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Substance abuse is a widespread problem in the United States and worldwide. This use within the pregnant population is thought to reflect a pattern similar to the general population, with estimates of 10% to 15% of pregnant women experiencing substance abuse. Illicit substance use during pregnancy has increased substantially during the past decade in the United States. During the past decade, novel or atypical substances have emerged and become increasingly popular. Occurrences of toxicity and untoward fetal effects from designer drug use must be kept high on the watch list for all who practice in maternal-fetal, newborn, and emergency departments.

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Introdução: a Estratégia de Saúde da Família (ESF) é um dos integrantes da Rede de Atenção Psicossocial (RAPS) e é considerado o serviço de porta de entrada dos usuários aos serviços do Sistema Único de Saúde (SUS). Nesse serviço, o enfermeiro é uma peça chave no cuidado a pessoa que faz uso de álcool e outras drogas, por possuir formação baseada nas ciências do cuidado humano, devido sua proximidade com os usuários do serviço e por ser o líder da equipe de saúde da família. Objetivo: analisar a atuação do enfermeiro da ESF no cuidado da pessoa que faz uso de Substâncias Psicoativas (SPA). Materiais e Métodos: trata-se de um estudo exploratório com abordagem quantitativa, realizado com enfermeiros da ESF, em um município de pequeno porte na região do Vale do Araguaia, no estado de Mato Grosso, Brasil, no período de novembro a dezembro de 2021, por meio de questionário autoaplicável. Os dados coletados foram duplamente digitados no programa Excel e posteriormente transportados para análise no programa estatístico SPSS (Statistical Package for the Social Science) versão 24.0, para medida de associação foi aplicado o Teste Exato de Fisher, considerando o intervalo de confiança de 95% e p valor de <0,05 e o odds ratio para avaliar razão de chance entre as variáveis. O estudo respeitou todos os aspectos éticos. Resultados: A amostra foi constituída por 16 enfermeiros, que atuam em Estratégia de Saúde da Família (ESF) há mais de cinco anos (75%), que atendem demanda de pessoa que fazem uso de SPA (94%), que acreditam ser possível tratar e acompanhar esse perfil de usuários (94%) neste nível assistencial, porém não sabem conduzir o atendimento (63%). Além disso, a atuação junto a essa população gera pouca satisfação profissional (67%), sobrecarga de trabalho (53,3%) e até mesmo constrangimento (20%). No serviço foram identificados fatores que dificultam sua assistência (87,5%), assim como facilitadores que auxiliam nesse atendimento (75%). A presença de facilitadores da assistência a pessoas que fazem uso de SPA apresentou 33 vezes mais chance de serem identificados por enfermeiros que cursaram a disciplina sobre SPA na graduação. Reconhecer a presença de facilitadores esteve diretamente associado com a forma que o enfermeiro avalia sua atuação profissional frente à pessoa que faz uso de SPA e com o fato deles acreditarem que podem colaborar para amenizar os prejuízos do consumo de SPA dessa população. Considerações finais: diante do exposto, observou-se que os enfermeiros reconheceram o seu potencial de desenvolver um importante papel no cuidado a estes usuários, sendo possível tratar e acompanhar esta demanda, contribuir para reduzir os danos do consumo, e reabilitar estas pessoas. Porém refere à existência de desafios que dificultam esta atuação, com destaque ao despreparo profissional para atuar neste cenário

