Authors:Karen M. von Deneen, Hadi Hussain, Junaid Waheed, Wen Xinwen, Dahua Yu, and Kai Yuan
Recently, there has been significantly increased participation in online gaming and other addictive behaviors particularly in adolescents. Tendencies to avoid social interaction and become more involved in technology-based activities pose the danger of creating unhealthy addictions. Thus, the presence of relatively immature cognitive control and high risk-taking properties makes adolescence a period of major changes leading to an increased rate of emotional disorders and addiction.
The critical roles of frontostriatal circuits in addiction have become the primary focus associated with reward in the striatum and cognitive control in the PFC. Internet gaming disorder (IGD) and nicotine addiction are currently becoming more and more serious.
In the light of neuroimaging, the similarity between brain mechanisms causing substance use disorder (SUD) and IGD have been described in previous literature.
In particular, two distinct brain systems affect the way we act accounting for uncharacteristic neural function in addiction: the affective system comprises of the striatum driven by emotional, reward-related, and internal stimuli, and a cognitive system consisting of the prefrontal cortex (PFC) supporting the ventral affective system's actions via inhibitory control.
Discussion and Conclusion
Therefore, as a novel concept, we focused on the implication of frontostriatal circuits in nicotine addiction and IGD by reviewing the main findings from our studies compared to those of others. We hope that all of these neuroimaging findings can lead to effective intervention and treatment for addiction especially during this critical period.
Authors:Liwei Zou, Xiaoyan Wu, Shuman Tao, Yajuan Yang, Qingjun Zhang, Xuedong Hong, Yang Xie, Tingting Li, Suisheng Zheng, and Fangbiao Tao
Background and aim
Problematic mobile phone use (PMPU) is prevalent and increases the risk for a variety of health problems. However, few studies have explored the neural mechanisms that might render adolescents more or less vulnerable. Here, we aimed to identify whether PMPU is associated with depressive symptoms and whether this relationship is moderated by intrinsic functional connectivity (iFC) which is associated with PMPU.
In this longitudinal study, we included 238 students (mean age = 19.05, SD = 0.81) that came from a university in Hefei, China. They all finished MRI scans at baseline and completed questionnaires both at baseline and 1 year later. A self-rating questionnaire for adolescent problematic mobile phone use and depression anxiety stress scale-21 were used to assess PMPU and depressive symptoms. We first assessed the relationship between PMPU and depressive symptoms using an autoregressive cross-lagged model. Then, we detected the brain regions that were associated with PMPU. Moreover, the neuroimaging results were extracted to explore whether the iFC of these brain regions moderated the relationship between PMPU and depression.
Consistent with our hypotheses, PMPU was positively associated with depressive symptoms, and the relationship between PMPU and depressive symptoms was moderated by iFC of the left parahippocampal gyrus-right middle temporal gyrus both at baseline and after 1 year (β = 0.554, P = 0.003; β = 0.463, P = 0.016, respectively).
These results advance the understanding of PMPU and suggest that iFC of the left parahippocampal gyrus-right middle temporal gyrus may be a neurobiological contributor to its relationship with depressive symptoms.
Authors:Robert Edgren, Pia Pörtfors, Susanna Raisamo, and Sari Castrén
Background and aims
Research recognizes the extent of harm experienced by concerned significant others (CSOs) of gamblers. This systematic review’s aims are to examine the interventions for CSOs, evaluate potential benefits, and thematically describe treatment processes. The Stress-Strain-Coping-Support model (SSCS) served as the theoretical framework.
Database searches were conducted in: MEDLINE, CINAHL Complete, Web of Science Core Collection, Social Services Abstracts, Applied Social Science Index and Abstracts, Cochrane Central Register of Controlled Trials, and APA PsycInfo (between 01/Jan 2011–10/Jun 2021). Other search methods were also utilized. Inclusion criteria: interventions for CSOs with CSO specific outcomes. The Evidence Project Risk of Bias Tool was used for assessment.
