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Introduction: Ketamine is a dissociative anesthetic that acts as an antagonist to NMDA receptors, which play a crucial role in strengthening learning and memory. Not surprisingly, its repeated use may be associated with impaired cognitive functions. Objective: The aim of this paper is to carry out a scoping review of the scientific literature on the neurocognitive effects of recreational ketamine use. Method: A bibliographic search was conducted in PyscINFO, PubMed, Scopus and Web of Science for the period 2000-2020. Eventually, 25 original articles were included in the review. Results and conclusions: The findings reveal that 1) acute ketamine use produces deficits in working memory, semantic memory, and episodic memory, 2) frequent ketamine use has been associated with impairment in episodic memory and possibly in learning, executive function, attention, and semantic memory, 3) people diagnosed with ketamine use disorder have deficits in visual and verbal episodic memory, working memory and attention, 4) deficits detected may improve and even be reverted after a period of abstinence. [ABSTRACT FROM AUTHOR]

Background. Information on the way menstrual cycle phases can influence the achievement of tobacco abstinence is contradictory. Objective. A scope review was conducted to determine the effect of the menstrual cycle on tobacco abstinence, considering the phases of the cycle, hormone levels, and premenstrual syndrome. Method. A literature search was conducted in Scopus, PubMed, MEDLINE, and PsycINFO databases. Ten articles comparing the phases of the menstrual cycle or analyzing the association between premenstrual syndrome and a withdrawal condition (length of abstinence or withdrawal symptoms) were included. Results. Two main results were identified: 1) there is no difference in withdrawal symptoms and craving between menstrual cycle phases and 2) abstinence rates in the studies were higher during the luteal phase. Discussion and conclusion. The advisability of suggesting that women wishing to quit smoking should begin to do so at the start of the luteal phrase is discussed. However, smoking cessation interventions must consider all the symptoms experienced during the luteal phase. [ABSTRACT FROM AUTHOR]

Copyright of Revista Internacional de Investigación en Adicciones is the property of Centros de Integracion Juvenil A.C. (CIJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this fictionalized conversation with the creator of psychoanalysis, the author raises her concerns regarding the difficulties that could arise from the intrusion of the institutional into the analyst's practice. The discussion focuses particularly on analytic ethics. Freud's responses are, in large part, textual statements taken from various passages in his works. In her farewell to Prof. Freud, the author expresses the need to constantly question the role of the institutional in the psychoanalytic training. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Electrónica de Psicología Iztacala is the property of Facultad de Estudios Superiores Iztacala and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Alcoholic hepatitis is a frequent condition in the Mexican population. It is characterized by acute-on-chronic liver failure, important systemic inflammatory response, and multiple organ failure. The severe variant of the disease implies elevated mortality. Therefore, the Asociación Mexicana de Gastroenterología and the Asociación Mexicana de Hepatología brought together a multidisciplinary team of health professionals to formulate the first Mexican consensus on alcoholic hepatitis, carried out utilizing the Delphi method and resulting in 37 recommendations. Alcohol-related liver disease covers a broad spectrum of pathologies that includes steatosis, steatohepatitis, different grades of fibrosis, and cirrhosis and its complications. Severe alcoholic hepatitis is defined by a modified Maddrey’s discriminant function score ≥ 32 or by a Model for End-Stage Liver Disease (MELD) score equal to or above 21. There is currently no specific biomarker for its diagnosis. Leukocytosis with neutrophilia, hyperbilirubinemia (>3 mg/dl), AST > 50 U/l (< 400 U/l), and an AST/ALT ratio > 1.5-2 can guide the diagnosis. Abstinence from alcohol, together with nutritional support, is the cornerstone of treatment. Steroids are indicated for severe disease and have been effective in reducing the 28-day mortality rate. At present, liver transplantation is the only life-saving option for patients that are nonresponders to steroids. Certain drugs, such as N-acetylcysteine, granulocyte-colony stimulating factor, and metadoxine, can be adjuvant therapies with a positive impact on patient survival. Resumen: La hepatitis alcohólica es una condición frecuente en población mexicana, se caracteriza por insuficiencia hepática aguda sobre crónica, importante reacción inflamatoria sistémica y fallo multiorgánico, que en la variante grave de la enfermedad implica una elevada mortalidad. Por lo anterior, la Asociación Mexicana de Gastroenterología y la Asociación Mexicana de Hepatología conjuntaron un equipo multidisciplinario de profesionales de la salud para elaborar el primer consenso mexicano de hepatitis alcohólica. El consenso fue elaborado con la metodología Delphi, emitiendo 37 recomendaciones. La enfermedad hepática relacionada al consumo de alcohol comprende un amplio espectro, que incluye esteatosis, esteatohepatitis, fibrosis en diferentes grados, cirrosis y sus complicaciones. La hepatitis alcohólica grave se define por una función modificada de Maddrey ≥32 o por un puntaje de MELD (Model for End-Stage Liver Disease) igual o mayor a 21. Actualmente no existe un biomarcador específico para el diagnóstico. La presencia de leucocitosis con neutrofilia, hiperbilirrubinemia (>3 mg/dL), AST > 50 U/L ( 1.5-2 pueden orientar al diagnóstico. La piedra angular del tratamiento es la abstiencia junto con el soporte nutricional. Los esteroides estan indicados en la forma grave, en donde han resultado efectivos para reducir la mortalidad a 28 días. El trasplante hepático es en la actualidad la única opción con que se cuenta para salvar la vida de pacientes no respondedores a esteroides. Ciertos fármacos, como la N-acetilcisteína, el factor estimulante de colonias de granulocitos, y la metadoxina pueden ser una terapia adyuvante que puede impactar en la sobrevida de los pacientes.

