Incidencias del COVID-19 en el consumo de sustancias y en las modalidades de atención de dispositivos de abordaje territorial / Impacts of the COVID-19 pandemic on substance use and on the modalities of care of territorial community centers

RESUMEN INTRODUCCIÓN: La pandemia por COVID-19 incidió en los ritmos y frecuencias de consumo de sustancias, así como en su abordaje. El objetivo fue analizar las modificaciones en el consumo de sustancias y en los dispositivos de abordaje territorial respecto a la demanda de atención, y las limitaciones y oportunidades para dar respuesta en contexto de crisis sociosanitaria. MÉTODOS: Se llevó a cabo una investigación cualitativa a través de 10 entrevistas a trabajadores/as que se desempeñaban en dispositivos territoriales del Área Metropolitana de Buenos Aires. El relevamiento de los datos secundarios fue realizado a través de buscadores de la web en sitios oficiales. RESULTADOS: Se identificaron variaciones en el consumo de sustancias y las frecuencias. Se incrementaron las situaciones de vulnerabilidad psicosocial de la población. Las consultas relacionadas con acceso a derechos fueron las más frecuentes. La modalidad remota y el uso de herramientas digitales permitieron continuar con ciertas intervenciones, pero al mismo tiempo tuvieron limitaciones (como sobrecarga de trabajo). Las estrategias implementadas para facilitar la accesibilidad fueron variables. Los equipos refirieron una compleja adaptación a las nuevas modalidades y dinámicas de atención, asistencia y acompañamiento. DISCUSIÓN: La pandemia ha demostrado el rol invaluable de los dispositivos de abordaje territorial. Resulta imperioso acrecentar y fortalecer la red con recursos humanos y materiales acordes.

ABSTRACT INTRODUCTION: The COVID-19 pandemic affected both rhythms and frequencies of substance use as well as its approach. The aim was to analyze the changes in substance use and in territorial community centers related to health care demand, along with limitations and opportunities to provide solutions in the context of a social and health crisis. METHODS: A qualitative research was conducted through 10 interviews to employees working in territorial community centers in the Metropolitan Area of Buenos Aires. The secondary data were collected through web search engines in official sites. RESULTS: Variations in substance use and frequencies have been identified. There was a higher psychosocial vulnerability among the population. Inquiries related to access to rights were the most frequent ones. The remote modality and the use of digital tools allowed some interventions to continue, but at the same time they had limitations (such as work overload). The strategies implemented to facilitate accessibility varied. Teams reported a complex adaptation to new modalities and dynamics of care, assistance and support. DISCUSSION: The pandemic has shown the invaluable role played by territorial community centers. It is of utmost importance to provide human resources and necessary materials to extend and strengthen the network of territorial community centers.

Histórias de vidas de universitários e uso de substâncias psicoativas / Life stories of college students and use of psychoactive substances / Historias de vida de estudiantes universitarios y uso de substancias psicoactivas

O objetivo deste estudo foi compreender, por meio das histórias de vidas, aspectos relacionados ao uso de substâncias psicoativas por estudantes universitários. Participaram 15 estudantes de ambos os gêneros e com idades entre 18 e 28 anos, de diferentes cursos de graduação que já fizeram uso de alguma substância psicoativa. Foi aplicado um questionário sócio demográfico e um relato autobiográfico; na sequência, as entrevistas narrativas foram realizadas. Para análise dos dados utilizou-se da análise temática que identificou quatro categorias: Conflitos familiares na infância e adolescência; Experiências com o uso de drogas na adolescência e na vida universitária; Formas de tratamento; e Prevenção na educação. Foi observado que os fatores comportamentais, ambientais, sociais e familiares, demonstram estar associados ao uso de drogas. Este estudo traz dados relevantes que podem contribuir no planejamento de ações preventivas sobre o uso de drogas no âmbito universitário (AU).

The aim of this study was to understand, through life stories, aspects related to the use of psychoactive substances by university students.The study included 15 students of both genders and aged between 18 and 28 years, from different undergraduate courses who have already used some psychoactive substanceA sociodemographic questionnaire and an autobiographical report were applied; then, narrative interviews were carried out.For data analysis, the thematic category analysis was used, four categories wereidentified: Family conflicts in childhood and adolescence;Experiences with drug use in adolescence and university life;Forms of treatment;and Prevention in education. It was observed in this study that behavioral, environmental, social and family factors, demonstrate to be associated with drug use. This study provides relevant data that can contribute to the planning of preventive actions on drug use at the university level (AU).

El objetivo de este estudio fue comprender, a través de historias de vida, aspectos relacionados con el uso de sustancias psicoactivas por parte de estudiantes universitarios.El estudio incluyó a 15 estudiantes de ambos sexos y con edades comprendidas entre los 18 y los 28 años, de diferentes cursos de grado que ya han consumido alguna sustancia psicoactiva. Se aplicó un cuestionario sociodemográfico y un informe autobiográfico; luego, se realizaron entrevistas narrativas. Para el análisis de los datos se utilizó el análisis de categorías temáticas, se identificaron cuatro categorías: Conflictos familiares en la infancia y la adolescencia; Experiencias con el consumo de drogas en la adolescencia y la vida universitaria;Formas de tratamiento;y Prevención en la educación. Se observó en este estudio que factores conductuales, ambientales, sociales yfamiliares demuestran estar asociados con el consumo de drogas. Este estudio aporta datos relevantes que pueden contribuir a la planificación de acciones preventivas sobre el consumo de drogas a nivel universitario (AU).

