Alcohol consumption and binge drinking among university students in a city in the state of Rondônia / Consumo de álcool e prática de binge drinkingentre universitários em uma cidade no interior de Rondônia

Objective: to verify the prevalence and pattern of alcohol consumption among the academics of a higher educa-tion institution located in the interior of the state of Rondônia. Methods: cross-sectional and observational study with all students enrolled in the institution in 2017. Were used the Alcohol, Smoking and Substance Involvement Screening Test to identify alcohol consumption and other classes of psychoactive substances. To characterize binge drinking was adopted the definition by the National Institute on Alcohol and Alcoholism and, and exclusion criteria was defined the questionnaire was not filled in completely and the request of the participant. The data were ana-lyzed with SPSS program 17. The univariate analysis was used to describe quantitative variables and the bivariate analysis to verify the association between the use of alcoholic beverages and the independent variables (sex, age) the level of significance was set at 5%. Results: 518 subjects participated in the study, with a mean age of 23.1 years, of which 355 (68.5%) were female and 163 (31.5%) were male. Among these, 385 (74.3%) stated that they consume alcoholic beverages, 282 (54.4%) started consuming less than 18 years and 239 (57%) reported practic-ing BD. Among BD practitioners, 48.9% do so at least once a month.Conclusion: there was a high prevalence of alcohol consumption and binge drinking among university students, which predisposes these individuals to physical, emotional, and social problems. Such findings should serve as a warning for the need for public policies aimed at preventing alcohol consumption that begins during adolescence (AU)

Objetivo: verificar a prevalência e o padrão de consumo de álcool entre acadêmicos de uma instituição de ensino superior do interior do estado de Rondônia. Método: estudo transversal e observacional com todos os estudantes matriculados no ano de 2017. Foi utilizado o Alcohol, Smoking and Substance Involvement Screening Test para identificar o consumo de álcool e outras classes de substâncias psicoativas. Para a caracterização de binge drinkingadotou-se a definição do National Institute on Alcohol and Alcoholism e, como critérios de exclusão, definiu-se o não preenchimento completo do questionário e solicitação do participante. Os dados foram analisados com o auxílio do programa SPSS 17. Procedeu-se à análise univariada para descrição das variáveis quantitativas e análise bivariada para verificar a associação entre o uso de bebidas alcoólicas e as variáveis independentes (sexo, idade), adotan-do-se o nível de significância de 5%. Resultados: participaram do estudo 518 indivíduos, com média de idade de 23,1 anos, sendo 355 (68,5%) do sexo feminino e 163 (31,5%) masculino. Dentre esses, 385 (74,3%) afirmaram que consomem bebidas alcoólicas, 282 (54,4%) iniciaram o consumo com menos de 18 anos e 239 (57%) referiram praticar o BD. Entre os praticantes de BD, 48,9% o fazem pelo menos uma vez ao mês.Conclusão: observou-se elevada prevalência de consumo de bebidas alcoólicas e de prática de binge drinking entre os universitários, o que predispõe esses indivíduos a problemas físicos, emocionais e sociais. Tais achados devem alertar para a necessidade de políticas públicas que visem a prevenção de consumo de álcool que se inicia durante a adolescência (AU)

Acute effect of the COVID-19 pandemic on emergency transportation due to acute alcoholic intoxication: a retrospective observational study

BACKGROUND@#The COVID-19 pandemic has caused changes in people's drinking habits and the emergency management system for various diseases. However, no studies have investigated the pandemic's impact on emergency transportation for acute alcoholic intoxication. This study examines the effect of the pandemic on emergency transportation due to acute alcoholic intoxication in Kochi Prefecture, Japan, a region with high alcohol consumption.@*METHODS@#A retrospective observational study was conducted using data of 180,747 patients from the Kochi-Iryo-Net database, Kochi Prefecture's emergency medical and wide-area disaster information system. Chi-squared tests and multiple logistic regression analyses were performed. The association between emergency transportation and alcoholic intoxication was examined. The differences between the number of transportations during the voluntary isolation period in Japan (March and April 2020) and the same period for 2016-2019 were measured.@*RESULTS@#In 2020, emergency transportations due to acute alcoholic intoxication declined by 0.2%, compared with previous years. Emergency transportation due to acute alcoholic intoxication decreased significantly between March and April 2020, compared with the same period in 2016-2019, even after adjusting for confounding factors (adjusted odds ratio 0.67; 95% confidence interval 0.47-0.96).@*CONCLUSIONS@#This study showed that lifestyle changes due to the COVID-19 pandemic affected the number of emergency transportations; in particular, those due to acute alcoholic intoxication decreased significantly.

Consumo de alcohol en estudiantes de Licenciatura de Medicina UNIBE Costa Rica. Febrero-Marzo, 2015 / Alcohol consumption in bachelor´s students of medicine at UNIBE Costa Rica. February-March, 2015

Resumen Español: El objetivo general de esta investigación consistió en estimar la prevalencia y los patrones de consumo de alcohol en universitarios de licenciatura de medicina de la UNIBE entre febrero-marzo 2015. La población en estudio correspondió con 231 estudiantes de licenciatura matriculados en la carrera de medicina en el periodo de febrero a marzo del año 2015 en la Universidad Iberoamericana (UNIBE). Para este cálculo se consideró un intervalo de confianza del 95%, una prevalencia esperada del 20% y nivel alfa del 5 %. La estimación de la muestra fue de n= 120 individuos. La selección se hizo por muestreo sistemático. Con el presente trabajo se logró estimar la prevalencia del consumo de alcohol en estudiantes de licenciatura UNIBE, que corresponde con un 68.9%. De acuerdo con los resultados del presente estudio es posible afirmar que la prevalencia de consumo de alcohol es alta en la población universitaria estudiada. Además se halló que los patrones de consumo que tienen los estudiantes incluyen: 1) frecuencia de consumo corresponde con menos de 1 vez al mes, 2) la edad de inicio más frecuente corresponde con 18 años o incluso menos, 3) ocasiones de consumo la principal razón corresponde con momentos especiales y 4) bebida más consumida corresponde con la cerveza y no existen diferencias significativas entre sexos. Dentro de los desafíos futuros que nacen a partir de este estudio se encuentran: la búsqueda de intervenciones destinadas a disminuir la dependencia alcohólica y potenciar el consumo de alcohol responsable, en estudiantes de medicina.

