Atenção Profissional a Familiares de Dependentes de Álcool no CAPs AD / Professional Care for Family Members of Alcohol Dependents in the CAPs AD / Atención Profesional a Familiares de Dependientes de Alcohol en el CAPs AD

Familiares de dependentes de álcool vivem intenso sofrimento emocional que os vulnerabiliza a ponto de necessitarem cuidado profissional. No Brasil, o Centro de Atenção Psicossocial Álcool e Drogas (CAPs AD) é o serviço público de referência no atendimento psicossocial a usuários de álcool e outras drogas. A partir da constatação da inexistência de artigos científicos sobre intervenções com familiares dos dependentes de álcool no CAPs AD, dada a profusão de trabalhos que tratam do dependente ou das políticas públicas que fundamentam o serviço, elaboramos três hipóteses sobre essa lacuna. A primeira propõe que na base dessa ausência de modalidades terapêuticas específicas esteja a concepção de que o cuidado aos familiares no CAPs AD é o mesmo e independe das peculiaridades de cada substância psicoativa. A segunda hipótese parte do fato de que a constante ameaça de aniquilamento dos próprios CAPs AD e a consequente luta para sua sobrevivência comprometeria pesquisas para o desenvolvimento de intervenções cada vez mais especializadas. E, finalmente, a hipótese de que a maior demanda de atendimento de usuários de mais de uma substância desarticularia a proposição de intervenções com familiares de dependentes de álcool. Esperamos que este estudo contribua para a elaboração de intervenções mais afinadas às necessidades desse público.

Family members of alcohol dependents live intense emotional suffering that makes them vulnerable to the point of needing professional care. In Brazil, the Psychosocial Care Center for Alcohol and Drugs (CAPSad) is the public service of reference in psychosocial care for users of alcohol and other drugs. Based upon the lack of studies on interventions for family members of alcohol dependents in the CAPSad, contrasting with the profusion of works that deal with the dependent or the public policies that support the service, we elaborated three hypotheses about this gap. The first one proposes that at the center of this abscense of specific therapeutic modalities there is the idea that care for family members in the CAPSad is the same and does not depend on the peculiarities of each psychoactive substance. The second hypothesis derives from the fact that the constant threat of annihilation of the CAPSad themselves and the struggle for their survival would compromise the development of increasingly specialized interventions. At last, the hypothesis that the greater demand for assistance from multiple substance users would dismantle the proposal of interventions with family members of alcohol dependents. We expect that this study will contribute to the development of interventions in accord with the needs of this audience.

Familiares de dependientes de alcohol viven intenso sufrimiento emocional que los vulnera hasta que necesiten cuidado profesional. En Brasil, el Centro de Atención Psicosocial Alcohol y Drogas (CAPs AD) es el servicio público referencial a la atención psicosocial a usuarios de alcohol y drogas. Desde la constatación de la inexistencia de ensayos sobre intervenciones con familiares de dependientes de alcohol en CAPs AD, dada la profusión de trabajos que tratan del dependiente o de las políticas públicas que fundamentan el servicio, se elaboró tres hipótesis sobre esa brecha. La primera propone que en la base de esa ausencia de modalidades terapéuticas específicas esté una concepción de que el cuidado a los familiares en CAPs AD es lo mismo y no depende de las peculiaridades de cada material psicoactivo. La segunda hipótesis parte del hecho de que la constante amenaza de aniquilación de los CAPs AD y consecuente lucha para su sobrevivencia comprometería investigaciones al desarrollo de intervenciones todavía más especializadas. Finalmente, la hipótesis de que la mayor demanda de atención a usuarios de más de una sustancia desestructuraría la proposición de intervenciones con familiares de dependientes de alcohol. Se espera que este estudio contribuya a la elaboración de intervenciones específicas a las necesidades de ese público.

"La ruptura en el cuidado": Experiencias de mujeres madres con abuso de alcohol y su atención en México / "The break in care": Mothers' experiences with alcohol abuse and care in Mexico

RESUMEN Este artículo se propone analizar las experiencias sobre la maternidad y los cuidados de mujeres madres que asisten a grupos de apoyo mutuo en la Ciudad de México y el Estado de México para autoatender los daños asociados al alcohol. A partir del marco conceptual de la salud colectiva y la perspectiva de género, se concibe que la condición de género y socioeconómica inciden en la determinación social del alcoholismo y en el proceso salud-enfermedad-atención-cuidado. Desde este enfoque, de mayo de 2020 a enero de 2021, se realizó un estudio cualitativo, en el que se entrevistó a diez mujeres elegidas bajo ciertos criterios y se realizó observación no participante en un grupo femenino Alcohólicos Anónimos. Entre los principales resultados, se reconoce una trayectoria de abuso de alcohol y su atención, concatenada con la trayectoria de cuidados. Este hallazgo delimitó la categoría de "ruptura en el cuidado" para develar el maltrato, la precarización de vida y salud de las mujeres y sus hijos e hijas.

ABSTRACT This article aims to analyze the experiences related to motherhood and care among mothers who attend mutual support groups to address alcohol-related harm in Mexico City and the State of Mexico. Drawing on the conceptual framework of collective health from a gender perspective, we contend that socioeconomic and gender-related factors influence the social determination of alcoholism and the health-disease-attention-care process. A qualitative study was conducted between May 2020 and January 2021, which included interviews with ten women who were selected based on specific criteria, as well as non-participant observation in a women's Alcoholics Anonymous group. The main findings show how trajectories of alcohol abuse and its management are interconnected with trajectories of care. From there, it was possible to identify a "break in care," a category that sheds light on mistreatment and the precariousness of life and health of women and their children.

Theoretical-methodological rationales in caring for family members of people with alcohol use disorders / Racionalidades teórico-metodológicas no cuidado aos familiares de pessoas com transtornos por uso de álcool

Objective: The present study aims to understand the theoretical-methodological rationales which guide psychological care practices for family members of people with alcohol use disorders. Method: For this theoretical-reflective study we conducted a systematic search for literature review articles to learn about the modality of interventions, their theoretical-methodological frameworks and clinical or efficacy results. Afterwards, a complementary search for articles and book chapters was conducted to map and analyze the most used professional care practices and their theoretical assumptions. Results: We identified six theoretical-methodological rationales that guide the professional's clinical reasoning in caring for family members, which are organized around key concepts about their emotional suffering: 1) family stress; 2) family dynamics; 3) behavioral repertoire deficit; 4) codependency; 5) inflexibility; 6) potential for psychological change. Conclusion: The identification of these rationales can aid professionals when planning their practices in a critical and informed manner.

