Doenças Neurodegenerativas/epidemiologia , Overdose de Opiáceos/mortalidade , Topiramato/uso terapêutico , Pessoas Transgênero , Estados Unidos/epidemiologia
3.
Trials ; 22(1): 909, 2021 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-34895317

RESUMO

BACKGROUND: The Philippines has been severely affected by the methamphetamine crisis. The government has launched a policy war against drug use, although the severe sanctions imposed on drug users have been criticized internationally. To help implement a more effective and humane approach to drug use, this study aimed to introduce a comprehensive treatment program for methamphetamine users based on cognitive-behavioral therapy (CBT) whose effectiveness will be evaluated through a randomized controlled trial. METHODS: Methamphetamine users admitted into government-run rehabilitation facilities are recruited and randomly assigned to either a CBT-based treatment program or existing therapeutic community (TC)-based treatment. The CBT treatment program was developed based on the Matrix Model that considers cultural and social factors in the Philippines. After 6 months of treatment, there will be a three-month follow-up, when the participants' drug use (tested through urine testing) and other psychological variables, including craving, coping skills, and well-being, will be compared. Potential participants are given a summary of the study and a consent form. The consent form is signed and dated by participants prior to their study participation. Ethical approval was obtained prior to the commencement of the study. DISCUSSION: This is the first randomized controlled trial to compare the residential CBT program and the TC model for methamphetamine users in the Philippines. The study aims to fill the current knowledge and capacity gaps by introducing a CBT-based treatment program to improve the psychosocial well-being of drug users in the Philippines. Moreover, if the effectiveness of the treatment program is demonstrated, anti-drug campaigns and severe sanctions against drug users may be reconsidered. TRIAL REGISTRATION: UMIN Clinical Trials Registry JPRN-UMIN000038597 . Registered on 15 November 2019. Protocol version October 17, 2021 ver.2.


Assuntos
Terapia Cognitivo-Comportamental , Metanfetamina , Humanos , Metanfetamina/efeitos adversos , Filipinas , Ensaios Clínicos Controlados Aleatórios como Assunto , Centros de Reabilitação , Tratamento Domiciliar
4.
Front Public Health ; 9: 739068, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34926370

RESUMO

Background: Positive affect (PA) is crucial for individuals to cope with the current pandemic and buffer the lingering fears after it, especially for patients with substance-use disorders (SUDs). The current study aimed to explore PA and its related factors during the COVID-19 pandemic in male patients with the heroin-use disorder (HUD) and patients with the methamphetamine-use disorder (MAUD), respectively. Methods: A total of 325 male patients with SUDs (106 with HUD and 219 with MAUD, all were single-substance users) in a compulsory rehabilitation center underwent semi-structured interviews during the pandemic. The demographic information, drug-use characteristics, active coping styles (ACSs, by Simple Coping Style Questionnaire), and PA (by the Positive and Negative Affect Scale) of participants were collected and recorded. Results: There were significant differences between the two groups in age, the proportion of full-time workers before the epidemic, duration of drug use, the proportion of patients with long-term withdrawal during the epidemic, cravings, ACS, and PA. Correlation and multiple linear regression analysis showed that duration of drug use, ACS, and stable jobs were significant predictive factors for PA in patients with HUD, while long-term withdrawal, ACS, and stable jobs during the epidemic were significant predictive factors for PA in patients with MAUD. Conclusions: Our study demonstrated the factors for PA in patients with HUD and MAUD during the pandemic. The results provided a basis for the comprehensive understanding of the PA of patients with SUDs and the development of targeted treatments.


