Intervención educativa sobre el alcoholismo y sus consecuencias para la salud en adolescentes de preuniversitario

Introducción: El alcoholismo es una enfermedad crónica incurable y la toxicomanía de mayor relevancia mundial. El consumo de alcohol se ha incrementado en la adolescencia, lo que confiere relevancia a la prevención y connota la importancia de exponer el nivel de conocimientos acerca del alcoholismo y sus consecuencias perjudiciales para la salud en adolescentes. Método: intervención educativa en adolescentes del municipio Camagüey, de diciembre de 2021 a mayo de 2022. El universo estuvo conformado por los adolescentes de onceno grado del Instituto preuniversitario Enrique José Varona, Reparto Julio Antonio Mella, perteneciente al área de salud del mismo nombre en el municipio Camagüey. La muestra seleccionada de forma intencional quedó integrada por 22 estudiantes. Se utilizaron métodos teóricos y de los empíricos el APGAR familiar, el cuestionario AUDIT y un cuestionario sobre conocimientos de alcoholismo, aplicado antes y después de la intervención. Resultados: cerca de la mitad de la muestra (45,56 %) percibió algún grado de disfunción familiar y el 90,90 % de los adolescentes había ingerido bebidas alcohólicas antes, aunque se constató bajo riesgo al consumo de alcohol en el 95,45 % de la muestra. Antes de la intervención el 72,73 % de los estudiantes tenía bajo nivel de conocimientos y después de la misma todos se ubicaron en niveles entre alto (68,18 %) y medio (31,82 %). Discusión: las intervenciones educativas grupales de tres sesiones o más, son eficaces en la prevención del consumo de alcohol en adolescentes, con independencia de su contenido; lo que explica que la presente investigación corrobore sus potencialidades en pos de una mejoría importante en el nivel de conocimientos de los adolescentes de preuniversitario acerca del alcoholismo y sus consecuencias perjudiciales para la salud.

Introduction: Alcoholism is an incurable chronic disease and the world-wide drug addiction. Alcohol consumption has been increased in adolescence, which confers relevance to the prevention and connotes the importance of exposing the level of knowledge about alcoholism and its harmful consequences for adolescent health. Method: an educational intervention in adolescents from the Camagüey municipality, from December 2021 to May 2022. The universe was made up of eleventh-grade teenagers from the Enrique José Varona Pre-University Institute, Julio Antonio Mella neighborhood, belonging to the health area of the same name in the Camagüey municipality. The intentionally selected sample was integrated by 22 students. Theoretical methods were used and of the empirical ones, the family APGAR, the AUDIT questionnaire and a questionnaire on knowledge of alcoholism, applied before and after the intervention. Results: about half of the sample (45.56%) perceived some degree of family dysfunction and the 90.90% of adolescents had ingested alcoholic beverages before, although low risk of alcohol consumption was found in 95.45% of the sample. Before the intervention, 72.73% of the students had a low level of knowledge and after it everyone located at levels between high (68.18%) and medium (31.82%). Discussion: group educational interventions of three sessions or more are effective in the prevention of alcohol consumption in adolescents, with independence of its content; which explains that the present research corroborates its potential in pursuit of an important improvement in the level of knowledge of college adolescents about alcoholism and its harmful consequences to health.

Factores predisponentes a enfermedades no transmisibles en un área de salud del municipio de Santiago de Cuba / Predisposing factors to non-communicable diseases in a health area from Santiago de Cuba municipality i: en

Introducción: Hoy en día las enfermedades no transmisibles constituyen un grave problema que afecta el estado de salud de la población, con una tendencia ascendente preocupante. Objetivo: Identificar los factores predisponentes a las enfermedades no transmisibles en pacientes de un área de salud. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 286 individuos, escogidos a través de un muestreo aleatorio bietápico en el área de salud Josué País García del municipio de Santiago de Cuba, durante el 2021. Las variables analizadas fueron antecedentes patológicos personales, consumo de productos del tabaco y alcohol, hábitos dietéticos y evaluación nutricional. Se utilizaron como medidas de resumen las frecuencias absolutas, el porcentaje y la tasa de prevalencia para variables cualitativas; la media aritmética y el mínimo e intervalo de confianza para variables cuantitativas. Resultados: El mayor riesgo de presentar hipertensión arterial figuró en las féminas (35,6 %) y existió alta prevalencia de fumadores en hombres (30,5 %) y mujeres (27,7 %). Asimismo, predominaron la exposición al humo de tabaco (fumadores pasivos) y el consumo de alcohol en edades tempranas (25-34 años). De los encuestados, 33,3 % resultó estar sobrepeso u obeso. Conclusiones: Los factores predisponentes a las enfermedades no transmisibles pudieran estar asociados con estilos de vida no saludables como el consumo de productos del tabaco y el alcohol, los hábitos dietéticos inadecuados y el sobrepeso.

Introduction: Nowadays non-communicable diseases are a serious problem that affects the health of the population, with a worrying upward tendency. Objective: To identify the predisposing factors to non-communicable diseases in patients from a health area. Methods: An observational, descriptive and cross-sectional study of 286 individuals, chosen by a two-stage random sampling in Josué País García health area from Santiago de Cuba municipality, was carried out during 2021. The analyzed variables were personal pathological history, consumption of tobacco and alcohol products, dietary habits and nutritional evaluation. The absolute frequencies, percentage and prevalence rate were used as summary measures for qualitative variables; the arithmetic mean and the minimum and interval of confidence were used for quantitative variables. Results: The highest risk of presenting hypertension was in females (35.6%) and there was a high prevalence of smokers in men (30.5%) and women (27.7%). Also, the exposure to tobacco smoke (passive smokers) and alcohol consumption at an early age (25-34 years) prevailed. Of those interviewed, 33.3% was overweight and obese. Conclusions: The predisposing factors to non-communicable diseases could be associated with the non healthy lifestyle as the consumption of tobacco and alcohol products, inadequate dietary habits and overweight.

