Drug Consumption Research Articles

Unpacking the Effects of Decriminalization: Understanding Drug Use Experiences and Risks among Individuals Who Use Drugs in British Columbia

ObjectivesOn January 31, 2023, a three-year exemption from the Controlled Drugs and Substances Act was granted to the Canadian province British Columbia (BC), allowing the cumulative possession of 2.5 g of specific unregulated drugs amongst adults. The goals of the policy are to reduce health, social, and economic harms associated with criminalization, stigma, drug overdose deaths, as well as drug seizures, arrests, and associated enforcement and court costs. As the inaugural year has passed, we aimed to assess people who use drugs’ awareness and knowledge of the, as well as the policy’s impact on their drug use patterns and overdose risk.MethodsWe conducted 100 telephone-based semi-structured interviews with people who use drugs from across BC, exploring changes in drug use experiences and perceived overdose risk since the implementation of the policy. Participants also completed an interviewer-administered survey assessing socio-demographics and substance use patterns. We utilized a qualitative content analysis approach to analyze the interview data.ResultsOur findings indicate a general awareness of the policy among participants, although some policy details were often misunderstood, and participants expressed the need for more widespread dissemination of policy information. While the majority of participants reported that their drug use patterns remained unchanged after decriminalization, some made subtle adjustments, such as carrying under the 2.5 g threshold to minimize the risk of criminalization. Participants highlighted several policy benefits and concerns, including its potential to reduce criminalization and stigmatization, but also increase public drug consumption. Participants offered suggestions for policy improvement.ConclusionThese findings underscore the need for ongoing monitoring of the impacts of decriminalization regarding its potential impact on people who use drugs’ drug use patterns and related risks. Reevaluation of the possession threshold and efforts to enhance education and awareness about the policy could help achieve the policy’s goals.

MEDICATION IN THE COVID-19 PANDEMIC: Consumption of psychodrugs in two pharmacies in south fluminense

Social isolation and changes in routine during the COVID-19 pandemic had impacts on the mental health of the population and medicalization was used as a response to this problem. It is understandable that people face difficulties during periods of social deprivation, which can lead to symptoms such as fear, sadness and anxiety. However, it is important to emphasize that the approach to mental health should not be limited to medicalization alone. A study was carried out through document analysis in two pharmacies in the municipality of Barra Mansa, in Rio de Janeiro, in which the psychotropic drugs dispensed before, during and after the COVID-19 pandemic were quantified. The results obtained revealed that in pharmacy A from 2018 to 2019 there was a tendency towards an increase in the consumption of psychotropic drugs, with emphasis on antipsychotics, however the total consumption from 2019 to 2020 during the COVID-19 pandemic fell by 9.02%. In pharmacy B, in 2020, at the height of the COVID-19 pandemic in Brazil in 2021, there was a 26.35% reduction in the total consumption of psychotropic drugs. During the period of decline in cases of the disease in 2022, a 3.14% drop in the consumption of these medications was observed, but the consumption of anxiolytics increased by 149%. These results only show an increase in the consumption of antipsychotics in the pre-crisis period and an increase in the consumption of anxiolytics in the post-crisis period, highlighting medicalization, especially in the use of anxiolytics due to the dependence and tolerance that lead to prolonged use of these drugs.

Comparison of Preoperative and Postoperative Ultrasound-Guided Caudal Block Analgesia for Lower Limb Surgeries in Pediatrics: A Randomized Controlled Trials