Assuntos
COVID-19 , Metanfetamina , Preparações Farmacêuticas , Adaptação Psicológica , Heroína , Humanos , Masculino , Metanfetamina/efeitos adversos , Pandemias , SARS-CoV-2
5.
J Clin Exp Neuropsychol ; 43(6): 599-610, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34612792

RESUMO

OBJECTIVE: To evaluate whether cognitive performance in adults with active methamphetamine use (MA-ACT) differs from cognitive performance in adults in remission from MA use disorder (MA-REM) and adults without a history of substance use disorder (CTLs). METHOD: MA-ACT (n = 36), MA-REM (n = 48), and CTLs (n = 62) completed the Neuropsychological Assessment Battery (NAB). RESULTS: The MA-ACT group did not perform significantly worse than CTLs on any NAB Index. The MA-REM group performed significantly (p < 0.050) worse than CTLs on the NAB Memory Index. The MA-ACT group performed significantly better than CTLs and the MA-REM group on the Executive Functions Index. CONCLUSIONS: Some cognitive deficits are apparent during remission from MA use, but not during active use; this may result in clinical challenges for adults attempting to maintain recovery and continue with treatment.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas , Metanfetamina , Adulto , Transtornos Relacionados ao Uso de Anfetaminas/complicações , Cognição , Função Executiva , Humanos , Metanfetamina/efeitos adversos , Testes Neuropsicológicos
6.
Addict Sci Clin Pract ; 16(1): 62, 2021 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-34635170

RESUMO

BACKGROUND: Methamphetamine/amphetamine use has sharply increased among people with opioid use disorder (OUD). It is therefore important to understand whether and how use of these substances may impact receipt of, and outcomes associated with, medications for OUD (MOUD). This systematic review identified studies that examined associations between methamphetamine/amphetamine use or use disorder and 3 classes of outcomes: (1) receipt of MOUD, (2) retention in MOUD, and (3) opioid abstinence during MOUD. METHODS: We searched 3 databases (PubMed/MEDLINE, PsycINFO, CINAHL Complete) from 1/1/2000 to 7/28/2020 using key words and subject headings, and hand-searched reference lists of included articles. English-language studies of people with documented OUD/opioid use that reported a quantitative association between methamphetamine/amphetamine use or use disorder and an outcome of interest were included. Study data were extracted using a standardized template, and risk of bias was assessed for each study. Screening, inclusion, data extraction and bias assessment were conducted independently by 2 authors. Study characteristics and findings were summarized for each class of outcomes. RESULTS: Thirty-nine studies met inclusion criteria. Studies generally found that methamphetamine/amphetamine use or use disorder was negatively associated with receiving methadone and buprenorphine; 2 studies suggested positive associations with receiving naltrexone. Studies generally found negative associations with retention; most studies finding no association had small samples, and these studies tended to examine shorter retention timeframes and describe provision of adjunctive services to address substance use. Studies generally found negative associations with opioid abstinence during treatment among patients receiving methadone or sustained-release naltrexone implants, though observed associations may have been confounded by other polysubstance use. Most studies examining opioid abstinence during other types of MOUD treatment had small samples. CONCLUSIONS: Overall, existing research suggests people who use methamphetamine/amphetamines may have lower receipt of MOUD, retention in MOUD, and opioid abstinence during MOUD. Future research should examine how specific policies and treatment models impact MOUD outcomes for these patients, and seek to understand the perspectives of MOUD providers and people who use both opioids and methamphetamine/amphetamines. Efforts to improve MOUD care and overdose prevention strategies are needed for this population.


Assuntos
Buprenorfina , Metanfetamina , Transtornos Relacionados ao Uso de Opioides , Buprenorfina/uso terapêutico , Humanos , Metadona/uso terapêutico , Metanfetamina/efeitos adversos , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia
7.
Transl Psychiatry ; 11(1): 519, 2021 10 09.
Artigo em Inglês | MEDLINE | ID: mdl-34628468

