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1.
Front Psychol ; 13: 862334, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35450336

RESUMO

The increasing presence of women, especially university women, in risky alcohol consumption such as Binge Drinking (BD), which is associated with gender-specific biopsychosocial problems, makes it necessary to analyze the variables underlying BD in order to adjust possible interventions more in line with their reality. The motives and expectancies of this pattern of consumption, as well as the consequences derived from it, are some of the variables that are shown to have the greatest weight in the prediction of BD. In the present study we analyze, on the one hand, the performance of these variables among college women with alcohol use, and on the other hand, which of these variables allow us to classify BD. A total of 501 female university consumers of alcohol (mean age 19.02 years) were assessed. Specifically, they completed a self-report of alcohol consumption (77.1% engage in BD), the Expectancy Questionnaire (EQ), the Drinking Motives Questionnaire (DMQ-R) and the Alcohol Consumption Consequences Evaluation (ACCE). BD female students scored significantly higher on these instruments, except for compliance motives. The logistic regression analysis carried out to estimate the probability of performing BD using the social and conformity motives, the ACCE and positive expectancies correctly estimated (χ2 8 = 9.149, p < 0.33) 88.6% of the cases and explained 26.2% of the BD. Thus, young women with a level of consequences classified as high risk (>25 in ACCE) have a 3.55-fold increase in the probability of having BD, compared to women classified as low risk by the ACCE. On the other hand, women classified as moderate risk by the ACCE have a 4.77-fold increase in the probability of having BD. In the case of social motives and positive expectancies, their increase multiplies by 1.165 and 1.024, respectively, the probability of having BD. The results of this study highlight the importance of adapting preventive measures to the consequences experienced by BD university students, especially in relation to the social motives and positive expectancies that modulate decision-making when engaging in this pattern of consumption.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34501790

RESUMO

We conducted a review to analyze the 100 most-cited studies on binge drinking (BD) in the Web of Science (WoS) database to determine their current status and the aspects that require further attention. We carried out a retrospective bibliometric analysis in January 2021. The year of publication, authors, design, subject, journal, institution and lead author's country, as well as the definition of BD, were extracted from the articles. The data on the country, year, thematic category of the journals and their rank were obtained from the Institute for Scientific Information (ISI) Journal Citation Reports 2020. The number of citations was collected from the WoS, and the h index was collected from the Scopus database. The citation density and Bradford's law were calculated. The majority of the articles were empirical quantitative studies with a cross-sectional design published between 1992 and 2013 in 49 journals. There were 306 authors, mostly English-speaking and from the USA. The definitions used to describe BD are not homogeneous. The most-cited topics were the analysis of consequences, determinants and epidemiology. There is a need to unify the definitions of BD and base them on scientific evidence. The multidisciplinary nature of BD is not well reflected in each of the thematic areas discussed in this work.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Bibliometria , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Bases de Dados Factuais , Humanos , Estudos Retrospectivos
3.
Acta Reumatol Port ; 45(2): 89-94, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32895350

RESUMO

OBJECTIVES: After consultations, the physician's perceptions differ from the patient's perceptions concerning illness level, cause, and nature of the problem and content of the consultation. Agreement on problems requiring follow-up was associated with a better outcome. The primary aim of this study was to build and validate an instrument that could assess physician-patient agreement in the rheumatology consultation. The secondary objective was to assess agreement association with patient's clinical and sociodemographic data. MATERIALS AND METHODS: A ten-item questionnaire - "Consultation Assessment Instrument" (CAI) - was developed for this study to assess the physician-patient agreement. Ten physicians and 102 patients diagnosed with an inflammatory joint disease under biological therapy were included. The items were evaluated and the index of proportional agreement for the dichotomized answers "agree" (Ppos) and "disagree" (Pneg) was calculated. RESULTS: Consultation satisfaction was the item with the highest agreement. On the opposite end, the item about the explanation of treatment importance was the item with the lowest agreement between patient and physician. Except for one item, the high level of agreement between patient and physician was due to a higher Ppos. Index of proportional agreement was high for 9 of the 10 items (0.816≤ Iv ≤0.990). Patients with lower disease activity scores had a more positive experience. A good internal consistency was obtained for both patient's and physician's questionnaire (α = 0.88 and α = 0.80, respectively). CONCLUSIONS: Both patient and physician showed a positive experience towards Rheumatology consultation. Physician-patient agreement was high in the majority of the consultation aspects (mean Iv = 0,93). A good internal consistency was obtained for both patient's and physician's questionnaire. CAI could be useful as a mental checklist in daily practice or as an educational tool for training consultation skills.


