Repositório Institucional - Unifesp :: Navegando por Palavras-chave "alcoholism"

Navegando por Palavras-chave "alcoholism"

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Acompanhamento nutricional de cirróticos com história pregressa de alcoolismo
(Pontifícia Universidade Católica de Campinas, 1998-12-01) Reis, Nelzir Trindade; Cople, Cláudia Dos Santos [UNIFESP]; Universidade Gama Filho; Universidade Federal de São Paulo (UNIFESP)
The protein-calorie malnutrition is very common in the cirrhotic patients and it represents a risk in the morbidity and mortality rates increase. Independently of the etiologic factor, its prevalence is high and has repercussions in both sexes. This cases study had the objective of verifying the impact of alcoholic cirrhosis in the nutritional status and the efficacy of the diet therapy in the reversion of malnutrition. Fifty patients (47 men and 3 women) were studied. They were attended at the Nutrition Ambulatory, where an objective nutritional assessment was carried out wish anthropometric, biochemical and clinical parameters and dietetic history in three distinct moments (beginning, 8th and 18th month of treatment). The first results revealed that 96% of the cirrhotic patients presented some level of malnutrition and in the 18th month the nutritional parameters were normalized.
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Alcohol-dependent patients receiving specialised outpatient care: an overview of gender issues
(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2010-01-01) Elbreder, Márcia Fonsi [UNIFESP]; Silva, Rebeca de Souza e [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: The objective of the present study, with focus on gender, was aimed at evaluating alcohol-dependent individual in terms of socio-demographic variables related to alcohol consumption and therapeutic interventions. METHODS: This is a retrospective cross-sectional study of 1,051 patients (833 men and 218 women), with diagnosis of alcohol dependence syndrome, according to ICD-10 criteria, who had sought treatment for the first time at a specialised health centre between 2000 and 2006. RESULTS: The results showed that women, compared to men, are more likely to be unemployed and without partner, in addition to having higher educational level, latter age of alcohol initiation, needing less outpatient alcohol detoxification program, consuming more fermented beverage, presenting less psychiatric comorbidities, and using less coadjutant medications during treatment. CONCLUSION: We can state that some peculiarities exist permeating both gender and alcohol consumption. A further focus on the characteristics of each population is needed to facilitate the adequate use of therapeutic interventions according to gender specificities.
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Avaliação multidimensional do usuário de drogas e a Escala de Gravidade de Dependência
(Sociedade de Psiquiatria do Rio Grande do Sul, 2010-01-01) Kessler, Felix; Faller, Sibele; Souza-Formigoni, Maria Lucia Oliveira de [UNIFESP]; Cruz, Marcelo Santos; Brasiliano, Sílvia; Stolf, Anderson Ravy; Pechansky, Flavio; Universidade Federal do Rio Grande do Sul Centro de Pesquisa em Álcool e Drogas; UFRGS CPAD; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro Instituto de Psiquiatria Programa de Estudos e Assistência ao Uso Indevido de Drogas; Universidade de São Paulo (USP)
INTRODUCTION: Before initiating any treatment for substance abuse, the assessment of problems related to the consumption of those substances is of paramount importance. Considering the complexity of this evaluation, the instrument most widely used in the present days for a multidimensional approach to these patients is the Addiction Severity Index (ASI). OBJECTIVE: The present study presents a literature review, a clinical case vignette, comments on different aspects of the scale, and the discussion of topics covered in the evaluation process, and aims at providing support to health professionals in the sense of systematizing the assessment of these patients. METHOD: The literature review was conducted on MEDLINE, LILACS, and PsycINFO databases, using the keywords assessment and evaluation together with substance-related disorders and other terms presented as synonyms in the Medical Subject Headings. RESULTS AND CONCLUSION: There is a paucity of articles in the literature focusing on the topic, and no other instruments designed to provide a general overview of substance users (as is the case with the ASI) are available in Brazil. The use of a scale with these characteristics may be useful for the Brazilian public health system, allowing for the early identification of problems and promoting an improvement in the quality of treatment provided to these patients.
