The influence of the family in the development and treatment of heroin addiction

openL’obiettivo principale di questa tesi è testimoniare l’importanza delle relazioni ed in particolare del sistema famigliare in una psicopatologia come la dipendenza da eroina vista ancora dal senso comune come una scelta sbagliata, un conseguenza dello “sballo”, un semplice meccanismo biochimico. Ma esaminando la letteratura il retroscena si è rivelato molto più complesso. Dopo la grande diffusione avuta fra gli anni ottanta e novanta del secolo scorso, la produzione di eroina è ancora molto frequente, con un traffico che ha saputo resistere anche agli ostacoli posti dalla pandemia e una media di otto overdose ogni dieci morti da iniezione. Oltre alla sieropositività ad aggravare ancora di più il quadro patologico sono le diagnosi di comorbidità suggerite dal manuale diagnostico e statistico dei disturbi mentali: depressione, disturbi esternalizzanti, borderline e bipolare, schizofrenia. Nonostante la predisposizione genetica, un profilo di personalità distinto da tratti impulsivi ed esperienze traumatiche o di abuso nella prima infanzia, l’instaurarsi di un attaccamento disorganizzato e capacità genitoriali inefficienti durante l’adolescenza (ad esempio uno scarso monitoraggio) si sono rivelati i principali predittori di comportamenti devianti associati all’abuso di sostanze. Una carenza di accudimento che il modello eziopatogenetico relazionale rintraccia nei rapporti irrisolti del genitore con il proprio caregiver. Nel suo complesso questa situazione non fornisce al ragazzo dei validi esempi con cui identificarsi, spingendolo a cercare conforto nella droga. A tal proposito gli interventi in grado di coinvolgere primariamente e non in modo ausiliario le figure genitoriali si sono rivelati particolarmente efficaci rispetto alle tecniche solitamente adottate (trattamento farmacologico, terapia individuale e comunità terapeutica), a testimonianza della centralità della famiglia e del suo ruolo chiave nell’insorgenza e nel recupero dalla tossicodipendenza.The main objective of this thesis is to testify the importance of relationships and in particular of the family system in a psychopathology such as heroin addiction, still seen by common sense as a wrong choice, a consequence of the "high", a simple biochemical mechanism . But looking at the literature, the background turned out to be much more complex. After the great diffusion between the eighties and nineties of the last century, the production of heroin is still very frequent, with a traffic that has been able to resist even the obstacles posed by the pandemic and an average of eight overdoses for every ten deaths from injection. In addition to seropositivity, the diagnoses of comorbidities suggested by the diagnostic and statistical manual of mental disorders further aggravate the pathological picture: depression, externalizing, borderline and bipolar disorders, schizophrenia. Despite the genetic predisposition, a personality profile distinct from impulsive traits and traumatic or abusive experiences in early childhood, the establishment of disorganized attachment and inefficient parenting skills during adolescence (e.g. poor monitoring) proved to be the main predictors of deviant behavior associated with substance abuse. A lack of care that the relational etiopathogenetic model traces in the unresolved relationships of the parent with their caregiver. Taken as a whole, this situation does not provide the boy with valid examples to identify with, prompting him to seek support in drugs. In this regard, the interventions capable of involving the parental figures primarily and not in an auxiliary manner have proved to be particularly effective with respect to the techniques usually adopted (pharmacological treatment, individual therapy and therapeutic community), reflecting the centrality of the family and its key role in the onset and recovery from drug addiction

Systemic reuse models for sustainable glass packaging design and innovation

The Italian glass packaging industry is the first in Europe, with 21.3% of production value. It has 14 companies with 39 factories, 7,800 employees and a growing annual turnover of 2.4 billion euros. This trend of production preserves, on the one hand, a good synergy concerning the recycling process, but at the same time, it needs to reduce environmental impacts through reuse practices. This research and analysis work was carried out in collaboration with a company that designs and produces glass packaging, focusing on and evaluating the current reuse and returnable-empty models, outlining the opportunities for a transition towards systemic business that stimulates innovation in new sectors. Subsequently, through a research-through-design approach, a second concept phase defines which guidelines to design packaging within returnable vacuum systems in new sectors and which strategies are feasible to start a transition

