• 【成瘾的生物心理社会精神模式是否适用于伊斯兰背景?约旦成瘾者治疗的定性研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.drugalcdep.2016.11.019 复制DOI
    作者列表:Ghaferi HA,Bond C,Matheson C
    BACKGROUND & AIMS: BACKGROUND:There is a dearth of research in the published literature on substance use and addiction in the Middle East and Islamic countries. This study was the first to explore whether the biopsychosocial-spiritual model of addiction was relevant to an addicted treatment population in Jordan, an Islamic country. METHODS:A qualitative study design using semi-structured, face-to-face interviews were conducted with a sample of 25 males in addiction treatment. The sample was drawn from a cohort of in-patients at a treatment centre in Amman, Jordan who had already participated in a quantitative survey. A purposive sample was selected to ensure the inclusion of a range of characteristics that might affect their experience of developing addiction and its consequences, i.e., age, marital status and educational level. Interviews were transcribed and thematic analysis conducted using verbatim quotes to illustrate themes. Themes were mapped onto the biopsychosocial-spiritual model of addiction. RESULTS:This study found addiction was associated with a range of health (physical and psychological), social and spiritual factors. Unpleasant physical withdrawal effects, psychological symptoms, such as anxiety and suicide attempts, were experienced. There was breakdown in marital and family relations, loss of employment, involvement in crime and neglect of religious practices, resulting in social isolation. CONCLUSION:This study found that, despite some differences in emphasis, the biopsychosocial, spiritual model of addiction fit wel,l particularly given the relative importance of religion in Islamic culture. Spirituality was not explored and further study of spirituality versus religious practice in this culture is recommended.
    背景与目标:
  • 【癌基因成瘾与癌基因失忆症: 也许不仅仅是一个坏习惯?】 复制标题 收藏 收藏
    DOI:10.1158/0008-5472.CAN-07-5832 复制DOI
    作者列表:Felsher DW
    BACKGROUND & AIMS: :Cancer is a multistep process whereby genetic events that result in the activation of proto-oncogenes or the inactivation of tumor suppressor genes usurp physiologic programs mandating relentless proliferation and growth. Experimental evidence surprisingly illustrates that the inactivation of even a single oncogene can be sufficient to induce sustained tumor regression. These observations suggest the hypothesis that tumors become irrevocably addicted to the oncogenes that initiated tumorigenesis. The proposed explanation for this phenomenon is that activated oncogenes result in a signaling state in which the sudden abatement of oncogene activity balances towards proliferative arrest and apoptosis. Indeed, substantial evidence supports this hypothesis. Here, we propose an alternative, although not necessarily mutually exclusive, explanation for how oncogenes initiate and sustain tumorigenesis. We suggest that oncogene activation initiates tumorigenesis precisely because it directly overrides physiologic programs inducing a state of cellular amnesia, not only inducing relentless cellular proliferation, but also bypassing checkpoint mechanisms that are essential for cellular mortality, self-renewal, and genomic integrity. Because no single oncogenic lesion is sufficient to overcome all of these physiologic barriers, oncogenes are restrained from inducing tumorigenesis. Correspondingly, in a tumor that has acquired the complete complement of oncogenic lesions required to overcome all of these safety mechanisms, the inactivation of a single oncogene can restore some of these pathways resulting in proliferative arrest, differentiation, cellular senescence, and/or apoptosis. Thus, oncogenes induce cancer because they induce a cellular state of enforced oncogenic amnesia in which, only upon oncogene inactivation, the tumor becomes aware of its transgression.
