Dm Disease-A-Month最新文献

The subject of substance use disorders in the pediatric population remains a disturbing conundrum for clinicians, researchers and society in general. Many of our youth are at risk of being damaged and even killed by drug addictions that result from the collision of rapidly developing as well as vulnerable central nervous systems encountering the current global drug addiction crisis. A major motif of this chemical calamity is opioid use disorder in adolescents and young adults that was stimulated by the 19th century identification of such highly addictive drugs as morphine, heroin and a non-opiate, cocaine. This analysis focuses on the pervasive presence of opioid drugs such as heroin and fentanyl that has become a major tragedy in the 21st century arising from an overall substance use and misuse phenomenon rampant in global society. Themes covered in this article include the history of addictive drugs in humans, diagnostic terms in use, the role of neurobiology in drug addiction, and current psychopharmacologic approaches to opioid overdose as well as addiction. Our youth are continuously confronted by dangers of high-risk behaviors including death and injury from opioid use disorders due to their central nervous system neuroplasticity as well as the widespread availability of these harmful chemicals. Healthcare professionals should actively assist our youth who unknowingly and even innocently encounter this deadly menace in the 21st century.

Background: While an association between cannabis use and the risk of atherosclerotic cardiovascular diseases (ASCVD) has been reported numerous times, it remains inconclusive as to whether this link is causal in nature. We sought to consolidate data from observational studies to explore the association between ever use of cannabis and ASCVD outcomes, including myocardial infarction, stroke, and a combined measure of any adverse cardiovascular events in comparison to non-users or controls.

Methods: We performed a systematic literature search on PubMed, Scopus, ScienceDirect, and Cochrane Library for relevant studies from inception until April 2024. Statistical analyses utilized RevMan 5.4 with a random effects model. The study protocol has been registered with PROSPERO (CRD42024530366).

Results: Our analysis incorporated data from 17 studies involving a total of 1,902,481 individuals aged between 18 and 74 years, with a mean follow-up duration of 8.5 years. Upon pooled analysis, no statistically significant association was found between cannabis use and the risk of myocardial infarction compared to non-users, with an RR of 1.25 (95% CI: 0.91-1.71, p = 0.17). Similarly, while the risk of stroke showed no significant association with cannabis use (RR: 1.38, 95% CI: 0.88 to 2.16, p = 0.16), a statistically significant association was observed between ever use of cannabis and the composite of any adverse cardiovascular events (RR: 1.48, 95% CI: 1.16-1.90, p = 0.002).

Conclusion: The evident statistical correlations between cannabis use and adverse cardiovascular outcomes underscore its potential as a risk factor for cardiovascular disease, suggesting plausibility for a causal relationship between cannabis use and ASCVD. With rising trends in medical cannabis use and cannabis use disorder across age demographics, heightened risk awareness and informed decision-making regarding cannabis consumption are critical priorities in healthcare and public health initiatives.

Diabetic kidney disease is a leading cause of kidney failure worldwide and is easily detectable with screening examination. Diabetes causes hyperfiltration and activation of the renin-angiotensin aldosterone system by hemodynamic changes within the nephron, which perpetuates damaging physiology. Diagnosis is often clinical after detection of heavy proteinuria in a patient with diabetes,but can be confirmed by observation of histologic stages on kidney biopsy. Mainstays of treatment include angiotensin conversion or receptor blockade, mineralocorticoid receptor blockade, and tight glucose control. Newer agents favored in diabetic kidney disease are sodium glucose-cotransporters and glucagon-like peptide 1 receptor agonists, both for glycemic control and for various methods of reversing damaging physiology.