Objetivo: Este estudo objetiva compreender as racionalidades teórico-metodológicas que guiam práticas psicológicas de cuidado a familiares de pessoas com transtornos por uso de álcool. Método: Para este estudo teórico-reflexivo realizamos uma busca sistemática de artigos de revisão de literatura para compreender as modalidades de intervenção, seus enquadres teórico-metodológicos e resultados clínicos ou eficácia. Na sequência, uma busca complementar de artigos e capítulos de livro foi conduzida a fim de mapear e analisar as práticas de cuidado profissional mais utilizadas, bem como seus pressupostos teóricos. Resultados: Foram identificadas seis racionalidades teórico-metodológicas que guiam o raciocínio clínico do profissional em torno de conceitos-chave sobre o sofrimento emocional dos familiares: 1) estresse familiar; 2) dinâmica familiar; 3) déficit de repertório comportamental; 4) conduta codependente; 5) rigidez das defesas psíquicas; 6) potencialidade para a mudança psicológica. Conclusão: A identificação dessas racionalidades auxilia o profissional no planejamento de suas práticas de modo crítico e informado.

Epidemiology and risk factors of hypoglycemia in subjects with type 1 diabetes in Brazil: a cross-sectional, multicenter study

ABSTRACT Objective: The aim of this study was to investigate the factors associated with hypoglycemia and severe hypoglycemia (SH) in individuals with type 1 diabetes mellitus (T1D) in Brazil. Materials and methods: This multicenter, cross-sectional study was conducted between August 2011 and August 2014 across 10 Brazilian cities. The data were obtained from 1,760 individuals with T1D. Sociodemographic and clinical characteristics related to hypoglycemic events in the previous 4 weeks were evaluated. Results: Of 1,760 individuals evaluated, 1,319 (74.9%) reported at least one episode of hypoglycemia in the previous 4 weeks. The main factors associated with hypoglycemia were lower hemoglobin A1c (HbA1c) level, better adherence to self-monitoring of blood glucose (SMBG), and higher education level. Episodes of SH were reported by 251 (19%) individuals who, compared with subjects with nonsevere hypoglycemia, received lower doses of prandial insulin and higher doses of basal insulin, in addition to reporting less frequent use of long-acting basal insulin analogs. The percentage of SH episodes was evenly distributed across all ranges of HbA1c levels, and there were no correlations between the mean number of nonsevere or severe hypoglycemic events and HbA1c values. Higher alcohol consumption and more frequent hospitalizations were independently associated with SH. Conclusion: Although individuals presenting with hypoglycemia had lower HbA1c values than those not presenting hypoglycemia, there were no correlations between the number of nonsevere hypoglycemia or SH and HbA1c values. Also, the frequency of SH was evenly distributed across all ranges of HbA1c values. Better adherence to SMBG and higher education level were associated with hypoglycemia, while alcohol consumption, higher doses of basal insulin, and more frequent hospitalizations in the previous year were associated with SH.

Perceived discrimination and alcohol consumption in an indigenous population / Discriminación percibida y consumo de alcohol en una población indígena

Abstract Introduction Indigenous populations are considered a vulnerable minority and have characteristics such as poverty, difficulties to access food, housing, and educational backwardness; these conditions make them prone to alcohol consumption problems. Dependence on alcohol consumption probably arises as a symbol of protest, challenge, and response to social anguish, which has in turn repercussions in marginal population sectors that have conditions of fragility due to exploitation and discrimination, such as indigenous people. Objective To know the effect of perceived discrimination on alcohol consumption in Mexican indigenous population. Method Research design was descriptive, correlational check-model, with a sample of 362 adults from two indigenous communities. Results A simple linear regression model was performed, which shows a significant effect in the entire model (F[248] = 78.312, p = .001), which explains 49% of the variance of alcohol consumption. A significant positive influence was also found from the perceived discrimination variable (β = .626, p < .001) on alcohol consumption. Discussion and conclusion The studied indigenous communities had characteristics that the literature highlights as risk factors for developing addictive behaviors of alcohol consumption. These results coincide with those of the National Commission for the Development of Indigenous Peoples. Indigenous population present discrimination problems that are associated with alcohol consumption problems.

Resumen Introducción Las poblaciones indígenas se consideran minoritarias y vulnerables, y se caracterizan por su pobreza, dificultad para acceder a la alimentación, la vivienda y el rezago educativo. Estas condiciones los vuelven propensos a presentar problemas de consumo de alcohol. La dependencia al consumo de alcohol surge probablemente como símbolo de protesta, reto y respuesta a la angustia social, lo cual repercute en los sectores poblacionales marginales que poseen condiciones de fragilidad por la explotación y discriminación como los pueblos indígenas. Objetivo Conocer el efecto de la discriminación percibida en el consumo de alcohol en poblaciones indígenas mexicanas. Método El diseño del estudio fue descriptivo, correlacional de comprobación de modelo, con una muestra de 362 adultos de dos comunidades indígenas. Resultados Se realizó el modelo de regresión lineal simple el cual muestra efecto significativo en la totalidad del modelo (F[248] = 78.312, p = .001), explica el 49% de la varianza del consumo de alcohol, además se encontró influencia positiva significativa de la variable discriminación percibida (β = .626, p < .001) sobre el consumo de alcohol. Discusión y conclusión Las comunidades indígenas estudiadas poseen características que la literatura destaca como factores de riesgo para desarrollar conductas adictivas de consumo de alcohol, estos resultados coinciden con lo expuesto por la Comisión Nacional para el Desarrollo de los Pueblos Indígenas. Las poblaciones indígenas presentan problemas de discriminación que se asocian con los problemas de consumo de alcohol.

Why MBBS Students are Taking to Substance Abuse ? — A Retrospective Study on the Pattern and Causes of Substance Abuse among the MBBS Students of West Bengal

Background : Substance abuse is an important health hazard and also a major preventable cause of morbidity and mortality. This habit not only affects health, education and occupational career, but also incurs huge financial and social burden to the society specially when the doctors are involved in it. Aims and objectives : To estimate the prevalence of substance abuse, its pattern and causes among the MBBS students of West Bengal. Methods : A questionnaire based cross-sectional retrospective study was designed to collect data from the Medical Officers of the State to record their experience of substance abuse during their MBBS course. Results : The prevalence of substance abuse was 22% among the study participants. Smoking Tobacco was most common (16.67%). 76% of the subjects with substance abuse spend Rs1000 or less per month. The prevalence was 25% in upper class and 22.22% among those who belonged to lower class of socio-economic status as per BG Prasad Classification. Curiosity was the reason as per 34.5% of the subjects followed by depression (23.25%), peer pressure (13%) study pressure by 15%; media influence by 11%; to cope with home problems by 10.75% and parental influence by 2.25% of the study subjects. Conclusion : The institution should keep a Psychological Counselor who can guide the students who suffer from problems related to Depression, Peer pressure, Study pressure that may lead to substance abuse. Allotting, hobbies, sports and recreation would help in keeping away from substance abuse

