Psychoactive substance abuse and associated factors among middle school students in Liaoning / 中国学校卫生

Objective@#To investigate psychoactive substance abuse and associated factors among middle school students in Liaoning, and to provide policy suggestions and reference opinions for relevant departments.@*Methods@#A questionnaire survey was conducted among 12 598 middle school students in 10 cities of Liaoning by multi stage stratified cluster sampling. Multivariate Logistic regression model was used to analyze associated factors of psychoactive substance abuse.@*Results@#About 0.94% ( n =118) of all participants reported substance abuse behavior, the highest abuse rate was in the third grade students in vocational middle school, the most common psychoactive substance was “laughing balloon”, accounting for 0.57%. Multivariate Logistic regression analysis revealed that girls, moderate academic burden were generally negatively associated with more psychoactive substance use( OR = 0.57 , 0.58, P <0.05). Academic performance class was ranked in the last ten, monthly pocket money more than 500 yuan and sleep with medication were generally positively associated with more psychoactive substance use ( OR =1.93, 2.52, 4.29, P < 0.05 ).@*Conclusion@#The problem of psychoactive substance abuse among middle school students can not be ignored. Effective prevention and control of psychoactive substance abuse can be achieved through publicity, education, awareness raising, early intervention, counseling and treatment, and through coordination of adolescents, families, schools, government and the society.

Trends of substance abuse behavior among adolescents in Guangdong Province, 2007-2016 / 中国学校卫生

Objective@#To analyle prevalence and trend of substance abuse behaviors among adolescents in Guangdong province and to provide theoretical evidence for effective interventions.@*Methods@#Data regarding smoking, drinking, drugs abuse from Adolescents Health Risk Behavior Survey in 2007, 2010, 2013 and 2016 were collected and comparatively analyzed.@*Results@#The incidences of tried smoking(27.37%), current smoking(8.32%), passive smoking(45.52%), current drinking(27.97%) and drug using(0.75%) in 2016 were lower than that in 2007(32.40%, 10.81%, 52.69%, 31.97%, 1.35%), and the average annual decrease rate were 1.89%, 2.95%, 1.64%, 1.50%, 6.75%, respectively(χ2=152.73, 92.50, 313.92, 46.48, 46.64, P<0.01). During the past decate, the incidences of current smoking in rural adolescents(12.02%, 10.64%, 9.99%, 10.10%) were significantly higher than that in urban adolescents(8.88%, 8.52%, 8.17%, 6.56%)(χ2=54.46, 26.62, 25.23, 100.43, P<0.01); the incidences of current drinking in urban adolescents(33.57%, 30.37%, 35.76%, 30.46%) were significantly higher than that in rural adolescents(30.97%, 28.48%, 28.47%, 25.32%)(χ2=16.71, 10.13, 153.47, 81.76, P<0.01); the incidence of current drinking was the highest among college students in each monitoring year(47.71%, 41.76%, 42.36%, 37.77%)(χ2=583.37, 681.25, 610.04, 729.02, P<0.01); the incidence of current smoking was the highest among vocational school students in each monitoring year(16.36%, 17.00%, 14.90%, 16.71%)(χ2=256.45, 515.61, 339.63, 742.52, P<0.01); In addition to the incidence of drug abuse was the highest among college students in 2010(2.02%), vocational school students were the highest in other years(χ2=66.92, 34.38, 23.08, 20.55, P<0.01).@*Conclusion@#Smoking and drug abuse among adolescents in Guangdong showed a declining trend by years, as well as the prevalence of drinking behavior. Strengthened intervention should be targeted on smoking behavior among rural students, drinking behavior among urban students, and smoking behavior and drug abuse among vocational school students.

Complicaciones del uso de la heroína parenteral: artículo de revisión / Parenteral heroin complications: Article review / Complicações do uso da heroína parenteral: artigo de revisão

Revisión narrativa que buscó recopilar informacion sobre complicaciones del uso de la heroína parenteral. Fueron captados artículos científicos, revisiones y casos clínicos en las bases de datos Scielo, Lilacs, Medline. La heroína es una sustancia psicoactiva y su uso tiene consecuencias adversas para la salud física y mental; las complicaciones físicas más frecuentes son infecciones por virus como el HIV, las hepatitis B y C, infecciones de piel, tuberculosis, embolias pulmonares y enfermedades renales. Otras complicaciones frecuentes son los trastornos mentales como depresión, trastornos de personalidad y el uso concomitante de otras sustancias, como el cannabis y la cocaína. Para el profesional de enfermería es importante conocer las complicaciones del uso de la heroína para planear procesos integrales y elaborar programas de reduccion de riesgos y daños derivados del uso de la sustancia.