Alcohol, su dependencia y estrategias de afrontamiento según la Terapia Cognitiva / Álcool, sua dependência e enfrentamento do estresse segundo a Terapia Cognitiva / Alcohol, its dependence and coping streies according to Cognitive Therapy

El uso de sustancias psicoactivas contribuye a la aparición de diferentes trastornos cuando se asocia con variaciones sociales y la fisiopatología del individuo, como aspectos genéticos, ambientales y neurológicos. Así, surge la necesidad de producir métodos de revisión de la literatura, entre los cuales destacamos la revisión integradora. Las palabras clave "alcohol" Y "estrategias de afrontamiento" Y "terapia cognitiva" fueron cruzadas en las bases de la Biblioteca Virtual en Salud (BVS) y SciELO, resultando en 200 artículos publicados en portugués, inglés y español, de 2018 a 2022. La inclusión los criterios fueron: ser un artículo de investigación completo; publicado en portugués, inglés y español; estar disponible electrónicamente y abordar el tema en estudio. Los resultados indicaron avances en prácticas que involucran la práctica de la TC y que, asociadas a otras técnicas de intervención, modifican el perfil tradicional de atención al paciente. Así, la literatura apunta para una mayor demanda de rehabilitación en la que se inserta la Terapia Cognitivista AU

O uso de substâncias psicoativas contribuem para o aparecimento de diferentes transtornos quando associadas a variações sociais e à fisiopatologia do indivíduo, como aspectos genéticos, ambientais e neurológicos. Desta forma, há necessidade de produção demétodos de revisão de literatura, dentre estes, destacamos a revisão integrativa. Foram cruzados os unitermos "álcool" AND "estratégias de enfrentamento" AND "terapia cognitiva" nas bases da Biblioteca Virtual em Saúde (BVS) e SciELO, resultando em 200 artigos publicados em português, inglês e espanhol, no período de 2018 a 2022. Os critérios de inclusão foram: ser artigo de pesquisa completo; publicado nos idiomas português, inglês e espanhol; estar disponível eletronicamente e abordar o tema em estudo. Os resultados indicaram avanços nas práticas que envolvem a prática da TC e que associadas a outras técnicas de intervenção, modificam o perfil tradicional de atenção aos pacientes. Assim a literatura aponta uma maior demanda de reabilitação na qual a Terapia Cognitivista está inserida AU

The use of psychoactive substances contributes to the appearance of different disorders when associated with social variations and the pathophysiology of the individual, such as genetic, environmental and neurological aspects. Thus, there is a need to produce literature review methods, among which we highlight the integrative review. The keywords "alcohol" AND "coping strategies" AND "cognitive therapy" were crossed in the bases of the Virtual Health Library (VHL) and SciELO, resulting in 200 articles published in Portuguese, English and Spanish, from 2018 to 2022. The inclusion criteria were: being a complete research article; published in Portuguese, English and Spanish; be electronically available and address the topic under study. The results indicated advances in practices that involve the practice of CT and that, associated with other intervention techniques, modify the traditional profile of patient care. Thus, the literature points to a greater demand for rehabilitation in which Cognitivist Therapy is inserted AU

Aceitabilidade e aplicabilidade de um programa de intervenção com usuários dependentes de substâncias / Acceptability and applicability of an intervention programme with substance addicts

Resumo A complexidade dos problemas relacionados com o uso problemático de substâncias requer questionamento regular das práticas. O objetivo deste artigo é explorar a aceitabilidade e a aplicabilidade de um programa de intervenção com pessoas dependentes de substâncias. Estudo qualitativo. Recolha de dados, realizada através de 1 grupo focal com 6 enfermeiros e 6 entrevistas semiestruturadas a usuários em tratamento. Utilizou-se à análise textual lexicográfica. No grupo focal, foram analisados 151 segmentos de texto, retendo 85,8% do total para a criação de cinco classes. A análise de similitude conduziu à formação de dois núcleos centrais, representados pelas palavras: Enfermeiro e Intervenção. Das entrevistas, foram analisados 252 segmentos de texto, retendo 71,83% para a criação de 5 classes. A análise de similitude conduziu à formação de três núcleos centrais, representados pelas palavras: querer, programa e ver. Os enfermeiros reconhecem a necessidade de uma abordagem mais estruturada, centrada nas necessidades das pessoas e flexível. Os usuários, acrescentam a necessidade de ser flexível, sem tempo definido à partida, promovendo trabalho, suporte terapêutico para abstinência e gestão das comorbilidades.

Abstract The complexity of the problems related to the harmful use of substances requires regular questioning of practices. This article aims to explore the acceptability and applicability of an intervention programme for patients with problematic substance use. Qualitative study. Data collection, through a focus group with 6 nurses and 6 semi-structured interviews with patients under treatment. We have used lexicographic textual analysis. From the focus group, 151 text segments were analysed, retaining 85.8% of the total for the creation of five classes. An analysis of similarity led to the formation of two central nuclei, represented by the words "Nursing" and "Intervention". From interviews, 252 text segments were analysed, retaining 71.83% for the creation of 5 classes. An analysis of similarity led to the formation of three central nuclei, represented by the words "want", "programme" and "see". Nurses recognise the need for a more structured and flexible approach focused on people's needs. Users also affirm the need for flexible interventions, without a pre-established time frame, that promote labour integration, therapeutic support for abstinence and management of comorbidities.

Nocardiosis pulmonar y del sistema nervioso central: el alcoholismo como factor de inmunocompromiso / Pulmonary and central nervous system nocardiosis: Alcoholism as an immunocompromising factor

