Relationships of habitual daily alcohol consumption with all-day and time-specific average glucose levels among non-diabetic population samples

BACKGROUND@#Alcohol consumption is a prevalent behavior that is bi-directionally related to the risk of type 2 diabetes. However, the effect of daily alcohol consumption on glucose levels in real-world situations in the general population has not been well elucidated. This study aimed to clarify the relationship between alcohol consumption and all-day and time-specific glucose levels among non-diabetic individuals.@*METHODS@#We investigated 913 non-diabetic males and females, aged 40-69 years, during 2018-2020 from four communities across Japan. The daily alcohol consumption was assessed using a self-report questionnaire. All-day and time-specific average glucose levels were estimated from the interstitial glucose concentrations measured using the Flash glucose monitoring system for a median duration of 13 days. Furthermore, we investigated the association between all-day and time-specific average glucose levels and habitual daily alcohol consumption levels, using never drinkers as the reference, and performed multiple linear regression analyses after adjusting for age, community, and other diabetes risk factors for males and females separately.@*RESULTS@#All-day average glucose levels did not vary according to alcohol consumption categories in both males and females. However, for males, the average glucose levels between 5:00 and 11:00 h and between 11:00 and 17:00 h were higher in moderate and heavy drinkers than in never drinkers, with the difference values of 4.6 and 4.7 mg/dL for moderate drinkers, and 5.7 and 6.8 mg/dL for heavy drinkers. Conversely, the average glucose levels between 17:00 and 24:00 h were lower in male moderate and heavy drinkers and female current drinkers than in never drinkers; the difference values of mean glucose levels were -5.8 for moderate drinkers, and -6.1 mg/dL for heavy drinkers in males and -2.7 mg/dL for female current drinkers.@*CONCLUSIONS@#Alcohol consumption was associated with glucose levels in a time-dependent biphasic pattern.

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)

Analysis of transport and vehicular crash cases using the Online National Electronic Injury Surveillance System (ONEISS) from 2010 to 2019

Introduction@#Around 1.35 million people die due to road traffic accidents yearly. In the Philippines, there is an increasing trend of mortality and morbidity caused by road crashes. @*Objective@#The objective of the study is to show the epidemiology of transport and vehicular crash (TVC) cases in the Philippines using the Department of Health (DOH) Online National Electronic Injury Surveillance System (ONEISS) from 2010 to 2019. @*Methods@#We used data from ONEISS, a web-based system to electronically capture injury-related data from health facilities, store data in a centralized and secure location, process and consolidate data, and transform this data into meaningful information. For Transport and Vehicular Crash cases, risk factors such as drug use, alcohol use, mobile phone use, seatbelt, and helmet use are included. There are also data on vehicle type, place of crash, and activity. Descriptive and inferential statistics were computed to explore and analyze the ONEISS dataset, particularly the epidemiology of transport and vehicular crashes (TVC). @*Results@#There were a total of 296,760/894,989 (31%) patients admitted due to transport and vehicular crash (TVC) based on the 10-year data from ONEISS (2010–2019). There was an increasing trend in the number of transport/ vehicular crashes (TVC) during this period, with an average increase of 25.58% cases per year. Most victims were drivers (45.6%), males (72.5%), and from the younger age group (0-30 years old). Fatal crashes were observed to occur from 6:00 pm to 5:00 am while most accidents occurred during leisure activities (32.5%). The highest reported contributing factor was drunk driving (n = 25,537). There was observed low compliance on the use of vehicular safety equipment. The most common types of injuries for the TVC victims were abrasions, contusions, burns, and concussions while the vehicle most involved in TVC was the motorcycle. Motorcycle use was found to be associated with worse emergency room (ER) outcomes (p <.0001) and the highest injury types such as multiple injuries, abrasion, avulsion and burn. Alcohol use was also significantly associated with multiple injuries, abrasion, avulsion, burn, open fracture, open wound, and amputation (p < 0.05). @*Conclusion@#The trend of road traffic vehicular crashes affecting mainly the younger population has economic repercussions. Motorcycles are also most involved in crashes, hence, the need for motorcycle safety laws in the country. There is also a need to strengthen current laws and legislation governing road safety and to focus on structuring a systematic post-crash response for both the local government and hospitals throughout the Philippines.

