Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 101.316
Filtrar
1.
Nervenarzt ; 91(1): 77-90, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31919549

RESUMO

Despite their knowledge about the risks and treatment options for substance abuse disorders, physicians are not immune to them. Meanwhile, a number of studies have shown that physicians have an increased risk of depression, addictive diseases and burnout due to the occupation-linked mental and physical burden and in particular an increased prevalence of substance-related disorders, especially alcohol abuse or dependence and drug abuse. Drug dependence among physicians seems to be even higher than in the general population due to the relatively easy access to psychoactive medications, in particular hypnotic drugs, benzodiazepines, ketamine and opioids; however, the prognosis is good. According to data from the medical associations, three quarters of those affected for the first time and every sixth relapsed physician can be helped with preservation of the license and working as physicians.


Assuntos
Alcoolismo , Comportamento Aditivo , Médicos , Transtornos Relacionados ao Uso de Substâncias , Benzodiazepinas , Humanos , Médicos/psicologia , Prevalência
2.
Expert Opin Pharmacother ; 21(3): 287-296, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31928246

RESUMO

Introduction: Gambling disorder is classified as an addictive disorder and is associated with significant distress and impairment in personal, social, occupational or other important areas of functioning. Although no pharmacotherapy has a formal indication for gambling disorder, data suggest potential benefits of specific medications.Area covered: This systematic review evaluated findings from 19 randomized controlled trials testing pharmacotherapies for the treatment of gambling disorder.Expert opinion: Few randomized controlled trials have studied pharmacotherapies for gambling disorder. Though results are limited, opioid antagonists like naltrexone showed promise in the pharmacological treatment of gambling disorder. Pharmacotherapy combined with psychotherapy treatments for gambling disorder may provide better rates of patient retention in comparison to pharmacology-only treatments, though further research is needed in this area. Future studies should address gaps relating to considerations of racial, ethnic, gender and other individual differences in clinical studies. Because gambling disorder often co-occurs with other psychiatric disorders, additional research is needed to test treatments for dually diagnosed patients.


Assuntos
Comportamento Aditivo/tratamento farmacológico , Jogo de Azar/tratamento farmacológico , Diagnóstico Duplo (Psiquiatria) , Humanos , Naltrexona/uso terapêutico , Antagonistas de Entorpecentes/uso terapêutico , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico
3.
Aten. prim. (Barc., Ed. impr.) ; 52(1): 47-53, ene. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-3528

RESUMO

El Proyecto ÉVICT (Evictproject.org), a raíz del aumento de consumo de cannabis en población juvenil española, ha estudiado su asociación con el tabaco, concluyendo que el consumo conjunto de tabaco y cannabis: tiene una influencia en el proceso de aprender a fumar, pues el inicio puede ser conjunto y con influencia bidireccional; tiene una influencia en el desarrollo de dependencia pues su interacción es relevante para el desarrollo de este trastorno, y tiene una influencia en la toxicidad, pues probablemente, el fumar tabaco y cannabis genera mayores problemas que fumar solo una de las 2. Y, por tanto, el equipo EVICT emite unas consideraciones en prevención: diferenciar uso medicinal y recreativo; comunicar que fumar cannabis no es terapéutico ni inocuo, y puede ayudar a generar dependencia de nicotina o, menos frecuentemente, al propio cannabis. Consideraciones en abordaje y tratamiento: en personas que consumen tabaco/cannabis debemos plantear como primera opción el cese de las 2 sustancias. Consideraciones en reducción de daños: a quienes solo consumen productos de tabaco/cannabis, los programas serían más aplicables a aquella cuyo consumo se considere más problemático


