Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.838
Filtrar
1.
Rev Bras Epidemiol ; 22Suppl 1(Suppl 1): e190009, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31576985

RESUMO

INTRODUCTION: Knowledge about risky sexual behavior among young people has been widely acknowledged as a key tool to controlling the spread of HIV. This article aimed at presenting the risk behavior of Brazilian Army conscripts toward HIV infection according to the country's geographic regions. . METHOD: We collected data from 37,282 conscripts, aged 17 to 22, during enlistment in the Brazilian Army in 2016. The prevalence of HIV infection, both self-reported and measured through laboratory results, and risk behavior factors were estimated by region. RESULTS: 75% of the sample of conscripts reported to have already started sexual activity, and the average age of their sexual initiation was 15. Condom use varied according to the type of sexual relationship, being lower among steady partners and greater among less stable relationships. HIV prevalence assessed by laboratory tests was 0.12% across the country and the highest prevalence was observed in the North region (0.24%). Alcohol and illicit drug usage was higher in the South region. DISCUSSION: The study allowed the observation of risk behavior monitoring for HIV infection among young Brazilians. Lower condom usage among steady partners may be contributing to an increase in the number of HIV-infected individuals. CONCLUSION: Results suggest the need to intensify prevention campaigns to disseminate safe sex practices among young people, in addition to the expansion of testing offer to this population.


Assuntos
Infecções por HIV/etiologia , Comportamentos de Risco à Saúde , Militares/estatística & dados numéricos , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Brasil/epidemiologia , Preservativos/estatística & dados numéricos , Estudos Transversais , Geografia , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Medição de Risco , Fatores de Risco , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
2.
Medicine (Baltimore) ; 98(39): e17071, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574806

RESUMO

Access to antiretroviral-based HIV prevention has been marked by sex asymmetries, and its effectiveness has been compromised by low clinical follow-up rates. We investigated risk profiles of women who received nonoccupational post-exposure prophylaxis (nPEP), as well as the rates and predictive factors of loss to follow-up after nPEP initiation.Retrospective study evaluating 501 women who received nPEP between 2014 and 2015 at 5 HIV centers (testing centers-VCT, outpatient clinics, and infectious diseases hospital). Risk profiles were drawn based on the characteristics of the women and their sexual partners, and then stratified by sociodemographic indicators and previous use of HIV prevention services. Loss to follow-up (LTFU) was defined as not presenting for follow-up visits or for HIV testing after nPEP initiation. Predictors of LTFU were analyzed by calculating adjusted prevalence ratios (aPRs).Approximately 90% of women had sexual encounters that met the criteria established in the Brazilian guidelines for nPEP. Those who declared to be sex workers (26.5%) or drug users (19.2%) had the highest social vulnerability indicators. In contrast, women who had intercourse with casual partners of unknown HIV risk (42.7%) had higher education and less experience with previous HIV testing (89.3%) or nPEP use (98.6%). Of the women who received nPEP after sexual intercourse with stable partners, 75.8% had HIV-infected partners. LTFU rate was 72.8% and predictors included being Black (aPR = 1.15, 95% confidence interval [CI]: 1.03-1.30), using drugs/alcohol (aPR = 1.15, 95% CI: 1.01-1.32) and having received nPEP at an HIV outpatient clinic (aPR = 1.35, 95% CI: 1.20-1.51) or at an infectious diseases hospital (aPR = 1.37, 95% CI: 1.11-1.69) compared with a VCT. The risk of LTFU declined as age increased (aPR 41-59 years = 0.80, 95% CI: 0.68-0.96).Most women who used nPEP had higher socioeconomic status and were not part of populations most affected by HIV. In contrast, factors that contribute to loss to follow-up were: having increased social vulnerability; increased vulnerability to HIV infection; and seeking nPEP at HIV treatment services as opposed to at a VCT.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/prevenção & controle , Profilaxia Pós-Exposição , Sexo sem Proteção , Adolescente , Adulto , Brasil , Coito , Feminino , Seguimentos , Humanos , Adesão à Medicação , Pessoa de Meia-Idade , Estudos Retrospectivos , Assunção de Riscos , Trabalho Sexual , Classe Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto Jovem
3.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 145-151, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538461