Ley de embriaguez habitual en Honduras y su relación con el análisis pericial toxicológico / Habitual Drunkenness Law in Honduras and its relationship with the toxicological expert analysis

A pesar que el número de accidentes de tránsito que involucran a conductores ebrios se ha disparado y que los legisladores tienen una gran presión para encontrar una solución razonable a la cuestión de la conducción bajo los efectos del alcohol especialmente en lo que respecta a los límites máximos permitidos, esa relación entre lo jurídico y lo científico, no siempre se concreta. El examen para la determinación de alcohol en muestras biológicas que se realiza en los laboratorios de Toxicología Forense de la Dirección de Medicina Forense fue validado y acreditado. Este proceso de validación permitió observar que el valor referido en la Ley de Penalización de la Embriaguez Habitual señala valores que podrían indicar un error en la aplicación de las unidades y de no ser así, dicho valor no sería significativo en cuanto a la determinación y cuantificación del etanol por la metodología actualmente utilizada en los laboratorios. La importancia del asesoramiento técnico científico para el uso adecuado de unidades y valores de referencia es indispensable para una interpretación objetiva de nuestra legislación y facilita el punto de unión entre la ciencia forense y la ciencia jurídica...(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.

Guía técnica para la atención de salud mental de personas con intoxicación alcohólica / Technical guide for the mental health care of people with alcohol poisoning

El documento contiene los criterios para la atención de salud mental de las personas con intoxicación alcohólica en establecimientos de salud.

Análisis de los efectos del consumo de alcohol en la morbi-mortalidad por trauma craneoencefálico / Analysis of the effects of alcohol consumption in traumatic brain injury´s morbidity and mortality

Resumen La intoxicación con alcohol está frecuentemente asociada con trauma craneoencefálico (TCE), pero el impacto del alcohol en la patogénesis y el pronóstico del TCE sigue siendo poco clara. La literatura actual provee evidencia en términos de datos clínicos y experimentales que respaldan los efectos neuroprotectores del alcohol en pacientes con TCE. Para establecer de manera significativa esta relación es necesario el desarrollo de estudios prospectivos observacionales fuertes, con el fin de comprender los efectos del alcohol en los resultados clínicos a largo plazo (incluyendo el resultado neurológico) en pacientes con TCE con una apropiada selección y ajuste del riesgo basal.

Abstract Alcohol intoxication is often associated with traumatic brain injuries (TBIs), but the impact of alcohol on the pathogenesis and prognosis of TBIs remains unclear. Current literature provides evidence in terms of experimental and clinical data supporting alcohol's neuroprotective effects in patients with TBIs. To establish in a significative way this association, there lies a need for strong prospective observational studies, in order to comprehend the effects of alcohol on the long-term outcomes (including the neurological outcome) in patients with TBI with proper selection and baseline risk adjustment.

Contributions of parenting styles and parental drunkenness to adolescent drinking

Objective: To estimate the association of parental drunkenness and parenting style with alcohol consumption among adolescents and the contributions of parental drunkenness and parenting style to the prevalence of binge drinking among adolescents. Method: Cross-sectional survey of a representative sample of secondary students aged 13 to 18 from 27 Brazilian state capitals (n=17,028). Private and public schools were included. A self-report questionnaire collected data on adolescents' alcohol drinking behavior, parenting styles, and parenting and peer models of drunkenness. Results: Non-authoritative parenting style and parental drunkenness are associated with binge drinking among adolescents. Authoritarian, indulgent, and negligent parenting styles were associated with 1.50-, 2.51-, and 2.82-fold increases in prevalence of adolescent binge drinking, and parental drunkenness, with a 1.99-fold increase. The non-authoritative parenting style made a larger contribution than parental drunkenness to adolescent binge drinking. Conclusions: Non-authoritative parenting style and parental drunkenness seem to play an important role in adolescents' binge drinking behavior. At the population level, parenting style appears associated with a greater contribution to this behavior among adolescents. Prevention strategies targeting parental drunkenness may be bolstered if a broader approach including parenting styles is in place.

