Base de dados : MEDLINE
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[PMID]:28822350
[Au] Autor:Liu J; Wang LN
[Ad] Endereço:Department of Neurology, Xuanwu Hospital, Capital Medical University, Changchun Street 45, Beijing, China, 100053.
[Ti] Título:Baclofen for alcohol withdrawal.
[So] Source:Cochrane Database Syst Rev;8:CD008502, 2017 08 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Baclofen shows potential for rapidly reducing symptoms of severe alcohol withdrawal syndrome (AWS) in people with alcoholism. Treatment with baclofen is easy to manage and rarely produces euphoria or other pleasant effects, or craving for the drug. This is an updated version of the original Cochrane Review published in 2015, Issue 4. OBJECTIVES: To assess the efficacy and safety of baclofen for people with AWS. SEARCH METHODS: We updated our searches of the following databases to March 2017: the Cochrane Drugs and Alcohol Group Specialised Register, CENTRAL, PubMed, Embase, and CINAHL. We also searched registers of ongoing trials. We handsearched the references quoted in the identified trials, and sought information from researchers, pharmaceutical companies, and relevant trial authors about unpublished or uncompleted trials. We placed no restrictions on language. SELECTION CRITERIA: We included all randomised controlled clinical trials (RCTs) evaluating baclofen versus placebo or any other treatment for people with AWS. We excluded uncontrolled, non-randomised, or quasi-randomised trials. We included both parallel group and cross-over studies. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included three RCTs with 141 randomised participants. We did not perform meta-analyses due to the different control interventions. For the comparison of baclofen and placebo (1 study, 31 participants), there was no significant difference in Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scores (very low quality evidence). For the comparison of baclofen and diazepam (1 study, 37 participants), there was no significant difference in CIWA-Ar scores (very low quality evidence), adverse events (risk difference (RD) 0.00, 95% confidence interval (CI) -0.10 to 0.10; very low quality evidence), dropouts (RD 0.00, 95% CI -0.10 to 0.10; very low quality evidence), and dropouts due to adverse events (RD 0.00, 95% CI -0.10 to 0.10; very low quality evidence). For the comparison of baclofen and chlordiazepoxide (1 study, 60 participants), there was no significant difference in CIWA-Ar scores (mean difference (MD) 1.00, 95% CI 0.70 to 1.30; very low quality evidence), global improvement (MD 0.10, 95% CI -0.03 to 0.23; very low quality evidence), adverse events (RD 2.50, 95% CI 0.88 to 7.10; very low quality of evidence), dropouts (RD 0.00, 95% CI -0.06 to 0.06; very low quality evidence), and dropouts due to adverse events (RD 0.00, 95% CI -0.06 to 0.06; very low quality evidence). AUTHORS' CONCLUSIONS: No conclusions can be drawn about the efficacy and safety of baclofen for the management of alcohol withdrawal because we found insufficient and very low quality evidence.
[Mh] Termos MeSH primário: Transtornos Induzidos por Álcool/tratamento farmacológico
Baclofeno/uso terapêutico
Clordiazepóxido/uso terapêutico
Diazepam/uso terapêutico
Agonistas GABAérgicos/uso terapêutico
Síndrome de Abstinência a Substâncias/tratamento farmacológico
[Mh] Termos MeSH secundário: Baclofeno/efeitos adversos
Clordiazepóxido/efeitos adversos
Diazepam/efeitos adversos
Etanol/efeitos adversos
Agonistas GABAérgicos/efeitos adversos
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (GABA Agonists); 3K9958V90M (Ethanol); 6RZ6XEZ3CR (Chlordiazepoxide); H789N3FKE8 (Baclofen); Q3JTX2Q7TU (Diazepam)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170820
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008502.pub5


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[PMID]:28684599
[Au] Autor:Li X; Cannon AR; Hammer AM; Morris NL; Choudhry MA
[Ad] Endereço:Alcohol Research Program, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, Illinois, USA.
[Ti] Título:IL-23 restoration of Th17 effector function is independent of IL-6 and TGF-ß in a mouse model of alcohol and burn injury.
[So] Source:J Leukoc Biol;102(3):915-923, 2017 Sep.
