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Morais WBES, do Nascimento FF, da Penha JC, Andrade JX, Mascarenhas MDM, Rodrigues MTP. Trend in mortality from mental and behavioral disorders due to alcohol use in Brazil, 2010-2021. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2024; 33:e20231483. [PMID: 39016404 PMCID: PMC11251453 DOI: 10.1590/s2237-96222024v33e20231483.en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 04/30/2024] [Indexed: 07/18/2024] Open
Abstract
OBJECTIVE To analyze the trend in mortality from mental and behavioral disorders due to alcohol use in Brazil, 2010-2021. METHODS This was an time series study using Mortality Information System data. Annual percentage change (APC) and 95% confidence intervals (95% CI) were calculated using Prais-Winsten linear regression. RESULTS Mortality showed a stationary trend for Brazil as a whole (APC = 0.6; 95%CI -4.2;3.0), a falling trend in individuals aged 20-29 years in the South (APC = -7.4; 95%CI -10.0;-4.3) and Northeast (APC = -3.4; 95%CI -6.4;-0.4) regions, in people aged 30-39 in the Midwest region (APC = -3,8; 95%CI -7.4;-0.1) and 40-49 in the South (APC = -2.1; 95%CI -3.8;-0.4), North (APC = -3.1; 95%CI -5.7;-0.5) and Midwest (APC = -2.9; 95%CI -5.5;-0.3) regions. CONCLUSION Mortality from mental and behavioral disorders due to alcohol use showed a stationary trend nationally and a falling trend in some age groups regionally.
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Affiliation(s)
| | | | - Jardeliny Corrêa da Penha
- Universidade Federal do Piauí, Programa de Pós-Graduação em Saúde e Comunidade, Teresina, PI, Brazil
| | - Jesusmar Ximenes Andrade
- Universidade Federal do Piauí, Programa de Pós-Graduação em Saúde e Comunidade, Teresina, PI, Brazil
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de Melo Bastos Cavalcante C, Bruno Oliveira K, Maria Araújo de Souza F, Maria Jatobá Hasten Reiter M, Rodrigues Melo da Silva B, Lavínia da Silva Oliveira K, Vinicius Dos Santos Sales M, Larissa Dias Pacheco A, Santos Siqueira E, de Araújo Costa M, Gomes Dos Santos Neto J, Gabriely Duarte Torres R, Catarina R Leite A, Santana de Melo I, Salgueiro Machado S, Duzzioni M, Leite Góes Gitaí D, Wagner de Castro O. Crack cocaine inhalation increases seizure susceptibility by reducing acetylcholinesterase activity. Epilepsy Behav 2024; 156:109832. [PMID: 38761450 DOI: 10.1016/j.yebeh.2024.109832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
Crack cocaine is a highly addictive and potent stimulant drug. Animal studies have shown that the cholinergic system plays a role in neurotoxicity induced by cocaine or its active metabolites inhalation. Behavioral alterations associated with crack cocaine use include hyperactivity, depressed mood, and decreased seizure threshold. Here we evaluate the acetylcholinesterase (AChE) and reactive oxygen species (ROS) activity, behavioral profile, and the threshold for epileptic seizures in rats that received intrahippocampal pilocarpine (H-PILO) followed by exposure to crack cocaine (H-PILO + CRACK). Animals exposed to H-PILO + CRACK demonstrated increased severity and frequency of limbic seizures. The AChE activity was reduced in the groups exposed to crack cocaine alone (CRACK) and H-PILO + CRACK, whereas levels of ROS remained unchanged. In addition, crack cocaine exposure increased vertical locomotor activity, without changing water and sucrose intake. Short-term memory consolidation remained unchanged after H-PILO, H-PILO + CRACK, and CRACK administration. Overall, our data suggest that crack cocaine inhalation reduced the threshold for epileptic seizures in rats submitted to low doses of pilocarpine through the inhibition of AChE. Taken together, our findings can be useful in the development of effective strategies for preventing and treating the harmful effects of cocaine and crack cocaine on the central nervous system.
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Affiliation(s)
| | - Kellysson Bruno Oliveira
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Fernanda Maria Araújo de Souza
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | | | - Bianca Rodrigues Melo da Silva
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | | | | | - Amanda Larissa Dias Pacheco
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Edite Santos Siqueira
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Maisa de Araújo Costa
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - José Gomes Dos Santos Neto
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Rayssa Gabriely Duarte Torres
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Ana Catarina R Leite
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Igor Santana de Melo
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Sônia Salgueiro Machado
- Institute of Chemistry and Biotechnology, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Marcelo Duzzioni
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Daniel Leite Góes Gitaí
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Olagide Wagner de Castro
- Department of Physiology, Institute of Biological Science and Health of Federal University of Alagoas, Maceió, Alagoas, Brazil.
