Consumo de drogas: enfrentamiento a un problema latente / Drug use: confronting a latent problem i: en

Algunas situaciones ponen en riesgo a Cuba en cuanto al uso de drogas, entre ellas el aumento del turismo, las relaciones con países que poseen altas tasas de consumo, la ubicación geográfica en corredores de narcotraficantes y la alta prevalencia de drogas porteras. Al respecto, el Sistema Nacional de Salud debe estar preparado para la prevención del problema y la atención a los afectados, de manera que resulta necesario mantener una información actualizada sobre los factores de riesgo y los principales productos utilizados por los consumidores. En la presente revisión bibliográfica sobre el tema se busca llamar la atención de los trabajadores de la salud en tal sentido, se ofrecen datos sobre la magnitud del problema y se abordan elementos de sus antecedentes, así como de la clasificación de las drogas, los factores de riesgo asociados a su consumo y las bases jurídicas para su control en Cuba.

Some situations put Cuba at risk for drug use, such as an increase in tourism, relations with countries that have high rates of substance abuse, the geographic location in drug trafficking corridors, and the high prevalence of "opening doors" drugs. In this regard, the National Health System must be prepared to prevent the problem and care for those affected, so it is necessary to maintain updated information on risk factors and main products used by consumers. In the present literature review on the subject, it is sought to draw the attention of health workers to this point, data on the magnitude of the problem and elements of its background are offered, as well as drug classification, the risk factors associated with its use and the legal bases for its control in Cuba.

Estimulantes de tipo anfetamínico en estudiantes de medicina latinoamericanos: una revisión / Amphetamine-type stimulants in Latin American medicine students: a review

Introducción: el consumo de estimulantes de tipo anfetamínico (ETA) y sus derivados está cada vez más presente en los estudiantes universitarios y, en particular, en los programas de medicina. El objetivo principal de este estudio fue revisar la literatura sobre el uso de ETA y sus derivados en estudiantes de medicina latinoamericanos. Materiales y método: se realizó una revisión de la literatura disponible, utilizando las bases de datos PubMed, SciELO y LILACS. Se encontraron un total de 1.054 artículos, de los cuales 17 fueron seleccionados para esta revisión. Resultados: la revisión muestra, en general, una mayor frecuencia de uso de ETA en estudiantes de medicina de América Latina en comparación con la población general y estudiantes de otras carreras universitarias. También existe una tendencia a un mayor uso en hombres, de mayor nivel socioeconómico y en cursos posteriores del programa. La razón más informada para usar ETA fue aumentar el rendimiento académico. Como factor protector se destacaron los deportes, el tiempo en familia y la profesión de alguna creencia religiosa. De los artículos seleccionados, no se encontraron estudios sobre las consecuencias a largo plazo del uso de ETA en estudiantes de medicina. Discusión: en resumen, los estudiantes de medicina latinoamericanos tienen un alto consumo de ETA, por lo que es evidente la necesidad de nuevos estudios para mejorar la precisión estadística, determinar factores de riesgo específicos, estudiar las consecuencias a largo plazo y establecer políticas de prevención y tratamiento.

Introduction: the consumption of amphetamine-type stimulants (ATS) and their derivatives are increasingly present in university students and in particular in medical programs. The main objective of this study was to review the literature on the use of ATS and their derivatives in Latin American medical students. Materials and method: a review of the literature available was performed, using PubMed, SciELO, and LILACS databases. A total of 1054 articles were found, of which 17 were selected for this review. Results: the review generally shows a higher frequency of use of ATS in medical students of Latin America compared to the general population and students from other university degrees. There is also a tendency of a higher use in men, from higher socioeconomic status, and in later courses of the program. The most reported reason for using ATS was to increase the academic performance. As a protective factor, sports, family time and professing some religious belief stood out. Of the selected articles, no studies were found on the long-term consequences of the use of ATS in medical students. Discussion: in summary, Latin American medical students have a high consumption of ATS, and therefore there is an evident need for new studies to improve statistical precision, to determine specific risk factors, to study long-term consequences, and to stablish prevention policies and treatment.

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.

A review of Cochrane reviews on pharmacological treatment for attention deficit hyperactivity disorder / Revisão de revisões Cochrane sobre o tratamento farmacológico para transtorno do déficit de atenção e hiperatividade

ABSTRACT. Attention deficit hyperactivity disorder (ADHD) is one of the most frequent childhood psychiatric problems. Objective: The objective of this study was to identify, synthesize the results, and critically evaluate all Cochrane systematic reviews (SRs) on the pharmacological interventions for children and adolescents (up to age 18) diagnosed with ADHD. Methods: The search was performed in the Cochrane Database of Systematic Reviews (via Wiley) in July 2020. Results: The search strategy resulted in four SRs of high methodological quality, analyzing 51 randomized clinical trials (9,013 participants). Compared to placebo, treatment with tricyclic antidepressants (TCAs) (desipramine), amphetamine, and methylphenidate showed improvement in symptoms such as difficulty concentrating, impulsivity, and hyperactivity in the short term (up to 6 months). There was an increase in the occurrence of adverse events, such as reduced appetite, difficulty sleeping, and abdominal pain. Insufficient evidence was found to support the effects of supplementation with polyunsaturated fatty acids. Conclusions: The use of TCAs, amphetamine, and methylphenidate in children and adolescents with ADHD seems to present positive effects and higher rates of minor adverse events when compared to placebo.

