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de Souza Schwarz P, Dos Santos BP, Birk L, Eller S, de Oliveira TF. Development of an innovative analytical method for forensic detection of cocaine, antidepressants, and metabolites in postmortem blood using magnetic nanoparticles. Anal Bioanal Chem 2024; 416:3239-3250. [PMID: 38573343 DOI: 10.1007/s00216-024-05273-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/18/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
Cocaine and antidepressants rank high globally in substance consumption, emphasizing their impact on public health. The determination of these compounds and related substances in biological samples is crucial for forensic toxicology. This study focused on developing an innovative analytical method for the determination of cocaine, antidepressants, and their related metabolites in postmortem blood samples, using unmodified commercial Fe3O4 nanoparticles as a sorbent for dispersive magnetic solid-phase extraction (m-d-SPE), coupled with liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) analysis. An aliquot of 100 µL of whole blood and 5 µL of the internal standard pool were added to 30 mg of nanoparticles. The nanoparticles were separated from the sample using a neodymium magnet inserted into a 3D-printed microtube rack. The liquid was then discarded, followed by desorption with 300 µL of 1/1/1 acetonitrile/methanol/ethyl acetate. The sample was vortexed and separated, and 1.5 µL of the organic supernatant was injected into the LC-MS/MS. The method was acceptably validated and successfully applied to 263 postmortem blood samples. All samples evaluated in this study were positive for at least one substance. The most frequent analyte was benzoylecgonine, followed by cocaine and cocaethylene. The most common antidepressants encountered in the analyzed samples were citalopram and fluoxetine, followed by fluoxetine's metabolite norfluoxetine. This study describes the first report of this sorbent in postmortem blood analysis, demonstrating satisfactory results for linearity, precision, accuracy, and selectivity for all compounds. The method's applicability was confirmed, establishing it as an efficient and sustainable alternative to traditional techniques for forensic casework.
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Affiliation(s)
- Patricia de Souza Schwarz
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil.
| | - Bruno Pereira Dos Santos
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Letícia Birk
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Sarah Eller
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
| | - Tiago Franco de Oliveira
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, 90050-170, Brazil
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Galvão PVM, da Silva CMFP. Analysis of age, period, and birth cohort effects on suicide mortality in Brazil and the five major geographic regions. BMC Public Health 2023; 23:1351. [PMID: 37442995 PMCID: PMC10347758 DOI: 10.1186/s12889-023-16289-0] [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: 05/05/2022] [Accepted: 07/11/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVE Estimate the effects of age, period, and birth cohort on suicide mortality in Brazil by major geographic region in the overall population and by sex. METHODS This was a time trend ecological study. National and regional suicide mortality data from 1981 to 2020 were analyzed for the overall population and by sex. Age, period, and cohort effects were calculated with a Poisson regression model using estimable functions with the Epi package of the R statistical program, version 4.2.1. RESULTS There were 272,716 suicides in individuals ranging from 20 to 79 years old. In the overall population, the age model-adjusted suicide mortality rates showed an upward pattern for Brazil. The most recent cohort showed the highest associated risk, 1.67 (95%CI 1.63; 1.71), while for the reference period, it was the highest risk among all the periods. CONCLUSIONS Suicide mortality rates have shown an upward trend with advancing age in both men and women in the Brazilian population. However, the behavior of the period effect and cohort depends on the population analyzed and regional distribution.
