Drug Consumption Research Articles

The Connection Between Drug-Related Detentions and Drug-Related Violence: Another Failure of the War on Drugs in Mexico

ABSTRACT This paper analyses the relationship between drug-related detentions for possession or petty dealing and drug-related violence. Two theoretical mechanisms are explored: (i) when a dealer is detained, the market is disrupted, and competition increases; (ii) when a consumer is detained, other consumers are deterred and seek new dealers, generating competition among groups and, consequently, increasing violence. These hypotheses are quantitatively evaluated using geocoded data from local San Luis Potosí, Mexico markets. Results suggest a relationship between drug-related violence and detentions occurring in a nearby location. These results emphasize the inefficacy of drug law enforcement strategies for reducing violence related to illegal drug markets in local settings and open the discussion for exploring different policies to reduce violence related to organized crime and the harms associated with illegal drug consumption.

Describing the effect of COVID-19 on sexual and healthcare-seeking behaviours of men who have sex with men in three counties in Kenya: a cross-sectional study

BackgroundWhile the COVID-19 pandemic disrupted HIV preventative services in sub-Saharan Africa, little is known about the specific impacts the pandemic has had on men who have sex with men (MSM)...

Comparison of propofol versus dexmedetomidine sedation for awake C-MAC® D-Blade video laryngoscopic nasotracheal intubation in patients with difficult airway: A randomised clinical study.

Awake intubation is the preferred method for securing difficult airways. We compared intravenous (IV) propofol and dexmedetomidine for C-MAC® D-blade-guided anticipated difficult nasotracheal intubation under conscious sedation. This randomised study included 60 patients with difficult airway (El-Ganzouri Score 4-9). After adequate airway preparation with IV midazolam 0.03 mg/kg and IV fentanyl 1 µg/kg, in Group P, propofol was infused at 250 µg/kg/min and in Group D, dexmedetomidine was infused at 1 μg/kg over 10 min, then at 0.5 μg/kg/h till a bispectral index (BIS) value 65-70 was achieved. Patients underwent C-MAC® D-blade video laryngoscope-guided nasotracheal intubation. The intubation score was the primary outcome measure. Secondary outcome measures included haemodynamic parameters, intubation time, number of attempts, the incidence of failed awake intubation, glottic view, time to achieve desired BIS, complications, study drug consumption and patient-reported satisfaction with the awake intubation technique. Quantitative variables were compared between groups using unpaired t-test/Welsch test/Mann-Whitney Test. Qualitative variables were correlated using the Chi-square test/Fisher's exact test. A P value of <0.05 was considered statistically significant. The intubation score was significantly higher in Group D versus Group P (P = 0.007). Patient reaction to intubation, haemodynamic parameters and percentage of glottis opening score were more favourable in Group P. Coughing and vocal cord movement were comparable between the groups (P > 0.05). The time to target BIS was four times longer, and the time to intubate was 6 seconds longer in Group D. Successful awake C-MAC® D-blade video laryngoscopic intubation can be performed under dexmedetomidine/propofol conscious sedation, with propofol giving a better intubation score.

Nationwide assessment of illicit drug consumption patterns in South Korea using wastewater-based epidemiology during the COVID-19 pandemic (2020–2022)

Illicit drugs have become a crucial global social issue, with South Korea experiencing a continuous increase in the number of offenders and drug smuggling. This study employed wastewater-based epidemiology to investigate consumption patterns of 8 illicit drugs and their 7 metabolites during the COVID-19 pandemic (2020–2022) in South Korea. Ten compouds were detected in the wastewater influent. Methamphetamine (METH) was prevalent in samples, followed by amphetamine and ecstasy (MDMA). Interestingly, MDMA and ketamine (KET), which were not detected in previous Korean studies conducted before COVID-19 pandemic, were detected in this study. METH exhibited the highest consumption rates, decreasing from 16.6 to 12.4 mg/day/1000 people between 2020 and 2022, while MDMA increased over the three years (mean: 1.16, 1.24, and 1.62 mg/day/1000 people in 2020, 2021, and 2022, respectively) (p < 0.05). Significant correlations were identified between regional income levels and the consumption rates of METH (p < 0.01), MDMA (p < 0.01), and KET (p < 0.05). Furthermore, METH and MDMA consumption rates in cities were positively correlated with the number of drug offenders arrested and local clubs in those cities. The findings of this study provide valuable insights into shaping regulatory policies related to illicit drugs and future studies.

