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Results from studies on brain activity in situations of hypoxia, application of anesthetics and other psychoactive drugs, epileptic seizures, electrical stimulation of brain areas, lucid dreams, and dream-like hallucinations of several geneses have shown that the reports of people who had perceptions and experiences related to these situations showed strong accordance with NDE reports. NDE themes can be reproduced experimentally, often in a predictable way. Such contexts and situations can be used as scientifically appropriate models for NDE release. Knowledge about and control of brain activation during the occurrence of NDE-like phenomena can be essential for understanding their generation.
A retrospective analysis of paediatric infective endocarditis characterised causative pathogens, antimicrobial susceptibility patterns, and treatment outcomes to guide clinical decision-making.
Methods:
The data of patients who received infective endocarditis between 2016 and 2023 were retrospectively collected from the medical records database. The clinical characteristics, treatment plans, and pharmaceutical monitoring characteristics were analysed and summarised.
Results:
A total of 12 paediatric infective endocarditis cases were identified. Bacterial isolates included 27 Gram-positive and 1 Gram-negative strains. The most common pathogen was Staphylococcus aureus (n = 13), all methicillin-resistant Staphylococcus aureus (MRSA), followed by Abiotrophia defectiva (n = 6), Streptococcus mitis (n = 5), Streptococcus sanguinis (n = 2), Bacillus cereus (n = 1), and Klebsiella oxytoca (n = 1). Antimicrobial therapy primarily involved linezolid, vancomycin, and cephalosporin/enzyme inhibitor combinations. Cardiac glycosides were used in 10 cases, and all patients received phosphocreatine to support myocardial energy metabolism. Therapeutic drug monitoring for vancomycin was performed in 25% of cases, while no therapeutic drug monitoring was conducted for meropenem or linezolid.
Conclusion:
All the causative organisms were predominantly Gram-positive cocci, with MRSA accounting for the largest proportion; different streptococci varied considerably in terms of drug resistance. The antimicrobial drugs used were predominantly linezolid and glycopeptides. The rate of blood concentration monitoring was low.
This study examines how to counter the legalization of proceeds from illicit drug trafficking in the context of Kazakhstan’s digitalizing economy. It analyses industry reports and applies Walker’s gravity formula and a related conceptual model. Such proceeds account for 2 to 5% of annual gross domestic profit globally, highlighting a serious economic issue. In Kazakhstan, this problem is intensified by the country’s location on major drug trafficking routes and insufficient alignment of its financial sector with international standards for monitoring financial transactions. The risks are worsened by the anonymity and speed of digital tools, which hinder the detection and blocking of suspicious activity. Criminals exploit digital technologies – such as debit cards, peer-to-peer platforms and privacy coins – to launder illicit funds. To combat this, the study recommends using big-data analytics to detect risks, machine learning to respond to them, international cooperation to establish transaction standards, and continuous monitoring to ensure compliance. Implementing these measures will require multi-sectoral reforms and coordinated efforts across public administration.
National narcotics agencies are a feature of law enforcement for drug crimes worldwide. They exist in most Southeast Asian nations that retain the death penalty for drug offences, including in Indonesia (Badan Narkotika Nasional); Singapore (Central Narcotics Board); Thailand (Narcotics Control Board); and Malaysia (Agensi Antidadah Kebangsaan). This chapter undertakes a comparative study of national narcotics agencies in Southeast Asia. Each of the aforementioned four agencies plays an outsize role in shaping both public opinion and government policy on the death penalty for drugs and on punitive responses to non-capital drug crimes more generally. Previous NGO reports and academic studies on Southeast Asian drug policy have failed to consider the institutional dimensions of drug control: this chapter aims to rectify this particular gap in the literature. Comparing relevant institutions across the region, this chapter accounts for organisational similarities and differences, explores the relationship between anti-drugs and other state institutions, and suggests modest policy recommendations.
The Singapore Government is well known for its stout defence of the use of capital punishment in the face of international criticism. It recently released studies to support claims of its effective deterrence against drug offending. However, domestic support for the death penalty, evidence for its effectiveness in controlling drug offences, and case law on capital drug offences are more nuanced than what appears at first sight. This chapter examines recent social, political, judicial, and regional developments, which may shape Singapore’s future death penalty policy and practice for drug offences.
Edited by
Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath,Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester,Alex Goodwin, Royal United Hospitals NHS Foundation Trust, Bath,Samuel Nava, Severn Deanery, Bristol
This chapter covers the complex topics of pharmacokinetic and pharmacodynamics, core topics for anaesthetic exams and for practising anaesthetists. This includes route of drug administration, bioavailability, metabolism and elimination. We discuss one, two and three-compartment modelling for total intravenous anaesthesia including target-controlled infusion models. Pharmacodynamics covers drug-receptor interactions and their mechanism of action. This extends to drug isomerism, agonism and antagonism, and pharmacogenetics.