Efeito de intervenções breves na redução do consumo de álcool em adultos: revisão sistemática / The effect of brief interventions on reducing alcohol consumption in adults: a systematic review / Efecto de las intervenciones breves en la reducción del consumo de alcohol en adultos: revisión sistemática

RESUMO Objetivo: sintetizar evidências sobre efeitos das intervenções breves na redução do consumo de bebidas alcóolicas entre adultos. Método: estudo de revisão sistemática, cadastrado protocolo na International Prospective Register of Systematic Reviews, registro nº CRD42020153034. A busca foi realizada em 2020, em bases de dados eletrônicas e foram incluídos ensaios clínicos randomizados que avaliavam os efeitos de Intervenções Breve em adultos bebedores de álcool. Resultados: foram avaliados 11 artigos. Todos os estudos realizaram, nos grupos controle e experimental, teste de identificação do padrão de consumo de álcool, com oferta de feedback para o usuário em seguida. As intervenções utilizam metodologias que incitam o usuário à tomada de decisão, bem como manter a decisão tomada e evitar recaídas. Conclusão: esta pesquisa contribui para o ensino e assistência em saúde, por meio de reflexões sobre a identificação do abuso de álcool e compilado sobre a aplicação e impacto das Intervenções Breves.

ABSTRACT Objective: to synthesize evidence on the effects of brief interventions on reducing alcohol consumption among adults. Method: systematic review study, protocol registered in the International Prospective Register of Systematic Reviews, registration no. CRD42020153034. The search was conducted in 2020, in electronic databases and randomized clinical trials that evaluated the effects of Brief Interventions in adult alcohol drinkers were included. Results: 11 articles were evaluated. All studies performed, in the control and experimental groups, a test to identify the pattern of alcohol consumption, with feedback offered to the user afterwards. The interventions use methodologies that encourage the user to make a decision, as well as maintain the decision made and avoid relapse. Conclusion: this research contributes to health care teaching and assistance, through reflections on the identification of alcohol abuse and compiled on the application and impact of Brief Interventions.

RESUMEN Objetivo: sintetizar las pruebas sobre los efectos de las intervenciones breves para reducir el consumo de alcohol entre los adultos. Método: estudio de revisión sistemática, protocolo registrado en el Registro Internacional Prospectivo de Revisiones Sistemáticas, número de registro CRD42020153034. La búsqueda se realizó en 2020, en bases de datos electrónicas y se incluyeron ensayos clínicos aleatorios que evaluaron los efectos de las Intervenciones Breves en bebedores de alcohol adultos. Resultados: Se evaluaron 11 artículos. Todos los estudios realizaron, en los grupos de control y experimental, una prueba para identificar el patrón de consumo de alcohol, con una retroalimentación ofrecida al usuario después. Las intervenciones utilizan metodologías que incitan al usuario a tomar una decisión, así como a mantener la decisión tomada y evitar recaídas. Conclusión: esta investigación contribuye a la docencia y a la atención sanitaria, a través de reflexiones sobre la identificación del abuso de alcohol y recopiladas sobre la aplicación y el impacto de las Intervenciones Breves.

Comparative Study of Serum LDL And HDL In Alcoholics & Non-Alcoholics

Background : Alcohol abuse is one of the major form of addiction and a major threat to public health in developed as well as developing countries. Alcohol intake is increased in quantity and frequency over last few decades. Alcohol consumption pre-disposes subjects to changes in serum Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL) which are associated with cardiovascular risk. Methods : 100 alcoholics were compared with 100 non-alcoholics. Alcohol drinking history was assessed by interview and questionnaire and we measured serum LDL and HDL level. Results : There were significant rise in HDL and LDL in chronic alcoholics when compared with non alcoholics with p value

Prevalencia de consumo de alcohol en estudiantes universitarios de enfermería / Prevalence of alcohol consumption in nursing students

Introducción El consumo de alcohol es un problema de salud pública, que afecta la vida de los jóvenes universitarios. Esto debido a que, al ser una droga de tipo legal, estimula el consumo y hace que se coloque como la de mayor uso con impacto en la salud y la formación universitaria. Objetivo Identificar el consumo de alcohol en estudiantes universitarios de enfermería de una institución pública de Minatitlán Veracruz, México. Métodos Estudio descriptivo y transversal, realizado entre octubre y noviembre de 2020. Participaron de forma voluntaria y anónima 260 estudiantes universitarios de licenciatura en enfermería. La información fue recolectada mediante dos instrumentos. El primero indagó datos personales y el segundo fue el Test de Identificación de los Trastornos Debidos al Consumo de Alcohol (AUDIT). Resultados El 64,6% de los estudiantes indicó consumo de alcohol alguna vez en la vida, con inicio a los 16,3 años. La bebida de preferencia fue la cerveza (53,6%). Los principales proveedores de la bebida alcohólica fueron amigos (62,5%) y familiares (34,5%). El 59,6% tiene consumo de bajo riesgo, 4,6% consume de riesgo y 0,4% reporta dependencia. No hubo diferencias significativas entre el patrón de consumo y las actividades en el tiempo libre (X2 = 25,970; p = 0,355). Se encontró relación de los patrones de consumo de alcohol de los estudiantes con la edad, semestre que cursa actualmente, consumo alguna vez en la vida, así como el consumo de la familia y los amigos (p < 0,01). Conclusiones Existe una estrecha relación entre el inicio y mantenimiento del consumo de alcohol con el contexto social, familiar y escolar de los estudiantes de enfermería. Este resultado indica la necesidad de realizar programas de salud que den seguimiento al consumo durante la formación universitaria.

Introduction Alcohol consumption is a public health problem that affects university students. The legality of alcohol facilitates consumption among the young and makes it the most used drug in this population, impacting health and university education. Objective To identify alcohol consumption among nursing students of a public institution in Minatitlán, Veracruz, Mexico. Methods Descriptive cross-sectional study, conducted between October and November 2020. A total of 260 nursing students participated voluntarily and anonymously. The information was collected using two instruments. The first one inquired about personal data, and the second one evaluated drinking through the Alcohol Use Disorders Identification Test (AUDIT). Results We found that 64.6% of students reported drinking at least once, with a mean age at drinking onset of 16.3 years. The preferred beverage was beer (53.6%), and the main providers of alcoholic beverages were friends (62.5%) and family (34.5%). A total of 59.6% of students had a low risk drinking patter, 4.6% had a high-risk drinking patter, and 0.4% reported dependence. There were no significant differences between drinking patterns and leisure time activities (X2 = 25.970; p = 0.355). There was a significant relationship between students' alcohol consumption patterns and age, current semester, drinking at least once, and drinking with family and friends (p < 0.01). Conclusions There is a close relationship between the initiation and maintenance of alcohol consumption with nursing students' social, family, and school context. These findings should encourage health programs that follow up on alcohol consumption during university training.

