Validation of the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) in acute psychiatric inpatients. / Validación de la prueba de detección de consumo de alcohol, tabaco y sustancias (ASSIST) en pacientes con trastorno psiquiátrico ingresados en una unidad de agudos.

The aims of this study were to examine the psychometric properties of The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in psychiatric inpatients, due to the scarcity of screening instruments validated in this population. Patients from Hospital Clínic's psychiatric ward (n = 202) completed: ASSIST, Addiction Severity Index (ASI), MINI-International Neuropsychiatric Interview (MINI), Alcohol Use Disorders Identification Test (AUDIT), Fagerström Test for Nicotine Dependence (FTND), Severity of Dependence Scale (SDS), and Drug Abuse Screening Test (DAST). Reliability and validity evidences based on internal structure (Exploratory and Confirmatory Factor Analyses) and on the relation to other variables were obtained. Excellent internal consistency was found for Total Substance Involvement (TSI) (α = .92 and ω = .93) and for Specific Substance Involvement (SSI) scores (α = .88 - .96 and ω = .89 - .95). Analysis of internal structure for tobacco, alcohol and cannabis subscales resulted in unidimensional models with adequate goodness-of-fit indices. ASSIST scores were significantly correlated with those of ASI (r = .795 to r = .953), AUDIT (r = .864), FTND (r = .808), DAST (r = .831), SDS (r = .519) and with "number of diagnoses of abuse/dependence" in MINI-Plus (TSI: r = .857 to r = .862; SSI: r = .646 to r = .834). Receiver operating characteristic analysis (ROC) and Mann-Whitney's U test found good discriminative validity evidences. ASSIST scores showed good reliability and there were validity evidences that support its use for identifying risk levels of tobacco, alcohol and other substance use in psychiatric patients.

Los objetivos fueron examinar las propiedades psicométricas de la prueba de detección de consumo de alcohol, tabaco y sustancias (ASSIST) en pacientes con trastorno psiquiátrico. Un total de 202 pacientes ingresados en psiquiatría del Hospital Clínic completaron: ASSIST, Índice de gravedad de la adicción (ASI), MINI-Entrevista Neuropsiquiátrica Internacional (MINI), cuestionario de identificación de los trastornos debidos al consumo de alcohol (AUDIT), Test de Fagerström (FTND), Escala de gravedad de la dependencia (SDS) y Prueba de detección de abuso de drogas (DAST). Se obtuvieron la fiabilidad y evidencia de validez de la estructura interna (análisis factorial exploratorio/confirmatorio) y de la relación con otras variables. Se encontró excelente consistencia interna en puntuaciones de riesgo total (TSI) (α = ,92 y ω = ,93) y de cada sustancia (SSI) (α = ,88 - ,96 y ω = ,89 - ,95). La estructura interna de tabaco, alcohol y cannabis resultó en modelos unidimensionales con índices de bondad de ajuste adecuados. Las puntuaciones del ASSIST correlacionaron significativamente con: ASI (r = ,795 a r = ,953), AUDIT (r = ,864), FTND (r = ,808), DAST (r = ,831), SDS (r = ,519) y «número de diagnósticos de abuso/dependencia¼ en MINI-Plus (TSI: r = ,857 - ,862; SSI: r = ,646 - ,834). El análisis de curva ROC y U de Mann-Whitney mostraron evidencias de validez discriminativa. Las puntuaciones del ASSIST tienen buena fiabilidad y existen evidencias de validez para su uso en la detección del nivel de riesgo de consumo de tabaco, alcohol y sustancias en pacientes con trastorno psiquiátrico.

Validación de la prueba de detección de consumo de alcohol, tabaco y sustancias (ASSIST) en pacientes con trastorno psiquiátrico ingresados en una unidad de agudos / Validation of the Alcohol Smoking and Substance Involvement Screening Test (ASSIST) in acute psychiatric inpatients

