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This article deals with teacher interventions in crisis situations regarding a direct threat of students using psychoactive drugs on school premises, particularly in the difficult period of adolescence: 12–16 years of age. The focus of the research was on teacher interventions in situations where students are threatened by psychoactive substances. The research problem was whether the age and experience of the teacher were determinants of such an intervention. It investigated the relevance that a teacher’s age and experience have on their attitude and manner of intervening on behalf of a student when there is an imminent threat from psychoactive substances. The research investigated the importance of a teacher’s age and work experience in their attitude and the manner in which they intervene. It was carried out from 2017 to 2019 among teachers at middle schools in Bielsko-Biala, using the diagnostic survey method and a questionnaire. Statistical analysis of the results showed no statistically significant difference in teachers’ declarations of readiness for intervention. Regardless of age and tenure, the respondents declared a high readiness to intervene. On the other hand, there were statistically significant differences according to the teachers’ age and seniority in how the intervention was carried out. Teachers from different age and seniority groups (defined by a specific length of service) more often or less often took some of the actions envisaged in the intervention procedure. Thus, it is feasible to speak of a readiness, or lack thereof, to take certain intervention actions.

O estudo centrou-se no objetivo geral de analisar os fatores biológicos, psíquicos e patológicos que impulsionam o consumo de fármacos psicoativos entre os estudantes de Medicina na cidade de Teresina-Pi. Para tanto, a realização dapráxismetodológica utilizada foi estruturada numa abordagem quantitativa que recorreu as pesquisas descritiva e de campo tendo como base de amostragem probabilística do tipo aleatória simples envolvendo um quantitativo final de 312 alunos. A coleta deu-se por meio de questionário eletrônico elaborado na plataformagoogle form’se distribuído aos estudantes por envio dolinknowhatsapp. A conclusão constatada corresponde ao fato de que os alunos do curso de Medicina analisados estão enfrentando uma situação complexa de problemas psicoemocionais, em especial, ansiedade e depressão, motivada, principalmente, pela pressão inerente da formação que estão realizando em uma faculdade privada da cidade de Teresina, Piauí. Para lidarem com esses “problemas” estão recorrendo a psicofármacos que vem os ajudando a enfrentar os desafios que, também, estendem-se às pressões familiares. Contudo, nem todos estão sendo assistidos por profissionais do ramo como, por exemplo, psiquiatras sendo que alguns estão se medicando sem prescrição médica tendo ainda o fato de que muitos não estão buscando o psicólogo.

Antecedentes: los psicofármacos constituyen uno de los tratamientos farmacológicos más comunes en la población pediátrica. Aunque generalmente son bien tolerados, los ingresos en urgencias pediátricas debido a reacciones adversas al tratamiento por psicofármacos son un gran problema a nivel mundial. Objetivos: revisar el beneficio de la farmacogenética para el tratamiento con psicofármacos en la población pediátrica, examinar la adaptación de las guías farmacogenéticas a esta población específica, evaluar el coste/beneficio y reflexionar sobre la educación de la farmacogenética en el campo clínico. Métodos: se realiza una revisión sistemática de estudios científicos y clínicos sobre el uso de la farmacogenética para la personalización del tratamiento con psicofármacos en niños y adolescentes mediante documentos científicos. Resultados: se identificaron 25 artículos donde se evidencian los beneficios de la implementación de la farmacogenética en pacientes pediátricos tratados con psicofármacos. Conclusiones: un 15% de los pacientes pediátricos mejorarían su respuesta a psicofármacos si se tuviese en cuenta su perfil de metabolización individual. Aunque las guías de implementación de la farmacogenética empiezan a considerar a la población pediátrica, el nivel de evidencia clínica es todavía muy bajo. Se requiere un mayor número de estudios, un tamaño de muestra más grande, tener en cuenta la polifarmacia, un rango de edad más amplio que considere la ontogenia. Invertir en pruebas farmacogenéticas supone coste/beneficio a largo plazo tanto para el paciente y el sistema de salud. Por último, es importante educar a los profesionales de la salud pediátrica sobre el uso de la farmacogenética en la práctica clínica. Background: psychotropic drugs are among the most common pharmacological treatments in the pediatric population. Although they are generally well tolerated, admissions to pediatric emergencies due to adverse reactions to psychoactive drug treatment are a major problem worldwide. Objectives: in order to review the benefit of pharmacogenetics for treatment with psychotropic drugs in the pediatric population, to examine the adaptation of pharmacogenetic guidelines to this specific population, to evaluate the cost/benefit, and to reflect on the education of pharmacogenetics in the clinical field. Method: systematic review on scientific and clinical studies about use of pharmacogenetics on personalized treatment with psychoactive drugs in children and adolescents Results: a total of 25 articles indicate the benefits of implementing pharmacogenetics in pediatric patients treated with psychoactive drugs. Conclusions: taking into account the individual psychoactive drug metabolism, would improve by 15% the outcome response to these drugs. Although the guides of pharmacogenetics implementation started considering pediatric population, they yet display a very low clinical evidence. Therefore, a larger number of studies with a larger sample size are required, taking into account polypharmacy, and a broader age range that considers ontogeny. Investing in pharmacogenetic tests entails a long-term cost/benefit for both the patient and the health system. Finally, it´s important to educate healthcare professionals about the use of pharmacogenetics in the clinical practice. Graduado o Graduada en Psicología por la Universidad Pública de Navarra Psikologian Graduatua Nafarroako Unibertsitate Publikoan

Objective:Abuse of psychoactive drugs for therapeutic purposes is becoming more common due to their addiction potential. In many studies, quetiapine has been reported to be abused with illicit drugs. We aimed to point to the abuse and addiction potential of quetiapine by the rates of quetiapine abuse in blood samples of 4,293 cases who came to our Forensic Toxicology Laboratory by using liquid chromatography-tandem mass spectrometry method.Methods:All cases who were caught by law enforcement officers while using or trading drugs as a requirement of the judicial process initiated were drug users or dealers and then they were brought to our forensic toxicology laboratory to obtain blood and urine samples. Quantification in blood samples was performed in routine laboratory analysis. The cases were asked whether they used any prescription drugs. The therapeutic drug users were excluded in this study.Results:Quetiapine was positive in 50 of 4,293 cases (1.16%). 93.8% (n=4028) of all cases and all of the positive quetiapine were male. While quetiapine was used alone in 11 of 50 cases with quetiapine positivity, quetiapine was used simultaneously with one or more groups of illicit drugs in the remaining 39 cases.Conclusion:In this study, the most common use of cannabis and quetiapine was determined in cases with drugs of abuse. The monitoring of quetiapine is essential for preventing drug abuse especially in prone population such as illicit drug abusers and addicts. Forensic Toxicology Laboratories play an important role in taking necessary preventions related to drug abuse.

Introduction: Psychoactive drug is a worrisome and emerging global problem. This is a disturbing matter, especially in the case of medical students, as it affects not only their health and academic performance alone but their clinical efficiency as well. This study aims to determine the prevalence of psychoactive drug use among medical students in a medical college in Nepal. Methods: A descriptive cross-sectional study was conducted after receiving ethical clearance from the Institutional Review Committee (Ref: 258/19) among undergraduate medical students from December 2019 to June 2020. Convenience sampling was used to collect data. Data analysis was done in the Statistical Package for Social Sciences. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: The prevalence of psychoactive drug abuse was found to be 76 (44.2%) [CI= 43.6%–44.8%]. The study showed males 59 (59%) were more indulged in abuse than females 17 (23.6%). Alcohol 72 (41.86%) was the most commonly used, then was tobacco 24 (13.95%) followed by cannabis 17(9.88%). Only two students were sedative and opioid abusers. Pleasure 38 (31.70%) and experimentation 29 (24.20%) were the two major causes of substance abuse. Tobacco was used more frequently 14 (58.33%) used daily and found to have more financialand health-related issues in the last three months. Conclusions: Even almost half of the students were using some form of psychoactive drugs, the majority of them were occasional users. Proper counseling needs to be done to address this problem. Further study should be conducted to address the influencing factors and adverse outcomes.

Antidepressants, antiepileptics, mood stabilizers, and antipsychotics are extremely broadly used psychoactive drugs. These drug terms are universally used in the literature. However, the indications of these drugs have broadened substantially and overlap. The mismatch between drug classification and clinical uses causes a lot of confusion in communication and renders literature searches increasingly difficult. Therefore, we propose to drop the above terms altogether and replace them by simple mechanistic terms. Antidepressants are re-named as norepinephrine/serotonin (NE/5-HT) enhancers, antiepileptics comprising drugs with different mechanisms become neuronal inhibitors with pleiotropic effects (NIPEs), and antipsychotics become antagonists at multiple G protein–coupled receptors (mGPCR antagonists). Alkali metal ions, comprising lithium, are integrated into NIPEs. The terms “typical/first-generation/conventional” and “atypical/second-generation/non-conventional” antipsychotics should be dropped, because the original criterion for distinction, i.e., the presence and absence of extrapyramidal motor effects, respectively, is not valid anymore. The suggested changes in drug nomenclature have already been implemented into a recent textbook (Seifert R, Basic Knowledge of Pharmacology). The revised nomenclature ensures consistency with other fields of pharmacology and assignment of drug classes to indications without causing confusion. The authors acknowledge that the change in drug nomenclature is a cultural process that will take time and openly discuss the problems associated with the proposal. Ultimately, international learned societies will have to agree on a new nomenclature. Electronic supplementary material The online version of this article (10.1007/s00210-020-01918-x) contains supplementary material, which is available to authorized users.

OBJECTIVE: Data on the relationship between fall and psychoactive drug use among Turkish older people are limited. This study aims to investigate the prevalence of falls and the associations between psychoactive drug use and falls in community-dwelling Turkish older people. METHODS: This single center study was performed using the medical records of subjects aged over 65 years admitted to the geriatric care unit. Demographic and lifestyle factors, clinical characteristics, medications, and data on mood, cognitive status, and functional performance were obtained from the comprehensive geriatric assessment records. Based on a fall history in the last 12 months, subjects were grouped as fallers and non-fallers. Subjects treated with a psychoactive drug were identified. RESULTS: Among the total of 429 subjects, there were 184 (42.9%) fallers and 245 (57.1%) non-fallers. Of those, 33.3% were on psychoactive drug treatment. The proportion of psychoactive drug users was higher in the fallers group compared to non-fallers (45.1% vs. 24.5%, p

International audience; This multicenter study was conducted in French memory clinics during the first COVID-2019 lockdown (March-May 2020). The objective was to evaluate the effect of a telemedicine consultation on treatment modification in dementia care. Among 874 patients who had a telemedicine consultation, 103 (10.7%) had treatment modifications, in particular those living with a relative or diagnosed with Alzheimer's disease. A control group of patients referred March-May 2019 was also included. Treatment modification rate was similar between periods with an adjusted percentage difference of -4% (p = 0.27). Telemedicine consultations allowed treatment modifications with only a minor short-term negative impact on therapeutic strategies.