Relationship between Protein Oxidation Biomarkers and Uterine Health in Dairy Cows during the Postpartum Period

High neutrophil (PMN, Polymorphonuclear neutrophil) counts in the endometrium of cows affected by endometritis, suggests the involvement of oxidative stress (OS) among the causes of impaired fertility. Protein oxidation, in particular, advanced oxidation protein products (AOPP), are OS biomarkers linked to PMN activity. To test this hypothesis, the relationship between protein oxidation and uterus health was studied in thirty-eight dairy cows during the puerperium. The animals were found to be cycling, without any signs of disease and pharmacological treatments. PMN count was performed either through a cytobrush or a uterine horn lavage (UHL). Cows were classified into four groups, based on the uterine ultrasonographic characteristics and the PMN percentage in the uterine horns with a higher percentage of high neutrophil horn (HNH). They were classified as: Healthy (H); Subclinical Endometritis (SCE); Grade 1 Endometritis (EM1); and Grade 2 Endometritis (EM2). AOPP and carbonyls were measured in plasma and UHL. UHL samples underwent Western blot analysis to visualize the carbonyl and dityrosine formation. Plasma AOPP were higher (p < 0.05) in EM2. AOPP and carbonyl group concentrations were higher in the HNH samples (p < 0.05). Protein concentration in the UHL was higher in the EM2 (p < 0.05). Carbonyl and dityrosine formation was more intense in EM1 and EM2. Protein oxidation observed in the EM2 suggests the presence of an inflammatory status in the uterus which, if not adequately hindered, could result in low fertility

Perspectiva crítica da família e pessoas próximas sobre fatores de risco familiares e comunitários em relaçâo ao uso de drogas ilícitas em São José, Costa Rica

This article presents the results of a quantitative study. The purpose was to describe the perspective of family members and acquaintances of illicit drug users about family and community risk factors that can contribute to addiction to illicit drugs. A questionnaire was used for data collection. The population consisted of 100 individuals, 18 years of age or older, who reported being affected by their relationship with an illicit drug user (relative or acquaintance). Most users (82%) were men, with an average age of 27.3 years. Family risk factors included: family rejection (99%), not feeling loved (98%), lack of communication (95%), family conflicts and violence (95%). Social or community factors included: 99% having friends who use drugs, 99% peer pressure, 93% living in an unsafe area, and 99% experienced a stressful event. The critical perspective proposes to use more prevention strategies to avoid risk factors in the family and community.En este estudio se presentan los resultados de una investigación cuantitativa, parte de un estudio multicéntrico, cuyo objetivo fue describir las perspectivas que tienen la familia y las personas cercanas a usuarios de drogas ilícitas, cuestionándose sobre cuáles serían los factores de riesgo familiar y comunitario que contribuyen a la adicción de drogas ilícitas. Se encuestó a 100 sujetos mayores de 18 años, familiares o personas cercanas a sujetos que han estado usado drogas ilícitas. Se encontró que la mayoría eran hombres, con edad promedio de 27.3 años. Los factores de riesgo provenientes de la familia identificados fueron: ser rechazado 99%, sentirse no amado 98%, falta de comunicación 95%, conflictos y violencia familiar 95%. Los factores sociales o comunitarios fueron: 99% tener amigos que usan drogas, 99% presión de los amigos, 93% vivir en un área insegura y 94% experimentar un evento estresante. Se concluyó, según su perspectiva crítica, que se debe trabajar más sobre las estrategias de prevención de factores de riesgo tanto en la familia como en la comunidad.São apresentados aqui os resultados de pesquisa quantitativa, cujo objetivo foi descrever as perspectivas da família e das pessoas próximas aos usúarios de drogas ilícitas, sobre os fatores de risco familiar e comunitário que contribuem para a adição de drogas ilícitas. Utilizou-se questionário aplicado em população de 100 pessoas, maiores de 18 anos, que se identificaram como afetadas por terem relação com familiar ou pessoa próxima que usa ou têm usado drogas ilícitas. Dentre os usuários, 82% eram homens, tinham idade média de 27,3 anos. Os fatores de risco familiares foram a rejeição pela família (99%), não se sentir amado (98%), falta de comunicação (95%), conflitos e violência familiar (95%). Fatores sociais ou comunitários: 99% referem ter amigos que usam drogas, 99% pressão dos amigos, 93% pelo fato de viverem em área sem segurança e 99% por experimentar um evento estressante. A perspectiva crítica propõe trabalhar mais sobre estratégias de prevenção de fatores de risco na família e na comunidade