RESUMO. Déficit de atenção e hiperatividade (TDAH) é uma das mais frequentes condições psiquiátricas da infância. Objetivo: O objetivo deste artigo foi identificar, sintetizar os resultados e avaliar criticamente todas as revisões sistemáticas (RS) da Cochrane sobre as intervenções farmacológicas para crianças e adolescentes (até 18 anos de idade) diagnosticados com transtorno do déficit de atenção com hiperatividade. Métodos: A pesquisa foi realizada na base de dados Cochrane de Revisões Sistemáticas — CDSR (via Wiley) em julho de 2020. Resultados: A estratégia de busca resultou em quatro RS de alta qualidade metodológica, que analisavam 51 ensaios clínicos randomizados (9.013 participantes). Comparado ao placebo, o tratamento com antidepressivos tricíclicos (desipramina), anfetamina e metilfenidato apresentou melhora nos sintomas, como dificuldade de concentração, impulsividade e hiperatividade no curto prazo (até seis meses). Houve aumento na ocorr≖ncia de eventos adversos, como redução do apetite, dificuldade para dormir e dor abdominal. Foram encontradas evid≖ncias insuficientes para apoiar os efeitos da suplementação com ácidos graxos poli-insaturados. Conclusões: Com base nos resultados de revisões sistemáticas Cochrane, o uso de antidepressivos tricíclicos, anfetamina e metilfenidato em crianças e adolescentes com TDAH parece apresentar efeitos positivos e taxas mais elevadas de eventos adversos menores quando comparado ao placebo. Dado o alto risco de viés nos estudos primários incluídos nessas RS, ainda são necessários novos ensaios clínicos randomizados com rigor metodológico para apoiar esses achados.

Related factors of troublemaking among patients with mental disorders caused by amphetamine-type stimulants / 四川精神卫生

ObjectiveTo explore the related factors of troublemaking behaviors among patients with mental disorders induced by amphetamine-type stimulants （ATS）， and to provide references for the formulation of relevant intervention measures for ATS-induced mental disorders. MethodsA total of 105 patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） for ATS-induced mental disorders were included， and classified into troublemaking group and non-troublemaking group. The general demographic data and clinical data of the selected individuals were collected， and all patients were assessed using Social Support Rating Scale （SSRS）. Then univariate analysis and multivariate Logistic regression model were used to screen the related factors of troublemaking behaviors. ResultsThe scores of SSRS， objective support dimension and social support utilization dimension were significantly lower in troublemaking group than those in non-troublemaking group， with statistical differences ［（24.10±6.59） vs. （28.94±5.59）， t=3.364， P=0.001； （5.50±1.96） vs. （8.20±2.13）， t=5.183， P<0.01； （4.60±2.26） vs. （6.28±1.90）， t=3.435， P=0.001］. Multivariate Logistic regression analysis showed that male （OR=6.061， P=0.014） was a risk factor， while high social support level （OR=0.873， P=0.018） was the protective factor for troublemaking behaviors among patients with ATS-induced mental disorders. ConclusionPatients with ATS-induced mental disorders of the males and with low social support level are at high risk of troublemaking behaviors.

Amphetamine causing damage of dopamine cells via inhibiting of protein kinase B / glycogen synthase kinase-3β/ collapsin response mediator protein-2 signal pathway / 解剖学报

Objective To explore the damage mechanism of dopamine cells induced by amphetamine (AMPH). Methods The damage model of dopaminergic cells in mice was established by intraperitoneal injection of AMPH. The mice were randomly grouped into control, saline, amphetamine treatment for 1 day, 7 days, 14 days and 28 days. Each group contained 10 mice. The model of cell injury was established by use of AMPH in PC12 cells. The dopaminergic fibers of corpus striatum and PC12 cells were observed by the immunohistochemistry and immunofluorescence method, and changes of proteins in the protein kinase B (Akt) / glycogen synthase kinase 3β(GSK-3β) / collapsin response mediator protein 2 (CRMP-2) signal pathway were detected by Western blotting. Results AMPH caused the damage of dopaminergic fibers in the mouse corpus striatum and PC12 cells. Meanwhile, AMPH inhibited Akt and GSK-3β phosphorylation levels, and increased phosphorylated CRMP-2 level. Nerve growth factor(NGF), an agonist of Akt, or SB216763, an inhibitor of GSK-3β protected PC12 cells against AMPH-induced toxicity through upregulation of Aat and GSK-3β phosphorylation and downregulated of phosphorylation CRMP-2. Conclusion AMPH causes damage of dopamine cells via inhibition of Akt/ GSK-3β/ CRMP-2 signal pathway.

