Cannabis is the most used illicit substance in the world. As many countries are moving towards decriminalization, it is crucial to determine whether and how cannabis use affects human brain and ...behavior. The role of the cerebellum in cognition, emotion, learning, and addiction is increasingly recognized. Because of its high density in CB1 receptors, it is expected to be highly affected by cannabis use. The aim of this systematic review is to investigate how cannabis use affects cerebellar structure and function, as well as cerebellar‐dependent behavioral tasks. Three databases were searched for peer‐reviewed literature published until March 2018. We included studies that focused on cannabis effects on cerebellar structure, function, or cerebellar‐dependent behavioral tasks. A total of 348 unique records were screened, and 40 studies were included in the qualitative synthesis. The most consistent findings include (1) increases in cerebellar gray matter volume after chronic cannabis use, (2) alteration of cerebellar resting state activity after acute or chronic use, and (3) deficits in memory, decision making, and associative learning. Age of onset and higher exposure to cannabis use were frequently associated with increased cannabis‐induced alterations. Chronic cannabis use is associated with alterations in cerebellar structure and function, as well as with deficits in behavioral paradigms that involve the cerebellum (eg, eyeblink conditioning, memory, and decision making). Future studies should consider tobacco as confounding factor and use standardized methods for assessing cannabis use. Paradigms exploring the functional activity of the cerebellum may prove useful as monitoring tools of cannabis‐induced impairment.
Cannabis use affects cerebellar structure and function, as differences between users and controls have been found in the cerebellar volume, activity patterns, and cerebellar‐dependent behavioral tasks. Monitoring cerebellar‐dependent functions might prove useful for the development of clinical tools that could be used as cerebellar‐alteration biomarkers. These tools would let clinicians explore cannabis‐induced brain alterations, treatment monitoring, and rehabilitation of cannabis‐dependent individuals.
The limited availability of red cells with extremely rare blood group phenotypes is one of the global challenges in transfusion medicine that has prompted the search for alternative self‐renewable ...pluripotent cell sources for the in vitro generation of red cells with rare blood group types. One such phenotype is the Rhnull, which lacks all the Rh antigens on the red cell membrane and represents one of the rarest blood types in the world with only a few active blood donors available worldwide. Rhnull red cells are critical for the transfusion of immunized patients carrying the same phenotype, besides its utility in the diagnosis of Rh alloimmunization when a high‐prevalence Rh specificity is suspected in a patient or a pregnant woman. In both scenarios, the potential use of human‐induced pluripotent stem cell (hiPSC)‐derived Rhnull red cells is also dependent on ABO compatibility. Here, we present a CRISPR/Cas9‐mediated ABO gene edition strategy for the conversion of blood type A to universal type O, which we have applied to an Rhnull donor‐derived hiPSC line, originally carrying blood group A. This work provides a paradigmatic example of an approach potentially applicable to other hiPSC lines derived from rare blood donors not carrying blood type O.
CRISPR/Cas9 mediated ABO gene edition allows the conversion of blood type A to universal type O in Rhnull donor‐derived hiPSCs
A targeted knock‐in strategy allows to reproduce the c.261delG polymorphism present in the most common inactive ABO*O.01 allele
This work provides a new approach potentially applicable to cell lines established from rare blood donors not carrying blood type O
New conceptual and technological solutions have been proposed to solve addictive disorders and will be presented in the future. In this Special Issue, we present some of the new assessment tools and ...treatment options for internet addiction, alcohol, cannabis, cocaine, and gambling disorders.
