Alcohol consumption in our country remains high,with effects in different health areas, namely at the in-patient level. In this article we aimed to study thenatural history of alcohol withdrawal syndrome, the different therapeutic approaches and the referencestrategies after discharge. In order to do so, aretrospective study was performed and 81 in-patientswith the diagnosis (primary or secondary) of alcoholwithdrawal syndrome were studied. The most frequentcomplications encountered were rhabdomyolysis (51%)and seizures (39%). The drugs most often usedtherapeutically were neuroleptics and benzodiazepines.After discharge, there was no patient referral or follow-up in half of the cases. We concluded that alcoholwithdrawal syndrome is a frequent diagnosis and thereis a need for the implementation of therapeuticprotocols and better follow-up after discharge, if wewant to change the natural history of this disease. 

Excessive alcohol consumption is a major source of social, economic and health problems. Brief interventions (BI) are low in cost and have proven to be effective across the spectrum of alcohol problems (Babor and Higgins-Biddle, 2001). There have been numerous randomized clinical trials of brief interventions in a variety of health settings, finding that BI were often as effective as more extensive treatments (Bien et al., 1993; Kahan et al., 1995; Wilk et al. 1997). Brief interventions can help reduce the drinking levels of nondependent drinkers who drink more than the recommended limits. Adolescents and young people face a high risk of becoming heavy drinkers and experiencing negative consequences of alcohol use. Brief interventions, aimed at young people, are very important, namely because is the heaviest drinking period in life and young people do not see drinking as a problem. Despite the evidence for their usefulness, however, brief interventions for alcohol-related problems have not yet been widely implemented in Portugal primary care settings. Aim: evaluation of the effectiveness of Clinical Nurse Specialist screening and brief intervention in reducing excessive alcohol consumption among young people (students curso de formação profissional) Methods: Pre-experimental design, one-group pretest-posttest design. 39 students aged between 16-25 years, from both genders. Excessive consumption was identified opportunistically via the Alcohol Use Disorders Identification Test (AUDIT). After baseline assessment, adolescents received either a 20 minutes brief intervention using the Alcohol Education protocol for low Risk Drinkers and Abstainers [AUDIT screening test/Zone I (0-7)]; Simple Advice protocol for Risk Drinkers [Zone II (8-15)]; and Simple Advice plus Brief Counseling protocol [Zone III (16-19)]; Referral to Specialist for Diagnostic Evaluation and Treatment [Zone III (20-40)]. Follow-up occurred at 6 months post intervention. Findings: Pretest Zone I - 74.4%; Zone II - 20.5%; Zone III- 5.1%. Majority of adolescents reduced their alcohol consumption between assessment and subsequent measurement (Zone I - 90%). Discussion: The brief intervention evaluated in this study had effect. A pre-experimental design has little control over environmental factors that could affect the outcome of a study. Another studies with experimental designs is required to evaluate the effectiveness of CNS screening and brief alcohol intervention in primary care.

Introduction: Previous studies have suggested that alcohol expectancies influence both the behavioural effects and different consumption patterns and can be modified via preventative efforts (Rönnback et al., 1999; Barroso, 2009). Expectancies are formed early, even prior to personal experiences of alcohol consumption through social learning processes during childhood and adolescence (Miller et al., 1990; Goldman et al., 1991; Perez-Aranibar et al., 2005). Objective: The aim of this study is to translate and adapt the Alcohol Expectancy Questionnaire - Adolescent Form (AEQ-A: Goldman et al., 1982) for usage within the Portuguese adolescent population. Methods: This process of adaptation included three studies with adolescents (n=654; n=205 and n=212). Internal consistency, construct validity and concurrent validity were assessed. The three psychometric studies resulted in the development of a Scale of Positive Alcohol Expectancies (EEPA-A/AEQ-A). Results: This new version of the AEQ-A revealed a good internal consistency (Cronbach's alpha = 0.94). Factor analysis (KMO = .890; Bartlett' test = 4419.729; p = .000) with the Varimax orthogonal rotation of the 49 remaining items revealed 4 factors with eigenvalues ≥ 1, explaining 40.81% of the total variance: Factor I. Facilitator of interpersonal relationships; Factor II. Stimulation and tension reduction; Factor III. Escape from negative emotional states; Factor IV. Change in social behavior and sexual arousal (? = .82 to .85). The factor associated with the modification of social behavior and sexual activation was significantly higher in adolescents who had consumed alcohol and had experienced intoxication (p= .000). The escape from negative emotional states factor was significantly higher in adolescents who had experienced intoxication (p= .034). Conclusions: This solution and its interpretation presented herein therefore incorporates much of the previously established knowledge in the expectancies literature. It contains 49 Likert-type items, with good reliability as well as construct validity. This scale displays sensitivity to previous alcohol consumption even in cases of experimental consumption, is useful for the behavioral research of alcohol consumption amongst Portuguese adolescents.