Prevention of Metamphetamine Use Relapse Through Improving Effective Information, Education and Communication (IEC): An Open Cluster-Randomized-Controlled Trial / Lao Medical Journal

Background and Rational@#In Lao PDR, relapse of metamphetamine use following discharge from rehabilitation center is unacceptably high (~50%). Good preparedness and IEC provision to the rehabilitated addicts before discharge from the rehabilitation center is likely to be vital to prevent relapse. Effective IEC would probably help to reduce the rate of relapse.@*Methodology@#This was an open cluster-randomized-controlled trial to assess the newly developed IEC package among metamphetamine users. The intervention group received new IEC package (education message + brochure + telephone contact number + follow-up) while the conventional advice was given to control group. The study participants were followed up for 6 months by telephone (at 1, 3, 6 months). The primary endpoint was the relapse rate.@*Result@#One hundred and eighty-one addicts were enrolled in the trial (93 in intervention and 88 in control groups). Ninety-six subjects were male. The overall mean (SD) age of the participants was 26.5 (6.1) years and the overall median (range) duration of drug use was 5 (0.5 – 26) years and these figures were not significantly different between the groups (P=0.50 and P=0.97), respectively). The proportion of the participants who were lost to follow-up was 8%. Sixty percents of the study subjects completed 6-months follow up and this was not statistically different between the groups (P=0.93). The overall percentage of relapse was 39% (65/166) [36% (31/85) in intervention and 42% (34/81) in control groups, P=0.38). The median (range) duration of relapse was 30 (1 – 160) days and this was not significantly different between the groups (P=0.38). In a multiple logistic regression model, contact with drug users following discharge from the rehabilitation center was significantly associated with relapse [AOR = 73, 95%CI = 39 – 405, P<0.001] while having a permanent job following discharge was a protective factor for relapse [AOR = 0.03 (0.004 – 0.27), P=0.002].@*Conclusion@#The relapse rate of metamphetamine use was lower in the group with new IEC package than in control group but this was not statistically significant. Further study with a larger scale is strongly recommended

Effect of mindfulness-based intervention on functional connectivity of resting state electroencephalogram of amphetamine-type stimulants use patients / 上海交通大学学报（医学版）

Objective • To test the mechanism of mindfulness-based intervention in patients with amphetamine-types stimulants use disorders. Methods • Forty participants from a drug rehabilitation center in Shanghai who had amphetamine-type stimulants use disorders were enrolled in this randomized controlled trial and randomly divided into either the intervention group or control group. The control group only received the normal treatment, while the intervention group received mindfulness-based intervention as well as normal treatment. Resting state electroencephalogram and mindfulness attention awareness were assessed before and after the intervention. Results • Compared with the control group, the scores of mindfulness attention awareness improved significantly in the intervention group (P=0.000), and functional connectivity of frontal cortex (F4 and F5) under the eyeopen state and parietal-occipital cortex (P7 and O2) under the mindfulness state increased significantly in the intervention group in β oscillations (P=0.000). Moreover, the functional connectivity of parietal-occipital cortex was significantly correlated with the mindfulness attention awareness scores in the intervention group (P=0.000). Conclusion • Mindfulness-based intervention is effective in improving the mindfulness attention awareness and increasing the electroencephalogram functional connectivity of partial frontal and parietal-occipital cortex for patients with amphetamine-type stimulants use disorders.

The status quo of amphetamine type stimulants use among residents aged 15-64 in a border city of Yunnan province, 2014 / 中华流行病学杂志

Objective@#To understand status of amphetaminetype stimulants (ATS) use among residents aged 15-64 in a border city of Yunnan province.@*Methods@#Using the stratified cluster random sampling method, a total of 3 130 residents were recruited through both anonymous questionnaire and interview, regarding their health-related behaviour and ATS use.@*Results@#Among 3 130 residents aged 15-64 years in this city, the overall prevalence rates of ATS use were 4.0% (126/3 130) in the lifetime and 2.6% (82/3 130) in the past one year, while the prevalence of ATS use disorder in the past year was 2.3% (73/3 130). The prevalence rates of lifetime ATS use and in the past year were 7.5% (108/1 443) and 5.1% (73/1 443) in the high epidemic area, 7.3% (122/1 682) and 4.8%(80/1 682) in males, 5.2% (118/2 260) and 3.4% (77/2 260) in 18-45 age group, 4.6%(63/1 361) and 3.4% (46/1 361) in the ones having had elementary school education, 10.3% (50/487) and 8.6% (42/487) in unmarried group, 17.1% (19/111) and 12.6% (14/111) in either divorced, widowed or separated group, 4.8% (108/2 256) and 3.2% (72/2 256) in the farmers group, 6.0% (99/1 643) and 4.4% (73/1 643) in the non-religious groups (neither Buddhism nor Christianity), 15.2% (97/639) and 11.9% (76/639) in groups with negative hobbies which were 1.3% (29/2 314) and 0.3%(6/2 314) higher than the ones with positive hobbies, 8.5% (84/992) and 6.3% (62/992) in the ones negatively managing the stress which were 2.0% (42/2 138) and 0.9% (20/2 138) higher than the ones that treating the stress in a positive way.@*Conclusions@#The prevalence rates of ATS use and ATS use disorder in the past one year appeared high among those residents aged 15-64 years in the border city of Yunnan province. Prevention and intervention programs should be carried out for the target groups as soon as possible.

