Factores explicativos y consecuencias del consumo de alcohol en estudiantes universitarios

Esta tesis presenta los resultados de un estudio de cohortes de 9 años de seguimiento entre estudiantes de la Universidade de Santiago de Compostela diseñado para identificar los factores explicativos y las consecuencias del consumo de alcohol. La menor edad de inicio de consumo de alcohol y el tener expectativas positivas respecto a éste se muestran como factores de riesgo en ambos géneros. En cuanto a las consecuencias del consumo, el estudio muestra al consumo intensivo como factor de riesgo de accidentes de tráfico, sexo no seguro y lesiones relacionadas con el consumo de alcohol

Population Attributable Fraction of Early Age of Onset of Alcohol Use in Alcohol Abuse and Dependence: A 3-Year Follow-Up Study in University Students

Background: we aimed to determine the risk factors and associated population attributable fractions (PAFs) for the age of onset of alcohol use and also to identify protective factors. Methods: we analyzed follow-up data collected between autumn 2011 and spring 2016 (n = 5170) from the first two cohorts (2011, 2012) of the Spit for ScienceTM project. The dependent variables were alcohol abuse and dependence, and the independent variables were age of drinking onset, residence, ethnicity, religiosity, sexual orientation and work status. We determined the odds ratios (OR) using multilevel logistic regression for repeated measures in SPSSv.20. Results: the early onset of alcohol use was associated with an increased risk of alcohol abuse and dependence among females (OR = 14.98; OR = 11.83) and males (OR = 7.41; OR = 6.24). The PAFs for the early onset of alcohol use in alcohol abuse and dependence were respectively 80.9% and 71.7% in females and 71.0% and 63.5% in males. Among females, being white (OR = 1.58; OR = 1.51), living off-campus (OR = 1.73; OR = 2.76) and working full-time (OR = 1.69; OR = 1.78) were also risk factors. Strong religious beliefs were found to protect males from alcohol abuse (OR = 0.58), while same-gender sexual orientation increased the risk among females (OR = 2.09). Conclusion: delaying the age of onset by one year would reduce alcohol abuse among young adultsSpit for Science: The Student Survey was supported by the Virginia Commonwealth University, the NIAAA [P20 AA107828, R37AA011408, K02AA018755, and P50 AA022537] and the National Center for Research Resources and National Institutes of Health Roadmap for Medical Research [UL1RR031990]S

Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students

Aim: The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. Methods: We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. Results: The incidence rate of alcohol-related injuries was 0.028 year−1 for females and 0.036 year−1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR] = 2.64 and OR = 3.68), while being more than 23 is a protective factor (OR = 0.34). For males, bivariate analysis also showed HED like risk factor (OR = 4.69 and OR = 2.51). Finally, the population attributable fraction for HED among females was 37.12%. Conclusions: HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HEDThis work was supported by the Spanish National Plan on Drugs (N.P.D)(grant number 2005/PN014), and MICINN (grant number PSI2011-22575)S

Patterns of Alcohol Consumption in Spanish University Alumni: Nine Years of Follow-Up

The aim of this study was to empirically identify different profiles of Spanish university alumni, based on their alcohol use over 9 years, and to further characterize them. A cohort study was carried out between 2005 and 2015 among university students (Compostela Cohort-Spain; n2015 = 415). Alcohol consumption was measured using the Alcohol Use Disorder Identification Test (AUDIT). A two-stage cluster analysis, based on their AUDIT total scores was carried out separately for males and females. The further characterization of every profile was based on demographic data, age at onset of alcohol use, positive alcohol-related expectancies, tobacco and cannabis use, as well as their answers to some European Addiction Severity Index items. Five different clusters were identified: Low users (29.2%), Moderated users (37.2%), At-risk users (14.2%), Decreasing users (13.2%) and Large users (6.2%) for females, and Low users (34.4%), At-risk users (25.6%), High-risk users (15.6%), Decreasing users (14.4%) and Large users (10.0%) for males. Being a cannabis user or a smoker was positively associated to those more hazardous clusters in both genders. Regarding females, significant differences in the age of onset and high positive expectancies were found. However, there were few significant differences among the groups in relation to their employment status and social relations. The results reveal the existence of different typologies of alcohol users among university alumni, with differences among males and females. Modifying positive expectancies, limiting access to alcohol at a young age, and reducing uses of other substances uses are key to promote healthier alcohol use profiles and to prevent hazardous usesThis work was supported by a grant from the Plan Nacional sobre Drogas (Spain) (2005/PN014) and from Fondo de Investigación Sanitaria (Spain) (PI15/00165). Eduardo López-Caneda was supported by the SFRH/BPD/109750/2015 Postdoctoral Fellowship of the Portuguese Foundation for Science and Technology as well as by the Psychology Research Centre (UID/PSI/01662/2013), co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653)S