Inglés The main objective of this investigation was to estimate the prevalence and consumption pattterns of alcohol in bachelor´s students of medicine at UNIBE between the months of January and March 2015. The population consisted of 231 bachelor students enrolled in the career of medicine between February and March at Iberoamerican University (UNIBE). For this calculation a confidence interval of 95% and an estimated prevalence of 20% were used, with an alpha level of 5%. The estimation of the sample was n= 120 individuals. The selection was made with systematic sampling. With this investigation it was possible to estimate the prevalence of alcohol consumption in the population of bachelor medical students at UNIBE, which corresponds with 68.9%, which show that the alcohol prevalence is high in this population. Also it was found that the consumption patterns of alcohol among students include:1) frequency of consumption at least once a month, 2) the age of onset which was more frequent was 18 years or less, 3) the main reason of consumption was special occasions, and 4) the beverage mostly consumed corresponds with beer and there were no significant differences between sexes. Within the future challeges that come out of this investigation is the search of interventions destined to reduce the alcoholic dependence and potentiate the responsible consumption of alcohol amongst medical students.

Papel protector del ácido fólico en un biomodelo de intoxicación alcohólica prenatal en ratas Wistar / Protective role of folic acid in a biomodel of prenatal alcohol intoxication in Wistar rats

Introducción: el etanol es un agente teratógeno cuyo consumo excesivo representa un importante problema de salud a nivel mundial. Objetivo: demostrar el papel protector del ácido fólico sobre el Sistema Nervioso Central y las dimensiones craneofaciales, en un biomodelo de intoxicación alcohólica prenatal en ratas Wistar. Métodos: estudio experimental con crías de tres grupos de ratas gestantes: sin intoxicación alcohólica; con 5 ml de etanol al 40 por ciento durante la gestación y con 5 ml de etanol al 40 por ciento más 200 µg/día de ácido fólico. Se evaluó en las crías la presencia de meningocele, encefalocele y microcefalia, y se midieron las dimensiones craneofaciales. Se utilizó la comparación de proporciones para muestras independientes, la prueba de Kruskal-Wallis y se estimó una asociación de riesgo estadísticamente significativa para un intervalo de confianza del Odds-Ratio que no contenga la unidad. Resultados: la suplementación con ácido fólico en ratas gestantes con intoxicación alcohólica, evitó en las crías la aparición de encefalocele, redujo la microcefalia, la disminución del diámetro biparietal y de la distancia entre los globos oculares, sin embargo, no logró evitar totalmente los daños en el Sistema Nervioso Central, ni impedir la disminución del diámetro anteroposterior ni de la distancia poro nasal-oreja. Conclusión: el biomodelo demostró el efecto tóxico del etanol y la protección del ácido fólico sobre el Sistema Nervioso Central y algunas dimensiones craneofaciales de las crías. Una dosis superior de ácido fólico a la utilizada en el experimento, pudiera ser recomendada para lograr una mayor protección de la descendencia(AU)

Introduction: ethanol is a teratogenic agent and its excessive consumption represents a major worldwide health problem. Objective: to demonstrate the protective role of folic acid on the Central Nervous System and craniofacial dimensions in a biomodel of prenatal alcohol intoxication in Wistar rats. Methods: an experimental study with offspring of three groups of pregnant rats: without alcohol intoxication; with 5 ml of 40 percent ethanol during gestation and with 5 ml of 40 percent ethanol plus 200 µg/day of folic acid. The presence of meningocele, encephalocele and microcephaly was evaluated in the offspring and the craniofacial dimensions were measured. The comparison of proportions for independent samples, the Kruskal-Wallis test and a statistically significant risk association was estimated for an Odds-Ratio confidence interval not containing the unit. Results: supplementation with folic acid in pregnant rats with alcohol intoxication prevented the onset of encephalocele of the offspring, reduce the microcephaly, diminution of the biparietal diameter and the distance between the eyeballs, however the damage of the Central Nervous System could not completely avoided, and not prevent the reduction of the anteroposterior diameter or the nasal-ear pore distance. Conclusion: the biomodel demonstrated the toxic effect of ethanol and the protection of folic acid on the Central Nervous System and some craniofacial dimensions of the offspring. A higher dose of folic acid, than the one used in the research, could be recommended to achieve a better protection of the offspring(AU)

Magnitud y características de la intoxicación por alcohol metílico. Hospital Nacional Dos de Mayo / Magnitude and features of methanol poisoning. Hospital Nacional Dos de Mayo