[Is] ISSN:1938-3673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:T cells play a critical role in host defense against intestinal bacteria. We have shown that ethanol combined with burn injury suppresses Peyer's patch (PP) Th17 cytokines 1 d after injury. We assessed the mechanism of suppressed Th17 effector functions. Mice were gavaged with ethanol 4 h before burn injury and euthanized 1, 3, and 7 d after injury. Mesenteric lymph nodes (MLNs), PPs, and spleen Th1 and Th17 cytokines were assessed. A significant decrease in IL-17, IL-22, IL-2, and IFN-γ were observed in all 3 lymphoid organs 1 and 3 d after injury. We used splenic cells to study the role of IL-6, IL-23, TGF-ß, and aryl hydrocarbon receptor (AHR) in suppressing Th17 cytokines. We also assessed whether the AHR agonist 6-formylindolo (3, 2-b) carbazole (FICZ) modulates Th17 cytokines. We found a significant decrease in IL-6 and TGF-ß after ethanol and burn; IL-23 was undetectable. The reconstitution of IL-23 in culture medium increased IL-17 by 2-fold and IL-22 by 20-fold in cells from burn ethanol mice. The restoration of IL-6 and TGF-ß combined did not influence the release of Th17 cytokines. We observed that AHR was necessary for IL-23 restoration of IL-22 after ethanol and burn injury. The AHR agonist FICZ enhanced IL-22, but not IL-17. None of these treatments influenced the release of Th1 cytokines. Together, these results suggest that IL-23 plays a critical role in regulation of Th17 cytokines. Furthermore, IL-6 and TGF-ß do not appear to influence IL-23-mediated restoration of Th17 cytokines after ethanol and burn injury.
[Mh] Termos MeSH primário: Transtornos Induzidos por Álcool
Queimaduras
Interleucina-23
Interleucina-6/imunologia
Células Th17/imunologia
Fator de Crescimento Transformador beta/imunologia
[Mh] Termos MeSH secundário: Transtornos Induzidos por Álcool/tratamento farmacológico
Transtornos Induzidos por Álcool/imunologia
Transtornos Induzidos por Álcool/patologia
Animais
Queimaduras/tratamento farmacológico
Queimaduras/imunologia
Queimaduras/patologia
Modelos Animais de Doenças
Interleucina-23/imunologia
Interleucina-23/farmacologia
Masculino
Camundongos
Células Th1/imunologia
Células Th1/patologia
Células Th17/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Interleukin-23); 0 (Interleukin-6); 0 (Transforming Growth Factor beta); 0 (interleukin-6, mouse)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170708
[St] Status:MEDLINE
[do] DOI:10.1189/jlb.3A1216-527R


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[PMID]:28266937
[Au] Autor:Salottolo K; McGuire E; Mains CW; van Doorn EC; Bar-Or D
[Ad] Endereço:1Trauma Research Department, Swedish Medical Center, Englewood, CO. 2Trauma Research Department, St. Anthony Hospital, Lakewood, CO. 3Trauma Research Department, Medical Center of Plano, Plano, TX. 4Trauma Research Department, Penrose Hospital, Colorado Springs, CO. 5Molecular Biology Department, Rocky Vista University, Parker, CO.
[Ti] Título:Occurrence, Predictors, and Prognosis of Alcohol Withdrawal Syndrome and Delirium Tremens Following Traumatic Injury.
[So] Source:Crit Care Med;45(5):867-874, 2017 May.