RESUMO

Nonsyndromic cleft lip with or without cleft palate is the most common craniofacial anomaly affecting around 1 in 700 live births worldwide. Clefts of the human face can be classified anatomically as cleft palate only (CPO), cleft lip only (CLO), cleft lip and palate (CLP) or a combined group of cleft lip with or without cleft palate (CL/P), based on different in embryologic development. These malformations have some genetic origin, in fact several association studies have been performed to obtain important information about the candidate genes; but more important are gene-environment interactions that play an increasing role in its etiology. Epidemiological studies have shown how environmental factors (alcohol, smoking, drugs), as well as possible gene-environment interactions, play an important role in the onset of the malformation. On the contrary, folic acid intake seems to have a protective effect. In this review, we analyze the role of environmental factors related to onset of cleft.


Assuntos
Fenda Labial/etiologia , Fissura Palatina/etiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Fenda Labial/genética , Fissura Palatina/genética , Ácido Fólico/administração & dosagem , Interação Gene-Ambiente , Humanos , Fumar/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações
4.
Praxis (Bern 1994) ; 108(12): 793-798, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31530127

RESUMO

Fatigue - a Common Symptom in General Practice Abstract. When patients suffering from fatigue consult a GP surgery, GPs should understand what patients mean by fatigue, how strongly they are affected in everyday life and how they themselves explain the symptom. In a next step, dangerous diseases such as depression, addiction or sleep apnea syndrome must be excluded. The main somatic and psychiatric causes of fatigue should be explored simultaneously with a more in-depth history. A simple physical exam and a few lab examinations are sufficient to capture the major disorders that present with the isolated symptom of fatigue. For further care, a primary biopsychosocial approach with a viable physician-patient relationship is crucial. Rough conclusions based on laboratory findings should be avoided; comorbidities must be considered.


Assuntos
Fadiga , Medicina Geral , Comorbidade , Depressão/complicações , Depressão/diagnóstico , Medicina de Família e Comunidade , Fadiga/diagnóstico , Fadiga/etiologia , Humanos , Síndromes da Apneia do Sono/complicações , Síndromes da Apneia do Sono/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/diagnóstico
5.
Nervenarzt ; 90(9): 926-931, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31407043

RESUMO

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common comorbidity in adult patients with substance use disorders (SUDs). The diagnostics and treatment of ADHD with SUD are often a challenge, also with respect to the prescription of stimulants. Recently, a group of international experts developed a consensus paper on the diagnosis and treatment of comorbid ADHD and SUD. In addition, the German S3 guidelines on ADHD have been published, which also give advice on the treatment of ADHD in comorbid SUD. The German S3 guidelines on alcohol-related disorders and methamphetamine-related disorders also address ADHD as a comorbidity. METHODS: Summary of consensus and guideline recommendations, supplemented with the most recent literature. CONCLUSION: In recent years new findings on the comorbidity of ADHD in patients with SUD have emerged. A series of screening and diagnostic instruments have meanwhile been evaluated in this patient group. The consensus paper and various guidelines therefore provide clinicians with specific help in detecting ADHD in patients with SUD and in conducting further diagnostics and treatment of both disorders. For example, the importance of stimulants in the treatment of patients with SUD and ADHD has significantly changed and first studies on psychotherapeutic interventions specific to this comorbidity are now available.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Estimulantes do Sistema Nervoso Central , Transtornos Relacionados ao Uso de Substâncias , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Comorbidade , Alemanha , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações
7.
Am Surg ; 85(7): 781-787, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31405429

