Álcool e alcoolismo entre adolescentes da rede estadual de ensino de Cuiabá, Mato Grosso

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.OBJETIVO: Estimar a prevalência de consumo de álcool e do alcoolismo entre estudantes adolescentes trabalhadores e não trabalhadores. MÉTODOS: Estudo transversal, realizado por amostragem estratificada sistemática, composta por 993 adolescentes trabalhadores e 1.725 não-trabalhadores. Foram incluídos os estudantes matriculados em 1998, na rede estadual de ensino de Cuiabá, MT. Aplicou-se, em sala de aula, um questionário de auto-preenchimento anônimo. Utilizou-se as análises univariada, bivariada e regressão logística. RESULTADOS: Verificaram-se prevalências de 71,3% para o consumo de álcool e 13,4% para alcoolismo na amostra total, sendo maior entre os estudantes trabalhadores (81,0% e 14,9%) comparativamente aos não-trabalhadores (65,8% e 12,6%). Além da associação do uso de álcool com o trabalho, observou-se tanto semelhanças quanto diferenças entre os dois grupos. O alcoolismo não está associado ao trabalho, mas ao sexo masculino (RO=1,61; IC 95%: 1,18-2,19) e história de álcool na família tanto entre os não-trabalhadores (RO=2,19; IC 95%: 1,60-2,99) quanto entre trabalhadores (RO=2,10; IC 95%: 1,42-3,12). CONCLUSÕES: Os resultados indicam alta prevalência de consumo de álcool e alcoolismo, sendo maior entre os adolescentes trabalhadores. Os fatores sociodemográficos, familiares e relacionados a trabalho devem ser considerados na implementação de ações educativas nessa população, visando a mudanças de comportamento relacionadas ao consumo de álcool

Prothrombin G20210A gene mutation, factor V Leiden and anticardiolipin antibodies do not influence renal graft survival after transplantation

INTRODUCTION: Thromboembolic complications are important risk factors for graft failure and worse renal transplantation outcome. Patients with thrombophilic disorders have a higher risk of thromboembolic complications. The prevalence of thrombophilic disorders and the associated risk for graft failure and for intravascular thrombosis were analyzed in renal transplant recipients. METHODS: This is a cohort study of 388 adult recipients investigated regarding the presence of thrombophilia, through the search for anticardiolipin antibodies (aCL) via ELISA and FV G1691A and PT G20210A gene mutations by multiplex PCR. RESULTS: Thrombophilic disorders were identified in 25.8% of the patients. The 2-year graft survival was similar among patients with and without thrombophilic disorder (94% versus 94%, p = 0.53), and so was the survival free of intravascular thrombosis (97% versus 97%, p = 0.83). The prevalence of intravascular thrombosis was similar in both groups (3% versus 3.5%, p = 0.82). Patients with previous kidney transplantation had a higher risk of graft failure (OR 20.8, p < 0.001) and of intravascular thrombosis (OR 6.8, p = 0.008). CONCLUSIONS: The prevalences of FV G1691A and PT G20210A gene mutations in this cohort of patients were similar to those of the general non-transplanted population. The prevalence of aCL antibodies was higher in this cohort than that observed in healthy individuals. The thrombophilic markers studied did not predict the medium-term survival of renal transplant.INTRODUÇÃO: Complicações tromboembólicas são importantes fatores de risco para perda do enxerto e pior evolução após o transplante renal. Pacientes com defeito trombofílico apresentam maior risco de complicações tromboembólicas. Foram analisados, entre receptores de transplante renal, a prevalência de defeito trombofílico e o risco atribuído a esta condição para a perda do enxerto e para o desenvolvimento de tromboses intravasculares. MÉTODOS: Estudo do tipo coorte incluindo 388 receptores adultos analisados quanto à presença de trombofilia de acordo com a pesquisa de anticorpos anticardiolipina (aCL) por ELISA e das mutações G1691A no gene do fator V (FV) e G20210A no gene da protrombina (PT) por PCR multiplex. RESULTADOS: Defeito trombofílico foi identificado em 25,8% dos pacientes. As taxas de sobrevida de 2 anos do enxerto foram semelhantes entre os pacientes com e sem defeito trombofílico (94% versus 94%, p = 0,53), bem como a sobrevida dos enxertos livres de tromboses intravasculares (97% versus 97%, p = 0,83). Pacientes com defeito trombofílico apresentaram prevalência de tromboses intravasculares semelhante à do grupo-controle (3% versus 3,5%, p = 0,82). O transplante renal anterior foi associado a maior risco de perda de enxerto (OR 20,8, p < 0,001) e de ocorrência de tromboses intravasculares (OR 6,8, p = 0,008). CONCLUSÕES: As prevalências das mutações FV G1691A e PT G20210A na população estudada foram semelhantes às da população geral não transplantada, e a prevalência de anticorpos aCL superou a observada entre os indivíduos sadios. Não houve associação entre os marcadores de trombofilia estudados e a sobrevida em médio prazo do transplante renal.UNIFESP Departamento de Medicina, Disciplina de HematologiaUNIFESP Departamento de Medicina, Disciplina de NefrologiaUNIFESP Departameto de Medicina, Disciplina de ReumatologiaUNIFESP Departamento de Medicina Preventiva, Disciplina de BioestatísticaUniversidad de Antofagasta Departamento de Tecnologia MedicaUNIFESP, Depto. de Medicina, Disciplina de HematologiaUNIFESP, Depto. de Medicina, Disciplina de NefrologiaUNIFESP, Departameto de Medicina, Disciplina de ReumatologiaUNIFESP, Depto. de Medicina Preventiva, Disciplina de BioestatísticaSciEL

