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PubMed2005

Universal approach for selective trace metal determinations via sequential injection-bead injection-lab-on-valve using renewable hydrophobic bead surfaces as reagent carriers.

A new concept is presented for selective and sensitive determination of trace metals via electrothermal atomic absorption spectrometry based on the principle of bead injection (BI) with renewable reversed-phase surfaces in a sequential injection-lab-on-valve (SI-LOV) mode. The methodology involves the use of poly(styrene-divinylbenzene) beads containing pendant octadecyl moieties (C18-PS/DVB), which are preimpregnated with a selective organic metal chelating agent prior to the automatic manipulation of the beads in the microbore conduits of the LOV unit. By adapting this approach, the immobilization of the most suitable chelating agent can be effected irrespective of the kinetics involved, optimal reaction conditions can be used for implementing the chelating reaction of the target metal analyte with the immobilized re-agent, and an added degree of freedom is offered in selecting the most favorable elution mode in order to attain the highest sensitivity. The potential of the SI-BI-LOV scheme is demonstrated by taking Cr(VI) as a model analyte, using a 1,5-diphenylcarbazide (DPC)-loaded bead column as the active microzone. As this reaction requires the use of high acidity, it is also shown that the bead material exhibits excellent chemical stability at low pH values. On-line pH sample adjustment prevents alteration of the original distribution of chromium species while ensuring fast rates for the DPC-Cr(VI) reaction. The proposed procedure was successfully applied to the determination of trace levels of Cr(VI) in natural waters containing high levels of dissolved salts (such as seawater and hard tap water) without requiring any dilution step. Method validation was performed by determination of total chromium in an NIST standard reference material (NIST 1640, natural water) after Cr(III) oxidation, and the results were in good agreement with the certified value.

Journal Article↗
PubMed2006

Hyphenating multisyringe flow injection lab-on-valve analysis with atomic fluorescence spectrometry for on-line bead injection preconcentration and determination of trace levels of hydride-forming elements in environmental samples.

In this work the third generation of flow injection analysis, that is, the so-called micro-lab-on-valve (microLOV) approach, is proposed for the first time for the separation, preconcentration, and monitoring of metalloids as hyphenated with atomic fluorescence spectrometry (AFS). This was made feasible by interfacing the micromachined LOV-module with AFS by a multisyringe flowing stream network for on-line postcolumn derivatization of the eluate aimed at generation of hydride species. The potential of this new hyphenated technique for environmental assays was ascertained via determination of ultratrace level concentrations of total inorganic arsenic in freshwater. Employing quantitative preoxidation of As(III) to As(V) in the samples by means of permanganate, the method involves preconcentration of arsenate at pH 10 on a renewable anion exchanger, namely, Q-Sepharose, packed in a LOV microcolumn. The analyte species is afterward stripped out and concurrently prereduced by a 300 microL eluent plug containing 6 mol L(-)1 HCl and 10% KI. The eluate is downstream merged with a metered volume of sodium tetrahydroborate (0.3% w/v) for generation of arsine, which is subsequently quantified by AFS. The flow system facilitates on-column reduction of the retained arsenic with no need for application of programmable stopped flow. Yet, the high concentration of reductant and extreme pH conditions for elution hinder the sorbent to be reused due to gradual deactivation of the functional moieties, so that maximum benefit can be taken from the application of the bead renewable strategy. The proposed procedure is characterized by a high tolerance to metal species and interfering hydride-forming elements. In fact, ratios of Se(IV) to As < or = 5000 and Sb(V) to As < or = 500 are tolerated at the 10% interference level. Under the optimized experimental conditions, a detection limit (3sigma) of 0.02 ng mL(-1) As, a dynamic linear range of 0.05-2.0 ng mL(-1) As (by tailoring the AFS gain), an enrichment factor of 8.8 for arsenate, and a precision better than 6.0% at the 0.1 ng mL-1 level were obtained for the bead-injection mode whenever the loading sample volume was affixed at 3.0 mL. The reliability and accuracy of the automated procedure was ascertained by determining total inorganic arsenic in both spiked environmental waters and certified reference materials of variable matrix complexity (TMDA-54.3 and ERM-CA010) at the low ng mL(-1) level. No significant differences were found between the experimental results and the certified values at a significance level of 0.05.