La nocardiosis es una enfermedad de distribución mundial; de forma habitual se encuentra en zonas tropicales y afecta principalmente a pacientes inmunocomprometidos, sin embargo, también existen casos reportados de infección en personas inmunocompetentes. Esta infección es causada por actinomicetos del género Nocardia spp. que son bacterias Gram positivas, saprófitos ambientales. Aunque la exposición a Nocardia spp. es casi universal, solo una pequeña fracción de las personas expuestas desarrollan la enfermedad. Se presenta el caso de un hombre de 47 años, sin dato de inmunosupresión, procedente de un área rural de Boyacá, que consultó por un cuadro clínico de cefalea intensa e intermitente, con parestesias y, finalmente, alteración del estado de conciencia. Se practicó una resonancia magnética cerebral, en la que se evidenció una lesión que ocupaba espacio de localización córtico-subcortical en la región fronto-témporo-parietal izquierda, con efecto compresivo y desplazamiento de las cavidades del sistema ventricular. Se sospechó, inicialmente, una lesión neoplásica o un absceso cerebral. El paciente fue sometido a una resección quirúrgica, y el cultivo de la lesión documentó Nocardia africana/nova; en estudios posteriores, se evidenció un posible foco pulmonar primario. Como único factor de riesgo en el paciente, se documentó alcoholismo. Completó seis semanas de tratamiento antibiótico intrahospitalario con evolución clínica y radiológica, y egresó con plan de un año de terapia antibiótica ambulatoria. Aunque la enfermedad por Nocardia spp. afecta principalmente a pacientes inmunocomprometidos, la "evidencia" clínica demuestra que este microorganismo también puede ser una amenaza para individuos sin los factores de riesgo tradicionales para inmunosupresión.

Nocardiosis is a disease with worldwide distribution. It is usually found in tropical areas and mainly affects immunocompromised patients, however, there are also cases where its infection has been reported in immunocompetent patients. This pathology is caused by bacteria known as Nocardia spp., which are gram-positive microorganisms and environmental saprophytes, and although exposure to Nocardia spp. is almost universal, only a small fraction of exposed people develops the disease. We present the case of a 47-year-old man, with no evidence of immunosuppression, from a rural area of Boyacá, who was admitted due to intense and intermittent headache accompanied by paresthesia and, finally, a decrease in consciousness. A brain magnetic resonance was performed and evidenced a fronto-temporo- occipital space-occupying lesion in the cortico-subcortical region with a compressive effect and displacement of the ventricular system cavities. It was suspected at first a neoplastic lesion or a brain abscess. The lesion was surgically resected, and its culture showed Nocardia africana/nova. In later studies a possible primary pulmonary focus was evidenced. Alcoholism was the only risk factor documented. The patient completed 6 weeks of hospital antibiotic treatment with favorable clinical and radiological evolution and was discharged with a 1-year plan of outpatient antibiotic therapy. Although Nocardia spp. mainly affects immunocompromised patients, evidence shows that this microorganism can also be a threat to individuals without traditional immunosuppression risk factors.

O álcool na atenção primária à saúde: atitude dos profissionais de saúde quanto ao consumo e uso prejudicial de álcool e o alcoolismo / Alcohol in primary health care: attitude of health professionals regarding the consumption and harmful use of alcohol and alcoholism

Resumo Avaliaram-se fatores associados às atitudes de profissionais da Atenção Primária à Saúde (APS) quanto ao consumo e uso prejudicial de álcool e o alcoolismo dos usuários, além de suas percepções sobre possíveis mudanças no consumo de álcool durante a pandemia de covid-19. Trata-se de pesquisa avaliativa feita no interior de São Paulo em 2020. Analisaram-se características sociodemográficas sobre o consumo de álcool e a atitude com os usuários. Dos 94 profissionais do município, 65 participaram, sendo 67,7% deles com experiência no tema. A maioria (80%) não modificou seu consumo durante a pandemia, mas 50,8% deles perceberam aumento no consumo pelos usuários. Identificaram-se atitudes positivas em relação a ser do sexo masculino (p=0,014) e ter cor da pele branca (p=0,020), residir sozinho (p=0,047) e maior consumo pelos profissionais (p=0,037). Atuar na Estratégia Saúde da Família (ESF) associou-se com atitudes mais positivas (p=0,029). Concluiu-se que características pessoais influenciam na atitude, assim como o tipo de serviço. Há muito o que avançar em relação às atitudes dos profissionais de saúde para que ofereçam assistência adequada aos usuários que consomem álcool. Porém, a disseminação de conhecimento específico sobre a doença e a pessoa que faz uso de álcool parece ser uma das principais estratégias de enfrentamento deste importante agravo à saúde.

Abstract Factors associated with the attitudes of Primary Health Care (PHC) professionals regarding the consumption and harmful use of alcohol and the users' alcoholism were evaluated, in addition to their perceptions about possible changes in alcohol consumption during the COVID-19 pandemic. This is an evaluative study conducted in the interior of São Paulo in 2020. Sociodemographic characteristics regarding alcohol consumption and attitude towards users were analyzed. A total of 65 of the 94 professionals in the municipality participated, with 67.7% of them having experience in the subject. Most (80%) did not change their consumption during the pandemic, but 50.8% noticed an increase in consumption by users. Positive attitudes towards being male (p=0.014) and having white skin color (p=0.020), living alone (p=0.047) and higher consumption by professionals (p=0.037) were identified. Acting in the Family Health Strategy (Estratégia Saúde da Família - ESF) was associated with more positive attitudes (p=0.029). In conclusion, personal characteristics influence the attitude, as well as the type of service. There is much to be done regarding the attitudes of health professionals to offer adequate care to users who consume alcohol. However, disseminating specific knowledge about the disease and the alcohol user seems to be one of the main coping strategies for this important health problem.

Internações por transtornos mentais e comportamentais devidos ao uso de álcool no Brasil e regiões: análise de tendência temporal, 2010-2020 / Hospitalizaciones por trastornos mentales y de conducta por consumo de alcohol en Brasil y regiones: análisis de tendencia temporal, 2010-2020 / Hospitalizations for mental and behavioral disorders due to alcohol use in Brazil and regions: a temporal trend analysis, 2010-2020

Objective: to analyze the trend in hospitalization rates for mental and behavioral disorders due to alcohol use (ICD-10: F10.0), Brazil and its five regions, 2010-2020. Methods: this was an ecological time-series study using data from the Hospital Information System of the Brazilian National Health System; to calculate the trend in hospitalizations, we used the Prais-Winsten generalized linear regression model and the Stata Statistical Software 14.0; a decreasing trend was considered when p-value < 0.05, and the regression coefficient was negative. Results: in the period analyzed, there were 423,290 hospitalizations for mental and behavioral disorders due to alcohol use in the country; the data analyzed showed a decreasing trend in adult hospitalization rates for this cause in the country (p-value < 0.001; 95%CI -0.094;-0.079) and in all its regions, for both sexes (p-value < 0.001). Conclusion: hospitalizations for mental and behavioral disorders due to alcohol use have reduced in Brazil and in its macro-regions.