Copyright of Revista Psicologia Clínica is the property of Faculdades Catolicas - Pontificia Universidade Catolica do Rio de Janeiro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A descriptive and cross-sectional study of 200 adolescents with 10-19 years belonging to America I health area in Contramaestre municipality, Santiago de Cuba province was carried out from January to December,2016, inorder to characterize those who consumed alcoholic drinks. There were 177 drinkers and the beginning of consumption was more frequent between 10-16 years. A risk of pathological consumption was evidenced in the male sex. The harmful and alcoholic risk consumers, manifested the necessity to drink alcohol in the activities, since it produced them favorable effects; therefore, it was proposed to foment the antialcoholic education among the members of this populational group.

Intrathecal therapy (IT) is an effective treatment indicated in the management of chronic refractory pain, although it is not without possible complications. We describe a case of infection after the 4th replacement of an intrathecal morphine (IM) pump, which led to the device removal and the consequent difficulty for the systemic management of high doses of opioids. A 77-year-old man, multi-pathological, with failed back syndrome and carrying a high-dose MI pump for 25 years. Generator replacement was complicated by surgical wound infection, initially treated conservatively with antibiotics and surgical debridement. A preventive decrease in the dose of MI was started. After failure of conservative treatment, removal of the device was required, initiating intravenous opioid replacement regimen initially, and later orally. During the postoperative period, the patient experiences acute confusional syndrome with agitation, altered level of consciousness, and hypercapnic respiratory failure. This condition requires multidisciplinary treatment with adjustment of the opioid dose, administration of antipsychotic drugs, sedatives and adaptation of non-invasive mechanical ventilation. Complications such as infection of the IT device can lead to an abrupt withdrawal of the drug with the consequent withdrawal syndrome (WS). Need to substitute systemically for high doses of IT opioids is highly complex. The patient developed an acute confusional syndrome, hard to manage and initially attributed to WS. Other differential diagnoses of the situation were opioid intoxication, hypoxia, hypercapnia, infection, adverse effects of antibiotics... Adjustment of the opioid dose and treatment with antipsychotics (aripiprazole) allowed to control the symptoms. [ABSTRACT FROM AUTHOR]

El uso de teléfonos celulares ha aumentado exponencialmente en la mayoría de los países del mundo. Desde una perspectiva psicológica, se han desarrollado diferentes técnicas para evaluar el nivel de dependencia hacia el uso del teléfono móvil, y el test TDMB es una de las más utilizadas. Objetivo. El objetivo principal del trabajo fue realizar la adaptación y validación al contexto argentino del cuestionario TDMB y sus relaciones con la impulsividad. Método. Participaron del estudio 339 adultos residentes en Argentina, con edades entre los 18 y 65 años (M = 37.66; DT = 12.87), siendo el 74.3% mujeres. La batería de evaluación incluyó el TDMD, la UPPS-P para evaluar impulsividad y variables ad-hoc relacionadas con el uso del teléfono celular. Resultados. Se obtuvieron propiedades psicométricas adecuadas para la versión argentina del TDMB. Asimismo, se observaron relaciones entre todas las dimensiones del cuestionario y la impulsividad, como también diferencias según la edad y el sexo de los participantes. Se discuten los alcances y límites de la prueba, así como sus relaciones con la impulsividad y el uso cotidianodel teléfono móvil.