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Veras Eloy Santos J, Fonseca da Silva NA, Marcolela Andreoli Sartes L, Bohrer Schuch J, Paim Kessler FH, Barbosa Terra M. Psychiatric and obstetric characteristics of pregnant crack users admitted to a referral center in Southern Brazil. J Addict Dis 2023:1-10. [PMID: 38047869 DOI: 10.1080/10550887.2023.2279473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
BACKGROUND Psychoactive substance use among pregnant women has reached alarmingly high rates. Our aim was to characterize the psychiatric and clinical profiles of pregnant crack users in Brazil. METHODS This was a cross-sectional study of 24 pregnant crack users admitted to a referral hospital for psychiatric disorders in pregnant women, in Porto Alegre, Brazil, over three years. The following instruments were applied: a clinical-obstetric questionnaire; the condensed version of the Addiction Severity Index; a diagnostic interview for psychoactive substance use based on DSM-5; the Mini International Neuropsychiatric Interview for DSM-IV; and the Semi-Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). RESULTS Most patients had severe crack dependence and used other substances, such as tobacco, cannabis, and alcohol. The median duration of crack use was three years, ranging between three and 12 years. Most women subsisted from illegal or informal activities; a fifth had previously been arrested and often had relationship problems. Twenty percent had HIV (n = 5), and 37.5% (n = 9) had syphilis. Borderline personality disorder was the most prevalent mental condition (62.5%), followed by suicidal tendencies (45.8%), hypomanic episodes due to substance use (37.5%), and past major depressive episodes (33.3%). CONCLUSIONS An alarmingly high prevalence of consumption of other drugs, psychiatric disorders, and difficult-to-treat personality disorders was observed in our study. Investigating the psychiatric profile of women who use substances is essential to minimize the impacts on the mother and child, optimize therapeutic approaches to comorbidities, and enable more effective relapse prevention.
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Affiliation(s)
- Jéssica Veras Eloy Santos
- Department of Internal Medicine, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | | | | | - Jaqueline Bohrer Schuch
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felix Henrique Paim Kessler
- Graduate Program in Psychiatry and Behavioral Sciences, Department of Psychiatry and Legal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mauro Barbosa Terra
- Department of Internal Medicine, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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Santos RRD, Hacker MDAVB, Mota JCD, Bastos FI. Housing characteristics of crack cocaine users in Northeast Brazil, 2011-2013. CIENCIA & SAUDE COLETIVA 2022; 27:2407-2416. [PMID: 35649027 DOI: 10.1590/1413-81232022276.16522021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 12/03/2021] [Indexed: 11/22/2022] Open
Abstract
We compared sociodemographic characteristics, substance use patterns, sexual behavior, use of health services, and criminal records of homeless vs. domiciled users. Data are from the Brazilian National Survey on Crack Use. A discriminant model and correspondence analysis cross-compared characteristics of users according to their housing status. The logistic model revealed associations between "living in the streets" and female gender and intermittent work. "Homelessness" was also associated with the use of tobacco and "oxi" in the previous 30 days, reliance on soup kitchens, low access to public mental health services, and arrests in the previous year. Correspondence analysis highlighted the spatial proximity of the variables as follows: "having traded sex for drugs", "informal work", "age 31 years or older", "access to public mental health services", "problems with law enforcement", and female gender with homeless crack users. People who smoke crack cocaine in Northeast Brazil are seldom studied. Their profiles, stratified according to their housing conditions, show subgroups with specific characteristics. While domiciled users have access to specialized clinics, homeless users basically reported access to free food and harm reduction services.
