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[PMID]:22105626
[Au] Autor:Kendler KS; Aggen SH; Prescott CA; Crabbe J; Neale MC
[Ad] Endereço:Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. kendler@vcu.edu
[Ti] Título:Evidence for multiple genetic factors underlying the DSM-IV criteria for alcohol dependence.
[So] Source:Mol Psychiatry;17(12):1306-15, 2012 Dec.
[Is] ISSN:1476-5578
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:To determine the number of genetic factors underlying the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for alcohol dependence (AD), we conducted structural equation twin modeling for seven AD criteria, plus two summary screening questions, in 7133 personally interviewed male and female twins from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, who reported lifetime alcohol consumption. The best-fit twin model required three genetic and two unique environmental common factors, and criterion-specific unique environmental factors. The first genetic factor was defined by high loadings for the probe question about quantity and frequency of alcohol consumption, and tolerance criterion. The second genetic factor loaded strongly on the probe question about self-recognition of alcohol-related problems and AD criteria for loss of control, desire to quit, preoccupation and activities given up. The third genetic factor had high loadings for withdrawal and continued use despite the problems criteria. Genetic factor scores derived from these three factors differentially predicted patterns of comorbidity, educational status and other historical/clinical features of AD. The DSM-IV syndrome of AD does not reflect a single dimension of genetic liability, rather, these criteria reflect three underlying dimensions that index risk for: (i) tolerance and heavy use; (ii) loss of control with alcohol associated social dysfunction and (iii) withdrawal and continued use despite problems. While tentative and in need of replication, these results, consistent with the rodent literature, were validated by examining predictions of the genetic factor scores and have implications for gene-finding efforts in AD.
[Mh] Termos MeSH primário: Alcoolismo/genética
Diagnostic and Statistical Manual of Mental Disorders
Doenças em Gêmeos/genética
Modelos Estatísticos
[Mh] Termos MeSH secundário: Adulto
Alcoolismo/diagnóstico
Doenças em Gêmeos/diagnóstico
Grupo com Ancestrais do Continente Europeu/genética
Grupo com Ancestrais do Continente Europeu/psicologia
Feminino
Interação Gene-Ambiente
Humanos
Masculino
Sistema de Registros/estatística & dados numéricos
Fatores de Risco
Gêmeos Dizigóticos/genética
Gêmeos Dizigóticos/psicologia
Gêmeos Monozigóticos/genética
Gêmeos Monozigóticos/psicologia
Virginia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, U.S. GOV'T, NON-P.H.S.; VALIDATION STUDIES
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121121
[St] Status:MEDLINE
[do] DOI:10.1038/mp.2011.153


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[PMID]:22990035
[Au] Autor:Sanaei-Zadeh H
[Ti] Título:Use of intravenous fluids for the treatment of patients intoxicated with ethanol (alcohol): is it a scientific-based practice?
[So] Source:Eur J Emerg Med;19(6):409-10; author reply 410, 2012 Dec.
[Is] ISSN:1473-5695
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Intoxicação Alcoólica/reabilitação
Alcoolismo/reabilitação
Atitude do Pessoal de Saúde
Serviço Hospitalar de Emergência/organização & administração
Etanol/envenenamento
Condutas na Prática dos Médicos/estatística & dados numéricos
Papel do Médico
[Mh] Termos MeSH secundário: Humanos
[Pt] Tipo de publicação:COMMENT; LETTER
[Nm] Nome de substância:
64-17-5 (Ethanol)
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121030
[St] Status:MEDLINE
[do] DOI:10.1097/MEJ.0b013e3283521265


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[PMID]:22186151
[Au] Autor:Schwan R; Di Patritio P; Albuisson E; Malet L; Brousse G; Lerond J; Laprevote V; Boivin JM
[Ad] Endereço:CHU de Nancy, Addiction Treatment and Prevention Center, Hôpital de Brabois, Bâtiment Philippe Canton, Rue du Morvan, Vandoeuvre-Les-Nancy, Cedex, France. r.schwan@chu-nancy.fr
[Ti] Título:Usefulness of brief intervention for patients admitted to emergency services for acute alcohol intoxication.
[So] Source:Eur J Emerg Med;19(6):384-8, 2012 Dec.