Objetivo: analizar la tendencia de las tasas de hospitalizaciones por trastornos mentales y comportamentales debidos al consumo de alcohol (CID-10 F10.0) en Brasil y sus regiones, entre 2010 y 2020. Métodos: estudio de series temporales ecológicas, con datos extraídos del Sistema de Información Hospitalaria del Sistema Único de Salud. Se utilizó la regresión lineal generalizada de Prais-Winsten para calcular la tendencia de las hospitalizaciones; los análisis se realizaron con el software Stata 14.0. La tendencia se consideró descendente cuando p-valor < 0,05 y coeficiente de regresión negativo. Resultados: 423.290 hospitalizaciones ocurrieron en Brasil en el período. Los datos analizados permitieron observar una tendencia decreciente en las tasas en adultos por esta causa en Brasil (p-valor < 0,001; IC95% -0,094;-0,079) y en todas las regiones para ambos sexos (p-valor< 0,001). Conclusión: hubo una reducción en las hospitalizaciones por trastornos mentales y comportamentales debido al consumo de alcohol en Brasil y regiones.

Objetivo: analisar a tendência das taxas de internações por transtornos mentais e comportamentais devidos ao uso de álcool (CID-10: F10.0), Brasil e suas cinco regiões, 2010-2020. Métodos: estudo ecológico de série temporal, com dados do Sistema de Informações Hospitalares do Sistema Único de Saúde; para o cálculo da tendência de internações, utilizou-se a regressão generalizada linear de Prais-Winsten e o software estatístico Stata 14.0; considerou-se tendência declinante quando p-valor < 0,05, com coeficiente da regressão negativo. Resultados: no período analisado, ocorreram 423.290 internações por transtornos mentais e comportamentais decorrentes do uso do álcool, no país; os dados analisados permitiram observar uma tendência declinante das taxas de internação de adultos por essa causa no país p-valor < 0,001; IC95% -0,094;-0,079) e em todas as suas regiões, para ambos os sexos (p-valor < 0,001). Conclusão: as internações por transtornos mentais e comportamentais devidos ao uso de álcool se reduziram, no Brasil e em suas macrorregiões.

Combined physical training associated with multidisciplinary intervention in the treatment of alcohol use disorder: a study with n of 1 / O treinamento físico combinado associado à intervenção multiprofissional no tratamento do transtorno por uso de álcool: um estudo com n de 1

ABSTRACT Objective: Substance misuse can lead to several consequences for physical and mental health. Physical exercise is an important ally to pharmacological and psychotherapeutic treatment for substance use. However, the literature is still scarce regarding long-term interventions. Thus, this study aims to describe the acceptability and effects of combined physical training intervention (aerobic and strength). Methods: This study comprises an n-of-1 clinical trial that was performed with a 64-year-old male individual with alcohol use disorder. The treatment lasted 12 weeks and evaluated the association of multidisciplinary interventions on quality of life, depressive symptoms, cognitive impairment, and anxiety. Results: The participant improved general quality of life (12.5%), no alterations were found for depressive symptoms, there was an improvement in cognition (20%), as well a reduction in the trait (16.2%) and state (14.7%) anxiety symptoms of the participant. Conclusions: These findings allude to the importance of non-drug therapeutic resources such as structured physical exercise, associated with other offers in the treatment of alcohol use disorder.

RESUMO Objetivo: O uso de substâncias psicoativas pode levar a diversas consequências à saúde física e mental. O exercício físico é um importante aliado ao tratamento farmacológico e psicoterápico para o uso de substâncias. No entanto, a literatura ainda é escassa em relação às intervenções de longa duração. Dessa forma, este estudo objetiva descrever a aceitabilidade e os efeitos de uma intervenção de treinamento físico combinado (aeróbico e força). Métodos: Este estudo compreende um n-of-1 clinical trial que foi realizado com um indivíduo do sexo masculino, de 64 anos de idade, com transtorno por uso de álcool. O tratamento teve a duração de 12 semanas e avaliou a associação de intervenções multiprofissionais sobre a qualidade de vida, sintomas depressivos, comprometimento cognitivo e ansiedade. Resultados: O participante melhorou a qualidade de vida geral (12,5%), não foram encontradas alterações para sintomas depressivos, houve melhora na cognição (20%), bem como redução nos sintomas de ansiedade traço (16,2%) e estado (14,7%) do participante. Conclusões: Esses achados aludem à importância de recursos terapêuticos não medicamentosos como o exercício físico estruturado, associados às demais ofertas no tratamento para o transtorno por uso de álcool.

Aspectos clínico-epidemiológicos de pacientes con tuberculosis, Guantánamo 2013-2018

Introducción: A pesar de los esfuerzos de la ciencia para la eliminación de la tuberculosis, esta es considerada actualmente una enfermedad reemergente. En provincia Guantánamo no se encontraron investigaciones referida a este tema. Objetivo: Describir los aspectos clínico-epidemiológicos de pacientes con tuberculosis en el periodo comprendido de 2013-2018 en la provincia de Guantánamo. Método: Se realizó un estudio descriptivo, transversal retrospectivo de pacientes con tuberculosis. El universo de estudio quedó constituido por 103 pacientes (N꓿103) constatados en la base de datos del programa Centro Provincial de Higiene, Epidemiología y Microbiología Guantánamo. Las variables estudiadas fueron: edad, sexo, grupo de riesgo, municipio al que pertenece y formas clínicas. Se utilizó como medida de resumen la frecuencia absoluta y relativa. Resultados: El mayor número de pacientes con tuberculosis se encontró en el grupo de 40-49 años (28,16 %), se destacó el grupo de 50-59 del sexo masculino con un 15,53 %. El municipio que más casos aportó fue el de Guantánamo con 67 (65,04 %), seguido de Jamaica con 10 casos (9,70 %). De los pacientes diagnosticados: 43 fueron fumadores (50,0 %), 19 alcohólicos (22,10 %) y 11 desnutridos (12,79 %). Se obtuvo como resultado que 72 pacientes (69,90 %) presentaron la forma pulmonar y 31 (30,10 %) presentaron la forma extrapulmonar. Conclusiones: A pesar de una adecuada red de diagnóstico, tratamiento y seguimiento de la tuberculosis en la provincia de Guantánamo, existen condiciones que determinan la ocurrencia de esta: factores socioeconómicos, sanitarios e individuales inadecuados, hacinamiento, desnutrición, alcoholismo, predisponen a la enfermedad.