Assuntos
Artrite , Visita a Consultório Médico , Relações Médico-Paciente , Autorrelato , Adulto , Artrite/diagnóstico , Artrite/tratamento farmacológico , Produtos Biológicos/uso terapêutico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
4.
Front Psychol ; 11: 649, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32322231

RESUMO

Instruments that evaluate alcohol use consequences among young people do not consider the intensive alcohol consumption pattern that is so characteristic during these ages. Some of these instruments are even ineffective in the Spanish population. Hence the interest in developing an instrument more adapted to the reality of our young people. A total of 601 university students (35.9% male and 64.1% female) from 18 to 20 years old were recruited. All of them answered a total of 77 items obtained from the review of both the scientific literature and the different scales used to measure consequences derived from alcohol consumption. In addition, they completed the AUDIT and the Timeline Followback for self-reported consumption. The data were analyzed using factor analysis and a two-parameter logistic model. ROC curve analysis was used to establish cut-off points for different risk levels of alcohol consumption distinguishing between genders. The final 43-item scale Alcohol Consumption Consequences Evaluation (ACCE) (Evaluación de Consecuencias derivadas del Consumo de Alcohol [ECCA]) shows adequate psychometric properties: α = 0.94; unidimensionality through exploratory factor analysis (EFA) (26.25% of explained variance) and confirmatory factor analysis (CFA) (RMSEA = 0.39; TLI and CFI > 0.90). In addition, ROC analyses, both at a global scale and distinguishing between genders, were able to characterize consumers with different levels of risk, obtaining areas under the curve between 0.82 and 0.88. A scale has been obtained that enables the establishment of cut-off points to distinguish between the consequences of low, moderate and high risk alcohol consumption. The clinical utility of the ACCE is highlighted by using one single instrument to perform the screening of a possible alcohol risk consumption as well as identifying the consequences that need to be worked on in the evaluated person's or group's intervention.

5.
Adicciones ; 32(4): 255-264, 2020 Nov 17.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31017997

RESUMO

The strong presence of Binge Drinking (BD) amongst university students, as well as the consequences associated with the same and the changes taking place over recent years regarding its conceptualization make it necessary to examine the usefulness of screening instruments used to detect this drinking pattern. This study examines the usefulness of a briefer adaptation of the AUDIT proposed by Cortés, Giménez, Motos, and Sancerni (2017a).College students self-administered the AUDIT, the revised items 2 and 3 (A2r and A3r), and completed a weekly self-report of their alcohol intake. BD was classified according to the amount consumed and the frequency of that consumption over the past six months. The AUDIT, AUDIT-C and items A2r+A3r (AR2I) were examined. The results obtained from a sample of 605 college students (18-21 years old/55.2% female) indicate that 449 meet the BD criteria. Items A2r and A3r, adapted to the most consensual definition of BD, were found to identify 98% of BD college students when using a cut-off point of ≥ 3 in females and ≥ 4 in males with optimum levels of sensitivity and specificity. The new adaptation, which includes fewer items, identifies BD college students more accurately. This confirms the need to adjust both consumption items from the model according to the pattern of consumption in college students to detect BD more precisely and as soon as possible.


La importante presencia del Binge Drinking (BD) entre estudiantes universitarios, junto con las consecuencias asociadas al mismo y los cambios experimentados en los últimos años en su conceptualización, hacen necesario revisar la utilidad de los instrumentos de cribado para detectar este patrón de consumo. Este estudio examina la utilidad de una adaptación del AUDIT propuesta por Cortés, Giménez, Motos y Sancerni (2017a).Una muestra de estudiantes universitarios cumplimentó el AUDIT, los ítems 2 y 3 revisados (A2r y A3r), y un autoinforme semanal de su consumo de alcohol. A partir de la cantidad máxima de alcohol consumido en una ocasión y de la frecuencia de dicho consumo en los últimos seis meses se clasificaron los jóvenes como BD o no-BD. Se examinaron las puntuaciones del AUDIT, AUDIT-C y de los ítems A2r+A3r (AR2I).Los resultados obtenidos con 605 universitarios (18-21 años/55,2% mujeres) indican que 449 cumplen criterios de BD. Los ítems A2r y A3r, adaptados a una definición más consensuada de BD, identifican el 98% de los estudiantes BD cuando se usa un punto de corte ≥ 3 en mujeres y ≥ 4 en varones, con valores óptimos de sensibilidad y especificidad.Esta adaptación realizada, que incluye menor número de ítems, identifica a los universitarios BD de manera más precisa. Se confirma la necesidad de ajustar ambos ítems de consumo de acuerdo al patrón de ingesta BD que realizan los estudiantes universitarios mejorando notablemente su detección y facilitando un abordaje temprano.