Journal Article↗
PubMed2000

Factors associated with injecting risk behaviour among serial community-wide samples of injecting drug users in Glasgow 1990-94: implications for control and prevention of blood-borne viruses.

AIMS: To examine the association between recipient-sharing of needles and syringes and demographic characteristics, injecting behaviour and needle and syringe exchange utilisation. DESIGN: Self-report data from serial cross-sectional surveys. SETTING: Multiple street, needle and syringe exchange and drug treatment sites throughout Glasgow. PARTICIPANTS: 2576 current injecting drug users (IDUs) recruited during 1990-94. FINDINGS: In the multiple logistic regression analysis, a significantly lower level of recipient-sharing was associated with respondents who resided within 1 mile of a needle and syringe exchange compared to those who lived further away (adjusted OR 1.3; 95% CI 1.0-1.6), and by IDUs who reported obtaining either 6-15, 16-30, or > 30 sterile needles and syringes in an average week from a needle exchange and/or pharmacist (adjusted ORs 0.55, 0.34, 0.25; 95% CIs 0.3-0.9, 0.2-0.6 and 0.2-0.4, respectively) compared to those who obtained no sterile equipment from these sources. Recipient-sharing of needles and syringes in the previous 6 months reduced significantly between 1990 (43%) and 1991-94 (27-33%) (p < 0.0001); this decline was not explained by needle and syringe exchange utilization, suggesting that additional factors were influencing behavioural change at that time. CONCLUSION: Our data indicate that improving injectors' convenience of access to exchange facilities and increasing the numbers of sterile needles and syringes available to them is likely to result in further reductions in recipient-sharing, and thus the potential for blood-borne virus transmission, among IDUs.

Adult↗
PubMed1989

Sexual behaviour of injecting drug users and associated risks of HIV infection for non-injecting sexual partners.

The sexual behaviour of 142 clients of syringe-exchange schemes was measured using a questionnaire interview based survey method. Two to four months later the questionnaire was repeated to provide measures of behavioural change. The majority of these clients were sexually active, 77% having one or more sexual partners in the 3 months prior to the first interview. Many of these clients (46% of those sexually active) had sexual partners who did not inject drugs. There is evidence that this group modified their sexual behaviour towards reducing their own risk of HIV infection, with more having no sexual partners (from 23% to 31%), a reduction in those having multiple partners (from 26% to 21%) and a slight increase in those with regular partners (from 49% to 52%). Not all clients in this group reduced their risk of infection by modifying their sexual behaviour. Some clients continued to engage in high risk sexual behaviour, having multiple partners (21%) and not using condoms (79%). Whilst overall there is evidence of changes in the sexual behaviour of the clients towards a reduced risk of infection, we have identified an associated increase in risk of transmission from them to their sexual partners. Drug injectors who continued to have sexual partners were more likely to have sexual partners who did not inject drugs.

Adult↗
PubMed1998

The moral universe of injecting drug users in the era of AIDS: sharing injecting equipment and the protection of moral standing.

Recent work on HIV counselling suggests that the protection of the moral status of the recipient is a key factor in the successful uptake of advice. This study suggests it may be equally important in the uptake of health promotion messages. A discourse analysis of the talk of 20 young injecting drug users (IDUs) identified a contradiction between their asserted self-identity as careful and socially responsible injectors, and their admission of risky lending and borrowing of injecting equipment. This contradiction was resolved by the production of discourses of exoneration, differentially tailored to the moral implications of lending and of borrowing. Lenders argued a form of 'market morality' wherein it was the duty of each to accept the consequences of his/her decisions. Lenders were therefore morally exonerated since moral failure was the 'borrowers'. Borrowing was usually depicted as 'desperate measures' for which moral culpability was disavowed because of 'powerlessness'. The exception of routine borrowing, acknowledged as risky and against community norms, was accounted for in a nihilistic discourse of indifference to infection and death. The need for a 'counter discourse' around notions of community is discussed.

Adolescent↗
PubMed1990

Distribution of 241Am in offspring from BALB/c mice injected with 241Am at 14 days of gestation: relation to calcium and iron metabolism and comparison with distribution of 241Am after injection of adults.

