Uso de drogas entre trabalhadores de regiões do Brasil

OBJECTIVE: Many business organizations in Brazil have adopted drug testing programs in the workplace since 1992. Rehabilitation, rather than layoff and disciplinary measures, has been offered as part of the Brazilian employee assistance programs. The purpose study is to profile drug abuse among company workers of different Brazilian geographical regions. METHODS: Urine samples of 12,700 workers from five geographical regions were tested for the most common illicit drugs of abuse in the country: marijuana, cocaine, and amphetamine. Enzyme multiplied immunoassay technique (EMIT) and gas chromatography coupled with mass spectrometry (GC/MS) were the techniques utilized for urine testing. The distribution of collected urine samples according to geographical regions was: 72.0% southeast, 13.8% northeast, 7.9% south, 5.7% central west and 0.6% north. RESULTS: Of all samples analyzed, 1.8% was found to be positive for drugs: 0.5% from the south region, 1.1% from northeast, 1.2% from central west, 1.3% from north, and 2.2% from southeast. Of these, 59.9% was marijuana, 17.7% cocaine, 14.6% amphetamine, and 7.7% associated drugs. CONCLUSIONS: The distribution of drugs found in the samples shows a regional variation. Marijuana, however, was found in all regions. Cocaine was seen only in central west and southeast regions. Amphetamine was found in northeast, central west, and southeast regions.OBJETIVO: No Brasil, desde 1992, inúmeras empresas comerciais e industriais vêm adotando programas de controle do uso de drogas de abuso no ambiente de trabalho. Nenhuma medida disciplinar ou demissionária é tomada sem antes se tentar a reabilitação do funcionário. O objetivo do estudo é apresentar o perfil do uso de drogas de abuso entre trabalhadores de diferentes empresas brasileiras. MÉTODOS: Amostras de urina de 12.700 indivíduos provenientes das cinco regiões geográficas brasileiras foram analisadas visando à detecção das principais drogas de abuso utilizadas no País: cocaína, maconha e anfetamina. A técnica de enzimaimunoensaio (EMIT) foi usada como análise de triagem para as substâncias pesquisadas. A confirmação dos resultados foi realizada pela espectrometria de massa associada à cromatografia em fase gasosa (GC/MS). A distribuição das amostras de acordo com as regiões geográficas foi: 72,0% foram coletadas na região Sudeste, 13,8% no Nordeste, 7,9% originaram-se na região Sul, 5,7% no Centro-Oeste e 0,6% na região Norte. RESULTADOS: Os resultados obtidos foram: 1,8% de todas as amostras analisadas foram positivas para a presença de drogas de abuso, sendo que 0,5% eram provenientes da região Sul, 1,1% da região Nordeste, 1,2% do Centro-Oeste, 1,3% da região Norte e 2,2% do Sudeste. A freqüência com que as diferentes drogas foram encontradas foi: 59,9% para maconha, 17,7% para cocaína, 14,6% para anfetamina e 7,7% para drogas em associação. CONCLUSÕES: A distribuição das drogas de abuso detectadas apresentou variações regionais. A maconha foi encontrada nas amostras de todas as regiões; a cocaína estava presente somente em amostras oriundas das regiões Centro-Oeste e Sudeste. A anfetamina foi detectada nas amostras provenientes do Nordeste, Centro-Oeste e Sudeste

Counterfeit medicines: relevance, consequences and strategies to combat the global crisis

Counterfeiting of medicines, also known as “falsification” or “adulteration”, is the process in which the identity, origin, or history of genuine medicines are intentionally modified. Currently, counterfeit medicines are a global crisis that affects and is mostly caused by developing countries in Asia, Africa and Latin America. These countries lack strict law enforcement against this practice and have low-income populations with medicinal needs. Lately, the crisis has escalated, impacting developed countries as well, e.g., the US and the EU, mainly via the Internet. Despite this extension, some current laws aim to control and minimize the crisis’ magnitude. Falsification of medicines maintains an illegitimate supply chain that is connected to the legitimate one, both of which are extremely complex, making such falsification difficult to control. Furthermore, political and economic causes are related to the crisis’ hasty growth, causing serious consequences for individuals and public health, as well as for the economy of different countries. Recently, organizations, technologies and initiatives have been created to overcome the situation. Nevertheless, the development of more effective measures that could aggregate all the existing strategies into a large functioning network could help prevent the acquisition of counterfeit medicines and create awareness among the general population