Association between tobacco and alcohol use among hospital inpatients / Associação do uso de álcool e tabaco entre pacientes hospitalizados

We aimed to evaluate concurrent use of alcohol and tobacco among hospitalized patients as well as to compare the use of both substances among people living with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome and those with other diagnoses. A cross-sectional study took place in a hospital in Minas Gerais (Brazil). Structured surveys were used to evaluate tobacco and alcohol use. Data analysis was conducted using descriptive statistics and chi-square test. We interviewed 972 patients, in which 20.3% were hazardous drinkers and 14.9% tobacco users. Almost half of the smokers (47.6%) were hazardous drinkers, while 15.5% of nonsmokers engaged in harmful consumption of alcohol (p < 0.001). Tobacco use was higher among people living with Human Immunodeficiency Virus when compared with patients that did not have an Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome diagnosis (32.1% vs 14.4%, p = 0.009). Our findings showed the association of tobacco use and hazardous drinking among hospitalized patients in Brazil and a higher prevalence of tobacco use among patients living with Human Immunodeficiency Virus. These findings can be used to develop smoking cessation interventions that address the comorbidities associated with substance use.

O presente estudo teve como objetivo avaliar a associação do uso de álcool e tabaco entre pacientes internados em um hospital geral e comparar o uso das duas substâncias entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida e outros diagnósticos. Realizou-se um estudo observacional em um hospital público para avaliação do uso de tais substâncias. Entre 972 pacientes, 20,3% fizeram uso prejudicial de álcool e 14,9% de tabaco. Quase metade dos tabagistas (47,6%) fizeram uso prejudicial do álcool, enquanto 15,5% dos não tabagistas relataram uso excessivo da substância (p < 0,001). A porcentagem de fumantes foi significativamente mais alta no grupo de pacientes que vivem com o Virus da Imunodeficiência Humana do que nos demais diagnósticos (32,1% vs 14,4%, p = 0,009). Percebe-se a associação do uso de tabaco e uso prejudicial de álcool entre pacientes hospitalizados e alta prevalência do uso de tabaco entre pacientes que vivem com o Vírus da Imunodeficiência Humana/Síndrome de Imunodeficiência Adquirida. Esses dados podem direcionar o planejamento de intervenções para cessação do consumo de tabaco que consigam direcionar as comorbidades relacionadas ao uso da substância

Efeito de intervenções breves na redução do consumo de álcool em adultos: revisão sistemática / The effect of brief interventions on reducing alcohol consumption in adults: a systematic review / Efecto de las intervenciones breves en la reducción del consumo de alcohol en adultos: revisión sistemática

RESUMO Objetivo: sintetizar evidências sobre efeitos das intervenções breves na redução do consumo de bebidas alcóolicas entre adultos. Método: estudo de revisão sistemática, cadastrado protocolo na International Prospective Register of Systematic Reviews, registro nº CRD42020153034. A busca foi realizada em 2020, em bases de dados eletrônicas e foram incluídos ensaios clínicos randomizados que avaliavam os efeitos de Intervenções Breve em adultos bebedores de álcool. Resultados: foram avaliados 11 artigos. Todos os estudos realizaram, nos grupos controle e experimental, teste de identificação do padrão de consumo de álcool, com oferta de feedback para o usuário em seguida. As intervenções utilizam metodologias que incitam o usuário à tomada de decisão, bem como manter a decisão tomada e evitar recaídas. Conclusão: esta pesquisa contribui para o ensino e assistência em saúde, por meio de reflexões sobre a identificação do abuso de álcool e compilado sobre a aplicação e impacto das Intervenções Breves.

ABSTRACT Objective: to synthesize evidence on the effects of brief interventions on reducing alcohol consumption among adults. Method: systematic review study, protocol registered in the International Prospective Register of Systematic Reviews, registration no. CRD42020153034. The search was conducted in 2020, in electronic databases and randomized clinical trials that evaluated the effects of Brief Interventions in adult alcohol drinkers were included. Results: 11 articles were evaluated. All studies performed, in the control and experimental groups, a test to identify the pattern of alcohol consumption, with feedback offered to the user afterwards. The interventions use methodologies that encourage the user to make a decision, as well as maintain the decision made and avoid relapse. Conclusion: this research contributes to health care teaching and assistance, through reflections on the identification of alcohol abuse and compiled on the application and impact of Brief Interventions.

RESUMEN Objetivo: sintetizar las pruebas sobre los efectos de las intervenciones breves para reducir el consumo de alcohol entre los adultos. Método: estudio de revisión sistemática, protocolo registrado en el Registro Internacional Prospectivo de Revisiones Sistemáticas, número de registro CRD42020153034. La búsqueda se realizó en 2020, en bases de datos electrónicas y se incluyeron ensayos clínicos aleatorios que evaluaron los efectos de las Intervenciones Breves en bebedores de alcohol adultos. Resultados: Se evaluaron 11 artículos. Todos los estudios realizaron, en los grupos de control y experimental, una prueba para identificar el patrón de consumo de alcohol, con una retroalimentación ofrecida al usuario después. Las intervenciones utilizan metodologías que incitan al usuario a tomar una decisión, así como a mantener la decisión tomada y evitar recaídas. Conclusión: esta investigación contribuye a la docencia y a la atención sanitaria, a través de reflexiones sobre la identificación del abuso de alcohol y recopiladas sobre la aplicación y el impacto de las Intervenciones Breves.

Fatores associados ao consumo abusivo de álcool em profissionais de enfermagem no estado de São Paulo, Brasil / Factors associated with alcohol abuse in nursing professionals in São Paulo State, Brazil

Resumo Objetivo: identificar fatores associados ao consumo abusivo de álcool entre profissionais de Enfermagem no estado de São Paulo. Métodos: trata-se de um estudo caso-controle aninhado a um transversal. Foram coletados dados sobre características demográficas, do estilo de vida, capacidade para o trabalho, aspectos ocupacionais, do ambiente de trabalho físico e psicossocial e de consumo abusivo de álcool (questionário CAGE). Foi realizada análise de regressão logística múltipla. Resultados: o estudo envolveu 119 casos e 356 controles. Após ajuste por idade, o consumo abusivo de álcool foi associado ao sexo masculino (OR: 3,39; IC95%:1,96;5,85), tabagismo atual ou pregresso (OR: 2,11; IC95%: 1,32;3,38) e à qualidade do sono ruim (OR: 1,91; IC95%:1,12;3,25); e negativamente associado a carga horária de trabalho semanal ≥50 horas (OR: 0,54; IC95%:0,32;0,92) e renda familiar mensal de ≥6,1 salários-mínimos (OR: 0,37; IC95%: 0,20;0,67). Conclusões: jornada de trabalho e características individuais estiveram associadas ao consumo abusivo de álcool. Programas de prevenção e tratamento do consumo abusivo de álcool em profissionais da Enfermagem deveriam ser implementados nos locais de trabalho, visando reduzir os danos causados pelo álcool para trabalhadores e pacientes.

