HENRIQUE SILVA BOMBANA
Projetos de Pesquisa
Unidades Organizacionais
IPER, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina
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- Prevalence of drugs in oral fluid from truck drivers in Brazilian highways(2017) BOMBANA, Henrique Silva; GJERDE, Hallvard; SANTOS, Marcelo Filonzi dos; JAMT, Ragnhild Elen Gjulem; YONAMINE, Mauricio; ROHLFS, Waldo Jose Caram; MUNOZ, Daniel Romero; LEYTON, VilmaTraffic accidents are responsible for 1.25 million deaths worldwide and are the most common cause of death among those aged 15-29 years. In Brazil, traffic accidents caused more than 44,000 deaths in 2014. The use of psychoactive drugs is an important risk factor for being involved in traffic accidents. Previous studies have found that psychoactive substances are commonly used by truck drivers in Brazil to maintain their extensive work schedule and stay awake while driving during nighttime hours. The state of Sao Paulo is one of the most important states regarding goods transportation. Important highways cross through Sao Paulo to other regions from Brazil and to other countries in Latin America. This study aims to determine the prevalence of illicit drug use by truck drivers in the state of Sao Paulo through toxicological analyses of oral fluid. Truck drivers were randomly stopped by police officers on federal roads during morning hours. Oral fluid samples were collected using the Quantisal (TM) device. In addition, a questionnaire concerning sociodemographic characteristics and health information was administered. Oral fluid samples were screened for amphetamine, cocaine, and tetrahydrocannabinol (Delta 9-THC) by ELISA and the confirmation was performed using ultra performance liquid chromatography with tandem mass spectrometry detection (UPLC-MS/MS). Of the 764 drivers stopped, 762 agreed to participate. The participants were driving an average of 614 km and 9.4 h a day. Of the total samples, 5.2% (n = 40) tested positive for drugs. Cocaine was the most frequently found drug (n = 21), followed by amphetamine (n = 16) and D9-THC (n = 8). All drivers were men with an average age of 42.5 years. With these results we were able to verify that many truck drivers were still consuming psychoactive drugs while driving, and cocaine was the most prevalent one. This reinforces the need for preventive measures aimed at controlling the use of illicit drugs by truck drivers in Brazil.
- Drink driving and speeding in Sao Paulo, Brazil: empirical cross-sectional study (2015-2018)(2019) ANDREUCCETTI, Gabriel; LEYTON, Vilma; CARVALHO, Heraclito Barbosa; SINAGAWA, Daniele M.; BOMBANA, Henrique S.; PONCE, Julio C.; ALLEN, Katharine A.; VECINO-ORTIZ, Andres I.; HYDER, Adnan A.Objectives To evaluate the prevalence of drink driving and speeding during 2015-2018 in Sao Paulo, Brazil. Design Cross-sectional observational study. Setting Roads representing the five main regions of the city of Sao Paulo in Brazil, one of the world's largest urban areas. Participants Drivers (N=10294) stopped at routine roadside breath testing checkpoints and those driving in selected roads for speeding measurement (N=414664). Primary and secondary outcome measures Microwave radar guns were used to measure the speed of vehicles, while the prevalence of drivers under the influence of alcohol was observed in police checkpoints. Data were collected during three consecutive years (2016-2018) following a baseline study established in 2015 using a city-level representative sample of observational data representing all days of the week. Results Alcohol-related fatalities kept at a constantly high percentage, with 39% of road traffic deaths involving alcohol in 2016. Drivers testing above the legal breath alcohol concentration limit showed a decreasing trend, from 4.1% (95% CI 2.9% to 5.5%) at baseline to 0.6% (95% CI 0.2% to 1.2%) in the end of 2018 (p<0.001); however, more than half of drivers refused breath tests at checkpoints despite steep legal penalties. The prevalence of speeding among all vehicles decreased from 8.1% (95% CI 7.9% to 8.2%) to 4.9% (95% CI 4.7% to 5.1%) by the end of 2016 (p<0.001), but then increased again to 13.5% (95% CI 13.2% to 13.9%) at the end of the study period (p<0.001). Conclusions Drink driving rates have reduced, likely due to an increase in drivers refusing breath alcohol tests, while speeding rates have increased significantly by the end of the study period, particularly among motorcycles. Future strategies aiming at reducing road traffic injuries in the major Brazilian city should tailor drink driving and speeding enforcement based on the new evidence provided here.