Background objective indicators of sleep and mental health problems in family caregivers have rarely been reported. Objective to study the use of prescription benzodiazepines and related drugs (BZDRD) in Finnish family caregivers and matched controls. Design prospective follow-up in 2012–17. Setting nationwide register-linkage study. Subjects all individuals who received family caregiver’s allowance in Finland in 2012 (N = 42,256; mean age 67 years; 71% women) and controls matched for age, sex and municipality of residence (N = 83,618). Methods information on purchases of prescription BZDRD, including the number of defined daily doses (DDDs), between 2012 and 2017 was obtained from the Dispensations Reimbursable under the National Health Insurance Scheme register. Background information was obtained from national registers. Results more caregivers than controls used BZDRD, both among women (users per 100 person-years: 17.2 versus 15.2, P Conclusions higher level of BZDRD use among caregivers indicates that caregivers have more sleep and mental health problems than non-caregivers. Adequate treatment of these problems and support for caregiving should be ensured for caregivers.

Introduction: Aging and old age have their own characteristic manifestations that affect individuals from the perspective of physical, psychological and social aspects. Old age is associated with certain risks, e.g. in association with changes of health status. This can affect the individual and influence the risk of the development of addiction. Harmful use of addictive substances and the risk of addiction are not related only to young people, but also to the elderly. Addictive substances which are used the most commonly include alcohol, psychoactive drugs and tobacco. Aims: The aim of the study was to map and describe patterns of substance use among seniors who use social services, specifically retirement homes for elderly and nursing services in the Central Bohemia region. Methods and sets: Data were obtained using a questionnaire survey within the quantitative research carried out in retirement homes for the elderly and nursing services in the Central Bohemia region. The social services were selected by the method of multi-stage random selection. The research set, which was selected by the method of deliberate sampling, consists of 100 respondents. Results: Respondents most often use alcohol, psychoactive drugs and tobacco. Prevalence use of tobacco and psychoactive drugs is higher among...

MDMA (3,4-methylenedioxymethamphetamine) is a chiral psychoactive recreational drug sold in illicit markets as racemate. Studies on the impact of MDMA on aquatic organisms are scarce. While enantioselectivity in toxicity in animals and humans has been reported, none is reported on aquatic organisms. This study aimed to investigate the ecotoxicological effects of MDMA and its enantiomers in Daphnia magna. For that, enantiomers (enantiomeric purity > 97%) were separated by liquid chromatography using a homemade semipreparative chiral column. Daphnids were exposed to three concentrations of (R,S)-MDMA (0.1, 1.0 and 10.0 µg L−1) and two concentrations of (R)- and (S)-enantiomers (0.1 and 1.0 µg L−1) over the course of 8 days. Morphophysiological responses were dependent on the substance form and daphnia development stage, and they were overall not affected by the (R)-enantiomer. Changes in swimming behaviour were observed for both the racemate and its enantiomers, but enantioselective effects were not observed. Reproductive or biochemical changes were not observed for enantiomers whereas a significant decrease in acetylcholinesterase and catalase activity was noted at the highest concentration of (R,S)-MDMA (10 µg L−1). Overall, this study showed that sub-chronic exposure to MDMA racemate and its enantiomers can interfere with morphophysiological and swimming behaviour of D. magna. In general, the (R)-enantiomer demonstrated less toxicity than the (S)-enantiomer., This work was financially supported by national funds through the FCT/MCTES (PIDDAC), under the project PTDC/CTA-AMB/6686/2020, and partially supported through the projects UIDB/04423/2020 and UIDP/04423/2020 (Group of Natural Products and Medicinal ChemistryCIIMAR).

Cannabis products (marijuana, weed, hashish) are among the most widely abused psychoactive drugs in the world, due to their euphorigenic and anxiolytic properties. Recently, hair analysis is of great interest in analytical, clinical, and forensic sciences due to its non-invasiveness, negligible risk of infection and tampering, facile storage, and a wider window of detection. Hair analysis is now widely accepted as evidence in courts around the world. Hair analysis is very feasible to complement saliva, blood tests, and urinalysis. In this review, we have focused on state of the art in hair analysis of cannabis with particular attention to hair sample preparation for cannabis analysis involving pulverization, extraction and screening techniques followed by confirmatory tests (e.g., GC–MS and LC–MS/MS). We have reviewed the literature for the past 10 years’ period with special emphasis on cannabis quantification using mass spectrometry. The pros and cons of all the published methods have also been discussed along with the prospective future of cannabis analysis.

Raphaële Bachtarzi,1 Anne Sophie Boureau,1 Charlotte Mascart,1 Eric Batard,2,3 Emmanuel Montassier,2,3 Pascale Bémer,2,4 Céline Bourigault,2 Gilles Berrut,1 Laure de Decker,1,2 Guillaume Chapelet1,21Centre Hospitalier Universitaire de Nantes, Clinical Gerontology Department, Nantes F-44000, France; 2Université de Nantes, EE MiHAR (Microbiotes, Hôtes, Antibiotiques et Résistance bacterienne), Institut de Recherche en Santé (IRS2), Nantes F-44200, France; 3Centre Hospitalier Universitaire de Nantes, Emergency Department, Nantes F-44000, France; 4Centre Hospitalier Universitaire de Nantes, Bacteriology Department, Nantes F-44000, FranceBackground: The worldwide dissemination of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major health concern. Previous studies have shown that psychoactive drugs have intrinsic antimicrobial activity and may play a role in the dissemination of antibiotic resistance. The objective of this study was to assess the association between prescriptions for psychoactive drug and urine colonization with ESBL-producing Enterobacteriaceae.Subjects: Ninety-five patients were included; 19 cases (urine colonization with an ESBL-producing Enterobacteriaceae) and 76 controls (urine colonization with non ESBL-producing Enterobacteriaceae); and were matched for age and gender.Methods: A retrospective 1:4 matched case–control study design was used. All patients colonized with an Enterobacteriaceae isolate in Nantes University Hospital from March to November 2014, were screened before inclusion in the study. Prescriptions data for psychoactive drugs were collected from the electronic medical records. Univariate and multivariate conditional logistic regression analyses were performed.Results: Thirty-seven patients (38.9%) were treated with psychoactive drugs, of whom 10 (52.6%) were in the ESBL-producing group and 27 (35.5%) were in the non-ESBL group. Mean (SD) age was 71.2 (23.1) years. In multivariate analyses, previous antimicrobial therapy within 6 months (OR=7.12, 95% CI 1.15–44.18; p=0.035) and previous colonization with an ESBL-producing organism (OR=44.87, 95% CI 1.26–1594.19; p=0.037) were associated with urine colonization with ESBL-producing Enterobacteriaceae.Conclusions: Our findings revealed that a history of previous antimicrobial therapy and previous colonization with ESBL-producing organisms are important risk factors in an elderly population. Psychoactive drugs were not associated with urinary carriage of ESBL-producing Enterobacteriaceae. Further studies are required to explore the relationship between psychoactive drugs and colonization with ESBL-producing Enterobacteriaceae.Keywords: ESBL, psychoactive drugs, antimicrobial resistance, elderly

The objective of the study : to assess the risk to develop active tuberculosis in HIV infected patients with history of substance abuse taking into account their CD4 count. Subjects and methods . A retrospective case-control study was conducted with enrollment of 171 patients: HIV Group included 85 persons, while TB/HIV Group – 86 persons. For screening for chronic alcohol/narcotic intoxication, the CAGE questionnaire was used, and tobacco dependence was detected according to the criteria of World Health Organization. CD4 counts were obtained by the retrospective analysis of medical records. The impact of the studied risk factors on the development of tuberculosis was estimated by calculating the odds ratio with the calculation of the 95% confidence interval. Results. Statistically significant association with the development of active tuberculosis was obtained for all factors studied (tobacco smoking: OR = 8.7, 95% CI 3.6-21.6, p = 0.01; chronic alcohol and narcotic intoxication: OR = 3.5, 95% CI 1.8-6.5, p = 0.001 and OR = 2.5, 95% CI 1.1-5.4, p = 0.026, respectively). In the group of patients with CD4 count above 200 cells/µL, there was a confident effect of smoking and clinically significant substance abuse on the risk to develop active tuberculosis, and the power of their effect increased: for tobacco smoking OR = 12; 95% CI 1,5-98,7, p = 0.012; for drug abuse, OR = 4.8, 95% CI 1.7-13.4, p = 0.002. The tendency of chronic alcohol intoxication providing impact on the risk to develop tuberculosis in patients with CD4 count above 200 cells/ μ l persisted, but there was no statistically significant relationship in calculating the odds ratio OR = 3.1, 95% CI 3.1–9.6, p = 0.082. The obtained data allow considering people living with HIV and possessing history of substance abuse as a group facing the high risk to develop tuberculosis in need close follow-up aimed to prevent tuberculosis.

Determination of psychoactive substances (PAS) and/or their metabolites in surface waters is crucial for environmental risk assessment, and disclosure of their enantiomeric fractions (EF) allows discrimination between consumption, direct disposal, and synthesis pathways. The aim of this study was to develop and validate an indirect method by gas chromatography coupled to mass spectrometry (GC–MS) based on derivatization using (R)-(−)-α-methoxy-α-(trifluoromethyl) phenylacetyl chloride as chiral derivatization reagent, for enantiomeric quantification of amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxymethamphetamine (MDMA), norketamine, buphedrone (BPD), butylone, 3,4-dimethylmethcathinone (3,4-DMMC), 3-methylmethcathinone, and quantification of 1-benzylpiperazine and 1-(4-metoxyphenyl)-piperazine. The method allowed to evaluate the occurrence, spatial distribution, and the EF of the target chiral PAS in Portuguese surface waters and in effluents from 2 wastewater treatment plants (WWTP). For that, water samples were pre-concentrated by solid phase extraction using OASIS® MCX cartridges, derivatized and further analyzed by GC–MS. Both enantiomers of AMP, (R)-MDMA, (S)-MAMP, and the first eluted enantiomer of BPD (configuration not assigned) were found in surface waters, while effluent samples showed both enantiomers of MDMA, (S)-MAMP, (R)-AMP, and the first eluted enantiomer of BPD and 3,4-DMMC. According to our knowledge, this is the first multiresidue analytical method by CG–MS enrolling cathinones, amphetamines, and piperazines. The presence of illicit synthetic cathinones in Douro River estuary is here reported for the first time, along with other amphetamine derivatives. The potential of the method to monitor consumption of the target PAS was demonstrated.

