Use of benzodiazepines and antidepressants in patients who attend a Rheumatology clinic / Prevalencia de consumo de benzodiacepinas y antidepresivos en los pacientes que acuden por primera vez a la consulta de reumatología

ABSTRACT Introduction: During the last decades, benzodiazepines (BZD) and antidepressants (ADP) have been among the most prescribed therapies in all developed countries. They have side effects, and BZD carry a risk of abuse and dependence disorders. The purpose of this study was to evaluate the prevalence of BZD and ADP among patients who attend a Rheumatology clinic, as well as the indication for these drugs. Methods: The study included patients who were referred for the first time to the Rheumatology clinic. Demographical data, reason for referral, and final diagnosis were recorded. The indication for ADP and/or BZD was recorded, as well as the duration of treatment. Sample size was estimated for a 0.05% alpha risk. Univariate and multivariate analyses were performed in order to study the relationships with the demographical or clinical characteristics. Results: A total of 350 patients were included (women 77.1%, men 22.9%). Most of them (73.4%) had been referred for musculoskeletal pain. More than a third (36.6%) of patients were on BZD and/or ADP. The most frequent reasons for their prescription were anxiety, depression, and insomnia. The final diagnosis in the clinic was a non-inflammatory condition in 82%, and an inflammatory one in 18%. In the univariate analyses, the use of BZD/ADP was associated with female gender (p<.001), unemployment (p<.001) and non-inflammatory final diagnosis (p < .001). In the multivariate analyses, the use of BZD and/or ADP was associated with female sex (p = .002 [OR 3.4, 95% CI; 1.6-7.4]), and a non-inflammatory final diagnosis, specifically fibromyalgia (p = .007 [OR 16.1, 95% CI; 2.2-120.7]). Conclusion: Use of BZD and ADP is high and associated with non-inflammatory disease.

RESUMEN Introducción: Durante las últimas décadas, las benzodiacepinas (BZD) y los antidepresivos (ADP) han estado entre las terapias más prescritas en todos los países desarrollados. Estos fármacos tienen efectos secundarios y las BZD pueden ocasionar abuso y problemas de dependencia. El objetivo de este estudio fue evaluar la prevalencia de consumo de BZD y ADP entre los pacientes que acuden a una consulta de reumatología por primera vez, así como la indicación para ellos. Métodos: Se incluyeron pacientes remitidos por primera vez a la consulta de reumatología. Se registraron los datos demográficos, el motivo de la derivación y el diagnóstico final. Con respecto al tratamiento con ADP y/o BZD, se registraron su duración y la indicación de la prescripción. El tamaño de la muestra se estimó para un riesgo alfa de 0,05%. Se realizaron análisis univariantes y multivariantes para estudiar las asociaciones con características demográficas o clínicas. Resultados: Se incluyeron 350 pacientes (mujeres 77,1%, hombres 22,9%). La mayoría de ellos habían sido remitidos por dolor musculoesquelético (73,4%). Más de un tercio (36,6%) de los pacientes estaban en tratamiento con BZD y/o ADP. Las causas más frecuentes para su prescripción fueron ansiedad, depresión e insomnio. El diagnóstico final fue patología no inflamatoria en el 82% de los casos e inflamatoria en el 18% de estos. En el análisis univariante, el uso de BZD y/o ADP se asoció con el sexo femenino (p< 0,001), el desempleo (p< 0,001) y el diagnóstico de patología no inflamatoria (p< 0,001). En el análisis multivariante, el uso de BZD y/o ADP se asoció con el sexo femenino (p=0,002 [OR 3,4; IC 95% 1,6-7,4]) y el diagnóstico de patología no inflamatoria, específicamente con la fibromyalgia (p = 0,007 [OR 16,1; IC 95% 2,2-120,7]). Conclusión: El consumo de BZD y ADP es frecuente y está asociado con patología no inflamatoria.

Avaliação comportamental pelo teste de preferência a sacarose em camundongos suíços machos tratados com extrato de Tribulus terrestris L / Behavioral evaluation by sucrose preference test in male swan mice treated with extract of Tribulus terrestris L

Introdução: O déficit de hormônios sexuais associa-se à depressão e, neste contexto, buscam-se plantas medicinais, como o Tribulus terrestris L. (TT). Objetivo: Investigar o efeito do declínio de testosterona, da suplementação com o propionato de testosterona e o TT no comportamento de animais. Métodos: O procedimento utilizou 40 camundongos suíços machos divididos em 4 grupos. Os grupos denominados controle e castrado receberam veículo aquoso durante o experimento. O grupo testosterona recebeu 20mg/kg do fármaco e o grupo TT recebeu 10 mg/kg do extrato das flores da planta. O comportamento foi avaliado pelo teste de preferência a sacarose. Ao fim do experimento o sangue coletado para dosagem de testosterona livre. Resultados e Discussão: O processo cirúrgico como um todo e o uso do anestésico quetamina evidenciaram suposto efeito ansiogênico. Conclusão: A alteração hormonal causada pela castração, além do estresse da cirurgia e da complexa farmacologia do anestésico, possui a capacidade de alterar o comportamento dos animais.

Introduction: Sexual hormone deficiency is associated with depression, and in this context, medicinal plants such as Tribulus terrestris L. (TT) are sought. Objective: To investigate the effect of testosterone decline, supplementation with testosterone propionate and TT on animal behavior. Methods: The procedure used 40 male Swiss mice divided into 4 groups. The groups called control and castrated received an aqueous vehicle during the experiment. The testosterone group received 20 mg / kg of the drug and the Tribulus group received 10 mg / kg of the plant extract. The behavior was evaluated by the sucrose preference test. At the end of the experiment the blood collected for free testosterone dosage. Results and Discussion: The surgical process as a whole and the use of the anesthetic ketamine evidenced an anxiogenic effect. Conclusion: The hormonal alteration caused by castration, besides the stress of surgery and the complex pharmacology of the anesthetic, has the capacity to alter the behavior of the animals.