Background-The cerebellum has been recently suggested as an important player in the addiction brain circuit. Cannabis is one of the most used drugs worldwide, and its long-term effects on the central ...nervous system are not fully understood. No valid clinical evaluations of cannabis impact on the brain are available today. The cerebellum is expected to be one of the brain structures that are highly affected by prolonged exposure to cannabis, due to its high density in endocannabinoid receptors. We aim to use a motor adaptation paradigm to indirectly assess cerebellar function in chronic cannabis users (CCUs). Methods-We used a visuomotor rotation (VMR) task that probes a putatively-cerebellar implicit motor adaptation process together with the learning and execution of an explicit aiming rule. We conducted a case-control study, recruiting 18 CCUs and 18 age-matched healthy controls. Our main measure was the angular aiming error. Results-Our results show that CCUs have impaired implicit motor adaptation, as they showed a smaller rate of adaptation compared with healthy controls (drift rate: 19.3 +/- 6.8° vs. 27.4 +/- 11.6°; t(26) = -2.1,
= 0.048, Cohen's
= -0.8, 95% CI = (-1.7, -0.15)). Conclusions-We suggest that a visuomotor rotation task might be the first step towards developing a useful tool for the detection of alterations in implicit learning among cannabis users.
Resumen Objetivo Describir el grado de reconocimiento del trastorno por uso de alcohol (TUA) y dependencia de alcohol por los médicos de atención primaria (MAP) y determinar su prevalencia. Diseño ...Estudio transversal. Emplazamiento Veinte centros de atención primaria de Cataluña. Participantes y mediciones Se encuestó a 23 MAP seleccionados al azar acerca del consumo de alcohol y otras enfermedades de sus pacientes. Se entrevistó y evaluó a 1.372 pacientes con la Composite International Diagnostic Interview (CIDI) para determinar el diagnóstico de TUA en el último año, y otros cuestionarios (el K10, de cribado, y el World Health Organization Disability Assessment Schedule 2.0) para evaluar la discapacidad y la salud mental. Resultados La CIDI diagnosticó TUA en un 9,6% del total de la muestra. Los MAP detectaron un 4,8% de TUA. La CIDI detectó mayor proporción de casos entre las edades más jóvenes, y el MAP detectó mayor porcentaje de TUA y dependencia de alcohol en personas de mayor edad y con enfermedades concomitantes. Los MAP identificaron el 28,8% de los casos diagnosticados de TUA por la CIDI. El 42,4% de los pacientes diagnosticados por el MAP no fueron identificados por la CIDI. Al utilizar como criterio diagnóstico indistintamente la CIDI o la impresión clínica del MAP, la prevalencia de TUA en atención primaria se situó en el 11,7%, y la de dependencia de alcohol, en el 8,6%. Conclusiones Los MAP reconocen poco el TUA en gente joven, mientras que detectan más la enfermedad en pacientes de mayor edad y con comorbilidades asociadas. La prevalencia de TUA es elevada en atención primaria.
Skin biopsies were obtained from two male patients with X-linked Alport syndrome (XLAS) with hemizygous COL4A5 mutations in exon 41 or exon 46. Dermal fibroblasts were extracted and reprogrammed by ...nucleofection with episomal plasmids carrying OCT3/4, SOX2, KLF4 LIN28, L-MYC and p53 shRNA. The generated induced Pluripotent Stem Cell (iPSC) lines AS-FiPS2-Ep6F-28 and AS-FiPS3-Ep6F-9 were free of genomically integrated reprogramming genes, had the specific mutations, a stable karyotype, expressed pluripotency markers and generated embryoid bodies which were differentiated towards the three germ layers in vitro. These iPSC lines offer a useful resource to study Alport syndrome pathomechanisms and drug testing.
A skin biopsy was obtained from a 25-year-old female patient with autosomal recessive Alport syndrome (ARAS) with the homozygous COL4A3 mutation c.345delG, p.(P166Lfs*37). Dermal fibroblasts were ...derived and reprogrammed by nucleofection with episomal plasmids carrying OCT3/4, SOX2, KLF4 LIN28, L-MYC and p53shRNA. The generated induced Pluripotent Stem Cell (iPSC) clone AS FiPS1 Ep6F-2 was free of genomically integrated reprogramming genes, had the specific homozygous mutation, a stable karyotype, expressed pluripotency markers and generated embryoid bodies which were differentiated towards the three germ layers in vitro. This iPSC line offers a useful resource to study Alport syndrome pathomechanisms and drug testing.
Dual diagnosis is the co-occurrence of a substance abuse disorder and a psychiatric condition. Gender has been found to be associated with differences in prevalence of mental disorders as well as ...outcome, prognosis and treatment-seeking.