Abstract Objective: to identify factors associated with alcohol abuse in nursing professionals in São Paulo State. Methods: this is a case-control nested in a cross-sectional study. We collected data on demographic characteristics, lifestyle, work ability, occupational features, physical and psychosocial work environment, and alcohol abuse (CAGE Questionnaire). Multiple logistic regression analyses were performed. Results: the study involved 119 participants in the case group and 356 in the control group. After age adjustment, alcohol abuse was associated with male sex (OR: 3.39; 95%CI: 1.96;5.85), current or former smoking (OR: 2.11; 95%CI: 1.32;3.38), and poor sleep quality (OR: 1.91; 95%CI: 1.12;3.25); and negatively associated with ≥50 weekly working hours (OR: 0.54;95%CI: 0.32;0.92) and a monthly family income ≥6.1 minimum wages(OR: 0.37; 95%CI: 0.20;0.67). Conclusions: working hours and individual characteristics were associated with alcohol abuse. Workplaces should implement programs to prevent and treat alcohol abuse in nursing professionals to reduce workers' and patients' alcohol-related harms.

Differences in microbiology and bacterial susceptibility between alcohol abuse and no alcohol abuse in intensive care unit patients / 中国综合临床

Objective:To investigate the differences in microbiological examination results between alcohol abuse and no alcohol abuse in adult ICU patients and the association between alcohol abuse and these differences.Methods:The adult patients with microbiological examination results were selected from the MIMIC-Ⅲ database and divided into two groups according to whether they had alcohol abuse. The two groups were matched by propensity score, and the similarities and differences in microbiological examination results were evaluated between the two groups after matching. The measurement data of non normal distribution were expressed by M ( Q1, Q3). Wilcoxon rank sum test was used for the comparison of the two groups, and the comparison of counting data was used χ 2 test or Fisher exact probability method. Results:After matching, the alcohol abuse patients were more likely to use mechanical ventilation (47.06% (1 379/2 930) vs. 52.66% (1 543/2 930), χ 2=18.14, P<0.001), had a higher positive rate in sputum samples (44.30% (400/903) vs. 49.41% (501/1 014), χ 2=4.81, P=0.028) and had a lower positive rate in other samples (26.85% (653/2 432) vs. 21.67% (541/2 496), χ 2=17.69, P<0.001). In blood samples, the percentage of Gram-negative bacteria was lower in the alcohol abuse group (26.87% (126/469) vs. 17.25% (74/429), χ 2=11.42, P<0.001), while the percentage of Gram-positive bacteria was higher (78.46% (368/469) vs. 86.01% (369/429), χ 2=8.17, P=0.004). The percentage of patients with Pseudomonas aeruginosa (3.75% (110/2 930) vs. 2.08% (61/2 930), χ 2=13.88, P<0.001) and Enterococcus sp. (8.19% (240/2 930) vs. 6.45% (189/2 930), χ 2=6.29, P=0.012) was lower in the alcohol abuse group. However, there was a higher percentage of patients with methicillin-resistant Staphylococcus aureus (2.32% (68/2 930) vs. 3.28% (96/2 930), χ 2=4.57, P=0.032) and Haemophilus influenzae (1.30% (38/2 930) vs. 2.01% (59/2930), χ 2=4.19, P=0.041) in the alcohol abuse group. For Staphylococcus aureus (61.10% (322/527) and 52.66% (267/507), χ 2=7.16, P=0.007) and Enterococcus sp. (75.83% (160/211) and 63.64% (56/88), χ 2=4.02, P=0.045), the alcohol abuse group had a lower resistance to levofloxacin; for Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae, the alcohol abuse group had a lower resistance to cephalosporins (all P<0.05). Conclusions:In adult ICU, alcohol abuse might increase the risks of using mechanical ventilation, and patients with alcohol abuse might be more prone to have respiratory tract infections. Alcohol abuse patients with blood infections were less likely to be infected with Gram-negative bacteria, but had a higher probability of Gram-positive bacteria infection. What is more, Alcohol abuse might increase the risks of infections with Haemophilus influenzae and methicillin-resistant Staphylococcus aureus. In alcohol abuse patients, the infection of Staphylococcus aureus, Enterococcus sp., Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae was less resistant to many antibiotics than that in no alcohol abuse patients.

O transtorno depressivo maior está associado ao diabetes mellitus tipo 2 em pacientes com hepatite C crônica / Major depressive disorder is associated with type 2 diabetes in patients with chronic hepatitis c infection

ABSTRACT BACKGROUND: Major depressive disorder (MDD) is commonly reported in patients with chronic hepatitis C (CHC); however, the factors behind the co-occurrence of these conditions have not been completely clarified yet. OBJECTIVE: We aimed to evaluate the frequency of mental disorders in CHC patients and to investigate variables associated with MDD. METHODS: CHC patients (n=151) attending a referral Centre for hepatitis were evaluated using the Mini-International Neuropsychiatry Interview and the Cut-Annoyed-Guilty-Eye (CAGE) Questionnaire. Multivariate analysis was used to evaluate independent covariates associated with current MDD. RESULTS: Seventy-six (50.3%) patients had, at least, one current psychiatric diagnosis with MDD (33.1%) being the most common. Current MDD was independently associated with age (≤50 yr.) (OR=2.57; 95%CI=1.25-5.29; P=0.01) and type 2 diabetes mellitus (OR=2.80, 95%CI=1.17-6.70; P=0.02). Cirrhosis was associated with type 2 diabetes mellitus (OR=5.09; 95%CI=1.73-15.04; P=0.03) and current alcohol abuse/dependence (OR=2.54; 95%CI=1.04-6.22; P=0.04). DISCUSSION: MDD is associated with type 2 diabetes in CHC patients. Even in the direct-acting antivirals (DAAs) era, characterized by great perspectives for the first ample cure of a chronic viral infection, we should ensure that the screening for psychiatric disorders takes place in the course of routine clinical care of patients chronically infected with hepatitis C virus.

