IVAN DIEB MIZIARA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de MedicinaLegal, Ética Médica e Medicina Social e do Trabalho, Faculdade de Medicina - Docente
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
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Alcohol use among fatally injured victims in SAo Paulo, Brazil: bridging the gap between research and health services in developing countries(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; LEMOS, Nikolas P.; MIZIARA, Ivan Dieb; YE, Yu; TAKITANE, Juliana; MUNOZ, Daniel Romero; REINGOLD, Arthur L.; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa deBackground and aimsMost studies reporting alcohol use among fatally injured victims are subject to bias, particularly those related to sample selection and to absence of injury context data. We developed a research method to estimate the prevalence of alcohol consumption and test correlates of alcohol use prior to fatal injuries. Design, Setting and ParticipantsCross-sectional study based on a probability sample of fatally injured adult victims (n=365) autopsied in SAo Paulo, Brazil. Victims were sampled within systematically selected 8-hour sampling blocks, generating a representative sample of fatal injuries occurring during all hours of the day for each day of the week between June 2014 and December 2015. MeasurementsThe presence of alcohol and blood alcohol concentration (BAC) were the primary outcomes evaluated according to victims' socio-demographic, injury context data (type, day, time and injury place) and criminal history characteristics. FindingsAlcohol was detected in 30.1% [95% confidence interval (CI)=25.6-35.1)] of the victims, with a mean blood alcohol level (BAC) level of 0.11%w/v (95% CI=0.09-0.13) among alcohol-positive cases. Black and mixed race victims presented a higher mean BAC than white victims (P=0.03). Fewer than one in every six suicides tested positive for alcohol, while almost half of traffic-related casualties were alcohol-positive. Having suffered traffic-related injuries, particularly those involving vehicle crashes, and injuries occurring during weekends and at night were associated significantly with alcohol use before injury (P<0.05). ConclusionsNearly one-third of fatal injuries in SAo Paulo between June 2014 and December 2015 were alcohol-related, with traffic accidents showing a greater association with alcohol use than other injuries. The sampling methodology tested here, including the possibility of adding injury context data to improve population-based estimates of alcohol use before fatal injury, appears to be a reliable and lower-cost strategy for avoiding biases common in death investigations.
- Introducing a new research method for evaluating alcohol and other drug use among fatally injured victims in Latin America(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; MIZIARA, Ivan Dieb; LEMOS, Nikolas P.; MUNOZ, Daniel Romero; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa
- Alcohol use among fatally injured victims in Sao Paulo, Brazil: bridging the gap between research and health services in developing countries (vol 112, pg 596, 2017)(2017) ANDREUCCETTI, Gabriel; LEYTON, Vilma; LEMOS, Nikolas P.; MIZIARA, Ivan Dieb; YE, Yu; TAKITANE, Juliana; MUNOZ, Daniel Romero; REINGOLD, Arthur L.; CHERPITEL, Cheryl J.; CARVALHO, Heraclito Barbosa de
- Alcohol in combination with illicit drugs among fatal injuries in Sao Paulo, Brazil: An epidemiological study on the association between acute substance use and injury(2018) ANDREUCCETTI, G.; CHERPITEL, C. J.; CARVALHO, H. B.; LEYTON, V; MIZIARA, I. D.; MUNOZ, D. R.; REINGOLD, A. L.; LEMOS, N. P.Injury deaths have a major impact on public health systems, particularly in the Latin American region; however, little is known about how different drugs, in combination or not with alcohol, interact with each injury type. We tested an epidemiological protocol for investigating alcohol and other drug acute use among fatally injured victims taking into account the injury context for all injury causes in Sao Paulo, Brazil. Blood alcohol and drug content were fully screened and confirmed following a probability sample selection of decedents (n = 365) during 19 consecutive months (2014-2015). Drug concentrations, including benzodiazepines, cannabis, cocaine, and opioids were determined by gas chromatography-mass spectrometry (GC-MS) or liquid chromatography tandem mass spectrometry (LC-MS/MS). Toxicology data were interpreted in combination with injury context retrieved from police records regarding cause, place of injury, and victims' criminal history. More than half of all fatally injured victims studied were under the influence of at least one substance (55.3%). Alcohol was the leading substance consumed before a fatal injury event (30.1%), followed by cocaine (21.9%) and cannabis (14%). Illicit drug use (cocaine and cannabis) comprised more than two thirds of all drug-related deaths. Alcohol-positive deaths are over-represented among road traffic injuries, while drug-positive deaths are more prevalent among intentional injuries. Victims who had previous criminal convictions were significantly more likely to have used illicit drugs compared to those who did not have a criminal background. We estimated that one in every two fatal injuries in the city of Sao Paulo is associated with acute substance use by the victim. The health burden attributed to alcohol- and drug-related fatal injury events has reached significant higher levels in Latin American cities such as Sao Paulo compared globally.