RESUMO

We hypothesize that soft tissue infections (SSIs) related to intravenous drug usage (IVDU) are associated with a more complicated and costly course than those not associated with IVDU. For the period 2005-2018, ICD 9/ICD 10 billing codes were used to identify patients admitted with SSIs and their causes/complications and associated costs. IVDU-related infections were then compared with non-IVDU-related infections. t test was used to compare treatment costs and length of stay. Logistic regression analysis was used to assess the likelihood/risk of specific events in the IVDU versus non-IVDU populations. Of 47,281 patients admitted with SSIs, 1323 were associated with IVDU. IVDU-related patients tended to be younger (36.2 vs 49.3 years, P = 0.001). Both cost and length of stay were significantly greater in the IVDU group ($30,471 vs $16,020, P = 0.001; 5.7days vs 3.7days, P = 0.001). In addition, IVDU admissions were more likely to be associated with chronic blood-borne infections (hepatitis B/C, HIV, P = 0.001) and a significantly greater incidence of secondary infectious complications, including endocarditis (P = 0.001), bacteremia (P = 0.001), and osteomyelitis (P = 0.003). SSI admissions related to IVDU are a unique subgroup of patients. These patients not only have longer and more costly lengths of stay but are also at higher risk for secondary complications such as chronic blood-borne viral illness and secondary bacterial infectious complications, such as bacteremia, endocarditis, and osteomyelitis. Further prospective study of these findings is warranted as we continue to battle the growing problem of IVDU in the United States.


Assuntos
Infecções dos Tecidos Moles/etiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Infecções Bacterianas/etiologia , Feminino , Custos Hospitalares , Hospitalização/economia , Humanos , Incidência , Tempo de Internação , Modelos Logísticos , Masculino , Análise de Regressão , Fatores de Risco , Infecções dos Tecidos Moles/epidemiologia , Viroses/etiologia
8.
Expert Rev Clin Pharmacol ; 12(9): 901-908, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31422705

RESUMO

Introduction: The current emphasis on combatting the opioid epidemic in the United States and across the globe is well warranted, but rates and variations of other drugs and substances of abuse may be inadvertently increasing as well. These drugs and substances deserve equal attention in the literature to equip healthcare practitioners with the knowledge to provide optimal care in overdose patients. Areas covered: This evaluation includes loperamide, gabapentin, and modafinil and was accomplished through a comprehensive literature review of PubMed, MEDLINE, SCOPUS, ProQuest Central, ProQuest Dissertations, and CINAHL. The results of forty-four pieces of literature are included in this evaluation. The objective of this review is to provide a repository of standard and emerging treatment modalities for loperamide, gabapentin and modafinil for the emergency medicine team. Expert opinion: Loperamide, gabapentin, and modafinil are becoming drugs of abuse, and as such, should be on the radar of healthcare providers. Recognizing their unique toxicity profiles is imperative in providing optimal resuscitative care.


Assuntos
Gabapentina/envenenamento , Loperamida/envenenamento , Modafinila/envenenamento , Overdose de Drogas/terapia , Tratamento de Emergência/métodos , Humanos , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
9.
J Opioid Manag ; 15(3): 205-212, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31343722

RESUMO

OBJECTIVE: This study describes the incidence of neonatal abstinence syndrome (NAS) in Ontario, Canada by year and health region from 2003 to 2016. DESIGN: The incidence of NAS diagnoses per 1,000 live births was calculated for the 36 local public health agency regions in Ontario from 2003 to 2016 using retrospective hospital admissions data. Infants with a diagnosis of NAS were identified using ICD-10 code P961. Local public health agency level data were aggregated and analyzed by geographic region and by Statistics Canada 2015 Peer Groups. RESULTS: The incidence of NAS in Ontario increased from 0.99 per 1,000 live births in 2003 to 5.94 per 1,000 live births in 2016. There were major differences in NAS incidence by geography, North Western Ontario had the greatest incidence across all years. Health regions with a rural and population center mix or mostly rural population had greater incidence rate of NAS compared to health regions with high density population centers. CONCLUSIONS: The incidence of NAS has dramatically increased across Ontario in the last decade. Actions should be taken to combat the continued increase in NAS rates, especially in health regions with disproportionately high incidence of NAS.