Introduction and objectives: Ropivacaine is a long-acting local anesthetic that causes prolonged anesthesia and is beneficial for a wide variety of surgeries. Systemic toxicity has been reported after usage of high dose ropivacaine or inadvertent intravascular administration. We report a case of ropivacaine withdrawal, which to our knowledge has not been previously described in the literature. Case report: The patient presented to our department with uncontrolled belt-like upper-abdominal pain, self-rated as a 9/10 on the numeric rating scale. We decided to use continuous epidural analgesia with ropivacaine through a multi-port epidural catheter. Pain was well controlled for one month without significant adverse effects. However, ropivacaine unexpectedly ran out and two hours later the patient developed agitation, generalized tremor, tachycardia, and tachypnea. These symptoms resolved 30 minutes after reinitiating epidural ropivacaine. Discussion: Our hypothesis of ropivacaine withdrawal was related to the timing of symptoms in relation to drug administration over two episodes. The possible mechanism of the observed withdrawal syndrome is upregulation of voltage-gated sodium channels after prolonged inhibition, resulting in increase in sodium influx and genetic variation. Resumo: Justificativa e objetivos: A ropivacaína é um anestésico local de ação prolongada indicado em uma ampla variedade de cirurgias. Toxicidade sistêmica tem sido relatada após o uso de dose alta de ropivacaína ou administração intravascular inadvertida. Relatamos um caso de crise de abstinência de ropivacaína que, até onde sabemos, não foi descrita anteriormente na literatura. Relato do caso: O paciente procurou nosso departamento com dor não controlada abdominal do tipo em cinta, avaliada pelo paciente como sendo 9/10 no escala de avaliação numérica. Decidimos usar analgesia peridural contínua com ropivacaína através de cateter peridural multiperfurado. A dor foi bem controlada por um mês sem efeitos adversos significativos. No entanto, a ropivacaína inesperadamente se esgotou e, duas horas depois, o paciente desenvolveu agitação, tremor generalizado, taquicardia e taquipneia. Esses sintomas regrediram completamente 30 minutos após o reinício da ropivacaína por via peridural. Discussão: Nossa hipótese de abstinência de ropivacaína foi relacionada à cronologia dos sintomas em relação à administração da droga ao longo de dois episódios. O possível mecanismo da síndrome de abstinência observada é a regulação positiva dos canais de sódio dependentes de voltagem após inibição prolongada, resultando em aumento do influxo de sódio e variação genética.

Desde los inicios del psicoanálisis, Freud y sus discípulos se enfrentaron con la problemática de cómo realizar tratamientos viviendo en lugares geográficos distantes. En la medida en que el psicoanálisis fue expandiéndose, la tendencia fue al establecimiento de tratamientos con una regularidad establecida y con las constantes materiales del consultorio, del cuerpo propio del analista y del paciente, como referentes para contener al proceso. Pese a esto, sigue sin haber psicoanalistas o psicoterapeutas en diversas regiones. Muchos analistas se muestran renuentes a los tratamientos a distancia, esto se debe a a) el temor al rompimiento del encuadre tradicional, b) el temor de que la transferencia no se despliegue si se está en un contacto a distancia, c) las dificultades en cuanto a la neutralidad y la abstinencia, y d) la necesidad de una posición más activa del analista. Este escrito tiene la finalidad de discutir sobre estos puntos para reflexionar sobre la posibilidad de establecer, formalmente, tratamientos psicoanalíticos a distancia. [ABSTRACT FROM AUTHOR]

