Addiction Rehab: Measurement of Subclinical Carotid Atherosclerosis May Help in Predicting Risk for Stroke in Patients With Diabetes.
Measurement of subclinical carotid atherosclerosis may help in predicting risk for stroke in patients with diabetes.
Filed under: Addiction Rehab
Metab Brain Dis. 2013 Feb 10;
Della-Morte D, Ricordi C, Guadagni F, Rundek T
Diabetes is one of the most important risk factor for stroke and cardiovascular disease (CVD), especially in young patients. The control of classical vascular risk factors failed in terms of prevention of stroke in patients with diabetes. In addiction, in these patients the glycemic control showed a benefit on microvascular disease but lacked an established benefit in macrovascular disease. Therefore, implementations of effective stroke prevention strategies appear necessary in patients with diabetes. Ultrasound surrogate or intermediate markers of carotid atherosclerosis include carotid intima-media thickness (cIMT), carotid plaque (CP), and carotid stiffness (STIFF) have been demonstrated to increase in patients with diabetes and to be able to predict risk for stroke. In this editorial we discuss the opportunity to prevent the onset of vascular disease in their “preclinical or subclinical” stage in patients with higher risk for stroke such as diabetic patients.
HubMed – addiction
Drinking Episodes during Abstinence-oriented Inpatient Treatment: Dual Perspectives of Patients and Therapists–A Qualitative Analysis{dagger}
Filed under: Addiction Rehab
Alcohol Alcohol. 2013 Feb 8;
Klingemann H, Schläfli K, Eggli P, Stutz S
Aims: Treatment programs are frequently confronted with the consumption of alcohol by patients during therapy. This is in conflict with the abstinence agreement upon admission, which is considered to be instrumental for positive treatment outcomes. This qualitative analysis aims, first, to identify the range of patients’ causal attributions, addiction concepts and control strategies detected in the narratives of off-site consumption episodes and, secondly, to compare this inventory with the response of the therapists. Methods: A total of 42 semi-structured face-to face interviews were conducted with patients and their therapists (n = 22) from two major Swiss inpatient alcohol clinics in 2010/2011. Interviews were conducted shortly after the detection of a patient’s off-premises alcohol consumption. Textual exploration and systematic coding used ATLAS.ti to identify themes, interpretative categories and prevention strategies shared by the therapists. Results: Elements of outpatient-controlled drinking programs are mirrored in the patients’ lay strategies, and similarities with self-change mechanisms can be observed. The dimensionality of therapists’ views of the consumption incidents-illustrated by their prevention recommendations-proves to be less differentiated than the control strategies and situational framing of the patients. Conclusions: The focus on abstinence only and the adoption of the loss-of-control concept limits therapists’ ability to feed patients’ reports of their drinking episodes and coping efforts into a strength-based approach including a wider range of treatment outcomes.
HubMed – addiction
Altered phosphorylation of GluA1 in the striatum is associated with locomotor sensitization induced by exposure to increasing doses of morphine.
Filed under: Addiction Rehab
Eur J Pharmacol. 2013 Feb 6;
Ding X, Liang J, Zheng X, Bai Y, Liu Z, Li Y, Xing X
Escalation of drug consumption is involved in the transition from drug use to addiction. Our previous study demonstrated that neuronal activation in ventral tegmental area (VTA) and substantia nigra (SN) was associated with behavioral sensitization induced by increasing doses of morphine. Here we sought to characterize the molecular mechanism underlying this behavioral sensitization. We compared mitogen-activated protein kinase (MAPK) signaling following pretreatment with either increasing doses or fixed doses of morphine before and after behavioral sensitization. We found phospho-MAPK markedly increased in ventral striatum and decreased in dorsal striatum after either pretreatment group, but no further change after sensitization induced by 10mg/kg morphine challenge. Furthermore, we also evaluated the level of phospho-glutamate receptor 1 at serine 845 (pSer845-GluA1) and 831 (pSer831-GluA1) sites in ventral striatum and dorsal striatum. The results showed a significant increase in pSer845-GluA1/GluA1 ratio in ventral striatum but not dorsal striatum after pretreatment with increasing doses of morphine but not after fixed-dose or saline pretreatment. Importantly, pSer845-GluA1/GluA1 ratio was increased exclusively in dorsal striatum and not ventral striatum following acute morphine challenge specifically paired with increasing-dose pretreatment and not fixed-dose or saline. These findings indicate that behavioral sensitization-induced by chronic pretreatment with increasing doses of morphine might be more closely associated with the dynamic GluA1 activity in the striatum rather than the modulation of MAPK signaling. These findings also indicate that GluA1 phosphorylation may occur independent of MAPK activation.
HubMed – addiction
Toward a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools.
Filed under: Addiction Rehab
Clin Psychol Rev. 2013 Jan 12; 33(3): 331-342
King DL, Haagsma MC, Delfabbro PH, Gradisar M, Griffiths MD
Pathological video-gaming, or its proposed DSM-V classification of “Internet Use Disorder”, is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat’s (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment.
HubMed – addiction
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