Background: Evaluating pain after surgery is particularly important in children due to their limited ability to communicate effectively. The intensity, duration, and threshold of pain make it challenging to assess in this age group. Objectives: The aim of this study was to compare the effects of ultrasound-guided caudal block at different timings on children's pain and drug consumption during unilateral knee osteotomy surgery. Methods: In a randomized clinical trial, fifty patients were randomly included in the study. The patients were children aged 2 - 6 years, candidates for unilateral osteotomy surgery under general anesthesia with total IV anesthesia (TIVA). The patients were divided into two groups based on the timing of the caudal block: The first group received the block after induction, and the second group received it after surgery and before extubation. Results: There was no statistically significant difference between the two groups in terms of the average amount of Propofol and narcotic consumption during recovery at different time points (P > 0.05). However, significant differences in pain levels were observed during the operation at 60 minutes (P-value < 0.001) and 120 minutes (P-value = 0.006) between the two groups. Pain scores at the start of recovery and at 2, 4, 6, 12, and 24 hours postoperatively were significantly lower in the second group than in the first group. Additionally, the mean difference in Bispectral Index (BIS) at 60 minutes between the two groups was significant (P-value = 0.003), but there was no significant difference at 120 minutes (P-value = 0.896). The second group consistently had significantly lower pain levels than the first group at all times. Conclusions: Based on the results of this study, patients who received a caudal block had lower pain scores, and performing the block before extubation had more beneficial effects on postoperative pain management in children undergoing osteotomy surgery than performing it after induction.

Analysis of methotrexate use practice in patients with rheumatoid arthritis and psoriatic arthritis

Background. Pharmacoepidemiological studies play a key role in optimizing pharmacotherapy for various diseases. In particular, significant progress in the treatment of rheumatoid arthritis (RA) and psoriatic arthritis (PsA) necessitates a detailed analysis of the consumption of disease-modifying antirheumatic drugs. The modern therapeutic concept for these conditions focuses on achieving and maintaining long-term remission, which positions methotrexate (MTX) as a first-line agent, characterized by high effectiveness, safety and advantageous pharmacoeconomic profiles.Objective: to investigate the characteristics of MTX use in real clinical practice among patients with RA and PsA during outpatient medical care.Material and methods. The study comprised two parts: a retrospective cross-sectional analysis of MTX consumption dynamics in 2018, 2020, and 2023 via ATC/DDD (Anatomical Therapeutic Chemical classification, ATC; defined daily dose, DDD) methodology, and a longitudinal non-interventional pharmacoepidemiological study conducted in 2023 using the medical information system “BARS. Healthcare”.Results. The ATC/DDD analysis demonstrated a significant increase in MTX consumption among patients with RA and PsA: from 302,428.6 to 319,114.3 DDDs per 1,000 patients per year for RA, and from 28,157.1 to 310,771.6 DDDs per 1,000 patients per year for PsA in 2018 and 2023, respectively. The most frequently prescribed dose of MT was 15 mg/week. The primary therapeutic combination for 55.8% of patients was “MT + nonsteroidal anti-inflammatory drugs”, with 32.7% of patients also receiving glucocorticoids (GCs) as part of this combination. The study identified a high frequency of prescriptions for proton pump inhibitors, GCs, and cholecalciferol, highlighting the activity of diseases under consideration, potential complications, and the necessity for the prevention of clinically significant drug interactions.Conclusions. The conducted study confirmed that MTX remains the main drug for the treatment of RA and PsA. The ATC/DDD analysis demonstrated a significant increase in MTX consumption in recent years, correlating with its therapeutic effectiveness and accessibility. The high frequency of concomitant prescriptions underscores the complexity of treating RA and PsA and the need for an interdisciplinary approach to ensure safety and efficacy of the therapy.

Sociopsychological factors of drug abuse among young females in Bangladesh and gender-specific vulnerabilities: Aligning with SDG 3 and SDG 5.

Drug consumption among young women in Bangladesh is increasing day by day. The research aims to analyze the factors influencing young females to take drugs in Bangladesh. This exploratory study was carried out using a qualitative research method. Primary data were collected via in-depth interviews. Seventeen addicted young women from Bangladesh were chosen for this study by a snowball sampling technique. The data from the interviews were thoroughly examined. Intimate relationships with family and friends have the greatest impact on women's drug use. Aligning with Sustainable Development Goal (SDG) 5 and SDG target 3.5, the study underscores the critical need for gender-sensitive approaches to address the unique vulnerabilities faced by young women. The findings revealed several factors that significantly impacted drug consumption among young women in Bangladesh, including the influence of social groups and peers, family-related issues, inadequate awareness and education on drugs, the ready availability of drugs, and psychological factors such as stress and curiosity. Additionally, women who use drugs often face severe social stigma and gender-based violence, which deters them from seeking help and exacerbates their addiction. Limited access to health services due to economic and societal constraints further hinders their ability to receive proper care and support. Implementing strategies that address these gender-specific factors will not only help mitigate drug abuse but also contribute to improved public health outcomes and advance sustainable development.