Consumo de drogas durante pré-natal de baixo risco: estudo transversal / Consumo prenatal de medicamentos de bajo riesgo: un estudio transversal / Low risk prenatal drug consumption: a cross-sectional study

Objetivo: estimar a prevalência de consumo de drogas por gestantes que realizavam pré-natal de baixo risco na atenção primária de saúde.Método: estudo observacional, transversal, realizado com 270 gestantes, em 14 unidades básicas de saúde de dois municípios do noroeste do Paraná, com altos índices de vulnerabilidade social. Utilizou-se formulário estruturado, características sociodemográficas, dados gestacionais e de uso de drogas pela gestante, e família e estatística descritiva. Resultados:eram pardas/negras, idade materna de 25 a 35 anos, com mínimo nove anos de instrução, companheiro fixo e multigestas. A prevalência do consumo de drogas, em poliuso, foi 46,2%: tabaco, 28,5%; álcool, 14%, e maconha, 3,3%.O uso de drogas apresentou padrão intergeracional e o companheiro utilizava drogas similares à gestante.Conclusão:destaca se a alta prevalência do envolvimento com drogas por gestantes e limitações e desafios dos profissionais de saúde para a detecção precoce do uso

Objective:to estimate the prevalence of drug use by pregnant women undergoing low-risk prenatal care in primary health care. Method:observational and cross-sectional study, carried out with 270 pregnant women, in 14 basic health units in two municipalities in northwestern Paraná, with high levels of social vulnerability. A structured form was used, sociodemographic characteristics, gestational data and drug use by the pregnant woman and her family, and descriptive statistics. Results:they were brown/black, maternal age from 25 to 35 years old, with a minimum of nine years of education, a steady partner and multipregnant. The prevalence of drug use, in polyuse, was 46.2%: tobacco, 28.5%; alcohol, 14%, and marijuana, 3.3%. The use of drugs showed an intergenerational pattern and the partner used drugs similar to the pregnant woman. Conclusion:the high prevalence of involvement with drugs by pregnant women and the limitations and challenges of health professionals for the early detection of use is highlighted.

Objetivo:estimar la prevalencia del uso de drogas entre las mujeres embarazadas que recibieron atención prenatal de bajo riesgo en la atención primaria de salud. Método:estudio observacional y transversal, realizado con 270 mujeres embarazadas, en 14 unidades básicas de salud en dos municipios del noroeste de Paraná, con altos niveles de vulnerabilidad social. Se utilizó un formulario estructurado, con características sociodemográficas, datos gestacionales y de consumo de drogas por parte de la gestante y su familia, y estadística descriptiva. Resultados:eran morenas/negras, edad materna de 25 a 35 años, con un mínimo de nueve años de educación, pareja estable y gestaciones múltiples. La prevalencia de consumo de drogas, en poliusos, fue del 46,2%: tabaco, 28,5%; alcohol, 14%, y marihuana, 3,3%. El consumo de drogas mostró un patrón intergeneracional y la pareja consumió drogas similares a la gestante. Conclusión:se destaca la alta prevalencia de involucramiento con drogas por parte de gestantes y las limitaciones y desafíos de los profesionales de la salud para la detección precoz del consumo

Factores Individuales Asociados al Consumo de Sustancias Ilícitas: Una Revisión de Revisiones / Individual Factors Associated with the Consumption of Illicit Substances: a Review of Reviews

RESUMEN Introducción: El consumo de drogas ilícitas está creciendo en Colombia según los estudios nacionales. Con ello también incrementa la prevalencia de los trastornos por uso de sustancias y del conjunto de afectaciones a la salud relacionadas con esta práctica. El conocimiento de los factores asociados al consumo de drogas ilícitas es necesario para orientar la atención integral del fenómeno. Métodos: Se trata de una revisión sistemática de revisiones sobre factores asociados al consumo de drogas ilícitas con siete bases de datos y evaluación de la calidad de los manuscritos de acuerdo con AMSTAR. Resultados: Se extrajo información de 38 revisiones sobre factores individuales asociados al consumo de drogas ilícitas. Los factores demográficos se asocian con el consumo con mediación de otros factores. Hay evidencia de la asociación entre trastornos mentales y del comportamiento y los trastornos de personalidad. Conclusiones: La probabilidad de consumo de sustancias ilícitas y de trastornos por su uso, se ve afectada por un conjunto de factores personales que incluyen características socio-demográficas, condiciones de salud mental, comportamiento sexual, el consumo de drogas legales, la edad de inicio y la percepción de riesgo.

ABSTRACT Introduction: According to national studies, the use of illicit drugs is growing in Colombia. With this, the prevalence of substance use disorders and the set of health effects related to this practice also increases. Knowledge of the factors associated with the use of illicit drugs is necessary to guide the comprehensive care of the phenomenon. Illicit drugs Methods: This is a systematic review of reviews on factors associated with the consumption of illicit drugs with seven databases and evaluation of the quality of the manuscripts according to AMSTAR. Results: Information was extracted from 38 reviews on individual factors associated with the use of illicit drugs. Demographic factors are associated with consumption through other factors. There is evidence of the association between mental and behavioural disorders and personality disorders. Conclusions: The likelihood of consumption of illicit substances and disorders due to their use is affected by a set of personal factors including sociodemographic characteristics, mental health conditions, sexual behaviour, legal drug use, age of onset and risk perception.