Introduction: Despite the scientific efforts to eliminate tuberculosis, it is currently considered as a reemerging disease. In Guantánamo province, no research closely related to the subject was found. Objective: To describe the clinical-epidemiologic aspects of patients with tuberculosis in Guantánamo province, period 2013-2018. Method: A descriptive, retrospective cross-sectional study of patients with tuberculosis was carried out. The study involved a total of 103 patients (N꓿103) recorded in a database manages at the Centro Provincial de Higiene, Epidemiología y Microbiología of Guantánamo. The variables studied were as follow: age, sex, risk group, municipality to which patients belong and, clinical forms. The absolute and relative frequencies were used as summary statistics method. Results: The highest number of patients with tuberculosis was found in 40 to 49 years age group (28.16%), and the male sex stood out in the group of age 50 to 59 (15.53%). The municipality with the highest number of cases was Guantánamo with 67 patients (65.04%), followed by Jamaica municipality with 10 patients (9.70%). Forty three of all the patients diagnosed with tuberculosis (50,0%) were addicted to smoking, 19 (22,10%) addicted to alcohol, and 11 (12,79%) in malnutrition state. As a result in the study, it was found in 72 patients (69.90%) presence of pulmonary tuberculosis and extrapulmonary tuberculosis in 31 active patients (30.10%). Conclusions: Despite of an adequate network of diagnosis, treatment and tuberculosis follow-up in the province of Guantánamo, there are several factors that determine the presence of the disease: for instance, the inadequate use of socioeconomic, sanitary and individual factors, including also aspects like overcrowding, malnutrition, and alcoholism.

Introdução: Apesar dos esforços da ciência para eliminar a tuberculose, atualmente é considerada uma doença reemergente. Na província de Guantánamo, não foram encontradas investigações relacionadas a este tema. Objetivo: Descrever os aspectos clínico-epidemiológicos de pacientes com tuberculose no período de 2013-2018 na província de Guantánamo. Método: Estudo descritivo, retrospectivo e transversal de pacientes com tuberculose. O universo do estudo foi composto por 103 pacientes (nº 103) encontrados no banco de dados do programa Centro Provincial de Higiene, Epidemiologia e Microbiologia de Guantánamo. As variáveis estudadas foram: idade, sexo, grupo de risco, município a que pertence e formas clínicas. Frequência absoluta e relativa foram usadas como medida sumária. Resultados: O maior número de doentes com tuberculose foi encontrado na faixa etária de 40 a 49 anos (28,16%), destacando-se a faixa de 50 a 59 anos do sexo masculino com 15,53%. O município que mais contribuiu com casos foi Guantánamo com 67 (65,04%), seguido de Jamaica com 10 casos (9,70%). Dos pacientes diagnosticados: 43 eram tabagistas (50,0%), 19 etilistas (22,10%) e 11 desnutridos (12,79%). Obteve-se como resultado que 72 pacientes (69,90%) apresentavam a forma pulmonar e 31 (30,10%) apresentavam a forma extrapulmonar. Conclusões: Apesar de uma rede adequada para o diagnóstico, tratamento e monitoramento da tuberculose na província de Guantánamo, existem condições que determinam sua ocorrência: fatores socioeconômicos, de saúde e individuais inadequados, superlotação, desnutrição, alcoolismo, predispõem à doença.

Analysis of 73 emergency visits in a university hospital in Beijing / 中国学校卫生

Objective@#To understand the current situation regarding emergency visits to a university hospital in Beijing, and to provide a basis for the standardized construction and formulation of emergency visit measures to university hospitals.@*Methods@#This study carried out a retrospective investigation and analysis of 73 emergency visits from September 2020 to December 2022 at a university hospital in Beijing.@*Results@#A total of 17 cases(23.3%) exhibited the most common of symptoms associated with convulsions during emergency visits to university hospital, while nine cases of abdominal pain(12.3%) and eight cases of dizziness( 11.0 %) were recorded. The proportion of males and females who presented to the emergency department was 60.3% and 39.7%, respectively. The top three diseases among emergency department outpatients included nervous system diseases(40 cases), gynecological diseases(seven cases), depression and alcoholism(six cases). The peak number of emergency visits occurred in April, May, September and November. The most frequent emergency visits presented from 13:00 to 18:00(32.9%), followed by 7:00 to 12:00(30.1%). Following emergency care, 12 cases improved, 54 cases were transferred to higher level hospitals for treatment, 2 depressive patients were taken home, 5 cases refused referral.@*Conclusion@#University hospitals should develop emergency plans for diseases related to emergency visits, provide targeted training for doctors and health education for teachers and students, and improve the emergency treatment capabilities.

Criminological Characteristics and Criminal Responsibility Capacity of Offenders with Alcoholism / 中山大学学报(医学科学版)

ObjectiveTo analyze the criminal behavior characteristics of alcohol-related crime offenders and explore the relationship between criminal behavior characteristics and criminal responsibility capacity. MethodsBasic information， alcohol use information， psychiatric symptoms before and after the crime， criminological behavioral characteristics and conclusion of judicial evaluation were collected. ResultsThe drinking history of the chronic alcoholism group 25.0 （13.3~30.0） years was significantly longer than that of the acute alcoholism group 1.2 （0~14.3） years. In the chronic alcoholism group， 85.0% drank alcohol at least once a day， 52.5% had morning or bedtime drinking habits， and 92.5% drank mainly alone. Violent crimes accounted for 57.6%. Delirium existed in 52.5% of the chronic alcoholics' mental state at the time of the crime， and 84.6% of the acute alcoholics' mental state was hazy. In the chronic alcoholism group， 42.5% committed the crime with pathological motive， and in the acute alcoholism group， 69.2% committed the crime with realistic motive. Acute alcoholism group 96.2% were assessed as complete criminal responsibility capacity， and chronic alcoholism group 50.0% were assessed as complete criminal responsibility capacity. ConclusionCompared with acute alcoholism offenders， chronic alcoholics had a longer drinking duration， more frequency drinking， and obvious morning drinking or bedtime drinking habits. The nature of alcoholism crime cases was mostly violent. Compared with the chronic alcoholism group， the acute alcoholism group had highly selective motives for committing crimes and were mostly rated as complete criminally responsibility.