Salinity influence on Mytilus galloprovincialis exposed to antineoplastic agents: a transcriptomic, biochemical, and histopathological approach

Nowadays, aquatic species face a variety of environmental risks associated with pharmaceutical consumption. More specifically, the increased number of cancer patients has been accompanied by an increased consumption of antineoplastic drugs, such as ifosfamide (IF) and cyclophosphamide (CP). These drugs have been found in aquatic ecosystems, raising concerns about their impact, especially on estuarine species, as marine waters are the final recipients of continental effluents. Simultaneously, predicted climatic changes, such as salinity shifts, may threaten organisms. Considering this, the present research aims to investigate the combined effects of IF and CP, and salinity shifts. For this, a transcriptomic, biochemical, and histopathological assessment was made using the bivalve species Mytilus galloprovincialis exposed for 28 days to IF and CP (500 ng/L), individually, at different salinity levels (20, 30, and 40). IF and CP up-regulated metabolism-related gene cyp3a1, with CP also affecting abcc gene, showing minimal salinity impact and highlighting the importance of these metabolic routes in mussels. Salinity shifts affected the transcription of genes related to apoptosis and cell cycle growth, such as p53, as well as the aerobic metabolism, the antioxidant and biotransformation mechanisms. These findings indicate mussels' high metabolic adaptability to osmotic stress. Under CP exposure and low salinity, mussels exhibited increased cellular damage and histopathological effects in digestive gland tubules, revealing detrimental effects towards M. galloprovincialis, and suggesting that a metabolic slowdown and activation of antioxidant mechanisms helped prevent oxidative damage at the control and high salinities. Overall, results reinforce the need for antineoplastics ecotoxicological risk assessment, especially under foreseen climate change scenarios.

Role of the Pharmacotherapeutic Monitoring Service (PMS) of the Community Pharmacy in the detection and resolution of adverse reactions to statins linked to possible diagnostic errors in elderly patients

The Medication Review in the Pharmacotherapeutic Follow-up Service (PFS) seems to be an effective method to study long-term drug safety in the outpatient setting. The adverse drug reactions (ADRs) that are not immediately obvious are difficult to identify and sometimes can be confused with a more common condition. Misdiagnosis by not associating the symptoms of AMR to its pharmacological cause causes its masking and hinders its detection. Detect in the SFT service the diagnostic errors related to the non-detection of adverse reactions to statins. The data obtained from the medication review at the Pharmacotherapeutic Follow-up Service (PFS) were pooled for analysis. The patients who received the service were selected with the "DLGM screening" tool, an acronym "Diagnosis load Generated by Medications", that allows us to describe adverse drug reactions (ADRs), when their symptoms are attributed to a pathology, without considering medication as a possible underlying cause.Only the results of patients over 60 years of age, who after a prolonged period of statin use gradually presented musculoskeletal disorders (MSD) and other symptoms theoretically described as possible ADRs, are shown. In 66 % of the cases, corresponding to 14 patients out of a total of 21 studied, the physician modified the treatment and in 92% of these cases there was improvement and a decrease of the consumption of analgesics drug, anti-inflammatory and other drugs used to treat ADR symptoms. DLGM screening identified hidden AMRs in 62 % of patients.

Isolation to stabilization: A Housing First approach to address homelessness in Kingston, Ontario.