Familiares e pessoas conhecidas de usuários de drogas ilícitas: recorte de opiniões sobre leis e políticas públicas de uma comunidade da Zona Oeste do Rio de Janeiro, Brasil

This article is part of the study "Illicit Drug Use in Seven Latin American Countries and Canada: Critical Perspectives of Family and Familiars" (7LACC), which investigated four domains: protective and risk factors; preventive initiatives; treatment facilities; and laws and policies. The article presents a section of the results based on four items of the laws and policies domain - as perceived by the family and acquaintances of illicit drug users living in the community. Participants were recruited in urban primary health care units located in Western Rio de Janeiro (city), Brazil. This multi-method, cross-temporal study performed interviews with 100 adults (18 years of age or older), all cognitively healthy. Results and key conclusions included non-compliance with the fundamental principles of the Unique Health System Legislation / Law 8.080/90 and the erroneous implementation of laws and public policies on illicit drug.Este articulo forma parte del estudio "Uso de Drogas Ilícitas en Siete Países Latino Americanos y Canadá - Las Perspectivas Críticas de la Familia y de Personas Conocidas" (7LACC). Fueron investigados cuatro dominios: factores protectores y de riesgo; iniciativas inhibidoras; facilidades de tratamiento; y, leyes y políticas. Se presenta una sección de resultados relacionados a leyes y políticas, describiendo como ellas fueron percibidas por familiares y personas cercanas a los usuarios de drogas ilícitas, que estaban inscritos en unidades primarias urbanas de asistencia a la salud, situadas en la zona occidental de la ciudad de Río de Janeiro, en Brasil. Se trata de una investigación transversal, que utilizó múltiples métodos, en la cual fueron entrevistados 100 adultos, que tenían más de 18 años de edad, sin problemas cognoscitivos. Los resultados y las principales conclusiones fueron el incumplimiento de los principios fundamentales del Sistema Unificado de Salud (SUS) / Ley 8.080/90 y la inadecuada implementación de leyes y políticas públicas relacionadas a las drogas ilícitas.Este artigo é parte do estudo "Uso de drogas ilícitas em sete países latino-americanos e Canadá: perspectivas críticas de familiares e pessoas conhecidas" (7LACC) que investigou quatro domínios: fatores protetores e de risco, iniciativas de prevenção, unidades de tratamento e leis e políticas. Apresenta uma seção dos resultados baseados em quatro itens do domínio leis e políticas - como percebidas por familiares e pessoas conhecidas de usuários de drogas ilícitas, residentes na comunidade, recrutados em unidades urbanas de cuidados primários à saúde, localizadas na zona oeste da cidade do Rio de Janeiro. Trata-se de estudo corte temporal, multimétodos que entrevistou 100 adultos maiores de 18 anos, cognitivamente saudáveis. Resultados e conclusões chave foram o não atendimento dos princípios fundamentais da legislação do Sistema Único de Saúde (SUS)/Lei 8.080/90 e a equivocada aplicação das leis e políticas públicas sobre drogas ilícitas