[Is] ISSN:1473-5695
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: In hospital emergency services, the prevalence of alcohol-related admissions is about 20%, of which 80% display elevated γ-glutamyl transpeptidase or carbohydrate deficient transferring (CDT). We investigated whether intensive case management (ICM) that included cognitive behavior-oriented brief intervention could decrease patient morbidity. METHODS: This study was a 13-month, prospective, exhaustive, longitudinal, controlled trial in an emergency department. Readmission rate of patients previously admitted to the emergency services for the same reason was chosen as an indicator of efficacy. RESULTS: A total of 203 patients were enrolled in the study: 106 in the intervention group, who received ICM, and 97 in the control group, who received standard care. In the control group, 59% of the patients were readmitted for the same reason in the 1-year follow-up against 32% in the intervention group. Thus, the 1-year readmission rate decreased by 45%. CONCLUSION: ICM in an emergency ward can successfully treat patients with alcohol problems and reduce relapse rate. Alcohol intervention should be part of the standard care in alcohol-related emergency admissions. It treats the alcohol problem early, effectively, and at low cost, and can have a major impact on long-term patient health.
[Mh] Termos MeSH primário: Intoxicação Alcoólica/reabilitação
Alcoolismo/reabilitação
Atitude do Pessoal de Saúde
Serviço Hospitalar de Emergência/organização & administração
Etanol/envenenamento
Condutas na Prática dos Médicos/estatística & dados numéricos
Papel do Médico
[Mh] Termos MeSH secundário: Medicina de Emergência
Inglaterra
Promoção da Saúde
Humanos
Admissão do Paciente/estatística & dados numéricos
Equipe de Assistência ao Paciente/organização & administração
Alta do Paciente/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
64-17-5 (Ethanol)
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121030
[St] Status:MEDLINE
[do] DOI:10.1097/MEJ.0b013e32834f369e


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[PMID]:22134421
[Au] Autor:Hindmarch PN; Land S; Wright J
[Ad] Endereço:Clinical Research Facility, Clinical Deanery, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, UK. paul.hindmarch@nuth.nhs.uk
[Ti] Título:Emergency physicians' opinions on the use of intravenous fluids to treat patients intoxicated with ethanol (alcohol): attitudes of emergency medicine physicians in the North East of England toward the use of intravenous fluids to treat individuals intoxicated with ethanol (alcohol) attending the emergency department compared with the scientific evidence.
[So] Source:Eur J Emerg Med;19(6):379-83, 2012 Dec.
[Is] ISSN:1473-5695
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: There is an apparent conflict between published evidence and UK emergency medicine (EM) physician practice with regard to the use of intravenous fluids to treat patients intoxicated with alcohol. We conducted a survey of all EM physicians in North East (NE) England to determine opinion with regard to this therapy, and compared this with the available evidence for its benefit. METHODS: We identified 136 EM consultants and trainees in NE England. Each one was contacted and asked to complete a questionnaire with regard to their opinion on the use of intravenous fluids for intoxicated patients, both with and without head injury. RESULTS: The majority (73%) of EM physicians in the NE England use intravenous fluids in their treatment of intoxicated patients. The treatment used varies, but the most commonly used fluid is 0.9% saline (volume range, 500-3000 ml; mean, 1300 ml). Fewer respondents (52%) would use intravenous fluids if the patient had suffered an apparent head injury. CONCLUSION: The use of intravenous fluids to treat intoxication is common practice among EM physicians in NE England. The available literature states that this practice is futile. However, there are significant limitations in these studies. This suggests that EM physicians might be using intravenous fluids therapy (IVT) because they are finding in their own practice it is effective. We hypothesize that IVT should improve care in most intoxicated patients as the result of a direct dilutional effect. Further research is required to establish the validity of existing EM physician's practice of using IVT.