The intersection of intimacy, abstinence and publishing in psychoanalysis is examined, laying out the conflict between the ethics of confidentiality vs. the ethics of publication at the service of the development of psychoanalysis. Publishing at its different levels must go through the internal censorship of the psychic apparatus, but the possible conflict that arises within the protection of privacy and the abstinence rule comes up with the out of session publishing. Finally, reference is made to the third censorship, operated by the evaluation committees of Congresses, Specialized Magazines, and other instances. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Saúde Coletiva is the property of MPM Comunicacao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A descriptive and cross-sectional study of 200 adolescents with 10-19 years belonging to America I health area in Contramaestre municipality, Santiago de Cuba province was carried out from January to December, 2016, in order to characterize those who consumed alcoholic drinks. There were 177 drinkers and the beginning of consumption was more frequent between 10-16 years. A risk of pathological consumption was evidenced in the male sex. The harmful and alcoholic risk consumers, manifested the necessity to drink alcohol in the activities, since it produced them favorable effects; therefore, it was proposed to foment the antialcoholic education among the members of this populational group. [ABSTRACT FROM AUTHOR]

Copyright of Portuguese Journal of Mental Health Nursing / Revista Portuguesa de Enfermagem de Saúde Mental is the property of Portuguese Society of Mental Health Nursing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A globalização da informação em múltiplos domínios da vida dos indivíduos congrega vantagens e riscos. O presente estudo propôs-se avaliar a existência de padrões de uso do smartphone potencialmente disfuncionais junto de uma amostra de conveniência constituída por 164 participantes adultos. Os participantes responderam a: versão portuguesa do Smartphone Addiction Inventory; questionário sociodemográfico; questionário de sintomas clínicos sugestivos de uso problemático/dependência de smartphones. Ainda que a maioria dos participantes (90.9%) não apresente sintomas de perturbação associada ao uso de smartphones, 6.7% apresenta sintomas moderados e 2.4% sintomas graves. Os resultados sugerem a importância da realização de rastreios neste domínio.

O presente estudo teve como objetivo adaptar linguística e culturalmente para a população portuguesa o Smartphone Addiction Inventory. Participaram 164 indivíduos, com idade média de 29.09 anos (DP=10.15), com nível de escolaridade maioritariamente do ensino superior (84.2%). Procedeu-se à tradução/adaptação do instrumento, em articulação com a equipa que desenvolveu a versão original. Os participantes responderam à versão portuguesa do SPAI, a um breve questionário sociodemográfico e a um questionário de avaliação de sintomas clínicos sugestivos de uso problemático e de dependência de smartphones. A versão portuguesa do SPAI revela apresentar boa fidelidade e razoável validade interna e externa.

O presente trabalho teve como foco a recuperação de usuários de drogas decorrentes de suas inserções em grupos de ajuda-mútua de Narcóticos Anônimos. Descrito o método da construção e análise de uma rede social formada pelos membros de uma associação baseada nos princípios terapêuticos dos doze-passos. Foram avaliadas as dimensões proximidade, afastamento, padrinho e confiança na rede. Uma das análises relaciona os atores quanto ao prestígio e a rejeição, e outra sobre o controle do fluxo de informações entre eles. A topologia é de uma rede Livre de escala. Os resultados mostraram que o uso da teoria de redes permite entender o papel de cada membro do grupo. O efeito da dinâmica de grupo identifica lideres que influenciam as pessoas da rede. O compartilhamento de valores na re-educação tem permitido que a abstinência seja um valor crucial.

In this theoretical study the aim was to analyze a specific project of drug detoxification exclusively directed to incarcerated people. This referred project is based on the logic of total abstinence. Although literature emphasizes harm reduction as a privileged strategy to deal with drug use in prisons, what we recognize are actions that emphasize abstinence, both in criminal proceedings and in prison units. One example of this type of action is the project mentioned above, sustained by a model that prohibits drug use and relapse. We understand the complexities involved in carrying out actions of harm reduction in prisons, given the specificities of this place. However, the use of drugs is part of prisons' routines. As such, it needs to be approached as a problem that goes beyond any individual prisoner; it is a part of the social node, both outside and inside prisons.

A young person tend to drink alcohol due to the curiosity, imitation belonging to a peer group and in some cases the motivation of the family. Alcohol is therefore socially tolerated moderate alcohol consumption can lead risk forms of consumption. The study shows that attempts to understand the consumption and abstinence from alcohol consumption among young people in secondary education who attend a school in the district of Evora in co use of learning spaces and leisure. The research was qualitative in nature developed using the direct method of data collection. Ten interviews were held, five to five to young consumers and non-consumers, the students of the 10th and 12th grades. The results point towards the first contact with alcoholic beverages held in nocturnal atmosphere by active or tacit influence of peers. The alcoholic behavior is common and inherent in party environments. A behavior modification, group membership, seems to indicate the change of individual behavior in relation to alcohol consumption. Young people are not consumers have tried drinking alcohol however, want the taste of some, or the effects they cause, are not stimulating consumption, unnecessary considering your intake to personal recovery and for peer interaction.