Miguel Ángel y el hígado de Noé: ¿Una lección secreta de anatomía? / Michelangelo and Noah's liver: a hidden anatomy lesson?

Miguel Ángel Buonarroti (1475 - 1564) es considerando uno de los más grandes artistas de la historia. Estudió en detalle la anatomía humana a través de la disección de cadáveres, práctica hasta entonces relegada por motivos religiosos. Desde que en el año 1990 el médico Frank Lynn Meshberger publicara su interpretación del fresco "La Creación de Adán" basada en la neuroanatomía, en donde comparaba la imagen de Dios con la de una sección sagital del cerebro humano, muchos autores han encontrado diversas referencias anatómicas ocultas en la obra de Miguel Ángel. En el presente trabajo exponemos el hallazgo de una inédita lección de anatomía hepática oculta en el fresco La Embriaguez de Noé de la Capilla Sixtina.

Michelangelo Buonarroti (1475 - 1564) is considered one of the greatest artists in history. He studied in detail the human anatomy through corpses dissection, practice until then relegated for religious reasons. Since the physician Frank Lynn Meshberger published in 1990 his interpretation of the fresco "The Creation of Adam" based on neuroanatomy, where he compared the image of God with a sagittal section of the human brain, many authors have found various hidden anatomical references in the work of Michelangelo. In the present paper we expose the finding of a hidden lesson on liver anatomy in the fresco The Drunkenness of Noah of the Sistine Chapel.

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)

Social norms regarding alcohol use and associated factors among university students in Turkey

Abstract Background Misperceptions on the higher rates of peer alcohol use are predictive of increased personal use among university students. Objectives This study aims to assess the prevalence, perceived peers' social norms and other predictors of alcohol use in a sample of Turkish university students. Methods This study is established upon the baseline Turkish data on alcohol use of the project Social Norms Intervention for the prevention of Polydrug usE (SNIPE). The data was obtained by a self-reported, online questionnaire from 858 students of Marmara University who were registered to the study web page. Results Alcohol use and drunkenness rates were 62.6%, and 40.9%, respectively. Twenty point two percent of students reported drinking alcohol at least once a week in the last two months. Majority of students (70.4%) reported that religion has an important or very important role in their lives. Perceived higher frequency of peer alcohol use (p<0.000) and drunkenness (p<0.000) were significantly associated with personal alcohol use frequency. Tobacco use rate was 60.2% and positively associated with alcohol use frequency (p<0.000). In all participants, male gender (OR: 1.56; 95% CI: 1.07-2.28), giving less importance to religion (OR: 20.91; 95% CI: 10.95-39.95), tobacco use everyday/almost everyday (OR: 17.88; 95% CI: 9.33-34.29), perceived positive peer attitude towards alcohol use (OR: 2.192; 95% CI: 1.25-3.82) and perceived higher frequency of peer alcohol use (OR: 3.487; 95% CI: 1.66-7.31) were found to be associated risk factors for alcohol use. Age (OR: 1.186, CI 95%: 1.03-1.36) and perceived positive peer attitude towards alcohol use (OR: 3.86, CI 95%: 1.84-8.09) were the additional risk factors among female student whereas perceived positive peer alcohol use frequency (OR: 8.08, CI 95%: 2.40-27.10) among male students. Discussion As the first study conducted in Turkey applying social norms theory, our results indicate the noticeable misperceptions of students regarding their peers' alcohol use. Based on our results, targeting both tobacco and alcohol use, and a gender-sensitive approach employing social norms interventions may enhance the preventive strategies for risky alcohol use among university students.

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.