Homelessness is a significant and growing public health concern across Canada. In Kingston, Ontario, the number of people experiencing chronic homelessness has more than doubled from 136 people in 2020 to 296 in 2023. An emergency shelter-in-place hotel program was established in April 2020 to provide non-congregate shelter to people experiencing homelessness and vulnerable to SARS-CoV-2 infections. Beyond preventing COVID transmission, the unintentional consequence was that a population that experienced chronic homelessness reduced drug consumption and became stable. In 2022, with increased funding from the Ministry of Health and the City of Kingston, a new Housing First program was implemented to transition individuals from homelessness to long-term stable housing. Between November 2022 and June 2023, a total of 34 clients initiated the program. Of these clients, 10 completed the program and were successfully housed, 10 remained active participants, and 14 were discharged before completion. Strengths and challenges were identified. Diverse services provided to meet the population's needs and strong collaborations with various community partners were facilitating factors. Inadequate external resources, a lack of evening and prosocial activities, and outside peers (not part of the program) who influenced recovery plans were identified as challenges. This program illustrates that simultaneously integrating housing, community building, mental health, and addiction services is possible and provides an innovative way to stabilize this vulnerable population of people experiencing homelessness. Results from this program and the knowledge generated through implementation are being used to further scale up the program.

Application of Fabric Phase Sorptive Extraction as a Green Method for the Analysis of 10 Anti-Diabetic Drugs in Environmental Water Samples

Due to the increased prevalence of diabetes, the consumption of anti-diabetic drugs for its treatment has likewise increased. Metformin is an anti-diabetic drug that is commonly prescribed for patients with type 2 diabetes and has been frequently detected in surface water and wastewaters, thus representing an emerging contaminant. Metformin can be prescribed in combination with other classes of anti-diabetic drugs; however, these drugs are not sufficiently investigated in environmental samples. Fabric phase sorptive extraction (FPSE) has emerged as a simple and green method for the extraction of analytes in environmental samples. In this study, FPSE coupled with a high-performance liquid chromatography diode array detector (HPLC-DAD) was employed for the simultaneous analysis of different classes of anti-diabetic drugs (metformin, dapagliflozin, liraglutide, pioglitazone, gliclazide, glimepiride, glargine, repaglinide, sitagliptin, and vildagliptin) in environmental water samples. Four different fabric membranes were synthesized but the microfiber glass filter coated with sol-gel polyethylene glycol (PEG 300) was observed to be the best FPSE membrane. The parameters affecting the FPSE process were optimized using a combination of one-factor-at-a-time processes and the design of experiments. The FPSE was evaluated as a green extraction method, based on green sample preparation criteria. The FPSE-HPLC-DAD method achieved acceptable validation results and was applied for the simultaneous analysis of anti-diabetic drugs in surface and wastewater samples. Glimepiride was detected below the quantification limit in both lake and river water samples. Dapagliflozin, liraglutide, and glimepiride were detected at 69.0 ± 1.0 μg·L−1, 71.9 ± 0.4 μg·L−1, and 93.9 ± 1.3 μg·L−1, respectively, in the city wastewater influent. Dapagliflozin and glimepiride were still detected below the quantification limit in city wastewater effluent. For the hospital wastewater influent, metformin and glimepiride were detected at 1158 ± 21 μg·L−1 and 28 ± 0.8 μg·L−1, respectively, while only metformin (392.6 ± 7.7 μg·L−1) was detected in hospital wastewater effluent.

Drug consumption stigma and patient legitimacy: experiences of people who use drugs seeking care for chronic non-cancer pain in Nigeria

ABSTRACT This study explored how people who use drugs (PWUD) experience and respond to stigma in biomedical chronic non-cancer pain management. Thematic analysis of in-depth interviews with PWUD (n = 26) who had sought care for chronic non-cancer pain in public hospitals in Uyo, Nigeria, drew on the idea of stigma as process of social reproduction and the concept of borderwork. Accounts framed stigma as a normalised feature of healthcare that emerged under different circumstances and operated to position chronic non-cancer pain patients who were PWUD as illegitimate subjects underserving of care. Stigma was widely seen as something to be expected, and was often tolerated by PWUD due to its ubiquity. However, they enacted borderwork marking-off stigma experiences that violated values of fairness and humaneness as well as those that spurned traditional gender norms. Participants responded to intolerable stigma through various acts of resistance, including dropping out of care. Stigma creates barriers to adequate pain management and establishes a context where basic care is accessed at the cost of fundamental human rights and dignity. Routine toleration of stigma helps to naturalise the phenomenon and render it invisible. Resistance to stigma provides a basis for interventions to address all forms of stigma in healthcare.