RESUMO CONTEXTO: O transtorno depressivo maior (TDM) é comumente detectado em pacientes com hepatite C crônica. Entretanto, fatores potencialmente associados à coocorrência destas condições não são completamente conhecidos. OBJETIVO: Avaliar a frequência de transtornos mentais em pacientes com hepatite C crônica e investigar variáveis associadas ao TDM. MÉTODOS: Pacientes com hepatite C crônica (n=151) atendidos em um centro de referência para hepatite foram avaliados usando o Mini-International Neuropsychiatry Interview e o questionário Cut-Annoyed-Guilty-Eye (CAGE). Análise multivariada foi usada para avaliar as covariáveis independentes associadas ao TDM atual. RESULTADOS: Setenta e seis (50,3%) pacientes apresentaram pelo menos um diagnóstico psiquiátrico atual; dentre eles destaca-se o TDM (33,1%). TDM atual foi independentemente associado à idade (≤50 anos) (OR=2,57; IC95% = 1,25-5,29; P=0,01) e diabetes mellitus tipo 2 (OR=2,80, IC95% = 1,17-6,70; P=0,02). Cirrose foi associada ao diabetes mellitus tipo 2 (OR=5,09; IC95% = 1,73-15,04; P=0,03) e abuso/dependência de álcool atual (OR=2,54; IC95% = 1,04-6,22; P=0,04). DISCUSSÃO: TDM está associado a diabetes tipo 2 em pacientes com hepatite C crônica. Em vigência da era dos antivirais de ação direta, caracterizada por grandes perspectivas para a primeira cura ampla de uma infecção viral crônica, devemos assegurar que a triagem dos transtornos psiquiátricos ocorra durante o atendimento clínico de rotina de pacientes com infecção crônica pelo vírus da hepatite C.

Binge drinking e fatores associados em indígenas da etnia Karipuna / Binge drinking and associated factors in indigenous people from Karipuna / Binge drinking y factores asociados en indígenas de la etnia Karipuna

OBJETIVO: identificar a prevalência do uso em binge em indígenas Karipuna e verificar a associação desse uso com variáveis sociodemográficas, clínicas e comportamentais da amostra. MÉTODO: trata-se de um estudo transversal realizado com 230 indígenas de 12 aldeias Karipuna em Oiapoque. Obteve-se o rastreio do uso em binge por meio da Questão-Chave. Coletaram-se os dados entre maio e dezembro de 2017. Realizaram-se, a priori, a análise de frequência das variáveis envolvidas no estudo e, na sequência, o teste qui-quadrado e o modelo de regressão logística. RESULTADOS: revela-se que a prevalência do uso em binge foi de 24,8% de uma a três vezes; de 20,4% de quatro a seis vezes; de 12,2% de sete a dez vezes e de 9,6% em mais de dez vezes. Associaram-se os seguintes fatores: estudante (OR=2,99); migração da aldeia de origem (OR=2,22); uso de preservativo (OR=2,62) e relações sexuais após o consumo de álcool (OR=1,61). CONCLUSÃO: alerta-se que o uso ocasional de risco de álcool demanda consideração, bem como o conhecimento das particularidades da população ora investigada, a fim de estabelecer controle, planejamento de recursos terapêuticos para que se alcancem resultados efetivos nas ações planejadas e principalmente nas que são adotadas na prática a fim de prevenir um uso abusivo de álcool.

OBJECTIVE: to identify the prevalence of use in binge in indigenous Karipuna and to verify the association of this use with sociodemographic, clinical and behavioral variables of the sample. METHOD: this is a cross-sectional study carried out with 230 indigenous people from 12 Karipuna villages in Oiapoque. Binge use screening was obtained through the Key Question. Data was collected between May and December 2017. A priori, the frequency analysis of the variables involved in the study was carried out, following the chi-square test and logistic regression model. RESULTS: it is revealed that the prevalence of use in binge was 24.8% from one to three times; 20.4% four to six times; 12.2% seven to ten times and 9.6% more than ten times. The following factors were associated: student (OR = 2.99); migration from the village of origin (OR = 2.22); condom use (OR = 2.62) and sexual intercourse after alcohol consumption (OR = 1.61). CONCLUSION: it is warned that the occasional use of alcohol risk demands consideration, as well as knowledge of the particularities of the population now investigated, in order to establish control, planning of therapeutic resources so that effective results are achieved in the planned actions and especially in those that are adopted in practice in order to prevent alcohol abuse.

OBJETIVO: identificar la prevalencia del uso de binge en indígenas Karipuna y verificar la asociación de este uso con las variables sociodemográficas, clínicas y comportamentales de la muestra. MÉTODO: se trata de un estudio transversal realizado con 230 indígenas de 12 aldeas Karipuna en Oiapoque. Se obtuvo el rastreo del uso de binge por medio de la pregunta clave. Se recogieron los datos entre los meses de mayo y diciembre de 2017. Se realizaron, a priori, el análisis de la frecuencia de las variables del estudio y a continuación se realizó el test chi-cuadrado y el modelo de regresión logístico. RESULTADOS: se revela que la prevalencia del uso de binge fue de 24,8% de una a tres veces; de 20,4% de cuatro a seis veces; de 12,2% de siete a diez veces y de 9,6% en más de diez veces. Se asociaron los siguientes factores: estudiante (OR=2,99); migración de la aldea de origen (OR=2,22); uso de preservativo (OR=2,62) y relaciones sexuales después de consumo de alcohol (OR=1,61). CONCLUSIÓN: se advierte que el uso ocasional de riesgo de alcohol demanda atención, así como tomar conocimiento de las particularidades de la población que está siendo investigada, con la finalidad de establecer control y planificar recursos terapéuticos, para que sean alcanzados resultados efectivos, en las acciones planificadas y, principalmente, en aquellas que son adoptadas en la práctica, con la finalidad de prevenir el uso abusivo del alcohol.

Burnout Syndrome and Consumption of Alcohol and Illicit Substances in University Students / Síndrome de Burnout e Consumo de Álcool e Substâncias Ilícitas em Universitários / Síndrome de Burnout y Consumo de Alcohol y de Sustancias Ilícitas por Universitarios

Abstract The consumption of alcohol and illicit substances has shown alarming levels among young university students, and its use may be associated with the coping strategy of academic burnout. This review aimed to synthesize the scientific evidence related to the consumption of alcohol and illicit substances associated with burnout syndrome in university students. Searches were carried out in: Biblioteca Virtual em Saúde, PubMed, Web of Science, PsycNet and Scopus databases, with no year limitation and based on the PRISMA guideline. Among the 2.269 articles identified, 16 met the inclusion criteria. All studies evaluated students in the health area, 12 studies found an association between the variables, with alcohol and illicit substances consumption strongly related to burnout syndrome. It was concluded that there is an association between the studied variables, indicating that the presence of burnout syndrome in university students can result in the use of negative strategies as a coping measure.

