Dm Disease-A-Month最新文献

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Foreword: Ecstasy, Molly, MDMA: What health practitioners need to know about this common recreational drug 前言：摇头丸，莫利，摇头丸：健康从业者需要知道的关于这种常见的娱乐性药物。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-03-01 DOI: 10.1016/j.disamonth.2024.101850

Nancy Friedman B.A (Treasurer/GPF Foundation), Ross Friedman (President/GPF Foundation)

引用次数: 0

Cannabis use and atherosclerotic cardiovascular disease outcomes: A meta-analysis of multinational cohort data 大麻使用和动脉粥样硬化性心血管疾病结局：多国队列数据的荟萃分析

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-03-01 DOI: 10.1016/j.disamonth.2024.101849

Sneha Annie Sebastian MD , Yash Shah MD , Camelia Arsene MD, PhD, MHS , Geetha Krishnamoorthy MD, FACP

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.

背景：虽然大麻使用与动脉粥样硬化性心血管疾病（ASCVD）风险之间的关联已被多次报道，但这种联系是否具有因果性仍不确定。我们试图整合来自观察性研究的数据，以探索曾经使用大麻与ASCVD结果之间的关系，包括心肌梗死、中风，以及与非使用者或对照组相比任何不良心血管事件的综合测量。方法：系统检索PubMed、Scopus、ScienceDirect和Cochrane图书馆从成立到2024年4月的相关文献。统计分析采用RevMan 5.4，采用随机效应模型。该研究方案已在PROSPERO注册（CRD42024530366）。结果：我们的分析纳入了17项研究的数据，共涉及1,902,481名年龄在18至74岁之间的个体，平均随访时间为8.5年。经汇总分析，与不吸食大麻的人相比，吸食大麻与心肌梗死风险之间无统计学意义的关联，相对危险度为1.25 （95% CI: 0.91-1.71, p = 0.17）。同样，虽然卒中风险与大麻使用无显著关联（RR: 1.38, 95% CI: 0.88至2.16,p = 0.16），但观察到曾经使用大麻与任何不良心血管事件的组合之间存在统计学上显著的关联（RR: 1.48, 95% CI: 1.16至1.90,p = 0.002）。结论：大麻使用与不良心血管结果之间的明显统计相关性强调了其作为心血管疾病危险因素的潜力，表明大麻使用与ASCVD之间存在因果关系。随着各年龄人口中医用大麻使用和大麻使用障碍的上升趋势，提高对大麻消费的风险认识和知情决策是保健和公共卫生举措的关键优先事项。

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引用次数: 0

Opioid use and abuse in adolescents and young adults; dealing with science, laws and ethics: Charming the COBRAS 青少年和青年中阿片类药物的使用和滥用；处理科学，法律和道德：吸引眼镜蛇。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-03-01 DOI: 10.1016/j.disamonth.2025.101853

Donald E. Greydanus MD, DrHC(Athens) , Ahsan Nazeer MD , Dilip R. Patel MBBS, MBA, MPH

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.

对于临床医生、研究人员和整个社会来说，儿科人群的药物使用障碍仍然是一个令人不安的难题。在当前全球毒瘾危机的影响下，快速发育和脆弱的中枢神经系统发生碰撞，导致许多青少年面临被毒瘾损害甚至致死的风险。这场化学灾难的一个重要主题是青少年和年轻成年人的阿片类药物使用障碍，19 世纪对吗啡、海洛因和非阿片类药物可卡因等高成瘾性药物的鉴定刺激了这一现象。本文分析的重点是海洛因和芬太尼等阿片类药物的普遍存在，它已成为 21 世纪全球社会普遍存在的药物使用和滥用现象所引发的一大悲剧。本文涉及的主题包括人类使用成瘾药物的历史、使用中的诊断术语、神经生物学在药物成瘾中的作用，以及当前针对阿片类药物过量和成瘾的精神药理学方法。由于中枢神经系统的神经可塑性以及这些有害化学物质的广泛供应，我们的青少年一直面临着高风险行为的危险，包括阿片类药物使用障碍造成的死亡和伤害。在 21 世纪，医护人员应积极帮助那些在不知情甚至是无辜的情况下遇到这种致命威胁的青少年。