Evaluación de los cebadores TS3 e ITS4 para la detección de infecciones por Candida spp. en muestras de flujo vaginal y humor acuoso / Evaluation of ITS3 and ITS4 primers for detection of Candida spp. Candida spp. infections from vaginal samples and aqueous humor

Antecedentes. Los métodos convencionales para a identificación de levaduras del género Candida requieren mucho tiempo, necesitan cantidad importante de la muestra y, en muchos casos, es necesario realizar cultivo. Objetivos. Evaluar un par de cebadores para la identificación de levaduras del género Candida y demostrar su potencial aplicación para el diagnóstico de infecciones intraoculares. Materiales y métodos. Se utilizaron 17 cepas de referencia, 29 aislamientos clínicos de flujo vaginal, 7 muestras de humor acuoso y una de humor vítreo. Evaluamos tres métodos para el rompimiento de la pared celular: congelación descongelación, sonicación, y la enzima liticasa. Para la purificación del ácido nucleico, se utilizó en los tres casos el estuche comercial Wizard Genomics; en la reacción de PCR, el estuche comercial Go Taq Green Master Mix y los iniciadores ITS3 e ITS4 a una concentración de 0,5 µM. Resultados. De los tres métodos el que mejor resultados ofreció fue el uso de enzima liticasa más el estuche comercial. Con los iniciadores ITS3 e ITS4 fue posible identificar las levaduras únicamente a nivel de género y no se presentó reacción cruzada con otros microorganismos comúnmente encontrados en diferentes muestras de tejido humano. La sensibilidad fue de 100 fg. Se lograron identificar por PCR todos los aislamientos a partir de flujo vaginal y de una muestra de humor acuso. Para las demás muestras de humor acuoso el diagnóstico fue para otros agentes causales, entre ellos, Toxoplasma sp. Conclusión. Consideramos que ésta es una metodología adecuada, la cual permite identificar levaduras del género Candida con gran sensibilidad y reproducibilidad.

Background. Conventional methods for Candida identification are time consuming, require high amounts of the sample and in several cases the culture is mandatory. Aims. To evaluate two primers for the identification of Candida and to demonstrate their application for intraocular infections. Materials and methods. 17 Candida reference strains, 29 vaginal samples, 7 samples of aqueous humor and one of vitreous humor were studied. Three methods to lyse the Candida wall were analyzed: freezing-thawing, sonication and the use of lyticase. For nucleic acid purification the Wizard Genomics kit was used; in the PCR the commercial kit Go Taq Green Master Mix and the primers ITS3 and ITS4 were used. Results. The best method for lysis was the enzymatic lysis with lyticase. The primers ITS3 and ITS4 identified all the Candida strains and there were no cross-reaction with other microorganisms. The sensitivity of the PCR was 100 fg. All the samples of vaginal flux and Candida strains were identified and only one sample of aqueous humor was positive for the genus Candida. In the other samples of aqueous humor toxoplasmosis was the definitive diagnosis. Conclusion. PCR amplification for Candida is a sensitive and specific technique for the diagnosis.

A study of Physico-Chemical Interactions between Haemophilus Influenzae Type b and Meningococcus group C Conjugate Vaccines

Background: Haemophilus influenzae type b (Hib) and Meningococcal group C (MenC) conjugate vaccines; which protect against otitis media; bacteremia and invasive diseases; including pneumonia and meningitis; are attractive candidates for combination; since they are both administered to infants and children.A Hib-MenC combination booster at 12 mo has recently been introduced in the U.K. Objectives: To rule out the possibility for the individual vaccine components in a Hib-MenC combination to interact; rendering one or both of them less effective; this work assessed whether these two saccharide-protein conjugates; namely; Hib oligosaccharideCRM197 (Cross-Reacting Material 197) and MenC-CRM197; interact in solution. Furthermore an evaluation of the size and integrity of the vaccines was also performed. Methods: HPLC Size-exclusion chromatography (SEC) with UV-adsorption and refractive index detection was performed with a phosphate and non-phosphate saline buffer to characterize the size of Hib and MenC conjugates as individual components or when combined. Results: Hib-CRM197 eluted significantly earlier than MenC-CRM197 in both phosphate-saline and MOPS-saline buffers on a TSK5000 PWXL column.When combined; there was no significant change in their elution. Refractive index monitoring showed no evidence of significant free saccharide or free protein. Conclusions: By size-exclusion chromatography and refractive index detection methods; there was no indication of degradation; and no evidence of significant associative interactions between Hib-CRM197 and MenC-CRM197 in saline-based buffers; pH 7.2

Management of substance abuse

Este website contém informação pertinente ao uso e abuso de substâncias psicoativas e também informação sobre os objetivos e projetos da Organização Mundial da Saúde neste campo. Disponibiliza acesso a base de dados e documentos sobre alcoolismo em PDF.

Centro de Información y Educación para la Prevención del Abuso de Drogas - CEDRO

Organização não governamental peruana com atuação na prevenção do uso de drogas e promoção da conscientização da população sobre a cadeia produção, tráfico e consumo. Apresenta a estratégia de trabalho da ONG, informação sobre drogas, princípios para o desenvolvimento alternativo das comunidades envolvidas com a produção da matéria-prima para elaboração de drogas, estatísticas nacionais, legislação, publicações e acesso à biblioteca, entre outras.