Resumo O consumo de álcool e substâncias ilícita tem apresentado níveis alarmantes entre jovens universitários, e seu uso pode estar associado à estratégia de enfrentamento do burnout acadêmico. Esta revisão teve por objetivo sintetizar as evidências científicas relacionadas ao consumo de álcool e substâncias ilícitas associadas a síndrome de burnout em estudantes universitários. Foram realizadas buscas nas bases: Biblioteca Virtual em Saúde, PubMed, Web of Science, PsycNet e Scopus, sem limitação de ano e baseado na guia PRISMA. Entre os 2.269 artigos identificados, 16 atenderam aos critérios de inclusão. Todos os estudos avaliaram estudantes da área da saúde, 12 estudos encontraram associação entre as variáveis, sendo o consumo de álcool e substâncias ilícitas fortemente relacionado à sindrome de burnout. Concluiu-se que há associação entre as variáveis estudadas, indicando que a presença da síndrome de burnout em universitários pode resultar no uso de estratégias negativas como medida de enfrentamento.

Resumen El consumo de alcohol y de sustancias ilícitas ha mostrado niveles alarmantes entre los jóvenes universitarios, y su uso puede estar asociado con estrategias de enfrentamiento del burnout académico. Esta revisión tuvo como objetivo sintetizar la evidencia científica relacionada con el consumo de alcohol y de sustancias ilícitas asociadas al síndrome de burnout en estudiantes universitarios. Las búsquedas se realizaron en las bases Biblioteca Virtual en Salud, PubMed, Web of Science, PsycNet y Scopus, sin limitación de año y basándose en la guía PRISMA. De los 2.269 artículos encontrados, 16 cumplieron los criterios de inclusión. Todos los estudios evaluaron estudiantes del área de salud y 12 estudios encontraron asociación entre las variables, entre los que el consumo de alcohol y de sustancias ilícitas estuvo fuertemente relacionado con el síndrome de burnout. Se concluyó que existe asociación entre las variables estudiadas, indicando que la presencia de síndrome de burnout en estudiantes universitarios puede resultar en el uso de estrategias negativas como medida de enfrentamiento.

Construção e validação de tecnologia educacional sobre consumo de álcool entre universitários / Construcción y validación de tecnología educativa sobre el consumo de alcohol en estudiantes universitarios / Construction and validation of educational technology about alcohol consumption among university students

RESUMO Objetivo: construir e validar tecnologia educacional sobre consumo de álcool para universitários. Método: estudo metodológico, desenvolvido entre junho de 2015 e julho de 2019, em universidade pública do Amazonas, Brasil. Foram realizadas três etapas: construção, validação de conteúdo e validação de aparência. A validação de conteúdo foi realizada em duas fases com 15 profissionais, e a validação de aparência em uma única fase com 91 acadêmicos de quatro cursos da universidade. Resultados: a tecnologia educacional foi nomeada Consumo de Álcool entre Universitários e está disponível no formato de manual impresso e e-book. Apresentou Índice de Validade de Conteúdo de 0,62 na primeira fase e 0,95 na segunda. Quanto à aparência, obteve Índice de Validade Semântica de 0,89. Considerações finais: o manual mostrou-se válido para utilização entre universitários, e pode contribuir com intervenções educativas nesse âmbito em instituições de ensino superior.

RESUMEN: Objetivo: construir y validar tecnología educativa sobre el consumo de alcohol en estudiantes universitarios. Método: estudio metodológico, desarrollado entre junio de 2015 y julio de 2019, en una universidad pública del Amazonas, Brasil. Se realizaron tres etapas: construcción, validación de contenido y validación de aspecto. La validación de contenido tuvo lugar en dos fases con 15 profesionales, y la validación de aspecto se desarrolló en una única fase con 91 estudiantes de cuatro carreras de la universidad. Resultados: a la tecnología educativa se la denominó Consumo de Alcohol entre Estudiantes Universitarios y está disponible en los formatos de manual impreso y de e-book. Presentó un Índice de Validez de Contenido de 0,62 en la primera fase y de 0,95 en la segunda. En relación al aspecto, obtuvo un Índice de Validez Semántica de 0,89. Consideraciones finales: el manual demostró ser válido para ser usado con estudiantes universitarios, y puede contribuir con intervenciones educativas en este ámbito en instituciones de enseñanza superior.

ABSTRACT Objective: to build and validate educational technology about alcohol consumption among university students. Method: a methodological study conducted between June 2015 and July 2019 in a public university of Amazonas, Brazil. Three stages were conducted: construction, content validation, and face validation. Content validation was carried out in two phases with 15 professionals, and face validation in a single phase with 91 students from four undergraduate courses of the university. Results: the educational technology was named Alcohol Consumption among University Students and is available in print and as an e-book. It presented a Content Validity Index of 0.62 in the first phase, and of 0.95 in the second phase. As for appearance, the Semantic Validity Index was 0.89. Final considerations: the manual showed to be valid for use among university students, and can contribute with educational interventions within this context in higher education institutions.

A experiência de rosa vermelha no contexto do alcoolismo paterno / Red rose's experience in the context of her father's alcoholism / La experiencia de rosa roja en el contexto del acoholismo paterno

Os filhos de alcoolistas sofrem o impacto de uma relação parental marcada pela violência e imprevisibilidade. O objetivo deste estudo é ilustrar a experiência emocional de filhos de alcoolistas com o relato emblemático de um dos 12 participantes de uma pesquisa psicanalítica empírica. Foi realizada uma entrevista psicanalítica com Rosa Vermelha por meio do uso de uma Narrativa Interativa sobre o drama de um filho que aguarda a chegada do pai alcoolizado. Rosa completou a narrativa expressando-se imaginativamente sobre a convivência com o progenitor. O material narrativo foi analisado à luz da psicanálise winnicottiana, resultando em quatro campos de sentidos que comunicam a experiência emocional de filhos de alcoolistas: "Marcas da Violência"; "Desejo Soberano", "Sobrevivendo ao Caos" e "De volta à minha vida". O intenso sofrimento emocional desses filhos que precisam assumir responsabilidades precocemente enseja a produção de futuras pesquisas que subsidiem práticas no contexto do alcoolismo (AU).