Exposure assessment of titanium dioxide via drugs available on the French market: A nationwide descriptive study

Based on potential adverse health effects including genotoxicity concerns, the European Union banned titanium dioxide (TiO2) as a food additive in 2022, but food-grade TiO2 can still be used in pharmaceutical products. This study described the presence of TiO2 in drugs available on the French market and estimated the population exposure to TiO2 through drug consumption. We used annual drug claim data aggregated at the national level together with data on the TiO2 content of pharmaceutical products available on the French market in 2001-2020. Of the 17171 pharmaceutical specialties identified on the French market between 2001 and 2020, 38% contained TiO2. That figure reached 95% for capsules, 92% for film-coated tablets, 74% for coated tablets and 66% for soft capsules. Only 1% of non-oral specialties contained TiO2. The median TiO2 amount in one common dispensing unit was 1.5mg for oral specialties containing TiO2. We estimated that the mean exposure to TiO2 per inhabitant through the consumption of reimbursed drugs between 2012 and 2020 was 1.71mg per day, with women (1.81mg/d) slightly more exposed than men (1.54mg/d) and people older than 59 years (4.00mg/d) much more exposed than younger people (1.24 and 0.21mg/d for 20-59 and<20 years old individuals, respectively). This study highlights a widespread presence of TiO2 in drugs on the French market. The health impact of exposure to TiO2 through drug consumption should be evaluated in future epidemiological studies.

The ReCoDe addiction research consortium: Losing and regaining control over drug intake-Findings and future perspectives.

Substance use disorders (SUDs) are seen as a continuum ranging from goal-directed and hedonic drug use to loss of control over drug intake with aversive consequences for mental and physical health and social functioning. The main goals of our interdisciplinary German collaborative research centre on Losing and Regaining Control over Drug Intake (ReCoDe) are (i) to study triggers (drug cues, stressors, drug priming) and modifying factors (age, gender, physical activity, cognitive functions, childhood adversity, social factors, such as loneliness and social contact/interaction) that longitudinally modulate the trajectories of losing and regaining control over drug consumption under real-life conditions. (ii) To study underlying behavioural, cognitive and neurobiological mechanisms of disease trajectories and drug-related behaviours and (iii) to provide non-invasive mechanism-based interventions. These goals are achieved by: (A) using innovative mHealth (mobile health) tools to longitudinally monitor the effects of triggers and modifying factors on drug consumption patterns in real life in a cohort of 900 patients with alcohol use disorder. This approach will be complemented by animal models of addiction with 24/7 automated behavioural monitoring across an entire disease trajectory; i.e. from a naïve state to a drug-taking state to an addiction or resilience-like state. (B) The identification and, if applicable, computational modelling of key molecular, neurobiological and psychological mechanisms (e.g., reduced cognitive flexibility) mediating the effects of such triggers and modifying factors on disease trajectories. (C) Developing and testing non-invasive interventions (e.g., Just-In-Time-Adaptive-Interventions (JITAIs), various non-invasive brain stimulations (NIBS), individualized physical activity) that specifically target the underlying mechanisms for regaining control over drug intake. Here, we will report on the most important results of the first funding period and outline our future research strategy.