- Trends in the use of psychoactive substances by truck drivers in SAo Paulo State, Brazil: A time-series cross sectional roadside survey (2009-2016)(2019) LEYTON, Vilma; BOMBANA, Henrique Silva; MAGALHAES, Juliana Gallottini; PANIZZA, Helena Nascimento; SINAGAWA, Daniele Mayumi; TAKITANE, Juliana; CARVALHO, Heraclito Barbosa de; ANDREUCCETTI, Gabriel; YONAMINE, Mauricio; GJERDE, Hallvard; MUNOZ, Daniel RomeroObjective: Truck drivers represent a group that is susceptible to the use of stimulant substances to reduce the symptoms of fatigue, which may be caused by a stressful and exhausting work environment. The use of psychoactive substances may increase the risk for involvement in road traffic crashes. Previous studies have demonstrated that amphetamine, cocaine, and cannabis are the 3 main drugs used by Brazilian truck drivers. We studied the prevalence of amphetamine, benzoylecgonine (indicating use of cocaine), and -9-tetrahydrocannabinol-9-carboxylic acid (THC-COOH; indicating use of cannabis) in urine samples from truck drivers in the state of SAo Paulo, Brazil, using the same methodology during 8 years (2009-2016).Methods: Samples were collected during a health program supported by the Federal Highway Police. Toxicological analyses were performed using immunoassays and gas chromatography-mass spectrometry.Results: The total prevalence of illicit drugs was 7.8%. Benzoylecgonine was the most prevalent substance (3.6%), followed by amphetamine (3.4%) and THC-COOH (1.6%). We found the highest drug prevalence in 2010 (11.3%) and the lowest in 2011 (6.1%). We could detect a slight change in the pattern of stimulant use: until 2010, amphetamine was the most prevalent substance; however, in 2011 benzoylecgonine became the most frequently detected substance. This lasted until 2015, probably due to changes in Brazilian legislation regarding appetite suppressants; the most common one is metabolized to amphetamine.Conclusion: These data show that the use of psychoactive substances by truck drivers in Brazil did not decrease during the study period. This reinforces the need for further preventive measures to reduce drug use among drivers, which could lead to a decrease in traffic crashes in Brazil.
- HAIR TESTING: AN INEFFECTIVE DUI STRATEGY IN BRAZIL(2018) LEYTON, Vilma; ANDREUCCETTI, Gabriel; MEIRA JUNIOR, Antonio Edson Souza; SANTOS, Marcelo Filonzi Dos; BOMBANA, Henrique Silva; WALLS, H. Chip; GREVE, Julia Maria D'Andrea; CARVALHO, Heraclito Barbosa de; MONTAL, Jose Heverardo da Costa; ADURA, Flavio Emir; YONAMINE, Mauricio
- Use of alcohol and illicit drugs by trauma patients in Sao Paulo, Brazil(2022) BOMBANA, Henrique Silva; BOGSTRAND, Stig Tore; GJERDE, Hallvard; JAMT, Ragnhild Elen Gjulem; CARVALHO, Heraclito Barbosa de; ANDREUCCETTI, Gabriel; BERNINI, Celso de Oliveira; MUNOZ, Daniel Romero; LEYTON, Vilma; GREVE, Julia Maria D'AndreaIntroduction: Alcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited. Aims: To estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil. Methods: Blood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs. Results: A total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18-39 years (41%), for singles (43%), and for patients injured at nighttime (4 4%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (4 4%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%). Conclusion: The use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis.
- Hollow-fibre liquid-phase microextraction and gas chromatography-mass spectrometric determination of amphetamines in whole blood(2020) BOMBANA, Henrique Silva; SANTOS, Marcelo Filonzi dos; MUNOZ, Daniel Romero; LEYTON, VilmaHere, we present a fully validated method using a hollow-fibre liquid-phase microextraction technique for the determination by gas chromatography-mass spectrometry (GC-MS) of amphetamine (AMP), methamphetamine (MET), fenproporex (FEN), 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA) and 3,4-methylenedioxyethylamphetamine (MDEA) in whole blood. The validation parameters presented successful values within those recommended by the Scientific Working Group for Forensic Toxicology (SWGTox) in the Standard Practices for Method Validation in Forensic Toxicology. The limits of detection ranged from 1 to 3 ng/mL, and the limits of quantification ranged from 2 to 5 ng/mL. The determination coefficients (r(2)) ranged from 0.990 to 0.997, and the method presented good intraday and interday accuracy (from 90.4% to 97.2%) and satisfactory recovery (from 68% to 110%). No carryover was observed. The heteroscedasticity was tested, and only AMP presented homoscedasticity. Weighting factors were applied to correct the linearity of MET (1/x(2)), MDA (1/x), FEN (1/x(1/2)), MDMA (1/x(2)) and MDEA (1/y). Dilution integrity was tested at ratios of 1:2, 1:5 and 1:10, and all maintained intraday precision (from 94.9% to 99.3%) and interday precision (from 89.4% to 94.9%). The validated method was applied to six real whole blood samples from individuals suspected of consuming ecstasy, and MDMA, MDA and amphetamine were successfully identified and quantified.
