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- ItemAcesso aberto (Open Access)Alcohol use and falls among the elderly in Metropolitan São Paulo, Brazil(Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, 2009-12-01) Lima, Maria Cristina Pereira; Simão, Maria Odete; Oliveira, Janaina Barbosa De; Cavariani, Mariana Braga; Tucci, Adriana Marcassa [UNIFESP]; Kerr-correa, Florence; Universidade Estadual Paulista (UNESP); Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)The objectives of this study are to identify the pattern of alcohol use among the elderly and to analyze its association with falls. A population-based survey was conducted in a sample of Metropolitan São Paulo, Brazil, using the GENACIS questionnaire, Gender, Alcohol and Culture: An International Study. Adjusted prevalence ratios were calculated using Poisson Regression with robust variance, and the dependent variable was the occurrence of falls. Interviews were carried out with 432 subjects whose average age was 69.5 years. Regarding alcohol use 50.9% were lifetime abstainers, 25.5% had not drunk in the previous year and 23.6% were current drinkers. Among the latter, 14 (13.7%) were heavy drinkers. In the previous year 24.5% people had falls, which were associated with being a heavy drinker and being older. Although a relationship between being a heavy drinker and falls found in this survey does not allow for inferences on causality, this association supports the hypothesis that alcohol abuse in later life might be related with health problems.
- ItemAcesso aberto (Open Access)Álcool e alcoolismo entre adolescentes da rede estadual de ensino de Cuiabá, Mato Grosso(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-08-01) Souza, Delma Perpétua Oliveira de [UNIFESP]; Areco, Kelsy Nema [UNIFESP]; Silveira, Dartiu Xavier da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To estimate the prevalence of alcohol consumption and alcoholism among working and non-working adolescents. METHODS: Cross-sectional study with a systematic, stratified sample 993 working adolescents and 1,725 non-working adolescents. The study included students enrolled in 1998 in the state public network schools of a city in Center-Western Brazil. An anonymous, self-administered questionnaire was completed by subjects in the classroom. Univariate and bivariate analyses and logistic regression were used. RESULTS: We found prevalences of 71.3% for alcohol consumption and 13.4% for alcoholism in the total sample, and higher prevalences among working students (81.0% and 14.9%) than among non-workers (65.8% and 12.6%). In addition to the association between alcohol use and work, we found both differences and similarities between the two groups. Alcoholism is not associated with work but is associated with male sex (OR=1.61; 95% CI: 1.18-2.19) and family history of alcohol use among both non-workers (OR=2.19; 95% CI: 1.60-2.99) and workers (OR=2.10; 95% CI: 1.42-3.12). CONCLUSIONS: The results of the present study indicate a high prevalence of alcohol consumption and alcoholism, which is higher among working adolescents. Sociodemographic, family, and work-related factors must be considered when attempting to implement educational measures aimed at changing alcohol-related behaviors in this population.
- ItemSomente MetadadadosAnálise das áreas neurais envolvidas na tomada de decisão em ratos submetidos à ingestão crônica de álcool(Universidade Federal de São Paulo (UNIFESP), 2017-03-14) Zangirolame, Carolline Marques Santos [UNIFESP]; Céspedes, Isabel Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Drug dependence is a worldwide and frequent problem involving young people and adults, with alcohol being the drug most commonly used and associated with numerous social and health problems. However, not all people who drink alcohol become dependent. The transition from occasional use to dependence is influenced by positive and negative refluxes (relief of unpleasant symptoms such as stress or depression or withdrawal symptoms). Compulsive alcohol ingestion has been strongly associated with neurotransmission systems involved in reward (mainly dopaminergic) and stress response (mainly CRFergic) processes. Loss of control is attributed to a dysfunction of regions belonging to these two systems, the pre-frontal cortex, the hippocampus and the companion, which form the main circuit of decision making. This study aimed at analyzing the neural areas of superior control of the stress response and that are also associated with behavioral decision making (pre-frontal cortex, hippocampus and amygdala) in Wistar rats submitted to chronic alcohol ingestion by the paradigm of two bottles and intermittent supply protocol. Animals of the control group and the alcohol group underwent the tests of labyrinth in elevated cross and open field to evaluate their anxiety state, by the test of decision making for behavioral evaluation of this task and after euthanasia of this animals was performed immunoreactivity to the protein ΔFosB, to analyze the level of neuronal activation of the areas associated to the decision making described above. The protocol of intermittent supply and oral administration of 20% alcohol to Wistar rats during the studied period (four weeks) did not promote a significant increase in the consumption pattern of the alcohol solution during the period, did not interfere in the weight or in the consumption of the feed. Also, this chronic consumption of alcoholic solution had no effect on anxiety and decision-making behaviors. Nevertheless, the immunoreactivity data to the DelaFosB protein showed that the animals that consumed the alcoholic solution showed hypoactivity in the area corresponding to the infra-limbic cortex, and hyperactivity in the central amygdala and the hippocampus CA3 area, demonstrating less activity in one Area of rational behavior control, and greater activity in an area associated with memory recruitment and in another area associated with impulsive decision making.