RESUMO

Methamphetamine (METH) use, most prevalent in young adults, has been associated with high rates of morbidity and mortality. The relationship between METH use and accelerated biological aging, which can be measured using leukocyte telomere length (LTL), remains unclear. We examined whether young adult METH users have shorter LTL and explored the relationship between characteristics of METH use and LTL by using Mendelian randomization (MR) analysis. We compared the LTL for 187 METH users and 159 healthy individuals aged between 25 and 34 years and examined the relationship of LTL with METH use variables (onset age, duration, and maximum frequency of METH use) by using regression analyses. In addition, 2-stage-least-squares (2SLS) MR was also performed to possibly avoid uncontrolled confounding between characteristics of METH use and LTL. We found METH users had significantly shorter LTL compared to controls. Multivariate regression analysis showed METH use was negatively associated with LTL (ß = -0.36, P < .001). Among METH users, duration of METH use was negatively associated with LTL after adjustment (ß = -0.002, P = .01). We identified a single nucleotide polymorphism (SNP) rs6585206 genome-wide associated with duration of METH use. This SNP was used as an instrumental variable to avoid uncontrolled confounding for the relationship between the use duration and LTL shortening. In conclusion, we show that young adult METH users may have shorter LTL compared with controls and longer duration of METH use was significantly associated with telomere shortening. These observations suggest that METH use may accelerate biological senescence.


Assuntos
Metanfetamina , Telômero , Adulto , Envelhecimento , Humanos , Leucócitos , Metanfetamina/efeitos adversos , Telômero/genética , Encurtamento do Telômero , Adulto Jovem
8.
Trials ; 22(1): 650, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556153

RESUMO

INTRODUCTION: Cognitive deficit is a common syndrome of methamphetamine (MA) dependence. It is related to decision-making, control ability, and social functioning. High-intensity interval training (HIIT) is a training technique that requires people to work out at full intensity during a short period. Many studies have already shown the potential effects of HIIT on cognitive functions. The purpose of this trial is to evaluate the cognitive effects of HIIT on individuals with MA dependence. METHODS AND ANALYSIS: A total of 240 individuals with MA dependence will be randomly assigned to the HIIT group, moderate-intensity continuous training (MICT) group and control (CON) group. HIIT will consist of a 24-min HIIT exercise on a treadmill. MICT will consist of a 1-h body-mind exercise. CON will be their traditional intervention. The experimental period will be 12 months with 3 interventions weekly for the first 6 months and follow-up for the next 6 months. All subjects will be given cognitive tests at baseline, after intervention and at follow-up. Cognitive performances will be compared by a mixed-model analysis for repeated measures. DISCUSSION: HIIT training may reduce illicit drug cravings amongst individuals with MA dependence; hence, HIIT may have a good effect on the cognitive functions, such as memory and executive function, of individuals with MA dependence. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000032492 . Registered on April 30, 2020 ( http://www.chictr.org.cn/edit.aspx?pid=52127&htm=4 ).


Assuntos
Treinamento Intervalado de Alta Intensidade , Metanfetamina , Cognição , Exercício Físico , Teste de Esforço , Humanos , Metanfetamina/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Addict Sci Clin Pract ; 16(1): 57, 2021 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-34565489

RESUMO

BACKGROUND: Stimulant use has increased across the US, with concomitant opioid and methamphetamine use doubling between 2011 and 2017. Shifting patterns of polysubstance use have led to rising psychostimulant-involved deaths. While it is known that individuals who use methamphetamine require greater access to treatment, there is still little known about methamphetamine use and treatment among individuals who are already engaged in outpatient substance use treatment. OBJECTIVES: To characterize care-engaged individuals who use methamphetamine to guide harm reduction and treatment strategies. METHODS: Retrospective cohort study of individuals at a large academic medical center in Massachusetts with ≥ 2 positive methamphetamine oral fluid toxicology tests between August 2019 and January 2020. We performed descriptive analysis of sociodemographic, medical, and drug use characteristics and a comparative analysis of injection methamphetamine use versus other routes of use. RESULTS: Included were 71 individuals [56 male (80%), 66 non-Hispanic white (94%), median age 36 (IQR 30-42)]. Nearly all had opioid (94%) and stimulant use disorder (92%). Most had (93%) or were (83%) being treated with medications for opioid use disorder, but few received pharmacologic treatment for methamphetamine use disorder (24%). None received contingency management treatment. People who inject methamphetamine (68%) were more likely to have a history of overdose (91% vs. 70%; p = 0.02), have HCV (94% vs. 52%; p < 0.01), use fentanyl (93% vs. 65%; p = 0.02), and engage in sex work (19% vs. 0%; p = 0.03) compared to those who used via other routes. Both groups had prevalent homelessness (88% vs. 73%; p = 0.15), incarceration (81% vs. 64%; p = 0.11), depression (94% vs. 87%; p = 0.34), and bacteremia (27% vs. 22%; p = 0.63). CONCLUSIONS: Individuals in our study had high prevalence of polysubstance use, particularly concomitant methamphetamine and opioid use. Individuals who were well connected to substance use treatment for their opioid use were still likely to be undertreated for their methamphetamine use disorder and would benefit from greater access to contingency management treatment, harm reduction resources, and resources to address adverse social determinants of health.


