Pharmacological Treatment of Alcohol Cravings.

(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.

Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORT-prospective, randomised controlled clinical trial.

AIMS: To test the hypothesis of a semi-supervised home physical exercise programme that is likely to improve the functional mobility and quality of life (QOL) of elderly in the community. METHODS: This trial included elderly adults (88% female) aged 60 years or older and who were sedentary and without cognitive decline. The participants were randomly assigned to an intervention group (IG, home physical exercise and sleep hygiene) and a control group (CG, sleep hygiene). The International Questionnaire on Physical Activity, mental state mini-exam, World Health Organization Quality of Life Instrument-Older Adults Module (WHOQOL-OLD) and the Timed Up and Go (TUG) tests were conducted before and after the 12-week intervention period. RESULTS: The study was concluded with 125 elderly participants. Anthropometric data were indicative of pre-obesity, with a mean body mass index of 27.3 ± 4, a low-income socio-economic profile (78% ≤ 2 SM) and low schooling rates (76% ≤ 3 years of study). Most of the elderly (87%) were considered physically active with IPAQ > 150 min/week. The group of elderly people who performed the home physical exercise programme showed a significant improvement in functional mobility according to the time of execution of the TUG test before (9.1 ± 2) and after (7.1 ± 1) with an average reduction of 2 ± 1 s (P < .01). The difference in the QOL of the elderly who participated in the exercise protocol was also observed, verified through the WHOQOL-OLD global score, which presented an initial score of 85 ± 10, changing to 90.4 ± 9 after the intervention. CONCLUSION: Semi-supervised physical home exercise is safe and effective in improving the functional mobility and QOL of sedentary elderly people in the community.

Systemic Inflammation in Severe Obese Patients Undergoing Surgery for Obesity and Weight-Related Diseases.

BACKGROUND: Obesity is a worldwide disease related to genetic, environmental, and behavioral factors, and it is associated with high rates of morbidity and mortality. Recently, obesity has been characterized by a low-grade inflammatory state known as inflammome indicated by chronic increases in circulating concentrations of inflammatory markers. The purpose of this study was to evaluate the effect of weight loss induced by surgery for obesity and weight-related diseases on pro-inflammatory cytokine (TNF-α) and anti-inflammatory adipokine (adiponectin) levels, and on an adipose-derived hormone (leptin) in severely obese subjects. METHODS: This randomized, controlled trial involved 55 severe obese patients (50 women, age 18-63 years, and body mass index of 35.7-63 kg/m2) who underwent bariatric surgery (BS). Patients with a BMI > 65 kg/m2 and clinical and mental instability, or significant and unrealistic expectations of surgery were excluded. Blood samples were collected during the fasting period to analyze tumor necrosis factor alpha (TNF-α), adiponectin, and leptin levels by enzyme-linked immunosorbent assay. RESULTS: At baseline, no significant difference was observed in the anthropometric, demographic, clinical characteristics and biochemistry and inflammatory markers between the control group (CG) and bariatric surgery group (BSG). The same finding was also observed when we compared the baseline variables to those at the 6-month follow-up in the CG. However, the same variables in the BSG group were significantly different between baseline and the 6-month follow-up after BS. CONCLUSIONS: Weight loss induced by surgery for obesity and weight-related diseases reduced the inflammome state in severely obese patients.

High prevalence of type 2 diabetes mellitus in Xavante Indians from Mato Grosso, Brazil.

OBJECTIVE: To estimate the prevalence of diabetes, hypertension, obesity, and describe demographic, anthropometric and medical characteristics, in a genetically distinct population: the Brazilian Xavante Indians. DESIGN: Population-based survey carried out among 948 Xavante from Mato Grosso, Brazil. Fasting and 2-hour after 75 g glucose capillary glycemia were measured by a portable glucometer (HemoCue Glucose201+). Diabetes was defined according to WHO criteria. Anthropometric data and medical characteristics were measured, and fat mass (%) was evaluated using bioelectrical impedance. Blood pressure was measured by an automated device (OMRON 742INTC), and hypertension was defined according to WHO criteria. RESULTS: Age-adjusted prevalence rates with 95% confidence intervals were diabetes: 28.2% (25.3-31.1) in general, 18.4% (14.9-22.2) in men and 40.6% (36.2-45.1) in women (P<.001); impaired glucose tolerance: 32.3% (20.5-26.0) in general, 29.7% (25.4-33.9) in men and 34.4% (30.2-38.8) in women (P>.05); hypertension: 17.5% (15.1-19.9) in general. Obesity was found in 50.8% of the individuals. Fat mass (%) was associated with diabetes in men (P<.05) and women (P<.05). Thigh circumference and waist/ thigh ratio were lower in those with diabetes, in men and women (P<.001). CONCLUSIONS: The high prevalence of diabetes and obesity in Xavante is likely related to their recent change in food habits and physical activities. Our results should raise awareness about the magnitude of this health problem and also indicate that it could increase dramatically in the future if no preventive actions are adopted.