Asociación de los factores del estilo de vida con la sarcopenia: Revisión sistemática / Association of lifestyle factors with sarcopenia: Systematic Review

Resumen Objetivo: Identificar la asociación entre los factores de nutrición, actividad física, consumo de alcohol, tabaco y sueño con la sarcopenia en personas mayores. Materiales y métodos: Se realizó una búsqueda de la evidencia disponible en las bases de datos Dialnet, Science Direct, Scielo, and PubMed. Para las estrategias de búsqueda, se consideraron los términos en español e inglés, acorde a los Descriptores en Ciencias de la Salud y los Medical Subject Headings. Se emplearon los operadores booleanos "AND" y "OR". Un total de 21 estudios fueron analizados y sintetizados. Resultados: Se identificó que el consumo de nueces, frutas y omega tres puede asociarse con una menor probabilidad para desarrollar sarcopenia. El mantenerse activo sugiere una menor probabilidad para que se presente sarcopenia, en contraste las personas mayores sedentarias tienen mayores riesgos. El consumo de alcohol es un factor que se asocia con mayor probabilidad para generar sarcopenia en mujeres. En la mayoría de los estudios, el consumo de tabaco no muestra asociación significativa con la sarcopenia. En cuanto al sueño, se reporta que dormir menos de 6 horas o más de 8 horas puede incrementar la probabilidad de presentar sarcopenia en mujeres. Conclusiones: Es ideal considerar la identificación oportuna de estos factores de riesgo que están presentes en el estilo de vida, y que son susceptibles a ser modificados durante las etapas previas a la tercera edad.

Abstract Objective: To identify the association between the factors of nutrition, physical activity, alcohol consumption, tobacco and sleep with sarcopenia in older people. Materials and methods: A search of the available evidence was carried out in the Dialnet, Science Direct, Scielo, and PubMed databases. For the search strategies, the terms in Spanish and English were considered, according to the Descriptors in Health Sciences and the Medical Subject Headings. The Boolean operators "AND" and "OR" were used. A total of 21 studies were analyzed and synthesized. Results: It was identified that the consumption of nuts, fruits and omega three may be associated with a lower probability of developing sarcopenia. Staying active suggests a lower probability of sarcopenia, in contrast, sedentary older people have higher risks. Alcohol consumption is a factor that is associated with a higher probability of generating sarcopenia in women. In most studies, tobacco use shows no significant association with sarcopenia. Regarding sleep, it is reported that sleeping less than 6 hours or more tan 8 hours can increase the probability of presenting sarcopenia in women. Conclusions: It is ideal to consider the timely identification of these risk factors that are present in the lifestyle, and that are likely to be modified during the stages prior to old age.

El desafío de la neuropatía óptica epidémica cubana / The challenge of the Cuban epidemic optic neuropathy

A partir del trienio 1989-1991 la economía cubana comenzó a debilitarse por la caída de los precios del azúcar y el petróleo, así como por el descenso de la cotización del dólar americano y la desintegración de la Unión Soviética, que trajo aparejada la carencia de divisas convertibles, combustibles, alimentos, y además imposibilitó la solicitud de créditos a instituciones financieras internacionales. Se inició, así, el llamado «período especial¼, fundamentado en un plan para enfrentar un posible bloqueo militar en tiempos de paz, y durante el cual fueron racionalizados estrictamente los alimentos y disminuyeron las industrias esenciales y el transporte. En tales circunstancias apareció una rara enfermedad que se convirtió en epidemia, la cual fue nombrada neuropatía óptica epidémica cubana; esta afectó a más de 50 000 cubanos y se convirtió en un verdadero desafío para la comunidad médica del país. Al respecto, en el presente artículo se analizan sucesos históricos relacionados con el surgimiento de dicha oftalmopatía, se defiende la teoría de su causa tóxico-nutricional debido a la situación de Cuba en aquel momento y se destaca el liderazgo del Comandante en Jefe Fidel en la conducción de las acciones multidisciplinarias que llevaron a controlar dicha epidemia, lo que resultó un logro para el Sistema Nacional de Salud y un triunfo de la Revolución cubana.

Since the triennium 1989-1991 the Cuban economy began to weaken due to the fall of sugar and petroleum prices, as well as due to the descent in the rate of the American dollar and due to the disintegration of the Soviet Union that brought the lack of convertible foreign currencies, fuels, foods, and disabled the application of credits to international financial institutions. This way, began the so call "special period", based in a plan to face a possible military blockade in times of peace, and during which foods were strictly rationalized and the essential industries and transport diminished. In such circumstances a strange disease appeared that became epidemic, which was named Cuban epidemic optic neuropathy; it affected more than 50 000 Cubans and became a true challenge for the medical community of the country. In this respect, historical events related to the emergence of this ophtalmopathy are analyzed in this work, that defends the theory of its toxic-nutritional cause due to the situation of Cuba in that moment and the leadership of Commander in Chief Fidel is outstanding in the conduction of the multidisciplinary actions that lead to control this epidemic, what became an achievement for the Health National System and a victory of the Cuban Revolution.