    背景与目标: : 癌症是一个多步骤的过程,其中导致原癌基因激活或抑癌基因失活的遗传事件会破坏生理程序,从而迫使其持续增殖和生长。实验证据令人惊讶地表明,即使是单个癌基因的失活也足以诱导肿瘤持续消退。这些观察结果表明,肿瘤对引发肿瘤发生的癌基因不可撤销地上瘾的假设。对这种现象的拟议解释是,活化的癌基因导致信号传导状态,其中癌基因活性的突然减弱与增殖停滞和凋亡平衡。事实上,大量证据支持这一假设。在这里,我们提出了一种替代的,尽管不一定相互排斥的解释,以解释癌基因如何启动和维持肿瘤发生。我们建议癌基因激活启动肿瘤发生,正是因为它直接超越了诱导细胞失忆症状态的生理程序,不仅诱导细胞持续增殖,而且绕过了细胞死亡,自我更新和基因组完整性必不可少的检查点机制。由于没有单一的致癌病变足以克服所有这些生理障碍,因此抑制了癌基因诱导肿瘤发生。相应地,在获得克服所有这些安全机制所需的完整致癌病变的肿瘤中,单个癌基因的失活可以恢复其中一些途径,从而导致增殖停滞,分化,细胞衰老和/或细胞凋亡。因此,癌基因会诱发癌症,因为它们会诱导一种强制的致癌性遗忘的细胞状态,在这种状态下,只有在癌基因失活后,肿瘤才会意识到其侵袭。
  • 【互联网游戏障碍中壳核对前额叶皮层的抑制性神经调节: 成瘾如何损害执行控制。】 复制标题 收藏 收藏
    DOI:10.1556/2006.2020.00029 复制DOI
    作者列表:Wang M,Dong H,Zheng H,Du X,Dong GH
    BACKGROUND & AIMS: Background and aims:Individuals with addictive disorders are usually characterized by impaired executive control, persistent craving and excessive reward-seeking. However, it is unclear whether there is a deviation in the connection pattern among the neural systems implicated in these problem behaviors. Methods:One hundred thirty-six online gaming players were recruited in the current study (68 Internet gaming disorder (IGD) subjects and 68 recreational game users (RGUs) who served as controls matched on age, sex, years of education, and years of gaming). Dynamic interactions among the reward system (striatum), control system (prefrontal cortex), and the interoceptive awareness system (insula) were calculated and compared when subjects were facing gaming cues. Results:The results revealed that RGUs showed a significant positive correlation in the putamen-middle frontal gyrus (MFG)-insula neural pathway when facing gaming cues, which was missing in the IGD subjects. Additionally, dynamic causal modeling (DCM) analysis revealed that the MFG region was more inhibited by the putamen in the IGD subjects relative to the RGUs. Conclusions:These findings suggest that the inhibitory neuromodulation of the putamen to the prefrontal cortex in IGD individuals undermines the balance among the tripartite systems. Our findings provide novel neurobiological evidence for understanding the internal connection bias of the addicted individual's neural system and how the addictive disorder impairs executive control; consequently, the pathway from the striatum to the prefrontal cortex may serve as a potential biomarker to predict the risk of developing an addiction.
    背景与目标:
  • 【寻找一种新的药物治疗药物和酒精成瘾的药物: N-甲基-D-天冬氨酸 (NMDA) 拮抗剂。】 复制标题 收藏 收藏
    DOI:10.1016/s0376-8716(99)00107-6 复制DOI
    作者列表:Bisaga A,Popik P
    BACKGROUND & AIMS: :The most challenging aspect of treating alcohol and drug addiction is the relapsing course of these disorders. Although substitution therapies for nicotine and opioid dependence have proven to be relatively effective, there is a need for new pharmacotherapies designed to decrease the frequency and severity of relapse. The aim of this paper is to provide an overview of the potential utility of N-methyl-D-aspartate (NMDA) receptor antagonists as treatments for substance abuse as shown in preclinical models and preliminary clinical trials. It is hypothesized that NMDA receptors mediate the common adaptive processes that are involved the development, maintenance, and expression of drug and alcohol addiction. Modulation of glutamatergic neurotransmission with NMDA receptor antagonists offers a novel treatment approach. It is proposed that NMDA antagonists may have multiple functions in treating addictions, including an attenuation of withdrawal effects, normalization of the affective changes following initiation of abstinence which arise from neurochemical changes resulting from chronic addiction, and an attenuation of conditioned responses arising from drug-related stimuli.
