Influ��ncia do uso de drogas il��citas na an��lise seminal e hormonal

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

Potenciais intera����es medicamentosas respons��veis por interna����es hospitalares

As intera����es medicamentosas (IM) s��o consideradas um problema de sa��de p��blica, pois podem causar resultados negativos �� sa��de dos usu��rios de medicamentos. Portanto o referido trabalho teve como objetivos: estimar a preval��ncia de interna����es hospitalares relacionadas a Potenciais IM (PIM); identificar os sinais e sintomas, e os fatores de risco para a hospitaliza����o relacionados �� PIM. Metodologia: Realizou-se estudo transversal na cl��nica geral de um hospital privado do interior de S��o Paulo (Brasil), em maio de 2006, com pacientes acima de 18 anos, com tempo de hospitaliza����o superior a 24horas, sendo os mesmos entrevistados sobre os sintomas/motivos de interna����o e os medicamentos que haviam utilizado previamente �� hospitaliza����o. Calculou-se Odds-ratiopara identificar fatores de risco, sendo encontrado os seguintes resultados: 168 pacientes utilizando mais de um medicamento, dos quais 57 apresentaram PIM, sendo que em 17(10,1%), os sinais e sintomas da PIM possivelmente foram a causa da hospitaliza����o. A maioria das manifesta����es cl��nicas das PIM foram sintomas cardiovasculares (44,3%), gastrintestinais (17,2%) e musculoesquel��ticos (13,8%) e 10% das PIM foram consideradas potencialmente perigosas. N��o foram detectados fatores de risco relacionados ao g��nero, idade, uso de medicamentos de estreita faixa terap��utica para hospitaliza����o por PIM. A polimedica����o foi fator de risco para ocorr��ncia de PIM (p < 0,0001) opostamente ao aumento da idade que revelou ser um fator de prote����o (p=0,02). Conclus��o: Se faz necess��rio seguimento farmacoterap��utico de pacientes que utilizam f��rmacos de estreita faixa terap��utica, pois estas subst��ncias est��o frequentemente envolvidas em IM perigosas. Palavras-chave: Problema relacionado ao medicamento. Resultado negativo associado ao medicamento. Erros de medica����o. Intera����es de medicamentos.

Aspectos psicossociais e condi����es bucais em dependentes qu��micos internados para desintoxica����o

P��s-gradua����o em Odontologia - FOA

Fatores progn��sticos para o abandono precoce do tratamento da depend��ncia do ��lcool, crack e outras drogas em uma comunidade terap��utica

P��s-gradua����o em Sa��de Coletiva - FMB

Caminhos de uma rede: o percurso do usu��rio de ��lcool e outras drogas

P��s-gradua����o em Psicologia - FCLAS

Epidemiologia molecular do v��rus da Hepatite C: an��lise comparativa de diferentes regi��es subgen��micas aplicadas a estudos de associa����o gen��tica

Coordena����o de Aperfei��oamento de Pessoal de N��vel Superior (CAPES)

Mycobacterium tuberculosis population structure shift in a 5-year molecular epidemiology surveillance follow-up study in a low endemic agro-industrial setting in S��o Paulo, Brazil

Funda����o de Amparo �� Pesquisa do Estado de S��o Paulo (FAPESP)

Redes de aten����o �� sa��de para gestantes usu��rias de ��lcool e/ou outras drogas

P��s-gradua����o em Sa��de Coletiva - FMB

Drogas, sujeito e proibicionismo: uma discuss��o sobre os modelos de aten����o aos usu��rios de drogas

P��s-gradua����o em Psicologia - FCLAS

Frequency of subtype B and F1 dual infection in HIV-1 positive, Brazilian men who have sex with men

Background: Because various HIV vaccination studies are in progress, it is important to understand how often inter- and intra-subtype co/superinfection occurs in different HIV-infected high-risk groups. This knowledge would aid in the development of future prevention programs. In this cross-sectional study, we report the frequency of subtype B and F1 co-infection in a clinical group of 41 recently HIV-1 infected men who have sex with men (MSM) in Sao Paulo, Brazil. Methodology: Proviral HIV-1 DNA was isolated from subject's peripheral blood polymorphonuclear leukocytes that were obtained at the time of enrollment. Each subject was known to be infected with a subtype B virus as determined in a previous study. A small fragment of the integrase gene (nucleotide 4255-4478 of HXB2) was amplified by nested polymerase chain reaction (PCR) using subclade F1 specific primers. The PCR results were further confirmed by phylogenetic analysis. Viral load (VL) data were extrapolated from the medical records of each patient. Results: For the 41 samples from MSM who were recently infected with subtype B virus, it was possible to detect subclade F1 proviral DNA in five patients, which represents a co-infection rate of 12.2%. In subjects with dual infection, the median VL was 5.3 x 10(4) copies/ML, whereas in MSM that were infected with only subtype B virus the median VL was 3.8 x 10(4) copies/ML (p &gt; 0.8). Conclusions: This study indicated that subtype B and F1 co-infection occurs frequently within the HIV-positive MSM population as suggested by large number of BF1 recombinant viruses reported in Brazil. This finding will help us track the epidemic and provide support for the development of immunization strategies against the HIV.