Los opioides usados durante más de cinco días, para sedación en paciente pediátrico, deben ser retirado de forma progresiva con el objetivo de prevenir abstinencia. Para este propósito las pautas de retirada con metadona enteral son frecuentemente utilizadas. Sin embargo, la dificultad en la apliación de protocolos y la diferencia entre pacientes, hacen que esta práctica no esté exenta de dificultad. En este artículo intentamos dar respuesta o al menos sugerir pautas, para realizar esta práctica. ABSTRACT Use of methadone for sedation weaning in critical ill patient Opioids used for more than five days in sedation, should be withdrawn progressively in order to prevent abstinence syndrome. Methadone are frequently used for this purpose. However, the difficulty in the application of protocols and the difference between patients, make this practice not free of difficulty. In this review we try to answer or at least suggest guidelines to carry out this practice.

Copyright of Paideia (0103863X) is the property of Paideia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A ropivacaína é um anestésico local de ação prolongada indicado em uma ampla variedade de cirurgias. Toxicidade sistêmica tem sido relatada após o uso de dose alta de ropivacaína ou administração intravascular inadvertida. Relatamos um caso de crise de abstinência de ropivacaína que, até onde sabemos, não foi descrita anteriormente na literatura. O paciente procurou nosso departamento com dor não controlada abdominal do tipo em cinta, avaliada pelo paciente como sendo 9/10 no escala de avaliação numérica. Decidimos usar analgesia peridural contínua com ropivacaína através de cateter peridural multiperfurado. A dor foi bem controlada por um mês sem efeitos adversos significativos. No entanto, a ropivacaína inesperadamente se esgotou e, duas horas depois, o paciente desenvolveu agitação, tremor generalizado, taquicardia e taquipneia. Esses sintomas regrediram completamente 30 minutos após o reinício da ropivacaína por via peridural. Nossa hipótese de abstinência de ropivacaína foi relacionada à cronologia dos sintomas em relação à administração da droga ao longo de dois episódios. O possível mecanismo da síndrome de abstinência observada é a regulação positiva dos canais de sódio dependentes de voltagem após inibição prolongada, resultando em aumento do influxo de sódio e variação genética. Ropivacaine is a long‐acting local anesthetic that causes prolonged anesthesia and is beneficial for a wide variety of surgeries. Systemic toxicity has been reported after usage of high dose ropivacaine or inadvertent intravascular administration. We report a case of ropivacaine withdrawal, which to our knowledge has not been previously described in the literature. The patient presented to our department with uncontrolled belt‐like upper‐abdominal pain, self‐rated as a 9/10 on the numeric rating scale. We decided to use continuous epidural analgesia with ropivacaine through a multi‐port epidural catheter. Pain was well controlled for one month without significant adverse effects. However, ropivacaine unexpectedly ran out and two hours later the patient developed agitation, generalized tremor, tachycardia, and tachypnea. These symptoms resolved 30 minutes after reinitiating epidural ropivacaine. Our hypothesis of ropivacaine withdrawal was related to the timing of symptoms in relation to drug administration over two episodes. The possible mechanism of the observed withdrawal syndrome is upregulation of voltage‐gated sodium channels after prolonged inhibition, resulting in increase in sodium influx and genetic variation. [ABSTRACT FROM AUTHOR]

Objetivo: Analizar los factores predictores de los resultados del tratamiento del tabaquismo según sexo, en personas fumadoras que solicitan tratamiento para dejar de fumar en una unidad de tabaquismo. Métodos: Estudio transversal en personas fumadoras que iniciaron tratamiento en una unidad de tabaquismo entre los años 2002 y 2007. Se recogieron variables sociodemográficas, de patrón de consumo, del entorno del paciente respecto al tabaco y la presencia de comorbilidad psiquiátrica. Se realizó tratamiento multicomponente: psicológico y farmacológico. Se consideró éxito del tratamiento la abstinencia continua validada con CO Objective: To identify factors predictive of the outcome of a smoking cessation program by gender. Methods: A cross-sectional study of smokers starting treatment in a smoking cessation clinic from 2002 to 2007 was conducted. The variables consisted of data on sociodemographic factors, smoking habits, the social context of smoking and psychiatric comorbidity prior to or during the smoking cessation process. All patients received multicomponent treatment consisting of psychological and pharmacological interventions. Success was defined as self-reported continuous abstinence confirmed by cooximetry (CO