Effects of N-acetylcysteine on amphetamine-induced sensitization in mice

Objective: N-acetylcysteine (NAC) is beneficial in psychiatric conditions, including schizophrenia. Patients with schizophrenia exhibit mesolimbic dopamine hyperfunction consequent to an endogenous sensitization process. This sensitization can be modeled in rodents by repeated exposure to psychostimulants, provoking an enduring amplified response at subsequent exposure. The aim of this study was to investigate the effects of NAC on amphetamine sensitization in mice. Methods: D-amphetamine was administered to C57BL/6 mice three times a week for 3 weeks; the dose was increased weekly from 1 to 3 mg/kg. NAC (60 mg/kg) or saline was administered intraperitoneally before saline or amphetamine during the second and third weeks. After a 4-week washout period, latent inhibition (LI) and the locomotor response to amphetamine 2 mg/kg were assessed. Results: Sensitization disrupted LI and amplified the locomotor response; NAC disrupted LI in control mice. In sensitized animals, NAC attenuated the enhanced locomotion but failed to prevent LI disruption. Conclusion: NAC warrants consideration as a candidate for early intervention in ultra-high risk subjects due to its safety profile and the relevance of its mechanism of action. Supplementing this proposition, we report that NAC attenuates sensitization-induced locomotor enhancement in mice. The finding that NAC disrupted LI incites a cautionary note and requires clarification.

Avaliação da presença de cocaína e anfetamina em amostras de sangue post mortem e de indivíduos vivos, utilizando técnica de microextração em fase líquida (HF-LPME) / Amphetamine, cocaine and tetrahydrocannabinol evaluation in blood samples of living people and post mortem blood samples using microextraction technique in liquid phase (HF-LPME)

Estima-se atualmente que mais de 5% da população mundial vem fazendo uso recreativo de algum tipo de substância psicoativa, sendo que o direito a esse uso é tema recorrente da sociedade contemporânea. Por apresentar riscos associados à saúde e a segurança das populações, o uso abusivo dessas substâncias tem instigado a toxicologia social na busca de respostas, com as quais se possa caracterizar, analisar e gerenciar esses riscos. Drogas de grande consumo no Brasil são a anfetamina, cocaína e Cannabis sativa. Esta tese desenvolveu uma nova metodologia para detectar e quantificar anfetamina, cocaína e tetrahidrocanabinol em sangue total, com uso de microextração em fase líquida via fibra de polipropileno (HF-LPME), seguida de cromatografia gasosa acoplada a espectrometria de massa (GC-MS). Trata-se de uma técnica que apresenta vantagens sobre as tradicionais, uma vez que demanda quantidades menores de solvente orgânico, diminuindo riscos e custos de processo. Também propôs um estudo com a aplicação dos métodos em 69 amostras de sangue de vivos e de post mortem, as quais foram obtidas por convênio com a superintendência da polícia técnica científica de São Paulo (SPTC/SP). Os métodos desenvolvidos foram validados de acordo com diretrizes internacionais de interesse forense. Como resultado da validação, os métodos desenvolvidos se mostraram precisos e exatos para anfetamina e cocaína. O limite de detecção da cocaína foi de 5 ng . mL-1 e o limite de quantificação de 10 ng . mL-1. Quanto a anfetamina, os limites de detecção e de quantificação foram de 5 ng . mL-1. A técnica de HF-LPME não foi aplicável ao tetraidrocanabinol (Δ9-THC). Como resultado da análise das amostras, 40% delas apresentaram resultados positivos para cocaína. Desses positivos, 35% foram oriundos das matrizes de sangue de vivos e 64% oriundos de sangue post mortem. Nenhuma delas apresentou resultado quantificável para anfetamina

It is currently estimated that more than 5% of the world's population has been doing recreational use of some kind of psychoactive substances and the legal right to such use is a recurring theme debated by contemporary society. Due to the risks associated with populations health and safety, the abusive use of these substances has been instigating by social toxicology to search for answers to characterize, analyze and manage these risks. Drugs of great consumption in Brazil are, amphetamine cocaine and marijuana. This thesis proposes to develop a new methodology to detect and quantify psychoactive drugs in whole blood with the use of liquid phase microextraction by polypropylene fiber (HFLPME), followed by gas chromatography coupled to mass spectrometry (GC-MS). It is a technique that presents advantages compared with traditional ones, because of the smaller amounts demands of organic solvent, reducing risks and process costs. It also proposes a study with 69 blood samples taken from living persons and post mortem blood samples, which were obtained by agreement with the Superintendency of São Paulo Scientific Technical Police (SPTC / SP). The methods developed were validated according to international guidelines of forensic interest. As a result of the validation, the methods developed were precise and accurate for amphetamine and cocaine. The limit of cocaine detection was 5 ng . mL-1 and the limit of quantification was 10 ng . mL-1. As for amphetamine, the limits of detection and quantification were 5 ng . mL-1. The HF-LPME technique was not applicable to tetrahydrocannabinol (Δ9-THC). As a result of the sample analysis, 40% of them presented positive results for cocaine. Of these, 35% were from blood samples taken from living persons and 64% from the post mortem blood samples. None of the samples presented quantifiable results for amphetamine

Amphetamine-type stimulant use and conditional paths of consumption: data from the Second Brazilian National Alcohol and Drugs Survey

Objective: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. Method: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. Results: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. Conclusion: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.