    背景与目标: : 治疗酒精和药物成瘾最具挑战性的方面是这些疾病的复发过程。尽管尼古丁和阿片类药物依赖的替代疗法已被证明是相对有效的,但仍需要旨在降低复发频率和严重程度的新药物疗法。本文的目的是概述N-甲基-D-天冬氨酸 (NMDA) 受体拮抗剂作为药物滥用治疗的潜在用途,如临床前模型和初步临床试验所示。假设NMDA受体介导共同的适应过程,这些过程涉及药物和酒精成瘾的发展,维持和表达。用NMDA受体拮抗剂调节谷氨酸能神经传递提供了一种新的治疗方法。有人提出,NMDA拮抗剂在治疗成瘾方面可能具有多种功能,包括减弱戒断效应,戒断开始后情绪变化的正常化 (由慢性成瘾引起的神经化学变化引起) 以及药物引起的条件性反应的减弱相关刺激。
  • 【使用成瘾严重程度指数预测精神和医疗卫生服务利用情况。】 复制标题 收藏 收藏
    DOI:10.1300/J069v25n04_01 复制DOI
    作者列表:Wryobeck JM,Chermack ST,Closser MH,Blow FC
    BACKGROUND & AIMS: :This study assessed the utility of adding the Addiction Severity Index (ASI) to demographic and clinical diagnostic information for the purpose of predicting subsequent substance use disorder service use, and use of other healthcare services by 260 veterans admitted for outpatient substance use disorder treatment. Data collected included demographics, clinical diagnoses, assessment data from the ASI, as well as measures of six-month health service utilization (e.g., substance use disorder services, other mental health services, outpatient medical visits, urgent care visits, inpatient psychiatric and medical). Multivariate analysis using Tobit regression models showed six out of seven ASI scales were significant predictors, and that combining ASI data with demographics and clinical data significantly improved prediction of health care services. It also was found that certain psychiatric and medical diagnoses were related to service use measures, and that a diagnosis of depression was related to overall healthcare utilization.
    背景与目标: : 这项研究评估了将成瘾严重程度指数 (ASI) 添加到人口统计学和临床诊断信息中的效用,以预测随后的物质使用障碍服务的使用情况,以及260名接受门诊物质使用障碍治疗的退伍军人使用其他医疗服务的情况。收集的数据包括人口统计学,临床诊断,ASI的评估数据以及六个月卫生服务利用率的衡量标准 (例如,物质使用障碍服务,其他精神卫生服务,门诊就诊,紧急护理就诊,住院精神病和医疗)。使用Tobit回归模型进行的多变量分析显示,七个ASI量表中有六个是重要的预测指标,并且将ASI数据与人口统计学和临床数据相结合可以显着改善对医疗保健服务的预测。还发现某些精神病学和医学诊断与服务使用措施有关,而抑郁症的诊断与总体医疗保健利用有关。
  • 【烟碱乙酰胆碱受体的遗传变异性和尼古丁成瘾: 来自人类和动物研究的融合证据。】 复制标题 收藏 收藏
    DOI:10.1016/j.bbr.2008.05.006 复制DOI
    作者列表:Portugal GS,Gould TJ
    BACKGROUND & AIMS: :Tobacco smoking is a leading preventable cause of death in the United States and produces a major health and economic burden. Although the majority of smokers want to quit, few are successful. These data highlight the need for additional research into the neurobiology of tobacco dependence. Addiction to nicotine, the main psychoactive component of tobacco, is influenced by multiple factors that include individual differences in genetic makeup. Twin studies have demonstrated that genetic factors can influence vulnerability to nicotine addiction, and subsequent research has identified genes that may alter sensitivity to nicotine. In humans, genome-wide and candidate gene association studies have demonstrated that genes encoding nicotinic acetylcholine receptor (nAChR) proteins are associated with multiple smoking phenotypes. Similarly, research in mice has provided evidence that naturally occurring variability in nAChR genes is associated with changes in nicotine sensitivity. Furthermore, the use of genetic knockout mice has allowed researchers to determine the nAChR genes that mediate the effects of nicotine, whereas research with knockin mice has demonstrated that changes to nAChR genes can dramatically alter nicotine sensitivity. This review will examine the genetic factors that alter susceptibility to nicotine addiction, with an emphasis on the genes that encode nAChR proteins.
