VILMA LEYTON
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 - Líder
LIM/40 - Laboratório de Imunohematologia e Hematologia Forense, Hospital das Clínicas, Faculdade de Medicina - Líder
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- A continuidade do uso de anfetaminas por motoristas de caminhão no Estado de São Paulo, Brasil, a despeito da proibição de sua produção, prescrição e uso(2013) OLIVEIRA, Lucio Garcia de; ENDO, Ligia Goes; SINAGAWA, Daniele Mayumi; YONAMINE, Mauricio; MUNOZ, Daniel Romero; LEYTON, VilmaAmphetamine use by truck drivers for occupational purposes is widely known. The production and consumption of amphetamines was banned by the Brazilian National Health Surveillance Agency (ANVISA) in October 2011. This study analyzes persistent amphetamine use by truck drivers since the ban was implemented. A convenience sample of 427 truck drivers was taken along highways in Sao Paulo State in 2012. Participants were asked to answer a structured questionnaire and provide a urine sample to screen for recent amphetamine consumption through toxicological analysis. Among the interviewed drivers, 7% had used some illicit drug recently and 2.7% had used amphetamines. Amphetamines are still consumed by truck drivers despite the risks and the recent ban. The authorities should thus monitor the possession and use of amphetamines by drivers in order to effectively enforce the ban.
- Attention performance among Brazilian truck drivers and its association with amphetamine use: pilot study(2013) OLIVEIRA, Lucio Garcia de; SANTOS, Bernardo dos; GONCALVES, Priscila Dib; CARVALHO, Heraclito de Barbosa; MASSAD, Eduardo; LEYTON, VilmaThe aim of this article was to describe the attention functioning of twenty-two truck drivers and its relationship with amphetamine use. Those drivers who reported using amphetamines in the twelve months previous to the interview had the best performance in a test evaluating sustained attention functioning. Although amphetamine use may initially seem advantageous to the drivers, it may actually impair safe driving. The findings suggest the importance of monitoring the laws regarding amphetamine use in this country.
- Detecting Alcohol and Illicit Drugs in Oral Fluid Samples Collected from Truck Drivers in the State of Sao Paulo, Brazil(2013) YONAMINE, Mauricio; SANCHES, Livia Rentas; PARANHOS, Beatriz Aparecida Passos Bismara; ALMEIDA, Rafael Menck de; ANDREUCCETTI, Gabriel; LEYTON, VilmaObjective: Alcohol and drug use by truck drivers is a current problem in Brazil. Though there is evidence that alcohol consumption is occurring in higher proportions, the use of stimulant drugs to avoid fatigue and to maintain the work schedule has also been reported. The purpose of this study was to estimate the incidence of alcohol and illicit drug use among truck drivers on Sao Paulo state roads. Sao Paulo is the most populous state in Brazil and has the largest industrial park and economic production in the country. Methods: Data were assessed not only using a questionnaire but also, and more reliably, through toxicological analysis of oral fluid samples. Between the years 2002 and 2008, 1250 oral fluid samples were collected from truck drivers on the roads during morning hours. The samples were tested for the presence of alcohol, cocaine, tetrahydrocannabinol (THC), and amphetamine/methamphetamine. A previously published, validated gas chromatographic (gas chromatographyflame ionization detection and gas chromatographymass spectrometry) method was applied to the samples for alcohol and drug detection. Results: Of the total analyzed samples, 3.1 percent (n = 39) were positive: 1.44 percent (n = 18) were positive for alcohol, 0.64 percent (n = 8) for amphetamines, 0.56 percent (n = 7) for cocaine, and 0.40 percent (n = 5) for THC. In one case, cocaine and THC were detected. The results are indicative of the extent of alcohol and drug use by truck drivers in the state of Sao Paulo, Brazil. Conclusions: This research provides evidence that not only alcohol but also illicit drug use is a real problem among professional drivers. The use of these substances should be controlled to better promote safe driving conditions on Brazilian roads.
