Epidemiological and molecular characteristics of HIV-1 infection among female commercial sex workers, men who have sex with men and people living with AIDS in Paraguay

An HIV seroprevalence and molecular study was conducted among 935 subjects: 723 female commercial sex workers, 92 men who have sex with men and 120 HIV-positive volunteers. The reported injection drug use rates were 0.7% in female commercial sex workers and 3% in men who have sex with men. Sexually transmitted infections were reported in 265 (37%) of the female commercial sex workers and 38 (41%) of the men who have sex with men. A total of 20 (2.8%) female commercial sex workers and 12 (13%) men who have sex with men became HIV infected during the study period. A history of sexually transmitted infection increased the risk of subsequent HIV infection twofold (adjusted odds ratio of 2.5) among the female commercial sex workers, while cocaine use had an adjusted odds ratios of 6.61 among men who have sex with men. From 130 samples, and based on heteroduplex mobility assaying for the env gene, with sequencing of part of pol and/or full genomes, subtype B was the predominant subtype identified (66%); followed by subtype F (22%) and subtype C (4%). Recombinant CRF12-BF strains were identified in 6% and CRF17_BF was identified in 2%.

Hepatitis C virus and human T-lymphotropic virus coinfection: epidemiological, clinical, laboratory and histopathological features

Twenty-four hepatitis C virus patients coinfected with human T-lymphotropic virus type 1 were compared with six coinfected with HTLV-2 and 55 with HCV alone, regarding clinical, epidemiological, laboratory and histopathological data. Fischer's discriminant analysis was applied to define functions capable of differentiating between the study groups (HCV, HCV/HTLV-1 and HCV/HTLV-2). The discriminant accuracy was evaluated by cross-validation. Alcohol consumption, use of intravenous drugs or inhaled cocaine and sexual partnership with intravenous drug users were more frequent in the HCV/HTLV-2 group, whereas patients in the HCV group more often reported abdominal pain or a sexual partner with hepatitis. Coinfected patients presented higher platelet counts, but aminotransferase and gamma-glutamyl transpeptidase levels were higher among HCV-infected subjects. No significant difference between the groups was seen regarding liver histopathological findings. Through discriminant analysis, classification functions were defined, including sex, age group, intravenous drug use and sexual partner with hepatitis. Cross-validation revealed high discriminant accuracy for the HCV group.

Use of licit and illicit drugs at the university of Alfenas

This paper reports the study of drug consumption carried out within the population of undergraduate students from 2 colleges of Alfenas, in the state of Minas Gerais state. Both licit and illicit drugs were studied, including alcohol, tobacco, marijuana, cocaine, heroin, crack, inhalants, glue, tranquilizers, stimulants, and others. METHODOLOGY: The research included a wide bibliographical search and the application of a questionnaire to approximately 23% of the students (total of 6500 students). RESULTS: A total of 1500 students participated in this investigation. The results demonstrated that there was a significant consumption of both licit and illicit drugs. The pattern of drug consumption in the research sample was similar to other investigations conducted in Brazil and in other countries. DISCUSSION: It was observed that 55% of the university students use drugs. However, the most surprising finding was that most of the students (88%) answered "yes" to the inquiry, "Have you already tried any type of drug, including alcohol and cigarettes?" The students revealed that they had taken drugs even prior to the admission to the university. The results suggest clearly that the university environment does not necessarily represent the starting point for student drug consumption.

Relação entre o craving por tabaco e o craving por crack em pacientes internados para desintoxicação

OBJETIVO: Verificar se há relação entre aumento do craving por crack e aumento do craving por tabaco em pacientes internados para desintoxicação. MÉTODO: Ensaio clínico tipo quase-experimental de análise quantitativa. Amostra composta por 32 homens dependentes de cocaína (crack) e tabaco, em duas a três semanas de abstinência. Realizou-se intervenção em grupo, no qual, inicialmente, foram aplicados: CCQB (Cocaine Craving Questionnaire-Brief ), QSUB (Questionnaire of Smoking Urges-Brief ) e BAI (Inventário Beck de Ansiedade). Em seguida, foram aplicadas imagens relacionadas ao crack e reaplicados CCQB, QSUB e BAI. Após, foi realizada entrevista individual em que se aplicaram FSD (Ficha com Dados Sociodemográficos) e FTND (Fagerström Test for Nicotine Dependence). RESULTADOS: A partir da exposição de imagens relativas ao crack, houve aumento significativo do craving por crack, do craving por tabaco e dos sintomas de ansiedade, estando essas medidas correlacionadas positivamente entre si. CONCLUSÃO: Os resultados indicam uma associação significativa entre craving por crack e craving por tabaco, sugerindo que a abstinência de tabaco pode ajudar na eficácia do tratamento para dependência de crack.

