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[PMID]:28456895
[Au] Autor:Vidot DC; Lerner B; Gonzalez R
[Ad] Endereço:School of Nursing and Health Sciences, University of Miami, 5030 Brunson Ave, Coral Gables, FL, 33146, USA. DVidot@miami.edu.
[Ti] Título:Cannabis Use, Medication Management and Adherence Among Persons Living with HIV.
[So] Source:AIDS Behav;21(7):2005-2013, 2017 Jul.
[Is] ISSN:1573-3254
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cannabis is used to relieve nausea, trigger weight gain, and reduce pain among adults living with HIV; however, the relationship between its use and medication adherence and management is unclear. Participants (N = 107) were from an ongoing cohort study of community-dwelling HIV+ adults, stratified by cannabis (CB) use: HIV+/CB+ (n = 41) and HIV+/CB- (n = 66). CB+ participants either tested positive in a urine toxicology screen for THC or had a self-reported history of regular and recent use. HIV-status was provided by physician results and/or biomarker assessment. Adherence was measured via the Morisky scale and medication management was assessed via the Medication Management Test-Revised. After adjusting for gender, we found no association between cannabis use group and adherence nor medication management. The amount of cannabis used was also not associated with measures of adherence and management. Preliminary findings suggest that cannabis use may not adversely influence medication adherence/management among adults living with HIV.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/uso terapêutico
Infecções por HIV/tratamento farmacológico
Uso da Maconha/epidemiologia
Adesão à Medicação/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Ansiedade
Cannabis
Estudos de Casos e Controles
Estudos de Coortes
Depressão
Feminino
Infecções por HIV/epidemiologia
Seres Humanos
Masculino
Meia-Idade
Autoadministração
Autorrelato
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE
[do] DOI:10.1007/s10461-017-1782-x


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[PMID]:29360841
[Au] Autor:Uthman RT; Sutton AJ; Jackson LJ; Uthman OA
[Ad] Endereço:Health Economics Unit, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
[Ti] Título:Does directly administered antiretroviral therapy represent good value for money in sub-Saharan Africa? A cost-utility and value of information analysis.
[So] Source:PLoS One;13(1):e0191465, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Successful antiretroviral therapy (ART) relies on the optimal level of ART adherence to achieve reliable viral suppression, avert HIV drug resistance, and prevent avoidable deaths. It has been shown that there are various groups of people living with HIV at high-risk of non-adherence to ART in sub-Saharan Africa. The objective of this study was to examine the cost effectiveness and value-of-information of directly administered antiretroviral therapy (DAART) versus self-administered ART among people living with HIV, at high risk of non-adherence to ART in sub-Saharan Africa. METHODS AND FINDINGS: A Markov model was developed that describes the transition between HIV stages based on the CD4 count, along with direct costs, quality of life and the mortality rate associated with DAART in comparison with self-administered ART. Data used in the model were derived from the published literature. A health system perspective was employed using a life-time time horizon. Probabilistic sensitivity analysis was performed to determine the impact of parameter uncertainty. Value of information analysis was also conducted. The expected cost of self-administered ART and DAART were $5,200 and $15,500 and the expected QALYs gained were 8.52 and 9.75 respectively, giving an incremental cost effectiveness ratio of $8,400 per QALY gained. The analysis demonstrated that the annual cost DAART needs to be priced below $200 per patient to be cost-effective. The probability that DAART was cost-effective was 1% for a willingness to pay threshold of $5,096 for sub-Saharan Africa. The value of information associated with the cost of DAART and its effectiveness was substantial. CONCLUSIONS: From the perspective of the health care payer in sub-Saharan Africa, DAART cannot be regarded as cost-effective based on current information. The value of information analysis showed that further research will be worthwhile and potentially cost-effective in resolving the uncertainty about whether or not to adopt DAART.