Habilidades de enfrentamento antecipatório são importantes para a manutenção da abstinência de álcool e outras drogas. Apesar disso, não se dispõe de instrumentos para avaliá-las em contexto brasileiro. Este artigo descreve as etapas iniciais da construção de um instrumento de medida para a avaliação desse repertório, o que envolveu várias etapas. Inicialmente, com base na literatura, em instrumentos semelhantes e em entrevistas, foram redigidos 92 itens, que contemplavam 14 classes de habilidades, definidas e exemplificadas no texto. A qualidade semântica e de construto dos itens foi aferida por juízes resultando na eliminação de 24 itens. A nova versão, passou por um pré-teste de funcionamento e estudo piloto com participantes em tratamento de abuso ou dependência de álcool ou outras drogas. Novos ajustes foram realizados e o conjunto final, de 67 itens, recebeu o nome de Inventário de Habilidades de Enfrentamento Antecipatório para Abstinência de Álcool e Outras Drogas (IDHEA-AD). Discute-se cada uma das etapas e são apresentadas propostas para estudos futuros.

Las vulvovaginitis corresponden a las inflamaciones de la vulva y la vagina. La etiología en su mayoría es secundaria a una infección. Los principales agentes etiológicos son: Candida albicans, Gardenerella vaginalis y Trichomonas. Las infecciones de transmisión sexual son un motivo de preocupación y consulta creciente en el grupo de adolescentes, siendo las más frecuentes las causadas por Chlamydia Trachomatis, Virus Papiloma Humano y Virus Herpes simple. En este capítulo se revisan las diferentes etiologías, entregando además al ginecólogo general, algunas herramientas que facilitan el abordaje, el diagnóstico y el tratamiento en este grupo etario.

Objetivo: Avaliar a associação entre a resposta ao tratamento da dependência de nicotina com bupropiona e a presença do polimorfismo SLC6A3 3’UTR VNTR, localizado no gene que codifica o transportador dopaminérgico. Método: Foram acompanhados no Ambulatório de Tabagismo do Instituto de Psiquiatria da Faculdade de Medicina da USP 100 pacientes do sexo masculino com diagnóstico de dependência de nicotina, sem outras patologias. Todos receberam bupropiona até 300 mg ao dia por 12 semanas, associada à terapia cognitivo-comportamental em grupo. A Escala de Fagerström foi aplicada no início e no final do tratamento, e avaliou-se a parada do uso de cigarros na última semana de tratamento e um mês após. Os pacientes tiveram 10 ml de sangue colhidos e genotipados para a existência do polimorfismo SLC6A3 3’UTR VNTR. Resultados: Não foi encontrada associação entre cessação do uso de cigarro e presença do polimorfismo. Conclusão: São necessários mais estudos para avaliar se a presença do polimorfismo SLC6A3 3’UTR VNTR estaria relacionada à melhor resposta ao tratamento da dependência de nicotina.