Background A common screening instrument for substance use disorders (SUDs) is the Drug Use Disorders Identification Test (DUDIT) which includes a short form regarding only drug consumption (DUDIT-C). We aim to assess if a German version of the DUDIT, adapted for adolescents, is a suitable screening instrument in a sample of adolescent psychiatric patients. Methods N = 124 (54 female) German adolescent (M = 15.6 + 1.5 years) psychiatric patients completed the DUDIT and received a diagnostic interview (MINI-KID) assessing DSM-5 SUD criteria. A confirmatory factor analysis (CFA), receiver operating characteristic (ROC) curves, the area under the curve (AUC), and Youden’s Index were calculated. Results A two-factor model of the DUDIT shows the best model fit (CFI = 0.995, SRMR = 0.055, RMSEA = 0.059, WRMR = 0.603). The DUDIT as well as the DUDIT-C show high diagnostic accuracy, with AUC = 0.95 and AUC = 0.88, respectively. For the DUDIT a cut-off value of 8.5 was optimal (sensitivity = 0.93, specificity = 0.91, J = 0.84), while for the DUDIT-C the optimal cut-off value was at 1.5 (sensitivity = 0.86, specificity = 0.84, J = 0.70). Conclusion This is the first psychometric evaluation of the DUDIT in German, adolescent psychiatric outpatients, using the DSM-5 diagnostic criteria. The DUDIT as well as the DUDIT-C are well suited for use in this population. Since in our sample only few patients presented with a mild or moderate SUD, our results need to be replicated in a sample of adolescents with mild SUD.

Background: Prurigo nodularis (PN) is a chronic refractory itchy dermatosis. Although psychiatric comorbidity is known, research in cognitive impairment is lacking. We evaluated the occurrence and types of cognitive impairment in a series of inpatients with PN. Methods: This was a retrospective chart review of all the patients with PN admitted to a referral neurological institute from September 2018 to March 2021. Any neurological and psychiatric disorder, along with neuroactive drugs taken, were concomitantly assessed. Results: A total of 16 patients with PN (median age: 70 years, two males) were selected from a total of 1806 hospital admissions. Most of them had a neurodegenerative cognitive disorder, from mild cognitive impairment (8) to Alzheimer’s disease (1), followed by mixed disorder (degenerative and vascular) in six and vascular dementia in one. Comorbid psychiatric diseases (anxiety and depression) were more common than either individual condition, followed by bipolar disorder, whereas two patients did not show psychiatric manifestations. Most patients were on combined treatment with benzodiazepines and antidepressants. Conclusion: Cognitive impairment can be observed in PN. In addition to screening for psychiatric comorbidity and initiating appropriate treatment or referral, clinicians may also consider the presence of cognitive impairment in PN of both degenerative and vascular origin.

Submitted by SILVIO DE AZEVEDO SOARES (silvio.azevedo@unesp.br) on 2021-06-14T14:58:37Z No. of bitstreams: 1 Tese versão final Silvio de Azevedo Soares.pdf: 3394998 bytes, checksum: a2338307c13f32df3a07495101bb3c26 (MD5) Approved for entry into archive by Satie Tagara (satie@marilia.unesp.br) on 2021-06-14T17:26:00Z (GMT) No. of bitstreams: 1 soares_sa_dr_mar.pdf: 3394998 bytes, checksum: a2338307c13f32df3a07495101bb3c26 (MD5) Made available in DSpace on 2021-06-14T17:26:00Z (GMT). No. of bitstreams: 1 soares_sa_dr_mar.pdf: 3394998 bytes, checksum: a2338307c13f32df3a07495101bb3c26 (MD5) Previous issue date: 2021-05-21 Não recebi financiamento Este trabalho tem por objetivo descrever – no atual contexto de medicalização e psiquiatrização do social – as singularidades políticas e subjetivas que se podem desdobrar do discurso da psiquiatria neurobiológica contemporânea em relação ao uso de psicofármacos (em particular, do Prozac), como também destacar traços de resistência ao emprego desses medicamentos. Para alcançar esse objetivo, lanço mão das ferramentas analíticas da genealogia tal como desenvolvida por Foucault. Nesse sentido, a questão dessa pesquisa passa pela concepção dos psicofármacos como um dispositivo, uma rede histórica e singular de práticas de poder, discursos de saber e modos sujeição. Para demarcar as especificidades político-subjetivas do atual dispositivo psicofármacos realizo uma análise das relações de poder-saber-sujeição que atravessam a psiquiatria em dois intervalos históricos distintos. No primeiro período, a partir de uma revisão bibliográfica dos cursos de Foucault O poder psiquiátrico, Os anormais, do seu livro História da Loucura e de outros ditos e escritos de seu período genealógico, trato da consolidação da psiquiatria na França do século XIX (sublinhando o uso asilar de substâncias com efeitos psicoativos). Antes de tratar dos discursos contemporâneos sobre os psicofármacos, em um exercício de acontecimentalização, analiso – numa reflexão amparada em revisão bibliográfica – cinco pequenos acontecimentos (no sentido foucaultiano de inversão de forças) que participaram da naturalização dos psicofármacos como a principal tecnologia da psiquiatria atual: a) a especificação dessa classe de medicamentos a partir dos anos 1950; b) o desenvolvimento das neurociências nos anos 1960; c) os movimentos antipsiquiátricos dos anos 1960-1970; d) a consolidação da psiquiatria neurobiológica com a publicação em 1980 da terceira edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-III); e) a emergência de uma nova geração de psicofármacos no final dos anos 1980 e início dos 1990: os inibidores seletivos de recaptação da serotonina (ISRS). Nessa reflexão genealógica destaco como se desenvolveu uma interface psiquiátrica do farmacopoder (tal como descrita por Preciado) e se constituiu uma dimensão neuro da biopolítica molecular (como delineada por Rose). Em seguida trato dos discursos sobre a utilização contemporânea dos psicofármacos, circunscrevendo como unidades de análise: manuais de psiquiatria e psicofarmacologia, manual de saúde mental do Ministério da Saúde, publicações da Associação Brasileira de Psiquiatria, o best-seller internacional Ouvindo o Prozac do psiquiatra estadunidense Peter Kramer e o documentário Estamira (compreendido como um documentário de inspiração genealógica por possibilitar a veiculação de discursos sujeitados). Diante dos conteúdos desse corpus documental examino: a) como, nesses enunciados, se traçam ações de poder-sujeição e de governo de condutas, bem como tentativas de resistências; b) como esse conjunto de proposições sobre psicofármacos pode integrar uma estratégia neoliberal de governo das condutas (em nome da recuperação, manutenção ou potencialização do capital humano dos indivíduos). O argumento desse trabalho é a de que o atual dispositivo psicofármacos configura-se como um dos elementos táticos de uma biopolítica neuromolecular que apresenta convergências com as estratégias neoliberais de governo das condutas (de um sujeito “empresário de si” em um contexto de concorrência interindividual generalizada). This work aims to describe – in the current context of medicalization and psychiatryzation of social – the political and subjective singularities that can unfold from the discourse of contemporary neurobiological psychiatry in relation to the use of psychoactive drugs (in particular, the drug Prozac), as also to highlight traces of resistance to the use of these drugs. To achieve this goal, I use the analytical tools of genealogy as developed by Foucault. In this perspective, the question of this research involves the conception of psychoactive drugs as a dispositive, a historical and singular network of power practices, discourses of knowledge and modes of subjection. In order to demarcate the political-subjective specificities of the current psychoactive drugs dispositive, I carry out an analysis of the relations of power-knowledge-subjection that cross psychiatry in two distinct historical intervals. In the first period, based on a bibliographic review of Foucault's courses The psychiatric power, The freaks, from his book History of Madness and other sayings and writings from his genealogical period, I analyze the consolidation of psychiatry in 19th century France (underlining the asylum use of chemical substances with psychoactive effects). Before addressing the contemporary discourses about psychoactive drugs, in an exercise of causal demultiplication, I analyze – in a reflection supported by a bibliographic review – five little events (in the Foucaultian sense of inversion of forces) that constituted the naturalization of psychoactive drugs as the main therapeutic technology of psychiatry current: a) the specification of this class of medicines from the 1950s; b) the development of neurosciences in the 1960s; c) the antipsychiatry struggles in the years 1960-1970; d) the consolidation of neurobiological psychiatry with the publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980; e) the emergence of a new generation of psychotropic drugs in the late 1980s and early 1990s: the selective serotonin reuptake inhibitors (SSRIs). In this genealogical reflection, I highlight how a psychiatric interface of pharmacopower was developed (as described by Preciado) and a neuro dimension of molecular biopolitics was constituted (as outlined by Rose). Then I deal with the discourses on the contemporary use of psychiatric drugs, circumscribing as units of analysis: psychiatry and psychopharmacology manuals, mental health manual from the Ministry of Health of Brazil, publications from the Brazilian Association of Psychiatry, the international bestseller Listening to Prozac by American psychiatrist Peter Kramer and the documentary Estamira (understood as an inspirational documentary genealogical for making it possible to convey subdueds speeches). Given the content of this documents, I examine: a) how the actions of power-subjecting and government of conducts are outlined, as well as resistance practices; b) how this set of enunciated about psychotropic drugs can integrate a neoliberal conduct strategy (in the name of recovering, maintaining or enhancing the human capital of individuals). The argument of this work is that the current psychoactive drugs dispositive is configured as one of the tactical elements of a neuromolecular biopolitics that presents convergences with the neoliberal strategies of government of conduct (of a subject “entrepreneur of himself” in a context of inter-individual competition generalized).