Amphetamine-like substances and synthetic cathinones in Portuguese wastewater influents: Enantiomeric profiling and role of suspended particulate matter

Wastewater based epidemiology (WBE) has been used worldwide to estimate drug consumption routinely. Even though WBE provides valuable data to support legal and health interventions associated to drug use, monitoring studies in Portuguese wastewaters are scarce. Hence, this work aimed to estimate the consumption of some conventional abuse and illicit drugs such as amphetamine (AMP), methamphetamine (MAMP), 3,4-methylenedioxymethamphetamine (MDMA), and the synthetic cathinones buphedrone (BPD), butylone (BTL), 3,4-dimethylmethcathinone (3,4-DMMC) and 3-methylmethcathinone (3-MMC), considering not only the liquid phase, but also the suspended particulate matter (SPM). Moreover, the enantiomeric profiling of the samples was studied, exploring for the first time the possible enantioselective sorption of these drugs onto SPM. For that, 24 h composite raw wastewaters were collected from a conventional wastewater treatment plant (WWTP) in Portugal. After extraction, the liquid phase and SPM extracts were derivatized with an enantiomerically pure reagent and then, analysed using a gas chromatography-mass spectrometry (GC-MS) analytical method. The results showed a low and non-enantioselective adsorption to SPM at environmental relevant levels. Only (S)-AMP was detected in two SPM samples, whereas AMP, MAMP, MDMA, BPD, and 3,4-DMMC were detected in the liquid phase. AMP was the most frequently found drug with an estimated load up to 166.0 mg day−1 1000 people−1 and mostly found with enrichment of (S)-AMP. Nevertheless, (R)-AMP was also determined, which may be related to the consumption of either the illicit racemic AMP or the medicine (R)-deprenyl. The use of MDMA, MAMP and synthetic cathinones (BPD and 3,4-DMMC) was also suggested in Portugal. Nevertheless, the levels and the consumption estimate of the target chemicals were lower than in other European countries or worldwide. These findings provide the first step to the implementation of WBE monitoring campaigns to assess the status of drug consumption in Portuguese communities, contributing to the understanding of drug use patterns and trends worldwide and helping enforce preventive measures.

Quality of Life and its Associated Factors Among the Elderly Community Dwellers in Rural Bihar – A Community-Based Cross-Sectional Study from Eastern India

Background: Aging, longevity, advanced health care, and demographic transition have altered the quality of life (QOL) among the elderly. This study was planned to assess the QOL among the elderly and the associated factors in rural Bihar. Methods: This community-based cross-sectional study among 395 elderlies residing in rural Bihar adopted a multistage sampling technique and a standard WHO-QOL BREF tool to assess the QOL. A multivariable linear regression analysis was performed and an adjusted beta-coefficient was reported to determine the factors determining the QOL. Results: A total of 33 [8.4% (95% CI: 6-11.5%)] out of 395 elderlies had poor QOL. Age [adjusted B= -0.19 (-0.3 to -0.07)], Females [adjusted B= -1.89 (-3.5 to -0.25)], No. of drugs consumed [adjusted B=1.7 (0.4 to 2.99)], presence of any of the comorbidity [adjusted B=-5.9 (-10.8 to -1.1)], presence of Polymorbidity [adjusted B=-3.5 (-6.6 to -0.4)] were found to be independent correlates of QOL scores among elderly. Conclusion: Almost one in ten elderlies had poor QOL. The physical domain of QOL was affected the most among all the domains. Increasing age, female gender, presence of any co-morbidity, presence of poly-morbidity, and more drug consumption were associated with decreasing QOL scores among the elderly.

Educational intervention on sexual violence to empower university students in developing healthy affective-sexual relationships

IntroductionSexual violence (SV) is frequent in universities, and a link has been demonstrated between SV and toxic substance use by university students in leisure settings. In Spain there is little scientific evidence in this regard, and SV prevention programmes are practically non-existent in Spanish universities. ObjectivesTo develop, implement, and evaluate an educational awareness-raising intervention regarding SV aimed at empowering university students to develop healthy affective-sexual relationships. MethodsParticipatory action research intervention, implemented with a convenience sample of students recruited in a public university and qualitatively evaluated using a phenomenological approach. ResultsThe sample was composed of 22 women students, whose discourse revealed that SV acts are normalized in university leisure settings featured by the consumption of alcohol and other drugs. Post-intervention, the participants showed an increased understanding of SV, a heightened awareness of SV, and a greater capacity to identify SV acts. The intervention empowered the participants in terms of coping with SV situations and in raising awareness in their own social circles. ConclusionsThe intervention changed the participants' attitudes and behaviours regarding SV, empowering them not only regarding their own affective-sexual relationships, but also in censoring attitudes and behaviours that foster SV, and in transmitting their acquired knowledge of SV in their social circles. Post-intervention, the participants considered themselves to be agents of social change in their environment and in terms of healthy affective-sexual relationships. Public contributionUniversity students participated in and evaluated an intervention that trained them to identify and to censor attitudes and behaviours that promote SV, empowered them as engines of social change, and showed them how to foster healthy affective-sexual relationships.

