Annals of medicine
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Drug addiction is characterized by motivational disturbances such as compulsive drug taking and episodes of intense drug craving. Recent advances using animal models of relapse have shown that drug-seeking behaviour can be triggered by drug-associated cues, by stress and by 'priming' injections of the drugs themselves, events also known to trigger drug craving in human drug addicts. Current evidence suggests that these stimuli all induce relapse, at least in part, by their common ability to activate the mesolimbic dopamine system. ⋯ Chronic neuroadaptations in dopamine receptor signalling pathways in the nucleus accumbens caused by repeated drug use are hypothesized to produce tolerance to the rewarding effects of D1-receptor stimulation, leading to increased drug intake during drug self-administration. Conversely, these same neuroadaptations are hypothesized to enhance drug craving by potentiating D2 receptor-mediated signals during abstinence. These findings identify D1 and D2-dopamine receptor mechanisms as potential targets for developing anticraving compounds to treat drug addiction.
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Review Comparative Study
Cellular adaptations of the heart muscle to exercise training.
Exercise training is unique in that it represents a stress that elicits positive adaptations in the heart. Hallmark adaptations of the heart to training include resting and submaximal exercise bradycardia, increases in end-diastolic dimension, improved ventricular function, and an increase in the resistance of the heart to ischaemic insult. ⋯ Over the last 20-25 years, considerable effort has been directed towards identifying the cellular basis for the global adaptations of the normal and pathologically involved heart to endurance exercise training. It is the intent of this brief review to identify some of the known and hypothetical cellular adaptations that underlie the positive effects of endurance exercise training on the heart.
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The first series of children with obstructive sleep apnoea syndrome was reported in 1976. Later it became apparent that children may have breathing disorders during sleep without frank apnoea or 'hypopnoeas'. This pattern could be detected by measuring the oesophageal pressure. ⋯ Excessive daytime sleepiness and obesity are not always present. Untreated children may develop cardiovascular complications. The condition is treatable with continuous or bilevel positive airway pressure, and may be cured with surgery.