Assessing Alcohol Dependence in Hospitalized Patients

Alcohol misuse is generally not detected in hospital settings. the goal of this study was to estimate the prevalence of alcohol abuse and dependence in hospitalized patients in a university hospital in São Paulo (Brazil). Patients were randomly selected from all hospital admissions. the final sample consisted of 169 adult inpatients. Two screening tools were used: the Short Alcohol Dependence Data (SADD) and the CAGE questionnaires. in this sample, 25.4% of patients could be considered alcohol dependent according to the CAGE questionnaire, whereas 32.9% of patients fulfilled the criteria according to the SADD. the only predictor of alcohol dependence was gender; male inpatients were 3.2 times more prone to alcohol dependence with female inpatients. All inpatients should be systematically screened for alcohol use disorders. the choice of the screening tool will depend on whether the goal is to identify inpatients with hazardous drinking behaviors or with established alcohol-related problems. To maximize proper case identification, the CAGE questionnaire should be used as a first-step screening tool, and patients who screen positive on this scale should be subsequently administered the SADD questionnaire to assess the severity of the condition.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, São Paulo, BrazilWeb of Scienc

Genome-wide association identifies nine common variants associated with fasting proinsulin levels and provides new insights into the pathophysiology of type 2 diabetes.

OBJECTIVE: Proinsulin is a precursor of mature insulin and C-peptide. Higher circulating proinsulin levels are associated with impaired β-cell function, raised glucose levels, insulin resistance, and type 2 diabetes (T2D). Studies of the insulin processing pathway could provide new insights about T2D pathophysiology. RESEARCH DESIGN AND METHODS: We have conducted a meta-analysis of genome-wide association tests of ∼2.5 million genotyped or imputed single nucleotide polymorphisms (SNPs) and fasting proinsulin levels in 10,701 nondiabetic adults of European ancestry, with follow-up of 23 loci in up to 16,378 individuals, using additive genetic models adjusted for age, sex, fasting insulin, and study-specific covariates. RESULTS: Nine SNPs at eight loci were associated with proinsulin levels (P < 5 × 10(-8)). Two loci (LARP6 and SGSM2) have not been previously related to metabolic traits, one (MADD) has been associated with fasting glucose, one (PCSK1) has been implicated in obesity, and four (TCF7L2, SLC30A8, VPS13C/C2CD4A/B, and ARAP1, formerly CENTD2) increase T2D risk. The proinsulin-raising allele of ARAP1 was associated with a lower fasting glucose (P = 1.7 × 10(-4)), improved β-cell function (P = 1.1 × 10(-5)), and lower risk of T2D (odds ratio 0.88; P = 7.8 × 10(-6)). Notably, PCSK1 encodes the protein prohormone convertase 1/3, the first enzyme in the insulin processing pathway. A genotype score composed of the nine proinsulin-raising alleles was not associated with coronary disease in two large case-control datasets. CONCLUSIONS: We have identified nine genetic variants associated with fasting proinsulin. Our findings illuminate the biology underlying glucose homeostasis and T2D development in humans and argue against a direct role of proinsulin in coronary artery disease pathogenesis

Factors related to the use of drugs among medical students

Universidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilWeb of Scienc

Evolutional patterns of drug use among medical students

Universidade Federal de São Paulo, Dept Psychiat, Addict Unit, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, Addict Unit, São Paulo, BrazilWeb of Scienc