The adolescence, stage of life represented by moments of discovery, presents itself as emblematic in the social context of drug use, which represents more and more growing each day. Objective: This is a descriptive qualitative study, which aimed to analyze the impact of using psychoactive drugs during adolescence it was executed in the period of March 2021, through an integrative review of the scientific literature. Methodology: The search was carried out on national and international basis, including the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), SciELO Brasil and PubMED, the search strategy was to use Boolean operators the following Health Sciences Descriptors (DeCS) in Portuguese: Drugs-Adolescents; Psychoactive Substances-Adolescents; Substance Abuse-Adolescents; Drug use-Adolescents. Results: A return of 2122 articles was obtained in the LILACS database, 425 in SciELO Brazil and 96 in PubMED, totaling 2643 articles, and in the delimitation of the inclusion criterion, 35 remained, and only 19 articles were selected to compose the research corpus. It was noticed that the earlier starts the use of psychoactive substances, the more visible are the effects of drugs on long-term behavior. Furthermore, this consumption also includes consequences on the cognitive development of the pubescent, such as a deficit in the learning process. Conclusions: A diversity of factors related to drug use in adolescence were evidenced, among which, the dynamics of family functioning, the cultural context, specific conflicts of this stage of life and socioeconomic condition stood out as the most present trigger pathways for the insertion of adolescents in the world of drugs. La adolescencia, fase de la vida representada por momentos de descubrimiento, se presenta como emblemática en el contexto social del consumo de drogas, siendo cada día más creciente. Objetivo: Se trata de un estudio cualitativo descriptivo, que objetivó analizar el impacto del uso de las sustancias psicoactivas durante la adolescencia, fue realizado en el período de marzo de 2021, a través de una revisión integradora de la literatura científica. Metodología: Se realizó una búsqueda en bases nacionales e internacionales, incluyendo la Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), SciELO Brasil y PubMED, la estrategia de búsqueda utilizó los operadores booleanos y sus Descriptores en Ciencias de la Salud (DeSC) en portugués: Drogas-Adolescentes; Sustancias Psicoactivas-Adolescentes; Abuso de sustancias-Adolescentes; Uso de drogas-Adolescentes. Resultados: Se obtuvo una devolución de 2122 artículos en la base de datos LILACS, 425 en SciELO Brasil e 96 en PubMED, totalizando 2643 artigos, pero en la delimitación del criterio de exclusión, se mantuvo 35, y solo se seleccionaron 19 artículos para componer el corpus de la investigación. Se encontró que cuanto antes se inicia el uso de sustancias psicoactivas, más visibles son los efectos de las drogas en el comportamiento a largo plazo. Además, este consumo también incluye consecuencias sobre el desarrollo cognitivo del adolescente, como, déficit en el proceso de aprendizaje. Conclusiones: Se evidenció una diversidad de factores relacionados con el uso de drogas en la adolescencia, entre los cuales, la dinámica del funcionamiento familiar, el contexto cultural, los conflictos específicos de esta fase y la condición socioeconómica se destacaron como las vías desencadenantes más presentes para la inserción de los adolescentes en el mundo de las drogas. A adolescência, fase da vida representada por momentos de descobertas, apresenta-se como emblemática no contexto social do consumo de drogas, mostrando-se cada dia mais crescente. Objetivo: Trata-se de estudo qualitativo descritivo, que objetivou analisar o impacto do uso de drogas psicoativas durante a adolescência, realizado no período de março de 2021, através de revisão integrativa da literatura científica. Metodologia: Realizou-se busca em bases nacionais e internacionais, incluindo a Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), SciELO Brasil e a PubMED, utilizou-se na estratégia de busca os operadores Booleanos e os respectivos Descritores em Ciências da Saúde (DeCS) em português: Drogas-Adolescentes; Substâncias Psicoativas-Adolescentes; Abuso de Substâncias-Adolescentes; Uso de drogas-Adolescentes. Resultados: Obteve-se um retorno de 2122 artigos na base de dados LILACS, 425 na SciELO Brasil e 96 na PubMED, totalizando 2643 artigos, sendo que, na delimitação do critério de inclusão, restaram 35, e apenas 19 artigos foram selecionados para compor o corpus da pesquisa. Constatou-se que quanto mais cedo o início do consumo de substâncias psicoativas, mais visível são os efeitos das drogas nos comportamentos a longo prazo. Além disso, esse consumo abarca também, consequências no desenvolvimento cognitivo do púbere, como, déficit no processo de aprendizagem. Conclusões: Evidenciou-se uma diversidade de fatores vinculados ao uso de drogas na adolescência, dentre os quais, a dinâmica do funcionamento familiar, o contexto cultural, conflitos específicos dessa fase e condição socioeconômica se destacaram como vias de gatilho mais presentes para a inserção dos adolescentes no mundo das drogas.

After the recent arrest of actress Rhea Chakraborty by the Narcotics Control Bureau, Mumbai under the famous NDPS Act a whirlwind of debates surrounding the validity of the Act and legalization of psychoactive drugs like marijuana and cannabis have uproared this country again. This Act which illegalized the sale and even possession of marijuana across India lead to Rhea’s arrest. But is this Act valid in the light of current issues? Does this Act cover all the necessary facets of the drug usage scenario? The answer can only be obtained after analyzing all the provisions of this Act which has continued to demonize all the users of cannabis and marijuana for ages., {"references":["Money Control News, How effective is the NDPS Act, under which Rhea Chakraborty was arrested? Sep. 2020, 19 3:31 pm. https://www.moneycontrol.com/news/india/how-effective-is-the-ndps-act-under-which-rhea-chakraborty-was-arrested-5820951.html Saurav Datta, Punjab's Recommendation of Mandatory Death Penalty for Drug Smuggling Is Problematic, The Wire, August 1,2018. Ronny Sen, What We Get Wrong About Drug Abuse, Akademi Mag, Sep. 2020, 21 2:11 pm. https://www.akademimag.com/what-we-get-wrong-about-drug-abuse"]}

The objectives of the study were to identify the points of conjunction regarding social representations of drugs for Catholic, Evangelical, Umbanda, Candomblé and Espirita religious groups and Analyze the influence of these representations in the inclusion of spirituality and religiosity in care practices in health and nursing. This descriptive study was developed from a mixed exploratory sequential approach. 1,400 subjects participated in this study, divided into seven social groups, each with 200 participants. Thus, when we analyze the set of results, we can observe that, in general, the social representations found here permeate each religion, religious doctrines and the knowledge of its faithful on the subject, in order to understand the implications for each religion, in order to propose health and nursing care that aims to reach the human being in its fullness as a biopsychosocial-spiritual being. Los objetivos del estudio fueron identificar los puntos de conjunción de las representaciones sociales de las drogas para los grupos religiosos católicos, evangélicos, umbanda, candomblé y espirita y analizar la influencia de estas representaciones en la inclusión de la espiritualidad y religiosidad en las prácticas asistenciales en salud y enfermería. Este estudio descriptivo se desarrolló a partir de un enfoque secuencial exploratorio mixto. 1.400 sujetos participaron en este estudio, divididos en siete grupos sociales, cada uno con 200 participantes. Así, cuando analizamos el conjunto de resultados, podemos observar que, en general, las representaciones sociales aquí encontradas permean cada religión, doctrinas religiosas y el conocimiento de sus fieles sobre el tema, con el fin de comprender las implicaciones para cada religión, en con el fin de proponer cuidados de salud y de enfermería que tengan como objetivo llegar al ser humano en su plenitud como ser biopsicosocial-espiritual. Os objetivos do estudo foram identificar os pontos de conjunção a respeito das representações sociais das drogas psicoativas para os grupos religiosos católicos, evangélicos, umbanda, candomblé e espírita e analisar a influência dessas representações na inclusão da espiritualidade e da religiosidade nas práticas de cuidado nas áreas da saúde e da enfermagem. Este estudo descritivo, foi desenvolvido a partir de uma abordagem com método misto exploratória sequencial. Participaram deste estudo 1.400 sujeitos, divididos em sete grupos sociais, cada um com 200 participantes. Assim, quando analisamos o conjunto de resultados, podemos observar que, de maneira geral, as representações sociais aqui encontradas perpassam em cada religião, pelas doutrinas religiosas e pelo conhecimento dos seus fiéis sobre o assunto, de modo a entender as implicações para cada religião, a fim de se propor um cuidado em saúde e em enfermagem que vise alcançar o ser humano em sua plenitude como um ser biopsicossocial-espiritual.

Predator‐inducible defenses constitute a widespread form of adaptive phenotypic plasticity, and such defenses have recently been suggested linked with the neuroendocrine system. The neuroendocrine system is a target of endocrine disruptors, such as psychoactive pharmaceuticals, which are common aquatic contaminants. We hypothesized that exposure to an antidepressant pollutant, fluoxetine, influences the physiological stress response in our model species, crucian carp, affecting its behavioral and morphological responses to predation threat. We examined short‐ and long‐term effects of fluoxetine and predator exposure on behavior and morphology in crucian carp. Seventeen days of exposure to a high dose of fluoxetine (100 µg/L) resulted in a shyer phenotype, regardless of the presence/absence of a pike predator, but this effect disappeared after long‐term exposure. Fluoxetine effects on morphological plasticity were context‐dependent as a low dose (1 µg/L) only influenced crucian carp body shape in pike presence. A high dose of fluoxetine strongly influenced body shape regardless of predator treatment. Our results highlight that environmental pollution by pharmaceuticals could disrupt physiological regulation of ecologically important inducible defenses., We examined short‐ and long‐term effects of fluoxetine on the anti‐predator phenotype in crucian carp. We found effects of fluoxetine on both behaviour and body shape, highlighting both proximate mechanism behind external defence regulation but also that environmental pollution by pharmaceuticals could disrupt physiological regulation of ecologically important inducible defences.