Assuntos
Consumo de Álcool na Faculdade , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Autorrelato , Adolescente , Feminino , Humanos , Masculino , Estudantes , Universidades , Adulto Jovem
6.
Adicciones (Palma de Mallorca) ; 32(4): 255-264, 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-198091

RESUMO

La importante presencia del Binge Drinking (BD) entre estudiantes universitarios, junto con las consecuencias asociadas al mismo y los cambios experimentados en los últimos años en su conceptualización, hacen necesario revisar la utilidad de los instrumentos de cribado para detectar este patrón de consumo. Este estudio examina la utilidad de una adaptación del AUDIT propuesta por Cortés, Giménez, Motos y Sancerni (2017a). Una muestra de estudiantes universitarios cumplimentó el AUDIT, los ítems 2 y 3 revisados (A2r y A3r), y un autoinforme semanal de su consumo de alcohol. A partir de la cantidad máxima de alcohol consumido en una ocasión y de la frecuencia de dicho consumo en los últimos seis meses se clasificaron los jóvenes como BD o no-BD. Se examinaron las puntuaciones del AUDIT, AUDIT-C y de los ítems A2r+A3r (AR2I). Los resultados obtenidos con 605 universitarios (18-21 años/55,2% mujeres) indican que 449 cumplen criterios de BD. Los ítems A2r y A3r, adaptados a una definición más consensuada de BD, identifican el 98% de los estudiantes BD cuando se usa un punto de corte ≥ 3 en mujeres y ≥ 4 en varones, con valores óptimos de sensibilidad y especificidad. Esta adaptación realizada, que incluye menor número de ítems, identifica a los universitarios BD de manera más precisa. Se confirma la necesidad de ajustar ambos ítems de consumo de acuerdo al patrón de ingesta BD que realizan los estudiantes universitarios mejorando notablemente su detección y facilitando un abordaje temprano


The strong presence of Binge Drinking (BD) amongst university students, as well as the consequences associated with the same and the changes taking place over recent years regarding its conceptualization make it necessary to examine the usefulness of screening instruments used to detect this drinking pattern. This study examines the usefulness of a briefer adaptation of the AUDIT proposed by Cortés, Giménez, Motos, and Sancerni (2017a). College students self-administered the AUDIT, the revised items 2 and 3 (A2r and A3r), and completed a weekly self-report of their alcohol intake. BD was classified according to the amount consumed and the frequency of that consumption over the past six months. The AUDIT, AUDIT-C and items A2r+A3r (AR2I) were examined. The results obtained from a sample of 605 college students (18- 21 years old/55.2% female) indicate that 449 meet the BD criteria. Items A2r and A3r, adapted to the most consensual definition of BD, were found to identify 98% of BD college students when using a cut-off point of ≥ 3 in females and ≥ 4 in males with optimum levels of sensitivity and specificity. The new adaptation, which includes fewer items, identifies BD college students more accurately. This confirms the need to adjust both consumption items from the model according to the pattern of consumption in college students to detect BD more precisely and as soon as possible


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Autorrelato/normas , Estudantes/estatística & dados numéricos , Comportamentos de Risco à Saúde , Fatores de Tempo , Fatores Sexuais , Fatores de Risco , Valores de Referência
7.
Clin Case Rep ; 7(10): 1932-1934, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31624612

RESUMO

Physicians should look more carefully for the potential reversible causes of acute heart failure, namely hypoparathyroidism. The recovery of left ventricular function with the treatment of hypoparathyroidism underlines the importance of calcium and the reversibility of this type of cardiomyopathy.

8.
Clin Case Rep ; 7(12): 2565-2567, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31893100

RESUMO

Colorectal perforation after barium enema it is a rare complication, but has a high mortality rate. With the emergence of endoscopic examinations, barium enemas have fallen into disuse and doctors are less aware of its complications. This case is of the utmost importance as failure to recognize it could be fatal.

9.
Clin Case Rep ; 7(12): 2571-2574, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31893102

RESUMO

With an increasingly aging population, it is of extreme importance to exclude potentially reversible dementias, such as hyperparathyroidism with hypercalcemia, in the differential diagnosis of a rapidly progressive dementia. According to literature, this entity is undervalued and it is highly relevant to be aware of it.