Prevalência do Uso de Álcool, Tabaco e Hipnóticos/Sedativos por Idosos Atendidos em Estratégias de Saúde da Família / Prevalence of Alcohol, Tobacco and Hypnotic/Sedative use by the Elderly in Family Health Strategies

Introdução: A população idosa está crescendo cada vez mais, e esse aumento da longevidade traz consigo a percepção sobre os prejuízos no acúmulo de carga tabágica e alcoólica. O idoso acumula também comorbidades que requerem medicações prescritas. Destaca-se o uso de hipnóticos/sedativos nesta população. Métodos: Estudo observacional com delineamento transversal prospectivo em indivíduos com 60 anos ou mais atendidos em três unidades de Estratégias de Saúde da Família. Resultados: Foram avaliados 350 idosos sendo a maioria da amostra composta por mulheres (61,1%), com a mediana de idade de 69,0, maioria era de casadas (53,7%), ensino fundamental incompleto (57,1%), aposentadas (68%) e com renda menor que 3 salários mínimos (56%). Dos entrevistados, 21,4% apresentavam transtorno depressivo maior, 16,9% transtorno de ansiedade generalizada e 48,0% insônia. 38,6% dos idosos, faziam uso de hipnóticos/sedativos, com prevalência de benzodiazepínicos (28%), 34% das pessoas fizeram uso de bebidas alcoólicas e 14,3%, de cigarros. Conclusão: Foi possível concluir que a população com maior prevalência sobre o uso de álcool, tabaco e hipnóticos/sedativos foi de mulheres, casadas, aposentadas, de baixa renda e baixa escolaridade. Tanto no álcool quanto no tabaco, o homem necessita mais de intervenção. Quando são analisadas ambas as substâncias, percebe-se que 54% dos que fumaram nos últimos 3 meses também ingeriram bebidas alcoólicas. Existe uma relação íntima entre as comorbidades estudadas e o uso de hipnóticos/sedativos, visto que estes são utilizados na maioria dos tratamentos dessas doenças. Tal relação já não foi possível ser feita com álcool e tabaco.

Introduction: The elderly population is growing progressively, and this increase in longevity brings with it the perception of the damages of accumulating a tobacco and alcohol load. The elderly also develop comorbidities that require prescribed medications. The use of hypnotics/sedatives in this population stands out. Method: observational study with prospective cross-sectional design in individuals aged 60 years or older seen at three Family Health Strategy units. Results: After evaluating 350 elderly, most of the sample was composed of women (61.1%), with a median age of 69.0, most were married (53.7%), had incomplete elementary school education (57.1%), were retired (68%) and had an income of less than three minimum wages (56%). Of the interviewed, 21.4% had major depressive disorder, 16.9% had generalized anxiety disorder, and 48.0% had insomnia. Also, 38.6% of the elderly used hypnotics/sedatives, with a prevalence of benzodiazepines (28%), 34% used alcoholic beverages, and 14.3% used cigarettes. Conclusion: It was possible to conclude that the population with the highest prevalence of the use of alcohol, tobacco, and hypnotics/sedatives were women, married, retired, with low income and low education. Both in alcohol and tobacco, men need more intervention. After analyzing both substances, it was clear that 54% of those who smoked in the last three months also drank alcoholic beverages. There is an intimate relationship between the comorbidities studied and the use of hypnotics/sedatives. Since these are predominant treatments for these diseases, such a relationship could not be made with alcohol and tobacco.

Childhood trauma subtypes may influence the pattern of substance use and preferential substance in men with alcohol and/or crack-cocaine addiction

Objective: To compare the prevalence and subtypes of childhood maltreatment (CM) between individuals with and without substance use disorder (SUD) and investigate the influence of different traumas on the preferential use of substances and the severity of dependence. Methods: The sample consisted of 1,040 men with SUD (alcohol users [n=315], crack-cocaine users [n=406], multiple-substance users [n=319]) and 201 controls. The Childhood Trauma Questionnaire (CTQ) and the Addiction Severity Index-6 (ASI-6) were used to assess CM and drug-use patterns. Results: Individuals with SUD had a higher prevalence of CM than controls (63.4 vs. 28.1%, respectively). Exposure to physical trauma was associated with alcohol use disorder and severity of alcohol use. In contrast, emotional trauma was associated with use of multiple substances and severity of drug use in crack-cocaine users. Conclusions: This study corroborates the association of CM with SUD susceptibility. Our results suggest that the type of CM may influence preferential substance use and addiction severity. In this sense, physical traumas are more associated with alcohol use, while emotional and sexual traumas favor use of multiple drugs, especially crack cocaine. These findings may help the development of tailored prevention and intervention strategies.

Liver cancer in Hidalgo State, Mexico: analysis of the status, risk factors and regional public health policy requirements: a cross-sectional correlational study

ABSTRACT BACKGROUND: In Latin America, liver cancer is one of the top causes of cancer mortality. It is the fifth most common cause of death among malignant tumors in Mexico and is the leading cause in Hidalgo State (43.8% of the population living in poverty). OBJECTIVE: To conduct a correlational analysis on the main risk factors for liver cancer in Hidalgo State, Mexico, including municipal disaggregation and comparison with the national level. DESIGN AND SETTING: Cross-sectional, correlational, descriptive and comparative epidemiological study using Mexican governmental databases covering 1990-2019. METHODS: A comprehensive review of the databases of the General Directorate of Health Information (DGIS) was performed to analyze official death figures, hospital discharges and national and municipal population projections, using specific search criteria defined in the Global Burden of Disease classification, based on the risk factors for liver cancer. RESULTS: Liver cancer rates showed an evident rise in Hidalgo (183%), moving from 21st place in Mexico in 1990 to 9th place in 2019. This increase was correlated with alcoholism. An increasing trend for liver cancer deaths, of 133.89%, is projected for 2030. Females and the population over 60 years of age are more affected. There are some critical regions with liver cancer death rates twice the national rate or more. CONCLUSION: Targeted effective public health strategies should be structured by identifying, characterizing and regionalizing critical marginalized municipalities that are vulnerable to alcoholism and other risk factors for liver cancer. This approach may be helpful for other states in Mexico or similar countries.