- ItemSomente MetadadadosAnálise do uso de drogas "anti-álcool" no tratamento do alcoolismo(Universidade Federal de São Paulo (UNIFESP), 1981) Porto, Jose Alberto Del [UNIFESP]; Masur, Jandira [UNIFESP]
- ItemAcesso aberto (Open Access)Avaliação dos esquemas iniciais desadaptativos: estudo psicométrico em alcoolistas(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2012-01-01) Silva, Jaqueline Garcia Da; Cazassa, Milton José; Oliveira, Margareth Da Silva [UNIFESP]; Gauer, Gabriel Chittó; Universidade Católica do Rio Grande do Sul; Universidade de Granada; PUCRS; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: This study aims at presenting the psychometric properties of the Young Schema Questionnaire - short form (YSQ-S2). METHOD: We conducted a quantitative study, cross-sectional comparing a clinical with a non-clinical group and Cronbach's alpha, t test Student and Discriminant Analysis were used to analyze the results. The sample consisted of 107 subjects, 51 alcoholics and 56 non-alcoholics. RESULTS: Statistically significant differences were found in the five areas and the 15 schemes assessed by the YSQ-S2 questionnaire when comparing the clinical and non-clinical groups. CONCLUSION: YSQ-S2 was found to be an instrument that can detect differences between clinical and non-clinical populations, its use being essential for a deeper assessment of the patient's personality.
- ItemAcesso aberto (Open Access)Avaliação dos padrões de uso de álcool em usuários de serviços de Atenção Primária à Saúde de Juiz de Fora e Rio Pomba (MG)(Associação Brasileira de Saúde Coletiva, 2007-12-01) Magnabosco, Molise De Bem; Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]; Ronzani, Telmo Mota; Universidade Federal de Juiz de Fora Departamento de Psicologia; Universidade Federal de São Paulo (UNIFESP)A significant part of the Brazilian population presents alcohol consumption patterns associated with high risk of development problems. Therefore, it is fundamental to verify the patterns of alcohol consumption among the population in order to outline primary and secondary prevention strategies. The aim of this study is to verify the patterns of alcohol consumption among the users of Primary Health Care in the cities of Juiz de Fora and Rio Pomba, in the state of Minas Gerais. We applied a screening test -the AUDIT- in a sample of 921 people selected during routine consultations. Considering data as a whole, 18.3% of the evaluated people were at the risk use zone; 77.9% had low hazardous alcohol use or were abstemious and 3.8% pointed toward the suggestive dependence zone. In general, men more frequently demonstrated hazardous behavior compared to women, which was also more prevalent in the 38 to 47 year-old-age group.
- ItemAcesso aberto (Open Access)Conceitos introdutórios de economia da saúde e o impacto social do abuso de álcool(Associação Brasileira de Psiquiatria - ABP, 2006-12-01) Moraes, Edilaine [UNIFESP]; Campos, Geraldo M [UNIFESP]; Figlie, Neliana Buzi [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Ferraz, Marcos Bosi [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Brazilian society bears high economic costs in view of the problems resulting from the alcohol consumption. There is a lack of economic studies into alcohol misuse or dependence in Brazil due to the limited financial resources, despite the huge health problems the country has been facing. This paper aims to introduce basic concepts of Heath Economics to health care practitioners, such as: Complete and Incomplete Economic Evaluation, Disease Costs, Cost Comparison, Types of Evaluation (cost-minimisation, cost-effectiveness, cost-utility, and cost-benefice), Point of View Analysis (from patient, health institution, Ministry of Health, or society), Types of Costs (direct, indirect and intangible), and other ones. In addition, research data on the impact of the alcohol consumption on the Brazilian society is described. We do not intend to exhaust the subjects addressed in this paper, but emphasise the need for more national researches that link the economic evaluation to the alcohol addiction issue in order to seek maximum efficiency by maximising the health care and minimising the scarce health system resources.