Introduction: the Family Health Strategy is one of the members of the Psychosocial Care Network and is considered the gateway service for users to the services of the Unified Health System. In this service, the nurse is a key player in the care of the person who uses alcohol and other drugs, for having training based on the sciences of human care, due to his proximity to the service users and for being the leader of the health. Objective: to analyze the role of family health strategy nurses in caring for people who use psychoactive substances. Materials and Methods: this is an exploratory study with a quantitative approach, carried out with nurses from the family health strategy, in a small municipality in the region of Vale do Araguaia, in the state of Mato Grosso, Brazil, in the period of november to december 2021, through a self-administered questionnaire. The collected data were double-entered in the Excel program and later transported for analysis in the SPSS statistical program (Statistical Package for the Social Science) version 24.0. Fisher's exact test was applied to measure the association, considering the 95% confidence interval and p value of <0.05 and the odds ratio to assess the odds ratio between the variables. The study respected all ethical aspects. Results: The sample consisted of 16 nurses, who work in the family health strategy for more than five years (75%), who meet the demand of people who use psychoactive substances (94%), who believe it is possible to treat and follow this user profile (94%) at this level of care, but they do not know how to conduct the service (63%). In addition, working with this population generates little job satisfaction (67%), work overload (53.3%) and even embarrassment (20%). In the service, factors were identified that hinder their assistance (87.5%), as well as facilitators who help in this service (75%). The presence of facilitators of assistance to people who use psychoactive substances was 33 times more likely to be identified by nurses who took the discipline on psychoactive substances at graduation. Recognizing the presence of facilitators was directly associated with the way nurses assess their professional performance towards the person who uses psychoactive substances and with the fact that they believe that they can collaborate to alleviate the harm caused by the consumption of psychoactive substances in this population. Final considerations: given the above, it was observed that nurses recognized their potential to play an important role in the care of these users, making it possible to treat and monitor this demand, contribute to reducing the harm caused by consumption, and rehabilitate these people. However, it refers to the existence of challenges that make this performance difficult, with emphasis on the professional unpreparedness to act in this scenario

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Objective: This study aimed to explore the effects of caffeine on balance function by determining the extent to which caffeine consumption affects postural sway and balance control in healthy individuals. Methods: Thirty healthy participants aged 20-35 years without any vestibular disorder were enrolled in this study. The participants were randomly divided into two groups, and those in Group 1 were given two cups of regular coffee (300-350 mg) while those in Group 2 were given two cups of decaffeinated coffee. The sensory organization test, the head shake sensory organization test, the limits of stability test, and the adaptation test were performed on all participants before and after coffee intake using computerized dynamic posturography. Results: The sensory organization test composite scores (p=0.001) and the head shake condition 5 (C5) equilibrium scores (p=0.001) of the participants in Group 1 showed a statistically significant increase after coffee intake while the composite scores (p=0.001) and the head shake condition (C5) equilibrium scores (p=0.001) of those in Group 2 showed a statistically significant decrease. There was a statistically significant difference between the two groups in the equilibrium scores in the pitch plane (p=0.001), the yaw plane (p=0.001), and the roll plane (p=0.001) of C5 after coffee intake. Conclusion: Consumption of an appropriate dose of caffeine may enhance body position, postural stability, and voluntary motor control ability. The combined use of the sensory organization test, the head shake sensory organization test, the adaptation test, and the limits of stability test in evaluating the balance mechanism in individuals with normal vestibular findings provides detailed information about postural sway.

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BACKGROUND: Our aim was to assess the occurrence and risk factors for psychotropic medication use after pediatric traumatic brain injury treated in the intensive care unit. METHODS: We combined data from the Finnish Intensive Care Consortium database, data on reimbursed medications from the Social Insurance Institute, and individual electronic health care data. We analyzed data on children aged five to 17 years treated for traumatic brain injury in intensive care units of four university hospitals in Finland during 2003 to 2013 and being alive six months after injury with no history of psychotropic medication use before traumatic brain injury. RESULTS: We identified 248 patients of whom 46 (19%) were prescribed a new psychotropic medication after traumatic brain injury. In multivariable logistic regression, a higher age associated with a higher probability for use of any psychotropic medication. Subgroup analyses showed that higher age associated with an increased risk of antidepressant and antipsychotic use but with a decreased risk of stimulant use. Apart from age, we found no other clinical, radiological, or treatment-related factors that significantly associated with subsequent use of psychotropics. Psychotropic medication was most common (45%) in children aged 12 to 17 years and had moderate disability at six-month follow-up. CONCLUSIONS: One fifth of children treated in the intensive care unit for traumatic brain injury were prescribed a new psychotropic medication during a median follow-up of three years and five months. Psychotropic medication was most common among teenagers with moderate post-traumatic disability. The need and use of psychotropics postinjury seem multifactorial and not related to any traumatic brain injury type.

