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Laranjeira, Ronaldo R
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[PMID]:29251975
[Au] Autor:Miguel AQC; Madruga CS; Cogo-Moreira H; Yamauchi R; Simões V; Ribeiro A; da Silva CJ; Fruci A; McDonell M; McPherson S; Roll JM; Laranjeira RR
[Ad] Endereço:National Institute of Policies on Alcohol and Drugs (INPAD).
[Ti] Título:Contingency management targeting abstinence is effective in reducing depressive and anxiety symptoms among crack cocaine-dependent individuals.
[So] Source:Exp Clin Psychopharmacol;25(6):466-472, 2017 12.
[Is] ISSN:1936-2293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although contingency management (CM) is effective in promoting abstinence and treatment retention among crack cocaine users who meet the criteria for cocaine dependence, less is known about its off-target effects. In this secondary analysis, we evaluated the impact of CM on depressive and anxiety symptoms in a sample of cocaine-dependent individuals under treatment. Sixty-five crack cocaine users who met the criteria for cocaine dependence were randomly assigned to receive 12 weeks of standard treatment alone (STA; n = 32) or 12 weeks of standard treatment plus CM (STCM; n = 33). The outcome measures of the secondary analysis were depressive and anxiety symptoms assessed with the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). At baseline, 59 (90.8%) of the participants reported at least mild depressive symptoms and 47 (72.5%) reported at least mild anxiety symptoms. The mean BDI-II (24.5 ± 12.1) and BAI (20.7 ± 13.5) scores in the sample as a whole was moderate. After treatment, the reported levels of depressive symptoms (ß = -9.6, p < .05) and anxiety symptoms (ß = -9.9, p < .05) were lower among the individuals receiving STCM than among those receiving STA. This study provides evidence that an STCM intervention targeting crack cocaine abstinence also produces significant reductions in depressive and anxiety symptoms. This low cost intervention also demonstrated significant promise and optimization potential for crack cocaine users in a setting of scarce resources and high mental health comorbidity. Relevance Statement: We found that the prevalence of depressive and anxiety symptoms were extremely high among crack cocaine users, and that, among such individuals, contingency management (CM) reduced depressive and anxiety symptomatology to a greater degree than did standard treatment. Our results suggest that CM targeting crack cocaine abuse can have off-target effects on psychiatric symptomatology. (PsycINFO Database Record
[Mh] Termos MeSH primário: Ansiedade/etiologia
Transtornos Relacionados ao Uso de Cocaína/complicações
Cocaína Crack
Depressão/etiologia
Psicoterapia de Grupo/métodos
Reforço (Psicologia)
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Escalas de Graduação Psiquiátrica
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180224
[Lr] Data última revisão:
180224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1037/pha0000147


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[PMID]:28724038
[Au] Autor:Antonio N; Diehl A; Niel M; Pillon S; Ratto L; Pinheiro MC; Silveira D; Otani TZ; Otani V; Cordeiro Q; Ushida R
[Ad] Endereço:Center for Integrated Mental Health (CAISM), Faculdade de Ciências Médicas da Santa Casa de São Paulo (FCMSCSP), São Paulo, SP, Brazil.
[Ti] Título:Sexual addiction in drug addicts: The impact of drug of choice and poly-addiction.
[So] Source:Rev Assoc Med Bras (1992);63(5):414-421, 2017 May.