- ItemAcesso aberto (Open Access)Consumo de álcool e tabaco entre idosos na atenção primaria à saúde em uma unidade básica no Brasil(Universidade Federal de São Paulo (UNIFESP), 2019-03-28) Figueroa Oviedo, Paulo César [UNIFESP]; Ferri, Cleusa Pinheiro [UNIFESP]; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4767701Y7; http://lattes.cnpq.br/5318912420995921; Universidade Federal de São Paulo (UNIFESP)Objective: To estimate the prevalence of alcohol and tobacco consumption among older people in primary care in Brazil, and identify the factors associated with this consumption before and after the age of 65. Methods: Secondary analysis of a cross-sectional study of 87 older people representing all people over 65 registered in a primary care unit (n=541). Alcohol and tobacco consumption was identified through self-report and confirmed by an informant. Fourteen units per week was used as the cut-off to identify at risk drinking before the age of 65 and seven units per week after this age. For moderate alcohol consumption, consumption of 1-6 units/weeks after 65 years (current consumption) and 1-13 units/weeks for the period before 65 years of age. For tobacco, information was obtained regarding the typical amount consumed (cigarettes per day) and for how long (in years), age at regular onset, and age at which smoking stopped. Weighted logistic regression was used to identify potential sociodemographic characteristics associated with alcohol and tobacco consumption. Results: 51.3% of the sample were women, almost half of the sample (43.2%) were 75 years of age or older. Fourteen participants were current drinkers (16.1%), and 6 of them (6.9%) were at risk drinkers. Only one current drinker started drinking after the age of 65. Thirty-two participants (34%) had drunk before the age of 65, and among them 11(15.8%) were assessed as having been at risk drinkers. Of these 11 drinkers who had past risk consumption, 2 (18.2%) had become moderate drinkers after the age of 65; 3 (27.3%) continued to be at risk drinkers and six (54.5%) had stopped drinking. Multivariate analysis was adjusted for sociodemographic characteristics. Only male gender was associated with past (OR= 3.83 95% CI 1,24- 11,88) and although not statistically significant there was a predominance of current alcohol consumption in men also. Regarding tobacco consumption, 6 (6.8%) participants reported current consumption and 27 (31.3%) reported being smokers before the age of 65. As per alcohol consumption, only male gender was associated with past consumption (before 65 years ago) (OR= 5.30 95% CI 1,65- 17,03). Due to the sample size and small number of current smokers it was not possible to run the adjusted analyses for current consumption. Conclusion: The prevalence of alcohol consumption among people over 65 is relatively high and it seems to start at a younger age and extends to this age group, with a small proportion of older people who have started drinking after 65 years. Male gender should be the target of interventions to reduce alcohol consumption at this age group. The elderly are more susceptible to the effects of alcohol and tobacco due to their greater physical fragility and the presence of comorbidities and polypharmacy. There is an urgent need for a better understanding of drinking behaviors among older people so that prevention and treatment strategies are better defined for that specific population. Larger and more robust studies are need to better understand this behavior among older Brazilians and the real need of interventions directed to this behavior among older people in primary care.
