Condições de saúde de pacientes do gênero feminino com dependência química

This study evaluated the general and oral health conditions of female patients included in a program for recovering drug addiction and patients who did not use drugs. By means of anamnesis and medical history, as well as medical and dental assessments, the health conditions of 160 patients were assessed; 80 presented drug dependence and 80 do not use drugs. The most frequently used drugs were tobacco, alcohol, and crack, usually in associations. The patients presenting chemical dependence had increased frequency of behavioral changes, as well as several diseases involving the immune and cardiovascular systems, detaching infectious and inflammatory reactions and delay in the process of tissue repair. In the oral cavity, it was verified a high occurrence of periodontitis and gingivitis. Chemical dependence showed to be associated to a high frequency of infections, arthritis, hypertension and behavioral changes, which normally would not be noted by health professionals, but that could compromise the results of medical and dental treatments.

Família Enterobacteriaceae, Acinetobacter baumannii e Pseudomonados na microbiota bucal de pacientes mantidos em unidades de terapia intensiva

Enteric organisms, pseudomonads and other opportunistic microorganisms in the oral microbiota have been linked to serious infections in patients hospitalized in intensive care units (ICU). The present study evaluated the presence of family Enterobacteriaceae, Pseudomonas aeruginosa, and Acinetobacter baumannii in the mouth of patients in ICU, correlating it with oral and systemic conditions. Data on health, socioeconomic status, medication use, drug addiction, medical and family histories of patients held for more than 72 hours in the ICU with a diagnosis of severe infection or that developed this condition after entry in said unit were obtained. Fifty patients provided clinical samples of supragingival and subgingival biofilms, saliva and oral mucous membranes were collected, as well as respiratory secretions from patients with pneumonia, blood and urine for sepsis. The presence of target microorganisms was carried out by polymerase chain reaction (PCR) and by culture using selective media. The Chi-square and Mann-Whitney tests were used for statistical analysis, and the significance level was 5%. The intraoral clinical conditions of the patients were poor. The family Enterobacteriaceae was the most prevalent, affecting 39.5% of the supragingival biofilm samples of patients attended in ICU and 18.6% of patients in the control group, besides the rods were the only group found in extraoral samples.

Classe mollicutes na boca de pacientes com dependência química

Drug addiction is one of the biggest public health problems worldwide, not only by the dimensions of the problem, but also by the severity of the damage, creating favorable conditions for opportunistic microorganisms such as class Mollicutes. This study aims to evaluate the presence of the main species and genera of this group in the subgingival biofilm of drug addiction patients, comparing them with non-dependent subjects. For this purpose, data on systemic health conditions, socioeconomic characteristics, drug addiction from 72 patients with drug addiction kept in rehab clinics and 100 non-dependent patients who formed the control group were obtained. Intra and extraoral clinical examinations were performed and samples of subgingival plaque were collected through sterile absorbent paper cones. The presence of different genera and species of the class Mollicutes was evaluated by PCR using the specific primers and conditions for each microorganism. The statistical analysis was performed using the Chi-square test for comparisons of three or more variables and the Mann-Whitney test, with significance level of 5%. Out of species and genera evaluated, Mycoplasma salivarium showed correlation with gingival inflammation in both patient groups and was more frequently detected among drug addiction patients

Ocorrência de microrganismos periodontopatogênicos em pacientes com dependência química

Drug addiction won dramatic aspects in terms of its dimensions and the effects that it imposes. These chemical agents are able to reduce the immune reactivity and tissue repair, and enhance microbial aggression, aggravating the destruction of the periodontium and other side effects. This study aimed to evaluate the presence of key periodontal pathogens in the mouth of drug addiction patients, comparing it with individuals who do not exhibit this dependence, as well as assess the influence of oral conditions on the occurrence of such microorganisms. For this purpose, data on systemic health conditions, socioeconomic, patterns of licit or illicit drug consumption of 100 patients with chemical dependency kept in rehabilitation clinics and an equal number of non-dependent patients, who formed the control group were obtained. Intra and extraoral clinical examinations were performed and samples of supragingival and subgingival biofilm, saliva and mucous membranes were collected. The presence of the targeted microorganism was assessed by polymerase chain reaction (PCR). It was found that Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola showed close correlation with bone loss and gingival bleeding in drug addiction dependents and control group, but the oral mucous membranes and saliva of addicts showed higher occurrence of these pathogens.

Role of the bed nucleus of the stria terminalis in cardiovascular changes following chronic treatment with cocaine and testosterone: A role beyond drug seeking in addiction?