[Mh] Termos MeSH primário: Intoxicação Alcoólica/reabilitação
Alcoolismo/reabilitação
Atitude do Pessoal de Saúde
Serviço Hospitalar de Emergência/organização & administração
Etanol/envenenamento
Condutas na Prática dos Médicos/estatística & dados numéricos
Papel do Médico
[Mh] Termos MeSH secundário: Medicina de Emergência
Inglaterra
Promoção da Saúde
Humanos
Admissão do Paciente/estatística & dados numéricos
Equipe de Assistência ao Paciente/organização & administração
Alta do Paciente/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
64-17-5 (Ethanol)
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121030
[St] Status:MEDLINE
[do] DOI:10.1097/MEJ.0b013e32834e909c


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[PMID]:22471388
[Au] Autor:Beech RD; Qu J; Leffert JJ; Lin A; Hong KA; Hansen J; Umlauf S; Mane S; Zhao H; Sinha R
[Ad] Endereço:Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519, USA. robert.beech@yale.edu
[Ti] Título:Altered expression of cytokine signaling pathway genes in peripheral blood cells of alcohol dependent subjects: preliminary findings.
[So] Source:Alcohol Clin Exp Res;36(9):1487-96, 2012 Sep.
[Is] ISSN:1530-0277
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Preclinical and clinical studies have implicated changes in cytokine and innate immune gene-expression in both the development of and end-organ damage resulting from alcohol dependence. However, these changes have not been systematically assessed on the basis of alcohol consumption in human subjects. METHODS: Illumina Sentrix Beadchip (Human-6v2) microarrays were used to measure levels of gene-expression in peripheral blood in 3 groups of subjects: those with alcohol dependence (AD, n = 12), heavy drinkers (HD; defined as regular alcohol use over the past year of at least 8 standard drinks/wk for women and at least 15 standard drinks/wk for men, n = 13), and moderate drinkers (MD; defined as up to 7 standard drinks/wk for women and 14 standard drinks/wk for men, n = 17). RESULTS: Four hundred and thirty-six genes were differentially expressed among the 3 groups of subjects (false discovery rate corrected p-value < 0.05). Two hundred and ninety-one genes differed between AD and MD subjects, 240 differed between AD and HD subjects, but only 6 differed between HD and MD subjects. Pathway analysis using DAVID and GeneGO Metacore(®) software showed that the most affected pathways were those related to T-cell receptor and Janus kinase-Signal transducer and activator of transcription (JAK-Stat) signaling. CONCLUSIONS: These results suggest the transition from heavy alcohol use to dependence is accompanied by changes in the expression of genes involved in regulation of the innate immune response. Such changes may underlie some of the previously described changes in immune function associated with chronic alcohol abuse. Early detection of these changes may allow individuals at high risk for dependence to be identified.
[Mh] Termos MeSH primário: Alcoolismo/sangue
Células Sanguíneas/fisiologia
Citocinas/fisiologia
Transdução de Sinal/fisiologia
[Mh] Termos MeSH secundário: Adulto
Consumo de Bebidas Alcoólicas/genética
Consumo de Bebidas Alcoólicas/metabolismo
Alcoolismo/genética
Citocinas/genética
Demografia
Diagnostic and Statistical Manual of Mental Disorders
Grupos Étnicos
Feminino
Expressão Gênica
Perfilação da Expressão Gênica
Humanos
Interleucina-15/genética
Interleucinas/genética
Janus Quinases/genética
Masculino
Análise em Microsséries
Meia-Idade
Recidiva
Fatores de Transcrição STAT/genética
Transdução de Sinal/genética
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Cytokines); 0 (Interleukin-15); 0 (Interleukins); 0 (STAT Transcription Factors); 0 (interleukin-21); EC 2.7.10.2 (Janus Kinases)
[Em] Mês de entrada:1301
[Cu] Atualização por classe:130506
[Lr] Data última revisão:
130506
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120907
[St] Status:MEDLINE
[do] DOI:10.1111/j.1530-0277.2012.01775.x


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[PMID]:22542217
[Au] Autor:Mertens JR; Kline-Simon AH; Delucchi KL; Moore C; Weisner CM
[Ad] Endereço:Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612-2304, United States. Jennifer.Mertens@kp.org
[Ti] Título:Ten-year stability of remission in private alcohol and drug outpatient treatment: non-problem users versus abstainers.
[So] Source:Drug Alcohol Depend;125(1-2):67-74, 2012 Sep 1.
