Biomedical subjects

A Gual

Publications and source records attributed to A Gual.

40 records · Page 3Linked to original sources

PubMedDate not supplied

Five-year outcome in alcohol dependence. A naturalistic study of 850 patients in Catalonia.

A prospective, multicentre study was designed to evaluate the impact of a treatment programme in alcohol-dependent patients (n = 850). Drinking status and measures related to quality of life such as morbidity, mortality, alcohol-related problems, and psychological and social functioning were assessed 5 years from the initial contact with the patient. Five years after the initial visit, drinking status followed a bimodal distribution: 371 patients (43.6%) were found to be abstinent, 323 (38%) were heavy drinkers, and only 55 (6.5%) were controlled drinkers. A total of 65 (7.6%) patients died during the study, 33 (3.9%) patients were lost to follow-up and three (0.3%) patients were not collaborative. Differences in health-related issues were identified for each of the drinking status categories. Abstinent patients presented with significantly better outcomes than controlled and heavy drinkers on most medical, socio-economic and psychological measures. Heavy drinkers showed significantly worse outcomes than controlled drinkers.

Adolescent↗

PubMedDate not supplied

Acamprosate during and after acute alcohol withdrawal: a double-blind placebo-controlled study in Spain.

To test acamprosate's role as an aid in preventing relapse after detoxification, 296 alcohol-dependent patients entered a prospective, multicentre, randomized, double-blind, parallel comparison of acamprosate treatment consisting of two 333 mg tablets given three times daily for 180 days with matching placebo treatment. Unlike previous studies, acamprosate was prescribed from the start of alcohol withdrawal, rather than after the detoxification process. During the treatment period, 110 patients dropped out. The two treatment groups were balanced with regard to baseline values and reasons for discontinuation. There was no difference between the groups in the severity of withdrawal symptoms as measured by the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol scale). Acamprosate given during withdrawal did not cause unwanted effects. The cumulative abstinence duration (CAD, main end-point) was 19 days longer in the acamprosate treatment group than the placebo treatment group (analysis of variance on ranks, P = 0.0006) and the stable recovery duration, defined as the number of abstinent days between the last relapse into any drinking and the end of the trial, was 16 days longer in the acamprosate treatment group (P = 0.021). Continuous abstinence, estimated by survival analysis on time to first relapse, was achieved by 35% of acamprosate-treated patients and 26% of placebo-treated patients (log rank P = 0.068). The geometric mean of the ratio final/baseline values for serum carbohydrate-deficient transferrin was 0.802 (placebo) and 0.733 (acamprosate) (P = 0.059). The geometric mean of the ratio final/baseline values for serum gamma-glutamyltransferase was 0.496 (placebo) and 0.415 (acamprosate) (P = 0.024) which corroborated the greater abstinence reported by the acamprosate group.

Acamprosate↗

PubMedDate not supplied

Sertraline for the prevention of relapse in detoxicated alcohol dependent patients with a comorbid depressive disorder: a randomized controlled trial.

AIMS: We performed a double-blind, placebo-controlled randomized trial of sertraline in recently detoxified alcohol-dependent patients with current depressive symptoms. The objectives of the study were to evaluate the efficacy of sertraline at achieving stable abstinence, at ameliorating depressive symptoms and at improving quality of life in these patients. METHODS: The study included 83 patients, who received either sertraline (50-150 mg/day) or placebo for 24 weeks. The primary outcome criteria were the rate of relapse into alcohol consumption and the rate of response on the Montgomery and Asberg Depression Rating Scale (MADRS). RESULTS: At the end of the treatment period, relapse rates were 23.1% in the placebo group and 31.8% in the sertraline group. Responder rates for depression were 38.5% for the placebo group and 44.2% for the sertraline group. There was no significant difference between treatment groups with either variable. However, when patients were stratified into severe (MADRS score >or=26) and moderate (MADRS score <26) depression at inclusion, a significant treatment benefit with sertraline was observed in the former group. Quality of life, determined by the SF-36, improved in both groups, with more benefit observed for the sertraline group on mental health items. Sertraline was well tolerated, and the incidence of adverse events was similar in the two treatment groups. CONCLUSIONS: The explanation for the overall good outcome in both treatment groups and for the inability to demonstrate a clear treatment effect may reside in the clinical features of the patients included.

Adult↗

PubMedDate not supplied

[Group psychotherapy with young alcoholics: specialization or integration?].

INTRODUCTION: Group therapy (GT) is widely used in the treatment of alcoholism. Nevertheless, few data are available on the inclusion criteria for specific individual, as well as on specific group, techniques for the management of some types or groups of patients with homogeneous characteristics. METHOD: Compliance with group therapy has been analyzed in a sample of 459 alcoholics under 36 years of age, 303 of whom were placed in specific GT for young people (Y groups) and 156 were allocated in standard GT (NY) groups. RESULTS: Similar rates of discharge (16.8% vs 18.6%), withdrawals and drop-outs (63.4% vs 61.5%) of patients have been found in both groups. No differences were found in the survival function of time of compliance adjusted for gender and age (Y: 27.2%, and NY: 33.3% at one year, and Y: 18.4%, and NY: 21% at 2 years). CONCLUSIONS: There is no scientific evidence to support the use of Y groups in the treatment of young alcoholics. On the other hand, the possibility still exists that the use of groups with composition, techniques and specific objectives may provide improvement in compliance and in the therapeutic results as long as they adequately identify the characteristics of the patients who may benefit from a homogeneous treatment.

Adult↗