Introduction: The professionals of primary health care have a crucial role in screening individuals with risk consumption and harmful alcohol. The effectiveness of brief interventions in reducing alcohol consumption however, in Portugal its use is not yet widespread in particularly in primary care. Objective: to evaluate the effect of Brief Interventions in reducing excessive alcohol consumption on users accessing health center services, Coimbra, Portugal. Methods: A pre-trial, with a single group, and the assessment before the intervention (5 months). The sample included 45 patients (19 females, Mean= 48 age, SD = 15.199), enrolled in the Health Center Ansião. We used a structured interview, using a questionnaire that included the AUDIT (Alcohol Use Disorders Identification Test), to evaluate the level of risk in relation to alcohol consumption. Interventions were made by previous protocol based on the level of risk identified, for data analysis resorting to the Wilcoxon test. Results: At baseline: 86.7% were at risk level I, 11.1% in the risk level II and 0% in the risk level III. In folow-up five months after the brief interventions, 95.6% were at risk level I, 2.2% in the risk level II and 0% in the risk level III. There was a positive effect on the progress of participants in respect to the levels of risk, with statistical significance (p = 0.046). Conclusions: Brief Interventions took effect in lowering and stabilizing the risk levels of alcohol consumption, reinforcing the importance of integration of Brief Interventions in Primary Health Care.

Os programas dirigidos aos adolescentes indicam que as intervenções mais efetivas para prevenir o consumo de tabaco e álcool incluem treinamento das habilidades sociais. No presente estudo desenvolveu-se uma intervenção educativa destinada a fortalecer os fatores protetores, autoestima e assertividade, aplicando canais de prevenção primária. O Modelo de Etapas Motivacionais de Componentes Múltiplos e a Teoria do Aprendizado Social proporcionam sustento teórico no presente estudo. Foram realizadas mensurações antes e depois de ter concluído a intervenção. Resultados: encontrou um aumento de autoestima com Me = 63.1 na primeira mensuração Me=84.38 ao final da intervenção. No nível de assertividade se aperfeiçoou significativamente de Me=60 a 81.2 ao finalizar a intervenção no grupo experimental (p

This study deals with the teaching of contents related to alcohol use prevention and reproductive health at 4 Education Schools/Colleges in Lima-Peru. 123 persons participated: teaching authorities, faculty, students and ex-students. The instrument for data collection and prospective analysis was elaborated and validated by the Pan-American Health Organization and adapted to this study. 40 indicators were selected for reproductive health and 32 for alcohol use prevention, which were distributed into 4 basic elements: context, structure, function and comprehensiveness, each of which were submitted to three scenarios, whose situations were defined in a continuum from stability to transformation. In view of these scenario, the results indicate moderate changes to different extents in the indicators (and consequently in the two subject areas), which were present across the 4 elements, in spite of a tendency towards stability that represents the maintenance of traditional perspectives and actions.