Los objetivos fueron examinar las propiedades psicométricasde la prueba de detección de consumo de alcohol, tabaco ysustancias (ASSIST) en pacientes con trastorno psiquiátrico. Untotal de 202 pacientes ingresados en psiquiatría del Hospital Clíniccompletaron: ASSIST, Índice de gravedad de la adicción (ASI), MINIEntrevista Neuropsiquiátrica Internacional (MINI), cuestionariode identificación de los trastornos debidos al consumo de alcohol(AUDIT), Test de Fagerström (FTND), Escala de gravedad de ladependencia (SDS) y Prueba de detección de abuso de drogas(DAST). Se obtuvieron la fiabilidad y evidencia de validez de laestructura interna (análisis factorial exploratorio/confirmatorio) yde la relación con otras variables. Se encontró excelente consistenciainterna en puntuaciones de riesgo total (TSI) (α = ,92 y ω = ,93) y decada sustancia (SSI) (α = ,88 - ,96 y ω = ,89 - ,95). La estructura internade tabaco, alcohol y cannabis resultó en modelos unidimensionalescon índices de bondad de ajuste adecuados. Las puntuaciones delASSIST correlacionaron significativamente con: ASI (r = ,795 a r =,953), AUDIT (r = ,864), FTND (r = ,808), DAST (r = ,831), SDS (r =,519) y «número de diagnósticos de abuso/dependencia» en MINIPlus (TSI: r = ,857 - ,862; SSI: r = ,646 - ,834). El análisis de curva ROCy U de Mann-Whitney mostraron evidencias de validez discriminativa.Las puntuaciones del ASSIST tienen buena fiabilidad y existenevidencias de validez para su uso en la detección del nivel de riesgode consumo de tabaco, alcohol y sustancias en pacientes con trastornopsiquiátrico. (AU)

The aims of this study were to examine the psychometric propertiesof The Alcohol, Smoking and Substance Involvement Screening Test(ASSIST) in psychiatric inpatients, due to the scarcity of screeninginstruments validated in this population. Patients from HospitalClínic’s psychiatric ward (n = 202) completed: ASSIST, AddictionSeverity Index (ASI), MINI-International Neuropsychiatric Interview(MINI), Alcohol Use Disorders Identification Test (AUDIT),Fagerström Test for Nicotine Dependence (FTND), Severity ofDependence Scale (SDS), and Drug Abuse Screening Test (DAST).Reliability and validity evidences based on internal structure(Exploratory and Confirmatory Factor Analyses) and on the relationto other variables were obtained. Excellent internal consistency wasfound for Total Substance Involvement (TSI) (α = .92 and ω = .93)and for Specific Substance Involvement (SSI) scores (α = .88 - .96 andω = .89 - .95). Analysis of internal structure for tobacco, alcohol andcannabis subscales resulted in unidimensional models with adequategoodness-of-fit indices. ASSIST scores were significantly correlatedwith those of ASI (r = .795 to r = .953), AUDIT (r = .864), FTND (r =.808), DAST (r = .831), SDS (r = .519) and with “number of diagnosesof abuse/dependence” in MINI-Plus (TSI: r = .857 to r = .862; SSI: r =.646 to r = .834). Receiver operating characteristic analysis (ROC) andMann-Whitney’s U test found good discriminative validity evidences.ASSIST scores showed good reliability and there were validityevidences that support its use for identifying risk levels of tobacco,alcohol and other substance use in psychiatric patients. (AU)

Role of Geitlerinema sp. DE2011 and Scenedesmus sp. DE2009 as Bioindicators and Immobilizers of Chromium in a Contaminated Natural Environment.

The aim of this work was to study the potential of the two phototrophic microorganisms, both isolated from Ebro Delta microbial mats, to be used as bioindicators and immobilizers of chromium. The results obtained indicated that (i) the Minimum Metal Concentration (MMC) significantly affecting Chlorophyll a intensity in Geitlerinema sp. DE2011 and Scenedesmus sp. DE2009 was 0.25 µM and 0.75 µM, respectively, these values being lower than those established by current legislation, and (ii) Scenedesmus sp. DE2009 was able to immobilize chromium externally in extracellular polymeric substances (EPS) and intracellularly in polyphosphate (PP) inclusions. Additionally, this microorganism maintained high viability, including at 500 µM. Based on these results, we postulate that Geitlerinema sp. DE2011 and Scenedesmus sp. DE2009 are good chromium-indicators of cytotoxicity and, further, that Scenedesmus sp. DE2009 plays an important role in immobilizing this metal in a contaminated natural environment.

Percepción de riesgo asociada a la prescripción continuada de benzodiacepinas en salud mental y atención primaria / Risk perception in the ongoing prescription of benzodiazepines in mental health and primary care

No disponible

Daño cerebral relacionado con el alcohol. Situación actual y llamada a la acción / Alcohol related brain damage. State of the art and a call for action

No disponible

Falta de registro de consumo de cannabis / Lack of cannabis consumption registry

No disponible

Biosorption of lead and copper by heavy-metal tolerant Micrococcus luteus DE2008.

