Programa de Estudos e Tratamento do Tabagismo (PROGETA) na Universidade Federal Fluminense / Research and treatment of smoking at Universidade Federal Fluminense

Objetivo: Apresentar o PROGETA (Programa de Estudos e Tratamento do Tabagismo) da Universidade Federal Fluminense e definir o perfil dos fumantes que procuram este programa. Metodologia: Foram avaliados 174 pacientes atendidos no PROGETA, a partir de dados sistemáticos colhidos através de entrevista no início do tratamento. Os autores investigaram a história da dependência à nicotina, assim como sua gravidade (escala de Fagerstrom) e a prevalência de co-morbidades sistêmicas e alcoolismo. Fatores correlacionados à abstinência ao final do tratamento intensivo foram estudados. Resultados: Nessa amostra, 74,7% dos indivíduos eram do sexo feminino, com média de idade de 50 anos. A idade de início do tabagismo foi em média aos 15 anos, havendo diferença significativa nesse dado entre pacientes alcoolistas e não alcoolistas. O grau de dependência de nicotina foi elevado ou muito elevado em 65,5% dos pacientes. Sessenta e oito por cento dos pacientes já tinham conseguido parar de fumar pelo menos uma vez. A ingestão de álcool na adolescência adiantou em cerca de 4 anos a introdução ao hábito de fumar. Apresentar tentativas anteriores bem sucedidas de interrupção do tabagismo foi altamente correlacionado ao sucesso do tratamento (p=0,028). Conclusão: A definição do perfil dos pacientes que buscam o tratamento pode levar a adaptações na metodologia de forma a obter melhores resultados. O alto número de pacientes que já alcançaram a abstinência anteriormente, mas voltaram a fumar, reforça a necessidade de prevenir as recaídas como parte do programa de tratamento. É apresentado o método utilizado pelo PROGETA, incluindo esta fase do tratamento.

Introduction: The aim of the present study was to describe PROGETA (Programa de Estudos e Tratamento do Tabagismo) and its methodology. The profile of smokers who seek treatment is also described. Methodology: One hundred seventy four patients were evaluated. Instrument was a standardized interview at the beginning of treatment. History of nicotinedependence as well as its severity were investigated (Fagerstrom scale). Prevalence of comorbidity, including alcoholism was also analysed. Correlation between variables related to nicotine dependence with abstinence at the end of intensive treatment was studied. Results: The sample was composed by 74.7% of female patients, mean age was 50 years old. Smokingwas initiated at 15 years old (mean). Nicotine dependence severity was high or very high in 65.5% of patients. Sixty eight per cent of patients had already stopped smoking in the past, at least once. Alcohol intake during adolescence resulted in earlier introduction to smoking. Patients who had been able to stop in previous treatments were found more succeful in the present treatment (Sperman correlation p=0.028). Conclusion: Knowledge of the profile of patients who seek treatment may lead tomethodological changes in order to achieve more succefull outcomes. The high number of patients who had already been able to stop smoking previously but relapsed, indicates the need for interventions of relapse as part of treatment. Methodology of PROGETA including this phasis of treatment is presented.

Ethanol in low chronic dose level attenuates major organic effects in malnourished rats

The aim of the present study was to evaluate the chronic toxicity of ethanol low blood levels in malnourished rats. Female Wistar rats (220 g) were subjected to either an ad libitum diet (W, well-nourished, n=10) or food restriction (M, malnourished, n=10). Water (WW and MW) or ethanol solution (W5 percent and M5 percent) was offered to half of each nutritional group (n=5) as the only fluid source. The treatment was continued for two months. After sacrifice, blood biochemical parameters and macroscopic, histologic and morphometric evaluation of the liver were performed. Results indicated that: Ethanol consumption was higher in malnourished rats and minimized body weight loss in malnourished rats, while it decreased the body weight gain in well-nourished ones. Behavioral ethanol intoxication was more severe in malnourished rats. Malnutrition decreased hematocrit and hemoglobin but, on the other hand, ethanol was a protective factor of that effect (hemoglobin: MW 10.6 mg/dl / ME 13.02 mg/dl, p< 0.05). Ethanol increased the relative liver weight of both well-nourished and malnourished rats. Ethanol intake minimized iron pigment, collagen area and binuclear hepatocyte/ field increased by malnutrition. These data are in accordance with previous reports which showed ethanol as an important source of calories and, even chronically, ethanol still attenuates the effects of malnutrition.

Brazilian study on substance misuse in adolescents: associated factors and adherence to treatment

OBJECTIVES: To investigate developmental and environmental factors associated to substance misuse in adolescents seen at a university day-hospital in Brazil and to verify the correlations between those factors and adherence to treatment. To compare factors associated to substance misuse in adolescents with the available scientific literature and to suggest specific preventive interventions for a national policy in Brazil. METHODS: Eighty-six adolescent's guardians were evaluated at admission to the service by using a semistructured interview including sociodemographic data, family relationship, perinatal and pregnancy histories, psychomotor and educational development, social relations, history of previous illnesses and family diseases, including drug abuse. RESULTS: The sample was predominantly male (90 percent). Adolescents referred from the criminal justice were older than those originating from other sources (16.4 x 15.4 years old p=.00). Forty-four percent of adolescents reported school failure, a level which is two times higher than Brazilian statistics. Forty percent of the sample had criminal involvement, mainly drug dealing. Cannabis was the most prevalent reported drug. Living with both parents was protective, delaying the age of initiation by one year. Domestic violence was more frequent among parents with illicit drugs abuse (38.1 percent x 12.5 percent, p<.05). Alcoholism and drug addiction in parents and relatives were about four times higher than those reported for the Brazilian population. No correlation was found between the investigated factors and adherence to treatment. CONCLUSION: Our results indicate that the programs must include treatment of adults and education of parents and parents to be. Withdrawal of treatment occurs in the first month, and seems to be related to factors extrinsic to the adolescent