Objetivo: Determinar la magnitud, características clínicas y bioquímicas de la intoxicación por alcohol metílico en pacientes admitidos al Servicio de Emergencia del Hospital Nacional Dos de Mayo. Materiales y métodos: Estudio analítico. La población fueron los pacientes que ingresaron a Emergencia del Hospital Nacional Dos de Mayo con diagnóstico de intoxicación por metanol (CIE 10: T51.1). Las variables fueron epidemiológicas (edad, sexo, ocupación, uso de narcóticos, cocaína, alcoholismo crónico e infección por HIV), clínicas (intoxicación por metanol) y bioquímicas (glicemia, urea, creatinina, electrolitos séricos y, especialmente, metanolemia). Se empleó el software SPSS, versión 23.00. Se determinaron medidas de tendencia central y de dispersión, y también Odds Ratio con sus respectivos intervalos de confianza al 95 %, se consideró estadísticamente significativo el valor de p< de 0,05. Resultados: El 90 % de casos fue ocasionado por ingesta accidental de bebida adulterada. El 87,5 % de los pacientes eran de nivel socioeconómico bajo. La metanolemia promedio fue de 72,04 mg/L (DE+39,70) y la mortalidad global fue de 12,5 %. El perfil bioquímico predominante fue acidosis metabólica severa con anión gap elevado. Conclusiones: La intoxicación por metanol representa el 0,15 % del total de consultas de emergencia; el perfil clínico se caracteriza por hipotensión, taquicardia, taquipnea, asociado a trastorno del sensorio, vómitos, midriasis y nistagmo, respectivamente. La acidosis metabólica severa se relacionó con incremento de morbimortalidad

Objective: To determine the magnitude, and clinical and biochemical features of methanol poisoning in patients admitted to the emergency room of the Hospital Nacional Dos de Mayo. Materials and methods: An analytical study was performed with data from patients diagnosed with methanol poisoning who were admitted to the emergency room of the Hospital Nacional Dos de Mayo, Lima, Peru. Collected data included age, gender, occupation, place of origin, cocaine use, chronic alcoholism, HIV infection, and clinical data associated with methanol poisoning. For the analysis, statistical measures of central tendency and dispersion were used, and 2x2 contingency tables were developed in the bivariate analysis. For the evaluation of the likelihood ratio, confidence intervals were established at 95 %, and a p-value < 0.05 was considered significant. Results: Ninety percent (90%) of the cases occurred due to the accidental ingestion of an adulterated drink. Eighty- seven point five percent (87.5 %) of the patients had low socioeconomic status. Average blood methanol level was 72.04 mg/L (SD ± 39.70) and overall mortality was 12.5 %. The predominant biochemical profile was severe high-anion gap metabolic acidosis. Conclusions: Methanol poisoning accounts for 0.15 % of total emergency room consultations. Its clinical profile is characterized by hypotension, tachycardia, tachypnea, sensory disorders, vomiting, mydriasis and nystagmus. Severe metabolic acidosis was associated with increased morbidity and mortality

Avaliação de pacientes vítimas de trauma cranioencefálico com sinais de intoxicação alcoólica / Evaluation of traumatic brain injury patients with signs of alcohol intoxication

RESUMO Objetivo: avaliar, em vítimas de traumatismo cranioencefálico, a influência da intoxicação alcoólica no tempo para submissão destes pacientes à tomografia de crânio, comparando também os achados tomográficos nos pacientes alcoolizados e não alcoolizados. Métodos: estudo retrospectivo de 183 pacientes com traumatismo cranioencefálico, divididos em dois grupos: 90 alcoolizados e 93 não alcoolizados. Foi calculado o intervalo de tempo desde a chegada do paciente ao pronto socorro até a realização da tomografia para comparação entre os grupos, e analisados os achados tomográficos. Resultados: no grupo alcoolizado, o percentual de pacientes do sexo masculino foi maior, a idade predominante situava-se entre os 31 e os 40 anos, a agressão foi o mecanismo de trauma mais frequente e estes pacientes apresentaram valores mais baixos na escala de coma de Glasgow. Observou-se que não houve diferença estatística entre os dois grupos quanto ao intervalo de tempo para realização de tomografia, bem como, em relação aos achados tomográficos. Além disso, nos pacientes alcoolizados, quando correlacionados os valores da escala de coma de Glasgow com o intervalo de tempo, não houve diferença entre valores de 13 a 15 (traumatismo cranioencefálico leve) e os iguais ou menores do que 12 (traumatismo cranioencefálico moderado e grave). Conclusão: os sinais de intoxicação alcoólica não influenciaram no intervalo de tempo para realização da tomografia. Os pacientes alcoolizados apresentaram escores mais baixos na escala de coma de Glasgow por efeito direto do álcool e não por uma maior prevalência de achados tomográficos.

ABSTRACT Objetive: to evaluate the influence of alcohol intoxication in the time to perform head computed tomography and tomographic findings in traumatic brain injury patients. Methods: a retrospective study of 183 traumatic brain injury patients, divided into two groups: 90 alcoholics and 93 non-alcoholics. Time interval from patient's arrival at emergency room to tomography was calculated for comparison between the groups, and tomographic findings were analyzed. Results: in the alcoholic group, the percentage of male patients was higher, the predominant age was between 31 and 40 years, aggression was the most frequent trauma mechanism, and these patients showed lower values on the Glasgow coma scale. It was observed that there was no statistical difference between the two groups regarding the time interval for tomography execution, as well as regarding the tomographic findings. In addition, in the alcoholic patients, when the Glasgow coma scale values were correlated with the time interval, there was no difference from scores 13 to 15 (mild traumatic brain injury) and those equal to or inferior than 12 (moderate and severe traumatic brain injury). Conclusion: signs of alcoholic intoxication did not influence the time interval for tomography execution. Patients under alcohol influence showed lower scores on the Glasgow coma scale due to the direct effect of alcohol and not due to a higher prevalence of tomographic findings.