A tragédia do alcoolismo: causas, consequências e prevenção / The tragedy of alcoholism: causes, consequences and prevention

O álcool é uma causa evitável de adoecimento, incapacidade e morte. O consumo dessa substância é o principal fator causal, desencadeante ou agravante de mais de duzentas condições e complicações clínicas. Dentre estas, as patologias mais comuns incluem câncer, diabetes, doenças infecciosas, neurológicas, cardiovasculares, do fígado, do pâncreas e do trato gastrointestinal, além de lesões não intencionais e intencionais. O álcool também pode gerar danos sociais, aumentando o custo total associado ao seu consumo. O uso crônico do álcool é responsável, em grande parte, pela violência doméstica e urbana, incluindo traumas provocados por acidentes de trânsito, mortes violentas, suicídios e incapacidades físicas e mentais, com ferimentos, dores e anos de vida perdidos. A partir de evidências científicas acumuladas ao longo das últimas décadas sobre os riscos de desenvolver doenças relacionadas ao álcool, foi possível à Organização Mundial da Saúde (OMS) propor aos países um conjunto de diretrizes, incluindo testes (como o Audit), para avaliar o consumo de baixo risco, o uso nocivo e a dependência química ao álcool. Em 2018, foram lançadas duas importantes publicações sobre o álcool. A OMS apresentou o Relatório global sobre álcool e saúde, alertando quanto aos riscos do consumo da substância, enquanto a prestigiosa Lancet publicou revisão sistemática sobre álcool e carga de doença para 195 países e territórios, cobrindo o intervalo entre 1990 e 2016. 8 Segundo dados do relatório da OMS, em 2016, o álcool era consumido por 2,3 bilhões de pessoas, com 15 anos ou mais de idade, sendo 43% bebedores frequentes. O uso nocivo do álcool resultou em 3 milhões de mortes em todo o mundo e quase 133 milhões de anos de vida ajustados por incapacidade (DALY). O Conselho Federal de Medicina, por meio de sua Comissão de Drogas Lícitas e Ilícitas, pretende instrumentalizar o debate entre médicos e sociedade em geral sobre os riscos do uso de álcool para a saúde. Isso porque acredita que todos os esforços devem ser envidados na adoção de políticas públicas para prevenir a iniciação do alcoolismo entre jovens, a fração da população mais vulnerável aos efeitos do marketing e da propaganda de bebidas. O consumo de álcool, especialmente quando se trata de uso problemático ou crônico e abusivo, deve ser objeto de atenção não só de médicos e outros profissionais de saúde, mas de diferentes segmentos da sociedade, dentre eles, educadores, legisladores, gestores e magistrados.

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

Famílias de usuários de bebida alcoólica: aspectos estruturais e funcionais fundamentados no Modelo Calgary / Alcoholic beverage users: structural and functional aspects based on the Calgary Model

Objetivo: descrever os aspectos estruturais e funcionais e as redes de apoio e sustentação de famílias que convivem com usuários de bebida alcoólica. Métodos: estudo descritivo de corte transversal, referencial metodológico do Modelo Calgary de Avaliação da Família, a partir de entrevistas semiestruturadas, com as ferramentas genograma e ecomapa, realizadas com familiares de quatro trabalhadores da construção civil internados por agravos ligados ao uso de bebida alcoólica, e notificados a um centro de informação e assistência toxicológica. Resultados: houve redução dos filhos entre as gerações, mas o uso de drogas esteve em expansão nas famílias. Foram encontradas relações familiares distantes e conflituosas. A rede de apoio da vizinhança foi apontada com vínculo forte, porém o apoio da Atenção Primária da Saúde consistiu vínculo fraco. Conclusão: a avaliação estrutural e funcional das famílias propiciou conhecimento para processos de promoção, tratamento e recuperação da saúde, para restabelecer as relações familiares fragilizadas.

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.

Intoxicação por etanol em bovinos alimentados com bagaço de malte acrescido de levedura de cerveja / Ethanol poisoning in cattle fed with malted barley waste with brewer's yeast