[Mh] Termos MeSH primário: Fármacos Anti-HIV/administração & dosagem
Fármacos Anti-HIV/economia
Terapia Diretamente Observada/economia
Infecções por HIV/tratamento farmacológico
Infecções por HIV/economia
[Mh] Termos MeSH secundário: África ao Sul do Saara
Análise Custo-Benefício
Seres Humanos
Cadeias de Markov
Adesão à Medicação
Modelos Econômicos
Anos de Vida Ajustados por Qualidade de Vida
Autoadministração/economia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-HIV Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191465


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[PMID]:28451642
[Au] Autor:Moschak TM; Carelli RM
[Ad] Endereço:Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, NC 27599.
[Ti] Título:Impulsive Rats Exhibit Blunted Dopamine Release Dynamics during a Delay Discounting Task Independent of Cocaine History.
[So] Source:eNeuro;4(2), 2017 Mar-Apr.
[Is] ISSN:2373-2822
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The inability to wait for a large, delayed reward when faced with a small, immediate one, known as delay discounting, has been implicated in a number of disorders including substance abuse. Individual differences in impulsivity on the delay discounting task are reflected in differences in neural function, including in the nucleus accumbens (NAc) core. We examined the role of a history of cocaine self-administration, as well as individual differences in impulsivity, on rapid dopamine (DA) release dynamics in the NAc core. Rats with a history of cocaine or water/saline self-administration were tested on delay discounting while being simultaneously assayed for rapid DA release using electrochemical methods. In controls, we found that cue DA release was modulated by reward delay and magnitude, consistent with prior reports. A history of cocaine had no effect on either delay discounting or DA release dynamics. Nonetheless, independent of drug history, individual differences in impulsivity were related to DA release in the NAc core. First, high impulsive animals exhibited dampened cue DA release during the delay discounting task. Second, reward delay and magnitude in high impulsive animals failed to robustly modulate changes in cue DA release. Importantly, these two DAergic mechanisms were uncorrelated with each other and, together, accounted for a high degree of variance in impulsive behavior. Collectively, these findings demonstrate two distinct mechanisms by which rapid DA signaling may influence impulsivity, and illustrate the importance of NAc core DA release dynamics in impulsive behavior.
[Mh] Termos MeSH primário: Cocaína/administração & dosagem
Desvalorização pelo Atraso/efeitos dos fármacos
Dopamina/metabolismo
Comportamento Impulsivo
Núcleo Accumbens/efeitos dos fármacos
Núcleo Accumbens/metabolismo
[Mh] Termos MeSH secundário: Animais
Condicionamento Operante
Masculino
Ratos Long-Evans
Recompensa
Autoadministração
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Nome de substância:
I5Y540LHVR (Cocaine); VTD58H1Z2X (Dopamine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:29226721
[Au] Autor:Farkas H; Debreczeni ML; Kohalmi KV
[Ad] Endereço:a Hungarian Angioedema Center, 3rd Department of Internal Medicine , Semmelweis University , Budapest , Hungary.
[Ti] Título:Investigational drugs in phase I and phase II clinical trials for hereditary angioedema.
[So] Source:Expert Opin Investig Drugs;27(1):87-103, 2018 Jan.
[Is] ISSN:1744-7658
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Hereditary angioedema (HAE) with C1-inhibitor deficiency (C1-INH-HAE) is a rare bradykinin-mediated disease characterized by recurrent subcutaneous and/or submucosal angioedematous attacks (HAE attacks), which occur unpredictably. The recurrent HAE attacks do not respond to conventional treatments, and may evolve into a life-threatening condition; therefore, special therapy is required. Areas covered: The agents used so far for the acute management of HAE attacks act by blocking the release of bradykinin, or its binding to its receptor. By contrast, the investigational medicinal products under evaluation in Phase I and II clinical trials are targeted at the prevention of HAE attacks. Chemically, these new drugs are small synthetic molecules, oligonucleotides, or antibodies, which inhibit either kallikrein, or Factor XII. Expert opinion: The key considerations for the development of new medicinal products include more straightforward dosing, self-administration, longer duration of action, and keeping the patient attack-free. This review summarizes the status and the findings of the currently ongoing Phase I and Phase II clinical trials of C1-INH-HAE.
