Female breast cancer and alcohol consumption: a review of the literature.

CONTEXT: Consumption of alcoholic beverages is one of the single most important known and modifiable risk factor for human cancer. Among women, breast cancer is the most common cancer worldwide and the leading cause of cancer-related mortality. Consumption of alcoholic beverages is causally associated with female breast cancer and the association shows a linear dose-response relationship. The role of heavy drinking has been long recognized and even a moderate intake is associated with an increased risk for breast cancer. The present review is an update of the current evidence on the association between alcohol consumption and breast cancer risk. The aim is to gain further insight into this association and to improve our current understanding of the effects of the major modifying factors. EVIDENCE ACQUISITION: Epidemiologic and experimental studies published since the most recent International Agency for Research on Cancer (IARC) Monograph on alcoholic beverages were identified in PubMed using a combination of keywords such as alcohol, breast cancer, polymorphisms, menopausal status. EVIDENCE SYNTHESIS: Cumulative lifetime consumption, drinking frequency, drinking patterns and timing of exposure each modulate the association between alcohol consumption and breast cancer. Hormonal status, genetic polymorphisms, and nutritional factors may interact with ethanol metabolism and further influence breast cancer risk. CONCLUSIONS: Better standardization among experimental and epidemiologic designs in assessing alcohol intake and timing of exposure may improve our understanding of the heterogeneity observed across studies, possibly allowing the quantification of the effects of occasional heavy drinking and the identification of a window of higher susceptibility to breast cancer development.

Monitoring ecstasy content in France: results from the National Surveillance System 1999-2004.

The French National Identification System for Drugs and Other Substances (SINTES) is an original scheme gathering analytical information for synthetic drugs, both through police and customs' seizures in the entire country and collection of samples and questionnaires directly from the users by social field workers. Between July 1999 and June 2004, 9543 samples were included. Tablets (7004) were mainly containing MDMA (82%) and caffeine was the most frequent blended psychoactive substance. Mean MDMA dosage of tablets decreased from 1999 to 2003 and dosage for tablets bearing the same logo appeared to be highly variable. Notwithstanding the difficulties for data collection due to the illicit nature of these drugs, this surveillance and early warning system, which combines the cooperative efforts of law enforcement laboratories and social workers, provided relevant and timely information. It is accurate regarding the follow-up of trends in drugs' composition, and the identification of new or potentially dangerous substances, to the professionals, the public, and the European partners.

Characteristics and behaviors of ketamine users in France in 2003.

The increase in recreational use of ketamine in France led to the carrying out of a survey aimed at depicting the sociological profiles of French ketamine users, their addictive behaviors, and the characteristics relevant to the use of the substance. This survey is based upon the analysis of 250 questionnaires, 24 semi-directive interviews, and two focus groups. Data was collected between July 2002 and June 2003 among individuals who had used ketamine at least once since January 1, 2001. The respondents were mostly males with a polydrug addiction, aged about 24, with little post-secondary education and no steady job. Ketamine was generally the last substance experimented with throughout their lifetime, as of the age of 22. The article reviews the frequency of ketamine use observed in the population surveyed, as well as the routes of administration, the quantities used, the circumstances of use, the sought-after effects and those experienced, and the risks perceived by the users themselves. The data collected provides working facts to allow for the development and implementation of policies for preventing the use and abuse of ketamine among vulnerable populations.

Eficácia do aconselhamento para doenças sexualmente transmissíveis em unidades de referência da cidade de Fortaleza, CE, Brasil / Efficacy of couselling in STD reference health units in the city of Fortaleza, CE, Brazil

Avalia a eficácia do aconselhamento para DST seguindo a recomendação nacional. O estudo foi realizado em pacientes com DST atendidos em quatro unidades públicas de saúde de referência de Fortaleza, nordeste do Brasil

[Characteristics of the patients seen in 1999 by referral centres for sexually transmitted diseases in Ceará (Northeast Brazil)]. / Caractéristiques des patients pris en charge en 1999 par des centres de référence pour les maladies sexuellement transmissibles au Cearà, Nordeste du Brésil.

Since 1995, in the State of Ceará, in Northeast Brazil, there is a public health project focusing on training and continuing education of health reference teams taking care of patients with sexually transmitted diseases (STD). An information system including a patient's form was worked out and established. The characteristics of the patients seen at consultation in 1999 are described. Ten units provided 1,478 filled forms. Women are more present than men (72% vs 28%). Multipartnership during the last three months is more frequent among males (52%) than among females (5%). Taking antibiotics prior to the first medical advice was frequent in the male population (17%). The main syndromes presented by women were vaginal discharge (81%) and genital warts (19%), whereas with men genital warts (47%) and urethral discharge (43%) were more frequent. The frequency of positive serology for syphilis and HIV among patients presenting an STD syndrome was 7.9% and 1.3%, respectively. It was higher among males (12% and 3%) than among females (7% and 1%). The way the referral facilities are used is different according to sex, the women corning more often spontaneously. The need for accurate etiologic data for each STD syndrome was identified. The analysis of the data resulting from these STD referral units allowed to produce relevant information whose follow-up will be of great interest for both health professionals and decision-makers.

[Addictions in France: current status]. / Les addictions en France: état des lieux.

Today, we can draw a picture of addiction behaviours linked to psychoactive products by distinguishing "use" and "problematic use". These are operational terms that imperfectly cover the established concepts of "use", "abuse" and "dependency". Alcohol and tobacco occupy the front place in the field of addictions in France, not only by the levels of consumption but also by the related health harms induced. We can also note a consumption of medicines without prescription among young girls (17.4% of those aged 14 to 18) and a "potentially problematic use" of cannabis among young men (14% of those aged 18). The consumption of other drugs is very marginal and most of health harms induced is due to problematic consumption of opiate drugs and cocaine.