Neural plasticity has been observed in the bed nucleus of the stria terminalis (BNST) following exposure to both cocaine and androgenic-anabolic steroids. Here we investigated the involvement of the BNST on changes in cardiovascular function and baroreflex activity following either single or combined administration of cocaine and testosterone for 10 consecutive days in rats. Single administration of testosterone increased values of arterial pressure, evoked rest bradycardia and reduced baroreflex-mediated bradycardia. These effects of testosterone were not affected by BNST inactivation caused by local bilateral microinjections of the nonselective synaptic blocker CoCl2. The single administration of cocaine as well as the combined treatment with testosterone and cocaine increased both bradycardiac and tachycardiac responses of the baroreflex. Cocaine-evoked baroreflex changes were totally reversed after BNST inactivation. However, BNST inhibition in animals subjected to combined treatment with cocaine and testosterone reversed only the increase in reflex tachycardia, whereas facilitation of reflex bradycardia was not affected by local BNST treatment with CoCl2. In conclusion, the present study provides the first direct evidence that the BNST play a role in cardiovascular changes associated with drug abuse. Our findings suggest that alterations in cardiovascular function following subchronic exposure to cocaine are mediated by neural plasticity in the BNST. The single treatment with cocaine and the combined administration of testosterone and cocaine had similar effects on baroreflex activity, however the association with testosterone inhibited cocaine-induced changes in the BNST control of reflex bradycardia. Testosterone-induced cardiovascular changes seem to be independent of the BNST. © 2013 IBRO.

Stress Abolishes the Effect of Previous Chronic Ethanol Consumption on Drug Place Preference and on the Mesocorticolimbic Brain Pathway

BackgroundConditioned place preference (CPP) to ethanol (EtOH) is an important addiction-related alteration thought to be mediated by changed neurotransmission in the mesocorticolimbic brain pathway. Stress is a factor of major importance for the initiation, maintenance, and reinstatement of drug abuse and modulates the neurochemical outcomes of drugs. Thus, the aim of this study was to investigate the effects of concomitant exposure to chronic EtOH and stress on CPP to this drug and alterations of dopaminergic and serotonergic neurotransmission in mice.MethodsMale Swiss mice were chronically treated with EtOH via a liquid diet and were exposed to forced swimming stress. After treatment, animals were evaluated for conditioning, extinction, and reinstatement of CPP to EtOH. Also, mice exposed to the same treatment protocol had their prefrontal cortex (PFC), nucleus accumbens (NAc), and amygdala dissected for the quantitation of dopamine, serotonin, and their metabolites content.ResultsData showed that previous chronic exposure to EtOH potentiated EtOH conditioning and increased dopaminergic turnover in PFC. Exposure to stress potentiated EtOH conditioning and decreased dopaminergic turnover in the NAc. However, animals exposed to both chronic EtOH and stress did not display alterations of CPP and showed an elevated content of dopamine in amygdala. No treatment yielded serotonergic changes.ConclusionsThe present study indicates that previous EtOH consumption as well as stress exposure induces increased EtOH conditioning, which can be related to dopaminergic alterations in the PFC or NAc. Interestingly, concomitant exposure to both stimuli abolished each other's effect on conditioning and PFC or NAc alterations. This protective outcome can be related to the dopaminergic increase in the amygdala.

Drug addictions and sexual violence in childhood and adolescence: analyzing life stories

The sexual abuse suffered in childhood and adolescence, in addition to damage to physical and psychological health of the victim, is considered as an important risk factor for alcohol and drugs addiction, development of psychopathology and psychosocial damage in adulthood. In addition to the pain and humiliation that are submitted by the abuse, children and adolescents also experience shame and guilt which require them to adopt coping strategies to endure those feelings. The use of psychoactive substances is a recognized way of dealing with the pains of living. This work, which is of narrative style, analyses and discusses, through five case reports, chemical dependency as a result of sexual abuse suffered in childhood and/or adolescence. The eight subjects in this study are male and have suffered sexual violence in this age period of life. Their ages range from 23 years to 39 years, and all are admitted to a therapeutic community in a city in the interior of Sao Paulo state, in Brazil, for treatment of chemical dependency, being met by the Department of Psychology. The reasons for the choice of the participants for treatment modality for patients are: difficult to stop using drugs, even unwilling to take it, they have easy access to it; the feeling of losing control over their lives; by successive losses as a result of drug use, and for fear that their lives had a tragic ending. With the exception of two participants, the others do not classify that as a child suffered sexual violence. However, all attribute that facilitated their entry into the world of drugs. Seven participants experienced such violence in childhood (between 7 years and 9 years) and adolescence (age 14). The attackers were people closed to the victims—in the case of two victims, their families, with the exception of one participant who was raped by a stranger. Six participants declared themselves as homosexual. Another participant does not claim to be homosexual, but presents difficulties in terms of sexuality. Two participants are HIV positive. The start of psychoactive substances use occurred during adolescence (12 years to 17 years). The participants see drugs as an anesthetic to the pain of the soul, a way to get pleasure, but they get charged expensively, as it increases the feeling of emptiness, guilt, helplessness, worthlessness and hopelessness. Although participants have sought help to deal with addiction, it is noted that throughout the life course the issue of sexual violence was not treated. It was noted that the patients have a double stigma in society: the issue of drugs addiction and the orientation of sexual desire, because the majority of participants are homosexual. The results reinforce the need for effective action geared to accommodate the victims of sexual violence and effective preventive measures to prevent children and adolescents from being abused.