Design and synthesis of magnesium and palladium hybrid nanoparticles using Cyperus rotundus: An assessment of antimicrobial and anticancer applications

Multidrug resistance is an instance of the increased use of traditional drug therapy, which includes the consumption of antibiotics and anticancer drugs. It will take alternative treatments to overcome this obstacle. Nanoparticles that are biosynthesized are extensively used to address a range of illnesses. This study aims to investigate the aqueous extracts of Cyperus rotundus used to biosynthesis hybrid nanoparticles using magnesium (Mg) and palladium (Pd) nanoparticles (NPs). Herein, different characterization techniques are used to the reveal desired physiochemical properties and potential biomedical applications of the biosynthesized NPs. With the use of centre composite design (CCD), the most significant parameters and their interactions that are likely to affect nanoparticle synthesis were assessed and identified in order to improve the quality of the experiments. The Mg/Pd NPs exhibit exerting antimicrobial activity against Gram positive and Gram negative bacterial and fungal pathogens. Significant anticancer activity was observed in the biogenic hybrid NPs against the human hepatocellular carcinoma (HuH-7) cell line. In silico molecular docking studies confirmed strong binding interactions of D-Glucose cyclic 1, 2-ethandiylmercaptal pentaacetate compound with the HuH-7 cancer cell line, as well as with EGFR tyrosine kinase inhibitor resistance and Bcl2 gene target proteins. The findings also point to intriguing possibilities for incorporating C. rotundus extract-assisted hybrid nano-biosynthesis, which is crucial for developing cutting-edge nanomedicines.

Innovative disposable pipette extraction for concurrent analysis of fourteen psychoactive substances in drug users’ sweat

Widespread consumption of drugs of abuse worldwide has caused concern: it adversely affects public health, individual safety, and social structures. Experts are particularly alarmed because new psychoactive substances have been increasingly detected in biological samples. In recent years, several studies have focused on developing methods to identify psychoactive substances in alternative biological matrices, such as sweat. This approach holds promise for monitoring substance use, especially in individuals undergoing rehabilitation. Among the commonly employed analytical procedures, extraction using disposable DPX tips stands out as a novel, miniaturized, and promising technique. This study aimed to validate and to apply a method to analyze various substances, including amphetamine, methamphetamine, MDMA, MDA, MDEA, cocaine, cocaethylene, anhydroecgonine methyl ester, dibutylone, N-ethylpentylone, 25E-NBOMe, 25CNBOMe, 2CC, 2C-E, fentanyl, and carfentanil, in sweat samples simultaneously. In this method, sweat is collected by using laboratory-developed patches, and extraction is conducted with DPX-SCX tips. Gas chromatography coupled to mass spectrometry is employed to separate, to identify, and to quantify the analytes. Validation results indicated that the quantification limit ranged from 2 to 30 ng of analyte/patch, and that the method was linear for analyte concentrations ranging from 2 to 1100 ng/patch. The validated method was applied to analyze 30 sweat samples collected from volunteers drug users and processed by using both the selected ion mode (SIM) and full scan. The method was able to detect and to quantify substances such as cocaine, cocaethylene, anhydroecgonine methyl ester, MDMA, MDA, nicotine, cotinine, caffeine, procaine, lidocaine, and ethylamphetamine simultaneously. The recovery rates ranged from 72.4 % to 97.1 %. The analytes were stable in the biological matrix. In conclusion, the validated method proved effective and allowed the target analytes to be quantified in sweat samples, highlighting that sweat is a viable matrix for analyzing drugs of abuse.