    背景与目标: : 在美国,吸烟是可预防的主要死亡原因,并造成重大的健康和经济负担。尽管大多数吸烟者都想戒烟,但很少有人成功。这些数据强调了对烟草依赖的神经生物学进行更多研究的必要性。烟草的主要精神成分尼古丁成瘾受多种因素影响,包括遗传构成的个体差异。双胞胎研究表明,遗传因素会影响尼古丁成瘾的脆弱性,随后的研究发现了可能改变尼古丁敏感性的基因。在人类中,全基因组和候选基因关联研究表明,编码烟碱乙酰胆碱受体 (nAChR) 蛋白的基因与多种吸烟表型相关。同样,对小鼠的研究提供了证据,表明nAChR基因的自然变化与尼古丁敏感性的变化有关。此外,基因敲除小鼠的使用使研究人员能够确定介导尼古丁作用的nAChR基因,而对敲除小鼠的研究表明,nAChR基因的改变可以显着改变尼古丁的敏感性。这篇综述将研究改变尼古丁成瘾易感性的遗传因素,重点是编码nAChR蛋白的基因。
  • 7 Addiction and withdrawal--current views. 复制标题 收藏 收藏

    【成瘾和戒断 -- 当前观点。】 复制标题 收藏 收藏
    DOI:10.1016/s1471-4892(01)00011-x 复制DOI
    作者列表:Melichar JK,Daglish MR,Nutt DJ
    BACKGROUND & AIMS: :The final common pathway of addiction (the dopamine hypothesis of reward) has recently been evolving, with the mesocorticolimbic dopaminergic system now seen as key to natural rewards and drug-seeking behaviour, though perhaps having less of a role in the maintenance of such behaviour. The perception of a common pathway has meant that treatments for one drug of addiction have 'crossed-over' and become possible treatments for other addictive drugs.
    背景与目标: : 成瘾的最终共同途径 (奖赏的多巴胺假说) 最近一直在发展,中皮质边缘多巴胺能系统现在被视为自然奖赏和寻求药物行为的关键,尽管在维持这种行为方面的作用可能较小。对共同途径的感知意味着对一种成瘾药物的治疗已经 “交叉”,并成为其他成瘾药物的可能治疗。
  • 【与之相关的最关键的未解决问题: 成瘾的心理分析理论: 说话的治疗方法能告诉我们有关药物使用和滥用的任何信息吗?】 复制标题 收藏 收藏
    DOI:10.3109/10826084.2012.753548 复制DOI
    作者列表:Matusow H,Rosenblum A
    BACKGROUND & AIMS: :The most critical unresolved issue associated with psychoanalysis is whether its core precepts belong in today's substance use armamentarium. Psychoanalytic theories have resisted the criterion of falsifiability, putting them at odds with the current paradigm for treating addiction. However, Freud's earliest pronouncement on the subject, "making the patient a collaborator in his own treatment" (i.e., therapeutic alliance) not only holds up to scientific scrutiny, but is a robust determinant in improving treatment outcomes. Psychoanalytic constructs today appear as conjectures, but recognition of the primacy of the collaborative therapeutic relationship is one example of how psychoanalytic observations have influenced current research.
    背景与目标: : 与精神分析相关的最关键的未解决问题是其核心戒律是否属于当今的物质使用武器。精神分析理论抵制了可证伪性的标准,使其与当前治疗成瘾的范式背道而驰。然而,弗洛伊德关于这一主题的最早声明 “使患者成为自己治疗的合作者” (即治疗联盟) 不仅具有科学依据,而且是改善治疗结果的有力决定因素。今天,精神分析结构似乎是猜想,但是对合作治疗关系的首要地位的认识是精神分析观察如何影响当前研究的一个例子。
  • 【丁丙诺啡在阿片类药物成瘾治疗中的应用。二.每日和隔日给药和突然戒断的生理和行为影响。】 复制标题 收藏 收藏
    DOI:10.1038/clpt.1990.67 复制DOI
    作者列表:Fudala PJ,Jaffe JH,Dax EM,Johnson RE
    BACKGROUND & AIMS: :Nineteen heroin-dependent male volunteers were administered buprenorphine sublingually, in ascending daily doses of 2, 4, and 8 mg. They were maintained on 8 mg daily through study day 18. On study days 19 through 36, subjects in group 1 continued to receive burprenorphine daily; subjects in group 2 received buprenorphine or placebo on alternate days. On days 37 through 52, all subjects received placebo. Subjects receiving buprenorphine on alternate days reported significantly greater urge for an opioid, increased dysphoria scores, and pupillary dilation on placebo days. After abrupt termination of buprenorphine, no withdrawal signs were detected with the Himmelsbach scale. However, subjects reported mild-to-moderate opioid withdrawal symptoms, peaking at 3 to 5 and lasting for 8 to 10 days. Daily administration of buprenorphine provided greater control of subtle opioid withdrawal symptoms, but subjects could tolerate a between-dose interval of 48 hours.