Marseille is a city that has long been sensationalistically associated in the public imagination with crime and drug dealing. This article begins by tracing the history of drug dealing and gang violence in the city, from its 19th century origins to the rise of what has been called the “French Connection” in the 1960s and 1970s, when Marseille played a central role in the global heroin trade. The city’s criminality subsequently became more local in scope in the 1980s and 1990s, and the second part of the article draws on recent research carried out in the Marseille cité of Félix-Pyat, a poor neighbourhood widely associated with gang violence and drug dealing, to explore the consequences of the changing nature of crime in the city for process of “criminal governance”. When considered historically and in relation to our previous research on gangs in Nicaragua and South Africa, we suggest that it might be appropriate to talk about there being “varieties” of criminal governance that come together as “assemblages” than can be constituted in fundamentally different ways.
The global incidences of leishmaniasis are increasing due to changing environmental conditions and growing poverty. Leishmaniasis, caused by the Leishmania parasite, presents itself in six different clinical forms, the cutaneous and the visceral diseases being the most prevalent. While the cutaneous form causes disfigurement, the visceral form could be fatal if not treated. With no available vaccines combined with serious side effects of current medications and emerging drug resistance, it is crucial to discover new drugs whether as novel compounds or as repurposed existing pharmaceuticals. In the realm of drug development, mitochondria are recognized as important pharmacological targets due to their critical role in energy control, which, when disrupted, leads to irreversible cell damage. Certain plant-based compounds able to target the parasite mitochondrion, have been studied for their potential anti-leishmanial effects.
Search results
These compounds have shown promising effects in eliminating the Leishmania parasite. Artemisinin and chloroquine, two anti-malarial drugs that target mitochondria, exert strong anti-leishmanial effectiveness in both in vitro cultures and in vivo animal models. Quinolones, coumarins and quercetin are other compounds with leishmanicidal properties, which disrupt mitochondrial activity to effectively eliminate parasites in animal models of the disease and could be considered as potential drugs.
Conclusions
Therefore, plant-based compounds hold promise as potential candidates for anti-leishmanial drug development.
Drug use is common. It is estimated that one in ten people in the UK have tried an illegal psychoactive drug in the last year.
Young people use more drugs than any other age group, many by their mid-teens.
Cannabis is the most commonly used illegal psychoactive drug.
People use psychoactive drugs to change the way they feel.
Psychoactive drug use can result in new feelings that would otherwise be hard to experience, or take away unwanted feelings. To feel good, or stop feeling bad.
Sometimes psychoactive drugs are used for social gain, bringing a sense of belonging and identity.
As we will see in Chapter 11, some people experience mental health problems which increase their risk of using drugs
The UK has two drug laws, the Misuse of Drugs Act 1971 and the Psychoactive Substances Act 2016. These laws place all psychoactive drugs under control and rank some drugs according to their potential to cause harm.
The UK drug laws make it an offence to produce, supply, import or export and, in some cases, possess a psychoactive drug.
This chapter explores ecoviolence along the Sea of Cortez, and Mexican cartels’ decades-long monopoly of the illegal drug market. Through this illicit economy, we unpack the convergence of illegal waste dumping, the illegal wildlife trade, money laundering, and human smuggling, and the role that Mexican, Chinese, and Fujian criminal organizations play in regional, interregional, and transnational exchanges to further criminal activities. The Sea of Cortez is a fascinating case study due to its geographic location as a historical hub for smuggling multiple commodities such as totoaba bladders, shark fins, drugs, diamonds, and precious metals. But the smuggling of immigrants has now come under the purview of these criminal networks. The chapter concludes with proposing a new analytical framework for studying ecoviolence, building expert capacity for undertaking research and analysis of policy development and enforcement.
A 76-year-old man complained about progressive dull feelings and weakness of the distal lower limbs that gradually progressed over a couple of months to the proximal legs and the hands. In addition, there was minor myalgia in the proximal muscles. He had had a myocardial infarction with cardiac arrhythmia three years earlier. He was treated with amiodarone afterwards. He did not have visual complaints and was otherwise healthy. He did not drink alcohol or use other drugs. He had not been treated with cytostatic drugs.
Topical applications of drugs onto the corneal surface will act directly on the neuromuscular junction of the iris muscles. The responses are dramatic, except for a few drugs that are metabolized by enzymes in the anterior chamber. This method was essential toward our understanding of how drugs act to produce their pharmacological effects. The action of systemically administered drugs is complicated by side effects of sedation and arousal. Pupillary reflexes have been proposed as a method to evaluate drug intoxications.
Trained in addictions in Edinburgh, perhaps an easier specialty given personal experience. Then obtained a consultant post in the Scottish Borders, and a year later one in Edinburgh.
This chapter reviews current options for pharmacological interventions for treating dementia and MCI. For the last 20 years, ACHe inhibitors have been the main option for symptomatic treatment of dementia. The evidence base for their effectiveness is considered. More recent developments are reviewed for pharmacological interventions intended to be disease-modifying. These aim to remove beta amyloid protein, which is the hallmark of Alzheimer’s disease, with the aim of halting the disease’s progress. This is an emerging field, with an evidence base which is still developing, but represents an exciting development.
