Increase in serum brain-derived neurotrophic factor levels during early withdrawal in severe alcohol users

Introduction: Changes in brain-derived neurotrophic factor (BDNF) have been linked to the neuroadaptative consequences of chronic alcohol use and associated with disease severity and prognosis. Few studies have evaluated the influence of drug withdrawal and clinical and sociodemographic data on BDNF levels in severe alcohol users. Objectives: Our goals were (1) to evaluate variation in BDNF levels during alcohol withdrawal and, (2) to assess the influence of putative confounding factors on BDNF levels. Methods: Our sample consists of 62 men with alcohol use disorder undergoing a detoxification process. Serum BDNF levels were measured using a commercial sandwich-ELISA kit, at two points: before and after the detoxification period. Results: We found an increase in BDNF levels during alcohol withdrawal (25.4±9.6 at admission vs. 29.8±10.2 ng/ml at discharge; p < 0.001), even after controlling for potential confounders (positive family history, number of days between blood sample collections, and age) (Generalized Estimating Equation: coefficient = -4.37, 95% confidence interval [95%CI] -6.3; -2.4; p < 0.001). Moreover, individuals who had first-degree relative with alcohol dependence had smaller increases in BDNF levels than individuals with no family history (14.8 [95%CI -5.3; 35.6] vs. 35.3 [95%CI 15.4; 74.8]; p = 0.005). Conclusions: In summary, variation in BDNF levels seems to be influenced by withdrawal in severe alcohol users. A positive family history of alcohol dependence could also be a factor that influences variation in this biomarker

Effects of childhood trauma on BDNF and TBARS during crack-cocaine withdrawal

Objective: To evaluate the association between childhood trauma (CT) and serum levels of brainderived neurotrophic factor (BDNF) and thiobarbituric acid-reactive substances (TBARS) during crackcocaine withdrawal. Method: Thirty-three male crack-cocaine users were recruited at admission to a public addiction treatment unit. Serum BDNF and TBARS levels were evaluated at intake and discharge. Information about drug use was assessed by the Addiction Severity Index-6th Version (ASI-6); CT was reported throughout the Childhood Trauma Questionnaire (CTQ). CTQ scores were calculated based on a latent analysis model that divided the sample into low-, medium-, and high-level trauma groups. Results: There was a significant increase in BDNF levels from admission to discharge, which did not differ across CT subgroups. For TBARS levels, we found a significant time vs. trauma interaction (F2,28 = 6.357, p = 0.005,Zp 2 = 0.312). In participants with low trauma level, TBARS decreased, while in those with a high trauma level, TBARS increased during early withdrawal. Conclusion: TBARS levels showed opposite patterns of change in crack-cocaine withdrawal according to baseline CT. These results suggest that CT could be associated with more severe neurological impairment during withdrawal

Socio-demographic and clinical characteristics of pregnant and puerperal crack-cocaine using women: preliminary data

Background: The literature provides several studies on the effects of cocaine when exposed to the fetus. However, the majority of these data comes from animal models. Objective: The objective of this study is to present socio-demographic and clinical data in crack-cocaine using pregnant women and their babies, as compared to non-users. Methods: Cross-sectional study, comprised by 56 dyads of crack-cocaine using mothers-babies and 89 control dyads. In addition to the socio-demographic data and the babies’ information, data collection was based on ABIPEMI for socioeconomic level, WAIS for IQ, MINI for psychopathology and ASSIST for drug use. Results: Most crack users, in comparison to non-users, did not have a partner (10.52% vs 4.4%, P = 0.001) and presented lower IQ (78.15, +/-8.07 vs 84.27 +/- 9.87; P = 0.002). The prevalence of antisocial personality disorder and suicide risk in users was higher than in non-users (24.44% vs none, P < 0.001; 28.26% vs 10.46% P = 0.01). Most of the users did not participate in prenatal care (75%). The babies that the crack-cocaine using mothers gave birth to weighed significantly less than the controls (2.858 g vs 3.240 g, P = 0.002). Discussion: Users had a higher degree of psychopathology and lower attendance in prenatal care. There was an overlap of adverse factors, both for exposed mothers and babies. The sum of these vulnerabilities could result in significant harm to the developing infant