Assuntos
Estimulantes do Sistema Nervoso Central , Overdose de Drogas , Metanfetamina , Transtornos Relacionados ao Uso de Opioides , Adulto , Analgésicos Opioides/uso terapêutico , Estimulantes do Sistema Nervoso Central/efeitos adversos , Estudos de Coortes , Overdose de Drogas/tratamento farmacológico , Humanos , Masculino , Metanfetamina/efeitos adversos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Estudos Retrospectivos
10.
Ned Tijdschr Geneeskd ; 1652021 07 08.
Artigo em Holandês | MEDLINE | ID: mdl-34346626

RESUMO

In this article we describe epidemiological, pharmacological and clinical aspects of abuse of metamphetamines, also known as crystal meth. These aspects are illustrated by two cases of methamphetamine abuse and the complications associated with it. Metamphetamine abuse is often associated with sexual activity, a combination known as 'chemsex'. A chronic addiction to chemsex can have devastating effects on the user's social, psychological, and physical wellbeing. We describe a patient suffering from recurrent relapses in his addiction to chemsex. Acute crystal meth intoxications can result in very serious complications. We describe a patient suffering from severe neurological complications and rhabdomyolysis.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas , Metanfetamina , Transtornos Relacionados ao Uso de Anfetaminas/complicações , Humanos , Metanfetamina/efeitos adversos , Comportamento Sexual
11.
Int J Gynaecol Obstet ; 155(2): 220-238, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34358330

RESUMO

BACKGROUND: Indigenous women are overrepresented among people who use (PWU) methamphetamine (MA) due to colonialism and intergenerational trauma. Prenatal methamphetamine exposure (PME) is increasing as the number of PWUMA of childbearing age grows. Yet impacts of MA in pregnancy and effective interventions are not yet well understood. OBJECTIVE: We conducted an environmental scan of published and grey literature (2010-2020) to determine effects of MA use in pregnancy for mothers and their offspring, effective interventions and implications for Indigenous women. SEARCH STRATEGY: A strategic search of Ovid Medline, Embase, ProQuest-Public Health and CINAHL databases identified academic literature, while Google and ProQuest-Public Health identified grey literature. SELECTION CRITERIA: Article selection was based on titles, abstracts and keywords. The time frame captured recent MA composition and excluded literature impacted by coronavirus disease 2019. DATA COLLECTION AND ANALYSIS: Data extracted from 80 articles identified 463 results related to 210 outcomes, and seven interventions. Analysis focused on six categories: maternal, neonatal/infant, cognitive, behavioral, neurological, and interventions. MAIN RESULTS: Maternal outcomes were more congruent than child outcomes. The most prevalent outcomes were general neonatal/infant outcomes. CONCLUSION: A lack of Indigenous-specific research on PME and interventions highlights a need for future research that incorporates relevant historical and sociocultural contexts.