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Affiliation(s)
- Raquel Rodrigues Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Oswaldo Cruz (Fiocruz). R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
| | | | - Jurema Corrêa da Mota
- Laboratório de Informações em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Rio de Janeiro RJ Brasil
| | - Francisco Inácio Bastos
- Laboratório de Informações em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Rio de Janeiro RJ Brasil
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Fernandes Silva E, de Oliveira VMC, Monteiro CFDS, da Silva A, Carvalho MSM, Magalhães RDLB. Tracking the pattern of alcohol consumption among homeless people. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2064347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Alice da Silva
- Nursing Department, Federal University of Piauí, Teresina, Brazil
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Brito C, Silva LND. População em situação de rua: estigmas, preconceitos e estratégias de cuidado em saúde. CIENCIA & SAUDE COLETIVA 2022; 27:151-160. [DOI: 10.1590/1413-81232022271.19662021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 10/13/2021] [Indexed: 11/22/2022] Open
Abstract
Resumo Representações sociais históricas sobre estigma e preconceito relacionado à População em Situação de Rua (PSR) provocam sofrimento psíquico, sentimento de vergonha, afastamento das relações familiares e sociais. Esse artigo objetivou entender como a PSR e os profissionais de saúde percebem, reproduzem, elaboram e lidam as representações produzidas por suas condições sociais. Pesquisa qualitativa, que envolve Observação Participante; Entrevistas com 24 PSR e Grupo Focal com profissionais dos serviços que prestam cuidado à PSR. O estudo foi realizado no município do Rio de Janeiro em local onde o uso do crack tem prevalência importante. Análise foi realizada pelo método da narrativa fenomenológica. O estereótipo provoca uma autoimagem de pessoa indigna, indesejada, que justifica discriminações cotidianas e, sobretudo, a perda da condição mais importante de todos os seres: sua condição humana, além de legitimar desassistência e violência contra elas. Aprofundar as relações entre preconceitos e discriminações em contexto de população vulnerável e serviços de saúde, pode auxiliar projetos terapêuticos que promovam diminuição do sofrimento psíquico, melhor assistência e reconhecimento social de cidadania da PSR.
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Camargo PDO, Oliveira MMD, Raupp LM, Pereira GB, Ramos CI. Políticas públicas e sociais frente à vulnerabilidade social no território da Cracolândia. SAUDE E SOCIEDADE 2022. [DOI: 10.1590/s0104-12902022200969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo O presente estudo tem como objetivo discutir a operacionalização das políticas públicas e sociais frente à vulnerabilidade social no território da Cracolândia. Realizou-se uma etnografia a partir de observação participante com construção de diário de campo e entrevistas etnográficas. Foram entrevistadas pessoas que fazem uso de drogas nas cenas de uso e/ou que frequentam o Centro de Convivência É de Lei e os agentes redutores de danos dessa Organização Não Governamental (ONG). O estudo foi desenvolvido em 2018 na cidade de São Paulo. Para a análise dos dados, utilizou-se a Teoria Interpretativa. As políticas sociais voltadas para usuários de drogas devem considerar os determinantes sociais em saúde que são causadores de diversas desigualdades. Não é aceitável que as ações de saúde para pessoas em vulnerabilidade social não enfoquem questões de moradia, alimentação, escolaridade, trabalho e renda. Sendo assim, é necessário que as políticas públicas assumam e desempenhem seu caráter intersetorial e interdisciplinar, caso contrário, continuarão a ser arbitrárias e sem sucesso no cuidado de pessoas que precisam do auxílio e não da tutela e repreensão do Estado.
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do Nascimento RS, Baia KLN, de Souza SB, Fontoura GMG, Nunes PF, Machado LFA, Kupek E, Fischer B, Martins LC, Oliveira-Filho AB. Hepatitis E Virus in People Who Use Crack-Cocaine: A Cross-Sectional Study in a Remote Region of Northern Brazil. Viruses 2021; 13:926. [PMID: 34067873 PMCID: PMC8156048 DOI: 10.3390/v13050926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 12/19/2022] Open
Abstract
People who use crack-cocaine (PWUCC) have numerous vulnerabilities and pose a challenge to health and social assistance services. The exposure to pathogens and risk situations occur differently according to each individual, region and social group. This study identified the presence, genotypes and factors associated with hepatitis E virus (HEV) exposure among a community-recruited cohort of 437 PWUCC in northern Brazil. Epidemiological information was collected through community-based assessments and interviews. Thereafter, blood and fecal samples were collected and tested for HEV using an immunoenzymatic assay, and the genotype was identified by PCR. Logistic regressions were used to identify the risk factors independently associated with exposure to HEV. In total, 79 (18.1%) PWUCC were exposed to HEV: 73 (16.7%) for IgG and six for IgG + IgM. HEV RNA was detected in six fecal samples and in two blood samples from PWUCC with IgM + IgG. Subtype 3c was identified in all of the samples. The factors associated with exposure to HEV were low monthly income, unstable housing (e.g., homelessness), crack-cocaine use ≥40 months, and the shared use of crack-cocaine equipment. The current study provides unique initial insights into HEV status and risk factors among PWUCC in a remote area in Brazil, with diverse implications for urgently improved diagnosis, prevention, and treatment intervention needs.