Acesso aberto (Open Access)
O comportamento de beber entre dependentes de álcool: estudo de seguimento
(Faculdade de Medicina da Universidade de São Paulo, 2006-01-01) Fontes, Andrezza [UNIFESP]; Figlie, Neliana Buzi [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
BACKGROUND: Alcohol dependents seeking specialized alcohol treatment present modest rates of success in treatment programs. Alcohol dependents with gastrointestinal diseases present a worse prognostic and increased mortality rate compared with other non-alcoholic gastroenterology outpatients and the general population. OBJECTIVE: To present the results of a study verifying outcomes of alcohol dependents following their treatment in one of two different clinic types. METHODS: Follow-up study on 228 alcohol dependents: 114 from a specialist alcohol treatment service and 144 from a gastroenterology clinic, both located within the Hospital São Paulo (UNIFESP). RESULTS: A high rate of mortality was found for the overall sample (15%; n = 34), with 70.5% (n = 24) of these deaths occurring in the gastroenterology clinic. The outpatients from the specialist alcohol treatment service were younger and more severely dependent on alcohol, having suffered from more alcohol-related problems in both emotional and mental health aspects. Patients in the gastroenterology group reported less pain but greater social compromise. CONCLUSION: Constant adaptation of interventions to meet alcohol dependents' needs was evidenced, along with a need to implement more effective treatment approaches, coupled with psychosocial interventions to tackle drink use within the gastroenterology clinic itself.
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Does co-occurring social phobia interfere with alcoholism treatment adherence and relapse?
(Elsevier B.V., 2006-12-01) Terra, Mauro Barbosa; Tannhauser Barros, Helena Maria; Stein, Airton Tetelbom; Figueira, Ivan; Athayde, Luciana Dias; Spanemberg, Lucas; Possa, Marianne de Aguiar; Daruy Filho, Ledo; Silveira, Dartiu Xavier da; Fdn Fac Fed Ciencias Med Porto; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP)
This study investigates the impact of social phobia on adherence to and outcomes 6 months following standard alcohol treatment and Alcoholics Anonymous (AA) group meetings among alcohol-dependent patients with and without social phobia. in a cohort study, 300 detoxified alcohol-dependent individuals in Porto Alegre, Brazil, were interviewed during, as well as 3 and 6 months after hospital detoxification. At both follow-up points, treatment adherence was low and relapse rates were high among patients with and without social phobia, and no significant differences were seen between the two groups of patients in relapse, adherence to AA, or adherence to psychotherapy. Findings from this sample suggest that although alcohol-dependent patients with social phobia showed a tendency for less adherence at AA and felt less integrated with their AA group, social phobia comorbidity was not a significant risk factor for alcohol use relapse or for nonadherence to AA or psychotherapy. (c) 2006 Elsevier Inc. All rights reserved.
Acesso aberto (Open Access)
Efeitos comportamentais e moleculares de fitocanabinoides em camundongos submetidos ao modelo da sensibilização locomotora induzida pelo etanol
(Universidade Federal de São Paulo (UNIFESP), 2015-10-30) Filev, Renato [UNIFESP]; Mello, Luiz Eugenio Araujo de Moraes [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Drug dependence, including alcoholism, is a neuroadaptative process induced by mesolimbic dopaminergic pathway sensitization. Several neurochemical mechanisms increase the incentive salience of motivational agents, in our case, ethanol. This sensitization seems to play an important role on craving development, and when associated to cues or stress, could induce relapse. Experimental studies suggest that endocannabinoid system is involved on ethanol pharmacological effects and in the modulation of motivational circuit. Recently, we have found that rodents submitted to locomotor sensitization and then to 5 days of drug withdrawal show increased type 1 cannabinoid receptor (CB1) expression on prefrontal cortex and striatum. Furthermore, case reports and observational studies suggest Cannabis use to mitigate the problematic use of ethanol. Therefore,here we aimed to verify whether phytocannabinoids (CBD and THC) influence the maintenance of locomotor sensitization induced by ethanol. Additionally, we investigated CB1 receptor and c-Fos expression. CBD (2.5; 5.0; 10 and 50 mg/kg, i.p.) did not affect the maintenance of locomotor sensitization. On the other hand, there was a significant inhibitory effect of THC (2.5 mg/kg, i.p.) in this behavioral response, when administered alone or in conjunction with CBD (in a 1:1 proportion). THC did not change consistently c-Fos expression, but prevented CB1 receptor upregulation in the ventral striatum. Contrary to our hypothesis, there was no correlation between behavioral and molecular results. The behavioral results point to potential therapeutic effects of THC in alcoholism. THC/CBD association showed to be effective on the proposed model. Thus, as already recognized for the treatment of other human conditions, our findings bring new insights for the development of clinical trials using the association of THC/CBD in alcohol-related problems.