10.
Front Med (Lausanne) ; 5: 40, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29662880

RESUMO

OBJECTIVES: The classification of disease activity states in rheumatoid arthritis (RA) can be achieved through disease activity indices, such as the Disease Activity Score in 28 joints erythrocyte sedimentation rate (DAS28-ESR), the Simplified Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI). Subjective measurements, such as patient reported outcomes have been incorporated into several of these indices alongside more objective assessments, such as increases in the ESR and C-reactive protein. Moreover, while they use similar criteria, different indices weight these criteria to different extents. Therefore, the classifications based on each evaluation may not always be the same. We aim to compare the performance of the three indices and their individual components in two different populations. METHODS: Data from Dutch and Portuguese adherent centers were extracted from the METEOR database, a multinational collaboration on RA. We included a total of 24,605 visits from Dutch centers (from 5,870 patients) and 20,120 visits from Portuguese centers (from 3,185 patients). We compared the disease activity states as evaluated by the DAS28-ESR, CDAI, and SDAI across the two populations. In addition, we analyzed the individual components of each evaluation, including their respective contributions to the outcome, in each population. RESULTS: We found significant differences in the disease activity states classified with the DAS28-ESR between the two populations. SDAI and CDAI had more congruous results. While the proportion of visits to Dutch and Portuguese centers that were classified as "in remission" was very similar between the CDAI and SDAI, the DAS28-ESR gave discordant results. Dutch patients had lower ESRs, which is more heavily weighted in the DAS28-ESR. In addition, even though the mean physicians' global assessment values did not vary significantly for Dutch vs Portuguese physicians, we found that doctors at Portuguese centers overall scored the physician's global assessment lower than Dutch physicians for patient visits classified by disease activity state. CONCLUSION: While the CDAI and SDAI assigned disease activity states that were largely similar, the DAS28-ESR was often discordant across the two populations. Moreover, we found that physicians, more than patients, evaluated disease activity differently among the Portuguese and Dutch populations.

11.
Front Psychol ; 8: 910, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28642722

RESUMO

This study analyzes the appropriateness of an improved version of one of the most frequently used instruments for the screening of high-risk alcohol consumption. This adaptation was created in accordance with certain limitations recognized by other researchers and in an attempt to adjust the content and scales of some items to a more consensual definition of binge drinking. After revising items 2 and 3, the areas under the ROC curves of the AUDIT and of different abbreviated versions were calculated. A total of 906 minors (468 females) between the ages of 15 and 17 were evaluated. Stratified sampling was conducted on a population of high school students in the city of Valencia (Spain). One school was randomly chosen from each of the city's 16 school districts. Information was collected on sociodemographic aspects, consumption patterns and the AUDIT containing the improved items. The percentage of underage BD reached 36%, regardless of gender or age. BD groups have been differentiated by different intensity levels, both in males and females. Upon comparing the effectiveness of the distinct versions of the AUDIT, it is recommended that researchers and clinics use the combination of the revised items 2 and 3 to ensure a more precise identification of underage BD. A cut-off point of 5 for this test would permit identification of 94% of the underage BD and would notably reduce false positives.

12.
Psicothema (Oviedo) ; 29(2): 229-235, mayo 2017. tab, graf
Artigo em Inglês | IBECS | ID: ibc-163075

RESUMO

BACKGROUND: The increasingly precise conceptualization of Binge Drinking (BD), along with the rising incidence of this pattern of intake amongst young people, make it necessary to review the usefulness of instruments used to detect it. Little evidence exists regarding effectiveness of the AUDIT, AUDIT-C and AUDIT-3 in the detection of BD. This study evaluates their utility in a sample of university students, revealing the most appropriate cut-off points for each sex. METHODS: All students self-administered the AUDIT and completed a self-report of their alcohol consumption. A Two-step cluster analysis differentiated 5 groups of BD in terms of: the quantity consumed, the frequency of BD over the past six months and gender. A ROC curve adjusted cut-off points for each case. RESULTS: 862 university students (18-19 years-old/59.5% female), 424 (49.2%) from Valencia and 438 (50.8%) from Madrid, had cut-off points of 4 in AUDIT and 3 in AUDIT-C as a better fit. In all cases, the best classifier was AUDIT-C. Neither version properly classifies students with varying degrees of BD. CONCLUSIONS: All versions differentiate BD from non-BD, but none are able to differentiate between types of BD


