Ketamine in Substance Use Disorder Treatment: A Narrative Review.

Substance use disorder (SUD) continues to pose a significant global health challenge, necessitating innovative and effective therapeutic interventions. Ketamine, traditionally recognized for its anesthetic properties, has emerged as a novel and promising avenue for the treatment of SUD. This narrative review critically examines the current body of literature surrounding the use of ketamine in various forms and settings for individuals grappling with substance abuse. The review explores the neurobiological underpinnings of ketamine's potential therapeutic effects in SUD, shedding light on its impact on glutamatergic neurotransmission, neuroplasticity, and reward pathways. Special attention is given to the psychotropic and dissociative properties of ketamine, exploring their implications for both therapeutic outcomes and patient experience. Ultimately, this review aims to provide a comprehensive overview of the current state of knowledge regarding ketamine's role in the treatment of SUD, emphasizing the need for further research and clinical exploration. As we navigate the complex terrain of addiction medicine, understanding the nuances of ketamine's potential in SUD holds promise for the development of more effective and personalized therapeutic strategies.

Efficiency of lung ventilation for people performing wind instruments.

BACKGROUND: Wind instruments musicians are particularly prone to excessive respiratory efforts. Prolonged wind instruments performing may lead to changes in respiratory tracts and thus to respiratory muscles overload. It may result in decreasing lung tissue pliability and, as a consequence, in emphysema. Aim of the research has been to describe basic spirometric parameters for wind players and causes of potential changes. MATERIAL AND METHODS: Slow and forced spirometry with the use of Micro Lab Viasys (Micro Medical, Great Britain) was conducted on 31 wind musicians (group A). A survey concerning playing time and frequency, weight of instruments, and education on diaphragmatic breathing was conducted. The control group included 34 healthy persons at similar age (group B). The results were statistically described using Excel and Statistica programmes. RESULTS: The respiratory parameters were within the range of physiological norms and forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) exceeded in both groups the values of 100%. Forced vital capacity and expiratory vital capacity (EVC) values were significantly lower in the group of musicians than in the control group (p < 0.001). In 45% the group A used diaphragmatic breathing, in 31% of examinees mixed respiratory tract was observed. The significant discrepancy of individual parameters was obtained regarding age and the length of time when performing wind instrument. CONCLUSIONS: Spirometric parameters relative to standards may prove a good respiratory capacity. Peak expiratory flow (PEF) and FEV1 may indicate that a proper technique of respiration during performance was acquired. The length of time when performing wind instrument may influence parameters of dynamic spirometry. Med Pr 2016;67(4):427-433.

Professional experience and ergonomic aspects of midwives' work.

OBJECTIVES: The most frequent manner of attending childbirth imposes on midwives assuming poor body position affecting the musculoskeletal system. Long professional experience does not mitigate the negative effects. The adopted movement habit, as well as the type, number and frequency of actions influence the body posture. The aim of the study was to identify ergonomic threats of basic occupational midwives activities and how particular spinal segments arrangements while attending childbirth using the same technique in senior midwives differ from those of junior ones. It was also checked whether pain influences the working position assumed by midwives. MATERIALS AND METHODS: Examinations were conducted in 95 midwives aged 21-50 (X = 29.25 ± 9.34): 51 graduates of BSc midwifery who worked 680 h in delivery rooms during obligatory practical classes and apprenticeship and 44 senior midwives with professional experience of 7-27 years (X = 14.84 ± 5.98). The study was threefold. The spinal alignment while performing work activities associated with attending childbirth was assessed using the OWAS system and the SonoSens Monitor, the center of gravity projection on basal plane--using the AccuGait AMTI stabilometric platform. The measurements were taken during a simulation of attending childbirth (on examination model). A survey was conducted aimed at identifying spinal pain. RESULTS: Midwives' working postures require unnatural body alignments. Postural instability in the working position and no maximal usage of basal plane were observed. The work overload may afflict the musculoskeletal system, which was confirmed by different pain discomforts in 67.3% of the examinees. CONCLUSIONS: Spinal alignment while attending childbirth is individually differentiated and in every case non-ergonomic. Identifying explicitly spinal overloads is difficult, but the most prevalent ones affect lumbar and cervical regions altogether. Spinal pain is frequently noted, both in junior and senior midwives, and is characteristic for midwives working in maximal movement ranges.

Telereceptive and proprioceptive control of balance vs. body stability in elderly people.

BACKGROUND: Maintaining functional fitness is an important problem in elderly people. Effective balance control is one of its main aspects. Evaluation and diagnosis of the weakest link in balance control (especially in this age group) facilitates appropriate prevention and rehabilitation. The goal of this study was to determine the role of the optic teleceptor and proprioception in maintaining body stability of elderly people. MATERIAL AND METHODS: Balance control effectiveness and body stability was examined in 43 elderly people aged 65 and over by exposure to changing stimuli affecting tele- and proprioception. The participants were given false suggestions as to the vertical and horizontal planes of reference, and the position of the base was changed in different directions. Stabilographic parameters were acquired using an AccuGait platform. The results were compared with a control group of 53 healthy people under 30 years old. All study data were subjected to a statistical analysis. RESULTS: Proprioceptive impulsation coming from the base was the key factor in body balance control. The results show a higher risk of falls in elderly people, especially during backwards inclination. CONCLUSIONS: Changing spatial points of reference and position of the base activate body balance regulation mechanisms. The efficiency of these mechanisms in maintaining body stability is lower among elderly people, which indicates a need to implement appropriate prophylactic programmes in this age group.