- Uso de anfetaminas por motoristas de caminhão em rodovias do Estado de São Paulo: um risco à ocorrência de acidentes de trânsito?(2013) TAKITANE, Juliana; OLIVEIRA, Lucio Garcia de; ENDO, Ligia Goes; OLIVEIRA, Keziah Cristina Barbosa Gruber de; MUNOZ, Daniel Romero; YONAMINE, Mauricio; LEYTON, VilmaThe use of amphetamines in Brazil is common among truck drivers, which may be an important factor in the occurrence of traffic accidents. This article seeks to estimate the prevalence of amphetamine use among truck drivers. Drivers (N = 134) were stopped on two different highways in Sao Paulo state and they were asked to answer a questionnaire and provide a urine sample for toxicological analysis. All data were analyzed on Stata 8.0. All participants were males with low levels of schooling, whose mean age was 40.8 years. The presence of amphetamines was detected in 10.8% of all urine samples collected, being commonly justified in order to make truck drivers able to maintain their state of awareness. Amphetamine use was detected among truck drivers on Sao Paulo highways. The problem is that when the stimulant effects wear off, sleepiness due to sleep deprivation reduces concentration and good driver performance, making drivers vulnerable to traffic accidents and the related effects.
conferenceObject Risk factors for cardiovascular disease, metabolic syndrome and sleepiness in truck drivers(2013) MANSUR, A. P.; TAKADA, J. Y.; AVAKIAN, S. D.; LINS, S. M. B.; ROCHA, M. A. B. S.; SANTOS, A. J.; ANDRADE, A. M. C. A.; VASCONCELOS JR., J. R.; MONTEIRO, L. B. M.; LEYTON, V.- Hollow fiber-liquid phase microextraction of barbiturates in liver samples(2013) MENCK, Rafael Almeida; OLIVEIRA, Carolina Dizioli Rodrigues de; LIMA, Diogenes Saulo de; GOES, Ligia Endo; LEYTON, Vilma; PASQUALUCCI, Carlos Augusto; MUNOZ, Daniel Romero; YONAMINE, MauricioBarbiturates, especially phenobarbital, are involved in intoxication cases in Brazil and other countries. Liver tissue can be a useful alternate specimen when blood is not available (decomposition, severe fire, and exsanguination cases). Because the liver is a very complex matrix, it is essential is to eliminate potential interfering substances in this specimen before instrumental analysis of target compounds. In recent years, novel strategies for sample preparation have gained acceptance in the field of analytical toxicology. The objective of this work was to develop a gas chromatography-mass spectrometry (GC-MS) method using hollow fiber-liquid phase microextraction (HF-LPME) for determination of barbiturates (phenobarbital, secobarbital, pentobarbital, and butalbital) in liver samples. An aliquot of homogenized and acidified liver in aqueous solution (equivalent to 50 mg tissue) was submitted to extraction by the use of a 9-cm hollow fiber. The fiber was filled with eucalyptus oil in its pores and its lumen was filled with a NaOH solution (pH 13; acceptor phase). After extraction in an ultrasonic bath for 5 min, the acceptor phase was withdrawn and derivatized in the injector port of the GC-MS with trimethylanilinium hydroxide for flash methylation. A totally ""green chemistry"" approach of the sample extraction was obtained, because relatively large amounts of organic solvent generally used for extraction could be substituted by an essential oil used as a supported liquid membrane for HF-LPME. This method was validated and successfully applied to liver samples collected from five deceased persons with previous history of exposure to barbiturates. Phenobarbital concentrations in the liver found in these actual cases ranged from 1.3 to 16.7 mu g/g.