- ItemSomente MetadadadosContribuição ao estudo da secreção pancreática exocrina em alcoólatras: caracterização do estado de hipersecreção(Universidade Federal de São Paulo (UNIFESP), 1978) Neves, Manoel Martins das [UNIFESP]
- ItemAcesso aberto (Open Access)Desenvolvimento piloto de aplicativo para smartphones para controle de ingestão de bebidas alcoólicas por jovens universitários brasileiros com emprego de estratégias neurocientíficas(Universidade Federal de São Paulo, 2020-12-07) Furlaneto, Fabian [UNIFESP]; Céspedes, Isabel Cristina [UNIFESP]; Scachetti, Rodolfo Eduardo [UNIFESP]; http://lattes.cnpq.br/1607421823893275; http://lattes.cnpq.br/5014274675948150; http://lattes.cnpq.br/8628537426008786; Universidade Federal de São Paulo (UNIFESP)Introdução: As consequências prejudiciais associadas ao uso de álcool representam um custoso problema mundial associado a diversas patologias, anos de vida perdidos por incapacidade e morte, com destaque na incidência sobre os jovens e sobre as implicações causadas pelos episódios de binge drinking. Este comportamento de beber pesado em um único episódio gera consequências em vários aspectos da vida do indivíduo e da sociedade, tais como prejuízos à saúde, morte, violência, negligência infantil, sobrecarga do sistema de saúde, economia, entre outros. Objetivos: Compreender os aspectos cognitivo-emocionais de jovens universitários com idade entre 18 e 30 anos sobre o uso e abuso de álcool para desenvolver um aplicativo piloto com a finalidade de induzir a uma significativa redução no padrão de binge drinking, fortalecendo seu processo de tomada de decisão no controle do consumo. Método: Foram entrevistados 39 jovens que tiveram avaliados o seu padrão de beber por meio dos instrumentos AUDIT, Q/F e ADS. Para compreender os sentimentos e pensamentos sobre o álcool utilizamos o ZMET, com o qual avaliamos as palavras, imagens, sons e atividades que estariam associados ao beber como elementos orientadores para o desenvolvimento do aplicativo. Com o app, denominado All cool, 34 jovens utilizaram o programa de modo piloto e também foram avaliados pelo AUDIT, Q/F e ADS antes e após 6 semanas de uso. Resultados: Para o desenvolvimento do All cool a partir dos dados coletados pelo ZMET, os elementos norteadores foram as palavras ‘bebida’ e ‘amigos’. Após um uso de 6 semanas pelos voluntários da segunda fase, não encontramos diminuição significativa dos episódios de binge drinking pelos usuários do app. Conclusão: Concluímos que aprofundar o conhecimento sobre sujeitos pode ajudar no desenvolvimento de estratégia digital para possível controle de binge drinking em estudantes universitários, apesar do revés nos resultados do nosso piloto. Finalizamos apontando a necessidade de novos testes e possíveis ajustes no app, especialmente no quesito engajamento, o mais desafiador quando se trata de uma atividade cujo traço é a desconexão do quotidiano.
- ItemSomente MetadadadosDisfunção pancreática precoce em etilistas assintomáticos(Universidade Federal de São Paulo (UNIFESP), 1992) Neves, Manoel Martins das [UNIFESP]
- ItemSomente MetadadadosEfeitos do exercício físico sobre funções cognitivas em indivíduos dependentes de álcool e outras drogas associadas(Universidade Federal de São Paulo (UNIFESP), 2017-03-14) Silva, Regiane Dias Amorim [UNIFESP]; Céspedes, Isabel Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The harms caused by the consumption of alcohol and other drugs In the central nervous system, associated with a variety of cognitive deficits such as Impairments in prospective memory, executive functions, attention and abstraction And problem solving. On the other hand, it has been demonstrated that the beneficial effects of Exercise and mental health are related to biochemical changes Release of several neurotransmitters and neural factors, demonstrated by means of And cognitive abilities. Thus, the objective of this project was to evaluate the Cognitive strategies promoted by a protocol of moderate physical exercise in individuals dependent on Alcohol and other associated drugs. The study was composed of 29 participants divided into two Groups: G1 = 6 individuals dependent on alcohol and other drugs, not submitted to the protocol of Exercise and G2 = 23 individuals with alcohol and other drug dependence who underwent Protocol of regular aerobic physical exercises through walking / running. The intervention by Physical exercise had a duration of 5 weeks (3x per week) and the instruments of analysis Used were: Borg scale for the monitoring and perception of effort threshold; Physical Activity Readiness Questionnaire (PAR-Q) To identify possible risks in the practice of physical exercises; International Questionnaire on Physical Activity Questionnaire (IPAQ) that estimates the weekly time Spent on physical activities of daily life; 6-minute Walk Test to assess ability functional; Involvement Screening Test with Alcohol, Cigarette and Other Substances (Alcohol Smoking and Substance Involvement Screening Test (ASSIST) which assesses the pattern of Drugs of abuse; State-Trait Anxiety Inventory (IDATE) that Evaluates the trait and state of anxiety; Beck Depression Inventory - BDI) that measures depression; King's Word List (Rey Auditory Verbal Learning Test - RAVLT) that evaluates functions such as short-term verbal auditory memory, learning index, Memory and information retention; Stroop (Victory Version) test that assesses flexibility Mental memory, working memory, information processing speed, semantic activation And the ability to withstand a characteristic response; And the Brunel Humor Scale which evaluates Mood states at different times. By means of a protocol of 5 weeks of exercise Moderate aerobic physical activity, there is an increase in vigor, a decrease in fatigue and Confusion, improvement in short-term memory, learning, recognition index, Depression and anxiety and better performance in mental flexibility.
