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1.
Anticancer Res ; 40(4): 2059-2064, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234897

RESUMO

BACKGROUND/AIM: Prolonged use of glucocorticoids (GC) in glioma treatment can lead to adrenal insufficiency (AI) and subsequent steroid dependence due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis. This is challenging to diagnose due to its nonspecific clinical symptoms erroneously ascribed to treatment. This study aimed to evaluate the risk factors predisposing patients with gliomas to develop AI. PATIENTS AND METHODS: Charts in the neuro-oncology clinic from July 2018 to March 2019 were reviewed. Inclusion criteria included >18 y/o with WHO Grade II-IV gliomas, and secondary AI. Demographic profile, tumor characteristics, and treatment profile were compared. RESULTS: The majority of patients were started on high dose dexamethasone at >8 mg daily, and were on dexamethasone for 4-8 months. The minimum dose needed to prevent symptoms was 0.5 mg to 2 mg daily. The majority received standard radiation doses ranging from 54-60 Gy. Most patients had radiation exposure to the HPA axis within the prescription isodose levels. CONCLUSION: Prolonged steroid dependency can result from chronic GC use in patients with glioma. Dose and duration of GC are risk factors for its development. Radiation exposure to the HPA axis may also be a contributing factor.


Assuntos
Insuficiência Adrenal/tratamento farmacológico , Glioma/tratamento farmacológico , Glucocorticoides/efeitos adversos , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Insuficiência Adrenal/induzido quimicamente , Insuficiência Adrenal/patologia , Adulto , Dexametasona/administração & dosagem , Feminino , Glioma/complicações , Glioma/patologia , Glucocorticoides/administração & dosagem , Humanos , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Sistema Hipotálamo-Hipofisário/patologia , Masculino , Pessoa de Meia-Idade , Sistema Hipófise-Suprarrenal/patologia , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/patologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-31547477

RESUMO

Advances in experimental psychology have provided evidence for the presence of attentional and approach biases in individuals with substance use disorders. Traditionally, reaction time tasks, such as the Stroop or the Visual Probe Task, are commonly used in the assessment of attention biases. The Visual Probe Task has been criticized for its poor reliability, and other research has highlighted that variations remain in the paradigms adopted. However, a gap remains in the published literature, as there have not been any prior studies that have reviewed stimulus timings for different substance use disorders. Such a review is pertinent, as the nature of the task might affect its effectiveness. The aim of this paper was in comparing the different methods used in the Visual Probe Task, by focusing on tasks that have been used for the most highly prevalent substance disorders-that of opiate use, cannabis use and stimulant use disorders. A total of eight published articles were identified for opioid use disorders, three for cannabis use disorders and four for stimulant use disorders. As evident from the synthesis, there is great variability in the paradigm adopted, with most articles including only information about the nature of the stimulus, the number of trials, the timings for the fixation cross and the timings for the stimulus set. Future research examining attentional biases among individuals with substance use disorders should take into consideration the paradigms that are commonly used and evaluate the optimal stimulus and stimulus-onset asynchrony timings.


Assuntos
Viés de Atenção , Tempo de Reação , Transtornos Relacionados ao Uso de Substâncias/patologia , Humanos , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Percepção Visual
4.
BMC Infect Dis ; 19(1): 821, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533734

