There is ample evidence of the teratogenic effects of prenatal alcohol exposure, with long-term consequences throughout the entire life cycle. Nevertheless, research on risk perception of alcohol consumption among pregnant women is scarce. In order to analyze risk perception of alcohol consumption during pregnancy, a cross-sectional study was conducted with a random sample of 426 pregnant women (in their 20th week of gestation) receiving care at the outpatient clinics of a public university hospital in the southern European city of Seville (Spain). Data were collected through structured face-to-face interviews conducted by trained health professionals using a customized questionnaire. Data analysis included structural equation modeling. Only 48.1% of the sample indicated that the sequelae from alcohol consumption during pregnancy were life-long. The structural equation model showed that a lower risk perception about beer and wine consumption, and a lower educational level, were related to more frequent alcohol consumption. Younger participants showed lower risk perception concerning beer consumption. Higher levels of education were related to a greater risk perception of beer. Healthcare institutions should articulate programs that facilitate health advice regarding alcohol consumption during pregnancy, particularly when providing care for women with low educational levels.

/pdf/pregnant-women-s-risk-perception-of-the-teratogenic-effects-2wwkwi9qs0.pdf

Pregnant Women’s Risk Perception of the Teratogenic Effects of Alcohol Consumption in Pregnancy

Objective 
To quantify the association between the presence and type of drug detected and trauma recidivism in a cohort of patients admitted due to trauma.


Method 
A cohort study was conducted based on data from a project where the presence of alcohol and other drugs (cannabis, cocaine, amphetamines, methamphetamines, tricyclic antidepressants, barbiturates, opiates and benzodiazepines) was analysed in 1,187 patients aged 16 to 70 years admitted due to trauma. The patients were followed for a period of between 10 to 52 months until June 2016. For this study, the recurrence of injuries from a sample of 929 patients from this cohort was analysed according to their consumption profile. Survival curves were estimated and adjusted Hazard Rate Ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated.


Results 
The incidence rate of TR was 10.94 cases per 100 patient-years in the group of patients negative for substances and 27.99 per 100 patient-years in positive patients. The survival curves show very significant differences in cumulative recurrence-free survival between the groups (Log Rank: p<0.001). Both the aHRR and the aIRR estimates show an increased risk of re-injury due to alcohol consumption (aIRR: 2.33 (1.72–3.15), p<0.001), cannabis use (aIRR: 1.87 (1.09–3.20), p = 0.022) and polydrug use (aIRR: 2.34 (1.80–3.04), p<0.001).


Conclusions 
The presence of alcohol and/or illicit drugs in these patients doubles the risk of trauma recidivism.

/pdf/association-between-the-detection-of-alcohol-illicit-drugs-lam2nlwokm.pdf

Association between the detection of alcohol, illicit drugs and/or psychotropic medications/opioids in patients admitted due to trauma and trauma recidivism: A cohort study.

The abuse of cocaine and its derivatives presents a likely risk factor for injury. Trauma incurred by cocaine and derivative abusers may be more severe than that incurred by non-users. To ascertain the presence of cocaine and its derivatives in trauma patients and to correlate RTS (Revised Trauma Score) and ISS (Injury Severity Score) with the presence of cocaine and its derivatives in blood and urine samples. All trauma victims treated in an emergency unit between November 11, 2012 and September 15, 2013 were included in the study. Blood and urine samples were collected on admission to hospital. RTS and ISS scores were then compared with the presence or absence of cocaine and its derivatives in the samples. The associations between RTS   16 and the independent variables were evaluated by the gross odds ratio values, determined by univariate logistic regression. Multivariate analysis was performed using multivariate logistic regression. Of 453 patients (83.7% male) included in the study, 28.6% presented ISS > 16 and 33.6% presented RTS   16 (1.76 times greater). For the trauma patients included in our study, the use of cocaine and its derivatives was shown to be associated with more severe traumas, as demonstrated by their RTS and ISS scores.

Prevalence of cocaine and derivatives in blood and urine samples of trauma patients and correlation with injury severity: a prospective observational study

Assessing Chinese coach drivers’ fitness to drive: The development of a toolkit based on cognition measurements

부산지역 근로자들에서 Alcohol Use Disorders Identification Test (AUDIT)와 간기능 검사와의 연관성 조사

A high perception of risk may exert a preventive effect against the initiation of risky activities. The aims of the present study were (1) to analyze the risk perception for traumatic incidents according to drug intake (alcohol, cannabis, cocaine, no consumption) by trauma patients admitted to our hospital, and (2) to explore the influence of drugs on trauma recidivism. Between 1 November 2011 and 1 April 2012, 404 patients aged between 16 and 70 years were admitted to our hospital for trauma cases. In 363 (89.9 %) of the patients, data were gathered on age, the trauma mechanism, and the consumption of alcohol and other drugs. Out of these 363 patients, 286 (78.8 %) attended a motivational interview and reported their consumption habits and their perception of the risk of trauma after alcohol and/or illegal drug consumption, as well as the antecedents of previous traumatisms. Alcohol and/or illegal drugs were detected in 37 % of the sample, with alcohol being the most frequently detected, followed by cannabis, cocaine, and other drugs. Among the trauma patients with no consumption, a high perception of trauma risk was associated with alcohol intake by 95.9 %, with cannabis consumption by 68.4 %, and with cocaine consumption by 53.4 %, whereas these percentages were significantly lower for patients testing positive for substances (79.3, 21.1, and 8.3 % respectively). Among the patients experiencing their first trauma, the mean age was almost 15 years younger in those who were positive for these substances than in those who were negative (p < 0.001). Finally, a history of previous trauma was reported by a majority (64 %) of the trauma patients testing positive for alcohol and/or drugs, but by a minority (36 %) of those testing negative (p < 0.001). The low perception of risk associated with alcohol, cannabis, or cocaine consumption by trauma patients under the influence of these substances on admission may be a predisposing factor for recidivism. Recommendations for both primary and secondary prevention are presented.

Trauma risk perception related to alcohol, cannabis, and cocaine intake.

The duodenal diverticulum is a common entity, being the second in frequency among digestive tract and mostly asymptomatic. It could be found during endoscopic or surgical procedures, making procedures on the biliary tract more difficult. The objective of this study is to assess the prevalence of duodenal diverticula in cadaveric material and compare findings with the reviewed literature. An observational descriptive study was carried out. 70 in-situ and ex-situ duodenum-pancreatic blocks were dissected from human adult corpses previously fixed in formaldehyde solution. The presence of duodenal diverticula was studied by establishing its prevalence, number, location in relation to the duodenal parts and edges, and the relationship with the major duodenal papilla (MDP). Regarding the prevalence, 16 (22,8%) duodenal diverticula were found in the analysed cases. These predominated in the descending part of the duodenum (D2). All of them were unique and were located on the mesenteric edge. Regarding their relationship with MDP, there was a predominance of the intradiverticular papilla. The duodenal diverticulum is a frequent entity and the prevalence reported in literature is different within each type of study (cadaveric, ERCP and CT). Our results evidence the highest prevalence if compared to other cadaveric studies analysed. In our study, as well as in the reviewed literature, duodenal diverticula are mostly located in the D2, in relation to MDP

Presence of duodenal diverticula in cadaveric study

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Trauma risk perception related to alcohol, cannabis, and cocaine intake.

Presence of duodenal diverticula in cadaveric study