Tracking the surge of psychiatric pharmaceuticals in urban rivers of Curitiba amidst and beyond the SARS-CoV-2 pandemic

The heightened contamination of urban rivers with psychiatric drugs poses significant environmental and public health risks due to their persistence and bioaccumulative nature. In this study, we assessed the concentrations of 10 psychiatric medicines in water and sediment samples from three rivers in Curitiba, Brazil, spanning the SARS-CoV-2 pandemic from September 2020 to November 2023. Our analysis revealed substantial variations in drug concentrations across rivers and sampling periods, with fluoxetine and sertraline being the most prevalent in waters (up to 1118 ng L−1) and sediments (up to 70 ng g−1 DW). Sediments emerged as primary repositories for psychiatric drugs. The COVID-19 pandemic notably impacted drug concentrations, with fluoxetine and alprazolam concentrations surging by up to 741 % and 524 %, respectively, compared to pre-pandemic levels. The current concentrations of drugs in rivers pose risks to aquatic life. Despite variations, overall drug concentrations increased by 20 % for fluoxetine and 15 % for alprazolam after the pandemic. These findings underscore the persistent environmental risks associated with heightened drug consumption, emphasizing the urgent need for continued monitoring and intervention strategies to mitigate ecological and public health impacts.

Real-world insights into the management of hemophilia A in Italy: treatment patterns and healthcare resource utilization

PurposeThis real-world analysis described the Hemophilia A (HA) population in Italy, evaluating drug utilization and consumption of factor VIII (FVIII) products of patients under prophylaxis and on-demand therapy.MethodsFrom Jan-2017 to Jun-2022, male patients with HA were identified through prescriptions of FVIII products [extended half-life FVIII, standard half-life recombinant FVIII, and plasma-derived FVIII (EHL FVIII, SHL rFVIII, and pdFVIII, respectively)], or emicizumab or FVIII plus von Willebrand factor or HA-related hospitalization using administrative flows of Italian healthcare entities. Patients on treatment with FVIII products during 2021–2022 were stratified by treatment regimen (prophylaxis/on-demand). The mean annual consumption expressed in International Units (IU) of EHL FVIII and SHL FVIII in patients treated during 2021–2022 having at least 12-month follow-up were assessed.ResultsAmong included HA patients, 145 (39.5%) received EHL FVIII and 222 (60.5%) SHL FVIII. Of 165 patients on prophylaxis, 105 (64%) received an EHL FVIII and 60 (36%) an SHL FVIII. The mean annual consumption of FVIII was 336,700 IU (median 319,000 IU) for EHL FVIII and 440,267 IU (median 360,500 IU) for SHL FVIII. Specifically, for patients on EHL FVIII, the most common drugs were efmoroctocog alfa (N = 51) and damoctocog alfa pegol (N = 50), followed by turoctocog alfa pegol (N = 25) and rurioctocog alfa pegol (N = 19). Of 702 HA patients initially treated with FVIII products, 74 (10.5%) switched to emicizumab during follow-up.ConclusionThese findings revealed an extensive use of EHL FVIII products, suggesting growing efforts from clinicians to optimize prophylactic strategies and achieve better bleeding protection.