EVICT project has noted the increase in cannabis use in the Spanish youth population, and has studied its association with tobacco, concluding that: It has an influence in the learning to smoke process: The beginning can be combined and with bi-directional influence. It has an influence on dependence the development of dependence. Their interaction is relevant in the development of dependence. It has an influence on toxicity: Smoking tobacco and cannabis generates greater problems than smoking tobacco alone. And, therefore, the EVICT team issues some considerations: Prevention considerations. Differentiate between therapeutic and recreational use. Smoking cannabis is not therapeutic nor innocuous, and can affect the development of nicotine dependence, or, less frequently, cannabis dependence. Approach and treatment considerations. In A first option of cessation of both must be proposed in people who consume tobacco and cannabis Harm Reduction. To those that only consume tobacco/cannabis: Harm Reduction programs should be more applicable to those in whom consumption is considered more problematic


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Fumar/epidemiologia , Fumantes , Tabagismo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Abuso de Maconha/epidemiologia , Dependência Mimética , Tabagismo/prevenção & controle , Prevenção do Hábito de Fumar/legislação & jurisprudência
4.
Epidemiol Psychiatr Sci ; 29: e94, 2020 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-31973775

RESUMO

AIMS: Previous studies analysing blood alcohol concentration (BAC) at the time of suicide have primarily focused on sociodemographic factors. Limited research has focused on psychosocial factors and co-ingestion of other substances to understand the mechanisms of how alcohol contributes to death by suicide. The aim was to examine time trends, psychosocial factors related to acute alcohol use and co-ingestion of alcohol and other substances before suicide. METHODS: The Queensland Suicide Register in 2004-2015 was utilised and analysed in 2019. The cut-off point for positive BAC was set at ⩾0.05 g/dl. Substances were categorised as medicines, illegal drugs and other. Medicines were coded by the Anatomical Therapeutic Chemical (ATC) classification system. Joinpoint regression, univariate odds ratios, age and sex-adjusted odds ratios and Forward Stepwise logistic regression were performed. RESULTS: BAC information was available for 6744 suicides, 92% of all cases in 2004-2015. The final model showed that independent factors distinguishing BAC+ from BAC- were: age group 25-44 years, Australian Indigenous background, being separated or divorced, hanging, diagnosis of substance use, lifetime suicidal ideation, relationship and interpersonal conflict, not having psychotic and other psychiatric disorder, and no nervous system drugs or any other substances in blood at the time of suicide. CONCLUSIONS: Our findings suggest that people who die by suicide while under the influence of alcohol are more likely to be under acute stress (e.g. separation) and not have earlier psychiatric conditions, except substance use. This highlights the importance of more strict alcohol policies, but also the need to improve substance use treatment.


Assuntos
Consumo de Bebidas Alcoólicas/sangue , Concentração Alcoólica no Sangue , Sistema de Registros/estatística & dados numéricos , Suicídio/estatística & dados numéricos , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Austrália/epidemiologia , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Suicídio/psicologia
8.
N C Med J ; 81(1): 36-40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31908332

RESUMO

North Carolina has been at the forefront of offering treatment for perinatal substance use disorders for over 25 years. Wraparound services, understanding of the fourth trimester, the importance of medication-assisted treatment, and learning from past false predictions regarding illicit prenatal exposure contribute to a nurturing, supportive approach for the mother, child, and families.


Assuntos
Assistência Perinatal , Transtornos Relacionados ao Uso de Substâncias/terapia , Feminino , Humanos , North Carolina , Gravidez
9.
Psychiatr Prax ; 47(1): 22-28, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31910457

RESUMO

INTRODUCTION: Over the last decade, methamphetamine use has spread rapidly in Europe, leading to a significant medical shortfall in many regions. To date, there are no standardized German-language therapy programs for qualified detoxification and motivation treatment. We have developed a therapy manual ("CrystalClean") over 15 therapy modules, which was evaluated in the present pilot study with regard to feasibility and acceptability. METHODS: Observational study with systematic interviews over 3 months on 31 patients with methamphetamine dependence. RESULTS: Acceptability of most modules was rated as high by both patients and therapists. In addition, the manual was considered to be well feasible in inpatient daily routine. However, contact terminations frequently occurred when switching to outpatient treatment. CONCLUSION: Results from our study point to a high acceptance of the manual for the accompaniment of qualified detoxification and motivation treatment in patients with methamphetamine dependence. Feasibility in the clinical setting can be improved by reducing the number of modules to the 12 best evaluated and by increasing the frequency of therapies.


