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  • 1
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Ltd
    Addiction 98 (2003), S. 0 
    ISSN: 1360-0443
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin , Psychologie
    Notizen: Aims  Medications play a limited role in the treatment of alcoholism. This paper examines physicians’ opinions about and use of two alcoholism medications currently approved in the US—disulfiram and naltrexone—and one alcoholism medication—acamprosate—that might be approved.Design  A total of 1388 substance abuse specialist physicians who were members of the American Academy of Addiction Psychiatry or the American Society of Addiction Medicine completed a questionnaire in 2001 (65% response rate).Findings  The average percentages of physicians’ patients with alcoholism who were prescribed the following medications were: 13% (naltrexone), 9% (disulfiram), 46% (antidepressants) and 11% (benzodiazepines). Almost all physicians had heard of naltrexone and disulfiram, but their self-reported level of knowledge about these medications was lower than for antidepressants. Physicians estimated that naltrexone had a small-to-medium effect size, which was similar in magnitude to the effect size reported in recent meta-analyses of randomized clinical trials. Physicians identified the following three courses of action as the most likely to result in greater use of medications to treat alcohol dependence: more research to develop new medications (33%), more education of physicians about existing medications (17%), and increased involvement of physicians in alcoholism treatment (17%).Conclusions  Physicians’ low rate of use of naltrexone may reflect its small-to-medium effect size.
    Materialart: Digitale Medien
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  • 2
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Addiction 91 (1996), S. 0 
    ISSN: 1360-0443
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin , Psychologie
    Notizen: Structured or semi-structured interviews, including the Structured Clinical Interview far DSM-III-R (SCID), are used widely to maximize the reliability and validity of psychiatric diagnoses. Although the reliability of such interviews appears adequate, there has been little effort to evaluate their validity. In a sample of 100 substance abuse patients, we evaluated the concurrent, discriminant and predictive validity of SCID substance use diagnoses, as well as co-morbid disorders that occur commonly among these patients. The validity of current and life-time substance use diagnoses obtained by a research technician using the SCID was good; it was moderate for antisocial personality disorder and major depression and poor for anxiety disorders. Although accurate diagnosis of substance use disorders in substance abuse patients can be accomplished by a research technician, the diagnosis of co-morbid psychiatric disorders requires either additional expertise or the use of a diagnostic instrument specially designed for that purpose.
    Materialart: Digitale Medien
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  • 3
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Science Ltd
    Addiction 98 (2003), S. 0 
    ISSN: 1360-0443
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin , Psychologie
    Notizen: Aim  This study examined the effect of nicotine deprivation on alcohol and smoking urges in a sample of alcohol-dependent smokers in early recovery.Design   Using a within-subjects design, participants underwent two cue-reactivity laboratory sessions in which they rated their urges for alcohol and cigarettes during the following three trials: baseline, neutral cue and mood induction combined with alcohol beverage cue exposure. One session was completed after 34 hours of nicotine deprivation and another in a non-deprived state.Participants   Forty alcohol-dependent heavy smokers recruited from a substance abuse day treatment program.Measurements   Self-reported urge to drink, urge to smoke and salivation.Findings   Results showed that during the non-deprived session, alcohol cue presentations were associated with significant increases in urges to drink and urges to smoke. Acute nicotine deprivation led to increased smoking urges, but was not associated with increased urges to drink alcohol.Conclusions   Findings suggest that the acute effects of smoking cessation are unlikely to increase risk of relapse to alcohol in alcoholic patients who are undergoing treatment.
    Materialart: Digitale Medien
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  • 4
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Addiction biology 2 (1997), S. 0 
    ISSN: 1369-1600
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: The adenylyl cyclase signal transduction system, a ubiquitous second messenger system, has been identified as a potential marker for genetic risk of alcohol and drug dependence. Using the polymerase chain reaction (PCR) to amplify exon 13 of the Gsα gene, two alleles were distinguished by denaturing gradient gel electrophoresis. One allele, designed A, contained the previously published C in the codon for asparagine 371, while the second allele, designated A, contains a C-T transition that conserves the asparagine residue at codon 371. The neutral polymorphism eliminates a Fok I restriction enzyme cleavage site, allowing use of restriction fragment length polymorphisms of PCR products to determine allelic frequency in 235 subjects with alcohol and/or drug dependence and in 85 control subjects. Since allele frequencies differ significantly by race, comparisons between affected individuals and controls were conducted separately for white and black groups. Within race, there were no significant differences in the frequency of the A allele among alcoholics, subjects dependent on cocaine or opioids, subjects dependent on these drugs and alcohol, and controls. We conclude that there is no association between alcohol and/or drug dependence and alleles of an exon 13 polymorphism of the Gsα gene in either black or white individuals.
    Materialart: Digitale Medien
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  • 5
    Digitale Medien
    Digitale Medien
    Oxford, UK : Carfax Publishing, Taylor & Francis Ltd
    Addiction 94 (1999), S. 0 
    ISSN: 1360-0443
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin , Psychologie
    Notizen: Aims. The aim of this article is to examine the validity of a cue-reactivity paradigm for evaluating medications to treat cocaine dependence and to critically review cocaine pharmacotherapy studies that use this method. Methods. A Medline computerized search was performed to identify randomized, controlled medication studies for cocaine dependence that employed a cue-reactivity paradigm. Relevant bibliographies of these articles were also reviewed. Eleven placebo-controlled studies were identified in the English language literature. Four of these studies used agents that block dopaminergic neurotransmission, two studies used agents that modify the serotonergic system, and two studies used nicotinergic agents. The other three studies employed a mood stabilizer, an opioid antagonist or a psychostimulant. Results. There has been little research examining the theoretical basis of the cue-reactivity model, as applied to the screening of medications to treat cocaine dependence. From a methodological viewpoint, most studies have shown that exposure to cocaine-related stimuli increases subjective and physiological reactivity in cocaine-dependent patients, but methods used to present the cues and to measure cue reactivity have not been consistent across studies. Similarly, the observed increase in subjective and physiological reactivity to cocaine cues has varied within and across studies. Conclusions. If a cocaine cue-reactivity paradigm is to be used to evaluate medications for treatment of cocaine dependence, the validity of the model must first be demonstrated and a consistent methodology for cue presentation and measurement of responses must be developed.