Comparative study of prevalence of hypothyroidism in cirrhotic patients and normal individuals

Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis due to hepatitis. The risk of death due to all cause is increased 12-fold with cirrhosis. Alcoholic liver cirrhosis develops between 10-20% of individuals who drink heavily for a decade or more. Chronic hepatitis B is probably the most common cause of cirrhosis worldwide. The aim and objective of thisstudy was tocompare the prevalence of hypothyroidism between cirrhotic patients andnormal healthy individuals.Methods: The present study constitutes of 50 patients with cirrhosis of liver who met our inclusion criteria. They were selected from the patients admitted in medical wards and gastroenterology ward of RNT medical college, Udaipur.Results: Majority of patients were of serum albumin level class III about 67%. Increased TSH level as compare to level of serum albumin in cirrhotic patients. When serum albumin level decreases then percent of TSH level increases. Majority of patientswere from serum bilirubin class III (71%). Majority were from serum bilirubin class III about 70%. Conclusions: All cirrhotic patients should undergo for evaluation of endocrinological evaluation as these patients are associated with development of hypothyroidism. After diagnosis the treatment of endocrinological disorder especially hypothyroidism may increase survival.

A comparative study of skeletal muscle fatigue in alcoholic and non-alcoholic sedentary human beings

Background: Physical fatigue, or muscle fatigue, is the temporary physical inadequacy of a muscle to perform adequately and to sustain an intended power generation, occurred from the contraction of muscle against a load with a decrease in both force and speed of shortening. Growing at unprecedented rate, chronic alcoholism is hampering health and well-being of the individuals at small and social and economic loss at large. Even though its effects are seen on every system of the human body, only few studies were done in relation to its effects on skeletal muscles. Aim and Objectives: To find and compare the duration of onset of fatigue and work done in isotonically contracting skeletal muscle in alcoholic and nonalcoholic sedentary healthy subjects. Materials and Methods: A sample size of 100, age and sex-matched sedentary individuals are recruited for the study and are categorized into Group 1 (50 alcoholics) and the Group 2 (non-alcoholic). Duration of the fatigue and work done in isotonically contracting muscle was estimated by Mosso’s ergography and compared using student’s t test. Windostat version 9.2 software was used for all statistical analysis. Throughout the study, the statistical significance was set at P ? 0.05 using two-sided tests for all analysis. Results: The duration of fatigue was significantly lower in alcoholics than non-alcoholics (P ? 0.05). The mean duration of fatigue was 2.980 min in alcoholics and 4.210 min in non-alcoholics. The work done was significantly lower in alcoholics than non-alcoholics (P ? 0.05). The mean work done was 4.363 kgm in alcoholics and 5.913 kgm in non-alcoholics. Conclusion: The work done was significantly lower in alcoholics than non-alcoholics (P ? 0.05). Hence, chronic alcoholism causes early onset of fatigue in the skeletal muscles and also decreases the amount of work done.

Lifestyle Behaviour and Obstructive Sleep Apnea (OSA): An Association Study Among Young Adults

Introduction: Lifestyle changes like low physical activity, smoking and consumption of alcohol have been reported to have an impact on Obstructive Sleep Apnea. Smoking was found to be associated with nocturnal hypoxemia and disturbed sleep. Apneic episodes are increased after alcohol consumption. Objectives: To determine the risk of developing Obstructive Sleep Apnea among young adults.Material and Methods: Participants were asked to fill in an online generated questionnaire on lifestyle habits in addition to the modified Berlin questionnaire and Epworth questionnaire. A total of 209 study participants were included in the study. A Chi-square test was applied.Results: Among 209 participants, 47(22.5%) were females and 162 (77.5%) were males. Snoring was reported in 90 (43.1%) of study participants. Around thirty-three, percent of participants were at higher risk of developing Obstructive Sleep Apnea and Obstructive Sleep Apnea was predicted in 21.5%. No as-sociation was found between the lifestyle behavioural factors and Obstructive Sleep Apnea.Conclusion: Though a significant association was not found between selected lifestyle factors and Ob-structive Sleep Apnea risk, the role of lifestyle factors could not be undermined. A healthy lifestyle helps in preventing the occurrence of Obstructive Sleep Apnea.

Dental and Periodontal Conditions in Alcoholics from a Brazilian Recovery Centera

ABSTRACT: The aim of this study was to evaluate the dental and periodontal condition of alcohol-dependents from a Brazilian Recovery Center. Sixty male individuals (30 alcoholic and 30 non-alcoholic) and aged between 32 and 72 years old were clinically evaluated. Interviews, dental and periodontal clinical examinations were obtained from all participants. The Pearson Chi-Square Test and Exact Fisher test were used to compare categorical data. The t-Student's test was adopted for non-categorical data. Multiple logistic regressions were used to evaluate the association of variables in the groups. The alcoholics were younger, consumed more tobacco, had lower frequency of tooth brushing and dental flossing, higher number of missing and decayed teeth, more residual root, and more teeth with presence of visible plaque index (OR = 0.5, 95 % Cl = 4.4 to 5.5), when compared to the non-alcoholics. Alcoholics at the Recovery Center performed poor oral hygiene, had higher number of sites with periodontal disease, and worse oral hygiene than non-alcoholic individuals. As regards professional follow-up, there was similarity between the groups evaluated.

RESUMEN: El objetivo de este estudio fue evaluar las condiciones dentales y periodontales de los alcohólicos de un Centro de Recuperación de Brasil. Sesenta hombres (30 alcohólicos y 30 no alcohólicos) y con edades comprendidas entre 32 y 72 años fueron evaluados clínicamente. Se obtuvieron entrevistas, exámenes clínicos dentales y periodontales de todos los participantes. La prueba de Chi-cuadrado de Pearson y la prueba exacta de Fisher se utilizaron para comparar datos categóricos. La prueba de t-Student se adoptó para datos no categóricos. Se utilizaron regresiones logísticas múltiples para evaluar la asociación de variables en los grupos. Los alcohólicos eran más jóvenes, consumían más tabaco, tenían menor frecuencia de cepillado dental y uso de hilo dental, mayor número de dientes perdidos y cariados, más raíz residual y más dientes con presencia de índice de placa visible (OR = 0,5, 95 % Cl = 4,4 a 5,5), en comparación con los no alcohólicos. Los alcohólicos en el Centro de Recuperación realizan una mala higiene bucal, tenían un mayor número de sitios con enfermedad periodontal y una peor higiene bucal que los no alcohólicos. En cuanto al seguimiento profesional, hubo similitud entre los grupos evaluados.