[Is] ISSN:1879-0046
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study examined stability of remission in patients who were abstainers and non-problem users at 1-year after entering private, outpatient alcohol and drug treatment. We examined: (a) How does risk of relapse change over time? (b) What was the risk of relapse for non-problem users versus abstainers? (c) What individual, treatment, and extra-treatment characteristics predicted time to relapse, and did these differ by non-problem use versus abstinence? METHODS: The sample consisted of 684 adults in remission (i.e., abstainers or non-problem users) 1 year following treatment intake. Participants were interviewed at intake, and 1, 5, 7, 9, and 11 years after intake. We used discrete-time survival analysis to examine when relapse is most likely to occur and predictors of relapse. RESULTS: Relapse was most likely at 5-year, and least likely at 11-year follow-up. Non-problem users had twice the odds of relapse compared to abstainers. Younger individuals and those with fewer 12-step meetings and shorter index treatment had higher odds of relapse than others. We found no significant interactions between non-problem use and the other covariates suggesting that significant predictors of outcome did not differ for non-problem users. CONCLUSIONS: Non-problem use is not an optimal 1-year outcome for those in an abstinence-oriented, heterogeneous substance use treatment program. Future research should examine whether these results are found in harm reduction treatment and self-help models, or in those with less severe problems. Results suggest treatment retention and 12-step participation are prognostic markers of long-term positive outcomes for those achieving remission at 1 year.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/psicologia
Alcoolismo/reabilitação
Assistência Ambulatorial/estatística & dados numéricos
Centros de Tratamento de Abuso de Substâncias/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Feminino
Seguimentos
Nível de Saúde
Humanos
Tempo de Internação
Masculino
Meia-Idade
Valor Preditivo dos Testes
Modelos de Riscos Proporcionais
Recidiva
Fatores Socioeconômicos
Análise de Sobrevida
Resultado de Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1212
[Cu] Atualização por classe:130506
[Lr] Data última revisão:
130506
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:120814
[St] Status:MEDLINE
[do] DOI:10.1016/j.drugalcdep.2012.03.020


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[PMID]:22938859
[Au] Autor:Gilpin NW
[Ad] Endereço:Department of Physiology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States. ngilpi@lsuhsc.edu
[Ti] Título:Neuropeptide Y (NPY) in the extended amygdala is recruited during the transition to alcohol dependence.
[So] Source:Neuropeptides;46(6):253-9, 2012 Dec.
[Is] ISSN:1532-2785
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:Neuropeptide Y (NPY) is abundant in the extended amygdala, a conceptual macrostructure in the basal forebrain important for regulation of negative affective states. NPY has been attributed a central role in anxiety-like behavior, fear, nociception, and reward in rodents. Deletion of the NPY gene in mice produces a high-anxiety high-alcohol-drinking phenotype. NPY infused into the brains of rats selectively bred to consume high quantities of alcohol suppresses alcohol drinking by those animals, an effect that is mediated by central amygdala (CeA). Likewise, alcohol-preferring rats exhibit basal NPY deficits in CeA. NPY infused into the brains of alcohol-dependent rats blocks excessive alcohol drinking by those animals, an effect that also has been localized to the CeA. NPY in CeA may rescue dependence-induced increases in anxiety and alcohol drinking via inhibition of downstream effector regions that receive GABAergic inputs from CeA. It is hypothesized here that NPY modulates anxiety-like behavior via Y2R regulation of NPY release, whereas NPY modulation of alcohol-drinking behavior in alcohol-dependent animals occurs via Y2R regulation of GABA release.
[Mh] Termos MeSH primário: Alcoolismo/fisiopatologia
Tonsila do Cerebelo/fisiologia
Neuropeptídeo Y/fisiologia
[Mh] Termos MeSH secundário: Alcoolismo/genética
Animais
Modelos Animais de Doenças
Humanos
Transtornos do Humor/fisiopatologia
Neuropeptídeo Y/genética
Recrutamento Neurofisiológico/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; REVIEW
[Nm] Nome de substância:
0 (Neuropeptide Y)
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121126
[St] Status:MEDLINE


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[PMID]:23013114
[Au] Autor:Kermode M; Songput CH; Sono CZ; Jamir TN; Devine A
[Ad] Endereço:Nossal Institute for Global Health, University of Melbourne, 161 Barry St Carlton, Melbourne, Victoria, 3010, Australia. mkermode@unimelb.edu.au
[Ti] Título:Meeting the needs of women who use drugs and alcohol in North-east India - a challenge for HIV prevention services.