S’ha realitzat un estudi analític retrospectiu de casos i controls de base poblacional, per identificar i explorar els factors clínics i farmacològics associats a la mort per suïcidi en aquelles persones que han tingut interacció prèvia amb el sistema de salut pública. Els casos es van obtenir a partir dels registres de l’Institut de Medicina Legal i Ciències Forenses de Catalunya per la província de Barcelona durant els anys 2010 a 2015, i els controls es van seleccionar a l’atzar entre la població atesa pels centres d’atenció primària al mateix període, en una raó de 20 a 1 i amb una distribució d’edat, sexe i lloc de residència iguals als casos. Es van vincular dades clíniques de primària i de facturació de medicaments, que es van extreure i anonimitzar per a l’estudi. S’han obtingut paràmetres clínics, assistencials i socials, que s’han analitzat en models univariable i utilitzat per ajustar el model estadístic que va analitzar la relació entre exposicions farmacològiques i risc de suïcidi. S’han estudiat diferents grups de psicofàrmacs, amb èmfasi en els subtipus d’antidepressius, i també hipocolesterolemiants, antihipertensius i altres fàrmacs d’interès. D’un total de 2.109 persones que consten en els registres de morts per suïcidi, 971 van interaccionar prèviament amb el sistema sanitari d’atenció primària, i per a aquestes es van seleccionar 19.420 controls. Entre les 971 persones que van tenir algun contacte assistencial previ, un 33% va morir durant la setmana següent i un 58,5% durant el mes següent a la darrera consulta. Després d’ajustar per altres factors de risc no farmacològics, l’antecedent de qualsevol exposició a fàrmacs dels grups d’antipsicòtics, antidepressius, ansiolítics i hipnosedants, antiepilèptics i opioides s’associa a un increment significatiu de el risc de suïcidi, amb estimadors de risc moderats, entre 1,47 i 2,29. Aquells pacients amb exposicions a antiepilèptics, antipsicótics, opioides i antidepressius sense dispensació d’aquests medicaments en els darrers tres mesos van tenir riscs més elevats. Cap dels grups farmacològics no psiquiàtrics ha mostrat patrons consistents d’increments de risc. En base a aquests resultats s’ha confirmat la hipòtesi que determinats factors clínics, especialment de salut mental i de freqüentació sanitària, i l’exposició a determinats medicaments actius sobre el sistema nerviós, s’associen a un major risc de suïcidi. La disponibilitat de dades en els registres mèdics electrònics d’atenció primària representa una oportunitat per crear eines de detecció de el risc en la història clínica electrònica que permetin indicar accions preventives i un seguiment individualitzat. Se ha realizado un estudio analítico retrospectivo de casos y controles de base poblacional, para identificar y explorar los factores clínicos y farmacológicos asociados a la muerte por suicidio en aquellas personas que han tenido interacción previa con el sistema de salud pública. Los casos se obtuvieron a partir de los registros del Institut de Medicina Legal i Ciències Forenses de Catalunya para la provincia de Barcelona durante los años 2010 a 2015, y los controles se seleccionaron al azar entre la población atendida por los centros de atención primaria en el mismo periodo, en una razón de 20 a 1 y con una distribución de edad, sexo y lugar de residencia iguales a los casos. Se vincularon y extrajeron datos clínicos de primaria y de facturación de medicamentos, anonimizados para el estudio. Se han obtenido parámetros clínicos, asistenciales y sociales, que se han analizado en modelos univariable y utilizado para ajustar el modelo estadístico que analizó la relación entre exposiciones farmacológicas y riesgo de suicidio. Se han estudiado distintos grupos de psicofármacos, con énfasis en los subtipos de antidepresivos, y también hipocolesterolemiantes, antihipertensivos y otros fármacos de interés. Tuvieron interacciones con el sistema sanitario de atención primaria 971 personas de las 2.109 que constaban en los registros de muertes por suicidio. Para estas se seleccionaron 19.420 controles. Entre las 971 personas con algún contacto asistencial previo, un 33% y un 58,5% murieron durante la semana o el el mes siguiente a la consulta, respectivamente. Después de ajustar por otros factores de riesgo no farmacológicos, el antecedente de cualquier exposición a fármacos antipsicóticos, antidepresivos, ansiolíticos e hipnosedantes, antiepilépticos y opioides se asoció a un incremento significativo del riesgo de suicidio, con estimadores de riesgo moderados, entre 1,47 y 2,29. Aquellos pacientes con exposiciones a antiepilépticos, antipsicóticos, opioides y antidepresivos que no tuvieron ninguna dispensación de estos medicamentos en los últimos tres meses tuvieron riesgos más elevados. Ninguno de los fármacos no psiquiátricos analizados ha mostrado patrones consistentes de incrementos de riesgo sustancial. En base a estos resultados se ha confirmado la hipótesis de que determinados factores clínicos, especialmente de salud mental y de frecuentación sanitaria, y la exposición a determinados medicamentos activos sobre el sistema nervioso, se asocian a un mayor riesgo de suicidio. La disponibilidad de datos en los registros médicos electrónicos de atención primaria representa una oportunidad para crear herramientas de detección del riesgo en la historia clínica electrónica que permitan indicar acciones preventivas y un seguimiento individualizado. A retrospective analytical population-based study of cases and controls has been carried out to identify and explore clinical and pharmacological factors associated with death by suicide in those people who have had previous interaction with the public health system. The cases were obtained from the records of the Institut de Medicina Legal i Ciències Forenses de Catalunya for the province of Barcelona during the years 2010 to 2015, and the controls were randomly selected from the population attended by primary care centers in the same period, in a ratio of 20 to 1 and with a distribution of age, sex and place of residence equal to the cases. Data from primary care registries and drug invoicing were linked, extracted and anonimised for the study. Clinical, healthcare and social parameters have been obtained, which have been analyzed in univariate models and used to adjust the statistical model that analyzed the relationship between drug exposures and suicide risk. Different groups of psychotropic drugs have been studied, with an emphasis on antidepressant subtypes, as well as cholesterol-lowering drugs, antihypertensive drugs, and other drugs of interest. 971 people out of 2,109 registered in the suicide death registers had interactions with the primary care health system. For these, 19,420 controls were selected. Among the 971 people with some previous healthcare contact, 33% and 58.5% died during the week or the month following system interaction, respectively. After adjusting for other non-pharmacological risk factors, the antecedent of any exposure to either antipsychotic drugs, antidepressants, anxiolytics and hypnosedatives, antiepileptics or opioids was associated with a significant increase in the risk of suicide, with moderate risk estimators, between 1.47 and 2.29. Those patients with exposures to antiepileptic drugs, antipsychotics, opioids and antidepressants who did not have any dispensation of these drugs in the last three months had higher risks. None of the non-psychiatric drugs analyzed have shown consistent patterns of substantial increases in risk. Based on these results, the hypothesis has been confirmed that certain clinical factors, especially mental health and health frequentation, and the exposure to certain drugs active on the nervous system, are associated with an increased risk of suicide. The availability of data in primary care electronic medical records represents an opportunity to create risk detection tools in the electronic medical record that may allow the indication of preventive actions and individualized follow-up. Universitat Autònoma de Barcelona. Programa de Doctorat en Farmacologia

Orthostatic hypotension (OH) is defined as an abnormal blood pressure reduction when standing and is frequently diagnosed in older adults. Pharmacological therapy is one of the main causes of orthostatic blood pressure impairment, leading to iatrogenic OH. Indeed, several medications may induce hypotensive effects and influence the blood pressure response to orthostatism. Hypotensive medications may also overlap with other determinants of OH, thus increasing the burden of symptoms and the risk of complications. Potentially hypotensive medications include both cardiovascular and psychoactive drugs, which are frequently prescribed in older patients. According to the available evidence, the antihypertensive treatment “per se” does not seem to predispose to OH, even if a higher risk is associated with polypharmacy and drug classes such as with diuretics and vasodilators. As concerns psychoactive medications, OH is a well-known adverse effect of tricyclic antidepressants, trazodone and antipsychotics. The knowledge of hemodynamic consequences of drug therapy may be helpful to improve OH treatment. A medication review is advisable in all patients presenting with OH, particularly at advanced age, aiming at optimizing medical treatment with a view to minimize the risk of iatrogenic OH.

Individuals who use anabolic-androgenic steroids (AAS) may engage in concurrent psychoactive drug use recreationally and/or as an additional training aid. Aside from cannabis, individuals who use AAS most commonly report concurrent use of stimulants such as amphetamines and cocaine. In this study, we examine demographic characteristics, frequency of heavy drinking, and nightclubbing in a sample of 993 men from the Global Drug Survey 2015 who reported both AAS and psychoactive drug use before exploring the relationship between motivation for AAS use and the propensity to concurrently engage with stimulant-type substances. Results of a logistic regression analysis suggest that the propensity for concurrent use of AAS and stimulants is greater when AAS use is motivated by weight loss goals, while performance goals are associated with reduced odds of concurrent stimulant use. Identifying individuals who are at risk of polydrug use and associated harms can inform targeted harm reduction strategies.

BackgroundHuman aging is a universal and regular process characterized by uneven and steady progression, inevitably affecting to some extent all levels of biological organization. In the structure of acute exotoxicosis, patients of gerontological age range from 10.3 to 12.9%. After 60, with an increase of years, there is a growth of mortality rate from 9.8% in elderly patients to 25.5% in long-livers. A certain role in its genesis is played by the premorbid background, i.e. somatic diseases preceding and accompanying acute exotoxicosis.Aim of studyTo identify the role of concomitant diseases in the course and outcome of acute poisoning by psychoactive drugs in patients over 60. MATErIALS AnD METhODS We retrospectively analyzed hospital records of 99 patients aged 60 to 90 years who died from poisoning with psychoactive drugs at the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2013–2016, as well as their autopsy, forensic and histological research data.ResultsIn gerontological patients with acute poisoning with psychoactive drugs, the main premorbid background (100%) is atherosclerotic lesion of the heart and vessels of different degree and extent. In case of lethal outcomes, in toxicogenic stage of poisoning on primary electrocardiograms, myocardial ischemia was revealed in 76.9% of cases, heart rhythm disturbances were detected in all patients, most often in the form of supraventricular extrasystoles (38.4%) and atrial fibrillation (23.1%). In the deceased patients during the somatogenic stage of poisoning, cardiac conduction disorders (31.3%) prevailed. Concomitant chronic lesions of the bronchopulmonary system, including terminal bronchi, contributed to the development of hypostatic pneumonia and its long, migratory course. In 50% of cases, large and small droplet fatty liver disease was detected, which could have a negative effect on the course of poisoning, altering biotransformation of toxicants.ConclusionAtherosclerotic lesion of the heart and vessels, as well as chronic bronchopulmonary disease and fatty liver disease are the main premorbid background factors, which have a negative effect on the course and outcome of acute poisoning with psychoactive drugs.

As the emerging contaminants, the environmental risks of drug-derived pollutants have attracted extensive attention. Citalopram (CTP) and mirtazapine (MTP) are commonly used as modern antidepressant drugs. Previous studies had proved that CTP and MTP entered the aquatic environment, but less reported the negative effects of the drugs on aquatic organisms. Herein, the effects on the feeding rate of Daphnia magna (D. magna) induced by psychotropic drugs CTP and MTP were investigated, which the possible mechanisms were analyzed with the oxidative stress and damage. Generally, the feeding rates of exposed D. magna under all concentrations of CTP and 1.03 mg/L of MTP were significantly decreased after exposure (p

Synthetic cannabinoids which is a subgroup of cannabinoids are commonly used for recreational drug use throughout the whole world. Although both marijuana and synthetic cannabinoids stimulate the same receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2), studies have shown that synthetic cannabinoids are much more potent than marijuana. The longer use of synthetic cannabinoids can cause severe physical and psychological symptoms that might even result in death, similar to many known illicit drugs. Main treatment options mostly involve symptom management and supportive care. The aim of this article is to discuss clinical and pharmacological properties of the increasingly used synthetic cannabinoids. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000): 317-328]

Tina Hovgaard Lützen,1 Bodil Hammer Bech,2 Jesper Mehlsen,3 Claus Høstrup Vestergaard,1 Lene Wulff Krogsgaard,1 Jørn Olsen,4 Mogens Vestergaard,1 Oleguer Plana-Ripoll,5 Dorte Rytter2 1Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark; 2Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus C, Denmark; 3Coordinating Research Centre, Frederiksberg Hospital, Frederiksberg, Denmark, 4Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; 5National Center for Register-based Research, Aarhus University, Aarhus V, Denmark Aim: No association between human papilloma virus (HPV) vaccination and numerous diseases has been found. Still, a large number of Danish women are reporting suspected adverse events. Other factors may play a role, and the aim of this study is to examine the association between psychiatric conditions, general practitioner (GP) attendance and indicators of psychological symptoms prior to HPV vaccination and the risk of referral to an HPV center following vaccination. Study design and setting: Register-based, matched case–control study. Cases were identified from five Danish, regional HPV centers, and health data for cases and controls were obtained from national registries. Participants: Cases were defined as women referred to an HPV center between January 1, 2015 and December 31, 2015 (n=1,496). Each case was matched with five controls on age, region and time of first vaccine registration. The total study population consisted of 8,976 women. Results: Overall, women above 18 years who had been referred to an HPV center were more likely to have used psychiatric medication (odds ratio [OR]: 1.88 [95% CI 1.48–2.40]) or to have been hospitalized because of a psychiatric disorder within 5 years prior to the first vaccine registration (OR: 2.13 [95% CI 1.59–2.86]). Specifically, referred women were more likely to have used antipsychotics, antidepressants, attention deficit hyperactivity disorder (ADHD) medication or anxiolytics, and to have been hospitalized for affective disorders or anxiety, but not to have been hospitalized for schizoid, ADHD or eating disorders. In addition, they were more likely to have had talk therapy or psychometric test performed prior to vaccination (OR: 1.72 [95% CI 0.1.35–2.18] and OR: 1.67 [95% CI 1.30–2.13], respectively). Referred women of all ages had higher use of GP before vaccination. Population attributable fraction analyses indicated that psychiatric medication, hospitalization due to a psychiatric disorder and use of talk therapy, or psychometric test “explained” 13%, 10%, 12% and 11% of the referrals, respectively. Results did not change substantially when adjusted for potential confounders. Conclusion: Women referred to HPV centers because of suspected adverse events after vaccination more often had preexisting psychiatric conditions, psychological symptoms or frequent GP attendance prior to HPV vaccination. Keywords: papillomavirus vaccines, adverse drug events, psychoactive drugs, general practice