This literature review sought to collect information on complications of parenteral use of heroin. Scientific articles, reviews, and case reports were selected from Scielo, Lilacs, and Medline databases. Heroin is a psychoactive substance and its use has mental and physical health consequences; among the most common physical consequences are blood-borne infectious diseases such as HIV, hepatitis B and C, skin infections, tuberculosis, pulmonary embolism, and renal disease. Other frequent complications include mental disorders, such as depression, personality disorders, and the concomitant abuse of other substances, such as cannabis and cocaine. It is important for nurses to be aware of the complications of heroin use in order to plan comprehensive processes and develop nursing programs that reduce the risks and harm resulting from use of the substance.

Revisão narrativa que buscou recopilar informação sobre complicações do uso da heroína parenteral. Foram captados artigos científicos, revisões e casos clínicos nas bases de dados Scielo, Lilacs, Medline. A heroína é uma substância psicoativa e seu uso tem consequências adversas para a saúde física e mental; as complicações físicas mais frequentes são infecções por vírus como o HIV, as hepatite B e C, infecções da pele, tuberculose, embolias pulmonares e doenças renais. Outras complicações frequentes são os transtornos mentais como depressão, transtornos de personalidade e o uso concomitante de outras substâncias, como a maconha e a cocaína. Para o profissional de enfermagem é importante conhecer as complicações do uso da heroína para planejar processos integrais e elaborar programas de redução de riscos e estragos derivados do uso da substância.

Endovascular repair combined with second-stage surgical debridement for ruptured femoral pseudoaneurysms due to drug injection / 中国医师杂志

Objective To evaluate the feasibility,safety,and efficacy of endovascular repair combined with second-stage surgical debridement for ruptured femoral pseudoaneurysms (RFP).Methods All patients who underwent emergency repair of an RFP in our institution between 2009 and 2013 were identified.Case notes were retrieved for clinical data.Results Seven patients were identified.All the patients were treated with emergent percutaneous stent-graft implantation and secondary surgical debridement.The procedure time was (55 ± 6.32) min,blood loss was (93.33 ± 25.03) ml,hospital stay was (9.5 ± 0.84) d,and no postoperative complications occurred.Conclusions stent graft implantation for the treatment of RFPs is safe and effective in short-or middle-term outcome.It is an alternative for RFPs and may be the better option,which makes the secondary surgical debridement feasible and viable.

Apoptosis in Adult Mouse Brain after Chronic Poisoning of Ketamine / 法医学杂志

Objective To study the effect of chronic poisoning of ketamine on brain cell apoptosis in adult mouse under different duration and doses. Methods The mouse model of chronic poisoning of ketamine was established on adult mouse by tail vein injection of ketamine twice every week with different doses (4, 10, 20 and 30 m g/kg). The mice were sacrificed after continuous injection of ketamine of 1, 2, 4, 8 and 12 weeks. The qualitative assessment of apoptosis was made by transmission electron microscope and the quantitative assessment was made by Caspase-3 im m umofluorescence staining method and terminal deoxynucleotidyl transferase-mediated dU TP nick end labeling (TUNEL ) to estimate the time point of apoptosis. All the experimental results were statistically analyzed. Results The neuron apoptosis was ob-served in hippocam pus and corpus striatum by transmission electron microscope one week after adminis-tration, and continued for eight weeks. High level of Caspase-3 expression was observed one week after administration, but with a lowlevel expression after 4 weeks. The num ber of TUNEL positive cells ob-viously increased one week after administration and maintained in ahigh num ber at 4 weeks. Conclu-sion Ketamine by tail vein injection could induce neuron apoptosis in adult mouse.

Mexico’s northern border conflict: collateral damage to health and human rights of vulnerable groups / El conflicto en la frontera norte de México: daños colaterales a la salud y los derechos humanos en grupos vulnerables

