Brain disease or biopsychosocial model in addiction? Remembering the Vietnam veteran study / ¿Modelo de enfermedad cerebral o biopsicosocial en adicciones? Recordando el Estudio de Veteranos de Vietnam

BACKGROUND: In recent years, we have repeatedly been told that addictions are a brain disease, leaving aside their classic biopsychosocial explanation. OBJECTIVE: To describe both models and discusses the weakness and reductionism of the brain disease model following the consumption of heroin by North American soldiers in the Vietnam war in the 1970s. METHOD: A literature review of the Vietnam Veteran Study in relation to drug consumption. RESULTS: The soldiers greatly increased their consumption of heroin in Vietnam, but almost all of them ceased using it upon returning home. The analysis of the environmental factors related to this self-healing is a critique of the brain disease model of addictions because it cannot explain this or other studies. CONCLUSION: The biopsychosocial model is still the best model to guide the field of addiction due to its utility, coherence, and efficacy in treatment

ANTECEDENTES: en los últimos años se escucha cada vez más la afirmación de que las adicciones son una enfermedad cerebral, dejando a un lado la clásica explicación biopsico-social en adicciones. OBJETIVO: describir ambos modelos y analizar la debilidad y reduccionismo del modelo de enfermedad cerebral siguiendo el Vietnan Veteram Study, sobre el consumo de heroína, en los soldados norteamericanos que participaron en la guerra del Vietnam. MÉTODO: revisión de la literatura del Vietnam Veteran Study en relación al consumo de drogas. RESULTADOS: los soldados incrementaron de modo importante el consumo de heroína en Vietnam, pero casi todos dejaron de consumirla a su vuelta a casa. Analizando los factores ambientales relacionados con esta auto-cura se hace una crítica del modelo de enfermedad cerebral en adicciones ya que el mismo no puede explicar este ni otros estudios. CONCLUSIÓN: el modelo biopsicosocial sigue siendo el mejor modelo para el campo de las adicciones debido a su utilidad, coherencia y eficacia en su tratamiento

Propuesta para la mejora de la condición física en militares veteranos / Proposal to improve the physical condition of the veteran military

Existen evidencias científicas fundadas de que el entrenamiento Interválico concurrente de alta intensidad mejora en gran medida la condición física de deportistas de todas las edades; además, bien dirigido permite reducir el riesgo de lesiones asociadas a la vejez. Material y método: Se realizó un estudio preexperimental con tratamiento de un grupo, formado por 7 Oficiales en la reserva del Ejército de Tierra (59,57 ± 2,07 años de edad, índice de masa corporal de 26,76 ± 2,84 kg/cm2) y deportistas habituales (4,14 ± 1,35 sesiones de entrenamiento a la semana). Durante 8 semanas, sustituyeron dos de sus días de entrenamiento habitual por dos días en los que se realizaban tareas de entrenamiento concurrente de alta intensidad, con una intensidad media (medida según la escala del esfuerzo percibido de 10 puntos de Borg) de 8,29 ± 0,74 puntos y una duración media de ejecución de 20,80 ± 5,77 minutos. Resultados: Se observaron mejoras estadísticamente significativas (p < 0,05) en las siguientes cualidades evaluadas mediante test validados de la condición física: agilidad en dos sentidos de giro distintos (derecho 3,81 ± 0,19 a 3,61 ± 0,21 segundos e izquierdo 3,90 ± 0,17 a 3,68 ± 0,18 segundos), potencia de tren inferior (salto horizontal, de 1,61 ± 0,09 a 1,72 ± 0,09 cm), resistencia muscular de tronco (flexo rotación en 90», de 39,14 ± 6,74 a 55,43 ± 10,94 repeticiones) y de tren superior (tracción, de 18,71 ± 7,52 a 26,29 ± 9,91 repeticiones y empuje, de 21,29 ± 4,82 a 29,71 ± 6,85 repeticiones) y resistencia cardiovascular (frecuencia de recuperación, de 96,57 ± 9,81 a 90,86 ± 8,69 pulsaciones min-1). Respecto a la cualidad flexibilidad, pese a que hubo variaciones positivas en los resultados, no fueron estadísticamente significativas. Conclusiones: La introducción de al menos dos rutinas semanales basadas en el entrenamiento concurrente de alta intensidad es positiva para militares veteranos, mejorando la mayoría de las cualidades físicas, especialmente, las manifestaciones de la fuerza (AU)