8257 Pancreatic Neuroendocrine Tumor Presenting As Carcinoid Syndrome

Abstract Disclosure: D. Phung: None. Introduction Pancreatic neuroendocrine tumors (NETs) are rare tumors that arise in neuroendocrine cells of the pancreas. These tumors secrete a wide array of hormones. Carcinoid syndrome is a result of well-differentiated neuroendocrine tumors that secrete biologically active amines and peptides that cause the clinical manifestation of flushing, diarrhea, cardiac involvement, and wheezing. Case Presentation A 57-year-old male presented to the clinic for symptoms of tachycardia, shortness of breath, dizziness, and sweating for the past year. He had past medical history of chronic kidney disease, history of previous cardiac arrest, history of previous myocardial infarction, congestive heart failure, hypertension and gastric reflux disease. No history of tobacco, alcohol, or drug consumption. No previous surgeries. Family history with heart disease and prostate cancer in his father. His symptoms began over the course of the past year. Initially began with shortness of breath, chest pain, weight gain which then developed into dizziness with standing, episodes of night time sweating. He had associated headaches that were occurring daily. Vomiting would occur intermittently three to four times weekly. He noted episodes of flushing with rash occurring in the upper chest and bilateral arms. Diarrhea and loose bowel movements would occur occasionally. On examination he had tachycardia with heart rate at 103 BPM. Lung fields clear throughout. Abdomen was soft, nontender, without masses palpated. On biochemical testing chromogranin A was highly elevated and remained elevated upon repeat testing. Initial imaging with CT abdomen and pelvis with contrast was negative. PET scanning confirmed and localized his NET, revealing increased tracer uptake and hypervascularity in the neck of pancreas as well as two regions in the right lower lobe of the liver. Following confirmation and localization of his tumor he was then referred for surgical evaluation and treatment. Discussion In our presented case, the patient presented with symptoms suggestive of carcinoid syndrome which was confirmed biochemically with elevated chromogranin A. Clinical suspicion remains critical in diagnosis of NETs. The patient presented with clinically suspicious carcinoid syndrome, but initial testing with CT scan was negative and required further PET-based tracing to uncover tumors. Our case highlights the importance of clinical examination and acumen in diagnosing neuroendocrine tumors. Presentation: 6/2/2024

8257 Pancreatic Neuroendocrine Tumor Presenting as Carcinoid Syndrome

Abstract Disclosure: D. Phung: None. Introduction Pancreatic neuroendocrine tumors (NETs) are rare tumors that arise in neuroendocrine cells of the pancreas. These tumors secrete a wide array of hormones. Carcinoid syndrome is a result of well-differentiated neuroendocrine tumors that secrete biologically active amines and peptides that cause the clinical manifestation of flushing, diarrhea, cardiac involvement, and wheezing. Case Presentation A 57-year-old male presented to the clinic for symptoms of tachycardia, shortness of breath, dizziness, and sweating for the past year. He had past medical history of chronic kidney disease, history of previous cardiac arrest, history of previous myocardial infarction, congestive heart failure, hypertension and gastric reflux disease. No history of tobacco, alcohol, or drug consumption. No previous surgeries. Family history with heart disease and prostate cancer in his father. His symptoms began over the course of the past year. Initially began with shortness of breath, chest pain, weight gain which then developed into dizziness with standing, episodes of night time sweating. He had associated headaches that were occurring daily. Vomiting would occur intermittently three to four times weekly. He noted episodes of flushing with rash occurring in the upper chest and bilateral arms. Diarrhea and loose bowel movements would occur occasionally. On examination he had tachycardia with heart rate at 103 BPM. Lung fields clear throughout. Abdomen was soft, nontender, without masses palpated. On biochemical testing chromogranin A was highly elevated and remained elevated upon repeat testing. Initial imaging with CT abdomen and pelvis with contrast was negative. PET scanning confirmed and localized his NET, revealing increased tracer uptake and hypervascularity in the neck of pancreas as well as two regions in the right lower lobe of the liver. Following confirmation and localization of his tumor he was then referred for surgical evaluation and treatment. Discussion In our presented case, the patient presented with symptoms suggestive of carcinoid syndrome which was confirmed biochemically with elevated chromogranin A. Clinical suspicion remains critical in diagnosis of NETs. The patient presented with clinically suspicious carcinoid syndrome, but initial testing with CT scan was negative and required further PET-based tracing to uncover tumors. Our case highlights the importance of clinical examination and acumen in diagnosing neuroendocrine tumors. Presentation: 6/2/2024

Smartphone Addiction among Adolescents in Southern Italy and Correlation with Other Risky Behaviors.