Insight into the mechanism of ferroptosis inhibition by ferrostatin-1

Ferroptosis is a form of cell death primed by iron and lipid hydroperoxides and prevented by GPx4. Ferrostatin-1 (fer-1) inhibits ferroptosis much more efficiently than phenolic antioxidants. Previous studies on the antioxidant efficiency of fer-1 adopted kinetic tests where a diazo compound generates the hydroperoxyl radical scavenged by the antioxidant. However, this reaction, accounting for a chain breaking effect, is only minimally useful for the description of the inhibition of ferrous iron and lipid hydroperoxide dependent peroxidation. Scavenging lipid hydroperoxyl radicals, indeed, generates lipid hydroperoxides from which ferrous iron initiates a new peroxidative chain reaction. We show that when fer-1 inhibits peroxidation, initiated by iron and traces of lipid hydroperoxides in liposomes, the pattern of oxidized species produced from traces of pre-existing hydroperoxides is practically identical to that observed following exhaustive peroxidation in the absence of the antioxidant. This supported the notion that the anti-ferroptotic activity of fer-1 is actually due to the scavenging of initiating alkoxyl radicals produced, together with other rearrangement products, by ferrous iron from lipid hydroperoxides. Notably, fer-1 is not consumed while inhibiting iron dependent lipid peroxidation. The emerging concept is that it is ferrous iron itself that reduces fer-1 radical. This was supported by electroanalytical evidence that fer-1 forms a complex with iron and further confirmed in cells by fluorescence of calcein, indicating a decrease of labile iron in the presence of fer-1. The notion of such as pseudo-catalytic cycle of the ferrostatin-iron complex was also investigated by means of quantum mechanics calculations, which confirmed the reduction of an alkoxyl radical model by fer-1 and the reduction of fer-1 radical by ferrous iron. In summary, GPx4 and fer-1 in the presence of ferrous iron, produces, by distinct mechanism, the most relevant anti-ferroptotic effect, i.e the disappearance of initiating lipid hydroperoxides

Rationing tests for drug-resistant tuberculosis - who are we prepared to miss?

BACKGROUND: Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. METHODS: A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. RESULTS: Overall, 147/1,545 (9.5%) subjects had culture-positive TB, of which 32 (21.8%) had DR-TB (MDR, 13.6%; isoniazid mono-resistant, 7.5%; rifampicin mono-resistant, 0.7%). A total of 553 subjects (35.8%) reported one or more MDR-TB risk factors; of these, 506 (91.5%; 95% CI, 88.9-93.7%) did not have TB, 32/553 (5.8%; 95% CI, 3.4-8.1%) had drug-susceptible TB, and only 15/553 (2.7%; 95% CI, 1.5-4.4%) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2%; 95% CI, 34.7-70.9). CONCLUSIONS: Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority

El consumo de drogas y su tratamiento desde la perspectiva de familiares y amigos de consumidores en Bogotá, Colombia