[Is] ISSN:1530-0293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We sought to determine occurrence, predictors, and prognosis of alcohol withdrawal syndrome and delirium tremens in patients with traumatic injury. DESIGN: Retrospective multicenter cohort study. SETTING: Three U.S. trauma centers. PATIENTS: Twenty-eight thousand one hundred one trauma patients admitted from 2010-2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Measures included occurrence of alcohol withdrawal syndrome and delirium tremens, injury characteristics, risk factors for alcohol withdrawal syndrome, clinical outcomes, pharmacologic treatment for alcohol withdrawal syndrome, and Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scores. Alcohol withdrawal syndrome severity was defined by CIWA-Ar score as minimal (< 10), moderate (10-20), and severe (> 20). Alcohol withdrawal syndrome developed in 0.88% (n = 246), including 12% minimal, 36% moderate, and 53% severe. Alcohol withdrawal syndrome progressed to delirium tremens in 11%. Before adjustment, alcohol withdrawal syndrome severity was associated with injury severity, hypokalemia, baseline CIWA-Ar score, and established alcohol withdrawal syndrome risk factors. Logistic regression identified the following predictors of delirium tremens: baseline CIWA-Ar score greater than or equal to 10 (odds ratio, 6.05; p = 0.02) and age greater than or equal to 55 (odds ratio, 3.24; p = 0.03). In patients with severe alcohol withdrawal syndrome, severe head injury also predicted progression to delirium tremens (odds ratio, 6.08; p = 0.01), and hypokalemia was borderline significant (odds ratio, 3.23; p = 0.07). Clinical outcomes of hospital length of stay, ICU length of stay, and alcohol withdrawal syndrome complications differed significantly by alcohol withdrawal syndrome severity and were worse with more severe manifestations of alcohol withdrawal syndrome. Mortality also significantly differed by alcohol withdrawal syndrome severity but was only greater in patients who progressed to delirium tremens (11.1%; p = 0.02); otherwise, there were no differences in mortality by severity (4%, 4%, and 0% by minimal, moderate, and severe alcohol withdrawal syndrome). CONCLUSIONS: Trauma patients with alcohol withdrawal syndrome experience a high occurrence of delirium tremens that is associated with significant mortality. These data demonstrate the predictive ability of baseline CIWA-Ar score, age, and severe head injury for developing delirium tremens.
[Mh] Termos MeSH primário: Transtornos Induzidos por Álcool/epidemiologia
Síndrome de Abstinência a Substâncias/epidemiologia
Centros de Traumatologia/estatística & dados numéricos
Ferimentos e Lesões/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Delirium por Abstinência Alcoólica/epidemiologia
Delirium por Abstinência Alcoólica/fisiopatologia
Transtornos Induzidos por Álcool/diagnóstico
Transtornos Induzidos por Álcool/fisiopatologia
Concentração Alcoólica no Sangue
Traumatismos Craniocerebrais/epidemiologia
Feminino
Seres Humanos
Tempo de Internação
Modelos Logísticos
Masculino
Meia-Idade
Prognóstico
Estudos Retrospectivos
Fatores de Risco
Índice de Gravidade de Doença
Fatores Sexuais
Síndrome de Abstinência a Substâncias/diagnóstico
Síndrome de Abstinência a Substâncias/fisiopatologia
Índices de Gravidade do Trauma
Sinais Vitais
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Blood Alcohol Content)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170509
[Lr] Data última revisão:
170509
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170308
[St] Status:MEDLINE
[do] DOI:10.1097/CCM.0000000000002371


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[PMID]:27987480
[Au] Autor:Ershova ES; Jestkova EM; Chestkov IV; Porokhovnik LN; Izevskaya VL; Kutsev SI; Veiko NN; Shmarina G; Dolgikh O; Kostyuk SV
[Ad] Endereço:Research Centre for Medical Genetics (RCMG), Moscow, 115478, Russia; V. A. Negovsky Research Institute of General Reanimatology, Moscow, 107031, Russia.
[Ti] Título:Quantification of cell-free DNA in blood plasma and DNA damage degree in lymphocytes to evaluate dysregulation of apoptosis in schizophrenia patients.
[So] Source:J Psychiatr Res;87:15-22, 2017 Apr.
[Is] ISSN:1879-1379
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Oxidative DNA damage has been proposed as one of the causes of schizophrenia (SZ), and post mortem data indicate a dysregulation of apoptosis in SZ patients. To evaluate apoptosis in vivo we quantified the concentration of plasma cell-free DNA (cfDNA index, determined using fluorescence), the levels of 8-oxodG in cfDNA (immunoassay) and lymphocytes (FL1-8-oxodG index, flow cytometry) of male patients with acute psychotic disorders: paranoid SZ (total N = 58), schizophreniform (N = 11) and alcohol-induced (N = 14) psychotic disorder, and 30 healthy males. CfDNA in SZ (N = 58) does not change compared with controls. In SZ patients. Elevated levels of 8-oxodG were found in cfDNA (N = 58) and lymphocytes (n = 45). The main sources of cfDNA are dying cells with oxidized DNA. Thus, the cfDNA/FL1-8-oxodG ratio shows the level of apoptosis in damaged cells. Two subgroups were identified among the SZ patients (n = 45). For SZ-1 (31%) and SZ-2 (69%) median values of cfDNA/FL1-8-oxodG index are related as 1:6 (p < 0.0000001). For the patients with other psychotic disorders and healthy controls, cfDNA/FL1-8-oxodG values were within the range of the values in SZ-2. Thus, apoptosis is impaired in approximately one-third of SZ patients. This leads to an increase in the number of cells with damaged DNA in the patient's body tissues and may be a contributing cause of acute psychotic disorder.