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Resumen Introducción: El consumo de drogas en Colombia está aumentado y su tamización es baja. La Organización Mundial de la Salud diseñó el ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) para determinar la prevalencia y el riesgo del consumo. El objetivo fue describir los usos del ASSIST en Colombia y el perfil de consumo de las poblaciones estudiadas con esta escala. Métodos: Revisión sistemática en Medline-Pubmed, Science-Direct, Scielo y Google-Scholar. Se garantizó exhaustividad, reproducibilidad y evaluación de la calidad. Se realizó síntesis cualitativa mediante proporciones. Resultados: Se incluyeron nueve estudios con 4 736 sujetos. La mayor proporción de sujetos presentó un consumo de bajo riesgo; en estudiantes fue 16,1 % para tabaco, 18,9 % alcohol y 17,9 % cannabis; entre líderes sociales fue 100 % en tabaco y cannabis, y 80 % alcohol; en desplazados 35,8 % para alcohol y 6,6 % cannabis; y en gestantes 58,4 % tabaco y 58,4 % alcohol. Los factores asociados fueron el desplazamiento forzado, violencia sexual, edad, escolaridad, depresión, estrato social y bajo soporte socio-familiar. Conclusión: Se evidencia la necesidad de mejorar la tamización del uso de drogas en el país, dado que una detección temprana es clave para articular acciones clínicas, epidemiológicas y de política pública.

Abstract Introduction: Drug use in Colombia has increased and its screening is low. The World Health Organization designed the ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) to screen the prevalence and risk of consumption. The objective was to describe the uses of ASSIST in Colombia and the consumption profile of the populations studied with this scale. Methods: A systematic review in Medline-Pubmed, Science-Direct, Scielo and Google-Scholar. The completeness, reproducibility and quality assessment was guaranteed. Qualitative synthesis was performed using proportions. Results: Nine studies with 4736 subjects were included. The highest proportion of subjects had low risk consumption; in students it was 16.1 % for tobacco, 18.9 % alcohol and 17.9 % cannabis; among social leaders it was 100% in tobacco and cannabis, and 80 % for alcohol; in displaced persons it was 35.8 % for alcohol and 6.6 % cannabis; and in pregnant women it was 58.4 % tobacco and 58.4 % alcohol. The factors associated with consumption were forced displacement, sexual violence, age, schooling, depression, social status and low social or family support. Conclusion: A low proportion of research was found with ASSIST. This demonstrates the need to improve the screening of drug use in the country, since an early detection of consumption is key to articulate clinical, epidemiological and public health policy actions.

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The article presents the literature and original data on the problems of falls in elderly patients. The connection of the fact of falling with initiation of therapy by a number of drugs known to have a negative impact on the risk of falling is considered. The article presents data on the frequency and structure of falls on the example of patients with cardiovascular diseases older than 75 years, treated in a multidisciplinary hospital. The analysis of the data showed a tendency of prevalence of the fact of falling in 1/3 patients (33,8%) in the first 5 days of hospital stay, which may be associated with high drug burden and the appointment of «new¼ drugs for the patient. The study noted that it was on the first day that the selection of therapy took place and additional drugs were often prescribed, leading to a state of polypragmasia. Analysis of individual groups of drugs was able to reliably confirm the relationship between the appointment of drugs that increase.

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Nicotine dependence has progressively become a foremost community health interest in both the developed and developing nations due to the economic burden and health-related problems. Smoking was significantly higher among patients with schizophrenia in comparison to the general population. Nicotine dependence is not only associated with public stress, but among patients with schizophrenia, smoking brings major challenges to the management. Nicotine may diminish the therapeutic efficacy of the bioavailability of the psychopharmacological agents in-vivo. These duo perturbations, i.e. two clinical conditions co-existed may prevent psychotic symptoms remission among patients suffering from schizophrenia who smoke at the same time. The aim of this review was to highlight the role of pharmacological treatment options and strategies for patients with nicotine dependence in schizophrenia with emphasis on the underlying neurobiological process. The role of nicotine replacement therapy, i.e. norepinephrine-dopamine reuptake inhibition (NDRI) e.g. bupropion and selective partial agonist of α4ß2 and full α7-nicotinic acetylcholine receptor e.g. varenicline was deliberated. An ideal choice of drug targets for patients with schizophrenia with nicotine dependence is pivotal to foster a better therapeutic alliance.