Micrococcus luteus DE2008 has the ability to absorb lead and copper. The effect of these metals on biomass and viability of this microorganism were investigated and removal of the metals from culture media was determined. Lead had no effect on the biomass expressed as mg Carbon/cm(3) of M. Iuteus DE2008, but in the case of copper, the minimum metal concentration that affected the biomass was 0.1 mM Cu(II). According to these results this microorganism shows a greater tolerance for lead. The minimum metal concentration that affected viability (expressed as the percentage of live cells) was 0.5 mM for both metals. M. luteus DE2008 exhibited a specific removal capacity of 408 mg/g for copper and 1965 mg/g for lead. This microorganism has a greater ability to absorb Pb(II) than Cu(II). M. luteus DE2008 could be seen as a microorganism capable of restoring environments polluted by lead and copper.

Bacterial community composition characterization of a lead-contaminated Microcoleus sp. consortium.

INTRODUCTION: A Microcoleus sp. consortium, obtained from the Ebro delta microbial mat, was maintained under different conditions including uncontaminated, lead-contaminated, and acidic conditions. MATERIALS AND METHODS: Terminal restriction fragment length polymorphism and 16S rRNA gene library analyses were performed in order to determine the effect of lead and culture conditions on the Microcoleus sp. consortium. RESULTS: The bacterial composition inside the consortium revealed low diversity and the presence of specific terminal-restriction fragments under lead conditions. 16S rRNA gene library analyses showed that members of the consortium were affiliated to the Alpha, Beta, and Gammaproteobacteria and Cyanobacteria. Sequences closely related to Achromobacter spp., Alcaligenes faecalis, and Thiobacillus species were exclusively found under lead conditions while sequences related to Geitlerinema sp., a cyanobacterium belonging to the Oscillatoriales, were not found in presence of lead. DISCUSSION: This result showed a strong lead selection of the bacterial members present in the Microcoleus sp. consortium. Several of the 16S rRNA sequences were affiliated to nitrogen-fixing microorganisms including members of the Rhizobiaceae and the Sphingomonadaceae. Additionally, confocal laser scanning microscopy and scanning and transmission electron microscopy showed that under lead-contaminated condition Microcoleus sp. cells were grouped and the number of electrodense intracytoplasmic inclusions was increased.

Vertical migration of phototrophic bacterial populations in a hypersaline microbial mat from Salins-de-Giraud (Camargue, France).

The spatio-temporal distribution of phototrophic communities of the hypersaline photosynthetic Camarguc microbial mat (Salins-de-Giraud, France) was investigated over a diel cycle by combining microscopic and molecular approaches. Microcoleus chthonoplastes and Halomicronema excentricum, the dominant cyanobacteria of this oxyphotrophic community, were observed with confocal laser scanning microscopy to determine their biomass profiles. Both bacteria have similar vertical distributions, varying from a homogenous distribution through the mat during the night, to a specific localization in the upper oxic zone of 1.5 mm during the day. Terminal restriction fragment length polymorphism of PCR-amplified pufM gene fragments revealed three groups of anoxyphototrophic populations, which varied according to the two opposite periods of the diel cycle under study. They were either specifically detected in only one period, or homogenously distributed through the mat in all periods, or located in specific zones of the mat depending on the period considered. Oxygen concentrations, pH and biomass of the major filamentous cyanobacteria were the determinative factors in the distribution of these anoxyphototrophs across the mat. Thus, vertical migration, cell-cell aggregate formation and metabolic switches were the most evident defence of the photosynthetic populations against the adverse effects of sulfide and oxygen fluxes during a diel cycle.

[Detection and handling of alcohol problems in primary care in Catalonia]. / Detección y abordaje de los problemas de alcohol en la atención primaria de Cataluña.

OBJECTIVE: To gain information on how well strategies for alcohol problem detection and interventions are being implemented in primary care in Catalonia, Spain. DESIGN: Longitudinal pre/post study to evaluate the impact of the distribution to primary care professionals of a training programme for detecting alcohol problems and intervening in them. Descriptive analysis of the basic situation, using interviews with patients and professionals and examination of clinical histories (CH). SETTING: Health districts that existed in Catalonia in 2001. PARTICIPANTS: Twenty eight health districts, 973 patients, 80 professionals, and 852 clinical histories examined. MAIN MEASUREMENTS: Data were collected, by means of questionnaires for professionals and patients and of ad-hoc instruments for examining clinical histories, on the levels of primary care screening for alcohol consumption and of intervention. RESULTS: There was a major disparity in the data between the 3 sources. Thus the screening of consumption and counselling was recorded much less in the CHs than amounts that patients said they received and that professionals said they performed. In addition, most of the at-risk drinkers that were seen in PC were not detected. On comparing them with non-risk drinkers we found significant differences in sex, job, familiarity with the centre and having been asked or not about their alcohol consumption. CONCLUSIONS: Given the deficiencies found in PC preventive activity on alcohol consumption and as alcohol consumption has such huge social and health repercussions on the general population, we think it is fully justified to introduce into PC specific training programmes on screening and brief intervention techniques for alcohol problems.