Assuntos
COVID-19 , Metanfetamina , Criança , Feminino , Humanos , Metanfetamina/efeitos adversos , Mães , Gravidez , SARS-CoV-2
12.
J Am Heart Assoc ; 10(16): e018370, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34365802

RESUMO

Background Although methamphetamine abuse is associated with the development of heart failure (HF), nationwide data on methamphetamine-associated HF (MethHF) hospitalizations are limited. This study evaluates nationwide HF hospitalizations associated with substance abuse to better understand MethHF prevalence trends and the clinical characteristics of those patients. Methods and Results This cross-sectional period-prevalence study used hospital discharge data from the National Inpatient Sample to identify adult primary HF hospitalizations with a secondary diagnosis of abuse of methamphetamines, cocaine, or alcohol in the United States from 2002 to 2014. All 2014 MethHF admissions were separated by regional census division to evaluate geographical distribution. Demographics, payer information, and clinical characteristics of MethHF hospitalizations were compared with all other HF hospitalizations. Total nationwide MethHF hospitalizations increased from 547 in 2002 to 6625 in 2014 with a predominance on the West Coast. Methamphetamine abuse was slightly more common among primary HF hospitalizations compared with all-cause hospitalizations (7.4 versus 6.4 per 1000; Cohen h=0.012; P<0.001). Among HF hospitalizations, patients with MethHF were younger (mean age, 48.9 versus 72.4 years; Cohen d=1.93; P<0.001), more likely to be on Medicaid (59.4% versus 8.8%; Cohen h=1.16; P<0.001) or uninsured (12.0% versus 2.6%; Cohen h=0.36; P<0.001), and more likely to present to urban hospitals (43.8% versus 28.3%; Cohen h=0.32; P<0.001) than patients with non-methamphetamine associated HF. Patients with MethHF had higher rates of psychiatric comorbidities and were more likely to leave the hospital against medical advice. Conclusions MethHF hospitalizations have significantly increased in the United States, particularly on the West Coast. Coordinated public health policies and systems of care are needed to address this rising epidemic.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/epidemiologia , Estimulantes do Sistema Nervoso Central/efeitos adversos , Disparidades nos Níveis de Saúde , Insuficiência Cardíaca/epidemiologia , Hospitalização/tendências , Metanfetamina/efeitos adversos , Determinantes Sociais da Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos Relacionados ao Uso de Anfetaminas/diagnóstico , Transtornos Relacionados ao Uso de Anfetaminas/terapia , Cardiotoxicidade , Estudos Transversais , Bases de Dados Factuais , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Prevalência , Medição de Risco , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
13.
Rev Esp Salud Publica ; 952021 Aug 31.
Artigo em Espanhol | MEDLINE | ID: mdl-34463310

RESUMO

OBJECTIVE: Chemsex is a term applicable to the use of drugs related to sex among men who have sex with men (MSM). Because it is a recent trend, there is little information about its management and consequences. The aim of the study was to describe the clinical profile of a sample of chemsex users who consulted for treatment. METHODS: This is a longitudinal and retrospective study of 53 patients who consulted for chemsex in an addiction unit of a general hospital in Barcelona, from January 2017 to June 2019. Data was collected from electronic medical records and a descriptive analysis was performed by calculating proportions and means. RESULTS: The most common drug used in chemsex was methamphetamine (81.1%; n=43) and 67.4% (n=29) of these used at least other two drugs. The prevalence of HIV infection was high (71.2%; n=37) and 72.1% (n=41) had psychiatric comorbidity, being the most common psychosis (37.2%; n=16). CONCLUSIONS: Methamphetamine was the most common drug chemsex user's seeked for treatment. Furthermore, there is a high prevalence of HIV diagnosis in this population. Both conditions can enhance the risk of suffering from psychosis and may explain why psychiatric comorbidity is so high in the sample.


Assuntos
Homossexualidade Masculina , Transtornos Mentais , Metanfetamina , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Estudos Longitudinais , Masculino , Transtornos Mentais/epidemiologia , Metanfetamina/efeitos adversos , Estudos Retrospectivos , Comportamento Sexual/estatística & dados numéricos , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/psicologia
14.
Am J Addict ; 30(6): 543-551, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34411367