Heavy drinking and non-medical use of prescription drugs among university students: a 9-year follow-up

Purpose: Investigations suggest non-medical use of prescription drugs (NMUPD) is associated with heavy drinking and polydrug use among university students. Our aim is to determine the prevalence of NMUPD among university students and to analyze its association with alcohol, tobacco, and cannabis use, and to study the role of the age of drinking onset. Methods: Cohort study among university Spanish students (n = 1382). Heavy drinking (HED) and risky consumption (RC) were measured with the Alcohol Use Disorders Identification Test. Questions related to tobacco and cannabis consumption were also formulated. NMUPD refers to sedative, anxiety, or pain medication intake within the last 15 days without medical prescription. All variables were measured at 18, 20, and 27 years. Multilevel logistic regression for repeated measures was used to obtain adjusted OR (odds ratios). We analyzed the results from a gender perspective. Results: Prevalence of NMUPD were higher in students who already partook in NMUPD at the beginning of the study. NMUPD in women at 27 is 3 times higher than at 18, while in men it is twice. Among females, RC (OR = 1.43) and cannabis consumption (OR = 1.33) are risk factors for NMUPD, while later onset of alcohol use (OR = 0.66) constitutes a protective factor. No significant differences were found for males. Conclusions: NMUPD is prevalent among university students. RC and early onset of alcohol use were associated with higher prevalence of NMUPD in females. The prevalence of NMUPD increased with age in both sexes. Strategies for reducing risky drinking and delaying onset of drinking should be provided for university students. Pharmacists and parents should be alerted to the risk of NMUPDPlan Nacional sobre Drogas (Spain) (2005/PN014) and Fondo de Investigación Sanitaria (Spain) (PI15/00165)S

The Use of Non-Prescribed Prescription Drugs and Substance Use Among College Students: A 9-Year Follow-Up Cohort Study

The use of non-prescribed prescription drugs (NPPD) is common in post-modern societies and a significant proportion of youth consume NPPD concomitantly to other drugs. We studied the prevalence of this consumption among university students in Spain, and its relationship to different patterns of alcohol, tobacco, and cannabis use. A cohort study among university students (n=1,380) (2005–2015) was carried out. Students completed self-administered questionnaires at initial (n=1,363, 98.7%), at 2 years (n=875, 75%) and 9 years of follow-up (n=415, 30.5%). Consumption of medicines (last 15 days), risky alcohol consumption (RC), heavy episodic drinking (HED), and tobacco and cannabis use were measured. Multilevel logistic regressions for repeated measures were generated using consumption of medicines with or without medical prescription as dependent variables. Prevalence of RC, HED, tobacco and cannabis had significant reductions during the follow-up. The use of NPPD increased over time, from 35.5% and 33.3% at 18 and 22 years old, respectively, to 49.6% at 27 years old. The highest rates were found among cannabis, tobacco, RC and HED users. For females, cannabis and RC constitute signitifant risk factors for use of NPPD. Conversely, for males, tobacco and cannabis were risk factors for such use of medicines. Later onset of alcohol consumption constitutes a protective factor for females. Our results reveal high prevalence of NPDD among university students. Those who consume NPPD are -at the same time- more likely to be alcohol, tobacco, and cannabis users than those who take medication under prescription. Preventive strategies should be reinforced and focused on this target population to decrease these high levels of poly-consumptionFunding for this study was provided by the Plan Nacional sobre Drogas (Spain) (2005/PN014) and the Fondo de Investigación Sanitaria (Spain) (PI15/00165). CC has been funded by the European Union’s Horizon 2020 research and innovation program with the Marie Sklodowska-Curie grant No. 754535S