19/768 records were included. Nine interventions were utilized: 3 CSO directed, 4 for couples, and 2 low threshold online interventions. A quantitative synthesis (N = 7 studies) of effect size estimates for depression and anxiety measures didn’t indicate any intervention to have better outcomes than others. Core themes in the treatment process identified in the qualitative synthesis (N = 7) included: information and understanding, social support, coping skills, communication, and strain. Limitations in the evidence related to sampling, control-conditions and outcome measurements.
Discussion and conclusion
Several interventions were identified, yet no specific interventions appeared more beneficial than others. Using the SSCS model, commonalities and differences in intervention content were identified, along with themes that influence treatment processes. The need for tailored interventions is discussed. Future treatment efficacy research should carefully select study designs and outcome measurements. PROSPERO (CRD42021229408).
Authors:Ariel Kor, Amir Djalovski, Marc N. Potenza, Orna Zagoory-Sharon, and Ruth Feldman
Addictive behaviors share clinical, genetic, neurobiological and phenomenological parallels with substance addictions. Despite the prevalence of compulsive sexual behaviors, particularly problematic pornography use (PPU), how neuroendocrine systems relate to PPU is not well understood. Preclinical studies demonstrate alterations in oxytocin and arginine vasopressin (AVP) function in animal models of addiction, but no human study has tested their involvement in PPU.
Participants included 122 males; 69 reported PPU, and 53 were demographically-matched participants without PPU. Plasma oxytocin and AVP levels and oxytocin-to-AVP balance were measured at baseline. Salivary oxytocin was assessed at baseline and in response to four videos depicting neutral/positive social encounters. Participants reported on empathy and psychiatric symptoms.
Baseline plasma AVP levels were elevated in men with PPU, and the ratio of oxytocin-to-vasopressin suggested AVP dominance. Men with PPU reacted with greater oxytocin increases to presentation of neutral/positive social stimuli. Decreased empathic tendencies were found in men with PPU, and this reduced empathy mediated links between oxytocin and pornography-related hypersexuality. Structural equation modeling revealed three independent paths to pornography-related hypersexuality; two direct paths via increased AVP and higher psychiatric symptoms and one indirect path from oxytocin to pornography-related hypersexuality mediated by diminished empathy.
Findings are among the first to implicate neuropeptides sustaining mammalian attachment in the pathophysiology of pornography-related hypersexuality and describe a neurobiological mechanism by which oxytocin-AVP systems and psychiatric symptomatology may operate to reduce empathy and lead to pornography-related hypersexuality.
Authors:Amal Ben Hassena, Sonda Guermazi-Toumi, Maroua Gdoura-Ben Amor, Mabrouka Saidani, Sonia Tlili, Lamia Khannous, Radhouane Gdoura, and Mariam Siala-Trigui
Urinary tract infections (UTIs) are the most frequent human infections in community and hospitals. This study aimed to determine the distribution of bacterial uropathogens among urinary tract infections diagnosed within the regional hospital Houcine Bouzaiene (Gafsa, South West Tunisia) during a survey of 54 days from the 8th of November to the 31st of December 2017. Enterobacterales strains were tested for antimicrobial resistance by disk diffusion method and extended-spectrum β-lactamase (ESBL) production was tested by double-disc synergy test. Strains were further subjected to a molecular assessment of ESBL and AmpC β-lactamase production by PCR.
Overall, 173 bacterial isolates were studied, out of which 91.3% were Enterobacterales. Escherichia coli was the dominant pathogen, followed by Klebsiella pneumoniae. High to moderate resistance rates were observed, ranging from 66% to 90.7% for penicillins, from 6.7% to 18.6% for cephalosporins and from 16.2% to 25.4% for fluoroquinolones. Enterobacterales with decreased susceptibility to third-generation cephalosporins (3rd GC) carried several resistance genes: blaCTX-M group 1 and group 9, and ACC and FOX AmpC β-lactamase genes. Overall, ESBLs and AmpC β-lactamases were detected in 57% and 14% of the 3rd GC-resistant isolates, respectively.