RESUMO

BACKGROUND AND OBJECTIVES: The adverse impact of chronic methamphetamine (MA) use on cognitive function has been described in previous studies, but limited evidence is available for abstinent users from prospective longitudinal studies. The aim of the present study was to assess cognitive function of varying abstinent duration. METHODS: This prospective longitudinal study was conducted with baseline and four follow-up interviews every 6 months over 2 years in 358 MA users in Guangdong province, China. The Montreal Cognitive Assessment (MoCA) was used to measure cognitive function. Generalized estimating equation (GEE) analysis was used to examine within-subjects relationships between abstinence and cognitive consequences over time. RESULTS: The repeated measure analysis of variance showed significant differences in the total MoCA score and all subscale scores (except Orientation) in the 24 months follow-up. The GEE model showed that abstinence from MA in the past 6 months predicted an increase of 0.66 (95% confidence interval [CI] = 0.29 to 1.05, p = .002) in MoCA score changes compared with the nonabstinence MA users. Abstinence in the past 12, 18, and 24 months predicted an increase in MoCA total score changes of 1.25 (95% CI = -0.23 to 2.74), 2.15 (95% CI = -0.79 to 5.09), and 5.28 (95% CI = -2.01 to 12.58), respectively, but none of these was statistically significant. DISCUSSION AND CONCLUSIONS: Cognitive function was potentially improved following 6 months of MA abstinence. SCIENTIFIC SIGNIFICANCE: This study extends prior research by long-term follow-up in big sample MA abstinence users. Findings from study support the need for a comprehensive measure to decrease MA use and promote the recovery of cognitive impairment.


Assuntos
Disfunção Cognitiva , Metanfetamina , Cognição , Humanos , Estudos Longitudinais , Metanfetamina/efeitos adversos , Estudos Prospectivos
16.
ACS Chem Neurosci ; 12(15): 2729-2748, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34297546

RESUMO

Methamphetamine (MA) can cross the placenta in pregnant women and cause placental abruption and developmental alterations in offspring. Previous studies have found prenatal MA exposure effects on the social and cognitive performance of children. Recent studies reported some alterations in structural and functional magnetic resonance imaging (MRI) of prenatal MA-exposed offspring. In this study, we aimed to investigate the effect of prenatal MA exposure on brain development using recently published structural, metabolic, and functional MRI studies. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed and SCOPUS databases for articles that used each brain imaging modality in prenatal MA-exposed children. Seventeen studies were included in this study. We investigated brain imaging alterations using 17 articles with four different modalities, including structural MRI, diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), and functional MRI (fMRI). The participants' age range was from infancy to 15 years. Our findings demonstrated that prenatal MA exposure is associated with macrostructural, microstructural, metabolic, and functional deficits in both cortical and subcortical areas. However, the most affected regions were the striatum, frontal lobe, thalamus and the limbic system, and white matter (WM) fibers connecting these regions. The findings from our study might have valuable implications for targeted treatment of neurocognitive and behavioral deficits in children with prenatal MA exposure. Even so, our results should be interpreted cautiously due to the heterogeneity of the included studies in terms of study populations and methods of analysis.


Assuntos
Metanfetamina , Efeitos Tardios da Exposição Pré-Natal , Adolescente , Encéfalo/diagnóstico por imagem , Imagem de Tensor de Difusão , Feminino , Humanos , Metanfetamina/efeitos adversos , Neuroimagem , Placenta , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/diagnóstico por imagem
17.
Forensic Sci Int ; 325: 110892, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34273604