Risco social de famílias de usuários de drogas internados por trauma físico social / Risk for the family of drug users hospitalized due to physical injury / Riesgo social para la familia de usuarios de drogas hospitalizado por un trauma fisico

Objetivo: Classificar o risco social de famílias de indivíduos internados por trauma físico e usuários de drogas, investigados como eventos sentinela. Métodos: Estudo exploratório-descritivo, realizado em um centro de assistência toxicológica do Paraná, com 30 eventos sentinela - indivíduos internados com diagnóstico de trauma físico associado à intoxicação por drogas de abuso, no período de abril a setembro de 2014. Instrumentos de coleta de dados foram um roteiro para entrevista semiestruturada e a Escala do Risco Familiar de Coelho e Savassi, respondidos por um familiar informante-chave. Os escores foram analisados descritivamente. Resultados: A pontuação dos escores da Escala de Risco Familiar indicou 19 famílias em risco social, sendo nove com Risco máximo, e famílias com percentuais sociodemográficos de camadas populares da população. Conclusão: Tempo de uso das drogas de abuso, desemprego e baixo vínculo social dos eventos sentinela, influenciaram os índices de risco familiar

Objetivo: Clasificar el riesgo social familiar delos consumidores de drogas a largo plazo y hospitalizado por un trauma físico. Método: Estudio exploratorio descriptivo, realizado en un centro de asistencia toxicológica de Paraná, con eventos centinela - 30 personas hospitalizadas con diagnóstico de trauma físico asociado a la intoxicación por drogas de abuso, de abril a septiembre de 2014. Instrumentos de recolección de datos fueron una hoja de ruta para la entrevista semiestructurada y Escala de Riesgo Familia de Coelho y Savassi, respondida por un informante clave familiar. Las puntuaciones se analizaron descriptivamente. Resultados: La puntuación de la Escala de Riesgo familia indicaron 19 familias en riesgo social, nueve con máximo riesgo, y las familias con el porcentaje sociodemográfico de las clases más bajas de la población. Conclusión: Uso del tiempo de las drogas de abuso, el desempleo y la baja vínculo social de los eventos centinela influyeron en los índices de riesgo de la familia

Objective: The study's purpose has been to classify the familiar social risk of long-term drug users and hospitalized due to physical trauma. Methods: It is a descriptive-exploratory study that was carried out in a toxicological assistance center from Parana State and through 30 sentinel events - hospitalized individuals diagnosed with physical trauma associated with poisoning by drugs abuse, over the period from April to September 2014. Data collection instruments were a semi-structured interview and the Coelho-Savassi's Family Risk Scale, where it was answered by a family key-informant. The scores were analyzed descriptively. Results: The Family Risk Scale score have indicated that 19 families were under social risk, where 9 of them were under maximum risk, and have also shown families with socio-demographic percentage matching the lower classes of the population. Conclusion: The following categories influenced the family risk rates: drugs of abuse use period; unemployment; and low social bond of sentinel events

Analysis of BMSCs-intervened viscoelasticity of sciatic nerve in rats with chronic alcoholic intoxication

Abstract Purpose: To investigate the impact of bone mesenchymal stem cells (BMSCs) intervention on the viscoelasticity of sciatic nerve in rats with chronic alcohol intoxication (CAI). Methods: The CAI rat models were prepared, divided into model groups, and treated with either BMSCs or basic fibroblast growth factor (bFGF). Then the rats underwent electrophysiological test and the serum levels of malondialdehyde (MDA), superoxide dismutase (SOD), and metallothionein (MT) were measured. Histological observation, stress relaxation test, and creep test were performed for the sciatic nerve of the CAI model in each group. Results: The MDA level of group BMSC was significantly lower (p<0.05) than that of groups MOD (the CIA model) and bFGF. The SOD and MT levels were higher in group BMSC than in groups MOD and bFGF (p<0.05). The motor nerve conduction velocity and amplitude were higher in group BMSC than in groups MOD and bFGF (p<0.05). The amounts of 7200s stress reduction and 7200 s strain increase of the sciatic nerve in group BMSC were greater than those in groups bFGF and MOD (p<0.05). Conclusion: Bone mesenchymal stem cells can improve the metabolism of free radicals, restore the tissue morphology and viscoelasticity of the chronic alcohol intoxication animal model, and positively affect the repairing of the injured sciatic nerve.

A case of acute bilateral thalamic infarction presenting in a sleep-like coma after alcohol ingestion

The artery of Percheron is a rare anatomical variant, in which a common trunk arises from one posterior cerebral artery and then branches to supply each of the thalami and the midbrain separately. Occlusion of this artery triggers a bilateral thalamic infarction. The most commonly reported clinical findings are an altered mental status, vertical gaze palsy, and memory impairment. A 51-year-old man was transferred to the emergency department with a sudden loss of consciousness after drinking alcohol. He appeared to be sleeping deeply. His wife insisted that he had not drunk a quantity of alcohol that would render him unconscious. Magnetic resonance imaging of the brain revealed an acute, bilateral, paramedian thalamic infarction. He was admitted and treated with antiplatelet agents. On the following day, four-vessel cerebral angiography revealed stenosis of the left, distal vertebral artery. Three weeks after admission, he was discharged with persistent hypersomnia, memory impairment, and behavioral changes.