RESUMO

BACKGROUND: Hepatitis C virus (HCV) is common in men who have sex with men (MSM) with HIV. The Swiss HCVree Trial targeted a micro-elimination by using a treat and counsel strategy. Self-reported condomless anal intercourse with non-steady partners was used as the selection criterion for participation in a counselling intervention designed to prevent HCV re-infection. The purpose of this study was to assess the ability of this criterion to identify men who engaged in other sexual risk behaviours associated with HCV re-infection. METHODS: Men who disclosed their sexual and drug- use behaviours during the prior 6 months, at study baseline, were included in the current study. Using a descriptive comparative study design, we explored self-reported sexual and drug-use risk behaviours, compared the odds of reporting each behaviour in men who reported and denied condomless anal intercourse with non-steady partners during the prior year and calculated the sensitivity/specificity (95% CI) of the screening question in relation to the other at-risk behaviours. RESULTS: Seventy-two (61%) of the 118 men meeting eligibity criteria reported condomless anal intercourse with non-steady partners during the prior year. Many also engaged in other potential HCV transmission risk behaviours, e.g., 52 (44%) had used drugs. In participants disclosing drug use, 44 (37%) reported sexualised drug use and 17 (14%) injected drugs. Unadjusted odds ratios (95% CI) for two well-known risk behaviours were 2.02 (0.80, 5.62) for fisting and 5.66 (1.49, 37.12) for injecting drug use. The odds ratio for sexualised drug use - a potential mediator for increased sexual risk taking - was 5.90 (2.44, 16.05). Condomless anal intercourse with non-steady partners showed varying sensitivity in relation to the other risk behaviours examined (66.7-88.2%). CONCLUSIONS: Although condomless anal intercourse with non-steady partners was fairly sensitive in detecting other HCV relevant risk behaviours, using it as the only screening criterion could lead to missing a proportion of HIV-positive men at risk for HCV re-infection due to other behaviours. This work also points to the importance of providing access to behavioral interventions addressing other sexual and drug use practices as part of HCV treatment. TRIAL REGISTRATION: Clinical Trial Number: NCT02785666 , 30.05.2016.


Assuntos
Infecções por HIV/patologia , Hepatite C/diagnóstico , Adulto , Infecções por HIV/complicações , Hepatite C/complicações , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Assunção de Riscos , Autorrelato , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/patologia
5.
Indian J Med Res ; 149(4): 489-496, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31411172

RESUMO

Background & objectives: Substance use disorders are a major public health concern in Punjab. However, reliable estimates of prevalence of substance use disorders are not available for the State. The present study reports estimates of prevalence of substance use disorders in Punjab, conducted as part of National Mental Health Survey, India. Methods: Using multistage stratified random cluster sampling, 2895 individuals from 719 households of 60 clusters (from 4 districts of Punjab) were interviewed. Mini International Neuropsychiatric Interview and Fagerstrom nicotine dependence scale were used to assess substance use disorders. Results: The sample comprised almost equal numbers of males and females. Nearly 80 per cent had less than or equal to high school education, and 70 per cent were married. The weighted prevalence of alcohol and other substance use disorders was 7.9 and 2.48 per cent, respectively. The prevalence of tobacco dependence was 5.5 per cent; 35 per cent households had one person with substance use disorder. The prevalence was highest in the productive age group (30-39 yr), urban metro and less educated persons. The prevalence of alcohol and other substance use disorders was much higher in Punjab as compared to other States where survey was done. Tobacco dependence was lowest in Punjab. Majority (87%) of the persons with substance use disorders did not suffer from any other mental disorder. Treatment gap was 80 per cent. Interpretation & conclusions: Punjab has a high burden of substance use disorders. The estimates will help clinicians and policymakers to plan the strategies against the menace of substance use disorders effectively.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Psicóticos/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Tabagismo/epidemiologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Índia/epidemiologia , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Transtornos Psicóticos/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Inquéritos e Questionários , Tabagismo/patologia , Adulto Jovem
6.
Chem Biol Interact ; 308: 130-136, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31129131