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Affiliation(s)
| | - Cosme Marcelo Furtado Passos da Silva
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Pernambuco, Brazil
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Moura EH, Sousa CMDS, Araújo ODD, Mascarenhas MDM. Atendimento pré-hospitalar às tentativas de suicídio: um estudo transversal. JORNAL BRASILEIRO DE PSIQUIATRIA 2022. [DOI: 10.1590/0047-2085000000358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
RESUMO Objetivo: Caracterizar o atendimento pré-hospitalar às vítimas de tentativa de suicídio. Métodos: Estudo transversal com dados de atendimento pré-hospitalar realizado pelo Serviço de Atendimento Móvel de Urgência (SAMU), em Teresina, Piauí, no período de julho/2015 a dezembro/2018. Foram realizadas análise descritiva com o teste Qui-quadrado de Pearson ou teste exato de Fisher e análise da densidade das tentativas de suicídio pela estimativa de Kernel. Resultados: Os atendimentos às tentativas de suicídio predominaram em mulheres (60,9%), adultos de 20 a 29 anos (28,4%), residentes na Região Centro/Norte (35,9%), aos domingos (16,5%) e nos turnos da tarde (32,9%) e noite (34,9%). Foram relatados reincidências de tentativas (9,2%), histórico de atendimento psiquiátrico (14,1%), uso abusivo de álcool (17,5%) e outras drogas (4,6%). O atendimento em ambulâncias de suporte avançado e maior mortalidade antes do socorro foram mais frequentes em vítimas do sexo masculino (40,8% e 5,8%, respectivamente). A Zona Centro/Norte da cidade concentrou as ocorrências para ambos os sexos. Conclusões: Os atendimentos pré-hospitalares às tentativas de suicídio em Teresina demonstraram grande demanda por vítimas do sexo feminino e jovens e maior densidade de ocorrência na Zona Centro/Norte da cidade. O uso de bebida alcoólica, os meios de autolesão mais letais e a mortalidade foram associados ao sexo masculino. Faz-se necessário divulgar essas informações, capacitar os profissionais sobre a prevenção e abordagem às tentativas de suicídio, além de promover políticas públicas capazes de reduzir as tentativas de suicídio.
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Santos MCLD, Giusti BB, Yamamoto CA, Ciosak SI, Szylit R. Suicide in the elderly: an epidemiologic study. Rev Esc Enferm USP 2021; 55:e03694. [PMID: 34076149 DOI: 10.1590/s1980-220x2019026603694] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 09/22/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To analyze the incidence and means of elderly suicide in Brazil. METHOD Epidemiologic, cross-sectional, quantitative, and retrospective study. The data were obtained in a platform maintained by the Ministry of Health and analyzed. The mortality rate was calculated and means and percentages regarding the employed means of suicide were obtained. RESULTS In this period, 8,977 suicides took place among the population over 60 years. The highest suicide rates were concentrated in the population over 80, which presented a mean 8.4/100,000 for this period, and between 70 and 79 years, with a mean rate of 8.2/100,000. Considering the total elderly population over 60 years, this value reached 7.8/100,000, whereas in the general population this was 5.3/100,000. The values are always higher among the elderly population: the mean rate in the last five years among the elderly is 47.2% higher than the mean for the general population. The main mean of suicide was hanging (68%), followed by firearm (11%), self-intoxication (9%), falling from a high place (5%), and undefined or undetermined means (6%). CONCLUSION Epidemiologic analyses bring visibility to the dyad aging and suicide, corroborating the pertinence of this theme.
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Affiliation(s)
| | - Barbara Bartuciotti Giusti
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Coletiva, São Paulo, SP, Brazil
| | - Clarissa Ayri Yamamoto
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Psiquiátrica, São Paulo, SP, Brazil
| | - Suely Itsuko Ciosak
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem em Saúde Coletiva, São Paulo, SP, Brazil
| | - Regina Szylit
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Tirolla RM, Girotto E, Guidoni CM. CLINICAL AND EPIDEMIOLOGICAL ANALYSIS OF SUICIDE ATTEMPTS IN CHILDREN ASSISTED BY A POISON CONTROL CENTER. REVISTA PAULISTA DE PEDIATRIA 2020; 39:e2019345. [PMID: 33146292 PMCID: PMC7594506 DOI: 10.1590/1984-0462/2021/39/2019345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/11/2020] [Indexed: 11/25/2022]
Abstract
Objective: To assess suicide attempts in children seeking care at a Poison Control
Center. Methods: Cross-sectional study with children (<12 years old) that attempted
suicide and were cared at the Poison Control Center in Londrina, Paraná,
Southern Brazil, from April 1985 to December 2018. Results: We identified 59 children, most of them females (74.6%), who used only one
product (77.9%). Among the products involved, medications were the most
important ones (88.1%). Neurological/psychiatric/muscular manifestations
(61.0%) were the main symptoms presented. The main reason identified for the
suicide attempt was conflicts with family and/or friends (27.1%). Suicide
attempts were more frequent in 2001-2003 and 2016-2018. Conclusions: Suicide attempts occurred mainly in female children with a single agent
(mainly medications), and the main reason was family conflicts..