- Toxicity of Synthetic Cannabinoids in K2/Spice: A Systematic Review(2023) OLIVEIRA, Mariana Campello de; VIDES, Mariana Capelo; LASSI, Dangela Layne Silva; TORALES, Julio; VENTRIGLIO, Antonio; BOMBANA, Henrique Silva; LEYTON, Vilma; PERICO, Cintia de Azevedo-Marques; NEGRAO, Andre Brooking; MALBERGIER, Andre; CASTALDELLI-MAIA, Joao Mauricio(1) Background: Synthetic cannabinoids (SCs) are emerging drugs of abuse sold as 'K2', 'K9' or 'Spice'. Evidence shows that using SCs products leads to greater health risks than cannabis. They have been associated with greater toxicity and higher addiction potential unrelated to the primary psychoactive component of marijuana, & UDelta;9-tetrahydrocannabinol (& UDelta;9-THC). Moreover, early cases of intoxication and death related to SCs highlight the inherent danger that may accompany the use of these substances. However, there is limited knowledge of the toxicology of Spice ingredients. This systematic review intends to analyze the toxicity of SCs compounds in Spice/K2 drugs. (2) Methods: Studies analyzing synthetic cannabinoid toxicity and dependence were included in the present review. We searched the PubMed database of the US National Library of Medicine, Google Scholar, CompTox Chemicals, and Web of Science up to May 2022. (3) Results: Sixty-four articles reporting the effects of synthetic cannabinoids in humans were included in our review. Ten original papers and fifty-four case studies were also included. Fourteen studies reported death associated with synthetic cannabinoid use, with AB-CHMINACA and MDMB-CHMICA being the main reported SCs. Tachycardia and seizures were the most common toxicity symptoms. The prevalence of neuropsychiatric symptoms was higher in third-generation SCs. (4) Conclusion: SCs may exhibit higher toxicity than THC and longer-lasting effects. Their use may be harmful, especially in people with epilepsy and schizophrenia, because of the increased risk of the precipitation of psychiatric and neurologic disorders. Compared to other drugs, SCs have a higher potential to trigger a convulsive crisis, a decline in consciousness, and hemodynamic changes. Therefore, it is crucial to clarify their potential harms and increase the availability of toxicology data in both clinical and research settings.
- Factors Contributing to Traffic Accidents in Hospitalized Patients in Terms of Severity and Functionality(2023) CANONICA, Alexandra Carolina; ALONSO, Angelica Castilho; SILVA, Vanderlei Carneiro da; BOMBANA, Henrique Silva; MUZAURIETA, Aurelio Alberto; LEYTON, Vilma; GREVE, Julia Maria D'AndreaTrauma-related injuries in traffic-accident victims can be quite serious. Evaluating the factors contributing to traffic accidents is critical for the effective design of programs aimed at reducing traffic accidents. Therefore, this study identified which factors related to traffic accidents are associated with injury severity in hospitalized victims. Factors related to traffic accidents, injury severity, disability and data collected from blood toxicology were evaluated, along with associated severity and disability indices with data collected from toxicology on victims of traffic accidents at the largest tertiary hospital in Latin America. One hundred and twenty-eight victims of traffic accidents were included, of whom the majority were young adult men, motorcyclists, and pedestrians. The most frequent injuries were traumatic brain injury and lower-limb fractures. Alcohol use, hit-and-run victims, and longer hospital stays were shown to lead to greater injury severity. Women, elderly individuals, and pedestrians tend to suffer greater disability post-injury. Therefore, traffic accidents occur more frequently among young male adults, motorcyclists, and those who are hit by a vehicle, with trauma to the head and lower limbs being the most common injury. Injury severity is greater in pedestrians, elderly individuals and inebriated individuals. Disability was higher in older individuals, in women, and in pedestrians.
- PREVALENCE OF BEHAVIORAL RISK FACTORS FOR ROAD TRAFFIC INJURIES IN THE CITY OF SAO PAULO: FINDINGS FROM THE BLOOMBERG INITIATIVE FOR GLOBAL ROAD SAFETY (BIGRS) 2015-2017(2018) ANDREUCCETTI, Gabriel; LEYTON, Vilma; CARVALHO, Heraclito B.; SINAGAWA, Daniele M.; BOMBANA, Henrique S.; PONCE, Julio C.; ALLEN, Katharine A.; VECINO-ORTIZ, Andres I.; HYDER, Adnan A.