Pattern and prevalence of substance abuse in Kashmiri population: a review

Substance abuse is rampant in modern world including Kashmir valley. It has become one of the major health concerns of the society. Here we present review of various studies about prevalence and effects of drug abuse in Kashmir valley. Different electronicdatabases PubMed, Science Direct and Google Scholar, for last 20 years were searched for articles describing drug abuse in Kashmir valley. Out of 10 results, 4 were reviewed published from 2012to 2021. In Kashmir, the consumption of opioids has increased significantly with heroin injection not being uncommon. Youth are more vulnerable to the menace which destroys the productive years of their life. Many factors like conflict 2012 to 2021 zone, peer pressure, unemployment, vulnerable to this menace, educational stress isresponsible for the substance abuse among individuals. Drug abuse threatens the social fabric of our community. It causes enormous suffering to not only the individual caught in this abuse but also his whole family. To overcome this menace multipronged approach is required with interventions at family and, community level, various government agencies, NGO抯 and most important by medical specialists.

Abuse of Xylazine by Human and its Emerging Problems: A Review from Forensic Perspective

@#Xylazine is a sedative, analgesic and muscle relaxant widely applied in the veterinary field. However, owing to its depressant effect, xylazine has become a substance of abuse by humans. Misuse of xylazine not only triggers unwanted consequences (death), but also linked with various crimes. Google Scholar, PubMed and SciFinder were used to retrieve articles and case reports in relation to the misuses of xylazine and established analytical methods for forensic investigation until November 2021. Literatures reported the accidental and intended poisoning of xylazine, recreational use of xylazine and as an adulterant in recreational drugs. In addition to being a facilitator of crime and sexual assault, it is administered illegally to food producing animals as a sedative and to sports animals as a doping agent. Problems associated with the abuse of xylazine were highlighted in this review, covering the unknown prevalence of xylazine abuse and the need to revise the regulatory status of xylazine. In addition, limited screening and confirmatory methods that can be readily utilised to detect xylazine either alone or simultaneously with other substances of abuse, particularly useful for forensic toxicology and narcotic section were available in the literature. As a conventionally used veterinary drug, xylazine is undoubtedly a potentially hazardous drug, and the investigations on its potential abuse would enhance routine forensic examination to keep pace with the status of illicit drugs.

Evaluation of the Implementation Process of the Tamojunto 2 0 Prevention Program in Brazilian Schools / Avaliação do Processo de Implementação do Programa Preventivo # Tamojunto 2 0 em Escolas Brasileiras / Evaluación del Proceso de Implementación del Programa Preventivo # Tamojunto 2. 0 en Escuelas Brasileñas

Abstract The #Tamojunto2.0 program (Unplugged) has been evaluated in Brazil in order to support its implementation as a national public policy. The aim of this study was to evaluate the implementation process of the #Tamojunto2.0 school-based program, disseminated by the Ministry of Health, in the prevention of alcohol and other drug use among adolescents. This is a mixed-methods study. The sample consisted of 13 teachers and eight managers of 8th grade classes of elementary education public schools located in two cities, and a training provider professional for the program's application. Observation, evaluation and semi-structured interview forms were used. Descriptive and thematic analyses were performed. The results indicate low implementation fidelity, good quality in the application of the program, and high student absenteeism. Aspects which facilitate or hinder implementation of the program are also presented. Such results are relevant for the large-scale implementation of #Tamojunto2.0.

Resumo O programa #Tamojunto2.0 (Unplugged) tem sido avaliado no Brasil com vistas a subsidiar sua implantação como política pública nacional. O objetivo deste estudo foi avaliar o processo de implementação do programa escolar #Tamojunto2.0, disseminado pelo Ministério da Saúde, na prevenção do uso de álcool e outras drogas entre adolescentes. Trata-se de estudo de métodos mistos. A amostra constituiu-se de 13 professores e oito gestores de turmas de 8º ano do ensino fundamental de escolas públicas localizadas em duas cidades, e uma profissional ministrante da formação para aplicação do programa. Foram utilizados formulários de observação, avaliação e roteiro de entrevista semiestruturada, os dados coletados foram submetidos às análises descritiva e temática. Os resultados indicam baixa fidelidade de implementação, boa qualidade na aplicação do programa, alto absenteísmo dos estudantes. São também apresentados aspectos que facilitam ou dificultam sua implementação. Tais resultados são relevantes para a implementação do #Tamojunto2.0 em larga-escala.

Resumen El programa # Tamojunto2.0 (Unplugged) ha sido evaluado en Brasil con miras a subsidiar su implementación como política pública nacional. El objetivo del estudio fue evaluar el proceso de implementación del programa escolar #Tamojunto2.0, difundido por el Ministerio de Salud, en la prevención del consumo de drogas en adolescentes. Es un estudio de métodos mixtos. La muestra se constituyó de 13 maestros y ocho directores de clases del 8º grado de Enseñanza Fundamental en escuelas públicas de dos ciudades, y un profesional provedor de capacitación para la aplicación del programa. Se utilizaron formularios de observación, evaluación y entrevista semiestructurada. Los datos se sometieron a análisis descriptivo y temático. Los resultados indican baja fidelidad en la implementación, buena calidad en la aplicación del programa, alto ausentismo estudiantil. También se presentan aspectos que facilitan o dificultan la implementación del programa. Estos resultados son relevantes para la implementación a gran escala de #Tamojunto2.0.