Objective. To compare distributions of human rights violations and disease risk; to juxtaposethese patterns against demographic and structural environmental variables, and to formulateimplications for structural interventions.Methods. Female sex workers who inject drugs were surveyed in Tijuana and CiudadJuarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs)were conducted (October 2008 to October 2009). Frequencies of individual and environmentalfactors, including police abuse, risk of HIV infection, and protective behaviors, were comparedbetween sites using univariate logistic regression.Results. Of 624 women, almost half reported police syringe confiscation despite syringesbeing legal; 55.6% reported extortion (past 6 months), with significantly higher proportions inCiudad Juarez (P < 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana,36.5% in Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in CiudadJuarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuanathan in Ciudad Juarez (64.2% and 83.4%, P < 0.001), paralleling the lower prevalence ofsexual risk behaviors there. Ciudad Juarez respondents reported significantly higher mediannumber of monthly clients (6.8 versus 1.5, P < 0.001) and lower median pay per sex act(US$ 10 versus US$ 20, P < 0.001) (in the past month). Relative to Tijuana, security deployment,especially the army’s presence, was perceived to have increased more in Ciudad Juarezin the past year (72.1% versus 59.2%, P = 0.001).Conclusions. Collateral damage from police practices in the context of Mexico’s drug conflictmay affect public health in the Northern Border Region. Itinerant officers may facilitate diseasespread beyond the region. The urgency for mounting structural interventions is discussed.

Objetivo. Comparar las distribuciones de las violaciones a los derechos humanos yel riesgo de enfermedades; yuxtaponer los patrones obtenidos con las variables demográficasy estructurales del entorno, y formular las implicaciones de llevar a cabointervenciones estructurales.Métodos. Se entrevistaron trabajadoras del sexo que consumían drogas inyectablesen Tijuana y Ciudad Juárez, México. Entre octubre del 2008 y octubre del 2009 sellevaron a cabo entrevistas estructuradas y pruebas para detectar infecciones de transmisiónsexual (ITS). Se compararon entre las dos ciudades las frecuencias de factoresindividuales y ambientales, como el abuso policial, el riesgo de infección por el VIH ylas conductas protectoras, usando regresión logística de una sola variable.Resultados. De 624 mujeres, casi la mitad comunicaron la confiscación de jeringaspor la policía a pesar de que es legal poseerlas; 55,6% informaron extorsión (en losúltimos 6 meses), con proporciones significativamente mayores en Ciudad Juárez(P < 0,001). Los informes de solicitación reciente de favores sexuales (28,5% en Tijuana,36,5% en Ciudad Juárez, P = 0,04) y de abuso sexual (15,7% en Tijuana, 18,3%en Ciudad Juárez) por la policía fueron comunes. La prevalencia de ITS fue significativamentemenor en Tijuana que en Ciudad Juárez (64,2% y 83,4%, P < 0,001), en formaanáloga a la menor prevalencia de conductas sexuales de riesgo en la primera ciudad.Las mujeres entrevistadas en Ciudad Juárez informaron una mediana del número declientes mensual significativamente mayor (6,8 frente a 1,5, P < 0,001) y una medianadel pago por acto sexual menor (US$ 10 frente a US$ 20, P < 0,001) en el último mes.En el último año, las mujeres entrevistadas percibieron un mayor aumento del desplieguede seguridad, especialmente la presencia del ejército, en Ciudad Juárez queen Tijuana (72,1% frente a 59,2%, P = 0,001).Conclusiones. Los daños colaterales derivados de las prácticas policiales en el contextodel conflicto de narcotráfico de México pueden afectar a la salud pública enla región de la frontera norte de México. Los oficiales itinerantes pueden facilitar lapropagación de enfermedades más allá de la región. Se analiza la urgencia para establecerintervenciones estructurales.

Prevalência, fatores de risco e genótipos da hepatite C entre usuários de drogas / Prevalencia, factores de riesgo y genotipos de la hepatitis C entre usuarios de drogas / Prevalence, risk factors and genotypes of hepatitis C virus infection among drug users, Central-Western Brazil

OBJETIVO: Avaliar a utilização da Escala de Depressão Pós-natal de Edimburgo como instrumento de triagem no sistema público de saúde. MÉTODOS: A Escala foi administrada entre o 40° e 90° dia do pós-parto, a 245 mulheres que tiveram parto em uma maternidade privada no município de Belo Horizonte (MG), entre 2005 e 2006. As participantes foram submetidas a uma entrevista psiquiátrica estruturada (Mini-Plus 5.0) utilizada como padrão-ouro para diagnóstico de depressão. Foram calculadas sensibilidade e especificidade da escala e utilizou-se a curva ROC para achar o melhor ponto de corte. Foi utilizado o teste t de Student para comparação das variáveis numéricas e o qui-quadrado para as variáveis categóricas. A confiabilidade foi aferida pelo coeficiente de consistência interna alfa de Cronbach. RESULTADOS: Foram diagnosticadas 66 mulheres com o quadro depressivo pós-parto (26,9 por cento da amostra). Não houve diferença entre mulheres com e sem depressão pós-parto em relação à idade, escolaridade, número de partos anteriores e estado civil. Utilizando-se o ponto de corte de 10, a sensibilidade da escala foi 86,4, a especificidade 91,1 e o valor preditivo positivo 0,78. CONCLUSÕES: As propriedades psicométricas da Escala a carcterizam como um bom instrumento de triagem da depressão pós-parto e seu uso disseminado no Sistema Único de Saúde poderia repercutir positivamente com aumento significativo na taxa de reconhecimento, diagnóstico, e tratamento da depressão pós parto.