Comprehensive Laboratory Analysis of Korean Acute Alcoholic Intoxication Patients Reveals the Need for a National Hepatitis B Virus Vaccination Program in Korea / 가정의학회지

BACKGROUND: Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem. METHODS: We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017. RESULTS: A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia ( 7.0%). Positive rates of hepatitis B surface antigen and anti-HBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively. CONCLUSION: Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

Avaliação de uma intervenção preventiva em motoristas usuários e não usuários de álcool - um estudo piloto / Evaluation of a preventive intervention in alcoholic and non-alcoholic drivers - a pilot study / Evaluación de una intervención preventiva en conductores usuarios y no usuarios de alcohol - un estudio piloto

Neste estudo piloto avaliamos os comportamentos de beber e dirigir e os conceitos de autocrítica sobre este tema em indivíduos que pretendiam dirigir após a saída de bares e restaurantes. Também avaliamos a eficácia de uma intervenção preventiva em seus comportamentos futuros de beber e dirigir. Os participantes tiveram seus níveis de alcoolemia (BAC) avaliados e responderam um questionário, recebendo um folheto informativo durante a intervenção breve. A maioria dos participantes (69%) apresentaram BAC abaixo dos limites criminais estabelecidos por lei e 31% acima deste limite. Após um mês, o questionário foi novamente aplicado e não se observou redução significativa no comportamento de beber e dirigir após um mês, indicando a necessidade de intervenções mais efetivas.

In this pilot study, we evaluated the drinking and driving behavior and the concepts of self-assessment on this theme of people who had consumed alcohol and intended to drive a motor vehicle after leaving bars and restaurants. We also evaluated the efficacy of a preventive intervention on their future behavior. The participants had their blood alcohol concentration (BAC) evaluated, answered a questionnaire and received a booklet during a very brief intervention. Most of the participants (69%) had BAC below the legally permitted level, and 31% above it. One month later, they answered the questionnaire once more and no significant reduction was observed in the use of alcohol before driving after the intervention, indicating the need for more effective interventions.

En este estudio piloto evaluamos los comportamientos de consumo de alcohol y los conceptos de autocrítica sobre este tema en personas con intención de conducir un vehículo automotor después de salir de bares y restaurantes. También evaluamos la eficacia de una intervención preventiva en comportamiento futuro de beber y conducir. Nosotros evaluamos el nivel de alcoholemia en la sangre (BAC) de los participantes, seguido de un cuestionario. Los participantes también recibieron durante la intervención un prospecto con información acerca del consumo de alcohol e accidentes de tráfico. La mayoría de los participantes (69%) estaban por debajo de los límites legales de BAC y el 31% por encima de este límite. Después de un mes, el cuestionario se aplicó de nuevo y no detectamos ninguna reducción en la conducta de beber y conducir, indicando la necesidad de intervenciones más eficaces.

The Validity of the Triage Tool as a Method to Screen Severe Alcoholic Intoxication Patients in the Emergency Department

PURPOSE: Altered mental status is common to alcohol intoxicated patients, resulting in difficulties to perform detailed physical examination and history taking. With this condition, the development of appropriate tools for evaluation was required. This study was conducted to investigate a better method for predicting the prognosis among alcohol intoxicated patients in the emergency department by modifying the Korean Triage Acuity Scale (KTAS). METHODS: We retrospectively reviewed the medical records of 1,155 alcohol intoxicated patients who presented to the ED between January and December of 2013. The correlation between admission and demographical characteristics of patients was analyzed. We applied the clinical values to KTAS (overdose category) and modified KTAS (alcoholic intoxication category). The efficiency of two triage methods was compared by using the receiver operating characteristic (ROC) curve analysis. RESULTS: Among these 1,155 patients, 201 were admitted and 954 were discharged. The sensitivity and specificity of the overdose category were 0.736 and 0.623, respectively. Those of the alcoholic intoxication category were 0.647 and 0.979, respectively. The area under ROC curves for overdose category and alcoholic intoxication category were 0.679±0.020 and 0.813±0.021, respectively (95% confidence interval, p<0.001). CONCLUSION: This study showed that the sensitivities of the overdose category and the alcoholic intoxication category were similar. However, the specificity of the alcoholic intoxication category was higher than that of the overdose category. Therefore, the alcoholic intoxication category was superior to the overdose category in predicting the prognosis among alcohol intoxicated patients.

Relationship between the Expression of α-syn and Neuronal Apoptosis in Brain Cortex of Acute Alcoholism Rats / 法医学杂志

OBJECTIVES@#To observe the changes of expression of α-synuclein （α-syn） and neuronal apoptosis in brain cortex of acute alcoholism rats and to explore the mechanism of the damage caused by ethanol to the neurons.@*METHODS@#The model of acute alcoholism rat was established by 50% alcohol gavage. The α-syn and caspase-3 were detected by immunohistochemical staining and imaging analysis at 1 h, 3 h, 6 h and 12 h after acute alcoholism. The number of positive cell and mean of optical density were detected and the trend change was analyzed. The variance analysis and t-test were also performed.@*RESULTS@#The number of α-syn positive cell and average optical density in brain cortex of acute alcoholism rat increased significantly and peaked at 6 hour with a following slight decrease at 12 h, but still higher than the groups at 1 h and 3 h. Within 12 hours after poisoning, the number of caspase-3 positive cell and average optical density in brain cortex of rats gradually increased.@*CONCLUSIONS@#The abnormal aggregation of α-syn caused by brain edema and hypoxia may participate the early stage of neuronal apoptosis in brain cortex after acute alcoholism.

Prevalence and risk of potentially adverse drug interactions in the treatment of acute alcohol poisoning

ABSTRACT The aim of this paper is to determine the profile of acute alcohol poisoning and to estimate the risk of potentially adverse drug interactions (ADIs) in patients intoxicated by alcohol when attended in emergency care at hospital. A descriptive serial cross-sectional study was performed with 4,271 individuals intoxicated by alcohol, from January 2009 to July 2011. Possible correlations were measured by Pearson's chi-square test. The data show high consumption in the population, especially in males between 25 and 59 years. The main circumstances for poisoning were alcohol misuse (96.3%). After treatment complete recovery from the signs or symptoms of the poisoning was observed in 96.88% cases; and death in 0.70%. The demonstration of potential risk for ADIs in medical care included 300 medical records which contained a history of acute alcohol poisoning. Possible drug-drug interactions (44.2%) and drug-alcohol interactions (55.8%) were demonstrated in 60.60% of analyzed medical records. Among these cases, 3%, 92.4% and 4.6% were classified as mild, moderate and severe, respectively. The measurement of ADIs aims to prevent clinical complications in medical care for alcohol misuse disorders.

