The cerebellum in drug craving

Craving has been considered one of the core features of addiction. It can be defined as the urge or conscious desire to use a drug elicited by the drug itself, drug-associated cues or stressors. Craving plays a major role in relapse, even after prolonged periods of abstinence, as well as in the maintenance of drug seeking in non-abstinent addicts. The circuitry of craving includes medial parts of the prefrontal cortex, ventral striatal zones, ventral tegmental area, ventral pallidum, and limbic regions. Interestingly, the cerebellum shows reciprocal loops with many of these areas. The cerebellum has been linked traditionally to motor functions but increasing evidence indicates that this part of the brain is also involved in functions related to cognition, prediction, learning, and memory. Moreover, the functional neuroimaging studies that have addressed the study of craving in humans repeatedly demonstrate cerebellar activation when craving is elicited by the presentation of drug-related cues. However, the role of cerebellar activity in these craving episodes remains unknown. Therefore, the main goal of this review is to provide a brief update on craving studies and the traditional neural basis of this phenomenon, and then discuss and propose a hypothesis for the function of the cerebellum in craving episodes.This work was supported by grant UJI (14I307.01/1

Locomotor activating effects and addiction-like features of MDPV as assessed in preclinical studies: a review.

Introducción: La 3,4-Methylenedioxypyrovalerone (mdpv) es un componente de las denominadas sales de baño, aparecidas en el mercado a final de la década del 2000 debido a la falta de precursores de síntesis de mdma, y su uso va en aumento. El ob- jetivo de este trabajo es clarificar sus características farmacológicas y potencialidades adictivas. Método: Mediante búsquedas en PubMed, 21 estudios relacionados con la química, farmacología o potencial adictivo del mdpv fueron seleccionados. Resulta- dos: El mdpv muestra ser capaz de inducir una potente hiperlocomoción, preferencias condicionadas, sensibilización conductual, autoadministración y altos puntos de corte en pruebas de razón progresiva. Conclusión: Los estudios revisados apuntan a que el mdpv es un potente psicoestimulante con un potencial adictivo similar al de la cocaí- na o la metanfetamina. Su abuso continuado podría llevar a una epidemia de adictos al mdpv.Introduction: 3,4-Methylenedioxypyrovalerone (mdpv) is a major component of the new psychoactive substances termed “bath salts”. These substances appeared on the drug market at the end of the last century given the lack of mdma precursors, caused by its worldwide prosecution by governments and police agencies, and its growing use. The goal of this work was to clarify its pharmacological features and addiction-like potentiali- ties. Methods: By PubMed searches, 21 studies related to mdpv chemistry, pharmaco logy or addictive features were selected. Results: mdpv is seen to be able to induce potent hyperlocomotion, conditioned place preference, behavioural sensitisation, self- administration and high breakpoints in progressive ratio schedules. Conclusion: The reviewed studies indicate that mdpv is a powerful psychostimulant with a similar addictive potential to that of cocaine or methamphetamine. Its abuse can lead to an epidemic of mdpv addicts

Castell de Castelldefels. Arqueologia, història, art

La recerca en el castell era adreçada a esbrinar els trets generals de l'evolució, però sense exhaurir el jaciment, atesa la inversió econòmica considerable que aquest procediment hagués suposat. En conseqüència, es va realitzar una excavació selectiva en punts ben significatius, la qual s'ha anat ampliant amb altres sondeigs fets paral·lelament a les obres iniciades el 2001, com veurem més endavant en un capítol a part,2 i que actualment continuen en curs. Els punts significatius excavats són els següents: l'indret on se suposava que havia de ser l'entrada principal, entre l'angle nord-est i els lavabos actuals (fig. 68, sondeig VII), els voltants de la porta del pati 1 (fig. 53, 54, 61, 62, sondeig I i fig. 55, sondeig VII) i els àmbits CA2, CA4, CA5 i CA6 (fig. 46, 47, 48, 49, 50, 56, 57, sondeigs IV, Vbis, V i VI, respectivament), tot això dins el cos A. Al cos B només es va dur a terme una rasa estratigràfica a la meitat septentrional de l'espai CB4 (fig. 51, 58, 59, 60, sondeig VIII), la qual va donar dades il·lustratives. A l'església i els edificis adjacents, en canvi, atès que les obres havien de començar ben aviat i que n'afectarien el subsòl, les cobertes i els paraments de manera substancial, hom va dur a terme una excavació extensiva a gairebé tot l'interior, llevat de la capella de la Salut, on només es va treballar a la meitat de llevant. Al mateix temps, es va realitzar una intervenció àmplia a la coberta d'aquest edifici, com també al subsòl i a la volta intermèdia de la sagristia. L'àrea de la rectoria també va ser excavada a fons, tot i que es van deixar alguns testimonis a R3. Totes aquestes recerques es Paral·lelament al treball de camp, es va enllestir l'aplegament de documentació sobre el castell i el temple. De tal manera que posseïm un recull interessant de notícies, sobretot des del segle XIV, mancat, però, d'algunes precisions, a causa de la dispersió notable dels textos i a la dificultat, de vegades insuperable, per accedir als fons particulars.3 També s'han dut a terme estudis d'història de l'art sobre determinats aspectes del conjunt, com ara la decoració de la sala principal del castell, l'ambientació de la resta de les estances o les restauracions portades a terme per Ramon Soriano (1897) i Enric Sagnier (1910)