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The objective of the present study was the criminalistics evaluation of the changes in the structure of the illegal drug market and the volume of drug sales that took place during the recent years. One of the most challenging problems associated with the new situation is the extensive distribution of synthetic cannabimimetics that constitutes one of the most serious threats to the public security. The criminological analysis of the forensic expert practice provided materials for the criminalistics characteristic of the recent events at the criminal drug market in several regions of this country as of 2014 with special reference to the cases of mass poisoning of the young people attributable to the use of the new psychoactive agents. The authors emphasize the important role of forensic medical and other forensic expertises for the identification and comprehensive evaluation of all the factors and circumstances associated with the current situation and characterizing the level of social unsafety under the conditions of the illegal trafficking of the new psychoactive substances. It is concluded that the further improvement of the criminal legislation is urgently needed to strengthen the responsibility for the participation in the subversive and terrorist activities.

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In Korea, an increasing number of people attempt to evade military conscription by posing as mental health patients. To verify the authenticity of mental illness, there is a need to detect wide range of psychoactive agents in biological specimens of conscription candidates. In this study, we developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for simultaneous determination of 18 psychoactive agents and 6 metabolites in human plasma. The method was characterized by the use of a simple, fast and cheap protein precipitation as sample preparation, a rapid run time (11min) and a low volume of plasma sample (200µL). The analytes were monitored under the scheduled multiple reaction monitoring (sMRM) positive and negative mode using electrospray ionization (ESI). The essential validation parameters including selectivity, linearity, accuracy, precision, matrix effect and recovery were satisfactory. The limit of detection ranged from 0.0005 to 0.001µg/mL, and limit of quantitation ranged from 0.005 to 0.025µg/mL. The developed method was successfully applied to 323 actual plasma samples submitted by Korea central physical examination center of military manpower administration in 2016, and is expected to contribute to the rapid and accurate disposition of military service.

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BACKGROUND: Predicting the popularity of and harm caused by psychoactive agents is a serious problem that would be difficult to do by a single simple method. However, because of the growing number of drugs it is very important to provide a simple and fast tool for predicting some characteristics of these substances. We were inspired by the Google Flu Trends study on the activity of the influenza virus, which showed that influenza virus activity worldwide can be monitored based on queries entered into the Google search engine. OBJECTIVE: Our aim was to propose a fast method for ranking the most popular and most harmful drugs based on easily available data gathered from the Internet. METHODS: We used the Google search engine to acquire data for the ranking lists. Subsequently, using the resulting list and the frequency of hits for the respective psychoactive drugs combined with the word "harm" or "harmful", we estimated quickly how much harm is associated with each drug. RESULTS: We ranked the most popular and harmful psychoactive drugs. As we conducted the research over a period of several months, we noted that the relative popularity indexes tended to change depending on when we obtained them. This suggests that the data may be useful in monitoring changes over time in the use of each of these psychoactive agents. CONCLUSIONS: Our data correlate well with the results from a multicriteria decision analysis of drug harms in the United Kingdom. We showed that Google search data can be a valuable source of information to assess the popularity of and harm caused by psychoactive agents and may help in monitoring drug use trends.

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Objetivos: avaliar o perfil dos pacientes idosos internados na Unidade de Psiquiatria do Hospital São Lucas da PUCRS, em Porto Alegre, Rio Grande do Sul.Métodos: Foi realizado um estudo descritivo a partir do banco de dados das internações psiquiátricas do Hospital.Foram incluídos no estudo pacientes com idade de 60 anos ou mais, internados no período de maio de 2008 a setembro de 2009 na Unidade de Psiquiatria.Resultados: do total de 294 pacientes internados na Unidade de Psiquiatria no período do estudo, 63 (21,4%) eram idosos, sendo incluídos no estudo. A idade média foi 69 anos, sendo 66,7% mulheres e 58,7% casados. O principal motivo das internações foi ideação suicida (39,6%). No momento da hospitalização, 84,2% dos pacientes faziam uso de pelo menos um psicofármaco.Conclusões: a alta prevalência de ideação suicida nos pacientes idosos da Unidade de Psiquiatria do Hospital São Lucas da PUCRS revela a importância da avaliação sistemática do risco de suicídio nesses pacientes.