[Is] ISSN:1806-9282
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Objective:: To compare the risk of comorbid sexual addiction in a sample of individuals with a diagnosis of substance dependence, stratifying the sample by drug of choice as well as by mono versus polysubstance addiction. Method:: All data were collected at Santa Casa de São Paulo, Brazil. The study sample comprised all alcohol or drug dependents admitted to the Addiction Treatment Unit between November 2013 and August 2014. A generalized linear model with a binomial distribution was performed to compare the odds of having a Sexual Addiction Screening Test (SAST) score greater than 6 points in the subgroups analyzed. Results:: A total of 133 participants were included in our analysis, all reporting cocaine/crack and/or alcohol as drug of choice. Polysubstance addicts had a significant higher risk of a positive screening for sexual addiction compared to monosubstance addicts, age-sex adjusted odds ratios of sexual addiction being respectively 2.72 (95CI 1.1-6.71) and 0.37 (95CI 0.15-0.91). The odds of a SAST score greater than 6 was not statistically different between the cocaine/crack and alcohol groups, respectively 0.38 (95CI 0.14-1.02) and 2.67 (95CI 0.98-7.25). We found a significant relation between stronger drug addiction and greater levels of sexual addiction in the cocaine/crack group (p=0.0012), but not in the alcohol group. Conclusion:: Our study reinforces the importance of assessing sexual behavior of drug addicts in clinical practice, especially considering users of multiple substances or with severe dependence.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Álcool/complicações
Comportamento Aditivo/induzido quimicamente
Transtornos Relacionados ao Uso de Cocaína/complicações
Medição de Risco/métodos
Comportamento Sexual/efeitos dos fármacos
Disfunções Sexuais Psicogênicas/induzido quimicamente
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Transtornos Relacionados ao Uso de Álcool/psicologia
Comportamento Aditivo/psicologia
Brasil
Transtornos Relacionados ao Uso de Cocaína/psicologia
Cocaína Crack/efeitos adversos
Usuários de Drogas/psicologia
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Escalas de Graduação Psiquiátrica
Fatores de Risco
Índice de Gravidade de Doença
Fatores Sexuais
Comportamento Sexual/psicologia
Fatores Socioeconômicos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE


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[PMID]:28678934
[Au] Autor:Halpern SC; Scherer JN; Roglio V; Faller S; Sordi A; Ornell F; Dalbosco C; Pechansky F; Kessler F; Diemen LV
[Ad] Endereço:Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
[Ti] Título:[Clinical and social vulnerabilities in crack users according to housing status: a multicenter study in six Brazilian state capitals].
[Ti] Título:Vulnerabilidades clínicas e sociais em usuários de crack de acordo com a situação de moradia: um estudo multicêntrico de seis capitais brasileiras..
[So] Source:Cad Saude Publica;33(6):e00037517, 2017 Jul 03.
[Is] ISSN:1678-4464
[Cp] País de publicação:Brazil
[La] Idioma:por
[Ab] Resumo:The study had the goal to evaluate psychoactive substance use severity, violence, physical and emotional health of crack users who seeks specialized treatment in Psychosocial Care Centers for Alcohol and Drugs (CAPSad) concerning housing status. This is a multicenter cross-sectional study in six Brazilian capitals with 564 crack users categorized into two groups (1) users who have been homeless sometime in life (n = 266) and (2) individuals who have never lived on streets (n = 298). To assess the substance use severity and the characteristics of the individuals, the Addiction Severity Index, 6th version (ASI-6) was used. Group 1 users showed worse indicators regarding alcohol, medical and psychiatric problems, employment and family support subscales, as well as greater involvement with legal problems, violence, sexual abuse, suicide risk and health related problems such as HIV/AIDS, hepatitis and tuberculosis. In addition they have lower income to pay for basic needs. After analysis and control for possible confounders, not having enough income to pay for basic needs, showing depression symptoms, and having been arrested for theft remained statistically significant. This study evaluated more deeply drug use severity and housing status of crack users. Interventions developed in outpatient treatment should be designed and tailored to specific profiles and demands of drug users, especially homeless individuals.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Transtornos Relacionados ao Uso de Cocaína/psicologia
Cocaína Crack/efeitos adversos
Pessoas em Situação de Rua/estatística & dados numéricos
Violência/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Brasil/epidemiologia
Cidades/epidemiologia
Estudos Transversais
Feminino
Nível de Saúde
Seres Humanos
Masculino
Transtornos Mentais/epidemiologia
Transtornos Mentais/psicologia
Fatores Socioeconômicos
Populações Vulneráveis
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170726
[Lr] Data última revisão:
170726
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE


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[PMID]:28591239
[Au] Autor:Antoniazzi RP; Sari AR; Casarin M; Moraes CMB; Feldens CA
[Ad] Endereço:Centro Universitário Franciscano, Santa Maria, RS, Brazil.
[Ti] Título:Association between crack cocaine use and reduced salivary flow.
[So] Source:Braz Oral Res;31:e42, 2017 Jun 05.