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C2: Editorial Board C2：编委会

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-02-01 DOI: 10.1016/S0011-5029(25)00014-8

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Information for Readers 读者资讯

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-02-01 DOI: 10.1016/S0011-5029(25)00016-1

引用次数: 0

Foreword for Erdheim-Chester disease: Comprehensive insights from genetic mutations to clinical manifestations and therapeutic advances 厄德海姆-切斯特病前言：从基因突变到临床表现和治疗进展的综合见解。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-02-01 DOI: 10.1016/j.disamonth.2024.101846

Jerrold B. Leikin MD (Senior Editor)

引用次数: 0

Erdheim–Chester disease: Comprehensive insights from genetic mutations to clinical manifestations and therapeutic advances 厄德海姆-切斯特病：从基因突变到临床表现和治疗进展的综合见解。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-02-01 DOI: 10.1016/j.disamonth.2024.101845

Rishabh Chaudhary MS , Anand Kumar PhD , Alpana Singh BS , Vipul Agarwal PhD , Mujeeba Rehman MS , Arjun Singh Kaushik MS , Siddhi Srivastava MS , Sukriti Srivastava MS , Vikas Mishra PhD

Erdheim–Chester disease (ECD) is an extremely rare non-Langerhans cell disorder that is believed to include both inflammatory and neoplastic characteristics. It is caused due to genetic mutations in proto-oncogenes like BRAF and MEK, while immunological pathways have an essential role in the onset and progression of the disease. Despite its rarity, ECD poses significant diagnostic and therapeutic challenges due to its heterogeneous clinical presentation and limited understanding of its underlying pathophysiology. Multiple organs can be affected, with the most frequent being long bones, central nervous system and retro-orbital abnormalities, pericardial and myocardial infiltration, interstitial lung disease, retroperitoneal fibrosis, and large blood vessel aberrations. Here, in this review, we comprehensively underline the current knowledge of ECD, including its epidemiology, clinical manifestations, genetics, pathophysiology, diagnostic modalities, and treatment options. By synthesizing existing literature and highlighting areas of ongoing research, this review aims to provide clinicians and researchers with a comprehensive understanding of ECD and guide future directions for improved patient care and outcomes.

埃尔德海姆-切斯特病（ECD）是一种极其罕见的非朗格汉斯细胞疾病，被认为包括炎症和肿瘤特征。它是由BRAF和MEK等原癌基因的基因突变引起的，而免疫途径在疾病的发生和发展中起重要作用。尽管罕见，但由于其异质性临床表现和对其潜在病理生理的了解有限，ECD构成了重大的诊断和治疗挑战。多脏器可受影响，最常见的是长骨、中枢神经系统和眶后异常、心包和心肌浸润、间质性肺疾病、腹膜后纤维化和大血管畸变。在这里，在这篇综述中，我们全面强调了ECD的现有知识，包括其流行病学，临床表现，遗传学，病理生理学，诊断方式和治疗方案。通过综合现有文献和突出正在进行的研究领域，本综述旨在为临床医生和研究人员提供对ECD的全面了解，并指导未来改善患者护理和结果的方向。

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Title Page 标题页

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-02-01 DOI: 10.1016/S0011-5029(25)00015-X

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Foreword for trafficking in the child and adolescent: Application of SAFETY and CARE for a global crisis of exploitation 前言贩卖儿童和青少年：安全和关怀在全球剥削危机中的应用。

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-01-01 DOI: 10.1016/j.disamonth.2024.101826

Jerrold B. Leikin MD FACOEM, FACP, FACEP, FACMT, FAACT, FASAM (Senior Editor Disease-A-Month)

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Title Page 标题页

IF 3.8 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month

Pub Date : 2025-01-01 DOI: 10.1016/S0011-5029(25)00005-7

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