Detección y abordaje de los problemas de alcohol en la atención primaria de Cataluña / Detection and handling of alcohol problems in primary care in Catalonia

Objetivo. Conocer el grado de implementación de las estrategias de detección e intervención en los problemas de alcohol en la atención primaria de Cataluña. Diseño. Estudio de evaluación del impacto de la diseminación de un programa de formación de los profesionales de atención primaria (AP) en la detección e intervención en los problemas de alcohol. Análisis descriptivo de la situación basal a partir de las entrevistas a pacientes, profesionales y el vaciado de las historias clínicas. Emplazamiento. Áreas básicas de salud (ABS) de Cataluña en el 2001. Participantes. Participaron 28 ABS seleccionadas aleatoriamente, 973 pacientes, 80 profesionales y 852 historias clínicas auditadas. Mediciones principales. Se recogieron datos sobre el nivel de cribado e intervención en el consumo de alcohol en la atención primaria a través de cuestionarios a profesionales y a pacientes y la auditoría de las historias clínicas. Resultados. Se observa una importante disparidad en los datos obtenidos a partir de las 3 fuentes. Así, el cribado de consumo y el consejo se registran mucho menos en la historia clínica de lo que los pacientes dicen recibirlo y de lo que los profesionales dicen hacerlo. Además, la mayor parte de los bebedores de riesgo atendidos en AP no son detectados y presentan diferencias significativas en cuanto al sexo, la profesión, la familiaridad con el centro y el hecho de haberles preguntado o no sobre su consumo de alcohol, en relación con los no bebedores de riesgo. Conclusiones. Dadas las deficiencias detectadas en la actividad preventiva de AP en relación con el consumo de alcohol y las enormes repercusiones sociales y sanitarias que ocasiona el consumo de alcohol en la población general, creemos que está ampliamente justificado impulsar la implementación en AP de programas específicos de formación sobre técnicas de cribado e intervención breve en los problemas de alcohol

Objective. To gain information on how well strategies for alcohol problem detection and interventions are being implemented in primary care in Catalonia, Spain. Design. Longitudinal pre/post study to evaluate the impact of the distribution to primary care professionals of a training programme for detecting alcohol problems and intervening in them. Descriptive analysis of the basic situation, using interviews with patients and professionals and examination of clinical histories (CH). Setting. Health districts that existed in Catalonia in 2001. Participants. Twenty eight health districts, 973 patients, 80 professionals, and 852 clinical histories examined. Main measurements. Data were collected, by means of questionnaires for professionals and patients and of ad-hoc instruments for examining clinical histories, on the levels of primary care screening for alcohol consumption and of intervention. Results. There was a major disparity in the data between the 3 sources. Thus the screening of consumption and counselling was recorded much less in the CHs than amounts that patients said they received and that professionals said they performed. In addition, most of the at-risk drinkers that were seen in PC were not detected. On comparing them with non-risk drinkers we found significant differences in sex, job, familiarity with the centre and having been asked or not about their alcohol consumption. Conclusions. Given the deficiencies found in PC preventive activity on alcohol consumption and as alcohol consumption has such huge social and health repercussions on the general population, we think it is fully justified to introduce into PC specific training programmes on screening and brief intervention techniques for alcohol problems

Characterization of functional bacterial groups in a hypersaline microbial mat community (Salins-de-Giraud, Camargue, France).

A photosynthetic microbial mat was investigated in a large pond of a Mediterranean saltern (Salins-de-Giraud, Camargue, France) having water salinity from 70 per thousand to 150 per thousand (w/v). Analysis of characteristic biomarkers (e.g., major microbial fatty acids, hydrocarbons, alcohols and alkenones) revealed that cyanobacteria were the major component of the pond, in addition to diatoms and other algae. Functional bacterial groups involved in the sulfur cycle could be correlated to these biomarkers, i.e. sulfate-reducing, sulfur-oxidizing and anoxygenic phototrophic bacteria. In the first 0.5 mm of the mat, a high rate of photosynthesis showed the activity of oxygenic phototrophs in the surface layer. Ten different cyanobacterial populations were detected with confocal laser scanning microscopy: six filamentous species, with Microcoleus chthonoplastes and Halomicronema excentricum as dominant (73% of total counts); and four unicellular types affiliated to Microcystis, Chroococcus, Gloeocapsa, and Synechocystis (27% of total counts). Denaturing gradient gel electrophoresis of PCR-amplified 16S rRNA gene fragments confirmed the presence of Microcoleus, Oscillatoria, and Leptolyngbya strains (Halomicronema was not detected here) and revealed additional presence of Phormidium, Pleurocapsa and Calotrix types. Spectral scalar irradiance measurements did not reveal a particular zonation of cyanobacteria, purple or green bacteria in the first millimeter of the mat. Terminal-restriction fragment length polymorphism analysis of PCR-amplified 16S rRNA gene fragments of bacteria depicted the community composition and a fine-scale depth-distribution of at least five different populations of anoxygenic phototrophs and at least three types of sulfate-reducing bacteria along the microgradients of oxygen and light inside the microbial mat.