RESUMO

Substance addiction is a chronic, relapsing mental disorder Characterized by compulsive drug seeking, and loss of control over drug intake and relapse after prolonged abstinence. Genetics has been shown to contribute towards an individual's vulnerability to addiction. Acetylecholine (ACh), a cholinergic neurotransmitter hydrolyzed by acetylcholinesterase (AChE), is an essential neurotransmitter and neuromodulator in central and peripheral nervous system and has regulatory influence on numerous neuronal functions including addiction. The present study was carried out to investigate the role of acetylcholinesterase (AChE) in addiction through measurement of enzyme activity and to find potential association of ACHE gene 3'UTR variants rs17228602 and rs17228616 in heroin, hashish and poly drug addicts. Both SNPs are located within microRNA (miRNA) recognition sites with potential to affect miRNA/transcript interaction. A total of 122 addicts of heroin, hashish and polydrug were recruited from local rehabilitation centers to participate in this study. AChE activity was measured in blood by Ellman's method. SNP genotyping was performed by restriction fragment length polymorphism (PCR-RFLP) and Sanger sequencing. The AChE activity was found significantly higher (p ≤ 0.005) in addicted cohort (mean ±â€¯standard error of mean 0.020 ±â€¯0.001 µmol/L/min; 95% confidence interval (CI) 0.018-0.022) in comparison to non-addicted healthy subjects (0.011 ±â€¯0.001 µmol/L/min; 95% confidence interval CI 0.010-0.013). A statistically significant association of ACHE rs17228602 SNP with addiction vulnerability in dominant (DM: Odd's ratio OR = 2.095, 95% CI = 1.157-3.807 p = 0.009) and allelic genetic models (OR = 1.854 95% CI = 1.082-3.187, p = 0.016) was observed. However, no statistically significant association of rs17228616 SNP with substance abuse disorder was found. The data presented here shows that AChE could play significant role in substance addiction. Further studies with larger sample size and other variants of AChE are recommended to identify novel therapeutic approaches for cholinergic based treatment of addiction.


Assuntos
Acetilcolinesterase/genética , Grupo com Ancestrais do Continente Asiático/genética , Transtornos Relacionados ao Uso de Substâncias/patologia , Regiões 3' não Traduzidas , Acetilcolinesterase/metabolismo , Alelos , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Heroína/efeitos adversos , Humanos , Cinética , MicroRNAs/química , MicroRNAs/metabolismo , Razão de Chances , Paquistão , Polimorfismo de Nucleotídeo Único , Transtornos Relacionados ao Uso de Substâncias/genética
9.
Korean J Gastroenterol ; 73(2): 105-108, 2019 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-30845387

RESUMO

Achalasia is a motility disorder of the esophagus that is characterized by loss of ganglionic neurons within the myenteric plexus of the lower esophageal sphincter (LES) resulting in failure of the LES to relax. Clinically this disorder presents with simultaneous dysphagia to solids and liquids, and if left untreated, leads to esophageal dilation, which can give rise to many adverse consequences. Extrinsic compression of respiratory structures is one such consequence, and rarely, cases of tracheal compression secondary to achalasia have been reported. However, cases of extrinsic bronchial compression are yet rarer. Here, we present a case series comprised of two patients with achalasia who presented with extrinsic bronchial compression by a dilated esophagus secondary to achalasia.


Assuntos
Obstrução das Vias Respiratórias/diagnóstico , Acalasia Esofágica/diagnóstico , Adulto , Obstrução das Vias Respiratórias/complicações , Asma/patologia , Endoscopia Gastrointestinal , Epilepsia/patologia , Acalasia Esofágica/etiologia , Esfíncter Esofágico Inferior/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Relacionados ao Uso de Substâncias/patologia , Tomografia Computadorizada por Raios X
10.
Psychopathology ; 52(1): 26-32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30879013