[So] Source:BMC Public Health;12:825, 2012.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The North-east Indian states of Manipur and Nagaland consistently report relatively high HIV prevalence. The targeted HIV prevention interventions in these two states are mostly delivered by non-government organizations (NGOs), and prevention of HIV transmission by injecting drug use is their main focus. Most injecting drug users (IDUs) are male, and the services are primarily tailored to meet their needs, which are not necessarily the same as those for women. This qualitative study describes the health service needs of women who use drugs and alcohol in Manipur and Nagaland, with the goal of identifying strategies and activities that can be implemented by NGOs wanting to improve their reach among vulnerable women. METHODS: In 2009-10, semi-structured in-depth interviews were conducted with 27 key informants and nine focus group discussions (FGDs) with women who use drugs and alcohol, and two FGDs with male IDUs. The thematic areas covered included: the context of female drug and alcohol use; drug and alcohol use patterns; HIV risk behaviours; barriers and facilitators of service use; perceived health needs; and expressed health service needs. The data were recorded, transcribed, translated and thematically analysed. RESULTS: The most problematic substance for women from Nagaland was alcohol, and for women from Manipur it was heroin. The most commonly identified health problems were primarily related to the women's drug and alcohol use, reproductive health and mental health. Other problems of major concern included social exclusion, violence, children's welfare, and financial difficulties. The expressed service needs of these women were women-only integrated health services, women-only detoxification and rehabilitation services, mental health services, desensitization of mainstream health workers, free access to medicines, assistance to meet basic needs, and a safe place for engaging in sex work. CONCLUSION: The expressed health and other service needs of women who use drugs and alcohol in Manipur and Nagaland do not match the services currently provided by HIV prevention NGOs, and this may, in part, account for the relatively poor uptake of these services by women. Strategies and activities that can be implemented by NGOs to strengthen their reach to vulnerable women are identified. However, many of these women's needs are beyond the scope of services typically offered by HIV prevention NGOs, and require a coordinated multi-sectoral response.
[Mh] Termos MeSH primário: Alcoolismo
Serviços de Saúde Comunitária
Infecções por HIV/prevenção & controle
Necessidades e Demandas de Serviços de Saúde
Abuso de Substâncias por Via Intravenosa
[Mh] Termos MeSH secundário: Adolescente
Adulto
Alcoolismo/reabilitação
Feminino
Grupos Focais
Acesso aos Serviços de Saúde/economia
Nível de Saúde
Humanos
Índia
Masculino
Transtornos Mentais
Meia-Idade
Pesquisa Qualitativa
Distribuição por Sexo
Classe Social
Abuso de Substâncias por Via Intravenosa/reabilitação
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121107
[St] Status:MEDLINE
[do] DOI:10.1186/1471-2458-12-825


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[PMID]:22931392
[Au] Autor:Bertholet N; Gaume J; Faouzi M; Gmel G; Daeppen JB
[Ad] Endereço:Department of Community Medicine and Health, Alcohol treatment center, Lausanne University Hospital, Beaumont 21b, P2, 02, Lausanne, 1011, Switzerland. Nicolas.Bertholet@chuv.ch
[Ti] Título:Predictive value of readiness, importance, and confidence in ability to change drinking and smoking.
[So] Source:BMC Public Health;12:708, 2012.
