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Giustino A, Natola A, Savoia G, De Salvia MA, Finelli C. Reduced Pharmacological Intervention of Prehospital Services for Acute Alcohol Intoxication during the COVID-19 Pandemic in A Large District of Southern Italy. J Clin Med 2024; 13:3057. [PMID: 38892768 PMCID: PMC11172439 DOI: 10.3390/jcm13113057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 05/14/2024] [Accepted: 05/22/2024] [Indexed: 06/21/2024] Open
Abstract
Background Stress during a pandemic increases the risk of alcohol consumption, which may require pharmacological management. Methods An observational single-center retrospective study was conducted from 1 January 2018 to 31 December 2021, and divided into 2-year periods (2018-2019 and 2020-2021). This study focused on calls to one of the emergency departments (EDs) of seven hospitals in the Bari (Italy) metropolitan area for patients requiring emergency services (ESs) who were either admitted or not admitted, due to their refusal. Results A 30% reduction in emergency calls for alcohol-related issues and a 41.17% reduction in calls for patients who refused to be admitted to the ED were observed during the pandemic. During the pandemic, an inverse association was found between pharmacological treatment and number of calls coded green (non-critical) and yellow (fairly critical) in patients admitted to EDs. An inverse association was also found for calls coded green in patients not admitted to EDs and pharmacological treatment. Metadoxine was administered in almost all alcohol-related emergencies, primarily in conjunction with drugs acting on the gastrointestinal tract, irrespective of age, the period considered, and whether patients were admitted or not admitted to the ED. Conclusions ES is the first and only out-of-hospital service encountered by numerous patients with alcohol-use disorders who refuse to be admitted to the ED. These patients should be directed by ES personnel to a multidisciplinary program to receive treatment for drinking, improve their quality of life, and reduce sanitation costs.
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Affiliation(s)
- Arcangela Giustino
- Department of Precision and Regenerative Medicine and Ionian Area, Medical School, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (A.G.); (M.A.D.S.)
| | - Annamaria Natola
- Operations Centre of Emergency Services (118)—Policlinico Hospital, Piazza Giulio Cesare, 11, 70124 Bari, Italy (G.S.)
| | - Giovanni Savoia
- Operations Centre of Emergency Services (118)—Policlinico Hospital, Piazza Giulio Cesare, 11, 70124 Bari, Italy (G.S.)
| | - Maria Antonietta De Salvia
- Department of Precision and Regenerative Medicine and Ionian Area, Medical School, University of Bari “Aldo Moro”, Piazza Giulio Cesare, 11, 70124 Bari, Italy; (A.G.); (M.A.D.S.)
| | - Carmine Finelli
- Department of Internal Medicine, Hospital “A. Maresca”–ASL Naples 3 Sud, Via Montedoro, 1, 80059 Torre del Greco (Naples), Italy
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2
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Palmese F, Bonavita ME, Pompili E, Reggidori N, Migliano MT, Di Stefano C, Grieco M, Colazzo S, Baldassarre M, Caraceni P, Foschi FG, Giostra F, Farina G, Del Toro R, Bedogni G, Domenicali M. Development and internal validation of a multivariable model for the prediction of the probability of 1-year readmission to the emergency department for acute alcohol intoxication. Intern Emerg Med 2024; 19:823-829. [PMID: 38095747 DOI: 10.1007/s11739-023-03490-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/17/2023] [Indexed: 04/24/2024]
Abstract
To develop and internally validate a multivariable logistic regression model (LRM) for the prediction of the probability of 1-year readmission to the emergency department (ED) in patients with acute alcohol intoxication (AAI). We developed and internally validated the LRM on a previously analyzed retrospective cohort of 3304 patients with AAI admitted to the ED of the Sant'Orsola-Malpighi Hospital (Bologna, Italy). The benchmark LRM employed readmission to the same ED for AAI within 1 year as the binary outcome, age as a continuous predictor, and sex, alcohol use disorder, substance use disorder, at least one previous admission for trauma, mental or behavioral disease, and homelessness as the binary predictors. Optimism correction was performed using the bootstrap on 1000 samples without replacement. The benchmark LRM was gradually simplified to get the most parsimonious LRM with similar optimism-corrected overall fit, discrimination and calibration. The 1-year readmission rate was 15.7% (95% CI 14.4-16.9%). A reduced LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness, performed nearly as well as the benchmark LRM. The reduced LRM had the following optimism-corrected metrics: scaled Brier score 17.0%, C-statistic 0.799 (95% CI 0.778 to 0.821), calibration in the large 0.000 (95% CI - 0.099 to 0.099), calibration slope 0.985 (95% CI 0.893 to 1.088), and an acceptably accurate calibration plot. An LRM based on sex, age, at least one previous admission for trauma, mental or behavioral disease, and homelessness can be used to estimate the probability of 1-year readmission to ED for AAI. To begin proving its clinical utility, this LRM should be validated in external cohorts.