Evolución clínica del alcoholismo tratado con naltrexona. Efectividad y seguridad en una muestra de 198 pacientes / Naltrexone in the treatment of alcoholism. Clinical evolution, safety and efficacy in a sample of 198 patients

FUNDAMENTO: Verificar la seguridad de naltrexona administrada durante 6 meses a pacientes dependientes del alcohol en tratamiento de deshabituación. Secundariamente, aportar nuevos datos sobre la evolución del deseo compulsivo de beber (craving) y del consumo alcohólico en pacientes tratados con naltrexona, así como el estudio de posibles factores pronósticos predictores de la respuesta al tratamiento. PACIENTES Y METODO: Estudio multicéntrico, prospectivo, con farmacovigilancia, con seguimiento de una cohorte de 198 pacientes mayores de 18 años que reunieron criterios DSM-IV de dependencia del alcohol, repartidos en 10 centros de estudio, a quienes se les administró naltrexona durante 6 meses. RESULTADOS: Un total de 77 pacientes (39,1 por ciento) presentaron algún acontecimiento adverso (AA) durante el transcurso del estudio, siendo los AA más referidos en frecuencia las náuseas/vómitos (13,7 por ciento), la somnolencia/sedación (12,8 por ciento) y la astenia-laxitud-fatigabilidad (10,3 por ciento). Sólo un 3,6 por ciento de los mismos fue considerado grave (6 AA). Respecto a los valores de laboratorio, no se observaron alteraciones hematológicas destacables mientras que descendieron significativamente respecto a los valores basales el colesterol, la bilirrubina total y directa, así como las transaminasas (ASAT/ALAT) y la -GT. En conjunto, los pacientes experimentaron una clara mejoría, objetivable tanto en la disminución del craving (de 22,5 a 5,3 en la escala OCDS; p < 0,01), como en la mejoría de la actividad global (de 68,7 a 85,4 en la EEAG; p < 0,01) y de la sintomatología depresiva (de 12,0 a 4,1 en la escala MDRS; p < 0,01). El tiempo hasta el primer consumo fue de 33 días y la duración acumulada de la abstinencia de 126 días. No se obtuvo ningún modelo predictivo de éxito del tratamiento con suficiente potencia estadística para su uso en la práctica clínica. CONCLUSIONES: La naltrexona presenta un buen perfil de seguridad para el tratamiento de pacientes alcohólicos. Dado que no se han podido establecer factores predictivos de respuesta al tratamiento, la cuestión de qué tipo de pacientes alcohólicos serían los más beneficiados con el tratamiento permanece abierta (AU)

Registro del consumo de bebidas alcohólicas mediante la unidad de bebida estándar. Diferencias geográficas / Standard Drinking Unit as a measure of alcohol consumption in Sapin. Regional differences

Realizamos un estudio para determinar el valor de la Unidad de Bebida Estándar del estado español, entendida como el contenido medio en alcohol de una consumición habitual con el objetivo de facilitar el registro de consumos de bebidas alcohólicas. Primero describimos la metodología empleada en la investigación de campo y los resultados obtenidos incidiendo en las diferencias regionales para la UBE dentro del territorio español. El valor de la UBE española se establece en 10 g que equivalen al contenido medio de alcohol de una consumición de vino o cerveza y a media de destilados. Las diferencias geográficas halladas dibujan un mapa que resulta familiar en las encuestas de consumo y venta de bebidas alcohólicas. La UBE más elevada se encuentra en el norte para descender en dirección al sur geográfico con niveles mínimos en Extremadura y Andalucía. El nivel medio de la UBE por autonomías se mantiene alrededor de los 10 gramos reflejando las mayores variaciones en los valores máximos y mínimos. El cálculo de los consumos alcohólicos mediante la UBE de 10 g contribuye a facilitar el trabajo clínico en atención primaria y en las intervenciones preventivas y además fortalece el rigor de las encuestas epidemiológicas (AU)