OBJECTIVE: Poor impulse control is thought to be one of the characteristics of alcohol addiction. The capacity to remain abstinent may be linked to cognitive bias related to three dimensions of impulsivity: motor, non-planning, and attentional impulsivity. The aim of this study was to evaluate the neuropsychological profile related to these impulsivity dimensions in alcohol-dependent patients within 15 -120 days of abstinence. METHOD: We compared 31 alcohol-dependent patients to 30 matched healthy controls regarding their performances on the Continuous Performance Task, the Iowa Gambling Test, and the Wisconsin Card Sorting Test, each of which is thought to tax primarily one of the three dimensions of impulsivity just outlined. RESULTS: When compared to controls, alcohol-dependent patients presented more commission errors on the Continuous Performance Task; made more disadvantageous choices on the Iowa Gambling Test; and made more perseverative errors on the Wisconsin Card Sorting Test. There was no significant correlation between performance on these tests and the length of abstinence. CONCLUSIONS: These results suggest that deficits related to motor, non-planning and attentional components of impulsivity exist in alcohol-dependent patients, in the period immediately after acute alcohol withdrawal. These results may help guide interventions designed to prevent the risk of relapse in alcohol-abstinent patients.OBJETIVO: O controle deficiente dos impulsos é considerado uma das características da dependência do álcool. A capacidade de permanecer abstinente pode estar ligada a viés cognitivo relacionado a três dimensões da impulsividade: motora, de atenção e por falta de planejamento. O presente estudo objetivou avaliar o perfil neuropsicológico relacionado a estas dimensões da impulsividade em pacientes dependentes de álcool em 15 a 120 dias de abstinência. MÉTODO: Nós comparamos o desempenho de 31 pacientes dependentes de álcool a 30 controles saudáveis na Continuous Performance Task, no Iowa Gambling Test e no Wisconsin Card Sorting Test, que são considerados testes capazes de avaliar primariamente as citadas dimensões de impulsividade. RESULTADOS: Em relação aos controles, o grupo pacientes dependentes de álcool cometeu mais erros de comissão na Continuous Performance Task; fez escolhas menos vantajosas no Iowa Gambling Test e mais erros perseverativos no Wisconsin Card Sorting Test. Não houve correlação significativa entre o desempenho nestes testes e o tempo de abstinência. CONCLUSÕES: Estes resultados sugerem que há déficits relacionados aos componentes da impulsividade (motores, atencionais e por não-planejamento) em pacientes dependentes de álcool, no período imediatamente após a fase aguda de retirada do álcool. Estes resultados podem ajudar a guiar intervenções para impedir o risco do recaída em pacientes em curto período de abstinência de álcool.

JUSTIFICATIVA E OBJETIVOS: A síndrome de abstinência tem alta prevalência em nosso meio e, além do desconforto, prolonga o tempo de internação. O objetivo deste estudo foi avaliar a influência da adição de clonidina por via oral, à infusão contínua de morfina e midazolam na sedação de crianças submetidas à ventilação mecânica. MÉTODO: Foi realizado um estudo aleatório, duplamente encoberto e placebo controlado na UTI Pediátrica do Hospital Geral de Caxias do Sul, no período de maio de 2005 a agosto de 2006. Foram Incluídas crianças com idade entre 1 e 36 meses, submetidas à ventilação mecânica por mais de 12 horas, que utilizaram morfina e midazolam em infusão contínua. Foram divididas em dois grupos: clonidina (5 µg/kg) e placebo, associados à infusão de morfina e midazolam. As doses dos sedativos em infusão contínua foram definidas pelos médicos assistentes. Diariamente foram registradas as doses de sedativos administradas nas 24 horas, assim como as doses intermitentes e aplicado o escore de Finnegan para definir e quantificar abstinência. Os grupos foram comparados quanto às doses de sedativos administradas, tempo de uso de infusão contínua, presença e duração da abstinência. RESULTADOS: Foram incluídas 69 crianças (31 no grupo clonidina e 38 no placebo). Os grupos foram semelhantes nas características gerais (peso, idade, sexo, indicação de ventilação mecânica). Ambos os grupos utilizaram altas doses cumulativas de sedativos, tanto em infusão contínua quanto intermitente. Completaram o estudo 59 pacientes, 25 no grupo clonidina e 34 no placebo. Em ambos os grupos a prevalência da abstinência foi semelhante (72% e 75%, respectivamente), sem diferença na sua duração e no tempo de ventilação mecânica. CONCLUSÕES: Em crianças submetidas à ventilação mecânica que utilizaram altas doses de opióides e diazepínicos, a adição de clonidina não promoveu redução nas doses diárias ou cumulativas de sedativos, não influiu na prevalência ou na evolução da abstinência.BACKGROUND AND OBJECTIVES: In our country, the abstinence syndrome has high prevalence and besides the distress prolongs the length of hospital stay. The aim of this study was to evaluate the influence of associating oral clonidine to the intravenous morphine plus midazolam continuous infusion in children submitted to mechanical ventilation. METHODS: Randomized, double blind, placebo controlled study, conducted in the PICU at the Hospital Geral of Caxias do Sul. All children (1-36 months) submitted to mechanical ventilation over 12 hours (May-2005/August-2006), which had used intravenous morphine and midazolam continuous infusion were included. They were randomized to received clonidine (5 µg/kg) or placebo associated to the sedative continuous infusion. The infusion sedative doses were at the discretion of the assistant physician. The administered doses in the previous 24 hours and the doses of intermittent sedation were daily collected. The abstinence syndrome was defined based on Finnegan Score. The groups were compared regarding the cumulative doses of sedatives, length of use of sedative continuous infusion, presence and duration of the abstinence. RESULTS: Were included 69 patients (31 in the clonidine group and 38 in the placebo group). The two groups were similar regarding the general characteristics (weight, age, gender, indication of mechanical ventilation). The midazolam and morphine doses (cumulative and intermittent doses) were not different in both groups. Completed the study 59 patients, 25 in clonidine group and 34 in placebo group. The prevalence of the abstinence was similar (72% and 75%, respectively), without difference in the recovery time neither related to the length of mechanical ventilation. CONCLUSIONS: In children submitted to mechanical ventilation using high dose of opioids and diazepinic infusion the addiction of clonidine did not decrease the daily doses neither the cumulative doses and nevertheless reduced the prevalence and the evolution of abstinence syndrome.