Ethanol-induced sensitization depends preferentially on D-1 rather than D-2 dopamine receptors

Behavioral sensitization, defined as a progressive increase in the locomotor stimulant effects elicited by repeated exposure to drugs of abuse, has been used as an animal model for drug craving in humans. the mesoaccumbens dopaminergic system has been proposed to be critically involved in this phenomenon; however, few studies have been designed to systematically investigate the effects of dopaminergic antagonists on development and expression of behavioral sensitization to ethanol in Swiss mice. We first tested the effects of D-1 antagonist SCH-23390 (0-0.03 mg/kg) or D-2 antagonist Sulpiride (0-30 mg/kg) on the locomotor responses to an acute injection of ethanol (2.0 g/kg). Results showed that all tested doses of the antagonists were effective in blocking ethanol's stimulant effects. in another set of experiments, mice were pretreated intraperitoneally with SCH-23390 (0.01 mg/kg) or Sulpiride (10 mg/kg) 30 min before saline or ethanol injection, for 21 days. Locomotor activity was measured weekly for 20 min. Four days following this pretreatment, all mice were challenged with ethanol. Both antagonists attenuated the development of ethanol sensitization, but only SCH-23390 blocked the expression of ethanol sensitization according to this protocol. When we tested a single dose (30 min before tests) of either antagonist in mice treated chronically with ethanol, both antagonists attenuated ethanol-induced effects. the present findings demonstrate that the concomitant administration of ethanol with D-1 but not D-2 antagonist prevented the expression of ethanol sensitization, suggesting that the neuroadaptations underlying ethanol behavioral sensitization depend preferentially on D-1 receptor actions. (C) 2010 Elsevier Inc. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Univ São Paulo, Inst Ciencias Biomed, Dept Farmacol, BR-05508900 São Paulo, BrazilUniv São Paulo, Fac Ciencias Farmaceut, BR-05508900 São Paulo, BrazilUniv Fed ABC, Ctr Matemat Comp & Cognicao, Santo Andre, SP, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psicobiol, São Paulo, BrazilWeb of Scienc

Organophosphate and carbamate poisonings in the northwest of Paraná state, Brazil from 1994 to 2005: clinical and epidemiological aspects

No presente estudo são apresentados aspectos clínicos e epidemiológicos de 529 casos de intoxicação por inseticidas organofosforados e carbamatos ocorridos na região noroeste do Estado do Paraná, Brasil, no período de 1994 a 2005. A saber, 105 pessoas de 257 pacientes (40,8%) que tentaram suicídio foram admitidas na Unidade de Tratamento Intensivo (UTI), com média de estadia hospitalar de 2 dias (de 1 a 40 dias). Pacientes do sexo masculino corresponderam a 56,4% dos casos de tentativa de suicídio e 16 indivíduos morreram. Todos os 140 pacientes intoxicados devido à exposição ocupacional eram adultos e 9 foram admitidos na UTI, com média de estadia hospitalar de 8 dias (de 1 a 16 dias). Destes casos, 2 pacientes faleceram. Dos 124 pacientes intoxicados devido à exposição acidental, a maioria era crianças e teve uma média de estadia hospitalar de 4 dias. Foram admitidos 20 pacientes na UTI e um morreu. Complicações gerais incluíram insuficiência respiratória, convulsões e pneumonia. A ingestão deliberada de organofosforados e carbamatos foi muito mais grave do que a intoxicação em decorrência da exposição ocupacional ou acidental. Homens na faixa de 15 a 39 anos foram os mais prováveis de tentar suicídio com esses agentes e tiveram admissões mais prolongadas na UTI com significativas complicações e mortalidade.In the present study, clinical and epidemiological aspects of 529 intoxication cases of organophosphate or carbamate pesticides in the northwest of the state of Paraná, Brazil, over a twelve-year period (1994-2005), are presented. One hundred-five of 257 patients (40.8%) who attempted suicide were admitted to Intensive Care Units (ICUs), with an average hospital stay of two days (range 1-40 days). Men corresponded to 56.4% of the cases of suicide attempts and sixteen individuals died. One hundred-forty patients intoxicated due to occupational exposure were all young adults and nine of them were admitted to ICU, with average hospital stays of eight days (range 1-16 days). Of these cases, two patients died. One hundred twenty-four patients intoxicated due to accidental exposure were mainly children and had a hospital average stay of four days. Twenty patients were admitted to the ICU, and one of them died. Overall complications included respiratory failure, convulsions, and aspiration pneumonia. Deliberate ingestion of organophosphates and carbamates was much more toxic than occupational and accidental exposure. Men aged 15-39 years were the most likely to attempt suicide with these agents and had more prolonged ICU with significant complications and mortality