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Ferreira TDG, Vedana KGG, do Amaral LC, Pereira CCM, Zanetti ACG, Miasso AI, Borges TL. Assistance related to suicidal behavior at a mobile emergency service: Sociodemographic and clinical associated factors. Arch Psychiatr Nurs 2019; 33:136-142. [PMID: 30927982 DOI: 10.1016/j.apnu.2018.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 09/17/2018] [Accepted: 11/17/2018] [Indexed: 11/19/2022]
Abstract
It is important to investigate the care given to people with suicidal behavior, as it is an important predictor of future death by suicide and there is a lack of studies on this issue in Brazil. This study had the objective of investigating assistance related to suicidal behavior at a mobile emergency service and sociodemographic and clinical associated factors. This was a quantitative, cross-sectional study based on documental information. The data were collected through manual consultation of nursing records in which call-outs for suicidal behavior in the year 2014 were documented. The data were analyzed using descriptive statistics, Chi-squared test, Fisher's exact test, correlation tests, and comparison of means tests. In the 313 records analyzed there was a predominance of adult women with self-inflicted drug poisoning, attended to in their own residence and referred to pre-hospital emergency medical services. There was a lack of documentation on signs, symptoms, and grievances in most cases. The interventions most carried out by the nurses were related to monitoring of clinical parameters. There were differences related to the victim's sex and lethality, suicide attempt method, referral to emergency services, and semester of occurrence (January-June, July-December). Suicide attempts through self-poisoning or self-inflicted injuries differed in relation to time of call-out, waiting time, lethality, documentation on clinical assessment and interventions, and referral to emergency services. This study enabled the charting of factors linked with suicidal behavior and associated factors; it offers reflections on limitations and nursing care potential in the prevention of reoccurrence of suicidal behavior.
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Bonfante HL, Silva RLF, Sampaio PR, Estephanin VV, Leite ICG. Perfil epidemiológico das intoxicações exógenas na cidade de Juiz de Fora - MG. HU REVISTA 2018. [DOI: 10.34019/1982-8047.2017.v43.2776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A intoxicação exógena é resultado dos efeitos nocivos da interação de uma substância química com o organismo. É considerada um problema de saúde pública, pois aumenta a morbidade e a mortalidade. O objetivo desse estudo foi caracterizar o perfil epidemiológico das intoxicações exógenas na cidade de Juiz de Fora - MG. Foi realizado um estudo retrospectivo, transversal e descritivo com dados oriundos de registros de casos ocorridos entre 1º de janeiro de 2013 a 1º de janeiro de 2014. As informações utilizadas foram consultadas em prontuários médicos e resultados de exames toxicológicos, sendo as variáveis contínuas descritas por média e desvio padrão. A associação entre sexo, faixa etária e tipo de intoxicação foi analisada por teste de Qui-quadrado, nível de significância 5%. Foram incluídos 154 prontuários. A idade média foi de 25 anos, com prevalência do sexo masculino (57%) e a letalidade de 4%. Os medicamentos constituíram as principais causas de intoxicações (42%). Em menores de 5 anos e em mulheres as medicações predominaram dentre as formas de intoxicações (p<0.01). Os resultados sugeriram que o perfil epidemiológico das intoxicações exógenas foi semelhante ao padrão nacional. Os dados avaliados indicaram que as intoxicações foram predominantemente para o sexo masculino e por meio de benzodiazepínicos, sendo a idade média de 25 anos dos indivíduos acometidos. As subnotificações e dados incompletos em prontuários dificultaram a avaliação completa acerca do assunto.