Evaluation of the Abuse Potential of Novel Amphetamine Derivatives with Modifications on the Amine (NBNA) and Phenyl (EDA, PMEA, 2-APN) Sites

Recently, there has been a rise in the number of amphetamine derivatives that serve as substitutes for controlled substances (e.g. amphetamine and methamphetamine) on the global illegal drug market. These substances are capable of producing rewarding effects similar to their parent drug. In anticipation of the future rise of new and similar psychoactive substances, we designed and synthesized four novel amphetamine derivatives with N-benzyl, N-benzylamphetamine HCl (NBNA) substituent on the amine region, 1,4-dioxane ring, ethylenedioxy-amphetamine HCl (EDA), methyl, para-methylamphetamine HCl (PMEA), and naphthalene, 2-(aminopropyl) naphthalene HCl (2-APN) substituents on the phenyl site. Then, we evaluated their abuse potential in the conditioned place preference (CPP) test in mice and self-administration (SA) test in rats. We also investigated the psychostimulant properties of the novel drugs using the locomotor sensitization test in mice. Moreover, we performed qRT-PCR analyses to explore the effects of the novel drugs on the expression of D1 and D2 dopamine receptor genes in the striatum. NBNA, but not EDA, PMEA, and 2-APN, induced CPP and SA in rodents. None of the test drugs have produced locomotor sensitization. qRT-PCR analyses demonstrated that NBNA increased the expression of striatal D1 dopamine receptor genes. These data indicate that NBNA yields rewarding effects, suggesting potential for abuse. Continual observation for the rise of related substances is thus strongly encouraged.

Identification of Methamphetamine Abuse and Selegiline Use: Chiral Analysis of Methamphetamine and Amphetamine in Urine / 法医学杂志

Objective To study the content variation of selegiline and its metabolites in urine, and based on actual cases, to explore the feasibility for the identification of methamphetamine abuse and selegiline use by chiral analysis. Methods The urine samples were tested by chiral separation and LC-MS/MS method using CHIROBIOTICTM V2 chiral liquid chromatography column. The chiral analysis of metham-phetamine and amphetamine were performed on the urine samples from volunteers of selegiline use and drug addicts whom suspected taking selegiline. Results After 5 mg oral administration, the positive test time of selegiline in urine was less than 7 h. The mass concentrations of R(-)-methamphetamine and R(-)-amphetamine in urine peaked at 7 h which were 0.86μg/mL and 0.18μg/mL and couldn't be de-tected after 80 h and 168 h, respectively. The sources of methamphetamine and amphetamine in the urine from the drug addicts whom suspected taking selegiline were analysed successfully by present method. Conclusion The chiral analysis of methamphetamine and amphetamine, and the determination of selegi-line's metabolites can be used to distinguish methamphetamine abuse from selegiline use.

Effect of cocaine and amphetamine-regulated transcript peptides on cortical synaptic plasticity in the model mice of ischemia-reperfusion injury / 中国脑血管病杂志

Objective To investigate the effect of cocaine and amphetamine-regulated transcript (CART ) peptides on cortical synaptic plasticity in ischemia-reperfusion (I/R ) injury mice. Methods A total of 288 healthy male specific pathogen free(SPF)grade Kunming mice aged 0 to 12 weeks were selected. They were divided into four groups:I/R group (n =81 ),I/R +CART group (n =81),sham operation group (n=63),and sham operation+CART group (n=63)according to the random number table method. A model of middle cerebral artery occlusion (MCAO)for 2 h and reperfusion was induced. Before reperfusion,the mice of the I/R+CART group were injected CART via tail vein (0. 5μg, 200μl)and the those of the sham operation+CART group were injected equal CART;repeated administration once every 24 hours. 2,3,5-Triphenyl tetrazolium chloride assay was used to detect cerebral infarction volume of the I/R group and the I/R+CART group at different time points (24 h,72 h,and day 7 )after achieving reperfusion. The transmission electron microscope was used to observe the ultrastructural changes of synapses at different time points,and the synaptic morphological parameters were analyzed quantitatively. Western blot was used to observe the expression level of postsynaptic density 95 (PSD-95)proteins in the surrounding area of cortical infarct at 72 h after reperfusion. Results (1 )Compared with the sham operation group,the number of synapses was significantly decreased in the cortical slices in the I/R group (3. 37 ± 0. 38μm2 vs. 7. 04 ± 0. 55μm2 ,2. 89 ± 0. 22μm2 vs. 6. 89 ± 0. 04μm2 ,3. 25 ± 0. 18μm2 vs. 6. 78 ± 0. 42μm2;all P0.05).Conclusion CART can reduce cerebral infarct volume of I/R in mice and improve synaptic plasticity of cortical neurons in mice after ischemic injury.

The investigation of emotional state among users of amphetamine-type-stimulants under compulsory seclusion rehabilitation in Shaoxing / 中国基层医药

Objective to investigate the emotional state and childhood trauma among users of amphetaminetype-stimulants under compulsory seclusion rehabilitation in Shaoxing.Methods A cross-sectional design was conducted on 140 users of ATS in Shaoxing compulsory isolation drug rehabilitation center,collecting general information using homemade questionnaires.Using the Patient Health Questionnaire (PHQ-9),Generalized Anxiety Disorder Scale (GAD-7) and Mood Disorder Questionnaire(MDQ) to investigate the emotional state of users of ATS.The Childhood Trauma Questionnaire (CTQ) was applied to explore the childhood trauma experiences of users of ATS.Results Among the 140 users of ATS,84 (60％) users had emotional problems,24 users (17.14％) of anxiety disorder,22 users (15.72％) of depression,27 users (19.28％) of depression and anxiety disorder.66 users (47.1％)experienced at least one childhood trauma.The most common childhood trauma is the physical neglect,60 users (42.9％),followed by emotional neglect in 23 users(16.4％),again sexual abuse in 18 users (12.9％),emotional abuse and physical abuse is relatively fewer.Conclusion Among users of ATS under compulsory seclusion rehabilitation,emotional problems is prevalent.Proper emotional intervention and treatment in users of ATS would promote their mental health,thereby reducing the re-use of ATS,better return to society life.