RESUMO O objetivo deste trabalho foi definir o perfil de intoxicação alcoólica aguda e estimar o risco de interações medicamentosas adversas (IMAs) potenciais em pacientes com intoxicação alcoólica atendidos na emergência hospitalar. Um estudo descritivo, serial, de corte transversal foi realizado com 4.271 indivíduos com intoxicação alcoólica, de janeiro 2009 a julho 2011. Correlações foram medidas pelo teste qui-quadrado. Os dados mostram alto consumo na população estudada, especialmente em homens de 25 a 59 anos. A principal circunstância de intoxicação foi o abuso (96,3%). Após tratamento, cura foi observada em 96,88% dos casos e morte em 0,7%. O risco de IMAs potenciais no atendimento médico incluiu 300 prontuários médicos com histórico de intoxicação alcoólica aguda. Possíveis interações medicamentosas (44,2%) e interações fármaco-álcool (55,8%) foram observadas em 60,6% dos prontuários analisados. Entre elas, 3%, 92,4% e 4,6% foram classificadas como leve, moderada e grave, respectivamente. A medição das IMAs visa a prevenir complicações clínicas no atendimento dos agravos devido ao abuso de álcool.

Involvement of adolescents from Northern Portugal with alcohol / Involucramiento de adolescentes del Norte de Portugal con el alcohol / Envolvimento de adolescentes do Norte de Portugal com o álcool

ABSTRACT Objective: to analyze the relationship between sociodemographic variables and involvement of adolescents with alcohol. Method: a cross-sectional descriptive and correlational study, with a quantitative approach, was conducted with a sample of 378 students who attended regular high school in the city of Chaves, in Northern Portugal. A questionnaire that included the Adolescent Alcohol Involvement Scale was used as data collection instrument. Results: most students were female (60.8%), aged between 17 and 18 years (53.2%), and fit in the category "Regular drinker without problems" (79.9%). Male adolescents were more commonly involved with alcohol (p=0.010). Conclusion: involvement with alcohol seems to be in an intermediate level, associated with gender, age group, level of schooling, and religious practice. These results justify the development of community interventions, with the aim of preventing alcohol consumption.

RESUMEN Objetivo: analizar la relación entre las variables sociodemográficas y el involucramiento de los adolescentes con el alcohol. Método: se realizó un estudio descriptivo-correlacional y transversal de enfoque cuantitativo, con una muestra de 378 estudiantes que asisten al colegio regular en el condado de Chaves, Norte de Portugal. Como instrumento de recolección de datos se utilizó un cuestionario que incluía la escala del Involucramiento de los Adolescente con el Uso de Alcohol. Resultados: la mayoría de los estudiantes de la muestra eran mujeres (60,8%), pertenecían al grupo de edad de 17-18 años (53,2%) y entraron en la categoría de "bebedor habitual sin problemas" (79,9%). Los hombres mostraron un mayor involucramiento con las bebidas alcohólicas (Mann-Whitney: p=0,010). Conclusiones: el involucramiento con el alcohol parece estar en un nivel intermedio, siendo relacionado con el sexo, edad, grado y práctica de una religión. Estos resultados justifican realizar intervenciones en la comunidad, para prevenir el consumo..

RESUMO Objetivo: analisar a relação entre variáveis sociodemográficas e envolvimento de adolescentes com o álcool. Método: estudo descritivo-correlacional, transversal de abordagem quantitativa, com uma amostra de 378 alunos, que frequentavam o ensino secundário regular, no Concelho de Chaves, Norte de Portugal. Como instrumento de coleta de dados, utilizou-se um questionário que incluía a escala de Envolvimento com o Álcool para Adolescentes. Resultados: a maioria dos alunos era do sexo feminino (60,8%), pertencia ao grupo etário dos 17-18 anos (53,2%) e enquadrava-se na categoria "bebedor habitual sem problemas" (79,9%). Os adolescentes do sexo masculino tinham um maior envolvimento com as bebidas alcoólicas (p=0,010). Conclusão: o envolvimento com o álcool parece estar num nível intermediário, relacionado com o sexo, grupo etário, ano de escolaridade e prática de uma religião. Esses resultados justificam o desenvolvimento de intervenções comunitárias, com o objetivo de prevenir o consumo de bebidas alcoólicas.

The neuroprotective effect of complex herbal medicine «Sedaphyte» on ethanol induced experimental alcoholic chronic intoxication / Монголын Анагаах Ухаан

BackgroundThe overindulging alcohol leads to the structural changes in neurons of the brain, and to damages ofthe brain cognitive processes.GoalTo determine the neuroprotective effect of complex herbal medicine «Sedaphyte» on ethanol inducedexperimental animal model.MethodsWe determined an abilities of avoid the inactive - unconditional reflex of rats on ethanol inducedexperimental model in dose 40% ethanol 9 ml/кg during 45 days per os. We were measured thequantity of malondialdehyde (MDA) and the activity of catalyze in brain tissue and analyzed thehistology of brain tissue. The water infusion of complex herbal medicine «Sedaphyte» used in dose1,0 ml/100g, also in comparison group was used Pyracetam in dose 200 mg/kgResultsThe complex herbal medicine «Sedaphyte» preserved the inactive - unconditional reflex of rats onchronically administrated ethanol in the form of keep in the dark chamber period was enhanced in67 - 70% after 24 hours and in 44, 3 - 66, 8% after 7 days in comparison with control group. Also“Sedaphute” was decreased the amount of dark hyperchromic cell in hippocampus of rats brain onethanol - induced alcoholic intoxication in 40%, the concentration of MDA in 52% and enhanced thecatalyse activity in 30% in comparison with control group.Conclusion. Our studies were shown that the complex herbal medicine “Sedaphyte” hasneuroprotective effect in the experimental alcoholic intoxication. The principal mechanism of thispharmacological neuroprotective action is connected with the inhibition on lipid peroxidation andstimulatation on the antioxidant system of complex herbal medicine “Sedaphyte”.