Addiction to smartphone is defined as the disability to cease using the device despite the physical, psychological, or social consequences. The diagnosis of this disorder is increasing exponentially among teenagers, even more so after Corona Virus Disease 2019 (COVID-19) pandemic. This study aims to analyze the risk of mobile phone addiction among teenagers in Italy and its relationship with other risk behaviors, such as drug consumption and emotional well-being, following the COVID-19 pandemic. A cross-sectional observational study was conducted in Catania, Sicily, during 2022. The study sample comprised 342 students from a secondary education center that answered to a validated Italian version of the Smartphone Addiction Scale Short Version (SAS-SV) accessing through computers and mobile devices. Subjective Wellbeing was measured with the Personal Wellbeing Index-School Children (PWI-SC). Also, they completed the NIAAA Brief Alcohol Use Screener. Our results showed that 30.1% of students who participated in the survey were classified with a smartphone addiction. Besides, most of the participants used the Smartphone for social networks (86.0%). Regarding the other aspects measured, the mean self-perceived well-being score measured with the PWI-SC was 55.5, and 36.2% of participants were categorized as "high risk" for depression. Finally, four out of ten participants were at "moderate or high risk" of an alcohol use disorder. Our results suggest that the use of mobile phones is increasing in adolescents, an age group also exposed to social and health problems.

The Contribution of the Skin Microbiome to Psoriasis Pathogenesis and Its Implications for Therapeutic Strategies.

Psoriasis is a common chronic inflammatory skin disease, associated with significant morbidity and a considerable negative impact on the patients' quality of life. The complex pathogenesis of psoriasis is still incompletely understood. Genetic predisposition, environmental factors like smoking, alcohol consumption, psychological stress, consumption of certain drugs, and mechanical trauma, as well as specific immune dysfunctions, contribute to the onset of the disease. Mounting evidence indicate that skin dysbiosis plays a significant role in the development and exacerbation of psoriasis through loss of immune tolerance to commensal skin flora, an altered balance between Tregs and effector cells, and an excessive Th1 and Th17 polarization. While the implications of skin dysbiosis in psoriasis pathogenesis are only starting to be revealed, the progress in the characterization of the skin microbiome changes in psoriasis patients has opened a whole new avenue of research focusing on the modulation of the skin microbiome as an adjuvant treatment for psoriasis and as part of a long-term plan to prevent disease flares. The skin microbiome may also represent a valuable predictive marker of treatment response and may aid in the selection of the optimal personalized treatment. We present the current knowledge on the skin microbiome changes in psoriasis and the results of the studies that investigated the efficacy of the different skin microbiome modulation strategies in the management of psoriasis, and discuss the complex interaction between the host and skin commensal flora.

Incidence Of Insomnia, Anxiety, Depression, Overweight And Drug And Alcohol Use Among Medical Students

Introduction: The existence of a toxicity in medical culture caused by chronified stress in the exercise of the profession by demanding excellence in practice and the adoption of infallible knowledge. As a result, doctors and medical students have shown higher rates of psychological distress, burnout and diagnosed mental illness. Methodology: A questionnaire consisting of 11 questions about sleep quality, depression, anxiety, diet and exercise was carried out among medical students. A total of 83 medical students from 7 different Brazilian educational institutions answered the questionnaire. Objective: To Carry out a descriptive of a quantitative nature and exploratory research through a structured and pre-planned questionnaire with questions regarding the quality of sleep, anxiety, diet, depression, alcohol and drug consumption by medical students, in different periods of training.