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The article investigates the intersection of temperance discourse and emergent naturalist aesthetics in Amelia E. Johnson's Clarence and Corinne (1890). Just as many novels published in the Black Woman's Era at the turn of the twentieth century, it parallels the tradition of white woman's fiction as defined by Nina Baym and the sentimental tradition as discussed by Jane Tompkins. In my analysis, I will show how Johnson's imagery resonates with both the drunkard narrative and seminal works of American naturalism, such Stephen Crane's Maggie (1893) and Theodore Dreiser's Sister Carrie (1900), and how Clarence and Corinne exemplifies salient--though rarely examined--interconnections between temperance discourse and naturalist aesthetics. Her appropriation and revision of hegemonic ideologies and fiction formats enables her to not only to engage in a critical dialogue with Victorian gender politics and the capitalist economy but also to relate to issues of specific relevance for the contemporary African American community, such as the rise of the retrogressionist discourse of black bestiality, post-Reconstruction failure of a free labor economy, and interracial patronage politics. [ABSTRACT FROM AUTHOR]

Copyright of Avances en PsicologÍa Latinoamericana is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

En este artículo se discute la posibilidad de usar una aproximación psicoanalítica para el tratamiento de pacientes con adicción. Los conceptos centrales de los llamados "clásicos" son analizados, discutiendo si la adicción puede ser considerada un síntoma psicoanalítico, una expresión de conflictos inconscientes. Se distinguen tres etapas en el proceso que lleva al desarrollo de una adicción. Se presenta el concepto de "rectificación subjetiva" de Lacan, con el fin de discutir el proceso de entrada a tratamiento desde una aproximación psicoanalítica. Se discute la necesidad de abstinencia. Se realiza una propuesta para establecer una aproximación técnicamente flexible a partir de la cual se puedan incluir las instancias y elementos terapéuticos requeridos sin renunciar al punto de vista psicoanalítico.This article discusses how possible it is to use a psychoanalytical approach to treat patients with drug addiction. Main concepts of the so called "classics" are analysed discussing if drug addiction can be considered a psychoanalytical sympton, an expression of unconscious conflicts. Three steps of the process leading to an addiction are distinguished. The concept of "subjective rectification" of Lacan is presented, aiming to discuss the entrance process to a treatment from a psychoanalytical point of view. The need of abstinence is discussed. A proposal is made to set a technically flexible approach, in order to include all the therapeutic instances and elements required without giving up a psychoanalytical point of view.

Foram entrevistados nove homens e três mulheres, residentes na região da cidade de Caxias do Sul - RS, todos diagnosticados como dependentes de substâncias, segundo critérios do DSM-IV, para que descrevessem suas experiências de abstinência e recaída nas tentativas de recuperação da dependência química. A análise qualitativa das entrevistas orientou-se pelos movimentos reflexivos de descrição, redução e interpretação fenomenológica. A experiência da abstinência foi atribuída aos seguintes constituintes e contextos experienciais: consciência do problema aditivo por parte do dependente, resgate de vínculos familiares, recomposição de auto-estima, afastamento de ambientes favorecedores da adição, e envolvimento em práticas religiosas. A ausência dos constituintes e contextos identificados na experiência de abstinência caracterizou a manutenção do consumo. Os elos experienciais interpretados como essenciais à experiência de abstinência foram as redes interpessoais de apoio - constituídas por profissionais, familiares e novos amigos - e o envolvimento como colaboradores na recuperação de outros dependentes químicos.