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Affiliation(s)
- Francesco Palmese
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, "S. Maria Delle Croci" Hospital, AUSL Romagna, Ravenna, Italy.
| | - Maria Elena Bonavita
- Department of Internal Medicine, "Degli Infermi" Hospital, AUSL Romagna, Faenza, Italy
| | - Enrico Pompili
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Nicola Reggidori
- Department of Internal Medicine, "Degli Infermi" Hospital, AUSL Romagna, Faenza, Italy
| | - Maria Teresa Migliano
- Department of Internal Medicine, "Degli Infermi" Hospital, AUSL Romagna, Faenza, Italy
| | - Cecilia Di Stefano
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Marta Grieco
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Stefano Colazzo
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Maurizio Baldassarre
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Center for Applied Biomedical Research-CRBA, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Paolo Caraceni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | | | - Fabrizio Giostra
- Emergency Department-Pronto Soccorso, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
| | - Gabriele Farina
- Emergency Department-Pronto Soccorso, "Degli Infermi" Hospital, AUSL Romagna, Faenza, Italy
| | - Rossella Del Toro
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, "S. Maria Delle Croci" Hospital, AUSL Romagna, Ravenna, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, "S. Maria Delle Croci" Hospital, AUSL Romagna, Ravenna, Italy
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
- Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, "S. Maria Delle Croci" Hospital, AUSL Romagna, Ravenna, Italy
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Sivertsen DM, Andersen KV, Becker U, Lisby M, Andersen O, Brünes N, Kirk JW. Acceptability Among Frontline Staff Toward Distributing an Anonymous Alcohol Survey in Emergency Departments: A Mixed Methods Study. J Addict Nurs 2023; 34:E53-E64. [PMID: 37669345 PMCID: PMC10510809 DOI: 10.1097/jan.0000000000000538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
ABSTRACT Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs.
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Strayer RJ, Friedman BW, Haroz R, Ketcham E, Klein L, LaPietra AM, Motov S, Repanshek Z, Taylor S, Weiner SG, Nelson LS. Emergency Department Management of Patients With Alcohol Intoxication, Alcohol Withdrawal, and Alcohol Use Disorder: A White Paper Prepared for the American Academy of Emergency Medicine. J Emerg Med 2023; 64:517-540. [PMID: 36997435 DOI: 10.1016/j.jemermed.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/06/2023] [Indexed: 03/30/2023]
Affiliation(s)
- Reuben J Strayer
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York.
| | - Benjamin W Friedman
- Department of Emergency Medicine, Montefiore, Albert Einstein College of Medicine, Bronx, New York
| | - Rachel Haroz
- Cooper Medical School of Rowan University, Cooper University Healthcare, Camden, New Jersey
| | - Eric Ketcham
- Department of Emergency Medicine, Department of Behavioral Health, Addiction Medicine, Presbyterian Healthcare System, Santa Fe & Española, New Mexico
| | - Lauren Klein
- Department of Emergency Medicine, Good Samaritan Hospital, West Islip, New York
| | - Alexis M LaPietra
- Department of Emergency Medicine, Saint Joseph's Regional Medical Center, Paterson, New Jersey
| | - Sergey Motov
- Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York
| | - Zachary Repanshek
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Scott Taylor
- Department of Emergency Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - Scott G Weiner
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Lewis S Nelson
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, New Jersey
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5
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Di Serio F, Giustino A, Calamita C, Savoia G, Lovero R, Mascolo E, Buttiglione M, Finelli C, Zambetta G, De Salvia MA. Acute alcohol intoxication across different age groups in 2014-2018: Prehospital care and biochemical correlates at a large University Hospital in southern Italy. Int Emerg Nurs 2022; 60:101113. [PMID: 34942538 DOI: 10.1016/j.ienj.2021.101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Risky alcohol consumption can occur from a young age and affects people of all age groups, sometimes requiring the intervention of the emergency medical services. OBJECTIVES Determining the timing and characteristics of emergency calls (to the "118" emergency number) relating to subjects in all age groups, in which alcohol was a contributing factor, along with the biochemical correlates, in a great metropolitan area. On the basis of these, future interventions would target specific training for nurses and paramedics working in emergency medical services. METHOD An observational single-centre retrospective study carried out from 1 January 2014 to 31 December 2018 involving patients requiring emergency care and attending the Emergency Department of an University Hospital. RESULTS Out of a total of 47,252 emergency calls, 2.22% were for alcohol-related conditions and mainly involved male patients (78.4%). A high incidence of alcoholic coma was found in patients aged 11 to 17 years. Emergency medical assistance was required mainly at night on weekdays by patients aged 11-17, 25-44 years and during the weekend and on weekdays by patients aged 18-24 years. A blood alcohol concentration higher than 50 mg/dL was found in more than 67% of patients aged 11-17 and 18-24 years at weekends. CONCLUSIONS The most alarming finding from our data is that, despite prevention policies, young people requiring emergency medical assistance showed similar alcohol levels as adults and a high incidence of alcoholic coma.