Assuntos
Analgésicos Opioides/efeitos adversos , Síndrome de Abstinência Neonatal , Transtornos Relacionados ao Uso de Substâncias/complicações , Humanos , Incidência , Lactente , Recém-Nascido , Síndrome de Abstinência Neonatal/epidemiologia , Ontário/epidemiologia , Estudos Retrospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
10.
MMW Fortschr Med ; 161(Suppl 5): 7-12, 2019 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-31313269

RESUMO

BACKGROUND: ADHD in childhood and adolescence is characterized by the symptoms hyperactivity, impulsivity, and inattentiveness; these symptoms may persist into adulthood or may manifest as restlessness, emotional instability, and disorganized behavior. In adults ADHD often occurs with increased substance use and is associated with an early onset of substance use, development of severe addiction, and decreased treatment effectiveness. METHOD: This overview will present and critically discuss current study results and evidence-based and consensus-oriented recommendations that ensure the most adequate care for patients with ADHD and addictive disorder. RESULTS AND CONCLUSIONS: For drug therapy, the current S3 guideline recommends methylphenidate, amphetamine salts, and atomoxetine, among others. Treatment of adult patients with ADHD and addiction with stimulants tends to be viewed critically; if required, long-acting medications should be used. Integrated treatment of ADHD and addiction, consisting of a combination of pharmacotherapy and psychotherapy, is recommended.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Cloridrato de Atomoxetina/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Humanos , Metilfenidato/uso terapêutico , Inquéritos e Questionários
11.
Toxicol Lett ; 314: 37-42, 2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31301370

RESUMO

OBJECTIVE: Ethanol intake can increase the sedative effects of gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL), although the real clinical impact is unknown. We studied the clinical impact of the co-ingestion of ethanol in patients presenting to the Emergency Department (ED) with acute toxicity related to GHB/GBL use. METHOD: We performed a secondary analysis of the Euro-DEN Plus Registry (14 countries, 22 EDs) which includes 17,371 consecutive patients presenting to the ED with acute recreational drug toxicity over 39 consecutive months (October 2013 - December 2016). We compared the epidemiological and clinical characteristics and ED management of patients identified as presenting with acute toxicity related to lone GHB/GBL (Group A) or GHB/GBL combined with ethanol (Group B) without other concomitant drugs. RESULTS: A total of 609 patients were included (age 32 (8) years; 116 women (19%); Group A: 183 patients and Group B: 426). The most common features were reduction in consciousness (defined as Glasgow Coma Score <13 points: 56.1%) and agitation/aggressiveness (33.6%). Those with ethanol co-ingestion were younger patients (Group A/B: 31.5/33.1 years, p = 0.029) and ethanol co-ingestion was associated with a lower frequency of bradycardia (23.5%/15.7%, p = 0.027) and more frequent arrival at the ED by ambulance (68.3/86.6%; p < 0.001), reduction in consciousness (58.9%/49.1%; p = 0.031), need for treatment in the ED (49.2%/60.4%; p = 0.011), use of sedatives (20.1%/12.8%; p = 0.034), admission to critical care units (22.4%/55.3%; p < 0.001), and longer hospital stay (stay longer than 6 h: 16.9%/28.4%; p = 0.003). CONCLUSIONS: Co-ingestion of ethanol increases the adverse effects of patients intoxicated by GHB/GBL, leading to greater depression of consciousness, need for treatment, admission to the ICU and longer hospital stay.


