ABSTRACT
BACKGROUND: The prevalence of alcohol use among Finnish liver transplant recipients has not been studied before. METHODS: We used self-report questionnaires and correlations between alcohol use liver biochemistry and depressive symptoms at the only transplant unit of the country, during a 6-month period in 2013. RESULTS: The final study population consisted of 207 recipients. After verbal consent, participants filled in Alcohol Use Disorder Identification Test C and Beck Depression Inventory-II. Twenty percent of patients had been transplanted because of alcoholic liver disease. Of the patients, 43% reported alcohol use any time after liver transplantation (LT) and 28% during the past 1 month. Nearly all of those who received LT during childhood reported alcohol use more often and more drinks per occasion. Statistically significant risk factors for harmful drinking were male sex, age younger than 18 years at transplantation, and years from transplantation. Neither cause nor the depression scores reached statistical significance. Alcohol users had statistically significant higher liver biochemistry markers. CONCLUSION: Our results revealed a 43% overall use of alcohol after LT and 28% use of alcohol within the last month and low depression scores. Among participants with alcohol liver disease origin, 39% and 34% any time and during the past 1 month, respectively, reported relapse. The alcohol consumption revealed in this study is similar to that of the general alcohol consumption tradition in Finland. Young males transplanted during their childhood were at most risk for harmful drinking.
Subject(s)
Alcohol Drinking/psychology , Depression/psychology , Liver Diseases/surgery , Liver Transplantation/psychology , Self Report , Adult , Age Factors , Aged , Aged, 80 and over , Alcohol Abstinence/psychology , Alcohol Drinking/adverse effects , Alcohol Drinking/epidemiology , Biomarkers/blood , Biomarkers/urine , Cross-Sectional Studies , Depression/diagnosis , Depression/epidemiology , Female , Finland/epidemiology , Health Behavior/ethnology , Health Knowledge, Attitudes, Practice , Humans , Liver Diseases/diagnosis , Liver Diseases/epidemiology , Liver Diseases/psychology , Liver Diseases, Alcoholic/epidemiology , Liver Diseases, Alcoholic/psychology , Liver Diseases, Alcoholic/surgery , Liver Transplantation/adverse effects , Male , Middle Aged , Prevalence , Prospective Studies , Risk Factors , Sex Factors , Time Factors , Treatment Outcome , Young AdultABSTRACT
In this case report, even a moderate dose of dexmedetomidine, a very selective alpha(2)-adrenergic agent, resulted in a rapid response to alcohol withdrawal delirium after the standard treatment. Psychiatrists should be aware of this relatively new drug that provides advantages over clonidine, heavy sedation and secondary restraints. Dexmedetomidine should be further evaluated in the treatment of specific forms of aggressive behavior and complicated withdrawal states.
Subject(s)
Alcohol Withdrawal Delirium/drug therapy , Dexmedetomidine/therapeutic use , Hypnotics and Sedatives/therapeutic use , Alcohol Withdrawal Delirium/psychology , Antidepressive Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Diazepam/therapeutic use , Drug Therapy, Combination , Haloperidol/therapeutic use , Humans , Male , Middle Aged , Thiamine/therapeutic useSubject(s)
Bipolar Disorder/diagnosis , Cocaine/adverse effects , Depression/diagnosis , Substance Withdrawal Syndrome/diagnosis , Acute Disease , Bipolar Disorder/therapy , Depression/therapy , Diagnosis, Differential , Finland , Follow-Up Studies , Humans , Male , Middle Aged , Psychotherapy/methods , Risk Assessment , Severity of Illness Index , Spouse Abuse , Substance Withdrawal Syndrome/therapyABSTRACT
A critical overview of Swedish and Finnish medical web portals for doctors is presented in this article. Three Swedish and three Finnish portals were analysed using 54 dichotomous questions, derived from the guidelines of the American Medical Association (AMA), and 17 technical heuristic questions for web usability. 34 portal features were cross-tabulated with all portals. None of the portals did adhere to the AMA guidelines perfectly. Several problems with advertising, sponsorship, and website privacy were observed. Besides professional functionalities, the portals provided services for personal communication and entertainment features. The incomplete correspondence between the AMA guidelines and the current praxis of Nordic web portals for doctors may have many reasons. However, it is safe to conclude that Swedish and Finnish portals for physicians have some severe publicistic or ethical problems. Every physician should note that website privacy is not enough respected.
