RESUMO
BACKGROUND: Shared etiological pathways of dopamine and serotonin neurotransmission play a central role in heavy alcohol intake and exacerbation in the symptoms of depression.We investigated the treatment efficacy of Quetiapine fumarate extended release (XR) in lowering alcohol intake in alcohol use disorder (AUD) patients indicated by the shared alleviation of depression ratings and patterns of heavy drinking. METHODS: Hundred and eight male and female heavy drinking AUD patients in the age range of 18 to 64 years. participated in a randomized clinical trial (RCT) to receive 12 weeks of quetiapine XR or placebo (N = 115). Participants were sub-grouped by the severity grading of depression using Montgomery-Asberg Depression Rating Scale (MADRS) (clinically relevant ⩾8 [CR], clinically non-relevant ⩽7 [CNR]) at baseline in both the groups. Drinking history and depression ratings were assessed at the patients' visits. RESULTS: Heavy drinking days (HDD) and total drinks (TD) were significantly fewer in CR patients at the treatment end. A true positive response in AUROC analysis supported the lowering of TD in CR patients. The number of drinking days (NDD) and average drinks per drinking day (AvgD) were lower in the CNR patients at treatment-end. Significant associations with increasing effect sizes were observed for all the heavy drinking measures (HDD, TD, NDD, and AvgD) and MADRS scores by the end of the treatment course. CONCLUSIONS: Baseline elevated depressive symptoms could likely predict the course of heavy alcohol drinking during the treatment, and efficacy outcome of a treatment. AUD patients with baseline clinically significant depression had a progressive lowering in heavy drinking markers significantly corresponding to the lowering of depression symptoms by the end of treatment with Quetiapine fumarate XR.ClinicalTrials.gov: NCT#0049862 (https://clinicaltrials.gov/ct2/show/NCT00498628?term=litten&draw=2&rank=3).
RESUMO
Growth of older population in United States (US) raises concerns for evaluation of health indices that could sustain their workability. This study aimed to characterize the association of health practices used by older working population and measures of quality and duration of their work. Forty (40) non-treatment seeking healthy working individuals residing within United States within 22 - 75 years of age were included in this study. Data were collected from the Customized Employee Biographical Questionnaire (EBQ) and Occupational Health Surveillance Questionnaire (OHRQ) by age groups as 22 - 31, 32 - 41, 42 - 51, 52 - 61 and 62+ and statistically analyzed. Length of working (LOW) showed close association with the duration of physical exercise (DPE) at adjusted R2 = 0.295 and type of work (TOW) at adjusted R2 = 0.598; and Education in the 62+ (oldest) age group. However such relationship was not observed in the 52 - 61 years age group even when DPE and Education were not significantly different from the 62+ group. In the 42 - 51 age group, significant correlation of LOW with DPE and TOW was found. Duration of physical activity could be an important factor associated with the duration of work in the oldest group. Type of work could be significant modifier in determining the length of working in older age-groups. Predecessor elderly groups might need to incorporate some of the measures that were significant in the oldest group, to improve their expectations to work longer. Larger studies could identify and capture various other measures that could be important both for the regional and national US perspective.