[Mh] Termos MeSH primário: Apoptose
Dano ao DNA
DNA/sangue
Linfócitos/patologia
Esquizofrenia Paranoide/sangue
Esquizofrenia Paranoide/patologia
[Mh] Termos MeSH secundário: Adulto
Transtornos Induzidos por Álcool/sangue
Transtornos Induzidos por Álcool/patologia
Nucleotídeos de Desoxiguanina/metabolismo
Desoxiguanosina/análogos & derivados
Desoxiguanosina/metabolismo
Feminino
Citometria de Fluxo
Seres Humanos
Linfócitos/metabolismo
Masculino
Escalas de Graduação Psiquiátrica
Transtornos Psicóticos/sangue
Transtornos Psicóticos/patologia
Piranos
Esquizofrenia
Estatísticas não Paramétricas
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Deoxyguanine Nucleotides); 0 (Pyrans); 139307-94-1 (8-oxodeoxyguanosine triphosphate); 143317-76-4 (1,5-bis(3,4-dimethoxyphenyl)tetrahydropyran); 88847-89-6 (8-oxo-7-hydrodeoxyguanosine); 9007-49-2 (DNA); G9481N71RO (Deoxyguanosine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161218
[St] Status:MEDLINE


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[PMID]:27922474
[Au] Autor:Barrett J; Jansen M; Cooper A; Felbinger M; Waters F
[Ad] Endereço:John Barrett, MA, BSN, RN, Duke University School of Nursing, Durham, NC. Maria Jansen, PharmD, Matthew Felbinger, PharmD, BCPS, and Faith Waters, MSN, RN, NEA-BC, Duke Regional Hospital, Durham, NC. April Cooper, PharmD, Duke Regional Hospital, Durham, and College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC.
[Ti] Título:Embracing a Nurse-Driven Alcohol Withdrawal Protocol Through Quality Improvement.
[So] Source:J Addict Nurs;27(4):234-240, 2016 Oct/Dec.
[Is] ISSN:1548-7148
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Alcohol withdrawal can lead to severe complications including seizures, delirium tremens, and death if not treated appropriately. Nurses are critical to the safety and outcomes of these patients. OBJECTIVE: The objective of this retrospective study was to determine if nursing education on a community hospital's alcohol withdrawal protocol led to improved nursing compliance. METHODS: This is a quality improvement project involving a two-part retrospective review-an initial needs assessment followed by nursing education and a subsequent posteducation retrospective review. The initial needs assessment included 65 patients. The subsequent posteducation group included 50 patients. RESULTS: Nursing compliance of 1-hour assessments increased after the educational intervention; however, there was no statistically significant difference in 6-hour assessment or medication administration protocol compliance between preeducation and posteducation groups. CONCLUSION: Nursing education is a good place to start in improving compliance with an alcohol withdrawal protocol, but physicians need to be included to increase standardization within the institution. Future study should look at the effectiveness of different assessment frequency intervals and its impact on patient-centered outcomes.
[Mh] Termos MeSH primário: Convulsões por Abstinência de Álcool/reabilitação
Transtornos Induzidos por Álcool/reabilitação
Árvores de Decisões
Padrões de Prática em Enfermagem/normas
[Mh] Termos MeSH secundário: Convulsões por Abstinência de Álcool/enfermagem
Transtornos Induzidos por Álcool/enfermagem
Protocolos Clínicos
Feminino
Seres Humanos
Capacitação em Serviço
Masculino
Meia-Idade
North Carolina
Garantia da Qualidade dos Cuidados de Saúde
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170313
[Lr] Data última revisão:
170313
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE


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[PMID]:27616301
[Au] Autor:Nobre MJ
[Ad] Endereço:Departamento de Psicologia, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto Universidade de São Paulo (USP), 14040-901 Ribeirão Preto, SP, Brazil; Departamento de Psicologia, Uni-FACEF, 14401-135, Franca, SP, Brazil; Instituto de Neurociências e Comportamento-INeC, Campus USP, 14040-901 Ribeirão Preto, SP, Brazil. Electronic address: mjnes@usp.br.