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Affiliation(s)
- Francesca Di Serio
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Arcangela Giustino
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Cesare Calamita
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Giovanni Savoia
- Operations Centre of Emergency Services (118) - Policlinico Hospital, Bari, Italy
| | - Roberto Lovero
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Elisa Mascolo
- Clinical Pathology Unit, AOU Policlinico Consorziale di Bari-Ospedale Giovanni XXIII, Bari, Italy
| | - Maura Buttiglione
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - Carmine Finelli
- Department of Internal Medicine, Hospital "Cavalier Raffaele Apicella"-ASL Naples 3 Sud, Pollena (Napoli), Italy
| | - Giovanni Zambetta
- Forensic Medicine, Hospital "Miulli", Acquaviva delle Fonti (Bari), Italy
| | - Maria A De Salvia
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy.
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6
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Collins SE, Goldstein SC, Suprasert B, Doerr SAM, Gliane J, Song C, Orfaly VE, Moodliar R, Taylor EM, Hoffmann G. Jail and Emergency Department Utilization in the Context of Harm Reduction Treatment for People Experiencing Homelessness and Alcohol Use Disorder. J Urban Health 2021; 98:83-90. [PMID: 33185824 PMCID: PMC7873130 DOI: 10.1007/s11524-020-00452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
People experiencing homelessness are disproportionately affected by alcohol use disorder (AUD). Abstinence-based treatment, however, does not optimally engage or treat this population. Thus, Harm Reduction Treatment for Alcohol (HaRT-A) was developed together with people with the lived experience of homelessness and AUD and community-based agencies that serve them. HaRT-A is a compassionate and pragmatic approach that aims to help people reduce alcohol-related harm and improve quality of life (QoL) without requiring abstinence or use reduction. The parent RCT showed that HaRT-A precipitated statistically significant reductions in alcohol use, alcohol-related harm, AUD symptoms, and positive urine toxicology tests. This secondary study tested HaRT-A effects on more distal, 6-month pre-to-posttreatment changes on jail and emergency department (ED) utilization. People experiencing homelessness and AUD (N = 168; 24% women) were recruited in community-based clinical and social services settings. Participants were randomized to receive HaRT-A or services as usual. Over four sessions, HaRT-A interventionists delivered three components: (a) collaborative tracking of participant-preferred alcohol metrics, (b) elicitation of harm-reduction and QoL goals, and (c) discussion of safer-drinking strategies. Administrative data on jail and ED utilization were extracted for 6 months pre- and posttreatment. Findings indicated no statistically significant treatment group differences on 6-month changes in jail or ED utilization (ps > .23). Exploratory analyses showed that 2-week frequency of alcohol use was positively correlated with number of jail bookings in the 12 months surrounding their study participation. Additionally, self-reported alcohol-related harm, importance of reducing alcohol-related harm, and perceived physical functioning predicted more ED visits. Future studies are needed to further assess how harm-reduction treatment may be enhanced to move the needle in criminal justice and healthcare utilization in the context of larger samples, longer follow-up timeframes, and more intensive interventions.