Acesso aberto (Open Access)
Ensaio clínico duplo-cego randomizado e placebocontrolado com naltrexona e intervenção breve no tratamento ambulatorial da dependência de álcool
(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2009-01-01) Castro, Luís André [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: The objective of this study is to evaluate the efficacy of naltrexone with brief intervention among patients with alcohol dependence. METHOD: This study is a 12-week randomized, double blind, placebo-controlled clinical trial. The sample of 71 patients was randomly divided in two groups (one receiving naltrexone and the other placebo). Alcohol-dependent subjects were treated with 50 mg of naltrexone or placebo daily for 12 weeks. Both treatment groups received brief intervention. The primary results for this study were relapse rate and change in drinking behaviors. RESULTS: In the intention-to-treat fewer naltrexone treated subjects relapsed (3% 21%; p = 0.054). Naltrexone with brief intervention was not effective in decreasing drinking days (6.2 + 10.6 3.05 + 7.3; p = 0.478), moderate drinking days (0 2.2 + 6.9; p = 0.345) and heavy drinking days (0.03 + 0.2 0.3 + 0.9; p = 0.887). Naltrexone was well tolerated. The most frequent adverse effects in our sample were: headache (25.4%), drowsiness (20.9%), nausea (16.4%), hyperphagia (16.4%), anorexia (14.9%), anxiety (10.4%), heartburn (10.4%) and irritability (10.4%). CONCLUSIONS: Although the naltrexone group showed a tendency to reduce relapse rate (> 5 drinks/day), no differences were found in other alcohol consumption variables between naltrexone and placebo groups. Further studies should examine the efficacy of this kind of treatment combination in the primary health care.
Acesso aberto (Open Access)
Estudo de fatores clínicos preditivos para crises epilépticas após acidente vascular cerebral isquêmico
(Academia Brasileira de Neurologia - ABNEURO, 1996-06-01) Fukujima, Marcia Maiumi [UNIFESP]; Cardeal, Jose Osmar [UNIFESP]; Lima, Jose Geraldo de Camargo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Preditive clinical factors for epileptic seizures after ischemic stroke. Clinical features of 35 patients with ischemic stroke who developed epilepsy (Group 1) were compared with those of 35 patients with ischemic stroke without epilepsy (Group 2). The age of the patients did not differ between the groups. There were more men than women and more white than other races in both groups. Diabetes melitus, hypertension, transient ischemic attack, previous stroke, migraine, Chagas disease, cerebral embolism of cardiac origin and use of oral contraceptive did not differ between the groups. Smokers and alcohol users were more frequent in Group 1 (p<0,05). Most patients of Group 1 presented with hemiparesis; none presented cerebellar or brainstem involvement. Perhaps strokes in smokers have some different aspects, that let them more epileptogenic than in non smokers.