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Affiliation(s)
- Raquel Silva do Nascimento
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, Brazil
| | - Karen Lorena N. Baia
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Samara Borges de Souza
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Linguagens e Saberes na Amazônia, Bragança 68600-000, Brazil
| | - Guilherme Martins G. Fontoura
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
| | - Patrícia Ferreira Nunes
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Luiz Fernando A. Machado
- Laboratório de Virologia, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém 66075-110, Brazil;
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis 88040-900, Brazil;
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand;
- Centre for Applied Research in Mental Health and Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo 04038-000, Brazil
| | - Luísa Caricio Martins
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
| | - Aldemir B. Oliveira-Filho
- Grupo de Estudo e Pesquisa em Populações Vulneráveis, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança 68600-000, Brazil; (R.S.d.N.); (K.L.N.B.); (S.B.d.S.); (G.M.G.F.)
- Programa de Pós-Graduação em Biologia Ambiental, Universidade Federal do Pará, Bragança 68600-000, Brazil
- Programa de Pós-Graduação em Doenças Tropicais, Universidade Federal do Pará, Belém 66055-240, Brazil; (P.F.N.); (L.C.M.)
- Programa de Pós-Graduação em Linguagens e Saberes na Amazônia, Bragança 68600-000, Brazil
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Franck MC, Monteiro MG, Limberger RP. [Toxicology of suicide cases in the state of Rio Grande do Sul, Brazil, 2017 to 2019Perfil toxicológico de los casos de suicidio en Rio Grande do Sul (Brasil), 2017-2019]. Rev Panam Salud Publica 2021; 45:e28. [PMID: 33727909 PMCID: PMC7954196 DOI: 10.26633/rpsp.2021.28] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/07/2020] [Indexed: 01/08/2023] Open
Abstract
Objetivo. Descrever o perfil toxicológico de todas as vítimas de suicídio no Rio Grande do Sul, Brasil, de 2017 a 2019. Métodos. Neste estudo descritivo e transversal, foram consultados todos os laudos periciais e as ocorrências policiais relacionados aos óbitos por suicídio no estado. Foram realizadas análises de correspondência múltipla e construídos modelos independentes de regressão logística, tendo como variáveis dependentes o etanol, os ansiolíticos, os antidepressivos, as substâncias ilícitas e os agentes tóxicos não medicamentosos. Resultados. Foram realizados 2 978 exames de alcoolemia, com resultado positivo em 28,5%. A chance de resultados positivos para alcoolemia foi 0,5 (IC95%: 1,1 a 2,2) vez maior para suicídio durante a noite, 1,0 (IC95%: 1,4 a 2,9) vez maior para suicídio aos finais de semana e 0,9 (IC95%: 1,3 a 2,7) vez maior na presença de antecedentes criminais. A pesquisa de psicotrópicos (2 900 amostras) detectou algum medicamento em 30,4%. Os ansiolíticos foram a classe mais frequente, com chance 1,5 (IC95%: 1,6 a 4,1) vez maior em mulheres e 0,8 (IC95%: 1,2 a 2,7) vez maior para suicídios ocorridos no outono-inverno. As substâncias ilícitas (n = 338) tiveram chance 4,1 (IC95%: 1,9 a 14,4) vezes maior de detecção na macrorregião de Pelotas em relação à de Passo Fundo e 1,2 (IC95%: 1,3 a 3,6) vez maior em pessoas com resultados positivos para etanol. Não houve diferença significativa entre adolescentes e adultos. Conclusões. Embora sem evidência de causalidade, os resultados mostram um vínculo entre o suicídio e diversos psicoativos. Os médicos legistas devem ser orientados quanto à necessidade de realização de exames toxicológicos em todos os casos de suicídio.