[Is] ISSN:1807-3107
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Crack cocaine use appears to have an impact on oral conditions. However, changes in the salivary flow among crack users have not been fully clarified. The aim of this study was to compare stimulated salivary flow and the occurrence of hyposalivation between crack users and non-users. A cross-sectional study was conducted involving 40 crack users and 40 controls matched for sex, age, and smoking habits. Interviews were conducted to acquire data on the perception of dry mouth (xerostomia) and drug use. Stimulated salivary flow was determined using the spitting method. A significant reduction in stimulated salivary flow was found among crack users in comparison to non-users (1.02 vs. 1.59 ml/min). A total of 42.5% and 15% of crack users had very low and low stimulated salivary flow, respectively. Moreover, 65% of users reported xerostomia in comparison to 37.5% non-users (p < 0.012). No significant association was found between xerostomia and hyposalivation (p = 0.384). A multivariate analysis revealed that individuals older than 26 years of age, those with a low household income, and crack users (prevalence ratio: 2.59) had a significant association with the occurrence of hyposalivation. A significant association was found between the use of crack and reduced salivary flow. The use of crack was associated with the occurrence of hyposalivation in the multivariate analysis.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/fisiopatologia
Cocaína Crack/efeitos adversos
Salivação/efeitos dos fármacos
Xerostomia/induzido quimicamente
[Mh] Termos MeSH secundário: Adolescente
Adulto
Estudos de Casos e Controles
Estudos Transversais
Índice CPO
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Salivação/fisiologia
Taxa Secretória/efeitos dos fármacos
Estatísticas não Paramétricas
Inquéritos e Questionários
Uso de Tabaco/efeitos adversos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170628
[Lr] Data última revisão:
170628
[Sb] Subgrupo de revista:D; IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE


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[PMID]:28403321
[Au] Autor:Paiva CB; Ferreira IB; Bosa VL; Narvaez JC
[Ad] Endereço:Programa de Pós-Graduação em Psicologia Clínica, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
[Ti] Título:Depression, anxiety, hopelessness and quality of life in users of cocaine/crack in outpatient treatment.
[So] Source:Trends Psychiatry Psychother;39(1):34-42, 2017 Jan-Mar.
[Is] ISSN:2238-0019
[Cp] País de publicação:Portugal
[La] Idioma:eng
[Ab] Resumo:Objective:: To identify symptoms of anxiety, depression, and feelings of hopelessness in patients in outpatient treatment for substance dependency and to test for correlations with various aspects of their quality of life. Methods:: A cross-sectional study of a sample of 25 men in recuperation from substance dependency, selected by convenience. We assessed symptoms of depression (Beck Depression Inventory-II), anxiety (Beck Anxiety Inventory), hopelessness (Beck Hopelessness Scale), and quality of life (World Health Organization Quality of Life instrument-Abbreviated version [WHOQOL-Bref]), and also analyzed sociodemographic profile, substance abuse, and family history. Categorical variables were expressed as frequencies and percentages and quantitative variables as means and standard deviations or as medians and interquartile ranges. We also analyzed Spearman correlations to a 5% significance level. Results:: The study revealed prevalence rates of 32% for depression, 24% for anxiety, and 12% for hopelessness, at a moderate/severe level. Correlations between Beck scales and WHOQOL-Bref were significant; but impacts differed in the four areas evaluated. Conclusions:: Overall, we observe global negative impacts on subjects' lives, affecting their psychiatric symptoms and quality of life and their relationships and occupational factors to a similar degree. The results show that the lower the scores on these scales, the better the quality of life in some areas, indicating that there is a negative correlation between psychiatric symptoms and quality of life.