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Liver necrosis induced by acute intraperitoneal ethanol administration in aged rats
(Taylor & Francis Ltd, 2002-03-01) Giavarotti, L.; D'Almeida, V; Giavarotti, KAS; Azzalis, L. A.; Rodrigues, L.; Cravero, AAM; Videla, L. A.; Koch, O. R.; Junqueira, VBC; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP); Univ Buenos Aires; Univ Chile
It is generally agreed that the deleterious pathophysiological effects of ethanol are caused, at least partially by an increase in free radical production. However, little attention has been directed to the effects of ethanol upon elderly organisms. Male Wistar rats at ages 3, 6,12,18 and 24 months were treated either with a single i.p. dose of 35% ethanol (v/v) at 3 g ethanol/kg body weight or an isovolumetric amount of 0.9% saline solution. We then assessed the plasma levels of transaminases and hepatic levels of oxidative stress-related parameters, followed by liver histological evaluation. the younger rats (3 months old) were not affected by the treatment with ethanol with respect to any of the studied parameters except for a lowering of total hepatic GSH and an increase in hepatic thiobarbituric acid reactants (TBARS) formation, while animals older than 3 months were increasingly more affected by the treatment. Acute ethanol treatment elicited the similar responses to those in the 3 months-old group, plus a decrease in the hepatic and plasma levels of beta-carotene and the plasma level of alpha-tocopherol, as well as an increase in the activity of plasma transaminases. in the 12,18 and 24 months old groups, there was increasing liver necrosis. These findings suggest that liver damage induced by acute ethanol administration in elderly rats may involve a lack of antioxidants.
Acesso aberto (Open Access)
Perfil de mulheres usuárias de álcool em ambulatório especializado em dependência química
(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2008-01-01) Elbreder, Márcia Fonsi [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Siqueira, Marluce Miguel De; Barbosa, Dulce Aparecida [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Espírito Santo Núcleo de Educação Aberta e a Distância
Although the number of women who use, abuse of and become addicted to alcohol is increasing, they are still not the main target of the health care services as their distinctive characteristics regarding psychoactive substances have not been taken into account by the public health policy decision-makers. OBJECTIVE: To characterise those women who use alcohol as well as to identify the pattern of alcohol consumption, clinical interventions, and previous treatments performed in this patient population. METHODS: This retrospective cohort study reviewed medical records of alcohol users who had sought treatments offered by UNIAD and UNIFESP between 2000 - 2006. A total of 192 patients were included in this study according to criteria for treatment dropout. RESULTS: The groups were found to have similar socio-demographic characteristics. Consumption of both fermented and distilled beverages were significantly higher in the dropout group (p = 0.002). Alcohol addiction was found to be significantly more severe in both groups (p < 0.001). Use of auxiliary medication (p < 0.001) and search for psychiatric consultation (p < 0.001) were significantly higher in the non-dropout group. CONCLUSION: Alcoholic women who abandoned the treatment during the first month, compared to those who did not, made more use of both fermented and distilled beverages, had consumed less units per week, used less auxiliary medications, and sought less treatments.
Acesso aberto (Open Access)
Posturografia estática em dependentes de drogas ilícitas e álcool
(Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial, 2012-10-01) Moreira, Daniela Affonso; Ganança, Mauricio Malavasi [UNIFESP]; Caovilla, Heloisa Helena [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The use of illicit drugs and alcohol can affect body balance. AIM: To evaluate balance control with static posturography in individuals addicted to illicit drugs, with or without alcohol abuse. Study design: Case-control, prospective. METHODS: 47 users of illicit drugs, with or without alcohol abuse, and a homogeneous control group consisting of 47 healthy individuals were submitted to a neurotological evaluation including Balance Rehabilitation Unit posturography. RESULTS: The stability threshold mean values were significantly lower (p < 0.0001) in users of illicit drugs, with or without alcohol abuse when compared to the control group; the mean values for sway velocity and ellipse area in all evaluated conditions were significantly higher (p <0.05) in the experimental group when compared to the control group, except for the ellipse area in static force surface and opened eyes (p = 0.168). CONCLUSION: The balance control of individuals addicted to illicit drugs with or without alcohol abuse could present stability threshold, sway velocity and ellipse area abnormalities in static posturography.