Conductas y escenarios de riesgo en la adolescencia: voces de adolescentes y sus padres en la ciudad de Medellín / Risk behaviors and scenarios in adolescence. Voices of adolescents and their parents in Medellín city

Objetivo: describir las conductas y los escenarios de riesgo que adolescentes y sus padres relatan de sus experiencias cotidianas. Metodología: se realizó una investigación cualitativa con enfoque fenomenológico hermenéutico que posibilitó acceder a los relatos de los participantes a través de siete entrevistas semiestructuradas con adolescentes y siete con padres. Los resultados muestran relatos sobre el riesgo en torno a la sexualidad y el consumo de sustancias psicoactivas en escenarios donde se relacionan con otros. Como conclusión se encuentra que hay una delgada línea entre la exploración y la práctica de riesgo y que los adolescentes, sujetos con capacidad de conciencia, pueden vivir las experiencias como una u otra de acuerdo con la presencia y el uso de los recursos con los que cuentan.

The objetive of this article is to describe the behaviors and risk scenarios that adolescents and their parents tell about their daily experiences. A qualitative research with a hermeneutical phenomenological approach was carried out that made it possible to access the participants' stories through seven semi-structured interviews with adolescents and other seven semi-structured interviews with their parents. The results show reports about the risk around sexuality and the consumption of psychoactive substances in contexts where they interact with people. As a conclusion, it is found that there is a little line between the exploration and the risk practice and the adolescents, subjects with the capacity for conscience, can live experiences as exploration or risk according to the presence and use of the resources they have

Insatisfação com a imagem corporal, uso de drogas e fatores associados entre adolescentes em três cidades brasileiras / Body dissatisfaction, drug use, and associated factors among adolescents in three Brazilian cities / Insatisfacción con la imagen corporal, uso de drogas y factores asociados entre adolescentes en tres ciudades brasileñas

Resumo Objetivo: analisar a associação entre uso de drogas e a insatisfação com a imagem corporal de adolescentes em três cidades brasileiras. Método: estudo transversal, aninhado em um ensaio controlado randomizado para avaliar o programa de prevenção ao uso de drogas em escolas brasileiras #TamoJunto2.0 do Ministério da Saúde. A amostra foi de 5.213 alunos de 73 escolas de três cidades brasileiras. O desfecho satisfação corporal foi analisado por meio da escala de Silhuetas de Stunkard e as variáveis explicativas foram o uso de drogas e dados sociodemográficos. Resultados: os adolescentes tinham entre 12 e 14 anos e cerca de 69,9% relataram insatisfação corporal, e no último ano 35,67% utilizaram álcool. A insatisfação por sobrepeso foi maior nas meninas (41,5%) e por baixo peso nos meninos (33,1%). Os adolescentes que usavam maconha apresentaram 39% (OR=1,39) mais chance de insatisfação por baixo peso e ser menina aumentou em 24% (OR=1,24) as chances de insatisfação por sobrepeso. Conclusão: os níveis de insatisfação corporal merecem atenção no cuidado de enfermagem hebiátrica e reforçam a necessidade de estratégias educativas abordando a imagem corporal e uso de drogas, a relacionando aos vários atributos subjetivos que podem afetar a saúde dos adolescentes, seja na comunidade ou escola.

Abstract Objective: analyze the association between drug use and body dissatisfaction among adolescents in three Brazilian cities. Method: cross-sectional study, using a nested randomized controlled trial to evaluate the drug use prevention program #TamoJunto2.0 of the Ministry of Health in Brazilian schools. The sample consisted of 5,213 students from 73 schools in three Brazilian cities. The outcome body satisfaction was analyzed using the Stunkard scale and the explanatory variables were drug use and sociodemographic data. Results: the adolescents were between 12 and 14 years old; about 69.9% of them reported body dissatisfaction, and 35.67% used alcohol in the previous year. Dissatisfaction due to overweight was higher among girls (41.5%) and dissatisfaction due to underweight was higher among boys (33.1%). Adolescents who used marijuana were 39% (OR=1.39) more likely to feel dissatisfied due to underweight and being a girl increased the chances of feeling dissatisfied due to overweight by 24% (OR=1.24). Conclusion: the levels of body dissatisfaction deserve attention in hebiatric nursing care and reinforce the importance of educational strategies addressing body image and drug use, relating them to the various subjective attributes that can affect the health of adolescents, whether in the community or at school.

Resumen Objetivo: analizar la asociación entre uso de drogas y la insatisfacción con la imagen corporal de adolescentes en tres ciudades brasileñas. Método: estudio transversal, anidado en un ensayo controlado aleatorio para evaluar el programa de prevención del uso de drogas en escuelas brasileñas #TamoJunto2.0 del Ministerio de la Salud. La muestra fue de 5.213 alumnos de 73 escuelas de tres ciudades brasileñas. El desenlace satisfacción corporal se analizó mediante la escala de Siluetas de Stunkard y las variables explicativas fueron el consumo de drogas y los datos sociodemográficos. Resultados: los adolescentes tenían entre 12 y 14 años y alrededor del 69,9% relató insatisfacción corporal, y en el último año el 35,67% consumió alcohol. La insatisfacción por sobrepeso fue mayor en las niñas (41,5%) y por bajo peso en los niños (33,1%). Los adolescentes que consumían marihuana tenían un 39% (OR=1,39) más de probabilidades de estar insatisfechos con el bajo peso y ser niña aumentó en un 24% (OR=1,24) las chances de insatisfacción por sobrepeso. Conclusión: los niveles de insatisfacción corporal merecen atención en el cuidado de enfermería hebiátrica y refuerzan la necesidad de estrategias educativas abordando la imagen corporal y el uso de drogas, relacionándola a los varios atributos subjetivos que pueden afectar la salud de los adolescentes, ya sea en la comunidad o en la escuela.