Aims: To assess the profile of elderly patients admitted to the Psychiatric Unity of Hospital São Lucas da PUCRS,Porto Alegre, Rio Grande do Sul, Brazil.Methods: A descriptive study from the database of psychiatric admissions to the Hospital was conducted. Data from patients aged 60 years or older, admitted from May 2008 to September 2009, were included.Results: Of 294 subjects admitted in the study period to the Psychiatric Unity, 63 (21.4%) were elderly, and were included in the study. The mean age in this subgroup was 69 years, 66.7% were women and 58.7% were married.The main reason for admission was suicidal ideation (39.6%). At the time of hospitalization, 84.2% of the patients used at least one psychoactive drug.Conclusions: The high prevalence of suicidal ideation among elderly in the psychiatric unit of HSL-PUCRS reveals the importance of systematic evaluation of suicide risk in this population.

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Objetivo. Analizar los factores que determinan el consumo juvenil de sustancias psicoactivas evaluando la capacidad predictiva de variables actitudinales, afectivas, relacionales a nivel familiar y grupal, así como académicas, entre otras. Material y métodos. Se ha seleccionado una muestra de 750 adolescentes del Principado de Asturias (España) (moda 15 años, media=14.69) escolarizados en el curso académico 2008-2009. Resultados. Se ha confirmado que los adolescentes que consumen alcohol y otras drogas presentan un perfil diferencial respecto a los no consumidores en factores relativos a la mayor permisividad actitudinal, efecto de modelado paterno y del grupo de iguales, insatisfacción institucional, inestabilidad emocional y manifestación de más conductas disruptivas con problemas de relación y búsquedas de atención. Conclusiones. A partir de nuestro modelo etiológico se concluye que el consumo juvenil de drogas está determinado por la interrelación de variables personales, familiares, escolares y psicosociales.

Objective. To offer an analysis of the factors that determine the consumption of psychoactive substances by youth and to evaluate the predictive capacity of variables related to attitude, affect, the family and groups, as well as academics, among others. Materials and Methods. A sample of 750 adolescents was selected at the Principado de Asturias (Spain) (mode 15 years of age, mean=14.69) enrolled during the 2008-2009 academic year. Results. It was confirmed that the teenagers who consumed alcohol and other drugs present a differential profile as compared to non-consumers with respect to greater attitudinal permissiveness, effect of paternal modelling and peer groups, institutional dissatisfaction, emotional instability, and manifestation of more disruptive conducts with problems relating to others and attention-seeking. Conclusions. From our ethiological model we conclude that the consumption of drugs by youth is determined by an interrelation of personal, familiar, school and psychosocial variables.

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O comércio popular de drogas vegetais sem garantia de qualidade implica risco sanitário. O presente estudo faz uma análise da rede de comércio popular de drogas vegetais psicoativas (DVPs) na cidade de Diadema e os riscos associados ao seu consumo. São apresentados dados parciais de um projeto realizado em colaboração com outras áreas de investigação. Métodos da etnofarmacologia, tais como entrevistas informais, semiestruturadas e observação participante foram utilizados para a realização do trabalho de campo, durante o qual selecionaram-se quatro comerciantes, a fim de registrar a obtenção, manipulação, acondicionamento e uso das DVPs comercializadas (nomes populares, receitas, partes utilizadas, contraindicações e doses). Foram registradas 63 DVPs distintas, e posteriormente categorizadas de acordo com suas possíveis ações psicoativas, predominando as estimulantes (67 por cento) e depressoras (27 por cento). Observaram-se deficiências na manipulação e acondicionamento das drogas por parte dos comerciantes, expondo seus clientes a possíveis riscos à saúde. Os resultados obtidos nesse estudo possibilitaram observar prioridades de adequação na comercialização de drogas vegetais no comércio popular a fim de resguardar a saúde de seus usuários, bem como a necessidade de promover um diálogo entre este e o sistema formal de saúde.

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