Although many researchers in psychology, religious studies, and psychiatry recognize that there is overlap in the experiences their subjects recount, disciplinary silos and challenges involved in comparing reported experiences have left us with little understanding of the mechanisms, whether biological, psychological, and/or sociocultural, through which these experiences are represented and differentiated. So-called mystical experiences, which some psychologists view as potentially sui generis, provide a test case for assessing whether we can develop an expanded framework for studying unusual experiences across disciplines and cultures. Evidence for the special nature of “mystical experience” rests on the operationalization of a metaphysically untestable construct in two widely used self-report scales: the Mysticism Scale and the Mystical Experiences Questionnaire. Consideration of the construct in light of research on alterations in sense of self induced by psychoactive drugs and meditation practices suggests that “positive experiences of undifferentiated unity” are not sui generis, but rather a type of “ego dissolution.” To better understand the nature and effects of unusual experiences, such as alterations in the sense of self, we need self-report measures that distinguish between generically worded experiences and the way they are appraised in terms of valence, significance, cause, and long-term effects in different contexts.

Introduction: tobacco use in companies is a major public health issue, which has prompted governments to legislate to regulate consumption in the workplace, and even more so within health facilities. We therefore wanted to carry out an overview and an analysis of the socio-professional factors that could be associated with the use of tobacco and other psychoactive substances. Materials and methods: we submitted a questionnaire to employees during two separate periods, from July to September 2017 and then March to July 2019. Results: the participation rate reached 23.2% with a prevalence of smokers of 42.1%; 83.9% had possible pathological use. 77.9% of smokers said they wanted to change their use within five years. Socio-professional factors associated with smoking were age, place of practice and work rhythm. Only the place of exercise was correlated with pathological use. For other psychoactive substances, alcohol was the most common substance used in front of cannabis. No occupational factors were significantly associated with these consumptions. Conclusion: the work environment may be a factor influencing the use of psychoactive substances. Support for these consumptions within companies then looks relevant and to encourage., Introduction : la consommation de tabac au sein des entreprises représente un enjeu de Santé Publique majeur, ce qui a poussé les pouvoirs publics à légiférer afin d’encadrer la consommation sur les lieux de travail, et d’autant plus au sein des établissements de santé. Nous avons donc souhaité réaliser un état des lieux ainsi qu’une analyse des facteurs socio-professionnels qui pourraient être associés à l’usage du tabac et d’autres substances psychoactives. Matériel et méthodes : nous avons soumis un questionnaire aux salariés durant deux périodes distinctes, de juillet à septembre 2017 puis de mars à juillet 2019. Résultats : le taux de participation a atteint 23,2% avec une prévalence de fumeurs de 42,1% ; dont 83,9% présentaient un possible usage pathologique. 77,9 % des fumeurs déclaraient vouloir modifier leur consommation dans les cinq ans. Les facteurs socio-professionnels associés à l’usage de tabac étaient l’âge, le lieu d’exercice et le rythme de travail. Seul le lieu d’exercice était corrélé à un usage pathologique. Concernant les autres substances psychoactives, l’alcool était la substance la plus fréquemment consommée devant le cannabis. Aucun facteur professionnel n’était associé significativement à ces consommations. Conclusion : l’environnement professionnel peut représenter un facteur influençant les usages de substances psychoactives. Une prise en charge de ces consommations au sein des entreprises parait alors pertinente et à encourager.

BACKGROUND: People have been using psychoactive substances for a long time. Over the last few years, this practice has spread among university students, who use these substances to improve their academic performance, relieve stress and increase concentration and memory. OBJECTIVES: To estimate the use of psychoactive drugs among healthcare students at a higher education institution in the city of Passo Fundo (RS), Brazil, and to ascertain the associated demographic and lifestyle factors. DESIGN AND SETTING: Cross-sectional study in a higher education institution. METHODS: We included 287 undergraduate medicine and dentistry students in this study. They answered a self-administered questionnaire regarding sociodemographic, lifestyle and health variables. The statistical analysis used univariate and bivariate analyses with Pearson’s chi-square test (P-value < 0.05). ­Multivariate analyses were used to estimate odds ratios (OR) and their respective 95% confidence intervals. The SPSS software, version 20.0, was used. RESULTS: The prevalence of use of psychoactive substances among the students was 24.7%. Among these students, high frequencies of psychoactive drugs had been prescribed by physicians (95.8%) and for the purpose of relaxation or stress relief (73.2%). Women, medical students (compared with dental students) and participants with lower academic performance were more likely to use psychoactive drugs. After the multivariate adjustment, the “course” and “academic performance” remained associated with use of psychoactive drugs. CONCLUSION: There was high prevalence of psychoactive drug use among the students at the higher education institution investigated. Some variables (female sex, medical students and low academic performance) were associated with the outcome.

The purpose of this research is to find factors related with drug consumption, which affect to mental health. The aim of research is to determinate the relationship between drug use and the development of mental disorders and to identify possible factors implicated in this association.

International audience; The adsorption of psychoactive drugs (PADs) onto sodium-exchanged montmorillonite (Na—Mt) was investigated under two pH conditions. At pH = 2.5, the adsorption was performed through cation exchange and the three PADs were intercalated within the Na—Mt layers. However, the adsorption capacity was lower than the theoretical cation exchange capacity of Na—Mt due to the impact of the acidic conditions on the adsorbent. At pH = 7.5, only Codeine was protonated and its adsorption through cation exchange resulted in the highest amount adsorbed among the tested PADs. Diazepam was adsorbed through weak electrostatic interactions, whereas Oxazepam appeared to be intercalated within Na—Mt layers despite its neutral charge. Consequently, the variation in pH strongly impacts the affinity of PADs for Na—Mt. These initial results highlight the impact of raw clay on the fate of these contaminants within environmental compartments and could pave the way for a green solution to the removal of PADs from wastewater effluents.

The article is devoted to the analysis of modern educational environment as a potential resource to increase the effectiveness of biofeedback in order to prevent drug abuse among students. The substantiated educational environment is an approach to understand such biofeedback effectiveness. Biofeedback efficiency depends on the rate of return and the quality of information about the biological system. The advantages of biofeedback in comparison with other methods of self-regulation are discussed. The phases of the biofeedback process are described as interconnected components of a single process that has become possible due to the hardware and software of the educational environment. The features of different biofeedback instruments and psychophysiological specific training conditions are considered. The research allows determining the effectiveness of work by biofeedback among teenagers. The results of forming experiment have statistically revealed a significant increase in the level of adolescent’s self-control in theexperimental group after the classes using biofeedback. Change of the attitude to drugs occurred only in the experimental group of adolescents who participated in the forming experiment. Thestudy received practical confirmation of the idea that the state of psychophysiological mechanisms with individual involvement in substance use can be objectively evaluated and managed by psychophysiological training aimed at improvement of self-regulation effectiveness. &nbsp

“Plants of the Gods” is a term referring to the religious meaning members of many primitive cultures worldwide attribute to plants containing hallucinogenic or mind-altering substances. The plants are customarily considered sacred and consumed in religious rituals in an attempt to reach and communicate with gods or revered ancestors. They are frequently used in healing rites. Occasionally, they are used for purely recreational purposes, this being their main use in the modern societies of both industrialized and underdeveloped nations. However, it must be noted that the hallucinogenic or psychedelic experiences, recreational, are not always euphoric. Plants of the Gods: Their Sacred, Healing, and Hallucinogenic Powers is well-written, fully illustrated with color photographs, and contains a good index. It is an effective compilation of ethnographic, historic, and neuropharmacologic information on the hallucinogenic plants of planet Earth and the psychological and sociological impact they have, particularly in primitive societies. The behavioral side effects and toxic manifestations that may be associated with transient or permanent neurological deficits or psychiatric conditions place them in the realm of neuropsychiatry, when affected individuals present to the emergency room or are referred for medical consultation.

This study reports on the prevalence and demographic correlates of substance use among individuals with mental illness in the Eastern Cape, South Africa. This cross-sectional study was conducted in the Outpatient Clinic of a large hospital in the Eastern Cape, South Africa. A pre-validated tool on alcohol and psychoactive drug use was administered to 390 individuals with mental illness. Multivariable logistic regression models were fitted to explore the demographic correlates of alcohol and psychoactive drug use. Of the total participants (N = 390), 64.4% and 33.3% reported lifetime (ever used) and past-year use of alcohol, respectively, but the prevalence of risky alcohol use was 18.5%. After adjusting for relevant covariates, only male sex, younger age, and rural residence remained significantly associated with risky alcohol use. The prevalence of ever-use and past-year use of psychoactive substances was 39.7% and 17.4%, respectively. The most common substance ever used was cannabis (37.4%). Male sex, younger age, owning a business, and being unemployed were significantly associated with higher odds of lifetime and past-year use of psychoactive substances. Findings highlight the need for dedicated infrastructure and staff training in the management of these dual diagnoses in the region.

Simple Summary The majority of dogs and cats are fearful during veterinary visits, and some individuals may show aggression as a result. We review ways to avoid negative experiences and promote positive emotions in animals visiting the veterinarian. Whenever an animal is in the practice, the veterinary team should endeavour to make the visit as pleasant as possible, by using non-threatening body language and by creating positive associations. High-value food (unless an animal needs to be fasted) or toys should be used generously throughout the visit. In the interaction with the animals, low-stress handling methods, brief pauses and adjusting the procedure based on the animal’s body language help them to feel secure. Distractions can be used to minimise perceived pain such as from injections. If a known painful area needs to be treated, pain killers are advised. For animals that are very fearful, several medication options are available that can be given prior to the veterinary visit to help them with their fears. With reward-based training, animals can learn to accept veterinary procedures. A stress-free veterinary visit benefits all involved parties—the animals, their owners, as well as the veterinary team. Abstract A high proportion of dogs and cats are fearful during veterinary visits, which in some cases may escalate into aggression. Here, we discuss factors that contribute to negative emotions in a veterinary setting and how these can be addressed. We briefly summarise the available evidence for the interventions discussed. The set-up of the waiting area (e.g., spatial dividers; elevated places for cat carriers), tailoring the examination and the treatment to the individual, considerate handling (minimal restraint when possible, avoiding leaning over or cornering animals) and offering high-value food or toys throughout the visit can promote security and, ideally, positive associations. Desensitisation and counterconditioning are highly recommended, both to prevent and address existing negative emotions. Short-term pain from injections can be minimised by using tactile and cognitive distractions and topical analgesics, which are also indicated for painful procedures such as ear cleanings. Recommendations for handling fearful animals to minimise aggressive responses are discussed. However, anxiolytics or sedation should be used whenever there is a risk of traumatising an animal or for safety reasons. Stress-reducing measures can decrease fear and stress in patients and consequently their owners, thus strengthening the relationship with the clients as well as increasing the professional satisfaction of veterinary staff.