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Affiliation(s)
- Maria Cristina Franck
- Instituto-Geral de Perícias do Rio Grande do Sul (IGP-RS), Departamento de Perícias Laboratoriais Porto Alegre (RS) Brasil Instituto-Geral de Perícias do Rio Grande do Sul (IGP-RS), Departamento de Perícias Laboratoriais, Porto Alegre (RS), Brasil
| | - Maristela Goldnadel Monteiro
- Pan American Health Organization (PAHO), Noncommunicable Diseases and Mental Health Washington, D.C. Estados Unidos Pan American Health Organization (PAHO), Noncommunicable Diseases and Mental Health, Washington, D.C., Estados Unidos
| | - Renata Pereira Limberger
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Farmacêuticas Porto Alegre (RS) Brasil Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-Graduação em Ciências Farmacêuticas, Porto Alegre (RS), Brasil
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Chaiben CL, Batista TBD, Penteado CAS, Barbosa MCM, Ventura TMO, Dionizio A, Rosa EAR, Buzalaf MAR, Azevedo-Alanis LR. Salivary proteome analysis of crack cocaine dependents. Arch Oral Biol 2020; 121:104952. [PMID: 33186792 DOI: 10.1016/j.archoralbio.2020.104952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Salivary proteomic analysis may help to understand physiopathological changes in crack cocaine dependents. This study aimed to compare the salivary protein profile between crack cocaine dependents and non-drug users. DESIGN Nine heavy smokers and alcohol consumers men admitted to rehab due to crack cocaine abuse and nine non-drug users age-matched men were evaluated. Unstimulated whole saliva was collected. Proteomic analysis was performed by mass spectrometer. Data were processed using ProteinLynx GlobalServer software. Results were obtained by searching the Homo sapiens database from the UniProt catalog. The search tool IBI-IMIM was used to identify proteins candidates for biomarkers. RESULTS The mean age of crack cocaine and control groups was 36.89 ± 7.78 and 35.78 ± 6.68 years, respectively. 458 salivary proteins were identified in both groups; 305 proteins in the crack cocaine group. Among the 68 proteins presented in both groups, 29 were down-regulated (i.e. "Statherin" and "Transforming growth factor-beta-induced protein ig-h3" were down-regulated at least 10-fold) and 27 up-regulated (i.e. "Negative elongation factor" was up-regulated 19-fold) in the crack cocaine group compared to controls. 90 out of the 458 proteins found in the proteomic analysis were identified as candidates for biomarkers of diseases. Among these, 65 (72.22 %) were detected in the crack cocaine group. CONCLUSION Crack cocaine dependents with chronic alcohol and tobacco use have a higher number of proteins in saliva compared to non-drug users. 22.3 % of salivary proteins present in crack cocaine dependents were present in controls; 3.9 % of them were expressed in similar quantity.
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Affiliation(s)
- Cassiano Lima Chaiben
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
| | - Thiago Beltrami Dias Batista
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
| | - Carlos Antonio Schäffer Penteado
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
| | - Maria Carolina Maciel Barbosa
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
| | - Talita Mendes Oliveira Ventura
- Bauru School of Dentistry, University of São Paulo, Alameda Doutor Octávio Pinheiro Brisolla, 9-75, Bauru, SP Postal Code: 17012-901, Brazil.
| | - Aline Dionizio
- Bauru School of Dentistry, University of São Paulo, Alameda Doutor Octávio Pinheiro Brisolla, 9-75, Bauru, SP Postal Code: 17012-901, Brazil.
| | - Edvaldo Antonio Ribeiro Rosa
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
| | - Marília Afonso Rabelo Buzalaf
- Bauru School of Dentistry, University of São Paulo, Alameda Doutor Octávio Pinheiro Brisolla, 9-75, Bauru, SP Postal Code: 17012-901, Brazil.
| | - Luciana Reis Azevedo-Alanis
- Graduate Program in Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição 1155, Curitiba, PR, Postal Code: 80215-901, Brazil.
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12
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[Synthesis of evidence: Guidance for the diagnosis and treatment of Chagas diseaseSíntese de evidências: Guia de diagnóstico e tratamento da doença de Chagas]. Rev Panam Salud Publica 2020; 44:e28. [PMID: 32523605 PMCID: PMC7279121 DOI: 10.26633/rpsp.2020.28] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introducción. La enfermedad de Chagas o tripanosomiasis americana es causada por el protozoo flagelado Trypanosoma cruzi, transmitido principalmente por insectos vectores (denominados popularmente en las diferentes zonas de la Región de las Américas “vinchucas”, “pitos”, “chinches”, “chirimachas” o “kissing bugs”). El parásito es transmitido por vía transplacentaria, transfusiones y, menos frecuentemente, por vía oral o trasplante de órganos. La implementación de políticas públicas y el manejo de la condición clínica requiere ser fortalecido debido a las dificultades diagnósticas y terapéuticas que presenta esta parasitosis sistémica. Para contribuir con ello, la Organización Panamericana de la Salud (OPS) desarrolló una guía para el manejo de la tripanosomiasis americana. Objetivos. Sintetizar las recomendaciones incluidas en la Guía para el diagnóstico y el tratamiento de la enfermedad de Chagas, publicada por la Organización Panamericana de la Salud en 2018, con el fin de presentar el adecuado diagnóstico y tratamiento de la enfermedad de Chagas y abordar aspectos sobre su implementación. Métodos. Se llevó a cabo una síntesis de la guía y sus recomendaciones. Adicionalmente, se realizó una búsqueda sistemática en PubMed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación. Resultados. Se presentan 10 recomendaciones aplicables a pacientes adultos y pediátricos con sospecha de enfermedad de Chagas, exposición a T. cruzi y diagnóstico confirmado de enfermedad de Chagas aguda, crónica y congénita. Se identificaron reportes que abordaron aspectos de implementación. Conclusiones. Las recomendaciones buscan proveer estrategias para el diagnóstico y tratamiento oportunos de la enfermedad de Chagas, así como consideraciones para su implementación.