Pregnant mice were given intravenous injections of 241Am citrate at 14 days of gestation. The fetal skeleton had a higher or similar uptake of 241Am per gram of fresh tissue than the liver. In comparison, the liver in adults concentrated 5 to 20 times more 241Am per gram of fresh tissue than the bones. Measurement of changes in calcium and iron content and concentration with time, showed that in the developing mice intensive calcification of bones determined the uptake of 241Am. The 241Am uptake was related to the calcium concentration of the fetal bones, which was greater at 14 days of gestation in the anterior bones, the mandibles and calvaria, than in the ribs and femurs. Transfer of 241Am to pups via milk resulted in further accumulation of 241Am in the skeleton and liver. The incorporation in the skeleton persisted after weaning and contributed to the lifetime body burden. The 241Am concentration decreased rapidly with time after injection in relation to the growth of the organs. Radiation dose rates and cumulative radiation doses were calculated for liver and bones of contaminated offspring.

Age Factors↗
PubMed1999

Methamphetamine use and sexual and injection risk behaviors among out-of-treatment injection drug users.

Our primary objective was to examine the relationship between methamphetamine use and sexual risk-taking behaviors--number of sexual partners, frequency of sexual behaviors with regular and casual partners, trading money or drugs for sex, and condom use--among male and female out-of-treatment injection drug users (OTIDUs). As a risk group for human immunodeficiency virus (HIV) transmission, we also investigated injection behaviors by methamphetamine use. Data were collected from 1392 OTIDUs within the California counties of Fresno, Sacramento, and San Diego. Excluded from this cross-sectional survey were male OTIDUs engaging in sex with only or mostly men since 1978. In bivariate analyses, we found that male OTIDUs with a history of methamphetamine use had more sex partners and participated in more acts of anal insertive intercourse with casual partners and vaginal intercourse with regular and casual partners than male OTIDUs never using methamphetamines. In addition, a greater percentage of male OTIDUs using methamphetamines reported trading sex for money or drugs. Methamphetamine-using female OTIDUs participated in more acts of vaginal intercourse with regular male sex partners than female OTIDUs never using methamphetamines. By multivariate logistic regression, we found methamphetamine use related to consistent condom use among male OTIDUs and among male sex partners of female OTIDUs. Discriminant function analyses revealed that sexual risk taking could be differentiated by methamphetamine use among male OTIDUs. Methamphetamine use also correlated with using shared needles or syringes among male and female OTIDUs and was related to not always disinfecting used needles or syringes with bleach. Our findings suggest that methamphetamines may contribute to heterosexual HIV transmission.

Adolescent↗
PubMed2005

Use of flow injection and sequential injection analysis schemes for the determination of trace-level concentrations of metals in complex matrices by ETAAS and ICPMS.

Despite their excellent analytical chemical capacities for determination of low levels of metal species, electrothermal atomic absorption spectrometry and inductively coupled plasma mass spectrometry often require suitable pretreatment (separation and preconcentration) of the sample material to facilitate the desired sensitivity and selectivity of measurement. Such pretreatment schemes are advantageously performed in flow injection (FI) or sequential injection (SI) manifolds, where all unit operations can be effected on-line and under enclosed and strictly controlled conditions. Various separation/preconcentration procedures are feasible, such as liquid-liquid extraction (possibly including back extraction), (co)precipitation with collection in knotted coils, adsorption on hydrophilic or hydrophobic reactors, hydride generation, or the use of ion-exchange/chelating packed columns. After describing the particulars and characteristics of FI and SI, we present, via selected examples, various separation/preconcentration FI/SI schemes for the determination of trace levels of metals, with particular emphasis on the use of the novel extension of FI/SI, that is, the so-called lab-on-valve concept.

Environmental Monitoring↗
PubMed2003

Towards more effective public health programming for injection drug users: development and evaluation of the injection drug user quality of life scale.