[Ti] Título:Environmental enrichment may protect against neural and behavioural damage caused by withdrawal from chronic alcohol intake.
[So] Source:Int J Dev Neurosci;55:15-27, 2016 Dec.
[Is] ISSN:1873-474X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Exposure to stress and prolonged exposure to alcohol leads to neuronal damages in several brain regions, being the medial prefrontal cortex (mPFC) one of the most affected. These changes presumably reduce the ability of the organism to cope with these stimuli and may underlie a series of maladaptive behaviours among which include drug addiction and withdrawal. Drug-addicted individuals show a pattern of behavior similar to patients with lesions of the mPFC. This impairment in the decision-making could be one of the mechanisms responsible for the transition from the casual to compulsive drug use. The environmental enrichment (EE) has a protective effect on the neural and cognitive impairments induced by psychoactive drugs, including ethyl alcohol. The present study aims to determine the influence of withdrawal from intermittent long-term alcohol exposure on alcohol preference, emotional reactivity and neural aspects of early isolated or grouped reared rats kept under standard or complex environments and the influence of social isolation on these measures, as well. Our results point out new insights on this matter showing that the EE can attenuate the adverse effects of withdrawal and social isolation on rat's behavior. This effect is probably due to its protective action on the mPFC integrity, including the cingulate area 1 (Cg1), and the prelimbic (PrL) and infralimbic cortex (IL), what could account for the absence of changes in the emotional reactivity in EE alcohol withdrawal rats. We argue that morphological changes at these cortical levels can afford the emotional, cognitive and behavioural dysregulations verified following withdrawal from chronic alcohol intake.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/fisiopatologia
Transtornos Induzidos por Álcool/complicações
Meio Ambiente
Transtornos Mentais/etiologia
Transtornos Mentais/terapia
[Mh] Termos MeSH secundário: Consumo de Bebidas Alcoólicas/psicologia
Transtornos Induzidos por Álcool/etiologia
Transtornos Induzidos por Álcool/psicologia
Análise de Variância
Animais
Animais Recém-Nascidos
Ansiedade/diagnóstico
Ansiedade/etiologia
Peso Corporal/efeitos dos fármacos
Modelos Animais de Doenças
Ingestão de Líquidos/efeitos dos fármacos
Etanol/sangue
Etanol/toxicidade
Masculino
Aprendizagem em Labirinto/efeitos dos fármacos
Ratos
Ratos Wistar
Isolamento Social/psicologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
3K9958V90M (Ethanol)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170328
[Lr] Data última revisão:
170328
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160913
[St] Status:MEDLINE


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[PMID]:27610450
[Au] Autor:Wellard L; Corsini N; Hughes C
[Ti] Título:Discussing alcohol and cancer with patients: Knowledge and practices of general practitioners in New South Wales and South Australia.
[So] Source:Aust Fam Physician;45(8):588-93, 2016 Aug.
[Is] ISSN:0300-8495
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Alcohol is associated with several cancers; however, the Australian community has low awareness of the link between alcohol consumption and cancer. Little information exists regarding when and why general practitioners (GPs) discuss alcohol with patients. OBJECTIVE: The objective of this article is to explore GPs' attitudes and practices when discussing alcohol with patients. This includes awareness of alcohol recommendations and evidence of the alcohol-cancer link, and discussion around barriers and enablers to encouraging patients' alcohol behaviour change. RESULTS: GPs did not routinely ask patients about their alcohol consumption or advise on drinking recommendations. Many had a broad understanding of alcohol as a cancer risk factor, but knowledge of the causal mechanisms and current evidence was limited. DISCUSSION: GPs are trusted health advisers. Providing them with up-to-date evidence on the alcohol-cancer link and drinking recommendations may encourage routine patient screening of alcohol consumption and delivery of simple education on the harms of long-term drinking.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/psicologia
Transtornos Induzidos por Álcool/psicologia
Atitude do Pessoal de Saúde
Clínicos Gerais/psicologia
Conhecimentos, Atitudes e Prática em Saúde
Neoplasias/psicologia
[Mh] Termos MeSH secundário: Adulto
Consumo de Bebidas Alcoólicas/efeitos adversos
Transtornos Induzidos por Álcool/etiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Neoplasias/induzido quimicamente
New South Wales
Relações Médico-Paciente
Austrália do Sul
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160910
[St] Status:MEDLINE


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[PMID]:27587219
[Au] Autor:Kilo S; Göen T; Drexler H
[Ad] Endereço:Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schillerstr. 25, 91054, Erlangen, Germany. sonja.kilo@fau.de.