ANTECEDENTES: la operacionalización cada vez más precisa del Binge Drinking (BD), unido a su elevada prevalencia entre los jóvenes, hace necesario revisar la utilidad de los instrumentos utilizados para detectarlo. Existe poca evidencia de la eficacia del AU-DIT y AUDIT-C en la detección del BD. Este artículo evalúa su utilidad en una muestra de universitarios, identificando los puntos de corte más adecuados, en función del sexo. MÉTODO: se cumplimentó el AUDIT y un autoregistro de consumo de alcohol. Un análisis de conglomerados en dos fases diferenció 5 grupos de BD en función de: cantidad consumida, frecuencia de realización en los últimos seis meses y género. Con curvas ROC se ajustaron los puntos de corte para cada caso. RESULTADOS: 862 universitarios (18-19 años/59,5% mujeres), 424 (49,2%) de Valencia y 438 (50,8%) de Madrid obtuvieron puntos de corte de 4 en AUDIT y 3 en AUDIT-C como mejor ajuste. En todos los casos el mejor clasificador de BD fue el AUDIT-C. Ninguna versión clasifica adecuadamente a estudiantes con diferente intensidad de BD. CONCLUSIONES: ambas versiones diferencian BD de noBD, pero ninguna de ellas permite distinguir entre tipos de BD


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Consumo de Álcool na Faculdade/psicologia , Psicometria/instrumentação , Transtornos Relacionados ao Uso de Álcool/diagnóstico , Comportamento Perigoso , Assunção de Riscos , Estudos Transversais , Transtornos Relacionados ao Uso de Álcool/epidemiologia
13.
Am J Hypertens ; 30(5): 510-517, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-27993838

RESUMO

BACKGROUND: Arterial stiffness, measured with pulse wave velocity (PWV), is now classified as a marker of target organ damage (TOD) alongside left ventricular hypertrophy and moderately increased albuminuria. Interventional studies on treated hypertensive patients have shown that PWV could be improved. Our aim was to assess changes in arterial stiffness after 1 year of routine clinical practice in never-treated hypertensive patients. PATIENTS AND METHODS: We studied 356 never-treated patients with suspected hypertension. After standard clinical assessment during which presence of TOD was evaluated, hypertension diagnosis was confirmed in 231 subjects who subsequently received standard routine care. Both hypertensive and the 125 controls came back for a follow-up visit after 1 year. RESULTS: Hypertensive patients were slightly older (46 ± 12 vs. 50 ± 12 years, P < 0.001), with higher mean arterial pressure (MAP)-adjusted PWV compared to controls (8.6 ± 2.0 vs. 8.0 ± 1.7 m/s, P < 0.001) and 47% of them presented 1 or more TOD. After 1 year of treatment, MAP was similar in both groups (94.9 vs. 96.2 mm Hg; P = ns), but adjusted PWV remained significantly higher in the hypertensive patients (7.8 ± 1.4 vs. 8.3 ± 1.7 m/s, P = 0.004). The prevalence of elevated PWV was reduced from 20% to 12%. All antihypertensive drugs achieved the same blood pressure (BP) and PWV reduction with the exception of vasodilating beta-blockers which gave slightly better results probably due to heart rate reduction. CONCLUSION: BP reduction in newly diagnosed hypertensive patients improves arterial stiffness within a year of real-life clinical practice. Patients with the highest PWV and the largest reduction of BP "destiffened" the most whatever antihypertensive class was used.


Assuntos
Anti-Hipertensivos/uso terapêutico , Pressão Arterial/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Rigidez Vascular/efeitos dos fármacos , Adulto , Estudos de Casos e Controles , Quimioterapia Combinada , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prevalência , Análise de Onda de Pulso , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento
14.
Univ. psychol ; 15(2): 243-254, abr.-jun. 2016. graf
Artigo em Espanhol | LILACS | ID: biblio-963157

RESUMO

Las implicaciones clínicas y sociales derivadas del consumo intensivo de alcohol (CIA) en universitarios motivan la necesidad de analizar los factores que favorecen su aparición. Este estudio evalúa cómo influye la cantidad de alcohol ingerido, la edad de inicio en el consumo de esta sustancia y los motivos asociados a esta conducta en la presencia de un mayor o menor número de consecuencias psicosociales. 312 estudiantes de primero de la Universidad de Valencia que realizan CIA cumplimentaron el instrumento IECI (Cortés et al., 2012): autoregistro de consumo, motivos asociados a esta ingesta y consecuencias psicosociales derivadas. Se confirman resultados de investigaciones precedentes. Ambos sexos duplican los gramos de alcohol que definen un CIA. Aparecen diferencias en los efectos esperados en función del sexo, así como en la edad de inicio en el consumo y en el número de consecuencias experimentadas. Los análisis de regresión de orden jerárquico muestran la importancia de la edad de inicio y los motivos, por encima de los gramos consumidos, para dar cuenta del deterioro psicosocial generado por la ingesta. Esto apoya la necesidad de atender a la combinación de variables en la explicación y posterior intervención para paliar las consecuencias derivadas del CIA.


