Increased Marijuana Use and Gender Predict Poorer Cognitive Functioning in Adolescents and Emerging Adults.

Increased marijuana use and gender predict poorer cognitive functioning in adolescents and emerging adults.

Filed under: Drug and Alcohol Rehabilitation

J Int Neuropsychol Soc. 2012 Jul; 18(4): 678-88
Lisdahl KM, Price JS

This study sought to characterize neuropsychological functioning in MJ-using adolescents and emerging adults (ages 18-26) and to investigate whether gender moderated these effects. Data were collected from 59 teens and emerging adults including MJ users (n = 23, 56% female) and controls (n = 35, 50% female) aged 18-26 (M = 21 years). Exclusionary criteria included independent Axis I disorders (besides SUD), and medical and neurologic disorders. After controlling for reading ability, gender, subclinical depressive symptoms, body mass index, and alcohol and other drug use, increased MJ use was associated with slower psychomotor speed/sequencing ability (p < .01), less efficient sustained attention (p < .05), and increased cognitive inhibition errors (p < .03). Gender significantly moderated the effects of MJ on psychomotor speed/sequencing ability (p < .003) in that males had a more robust negative relationship. The current study demonstrated that MJ exposure was associated with poorer psychomotor speed, sustained attention and cognitive inhibition in a dose-dependent manner in young adults, findings that are consistent with other samples of adolescent MJ users. Male MJ users demonstrated greater cognitive slowing than females. Future studies need to examine the neural substrates underlying with these cognitive deficits and whether cognitive rehabilitation or exercise interventions may serve as a viable treatments of cognitive deficits in emerging adult MJ users. HubMed – drug alcohol rehabilitation

 

[Gait disorders in the elderly: prospects for a symptomatic therapy].

Filed under: Drug and Alcohol Rehabilitation

Fortschr Neurol Psychiatr. 2012 May; 80(5): 260-6
Jahn K

Gait disorders are among the most common presenting symptoms in neurology. In the elderly, multiple causes of gait instability and dizziness may occur in the same subject. Relevant pathogenetic factors are sensory deficits (visual, vestibular, somatosensory), neurodegenerative processes (cortical, extrapyramidal, cerebellar), toxic factors (medication, alcohol) and anxiety (primary or as the result of falls). Reduced mobility reduces the quality of life; associated falls increase morbidity and mortality. The evaluation of aged people with the chief complaint “gait disorder” should focus on the identification of specific deficits. This is the prerequisite for reasoned therapy. Besides treatment of the underlying pathology there is a need for effective symptomatic therapy, in particular for degenerative disorders. Physical therapy with postural and locomotor training remains the basis of treatment; it can improve gait and prevent falls. So far, symptomatic drug treatment is unsatisfactory. Based on pathophysiology and uncontrolled studies, the most promising approaches are to support cholinergic neurotransmission in the midbrain and thalamus by central cholinesterase inhibitors and the regularisation of Purkinje cell function by potassium channel blockers. Brain stem nuclei which are target regions for deep brain stimulation (subthalamic and pedunculopontine nucleus) are known to be relevant for locomotor control (subthalamic and mesencephalic locomotor region). Accordingly, deep brain stimulation also affects posture and gait. The current literature on symptomatic therapy for gait disorders in the elderly is summarised.
HubMed – drug alcohol rehabilitation

 

Evaluating the impact of community-based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES).

Filed under: Drug and Alcohol Rehabilitation

Addiction. 2012 Nov; 107(11): 1998-2008
McKetin R, Najman JM, Baker AL, Lubman DI, Dawe S, Ali R, Lee NK, Mattick RP, Mamun A

To evaluate the impact of community-based drug treatment on methamphetamine use using inverse probability of treatment-weighted (IPTW) estimators to derive treatment effects.A longitudinal prospective cohort study with follow-ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow-up. IPTW estimators were used to adjust for pre-treatment differences between groups.Sydney and Brisbane, Australia.Participants were methamphetamine users entering community-based detoxification (n?=?112) or residential rehabilitation (n?=?248) services and a quasi-control group of methamphetamine users (n?=?101) recruited from the community.Frequency of methamphetamine use between interviews (no use, less than weekly, 1-2 days per week, 3+ days per week), continuous abstinence from methamphetamine use, past month methamphetamine use and methamphetamine dependence.Detoxification did not reduce methamphetamine use at any follow-up relative to the quasi-control group. Relative to quasi-control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of methamphetamine use at 3 months [odds ratio (OR)?=?0.23, 95% confidence interval (CI) 0.15-0.36, P?HubMed – drug alcohol rehabilitation

 

[The influence of treatment with formoterol, formoterol with tiotropium, formoterol with inhaled glucocorticosteroid and tiotropium on lung functions, tolerance of exercise and simple, morning everyday activities in patients with chronic obstructive pulmonary disease (COPD)].

Filed under: Drug and Alcohol Rehabilitation

Pneumonol Alergol Pol. 2012; 80(3): 255-62
Szmidt M

Bronchodilators – long-acting b2-adrenergic agonists (formoterol and salmeterol) and a long-acting antimuscarinic drug (tiotropium), are the main drugs applied in symptomatic treatment of COPD. In patients with COPD, dyspnea is frequently associated with simple everyday activities. Two questionnaires have been published recently as a means of assessing the patients’ ability to perform morning activities and symptoms. Dynamic hyperinflation is the pathophysiological disorder responsible for dyspnea and decreased exercise tolerance in COPD. Formoterol is faster than salmeterol in diminishing air-trapping. It has been shown that treatment with formoterol and tiotropium in COPD patients improves FEV(1), FVC, IC, symptoms score and quality of life in comparison with tiotropium applied alone. Among LABA and inhaled glucocorticosteroids combinations, those containing formoterol have a more beneficial effect on the ability to perform simple morning activities (budesonide/formoterol was better than fluticasone/salmeterol). Beclomethasone/formoterol – 400/24 mcg/die, in comparison with fluticasone/salmeterol – 500/100 mcg/die significantly reduced air-trapping and dyspnea in COPD patients. The comparison of budesonide/formoterol – 400/12 mcg 2 x die with beclomethasone/ /formoterol – 200/12 mcg 2 x die has shown similar influence of both combinations on FEV(1), dyspnea, 6-minute walk test, symptoms score and quality of life. The addition of budesonide and formoterol combination to tiotropium gives further benefits: reduces number of exacerbations, improves FEV1, symptoms score and performance of simple morning routines. Doctors should pay more attention to symptoms and limitations in simple activities in the morning and adequately adjust the treatment.
HubMed – drug alcohol rehabilitation

 

 

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