[Mh] Termos MeSH primário: Angioedemas Hereditários/tratamento farmacológico
Desenho de Drogas
Drogas em Investigação/uso terapêutico
[Mh] Termos MeSH secundário: Angioedemas Hereditários/fisiopatologia
Animais
Bradicinina/metabolismo
Ensaios Clínicos Fase I como Assunto
Ensaios Clínicos Fase II como Assunto
Drogas em Investigação/administração & dosagem
Drogas em Investigação/farmacologia
Seres Humanos
Receptores da Bradicinina/metabolismo
Autoadministração
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Drugs, Investigational); 0 (Receptors, Bradykinin); S8TIM42R2W (Bradykinin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE
[do] DOI:10.1080/13543784.2018.1415325


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[PMID]:29182634
[Au] Autor:Ortblad K; Kibuuka Musoke D; Ngabirano T; Nakitende A; Magoola J; Kayiira P; Taasi G; Barresi LG; Haberer JE; McConnell MA; Oldenburg CE; Bärnighausen T
[Ad] Endereço:Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America.
[Ti] Título:Direct provision versus facility collection of HIV self-tests among female sex workers in Uganda: A cluster-randomized controlled health systems trial.
[So] Source:PLoS Med;14(11):e1002458, 2017 Nov.
[Is] ISSN:1549-1676
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: HIV self-testing allows HIV testing at any place and time and without health workers. HIV self-testing may thus be particularly useful for female sex workers (FSWs), who should test frequently but face stigma and financial and time barriers when accessing healthcare facilities. METHODS AND FINDINGS: We conducted a cluster-randomized controlled health systems trial among FSWs in Kampala, Uganda, to measure the effect of 2 HIV self-testing delivery models on HIV testing and linkage to care outcomes. FSW peer educator groups (1 peer educator and 8 participants) were randomized to either (1) direct provision of HIV self-tests, (2) provision of coupons for free collection of HIV self-tests in a healthcare facility, or (3) standard of care HIV testing. We randomized 960 participants in 120 peer educator groups from October 18, 2016, to November 16, 2016. Participants' median age was 28 years (IQR 24-32). Our prespecified primary outcomes were self-report of any HIV testing at 1 month and at 4 months; our prespecified secondary outcomes were self-report of HIV self-test use, seeking HIV-related medical care and ART initiation. In addition, we analyzed 2 secondary outcomes that were not prespecified: self-report of repeat HIV testing-to understand the intervention effects on frequent testing-and self-reported facility-based testing-to quantify substitution effects. Participants in the direct provision arm were significantly more likely to have tested for HIV than those in the standard of care arm, both at 1 month (risk ratio [RR] 1.33, 95% CI 1.17-1.51, p < 0.001) and at 4 months (RR 1.14, 95% CI 1.07-1.22, p < 0.001). Participants in the direct provision arm were also significantly more likely to have tested for HIV than those in the facility collection arm, both at 1 month (RR 1.18, 95% CI 1.07-1.31, p = 0.001) and at 4 months (RR 1.03, 95% CI 1.01-1.05, p = 0.02). At 1 month, fewer participants in the intervention arms had sought medical care for HIV than in the standard of care arm, but these differences were not significant and were reduced in magnitude at 4 months. There were no statistically significant differences in ART initiation across study arms. At 4 months, participants in the direct provision arm were significantly more likely to have tested twice for HIV than those in the standard of care arm (RR 1.51, 95% CI 1.29-1.77, p < 0.001) and those in the facility collection arm (RR 1.22, 95% CI 1.08-1.37, p = 0.001). Participants in the HIV self-testing arms almost completely replaced facility-based testing with self-testing. Two adverse events related to HIV self-testing were reported: interpersonal violence and mental distress. Study limitations included self-reported outcomes and limited generalizability beyond FSWs in similar settings. CONCLUSIONS: In this study, HIV self-testing appeared to be safe and increased recent and repeat HIV testing among FSWs. We found that direct provision of HIV self-tests was significantly more effective in increasing HIV testing among FSWs than passively offering HIV self-tests for collection in healthcare facilities. HIV self-testing could play an important role in supporting HIV interventions that require frequent HIV testing, such as HIV treatment as prevention, behavior change for transmission reduction, and pre-exposure prophylaxis. TRIAL REGISTRATION: ClinicalTrials.gov NCT02846402.