Urine Drugs of Abuse Testing at Hospital Universiti Sains Malaysia: A Review of Trends from 2009 – 2019

@#Introduction: Substance abuse is a major social and health bane worldwide, including Malaysia, inflicting extensive morbidity and mortality. Our study aims to review the request and results of urine drugs of abuse testing conducted at the Pharmacology Laboratory of Hospital Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia, over a period of 11 years. Methods: Data for urine drugs of abuse testing requested and their results performed at the Pharmacology Laboratory between January 2009 and December 2019 was retrospectively extracted. Data on patient demographics, types of drugs requested, and types of drugs tested positive were analysed. Testing was performed using the enzyme multiplied immunoassay technique. Results: The absolute number and percentage of positive cases for amphetamine type stimulant (ATS) drugs has steadily risen over the past decade making it the current drug of abuse of most concern. Opiate abuse, although still seen, remained static. The peak age range for abusing drugs falls between 25–34 years with a male predominance; an alarming finding was of positive cases observed among neonates and children below the age of 12. Majority of requests came from the Psychiatric and Emergency Departments. Conclusion: Over the past eleven years, ATS abuse has superseded opiate in being the most abused drug type, detected even at young ages. Therefore, societal awareness and education on the dangers of ATS abuse, and intensive detection of ATS use must be implemented.

Projeto de vida de adolescentes que fazem uso problemático de substâncias psicoativas / Purpose in life in adolescents with problematic use of psychoactive substances / Proyecto de vida para adolescentes que hacen uso problemático de sustancias psicoactivas

RESUMO Este artigo tem como objetivo investigar os projetos de vida de adolescentes em tratamento ambulatorial especializado para o uso problemático de substâncias psicoativas. Realizou-se um estudo de caso coletivo com sete adolescentes do sexo masculino, entre 14 e 18 anos, ao longo de treze semanas. Utilizou-se uma entrevista semiestruturada e os dados foram analisados com base nas dimensões da Escala de Projetos de Vida para Adolescentes. Os resultados mostraram que houve mais projetos de vida nas dimensões Aspirações Positivas e Relacionamento Afetivos e menos projetos de vida nas dimensões Religião/Espiritualidade e Sentido da Vida. Concluiu-se que o tratamento no ambulatório serviu como um espaço para os adolescentes organizarem suas vidas e favoreceu a construção de seu projeto de vida.

ABSTRACT This paper aims to investigate the life purposes of adolescents undergoing specialized outpatient treatment for problematic use of psychoactive substances. A collective case study was carried out with seven male adolescents, between 14 and 18 years old, over thirteen weeks. A semi-structured interview was used, and the data were analyzed based on the dimensions of the Purpose in Life Scale for Adolescents. The results showed that there were more life purposes in the Positive Aspirations and Affective Relationship dimensions and fewer life projects in the Religion/Spirituality and Sense of Life dimensions. It was concluded that the treatment at the outpatient clinic served as space for adolescents to organize their lives and favored the construction of their life purposes.

RESUMEN Este artículo tiene como objetivo investigar los proyectos de vida de adolescentes en tratamiento ambulatorio especializado por uso problemático de sustancias psicoactivas. Realizó un estudio de caso colectivo con siete adolescentes varones, entre 14 y 18 años, durante trece semanas. Utilizó una entrevista semiestructurada y los datos fueron analizados con base en las dimensiones de Escala de Proyectos de Vida para Adolescentes. Los resultados mostraron que había más proyectos de vida en dimensiones de Aspiraciones Positivas y Relación afectiva y menos proyectos de vida en dimensiones de Religión/Espiritualidad y Sentido de la Vida. Se concluyó que el tratamiento en ambulatorio sirvió como un espacio para que los adolescentes organizaran su vida y favoreció la construcción de su proyecto de vida.

O transtorno depressivo maior está associado ao diabetes mellitus tipo 2 em pacientes com hepatite C crônica / Major depressive disorder is associated with type 2 diabetes in patients with chronic hepatitis c infection

ABSTRACT BACKGROUND: Major depressive disorder (MDD) is commonly reported in patients with chronic hepatitis C (CHC); however, the factors behind the co-occurrence of these conditions have not been completely clarified yet. OBJECTIVE: We aimed to evaluate the frequency of mental disorders in CHC patients and to investigate variables associated with MDD. METHODS: CHC patients (n=151) attending a referral Centre for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview and the Cut-Annoyed-Guilty-Eye (CAGE) Questionnaire. Multivariate analysis was used to evaluate independent covariates associated with current MDD. RESULTS: Seventy-six (50.3%) patients had, at least, one current psychiatric diagnosis with MDD (33.1%) being the most common. Current MDD was independently associated with age (≤50 yr.) (OR=2.57; 95%CI=1.25-5.29; P=0.01) and type 2 diabetes mellitus (OR=2.80, 95%CI=1.17-6.70; P=0.02). Cirrhosis was associated with type 2 diabetes mellitus (OR=5.09; 95%CI=1.73-15.04; P=0.03) and current alcohol abuse/dependence (OR=2.54; 95%CI=1.04-6.22; P=0.04). DISCUSSION: MDD is associated with type 2 diabetes in CHC patients. Even in the direct-acting antivirals (DAAs) era, characterized by great perspectives for the first ample cure of a chronic viral infection, we should ensure that the screening for psychiatric disorders takes place in the course of routine clinical care of patients chronically infected with hepatitis C virus.