    背景与目标: : 19名海洛因依赖型男性志愿者以每天2、4和8 mg的剂量向舌下注射丁丙诺啡。在研究第18天,他们每天维持8 mg。在研究的第19至36天,第1组的受试者继续每天接受burprenorphine; 第2组的受试者每隔几天接受丁丙诺啡或安慰剂。在第37至52天,所有受试者均接受安慰剂。每隔几天接受丁丙诺啡的受试者报告说,在安慰剂日,阿片类药物的冲动明显增加,烦躁不安评分增加和瞳孔扩张。丁丙诺啡突然终止后,Himmelsbach量表未检测到戒断迹象。然而,受试者报告了轻度至中度阿片类药物戒断症状,在3至5点达到峰值,持续8至10天。每天服用丁丙诺啡可更好地控制微妙的阿片类药物戒断症状,但受试者可以耐受48小时的剂量间隔。
  • 【具有网络成瘾和物质使用经验的青少年的三维人格。】 复制标题 收藏 收藏
    DOI:10.1177/070674370605101404 复制DOI
    作者列表:Ko CH,Yen JY,Chen CC,Chen SH,Wu K,Yen CF
    BACKGROUND & AIMS: OBJECTIVE:This study aimed to examine the differences in personality characteristics between adolescents with and without Internet addiction and substance use experience as defined by the Tridimensional Personality Questionnaire (TPQ), and to compare personality characteristics among groups of adolescents with both Internet addiction and substance use experience (comorbid group), those with only Internet addition (Internet addiction group), those with only substance use experience (substance experience group), and those without Internet addiction or substance use experience (control group). METHOD:In the cross-sectional investigation, we recruited 3662 students (2328 boys and 1334 girls) from high schools in southern Taiwan. Our investigation was conducted using the TPQ, the Chen Internet Addiction Scale, and Questionnaires for Experience in Substance Use. RESULTS:Adolescents with Internet addiction were more likely to have substance use experience. High novelty seeking (NS), high harm avoidance (HA), and low reward dependence (RD) predicted a higher proportion of adolescents with Internet addiction. High NS, low HA, and low RD predicted a higher proportion of adolescents with substance use experience. Of the 4 groups, the Internet addiction group had the highest HA scores and the comorbid group had the lowest HA scores. CONCLUSION:Adolescents with high NS and low RD should be provided with effective strategies for preventing Internet addiction and substance use. In addition, the Internet addiction group and the comorbid group should be provided with different preventative strategies focused on HA.
    背景与目标:
  • 【阿富汗喀布尔注射吸毒者成瘾治疗利用的横断面评估。】 复制标题 收藏 收藏
    DOI:10.1080/10826080802347669 复制DOI
    作者列表:Todd CS,Abed AM,Scott PT,Safi N,Earhart KC,Strathdee SA
    BACKGROUND & AIMS: :The purpose of this study was to describe prior use of detoxification and addiction-treatment programs among injection drug users (IDUs) in Kabul, Afghanistan. From 2005-2006, IDUs (n = 464) recruited into this cross-sectional study completed an interviewer-administered questionnaire and whole blood rapid testing with fingerstick samples for HIV, syphilis, and hepatitis C antibody and B surface antigen testing. Participants were predominantly male (99.8%), Afghan (98.9%), and had little formal education. Correlates of detoxification and addiction treatment were identified with logistic regression. The majority (94.0%, n = 435) felt great/urgent need for treatment, of whom 56.3% (n = 245) reported inability to access treatment. Prior detoxification was associated with new needle use with each injection (AOR = 1.91, 95% CI: 1.12-3.26) and prior incarceration (AOR = 1.81, 95% CI: 1.04-3.13). The study's limitations are noted. Rapid scale-up and subsidy of needle and syringe programs and opioid agonist treatment is urgently needed in Kabul.