Analysis of audit domains in freshman students in Spain: three cross-sectional surveys (2005, 2012 and 2016)

Purpose: We aimed to evaluate changes in the frequency of drinking, alcohol dependence and alcohol-related harm in freshman college students from 2005, 2012 and 2016, and identify riskassociated factors. Method: A cross-sectional study involving 5009 freshman students was carried out in Spain in 2005, 2012 and 2016. The Dimensions of Alcohol Use Disorders Identification Test (frequency of drinking, symptoms of dependence and alcohol-related harm) was analysed. Adjusted relative risks (RRs) and their 95% confidence intervals were estimated using negative binomial regression. Results: Place of residence, positive expectancies and early onset of alcohol consumption continue to be crucial conditions for developing patterns of risky consumption, alcohol dependence and harm. Women and men were more vulnerable to alcohol harm and dependence when living away from home, having higher economic status and positive alcohol expectancies. Cohorts from 2012 and 2016 were at lower risk of risky alcohol consumption. Men belonging to the 2012 and 2016 cohorts were at lower risk of alcohol negative consequences compared with the 2005 cohort. However, women remained vulnerable over time to alcohol dependence and harm. Starting drinking after 16 protects them both from alcohol dependence and harm. Conclusions: Women are more vulnerable to alcohol dependence and harm in recent cohorts of freshmen. Limiting access to alcohol at a younger age and working on false positive expectancies could benefit freshmen by avoiding alcohol damage and alcohol dependenceFunding for this study was provided by the AES: Strategic Action in Health (PI20/00131). AES played no further role in this studyS

Alcohol Consumption among Freshman College Students in Spain: Individual and Pooled Analyses of Three Cross-Sectional Surveys (2005, 2012 and 2016)

Objective: We aimed to evaluate changes in the prevalence of Heavy Episodic Drinking (HED) and Risky Consumption (RC) in freshman college students between 2005, 2012 and 2016; and to identify the explanatory variables of these patterns of consumption using individual and pooled analyses. Methods: A cross-sectional study involving 5260 students was carried out in Spain in 2005, 2012 and 2016. HED and RC were determined using the Alcohol Use Disorders Identification Test. Another questionnaire was used to measure parental education level and alcohol use, alcohol-related problems, age of onset of alcohol use and alcohol-related expectancies. Adjusted Odds Ratios (ORs) of RC and HED and their 95% Confidence Intervals were estimated using logistic regression. Results: An increase in the prevalence rates of HED and RC was observed among women during the three-study periods, nonetheless there was no statistically significant difference in the prevalence rates among men. High maternal educational level, living away from parental home, initiating drinking before the age of 15 and having positive expectancies about drinking are associated with higher prevalence of RC in both genders. High positive expectancies and early onset of alcohol use are associated with higher rates of HED among men and women. Students recruited in 2012 and 2016 are protected against RC in comparison to those recruited in 2005. Conclusions: The age of alcohol consumption onset is the most influencing factor on HED and RC for both genders in the three-study periods. Alcohol prevention campaigns targeting youth at early ages can reduce risky drinking behaviorsFunding for this study was provided by the Spanish National Plan on Drugs (PND, SPI/3462/2010). PND played no further rule in this studyS