RESUMO CONTEXTO: O transtorno depressivo maior (TDM) é comumente detectado em pacientes com hepatite C crônica. Entretanto, fatores potencialmente associados à coocorrência destas condições não são completamente conhecidos. OBJETIVO: Avaliar a frequência de transtornos mentais em pacientes com hepatite C crônica e investigar variáveis associadas ao TDM. MÉTODOS: Pacientes com hepatite C crônica (n=151) atendidos em um centro de referência para hepatite foram avaliados usando o Mini-International Neuropsychiatry Interview e o questionário Cut-Annoyed-Guilty-Eye (CAGE). Análise multivariada foi usada para avaliar as covariáveis independentes associadas ao TDM atual. RESULTADOS: Setenta e seis (50,3%) pacientes apresentaram pelo menos um diagnóstico psiquiátrico atual; dentre eles destaca-se o TDM (33,1%). TDM atual foi independentemente associado à idade (≤50 anos) (OR=2,57; IC95% = 1,25-5,29; P=0,01) e diabetes mellitus tipo 2 (OR=2,80, IC95% = 1,17-6,70; P=0,02). Cirrose foi associada ao diabetes mellitus tipo 2 (OR=5,09; IC95% = 1,73-15,04; P=0,03) e abuso/dependência de álcool atual (OR=2,54; IC95% = 1,04-6,22; P=0,04). DISCUSSÃO: TDM está associado a diabetes tipo 2 em pacientes com hepatite C crônica. Em vigência da era dos antivirais de ação direta, caracterizada por grandes perspectivas para a primeira cura ampla de uma infecção viral crônica, devemos assegurar que a triagem dos transtornos psiquiátricos ocorra durante o atendimento clínico de rotina de pacientes com infecção crônica pelo vírus da hepatite C.

Consumo de alcohol, marihuana y cocaína en estudiantes de medicina de la Pontificia Universidad Católica de Chile / Use of alcohol, marijuana and cocaine among medical students of the Pontificia Universidad Católica de Chile

Introducción: El uso de sustancias en adolescentes y adultos jóvenes es un problema importante en Chile. El objetivo de este trabajo es determinar la prevalencia de consumo de alcohol, marihuana y cocaína entre los estudiantes de medicina de la Pontificia Universidad Católica de Chile (PUC), estudiar su relación con ciertas variables psicosociales y contrastar con estudios previos. Métodos: Se diseñó una encuesta voluntaria y de autoreporte, que incluyó el cuestionario "AUDIT" para consumo de alcohol, preguntas de la encuesta de Servicio Nacional para la Prevención y Rehabilitación del Consumo de Drogas y Alcohol (SENDA) para consumo de marihuana y cocaína, y preguntas sobre características sociodemográficas. Resultados: Respondieron 559 estudiantes de un total de 857 (65,2%). La prevalencia de consumo de riesgo de alcohol fue 15,1%, mientras que de consumo perjudicial fue 5,2%. La prevalencia de consumo de marihuana fue 57,2% alguna vez en la vida, 38,2% el último año, y 18,5% el último mes. La prevalencia de consumo de cocaína fue 2,8% alguna vez en la vida, 1,6% el último año, y 0,5% el último mes. Se encontraron asociaciones significativas con las variables estudiadas. Conclusiones: Ha aumentado considerablemente el consumo de sustancias entre los estudiantes de medicina de la PUC. No obstante, la prevalencia es menor si se com-para con el resto de estudiantes de educación superior chilena y similar a lo reportado en estudios de Norteamérica y Europa.

Introduction: The objective of this work is to determine alcohol, cannabis and cocaine use prevalence among medical students from the Pontificia Universidad Católica de Chile, study its relationship with psychosocial variables and, compare our results with previous studies. Methods: A voluntary and self-report survey was designed, which included (AUDIT) for alcohol consumption, questions taken from the National Service for Prevention and Rehabilitation from Alcohol and Drugs ́ (SENDA) Survey for cannabis and cocaine use, and questions about the students ́ sociodemographics. Results: 559 students answered from a total of 857 (65.2%). Risky alcohol use prevalence was 15.1%, and harmful alcohol use prevalence was 5.2%. Cannabis use prevalence was 57.2% ever in their lifetime, 38.2% last year, and 18.5% last month. Cocaine use prevalence was 2.8% ever in their lifetime, 1.6% last year and 0.5% last month. Associations were found between substance use and our studied variables. Conclusions: Substance use among medical students from Pontificia Universidad Católica has risen considerably. However, the prevalence remains low compared to the prevalence in the rest of Chilean higher education students and similar to the reported one from studies in European and North American medical students.