Exposição ao álcool entre escolares e fatores associados / Exposición al alcohol entre escolares y factores asociados / Exposure to alcohol among adolescent students and associated factors

OBJETIVO : Analisar a prevalência de consumo de álcool entre escolares adolescentes e identificar fatores individuais e contextuais associados. MÉTODOS : Estudo baseado em dados da Pesquisa Nacional de Saúde Escolar (PeNSE), com amostra de 59.699 escolares do 9º ano, residentes nas capitais brasileiras e no Distrito Federal, em 2009. A associação entre consumo regular de álcool e as variáveis explicativas independentes foi medida utilizando-se o teste Qui-quadrado de Pearson com nível de significância de 0,05. As variáveis explicativas foram classificadas em quatro categorias (sociodemográficas, contexto escolar e familiar, fatores de risco e fatores de proteção). As análises multivariadas foram feitas por categoria, ajustadas por idade e sexo. As variáveis com p ≤ 0,10 foram inseridas no modelo final de análise multivariada. RESULTADOS : O maior consumo de álcool nos últimos 30 dias esteve independentemente associado a escolares: com 15 anos (OR = 1,46) ou mais, do sexo feminino (OR = 1,72), de cor branca, filhos de mães com maior escolaridade, que estudam em escola privada, que experimentaram tabaco (OR = 1,72) e drogas (OR = 1,81), que têm consumo regular de tabaco (OR = 2,16) e que já tiveram relação sexual (OR = 2,37). Os fatores relativos à família foram: faltar às aulas sem o conhecimento dos pais (OR = 1,49), pais não saberem o que escolares fazem no tempo livre (OR = 1,34), fazer menor número de refeições com os pais (OR = 1,22), relato de que os pais não se importariam se chegassem bêbados em casa (OR = 3,05), ou se importariam pouco (OR = 3,39), e ter sofrido violência doméstica (OR = 1,36). CONCLUSÕES : Os resultados confirmam a importância de considerar o álcool na adolescência como um fenômeno complexo, ...

OBJETIVO : Analizar la prevalencia de consumo de alcohol entre escolares adolescentes e identificar factores individuales y contextuales asociados. MÉTODOS : Estudio basado en datos de la Investigación Nacional de Salud Escolar (PeNSE), con muestra de 59.699 escolares del 9° (noveno) año, residentes en las capitales brasileñas y en el Distrito Federal, en 2009.La asociación entre consumo regular de alcohol y las variables explicativas independientes fue medida utilizándose la prueba de Chi-cuadrado de Pearson con nivel de significancia de 0,05. Las variables explicativas fueron clasificadas en cuatro categorías (sociodemográficas, contexto escolar y familiar, factores de riesgo y factores de protección). Los análisis multivariados fueron realizados por categoría, ajustados por edad y sexo. Las variables con p< 0,10 fueron insertadas en el modelo final de análisis multivariado. RESULTADOS : El mayor consumo de alcohol en los últimos 30 días estuvo independientemente asociado a escolares: con 15 años (OR= 1,46) o más, del sexo femenino (OR= 1,72), de color blanco, hijos de madres con mayor escolaridad, que estudian en escuela privada, que probaron el tabaco (OR= 1,72) y drogas (OR= 1,81), que tienen consumo regular de tabaco (OR= 2,16) y que ya tuvieron relación sexual (OR= 2,37). Los factores relativos a la familia fueron: faltar a las aulas sin el conocimiento de los padres (OR= 1,49), padres no saber lo que los escolares hacen en su tiempo libre (OR= 1,34), hacer menor número de comidas con los padres (OR= 3,05), o se importarían poco (OR= 3,39), y haber sufrido violencia doméstica (OR= 1,36). CONCLUSIONES : Los resultados confirman la importancia de considerar el alcohol en la adolescencia como un fenómeno complejo, multifactorial y socialmente determinado. .

OBJECTIVE : To describe the prevalence of alcohol consumption among adolescent school students and identify its individual and contextual associated factors. METHODS : The present research used data from the 2009 National School Health Survey (PeNSE), which included a sample of 59,699 9th grade students in Brazilian capitals and the Federal District. The association between regular alcohol consumption and independent explanatory variables was measured by means of the Pearson’s Chi-square test, with a 0.05 significance level. The explanatory variables were divided into four groups based on affinity (sociodemographic; school and family context; risk factors; and protection factors). A multivariate analysis was carried out for each group, always adjusting for age and sex. Variables with p < 0.10 were used in the final multivariate analysis model. RESULTS : The highest alcohol consumption in the preceding 30 days was independently associated with pupils aged 15 years (OR = 1.46) and over, female (OR = 1.72), white, children of mothers with higher education, studying in private school, students who had tried smoking (OR = 1.72) and drug use (OR = 1.81), with regular tobacco consumption (OR = 2.16) and those who have had sexual intercourse (OR = 2.37). The factors related to family were skipping school without parental knowledge (OR = 1.49), parents not knowing what children do in their free time (OR = 1.34), having fewer meals with their parents (OR = 1.22), reporting that parents do not care (OR = 3.05), or care little (OR = 3.39) if they go home drunk, and having suffered domestic violence (OR = 1.36). CONCLUSIONS : The results reinforce the importance of viewing alcohol consumption among adolescents as a complex, multifactorial and socially determined phenomenon. .