Hope matters to the glycemic control of adolescents and young adults with type 1 diabetes

This study investigated the association of hope and its factors with depression and glycemic control in adolescents and young adults with type 1 diabetes. A total of 113 patients were invited to participate. Significant negative correlations were found between hope and HbA1c and also between hope and depression. Hope showed a significant association with HbA1c and depression in the stepwise regression model. Among the hope factors, inner positive expectancy was significantly associated with HbA1c and depression. This study supports that hope matters to glycemic control and depression. Intervention strategies focusing on hope should be further explored.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo, BR-04023062 São Paulo, SP, BrazilUniversidade Federal de São Paulo, BR-04023062 São Paulo, SP, BrazilFAPESP: 2010/51872-0Web of Scienc

Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca

The aims of this study were to assess the impact of ceremonial use of ayahuasca—a psychedelic brew containing N,N-dimethyltryptamine (DMT) and β-carboline —and attendance at União do Vegetal (UDV) meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939). Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25–34 and over 34 years old, but not for the age range of 18–24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder

Outcomes of laser thermal therapy for recurrent head and neck cancer

OBJECTIVE: To review the outcomes of a phase II study using laser-induced thermal therapy (LIFT) as a palliative treatment for 106 patients with recurrent head and neck tumors.STUDY DESIGN: Retrospective study.SETTING: Tertiary hospital in the United States.SUBJECTS and METHODS: the primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method.RESULTS: the best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/- 6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors.CONCLUSION: in this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. the highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT. (c) 2010 American Academy of Otolaryngology Head and Neck Surgery Foundation. All rights reserved.Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of HealthFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Head & Neck Surg, Los Angeles, CA 90095 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USAUniv Miami, Dept Otolaryngol Head & Neck Surg, Miami, FL USAUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilDivision of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K23CA88921Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K22CA131509FAPESP: 08/54714-6Web of Scienc

Outcomes of laser thermal therapy for recurrent head and neck cancer

OBJECTIVE: To review the outcomes of a phase II study using laser-induced thermal therapy (LIFT) as a palliative treatment for 106 patients with recurrent head and neck tumors.STUDY DESIGN: Retrospective study.SETTING: Tertiary hospital in the United States.SUBJECTS and METHODS: the primary endpoints were tumor response and survival. Prognostic values were assessed by the Kaplan-Meier method.RESULTS: the best results were seen in oral cavity tumors, in which mean survival was 29.1 months, as compared to neck tumors (mean 14.4 +/- 6.9 months; range 7.5-20.7 months; with a 95% confidence interval). Further analysis showed that clinical factors such as gender, smoking, and alcohol use were not indicators of poor prognosis, whereas neck disease and tumor stage at first treatment were relevant factors.CONCLUSION: in this study, 40 out of 106 patients treated by LITT remained alive at the end of our follow-up, and a complete response was seen in 24 (22.6%) patients. the highest response rate was seen in oral cavity tumors, which suggests that tumor location at this site may be a predictor of favorable outcome with LITT. (c) 2010 American Academy of Otolaryngology Head and Neck Surgery Foundation. All rights reserved.Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of HealthFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Div Head & Neck Surg, Los Angeles, CA 90095 USAUniv Calif Los Angeles, David Geffen Sch Med, Dept Radiol Sci, Los Angeles, CA 90095 USAUniv Miami, Dept Otolaryngol Head & Neck Surg, Miami, FL USAUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Hlth Informat Dept, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilDivision of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K23CA88921Division of Head and Neck Surgery, Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at UCLA, National Institutes of Health: K22CA131509FAPESP: 08/54714-6Web of Scienc