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Affiliation(s)
- Susan E Collins
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA.
| | - Silvi C Goldstein
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Bow Suprasert
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Samantha A M Doerr
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Joanne Gliane
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Clarissa Song
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Victoria E Orfaly
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Rddhi Moodliar
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Emily M Taylor
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
| | - Gail Hoffmann
- University of Washington - Harborview Medical Center, 325 Ninth Ave, Box 359911, Seattle, WA, 98104, USA
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7
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Laferté C, Dépelteau A, Hudon C. Injuries and frequent use of emergency department services: a systematic review. BMJ Open 2020; 10:e040272. [PMID: 33376165 PMCID: PMC7778763 DOI: 10.1136/bmjopen-2020-040272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To review all studies having examined the association between patients with physical injuries and frequent emergency department (ED) attendance or return visits. DESIGN Systematic review. DATA SOURCE Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO databases were searched up to and including July 2019. ELIGIBILITY CRITERIA English and French language publications reporting on frequent use of ED services (frequent attendance and return visits), evaluating injured patients and using regression analysis. DATA EXTRACTION AND SYNTHESIS Two independent reviewers screened the search results, and assessed methodological quality using the Joanna Briggs Institute tool for prevalence studies. Results were collated and summarised using a narrative synthesis. A sensitivity analysis was performed to evaluate the repercussions of removing a study that did not meet the quality criteria. RESULTS Of the 2184 studies yielded by this search, 1957 remained after the removal of duplicates. Seventy-eight studies underwent full-text screening leaving nine that met the eligibility criteria and were included in this study: five retrospective cohort studies; two prospective cohort studies; one cross-sectional study; and one case-control study. Different types of injuries were represented, including fractures, trauma and physical injuries related to falls, domestic violence or accidents. Sample sizes ranged from 200 to 1 259 809. Six studies included a geriatric population while three addressed a younger population. Of the four studies evaluating the relationship between injuries and frequent ED use, three reported an association. Additionally, of the five studies in which the dependent variable was return ED visits, three articles identified a positive association with injuries. CONCLUSIONS Physical injuries appear to be associated with frequent use of ED services (frequent ED attendance as well as return ED visits). Further research into factors including relevant youth-related covariates such as substance abuse and different types of traumas should be undertaken to bridge the gap in understanding this association.
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Affiliation(s)
- Catherine Laferté
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Andréa Dépelteau
- École de Réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Catherine Hudon
- Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- École de Réadaptation, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Département de Médecine de Famille et de Médecine d'Urgence, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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8
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Leone S, Pellicano R, Testino G, Caputo F. Severe acute alcoholic hepatitis and liver transplantation: recent knowledge. MINERVA GASTROENTERO 2020; 66:87-89. [PMID: 32218428 DOI: 10.23736/s1121-421x.20.02688-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Silvia Leone
- Unit of Addiction and Hepatology, Alcohological Regional Center, ASL3, San Martino Polyclinic Hospital, Genoa, Italy
| | | | - Gianni Testino
- Unit of Addiction and Hepatology, Alcohological Regional Center, ASL3, San Martino Polyclinic Hospital, Genoa, Italy -
| | - Fabio Caputo
- Department of Internal Medicine, SS Annunziata Hospital, University of Ferrara, Cento, Ferrara, Italy
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Singh L, Joshi T, Tewari D, Echeverría J, Mocan A, Sah AN, Parvanov E, Tzvetkov NT, Ma ZF, Lee YY, Poznański P, Huminiecki L, Sacharczuk M, Jóźwik A, Horbańczuk JO, Feder-Kubis J, Atanasov AG. Ethnopharmacological Applications Targeting Alcohol Abuse: Overview and Outlook. Front Pharmacol 2020; 10:1593. [PMID: 32116660 PMCID: PMC7034411 DOI: 10.3389/fphar.2019.01593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/09/2019] [Indexed: 12/12/2022] Open
Abstract
Excessive alcohol consumption is the cause of several diseases and thus is of a major concern for society. Worldwide alcohol consumption has increased by many folds over the past decades. This urgently calls for intervention and relapse counteract measures. Modern pharmacological solutions induce complete alcohol self-restraint and prevent relapse, but they have many side effects. Natural products are most promising as they cause fewer adverse effects. Here we discuss in detail the medicinal plants used in various traditional/folklore medicine systems for targeting alcohol abuse. We also comprehensively describe preclinical and clinical studies done on some of these plants along with the possible mechanisms of action.