© 2019 The Authors. There is concern that psychoactive drugs present in the aquatic environment could affect the behaviour of fish, and other organisms, adversely. There is considerable experimental support for this concern, although the literature is not consistent. To investigate why, fish were exposed to three concentrations of the synthetic opiate tramadol for 23–24 days, and their anxiolytic behaviour in a novel tank diving test was assessed both before and after exposure. The results were difficult to interpret. The positive control drug, the anti-depressant fluoxetine, produced the expected results: exposed fish explored the novel tank more, and swam more slowly while doing so. An initial statistical analysis of the results provided relatively weak support for the conclusion that both the low and high concentrations of tramadol affected fish behaviour, but no evidence that the intermediate concentration did. To gain further insight, UK and Japanese experts in ecotoxicology were asked for their independent opinions on the data for tramadol. These were highly valuable. For example, about half the experts replied that a low concentration of a chemical can cause effects that higher concentrations do not, although a similar number did not believe this was possible. Based both on the inconclusive effects of tramadol on the behaviour of the fish and the very varied opinions of experts on the correct interpretation of those inconclusive data, it is obvious that more research on the behavioural effects of tramadol, and probably all other psychoactive drugs, on aquatic organisms is required before any meaningful risk assessments can be conducted. The relevance of these findings may apply much more widely than just the environmental risk assessment of psychoactive drugs. They suggest that much more rigorous training of research scientists and regulators is probably required if consensus decisions are to be reached that adequately protect the environment from chemicals. Ecotoxicology Research Group, Brunel University London funded the fish experiments. We would also like to thank Dr. Matt Winter, University of Exeter, for his support with the behavioural analysis. This study was also supported by the Ministry of Education, Culture, Sports, Science and Technology, Japan (MEXT) to a project on Joint Usage/Research Centre – Leading Academia in Marine and Environment Pollution Research (LaMer), and Japan Society for the Promotion of Science (JSPS) Grants-in-Aid (KAKENHI) for JSPS Fellows (JP26·2800), Scientific Research (A) (JP25257403), Scientific Research (A) (JP16H01784), and Young Scientists (JP18K18206).

OBJECTIVE: Investigate whether the use of psychoactive drugs would be a predictor of incidence of functional disability among seniors living in community. METHODS: It is a population-based longitudinal study, developed between January 1, 1997 and December 31, 2011, with older adults living in community. The association between the use of psychoactive drugs and the development of functional disability for instrumental (IADLs) and basic (BADLs) activities of daily living was tested using the extended Cox proportional hazards model, which considers the measure of exposure of interest throughout the follow-up period. The analyses were stratified by sex and adjusted by sociodemographic characteristics, health behavior and health conditions. RESULTS: After multivariate adjustment, the use of two or more psychoactive drugs in the female stratum was associated with disability for both IADLs (HR = 1.58; 95%CI 1.17–2.13) and BADLs (HR = 1.43; 95%CI 1.05–1.94), the use of benzodiazepines was associated with disability for IADLs (HR = 1.32; 95%CI 1.07–1.62), and the use of antidepressants was associated with disability for both IADLs (HR = 1.51; 95%CI 1.16–1.98) and BADLs (HR = 1.44; 95%CI 1.10–1.90). In the male stratum, the use of antipsychotics was associated with disability for IADLs (HR = 3.14; 95%CI 1.49–6.59). CONCLUSIONS: The study showed a prospective association between the use of psychoactive drugs and functional disability. These results indicate the need to carefully assess the prescription of psychoactive drugs for older adults and monitor their usage in order to detect damages to the health of users.

The main objective for this article is to explore how users of psychoactive drugs experience time and the role psychoactive drugs play in the management and construction of time. The data in this study consists of different kinds of written documents such as anecdotal accounts and scientific articles and reports which was collected using a purposeful sampling technique. One important result is that time is experienced and constructed differently among users of legal drugs compared to users of illegal drugs. The use of heroin is for example associated with shrinking time-horizons and being afraid of looking back and looking ahead, while smoking cigarettes is correlated with killing chronological time and instituting a parenthesis in normative time. Another conclusion is that users of illegal drugs experience greater problems synchronizing social and subjective time compared to users of legal substances. The results of my study also suggest that drug users´ experiences of time are intertwined with the social context and social meanings of drug use. Sociologisk Forsknings digitala arkiv

Empathogens or entactogens are a class of psychoactive drugs that produce experiences of emotional communion, oneness, relatedness, emotional openness, that is empathy or sympathy, as particularly observed and reported for experiences with 3, 4- methylenedioxymethamphetamine (MDMA). The term entactogen (Greek meaning, ‘’to touch within’’) was coined by Nichols (1986) to describe the psychactive effect of synthetic drugs 3, 4-methylendioxymetamphthamine (MDMA), 3, 4-methylendioxyamphthamine (MDA) and 3, 4-methylendioxy-N-ethyl-amphthamine (MDEA). Entactogens combine the catecholaminergic effects of methamphethamine, from which they are derived , with the serotogenic effect of psychodelics, exhibiting a unique profile of prosocial and interpersonal effects. Evidence for the distinction of entactogens from both methamphetamine and psychodelics come from studies of molecular structure activity relationhips and animal model of self-administration indicating the robustness of the drug family (Figure 1). The main focus of this presentation is MDMA, by far the most widely studied and recreationally used entactogens. This presentation provides a brief review of the history, proposed pharmacological mechanisms, safety issues, and clinical applications of the MDMA. Most clinical MDMA research in patients to date has focused on MDMA-assisted psychotherapy to treat posttraumatic stress disorder (PTSD). Other potential therapeutic applications for MDMA therapy will be also described, including contemporary studies treating anxiety associated with autism and the ongoing study exploring the potential role for MDMA-assisted psychotherapy to treat alcohol use disorder. MDMA therapy for PTSD is now entering the final Phase 3 stage of drug development, with a target set for licensing by the FDA and EMA in 2021. This means that if clinical efficacy criteria are achieved, MDMA would become a medicine. The results of our recent in silico study regarding ecotoxicity of entactogens and their metabolites will be also presented and dicused. Figure 1. Chemical structures of stimulant amphetamines, entactogens and phenylethylamine hallucinogens 1. Nichols DE. Differences between the mechanism of action of MDMA, MBDB, and the classic hallucinogens. Identification of a new therapeutic class: entactogens. J Psychoactive Drugs. (1986) 18:305–313. doi: 10.1080/02791072.1986.10472362 ; 2. Gouzoulis-Mayfrank E. Differential Actions of an Entactogen Compared to a Stimulant and a Hallucinogen in Healthy Humans, In The Heffter Review of Psychodelic Reasearch, 2001, 2: 64-72 ; 3. Sessa B, Higbed L, Nutt D. A Review of 3, 4-methylenedioxymethamphetamine (MDMA)-Assisted Psychotherapy, Front. Psychiatry (2019) 10: 1-7, 10.3389/fpsyt.2019.00138 ; 4. A Phase 3 Program of MDMA-Assisted Psychotherapy for the Treatment of Severe Posttraumatic Stress Disorder (PTSD), https://maps.org/research/mdma/ptsd/phase3, accessed March 2019

Background The worldwide dissemination of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has become a major health concern. Previous studies have shown that psychoactive drugs have intrinsic antimicrobial activity and may play a role in the dissemination of antibiotic resistance. The objective of this study was to assess the association between prescriptions for psychoactive drug and urine colonization with ESBL-producing Enterobacteriaceae. Subjects Ninety-five patients were included; 19 cases (urine colonization with an ESBL-producing Enterobacteriaceae) and 76 controls (urine colonization with non ESBL-producing Enterobacteriaceae); and were matched for age and gender. Methods A retrospective 1:4 matched case–control study design was used. All patients colonized with an Enterobacteriaceae isolate in Nantes University Hospital from March to November 2014, were screened before inclusion in the study. Prescriptions data for psychoactive drugs were collected from the electronic medical records. Univariate and multivariate conditional logistic regression analyses were performed. Results Thirty-seven patients (38.9%) were treated with psychoactive drugs, of whom 10 (52.6%) were in the ESBL-producing group and 27 (35.5%) were in the non-ESBL group. Mean (SD) age was 71.2 (23.1) years. In multivariate analyses, previous antimicrobial therapy within 6 months (OR=7.12, 95% CI 1.15–44.18; p=0.035) and previous colonization with an ESBL-producing organism (OR=44.87, 95% CI 1.26–1594.19; p=0.037) were associated with urine colonization with ESBL-producing Enterobacteriaceae. Conclusions Our findings revealed that a history of previous antimicrobial therapy and previous colonization with ESBL-producing organisms are important risk factors in an elderly population. Psychoactive drugs were not associated with urinary carriage of ESBL-producing Enterobacteriaceae. Further studies are required to explore the relationship between psychoactive drugs and colonization with ESBL-producing Enterobacteriaceae.

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No. of bitstreams: 5 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) COSTA_JUNIOR_WELFF_DISSERTACAO.pdf: 2024311 bytes, checksum: 3bf8f96742e70707d9696c13a39096da (MD5) ATA_DEFESA.pdf: 172395 bytes, checksum: 52ecf088a397746501a5624ad42a50f3 (MD5) TERMO_AUTORIZACAO.pdf: 168131 bytes, checksum: c7d734d0783aa26fa21815f10fb2c7d8 (MD5) CartaEncaminhamentoAutodep??sito.pdf: 28948 bytes, checksum: c269a750c65deb18010dffbc6c31bf1c (MD5) Previous issue date: 2018-09-10 92984381011 Faced with the requirements in the teaching of chemistry for third year high school students of EJA, this project proposes to analyze the pertinence of the cross-sectional theme, psychoactive drugs, as the guiding axis for the teaching of chemistry in EJA, through the understanding of the concept of psychoactive drugs; the contents of organic chemistry that relate to the theme; of the Science, Technology and Society (CTS) approach that will increase students' criticality; and through the Harm Reduction (RD) strategy, so that students gain a broader awareness of the effects of psychoactive drugs on the human body and society. Several strategies will also be developed, such as: expository classes, group dynamics, setting of word-of-mouth, cross-montage assembly, experimental class and assembly of some organic structures. O ensino de qu??mica para os alunos do terceiro ano do ensino m??dio da Educa????o de Jovens e Adultos (EJA) enfrenta atualmente diversos desafios, tais como drogas psicoativas. O presente trabalho procura contribuir de forma exigente no ensino de qu??mica para os alunos do terceiro ano do ensino m??dio uma vez que este projeto prop??e-se a analisar a pertin??ncia do tema transversal. As drogas psicoativas, como eixo norteador para o ensino de qu??mica na EJA, atrav??s da compreens??o do conceito de drogas psicoativas; dos conte??dos de qu??mica org??nica que se relacionem com o tema; do enfoque Ci??ncia, Tecnologia e Sociedade (CTS) que atuar?? na amplia????o da criticidade dos alunos; e atrav??s da estrat??gia Redu????o de Danos (RD), para que os alunos adquiram uma consci??ncia mais ampla dos efeitos das drogas psicoativas no corpo humano e na sociedade. Tamb??m ser??o desenvolvidas diversas estrat??gias como: aulas expositivas, din??mica de grupo, montagem de ca??a-palavras e de cruzadinha, aula experimental e constru????o de algumas estruturas org??nicas.