Consumo de substâncias psicoativas e os aspectos ocupacionais relacionados à saúde do trabalhador caminhoneiro / Consumption of psychoactive substances and occupational aspects related to the health of truck drivers

Introdução: Atualmente, uma das preocupações no contexto social, político e econômico da Organização Mundial de Saúde (OMS) são as vítimas acometidas por acidentes de trânsito nas rodovias do mundo. No âmbito nacional, os motoristas de caminhão participam efetivamente do transporte terrestre de cargas nas rodovias e estão vulneráveis a diversos agentes causadores de riscos e possíveis danos à saúde. Desta forma o presente estudo teve como Objetivos: identificar o perfil sociodemográfico dos motoristas de caminhão de transporte rodoviário de carga; identificar o processo de trabalho relacionado às características laborais desses motoristas; levantar o consumo de álcool, anfetaminas e cocaína pelos condutores de caminhão e sua associação com os riscos de acidentes automobilísticos. Métodos: Trata-se de estudo epidemiológico transversal descritivo com 354 motoristas de caminhão de transporte de cargas, que, ao passarem pela barreira fiscal no posto Nhangapi, na Rodovia Presidente Dutra, foram solicitados a permanecerem no local para averiguação do veículo e dos documentos fiscais. Os motoristas de caminhão responderam a um questionário estruturado, organizado em blocos de questões que incluíam perguntas referentes ao perfil sociodemográfico, ao trabalho profissional e à saúde e aos hábitos de vida, além do questionário ASSIST. Os dados foram digitados no programa EPI INFO (versão 3.5.2) e analisados no programa - SPSS (versão 2.0). Ainda, a variável de desfecho foi o consumo de substâncias psicoativas, e as variáveis de exposição foram sociodemográficas, relacionadas à saúde e ao trabalho. O período de estudo compreendeu os anos de 2015 a 2017. Resultados: evidenciou-se entre os motoristas de caminhão: maior prevalência para o consumo moderado e alto de bebidas alcoólicas, anfetaminas e cocaína; aqueles com até 42 anos de idade e os que se declararam brancos, maior prevalência para anfetaminas; os que viviam sem parceiros, para bebidas alcoólicas; os que tinham renda per capita inferior a um salário mínimo, para três substâncias psicoativas; os que relataram dirigir por 5 horas ou mais ininterruptamente, maior prevalência para cocaína; os que exerciam sua atividade laboral no período noturno por até 8 anos, para bebidas alcoólicas; os que conseguiam descansar por até 6 horas, para anfetamina e cocaína; e os que tinham carga horária de 13 horas ou mais diárias, para três substâncias psicoativas; os que tinham autopercepção de saúde regular/ruim apresentaram maior frequência para consumo de anfetaminas; os que reportaram 1 dia ou mais de absenteísmo, para bebidas alcoólicas; os com índice de massa corporal (IMC) de baixo peso/normal, para cocaína; os que possuíam insônia, para bebidas alcoólicas e anfetaminas; já os com transtornos mentais comuns (TMC), para três substâncias psicoativas. Conclusão: tais resultados corroboram para traçar o perfil demográfico, as características laborais e o consumo de substâncias psicoativas pelos motoristas de caminhão e evidenciar que são expostos a vários fatores, os quais intervêm na qualidade de vida e saúde destes, tornando esta uma questão de saúde pública, visto que esses trabalhadores trafegam pelas rodovias e podem ocasionar acidentes de trânsito.

Introduction: Currently, one of the concerns in the social, political and economic context of the World Health Organization (WHO) are the victims of traffic accidents on the world's roads. At the national level, truck drivers are effectively involved in the land transport of loads on the roads and are vulnerable to various agents causing risks and possible damage to health. Thus, the present study had as Objectives: to identify the sociodemographic profile of the drivers of road freight transport truck; identify the work process related to their labor characteristics; collect information on alcohol, amphetamine and cocaine use by truck drivers and their association with car accident risks. Methods: This is a descriptive cross-sectional epidemiological study analyzing 354 freight truck drivers, who, when passing through the fiscal barrier at the Nhangapi control, on the Presidente Dutra Road, were asked to remain in the place to investigate the vehicle and the tax documents. The truck drivers responded to a structured questionnaire, organized in blocks of questions that included some regarding the sociodemographic profile, professional work, health and lifestyle habits, in addition to the ASIST questionnaire. The data were entered in the EPI INFO program (version 3.5.2) and analyzed in the program - SPS (version 2.0). The outcome variable was the consumption of psychoactive substances, and the exposure variables were sociodemographic, related to health and work. The study was conducted from 2015 to 2017. Results: it was evident among truck drivers: higher prevalence of moderate and high consumption of alcoholic beverages, amphetamines and cocaine; those up to 42 years old and those who declared themselves white, higher prevalence of amphetamines; those who lived without a partner, higher prevalence of alcoholic beverages; those with per capita incomes below a minimum wage, higher prevalence of three psychoactive substances; those who stated that they were driving for 5 hours or more uninterruptedly, higher prevalence of cocaine; those who undertook their work in the night period for 8 years, higher prevalence of alcoholic beverages; those who managed to rest up to 6 hours, higher prevalence of amphetamine and cocaine; those who had a daily workload of 13 hours or more, higher prevalence of three psychoactive substances; those who had regular/poor health self-perception had a higher frequency of amphetamine use; those who reported 1 day or more of absenteeism, higher frequency of alcoholic beverages; those whose body mass index (BMI) was low weight/normal, higher frequency of cocaine; those who had insomnia, higher frequency of alcoholic beverages and amphetamines; and those with common mental disorders (CMD), higher frequency of three psychoactive substances. Conclusion: these results help to trace the demographic profile, occupational characteristics and consumption of psychoactive substances by truck drivers and show that they are exposed to several factors that intervene in their quality of life and health. It also becomes a public health issue, given that these workers travel on the roads and can cause traffic accidents.