Alcohol outlet density and alcohol consumption in Galician youth

Objetivo: Valorar la influencia que la densidad de los puntos de venta y los de venta y consumo de alcohol ejercen sobre los patrones de consumo de 1os/las jóvenes preuniversitarios/as de Galicia. Métodos: Se ha llevado a cabo un análisis transversal de la cohorte de estudiantes de la Universidad de Santiago de Compostela (Cohorte Compostela 2016). Se calcularon las prevalencias de consumo para cada uno de los municipios de procedencia de los/1as estudiantes de primer ciclo durante el año anterior a1 ingreso. Se valoró la asociación del consumo de riesgo de alcohol (CRA) y consumo intensivo de alcohol (CIA) con un modelo logístico, considerando como variables independientes la población del municipio, la densidad de locales de venta, la densidad de locales de venta y consumo de alcohol, y la densidad de ambos tipos de locales en el municipio. Resultados: La prevalencia de CRA fue del 60,5% (intervalo de confianza del 95% [IC95%]: 58,4-62,5) y la de CIA de 28,5% (IC95%: 26,7-30,2). Se observó una gran variabilidad según el municipio de procedencia. El modelo logístico multivariante mostró que los municipios con una densidad de 8,42-9,34 de ambos tipos de locales por mil habitantes presentaban mayor riesgo de CRA (odds Rátios [OR]:1.39; lC9S%: 4,09-1,78) y de CIA (OR= 4 ,29; lC95%: 1,01-i ,66). Conclusión: Estos datos sugieren la importancia de incluir la información del entorno al estudiar el consumo de alcohol. Conocer mejor el entorno podría ayudar a plantear políticas que fomenten en la población conductas más saludables.Objective: To assess the influence that alcohol outlet density, off- and on-alcohol premises, and alcohol consumption wield on the consumption patterns of young pre-university students in Galicia (Spain). Method: A cross-sectional analysis of a cohort of students of the University of Santiago de Compostela (Compostela Cohort 2016) was carried out. Consumption prevalence were calculated for each of the municipalities from the first-cycle students’ home residence during the year prior to admission. The association with risky alcohol consumption (RC) and binge-drinking (BD) was assessed with a logistic model considering as independent variables the municipality population, alcohol outlet density of off- premises, density of off- and on- premises and total density of both types of premises in the municipality. Results: The prevalence of RC was 60.5% (95% confidence interval [95%CI]: 58.4-62.5) and the BD was 28.5% (95%CI: 26.7-30.2). A great variability was observed according to the municipality of provenance. The multivariate logistic model showed municipalities with a density of 8.42-9.34 of both types of premises per thousand inhabitants presented a higher risk of RC (odds ratio [OR]: 1,39; 95%CI: 1.09-1.78) and BD (OR: 1.29; 95%CI: 1.01-1.66). Conclusion: These data suggest the importance of including environmental information when studying alcohol consumption. Knowing our environment better could help plan policies that encourage healthier behaviour in the population.Este trabajo ha sido financiado por el Plan Nacional sobre Drogas (2005/PN014) y el Fondo de Investigación Sanitaria (PI15/00165). C. Carbia está becada con el programa FPU (FPU13/04569) del Ministerio de EducaciónS

Presence of Bacterial DNA in Thrombotic Material of Patients with Myocardial Infarction

[Abstract] Infectious agents have been suggested to be involved in etiopathogenesis of Acute Coronary Syndrome (ACS). However, the relationship between bacterial infection and acute myocardial infarction (AMI) has not yet been completely clarified. The objective of this study is to detect bacterial DNA in thrombotic material of patients with ACS with ST-segment elevation (STEMI) treated with Primary Percutaneous Coronary Intervention (PPCI). We studied 109 consecutive patients with STEMI, who underwent thrombus aspiration and arterial peripheral blood sampling. Testing for bacterial DNA was performed by probe-based real-time Polymerase Chain Reaction (PCR). 12 probes and primers were used for the detection of Aggregatibacter actinomycetemcomitans, Chlamydia pneumoniae, viridans group streptococci, Porphyromonas gingivalis, Fusobacterium nucleatum, Tannarella forsythia, Treponema denticola, Helycobacter pylori, Mycoplasma pneumoniae, Staphylococus aureus, Prevotella intermedia and Streptococcus mutans. Thus, DNA of four species of bacteria was detected in 10 of the 109 patients studied. The most frequent species was viridans group streptococci (6 patients, 5.5%), followed by Staphylococus aureus (2 patients, 1.8%). Moreover, a patient had DNA of Porphyromonas gingivalis (0.9%); and another patient had DNA of Prevotella intermedia (0.9%). Bacterial DNA was not detected in peripheral blood of any of our patients. In conclusion, DNA of four species of endodontic and periodontal bacteria was detected in thrombotic material of 10 STEMI patients. Bacterial DNA was not detected in the peripheral blood of patients with bacterial DNA in their thrombotic material. Bacteria could be latently present in plaques and might play a role in plaque instability and thrombus formation leading to ACS