Children of alcoholics suffer the impact of a parental relationship characterized by violence and unpredictability. The objective of this study is to illustrate the emotional experience of children of alcoholics by the emblematic account of one of the 12 participants of an empirical psychoanalytic study. A psychoanalytic interview was conducted with the participant Red Rose by means of an Interactive Narrative about the suffering of a child awaiting the arrival of the intoxicated father. Rose completed the narrative through imaginative ideas about living with the alcoholic parent. The narrative material was analyzed in the light of winnicottian psychoanalysis, resulting in four fields of affective-emotional meaning which convey the emotional experience of children of alcoholics: "Scars of Violence"; "Sovereign Desire", "Surviving to Chaos" and "Back to my Life". The intense emotional suffering of those children who have early to take responsibilities suggests the need for further studies to subsidize practices in the context of alcoholism (AU).

Los hijos de alcohólicos sufren el impacto de una relación parental marcada por la violencia e imprevisibilidad. El objetivo de este estudio es presentar la experiencia emocional de hijos de alcohólicos con el relato emblemático de uno de los 12 participantes de una investigación psicoanalítica empírica. Se realizó una entrevista con la participante Rosa Roja utilizando una Narrativa Interactiva (NI) sobre el drama de un hijo que espera la llegada del padre alcoholizado. Rosa la completó expresándose imaginativamente sobre la convivencia con el progenitor alcohólico. El material narrativo fue analizado a la luz del psicoanálisis winnicottiana, resultando en cuatro campos de sentidos afectivo-emocionales: "Marcas de la Violencia"; "Deseo Soberano", "Sobreviviendo al Caos" y "De vuelta a casa". El intenso sufrimiento emocional de quienes necesitan madurar y asumir responsabilidades precozmente da lugar a la producción de nuevas investigaciones que subsidien prácticas psicosociales en el contexto del alcoholismo (AU)

Síndrome de burnout y dependencia al alcohol en estudiantes de medicina

RESUMEN Introducción: el síndrome de Burnout es una enfermedad mental causada por el estrés laboral, situación ampliamente asociada con los médicos y otros profesionales de salud, asimismo, el abuso de sustancias y la depresión también son problemas psiquiátricos que están relacionados con este ámbito. Objetivo: identificar la frecuencia de estudiantes de medicina del área clínica de la Universidad Nacional de Asunción con sospecha de Síndrome de Burnout y trastorno de abuso de alcohol. Metodología: estudio observacional, descriptivo, de corte transversal en estudiantes de medicina del área clínica de la Universidad Nacional de Asunción de Paraguay. Se utilizaron encuestas con la prueba de identificación de desórdenes de uso del alcohol (AUDIT-C), el inventario de Maslach y el screening de depresión PHQ-2. Resultados: de las 157 encuestas, el 43,9% cumplió con los criterios de Síndrome de Burnout, el 49% cumplió los criterios de abuso/dependencia de alcohol y el 38,9% tuvo criterios de alta probabilidad de trastorno depresivo mayor, de ellos la mayoría presentó ideación suicida en los últimos 12 meses. Conclusión: los resultados fueron parecidos a los hallados en la literatura, sin embargo, ciertos aspectos fueron mayores en este estudio, como el porcentaje que cumple los criterios de Síndrome de Burnout, abuso de sustancias e ideación suicida. El Síndrome de Burnout y la dependencia al alcohol son frecuentes en estudiantes de medicina y se asocian comúnmente a trastornos depresivos.

ABSTRACT Introduction: Burnout Syndrome is a mental disorder caused by occupational stress, a situation widely prevalent in doctors and other health professionals. Substance abuse and depression are also psychiatric problems that are related to this area. Objective: To identify the frequency of Burnout Syndrome and its association with Alcohol misuse in medical students in their clinical years at the National University of Asunción. Methodology: Observational, descriptive, cross-sectional study in medical students from the clinical area of the National University of Asunción, Paraguay. Surveys were used with the alcohol use disorder identification test (AUDIT-C), the Maslach inventory and the PHQ-2 depression screening. Results: Of the 157 surveys, 43.9% met the criteria for Burnout Syndrome, 49% met the criteria for alcohol misuse / dependence and 38.9% had high probability crite-ria for major depressive disorder. Most of them presented suicidal ideation in the last 12 months. Conclusion: The results were similar to those found in the literature, however, certain aspects were greater in this study, such as the percentage that meets the criteria for Burnout Syndrome, alcohol misuse and suicidal ideation. Burnout Syndrome and alcohol misuse are frequent in medical students and are commonly associated with depressive disorders.

Desnutrición en pacientes con enfermedad renal crónica hemodializados en el Hospital Regional de Coronel Oviedo

RESUMEN Introducción: Existe una estrecha relación entre la desnutrición y pacientes con enfermedad renal crónica en tratamiento con hemodiálisis. Objetivo: determinar la frecuencia de desnutrición en pacientes con enfermedad renal crónica hemodializados del Hospital Regional de Coronel Oviedo, durante el mes de septiembre del año 2019. Metodología: estudio observacional, descriptivo de corte transversal con muestreo no probabilístico. Se seleccionaron todos los pacientes hemodializados del Servicio de Nefrología del Hospital Regional de Coronel Oviedo, durante el mes de septiembre del año 2019 que en total fueron 59 pacientes. Resultados: la frecuencia de desnutrición fue del 32 % relacionando el peso seco actual con el peso ideal de cada uno de los pacientes. Utilizando el IMC, el 45,8 % tuvo estado nutricional normal, el 28,8 % corresponde a sobrepeso. El 3,4 % presentó desnutrición. La albúmina sérica estaba por debajo de 3,5 g/dl en el 27,1 %. Conclusión: En este estudio se demostró que la frecuencia de desnutrición en los hemodializados se encuentra en un rango bastante amplio dependiendo de los parámetros utilizados. La frecuencia varía con cada parámetro utilizado, y el resultado es más fidedigno si se utilizan diferentes parámetros.

ABSTRACT Introduction: there is a close relationship between malnutrition and patients with chronic kidney disease undergoing hemodialysis treatment. Objective: to determine the frequency of malnutrition in patients with hemodialysis chronic kidney disease of the Regional Hospital of Coronel Oviedo. Methods: observational descriptive cross-sectional study with non-probabilistic sampling. All hemodialysis patients selected from the nephrology department of the Regional Hospital of Coronel Oviedo during the month of September of the year 2019 which in total were 59 patients. Results: the frequency of malnutrition was 32% relating the current dry weight with the ideal weight of each of the patients. Using BMI, 45.8% had normal nutritional status, 28.8% correspond to overweight. The 3.4% presented malnutrition. Serum albumin was below 3.5 g / dl in 27.1%. Conclusion: this study shows that the frequency of malnutrition in hemodialysis patients is in a fairly wide modified range of the parameters used. The frequency varies with each parameter used and the result is more reliable if different parameters are used.