The psychometric properties of the Injection Drug User Quality of Life Scale (IDUQOL) were assessed in 61 Montreal IDUs in 2001, 85% of whom were reinterviewed within four weeks. The reliability of the IDUQOL was acceptable (ICC = 0.71) and concordance between the IDUQOL and the Flanagan Quality of Life Scale was moderate (Pearson coefficient = 0.57). Quality of life was negatively associated with injection cocaine and emergency department use with both instruments; these results were more striking for the IDUQOL. The IDUQOL is a culturally relevant quality of life instrument with good psychometric properties. The IDUQOL may be useful in the development and evaluation of interventions for IDUs.

Adult↗
PubMed1998

Multiple pregnancies obtained by testicular spermatid injection in combination with intracytoplasmic sperm injection.

Recent studies have shown that the injection of spermatid cells into the human oocyte can result in normal fertilization, embryo development and even delivery of live, healthy offspring. In our study, 23 azoospermic cases with severe spermatogenetic defects in their testicular biopsy are presented. The serum follicle stimulating hormone (FSH) concentrations and histopathological results of these males have been documented and compared in terms of fertilization and embryo development. The mean FSH value of the azoospermic males was 15.8 +/- 2.3 mIU/l, ranging from 1.6 to 39 mIU/l. Elongated spermatids were used in three cases only, as these more mature forms were mostly present in the testicular sample. In the remaining 20 cases, only round spermatids were found for use in intracytoplasmic sperm injection (ICSI). The fertilization rate with two pronuclei was 31.3%. The fertilization rate was found to be as high as 71% in three patients in the elongating and elongated spermatids group and as low as 25.6% in the round spermatid group. A few immature, non-motile spermatozoa were seen in only two cases from the elongated spermatid group. However, in the remaining cases, no spermatozoa were observed. The number of pronuclear (PN) arrest was quite high when only round spermatids were used (36.1%). Total fertilization failure was observed in two cases from the round spermatid group with Sertoli cell only and germ cell aplasia. A total of three pregnancies was achieved in 23 cases (13.0%), two from the elongated spermatid group and one from the round spermatid group. One biochemical pregnancy with a round spermatid resulted in an early spontaneous abortion and surprisingly, the remaining pregnancies were achieved with elongated spermatids resulting in multiple pregnancies. One twin and one triplet pregnancy were established following four embryo transfers in each patient. The twin pregnancy resulted in a live birth with two healthy babies; unfortunately, the triplet pregnancy ended in an abortion at 11 weeks. The use of testicular spermatids in the treatment of non-obstructive azoospermia may give hope by offering a novel treatment model. In cases with very severe spermatogenetic defect, even multiple pregnancies can be achieved with elongated spermatid cells by yielding a high implantation rate. However, the efficiency of round spermatids in achieving fertilization and pregnancy was disappointing.

Adult↗
PubMed1993

Factors associated with HIV seropositivity in European injecting drug users. The European Community Study Group on HIV in Injecting Drug Users.

OBJECTIVE: To study factors associated with HIV seropositivity among European injecting drug users (IDU). METHODS: Data on behavioural and other factors potentially associated with HIV status were collected retrospectively by personal interview with IDU (n = 2330) in a multicentre cross-sectional survey conducted in 12 European countries from 1989 to 1990. HIV status tested at the time of the survey was examined in relation to demographic data, history of imprisonment, travel to foreign countries, high-risk drug-using practices in the previous 6 months (re-using other IDU's injecting equipment without effective disinfection) and high-risk sexual behaviour in the last 6 months (multiple partners, unless none was IDU and condoms were always used). Analysis excluded IDU who claimed to be seropositive from previous testing. RESULTS: Imprisonment was significantly associated with current HIV status [odds ratio (OR), 1.70; 95% confidence interval (CI), 1.2-2.87]. High-risk drug-use practices were significantly associated with current HIV status in respondents not previously tested (OR, 2.86; 95% CI, 1.09-7.35) but not in respondents claiming to be seronegative. No significant association was found for high-risk sexual behaviour. CONCLUSIONS: Our experience supports the validity of retrospective investigation of behaviour in a population that is notoriously difficult to study. However, any interpretation of the apparently different associations of HIV status with high-risk sexual behaviour and high-risk drug-use practices must consider that factors tending to attenuate the correlations may operate differently in these two areas.