[Mh] Termos MeSH primário: Infecções por HIV/diagnóstico
Autoadministração/métodos
[Mh] Termos MeSH secundário: Adulto
Análise por Conglomerados
Feminino
Infecções por HIV/terapia
Seres Humanos
Programas de Rastreamento/métodos
Testes Sorológicos
Profissionais do Sexo
Estigma Social
Uganda/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pmed.1002458


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[PMID]:29061385
[Au] Autor:Hofford RS; Prendergast MA; Bardo MT
[Ad] Endereço:Department of Psychology, University of Kentucky, Lexington, KY, 40536, USA. Electronic address: rebecca.hofford@uky.edu.
[Ti] Título:Modified single prolonged stress reduces cocaine self-administration during acquisition regardless of rearing environment.
[So] Source:Behav Brain Res;338:143-152, 2018 Feb 15.
[Is] ISSN:1872-7549
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Until recently, there were few rodent models available to study the interaction of post-traumatic stress disorder (PTSD) and drug taking. Like PTSD, single prolonged stress (SPS) produces hypothalamic-pituitary-adrenal (HPA) axis dysfunction and alters psychostimulant self-administration. Other stressors, such as isolation stress, also alter psychostimulant self-administration. However, it is currently unknown if isolation housing combined with SPS can alter the acquisition or maintenance of cocaine self-administration. The current study applied modified SPS (modSPS; two hours restraint immediately followed by cold swim stress) to rats raised in an isolation condition (Iso), enrichment condition (Enr), or standard condition (Std) to measure changes in cocaine self-administration and HPA markers. Regardless of rearing condition, rats exposed to modSPS had greater corticosterone (CORT) release and reduced cocaine self-administration during initial acquisition compared to non-stressed controls. In addition, during initial acquisition, rats that received both Iso rearing and modSPS showed a more rapid increase in cocaine self-administration across sessions compared to Enr and Std rats exposed to modSPS. Following initial acquisition, a dose response analysis showed that Iso rats were overall most sensitive to changes in cocaine unit dose; however, modSPS had no effect on the cocaine dose response curve. Further, there was no effect of either modSPS or differential rearing on expression of glucocorticoid receptor (GR) in hypothalamus, medial prefrontal cortex, amygdala, or nucleus accumbens. By using modSPS in combination with Iso housing, this study identified unique contributions of each stressor to acquisition of cocaine self-administration.
[Mh] Termos MeSH primário: Cocaína/administração & dosagem
Corticosterona/sangue
Inibidores da Captação de Dopamina/administração & dosagem
Receptores de Glucocorticoides/metabolismo
Isolamento Social
Estresse Psicológico/sangue
[Mh] Termos MeSH secundário: Tonsila do Cerebelo/efeitos dos fármacos
Tonsila do Cerebelo/metabolismo
Animais
Abrigo para Animais
Masculino
Núcleo Accumbens/efeitos dos fármacos
Núcleo Accumbens/metabolismo
Córtex Pré-Frontal/efeitos dos fármacos
Córtex Pré-Frontal/metabolismo
Ratos
Ratos Sprague-Dawley
Restrição Física
Autoadministração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Dopamine Uptake Inhibitors); 0 (Receptors, Glucocorticoid); I5Y540LHVR (Cocaine); W980KJ009P (Corticosterone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE


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[PMID]:29293553
[Au] Autor:Persons AL; Bradaric BD; Dodiya HB; Ohene-Nyako M; Forsyth CB; Keshavarzian A; Shaikh M; Napier TC
[Ad] Endereço:Department of Psychiatry, Rush University Medical Center, Chicago, IL, United States of America.
[Ti] Título:Colon dysregulation in methamphetamine self-administering HIV-1 transgenic rats.