[Mh] Termos MeSH primário: Ansiedade
Transtornos Relacionados ao Uso de Cocaína/psicologia
Depressão
Esperança
Pacientes Ambulatoriais/psicologia
Qualidade de Vida
[Mh] Termos MeSH secundário: Adulto
Ansiedade/epidemiologia
Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Transtornos Relacionados ao Uso de Cocaína/terapia
Comorbidade
Cocaína Crack
Estudos Transversais
Depressão/epidemiologia
Família
Predisposição Genética para Doença
Seres Humanos
Masculino
Prevalência
Escalas de Graduação Psiquiátrica
Psicotrópicos/uso terapêutico
Qualidade de Vida/psicologia
Fatores Socioeconômicos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Crack Cocaine); 0 (Psychotropic Drugs)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170419
[Lr] Data última revisão:
170419
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE


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[PMID]:28296627
[Au] Autor:Lopes-Rosa R; Kessler FP; Pianca TG; Guimarães L; Ferronato P; Pagnussat E; Moura H; Pechansky F; von Diemen L
[Ad] Endereço:a Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS) , Porto Alegre , RS , Brazil.
[Ti] Título:Predictors of early relapse among adolescent crack users.
[So] Source:J Addict Dis;36(2):136-143, 2017 Apr-Jun.
[Is] ISSN:1545-0848
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Relapse is associated with a poor prognosis among drug users. Crack cocaine users are more prone to severe dependence because of the intensity of use. Additionally, initiating drug use during adolescence worsens users' prognosis due to the increased rates of impulsivity and other risk behaviors. This study aimed to identify the predictors of early relapse among adolescent crack users discharged from inpatient treatment. A cohort study was conducted with 89 psychiatric inpatients aged 12-17 years from two different hospitals in southern Brazil who met the criteria for crack abuse or dependence. Demographic data, substance use disorders, psychiatric comorbidities, and crack consumption profile were assessed during hospitalization using the Teen Addiction Severity Index, Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime, and Crack Consumption Profile. Participants were re-assessed at 1 and 3 months after hospital discharge to determine their crack cocaine use based on self-report, family/caregiver information, and urine tests, whenever possible. There were extremely high rates of relapse (valid percent) in the first and third months, 65.9 and 86.4%, respectively. Statistically significant associations were observed between relapse in the first month and length of cocaine/crack cocaine use, and length of hospital stay. Data at 3 months were not analyzed because of the small number of patients who did not relapse. The high rates and significant associations found in this study suggest that intensive outpatient treatment strategies targeting this population should be developed and implemented to prevent early relapse after detoxification. One of the possible approaches, based on recent studies, might explore motivation as a strategy to reduce the rate of early relapse.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Transtornos Mentais/epidemiologia
Transtornos Relacionados ao Uso de Substâncias/epidemiologia
[Mh] Termos MeSH secundário: Adolescente
Comportamento do Adolescente
Brasil/epidemiologia
Criança
Transtornos Relacionados ao Uso de Cocaína/psicologia
Comorbidade
Cocaína Crack
Diagnóstico Duplo (Psiquiatria)/estatística & dados numéricos
Feminino
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Recidiva
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1080/10550887.2017.1295670


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[PMID]:28273279
[Au] Autor:Mardini V; Rohde LA; Ceresér KM; Gubert CM; Silva EGD; Xavier F; Parcianello R; Röhsig LM; Pechansky F; Szobot CM
[Ad] Endereço:Serviço de Psiquiatria da Infância e Adolescência (SPIA), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.
[Ti] Título:TBARS and BDNF levels in newborns exposed to crack/cocaine during pregnancy: a comparative study.
[So] Source:Rev Bras Psiquiatr;39(3):263-266, 2017 Jul-Sep.
[Is] ISSN:1809-452X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Objectives:: To compare levels of a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and brain-derived neurotrophic factor (BDNF) in umbilical cord blood (UCB) between newborns exposed to crack/cocaine in utero (exposed newborns [EN], n=57) and non-exposed newborns (NEN, n=99), as well as in maternal peripheral blood at delivery. Methods:: This was a cross-sectional study. Potential confounders, including perinatal parameters, psychopathology, and use of other substances, were assessed. Results:: After adjusting for potential confounders, adjusted mean BDNF was significantly higher in EN (3.86 ng/mL, 95% confidence interval [95%CI] 2.29-5.43) than in NEN (0.85 ng/mL, 95%CI 0.47-1.23; p < 0.001; Cohen effect size: 1.12), and significantly lower in crack/cocaine mothers than in control mothers (4.03 ng/mL, 95%CI 2.87-5.18 vs. 6.67 ng/mL, 95%CI 5.60-7.74; p = 0.006). The adjusted mean TBARS level was significantly lower in EN (63.97 µM MDA, 95%CI 39.43-88.50) than NEN (177.04 µM MDA, 95%CI 140.93-213.14; p < 0.001; effect size = 0.84), with no difference between mother groups (p = 0.86). Conclusions:: The changes in TBARS levels observed in EN suggest that fetuses exposed to cocaine mobilize endogenous antioxidant routes since very early stages of development. The increase in BDNF levels in EN might indicate changes in fetal development, whereas the changes in BDNF levels in mothers provide evidence of the complex metabolic processes involved in drug use during pregnancy.