Introducción: Actualmente, una de las preocupaciones en el contexto social, político y económico de la Organización Mundial de la Salud son las víctimas de accidentes de tránsito en las carreteras del mundo. En el ámbito nacional, los conductores de camión participan efectivamente del transporte terrestre de cargas y están vulnerables a diversos agentes causadores de riesgos y posibles daños a la salud. Siendo así, el presente estudio tuvo como Objetivos: identificar el perfil sociodemográfico de los conductores de camión de transporte de carga; identificar el proceso de trabajo relacionado a sus características laborales; recopilar información sobre consumo de alcohol, anfetaminas y cocaína por los conductores de camión y su asociación con los riesgos de accidentes automovilísticos. Métodos: Este es un estudio epidemiológico transversal descriptivo analizando a 354 conductores de camión de transporte de cargas, a los que, al pasar por la barrera de control Nhangapi, en la Carretera Presidente Dutra, se solicitó que ahí permanecieran para averiguación del vehículo y de los documentos fiscales. Los conductores de camión respondieron a un cuestionario estructurado, organizado en bloques que incluían preguntas referentes a perfil sociodemográfico, trabajo profesional, salud y hábitos de vida, además del cuestionario ASIST. En cuanto a los datos, se introdujeron en el programa EPI INFO (versión 3.5.2) y se analizaron en el programa SPS (versión 2.0). La variable de resultado fue el consumo de sustancias psicoactivas y las variables de exposición fueron sociodemográficas, relacionadas a salud y trabajo. El estudio se llevó a cabo de 2015 a 2017. Resultados: quedó evidente entre los conductores de camión: mayor prevalencia de consumo moderado y alto de bebidas alcohólicas, anfetaminas y cocaína; aquellos de hasta 42 años y los que se declararon blancos, mayor prevalencia de anfetaminas; los que vivían sin pareja, de bebidas alcohólicas; aquellos cuyos ingresos per cápita inferiores a un salario mínimo, de tres sustancias psicoactivas; los que declararon que manejaban durante 5 horas o más ininterrumpidamente, mayor prevalencia de cocaína; los que ejercían su actividad laboral en el período nocturno desde hace 8 años, de bebidas alcohólicas; los que lograban descansar hasta 6 horas, de anfetamina y cocaína; los que tenían carga laboral diaria de 13 horas o más, de tres sustancias psicoactivas; los que tenían autopercepción de salud regular/mala presentaron mayor frecuencia de consumo de anfetaminas; los que reportaron 1 día o más de absentismo, de bebidas alcohólicas; aquellos cuyo índice de masa corporal (IMC) era de peso bajo/normal, de cocaína; los que sufrían insomnio, de bebidas alcohólicas y anfetaminas; y aquellos con trastornos mentales comunes (TMC), de tres sustancias psicoactivas. Conclusión: esos resultados ayudan a trazar el perfil demográfico, las características laborales y el consumo de sustancias psicoactivas por los conductores de camión y evidenciar que están expuestos a varios factores que intervienen en su calidad de vida y salud. Se vuelve también una cuestión de salud pública, puesto que esos trabajadores transitan por las carreteras y pueden causar accidentes de tránsito.

To Establish The Involvement Of Central Dopaminergic And Serotonergic Mechanism Of Ginger-Juice On Amphetamine And Lithium Treated Rat.

Background & Objective: To establish the involvement of central dopaminergic and serotonergic mechanismof ginger-juice (ZINGIBER OFFICINALE ROSCOE) CNS parameters in rat. Methodology: (A) Albino rats (n=6-12) were administered G.J at two doses (2ml & 4 ml/rat, p.o) as single administration and chronic treatment over period of 30 days. Following this assessment was done. Effect of treatment with G.J acutely and chronically (30days) administered, was assessed. Parameters used during assessment were total acidity, gastric volume & pH and ulcer index ‘UI’(acute and chronic). Results & Conclusion: Ginger administered itself did not affect loco motor activity as well as amphetamine-induced enhancement of loco motor activity.Lithium induced head twitches were enhanced after chronic administration indicating enhanced serotonergic system in the central nervous system.