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Bochner R, Freire MM. [Analysis of deaths by intoxication that occurred in Brazil from 2010 to 2015 based on the Mortality Information System (SIM)]. CIENCIA & SAUDE COLETIVA 2018; 25:761-772. [PMID: 32022215 DOI: 10.1590/1413-81232020252.15452018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 06/18/2018] [Indexed: 11/22/2022] Open
Abstract
Many studies analyze the epidemiological profile of deaths caused by a single toxic agent. However, broader mortality analyses can be obtained by evaluating multiple agents over the same period of time. For this purpose, a retrospective descriptive study was carried out of the deaths by intoxication registered in the Mortality Information System that occurred in Brazil from 2010 to 2015. Deaths were selected according to ICD-10 codes related to intoxication. There were 18,247 deaths and an increase of 3% of rates of mortality by intoxication during the period. The agents that caused the most deaths were pesticides (24%) followed by medication (23%) and street drugs (22%). With the exception of medication, where the female participation was 52%, there was a higher concentration of males for all agents and in most of the age groups. Only in the case of medication and pesticides was suicide the main circumstance of deaths. The results presented made it possible to define a mortality profile for each of the major toxic agents studied.
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Affiliation(s)
- Rosany Bochner
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Avenida Brasil 4365/Pavilhão Haity Moussatché/206, Manguinhos. 21045-900, Rio de Janeiro, RJ, Brasil.
| | - Marina Moreira Freire
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fiocruz. Avenida Brasil 4365/Pavilhão Haity Moussatché/206, Manguinhos. 21045-900, Rio de Janeiro, RJ, Brasil.
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de Medeiros Alves V, E Silva ACP, de Souza EVM, de Lima Francisco LCF, de Moura EL, de-Melo-Neto VL, Nardi AE. Suicide attempt in mental disorders (MeDi): Association with 5-HTT, IL-10 and TNF-alpha polymorphisms. J Psychiatr Res 2017; 91:36-46. [PMID: 28314127 DOI: 10.1016/j.jpsychires.2017.02.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 02/08/2017] [Accepted: 02/23/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Mental disorders (MeDi) and suicide attempts (SA) are influenced by environmental and genetic factors. Genetic polymorphism studies have identified some candidate genes for suicidal behaviour in people with MeDi. OBJECTIVE To evaluate MeDi and SA in relation to the presence of rs2020933 (5-HTT), rs1800871 (IL-10) and rs1800629 (TNF-α) polymorphisms. METHODS A questionnaire for identification and general data, a brief quality of life assessment (WHOQOL-brief), the scale of suicide ideation by Beck and the MINI International Neuropsychiatric Interview were used in this study. DNA was obtained using buccal mucosa swab samples, and genotyping was performed using real-time polymerase chain reaction. A total of 306 patients were assessed with MeDi; 161 patients had MeDi and a history of SA, and 145 patients had MeDi and no history of SA. The study had 175 subjects in the control group. RESULTS The TNF-α rs1800629 -308A/G genotype was significantly associated with function as a protection factor in the control group compared with MeDi without SA. The TNF-α rs1800629 -308G allele appeared as risk factor for MeDi compared to the control group, for female gender. Additionally, the -308A/G + A/A genotype appeared as protection factor for the control group compared to the group with MeDi. For TNF-α, the -308G allele appeared as risk factor for the number of SA (1 time) compared to the control group. CONCLUSION The IL-10 (rs1800871) and 5-HTT (rs2020933) SNPs were considered to have inadequate statistical power. The rs1800629 (TNF-α) polymorphism may be associated with MeDi without SA, MeDi in females and the number of SA (1 time) in the studied group.
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Affiliation(s)
- Verônica de Medeiros Alves
- Doctor in Mental Health at Institute of Psychiatry, Federal University of Rio de Janeiro, Federal University of Alagoas, Arapiraca, Alagoas, Brazil.