- Analysis of skeletal muscle has potential value in the assessment of cocainerelated deaths(2013) REES, Kelly A.; SEULIN, Saskia; YONAMINE, Mauricio; LEYTON, Vilma; MUNOZ, Daniel R.; GIANVECCHIO, Victor A. P.; POUNDER, Derrick J.; OSSELTON, M. DavidThis study assesses the interpretive value of cocaine, benzoylecgonine (BZE) and cocaethylene (COET) in skeletal muscle (rectus femoris) in cocaine-using decedents. The distribution of these analytes in cardiac muscle (CM), vitreous humour (VH), femoral blood (FB) and cardiac blood (CB) is also reported. In rectus femoris muscle, the spatial distribution of the analytes was examined across the whole rectus femoris muscle collected from seven fatalities in which cocaine was detected. In six of these cases, death was attributed to trauma and in one case the cause of death was undetermined but suspected to be drug related. In two additional cases analytes were detected in the blood and/or VH but not in the muscle. The muscle was sectioned into 12-15 approximately equal segments, each of which was analysed after homogenisation. Tissue and bio-fluid samples were extracted by solid phase extraction with confirmation and quantification by GC-ion trap-MS/MS. No significant variation was observed in the concentration of any analyte throughout the muscle in the 7 cases analysed. The results reported here are in contrast to a previous study in which great variation in the concentration of some basic drugs (mainly tricyclic antidepressants and benzodiazepines) was observed throughout the thigh muscle bulk (Williams and Pounder, 1997). Analyte concentrations in skeletal muscle (SM) correlated well with those in FB (p < 0.01). In general, the concentration of cocaine and COET followed the order VH > CM > SM > FB >= CB. Cocaine concentrations measured in VH were significantly higher than in blood and muscle. Inter-matrix variations in the concentrations of BZE and COET were less marked. The concentration of BZE exceeded that of cocaine in all matrices and in all cases except one where the time between death and drug intake was suspected to be short. In this case, the cocaine to BZE ratio measured in SM (2.66), CM (2.91) and VH (2.19) was higher than that measured in FB (0.97). Given that the concentrations of cocaine and its metabolites were uniformly distributed throughout the muscle and considering the good correlation observed between muscle and blood, muscle could be of interpretive value in cocaine related deaths. Further, since cocaine is known to have greater post-mortem stability in muscle than blood, concentrations measured in muscle may reflect more closely those at the time of death and might be of particular value in cases with an extended period between death and tissue sampling.
conferenceObject BLOOD ALCOHOL CONCENTRATION AND INTENT TO DRIVE AMONG NIGHTCLUB PATRONS IN SAO PAULO, BRAZIL(2013) PAGANO, A.; MILLER, B.; GRUBE, J.; COURSER, M.; ANDREUCCETTI, G.; LEYTON, V.The primary objectiveof this study was to examine patrons’ blood alcohol concentration (BAC) and intent todriveupon exiting nightclubs in São Paulo,Brazil. The secondaryobjectivewas todetermine whether certain patron characteristics might be associated with higher BACs when leaving these nightclubs. Recent changes in Driving Under the Influence(DUI) policy in Brazil have resulted in a lower legal BAC limit for driving (> 0.02, increased enforcement, and stricter fines and criminal proceedings against violators. The dataused for this study are from a pilot study of drug and alcohol use in São Paulo nightclubs conducted in November 2011. The study used portal methods (Voas et al., 2006) based on those used in prior club studies (Miller et al., 2005; Miller et al., 2009). Specifically, patrons were randomly intercepted as they approached the club and datawere collected at entrance and exit. Measures included researcher-administered interviews (e.g., background characteristics, mode of transport) self-report surveys (e.g., drug use and drinking habits), and biological (saliva, breath test) samples todirectly ascertain alcohol and drug use. Breath samples were collected using Intoxilizer 400PA units (CMI, Inc., Owensboro, KY), and oral fluid samples were collected using the Quantisal collection device (Immunalysis Corporation, Pomona, CA). For the present study, ANO-VAs, T-tests, and Chi-square tests were performed on interview, survey, and BAC data using SPSS (IBM,2011).The mean exit BACof our total sample (n= 112) was 0.06 (SD= 0.05). 27% ofpatrons intended to drive home using a car or motorcycle; 60% of these drivers were over the legal BAC limit. Nearly half of the drivers had BAC limits high enough to incur criminal charges (0.06). Self-reported binge drinking (defined as having 6 alcoholic drinks on a single occasion) in the last 30 days was significantly associated withhigher exit BAC(p= .000). Surprisingly, there were no significant differences in mean exit BAC between males (0.059) and females (0.058). Overall, our study indicates a substantial rate of DUI among club patrons in São Paulo. The pattern weidentified between binge drinking tendencies and negative alcohol outcomes (e.g., DUI)mirrors other studies (e.g., Grunewald, Treno, & Mitchell 1996). ings have important implications for DUI education and prevention efforts in Brazil.