Associação entre fissura e perfil antropométrico em dependentes de crack

OBJETIVO: Verificar a variação da fissura de dependentes de crack no decorrer da internação e a associação com perfil antropométrico. MÉTODOS: Trata-se de uma pesquisa quantitativa com delineamento transversal (n = 30). Avaliaram-se o perfil de consumo de substâncias psicoativas; dados sociodemográficos; variáveis antropométricas (peso, estatura, índice de massa corporal, relação cintura-quadril, perímetros, dobras cutâneas e diâmetro ósseo); e fissura avaliada por meio do Cocaine Craving Questionnaire Brief. As coletas de dados ocorreram nas 24 horas iniciais e finais do tratamento. RESULTADOS: Observou-se aumento significativo do percentual de gordura e diminuição significativa da fissura. Não se evidenciou associação entre variáveis antropométricas e fissura, tanto no início como ao final da internação. CONCLUSÃO: Houve significativa diminuição na fissura e modificação na composição corporal, entretanto não houve correlação entre essas variáveis.

Pregnant crack addicts in a psychiatric unit

OBJECTIVE: In this study we aim to characterize a sample of 85 pregnant crack addicts admitted for detoxification in a psychiatric inpatient unit. METHOD: Cross-sectional study. Sociodemographic, clinical, obstetric and lifestyle information were evaluated. RESULTS: Age of onset for crack use varied from 11 to 35 years (median = 21). Approximately 25% of the patients smoked more than 20 crack rocks in a typical day of use (median = 10; min-max = 1-100). Tobacco (89.4%), alcohol (63.5%) and marijuana (51.8%) were the drugs other than crack most currently used. Robbery was reported by 32 patients (41.2%), imprisonment experience by 21 (24.7%), trade of sex for money/drugs by 38 (44.7%), home desertion by 33 (38.8%); 15.3% were positive for HIV, 5.9% for HCV, 1.2% for HBV and 8.2% for syphilis. After discharge from the psychiatric unit, only 25% of the sample followed the proposed treatment in the chemical dependency outpatient service. CONCLUSION: Greater risky behaviors for STD, as well as high rates of maternal HIV and Syphilis were found. Moreover, the high rates of concurrent use of other drugs and involvement in illegal activities contribute to show their chaotic lifestyles. Prevention and intervention programs need to be developed to address the multifactorial nature of this problem.

Revisão sistemática sobre tratamentos psicológicos para problemas relacionados ao crack

OBJETIVO: O objetivo deste artigo é apresentar uma revisão sistemática da literatura sobre tratamentos psicológicos oferecidos para usuários de crack. MÉTODOS: Foi realizada uma revisão sistemática por meio de uma busca na literatura internacional e nacional, indexada nas bases de dados Medline, SciELO, Lilacs e Web of Science. Os descritores utilizados foram: crack or crack cocaine or cocaine smokers (crack) and psychosocial treatment or psycotherapy or psychosocial treatment (tratamento psicológico) e a busca incluiu artigos publicados no período de 2001 a 2011. RESULTADOS: No total foram encontrados 155 artigos por meio dos descritores utilizados. Os artigos foram agrupados em três dimensões: tratamentos psicossociais na internação e cuidados continuados, relaxamento respiratório e outras técnicas comportamentais e abordagens fundamentadas na Entrevista Motivacional, Cognitivo-Comportamental e Modelo Transteórico de Mudança. CONCLUSÃO: Com base nos estudos examinados, pode ser formulado um elenco de algumas intervenções que estão sendo estudadas para o tratamento de usuários de crack e algumas apresentam resultados satisfatórios. Os poucos esforços de comparação entre técnicas resultaram em evidências de pouca ou nenhuma diferença, ainda que se registre o benefício para os usuários na aplicação de qualquer delas. Não existe consenso acerca da efetividade no tratamento de usuários de crack. Parece oportuno e necessário o aprofundamento dos estudos nesse campo.

O uso da técnica cognitiva substituição por imagem positiva no manejo do craving em dependentes de crack

Objetivo O estudo visa avaliar a técnica cognitiva substituição por imagem positiva (SIP) no manejo do craving em dependentes de crack. Métodos Ensaio clínico do tipo quase-experimental de análise quantitativa. Amostra por conveniência, composta por 34 homens dependentes de cocaína/crack. Tinham o crack como a droga de escolha, haviam utilizado essa substância pela última vez entre 10 e 20 dias antes do início do tratamento. Os instrumentos aplicados foram: Cocaine Craving Questionnaire-Brief (CCQB), Escala Analógica Visual (EAV) para avaliar o craving e o quanto a técnica ajudou e uma ficha com dados sociodemográficos (FSD). Foram realizadas intervenções individuais. Inicialmente, foram aplicados o CCQB, a EAV e a FSD. Depois, os pacientes foram expostos a objetos relacionados ao uso do crack e foram reaplicados os instrumentos CCQB e EAV para mensuração da fissura. A seguir, foi realizada a técnica cognitiva substituição por imagem positiva e foram aplicados, pela terceira vez, o CCQB e a EAV. Resultados Os resultados desta pesquisa demonstraram uma redução dos escores do CCQB e da EAV pela técnica cognitiva SIP em uma amostra cujo perfil corresponde ao padrão geral dos usuários de crack. Conclusão Este estudo, apesar de algumas limitações metodológicas, sugere que a técnica cognitiva substituição por imagem positiva pode ser uma estratégia efetiva no manejo do craving em dependentes de crack.

Women users of crack: systematic review of Brazilian literature

ABSTRACT Objective To present Brazilian’s empirical studies that address this issue between the period of 2004 to 2014. Methods It is a Brazilian literature Systematic Review using the descriptors “crack cocaine” AND “women”, in the database Scopus, Lilacs, Medline and SciELO. Results From the 785 articles found, 16 articles contemplated the inclusion criteria. It was evidenced that the use of crack by women is related to physical and sexual violence, provoking HIV risks in consequence of prostitution, and social prejudice. Conclusion Given this reality, studies evaluating treatments in the Brazilian context are essential, according the specificities of women crack users.

Velhas e novas drogas: impactos da toxicodependência: estudo de caso na cidade de Braga

Dissertação de mestrado em Sociologia (área de especialização em Organizações e Trabalho)

Determinação de psicofármacos em cabelo humano por técnicas cromatográficas hifenadas: um método alternativo não-invasivo

Dissertação de mestrado em Técnicas de Caracterização e Análise Química

Indirect hydrogen analysis by gas chromatography coupled to mass spectrometry (GC-MS).

Gas chromatography (GC) is an analytical tool very useful to investigate the composition of gaseous mixtures. The different gases are separated by specific columns but, if hydrogen (H2 ) is present in the sample, its detection can be performed by a thermal conductivity detector or a helium ionization detector. Indeed, coupled to GC, no other detector can perform this detection except the expensive atomic emission detector. Based on the detection and analysis of H2 isotopes by low-pressure chemical ionization mass spectrometry (MS), a new method for H2 detection by GC coupled to MS with an electron ionization ion source and a quadrupole analyser is presented. The presence of H2 in a gaseous mixture could easily be put in evidence by the monitoring of the molecular ion of the protonated carrier gas. Copyright © 2013 John Wiley & Sons, Ltd.

First use of multiple substances: Identification of meaningful patterns

Context: Understanding the process through which adolescents and young adults are trying legal and illegal substances is a crucial point for the development of tailored prevention and treatment programs. However, patterns of substance first use can be very complex when multiple substances are considered, requiring reduction into a few meaningful number of categories. Data: We used data from a survey on adolescent and young adult health conducted in 2002 in Switzerland. Answers from 2212 subjects aged 19 and 20 were included. The first consumption ever of 10 substances (tobacco, cannabis, medicine to get high, sniff (volatile substances, and inhalants), ecstasy, GHB, LSD, cocaine, methadone, and heroin) was considered for a grand total of 516 different patterns. Methods: In a first step, automatic clustering was used to decrease the number of patterns to 50. Then, two groups of substance use experts, three social field workers, and three toxicologists and health professionals, were asked to reduce them into a maximum of 10 meaningful categories. Results: Classifications obtained through our methodology are of practical interest by revealing associations invisible to purely automatic algorithms. The article includes a detailed analysis of both final classifications, and a discussion on the advantages and limitations of our approach.

Population Normalization with Ammonium in Wastewater-Based Epidemiology: Application to Illicit Drug Monitoring

Fluctuations in ammonium (NH4+), measured as NH4-N loads using an ion-selective electrode installed at the inlet of a sewage treatment plant, showed a distinctive pattern which was associated to weekly (i.e., commuters) and seasonal (i.e., holidays) fluctuations of the population. Moreover, population size estimates based on NH4-N loads were lower compared to census data. Diurnal profiles of benzoylecgonine (BE) and 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC-COOH) were shown to be strongly correlated to NH4-N. Characteristic patterns, which reflect the prolonged nocturnal activity of people during the weekend, could be observed for BE, cocaine, and a major metabolite of MDMA (i.e., 4-hydroxy-3-methoxymethamphetamine). Additional 24 h composite samples were collected between February and September 2013. Per-capita loads (i.e., grams per day per 1000 inhabitants) were computed using census data and NH4-N measurements. Normalization with NH4-N did not modify the overall pattern, suggesting that the magnitude of fluctuations in the size of the population is negligible compared to those of illicit drug loads. Results show that fluctuations in the size of the population over longer periods of time or during major events can be monitored using NH4-N loads: either using raw NH4-N loads or population size estimates based on NH4-N loads, if information about site-specific NH4-N population equivalents is available.

Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with l- and d,l-methadone.

Sixty d,l- or l-methadone treated patients in maintenance therapy were interviewed for additional drug abuse and psychiatric comorbidity; 51.7% of the entire population had a comorbid Axis-I disorder, with a higher prevalence in females (P=0.05). Comorbid patients tended to have higher abuse of benzodiazepines, alcohol, cannabis, and cocaine, but not of heroin. They had received a significantly lower d,l- (P<0.05) and l-methadone dose than non-comorbid subjects. The duration of maintenance treatment showed an inverse relationship to frequency of additional heroin intake (P<0.01). Patients with additional heroin intake over the past 30 days had been treated with a significantly lower l-methadone dosage (P<0.05) than patients without. Axis-I comorbidity appears to be decreased when relatively higher dosages of d,l- (and l-methadone) are administered; comorbid individuals, however, were on significantly lower dosages. Finally, l-, but not d,l-methadone seems to be more effective in reducing additional heroin abuse.