Assuntos
4-Butirolactona/efeitos adversos , Consumo de Bebidas Alcoólicas/efeitos adversos , Transtornos da Consciência/etiologia , Etanol/efeitos adversos , Oxibato de Sódio/efeitos adversos , Drogas Ilícitas/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Agressão/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/psicologia , Estado de Consciência/efeitos dos fármacos , Transtornos da Consciência/diagnóstico , Transtornos da Consciência/psicologia , Transtornos da Consciência/terapia , Serviço Hospitalar de Emergência , Europa (Continente) , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Admissão do Paciente , Sistema de Registros , Fatores de Risco , Fatores de Tempo , Adulto Jovem
12.
J Forensic Leg Med ; 66: 134-137, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31301637

RESUMO

PURPOSE: The purpose of the work is to show and compare three reported cases of Excited Delirium Syndrome, which happened in Warsaw, Poland, from 2013 to 2017. We compared the results of three autopsy and toxicological findings of unexpectedly deceased males and the circumstances of their death, based on the police records. RESULTS: There were no significant findings of chronic diseases or multiple traumas leading us to the clear explanation of cause of death. We noted a rapid cardiopulmonary failure accompanied by drug abuse in all three cases, that happened following a stressful stimulus, evoked by a police restraint in prone position. All patients resembled similar external characteristics and BMI and had used drugs before death. CONCLUSION: A lack of the autopsy findings suggests the Excited Delirium Syndrome as a cause of death. The syndrome may be diagnosed after death, following the definition of exclusion of other somatic causes of death, preceded by symptoms during a stressful event. The syndrome occurs in overweight males, abusing especially stimulants. The physical restraint plays an important role in the initiation of the symptoms. The pathophysiology of the syndrome is poorly understood, but some theories underline dopamine transporters stimulation. To this day, there are no published Excited Delirium guidelines for forensic specialists or pathologists.


Assuntos
Morte Súbita/etiologia , Delírio/diagnóstico , Restrição Física/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/complicações , Adulto , Índice de Massa Corporal , Humanos , Masculino , Entorpecentes/análise , Obesidade/complicações , Polícia , Prisioneiros , Decúbito Ventral , Detecção do Abuso de Substâncias
13.
Nord J Psychiatry ; 73(6): 340-348, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31259640

RESUMO

Purpose: This study examined a developmental model that links affect-regulation difficulties in childhood with three dimensions of alexithymia in adolescence (difficulty identifying feelings, difficulty describing feelings, and externally oriented thinking) and substance use and depression in adulthood, while accounting for cumulative contextual risk in childhood, and testing potential gender moderation. Methods: Multiple group path analyses were conducted using data from the Northern Finland Birth Cohort 1986 (N = 6963). Analyses used data collected during prenatal/birth, childhood, adolescence, and young adulthood periods. Results: Our examination of early precursors for alexithymia indicated that the associations of affect-regulation problems in childhood with alexithymia were stronger for girls, potentially putting girls with affect-regulation difficulties in childhood at higher risk for developing alexithymia in adolescence. The associations of cumulative contextual risk in childhood with alexithymia, substance use disorder, and depression diagnosis in adulthood were significant for both girls and boys. Our findings in regard to substance use and depression disorders revealed that alexithymia in adolescence predicted depression diagnosis in adulthood, particularly due to a contribution from the alexithymia domain of 'difficulties identifying feelings.' However, none of the alexithymia domains was directly associated with substance use disorder in adulthood. Conclusions: Our study contributes to research that links alexithymia with difficulties in affect regulation and cumulative contextual risk in childhood, yielding findings that may be relevant for preventive interventions.