Evaluation of artificial drug incorporation into hair for the production of quality control samples

Hair analysis is thoroughly used in forensic toxicology although there are still some points of concern such as lack of reference material, whether for internal quality controls (IQC) or even for analytical validation process verification. Nonetheless spiked samples are still widely used, mainly for method development, it is not possible to evaluate its actual reproducibility and accuracy. As an alternative, IQC could be produced artificially by the laboratories themselves. The aim of this work was the evaluation of the phenomenon of artificial incorporation of drugs into hair to produce internal quality controls. These controls have been prepared according to the recommendations from the National Institute of Standards and Technology. For the amphetamine group, amphetamine and MDMA, showed different incorporation rates, of 0.17 up to 0.5% for amphetamine and 0.10 up to 0.4% for MDMA. As for cocaine, the incorporation rate was progressive over the course of days, ranging from 0.15 to 0.75%. The highest incorporation was found for diazepam, from 0.57%. to 3.75%. Lower rates were obtained for morphine, ranging from 0.08 to 0.25%, given that the incorporation rate of 0.25% has been reached on the ninth day. Some factors such as incubation time, agitation process and sample washing probably influenced the way analytes incorporate into the matrix including the effects of homogenization of the samples. Overall, knowing the incorporation profile of each analyte it is possible to produce IQC, with different concentrations. Thus, laboratories will have the fortified samples as a better tool for evaluating their own methodology

Validação de método para determinação de 3,4-metilenodioximetanfetamina (MDMA) em comprimidos de ecstasy por cromatografia em fase gasosa

O ecstasy é comercializado, de maneira ilegal, normalmente sob a forma de comprimidos, com cores, aspectos, dimensões e logotipos variados. Quimicamente, é a metilenodioximetanfetamina (MDMA), um composto sintético com propriedades estimulante central e alucinogênicas. Devido à grande expansão do abuso de ecstasy, também tem aumentado o número de casos de intoxicações, decorrentes diretamente da droga (MDMA e análogas) e/ou de eventuais adulterantes. Algumas substâncias análogas à MDMA, já identificadas em comprimidos de ecstasy são: metilenodioxietilanfetamina (MDEA), metilenodioxianfetamina (MDA), metanfetamina e anfetamina. Como possíveis adulterantes, geralmente são encontradas cafeína e efedrinas. O objetivo deste trabalho foi a validação de um método analítico para quantificar a MDMA em comprimidos ou cápsulas de ecstasy, através da cromatografia em fase gasosa com detector de nitrogênio/fósforo (GC/NPD). Além disso, substâncias análogas à MDMA e adulterantes também foram identificados. O método, que consiste na dissolução direta da amostra em metanol, centrifugação e diluição do sobrenadante, demonstrou ser simples, rápido e eficiente. Os limites de detecção e quantificação para a MDMA foram respectivamente de 1,5 e 3,0 mg/100 mg de comprimido. Amostras de comprimidos e cápsulas apreendidos como sendo ecstasy provenientes de 25 lotes foram analisadas, apresentando considerável variabilidade na composição e na quantidade de MDMA.Ecstasy is illegally commercialized in the form of tablets with different aspects, colors, sizes, and logotypes. Chemically, ecstasy is 3,4-methylenedioxymethamphetamine (MDMA), a synthetic compound with stimulant and hallucinogenic proprieties. Due to the great expansion of ecstasy abuse, the number of cases of intoxications by MDMA, analogs and eventual adulterant compounds has also increased. Some MDMA analog substances, such as 3,4-methylenedioxyethylamphetamine (MDEA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine and amphetamine have already been identified in ecstasy tablets. Caffeine and ephedrines are the most common adulterants also found. The aim of this paper is to describe the validation of an analytical method to quantify MDMA in ecstasy tablets and capsules. Gas-chromatography with nitrogen/phosphorous detector was used in the method, which consisted in the direct dissolution of the sample in methanol, centrifugation and convenient dilution of the supernatant. Analog substances to MDMA and adulterants were also identified. The limits of detection and quantification (LOQ and LOD) for MDMA were 1.5 and 3.0 mg/100 mg of tablet. Samples from 25 lots of tablets seized in the city of São Paulo were analyzed showing a considerable variability in composition and quantity of MDMA