Adolescent↗
PubMed1994

Consistent condom use in relationships between seropositive injecting drug users and sex partners who do not inject drugs.

OBJECTIVES: To study how condom use in injecting drug users' (IDU) relationships differs according to whether they are HIV-infected, and to whether their sex partner is an IDU. DESIGN AND METHODS: A total of 317 street-recruited IDU were HIV-antibody tested and interviewed about 421 relationships with particular sex partners. RESULTS: Condoms were consistently (100%) used in sex between partners (during the previous 30 days) in 33% of these relationships, and their use was significantly more frequent in relationships of seropositive IDU and in relationships with non-IDU partners. In relationships between seropositive IDU and non-IDU, consistent condom use was reported to be high (68%); this remained unchanged under multivariate controls. CONCLUSIONS: Self-reported condom use by IDU in New York, with its relatively mature epidemic, appears to be concentrated where it may most reduce the spread of HIV to non-IDU heterosexuals, i.e., in relationships between infected IDU and non-IDU partners. Differential condom use by serostatus and by partners' drug injection should be incorporated into mathematical models of the HIV epidemic. Causes of the high level of condom use in this subset of relationships may include drug injector altruism and pressure by sex partners; prevention programs should develop ways to use both of these factors to motivate increased condom use.

Adult↗
PubMed2000

Prevention of HIV infection in street-recruited injection drug users. The Collaborative Injection Drug User Study (CIDUS).

BACKGROUND: Injection drug users (IDUs) and their sex partners account for an increasing proportion of new AIDS and HIV cases in the United States, but public debate and policy regarding the effectiveness of various HIV prevention programs for them must cite data from other countries, from non-street-recruited IDUs already in treatment, or other programs, and from infection rates for pathogens other than HIV. METHODS: Participants were recruited from the street at six sites (Baltimore [Maryland], New York [two sites], Chicago [Illinois], San Jose [California], Los Angeles [California], and at a state women's correctional facility [Connecticut]), interviewed with a standard questionnaire, and located and reinterviewed at one or more follow-up visits (mean, 7.8 months later). HIV serostatus and participation in various programs and behaviors that could reduce HIV infection risk were determined at each visit. RESULTS: In all, 3773 participants were recruited from the street, and 2306 (61%) were located and interviewed subsequently. Of 3562 initial serum specimens, 520 (14.6%) were HIV-seropositive; at subsequent assessment, 19 people, all from the East Coast and Chicago, had acquired HIV. Not using previously used needles was substantially protective against HIV acquisition (relative risk [RR], 0.29; 95% confidence interval [CI], 0.11-0.80 ) and, in a multivariate model, was significantly associated with use of needle and syringe exchange programs (adjusted odds ratio [ORadj], 2.08; 95% CI, 1.15-3.85). Similarly, reduction of injection frequency was very protective against seroconversion (RR, 0.33; 95% CI, 0.14-0.80), and this behavior was strongly associated with participation in drug treatment programs (ORadj, 3.54; 95% CI, 2.50-5.00). In a separate analysis, only 37.5% of study-participants had sufficient new needles to meet their monthly demand. CONCLUSIONS: In this large multicity study of IDUs in the United States, several HIV prevention strategies appeared to be individually and partially effective; these results indicate the continued need for, and substantial gaps in, effective approaches to preventing HIV infection in drug users.

Adult↗
PubMed1991

Estimating hidden populations: a new method of calculating the prevalence of drug-injecting and non-injecting female street prostitution.

This paper outlines a new method we have developed for estimating the prevalence of streetworking prostitution and the proportions of female street-working prostitutes who are injecting drug users. This method is based on the capture/recapture approach and involves distinguishing new fieldwork contacts from repeat field work contacts. The size of the overall population can be modelled from records of the increasing ratio of repeat to new fieldwork contacts. The method may have a relevance beyond a concern with prostitution and drug injecting, and may be of value in estimating other hidden populations.

Female↗
PubMed2004

Non-fatal cocaine overdose among injecting and non-injecting cocaine users in Sydney, Australia.