    背景与目标: : 这项研究的目的是描述阿富汗喀布尔注射吸毒者 (idu) 中先前使用的排毒和成瘾治疗计划。从2005-2006年开始,招募到该横断面研究的idu (n = 464) 完成了面试官管理的问卷调查和全血快速测试,并用手指棒样本进行HIV,梅毒,丙型肝炎抗体和b型表面抗原测试。参与者主要是男性 (99.8%),阿富汗 (98.9%),很少接受正规教育。通过逻辑回归确定了排毒和成瘾治疗的相关性。大多数 (94.0%,n = 435) 感到非常/迫切需要治疗,其中56.3% (n = 245) 报告无法获得治疗。每次注射 (AOR = 1.91,95% CI: 1.12-3.26) 和先前监禁 (AOR = 1.81,95% CI: 1.04-3.13) 时,事先排毒与新针头使用有关。注意到这项研究的局限性。喀布尔迫切需要快速扩大和补贴针头和注射器计划以及阿片类激动剂治疗。
  • 【对密集门诊治疗后成瘾互助小组参与的3年研究。】 复制标题 收藏 收藏
    DOI:10.1111/j.1530-0277.2006.00165.x 复制DOI
    作者列表:Kelly JF,Stout R,Zywiak W,Schneider R
    BACKGROUND & AIMS: BACKGROUND:Addiction-focused mutual-help group participation is associated with better substance use disorder (SUD) treatment outcomes. However, little has been documented regarding which types of mutual-help organizations patients attend, what levels of participation may be beneficial, and which patients, in particular, are more or less likely to participate. Furthermore, much of the evidence supporting the use of these organizations comes from studies examining participation and outcomes concurrently, raising doubts about cause-effect connections, and little is known about influences that may moderate the degree of any general benefit. METHOD:Alcohol-dependent outpatients (N=227; 27% female; M age=42) enrolled in a randomized-controlled telephone case monitoring trial were assessed at treatment intake and at 1, 2, and 3 years postdischarge. Lagged-panel, hierarchical linear models tested whether mutual-help group participation in the first and second year following treatment predicted subsequent outcomes and whether these effects were moderated by gender, concurrent axis I diagnosis, religious preference, and prior mutual-help experience. Robust regression curve analysis was used to examine dose-response relationships between mutual-help and outcomes. RESULTS:Mutual-help participation was associated with both greater abstinence and fewer drinks per drinking day and this relationship was not found to be influenced by gender, Axis I diagnosis, religious preference, or prior mutual-help participation. Mutual-help participants attended predominantly Alcoholics Anonymous and tended to be Caucasian, be more educated, have prior mutual-help experience, and have more severe alcohol involvement. Dose-response curve analyses suggested that even small amounts of participation may be helpful in increasing abstinence, whereas higher doses may be needed to reduce relapse intensity. CONCLUSIONS:Use of mutual-help groups following intensive outpatient SUD treatment appears to be beneficial for many different types of patients and even modest levels of participation may be helpful. Future emphasis should be placed on ways to engage individuals with these cost-effective resources over time and to gather and disseminate evidence regarding additional mutual-help organizations.
    背景与目标:
  • 13 Renal complications of drug addiction. 复制标题 收藏 收藏

    【药物成瘾的肾脏并发症。】 复制标题 收藏 收藏
    DOI:10.1016/0090-4295(76)90511-2 复制DOI
    作者列表:Olivero J,Bacque F,Carlton CE Jr,Eknoyan G
    BACKGROUND & AIMS: The kidney is one of the target organs involved as a consequence of the systemic complications seen in drug abusers. This may manifest itself in one of the following formsacute hepatitis with modest proteinuria (less than 2 Gm. per day); bacterial endocarditis with hematuria, azotemia, and a focal or diffuse glomerulonephritis; the nephrotic syndrome with focal mesangial sclerosis and diffuse interstitial nephritis often pursuing a fulminant course terminating in uremia; acute renal failure secondary to rhabdomyolysis and myoglobinuria; polyarteritis nodosa with renal involvement; and obstructive uropathy secondary to fungus ball in the urinary tract.