Drinking onset, motives and alcohol use in the prediction of alcohol-related problems in undergraduate binge drinkers. The clinical and social implications derived from binge drinking (BD) in university students cause the need to analyze the factors which contribute to its appearance. This research assesses the influence of the amount of alcohol consumed, drinking onset and the motives associated with this behaviour in the presence of a greater or least number of psychological consequences. 312 first year university students at Valencia University performing BD completed the IECI instrument (Cortés et al., 2012): self report about consumption, associated motives to their consumption and the psychosocial consequences. Results are confirmed by previous research. Both sexes double the grams of alcohol which define a BD. Differences appear in the expected outcome depending on the sex as well as the age at which they drinking onset and the number of experienced consequences. The hierarchical regression analysis shows the importance of the drinking onset and the motives, above the quantity of consumed grams, in order to report the psychosocial impairment generated by the intake. This supports the need to comply with the combination of variables in the explanation and subsequent intervention to alleviate the consequences of the BD.

15.
Drug Alcohol Depend ; 158: 52-9, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26616473

RESUMO

BACKGROUND: The changes experienced in recent years in the conceptualization of binge drinking (BD) make it necessary to revise the usefulness of the existing instruments for its detection among minors. The AUDIT and its abbreviated versions have shown their utility in different populations and consumption ranges, but there has been little research into their use in the detection of BD among adolescents. This study tests the capacity of the AUDIT, AUDIT-C and AUDIT-3 to identify BD adolescents, indicating the optimal cut-off points for each sex. METHODS: High school students self-administered the AUDIT and completed a weekly self-report of their alcohol intake. BD is classified into different groups according to parameters like the quantity consumed and its frequency in the past six months, adjusting the cut-off points for each case. RESULTS: The results obtained with a sample of 634 adolescents (15-17 years old/52.2% female) indicate that cut-off points of 4 on the AUDIT and 3 on the AUDIT-C show the best fit. Dividing the sample by sexes, the AUDIT and the AUDIT-C would detect BD males with scores of 5 and 4, respectively (with the AUDIT-C being more sensitive), and BD females with a score of 3 on both (the more sensitive being the AUDIT). CONCLUSIONS: All three versions are adequate to classify BD adolescents but none of them made it possible to safely differentiate binge drinkers with different consumption intensities.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/diagnóstico , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Inquéritos e Questionários/normas , Consumo de Álcool por Menores , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo/diagnóstico , Alcoolismo/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Feminino , Humanos , Masculino , Autorrelato/normas , Estudantes/psicologia , Consumo de Álcool por Menores/psicologia
16.
Adicciones ; 27(2): 119-31, 2015 Jun 17.
Artigo em Inglês | MEDLINE | ID: mdl-26132301

RESUMO

The important implications generated by binge drinking among university students justify the interest to determine which factors predict its occurrence. Specifically, this study aims to assess the role of personality and drinking onset in predicting weekly alcohol consumption, and the impact of the whole set of variables in predicting the number of consequences associated with consumption in undergraduates. Two hundred and thirteen freshmen who were intensive consumers (binge drinkers) from the University Complutense of Madrid were evaluated. All of them filled in a self-registration of consumption, the BIS-11, the NEO-FFI and the IECI consequences associated with intake. The hierarchical regression analysis shows that the drinking onset appears to be a relevant predictor variable in explaining weekly consumption and the number of consequences. The same can be said of the weekly consumption variable with regard to the number of consequences. In general, the influence of personality is quite limited. It is interesting to point out that responsibility and impulsivity, along with age, explain most of the weekly consumption behavior among males. With respect to the consequences of consumption, only impulsivity and neuroticism contribute to explain them, but with less strength than age and weekly consumption. Our results justify the need to plan tighter interventions and consider new predictors that help to explain further weekly consumption in women.