Risk factors for hepatitis C virus infection in Inland Brazil: An analysis of pooled epidemiological sectional studies

In order to assess the contribution of different parenteral routes as risk exposure to the hepatitis C virus (HCV), samples from nine surveys or cross-sectional studies conducted in two Brazilian inland regions were pooled, including a total of 3,910 subjects. Heterogeneity among the study results for different risk factors was tested and the results were shown to be homogeneous. Anti-HCV antibodies were observed in 241 individuals, of which 146 (3.7%, 95% CI?=?3.24.4) had HCV exposure confirmed by immunoblot analysis or PCR test. After adjustment for relevant variables, a correlation between confirmed HCV exposure and injection drug use, tattooing, and advance age was observed. In a second logistic model that included exposures not searched in all nine studies, a smaller sample was analyzed, revealing an independent HCV association with past history of surgery and males who have sex with other males, in addition to repeated injection drug use. Overall, these analyses corroborate the finding that injection drug use is the main risk factor for HCV exposure and spread, in addition to other parenteral routes. J. Med. Virol. 84:756762, 2012. (C) 2012 Wiley Periodicals, Inc.

Prevalence and risk factors of Hepatitis C virus infection in Brazil, 2005 through 2009: a cross-sectional study

Abstract Background Hepatitis C chronic liver disease is a major cause of liver transplant in developed countries. This article reports the first nationwide population-based survey conducted to estimate the seroprevalence of HCV antibodies and associated risk factors in the urban population of Brazil. Methods The cross sectional study was conducted in all Brazilian macro-regions from 2005 to 2009, as a stratified multistage cluster sample of 19,503 inhabitants aged between 10 and 69 years, representing individuals living in all 26 State capitals and the Federal District. Hepatitis C antibodies were detected by a third-generation enzyme immunoassay. Seropositive individuals were retested by Polymerase Chain Reaction and genotyped. Adjusted prevalence was estimated by macro-regions. Potential risk factors associated with HCV infection were assessed by calculating the crude and adjusted odds ratios, 95% confidence intervals (95% CI) and p values. Population attributable risk was estimated for multiple factors using a case���control approach. Results The overall weighted prevalence of hepatitis C antibodies was 1.38% (95% CI: 1.12%���1.64%). Prevalence of infection increased in older groups but was similar for both sexes. The multivariate model showed the following to be predictors of HCV infection: age, injected drug use (OR���=���6.65), sniffed drug use (OR���=���2.59), hospitalization (OR���=���1.90), groups socially deprived by the lack of sewage disposal (OR���=���2.53), and injection with glass syringe (OR���=���1.52, with a borderline p value). The genotypes 1 (subtypes 1a, 1b), 2b and 3a were identified. The estimated population attributable risk for the ensemble of risk factors was 40%. Approximately 1.3 million individuals would be expected to be anti-HCV-positive in the country. Conclusions The large estimated absolute numbers of infected individuals reveals the burden of the disease in the near future, giving rise to costs for the health care system and society at large. The known risk factors explain less than 50% of the infected cases, limiting the prevention strategies. Our findings regarding risk behaviors associated with HCV infection showed that there is still room for improving strategies for reducing transmission among drug users and nosocomial infection, as well as a need for specific prevention and control strategies targeting individuals living in poverty.

Den flygande maran : En studie om ��tta narkotikabrukande kvinnor i Stockholm

Between April 1997 and November 1999, I followed eight socially excluded female drug users in an attempt to describe their lives and living conditions. The study employs an ethnographic approach with the focus being directed at the specific woman and her life in relation to the social context where this life is lived. The study���s objective has been to describe the lives and living conditions of the eight drug-using women, as well as the extent of the opportunities available to them, as being determined by mechanisms of social exclusion. Their lives are understood on the basis of a feminist and social constructionist perspective where perceptions of ���the drug-abusing woman��� are regarded as the result of constructions of gender and deviance. The theoretical perspectives proceeds from the idea that one is not born a woman but rather becomes one. The fundamental idea is that women become women by means of processes of femininisation, in the context of which certain ways of interpreting and presenting oneself as a woman are regarded as good and others as bad. Our images of ���the female drug addict��� are based on how we define and interpret deviance and on the cultural and social thought and behaviour patterns we ascribe to people on the basis of bodily differences. It is images of ���the good woman��� that defines what we regard as characteristic of ���the bad woman��� and vice versa. The findings are organised into three main topics: femininity, living conditions and social control. The main findings are: The women described themselves as women by relating to normative messages about how women ���are and should be���, and their drug use constituted a means of coping with life from their social position. Their life revolved to a large extent around money via a constant struggle to find enough to cover the rent, food and other basic necessities. And finally, how the women���s relations to societal institutions were formed by their social position as ���female drug addicts��� and how the asymmetry of these relations produced certain fixed patterns of action for the parties involved.

Original analytical methods for the determination of psychoactive compounds in complex matrices

This thesis work aims to develop original analytical methods for the determination of drugs with a potential for abuse, for the analysis of substances used in the pharmacological treatment of drug addiction in biological samples and for the monitoring of potentially toxic compounds added to street drugs. In fact reliable analytical techniques can play an important role in this setting. They can be employed to reveal drug intake, allowing the identification of drug users and to assess drug blood levels, assisting physicians in the management of the treatment. Pharmacological therapy needs to be carefully monitored indeed in order to optimize the dose scheduling according to the specific needs of the patient and to discourage improper use of the medication. In particular, different methods have been developed for the detection of gamma-hydroxybutiric acid (GHB), prescribed for the treatment of alcohol addiction, of glucocorticoids, one of the most abused pharmaceutical class to enhance sport performance and of adulterants, pharmacologically active compounds added to illicit drugs for recreational purposes. All the presented methods are based on capillary electrophoresis (CE) and high performance liquid chromatography (HPLC) coupled to various detectors (diode array detector, mass spectrometer). Biological samples pre-treatment was carried out using different extraction techniques, liquid-liquid extraction (LLE) and solid phase extraction (SPE). Different matrices have been considered: human plasma, dried blood spots, human urine, simulated street drugs. These developed analytical methods are individually described and discussed in this thesis work.