En este estudio, se presenta el análisis parcial de los resultados de un trabajo cuantitativo, relacionado con la perspectiva que tienen los familiares y amigos de consumidores frente al tratamiento para los problemas derivados del consumo de drogas ilícitas. Participaron 104 usuarios de los servicios de salud de Bogotá, El 58% considera el consumo como una enfermedad que necesita tratamiento. El 56% identifica el hospital general como la principal alternativa para el mismo y, 95% al Estado como el principal responsable de este. Las instituciones privadas son las más conocidas y dentro de estas, las comunidades terapéuticas y los grupos religiosos aparecen como los que más se comprometen con la problemática. Para el 73% los servicios existentes no son suficientes y el acceso a la utilización de los mismos es difícil. El estigma es la principal barrera para solicitar la atención, solo el 50% considera que los tratamientos son útiles. Es necesaria una mayor difusión de los recursos existentes, para aumentar su demanda y utilización.O trabalho apresenta análise dos resultados parciais de um estudo quantitativo, relacionado à perspectiva de familiares e amigos dos consumidores em relação ao tratamento de problemas decorrentes do consumo de drogas ilícitas. Dos 104 participantes, usuários dos serviços de saúde, em Bogotá, 58% consideram o consumo como doença que necessita de tratamento; 56% identificaram o hospital geral como a principal alternativa para os mesmos; 95% referem que o Estado é o principal responsável por isso. Instituições privadas são as mais conhecidas, e, dentre essas, comunidades terapêuticas e grupos religiosos aparecem como os mais comprometidos com o problema. Para 73%, os serviços existentes são inadequados e tanto o uso quanto o acesso são difíceis. O estigma é a principal barreira para procurar cuidados de saúde. Apenas 50% acredita que os tratamentos são úteis. Há necessidade de maior divulgação dos recursos existentes, para que se possa aumentar a sua aplicação e utilização.This article presents an analysis of the partial results from a quantitative study that addresses the perspective of drug users' family and friends regarding the treatment of problems resulting from the use of illicit drugs. Participants were 104 health service users in Bogotá. Of the participants, 58% consider that drug use is a disease that needs treatment; 56% stated the general hospital as the main alternative for treatment; 95% reported that the state accounted for this situation. Participants were more acquainted with private institutions, with therapeutic communities and religious groups being reported as the ones with the strongest commitment to the problem. For 73% of participants, the existing services are inappropriate and of difficult use and access. Stigma is the main barrier for a person to seek health care, and only 50% believe there is any use in treatments. There is a need for broader dissemination of the existing resources so as to increase their implementation and use

Aspectos legales del uso de drogas ilícitas en México

The objective of this cross-sectional, descriptive study was to obtain the opinions of a group of people about legal issues regarding addiction. Data collection was performed using a structured questionnaire with four themes. In order to participate, the individual could not use any drugs but should have a close relationship with a drug user. The data was processed using SPSS V. 14. There were 100 participants, 75% of whom were women, and 38% had a drug user as a friend, mainly cocaine and marijuana users. The participants had one opinion in common: laws should be more severe for people who use, sell, or transport drugs. The current laws do not improve consumers' criminal behavior. There is a need for further studies addressing people's opinion about this phenomenon in order to obtain a more realistic view of this drug issue.Este estudo teve como objetivo conhecer as opiniões de um grupo de pessoas sobre questões jurídicas no domínio dos vícios. É estudo transversal, descritivo. Para o levantamento, foi utilizado um questionário estruturado com quatro temas. Um dos critérios para a participação era de que a pessoa não usasse drogas e que tivesse alguém próximo que usasse. Os dados foram processados usando SPSS V. 14. Participaram 100 indivíduos, dos quais 75% eram do sexo feminino, 38% tinham relação amigável com um usuário de drogas ilícitas, principalmente consumidores de maconha e cocaína. Como opinião geral sugeriram que as leis deviam ser mais punitivas para aqueles que consomem, vendem ou transportam drogas. As leis vigentes não melhoram o comportamento criminoso dos consumidores. É importante conduzir estudos de opinião sobre o fenômeno para que se possa ter visão mais realista do problema do consumo de droga.El objetivo del estudio fue conocer las opiniones de un grupo de personas sobre aspectos legales en materia de adicción. Se trata de un estudio descriptivo transversal; se aplicó una encuesta estructurada, formada por 4 apartados. Uno de los criterios para participar fue que la persona no consumiera drogas y que conociera a alguien cercano que las consumía. Los datos obtenidos se procesaron en el paquete estadístico SPSS V. 14. Participaron 100 sujetos, en el cual, 75% eran del género femenino, 38% tenían una relación de amistad con un usuario de drogas ilícitas, el cual consumía mayoritariamente marihuana y cocaína. Como opinión general, se sugiere que las leyes sean más rigurosas para quienes consumen, venden o transportan drogas. Las leyes actuales no mejoran la conducta criminal de los consumidores. Es importante realizar otros estudios, de opinión sobre este fenómeno, que puedan ofrecer una visión más real del problema de las drogas