- ItemAcesso aberto (Open Access)Estrutura fatorial da Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) em dependentes de álcool tratados ambulatorialmente(Associação Brasileira de Psiquiatria - ABP, 2004-06-01) Figlie, Neliana Buzi [UNIFESP]; Dunn, John [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Royal Free & University College Medical SchoolOBJECTIVE: The aim of this study was to investigate the reliability and factor structure of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES), version 8,¹ a 19-item self-reported instrument developed to measure readiness to change in alcohol-dependent alcoholics. METHODS: A Confirmatory Factor analysis of the SOCRATES was performed based on the factor structures previously demonstrated by Miller & Tonigan² and Maisto et al.³ in a sample with 326 alcohol-dependent outpatients. The questionnaire was translated into Portuguese, cross-culturally adapted and back-translated into English. During this process SOCRATES underwent some modifications to simplify some complex question formats. RESULTS: The analysis showed that two correlated factors provided the best fit for the data and that these were similar to Maisto et al.'s³ factors. CONCLUSIONS: There was less evidence to support a three-factor structure. The results are compared to previous studies and the reasons for discrepancies are discussed.
- ItemSomente MetadadadosEstudo Do P16Ink4A Em Carcinoma Espinocelular De Orofaringe E Cavidade Oral Para Pesquisa Do Hpv(Universidade Federal de São Paulo (UNIFESP), 2017-09-28) Greggio, Barbara [UNIFESP]; Abrahão, Marcio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To describe the presence of HPV, in its active form, in squamous cell carcinoma of the oropharynx and oral cavity, by the study of the expression of the p16INK4a protein in immunohistochemical panel, and to relate it to smoking and alcoholism. Method: We selected 46 patients with oral cavity or oropharyngeal carcinoma, that were submitted to surgical treatment between 2014 and 2016. Of the 46 patients studied, 37 were male and 9 were female. Thirty-four patients had oral cavity carcinoma and 12 had oropharynx carcinoma. The 46 paraffin-embedded tumors tissues were analyzed in an immunhistochemistry panel for p16INK4a expression to study the presence of HPV infection in those samples. Results: HPV was present in 6 patients by the immunohistochemistry study of p16INK4a, representing 13.04% among the 46 patients. Among all the male patients, HPV was present in 10.81%. Among the female patients, it was present in 22.22%. Of the 34 patients with tumor in the oral cavity, HPV was present in 4. Of the 12 patients with oropharyngeal tumor, HPV was present in 2. Of all 11 non-smoking and non-alcoholic patients, HPV was present in 3. Among the 10 smoking patients , HPV was found in 1 and among the 25 alcoholic and smoking patients, HPV presented positivity in 2. Conclusion: The presence of HPV in squamous cell carcinoma of the oropharynx and oral cavity by the immunohistochemistry study of p16INK4a was 13.04% . Among the oral cavity tumors, this presence of HPV was 11.76% and in oropharyngeal tumors this presence was 16.66%. In the group of non-smokers and non-alcoholic patients, HPV was present in 27.27%. In smokers and alcohol users, it was present in 8% and in smokers, it was present in 10%.