[Mh] Termos MeSH primário: Fator Neurotrófico Derivado do Encéfalo/sangue
Cocaína Crack/farmacologia
Sangue Fetal/química
Substâncias Reativas com Ácido Tiobarbitúrico/análise
[Mh] Termos MeSH secundário: Adolescente
Adulto
Transtornos Relacionados ao Uso de Cocaína/sangue
Estudos Transversais
Feminino
Seres Humanos
Recém-Nascido
Meia-Idade
Oxirredução/efeitos dos fármacos
Período Pós-Parto/sangue
Gravidez
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Brain-Derived Neurotrophic Factor); 0 (Crack Cocaine); 0 (Thiobarbituric Acid Reactive Substances)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170309
[St] Status:MEDLINE


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[PMID]:28259655
[Au] Autor:Schuch-Goi SB; Goi PD; Bermudez M; Fara LS; Kessler FP; Pechansky F; Gama CS; Massuda R; von Diemen L
[Ad] Endereço:Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil. Electronic address: silvia_schuch@yahoo.com.
[Ti] Título:Accumbens volumes are reduced among crack-cocaine users.
[So] Source:Neurosci Lett;645:86-89, 2017 04 03.
[Is] ISSN:1872-7972
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:The brain reward system is known to be the neuroanatomical basis of addictive behaviors. Systemic, cognitive and functional consequences of crack-cocaine addiction are clinically evident, but the neuroanatomical underpinnigs are not yet well understood. We aim to assess the neuroanatomical differences between crack-cocaine patients and paired healthy controls. Fifteen crack-cocaine patients recently discharged from the Addiction Unit of the Hospital de Clínicas de Porto Alegre and fifteen controls matched for gender, age, education and handedness were scanned using a Philips Achieva 1.5T MRI equipment. All subjects had negative positive tests at admission and patients had at least 15days of detoxification. Active neurologic, inflammatory, cardiovascular or systemic comorbidities were excluded. Subcortical structure volumes were determined using Freesurfer v5.1. Controls had greater volumes in the left accumbens (t=3.604, df=28, p=0.001) compared to patients. Right accumbens volumes were also greater in controls (t=2.098, df=28, p=0.045). Groups did not differ regarding intracranial volumes (p=0.514). This preliminary and innovative data on crack-cocaine dependence suggests that there is a volumetric reduction of the accumbens, a region that has a significant role in motivation, pleasure, reward and reinforcement learning, and it could play a central role in the pathophysiology of this drug addiction. Therefore, these findings may contribute to understand some behavioral and cognitive deficits in this population.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/patologia
Cocaína Crack/efeitos adversos
Núcleo Accumbens/patologia
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Tamanho do Órgão
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170306
[St] Status:MEDLINE


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[PMID]:28230564
[Au] Autor:Odell AP; Reynolds GL; Fisher DG; Huckabay LM; Pedersen WC; Xandre P; Miocevic M
[Ad] Endereço:*School of Nursing, †Center for Behavioral Research and Services, and ‡Department of Psychology, California State University, Long Beach, CA; and §Department of Psychology, Arizona State University, Tempe, AZ.
[Ti] Título:Attention Deficit Hyperactivity Disorder, Aggression, and Illicit Stimulant Use: Is This Self-Medication?
[So] Source:J Nerv Ment Dis;205(5):372-379, 2017 May.