Applications of Capture-Recapture method for estimating the population size of injecting drug users in a city / 中华疾病控制杂志

Objective To study the application of Capture-Recapture method in estimating the size of population of injecting drug users (IDUs), and estimate the size of population in IDUs in a city using the data of detoxification center. Methods Capture-Recapture method was applied to estimating the size of population in IDUs in the city based on the data of detoxification center. Results The result of Capture-Recapture in estimating the IDUs in the city was 13 017. Conclusions It is economic and feasible to estimate the size of population in IDUs by applying the Capture-Recapture method. The result is reliable and the method is suitable in districts where health resources are limited.

Assessment of propofol-induced psychic dependence in rats / 中华麻醉学杂志

Objective To assess whether propofol call induce stable psychic dependence in the rats by self-administration experiment. Methods Twenty-four male SD rats 14 weeks old weighing 240一270 mg were studied. Anesthesia was performed with intraperitoneal injection of 3%sodium pentoharbitsl 40 ms/kg and atropine 03 mg/kg.A catheter wag inserted into the right external jugular vein. Penicillin(100 000 U)0.2 ml wag injected through the external jugular vein for anti-infection and heparin sodium(50U/ml)0.1 ml for anticoagulation. The self-administration experiment of 14 days was started after the 7 days of recovery. All the rats were randomly divided into 4 groups(n=6 each):contontrol group(C),propofol 0.56 mg/kg/l group(P1),propofol 1.00 mg/kg group(P2)and pmpofol 1.70 ms/kg group(P3).The experimental events were controlled by a computer with 50 times of the maximum injection per day.The times ofactive and inactive nose-poke response and times of drug iniection were recorded per day.Results Compared with group C and P1,the times of active nosepoke response and injections were significantly increased in group P2 and P3(P<0.01).The times of active nosepoke response and injections per day were significantly increased in group P3 than in group P2(P(0.01).There was no significant difference in the times of active nose-poke response and injections between group C and P1.There was no significant difference in inactive nose-poke resporme between the 4 groups.And the total daily doses of propofol injected in the last 3 days were significantly increased in a dose-dependent manner.Conclusion Propefol can induce the development of psychological dependence in rata and it is related to the dosage.

Políticas de drogas: prevención, participación y reducción del daño / Drug policies: prevention, participation and harm reduction

Este texto, después de una introducción al campo de las drogas, se inicia con el abordaje del concepto de prevención general, desde la perspectiva teórica de la antropología médica, para después abordar, de forma más específica, la prevención en dicho campo. Tanto en un nivel como en el otro, la participación de los propios interesados se revela como un elemento clave para su posible eficacia. Para ejemplificar la discusión se analizarán las aportaciones preventivas de los programas de reducción del daño en distintos ámbitos geográficos y temáticos como son, en este último caso, el de los consumos endovenosos de adultos socialmente "marginales" y el de los consumos de jóvenes "integrados" en contextos de ocio nocturno. En la última parte se plantea la necesidad de incorporar técnicamente la participación en las políticas y programas preventivos en el campo de las drogas, así como de ir creando un marco general más coherente con la potenciación de dicha participación que el predominante en la actualidad; para finalizar con unas reflexiones acerca del alcance teórico-político del concepto de reducción del daño.

After and introduction to the topic of drugs, this paper deals first with the concept of general prevention from the theoretical perspective of Medical Anthropology and then specifically with prevention in such field. At both levels, a key element is the participation of the ones involved. Preventive contributions to the programs of harm reduction will be analyzed in different environments such as the one of the intravenous consumption of "outcasts" and the consumption of the youngsters "integrated" to nocturnal-sloth-contexts. At the end, the article states the necessity to incorporate technically, the participation in the preventive programs and policies of drugs and to create a more coherent general framework than the existing one, finishing with some reflections about the concept of harm reduction.