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Predictors of relapse in 300 Brazilian alcoholic patients: A 6-month follow-up study
(Taylor & Francis Inc, 2008-01-01) Terra, Mauro Barbosa; Barros, Helena Maria Tannhauser; Stein, Airton Tetelbom; Figueira, Ivan; Athayde, Luciana Dias; Ott, Daniele Reimche; De Azambuja, Rita de Cassia Santos; Da Silveira, Dartiu Xavier [UNIFESP]; Fdn Fac Fed Ciencias Med Porto Alegre; Universidade Federal do Rio de Janeiro (UFRJ); Universidade Federal de São Paulo (UNIFESP)
Three hundred alcoholic patients were interviewed at hospitalization and again 3 and 6 months thereafter in Porto Alegre, Brazil, from March 2002 to January 2004. Assessment included the SCID-I to check for the presence of Axis I mental disorders, a questionnaire focusing on patient relationship with AA groups, and specific questions about participation in psychotherapy. A logistic regression analysis was performed to determine predictive variables for relapse or abstinence 6 months after discharge. Previous treatment for alcohol dependence (OR = 3.65; CI: 1.77-7.05) and being single (OR = 2.39; CI: 1.06-5.42) proved to be associated with relapse, whereas adherence to AA (OR = 0.31; CI: 0.15-0.66), presence of a comorbid depressive disorder (OR = 0.46; CI: 0.23-0.92), and probably adherence to psychotherapy (OR = 0.52; CI: 0.26-1.04) could be associated with abstinence. These findings reinforce the importance of psychotherapy and AA groups for alcoholics to remain abstinent for longer. the greater adherence to treatment observed among depressive alcohol dependents can be explained by the fact that this is a comorbid condition that acts as a protective factor against relapse.
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Psychosocial Difficulties and Female Sexual Dysfunctions
(Wiley, 2017) Lordello, Maria Claudia [UNIFESP]; Holzhacker, Suzane [UNIFESP]; Macri, Lilian [UNIFESP]; Veloso, Laise [UNIFESP]; Macedo, Zelia [UNIFESP]; Batista, Nina [UNIFESP]; Silva, Ivaldo [UNIFESP]
Acesso aberto (Open Access)
Religious beliefs and alcohol control policies: a Brazilian nationwide study
(Associação Brasileira de Psiquiatria - ABP, 2014-03-01) Lucchetti, Giancarlo; Koenig, Harold G.; Pinsky, Ilana [UNIFESP]; Laranjeira, Ronaldo [UNIFESP]; Vallada, Homero; Universidade Federal de Juiz de Fora (UFJF) Department of Medicine; Hospital João Evangelista (HOJE); Associação Médico-Espírita Internacional; Duke University Medical Center; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)
Objective: The connection between lower alcohol use and religiousness has been extensively examined. Nevertheless, few studies have assessed how religion and religiousness influence public policies. The present study seeks to understand the influence of religious beliefs on attitudes toward alcohol use. Methods: A door-to-door, nationwide, multistage population-based survey was carried out. Self-reported religiousness, religious attendance, and attitudes toward use of alcohol policies (such as approval of public health interventions, attitudes about drinking and driving, and attitudes toward other alcohol problems and their harmful effects) were examined. Multiple logistic regression was used to control for confounders and to assess explanatory variables. Results: The sample was composed of 3,007 participants; 57.3% were female and mean age was 35.7 years. Religiousness was generally associated with more negative attitudes toward alcohol, such as limiting hours of sale (p < 0.01), not having alcohol available in corner shops (p < 0.01), prohibiting alcohol advertisements on TV (p < 0.01), raising the legal drinking age (p < 0.01), and raising taxes on alcohol (p < 0.05). Higher religious attendance was associated with less alcohol problems (OR: 0.61, 95%CI 0.40-0.91, p = 0.017), and self-reported religiousness was associated with less harmful effects of drinking (OR: 0.61, 95%CI 0.43-0.88, p = 0.009). Conclusions: Those with high levels of religiousness support more restrictive alcohol policies. These findings corroborate previous studies showing that religious people consume less alcohol and have fewer alcohol-related problems.