La administración del antagonista GABA A bicuculina previene los efectos de la administración del agonista 5-HT 1A 8-OH-DPAT en las propiedades discriminativas de la anfetamina / Administration of GABA A receptor antagonist bicuculline prevents the effects of administration of 5-HT 1A receptor agonist on the discriminative properties of amphetamine

Resumen En esta investigación se evaluaron los efectos de la administración sistémica del antagonista GABAA bicuculina sobre los efectos del agonista 5-HT1A 8-OH-DPAT en las propiedades discriminativas de la anfetamina (ANF) utilizando el condicionamiento de aversión a los sabores. Los resultados mostraron que ni el 8-OH-DPAT, ni la bicuculina, sustituyeron la señal discriminativa de la ANF. Sin embargo, la administración del 8-OH-DPAT disminuyó la señal discriminativa de la ANF, y la administración de la bicuculina, previa a la administración del 8-OH-DPAT más una dosis de ANF, previno el efecto del 8-OH-DPAT sobre la señal discriminativa de la ANF. Estos datos apoyan la hipótesis de que las conductas relacionadas con la adicción a las drogas, como la ANF, involucran diferentes sistemas de neurotransmisión como la DA, la 5-HT y el GABA.

Abstract In this research, the effects of systemic administration of the GABAA receptor antagonist bicuculline on the effects of 5-HT1A receptor agonist 8-OH-DPAT on the discriminative properties of the AMPH using the conditioned taste aversion procedure were evaluated. The results showed that neither 8-OH-DPAT nor bicuculline administration did not substitute for AMPH. However, the 8-OH-DPAT administration decreased the discriminative signal of AMPH and the bicuculline administration, prior to the 8-OH-DPAT administration plus a dose of AMPH prevented the effect of the 8-OH-DPAT on discriminative signal of AMPH. These data support the hypothesis that addiction-related behaviors of drugs such as AMPH involve several neurotransmitter systems such as DA, 5-HT and GABA.

Safety and efficacy of fenproporex for obesity treatment: a systematic review / Segurança e eficácia do fenproporex para tratamento da obesidade: revisão sistemática

ABSTRACT OBJECTIVE To evaluate clinical evidence on the safety and efficacy of fenproporex for treating obesity. METHODS MEDLINE, LILACS and Cochrane Controlled Trials Register were searched as well as references cited by articles and relevant documents. Two authors independently assessed the studies for inclusion and regarding risk of bias, collected data, and accuracy. Eligible studies were all those placebo-controlled that provided data on the efficacy and safety of Fenproporex to treat obesity. RESULTS Only four controlled studies met the inclusion criteria. One randomized, placebo-controlled trial on Fenproporex was found on electronic databases. Three placebo-controlled studies (in non-indexed journals) were identified by hand-searching. Patients with cardiovascular and other comorbidities were excluded in all studies. Trials lasted from 40 to 364 days and doses ranged from 20 to 33.6 mg/d. All controlled studies found that weight loss among Fenproporex-treated patients was greater than that produced by the placebo, but drug effect was modest. Fenproporex produced additional weight reductions of 4.7 kg (one year), 3.8 kg (six months) and 1.55 kg (two months) in average, in relation to diet and exercise only (three trials). Insomnia, irritability, and anxiety were the most frequently reported side effects in the four studies. CONCLUSIONS There is a paucity of randomized, placebo-controlled trials on Fenproporex and those identified here present major methodological flaws. These studies suggest that Fenproporex is modestly effective in promoting weight loss. Nonetheless, they failed to provide evidence that it reduces obesity-associated morbidity and mortality. Data from these studies are insufficient to determine the risk-benefit profile of Fenproporex. Abuse potential and amphetamine-like adverse effects are causes for concern.

RESUMO OBJETIVO Avaliar a evidência clínica de segurança e eficácia do Fenproporex para tratamento da obesidade. MÉTODOS Pesquisamos publicações em qualquer idioma nas bases Medline, Lilacs Cochrane Controlled Trials Register e também referências citadas por artigos e documentos relevantes. Dois autores avaliaram independentemente os estudos para inclusão e quanto ao risco de viés, dados coletados e precisão. Foram elegíveis estudos controlados com placebo que forneceram dados sobre a eficácia e segurança do Fenproporex para tratar a obesidade. RESULTADOS Apenas quatro estudos controlados preencheram critérios de inclusão. Um estudo placebo-controlado aleatorizado do Fenproporex foi encontrado nas bases eletrônicas. Três estudos controlados (em periódicos não indexados) foram identificados por buscas manuais. Pacientes com comorbidades (cardiovasculares ou outras) foram excluídos em todos os estudos. A duração dos estudos foi de 40 a 364 dias, com doses de 20 a 33,6 mg/d. Todos os estudos controlados encontraram maior perda de peso entre pacientes tratados com Fenproporex, comparados aos que receberam placebo, mas o efeito foi modesto. O Fenproporex causou reduções adicionais de peso de 4,7 kg (após um ano), 3,8 kg (após seis meses) e 1,55 kg (após dois meses), em média, em relação à dieta e exercício apenas (três ensaios). Insônia, irritabilidade e ansiedade foram os eventos colaterais mais frequentes nos quatro estudos. CONCLUSÕES Ensaios clínicos placebo-controlado aleatorizado do Fenproporex são escassos e os estudos controlados identificados apresentam importantes falhas metodológicas. Esses estudos sugerem que o Fenproporex é modestamente eficaz em promover perda de peso. Entretanto, eles não fornecem evidências de que o Fenproporex atenua a morbidade e mortalidade associada à obesidade. Esses estudos são insuficientes para avaliar o perfil risco-benefício do Fenproporex. Potencial de abuso e efeitos adversos do tipo anfetamínico são motivos de preocupação.