Assuntos
Linguagem , Metanfetamina , Transtornos Relacionados ao Uso de Opioides/reabilitação , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Europa (Continente) , Estudos de Viabilidade , Alemanha , Humanos , Motivação , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , Tradução
10.
Am J Forensic Med Pathol ; 41(1): 52-55, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31895099

RESUMO

Characteristic injury patterns have been described in pedestrians struck by motor vehicles. The common injury pattern seen in upright pedestrians consists of a triad of head, pelvis, and lower extremity trauma. There are several factors such as vehicular type, design, mass and speed, and impact surfaces that influence the type and distribution of these injuries. We report a case that illustrates the importance of examination of the knee at autopsy when the typical lower extremity diaphyseal fractures that are usually seen in a motor vehicle-pedestrian collision are absent.


Assuntos
Acidentes de Trânsito , Fraturas do Fêmur/patologia , Traumatismos do Joelho/patologia , Pedestres , Adulto , Medicina Legal/métodos , Humanos , Masculino , Traumatismo Múltiplo/patologia , Transtornos Relacionados ao Uso de Substâncias , Ferimentos não Penetrantes/patologia
11.
Am J Forensic Med Pathol ; 41(1): 5-10, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32000222

RESUMO

Use of excessive force (UOEF) is an important and controversial topic but little is known about how injury severity is related to allegations of UOEF. We hypothesized that such complaints would be associated with more significant traumatic injuries. Emergency department records were searched for all individuals making UOEF complaints against an urban police department from 2010 to 2012. Demographic, diagnosis, and other medical data, including Injury Severity Score, were obtained. From police records, force used, suspect resistance and threat, and other call data were obtained. The same data were collected for a control group randomly chosen from all use-of-force events identified during the study period. Of the 235 complaints filed, 42 (18%) subjects had medical evaluation. The control group was significantly younger and more likely to be male; there was no significant difference in race or income. Major injuries were infrequent. No significant difference was found in Injury Severity Score or other medical variables between the 2 groups. Among the law enforcement variables, the only significant difference was a higher likelihood of psychiatric-related calls in the control group. The majority of patients alleging UOEF did not require immediate medical attention, and we found no relationship between injury severity and UOEF complaints.


Assuntos
Escala de Gravidade do Ferimento , Polícia , Ferimentos e Lesões/epidemiologia , Adulto , Estudos de Casos e Controles , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Washington/epidemiologia
12.
Lancet Psychiatry ; 7(2): 135-147, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31974072