Articles published in Medline, Web of Science and Journal Citation Reports up to December 2009 that examined gender, prevalence and clinical characteristics of dual-diagnosis patients aged over 18 were reviewed.
The distribution of Axis I disorders by gender is similar for dually diagnosed patients and single-disorder patients. The prevalence of psychotic and bipolar disorders is higher in men, whereas anxiety and affective disorders are more prevalent in women. Dually diagnosed females with psychotic disorders do not show better prognosis than men. Finally, polydrug use among dual-diagnosis individuals is more prevalent in males.
Background: Chemsex is a term applicable to
the use of drugs related to sex among men who have
sex with men (MSM). Because it is a recent trend,
there is little information about its management and
...consequences. The aim of the study was to describe
the clinical profile of a sample of chemsex users who
consulted for treatment.
Methods: This is a longitudinal and retrospective
study of 53 patients who consulted for chemsex in
an addiction unit of a general hospital in Barcelona,
from January 2017 to June 2019. Data was collected
from electronic medical records and a descriptive
analysis was performed by calculating proportions
and means.
Results: The most common drug used in
chemsex was methamphetamine (81.1%; n=43)
and 67.4% (n=29) of these used at least other two
drugs. The prevalence of HIV infection was high
(71.2%; n=37) and 72.1% (n=41) had psychiatric
comorbidity, being the most common psychosis
(37.2%; n=16).
Conclusions: Methamphetamine was the most
common drug chemsex user’s seeked for treatment.
Furthermore, there is a high prevalence of HIV
diagnosis in this population. Both conditions can
enhance the risk of suffering from psychosis and
may explain why psychiatric comorbidity is so high
in the sample.
Fundamentos: El fenómeno chemsex es una
práctica de consumo de sustancias asociada a las relaciones
sexuales en hombres que tienen sexo con
hombres. Debido a la novedad que supone, disponemos
de poca información en cuanto a su abordaje y
pronóstico desde el punto de vista de la salud mental.
El objetivo de este estudio fue describir el perfil de
una muestra de usuarios de chemsex que solicitaron
tratamiento para abandonar el consumo.
Métodos: Se realizó un estudio longitudinal retrospectivo
de una muestra de 53 sujetos que consultaron
en la unidad de adicciones de un hospital
de Barcelona en el período entre enero de 2017 y
junio de 2019 por consumo de drogas en contexto
de chemsex. Los datos se recogieron a través de una
revisión de historias clínicas y se realizó un análisis
estadístico de tipo descriptivo mediante el cálculo de
proporciones y medias.
Resultados: La metanfetamina fue la droga
principal por la que más frecuentemente se solicitaba
tratamiento (81,1%; n=43). De éstos, el 67,4%
(n=29) consumía además, como mínimo, otras dos
sustancias. El 71,2% (n=37) presentaba infección
por VIH. El 72,1% (n=41) de los sujetos presentó
comorbilidad psiquiátrica, siendo lo más frecuente la
sintomatología psicótica (37,2%; n=16).
Conclusiones: Un porcentaje elevado de usuarios
de chemsex presentan diagnóstico de VIH y la
droga principal más utilizada y por la que más consultaron
fue la metanfetamina. Ambas condiciones
podrían estar relacionadas con la elevada prevalencia
de sintomatología psicótica.
Addiction in its various forms represents an enormous challenge to society. Worldwide, it has been estimated that alcohol, tobacco and illicit drugs were responsible of more than 10 million deaths ...(Anderson et al, 2018), with a higher impact in developed countries where substance use disorders have been identified as responsible for life expectancy reversals (Rehm et al, 2016). Societal and medical responses to the problem are far from optimal, but the appearance of new technologies offers room for improvement, and lots of new initiatives have been launched and developed. In this Special Issue, we will describe and discuss how these new tools are helping to improve the assessment and treatment of substance use disorders. We will cover a wide variety of novelties that are being applied to addiction; e-health, APPs, digital phenotyping, ecological momentary assessment and interventions, wearable technology, computer-assisted tests, transcraneal magnetic stimulation, and virtual reality are just some examples of developments in a field that promises to create a real revolution in the assessment and treatment of addictions.
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