[Ti] Título:Cross-sectional study on N,N-dimethylformamide (DMF); effects on liver and alcohol intolerance.
[So] Source:Int Arch Occup Environ Health;89(8):1309-1320, 2016 Nov.
[Is] ISSN:1432-1246
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: There are still concerns regarding occupational exposure to hepatotoxic DMF. This study was designed to evaluate possible liver damaging effects of DMF under current workplace conditions in synthetic fibres industries. METHODS: Among other laboratory parameters, liver function parameters (alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase and gamma-glutamyltransferase), the mean corpuscular erythrocyte volume (MCV) and carbohydrate-deficient transferrin (CDT) of the workforce of two companies present at the days of study were investigated. Internal exposure to DMF was assessed via three different biomarkers [sum of N-methylformamide and N-hydroxymethyl-N-methylformamide, N-acetyl-S-(N-carbamoyl)cysteine (AMCC) and 3-methyl-5-isopropylhydantoin (MIH)]. Alcohol consumption was assessed by means of direct ethanol metabolites (ethylglucuronide and ethylsulfate). RESULTS: None of the tested liver enzyme activities showed a positive association with any of the three exposure markers, nor did CDT and MCV. CDT was negatively associated with AMCC and the ALP activity negatively with all three exposure markers. Changes in liver function are seen mainly in conjunction with ethanol consumption but also with increasing body weight and age. MCV was associated with smoking. Almost half of the workers stated to experience alcohol flush reaction. CONCLUSION: The present study indicates that long-term exposure to DMF, which was specified by median urinary AMCC levels of 4.84 mg/g creatinine and DMF haemoglobin adduct levels of 60.5 nmol/MIH/g globin, respectively, does not result in any adverse liver effects. In contrast, these DMF exposure levels still elicit certain alcohol intolerance reactions.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/fisiopatologia
Transtornos Induzidos por Álcool/etiologia
Dimetilformamida/análise
Doenças Profissionais/induzido quimicamente
Exposição Ocupacional/análise
[Mh] Termos MeSH secundário: Acetilcisteína/análogos & derivados
Acetilcisteína/urina
Adulto
Consumo de Bebidas Alcoólicas/efeitos adversos
Transtornos Induzidos por Álcool/fisiopatologia
Biomarcadores/urina
Creatinina/urina
Estudos Transversais
Dimetilformamida/efeitos adversos
Dimetilformamida/análogos & derivados
Monitoramento Ambiental/métodos
Índices de Eritrócitos
Formamidas/análise
Seres Humanos
Hidantoínas/sangue
Fígado/efeitos dos fármacos
Fígado/fisiopatologia
Testes de Função Hepática
Masculino
Meia-Idade
Doenças Profissionais/fisiopatologia
Exposição Ocupacional/efeitos adversos
Transferrina/análogos & derivados
Transferrina/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (3-methyl-5-isopropylhydantoin); 0 (Biomarkers); 0 (Formamides); 0 (Hydantoins); 0 (Transferrin); 0 (carbohydrate-deficient transferrin); 103974-29-4 (N-acetyl-S-(N-methylcarbamoyl)cysteine); 20546-32-1 (N-hydroxymethyl-N-methylformamide); 8696NH0Y2X (Dimethylformamide); AYI8EX34EU (Creatinine); WYQ7N0BPYC (Acetylcysteine); XPE4G7Y986 (methylformamide)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160903
[St] Status:MEDLINE


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[PMID]:27515133
[Au] Autor:Kendler KS; PirouziFard M; Lönn S; Edwards AC; Maes HH; Lichtenstein P; Sundquist J; Sundquist K
[Ad] Endereço:Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University,Richmond,VA,USA.
[Ti] Título:A National Swedish Twin-Sibling Study of Alcohol Use Disorders.
[So] Source:Twin Res Hum Genet;19(5):430-7, 2016 Oct.