O presente estudo traz uma sistematização acerca de experiências de atenção à saúde a pessoas que fazem uso prejudicial de álcool e outras drogas que têm por base as diretrizes da redução de danos no Brasil e no mundo. Foi realizado um levantamento bibliográfico em publicações de língua portuguesa e inglesa dos últimos dez anos hospedadas nas bases de dados SciELO, Lilacs, Medline e PsycINFO. Após a seleção do corpus, recorreu-se à metassíntese a fim de integrar o material obtido. Foi possível identificar e analisar avanços e impasses na implantação de estratégias de redução de danos, bem como comparar as diferentes abordagens identificadas nos serviços e ações de cuidado oferecidas aos usuários. Nota-se que a Redução de Danos tem se consolidado como estratégia de prevenção e tratamento e, dessa forma, torna-se imprescindível ampliar as produções acadêmica e científica na área. Abstract The present study attempts to systemize the experiences of those that have been treated in the primary health care system for alcohol and drug abuse with a view to obtaining reductions in the damages caused to Brazil and the world at large. A bibliographical study was conducted of publications in Portuguese and in English over the past ten years on the following databases SciELO, Lilacs, Medline and PsycINFO. After the selection of the corpus, meta-synthesis was carried out in order to integrate the material obtained. It was possible to identify and analyze advances and impasses in the implementation of harm reduction strategies, and to compare the different approaches identified in the services and care activities offered to users. We noticed that Harm Reduction has become consolidated as a prevention and health care strategy; therefore, it is essential that more academic and scientific research in this area is conducted.

Resumen: Aunque habitualmente se piensa que la actividad beneficiosa de los psicofármacos tiene que ver con la capacidad de estos para contrarrestar las condiciones biológicas que subyacen a los síntomas de los trastornos mentales, las pruebas que apoyan esta perspectiva son pequeñas y claramente insuficientes. Pudiera ser que los efectos beneficiosos se deban a las propiedades psicoactivas de los psicofármacos, al provocar estados mentales alterados en las personas que los toman, quienes pueden considerar esos estados más deseables que el sufrimiento mental original. Tener en cuenta este enfoque alternativo del tratamiento farmacológico en psiquiatría puede tener consecuencias significativas a la hora de proponer su uso, informar de sus efectos, prescribirlos a corto y largo plazo, y orientar la investigación necesaria para determinar los riesgos y beneficios de su uso. Abstract: Although it is commonly believed that the benefits of psychiatric drugs are related to their capacity to compensate the underlying biology of mental disorders, the evidence supporting this perspective is poor and clearly insufficient. These beneficial effects may be due to the psychoactive properties of psychotropic drugs, which cause altered mental states that people who take them might consider a preferred option, rather than the original mental suffering. Considering this alternative approach could have significant consequences in psychiatry when proposing their use, reporting their effects, prescribing them in the short and long term, and guiding the research needed to determine the risks and benefits of their use.

Submitted by Boris Flegr (boris@uerj.br) on 2021-01-07T15:11:24Z No. of bitstreams: 1 Deivisson_Tese completa_PPGMA.pdf: 3716079 bytes, checksum: 362e89cdeedf8a92563bd9613b8745de (MD5) Made available in DSpace on 2021-01-07T15:11:24Z (GMT). No. of bitstreams: 1 Deivisson_Tese completa_PPGMA.pdf: 3716079 bytes, checksum: 362e89cdeedf8a92563bd9613b8745de (MD5) Previous issue date: 2018-05-10 Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Population growth, coupled with growing demand for chemicals and pharmaceuticals, including packages, detergents, pesticides, pharmaceuticals compounds and personal care products, have led to an increasing presence of emerging contaminants in different environmental compartments. Psychoactive pharmaceuticals, such as anxiolytic and antidepressant drugs, are widely prescribed worldwide and are considered as emerging environmental contaminants. Such drugs have already been detected in different water matrices in different parts of the world, including Brazil. In addition, many of these compounds are not readily degraded and not totally removed by conventional sewage and water supply treatment plants. There is evidence that some Advanced Oxidation Processes AOPs can be applied to degrade these drugs in water, reaching high efficiency or even total removal. The general objective of this study is to assess the efficiency of the treatment by heterogeneous photocatalysis using as catalyst titanium dioxide (TiO2) commercial and composite of TiO2-activated carbon, both in suspension and impregnated in glass beads for the removal of anxiolytic drugs belonging to the benzodiazepine family in ultrapure water at environmentally relevant concentrations. The objectives of this investigation were: (i) to assess the occurrence of psychoactive drugs in different aqueous matrices, levels of contamination and removal achieved by conventional treatment plants, based on records in the literature; (ii) to assess the ecotoxicity pose by these drugs on aquatic bioindicators, based on records in the literature; (iii) to develop and apply commercial TiO2 immobilized onto glass beads in heterogeneous photocatalysis for photoactivity, characterization, leaching and regeneration studies; (iv) to synthesize and characterize the composite formed by TiO2/activated carbon for application in heterogeneous photocatalysis assays; (v) to assess the performance of TiO2 commercial catalyst and TiO2/activated carbon composite applied in suspension and impregnated onto glass beads in removing anxiolytic compounds (bromazepam, clonazepam and diazepam) from water. The literature review (219 articles and 1642 data/entries) about the occurrence in different aqueous matrices of seven psychoactive drugs, among which, six benzodiazepines (alprazolam, bromazepam, clonazepam, diazepam, lorazepam and oxazepam) and one antidepressant (citalopram) showed that drug concentrations in all aqueous matrices investigated ranged from 0.14 to 840,000 ng/L. Among TiO2/activated carbon composites evaluated, the one with 10% by weight of activated carbon (TiO2/AC10%), presented a synergistic effect between TiO2 and activated carbon, which promoted superior performance in the removal of target compounds (bromazepam, clonazepam and diazepam) when compared to commercial TiO2 separately in photocatalysis applications with the catalyst suspended or impregnated onto glass beads, even after several treatment cycles. Thus, the TiO2/AC10% composite can be considered an attractive alternative material to the use of the commercial TiO2-P25 catalyst for water/wastewater treatment and polishing applications O crescimento populacional associado à crescente demanda por produtos da indústria química e farmacêutica, incluindo materiais utilizados em embalagens, detergentes, defensivos agrícolas, fármacos e produtos de uso pessoal, tem resultado, nas últimas décadas, em um aumento crescente na presença de contaminantes emergentes em diferentes compartimentos ambientais. Fármacos psicoativos, tais como ansiolíticos e antidepressivos, são medicamentos prescritos em larga quantidade em nível mundial e são considerados contaminantes ambientais emergentes. Tais fármacos já foram detectados em diferentes matrizes de água, em várias partes do mundo, incluindo o Brasil. Além disso, tais compostos não são facilmente degradados e não são totalmente removidos em estações de tratamento convencional de esgoto e de água de abastecimento. Há evidências de que alguns Processos Oxidativos Avançados (POAs) podem ser aplicados para a degradação desses fármacos em água, atingindo-se alta eficiência ou total remoção. O objetivo geral deste estudo é avaliar a eficiência do tratamento por fotocatálise heterogênea utilizando como catalizador dióxido de titânio (TiO2) comercial e compósito sintetizado a base de TiO2-carvão ativado em suspensão e impregnado em esferas de vidro, para remoção de fármacos ansiolíticos da família dos benzodiazepínicos presentes em água ultrapura em concentrações de relevância ambiental. Os objetivos da investigação foram: (i) avaliar a ocorrência de fármacos psicoativos em diferentes matrizes aquosas e níveis de remoção alcançados em estações de tratamento convencional, com base em registros na literatura; (ii) avaliar a ecotoxicidade observada de tais fármacos, com base em registros na literatura; (iii) aplicar o TiO2 comercial imobilizado em esferas de vidro na fotocatálise heterogênea para estudos de fotoatividade, caracterização, lixiviação e regeneração; (iv) sintetizar e caracterizar o compósito TiO2/carvão ativado para aplicação em ensaios de fotocatálise heterogênea; (v) avaliar o desempenho do catalisador comercial TiO2 e o compósito TiO2/carvão ativado aplicado em suspensão e impregnados em esferas de vidro para remoção de fármacos ansiolíticos (bromazepam, clonazepam e diazepam) em água. Os resultados de uma revisão (219 artigos e 1642 dados/entradas) sobre ocorrência em diferentes matrizes aquosas de sete fármacos psicoativos, dentre as quais seis benzodiazepínicos (alprazolam, bromazepam, clonazepam, diazepam, lorazepam e oxazepam) e um antidepressivo (citalopram) revelaram que as concentrações dos fármacos investigados em todas as matrizes aquosas encontradas variaram entre 0,14 a 840.000 ng/L. Dentre os compósitos TiO2/carvão ativado testados, o que recebeu 10% em massa de carvão ativado (TiO2/AC10%), apresentou efeito sinérgico entre o TiO2 e o carvão ativado promovendo desempenho superior na remoção dos fármacos-alvos (bromazepam, clonazepam e diazepam), em comparação ao uso de TiO2 comercial para aplicações de fotocatálise com o catalisador em suspensão ou impregnado em esferas de vidro, mesmo após diversos ciclos de tratamento. Assim, o compósito TiO2/AC10% pode ser considerado um material superior alternativo ao uso do catalisador comercial TiO2-P25 para aplicações de tratamento e polimento final de água e esgotos

A set of psychoactive drugs has been analyzed with the use of quantitative structure-activity/property relationships methods. The purpose of this study was to demonstrate both the common and differentiating characteristics of the above-mentioned chemical compounds, physicochemical as well as pharmacological based on the quantum chemical calculations and selected biological activity data and chromatographic retention parameters. During the study, the ab initio model of molecular modeling was performed and PCA, FA, and MLR as the types of chemometric approach. QSAR/QSPR models were proposed based on chosen statistically significant descriptors. The relationship between the structure and biological activity data was able to class and describe the psychoactive properties of the molecules studied. The applied chemometric approaches revealed the influential features of tested structures responsible for their pharmacological activity together with some additional physicochemical properties.