| | - Aline Cristine Pereira E Silva
- Master in Health Sciences at Institute of Biological Sciences of Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Elaine Virgínia Martins de Souza
- PhD in Biotechnology in Health, Renorbio, Post- Graduate Program in Health Sciences, Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | | | - Edilson Leite de Moura
- Student of Biological Sciences, Federal University of Alagoas, Arapiraca, Alagoas, Brazil
| | - Valfrido Leão de-Melo-Neto
- Doctor in Psychiatry at Institute of Psychiatry, Federal University of Rio de Janeiro, Federal University of Alagoas, Maceió, Alagoas, Brazil
| | - Antonio E Nardi
- Postdoc in the Laboratory of Physiology of Respiration at Institute of Biophysics Carlos Chagas Filho, Panic & Respiration Laboratory, Institute of Psychiatry, Federal University of Rio de Janeiro, National Institute for Translational Medicine (INCT-TM), Rio de Janeiro, Brazil
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Zanetti NI, Ferrero AA, Centeno ND. Determination of fluoxetine in Dermestes maculatus (Coleoptera: Dermestidae) by a spectrophotometric method. Sci Justice 2016; 56:464-467. [DOI: 10.1016/j.scijus.2016.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/23/2016] [Accepted: 07/27/2016] [Indexed: 11/30/2022]
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dos Santos MF, Yamada A, Seulin SC, Leyton V, Pasqualucci CAG, Muñoz DR, Yonamine M. Liquid-Phase Microextraction and Gas Chromatographic-Mass Spectrometric Analysis of Antidepressants in Vitreous Humor: Study of Matrix Effect of Human and Bovine Vitreous and Saline Solution. J Anal Toxicol 2016; 40:187-93. [PMID: 26755541 DOI: 10.1093/jat/bkv141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
In forensic bioanalytical methods, there is a general agreement that calibrators should be prepared by fortifying analytes in matrix-based blank samples (matrix-based). However, in the case of vitreous humor (VH), the collection of blank samples for the validation and for routine analysis would require the availability of many cadavers. Besides the difficulty of obtaining enough blank VH, this procedure could also represent an ethical issue. Here, a study of matrix effect was performed taking into consideration human and bovine vitreous and saline solution (SS) (NaCl 0.9%). Tricyclic antidepressants [amitriptyline (AMI), nortriptyline (NTR), imipramine (IMI) and desipramine (DES)] were used as model analytes and were extracted from samples by means of liquid-phase microextraction and detected by gas chromatography-mass spectrometry. Samples of human and bovine VH and SS were prepared in six different concentrations of antidepressants (5, 40, 80, 120, 160 and 200 ng/mL) and were analyzed. Relative matrix effect was evaluated by applying a two-tailed homoscedastic Student's t-test, comparing the results obtained with the set of data obtained with human VH and bovine VH and SS. No significant matrix effect was found for AMI and NTR in the three evaluated matrices. However, a great variability was observed for IMI and DES for all matrices. Once compatibilities among the matrices were demonstrated, the method was fully validated for AMI and NTR in SS. The method was applied to six VH samples deriving from real cases whose femoral whole blood (FWB) was analyzed by a previously published method. An average ratio (VH/FWB) of ∼ 0.1 was found for both compounds.
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Affiliation(s)
- Marcelo Filonzi dos Santos
- Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Professor Lineu Prestes, 580 13B CEP: 05508-000, São Paulo, SP, Brazil
| | - Adrian Yamada
- Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Professor Lineu Prestes, 580 13B CEP: 05508-000, São Paulo, SP, Brazil
| | | | - Vilma Leyton
- Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | | | - Mauricio Yonamine
- Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Professor Lineu Prestes, 580 13B CEP: 05508-000, São Paulo, SP, Brazil
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Pires MCDC, Raposo MCF, Sougey EB, Bastos Filho OC, Silva TS, Passos MPD. Indicadores de risco para tentativa de suicídio por envenenamento: um estudo caso-controle. JORNAL BRASILEIRO DE PSIQUIATRIA 2015. [DOI: 10.1590/0047-2085000000078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Considerando o envenenamento como o método mais utilizado para a tentativa de suicídio e a escassez de evidências nacionais sobre o tema, investigamos alguns possíveis indicadores de risco nesse tipo de tentativa. Métodos Estudo do tipo caso-controle em uma emergência geral de um hospital público, na cidade do Recife com 220 indivíduos, distribuídos em dois grupos de 110 pacientes cada, que estavam em tratamento, sendo o grupo casos os sobreviventes de tentativa de suicídio por envenenamento e os controles, sem história de intoxicação/envenenamento nem tentativa de suicídio, pareados por gênero e idade. Resultados O gênero feminino predominou na amostra (70,9%), com idade média de 29 anos; 73% declararam etnia branca ou morena; menos da metade vivia em convívio marital; a maioria tinha religião; ambos tinham poucos anos de estudo. Houve diferença significativa (p = 0,003) para dependência financeira entre os grupos, com chance 2,25 vezes maior para tentar suicídio entre os casos. Ter sofrido fatos traumáticos e abuso sexual na infância revelou diferença significativa. Conclusões Foram considerados indicadores de risco no grupo caso: estar em dependência financeira de terceiros, ter sofrido abuso sexual na infância, ideação suicida, histórico de transtorno mental na família, possuir algum transtorno mental e, principalmente, comorbidade(s) psiquiátrica(s). No modelo de regressão, foi possível estimar uma chance de tentativa de suicídio por envenenamento de até 94,0% na presença conjunta de quatro fatores. A pesquisa representa uma das primeiras iniciativas para ampliação das discussões sobre os fatores de risco para tentativa de suicídio em âmbito nacional.