A Questionnaire to Evaluate Undergraduate Students' Consumption and Awareness of Non-Steroidal Anti-Inflammatory Drugs in Syria

This study aims to evaluate the level of awareness and consumption of NSAIDs among college undergraduate students in Syria. 60.1% of 309 participants were between 20 and 25 years old. 64.1% were females. 27.6% were medical college students. NSAID consumption was very high among participating students. 94.9% have used these drugs. 65.9% admit taking these medications between 2 to 10 times per month. Most participants prefer to take tablets and capsules (93.8%), especially for relieving pain (84.6%). The first choice of NSAIDs among students was ibuprofen 36.6%, then diclofenac 25.3%. 69.1% have not experienced any side effects as a result of taking NSAIDs. The study findings showed that the level of awareness among participants about NSAIDs was good since about 76% of participants have taken NSAIDs after food. However, most participants used NSAIDs without consulting a doctor or a pharmacist every 8 hours. In addition, some of them mentioned antibiotics as an example of NSAIDs. The college students who participated in this survey have a general knowledge of NSAIDs. Medical college students are more aware of the side effects, safety, and dosage of NSAIDs.

Terapi Non Farmakologi dalam Pengendalian Tekanan Darah pada Pasien Hipertensi

Changes in the pattern of communicable diseases to non-communicable diseases are classified as non-communicable diseases that do not cause scanning effects on other people and are a major factor in disorders of the blood vessels and chronic kidney disease, namely hypertension. Consumption of antihypertensive drugs continuously for a long time is not controlled and can increase the occurrence of Drug Related Problems (DRP). DRP is an effect experienced by the patient due to the involvement of the choice of treatment therapy used by the patient and is actually able to have an impact on the patient's condition such as non-adherence to drug consumption, drug side effects, or allergies that arise due to the drug consumed. This is proof that other alternative therapies are needed that are able to reduce the risk of dependence on drugs in maintaining the quality of life of people with hypertension, so the authors made a Literature Review on "Non-Pharmacological Therapy in Controlling Blood Pressure in Hypertensive Patients". To find out non-pharmacological therapy in controlling blood pressure in hypertensive patients. This type of research uses Literature Review with a Narrative Review approach. Where the database used is Clinical Key, Google Scholar, NCBI, textbook, MedScape, WHO, and data from the Indonesian Ministry of Health. Based on a Literature Review of the 12 articles analyzed in the study, it was stated that non- pharmacological therapy for hypertension is proven to be an alternative to lowering blood pressure through various means such as lifestyle interventions, biofeedback techniques, foot reflexology, slow deep breathing exercises, consumption various herbal plants to reduce the side effects of consuming synthetic drugs. Non-pharmacological therapy for hypertensive patients can reduce blood pressure with various methods.

Rare presentation of drug-induced oral erythema multiforme and its management: a case report

Aim. This case report discusses a rare variant of drug-induced erythema multiforme, focusing on its clinical features, diagnosis, and management. Background. Drug-induced erythema multiforme (DI-EM) is a hypersensitivity reaction occurring due to exposure to certain medications. DI-EM typically presents as erythematous and painful lesions on the oral mucosa, including the lips, tongue, and buccal mucosa. Case description. A 42-year-old male was referred to the Oral Medicine clinic with a chief complaint of painful lip ulceration and eruptions on the body after consuming medications. A detailed history was taken, and after a thorough examination, a perilesional biopsy for histopathological and immunopathological tests was performed. Following the exclusion of all other conditions with a similar presentation, a diagnosis of drug-induced erythema multiforme (DI-EM) was established. Conclusion. DI-EM can pose a diagnostic challenge due to its presentation. However, a diagnosis can be established by excluding other conditions associated with chronic inflammation or the formation of vesicles or bullae. Clinical Significance. DI-EM is a rare variant of EM with a very low prevalence in the general population, making it a challenging condition to diagnose due to its similarity in presentation with other mucocutaneous disorders. A thorough medical history, along with histopathology and immunology tests, coupled with ruling out other diseases and noting a positive history of recent drug consumption, aids in recognizing this condition, given the absence of any confirmatory diagnostic test. Early diagnosis and cessation of causative drugs, along with supportive medications, contribute to the complete resolution of the condition.