Las importantes implicaciones que genera el consumo intensivo de alcohol entre los jóvenes justifican el interés por determinar qué factores predicen su aparición. Concretamente, en este estudio se analiza el papel de la personalidad y edad de inicio en el consumo de alcohol en la predicción del consumo semanal de alcohol, y de todas estas variables en la predicción del número de consecuencias asociadas al consumo en jóvenes universitarios.Se evalúan 213 consumidores intensivos de primer curso de la Universidad Complutense de Madrid. Todos ellos cumplimentaron un autoregistro de consumo, el BIS-11, el NEO-FFI y el IECI de consecuencias asociadas a la ingesta.Los análisis de regresión de orden jerárquico muestran que la edad de inicio resulta ser una variable predictora relevante tanto en la explicación del consumo semanal como del número de consecuencias. Lo mismo puede decirse de la variable consumo semanal respecto a la del número de consecuencias.En líneas generales, el influjo de las variables de personalidad es bastante limitado. Tan sólo mencionar la responsabilidad e impulsividad, que junto con la edad, llegan a explicar gran parte de la conducta de consumo semanal entre varones. En lo que respecta a las consecuencias derivadas del consumo, sólo resultan explicativas, aunque en menor medida que la edad y el consumo semanal, la impulsividad y el neuroticismo.Esto justifica la necesidad de planificar intervenciones más ajustadas y de analizar nuevos predictores en el caso de las mujeres que permitan explicar en mayor medida su conducta de consumo semanal.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Feminino , Humanos , Masculino , Personalidade , Estudantes
17.
Med. clín (Ed. impr.) ; 145(2): 49-54, jul. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-138567

RESUMO

Fundamento y objetivo: Valorar la posible relación de la presión arterial central con el daño vascular. Material y método: Estudio observacional transversal en 393 pacientes con hipertensión arterial sin tratamiento farmacológico previo (166 mujeres). Se midieron las presiones clínicas (PA), ambulatorias de 24 h (PA24h) y centrales (PAC). Para determinar la presencia de lesión de órgano diana (LOD) se calculó el cociente albúmina/creatinina (CAC), la velocidad de onda de pulso y el índice de masa del ventrículo izquierdo (IMVI) por ecocardiografía. Resultados: Los pacientes con LOD tenían valores más altos de PA, PA24h y PAC. Al comparar las distintas mediciones de PA sistólica, la PA24h sistólica tuvo una mayor correlación con el CAC (test Z Steiger: 2,26; p = 0,02) y con el IMVI (test Z Steiger: 3,23; p = 0,01) que la PAC sistólica. La PA24h sistólica tuvo una mayor relación en el análisis de regresión múltiple con los índices de daño vascular analizados que las respectivas de PA y PAC tras corregir por edad, sexo y síndrome metabólico. Mediante un análisis de regresión logística, presentar cifras de PA24h sistólicas incluidas en el tercil superior fue el mejor predictor de presentar alguna de las LOD (odds ratio multivariante 3,4; IC al 95%: 2,5-5,5, p = 0,001). Conclusiones: La PAC no tiene mayor correlación con las LOD analizadas que otras medidas de PA periférica. La medición de la PA24h identifica mejor a los pacientes con daño vascular (AU)


Background and objective: The aim of this study was to assess the relationship between central blood pressure and vascular damage. Patients and methods: This cross-seccional study involved 393 never treated hypertensive patients (166 women). Clinical blood pressure (BP), 24 h blood pressure (BP24h) and central blood pressure (CBP) were measured. Vascular organ damage (VOD) was assessed by calculating the albumin/creatinine ratio (ACR), wave pulse pressure velocity and echocardiographic left ventricular mass index (LVMI). Results: Patients with VOD had higher values of BP, BP24h, and CBP than patients without ACR. When comparing several systolic BP, systolic BP24h had a higher linear correlation with CBP (Z Steiger test: 2.26; P = .02) and LVMI (Z Steiger test: 3.23; P = .01) than PAC. In a multiple regression analysis corrected by age, sex and metabolic syndrome, all pressures were related with VOD but systolic BP24hshowed the highest correlation. In a logistic regression analysis, having the highest tercile of systolic BP24h was the stronger predictor of VOD (multivariate odds ratio: 3.4; CI 95%: 2.5-5.5, P = .001). Conclusions: CBP does not have more correlation with VOD than other measurements of peripheral BP. Systolic BP24h is the BP measurement that best predicts VOD (AU)


Assuntos
Adulto , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Pressão Arterial/fisiologia , Sistema Cardiovascular/lesões , Análise de Onda de Pulso , Ecocardiografia , Albuminúria , Pressão Sanguínea , Pulso Arterial , Doenças Vasculares
18.
Bosn J Basic Med Sci ; 15(2): 31-6, 2015 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-26042510

RESUMO

Evidence gained from animals and humans suggests that the encephalic opioid system might be involved in the development of drug addiction through its role in reward. Our aim is to assess the influence of genetic variations in the opioid receptor mu 1 on alcohol and tobacco consumption in a Spanish population. 763 unrelated individuals (465 women, 298 men) aged 18-85 years were recruited between October 2011 and April 2012. Participants were requested to answer a 35-item questionnaire on tobacco and alcohol consumption, as well as to complete the AUDIT and Fagerström tests. Individuals were genotyped for three polymorphisms in the opioid receptor mu 1 (OPRM1) gene, using a TaqMan protocol. In males, the rs10485057 polymorphism was associated with total pure ethanol intake and with the risk of being an alcohol consumer. Also, this polymorphism was significantly associated with higher Fagerström scores. Rs1799971 had a different influence on adaptive and maladaptive patterns of alcohol use. Despite the limited sample size, our study might enrich current knowledge on patterns of alcohol use, because it encompasses both extreme and adaptive phenotypes, providing thus a wider perspective on this subject.