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Pires MCDC, Silva TDPSD, Passos MPD, Sougey EB, Bastos Filho OC. Risk factors of suicide attempts by poisoning: review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2014; 36:63-74. [DOI: 10.1590/2237-6089-2013-0044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Introduction: Suicide, a complex and universal human phenomenon, is a major public health problem. This study reviewed the literature about the major risk factors associated with suicide attempts by poisoning. Methods: An integrative review of the literature was performed in databases (LILACS, PubMed and MEDLINE) to search for studies published between 2003 and 2013, using the following keywords: suicide, attempted; poisoning; risk factors. Inclusion criteria were: original study with abstract, sample of adults, and attempted suicide by poisoning in at least 50% of the study population. Results: Two hundred and nineteen studies were retrieved and read by two independent examiners, and 22 were included in the study. The main risk factors for suicide attempts by poisoning were female sex, age 15-40 years, single status, little education, unemployment, drug or alcohol abuse or addiction, psychiatric disorder and psychiatric treatment using antidepressants. Conclusion: Further prospective studies should be conducted to confirm these risk factors or identify others, and their findings should contribute to planning measures to prevent suicide attempts.
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Takahama CH, Turini CA, Girotto E. Perfil das exposições a medicamentos por mulheres em idade reprodutiva atendidas por um Centro de Informações Toxicológicas. CIENCIA & SAUDE COLETIVA 2014; 19:1191-9. [DOI: 10.1590/1413-81232014194.00512013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 04/27/2013] [Indexed: 11/21/2022] Open
Abstract
O objetivo deste artigo é descrever os dados epidemiológicos referentes às exposições a medicamentos por mulheres em idade fértil atendidas por um Centro de Informações Toxicológicas. Realizou-se um estudo com mulheres em idade fértil, expostas a medicamentos entre 2007 e 2011. Foram estudadas variáveis relacionadas às pacientes, à ocorrência e ao medicamento envolvido, totalizando 777 notificações. Os dados foram obtidos do Sistema de Informação de Agravos de Notificação e processadas com o uso do programa Epi Info. A maioria das ocorrências (90,5%) foi intencional, em 33,7% dos casos foram utilizados de dois a três medicamentos e a frequência de hospitalização foi de 35,6%. Os medicamentos com atuação no Sistema Nervoso Central foram responsáveis por 59,9% das ocorrências, destacando-se os antiepilépticos (21,2%) e os antidepressivos (20,7%). Os principais fatores associados à hospitalização das pacientes foram: demora no atendimento após a ocorrência da exposição, pacientes com nível superior, contato com dois ou mais medicamentos e exposições a antiepilépticos e antidepressivos. Os resultados obtidos mostraram que as exposições a medicamentos representam um grave problema à saúde de mulheres em idade fértil e contribuem para o aumento das internações hospitalares.
