This is a descriptive exploratory study that aimed to verify nursing students' attitudes facing to the alcoholic drinks, alcoholism and alcoholics, according to their position in face of an attitudes scale items. For data collection, it was used the Scale of Attitudes to alcohol, alcoholism and alcoholic, applied to 144 nursing students. The results showed a tendency to negative attitudes of these students in face of alcoholism, alcoholic person and alcoholic drinks, since most participants were placed in category indifferent or disagree with the positive items, agreeing with negative scale items. We conclude that this trend of negative attitudes is connected to insufficient attention given to the subject during the nurses' education, being verified the need for greater importance to be given to this problem.

OBJECTIVES:

Pulmonary nocardiosis is an uncommon opportunistic infection affecting mainly immunocompromised patients. We herein present a case of nocardiosis without profound underlying immunodeficiency.

BACKGROUND:

A female, 84-years' old patient with stage IV chronic obstructive pulmonary disease (COPD) is presented. No profound causes of immunodeficiency existed, such as HIV infection, diabetes mellitus, malignancy, alcoholism, chemotherapy or previous corticosteroid intake. The patient recovered after treatment with trimethoprim/sulfamethoxazole for 6 months.

RESULTS:

One year after infection resolution, stimulation of the patient's blood monocytes with Nocardia antigens revealed defective production of tumor necrosis factor-alpha, interleukin (IL)-6 and IL-17.

CONCLUSION:

We provide preliminary evidence for a link between defective innate immune responses and predisposition for Nocardia infections. Further studies must be conducted in order to fully investigate this mechanism of infection acquisition.

Idiopathic scoliosis is a significant health problem which occurs in 2%-4% school kids in adolescent age. Reasons of occurrence are not quite clear, there are many theories, but probably it is multifactor disease. Among the theories that are mentioned some of them included environmental and behavioral factors.Research the impact of some environmental and behavioral factor on development and progression of idiopathic scoliosis in school kids.Research was conducted on 421 pupil in adolescent age, where 120 pupils was from urban schools and 301 pupil from rural schools. Environmental factors and habits like the bigger osteomuscular structure mobility at kids from rural schools, longer outdoor time spending, different nutrition, alcoholism and smoking, different obligations, etc. factors which can be cause of scoliosis development.In this research we assumed that different environmental and behavioral factors of school kids, which exist in rural and urban areas, can develop to different expression of scoliosis in these areas. In our research we proved that the scoliosis occurrence is more often in urban areas than in rural (Fisher's exact test P<0.001).It is necessary to research all factors of lifestyle individually, which are different between the urban and rural kids.

Background:

Gemella genus bacteria can produce localized or generalized severe infections, but very rarely they have been described as causingpulmonary infections or pleural empyemas.

Aim:

To characterize patients with empyema caused by Gemella genus bacteria. Material and

Methods:

The database of a Microbiology laboratory of a Spanish hospital was reviewed, searchingfor Gemella positive cultures ofpleural effusions in a period offive years.

Results:

We identified 12 patients (11 males) with Gemella spp pleural empyema. Eight were infected with G. haemolysans and four with G. morbillorum. All patients had predisposingfactors such as poor oral hygiene, smoking, chronic cardiovascular or respiratory disease, alcoholism or malignancies. In ten cases, a thoracic drainage tube was placed with fibrinolysis in seven. One patient needed surgery because of a relapse of the empyema. Two patients died because of an advanced neoplasm, and the empyema was resolved in the rest.

Conclusions:

Gemella pleural empyema can occur and its isolation must not be seen as a contamination.

Drug abuse is rarely limited to a single substance; polydrug use is the norm rather than the exception. In many cases, the misuse of potentially psychoactive substances can lead to serious intoxications and results in addictive behavior.A 22-year-old heroin-addicted woman presented in our clinic reporting a 2-year history of intravenous injection of an eyedrop solution containing 1% tropicamide, an antimuscarinic agent. She reported injecting tropicamide because it attenuated symptoms and signs of opiate withdrawal and it also has hallucinogenic and euphorigenic effects. Despite the large amounts (up to 1.5 g), the rapidity of injection, and the long-term use, tropicamide was relatively well tolerated, without life-threatening consequences.An outpatient detoxification program was performed without any sign or symptom caused by discontinuing tropicamide.The present case claims a role for pharmacological interactions, in addition to rewarding effects, in influencing drug association in polyabuse pattern.Moreover, this case underlines the need for physicians to be aware of the potential emergence of tropicamide as a drug of misuse, to prevent further harm.