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Affiliation(s)
- Laxman Singh
- Centre for Biodiversity Conservation & Management, G.B. Pant National Institute of Himalayan Environment & Sustainable Development, Almora, India
| | - Tanuj Joshi
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Devesh Tewari
- Department of Pharmacognosy, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Javier Echeverría
- Department of Environmental Sciences, Faculty of Chemistry and Biology, Universidad de Santiago de Chile, Santiago, Chile
| | - Andrei Mocan
- Department of Pharmaceutical Botany, “Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Archana N. Sah
- Department of Pharmaceutical Sciences, Faculty of Technology, Kumaun University Bhimtal Campus, Nainital, India
| | - Emil Parvanov
- Institute of Molecular Genetics, Academy of Sciences of the Czech Republic, Division BIOCEV, Prague, Czechia
| | - Nikolay T. Tzvetkov
- Institute of Molecular Biology “Roumen Tsanev”, Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Department Global R&D, NTZ Lab Ltd., Sofia, Bulgaria
| | - Zheng Feei Ma
- Department of Public Health, Xi’an Jiaotong-Liverpool University, Suzhou, China
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Yeong Yeh Lee
- School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Piotr Poznański
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Lukasz Huminiecki
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Mariusz Sacharczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Artur Jóźwik
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Jarosław O. Horbańczuk
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Joanna Feder-Kubis
- Faculty of Chemistry, Wrocław University of Science and Technology, Wybrzeże Wyspiańskiego, Wrocław, Poland
| | - Atanas G. Atanasov
- Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzebiec, Poland
- Department of Pharmacognosy, University of Vienna, Vienna, Austria
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
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10
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Further Utilization of Emergency Department and Inpatient Psychiatric Services Among Young Adults Admitted at the Emergency Department With Clinical Alcohol Intoxication. J Addict Med 2020; 14:32-38. [PMID: 32012139 DOI: 10.1097/adm.0000000000000529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess in a cohort of young adults admitted with alcohol intoxication (AI) to the Emergency Department (ED): how many patients are readmitted to the ED or to a Psychiatric Department (PD) inpatient unit; and which characteristics are associated with further ED and PD inpatient admissions. METHODS In 630 patients aged 18 to 30 years admitted for AI in 2006 to 2007 to the ED of a Swiss tertiary hospital, further ED and PD inpatient admissions through 2013 were assessed. Patient characteristics at the index (initial) ED visit were assessed using administrative and medical records. MEASUREMENTS Proportion of subjects with at least 1 further ED admission, 1 further ED admission with AI, and any PD admission over the study period.Associations between patients' characteristics at index visit and readmissions were assessed using backward selection multivariate regression analyses. RESULTS Mean age was 24, 66% were male, 60% had any ED/PD admissions during the study period, 17.9% a PD admission, and 13.8% were re-admitted to ED with AI. Disruptive behavior at the index visit was associated with further ED (odds ratio [OR] 1.69 [1.13; 2.54]) and PD admissions (OR 2.41 [1.44; 4.05]). Psychiatric diagnosis was associated with any further ED admission (OR 2.07 [1.41; 3.05]), with further ED admission with AI (OR 4.56 [2.36; 8.81]) and with PD admission (OR 3.92 [2.40; 6.41]). Female sex predicted any further ED admission (OR 1.65 [1.14; 2.39]). CONCLUSIONS Young adults presenting with alcohol intoxication have high rates of subsequent inpatient emergency and psychiatric admissions. Being female, presenting with disruptive behavior, and having a psychiatric diagnosis at the ED visit were predictors of further admissions.
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Affiliation(s)
- Gianni Testino
- Alcohological Regional Center of Liguria, ASL3 Liguria, San Martino Polyclinic Hospital, Genoa, Italy -
| | - Silvia Leone
- Alcohological Regional Center of Liguria, ASL3 Liguria, San Martino Polyclinic Hospital, Genoa, Italy
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Testino G, Balbinot P, Pellicano R. Alcohology: a medical specialization in real practice. Minerva Med 2019; 110:185-187. [PMID: 30784246 DOI: 10.23736/s0026-4806.19.05954-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Gianni Testino
- Alcohological Regional Centre, Ligurian Region, ASL3 c/o San Martino Hospital, Genoa, Italy -
| | - Patrizia Balbinot
- Alcohological Regional Centre, Ligurian Region, ASL3 c/o San Martino Hospital, Genoa, Italy
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