Prevalence of hepatitis C virus in alcoholic patients: role of parenteral risk factors / Prevalência do vírus da hepatite C em alcoolistas: a atuação dos fatores de risco parenterais

BACKGROUND: The prevalence of hepatitis C virus (HCV) infection is elevated in alcoholic patients, but the risk factors are unclear. The role of parenteral risk factors are indeterminated in this population. AIMS: To determine the prevalence of hepatitis C virus infection in alcoholic patients admitted to a detoxification unit and to evaluate the presence of underlying parenteral risk factors. METHODS: A total of 114 consecutive unselected alcoholic patients admitted to a single chemical dependency unit during 14 month were included. Epidemiological data and history of parenteral risk factors for hepatitis C virus infection were obtained with a standardized questionnaire. Blood was collected for determination of aminotransferases and anti-hepatitis C virus antibodies (ELISA-3). Positive samples were confirmed by polymerase chain reaction and tested for genotype. RESULTS: Among the 114 alcoholics, 17 (15 percent) were anti-hepatitis C virus positive. Of these, 12 (71 percent) had detectable serum HCV-RNA by PCR. Genotype 1 was found in six cases and genotype 3 in five (one patient was undetermined). Forty-nine (43 percent) patients had elevated serum ALT and/or AST at baseline. The comparison between the 17 positive and the 97 negative patients showed significant differences in mean serum ALT levels (42 ± 41 IU/L vs. 22 ± 20 IU/L), rate of elevated ALT (65 percent vs. 34 percent), and presence of parenteral risk factors (94 percent vs. 10 percent). Comparison between alcoholic patients with and without elevated aminotransferases showed significant difference only in the rate of positive anti-hepatitis C virus antibodies (24 percent vs. 7 percent). Furthermore, among the 17 anti-hepatitis C virus positive patients, the rate of detectable HCV-RNA was significantly higher in the 12 with elevated aminotransferases versus the 5 with normal aminotransferases (92 percent vs. 20 percent). CONCLUSIONS: There was a high prevalence of anti-hepatitis C virus antibodies in alcoholics and the majority was confirmed by the presence of detectable HCV-RNA. Intravenous drug use was the main risk factor for hepatitis C virus infection in this population.

RACIONAL: A prevalência da infecção pelo vírus da hepatite C (VHC) é elevada em pacientes alcoolistas, porém os fatores de risco não estão bem estabelecidos. O papel dos fatores de risco parenterais permanece ainda indefinido nessa população. OBJETIVOS: Determinar a prevalência da infecção pelo VHC em alcoolistas internados em uma unidade de desintoxicação, e avaliar a presença de fatores de risco parenteral subjacentes. PACIENTES E MÉTODOS: Foram estudados 114 alcoolistas, não selecionados, consecutivamente admitidos em uma unidade de dependência química durante 14 meses. Através de questionário estruturado, obtiveram-se os dados epidemiológicos e história de fatores de risco parenteral para infecção pelo VHC. Foi coletado sangue para determinação de aminotransferases e anticorpos anti-VHC (ELISA-3). As amostras positivas foram confirmadas pela PCR e determinado o genótipo. RESULTADOS: Entre os 114 alcoolistas, 17 (15 por cento) eram anti-VHC positivos. Doze (71 por cento) tinham RNA do VHC detectável por PCR no soro. O genótipo 1 foi encontrado em seis casos e o genótipo 3 em cinco (em um paciente foi indeterminado). Quarenta e quatro (43 por cento) pacientes tinham ALT e/ou AST elevadas. A comparação entre os 17 pacientes positivos e os 97 negativos mostrou diferenças significativas na média do nível da ALT (42 ± 41 UI/L vs. 22 ± 20 UI/L), na taxa de ALT elevada (65 por cento vs. 34 por cento), e na presença de fatores de risco parenteral (94 por cento vs. 10 por cento). A comparação entre alcoolistas com e sem aminotransferases elevadas mostrou diferença significativa apenas na taxa de anti-VHC positivo (24 por cento vs. 7 por cento). Entretanto, entre os 17 pacientes anti-VHC positivos, a taxa de RNA do VHC detectável no soro foi significativamente maior entre os 12 com aminotransferases elevadas do que entre os 5 com aminotransferases normais (92 por cento vs. 20 por cento). CONCLUSÃO: A prevalência de anti-VHC foi elevada em alcoolistas, sendo a maioria confirmada pela presença do RNA do VHC no soro. O uso de drogas injetáveis foi o principal fator de risco para infecção pelo VHC nesta população.