There is strong scientific evidence that concurrent high-intensity interval training improves the physical condition of athletes of all ages; in addition, if well-managed, it reduces the risk of injuries associated with old age. Material and method: A pre-experimental study was carried out with a treatment of a group consisting of 7 Officers in the reserve of the Army (59,57 ± 2,07 years old, body mass index of 26,76 ± 2,84 kg / cm2) and usual athletes (4,14 ± 1,35 training sessions per week). For 8 weeks, they replaced two of their usual training days for two days in which high-intensity concurrent training tasks were performed, with an average intensity (measured by Borg’s 10-point perceived effort scale) of 8,29 ± 0,74 points and an average execution time of 20,80 ± 5,77 minutes. Results: Statistically significant improvements (p < 0,05) were observed in the following qualities assessed by validated physical fitness tests: agility in two different directions of rotation (right, 3,81 ± 0,19 to 3,61 ± 0,21 seconds and left, 3,90 ± 0,17 to 3,68 ± 0,18 seconds); lower limb power (standing long jump, 1,61 ± 0,09 to 1,72 ± 0,09 cm); muscular strength of trunk (flexo rotation in 90”, 39,14 ± 6,74 to 55,43 ± 10,94 reps) and upper limb (pull 18,71 ± 7,52 to 26,29 ± 9,91 reps and push, 21,29 ± 4,82 to 29,71 ± 6,85 reps) and cardiovascular resistance (recovery frequency, 96,57 ± 9,81 to 90,86 ± 8,69 pulsations min-1). Regarding the flexibility quality, although there were positive variations in the results, they were not statistically significant. Conclusions: The introduction of at least two weekly routines based on concurrent high intensity training is positive for senior military personnel, improving most of the physical qualities, especially strength manifestations (AU)

Effects of the addition of acarbose to insulin and non-insulin regimens in veterans with type 2 diabetes mellitus

Objectives: The primary objective of the study was to assess the mean change in hemoglobin A1c (HbA1c) when acarbose was added to insulin and non-insulin regimens in patients with type 2 diabetes mellitus (T2DM). Secondary objectives were to evaluate the discontinuation rate of acarbose, and to assess the number of patients who were placed on insulin despite the addition of acarbose. Methods: A retrospective chart review was conducted on veterans with T2DM initiated on acarbose between October 1, 2013 and December 31, 2013. To be included, patients must have had a refill history indicating at least 3 months of acarbose use and HbA1c readings within 6 months prior to initiation and after at least 3 months of use. Excluded patients were those with type 1 diabetes mellitus, serum creatinine ≥2 mg/dL at acarbose initiation, or a diagnosis based on ICD-9 codes for an existing gastrointestinal condition or liver cirrhosis. The two-tailed, paired t-test was used for analysis of the primary objective and descriptive statistics were used for all other outcomes. Results: Of the 146 patients screened, 102 patients were included in the study. Exclusions were primarily due to patients not being on acarbose for at least 3 months (n=43). The average HbA1c before and after acarbose initiation was 9.08% (SD=1.74) and 8.43% (SD=1.74) respectively, with an average HbA1c reduction of 0.65% (n=102, p=0.0005). Forty patients (39.2%) discontinued acarbose after at least 3 months of use. Of the 73 patients not on insulin at the time of acarbose initiation, 19 (26%) were started on insulin therapy despite addition of acarbose. Conclusion: Acarbose can be considered in patients who may reach their HbA1c goal with minimal HbA1c reduction. However, adverse effects are a limitation to use. Potential risks and benefits should be assessed and discussed with the patient prior to prescribing acarbose (AU)

No disponible