ICO-ICS Praxis para el tratamiento médico y con irradiación del mieloma múltiple

Tractament mèdic; Tractament amb irradiació; Mieloma múltipleMedical treatment; Irradiation treatment; Multiple myelomaTratamiento médico; Tratamiento con irradiación; Mieloma múltipleEl mieloma múltiple (MM) és una neoplàsia de cèl·lules plasmàtiques que representa al voltant de l’1% del total de neoplàsies i el 10% de les neoplàsies hematològiques. Té una incidència aproximada de 4-5 nous casos/100.000 habitants/any i presenta una incidència màxima entre els 70 i 75 anys d’edat. Un 35% dels afectats té menys de 65 anys. Els objectius d'aquesta guia són: desenvolupar i difondre la ICO-ICSPraxi per al tractament del mieloma múltiple; disminuir la variabilitat terapèutica entre els pacients tractats en els diferents centres d’aquesta institució; implementar i avaluar els resultats de la terapèutica en els pacients amb mieloma múltiple tractats d’acord amb les recomanacions d’aquesta guia

Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study.

BACKGROUND: Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. OBJECTIVE: The objective of the study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (<39.0 weeks) deliveries. STUDY DESIGN: This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0-38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. RESULTS: A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101 of 730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, positive and negative predictive values of 74.3% (75 of 101), 88.6% (557 of 629), 51.0% (75 of 147), and 95.5% (557 of 583), respectively. Accuracy was 86.5% (632 of 730) and positive and negative likelihood ratios were 6.5 and 0.3, respectively. CONCLUSION: The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a noninvasive technique

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The cerebellum in craving

Treball Final de Grau en Psicologia. Codi: PS1048. Curs: 2013/2014Craving has been considered one of the core features of addiction. It can be defined as the urge or desire to use a drug that can be elicited by the drug itself, drug-associated cues or stressors, and many authors hypothesize that it accomplishes a major role in relapse even after prolonged abstinence periods and also in the maintenance of drug seeking and taking behaviors in non-abstinent addicts. The cerebellum is a subcortical structure that has traditionally been linked to motor functions, but an increasing number of evidences show that this part of the brain is also involved in function related to cognition, such as learning and memory. Moreover, this structure shows a number of reciprocal connections with the areas in the encephalon that have been traditionally related to addiction, like the striatal-cortico-limbic system. In addition, the functional neuroimaging studies that study craving in humans systematically show cerebellar activations when this part of the brain is analyzed. Therefore, the goal of this study is to provide a quick conceptualization of craving, its assessment and the traditional neural basis of this phenomenon, and then the cerebellar activations related to craving and its underlying processes will be discussed together with the possible functions of these activations

Cerebellar perineuronal nets in cocaine-induced pavlovian memory: Site matters

One of the key mechanisms for the stabilization of synaptic changes near the end of critical periods for experience-dependent plasticity is the formation of specific lattice extracellular matrix structures called perineuronal nets (PNNs). The formation of drug memories depends on local circuits in the cerebellum, but it is unclear to what extent it may also relate to changes in their PNN. Here, we investigated changes in the PNNs of the cerebellum following cocaine-induced preference conditioning. The formation of cocaine-related preference memories increased expression of PNN-related proteins surrounding Golgi inhibitory interneurons as well as that of cFos in granule cells at the apex of the cerebellar cortex. In contrast, the expression of PNNs surrounding projection neurons in the medial deep cerebellar nucleus (DCN) was reduced in all cocaine-treated groups, independently of whether animals expressed a preference for cocaine-related cues. Discriminant function analysis confirmed that stronger PNNs in Golgi neurons and higher cFos levels in granule cells of the apex might be considered as the cerebellar hallmarks of cocaine-induced preference conditioning. Blocking the output of cerebellar granule cells in a6Cre-Cacna1a mutant mice prevented re-acquisition, but not acquisition, of cocaine-induced preference conditioning. Interestingly, this impairment in consolidation was selectively accompanied by a reduction in the expression of PNN proteins around Golgi cells. Our data suggest that PNNs surrounding Golgi interneurons play a role in consolidating drug-related memories

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