[Is] ISSN:1832-4274
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The relationship between the genetic and environmental risk factors for alcohol use disorders (AUD) detected in Swedish medical, pharmacy, and criminal registries has not been hitherto examined. Prior twin studies have varied with regard to the detection of shared environmental effects and sex differences in the etiology of AUD. In this report, structural equation modeling in OpenMx was applied to (1) the three types of alcohol registration in a population-based sample of male-male twins and reared-together full and half siblings (total 208,810 pairs), and (2) AUD, as a single diagnosis, in male-male, female-female, and opposite-sex (OS) twins and reared-together full and half siblings (total 787,916 pairs). An independent pathway model fit best to the three forms of registration and indicated that between 70% and 92% of the genetic and 63% and 98% of the shared environmental effects were shared in common with the remainder unique to each form of AUD registration. Criminal registration had the largest proportion of unique genetic and environmental factors. The best fit model for AUD estimated the heritability to be 22% and 57%, respectively, in females and males. Both shared (12% vs. 6%) and special twin environment (29% vs. 2%) were substantially more important in females versus males. In conclusion, AUD ascertained from medical, pharmacy, and criminal Swedish registries largely share the same genetic and environmental risk factors. Large sex differences in the etiology of AUD were seen in this sample, with substantially stronger familial environmental and weaker genetic effects in females versus males.
[Mh] Termos MeSH primário: Transtornos Induzidos por Álcool/genética
Modelos Genéticos
Sistema de Registros
Irmãos
Gêmeos/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Transtornos Induzidos por Álcool/epidemiologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; TWIN STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160813
[St] Status:MEDLINE
[do] DOI:10.1017/thg.2016.62


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[PMID]:27256099
[Au] Autor:Okimasa S; Saito Y; Okuda H; Fukuda T; Yano M; Okamoto Y; Ono E; Ohdan H
[Ad] Endereço:Department of Surgery, Hiroshima General Hospital of West Japan Railway Company, 3-1-36, Futabanosato, Higashi-ward, Hiroshima, 732-0057, Japan. roadman1963@gmail.com.
[Ti] Título:Assessment of cancer pain in a patient with communication difficulties: a case report.
[So] Source:J Med Case Rep;10(1):148, 2016 Jun 02.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The number of patients who have difficulty with mutual understanding has been increasing recently due to an aging society. This emerging issue needs to be addressed. We report an instructive case of a patient who had communication difficulties due to dementia and sequelae of alcoholic encephalopathy. CASE PRESENTATION: A 66-year-old man of Mongolian race presented with coronary arteriosclerosis, spinal canal stenosis, transverse colon cancer, and alcoholic encephalopathy. We had been requested to remove wires that had been used for the closure of his chest in a coronary artery bypass grafting procedure. However, on admission, a tortured expression and abdominal distention were observed, along with emaciation. We diagnosed terminal stage cancer, and palliative care was offered. An abdominal computed tomographic scan revealed rectal cancer with stenosis and invasion to the adjacent tissues. A metallic stent was inserted, leading to reduction of the abdominal distention and an improvement of tachycardia. However, the patient's tortured expression was not completely relieved; therefore, an assessment of cancer pain was considered. The Abbey Pain Scale was applied. On the basis of the patient's score, analgesics and an opioid, among other medications, were administered. These led to relief of the patient's tortured expression and reduced his Abbey Pain Scale score. Following this, the patient's vital signs continued to be stable, and he was transferred to the referral institution. CONCLUSIONS: Management of cancer pain in elderly patients with mutual understanding difficulties must be performed carefully. In the case of our patient, staff at the referral institution informed us of the patient's latent torture, and we applied the Abbey Pain Scale. There was some confusion and uncertainty regarding clinical management throughout the patient's care; however, his condition eventually stabilized. We believe the application of the Abbey Pain Scale assists in the relief of cancer pain. However, accumulation of further cases and experiences to verify this assessment is required.
[Mh] Termos MeSH primário: Transtornos Induzidos por Álcool
Encefalopatias
Dor do Câncer/diagnóstico
Transtornos da Comunicação
Demência
Medição da Dor/métodos
Cuidados Paliativos/métodos
[Mh] Termos MeSH secundário: Idoso
Neoplasias Ósseas/secundário
Dor do Câncer/tratamento farmacológico
Dor do Câncer/etiologia
Seres Humanos
Neoplasias Hepáticas/secundário
Neoplasias Pulmonares/secundário
Masculino
Neoplasias Retais/complicações
Neoplasias Retais/diagnóstico por imagem
Neoplasias Retais/patologia
Neoplasias Retais/terapia
Stents
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160604
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-016-0935-2



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