[So] Source:PLoS One;13(1):e0190078, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The integrity and function of the gut is impaired in HIV-infected individuals, and gut pathogenesis may play a role in several HIV-associated disorders. Methamphetamine is a popular illicit drug abused by HIV-infected individuals. However, the effect of methamphetamine on the gut and its potential to exacerbate HIV-associated gut pathology is not known. To shed light on this scenario, we evaluated colon barrier pathology in a rat model of the human comorbid condition. Intestinal barrier integrity and permeability were assessed in drug-naïve Fischer 344 HIV-1 transgenic (Tg) and non-Tg rats, and in Tg and non-Tg rats instrumented with jugular cannulae trained to self-administer methamphetamine or serving as saline-yoked controls. Intestinal permeability was determined by measuring the urine content of orally gavaged sugars. Intestinal barrier integrity was evaluated by immunoblotting or immunofluorescence of colon claudin-1 and zonula occludens-1 (ZO-1), two major tight junction proteins that regulate gut epithelial paracellular permeability. Both non-Tg and Tg rats self-administered moderate amounts of methamphetamine. These amounts were sufficient to increase colon permeability, reduce protein level of claudin-1, and reduce claudin-1 and ZO-1 immunofluorescence in Tg rats relative to non-Tg rats. Methamphetamine decreased tight junction immunofluorescence in non-Tg rats, with a similar, but non-significant trend observed in Tg rats. However, the effect of methamphetamine on tight junction proteins was subthreshold to gut leakiness. These findings reveal that both HIV-1 proteins and methamphetamine alter colon barrier integrity, and indicate that the gut may be a pathogenic site for these insults.
[Mh] Termos MeSH primário: Colo/fisiopatologia
Infecções por HIV/fisiopatologia
HIV-1/genética
Metanfetamina/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Genótipo
Infecções por HIV/complicações
Mucosa Intestinal/fisiopatologia
Masculino
Ratos
Ratos Endogâmicos F344
Ratos Transgênicos
Autoadministração
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
44RAL3456C (Methamphetamine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190078


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[PMID]:29235821
[Au] Autor:Higgins K; Chambers CT
[Ti] Título:Needle fear and insulin self-injection.
[So] Source:Can Nurse;113(2):38, 2017 Mar-Apr.
[Is] ISSN:0008-4581
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Medo
Hipoglicemiantes/administração & dosagem
Insulina/administração & dosagem
Agulhas
[Mh] Termos MeSH secundário: Diabetes Mellitus/tratamento farmacológico
Seres Humanos
Autoadministração
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hypoglycemic Agents); 0 (Insulin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:27771284
[Au] Autor:Moorman DE; James MH; Kilroy EA; Aston-Jones G
[Ad] Endereço:Department of Neurosciences, Medical University of South Carolina, Charleston, SC 29425, USA; Department of Psychological and Brain Sciences & Neuroscience and Behavior Graduate Program, University of Massachusetts Amherst, Amherst, MA 01003, USA. Electronic address: moorman@cns.umass.edu.
[Ti] Título:Orexin/hypocretin-1 receptor antagonism reduces ethanol self-administration and reinstatement selectively in highly-motivated rats.
[So] Source:Brain Res;1654(Pt A):34-42, 2017 Jan 01.