Discursos e representações sobre o uso/abuso do álcool: um estudo da comunidade indígena / Speeches and representations about the use/abuse of alcohol: a study in the indigenous community

RESUMO Estudo descritivo e qualitativo realizado com 45 índios Potíguara em dois municípios da Paraíba, com o objetivo de conhecer as representações sociais elaboradas por esses indivíduos acerca do uso/abuso do álcool em sua comunidade, O instrumento utlizado foi uma entrevista semiestruturada, realizada por meio da Análise de Conteúdo Temática de Bardin. Constatou-se a emersão de quatro categorias, as quais versam sobre o conceito, as causas, as consequências e as alternativas para solucionar o problema do uso abusivo de álcool na comunidade Potíguara. Os resultados encontrados proporcionam um maior conhecimento das especificidades culturais potiguaras e podem auxiliar os órgãos competentes na implantação de políticas públicas que contemplem essa problemática.

ABSTRACT Descriptive and qualitative study conducted with 45 Potiguara Indians in two cities of Paraíba, in order to understand the social representations made by Potiguara Indians about the use/abuse of alcohol in their community. The instrument used was a semi structured interview, which was analyzed by qualitative analysis of Bardin. It was noted the emergence of four categories, which deal with the concept, causes, consequences and alternatives to solve the problem of alcohol abuse in the Potiguara community The results provide a better understanding of the potiguara's cultural specificities and can assist the institutions in the implementation of public politics that cover this problem.

A systematic review of alcohol use and sexual risk-taking in Latin America / Revisión sistemática de la relación entre el consumo de alcohol y la toma de riesgos sexuales en América Latina

OBJECTIVE: To provide an account of published literature on the association between alcohol use and sexual risk-taking, focusing on Latin America. METHODS: A search of MEDLINE, Embase, Web of Science, LILACS, and Cochrane databases identified 561 unique articles. After excluding those that were not directly relevant, 30 studies were retained for review. RESULTS: Twenty-seven studies showed direct or indirect associations between alcohol abuse and unprotected/risky sex. Three studies, however, showed no association between these variables, suggesting that the public health message of safer sex may have been effective. CONCLUSIONS: Further research is needed to identify factors and behaviors that could be modified to reduce the association between alcohol use disorders and risky sexual behavior.

OBJETIVO: Proporcionar una descripción de la bibliografía sobre la asociación entre el consumo de alcohol y la toma de riesgos sexuales, con foco en América Latina. MÉTODOS: Una búsqueda en las bases de datos MEDLINE, Embase, Web of Science, LILACS y Cochrane permitió seleccionar 561 artículos singulares. Tras excluir los que no eran pertinentes, se retuvieron 30 estudios para su análisis. RESULTADOS: Veintisiete estudios revelaron asociaciones directas o indirectas entre el consumo excesivo de alcohol y el sexo sin protección o de riesgo. Sin embargo, tres estudios no mostraron ninguna asociación entre estas variables, lo que sugiere que las recomendaciones de salud pública en pro de una actividad sexual de menor riesgo podrían haber sido eficaces. CONCLUSIONES: Se requiere llevar a cabo nuevas investigaciones para establecer los factores y los comportamientos que podrían ser objeto de modificación para reducir la asociación entre los trastornos por consumo de alcohol y el comportamiento sexual de riesgo.

Fatores associados a beber pesado episódico entre estudantes de medicina / Factors associated with heavy episodic drinking among medical students

INTRODUÇÃO: Beber pesado episódico (BPE) é importante problema de saúde pública, pelas conseqüências negativas para o indivíduo e a sociedade. O objetivo desse estudo foi investigar a prevalência de BPE entre estudantes de medicina e os fatores associados ao problema. MÉTODOS: Foram entrevistados todos os estudantes de medicina do 1º ao 8º períodos da Faculdade de Ciências Médicas e da Saúde de Juiz de Fora. Aplicou-se o questionário AUDIT, de forma auto-preenchida e anônima. RESULTADOS: A prevalência de uso de álcool foi de 91%. BPE teve prevalência de 25%, maior para os homens (p < 0,001). Houve associação positiva de BPE com ter iniciado o uso de álcool antes da faculdade e tabagismo em ambos os sexos, e associação negativa com ser praticante de religião para os homens e ter relacionamento fixo para as mulheres. CONCLUSÕES: Encontrou-se alta prevalência de BPE entre os estudantes de medicina. As faculdades deveriam ter papel mais ativo na orientação de seus estudantes quanto ao consumo de álcool, pois estes serão futuros promotores de saúde.

INTRODUCTION: Heavy episodic drinking (HED) is a major public health issue, with negative consequences for the individual and society. The aim of this study was to investigate the prevalence of HED among medical students and the factors associated with the problem. METHODS: We interviewed all the medical students from the 1st to 8th semesters at the Juiz de Fora School of Medical Sciences and Health. We applied the AUDIT questionnaire, which is self-completed and anonymous. RESULTS: The prevalence of alcohol use was 91%. HED was 25% more prevalent among men (p <0.001). HED was positively associated with having begun consuming alcohol before college and being a smoker in both sexes, and negatively associated with religious practice to men and having stable relationships for women. CONCLUSIONS: We found a high prevalence of HED among medical students. Colleges should take a more active role in guiding their students about the consumption of alcohol, as these students will be health promoters in the future.