AIM: To investigate the frequency of non-fatal cocaine overdose, and responses to overdoses, among injecting and non-injecting cocaine users. DESIGN: Cross-sectional study. SETTING: Sydney, Australia. PARTICIPANTS: Two hundred current cocaine users. MEASUREMENTS: Structured interview. FINDINGS: Thirteen per cent of the sample had overdosed on cocaine, 7% in the preceding 12 months. Cocaine injectors were more likely to have overdosed, both ever (17 v 6%) and in the preceding 12 months (9 v 3%). The most common symptoms of overdose were palpitations (68%), intense sweating (44%) and seizures (40%). The use of other drugs in combination with cocaine prior to the most recent overdose was prevalent (64%), most commonly opioids (40%), alcohol (24%) and cannabis (24%). Those who had overdosed were more likely to be female, had longer cocaine use careers, had used more cocaine in the preceding month and preceding 6 months, had higher levels of cocaine dependence and more extensive polydrug use. Twenty-four per cent had witnessed a cocaine overdose, 13% in the preceding 12 months. Injectors were more likely to have witnessed overdoses, both ever (35% v 8%) and in the preceding 12 months (20% v 3%). CONCLUSIONS: Experience of, and exposure to, overdose were not rare events. Cocaine users need to be aware of the possibility and nature of overdose, and that cocaine overdose can occur irrespective of method of use. There is a need to emphasise the potential danger of combining cocaine with other drugs.

Adult↗
PubMed1989

Pain on injection of methohexitone. The use of lignocaine to modify pain on injection of methohexitone during anaesthesia for electroconvulsive therapy.

The present study was designed to assess the incidence of pain when methohexitone was administered to 35 depressed patients who had electroconvulsive therapy, and to determine whether the use of lignocaine could modify this, without affecting seizure duration. The same patients were studied during three separate treatment sessions; they received either methohexitone alone or mixed with, or preceded by, lignocaine 10 mg. Six (17%) patients spontaneously complained of pain during injection of methohexitone alone; the use of lignocaine prior to methohexitone reduced this to zero (p less than 0.05). A total of 49% patients reported pain during injection of methohexitone; the use of lignocaine either mixed with, or given prior to, methohexitone significantly reduced this to 23% and 20% respectively (p less than 0.05). Seizure duration was not significantly different during the three treatments.

Adolescent↗
PubMed1995

Intentions to share injection paraphernalia: an empirical test of the AIDS Risk Reduction Model among injection drug users.

The AIDS Risk Reduction Model is a theory-based representation of sequential psychosocial processes by which people may attempt to change their HIV risk behavior. These processes are said to occur in three stages: 1) labeling one's risk behavior as problematic, 2) forming an intention to change behavior, and 3) taking action to accomplish change. Cognitive and perceptual factors are said to influence progress across stages. This study tests the degree to which hypothesized relationships among factors at Stages 1 and 2 are consistent with cross-sectional data collected from a sample of HIV-negative injection drug users who reported recent sharing of drug injection paraphernalia ("works"). Findings indicate that intentions to share works less often in the future may be influenced directly by drug users' perceived risk of infection, which in turn is influenced by their level of HIV knowledge, perceived susceptibility to HIV, and perceived peer norms regarding drug-related risk reduction.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Safer and unsafe injection drug use and sex practices among injection drug users in Halifax, Nova Scotia. An exploratory look at community and interpersonal influences.

OBJECTIVE: This qualitative study sought to explore the community and interpersonal (e.g., peer) influences affecting safer and unsafe injection drug use and sexual practices among injection drug users (IDUs) living in and around Halifax, Nova Scotia. METHODS: Sixty semi-structured interviews were conducted with IDUs, and key themes were identified. Two focus groups were also conducted to obtain feedback on the findings. RESULTS: There are key community and peer influences on drug use and sex practices. Needle exchange provides community access to clean needles, but when the needle exchange is closed, accessibility is an issue. Peers at times assist in reducing sharing by providing clean needles to friends who are without a needle or cannot access needles because of their circumstances (e.g., in prison). Peers also sometimes encourage condom use, but in certain contexts (e.g., with an intimate partner) condom use is often not supported. INTERPRETATION: Expanded and new prevention strategies--especially those utilizing peers--are urgently needed to discourage unsafe practices, and encourage safer practices among this population.

Adult↗