Wastewater-based epidemiology to monitor 68 NPS/conventional drug use in Taipei metropolitan area in Taiwan during and after COVID-19 pandemic

Amidst far-reaching COVID-19 effects and social constraints, this study leveraged wastewater-based epidemiology to track 38 conventional drugs and 30 new psychoactive substances (NPS) in northern Taiwan. Analyzing daily samples from four Taipei wastewater plants between September 2021 and January 2024—encompassing club reopenings, holidays, Lunar New Year, an outbreak, and regular periods—thirty-one drugs were detected, including 5 NPS. Tramadol, zolpidem tartrate, CMA, and MDPV were newly detected in Taiwanese sewage with frequency of 1.4 %− 89.0 %. Conventional drug use typically increased post-pandemic, aside from benzodiazepines and methadone. Methamphetamine showed 100 % frequency, indicating ongoing daily consumption despite COVID-19 measures. Methamphetamine and morphine's consumption dipped then rose around club reopening, hinting at limited access. The consumption trend of methadone appeared to compensate for the use of morphine. Ketamine and NPS demonstrated similar patterns throughout the entire period. NPS as party drugs seemed influenced by an unstable supply chain and complexities in implementation. Benzodiazepines, commonly abused alongside synthetic cathinones in Taiwan exhibited an opposing trend to NPS while aligned with acetaminophen, suggesting elevated stress and anxiety levels during the pandemic. No significant differences were observed in drug consumption between weekdays and weekends, potentially indicating that COVID-19 measures blurred the traditional distinctions between these timeframes. Environmental ImplicationNew psychoactive substances refer to chemically modified variants of controlled drugs designed to mimic the effects of the original drugs while evading modern detection methods, categorizing them as hazardous materials. The study presents a sewage monitoring project conducted from 2021 to 2024, collecting samples from four WWTPs to analyze NPS and conventional drug trends during and after the COVID-19 pandemic. The findings uncovered connections between drug consumption patterns and pandemic-related policies. In light of the persistent drug abuse and their environmental presence, the results bear critical importance for both environmental and public health. We provide a thorough assessment of these relationships and prioritize areas for future research.

Perioperative impact of ultrasound-guided ilioinguinal and iliohypogastric nerve blocks in patients undergoing pelvic fracture surgery.

Pelvic fractures present a severe and complex clinical challenge. This study aimed to compare ultrasound-guided ilioinguinal (IIN) and iliohypogastric nerve (IHN) blocks with conventional general anesthesia (GA) in patients undergoing internal fixation surgery for pelvic fractures. A retrospective analysis was conducted on 100 patients equally divided into ultrasound-guided and control groups. The study monitored hemodynamics, intraoperative anesthesia drug usage, postoperative pain levels, and the incidence of adverse reactions between the 2 groups. The ultrasound-guided group underwent ultrasound-guided IHN and IIN blocks combined with GA. The ultrasound-guided group exhibited significant advantages for hemodynamic measurements at specific time points, lower consumption of Propofol and Remifentanil, and reduced pain intensity across all evaluated time intervals (P < .05). The incidence rate of adverse reactions was significantly lower in the ultrasound group (P = .016). Ultrasound-guided anesthesia is a superior alternative to conventional GA for managing pelvic fractures through internal fixation surgery. It offers advantages in terms of hemodynamic stability, drug consumption, postoperative pain management, and adverse reaction reduction.

Wandering under the Oil Palm Canopy

Abstract During the past two decades, Indonesia has transformed a third of its rainforest into oil palm plantations. Although attention has been paid to the environmental consequences, the connection between oil palm cultivation and the evolving use of alcohol within local communities has received little attention. Studies conducted within rural communities have demonstrated that significant environmental changes frequently result in increased drug and alcohol consumption. Through an ethnographic study of an Indonesian village, this article reveals how the changing living and working environments have not only altered people’s ‘place-world’ but also their sense of identity and position in the world, leaving many disoriented and lost in the homogenous expanse of oil palm plantations. This has seemingly led to increased alcohol use among the village community. This finding offers a fresh and updated way to understand and interrogate the challenges with regard to present-day human-nature relations in agricultural interventions in Indonesia and beyond.