- ItemSomente MetadadadosEvolução E Fatores Associados Ao Ângulo De Fase Em Pacientes Com Pancreatite Crônica Alcoólica(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Freitas, Angelica Rocha De [UNIFESP]; Libera, Ermelindo Della [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives: Measure the values of phase angle (PA) and standardized phase angle (SPA) of patients with chronic alcoholic pancreatitis (CAP); compare the PA and SPA values of CAP patients with the PA values of control subjects; and to analyze the evolution and factors associated with the PA values of patients with PCA during the two-year follow-up period. Patients and methods: A case-control study was conducted to verify the values of phase angle (PA) and standardized phase angle (SPA) in patients with CAP, comparing these values with those of control individuals. In a second moment, a 2-year follow-up study was performed with only patients with CAP to check the progression of PA and SPA. Fifty-four male patients from the Pancreas and Biliary Pathology Outpatient Clinic of the Universidade Federal de São Paulo (UNIFESP) – Escola Paulista de Medicina (EPM), with diagnosis of chronic pancreatitis of alcoholic etiology (CAP). A total of 54 male subjects with no diagnosis of chronic diseases were included as control of the study. The patients were interviewed through a specific form to collect data related to the disease, gastrointestinal alterations, alimentary alterations, eating habits, smoking habits and / or alcoholism, nutritional status prior to the disease, and anthropometric and body composition evaluation. In relation to the evaluation of the nutritional status, the current weight (kg) was evaluated and its stature measured in meters. With the data of weight and height, the Body Mass Index (BMI) was calculated. The evaluation of patients with chronic alcoholic pancreatitis (CAP) was performed in 3 moments. The evaluation of control subjects was unique, in a transversal way. The evaluation of the body composition in patients and controls was done by means of an electric bioimpedance apparatus (BIA), of the brand Biodynamics® model 450. For the interpretation of the value of the phase angle (AF) obtained by the BIA examination, the standardized phase angle (SPA) was used. The analysis of the data was descriptive and with inferential tests, using the SPSS (IBM) Statistical Program 22.0, considering the significance level of 5%. Results: The median PA value was 6.2º in the CAP group and 7.3º in the control group. Lower PA value was found in the CAP group [6.09º (1.10) x 7.27º (0.85), p <0.001]. This result was also observed for the mean SPA value [-1.57 (1.22) x -0.12 (0.83), p <0.001]. When the mean values of PA and standardized phase angle (SPA) were observed in all the evaluations performed with the patients, there was stability in the values throughout the follow-up (p = 0.196). Such stability also occurred for normal and reduced scores for SPA values (p=0.766). When the groups were divided according to the median value of PA (less than the median and greater than or equal to the median), it was observed in the first evaluation that the mean age (years) was higher in the group with PA less than 6,2º [53.5 (9.51) x 46.89 (9.31), p=0.013]. Also, a higher prevalence of associated diabetes (AD) was observed in the group with PA less than 6.2º [69.2% (18) x 28.6% (8), p=0.003]. In the second evaluation, there was in the group with PA lower than 6.45º [53.45 (9.24) x 46.77 (8.29), p = 0.016]. There was also a higher prevalence of AD [68.2% (15) x 27.3% (6), p = 0.007], a higher prevalence of pancreatic enzyme use in the group with AF <6.45º, 9% (20) x 45.5% (10), p=0.001], and a higher prevalence of clinical history of diarrhea [50% (11) x 18.2% (4), p=0.026]. When comparing the groups in relation to the SPA classification, in the first evaluation, the highest prevalence of current smoking was observed in the group of patients withreduced SPA (77.8% (14) x 50% (18), x 19.4% (7), p=0.050], AD [72.2% (13) x 36.1% (13), p=0.012], clinical history of diarrhea 0.007] and clinical history of steatorrhea [38.9% (7) x 11.1% (4), p=0.017]. Still, the group with reduced SPA values presented a higher mean number of bowel movements per day compared to the group with normal SPA values [4.0 (4.96) x 2.0 (1.1), p=0.014]. In the second evaluation, higher prevalences were observed in the group with reduced values for SPA, of current smoking [91.7% (11) x 48.5% (16), p=0.009], use of the pancreatic enzyme [7% (11) x 60.6% (20), p=0.047], clinical history of diarrhea [66.7% (8) x 21.2% (7), p=0.004], and clinical history of steatorrhea [50% (6) x 9.1% (3), p=0.002]. In the third evaluation, higher prevalences of clinical history of diarrhea were found for the group with reduced values for SPA [66.7% (8) x 20.7% (6), p=0.005], and clinical history of steatorrhea [50% (6) x 6.9% (2), p=0.002]. Also, for this same group, a higher mean of daily bowel movements [3.50 (2.43) x 1.83 (1.04), p=0.039]. Conclusion: Patients with CAP had a median value of 6.2º to 6.45º degrees for PA and a mean value of 6.09º to 6.1º. For SPA, they presented values of -1.57 to -1.02 standard deviations from the reference values for healthy men. Mean PA and SPA values were significantly lower in patients with CAP compared to control subjects. The PA and SPA of patients with CAP remained stable during the two-year follow-up period. Age (years), smoking, presence of diabetes mellitus, use of pancreatic enzymes as replacement therapy, presence of diarrhea, presence of steatorrhea and number of bowel movements per day were clinical and nutritional factors associated with PA and SPA in patients with CAP.