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Zandomingo MNP, Oliveira JFD, Silva DDO, Porcino C, Suto CSS, Oliveira DS. Poverty, hunger, and abandonment: representations of the nursing team about homeless persons. Rev Bras Enferm 2020; 73 Suppl 1:e20190338. [PMID: 32490949 DOI: 10.1590/0034-7167-2019-0338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 09/26/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to know the structure of social representations of nursing team with regard to homeless persons. Method a qualitative research based on the structural approach of social representations. A total of 96 professionals from the nursing team working in the Psychosocial Care Network units of a Health District of Salvador, Bahia, Brazil, who answered the test of free association of words and a questionnaire with socio-demographic data. The data obtained were processed in softwares that allowed the organization of the frame of four houses and maximum similarity tree. RESULTS poverty, hunger, abandonment and unemployment are central elements of the image of homeless persons, living in a context permeated by drugs, dirt, neglect and vulnerability. Final considerations The social representation structure of homeless persons is anchored in stereotypes that can interfere both in the provision of care and in the access of the people to health services.
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Affiliation(s)
| | | | | | - Carle Porcino
- Universidade Federal da Bahia, Salvador, Bahia, Brazil
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14
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Ornell F, Stock BS, Scherer JN, Ornell R, Ligabue KP, Narvaez JCM, Dalbosco C, Dotta RM, Telles LB, Pechansky F, von Diemen L, Kessler FHP. High rates of incarceration due to drug trafficking in the last decade in southern Brazil. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:153-160. [PMID: 32696891 DOI: 10.1590/2237-6089-2019-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 11/04/2019] [Indexed: 06/11/2023]
Abstract
Introduction Drug-related crimes, especially drug trafficking, account for a large part of incarcerations not only in Brazil, but also worldwide. It is not clear whether the change in the drug law has contributed to the increase in the number of drug trafficking prisoners. Few studies have investigated gender differences and the growth of drug trafficking offenses in the Brazilian southern state of Rio Grande do Sul. Objective To investigate the growth of the prison population in the state of Rio Grande do Sul, emphasizing incarcerations for drug trafficking and gender differences. Method This was an ecological study using secondary data collected from official databases of the Brazilian National Penitentiary Department (Departamento Penitenciário [DEPEN]), affiliated with the Brazilian Ministry of Justice. Results Between 2006 and 2015, incarcerations increased by 27% (25% men, 83% women). Incarcerations for drug trafficking accounted for 11% of total arrests in 2006 (11% men, 20% women) and 45% in 2015 (47% men, 91% women), corresponding to an increase of 427% (415% among men, 723% among women). Conclusions Imprisonment for drug trafficking has increased considerably, especially among women. This may be due to factors such as: increase of drug trafficking, increase in the numbers of gangs in the state, and changes in the Brazilian drug law. These results highlight an emerging challenge in public health from the perspective of human rights and gender.
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Affiliation(s)
- Felipe Ornell
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bárbara S Stock
- Facultad de Ciencias Jurídicas, Económicas y Administrativas, Universidad Católica de Temuco, Temuco, AR, Chile
| | - Juliana N Scherer
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafaela Ornell
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Karina P Ligabue
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Joana C M Narvaez
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Carla Dalbosco
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata M Dotta
- Fundação Escola Superior do Ministério Público, Porto Alegre, RS, Brazil
| | - Lisieux B Telles
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix H P Kessler
- Centro Colaborador em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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15
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Roglio VS, Borges EN, Rabelo-da-Ponte FD, Ornell F, Scherer JN, Schuch JB, Passos IC, Sanvicente-Vieira B, Grassi-Oliveira R, von Diemen L, Pechansky F, Kessler FHP. Prediction of attempted suicide in men and women with crack-cocaine use disorder in Brazil. PLoS One 2020; 15:e0232242. [PMID: 32365094 PMCID: PMC7197800 DOI: 10.1371/journal.pone.0232242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/10/2020] [Indexed: 11/19/2022] Open
Abstract
Background Suicide is a severe health problem, with high rates in individuals with addiction. Considering the lack of studies exploring suicide predictors in this population, we aimed to investigate factors associated with attempted suicide in inpatients diagnosed with cocaine use disorder using two analytical approaches. Methods This is a cross-sectional study using a secondary database with 247 men and 442 women hospitalized for cocaine use disorder. Clinical assessment included the Addiction Severity Index, the Childhood Trauma Questionnaire, and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, totalling 58 variables. Descriptive Poisson regression and predictive Random Forest algorithm were used complementarily to estimate prevalence ratios and to build prediction models, respectively. All analyses were stratified by gender. Results The prevalence of attempted suicide was 34% for men and 50% for women. In both genders, depression (PRM = 1.56, PRW = 1.27) and hallucinations (PRM = 1.80, PRW = 1.39) were factors associated with attempted suicide. Other specific factors were found for men and women, such as childhood trauma, aggression, and drug use severity. The men's predictive model had prediction statistics of AUC = 0.68, Acc. = 0.66, Sens. = 0.82, Spec. = 0.50, PPV = 0.47 and NPV = 0.84. This model identified several variables as important predictors, mainly related to drug use severity. The women's model had higher predictive power (AUC = 0.73 and all other statistics were equal to 0.71) and was parsimonious. Conclusions Our findings indicate that attempted suicide is associated with depression, hallucinations and childhood trauma in both genders. Also, it suggests that severity of drug use may be a moderator between predictors and suicide among men, while psychiatric issues shown to be more important for women.