HEPATOTOXIC EFFECTS DUE TO THE COMBINED CONSUMPTION OF OPIOID DRUGS AND ALCOHOL

Introduction. Over the past 20 years, opioid consumption in the world has reached epidemic proportions, which has led to an increase in premature mortality and significantly changed the epidemiology of liver diseases. Aim. The study of features of liver injury with combined consumption of opioid drugs and alcohol. Materials and methods. A retrospective analysis of the medical data of 1,540 patients with the diagnoses of "Acute narcotic poisoning" and "Acute methadone poisoning" (ICD-10:Т40.0-Т40.3); 42 acts of forensic medical and forensic histological examination of death cases associated with illegal methadone and alcohol were considered. Clinical, biochemical, and pathohistological studies were used. Histological samples were examined using an Olympus CX 41 microscope in transmitted light, at magnifications of 100, 200, and 400 times. The SPSS Statistics 29.0.0.0 program was used, Pearson's correlation analysis was used, p≤0.05. Results. According to the results of forensic and histological studies, pronounced infiltration of the liver tissue by small lymphocytes (r=0.471, р=0.002) was found in persons with a long history of illegal methadone and alcohol consumption, which was combined with portal fibrosis (r=0.333, р=0.021) and, in some cases, moderate proliferation of bile ducts (r=0.203, p=0.047). Morphometric analysis of liver biopsies revealed sinusoidal dilatation, inflammatory and fibrotic changes of the terminal hepatic venules (r=0.501, p=0.017); sclerotic changes were noted from the expansion of the portal tracts due to fibrosis and to the initial signs of a partial structure violation, which indicates the transition to cirrhosis. Conclusions. The progressive spread of the practice of combined consumption of opioid drugs on the example of methadone and alcohol increases the risk of hepatotoxic effects, in particular, accelerating the development of fibrosis and cirrhosis.

Risk of Children Born with Autism Spectrum Disorders Reviewed from Prenatal Factors

One of the factors causing a child to be born with Autism Spectrum Disorder (ASD) is prenatal, which is when the child is still in the womb. This study aims to find out what prenatal factors affect children born with ASD. The research method used is quantitative descriptive with a retrospective approach. Data was collected by distributing online questionnaires to 33 respondents. The data were analyzed by univariate. The results showed that 51.5% of the risk of ASD children increased in YPPA when the mother was exposed to cigarette smoke, which was 17 people. Maternal emotional state factors 15.2%, complications during pregnancy 12.1%, drug consumption 21.2%, disease history 9.1%, and nutritional state 15.2%. There are no factors that cause children to be born with ASD from maternal age and gestational age. Exposure to secondhand smoke has a significant impact on the risk of children born with ASD

Análisis de los Principales Factores Determinantes del Aumento de los Homicidios en Uruguay y su Relación con los Grupos Criminales Vinculados al Narcotráfico

TThe main objective of this article is the analysis of the increase in homicides in Uruguay, and the relationship it may have with criminal groups linked to drug trafficking. Homicide is the type of crime that has increased the most in recent years, while crimes such as theft, robbery and domestic violence have decreased or increased slightly. Homicides grew a lot, especially homicides due to account settlements, causing concern to the current government authorities. With respect to the methodology used in this research, a mixed design was used, proposing as the main research techniques the analysis of secondary data from the Violence and Crime Observatory of the Ministry of the Interior and the in-depth interview that was carried out with expert professionals in security. public, such as sociologists, criminologists, forensic psychologists, among others. The main conclusions obtained in this work mention that the determining factors of the increases in homicides in Uruguay are: poverty, economic inequality, easy access to firearms, consumption of alcohol or other illicit drugs, lack of state presence in thepoorest neighborhoods and the impunity that criminals find in the judicial system. In turn, another important conclusion that emerges from the work is that the culture of drug trafficking, with its values and internal norms, has a fundamental impact on the increase in homicides due to account settlements.