Assuntos
Sintomas Afetivos/complicações , Depressão/complicações , Transtorno Depressivo/complicações , Psicologia do Adolescente , Transtornos Relacionados ao Uso de Substâncias/complicações , Adolescente , Adulto , Criança , Estudos de Coortes , Emoções , Feminino , Finlândia , Humanos , Masculino , Gravidez , Adulto Jovem
14.
Expert Opin Drug Saf ; 18(8): 753-758, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31177863

RESUMO

Objectives: Z-Drugs (ZDs) have been developed to limit benzodiazepines (BZDs) abuse for sleep disorders. Data on the liver toxicity of zolpidem (ZLM) are lacking or anecdotal. The authors evaluated the presence of drug-induced liver injury (DILI) among a cohort of high-dose ZLM abusers. Methods: Retrospective study analyzing clinical records of 1112 consecutive patients admitted for BZDs detoxification from 2003 to 2018. Inclusion criteria: age >18 y.o.; ZLM abuse/dependence; high-dose ZDs abuse. Exclusion criteria: missing lab data; lack of informed consent. Main outcome was the presence of DILI measured as elevation of ALT/AST levels >250 U/l. Results: A total of 107 patients met the eligibility criteria. Liver enzymes alterations were present in 9.3% (95% CI 4.6-16.5%); one patient (0.9%, 95% CI 0.0-2.8%) showed DILI criteria. BMI significantly influenced transaminases levels. No correlations between duration nor doses of ZLM abuse and transaminases levels were found. Conclusion: The present study shows a very low prevalence of DILI among high-dose ZLM abusers. The prevalence of hypertransaminasemia was in line with general population. On one hand ZLM has a substantially safe liver profile but on the other hand ZLM abuse and dependence, especially at very high doses, represents an emerging problem.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Medicamentos Indutores do Sono/administração & dosagem , Transtornos Relacionados ao Uso de Substâncias/complicações , Zolpidem/administração & dosagem , Adulto , Alanina Transaminase/metabolismo , Aspartato Aminotransferases/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Relação Dose-Resposta a Droga , Feminino , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Medicamentos Indutores do Sono/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/reabilitação , Zolpidem/efeitos adversos
15.
BMC Infect Dis ; 19(1): 515, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31185925

RESUMO

BACKGROUND: Most of studies on the relationship between drug use and HIV have focused largely on people who inject drugs. Non-injecting drug use is much more common than injecting drug use, and although it can also predispose people to HIV infection, it is not widely explored. We therefore conducted this study to explore the prevalence of HIV and identify risk factors for HIV infection among people who use non-injecting drugs (PWUD) in Cambodia. METHODS: This cross-sectional study was conducted in 2017. The Respondent Driven Sampling method was used to recruit the study participants who were interviewed face-to-face using a structured questionnaire. Blood samples were collected for HIV and syphilis testing. A multivariable logistic regression analysis was conducted to identify risk factors associated with HIV infection. RESULTS: In total, 1367 PWUD were included in this study, whose mean age was 28.0 (SD = 7.7) years. The majority (95.1%) of the participants used methamphetamine. The prevalence of HIV was 5.7, and 35.2% of the identified HIV-positive PWUD were not aware of their status prior to the survey. After adjustment for other covariates, HIV infection remained significantly associated with being in the age group of ≥35 (AOR = 2.34, 95% CI = 1.04-6.11), having lower level of formal education of ≤ 6 years (AOR = 2.26, 95% CI = 1.04-5.15), living on the streets (AOR = 2.82, 95% CI = 1.10-7.23), perception that their HIV risk was higher as compared to that of the general population (AOR = 3.18, 95% CI = 1.27-8.62), having used injecting drugs in lifetime (AOR = 3.8, 95% CI = 1.36-4.56), and having cuts or sores around the genital area in the past 12 months (AOR = 3.42, 95% CI = 1.09-6.33). CONCLUSIONS: The prevalence of HIV among PWUD in this study was more than 10 times higher than the prevalence in the general adult population. The findings reveal a higher vulnerability to HIV infection among specific sub-populations of PWUD, such as those who are homeless, who may benefit from tailored interventions that respond to their specific needs. To enhance HIV case finding, stratification of PWUD to facilitate HIV risk profiling based on socio-economic profiles and drug injection history is recommended.