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Revisão sistemática da literatura sobre estigma social e alcoolismo
(Programa de Pós-graduação em Psicologia, Universidade Federal do Rio Grande do Norte, 2011-08-01) Silveira, Pollyanna Santos Da [UNIFESP]; Martins, Leonardo Fernandes [UNIFESP]; Soares, Rhaisa Gontijo; Gomide, Henrique Pinto; Ronzani, Telmo Mota; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de Juiz de Fora
A large number of studies have focused on stigma and its health consequences. Drugs related disorders are pointed as the most stigmatized conditions in Latin America. Thus this paper aims to review the scientific literature about social stigma and alcoholism. A systematic review of literature was accomplished among four databases: LILACS (Latin American and Caribbean Center on Health Sciences Information), PsycInfo, PubMed and SciELO between 1997 and 2007 with these following keywords: stigma, stereotyped attitudes, stereotyping and alcoholism. Nine articles remained after exclusion and inclusion criteria application and were analyzed. In sum, the studies had no objectives, instruments and population convergence, illustrating an absence of a clear stigma measure method. Moreover the number of studies is not increasing as expected. As a public health concern, more funding and research is needed to development of prevention and rehabilitation procedures.
Acesso aberto (Open Access)
Treatment of drug dependence with Brazilian herbal medicines
(Sociedade Brasileira de Farmacognosia, 2006-12-01) Carlini, Elisaldo Araujo [UNIFESP]; Rodrigues, Eliana [UNIFESP]; Mendes, Fúlvio Rieli [UNIFESP]; Tabach, Ricardo [UNIFESP]; Gianfratti, Bruno [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
The topic Herbal Medicines in the Treatment of Addictions in a country must be preceded by answers to four questions: 1. Does the country in question possess a biodiversity rich enough to allow the discovery of useful medicines? 2. Do local people have tradition and culture to look for and use resources from Nature to alleviate and cure diseases, including drug dependence? 3. Is drug dependence (or addiction) present in the country in question? 4. Do people of that country recognize and diagnose such problem as a serious one? Alcohol is, by far, the most serious health problem when drug abuse is considered, reaching all of Brazilian society, including the Indians. On the contrary, other drugs may be considered as minor problems and they are not the main focus of this manuscript. The people living in Brazilian hinterland don t have access to public health systems. Consequently, these people seek assistance from curandeiros and raizeiros; the Indians are assisted by the shaman. These folk doctors do not know the academic medicine and therapeutics, and resort to the local plants to treat different ailments of their patients. Furthermore, alcohol abuse and dependence are not recognized by them, according to the rules and criteria of academic medicine. We have conducted a survey in many Brazilian books, Thesis concerning phytotherapy, and several databank. The results of such searches were very disappointing. No published papers from Brazilian authors concerning the use of plants for the treatment of addictions were found in the databases and there were only three very short notes in the masterly book written by Shultes and Raffauf (1990). From the Brazilian books on folk medicine employing medicinal plants, ten mentions were disclosed: most of them dealing with treatment of alcohol problems and two to counteract Ayahuasca dependence.
Acesso aberto (Open Access)
Uso potencial dos anticonvulsivantes no tratamento ambulatorial da dependência de álcool
(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2006-01-01) Castro, Luís André [UNIFESP]; Couzi, Carla [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Currently three medications (disulfiram, naltrexone and acamprosate) are approved by the FDA to treat alcohol dependence by the FDA. The classical anticonvulsive drugs are rarely employed as an alternative because of their side effects, but the latest generation of anticonvulsants could be useful. The anticonvulsants can be a alternative to BZD and other pharmacological treatments in the prevention of complications during the detoxification therapy, because of the absence of addictive properties and a better adverse effects profile than classical anticonvulsant drugs. Anticonvulsants such as carbamazepine, valproic acid, gabapentin and topiramate have shown to be excellent treatment for alcohol withdrawal and for the prevention of alcohol relapse. Although none of these agents have been approved by the FDA yet, there is growing evidence in the literature to support their use.

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