- ItemAcesso aberto (Open Access)First household survey on drug abuse in São Paulo, Brazil, 1999: principal findings(Associação Paulista de Medicina - APM, 2003-01-01) Galduróz, José Carlos Fernandes [UNIFESP]; Noto, Ana Regina [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Carlini, Elisaldo Araujo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT: In order to establish prevention programs regarding psychotropic drug use that are adapted to specific populations it is, first of all, important to have data on the realities of such consumption. Single data points are not enough for drawing up a profile of society in relation to drugs. OBJECTIVE: The aim of this household survey was to determine the incidence of illegal drug, alcohol, tobacco and psychotropic medication use, and thus the number of persons dependent on drugs, alcohol and nicotine, and to evaluate their perception regarding how easy it is to obtain psychotropic drugs. TYPE OF STUDY: Epidemiological survey. SETTING: All of the 24 cities in the State of São Paulo with more 200,000 inhabitants participated in the study. METHOD: The sampling was constructed from weighted probabilistic stratified conglomerates obtained via two-stage selection. In each municipality sampled, census sectors (generally 200-300 households) were first selected. Then, households and a respondent were selected to provide information from his/her point of view. The SAMHSA questionnaire (Substance Abuse and Mental Health Services Administration) of the U.S. Department of Public Health was used, after translation and adaptation to Brazilian conditions. RESULTS: A total of 2,411 persons aged 12-65 years old were interviewed, of whom 39.9% weremen. Lifetime use of any psychotropic drug other than alcohol and tobacco was 11.6%: much less than in the U.S. (34.8%). The alcohol dependence rate was 6%, similar to findings from other countries. Marijuana was the illegal drug most cited as used daily (6.6%): a prevalence much lower than in the U.S. (32.0%). Inhalant use was next in frequency of use (2.7%): about 10 times less than in the United Kingdom (20%). Cocaine use (2.1%) was about 5 times less than in the U.S. (10.6%). There was no report of heroin use, although there was a surprisingly high perception regarding the ease of obtaining heroin: 38.3% said it was easy to obtain. CONCLUSION: This study supports the implementation of better prevention programs regarding drug abuse in São Paulo state.
- ItemAcesso aberto (Open Access)Formal education and nurses' attitudes towards alcohol and alcoholism in a Brazilian sample(Associação Paulista de Medicina - APM, 2005-01-01) Pillon, Sandra Cristina; Laranjeira, Ronaldo [UNIFESP]; University of São Paulo Nursing School of Ribeirão Preto Department of Psychiatric Nursing and Human Sciences; World Health Organization Collaborating Center for development of Nursing Research; Universidade Federal de São Paulo (UNIFESP)CONTEXT AND OBJECTIVE: Nurses are one of the largest groups of healthcare professionals sharing in patient care responsibilities, including caring for those who use and abuse psychoactive substances. The objective was to evaluate the theoretical-practical knowledge acquired by nurses in undergraduate and postgraduate studies and their perceptions about alcohol users. DESIGN AND SETTING: Quantitative, descriptive survey at Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina and Hospital São Paulo. METHODS: The sample included nurses, students and nursing teachers. The survey included questions about sociodemographic characteristics; a nurses' attitudes and beliefs scale; and a questionnaire to identify formal nursing education on the use of alcohol and its consequences. RESULTS: 59.7% out of 319 volunteers were nurses, 22.7% were nursing teachers and 17.6% were nursing students. 70% of the participants had received little or no information on physical, family and social problems related to alcohol use; 87% had received little or no information on high risk related to specific segments of the population; 95% had received little or no information on nursing procedures for alcohol-abuse patients. CONCLUSION: Formal education regarding the use of alcohol and its consequences is limited, especially with regard to offering adequate care and management for patients who have problems with or are addicted to alcohol.