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Affiliation(s)
- Vinícius Serafini Roglio
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo Nunes Borges
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Center for Computational Sciences, Universidade Federal do Rio Grande, Porto Alegre, Brazil
- * E-mail:
| | - Francisco Diego Rabelo-da-Ponte
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Felipe Ornell
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Nichterwitz Scherer
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jaqueline Bohrer Schuch
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Ives Cavalcante Passos
- Molecular Psychiatry Laboratory, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Breno Sanvicente-Vieira
- Developmental Cognitive Neuroscience Lab, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo Grassi-Oliveira
- Developmental Cognitive Neuroscience Lab, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Lisia von Diemen
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Felix Henrique Paim Kessler
- Center for Drug and Alcohol Research, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Silva DDO, Oliveira JFD, Porcino C, Gomes AMT, Suto CSS, Carvalho ESDS. Homeless people's social representations about self-care. Rev Bras Enferm 2020; 73:e20180956. [PMID: 32159698 DOI: 10.1590/0034-7167-2018-0956] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 06/11/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To capture and analyze the structure of homeless people's social representations about self-care. METHODS Research based on the theory of social representations, with 122 people in street situation. A semistructured questionnaire and free evocation technique were applied with the inducing words "caring for myself is". The evocations were processed by the software Evoc and Iramuteq, allowing to identify central and peripheral elements and the connection between them. RESULTS For the group studied, "feeding oneself, personal hygiene, protecting oneself and visiting the doctor" are actions and attitudes that represent caring for themselves. In the streets, "feeding oneself" is an essential action for living/surviving that underpins the others. FINAL CONSIDERATIONS Despite behaviors based on the biomedical model, self-care was represented by extended actions to meet basic human needs. This study offers elements of reflection to rethink care practices developed by health professionals.
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Affiliation(s)
| | | | - Carle Porcino
- Universidade Federal da Bahia. Salvador, Bahia, Brazil
| | | | - Cleuma Sueli Santos Suto
- Universidade Federal da Bahia. Salvador, Bahia, Brazil.,Universidade do Estado da Bahia. Senhor do Bonfim, Bahia, Brazil
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Patrício ACFDA, Silva RARD, Araújo RFD, Silva RFD, Nascimento GTDS, Rodrigues TDDB, Leite MAP. Common mental disorders and resilience in homeless persons. Rev Bras Enferm 2019; 72:1526-1533. [DOI: 10.1590/0034-7167-2018-0541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/03/2019] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To identify common mental disorders and resilience in homeless persons. Method: Cross-sectional study with 49 homeless persons, assisted in the Casa da Acolhida Adulta and the Specialized Reference Center in a municipality in the Northeast of Brazil. Data collection performed between February and March 2018, using SRQ20 scales for common mental disorders and another for Resilience. Kruskal Wallis test, Student’s T-test and Chi-Square test were used. Results: In the study, 61.2% (30) participants have poor sleep; 69.4% (34) feel nervous, tense or worried; 71.4% (35) feel unhappy; 63.3% are unable to play a useful role in their lives; 71.4% (35) have common mental disorders, and 44.9% (22) presented low resilience. Resilience influences common mental disorders, which, in turn, are influenced by gender and age. Conclusion: Professionals who assist homeless persons need to have a look directed at common mental disorders and resilience.