RESUMO

BACKGROUND: Psychiatric disorders are established risk factors for self-harm. However, variation in the risk of self-harm by specific psychiatric disorder and stratified by gender and age is rarely examined in population-representative samples. This study aimed to investigate the risk of self-harm following diagnosis of different psychiatric disorders in an Asian population, through a review of inpatient records retrieved from the Hong Kong Clinical Data Analysis and Reporting System (CDARS). METHODS: For this nested case-control study, the inpatient data of people admitted for any reason to Hong Kong public hospitals, between Jan 1, 2000, and Dec 31, 2010, were extracted from CDARS. Cases were people aged 10 years or older who had been admitted to inpatient care with a first-listed record of psychiatric disorder during the study period. The seven psychiatric disorders of interest were: depression, alcohol misuse or dependence, personality disorders, bipolar disorders, anxiety disorders, schizophrenia, and substance misuse or dependence. Two control patients were matched per case from a subsample of all individuals with the same gender, age, and admission time (ie, same calendar year and month), who did not have any record of the psychiatric disorders of interest. Any patients with a history of self-harm diagnosis before, or at the same time as, the first diagnosis of psychiatric disorder (cases) or admission (controls), were excluded. For each diagnostic category, a Cox proportional hazard regression model was fitted to estimate the adjusted hazard ratio (HR; plus 95% CIs) of associated self-harm, adjusting for gender, age, control-matched admission time, 20 districts of residence, physical comorbidities established as risk factors for self-harm (diabetes, asthma, migraine, epilepsy, HIV, and cancer), and presence of the six other psychiatric disorders. We repeated this analysis in subgroups stratified by gender (male and female) and by age (adolescent, 10-24 years; young adult, 25-44 years; middle-aged, 45-64 years; and older people, ≥65 years). FINDINGS: Between 2000 and 2010, we followed up a cohort of 86 353 people with a first-recorded diagnosis of a psychiatric disorder of interest, and 134 857 matched controls. The highest risk of self-harm was observed in patients with substance misuse or dependence (adjusted HR vs matched controls, 9·6 [95% CI 8·4-11·0]), followed by those with personality disorders (3·7 [2·8-4·9]) and alcohol misuse or dependence (3·2 [2·9-3·7]). When stratified by gender and age, the highest risk of self-harm behaviour was found in the substance misuse or dependence group for both genders (for female patients: adjusted HR vs matched controls, 7·7 [6·0-9·8]; and for male patients, 10·5 [8·9-12·4]), and for all age groups (adolescent: 9·6 [7·2-12·7]; young adults: 10·2 [8·4-12·3]; middle-aged: 11·2 [8·0-15·6], and older people: 3·2 [1·7-6·1]). INTERPRETATION: First-recorded diagnoses of psychiatric disorders were significantly associated with an elevated risk of subsequent self-harm. The associations varied considerably by diagnostic categories across gender and age subgroups. Our findings highlight the need to develop more efficient and targeted preventive measures in psychiatric care management, with specific attention to demographic characteristics linked to increased risk within the same diagnostic category. FUNDING: None.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno Bipolar/epidemiologia , Transtorno Depressivo/epidemiologia , Transtornos da Personalidade/epidemiologia , Esquizofrenia/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Casos e Controles , Criança , Feminino , Seguimentos , Hong Kong/epidemiologia , Hospitais Públicos/estatística & dados numéricos , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Sistemas Computadorizados de Registros Médicos/estatística & dados numéricos , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Risco , Fatores Sexuais , Adulto Jovem
13.
Gesundheitswesen ; 82(1): 90-99, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30321875

RESUMO

BACKGROUND: Children and adolescents are seen as an important target group for reducing tobacco and alcohol consumption in the population. Data on substance use over a longer period of time for adolescents are a basis for addiction policy in the state of Brandenburg and show certain trends. METHODS: Adolescents of the 10th grade in the state of Brandenburg were asked in 2005, 2009, 2013 and 2017 about consumption of alcohol, tobacco and other psychoactive substances and about possibly helpful contact persons. A total of 42,221 adolescents with an average age of 15.7 years (standard deviation 0.7 years) were contacted. RESULTS: Regular (at least weekly) tobacco consumption decreased between 2005 and 2017 from 41 to 17% for girls and from 37 to 18% for boys. The regular consumption of alcohol decreased in girls from 18 to 9% and in boys from 34 to 15%. Boys drink more alcohol than girls. Tobacco use is lowest in high schools and there are differences between regions in the consumption of both substances. The adolescents see their peers as the main contact persons for problems with addictive substances. Professional help is accessed less often. CONCLUSION: The Brandenburg study describes a positive development. If the reduction is sustained or even continued, alcohol and tobacco consumption in the population will decrease. The results suggest strengthening the peer approach for addiction prevention.