Assuntos
Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/genética , Polimorfismo Genético/genética , Receptores Opioides mu/genética , Uso de Tabaco/etnologia , Uso de Tabaco/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos de Casos e Controles , Feminino , Frequência do Gene/genética , Interação Gene-Ambiente , Genótipo , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Fenótipo , Fatores Sexuais , Espanha/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/etnologia , Transtornos Relacionados ao Uso de Substâncias/genética , Inquéritos e Questionários , Uso de Tabaco/epidemiologia , Adulto Jovem
19.
Biomed Res Int ; 2015: 279890, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26000286

RESUMO

OBJECTIVES: To compare the effectiveness of TNF inhibitors (TNFi) and tocilizumab in rheumatoid arthritis (RA) treatment, according to different response criteria. METHODS: We included RA patients registered in the Rheumatic Diseases Portuguese Register treated with TNFi or tocilizumab for at least 6 months, between January 2008 and July 2013. We assessed remission/low disease activity (LDA) at 6 months according to DAS28, CDAI, and SDAI, as well as Boolean ACR/EULAR remission and EULAR response rate, adjusting for measured confounders. RESULTS: Tocilizumab-treated patients (n = 95) presented higher baseline disease activity and were less frequently naïve to biologics compared to TNFi users (n = 429). Multivariate logistic regression analysis including the propensity score for receiving tocilizumab showed that patients treated with tocilizumab were more likely to achieve remission or LDA according to DAS28 (OR = 11.0/6.2, 95% CI 5.6-21.6/3.2-12.0), CDAI (OR = 2.8/2.6, 95% CI 1.2-6.5/1.3-5.5), or SDAI (OR = 3.6/2.5, 95% CI 1.5-8.7/1.1-5.5), as well as a good EULAR response (OR = 6.4, 95% CI 3.4-12.0). However, both groups did not differ in Boolean remission (OR = 1.9, 95% CI 0.8-4.8) or good/moderate EULAR response (OR = 1.8, 95% CI 0.8-4.5). CONCLUSIONS: Compared with TNFi, tocilizumab was associated with greater likelihood of achieving DAS28, CDAI, and SDAI remission/LDA and EULAR good response. Boolean remission and EULAR good/moderate response did not differ significantly between groups.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Sistema de Registros , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Portugal , Indução de Remissão , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/metabolismo
20.
Biomed Res Int ; 2015: 490295, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25834819

RESUMO

BACKGROUND: The aim of our work was to replicate, in a Southern European population, the association reported in Northern populations between PTPRC locus and response to anti-tumor necrosis factor (anti-TNF) treatment in rheumatoid arthritis (RA). We also looked at associations between five RA risk alleles and treatment response. METHODS: We evaluated associations between anti-TNF treatment responses assessed by DAS28 change and by EULAR response at six months in 383 Portuguese patients. Univariate and multivariate linear and logistic regression analyses were performed. In a second step to confirm our findings, we pooled our population with 265 Spanish patients. RESULTS: No association was found between PTPRC rs10919563 allele and anti-TNF treatment response, neither in Portuguese modeling for several clinical variables nor in the overall population combining Portuguese and Spanish patients. The minor allele for RA susceptibility, rs3761847 SNP in TRAF1/C5 region, was associated with a poor response in linear and logistic univariate and multivariate regression analyses. No association was observed with the other allellic variants. Results were confirmed in the pooled analysis. CONCLUSION: This study did not replicate the association between PTPRC and the response to anti-TNF treatment in our Southern European population. We found that TRAF1/C5 risk RA variants potentially influence anti-TNF treatment response.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Artrite Reumatoide/genética , Estudos de Associação Genética , Antígenos Comuns de Leucócito/genética , Fator 1 Associado a Receptor de TNF/genética , Adalimumab/administração & dosagem , Adulto , Idoso , Alelos , Anticorpos Monoclonais/administração & dosagem , Artrite Reumatoide/patologia , Etanercepte/administração & dosagem , Cadeias HLA-DRB1/genética , Humanos , Infliximab/administração & dosagem , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética
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