RESUMO
BACKGROUND/AIMS: Some patients on opioid maintenance treatment (OMT) leave treatment temporarily or permanently. This study investigated whether patients interrupting their OMT differed from non-interrupters in sociodemographic and drug-use characteristics and examined acute/sub-acute somatic morbidity among the interrupters, prior to, during, and after OMT. METHODS: Cohort design. OBSERVATION PERIOD: 5 years prior to, up to first 5 years during, and up to 5 years after interruption of OMT. PARTICIPANTS: The sample (n = 200) comprised 51 OMT interrupters and 149 non-interrupters. Data on patient characteristics were obtained from interviews and OMT register information. Data on somatic morbidity were gathered from hospital records. MEASUREMENTS: Key patient characteristics among OMT interrupters and non-interrupters. Incidence rates of acute and sub-acute somatic disease incidents leading to hospital treatment (drug-related/non-drug-related/injuries) prior to/during/after OMT. RESULTS: Interrupters and non-interrupters did not differ in sociodemographic characteristics, while longer duration of amphetamine and benzodiazepine dependence predicted OMT interruption. Interrupters scored significantly higher on drug-taking and overdose during OMT but still had a significant 41% reduction in drug-related treatment, episodes. After interruption of treatment, such episodes increased markedly and were 3.6 times more frequent during the first post-OMT year compared to the pre-OMT period (p < 0.001). This increase was highest during the first months after OMT interruption. 2-5 years after interruption there was no significant increase. CONCLUSIONS: Increased somatic morbidity was found among OMT interrupters during the first year after OMT, and especially during the immediate post-treatment period.
Assuntos
Nível de Saúde , Tratamento de Substituição de Opiáceos/psicologia , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Transtornos Relacionados ao Uso de Opioides/psicologia , Cooperação do Paciente , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Buprenorfina/uso terapêutico , Estudos de Coortes , Feminino , Humanos , Masculino , Metadona/uso terapêutico , Noruega/epidemiologia , Cooperação do Paciente/psicologia , Fatores de TempoRESUMO
An experiment was conducted to test whether the magnitude of effects of heat shock on spermatozoal function were less for thermotolerant breeds (Brahman and other breeds with Brahman influence) than for breeds that evolved in northern Europe (Angus and Holstein). Frozen spermatozoa were thawed, purified by Percoll gradient centrifugation and incubated at 38.5, 41, or 42 degrees C for 4 h. Sperm motility was then analyzed with a Hamilton Thorn Motility Analyzer. Heat shock reduced the percentage of sperm that were motile, mean track speed, and mean path velocity. There were no significant breed x temperature interactions for these traits. The mean frequency of tail beat tended to be reduced by heat shock in bulls of Brahman-influenced breeds and, to a lesser extent, in Brahman bulls, but it was not affected by heat shock in Angus or Holstein bulls. For no traits were there significant temperature x bull within breed interactions. Overall, results indicate that 1) heat shock reduces motility of bovine spermatozoa and 2) genetic effects are unlikely to be an important determinant of the function of ejaculated sperm following heat shock.