Rastreamento de uso de álcool por gestantes de serviços públicos de saúde do Rio de Janeiro

OBJECTIVE: To assess the prevalence of suspected cases of alcohol use during pregnancy in women seeking care in public health services. METHODS: Cross-sectional study comprising 537 women randomly selected in public maternity hospitals in Rio de Janeiro, Southeastern Brazil, from March to October 2000. A well-trained team of female interviewers used the instruments Cut-down, Annoyed, Guilty, Eye-opener (CAGE), Tolerance Cut-down, Annoyed, Eye-opener (T-ACE) and Tolerance Worry Eye-opener Annoyed Cut-down (TWEAK) to assess suspect cases of alcohol misuse. The Chi-square test was used in the analysis according to socioeconomic and demographic variables. RESULTS: About 40% of women informed having used any type of alcoholic beverage during pregnancy. Beer was the most frequently used drink (83.9%). Depending on the measurement instrument used, estimates of alcohol misuse varied from 7.3% to 26.1%. Suspected cases of alcohol abuse were more common among non-white, older and less educated women; those not living with a partner; those reporting use of tobacco and illicit drugs either by one or both partners in a couple; and those with little social support. CONCLUSIONS: High prevalence of suspected alcohol misuse and its overlapping with several risk factors for adverse pregnancy outcomes indicate this is an important issue of public health concern requiring continuous screening during prenatal care.OBJETIVO: Avaliar a prevalência de casos suspeitos de uso inadequado de álcool durante a gestação entre mulheres atendidas na rede pública de saúde. MÉTODOS: Estudo transversal com 537 parturientes selecionadas aleatoriamente em maternidades públicas do Rio de Janeiro entre março e outubro de 2000. Entrevistadoras adequadamente treinadas identificaram os casos suspeitos de uso inadequado de álcool utilizando os instrumentos Cut-down, Annoyed, Guilty e Eye-opener (CAGE), Tolerance Cut-down, Annoyed e Eye-opener (T-ACE) e Tolerance Worry Eye-opener Annoyed Cut-down (TWEAK). Na análise segundo variáveis socioeconômicas e demográficas utilizou-se o teste qui-quadrado. RESULTADOS: Cerca de 40% das mulheres relataram fazer uso de algum tipo de bebida alcoólica durante a gestação, sendo a cerveja a bebida mais consumida (83,9%). Dependendo do instrumento de identificação, estimou-se que entre 7,3% e 26,1% das mulheres eram casos suspeitos de uso inadequado de álcool. A suspeição de utilização inadequada foi mais comum entre as mulheres de idade mais avançada; de baixa escolaridade; que não se declararam brancas; que não viviam com companheiro; que relataram tabagismo e uso de drogas ilícitas por um dos membros do casal; e com pouco apoio social. CONCLUSÕES: A alta prevalência de suspeição de uso inadequado de álcool e sua superposição com diferentes fatores de risco para desfechos deletérios na gestação indicam um importante problema de saúde pública, merecendo ser rotineiramente rastreada durante o acompanhamento pé-natal

Comparison between subjective feelings to alcohol and nitrogen narcosis: A pilot study

Nitrogen narcosis is often compared to alcohol intoxication, but no actual studies have been carried out in humans to test the comparability of these effects. If a common mechanism of action is responsible for the behavioral effects of these substances, biological variability of response to alcohol should correlate to that of nitrogen in the same individual. To test this hypothesis, subjective feelings were assessed in two separate occasions in 14 adult male, healthy volunteers, nonprofessional divers. in one occasion, each subject received 0.75 ml/kg (0.60 g/kg) alcohol 50% (v/v PO) and in another day underwent a simulated dive at 50 m for 30 min in a hyperbaric chamber. There was a significant correlation between reported feelings in the two sessions; subjects who felt less intoxicated after drinking also felt less nitrogen narcosis during the simulated dive. the results, although preliminary, raise the hypothesis that ethanol and nitrogen may share the same mechanisms of action in the brain and that biological differences might account for interindividual variability of responses to both ethanol and nitrogen.ESCOLA PAULISTA MED,DEPT PSYCHOBIOL,RUA BOTUCATU 862,1 ANDAR,BR-04023062 São Paulo,BRAZILESCOLA PAULISTA MED,DEPT PSYCHOBIOL,RUA BOTUCATU 862,1 ANDAR,BR-04023062 São Paulo,BRAZILWeb of Scienc