This bibliographic study surveys knowledge about alcohol and drugs produced by Brazilian nursing until 2004 and registered in online databases, in order to identify the presence of this theme; the origin of this knowledge and means of dissemination, as well as to analyze tendencies in this production. We used: BIREME, CAPES, USP Base of Dissertations and Theses. Abstracts with nurses as the authors or co-authors served as the basic material. Using common descriptors in this area, we found 218 abstracts. Production increased from the 1990's onwards (29.8% of the total). Scientific articles (50.4%) and theses (37.2%) were predominant. Knowledge tended towards three theme categories: use of alcohol and other drugs (62.9%); vulnerable populations (27.5%), and users of alcohol and other drugs (9.6%). Alcohol and drugs appeared as comorbidities in many studies and 38.4% of the articles were published in journals from other health areas.

O objetivo desta pesquisa foi avaliar a presença da relação entre os sonhos e craving em alcoolistas nos três primeiros dias de desintoxicação em unidades de internação hospitalar. Verificou-se se aqueles que tinham o craving aumentado relatavam sonhos com o tema "álcool" e analisou-se a qualidade do sono desses sujeitos. Foi um estudo transversal, de associação entre variáveis. A amostra foi de 77 sujeitos adultos do sexo masculino, dependentes de álcool, sem comorbidades clínicas ou psiquiátricas e não-dependentes de outras substâncias psicoativas, salvo a nicotina. Os instrumentos foram: entrevista estruturada; escala de avaliação do craving; questionário de avaliação do sono e dos sonhos; Mini-Mental State Examination e questionário Short-Form Alcohol Dependence Data. Quanto à fase inicial do sono, 67,6% considerou no mínimo satisfatória, 80,5% emitiu a mesma opinião quanto ao seu final, porém apenas 22,1% nunca apresentou interrupções durante o sono. Sonhar com álcool não foi um comportamento freqüente (27,3%), e a média de pontuação do craving foi "fraca", havendo associação entre sonhar com álcool e um aumento no craving (p < 0,001). Os sonhos podem ser mais bem aproveitados pelos profissionais da dependência química, devendo ser utilizados elementos sinalizadores de uma "situação de risco" nas técnicas de prevenção à recaída.

BACKGROUND: A tendency toward violent and impulsive behavior is enhanced following the consumption of alcohol and is important in determining the etiology of deaths by external causes. In this context suicide appears to result from an attitude brought about by alcohol consumption or an expression of that same pathology which leads to substance abuse. OBJECTIVES: Considering the inexistence nationwide of data on suicides occurring under the influence of alcohol, the aim of the present study was to analyze the prevalence of alcohol consumption prior to suicide. METHODS: Direct analysis of 632 medical examiner’s reports on suicide victims autopsied at the Examiner’s Office (Instituto Médico-Legal) of the State of Sao Paulo, in the year 2005. RESULTS: Of the 632 cases reviewed, 33,1% presented a positive Blood Alcohol Concentration (BAC), with a higher occurrence in the case of men (37,1%) than that of women (20,1%). Hangings presented the highest prevalence of intoxicated victims, at a rate of 38,9% of the cases; intoxications presented the highest BAC mean, at 1,78 g/L. CONCLUSIONS: The results demonstrate that roughly speaking, about one third of the suicides in our sample carried out by differing methods were subsequent to alcohol consumption.

BACKGROUND: Literature presents comorbidity between pathological gambling, substance use/abuse and affective disorders (depression being the most prevalent) in adults. The prevalence of depression disorder in elderly people is high, making them vulnerable to pathological gambling and substance abuse. With the increase of this population worldwide, more research regarding these issues has become necessary. OBJECTIVES: Assess the involvement of the elderly in gambling activities and its correlation with substance abuse. METHODS: Literature review of MEDLINE, LILACS and PsycINFO databases without time limits. RESULTS: Elderly recreational gamblers present alcohol consumption and good general health. Elderly problem gamblers present alcohol abuse, with more psychiatric disorders and heart disease than recreational gamblers. When compared with adult or young gamblers, the elderly present fewer problems with alcohol consumption. Conclusions: As with adults, in the elderly a correlation also exists between gambling and substance abuse. The more problematic the gambling is, the more problematic the substance (alcohol) abuse, and the higher the prevalence of mood disorders (depression). A causal relationship between these factors can not yet be affirmed however, as more research is needed.