[Is] ISSN:1539-736X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This study compares adults with and without attention deficit hyperactivity disorder (ADHD) on measures of direct and displaced aggression and illicit drug use. Three hundred ninety-six adults were administered the Wender Utah Rating Scale, the Risk Behavior Assessment, the Aggression Questionnaire (AQ), and the Displaced Aggression Questionnaire (DAQ). Those with ADHD were higher on all scales of the AQ and DAQ, were younger at first use of amphetamines, and were more likely to have ever used crack and amphetamines. A Structural Equation Model found a significant interaction in that for those with medium and high levels of verbal aggression, ADHD predicts crack and amphetamine. Follow-up logistic regression models suggest that blacks self-medicate with crack and whites and Hispanics self-medicate with amphetamine when they have ADHD and verbal aggression.
[Mh] Termos MeSH primário: Agressão/fisiologia
Anfetaminas/uso terapêutico
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia
Cocaína Crack/uso terapêutico
Automedicação
Transtornos Relacionados ao Uso de Substâncias/etiologia
[Mh] Termos MeSH secundário: Adulto
Grupo com Ancestrais do Continente Africano/etnologia
Agressão/efeitos dos fármacos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico
Transtorno do Deficit de Atenção com Hiperatividade/etnologia
Grupo com Ancestrais do Continente Europeu/etnologia
Feminino
Hispano-Americanos/estatística & dados numéricos
Seres Humanos
Los Angeles/etnologia
Masculino
Meia-Idade
Transtornos Relacionados ao Uso de Substâncias/etnologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amphetamines); 0 (Crack Cocaine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170524
[Lr] Data última revisão:
170524
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170224
[St] Status:MEDLINE
[do] DOI:10.1097/NMD.0000000000000668


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[PMID]:28158995
[Au] Autor:Prangnell A; Dong H; Daly P; Milloy MJ; Kerr T; Hayashi K
[Ad] Endereço:British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Urban Health Research Initiative, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
[Ti] Título:Declining rates of health problems associated with crack smoking during the expansion of crack pipe distribution in Vancouver, Canada.
[So] Source:BMC Public Health;17(1):163, 2017 Feb 03.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Crack cocaine smoking is associated with an array of negative health consequences, including cuts and burns from unsafe pipes, and infectious diseases such as HIV. Despite the well-established and researched harm reduction programs for injection drug users, little is known regarding the potential for harm reduction programs targeting crack smoking to reduce health problems from crack smoking. In the wake of recent crack pipe distribution services expansion, we utilized data from long running cohort studies to estimate the impact of crack pipe distribution services on the rates of health problems associated with crack smoking in Vancouver, Canada. METHODS: Data were derived from two prospective cohort studies of community-recruited people who inject drugs in Vancouver between December 2005 and November 2014. We employed multivariable generalized estimating equations to examine the relationship between crack pipe acquisition sources and self-reported health problems associated with crack smoking (e.g., cut fingers/sores, coughing blood) among people reported smoking crack. RESULTS: Among 1718 eligible participants, proportions of those obtaining crack pipes only through health service points have significantly increased from 7.2% in 2005 to 62.3% in 2014 (p < 0.001), while the rates of reporting health problems associated with crack smoking have significantly declined (p < 0.001). In multivariable analysis, compared to those obtaining pipes only through other sources (e.g., on the street, self-made), those acquiring pipes through health service points only were significantly less likely to report health problems from smoking crack (adjusted odds ratio: 0.82; 95% confidence interval: 0.73-0.93). CONCLUSIONS: These findings suggest that the expansion of crack pipe distribution services has likely served to reduce health problems from smoking crack in this setting. They provide evidence supporting crack pipe distribution programs as a harm reduction service for crack smokers.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Cocaína/epidemiologia
Cocaína Crack
Equipamentos e Provisões/provisão & distribuição
Redução do Dano
[Mh] Termos MeSH secundário: Adulto
Colúmbia Britânica/epidemiologia
Transtornos Relacionados ao Uso de Cocaína/etiologia
Transtornos Relacionados ao Uso de Cocaína/prevenção & controle
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Razão de Chances
Avaliação de Programas e Projetos de Saúde
Estudos Prospectivos
Assunção de Riscos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Crack Cocaine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170908
[Lr] Data última revisão:
170908
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170205
[St] Status:MEDLINE
[do] DOI:10.1186/s12889-017-4099-9



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