Heavy substance use (SU) and substance use disorders (SUD) have complex etiologies and often severe consequences. Certain personality traits have been associated with an increased risk for SU(D), but far less is known about personality changes related to SU(D). This review aims to synthesize the existing literature on this research question. A systematic literature search was conducted from November 2022 to February 2023 in PubMed, EbscoHost, and Web of Science. Peer-reviewed original papers on SU(D)-related personality changes were included. Of 55 included studies, 38 were observational population-based studies and 17 were intervention studies. Overall, personality and SU measures, samples, study designs, and statistical approaches were highly heterogenous. In observational studies, higher SU was most consistently related to increases in impulsivity-related traits and (less so) neuroticism, while interventions in the context of SU(D) were mostly associated with increases in conscientiousness and self-efficacy and lasting decreases in neuroticism. Findings for traits related to extraversion, openness, conscientiousness, and agreeableness were mixed and depended on SU measure and age. Studies on bidirectional associations suggest that personality and SU(D) both influence each other over time. Due to their strong association with SU(D), impulsivity-related traits may be important target points for interventions. Future work may investigate the mechanisms underlying personality changes related to SU(D), distinguishing substance-specific effects from general SU(D)-related processes like withdrawal, craving, and loss of control. Furthermore, more research is needed to examine whether SU(D)-related personality changes vary by developmental stage and clinical features (e.g. initial use, onset, remission, and relapse).
This chapter provides an overview of the antiviral drugs currently available, including maraviroc, aciclovir, penciclovir, ganciclovir, amantadine, zydovudine, adefovir, ribavirin, indinavir , oseltamivir, zanamivir, interferon alpha, rituximab , palivizumab, cidofovir, brincidofovir, foscarnet, remdesivir and paxlovid with an indication of their modes of action for treating virus infections, including HIV, herpes viruses, respiratory viruses, HBV, HCV, CMV, adenoviruses , BK, EBV (especially for PTLD), RSV, poxviruses and SARS-CoV-2.
Alcohol and drug misuse are no longer confined to younger people, as the baby boomer cohort of older people shows the fastest rise in rates of mortality from drugs and from alcohol. This chapter provides an overview of substance misuse in older people, starting with its terminological, epidemiological, and pharmacological aspects. It goes on to detail clinical aspects that include screening, diagnosis, and presentations such as alcohol withdrawal, self-harm, drug intoxication, overdose, drug withdrawal, and psychosis.
Particular attention is paid to age-related syndromes such as alcohol-related brain damage – amnestic syndrome and alcohol-related dementia. The chapter also considers the relevance of comorbid physical disorders that can affect a range of pathologies and dysfunctions, particularly in gastro-intestinal, respiratory, cardiovascular, and neurological systems.
The organisation of care is also discussed, in order to highlight the importance of multi-agency working to provide a range of interventions that include liaison old age psychiatry and hepatology. The chapter goes on to cover medico-legal aspects as well as substance misuse and driving. It concludes with a section on discharge planning, emphasising the role of multidisciplinary teams in harm reduction – as well that of carers, non-statutory organisations, medical, and mental health services.
Drug-impaired driving is a growing problem in the U.S. States regulate drug-impaired driving in different ways. Some do not name specific drugs or amounts. Others do identify specific drugs and may regulate cannabis separately. We provide up-to-date information about these state laws.
Deaths from suicides, drug poisonings, and alcohol-related diseases (‘deaths of despair’) are well-documented among working-age Americans, and have been hypothesized to be largely specific to the U.S. However, support for this assertion–and associated policies to reduce premature mortality–requires tests concerning these deaths in other industrialized countries, with different institutional contexts. We tested whether the concentration and accumulation of health and social disadvantage forecasts deaths of despair, in New Zealand and Denmark.
Methods
We used nationwide administrative data. Our observation period was 10 years (NZ = July 2006–June 2016, Denmark = January 2007–December 2016). We identified all NZ-born and Danish-born individuals aged 25–64 in the last observation year (NZ = 1 555 902, Denmark = 2 541 758). We ascertained measures of disadvantage (public-hospital stays for physical- and mental-health difficulties, social-welfare benefit-use, and criminal convictions) across the first nine years. We ascertained deaths from suicide, drugs, alcohol, and all other causes in the last year.
Results
Deaths of despair clustered within a population segment that disproportionately experienced multiple disadvantages. In both countries, individuals in the top 5% of the population in multiple health- and social-service sectors were at elevated risk for deaths from suicide, drugs, and alcohol, and deaths from other causes. Associations were evident across sex and age.
Conclusions
Deaths of despair are a marker of inequalities in countries beyond the U.S. with robust social-safety nets, nationwide healthcare, and strong pharmaceutical regulations. These deaths cluster within a highly disadvantaged population segment identifiable within health- and social-service systems.
This chapter discusses the pharmaceutical industry, with specific attention given to the role of intellectual property and R&D. The chapter also explains (broadly) the process by which a new drug is approved by the Food and Drug Administration. The key concept in the chapter is the tradeoff inherent in intellectual property protections: stronger protections spur more innovation but at the cost of higher prices for a longer period of time. On the other hand, weaker protections allow for more affordable products more quickly, but at the cost of reduced innovation. The end of chapter supplement explores the role of international trade agreements in solving research and development coordination problems.