Managing the Effects of Drug Use through Evidence-Based Measures

There are several causes or factors that contribute to the complex phenomenon of drug use and abuse. The scope and correlations of drug use vary depending on the type of drug, the social environment, the economic and cultural context, as well as the individual traits of the drug user. All these aspects should be taken into account when approaching the phenomenon through a mixture of interventions that include education, raising awareness, treatment and support. Moreover, as drug use is recognised as a dynamic phenomenon, strongly influenced by both individual and external conditions, it is important to address all its forms, in a complementary and multidisciplinary manner. The purpose of the paper is to explore practical applications of drug prevention interventions as methods used in managing the effects of drug use in certain population categories, while emphasising the link between evidence and practice

Spontaneous Bacterial Peritonitis due to Actinomyces Mimicking a Perforation of the Proximal Jejunum

Objective: Unusual clinical course Background: Pelvic-abdominal actinomycosis is a rare chronic condition caused by an anaerobic, gram-negative rod-shaped commensal bacterium of the Actinomyces species. When Actinomyces becomes pathogenic, it frequently causes a chronic infection with granulomatous abscess formation with pus. Due to diversity in clinical and radiological presentation, actinomycosis can easily be mistaken for several other conditions. Peritonitis without preceding abscess formation caused by Actinomyces species has been described in only few cases before in literature. Case report: We report a case of spontaneous pelvic-abdominal peritonitis with presence of pneumoperitoneum and absence of preceding abscesses due to acute actinomycosis mimicking a perforation of the proximal jejunum in a 42-year-old female with an intra-uterine contraceptive device in place. Explorative laparotomy revealed 2 liters of odorless pus but no etiological explanation for the peritonitis. The intra-uterine contraceptive device was removed. Cultivation showed growth of Actinomyces turicensis. The patient was successfully treated with penicillin. Conclusions: In the case of primary bacterial peritonitis or lower abdominal pain without focus in a patient with an intrauterine device in situ, Actinomyces should be considered as a pathoge