Assuntos
Consumo de Bebidas Alcoólicas , Fumar , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Comportamento do Adolescente , Feminino , Alemanha , Humanos , Masculino , Tabaco
14.
Forensic Sci Int ; 306: 110055, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31785512

RESUMO

Body fluid analysis has played a crucial role in ascertaining various characteristics and has greatly aided in reconstructing events during crime scene investigation. It is often presumed that crimes that involve violence and mental disturbances such as murder or sexual assault provide good sources of body fluids such as blood, saliva, semen, vaginal secretions, urine and tears. Tears are secreted in response to any emotional or stressful situations and may be found deposited on surfaces such as bedding, tissue paper or cloth. In the absence of the commonly noted body fluids such as blood or saliva, tears can play an important role that can lead to personal identification by examining the biochemistry and molecular aspects to obtain a full DNA profile. Additionally, identification of an individual may be done by carefully observing certain unique eye characteristics such as heterochromia which is highly individualistic. Characteristics of eyewear such as spectacles and contact lenses have unique properties and prescription criteria for correcting an individual's eyesight that can provide vital clues in understanding the visual ability of an individual. In crime scene investigation, the presence or absence of eyewear provides immense evidentiary value that has greatly aided in solving cases such as Janet Abaroa's Murder. This paper provides a systematic review of the possibility of using tears and eyewear for the purpose of forensic investigation and to statistically support the inferences with prescription databases which may be initiated across different populations. Forensic Optometry is yet to get streamlined along with the routinely followed investigative techniques and scientifically explored although no standard protocols exist to analyse eyewear. The use of behavioural optometry is gaining attention in the context of driving laws of different countries and is a simple but powerful indicator of abnormal behaviour. It is speculated that the last seen image referred to as an 'Optogram' of an individual may be captured in the retina since our eyes functions like a camera. Although this claim is considerably unexplored, it is quite possible that the last seen image of a criminal, objects or a place may be noted that can positively help in linking individuals at the scene of crime or identify the primary crime location. In this review, the potential for new insights into the analysis of tears, eye and eyewear characteristics have been explored.


Assuntos
Lentes de Contato , Impressões Digitais de DNA , DNA/isolamento & purificação , Óculos , Ciências Forenses/métodos , Lágrimas/química , Bases de Dados Factuais , Epitélio Anterior/química , Olho/patologia , Movimentos Oculares , Humanos , Mudanças Depois da Morte , Prescrições , Manejo de Espécimes , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Corpo Vítreo/química
15.
Forensic Sci Int ; 306: 110093, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31816483

RESUMO

Studies on the mortalities of drug abusers in China are scarce. This study explores the deaths of methamphetamine, opioid, and ketamine abusers in Shanghai (2004-2017) and Wuhan (2005-2017). Chi-square/Fisher's exact tests were used to compare the differences in terms of region, gender, age, cause of death, and the method used in the last drug abuse. Poisson regression models were used to estimate the rate ratios ("RRs") and annual percentage changes ("APCs"). 314 heroin, 43 methamphetamine, and 4 ketamine abusers were included. Furthermore, simultaneously, 6 abusers used heroin and methamphetamine, and 7 abusers used methamphetamine and ketamine. Heroin-related deaths have declined in Shanghai (APC, -16.1; 95 % CI, -18.4 to -11.3) and Wuhan (APC, -16.0; 95 % CI, -18.9 to -10.6), whereas methamphetamine-related deaths have increased in Wuhan (APC, 12.8; 95 % CI, 0.0 to 29.2). On the whole, in the two cities, males were more frequently observed than females in heroin-related deaths (4.4, 230/52). However, the gender ratios for methamphetamine- (1.8, 34/19) and ketamine-related deaths (1.2, 6/5) were close to one. In view of the mortality rates of the drug abusers in most Chinese cities were still unclear, it is thus important to improve mortality surveillance of the drug abusers at the national level.