Assuntos
Usuários de Drogas/estatística & dados numéricos , Infecções por HIV/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adolescente , Adulto , Camboja/epidemiologia , Estudos Transversais , Feminino , HIV , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Abuso de Substâncias por Via Intravenosa/complicações , Abuso de Substâncias por Via Intravenosa/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
17.
Rev Med Suisse ; 15(654): 1169-1172, 2019 Jun 05.
Artigo em Francês | MEDLINE | ID: mdl-31166666

RESUMO

Substance abuse among adolescents and young adults is common. For 5 to 7 % of young people, substance use become problematic, take a function in the psychic equilibrium of the subject and will stop the adolescent process. For some, continuing substances use will be associated with the development of a primary or secondary psychiatric disorder. People with a first psychotic episode (FEP) with cannabis use will stop their use for 50 % of them, with early management of the disorder, without targeted addictive intervention. For the other half, persistent substance uses deteriorate the evolution of psychotic disorders. The treatment aims to avoid such evolution.


Assuntos
Abuso de Maconha , Transtornos Psicóticos , Transtornos Relacionados ao Uso de Substâncias , Adolescente , Humanos , Transtornos Psicóticos/complicações , Transtornos Psicóticos/terapia , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/terapia , Adulto Jovem
18.
Nervenarzt ; 90(9): 961-974, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31172233

RESUMO

The prevalence rates of psychiatric disorders show a high risk for psychological impairment among physicians in Germany. There is evidence that the mental health of physicians exerts a significant influence on the quality of patient care. The estimated prevalence rates for burnout among physicians in Germany vary between 4% and 20% and for depression between 6% and 13%. In addition, there is evidence for impairment in the context of anxiety, suicidal tendencies and substance abuse. Importantly, work-related stress factors play an important role in the development of mental disorders among physicians. In addition to individual prevention and interventions, institutional measures have been shown to be effective as a preventive strategy. It is therefore important to establish effective interventions specifically tailored to physicians to reduce stress factors at work.


Assuntos
Ansiedade , Esgotamento Profissional , Depressão , Saúde Mental , Médicos/psicologia , Médicos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias , Ansiedade/complicações , Esgotamento Profissional/complicações , Depressão/complicações , Alemanha , Humanos , Saúde Mental/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/complicações
20.
Medicine (Baltimore) ; 98(23): e15943, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31169717

RESUMO

Young adults with longstanding ketamine abuse present with lower urinary tract symptoms (LUTSs), which may be accompanied by urinary tract infection (UTI). However, the morbidity and risk factors for ketamine-associated LUTS accompanied by UTI (KALAUTI) are still unknown. To ascertain these, we surveyed patients with a history of ketamine abuse and LUTS at the time of their initial presentation.One hundred untreated patients with ketamine-associated LUTS were initially surveyed at 3 medical institutions. The patients' basic demographic and clinical information, KALAUTI status, and possible risk factors were obtained via a questionnaire and analyzed.Eighty-one patients were finally enrolled. Eight patients (9.88%) had a definitive diagnosis of KALAUTI and 16 (19.75%) had suspected KALAUTI. The diagnosis of KALAUTI was ruled out in the remaining 57 patients (70.37%). Patients with upper urinary tract involvement, longer duration of drug use, or more severe LUTS (P < .05), were more prone to KALAUTI. Frequent urine culture and a higher voiding symptom score (VSS) were risk factors for KALAUTI (P < .05), increasing the risk of KALAUTI by 44.241- and 1.923-fold, respectively.The study indicates that frequent urine culture and severe VSS are risk factors for KALAUTI. The possibility of UTI should be considered in ketamine abusers with LUTS in the clinical setting.


Assuntos
Ketamina , Sintomas do Trato Urinário Inferior/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/complicações , Infecções Urinárias/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/induzido quimicamente , Masculino , Fatores de Risco , Inquéritos e Questionários , Fatores de Tempo , Infecções Urinárias/induzido quimicamente , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA