Trackers for Adverse Events in Child Mental Health: descriptive analysis using the global trigger tool

Abstract The goal of this study is to identify the global trigger tool trackers used to place the adverse drug events presented in children that use psychotropic drugs accompanied by Child-adolescent Psychosocial Care Centers. This is a descriptive study carried out with the secondary data of 112 child care records that began in January 2017 in two Child-adolescent Psychosocial Care Centers. A median of medicine per child was 1.71 and among the most used we were to risperidone 100%, followed by valproic acid and periciazine with 16% each. A total of 42 adverse drug events were found in 36 medical records, being agitation 29.7% and agressive 16.2%, being the most frequent, and in 45.2% of infants presenting only one event. 50 were trackers detected in 83.3%, two records that identified adverse drug events. In 38.8% were found only one tracker, the most found ones were: combination of psychotropic medicines 32%, abrupt reduction of medicine dose 22% and abrupt cessation of medicine 12%. Finally, the present study showed that the global trigger tool evidenced adverse drug events by means of the detection of trackers in children and that it had to offer interventions to improve the quality of psychiatric therapy within two community services.

Evidence that anandamide-signaling regulates human sperm functions required for fertilization.

Ejaculated mammalian sperm require several hours exposure to secretions in female reproductive tracts, or incubation in appropriate culture medium in vitro, before acquiring the capacity to fertilize eggs. Arachidonylethanolamide (AEA), also known as anandamide, is a novel lipid-signal molecule that is an endogenous agonist (endocannabinoid) for cannabinoid receptors. We now report that AEA is present in human seminal plasma, mid-cycle oviductal fluid, and follicular fluid analyzed by high-performance liquid chromatography/mass spectrometry. Sperm are sequentially exposed to these reproductive fluids as they move from the vagina to the site of fertilization in the oviduct. Specific binding of the potent cannabinoid agonist [(3)H]CP-55,940 to human sperm was saturable (K(D) 9.71 +/- 1.04 nM), suggesting that they express cannabinoid receptors. R-methanandamide [AM-356], a potent and metabolically stable AEA analog, and (-)delta(9) tetrahydrocannabinol (THC), the major psychoactive constituent of Cannabis, modulated capacitation and fertilizing potential of human sperm in vitro. AM-356 elicited biphasic effects on the incidence of hyperactivated sperm motility (HA) between 1 and 6 hr of incubation: at (2.5 nM) it inhibited HA, while at (0.25 nM) it stimulated HA. Both AM-356 and THC inhibited morphological alterations over acrosomal caps between 2 and 6 hr (IC(50) 5.9 +/- 0.6 pM and 3.5 +/- 1.5 nM, respectively). Sperm fertilizing capacity, measured in the Hemizona Assay, was reduced 50% by (1 nM) AM-356. These findings suggest that AEA-signaling may regulate sperm functions required for fertilization in human reproductive tracts, and imply that smoking of marijuana could impact these processes. This study has potential medical and public policy ramifications because of the incidence of marijuana abuse by adults in our society, previously documented reproductive effects of marijuana, and the ongoing debate about medicinal use of marijuana and cannabinoids.