The designer stimulant 4-methylmethcathinone (mephedrone) is among the most popular of the derivatives of the naturally occurring psychostimulant cathinone. Mephedrone has been readily available for legal purchase both online and in some stores and has been promoted by aggressive Web-based marketing. Its abuse in many countries, including the United States, is a serious public health concern. Owing largely to its recent emergence, there are no formal pharmacodynamic or pharmacokinetic studies of mephedrone. Accordingly, the purpose of this study was to evaluate effects of this agent in a rat model. Results revealed that, similar to methylenedioxymethamphetamine, methamphetamine, and methcathinone, repeated mephedrone injections (4ϫ 10 or 25 mg/kg s.c. per injection, 2-h intervals, administered in a pattern used frequently to mimic psychostimulant "binge" treatment) cause a rapid decrease in striatal dopamine (DA) and hippocampal serotonin (5-hydroxytryptamine; 5HT) transporter function. Mephedrone also inhibited both synaptosomal DA and 5HT uptake. Like methylenedioxymethamphetamine, but unlike methamphetamine or methcathinone, repeated mephedrone administrations also caused persistent serotonergic, but not dopaminergic, deficits. However, mephedrone caused DA release from a striatal suspension approaching that of methamphetamine and was self-administered by rodents. A method was developed to assess mephedrone concentrations in rat brain and plasma, and mephedrone levels were determined 1 h after a binge treatment. These data demonstrate that mephedrone has a unique pharmacological profile with both abuse liability and neurotoxic potential.
Editor's Note: With the Spring 2023 issue, we introduce a new recurring quarterly column in the Ochsner Journal. The column will focus on health care delivery and its impact on society. A particular emphasis will be placed on the role the environment, health equity, and social determinants play in health care delivery. A specific focus will be placed on the challenges of providing care to underserved populations and how health care systems are evolving to meet those needs. -R.A.An unprecedented joint editorial published simultaneously in 2021 in The Lancet, New England Journal of Medicine, and The BMJ stated that climate change will cause catastrophic harm to health that will be impossible to remediate unless action is taken. 1 The editorial reported that the science is unequivocal: a 1.5 °C expected rise in temperature above the preindustrial average will cause catastrophic harm to health. 1 A new era of climate change medicine is emerging. New diseases are being identified, existing ones are being exacerbated, and traditional health care delivery is being challenged. Climate, which has always been associated with health, is now one of the primary forces disrupting health care delivery.Climate change is impacting health in a myriad of ways, including the health impacts of increasingly frequent extreme weather events, such as heat waves, hurricanes, and floods. These events have led to the disruption of the food supply chain, increases in zoonoses, changing patterns of vectorborne diseases, and rising mental health issues. Without intervention, the crisis threatens to undo much of the progress made in global health and poverty reduction.Mesoamerican nephropathy, commonly called chronic kidney disease of unknown cause (CKDu), is a sentinel disease that has emerged and is directly related to exposure to increasing temperatures among field workers in Central America. 2,3 Hot spots for CKDu are in areas most impacted by rising temperatures. In Central America, CKD-driven in part by CKDu-has now become a significant cause of hospitalization and death. CKD is now the second leading cause of death in both Nicaragua and El Salvador. 4 The emergence of CKDu also demonstrates that marginalized populations, such as field workers, are the ones most impacted by climate change. 3,4 Infectious diseases are also evolving as a result of climate change. The 2022 Intergovernmental Panel on Climate Change reports that the prevalence of vector-borne diseases has increased in recent decades. 5 Warmer summers and milder temperatures have allowed pathogens to
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