Modelos Ecológicos del Desarrollo aplicados al consumo de drogas ilícitas: una revisión sistemática / Ecological Models of Development applied to the consumption of illicit drugs: a systematic review

Resumen El consumo de drogas ilícitas constituye un asunto de relevancia social y de salud pública. Los modelos ecológicos enriquecen la explicación de las variaciones en el consumo de sustancias ilícitas, al facilitar la inclusión de los factores individuales y del contexto en el que las personas se desenvuelven. Esta revisión sistemática tiene como objetivo identificar los conceptos sobre modelos ecológicos utilizados en la investigación sobre el consumo de drogas, cuáles son los niveles de determinación previstos y cuáles factores asociados al consumo de drogas de índole personal, familiary del contexto social amplio. A partir de 22 manuscritos incluidos en la fase final de la revisión se identificó una decena de denominaciones para los modelos ecológicos, así como niveles de determinación personal, familiar y del contexto social. Se perfilan los modelos ecológicos como estructuras conceptuales flexibles, dinámicas y con posibilidades de sustentar políticas públicas integrales con mejores resultados.

Abstract The consumption of illicit drugs is a matter of social relevance and public health. Ecological models enrich the explanation of variations in the consumption of illicit substances, by facilitating the inclusion of individual factors and the context in which people develop. This rapid review aims to identify the concepts of ecological models used in research on drug use, what are the levels of determination expected and what factors associated with the consumption of drugs of a personal, family and social nature. A dozen denominations were identified for the ecological models, from of 22 manuscripts included in the final phase of the review, as well as levels of personal, family and social context determination. Ecological models are outlined as flexible, dynamic conceptual structures with the potential to sustain comprehensive public policies with better results.

Tuberculosis case finding and case holding practices in selected Drug Abuse Treatment and Rehabilitation Centers (DATRCS) in Luzon, Philippines

@#<p style="text-align: justify;"><strong>Background and Objectives:</strong> Tuberculosis (TB) remains a public health problem in the Philippines despite trends indicating a decline in the burden of disease. Persons who use drugs who are confined in government-retained drug abuse treatment and rehabilitation centers (DATRCs) face an increased risk for TB because of the congestion in the facility coupled with the absence of guidelines on TB management specific to DATRCs. Thus, this study was conducted to document the current case finding and case holding practices as well as TB treatment pathway in six (6) Luzon-based, government-retained DATRCs.</p><p style="text-align: justify;"><strong>Methods:</strong> Key informant interviews were conducted with DATRC personnel involved in TB diagnosis and management in six selected DATRCs in Luzon, Philippines. Interviews were transcribed and coded for thematic analysis. We compared the DATRC practices with the provisions of the 2014 National TB Control Program (NTP) Manual of Procedures. Results were validated through a workshop with (a) a group of physicians and rehabilitation practitioners assigned in other DATRCs; and (b) a group of experts who have experience in managing or overseeing DATRCs in the country.</p><p style="text-align: justify;"><strong>Results:</strong> Two physicians and four nurses participated in the interviews. Variations in case finding and case holding practices in six DATRCs have been found. National guidelines exist for congregate settings but are more specific to jails/prisons, which are administratively and operationally different from DATRCs.</p><p style="text-align: justify;"><strong>Conclusion:</strong> Development of special guidelines for TB case finding and case holding in DATRCs as well as staff training on the latest NTP Manual of Procedures are recommended. However, gaps and inequities posed by the current set-up underscore the need to address health system-wide factors affecting the practice and performance of these facilities.</p><p style="text-align: justify;"><strong>Key Words:</strong> tuberculosis, case finding, case holding, drug abuse treatment and rehabilitation centers, Philippines</p>

Research Progress on the Effect of Synthetic Cathinones on Animal Behavior / 法医学杂志

Synthetic cathinones are a class of new psychoactive substances with a structure similar to amphetamine drugs, which can produce excitatory effects similar to drugs such as amphetamine and cocaine after being taken. In recent years, the abuse of synthetic cathinones worldwide has become increasingly serious, posing a serious threat to social security and public health. This article focuses on several common synthetic cathinones, collects their research results in animal autonomous activity experiments and drug dependence model experiments and summarizes their relevant experimental conclusions in animal body temperature regulation, learning and memory, and anxiety, in order to provide data reference and method guidance for the domestic development of related drug research.

Research Progress of Zebrafish Model in Toxicology and Its Application Prospects in Forensic Science / 法医学杂志

In recent years, zebrafish model has been widely concerned and recognized by scholars at home and abroad. As an animal model, zebrafish is of great research value because it is easy to feed, easy to operate, observe and analyze, and the model results can be highly combined with human body test data. Zebrafish model has been widely used in many fields, including basic medical science, clinical medicine, agricultural production, environmental toxicology and forensic science. This review introduces the biological characteristics of zebrafish, summarizes the research progress of zebrafish model in toxicology, and discusses the application prospect of zebrafish model in forensic science.

Abuse of Pharmaceutical Drugs and Its Prevention / 法医学杂志

Abuse of pharmaceutical drugs is a major public health and social problem worldwide. Mostly abused drugs mainly include opioids such as morphine, tramadol, methadone and fentanyl, sedative-hypnotics such as benzodiazepines and non-benzodiazepines, and central stimulants such as Ritalin (methylphenidate), Adderall (amphetamine and dextroamphetamine) and modafinil. Abuse of pharmaceutical drugs not only causes direct damage to multiple systems of the body, but also significantly increases risks of mental and physical diseases, imposing a heavy burden on individuals, families and society. Therefore, the prevention and control of pharmaceutical drug abuse are of vital importance. The Chinese government has taken strict administration measures for pharmaceutical drugs with abuse risk. However, confronting endless new drugs and changing abuse trends, it is necessary to further strengthen management and prevention of pharmaceutical drugs, monitor the trend of abuse, establish rapid response mechanisms, popularize relevant knowledge, and develop specific therapeutic drugs and intervention means, in order to promote prevention and treatment of pharmaceutical drug abuse.