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Sousa GSD, Silva RMD, Figueiredo AEB, Minayo MCDS, Vieira LJEDS. Circunstâncias que envolvem o suicídio de pessoas idosas. ACTA ACUST UNITED AC 2014. [DOI: 10.1590/1807-57622013.0241] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
O trabalho analisa experiências e relações familiares que antecederam o suicídio de idosos. Trata-se de pesquisa qualitativa, com método de autópsia psicossocial. Contempla casos de 16 idosos que cometeram suicídio entre 2006 a 2009 em três municípios do Nordeste Brasileiro. À luz da Análise de Conteúdo, elucidaram-se as categorias: experiências que antecederam o suicídio de pessoas idosas e enunciação do suicídio pelo idoso aos seus componentes familiares. Destacam-se os fatores associados ao suicídio: alterações de humor e expressões de estados depressivos, conflitos familiares permeados por dificuldades financeiras, e uso abusivo de álcool e ideação suicida por anunciação do desejo de antecipar seu fim. Tornam-se necessários o olhar abrangente e o ouvir reflexivo sobre o idoso por parte dos agentes sociais, familiares, amigos e diversos setores, especificamente o setor saúde, gestores e profissionais que provoquem mudanças significativas na dinâmica do serviço.
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Magalhães APND, Alves VDM, Comassetto I, Lima PC, Faro ACME, Nardi AE. Atendimento a tentativas de suicídio por serviço de atenção pré-hospitalar. JORNAL BRASILEIRO DE PSIQUIATRIA 2014. [DOI: 10.1590/0047-2085000000003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objetivo: Investigar as características das vítimas de tentativa de suicídio atendidas em serviço pré-hospitalar e os intervalos de tempo consumidos nessa fase de atendimento. Métodos: Estudo transversal utilizando dados da fase pré-hospitalar de atendimento às vítimas de tentativa de suicídio no município de Arapiraca, no ano de 2011. Para análise dos dados, foram realizados teste exato de Fisher, teste t de Student e regressão logística múltipla. Resultados: Foram atendidas 80 vítimas de tentativa de suicídio pelo serviço de atenção pré-hospitalar. As mulheres, com idade superior a dos homens, foram as que mais tentaram suicídio (n = 44, 55%), e a intoxicação por medicamentos foi o método mais utilizado (n = 44, 55%). As tentativas de suicídio ocorreram com maior frequência no outono (n = 29, 36,25%), no dia de domingo (n = 18, 22,5%), principalmente no período vespertino (n = 33, 41,25%). O tempo gasto para o atendimento pré-hospitalar variou entre 34,4 e 40,5 minutos. As variáveis que estiveram associadas às tentativas de suicídio por sexo foram idade (p = 0,03) e tempo de transporte (p = 0,01). Conclusão: Foram encontradas diferenças entre os sexos das vítimas de tentativa de suicídio atendidas pelo serviço de atenção pré-hospitalar. As mulheres apresentaram maior idade que os homens e o tempo de transporte foi maior em vítimas do sexo masculino, sugerindo maior gravidade nas tentativas de suicídio cometidas por esse grupo.
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Teixeira RKC, Yamaki VN, Yasojima EY, Brito MVH. Effect of copaiba oil in hepatic damage induced by acetaminophen in rats. Acta Cir Bras 2013; 28:526-30. [DOI: 10.1590/s0102-86502013000700008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Accepted: 06/13/2013] [Indexed: 11/22/2022] Open
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Corcoran P, Heavey B, Griffin E, Perry IJ, Arensman E. Psychotropic medication involved in intentional drug overdose: implications for treatment. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.13.23] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Menck RA, de Lima DS, Seulin SC, Leyton V, Pasqualucci CA, Muñoz DR, Osselton MD, Yonamine M. Hollow-fiber liquid-phase microextraction and gas chromatography-mass spectrometry of barbiturates in whole blood samples. J Sep Sci 2012; 35:3361-8. [DOI: 10.1002/jssc.201200444] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/27/2012] [Accepted: 08/02/2012] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | - Vilma Leyton
- Faculty of Medicine; University of São Paulo; Brazil
| | - Carlos Augusto Pasqualucci
- Faculty of Medicine; University of São Paulo; Brazil
- Death Verification Service; University of São Paulo; Brazil
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