O presente trabalho descreve um surto de intoxicação por etanol que afetou um rebanho bovino de aptidão leiteira alimentado com o subproduto de cervejaria denominado bagaço de malte, resíduo úmido de cervejaria (RUC), resíduo de cevada maltada ou simplesmente "cevada". O surto iniciou cerca de 24 horas após ao fornecimento de uma nova partida do subproduto que apresentava odor alcoólico. Análise cromatográfica e microbiológica de amostra deste subproduto confirmou a presença de etanol e Saccharomyces spp., respectivamente, indicando a adição de outro subproduto de cervejaria, a levedura de cerveja ou levedo. Os principais sinais clínicos observados foram diarreia, salivação, andar cambaleante e decúbito. A morbidade foi de 12,2% (5/41) e mortalidade de 2,4% (1/41). Uma vaca que morreu após um curso clínico de 3 dias foi necropsiada. Não foram observadas lesões macroscópicas significativas, mas na histopatologia havia rumenite necrosupurativa aguda, multifocal, moderada, com colonização bacteriana e fúngica secundária, indicando acidose ruminal concomitante. Em análise cromatográfica de amostras de conteúdo ruminal e fígado deste bovino foram detectadas quantidades variáveis de etanol. Os dados do presente estudo indicam que a possibilidade de intoxicação por etanol deve ser considerada em bovinos com sinais neurológicos e digestivos alimentados com RUC quando a este acrescentado levedura de cerveja.(AU)

An outbreak of ethanol poisoning that affected a dairy cattle herd fed with the brewery by-product known as malt bagasse, wet brewery residue, malted barley waste or "barley". The outbreak began about 24 hours after a new product of the by-product was offered to cattle that had an alcoholic odor. Chromatographic and microbiological analysis of this by-product sample confirmed the presence of ethanol and Saccharomyces spp., respectively, indicating the addition of another by-product brewery, brewer's yeast or yeast. The main clinical signs observed were diarrhea, salivation, staggering gait and decubitus. Morbidity was 12.2% (5/41) and mortality was 2.4% (1/41). A cow that died after a 3-day of clinical course was necropsied. No significant macroscopic lesions were observed, but in the histopathology, there was acute, multifocal, moderate necrosupurative rumenitis with secondary bacterial and fungal colonization, indicating concomitant ruminal acidosis. In the chromatographic analysis of samples of rumen and liver contents of this bovine, variable amounts of ethanol were detected. The data from the present study indicate that the possibility of ethanol intoxication should be considered in cattle with neurological and digestive signs fed with RUC when added to brewer's yeast.(AU)

Álcool e outras drogas na adesão do usuário à terapia antirretroviral em um serviço especializado no sertão do Pajeú de Pernambuco / Alcohol and other drugs in user adherence to antiretroviral therapy in a specialized service in the backlands of Pajeú of Pernambuco

Objetivo: verificar a associação entre o uso do álcool e outras drogas na adesão da pessoa vivendo com HIV à terapia antirretroviral. Métodos: estudo descritivo exploratório, com abordagem quantitativa, população de 100 usuários e amostra de 71, realizado no Serviço de Atendimento Especializado de Serra Talhada-PE. Foram utilizados dois instrumentos de coleta, questionário sobre dados sociodemográficos, aspectos clínicos e CEAT-VIH, que avalia o comportamento de adesão a TARV. Resultados: 56% era do sexo masculino, cor parda, e faixa etária entre 40-60 anos. 54,9% dos entrevistados disse fazer uso do álcool e /ou outras drogas. Sobre o nível de adesão das pessoas vivendo com HIV em tratamento, 93% foi classificado como nível de adesão inadequado. Não houve associação significativa (p=0,1232) entre o uso do álcool e outras drogas. Conclusão: estatisticamente não há associação significativa entra o uso do álcool e outras drogas com a adesão inadequada a TARV, no entanto, o uso exagerado expõe a pessoa a situação de vulnerabilidade.(AU)

Objective: to verify the association of the use of alcohol and other drugs in the adherence of the user to the antiretroviral therapy.Methods:exploratory descriptive study, with quantitative approach,population of 100 users, and sample of 71 users,performed at the Specialized Attention Service (SAE) of Serra Talhada-PE. Two collection instruments were used for interview, a questionnaire on socio-demographic data, clinical aspects and CEAT-VIH, which evaluates the adherence behavior to TARV.Results:56% were males, brown, and between 40-60 years old.54.9% of respondents said to make use of alcohol and / or other drugs.Concerning the level of adherence of people living with HIV on antiretroviral treatment, 93% were classified as inadequate adherence level.There was no significant association (p = 0.1322) between alcohol use and other drugs.Conclusion:statistically there is no significant association between the use of alcohol and other drugs with inadequate adherence to TARV,however, overuse exposes the person to vulnerability.(AU)

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.

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.