[Is] ISSN:1471-2458
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Visual analog scales (VAS) are sometimes used to assess change constructs that are often considered critical for change. Aims of Study: 1.) To determine the association of readiness to change, importance of changing and confidence in ability to change alcohol and tobacco use at baseline with the risk for drinking (more than 21 drinks per week/6 drinks or more on a single occasion more than once per month) and smoking (one or more cigarettes per day) six months later. 2.) To determine the association of readiness, importance and confidence with alcohol (number of drinks/week, number of binge drinking episodes/month) and tobacco (number of cigarettes/day) use at six months. METHODS: This is a secondary analysis of data from a multi-substance brief intervention randomized trial. A sample of 461 Swiss young men was analyzed as a prospective cohort. Participants were assessed at baseline and six months later on alcohol and tobacco use, and at baseline on readiness to change, importance of changing and confidence in ability to change constructs, using visual analog scales ranging from 1-10 for drinking and smoking behaviors. Regression models controlling for receipt of brief intervention were employed for each change construct. The lowest level (1-4) of each scale was the reference group that was compared to the medium (5-7) and high (8-10) levels. RESULTS: Among the 377 subjects reporting unhealthy alcohol use at baseline, mean (SD) readiness, importance and confidence to change drinking scores were 3.9 (3.0), 2.7 (2.2) and 7.2 (3.0), respectively. At follow-up, 108 (29%) reported no unhealthy alcohol use. Readiness was not associated with being risk-free at follow-up, but high importance (OR 2.94; 1.15, 7.50) and high confidence (OR 2.88; 1.46, 5.68) were. Among the 255 smokers at baseline, mean readiness, importance and confidence to change smoking scores were 4.6 (2.6), 5.3 (2.6) and 5.9 (2.7), respectively. At follow-up, 13% (33) reported no longer smoking. Neither readiness nor importance was associated with being a non-smoker, whereas high confidence (OR 3.29; 1.12, 9.62) was. CONCLUSIONS: High confidence in ability to change was associated with favorable outcomes for both drinking and smoking, whereas high importance was associated only with a favorable drinking outcome. This study points to the value of confidence as an important predictor of successful change for both drinking and smoking, and shows the value of importance in predicting successful changes in alcohol use. TRIAL REGISTRATION NUMBER: ISRCTN78822107.
[Mh] Termos MeSH primário: Alcoolismo/psicologia
Alcoolismo/reabilitação
Intenção
Autoeficácia
Abandono do Hábito de Fumar/psicologia
[Mh] Termos MeSH secundário: Feminino
Previsões
Humanos
Masculino
Estudos Prospectivos
Análise de Regressão
Suíça
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121107
[St] Status:MEDLINE
[do] DOI:10.1186/1471-2458-12-708


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[PMID]:22963934
[Au] Autor:Zetola NM; Modongo C; Kip EC; Gross R; Bisson GP; Collman RG
[Ad] Endereço:Division of Infectious Diseases, University of Pennsylvania, Philadelphia, Pennsylvania, USA. nzetola@hotmail.com
[Ti] Título:Alcohol use and abuse among patients with multidrug-resistant tuberculosis in Botswana.
[So] Source:Int J Tuberc Lung Dis;16(11):1529-34, 2012 Nov.
[Is] ISSN:1815-7920
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Data on alcohol abuse as a risk factor for the development of multidrug-resistant tuberculosis (MDR-TB) are scarce. OBJECTIVE: To describe the patterns of alcohol use in MDR-TB patients and to determine whether alcohol use is associated with the development of MDR-TB in Botswana. METHODS: We compared the level of alcohol use among MDR-TB patients against three control groups: 1) non-MDR-TB patients, 2) human immunodeficiency virus (HIV) infected patients without a history of TB, and 3) the general population. Alcohol use and abuse was measured with the Alcohol Use Disorders Identification Test 10 (AUDIT) questionnaire. RESULTS: Of a total national population of 164 MDR-TB cases, 114 (70%) were interviewed. MDR-TB cases had a lifetime prevalence of alcohol use of 35.1%, which was lower than that of all control groups (P < 0.001). MDR-TB cases had higher 1-month prevalence of alcohol dependence symptoms and a lower 1-year period prevalence of alcohol dependence symptoms (P < 0.01 and P = 0.01 respectively). Among patients with TB, alcohol abuse was found to be a risk factor for the development of MDR-TB. CONCLUSION: MDR-TB patients in Botswana have high rates of alcohol use and abuse. Among TB patients, alcohol abuse is associated with the diagnosis of MDR-TB, and could be an important modifiable factor.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/epidemiologia
Alcoolismo/complicações
Infecções por HIV/epidemiologia
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia
Tuberculose/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Consumo de Bebidas Alcoólicas/efeitos adversos
Alcoolismo/epidemiologia
Botsuana/epidemiologia
Estudos de Casos e Controles
Humanos
Masculino
Meia-Idade
Prevalência
Questionários
Fatores de Risco
Tuberculose/etiologia
Tuberculose Resistente a Múltiplos Medicamentos/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Mês de entrada:1302
[Cu] Atualização por classe:130503
[Lr] Data última revisão:
130503
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121009
[St] Status:MEDLINE
[do] DOI:10.5588/ijtld.12.0026



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