    Materialart: Digitale Medien
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  • 6
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Community dentistry and oral epidemiology 18 (1990), S. 0 
    ISSN: 1600-0528
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Abstract A relationship between alcoholism and dental pathology (particularly missing teeth), has been reported in studies of male, inpatient alcoholics. The present exploratory study was undertaken to assess how readily these findings can be generalized to an unselected sample of male and female dental patients. Data on drinking behavior, alcohol-related problems, and risk factors for alcoholism were obtained through an interview and questionnaire. A dental chart review provided measures of dental pathology. The results showed that measures of dental pathology (including tooth loss, carious teeth, and periodontal disease) correlated significantly with alcohol-related indicators. The associations were more evident for males than for females, which is consistent with some studies of alcohol-related medical consequences. The results suggest that further analytic studies of alcohol consumption and dental pathology are warranted. Because the relationship between tooth loss and harmful drinking was clearest among males with a history of conduct problems, subsequent research would benefit from a focus on this high-risk group.
    Materialart: Digitale Medien
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  • 7
    Digitale Medien
    Digitale Medien
    Oxford, UK : Blackwell Publishing Ltd
    Annals of the New York Academy of Sciences 708 (1994), S. 0 
    ISSN: 1749-6632
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Allgemeine Naturwissenschaft
    Materialart: Digitale Medien
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  • 8
    ISSN: 1547-0164
    Schlagwort(e): alcoholism ; alcohol dependence ; abstinence ; motivation ; readiness to change
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin , Psychologie
    Notizen: Abstract In order to evaluate the stages of change model as a predictor of abstinence among alcoholics, we examined abstinence rates at the end of treatment and at a 6-month posttreatment follow-up in 113 alcohol-dependent subjects participating in two 12-week, placebo-controlled pharmacotherapy trials. Hierarchical logistic regression was used to examine the predictive validity of stages of change variables. At the end of treatment and at follow-up, individuals with a higher predisposition toward action were more likely to be abstinent. Subjects who received an active medication (buspirone or fluoxetine) were more likely also to remain abstinent during the 6-month posttreatment follow-up. Scores on measures of precontemplation, contemplation, and maintenance failed to predict abstinence either at the end of treatment or at follow-up. Although none of the stages of change measures were associated with treatment completion, married or cohabiting individuals were more likely to complete treatment. Despite that scores on the precontemplation, contemplation, and maintenance subscales were not associated with abstinence, a measure of readiness for action contributed significantly to the prediction model.
    Materialart: Digitale Medien
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  • 9
    Digitale Medien
    Digitale Medien
    Springer
    Human genetics 〈Berlin〉 107 (2000), S. 86-88 
    ISSN: 1432-1203
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Biologie , Medizin
    Notizen: Abstract. The three opioid receptor genes, and in particular the µ and δ loci (OPRM1 and OPRD1, respectively), are compelling candidates to influence risk for substance dependence. Previous study of a variant at the OPRD1 locus, T921C, has shown association with opioid dependence. This variant does not alter protein sequence, and could not be directly responsible for a physiologic effect. We sequenced the OPRD1 coding region in six individuals with differing T921C alleles, to identify new common variants more likely to explain the association with phenotype. We identified one novel variant in exon 1, 80T→G, which predicts a change in amino acid sequence from phenylalanine (80T) to cysteine (80G) (F27C). We present here basic population genetics of this variant, and population genetic data for the T921C variant. We found significant differences in allele frequency between populations, and a maximum frequency of the 80G allele of 9%, in each of two European populations. This variant could contribute to the previously reported association results
    Materialart: Digitale Medien
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  • 10
    ISSN: 1432-2072
    Schlagwort(e): Key words Alcohol withdrawal ; Treatment ; Abecarnil ; Partial benzodiazepine agonists
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Treatment of the alcohol withdrawal syndrome is best accomplished using pharmacologic agents that have minimal interaction with alcohol, have limited adverse effects, and are without abuse potential. The partial benzodiazepine receptor agonist beta-carboline compound, abecarnil, has been shown in animal and human studies to possess a number of these characteristics and to be useful in the reduction of alcohol withdrawal convulsions in mice. In this study, 49 alcohol-dependent inpatients who exhibited at least moderate symptoms of uncomplicated alcohol withdrawal were treated over a 5-day detoxification period with abecarnil or diazepam and rated daily for alcohol withdrawal symptoms and adverse events. Both the abecarnil and diazepam treatment groups exhibited a similar marked reduction in withdrawal symptoms over time. In addition, similar rates of successful treatment and improvement were observed after 1 day of treatment and at termination in alcoholics treated with either medication. Overall, rates of adverse events and changes in liver enzymes were similar in both treatment groups and were generally benign. Because of the unique pharmacologic profile of abecarnil in animal and in non-clinical human studies, including anticonvulsant action, low abuse liability, and a favorable side effect profile, further study of compounds of the partial benzodiazepine receptor agonist type in the treatment of alcohol withdrawal syndromes seems warranted.
    Materialart: Digitale Medien
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