Psychosis with coexisting substance misuse: assessment and management in adults and young people.

This guideline offers best practice advice on the assessment and management of people with psychosis and coexisting substance misuse. Psychosis is a condition that affects a person’s mental state, including their thoughts, mood and behaviour. The symptoms of psychosis are:• hallucinations – hearing voices and sometimes seeing things that are not really there• delusions – having fixed beliefs that are false but which the person believes in completely. Substance misuse is a broad term encompassing, in this guideline, the harmful use of any psychotropic substance, including alcohol and either legal or illicit drugs. Use of such substances is harmful when it has a negative effect on a person’s life, including their physical and mental health, relationships, work, education and finances or leads to offending behaviour.This resource was contributed by The National Documentation Centre on Drug Use.

Should screening for Chlamydia trachomatis and Neisseria gonorrhoeae in HIV-men who have sex with men be recommended?

INTRODUCTION Sexually transmitted infections (STI) like Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been associated with increased risk of HIV acquisition (1). It has been also described as a high prevalence of asymptomatic CT and NG infections in men who have sex with men (MSM) (2). The aim of this study was to know the prevalence of CT and/or NG infections in asymptomatic HIV-MSM and the related factors. MATERIALS AND METHODS Prospective study of a cohort of asymptomatic HIV-MSM with follow-up in Malaga (southern Spain) during October 2012-May 2014. Patients with an opportunistic event or who received active antibiotic therapy for CT and/or NG in the previous month were excluded. All of them completed a questionnaire about sexual behaviour, barrier methods and recreational drugs use. Demographical, epidemiological, clinical, analytical and therapeutic data were also collected. Pharyngeal and rectal swabs, and urine samples were collected to be tested for CT and NG by nucleic acid amplification test (c4800 CT/NG. Roche Diagnostics, Mannheim, Germany) (3). STATISTICS ANALYSIS SPSS 17.0. RESULTS 255 patients were asked to participate and 248 of them accepted. Median age was 37.7 (30.6-46.3) years, median time since HIV diagnosis was 47.7 (10.5-104.1) months, and median CD4 cells count was 607 (440-824) cell/µL. There were 195 (78.6%) patients on antiretroviral therapy; 81.5% of them had undetectable viral load. 80.5% of the patients had a past history of STI. Infection by CT and/or NG was diagnosed in 24 (9.7%) patients. Overall four urine samples, two pharyngeal, and 15 rectal ones were positive for CT, and five pharyngeal and five rectal swabs were positive for NG. Two patients were co-infected by CT and NG: one with CT in urine and both in rectum, another with CT in urine and rectum and NG in pharynx. One patient presented CT in pharynx and rectum, and two patients NG in pharynx and rectum. Positive CT and/or NG tests were only related with detectable HIV viral load (OR 3.08, 95% CI 1.2-7.4; p=0.01). It was not related with sexual behaviour, nor with alcohol or recreational drugs use. CONCLUSIONS STI screening had a great acceptance in this population. There was a high prevalence of asymptomatic CT and/or NG infections. Rectum sample was the most effective one. Viral suppression could protect from these STI. Screening should be recommended in HIV-MSM.

Acute opiate overdose: characteristics of 190 consecutive cases.

AIMS: To characterize the population of drug users consulting the Emergency Room (ER) of a university hospital with acute opiate overdose (AOO) and to assess rate of referral to specialized treatment programme. DESIGN: Survey of a 12-month sample of AOO patients. MEASUREMENTS: Medical and psychosocial features of the drug users, details of emergency treatment and referral by a mobile resuscitation team (SMUR) and the ER of our hospital (CHUV-Lausanne, Switzerland). In addition fatal AOO cases were collected by the Institute of Forensic Medicine (IFM) during the same period. FINDINGS: One hundred and eighty-four cases of AOO (134 patients) were treated. The files of the IFM detailed six additional deceased cases. This population of drug users was characterized by an over-representation of men (73%), by young age (27.4 years), by a high rate of multi-drugs use (90%) and by a high rate of multiple previous overdoses (2.6). Average length of stay was 20.1 hours but 41% of cases stayed less than 8 hours. Only one patient was readmitted within an 8-hour period. When discharged, 78% returned home. Unexpectedly, 67% of patients were not referred to any therapeutic programme for drug addiction. CONCLUSION: This study shows the low mortality of AOO when treated but also demonstrates the need to improve psychosocial evaluation and referral of drug addicts admitted with AOO.

The causes of illegal drug industry growth in the Andes, Anti-Drug Policies and their effectiveness

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Avaliação da publicidade de medicamentos veiculada nas principais emissoras de rádio de Natal-RN

Drugs advertising is one of the most important marketing resources used by the pharmaceutical industry to induce people to buy these products although they do not have the real necessity to use them. The purpose of this article is to evaluate drugs advertisings transmitted on radio stations in Natal/RN, from October 2007 to September 2008. Were collected 228 advertising pieces, where, 21 were different among themselves and corresponded to 15 drugs. The results showed that 73,3% of the drugs ads were announced on AM station and 26,7% on FM station. The majority of the drugs were constituted of analgesics (26%), following by antiacids, vitamins, phitotherapics (13% each). The legal analysis showed that each advertising had some kind of infraction. The omission of the registration number happened in each advertising, following by the totally lack of contraindications (95,2%) and contraindications DCB/DCI (76,2%). In 42,9% advertisements were observed the relation between drugs use and physique/intellectual/emotional/sexual performance and/or beauty and 33% of them had abusive exploration of illnesses. The obligatory warning was omitted in 28,6% and the offer of financial bonus happened in 9,5% cases. The content analysis demonstrated that the most persuasion and convincing elements observed were indicatives of consumption appeal (34,2%). The study indicates the necessity of the topic drugs advertisements to be treated in a wide context, that is, to be discussed as a public health concern. Although the advertising regulation and inspection is the State responsibility , this should be shared with the advertising agency, pharmaceutical industry and media. Furthermore, it is indispensable to inform and to conscience the population of their rights in such mistaken situation

Estudo da bula de medicamentos: Uma análise da situação

This study was carried out in the city of Araraquara (SP, Brazil), where 1829 people selected randomly from 42 districts were interviewed with regard to their use of medicines, in particular whether and how they read the insert information sheet and the most frequently read items and problems encountered in the text. Surveys were performed in two stages, the first when package inserts were regulated in Brazil by Portaria SVS 110/1997 (Ministry of Health directive) and the second after the new regulation (RDC 140/2003) came into force. Out of 1829 people interviewed, 1597 reported using some medicine. The markedly similar results in both stages of the research pointed to the difficulties encounteved in reading the package inserts, due to the small letters, the obscure language and the massive amount of information. This paper shows that package inserts of medicines need to be simpler, so the patients have an idea of the importance of the medicine and are able to realize soon any problem that might appear due to the use of the medicine and what action they should take. Furthermore, it will be helpful to the evaluation of the package inserts of medicines, elaborated in conformity with RDC 140, if they work effectively as a source of information and guidance for the patient are not simply given a new layout, while maintaining items that impede their understanding and use.

Comportamento violentos(foco em bullying) e uso de substâncias psicoativas por alunos do ensino médio e fundamental de Botucatu, Brasil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Simulação computacional e síntese de polímero molecularmente impresso para extração em fase sólida (MISPE) de ciprofloxacina em urina

Pós-graduação em Química - IQ

Meninas confinadas. Perfil das jovens em cumprimento de medida de internação em São Paulo e no Pará

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Consumo de drogas adictivas en alumnos de la UNCuyo, Mendoza, Argentina.

Este trabajo muestra los resultados de una encuesta realizada en 2010 sobre consumo de drogas adictivas en alumnos de 7 Facultades de la UNCUYO y los compara con los resultados obtenidos 12 años antes con una encuesta equivalente. La encuesta fue semiestructurada, con 17 preguntas, autocumplimentada, individual y anónima, con una muestra de 1108 alumnos de ambos sexos. De esa encuesta se utilizaron 7 preguntas específicas sobre drogas adictivas y una pregunta sobre consumo de medicamentos en general, con 46 opciones entre las que figuraban 10 denominaciones comerciales de benzodiacepinas, como drogas adictivas de prescripción. Para las comparaciones estadísticas se utilizó Chi cuadrado. El ranking de drogas utilizadas fue relativamente similar en 1998 y 2010 pero, exceptuando tabaco y “otras drogas" que se mantuvieron estables, el resto aumentó alrededor de 4 veces en el periodo. El 82,8% de los alumnos manifestó consumir alcohol (siempre + a veces); de 1 a 5 vasos semanales el 79%. En todas las Facultades, cerveza y Fernet encabezaron el ranquing de preferencias por bebidas alcohólicas. La prevalencia del consumo de tabaco en el total de la muestra se mantuvo constante en 1998 y 2010 (alrededor del 28%) pero el consumo entre Facultades fue variable y en Artes fue significativamente más elevado (42%). Siguen en el ranking marihuana con 10% de prevalencia, tranquilizantes con alrededor del 6% y cocaína con poco más del 1%. Finalmente “otras drogas" (Hachis, LSD, extasis, anabólicos, anfetaminas, “hongos") representaron solamente un 3% de prevalencia. Artes y Ciencias Políticas mostraron las mayores prevalencias de consumo y Derecho e Ingeniería las menores. Esto indica implementar acciones preventivas y correctivas particulares para cada Facultad.

Emagrecer sem benefícios

A sociedade moderna tem instituído novos valores, crenças e formas de vida. Estamos sempre à procura de novas maneiras de tornar a vida do ser humano mais fácil e prática, privilegiando o menor esforço, o conforto e o sedentarismo. No entanto, este tipo de vida tem as suas consequências. Uma das principais decorre do facto de haver uma diminuição da atividade física, enquanto a ingestão calórica habitual do indivíduo pouco ou nada varia. Isto vai levar a que a maior parte da capacidade energética da comida que ingerimos não seja gasta e, como tal, vai depositar-se e acumular-se nos tecidos, originando aos poucos camadas de gordura cuja formação, não sendo controlada (o que é possível com uma mudança de hábitos), pode conduzir à obesidade. A obesidade não é só um problema estético, mas também um factor de risco para muitas doenças. São-nos apresentadas muitas opções para solucionar este problema, sendo que a grande maioria dos utentes prefere a opção que implica menos esforço: uso de medicamentos. Neste artigo são exploradas as vantagens e as contrapartidas deste tipo de ajuda, expondo factos que talvez o público desconheça e que devem ser considerados na hora da decisão.

Views of general practitioners and benzodiazepine users on benzodiazepines: A qualitative analysis

Effectively assisting benzodiazepine users to cease use requires a greater understanding of general practitioners' (GPs) and benzodiazepine users' views on using and ceasing benzodiazepines. This paper reports the findings from a qualitative study that examined the views of 28 GPs and 23 benzodiazepine users (BUs) in Cairns, Australia. A semi-structured interview was conducted with all participants and the information gained was analysed using the Consensual Qualitative Research Approach, which allowed comparisons to be made between the views of the two groups of interviewees. There was commonality between GPs and BUs on reasons for commencing benzodiazepines, the role of dependence in continued use, and the importance of lifestyle change in its cessation. However, several differences emerged regarding commencement of use and processes of cessation. In particular, users felt there was greater need for GPs to routinely advise patients about non-pharmacological management of their problems and potential adverse consequences of long-term use before commencing benzodiazepines. Cessation could be discussed with all patients who use benzodiazepines for longer than 3 months, strategies offered to assist in management of withdrawal and anxiety, and referral to other health service providers for additional support. Lifestyle change could receive greater focus at all stages of treatment. (c) 2005 Elsevier Ltd. All rights reserved.

Avaliação da atividade anti-Helicobacter pylori e citotóxica in vitro de extratos orgânicos obtidos das folhas de Encholirium spectabile e Syzygium cumini

Helicobacter pylori is a spiral, Gram negative, mobile, and microaerophilic bacteria recognized as a major cause of gastritis, ulcer, gastric cancer, and gastric low grade, B cell, mucosa – associated lymphoid tissue (MALT) lymphoma, constituting an important microorganism in medical microbiology. Its importance comes from the difficulty of treatment because the requirement of multiple drugs use, besides the increasing emergence of resistant and multiresistant strains to antibiotics used in th e clinic. In order to expand safe and effective therapeutic options , chemical studies on medicinal plants by obtaining extracts, fractions, isolated compounds or essential oils with some biological activity has been intensified . Given the above, the objective was to evaluate the inhi bitory activity of organic extracts derived from Syzygium cumini and Encholirium spectabile, with antiulcer history, and the essential oil, obtained from S. cumini, against H. pylori (ATCC 43504) by the disk diffusion method, for qualitative evaluation, an d determination of minimum inhibitory concentration (MIC) using the broth microdilution method, for quantitative analysis. Also was evaluated the extracts in vitro toxicity by a hemolytic assay using sheep red blood cells, and VERO and HeLa cells using the MTT assay to analyze cell viability. The extracts of both plant used in antimicrobial assays did not inhibit bacterial growth, however the essential oil of S. cumini (SCFO) proved effective, showing MIC value of 205 μg/mL (0.024 % dilution of the original oil). In the hemolytic assay, the same oil shows moderate toxicity, by promote 25% hemolysis at 1000 μg/mL. Regarding the cytotoxicity in cell culture, the SCFO, at 260 μg/mL, affected the cell viability around 80% of HeLa and 50% of VERO cells. So the oi l obtained from S. cumini leaves has antimicrobial activity against H. pylori and cytotoxicity potential, suggesting a source of new molecule drug candidates, since new stages of toxicity in vitro and in vivo, as well, chemical characterization be evaluate d. Moreover, the development of a prospective drug delivery system can result in a prototype to be used in preclinical tests.

Color Doppler ultrasound as a substitute to laparoscopy for the CL count in superovulated sheep.

This study aimed to evaluate the Color Doppler ultrasound as a substitute for laparoscopy for couting of corpora lutea (CL) in superovulated sheep. In conclusion, the Color Doppler ultrasonography is highly efficient to estimate the number of CLs in superovulated ewes. This represents an important advance because it replaces invasive laparoscopic procedure, avoids fasting, drugs use and unnecessary handling in animals that did not respond to the treatment. Therefore, the Color Doppler ultrasound can replace the laparoscopy for the assessment of superovulated sheep.

Cannabis use and other illicit drug use: Do subjective experiences during first cannabis use increase the probability of using illicit drug use?

Background and aims: Few studies have examined whether subjective experiences during first cannabis use are related to other illicit drug (OID) use. This study investigated this topic. Methods: Baseline data from a representative sample of young Swiss men was obtained from an ongoing Cohort Study on Substance Use Risk Factors (N ¼ 5753). Logistic regressions were performed to examine the relationships between cannabis use and of subjective experiences during first cannabis use with 15 OID. Results: Positive experiences increased the likelihood of using hallucinogens (hallucinogens, salvia divinorum, spice; p50.015), stimulants (speed, ecstasy, cocaine, amphetamines/methamphetamines; p50.006) and also poppers, research chemicals, GHB/GBL, and crystal meth (p50.049). Sniffed drugs (poppers, solvents for sniffing) and ''hard'' drugs (heroin, ketamine, research chemicals, GHB/GBL and crystal meth) were more likely to be used by participants who experienced negative feelings on first use of cannabis (p50.034). Conclusion: Subjective feelings seemed to amplify the association of cannabis with OID. The risk increased for drugs with effects resembling feelings experienced on first cannabis use. Negative experiences should also be a concern, as they were associated with increased risk of using the ''hardest'' illicit drugs.