- ItemAcesso aberto (Open Access)Freqüência de jogo patológico entre farmacodependentes em tratamento(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-04-01) Carvalho, Simone Villas Boas de [UNIFESP]; Collakis, Silvia Teresa [UNIFESP]; Oliveira, Maria Paula Magalhães Tavares de; Silveira, Dartiu Xavier da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To investigate the frequency of pathological gambling among alcohol and other substance abusers who sought specialized treatment. METHODS: Seventy-four outpatients from three different substance abuse treatment services were interviewed. The South Oaks Gambling Screen (SOGS) scale was used for the diagnosis of pathological gambling. The diagnosis of alcohol and other substances abuse was established according to the DSM-IV criteria and the Short Alcohol Dependence Data (SADD) scale. The Portuguese version of the Self-Report Questionnaire (SRQ) scale was used to detect psychiatric symptoms and the Center for Epidemiological Studies Depression Scale (CES-D) for depressive symptoms. Average scores obtained from the application of these scales were compared using the Student t-test. RESULTS: All subjects met the criteria for drug abuse, 61.6% met the alcohol dependence criteria, 60.3% for cocaine/crack, and 34.2% for cannabis. According to the SOGS scale, the majority of drug addicts (70.3%) were classified as social gamblers, 10.8% as problem gamblers and 18.9% as pathological gamblers. Psychiatric and depression symptoms were found in the sample. Pathological gambling patients showed more depression symptoms than non-pathological gambling patients. CONCLUSIONS: A high frequency of pathological gambling was found among the drug addicts interviewed. It is emphasized the importance of investigating pathological gambling among patients under treatment of drug abuse and to include strategies for the treatment of this disorder.
- ItemSomente MetadadadosHipersecreção pancreática em alcoólatras contribuição ao diagnóstico precoce de disfunção pancreática exocrina(Universidade Federal de São Paulo (UNIFESP), 1980) Neves, Manoel Martins das [UNIFESP]
- ItemAcesso aberto (Open Access)Hipocalcemia e síndrome convulsiva em alcoólatras - uma associação freqüentemente não diagnosticada(Associação Médica Brasileira, 1999-03-01) Kayath, M.j. [UNIFESP]; Argentoni, M. [UNIFESP]; Vieira, J.g.h. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Hypocalcemia can be a contributory factor for epilepsy and previous studies showed that ethanol decreases plasma calcium. PURPOSE: To establish the prevalence of hypocalcemia in the general convulsive population and to ascertain if there was a specific group of risk for hypocalcemia. METHODS: A prospective study of plasma ionized calcium measurement in 78 consecutive patients admitted owing to seizures at the Emergency Department of Escola Paulista de Medicina was performed. 22% of these patients were alcoholics. The plasma ionized calcium in 44 ambulatory non-convulsive alcoholics was also measured. RESULTS: A high prevalence of hypocalcemia was found in the alcoholic convulsive population (32%), in contrast with the non-alcoholic convulsive group and the alcoholic non-convulsive group (no calcium disturbance in both groups). The alcoholic convulsive group had values of ionized calcium statistically lower than the non-alcoholic convulsive group using the Mann-Whitney test (p<0.05) [median value= 1.20mmol/L; range= 1.04 - 1.32mmol/L/ median value= 1.24mmol/L; range= 1.16-1.29mmol/L respectively]. The alcoholic non-convulsive group had values of ionized calcium between 1.17 and 1.32mmol/L with median value of 1.26 mmol/L; these values were not different from those obtained with the non-alcoholic convulsive patients, however they were higher than the calcium levels in the alcoholic convulsive group (p<0.05). PTH levels, liver function tests, phosphatemia and amylasemia were normal in all patients. CONCLUSION: This study emphasizes the importance of serum calcium measurement in alcoholic patients presenting seizures and suggests that hypocalcemia correction might be important in these patients.