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Carolina Maria Motta Stoffel B, Felix Henrique PK, Flavio P, Lisia VD, Maria Fátima Olivier S, Tatiana HL, Marcelo SC, Marcelo SC. Crack users and violence. What is the relationship between trauma, antisocial personality disorder and posttraumatic stress disorder? Addict Behav 2019; 98:106012. [PMID: 31233950 DOI: 10.1016/j.addbeh.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 06/01/2019] [Accepted: 06/02/2019] [Indexed: 10/26/2022]
Abstract
TITLE Crack users and violence. What is the relationship between trauma, antisocial personality disorder and posttraumatic stress disorder? BACKGROUND Crack use is frequently related to severe social and psychiatric conditions including Antisocial Personality Disorder (ASPD) and Posttraumatic Stress Disorder (PTSD). Social vulnerabilities increase the frequency of traumatic exposure. The relationship of trauma and psychiatric disorders among crack users is still unclear. OBJECTIVES To describe the characteristics of crack users with ASPD and to verify of the association between ASPD and PTSD, ASPD and each type of traumatic event and the temporality of these events. METHODS Data from a multicenter cross-sectional sample of 733 crack users under treatment in six Brazilian capitals was obtained via interviews with Addiction Severity Index (ASI) 6 and Mini International Neuropsychiatric Interview (MINI). Demographic characteristics, psychiatric diagnosis and trauma history were examined. Descriptive and bivariate analyses were used to assess the relationship between the studied variables. RESULTS More than 80% of crack users with ASPD and >65% without this diagnosis report traumatic experiences. The prevalence of PTSD disorder among those with ASPD (47.3%) is lower than among those without (52.7%) this diagnosis. The traumatic experiences occur either before or after the first episode of drug use. CONCLUSIONS The high prevalence of ASPD and PTSD among crack users and their frequent exposure to severe traumatic events was verified as well as the fact that they are often victims and sometimes perpetrators of violence illustrating the complexity of the relationships between crack use, trauma and comorbidities.
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Costa MIFD, Viana TRF, Pinheiro PNDC, Cardoso MVLML, Barbosa LP, Luna IT. Social determinants of health and vulnerabilities to sexually transmitted infections in adolescents. Rev Bras Enferm 2019; 72:1595-1601. [PMID: 31644749 DOI: 10.1590/0034-7167-2018-0726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/04/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To verify the association between social determinants of health and the vulnerability of adolescents to Sexually Transmitted Infections (STIs). METHOD Cross-sectional study, performed with 287 students aged 11 to 17 years, in the outskirts of Fortaleza, Ceará, Brazil, from August do September 2016. Two instruments were used, one destined to social determinants of health and another to investigating the vulnerability to STIs. The magnitude of associations was expressed through odds ratio and interval of confidence, considering a 5% significance level. This research was approved by the Research Ethics Committee of the Federal University of Ceará. RESULTS 212 (73.9%) adolescents were considered more vulnerable, with a score ≥ 4. The intermediate social determinant "housing (home ownership)" obtained significant association with with the vulnerability to STIs (p of 0.022; CI 1.1 to 3.3; OR 1.9). CONCLUSION The intermediate social determinant "type of housing" influences the vulnerability to STAs.
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Escobar M, Scherer JN, Soares CM, Guimarães LSP, Hagen ME, von Diemen L, Pechansky F. Active Brazilian crack cocaine users: nutritional, anthropometric, and drug use profiles. ACTA ACUST UNITED AC 2018; 40:354-360. [PMID: 29451589 PMCID: PMC6899369 DOI: 10.1590/1516-4446-2017-2409] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 10/07/2017] [Indexed: 11/29/2022]
Abstract
Objective: To evaluate the nutritional status of crack users and to analyze its correlation with drug use profiles. Methods: Cross-sectional study with 108 crack users. Anthropometric data were assessed through body mass index (BMI) and bioimpedance (BIA) measurements. A blood test to analyze hematocrit, hemoglobin, glucose, and lipid profiles was also performed. Crack use was determined through a standardized interview. Results: Based on BMI and BIA, most individuals were eutrophic (about 70%). Regarding hematological parameters, we found that hemoglobin and hematocrit levels were below normal for 32.4 and 30.6% of patients, respectively. Considering normal parameters, a large part of the sample (60.2%) had low levels of HDL cholesterol and high levels of triglycerides (38%). There were no significant correlations between drug profile and nutritional variables. Conclusion: This is a pioneering study that examines the nutritional status of crack users. Our results showed that most crack users present normal anthropometric findings and the prevalence of underweight is low. However, blood analysis showed changes and a specific type of malnutrition.
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Affiliation(s)
- Mariana Escobar
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil.,Departamento de Nutrição, Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil
| | - Juliana N Scherer
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Cassia M Soares
- Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil
| | | | - Martine E Hagen
- Departamento de Nutrição, Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brazil
| | - Lisia von Diemen
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flavio Pechansky
- Centro de Pesquisa em Álcool e Drogas, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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