Determinação de efedrinas em urina por cromatografia em fase gasosa (CG/DNP) para o controle da dopagem no esporte

Ephedrines are sympathomimetic amines present in many pharmaceutical preparations used in the treatment of respiratory diseases due to their actions against broncospasm and congestion. Nowadays, several products sold as nutritional supplements contain ephedrines and are widely used in a diverse range of sports as weight loss aids and enhancement of athletic performance. However, the abuse of ephedrines may lead to a number of adverse effects including hypertension, headache, tachycardia and seizure. Due to their CNS stimulating action, ephedrines are included in the prohibited list of substances by the International Olympic Committee (IOC). Urinary threshold concentrations were established (ephedrine and methylephedrine >;10 µg/mL). The aim of this work was to develop and validate a method for the simultaneous determination of ephedrines present in urine samples for doping purposes by gas chromatography with nitrogenous-phosphorous detector (GC/NPD). The method was based on a liquid-liquid extraction of alkalinized urine and further derivatization with trifluoroacetic anhydride (TFA). The validated method showed to be simple, practical and linear at the studied concentrations range. Urine samples collected from volunteers, who reported the use of ephedrines, were submitted to the proposed method.Efedrinas são aminas simpatomiméticas componentes de diversas especialidades farmacêuticas, utilizadas no tratamento de doenças respiratórias devido à sua ação descongestionante e broncodilatora. Atualmente, diversos produtos comercializados como suplementos nutricionais contêm efedrinas e são amplamente utilizados no meio esportivo, com o objetivo de facilitar a queima de gorduras e melhorar o desempenho. Entretanto, o uso indiscriminado destas substâncias pode acarretar série de efeitos tóxicos como hipertensão, taquicardia, cefaléia e tremores. Devido à sua ação psicoestimulante, foram incluídas na lista de substâncias proibidas nas atividades esportivas pelo Comitê Olímpico Internacional (COI) e estabelecidas concentrações na urina para o controle da dopagem (efedrina e metilefedrina: 10 µg/mL). O presente trabalho teve como objetivo a validação de um método para quantificação de efedrinas, por cromatografia em fase gasosa acoplada a detetor de nitrogênio/fósforo (CG/DNP), em amostras de urina com a finalidade de controle da dopagem. O método consistiu em extração líquido-líquido e posterior derivação das efedrinas com anidrido trifluoroacético, e demonstrou ser simples e prático, apresentando linearidade nas faixas de concentração estudadas. Amostras de urina de voluntários que relataram uso de efedrinas foram submetidas à análise pelo método proposto

Late hyaluronidase injection in local anesthesia : morphofunctional evaluation in rat sciatic nerve block

Introduction: Despite the enhancing effects of hyaluronidase (HYAL) over duration of anesthesia, this enzyme could cause adverse effects when injected concomitantly with local anesthetics in dental blocks. Objective: This study aimed to assess the tissue alterations caused by a local anesthetic protocol consisting of a late HYAL injection and confirm its functional effectiveness. Materials and Methods: The protocol efficacy was proved by evaluating sensory and motor functions in rats. The sciatic nerve was blocked with 2% lidocaine (LID) with epinephrine (n = 25). Thirty minutes later, 75 TRU/ml HYAL was injected into the same site (experimental group, LID/HYAL). One week later, this protocol was repeated in the contralateral hindlimb, injecting only HYAL’s vehicle (control group, LID/vehicle [LID/V]). To observe the integrity of the local tissues, histological specimens were obtained 1, 24, 48, and 72 h after treatment with LID/HYAL or LID/V (n = 16 each) and stained with hematoxylin/eosin and picrosirius red. Results: Local inflammation was similar in both groups. The integrity of the nerve fibers was preserved, in spite of some inflammation‑associated injuries in the surrounding tissues. The reversible tissue disorganization caused by HYAL, probably facilitated the diffusion of the residual anesthetic to the nerve, resulting in a prolonged anesthetic effect (P < 0.05). Conclusions: No irreversible morphological alterations are caused by the administration of HYAL prior the end of the LID‑induced block. Moreover, this protocol prolongs LID’s anesthetic effect