[Is] ISSN:1872-6240
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:The orexin/hypocretin (ORX) system regulates motivation for natural rewards and drugs of abuse such as alcohol. ORX receptor antagonists, most commonly OX1R antagonists including SB-334867 (SB), decrease alcohol drinking, self-administration and reinstatement in both genetically-bred alcohol-preferring and outbred strains of rats. Importantly, levels of alcohol seeking and drinking in outbred rats are variable, as they are in humans. We have shown that OX1R antagonism selectively decreases homecage alcohol drinking in high-, but not low-alcohol-preferring rats. It is unknown, however, whether this effect is selective to homecage drinking or whether it also applies to alcohol seeking paradigms such as self-administration and reinstatement following extinction, in which motivation is high in the absence of alcohol. Here we trained Sprague Dawley rats to self-administer 20% ethanol paired with a light-tone cue on an FR3 regimen. Rats were then extinguished and subjected to cue-induced reinstatement. Rats were segregated into high- and low-ethanol-responding groups (HR and LR) based on self-administration levels. During self-administration and cue-induced reinstatement, rats were given SB or vehicle prior to ethanol seeking. In both conditions, OX1R antagonism decreased responding selectively in HR, but not LR rats. There were no non-specific effects of SB treatment on arousal or general behavior. These data indicate that ORX signaling at the OX1R receptor specifically regulates high levels of motivation for alcohol, even in the absence of direct alcohol reinforcement. This implicates the ORX system in the pathological motivation underlying alcohol abuse and alcoholism and demonstrates that the OX1R may be an important target for treating alcohol abuse.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/tratamento farmacológico
Benzoxazóis/farmacologia
Depressores do Sistema Nervoso Central/administração & dosagem
Comportamento de Procura de Droga/efeitos dos fármacos
Etanol/administração & dosagem
Antagonistas dos Receptores de Orexina/farmacologia
Ureia/análogos & derivados
[Mh] Termos MeSH secundário: Consumo de Bebidas Alcoólicas/metabolismo
Transtornos Relacionados ao Uso de Álcool/tratamento farmacológico
Transtornos Relacionados ao Uso de Álcool/metabolismo
Animais
Animais não Endogâmicos
Condicionamento Operante/efeitos dos fármacos
Condicionamento Operante/fisiologia
Sinais (Psicologia)
Modelos Animais de Doenças
Comportamento de Procura de Droga/fisiologia
Masculino
Motivação/efeitos dos fármacos
Motivação/fisiologia
Receptores de Orexina/metabolismo
Ratos Sprague-Dawley
Autoadministração
Ureia/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (1-(2-methylbenzoxazol-6-yl)-3-(1,5)naphthyridin-4-yl urea); 0 (Benzoxazoles); 0 (Central Nervous System Depressants); 0 (Hcrtr1 protein, rat); 0 (Orexin Receptor Antagonists); 0 (Orexin Receptors); 3K9958V90M (Ethanol); 8W8T17847W (Urea)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180101
[Lr] Data última revisão:
180101
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


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[PMID]:28747620
[Au] Autor:Finsterer J; Aliyev R
[Ad] Endereço:Department of Neurology, Krankenanstalt Rudolfstiftung, Vienna, Austria.
[Ti] Título:Chronic Inflammatory Demyelinating Polyneuropathy Variant with Creatine-Kinase Elevation and Vanishing Effect of Immunoglobulins.
[So] Source:Am J Case Rep;18:834-838, 2017 Jul 27.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Whether creatine-kinase (CK) is elevated or not in chronic inflammatory demyelinating polyneuropathy (CIDP) and its variants is not comprehensively investigated. CASE REPORT We report the case of a 47-year-old male who developed weakness of the left lower leg and the right index finger at age 42 years. At age 44 years, paresthesias and dysesthesias of both lower legs and mild right lower leg weakness additionally developed. CK was recurrently elevated since age 42 years but paraprotein and anti-myelin-associated glycoprotein (MAG)-antibodies were negative. Nerve conduction studies at age 43 years showed an axonal and demyelinating lesion with conduction blocks. Cerebrospinal fluid (CSF) investigations revealed mild pleocytosis and elevated protein, which is why CIDP variant was diagnosed. Immunoglobulins were administered with success. Because of recurrent relapses, immunoglobulins were increased at age 45 years, resulting in stabilization. Currently, the patient is infusing immunoglobulins subcutaneously himself. CONCLUSIONS CIDP variants may go along with CK elevation, an axonal lesion, pleocytosis, and asymmetry of the lesion. A vanishing effect of immunoglobulins over time may be characteristic of CIDP variants.
[Mh] Termos MeSH primário: Creatina Quinase/sangue
Imunoglobulinas Intravenosas/uso terapêutico
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/tratamento farmacológico
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/sangue
Polirradiculoneuropatia Desmielinizante Inflamatória Crônica/diagnóstico
Recidiva
Autoadministração
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulins, Intravenous); EC 2.7.3.2 (Creatine Kinase)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171201
[Lr] Data última revisão:
171201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE



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