Leptin inhibits signaling of dopamine in the nucleus accumbens, suggesting its role in regulating stress and its possible involvement in the neurobiology of reward system. The aim of this study was to review of the literature on the influence of leptin in the craving for alcohol and tobacco and whether there is already evidence that leptin may be a biomarker to indicate risk for craving and relapse. The review used as data bases Medline, LILACS and SciElo in the period between 2000 and 2012. Keywords were leptin, substance use disorders, craving and withdrawal, in Portuguese and English. Only 12 articles were met the inclusion criteria, relating leptin with craving in alcoholics (n = 10) and smokers (n = 2). No studies were found in the LILACS database. Leptin levels increase during abstinence and this may be related to a reduction of dopaminergic action in mesolimbic system, resulting in a greater intensity of craving and maintenance of addictive behavior. Although there are few studies, the most recent results indicate the usefulness of leptin as a marker of risk for relapse among smokers and alcoholics in abstinence.

Impaired inhibition of prepotent motor responding may represent an important risk factor for alcoholism. Alcohol use also may increase impulsive behaviors, including impaired response inhibition. Little is known about brain function underlying response inhibition among college-age drinkers based on their drinking patterns, despite college-age drinkers demonstrating high rates of alcohol use disorders. Our major objective was to compare behavior and associated brain activity measured with fMRI during a response-inhibition task in matched heavy- and light-alcohol-drinking college students. Participants were light (N=36) and heavy (N=56) drinkers, aged 18-20 years. We characterized blood oxygen level-dependent (BOLD) responses while participants performed an fMRI Go/No-Go task to quantify inhibitory behavior and brain activity. Behaviorally, group performance differences were observed for Go correct-hit and No-Go false-alarm reaction times with increased reaction times in heavy compared to light drinkers. During fMRI No-Go correct rejections, light drinkers exhibited greater BOLD response than did heavy drinkers in left supplementary motor area, bilateral parietal lobule, right hippocampus, bilateral middle frontal gyrus, left superior temporal gyrus and cingulate gyrus/ACC (BA24). Group differences in Go/No-Go-related regional activations correlated with alcohol-and impulsivity-related measures. These findings suggest that heavy alcohol drinkers may have dysfunction in brain regions underlying attention and response inhibition, leading to diminished abilities to suppress prepotent responding. The extent to which these tendencies relate to impulsive decision-making and behaviors in real-life settings and may guide intervention development warrants additional investigation.Neuropsychopharmacology accepted article preview online, 14 May 2013; doi:10.1038/npp.2013.119.

Neuroimaging studies have reported an association between white matter integrity and cognitive performance in normal aging and various neuropathological conditions. We compared alcoholics with controls and hypothesized that the degree of disconnection of white matter fibers would be negatively correlated with memory dysfunction scores. Diffusion tensor imaging (DTI) based tractography and PGI-memory scale (PGIMS) test was performed in 10 abstinent chronic alcoholic and 10 demographically equivalent control men. DTI measures [fractional anisotropy (FA), and mean diffusivity (MD)] from all of the major cerebral tracts were calculated and a comparison was done between patient group and controls. Spearman's rank correlation coefficient was computed between memory dysfunction score and DTI measures. Compared to controls alcoholic participants had significantly reduced FA in corpus callosum (CC), fornix (FX), and right hemispheric arcuate fasciculus (AF), anterior thalamic radiation (ATR) and inferior longitudinal fasciculus (ILF). A significant inverse correlation with memory dysfunction score was observed with right cingulum, right uncinate fasciculus, right ILF and left ILF. The inverse correlation of memory dysfunction score with FA of white matter tracts suggest that white matter deficit in these white matter fibers may contribute to underlying dysfunction in memory in alcoholism.

AIMS:

Investigators of the COMBINE (Combining Medications and Behavioral Interventions for Alcoholism) Study examined whether combining medications with a behavioral intervention would improve outcomes over monotherapies. Unexpectedly, the combination did not offer any advantage over either treatment alone. This study aimed to explain the lack of incremental benefit offered by the combination over either monotherapy by assessing the role of cravings as a treatment mediator and moderator.

DESIGN:

Secondary mediation and moderation analyses of COMBINE study data.

SETTING:

11 United States academic sites.

PARTICIPANTS:

863 patients randomized to one of four treatment groups: naltrexone (100mg/d; n=209), the Combined Behavioral Intervention (CBI, n=236), naltrexone and CBI combined (n=213), and placebo naltrexone (n=205).

MEASUREMENTS:

Percent Days Abstinent (PDA) measured between 13 and 16 weeks post-baseline. Cravings, the potential mediator/moderator, were measured at baseline, week 4 and week 12 using the Obsessive-Compulsive Drinking Scale.

FINDINGS:

Compared with placebo, naltrexone, CBI, and the combination all increased PDA by an additional 6-10 percentage points for those with high cravings (p<0.05 for all three treatment groups). None had significant effects on PDA for those with low cravings. The effects of all three treatments were at least partially mediated by cravings; craving reduction explained 48-53% of treatment effects (p<0.05 for all three treatment groups). Furthermore, naltrexone appeared to reduce cravings at 4 weeks, while CBI did not reduce cravings until 12 weeks.

CONCLUSIONS:

The Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) naltrexone + Combined Behavioral Intervention combination may not be more beneficial than either monotherapy because craving reduction is a common mechanism of both.