Mitigating the impact on healthcare workers in critical situations through a psychological first aid program in a university general hospital

Introduction: Natural disasters and health emergencies have significantly increased stress levels among healthcare professionals, particularly since the COVID-19 pandemic. Implementing strategies that promote resilience is crucial for maintaining the mental health of these professionals during such crises. This study details the design and implementation of a psychological support program for frontline healthcare workers and evaluates its feasibility and potential for replication by analyzing service demand and presenting complaints. Method: The program, named HCPAcomVC (HCPAwithYOU), was developed at Hospital de Clinicas de Porto Alegre (HCPA) and launched in April 2021. It utilized psychological first aid methods, a critical intervention for individuals experiencing high stress or trauma during COVID-19. Results: From April to July 2021, a program with 40 volunteers served 160 employees (out of the 6,843 dealing directly or indirectly with COVID-19 in our environment). The most frequent issues were mild psychiatric symptoms (29.7%) and high stress levels (22.3%), followed by moderate symptoms (16.2%), and minor psychopharmacological issues (10.8%). Critical cases such as severe symptoms (2.7%) and suicide risk (2.7%) were also addressed. The results show the program’s feasibility by detailing volunteer involvement and employee support. The types of complaints addressed confirm its relevance and highlight the model’s potential for replication. Conclusion: The rapid implementation of a supportive program for healthcare workers in an adverse scenario such as the COVID-19 proved feasible. This model can be reproduced quickly and effectively in other services that are a reference for the care of other pandemics or critical situations

Ethical, legal and social issues related to alcohol and drug research

To present some highlights and comments about ethical, legal and social issues related to alcohol and drug research

Alcohol, drugs, and risky sexual behavior are related to HIV infection in female adolescents Álcool, drogas e comportamento sexual de risco estão relacionados à infecção por HIV em mulheres adolescentes

OBJECTIVE: To examine associations between risk factors for HIV infection in a sample of young women who sought HIV testing in a city of southern Brazil. METHOD: Cross-sectional study with a consecutive convenience sample of 258 female adolescents aged 13 to 20 years evaluated in an anonymous testing site for HIV and sexually transmitted diseases in Brazil. Risk behavior for HIV was assessed with the Brazilian version of the Risk Assessment Battery and HIV status was assessed through ELISA (Enzyme Linked Immunosorbent Assay). RESULTS: Overall seropositivity rate was 7.4%. HIV-seropositive patients had significantly more sexual intercourse in exchange for money, higher rates of pregnancy and abortion, as well as earlier sexual debut. In multiple analyses with the inclusion of two composite variables (sex risk and drug risk), only drug risk was associated with positive HIV status (OR = 4.178; IC 95% = 1.476-11.827). CONCLUSION: Our findings suggest that high HIV seropositivity among female adolescents seeking HIV testing in Brazil directly reflects the need for effective interventions specifically designed to prevent risk behaviors in order to halt the spread of HIV infection.OBJETIVO: Descrever fatores de risco para infecção pelo HIV numa amostra de adolescentes do sexo feminino que procurou fazer o teste HIV em uma cidade do sul do país. MÉTODO: Num estudo transversal, 258 adolescentes do sexo feminino foram avaliadas em relação ao seu estado sorológico para o vírus HIV e comportamentos de risco utilizando-se a versão brasileira da escala Risk Assessment Battery. RESULTADOS: A taxa geral de soropositividade foi de 7,4%. As jovens soropositivas tiveram significativamente mais relações sexuais em troca de dinheiro, história de gravidez e aborto prévio, bem como iniciação sexual mais precoce do que as adolescentes soronegativas. Nas análises multivariadas, com a inclusão de duas variáveis compostas ("risco sexual" e "risco por drogas"), apenas "risco por drogas" esteve associada com o estado sorológico HIV positivo (OR = 4,178 IC 95% = 1,476-11,827). CONCLUSÃO: Nossos achados indicam que a alta soropositividade encontrada nas jovens adolescentes que procuraram testagem evidencia a necessidade de que se desenvolvam medidas de intervenção preventivas especialmente dirigidas para comportamento de risco em mulheres adolescentes para evitar a disseminação da infecção HIV