Assuntos
Analgésicos Opioides/envenenamento , Ketamina/envenenamento , Metanfetamina/envenenamento , Transtornos Relacionados ao Uso de Substâncias/mortalidade , Adolescente , Adulto , Distribuição por Idade , Analgésicos Opioides/efeitos adversos , Intoxicação por Monóxido de Carbono/mortalidade , China/epidemiologia , Feminino , Heroína/efeitos adversos , Heroína/envenenamento , Humanos , /envenenamento , Ketamina/efeitos adversos , Masculino , Metanfetamina/efeitos adversos , Pessoa de Meia-Idade , Distribuição por Sexo , Suicídio/estatística & dados numéricos , Adulto Jovem
16.
Clin Biochem ; 75: 70-77, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31707014

RESUMO

BACKGROUND: Dried specimens have been proposed in multiple environments to minimize costs associated with specimen storage and shipping in clinical studies. This report describes the development and validation of an automated method for qualitative toxicology screening of dried urine samples using LC-MS/MS. METHODS: Urine standards containing 41 compounds were prepared and applied to filter paper cards. Dried urine was eluted from the cards using a Dried Blood Spot (DBS) autosampler from Spark Holland, which was plumbed inline with a Thermo Scientific Turboflow chromatography system for subsequent MS/MS detection with selected reaction monitoring. Limits of detection, precision of peak areas, repeatability, and carryover studies were conducted. Concordance with a reference LC-MS/MS method using liquid samples was evaluated using remnant discarded specimens. RESULTS: The limit of detection ranged from 5 to 75 ng/mL for most compounds. At the LOD for each analyte, the peak area precision ranged from 8 to 29%. For 20 repeat injections of samples spiked at ±25% of the LOD, there was a 4% false positive rate for the 75% × LOD samples, and a 0.4% false negative rate for the +125% × LOD samples. In comparing 40 known positive specimens analyzed with the DUS method and a liquid urine reference method, there was 88% agreement. Analysis of 10 known negative specimens yielded negative results. There was no significant carryover detected up to 2000 ng/mL for any of the analytes in the assay. CONCLUSION: Using a robotic DUS sampling an inline HTLC-MS/MS system, we have developed and validated a fully-automated and robust method for multi-analyte detection of drugs of abuse in dried urine specimens.


Assuntos
Cromatografia Líquida/métodos , Ensaios de Triagem em Larga Escala , Detecção do Abuso de Substâncias/métodos , Transtornos Relacionados ao Uso de Substâncias/urina , Espectrometria de Massas em Tandem/métodos , Urinálise/métodos , Ensaios de Triagem em Larga Escala/instrumentação , Ensaios de Triagem em Larga Escala/métodos , Humanos , Limite de Detecção , Robótica/métodos
17.
J Forensic Sci ; 65(1): 97-102, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31386191

RESUMO

Understanding trends in substance use by gender among jail-based treatment program participants can inform policies and programs tailored to this population. Preprogram assessment data from 3509 individuals entering a jail-based substance use disorder treatment program in Missouri between 1998 and 2016 were analyzed. Primary outcome was program participants' strongly preferred substances. Demographic covariates and drug preferences were compared between males and females. Average yearly trends in preferred substances were calculated. While 25.8% of the sample preferred heroin, it was more strongly preferred by women (36.4%) than men (22.0%, p < 0.0001). Alcohol and marijuana were preferred more by males. Overall, preferences for heroin and methamphetamine increased over time while alcohol, marijuana, and other stimulants decreased. Women being more likely to prefer heroin and the increasing preference for heroin over time are consistent with national trends. Offering evidence-based treatment like pharmacotherapy and gender-sensitive approaches can help address the needs of this vulnerable population.