This study proved the high potential of K. pneumaniae species to develop resistance against commonly used antibiotics. Thus, rigorous monitoring of the antibiotic resistance of clinical pathogens have to be implemented in Tunisia. Our results are very relevant to evaluate efficiency of the Tunisian therapeutic strategies against UTIs and adapt them to the emerging problem of antimicrobial resistance.
Authors:Endre Kolossváry, Ildikó Szabó, Edit Dósa, Csaba Csobay-Novák, Katalin Farkas, and Zoltán Járai
Összefoglaló. A népesség öregedése, a meghatározó cardiovascularis
rizikótényezők – mint a cukorbetegség – egyre nagyobb arányú előfordulása, a
csökkenő akut cardiovascularis halálozás az alsó végtagi verőérszűkület növekvő
megjelenésével jár. Ezzel együtt szaporodnak a beavatkozást igénylő, jelentős
életminőség-romlást, illetve végtag-veszélyeztetettséget okozó, súlyosabb
esetek. Ilyenkor az alsó végtagi revascularisatio szüksége merül fel, ami az
utóbbi évtizedben az endovascularis beavatkozások számának növekedéséhez
vezetett. A beavatkozások technikai sikere mellett újabb szűkületek, elzáródások
veszélyével kell számolni. Ennek hátterében az atherosclerosis progressziója
mellett a beavatkozáshoz köthető, kontrollált érfalsérülés indukálta vascularis
remodelling (neointima-hyperplasia), valamint thromboticus tényezők állnak. Az
ér-nyitvamaradás hosszú távú biztosításának feltétele a fenti folyamatok
megelőzésére alkalmazott optimális gyógyszeres kezelés. Ennek biztosítása
elengedhetetlen a beavatkozást megelőzően, periprocedurálisan, majd az érintett
betegkör hosszú távú gondozása során. A gyógyszeres terápiás lehetőségek közül
az antithromboticus, antikoaguláns terápiának kiemelt jelentősége van. Az ezen
hatású gyógyszerek alkalmazását igen nehézzé teszi (i) a thromboticus elzáródás
kiújulása és a potenciális vérzés közötti dinamikusan változó egyensúly
bizonytalansága, (ii) az egyéb társbetegségek kapcsán felmerülő terápiás
szempontok egyidejű érvényesítése, valamint (iii) a napi ellátásban támpontot
adó tudományos bizonyítékok relatív hiánya. Az összefoglaló tanulmány a fenti
gyógyszerterápiás terület legújabb eredményeit kísérli meg elemezni. Orv Hetil.
2022; 163(3): 98–108.
Summary. The aging of the population, the increasing prevalence of
important risk factors of atherosclerosis, like diabetes, and the declining
mortality of acute cardiovascular conditions lead to increased peripheral
arterial disease incidence. At the same time, cases showing a severe decline in
quality of life or danger of limb loss get more prevalent that demands vascular
interventions. In such cases, revascularization is recommended, and
consequently, in the last decade, an expansion in endovascular procedures can be
seen. Considering these procedures, besides a technical success, the risk of new
stenosis or occlusion may be imminent. This may be accounted for the progression
of atherosclerosis and the controlled vascular injury caused by the procedure
itself that induces vascular remodeling (neointima hyperplasia) and thrombotic
hyperactivity. The long-term vascular patency is closely associated with the
success of an optimal medical treatment strategy. Its effect is considered
essential prior to the endovascular procedure, perioperatively, and in the phase
of long-term follow-up of the affected patients. In this scenario,
antithrombotic and anticoagulant therapy regimes bear particular relevance. The
use of this kind of drugs is challenged by (i) the uncertainty of dynamic
changes of balance between the thrombotic reocclusion and the risk of bleeding,
(ii) the interplay of treatment strategy related to concomitant diseases, (iii)
the relative lack of high-level scientific pieces of evidence guiding daily
routine. The narrative review makes an effort to provide new findings and an
analysis of this therapeutic field. Orv Hetil. 2022; 163(3): 98–108.