Relación entre trastornos de personalidad y abuso de drogas en pacientes del Hospital Santa Rosita / Relationship between personality disorders and drug abuse in the Hospital Santa Rosita patients

INTRODUCCIÓN: los trastornos de personalidad corresponden a un eje específico del diagnóstico multiaxial mental de una persona, representando patrones distorsionados del pensamiento y comportamiento, estos guardan una comorbilidad bastante amplia con otros trastornos mentales y enfermedades. Las drogas son agentes que modifican el funcionamiento de los órganos con los que interaccionan, uno de ellos es el cerebro. OBJETIVO: establecer la relación entre los trastornos de personalidad y abuso de drogas en pacientes ingresados en Salas Agudas del Hospital Psiquiátrico Santa Rosita en Honduras. MATERIALES Y MÉTODOS: estudio descriptivo, retrospectivo, con selección aleatoria de los expedientes médicos de los pacientes ingresados por consumo nocivo de drogas, con una muestra significativa de los expedientes de pacientes que fueron diagnosticados concomitantemente con un trastorno de la personalidad por parte del servicio de psiquiatría según criterios de la Clasificación Internacional de las Enfermedades CIE-10, durante su estadía en la sala, se les aplicó un instrumento específico para la recolección de datos y su posterior análisis utilizando el programa estadístico Epi Info 7 buscando responder la frecuencia de los trastornos de personalidad en pacientes con abuso de drogas. RESULTADOS: los pacientes atendidos por abuso de una determinada droga sea lícita o ilícita, presentaron trastornos de personalidad con una frecuencia de 41%, en caso de ser más de una droga aumento a 49% basándose en la Clasificación Internacional de las Enfermedades. CONCLUSIÓN: los trastornos de personalidad más frecuentes que se asocian al abuso de una droga fueron en orden descendente: el trastorno de la personalidad Asocial, Limítrofe y Trastorno Mixto de la Personalidad; sin embargo en el abuso concomitante de varias drogas al momento del ingreso, presentaron: trastorno de la personalidad Histriónico, Esquizoide, Paranoide y otros trastornos específicos.(AU)

INTRODUCTION: personality disorders correspond to a specific axis in the multiaxial mental diagnosis of a person, they represent distorted patterns in thinking and behavior, these disorders have a wide comorbidity with other mental disorders and diseases. Drugs are agents that modify the function of the organs which they interact with, the brain is one of them. OBJECTIVES: establish the relationship between personality disorders and drug abuse on the intern patients in acute rooms of the Santa Rosita Psychiatric Hospital, Honduras. MATERIALS AND METHODS: descriptive, retrospective study, realised after having a random selection of the medical expedients of patients that entered because of drug abuse, with a significant sample from the patients medical records that had been also diagnosed with personality disorders by the Psychiatry service following the International Classification of Diseases ICD-10 criteria while being in the hospital wards, this process followed by an application of a specific instrument to recollect detailed information and analysis using Epi Info 7 statistics program, looking to respond to the frequency of PD that coexists in patients with drug abuse. RESULTS: the patients attended by cause of an determined licit or ilicit drug abuse presented personality disorders in 41% of the population, in the case of abuse of more than one drug when admitted to the hospital it ascended to 49% following de International Classification of Diseases. CONCLUSIONS: The most frequent personality disorders associated to the abuse of one drug, in descending order were: asocial borderline and mixed personality disorders. Nevertheless in case of several drug abuse at the time of their medical admission were Histrionic, Schizoid, Paranoid and other specific personality disorders.

Depression, anxiety, and drug usage history indicators among institutionalized juvenile offenders of Brasilia

Abstract Introduction: One of the most serious socio-educational measures for children and adolescents in conflict with the law in Brazil is their internment. This measure may represent an additional source of stress to this population and present significant impacts in the mental health context. This study aims to describe anxiety levels, depression, and addictive consumption, as well as to estimate the causalities and interactions of these variables. Methods: Herein, we report a study in which 175 male juveniles from youth detention institutions of the Federal District voluntarily completed the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), and a short self-rating questionnaire asking whether and how often they had experienced cannabis, alcohol, and other "hard" psychotropic drugs (e.g., crack, cocaine, amphetamine) 1 year prior to institutionalization. Results: Of the total participants, 28.00% showed moderate to severe depression scores and 34.28% showed moderate to severe anxiety scores. In addition, the vast majority of participants also reported some antecedent drug abuse, including cannabis, alcohol, and other "hard drugs." The BDI scores moderately correlated with BAI, but none of these parameters considerably correlated with the antecedent drug abuse. Conclusions: The data indicate potentially concerning levels of emotional distress in these institutionalized juveniles which seem to be independent of addictive behaviors. These data deserve attention and further investigation. Thus, a need for preventative mental health for the general population and socio-educational intervention aimed at interned youth which can decrease levels of emotional stress is emphasized.