RESUMO

BACKGROUND/AIMS: Little research effort has so far been dedicated to the analysis of the hypothalamic-pituitary-adrenal axis of aetiologically differing subgroups of patients with panic disorder (PD). The current study aimed at a deeper understanding of the cortisol stress response in cannabis-induced PD (CIPD) patients. METHODS: Matched groups of 7 PD patients (mean age ± SD: 32.95 ± 9.04 years), 7 CIPD patients (31.94 ± 8.40 years), and 7 healthy controls (HC) (31.13 ± 8.57 years) were included in the study. The Trier Social Stress Test (TSST) was used for stress induction. Salivary cortisol samples were collected and panic- and depression-related questionnaires were applied. RESULTS: A stress response to the TSST was found in 28.6% of PD patients, in 51.1% of CIPD patients, and in 100% of HC subjects. Statistical analyses revealed a cortisol hyporesponsiveness in PD and CIPD patients. While cortisol values of PD patients and HC participants differed significantly, CIPD patients' cortisol courses balanced between those of PD patients and HC subjects. CONCLUSIONS: Current findings show a distinctive pattern of the stress-induced cortisol reaction in CIPD patients, which is markedly different from the hormonal response in PD patients as well as HC subjects. Previous findings of cortisol hyporesponsiveness in PD patients compared to HC subjects were confirmed.


Assuntos
Cannabis/efeitos adversos , Hidrocortisona/metabolismo , Transtorno de Pânico/induzido quimicamente , Saliva/química , Estresse Psicológico/induzido quimicamente , Transtornos Relacionados ao Uso de Substâncias/etiologia , Adulto , Feminino , Humanos , Sistema Hipotálamo-Hipofisário , Masculino , Transtorno de Pânico/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Inquéritos e Questionários
11.
Drug Alcohol Depend ; 197: 288-298, 2019 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-30875650

RESUMO

Individuals who abuse substances often differ from nonusers in their brain structure. Substance abuse and addiction is often associated with atrophy and pathology of grey matter, but much less is known about the role of white matter, which constitutes over half of human brain volume. Diffusion tensor imaging (DTI), a method for non-invasively estimating white matter, is increasingly being used to study addiction and substance abuse. Here we review recent DTI studies of major substances of abuse (alcohol, opiates, cocaine, cannabis, and nicotine substance abuse) to examine the relationship, specificity, causality, and permanence of substance-related differences in white matter microstructure. Across substance, users tended to exhibit differences in the microstructure of major fiber pathways, such as the corpus callosum. The direction of these differences, however, appeared substance-dependent. The subsample of longitudinal studies reviewed suggests that substance abuse may cause changes in white matter, though it is unclear to what extent such alterations are permanent. While collectively informative, some studies reviewed were limited by methodological and technical approach. We therefore also provide methodological guidance for future research using DTI to study substance abuse.


Assuntos
Pesquisa Biomédica/tendências , Corpo Caloso/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Corpo Caloso/patologia , Corpo Caloso/ultraestrutura , Feminino , Humanos , Estudos Longitudinais , Masculino , Sensibilidade e Especificidade , Transtornos Relacionados ao Uso de Substâncias/patologia , Substância Branca/patologia , Substância Branca/ultraestrutura
13.
Transl Psychiatry ; 9(1): 78, 2019 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-30741945

RESUMO

Cigarette smoking has been associated with dementia and dementia-related brain changes, notably gray matter (GM) volume atrophy. These associations are thought to reflect the co-morbidity of smoking and vascular, respiratory, and substance use/psychological conditions. However, the extent and localization of the smoking-GM relationship and the degree to which vascular, respiratory, and substance use/psychological factors influence this relationship remain unclear. In the Coronary Artery Risk Development in Young Adults CARDIA cohort (n = 698; 52% women; 40% black participants; age = 50.3 (SD = 3.5)), we examined the associations of smoking status with total GM volume and GM volume of brain regions linked to neurocognitive and addiction disorders. Linear regression models were used to adjust for vascular, respiratory, and substance use/psychological factors and to examine whether they modify the smoking-GM relationship. Compared to never-smokers, current smokers had smaller total GM volume (-8.86 cm3 (95%CI = -13.44, -4.29). Adjustment for substance use/psychological - but not vascular or respiratory - factors substantially attenuated this association (coefficients = -5.54 (95% CI = -10.32, -0.76); -8.33 (95% CI = -12.94, -3.72); -7.69 (95% CI = -6.95, -4.21), respectively). There was an interaction between smoking and alcohol use such that among alcohol non-users, smoking was not related to GM volumes and among alcohol users, those who currently smoked had -12 cm3 smaller total GM, specifically in the frontal and temporal lobes, amygdala, cingulate, and insula. Results suggest a large-magnitude association between smoking and smaller GM volume at middle age, accounting for vascular, respiratory, and substance use/psychological factors, and that the association was strongest in alcohol users. Regions suggested to be most vulnerable are those where cognition and addiction processes overlap.


Assuntos
Encéfalo/patologia , Fumar Cigarros/efeitos adversos , Substância Cinzenta/patologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Encéfalo/diagnóstico por imagem , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/patologia
14.
Methods Mol Biol ; 1941: 107-135, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30707431

RESUMO

Development of the whole-cell patch-clamp electrophysiology technique has allowed for enhanced visualization and experimentation of ionic currents in neurons of mammalian tissue with high spatial and temporal resolution. Electrophysiology has become an exceptional tool for identifying single cellular mechanisms underlying behavior. Specifically, the role of glutamatergic signaling through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptors underlying behavior has been extensively studied. Here we will discuss commonly used protocols and techniques for performing whole-cell patch-clamp recordings and exploring AMPA and NMDA receptor-mediated glutamatergic responses and alterations in the context of substance abuse.


Assuntos
Encéfalo/metabolismo , Eletrofisiologia/métodos , Ácido Glutâmico/metabolismo , Técnicas de Patch-Clamp/métodos , Receptores de AMPA/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Animais , Encéfalo/citologia , Transtornos Relacionados ao Uso de Substâncias/patologia
15.
Asian Pac J Cancer Prev ; 20(2): 451-455, 2019 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-30803207

RESUMO

Aim: Correlation of habit duration and frequency with clinical grading and histopathologic grouping of oral submucous fibrosis (OSMF). Materials and methods: 48 patients with OSMF were included in the study. Detailed history of each patient, clinical profile and habit history were recorded. Biopsy was performed for histopathological correlation. All the findings were correlated with Kerr et al and Khanna and Andrade classification. Statistical Analysis: Kruskal-wallis test was performed to assess the correlation between the study findings. Results: Out of 48 OSMF cases majority were males. Maximum cases were in clinically and histopathologically respectively. Mouth opening was directly proportional with histopathological grouping as per Khanna et al. No correlation between frequency and habit duration with respect to different stages or severity of the OSMF was noted. Conclusion: Disease staging of OSMF clinically and histopathologically is not directly impacted by habit duration and frequency. Rather than habit centered history and management accordingly, more focus should be given to genetics and susceptibility of patient for OSMF development and progression.


Assuntos
Areca/efeitos adversos , Fibrose Oral Submucosa/etiologia , Fibrose Oral Submucosa/patologia , Transtornos Relacionados ao Uso de Substâncias/etiologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
16.
Int J Eat Disord ; 52(2): 175-182, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30638270

RESUMO

OBJECTIVE: The relationship between eating disorders (EDs) and substance use (SU) has only been briefly described in literature using mainly adult populations. This study examined the prevalence and characteristics of SU among patients of an adolescent ED outpatient treatment program. METHOD: A retrospective chart analysis was conducted to determine and subsequently compare medical status, psychosocial factors, treatment course and outcome between patients with and without SU. RESULTS: Over 60% of patients with SU status (n = 203) reported regularly consuming substances. 33.4% of substance users received a diagnosis involving purging behaviors compared to 5.9% of nonusers. Females composed 96.4% and 81.7% of users and nonusers, respectively. Users reported significantly more self-harm (57.7% of users vs. 38.6% of nonusers) but did not differ significantly in terms of trauma (abuse or victimization; 48.3% of users vs. 44.9% of nonusers). The percentage of ideal body weight significantly improved throughout treatment and did not differ by SU with a mean increase of 5.29% (SD = 13.6) among nonusers compared to 5.45% (SD = 7.5) of users. While users and nonusers did not differ before and after treatment in ED severity, users were more likely than nonusers to drop-out of treatment (41.5% of users vs. 25.2% of nonusers). DISCUSSION: Adolescents with SU benefit from ED outpatient treatment as much as those without SU, however, users are more likely to drop-out. Therefore, treatment should target these adolescents' emotional dysregulation to improve treatment compliance. Further research is necessary to determine the efficacy of such an approach.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Transtornos da Alimentação e da Ingestão de Alimentos/patologia , Feminino , Humanos , Masculino , Pacientes Ambulatoriais , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/patologia
17.
Clin Chem ; 65(2): 242-253, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30305277

RESUMO

BACKGROUND: Since 2013, an unprecedented surge in fentanyl overdose deaths has been caused by heroin laced with illicitly produced fentanyl and/or fentanyl analogs (FAs) sold as heroin. The US Drug Enforcement Agency's National Forensic Laboratory Information System reported a >300% increase in fentanyl encounters from 4697 in 2014 to 14440 in 2015. In 2015, the CDC reported 9580 deaths caused by synthetic opioids, primarily fentanyl, a 72% increase from 2014. The European Monitoring Centre for Drugs and Drug Addiction has also encountered several new FAs in the heroin supply. Counterfeit pharmaceuticals containing mixtures of fentanyl and FAs continue to be a poorly recognized worldwide problem despite the WHO classifying several FAs as a serious threat to public health. CONTENT: This review covers the epidemiology of fentanyl abuse and discusses the clinical practice implications of widespread fentanyl abuse. It includes a historical perspective on the illicit FAs that have appeared in the US and European Union and reviews the methods available to identify FAs and emerging technologies useful for identifying previously undescribed analogs. A compilation of structural and mass spectral data on FAs reported thus far is provided. SUMMARY: Fentanyl and FAs have evolved into a global public health threat. It is important to understand the analytical, clinical, and regulatory efforts underway to assist communities affected by the current fentanyl epidemic.


Assuntos
Analgésicos Opioides/administração & dosagem , Fentanila/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/patologia , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/análise , Europa (Continente)/epidemiologia , Fentanila/efeitos adversos , Fentanila/análogos & derivados , Humanos , Insuficiência Respiratória/etiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Estados Unidos/epidemiologia
18.
J Cutan Pathol ; 46(1): 84-87, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30311260

RESUMO

Acquired perforating calcific collagenosis (APCC), which is characterized by the calcification of dermal collagen fibers with subsequent transepidermal elimination and perforation, is an extremely rare entity. Thus far, it has only been reported in a patient with direct contact exposure to calcium chloride. Here, we report a unique case of APCC occurring in a drug addict admitted for rhabdomyolysis. The present case is a 20-year-old male patient hospitalized for drug-related rhabdomyolysis and multiple organ damage. During hospitalization, he gradually developed unusual skin rashes. There were multiple confluent umbilicated and keratotic erythematous to brownish papules and plaques with scratch-like linear plaques on his lower abdomen, inguinal areas and gluteal sulci. Also, multiple well-demarcated flesh-colored rough, hard and thin plaques with a "crepe paper"-like texture were found on the bilateral popliteal fossae, olecranon fossae and axillae. The histopathology of two biopsied lesions demonstrated acquired perforating calcific collagenosis. The lesions appeared during the rhabdomyolysis-related hypercalcemia phase and resolved spontaneously after the calcium level returned to normal. This is the first reported case of disseminated APCC occurring during transient hypercalcemia due to rhabdomyolysis.


Assuntos
Calcinose , Hipercalcemia , Rabdomiólise , Dermatopatias , Transtornos Relacionados ao Uso de Substâncias , Adulto , Calcinose/diagnóstico , Calcinose/etiologia , Calcinose/metabolismo , Calcinose/patologia , Humanos , Hipercalcemia/diagnóstico , Hipercalcemia/etiologia , Hipercalcemia/metabolismo , Hipercalcemia/patologia , Masculino , Rabdomiólise/diagnóstico , Rabdomiólise/etiologia , Rabdomiólise/metabolismo , Rabdomiólise/patologia , Dermatopatias/diagnóstico , Dermatopatias/etiologia , Dermatopatias/metabolismo , Dermatopatias/patologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Transtornos Relacionados ao Uso de Substâncias/patologia
19.
Eur Arch Psychiatry Clin Neurosci ; 269(3): 309-315, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29766293

RESUMO

Addiction is a chronic relapsing disorder and is one of the most important issues in the world. Changing the level of neurotransmitters and the activities of their receptors, play a major role in the pathophysiology of substance abuse disorders. It is well-established that N-methyl-D-aspartate receptors (NMDARs) play a significant role in the molecular basis of addiction. NMDAR has two obligatory GluN1 and two regionally localized GluN2 subunits. This study investigated changes in the protein level of GluN1, GluN2A, and GluN2B in the prefrontal cortex of drug abusers. The medial prefrontal cortex (mPFC), lateral prefrontal cortex (lPFC), and orbitofrontal cortex (OFC) were dissected from the brain of 101 drug addicts brains and were compared with the brains of non-addicts (N = 13). Western blotting technique was used to show the alteration in NMDAR subunits level. Data obtained using Western blotting technique showed a significant increase in the level of GluN1 and GluN2B, but not in GluN2A subunits in all the three regions (mPFC, lPFC, and OFC) of men whom suffered from addiction as compared to the appropriate controls. These findings showed a novel role for GluN1, GluN2B subunits, rather than the GluN2A subunit of NMDARs, in the pathophysiology of addiction and suggested their role in the drug-induced plasticity of NMDARs.


Assuntos
Proteínas do Tecido Nervoso/metabolismo , Córtex Pré-Frontal/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo , Transtornos Relacionados ao Uso de Substâncias/metabolismo , Adulto , Autopsia , Humanos , Masculino , Córtex Pré-Frontal/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia
20.
J Histochem Cytochem ; 67(3): 185-202, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30562121

RESUMO

Electron microscopy (EM) studies of the postmortem human brain provide a level of resolution essential for understanding brain function in both normal and disease states. However, processes associated with death can impair the cellular and organelle ultrastructural preservation required for quantitative EM studies. Although postmortem interval (PMI), the time between death and preservation of tissue, is thought to be the most influential factor of ultrastructural quality, numerous other factors may also influence tissue preservation. The goal of the present study was to assess the effects of pre- and postmortem factors on multiple components of ultrastructure in the postmortem human prefrontal cortex. Tissue samples from 30 subjects were processed using standard EM histochemistry. The primary dependent measure was number of identifiable neuronal profiles, and secondary measures included presence and/or integrity of synapses, mitochondria, and myelinated axonal fibers. Number of identifiable neuronal profiles was most strongly affected by the interaction of PMI and pH, such that short PMIs and neutral pH values predicted the best preservation. Secondary measures were largely unaffected by pre- and postmortem factors. Together, these data indicate that distinct components of the neuropil are differentially affected by PMI and pH in postmortem human brain.


Assuntos
Histocitoquímica/normas , Fibras Nervosas Mielinizadas/ultraestrutura , Neurônios/ultraestrutura , Neurópilo/ultraestrutura , Córtex Pré-Frontal/ultraestrutura , Sinapses/ultraestrutura , Adulto , Doenças Cardiovasculares/patologia , Estudos de Casos e Controles , Causas de Morte , Feminino , Histocitoquímica/métodos , Humanos , Concentração de Íons de Hidrogênio , Masculino , Transtornos Mentais/patologia , Pessoa de Meia-Idade , Mitocôndrias/ultraestrutura , Mudanças Depois da Morte , Córtex Pré-Frontal/anatomia & histologia , Córtex Pré-Frontal/patologia , Transtornos Relacionados ao Uso de Substâncias/patologia , Fatores de Tempo , Preservação de Tecido/métodos
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