RESUMO

BACKGROUND: The concentration levels of major and trace elements are significantly correlated with human health. However, studies profiling major and trace elements among female using methamphetamine are rare. This study aims to investigate the major and trace elements changes and discover elemental biomarkers in plasma of female methamphetamine (METH) addicts in six months' compulsory treatment. METHODS: A total of 60 female METH addicts selected from drug rehabilitation center were randomly divided into three equal groups: (1) Detoxification for one month; (2) Detoxification for three months; (3) Detoxification for six months. Twenty healthy women, without drug abuse history were selected as control group. Four major elements including Na, Mg, K, Ca and twelve trace elements including V, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Mo, Sn, Pb were determined using inductively coupled plasma mass spectrometry (ICP-MS). The results were analyzed using One-way Analysis of Variance (ANOVA) and Student-Newman-Keuls (SNK test). Elemental biomarkers were discovered based on orthogonal partial least squares discriminant analysis (OPLS-DA). RESULTS: The four groups used in the study were divided into four significant sections according to scatter plots. The total elemental concentrations of three METH withdrawal groups were increased compared to the control group. Over six months, element contents of the withdrawal groups gradually equaled element contents of the control group in compulsory treatment. The variable importance in the projection values (VIP > 1) of OPLS-DA model and SNK test (p < 0.05) revealed Fe, Cu, Cr and Se as elemental biomarkers. CONCLUSION: Major and trace elements demonstrated significant differences between control group and three METH withdrawal groups. Fe, Cu, Cr and Se are potential elemental biomarkers among METH-abused female groups. Metabolic disorders of major and trace elements exist in the female methamphetamine addicts.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas/reabilitação , Oligoelementos/sangue , Adulto , Biomarcadores/sangue , Feminino , Humanos , Espectrometria de Massas/métodos , Metanfetamina/efeitos adversos , Centros de Tratamento de Abuso de Substâncias
18.
Am J Cardiol ; 154: 86-91, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34233837

RESUMO

Methamphetamine-associated cardiomyopathy (MACM) in an increasingly prevalent disease yet presenting clinical characteristics have not been well studied. We studied consecutive patients with MACM presenting between June 2018 and March 2020 who were interviewed for drug use and medical history. We retrospectively identified an age- and gender-matched cohort of Non-MACM (NMACM) patients and compared clinical characteristics. 140 patients (70 MACM and 70 NMACM) were studied. MACM patients were young (49.6 ± 10 years) and predominantly male (94%). Compared to NMACM, MACM patients were more likely to be Caucasian (21% vs 6%, p = 0.007) and homeless (47% vs 7%, p = 0.001). MACM was characterized by lower left ventricular ejection fraction (EF) (p <0.001) and greater LV end diastolic volume (LVEDV) (p = 0.024). Right ventricular (RV) dilation was present more often (p = s0.001) and was more often severe (p = 0.03). Among MACM cases, half of the cohort developed MACM within 5 years of starting MA (18% within 1 year). There was no apparent relationship between frequency or amount of MA used weekly with time until heart failure onset. Drug use patterns were not clearly related to the degree of LV structural change however there were more consistent, significant associations with RV and right atrial (RA) size parameters. In conclusion, patients with MACM have more severe myocardial impairment with lower EF, greater LVEDV and RV dilation. Drug use patterns do not clearly impact degree of LV structural changes by echocardiography however may be related to RV and RA size.


Assuntos
Transtornos Relacionados ao Uso de Anfetaminas , Cardiomiopatias/fisiopatologia , Estimulantes do Sistema Nervoso Central/efeitos adversos , Metanfetamina/efeitos adversos , Administração Intranasal , Adulto , Cardiomiopatias/induzido quimicamente , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/epidemiologia , Cardiotoxicidade , Estudos de Casos e Controles , Ecocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fumar , Volume Sistólico , Disfunção Ventricular Esquerda
19.
J Exp Biol ; 224(13)2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34229347

RESUMO

Illicit drug abuse presents pervasive adverse consequences for human societies around the world. Illicit drug consumption also plays an unexpected role in contamination of aquatic ecosystems that receive wastewater discharges. Here, we show that methamphetamine, considered as one of the most important global health threats, causes addiction and behavior alteration of brown trout Salmo trutta at environmentally relevant concentrations (1 µg l-1). Altered movement behavior and preference for methamphetamine during withdrawal were linked to drug residues in fish brain tissues and accompanied by brain metabolome changes. Our results suggest that emission of illicit drugs into freshwater ecosystems causes addiction in fish and modifies habitat preferences with unexpected adverse consequences of relevance at the individual and population levels. As such, our study identifies transmission of human societal problems to aquatic ecosystems.


Assuntos
Metanfetamina , Poluentes Químicos da Água , Animais , Ecossistema , Humanos , Metanfetamina/efeitos adversos , Truta , Poluentes Químicos da Água/toxicidade
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