Edible ultrasmall polyphenolic nanozymes for oral treatment of alcohol-induced acute gastritis

Excessive alcohol consumption and prolonged administration of non-steroidal anti-inflammatory drugs (NSAIDs) lead to gastritis which affects millions globally, yet safe and effective treatment options remain limited. While a range of nanozymes have been employed in the oral treatment of inflammatory bowel disease (IBD), the research directed toward gastritis therapy remains unexplored. The challenges of rapid gastric emptying, harsh gastric acid erosion, and the non-edible ingredient constitution hinder the practical use of nanozymes in this context. Herein, three types of sub-10 nm ultrasmall iron-polyphenol nanozymes (UIPNs) were synthesized by using fully edible natural active polyphenols, iron ions and PVP. UIPNs rapidly penetrated the gastric mucosa, resided in the stomach for over 12 h, and remained stable in the harsh acidic environment. They exhibited excellent enzyme-like activities of catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD). Compared to omeprazole, all three types of UIPNs showed superior activity, with Fis UIPNs demonstrating the best performance in preventing and protecting against alcohol-induced gastric mucosal injury in mice. The fully food-sourced components, constructed into ultrasmall nanozymes via non-covalent interactions, ensure long-term safety and hold promise for playing significant roles in various gastrointestinal diseases.

Investigating the Status of Social Support in Type 2 Diabetes Patients in Southeast Iran

Abstract Objective: Social support plays a crucial role in modifying health-related behaviors aimed at controlling chronic diseases, such as type 2 diabetes. This research investigates the social support status of patients with type 2 diabetes in Kerman, Iran. Materials and Methods: This cross-sectional study utilized a descriptive-analytical approach and investigated 184 patients referred to the diabetes clinic. The participants were selected through systematic sampling, and data were collected using a questionnaire. Descriptive statistics, including frequency, mean, and standard deviation, were calculated. Multivariate linear regression was employed to analyze the data, which were entered into the Statistical Package for the Social Sciences version 16 statistical software. Results: The findings indicate that social support was most prominent in the area of nutrition, whereas it was least prominent in the area of exercise. Gender was found to have a statistically significant relationship with both nutritional status and drug consumption dimensions, as women demonstrated lower average scores in these areas compared to men. Moreover, gender and education were observed to impact the dimension of general care. However, none of the demographic characteristics analyzed showed a statistically significant relationship with exercise and physical activity. Conclusion: It is crucial to give ample attention to supporting and empowering patients’ families and social groups. Furthermore, adding psychological dimensions to social support could be beneficial. These findings underscore the importance of tailored interventions that target specific areas of support, such as exercise and general care, and take into account the differences between men and women.

Synthesis of Thioglycolic Acid-Modified Molybdenum Disulfide Nanosheets for Electrochemical Sensing and Its Application in Molnupiravir Detection

In the modern world, population growth, industrialization, and lifestyle changes have led to a rise in existing and new diseases, increasing global drug consumption. Proper pharmaceutical dosage is vital since drugs are only effective within specific concentration ranges. Therefore, developing reliable analytical methods for drug analysis in pharmaceuticals and biological samples is essential. Electroanalytical methods are particularly advantageous due to their low cost, ease of use, and rapid response. This study introduces a highly sensitive electrochemical sensor based on thioglycolic acid (TA)-decorated metallic phase molybdenum disulfide (MP-MoS2) nanosheets for the selective detection of molnupiravir (MOL), an antiviral drug used in Covid-19 treatment. The TA@MP-MoS2 nanomaterial was characterized using FTIR, TEM, and EIS. Screen-printed carbon electrodes (SPCE) were modified with TA@MP-MoS2 nanosheets to evaluate their electro-chemical and catalytic behaviours towards MOL by cyclic voltammetry (CV) and square wave voltammetry (SWV). The sensor displayed a well-defined electro-oxidation signal for MOL at 0.534 V, with the linear responses in two concentration ranges: 0.50–3.40 μM and 3.40–9.55 μM, and a low detection limit of 22.6 nM. The proposed design that has promising results could be an alternative strategy to fabricate the sensitive sensor for the detection of antiviral agents in real samples.