    背景与目标: 由于吸毒者的全身并发症,肾脏是涉及的靶器官之一。这可能表现为以下形式之一的急性肝炎,具有适度的蛋白尿 (每天少于2 Gm); 细菌性心内膜炎,伴有血尿,氮质血症和局灶性或弥漫性肾小球肾炎; 肾病综合征,伴有局灶性系膜硬化和弥漫性间质性肾炎,通常在尿毒症中进行暴发性病程; 横纹肌溶解和肌红蛋白尿继发的急性肾功能衰竭; 结节性多动脉炎伴肾脏受累; 和继发于尿道真菌球的梗阻性尿病。
  • 【早期生活对注射吸毒风险的影响: 基于爱丁堡成瘾队列的病例对照研究。】 复制标题 收藏 收藏
    DOI:10.1111/add.12056 复制DOI
    作者列表:Macleod J,Hickman M,Jones HE,Copeland L,McKenzie J,De Angelis D,Kimber J,Robertson JR
    BACKGROUND & AIMS: AIMS:To investigate childhood influences on onset of injection drug use. DESIGN:Matched case-control study. SETTING:Edinburgh, Scotland. PARTICIPANTS:A total of 432 individuals presenting at a community health facility with injection drug use and 432 age- and sex-matched non-injecting controls recruited through the same facility. MEASUREMENTS:Main exposures considered were family structure and experience of public care, carer substance use, physical and sexual victimization and conduct problems, all measured at personal interview. The outcome was history of adult injection drug use recorded in medical records corroborated at personal interview. FINDINGS:Compared to two-parent families all other family structures were associated with increased risk of injection drug use, the greatest increased risk being associated with public care. Violence, criminality and financial problems in the family were also associated with increased risk, as were all types of carer substance use. The greatest increased risk was associated with markers of early conduct problems, particularly school exclusion and childhood contact with the criminal justice system. In multivariable analyses the strongest risk factors for later injecting were always having lived with a relative or family friend (not always a parent) and in care/adopted/foster home at any point [odds ratio (OR) = 2.66, 95% confidence interval (CI): 1.02-6.92 and OR = 2.17, 95% CI: 0.91-5.17, respectively], experienced violence from parent or carer (OR = 2.06, 95% CI: 1.26, 3.38) and early evidence of conduct problems [ever excluded from school (OR = 2.73, 95% CI: 1.68, 4.45); childhood criminality (ever arrested by police pre-adult OR = 3.05, 95% CI: 1.90, 4.89, ever been in borstal/young offenders/list D school OR = 4.70, 95% CI: 2.02, 10.94)]. After adjustment for family structure and conduct problems, sexual victimization was associated weakly with injecting onset (OR = 1.29, 95% CI: 0.76-2.19). More than 70% of injection drug use onset appeared attributable to the risk factors identified. CONCLUSIONS:Injection drug use in adults is associated strongly with prior childhood adversity, in particular not living with both parents and early conduct problems. Prevention initiatives should also consider these risk factors.
    背景与目标:
  • 【钙调神经磷酸酶 (PPP3CA) 基因的精细定位揭示了新的替代剪接模式,5'UTR三核苷酸重复与成瘾脆弱性的关联以及阿尔茨海默氏病中的同种型表达差异。】 复制标题 收藏 收藏
    DOI:10.3109/10826084.2010.482449 复制DOI
    作者列表:Chiocco MJ,Zhu X,Walther D,Pletnikova O,Troncoso JC,Uhl GR,Liu QR
    BACKGROUND & AIMS: :Fine mapping of calcineurin (PPP3CA) gene identified single nucleotide polymorphisms (SNPs) and simple sequence repeat polymorphisms that are associated with addiction vulnerability. A trinucleotide repeat marker, located in the 5'untranslated region (5'UTR) of the PPP3CA mRNA, exhibited significantly different genotype and allele frequencies between abusers and controls in the NIDA African-American sample. The polymorphism showed allelic-specific expression in mRNA extracted from postmortem brain specimens. Novel alternatively spliced isoforms of PPP3CA were identified and their expressions were found altered in brain regions of postmortem Alzheimer's disease patients. These data underscore the importance of calcineurin gene in the molecular mechanism of addiction and Alzheimer's diseases.
    背景与目标: 钙调神经磷酸酶 (PPP3CA) 基因的精细定位确定了与成瘾脆弱性相关的单核苷酸多态性 (snp) 和简单序列重复多态性。位于PPP3CA mRNA的5' 非翻译区 (5'UTR) 的三核苷酸重复标记在NIDA非裔美国人样品中的滥用者和对照之间表现出显着不同的基因型和等位基因频率。多态性显示从死后脑标本中提取的mRNA中的等位基因特异性表达。鉴定出PPP3CA的新型剪接同工型,并在死后阿尔茨海默氏病患者的大脑区域发现它们的表达发生了变化。这些数据强调了钙调神经磷酸酶基因在成瘾和阿尔茨海默氏病分子机制中的重要性。

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