Assuntos
Comportamento de Escolha , Prisioneiros , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Distribuição por Idade , Consumo de Bebidas Alcoólicas , Cannabis , Cocaína , Cocaína Crack , Feminino , Heroína , Humanos , Masculino , Metanfetamina , Missouri/epidemiologia , Medicamentos sob Prescrição , Distribuição por Sexo , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Adulto Jovem
18.
Forensic Sci Int ; 306: 110070, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31786517

RESUMO

Propofol abuse has been reported worldwide, suggesting the need to establish analytical methods for human biological samples to investigate the abuse of propofol. This study aimed to investigate the relationship between dose and hair concentration using a simple and rapid analytical method developed and validated in this study. In the sample preparation, hair samples were washed with distilled water and methanol and extracted in methanol during 16h at room temperature. After centrifugation and evaporation, the residue was reconstituted and filtered through a 0.22µm membrane filter before LC-MS/MS analysis. The precursor-to-product ion transitions were 353 → 175, 113 for propofol glucuronide and m/z 370 → 175, 113 for internal standard(propofol glucuronide-d17). The calibration curves were satisfactory (R2=0.9997) and the limits of detection and quantification were 2 and 5pg/mg, respectively. In addition, this study collected the history of propofol use from subjects using a questionnaire and analyzed subjects' hair samples using a validated analytical method. As a result, the concentrations of propofol glucuronide ranged from 7 to 122pg/mg (mean : 51pg/mg). There were cases of positive relationships, but generally there was no correlation between dose and hair concentration.


Assuntos
Glucuronídeos/análise , Cabelo/química , Hipnóticos e Sedativos/análise , Propofol/análise , Detecção do Abuso de Substâncias/métodos , Adulto , Cromatografia Líquida , Feminino , Toxicologia Forense , Glucuronídeos/administração & dosagem , Humanos , Hipnóticos e Sedativos/administração & dosagem , Masculino , Pessoa de Meia-Idade , Propofol/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Espectrometria de Massas em Tandem , Adulto Jovem
19.
J Forensic Sci ; 65(1): 160-165, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31343744

RESUMO

The characteristics of mental disorders, as well as deficiencies in their treatment, must be properly defined. This was a prospective, longitudinal, observational study, in which all men referred to a penitentiary psychiatric consultation of three penitentiary centers in Spain were invited to participate. Those who consented to participation (1328) were interviewed at the baseline timepoint and at intervals for up to 3 years. The presence of mental disorders was high: 68.2% had a cluster B personality disorder, 14% had an affective and/or anxiety disorders, 13% had schizophrenia, and over 80% had a dual disorder. Polypharmacy was the norm. Moreover, the health care received in prison did not match that provided in the community in terms of quantity and quality. These results should help to facilitate the design of mental healthcare provision for prisoners, focusing on both the most frequent patient profiles and equality of care.


Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Prisioneiros/psicologia , Prisões , Adulto , Coinfecção , Feminino , Infecções por HIV/epidemiologia , Hepatite C Crônica/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Polimedicação , Estudos Prospectivos , Psicotrópicos/uso terapêutico , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
20.
J Forensic Sci ; 65(1): 61-66, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31310334

RESUMO

Unregulated cacti from the genus Echinopsis are used recreationally as mescaline-containing alternatives to the outlawed peyote. Echinopsis-derived plant materials appear in a variety of nondescript forms, making rapid assessment of whether they are mescaline-containing materials or simply innocuous plant-derived food products, very challenging. Reported here is a DART-HRMS approach for the rapid detection of mescaline in whole plant material and a validated method for the quantification of mescaline in cactus tissue, using mescaline-d9 as the internal standard. Calibration curves exhibited R2 values of ≥0.995, and the method exhibited a LLOQ and a linear range of 1 ppm and 1-100 ppm, respectively. Application of the method to commercially available Echinopsis spp. yielded results consistent with previous studies performed by GC- and LC-MS, with mescaline levels of <2% dry weight in all cases. Therefore, DART-HRMS is a suitable technique for the rapid screening of mescaline and its subsequent quantification within complex plant-derived matrices.


Assuntos
Cactaceae/química , Alucinógenos/análise , Espectrometria de Massas/métodos , Mescalina/análise , Toxicologia Forense , Humanos , Transtornos Relacionados ao Uso de Substâncias
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA