***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIMS ( i ) To evaluate the effect of receiving one of two brief interventions in reducing alcohol consumption among general hospital patients compared with usual care . ( ii ) To assess whether a brief intervention of self-efficacy enhancement was superior to a self-help booklet in reducing alcohol consumption . DESIGN A three-arm cluster r and omized controlled trial . SETTING Seven general medical , six general surgical , one dermatology and two otolaryngology wards of a large teaching hospital covering a large urban and rural area . PARTICIPANTS A total of 215 of 789 in- patients aged 18 - 75 years , who screened positive for alcohol consumption in excess of national recommended limits according to a 7-day retrospective drinking diary . INTERVENTIONS Participants were allocated to receive one of three interventions : ( i ) face-to-face self-efficacy enhancement ; ( ii ) a self-help booklet ; or ( iii ) usual care . MEASUREMENTS The primary outcome measure was change in reported alcohol consumption at 6-month follow-up as measured by a 7-day retrospective drinking diary . Secondary outcomes were change in : number of alcohol drinking days in last week ; the maximum units of alcohol consumed on any one day in last week ; and Drinking Refusal Self-efficacy Expectancy Question naire score . FINDINGS Compared to the usual care group the self-efficacy enhancement group ( -10.1 units 95 % CI -16.1 to -4.1 ) and the self-help booklet group ( -10.0 units 95 % CI -16.0 to -3.9 ) had greater reductions in self-reported weekly alcohol consumption . There was no evidence that self-efficacy enhancement was superior to the self-help booklet ( P = 0.96 ) . CONCLUSIONS Brief interventions delivered in hospital offer simple means of helping heavy drinkers to reduce their alcohol consumption Background Patients with hazardous alcohol intake are overrepresented in emergency departments and surgical wards . These patients have an increased risk of postoperative complications with prolonged hospital stays and admissions to intensive care unit after surgery . In elective surgery , preoperative alcohol cessation interventions can reduce postoperative complications , but no studies have investigated the effect of alcohol cessation intervention at the time of acute fracture surgery . This protocol describes a r and omised clinical trial that aims to evaluate the effect of a new gold st and ard programme for alcohol cessation intervention in the perioperative period regarding postoperative complications , alcohol intake and cost-effectiveness . Methods / Design Patients with hazardous alcohol intake undergoing ankle fracture surgery will be recruited into the trial from multiple orthopaedic wards at university hospitals in Denmark , Sweden and Norway . Included patients will be r and omly allocated to either st and ard care or the gold st and ard programme aim ed at complete alcohol abstinence before , during and 6 weeks after surgery . It includes a structured patient education programme and weekly interventions meetings at the orthopaedic outpatient clinic . Furthermore , patients are provided with thiamine and B-vitamins , alcohol withdrawal prophylaxis and treatment , and disulfiram to support abstinence . Alcohol intake is biochemically vali date d ( blood , urine and breath tests ) at the weekly intervention meetings and follow-up visits . Follow-up assessment s will be conducted 6 weeks and 3 , 6 , 9 and 12 months after surgery for all patients . The effect of the gold st and ard programme will be assessed comparing the outcome measures between the intervention and control group at each follow-up point . Discussion The study will provide new knowledge about how to prevent alcohol-related postoperative complications at the time of acute fracture surgery . If effective , the results will be a benefit for the clinical course , patients and society alike . Trial registration The protocol is registered in Clinical Trials.gov ( I d : NCT00986791 ) PURPOSE The proximate use of illicit drugs or alcohol ( substance use ) is the most common precipitator of facial injuries among socioeconomically disadvantaged population s. Reducing these risky behaviors could minimize adverse health sequelae and potential reinjury . The objective of our study was to test whether a culturally competent , personalized motivational intervention incorporated into surgical care could significantly reduce existing substance use behaviors in facial injury patients . PATIENTS AND METHODS Substance-using subjects ( n = 218 ) presenting with facial injuries to a level 1 trauma center were r and omly assigned to either a personalized motivational intervention ( PMI ) condition or a health-information ( HI ) control condition . After a brief assessment of the individual 's substance use severity and willingness to change these behaviors , both groups attended 2 counseling sessions with a trained interventionist . The PMI subjects ( n = 118 ) received individualized , motivational interventions , whereas the HI subjects ( n = 100 ) received only general health information . Both groups were reassessed at 6 and 12 months postinjury , and changes in substance-use patterns were measured to assess the effects of intervention . RESULTS The PMI and HI groups were closely matched on their sociodemographic and substance use characteristics . Subjects in the PMI group showed statistically significant declines in drug use at both the 6- and 12-month assessment s. The intervention 's effect on lowering illicit drug use was greatest at the 6-month assessment but had weakened by the 1-year follow-up . The efficacy of the PMI was moderated by an individual 's initial drug use severity ; individuals with greater drug use dependency at baseline were seen to have larger intervention effects , as did individuals who were most aware of their drug problem and willing to change their substance use behaviors . Unlike illicit drug use , changes in alcohol use did not differ significantly between the intervention and control groups , irrespective of an individuals ' recognition of the alcohol problem or willingness to take steps to address it . CONCLUSION A culturally competent , motivational intervention integrated into the care of vulnerable patients with facial injury can reduce illicit drug use behaviors . Subgroups of injured patients appear to benefit most from such personalized motivational interventions . A better articulation of target population s , intervention content , and delivery would allow for directed interventions and an appropriate focusing of limited time and health care re sources Abstract Objective : To evaluate the influence of preoperative abstinence on postoperative outcome in alcohol misusers with no symptoms who were drinking the equivalent of at least 60 g ethanol/day . Design : R and omised controlled trial . Setting : Copenhagen , Denmark . Subjects : 42 alcoholic patients without liver disease admitted for elective colorectal surgery . Interventions : Withdrawal from alcohol consumption for 1month before operation ( disulfiram controlled ) compared with continuous drinking . Main outcome measures : Postoperative complications requiring treatment within the first month after surgery . Perioperative immunosuppression measured by delayed type hypersensitivity ; myocardial ischaemia and arrhythmias measured by Holter tape recording ; episodes of hypoxaemia measured by pulse oximetry . Response to stress during the operation were assessed by heart rate , blood pressure , serum concentration of cortisol , and plasma concentrations of glucose , interleukin 6 , and catecholamines . Results : The intervention group developed significantly fewer postoperative complications than the continuous drinkers ( 31 % v 74 % , P=0.02 ) . Delayed type hypersensitivity responses were better in the intervention group before ( 37 mm2 v 12 mm2 , P=0.04 ) , but not after surgery ( 3 mm2 v 3 mm2 ) . Development of postoperative myocardial ischaemia ( 23 % v 85 % ) and arrhythmias ( 33 % v 86 % ) on the second postoperative day as well as nightly hypoxaemic episodes ( 4 v 18 on the second postoperative night ) occurred significantly less often in the intervention group . Surgical stress responses were lower in the intervention group ( P≤0.05 ) . Conclusions : One month of preoperative abstinence reduces postoperative morbidity in alcohol abusers . The mechanism is probably reduced pre clinical organ dysfunction and reduction of the exaggerated response to surgical stress We have compared 2 % lignocaine 3.5 ml with 0.5 % hyperbaric bupivacaine 3 ml in a r and omized , double-blind study in 30 patients undergoing subarachnoid anaesthesia for transurethral surgery . A sensory level of T10 was produced more quickly ( P = 0.0001 ) and maximum height reached sooner ( P = 0.0002 ) with lignocaine , although there was a greater reduction in systolic arterial pressure ( P = 0.03 ) and a trend towards slower heart rates ( P = 0.056 ) . Return of full sensory and motor function occurred earlier with lignocaine ( P = 0.00005 and P = 0.02 ) Objectives We compared the effectiveness of the Gold St and ard Programme ( a comprehensive smoking cessation intervention commonly used in Denmark ) with other face-to-face smoking cessation programmes in Denmark after implementation in real life , and we identified factors associated with successful quitting . Design Prospect i ve cohort study . Setting A total of 423 smoking cessation clinics from different setting s reported data from 2001 to 2013 . Participants In total , 82 515 patients were registered . Smokers ≥15 years old and attending a programme with planned follow-up were included . Smokers who did not want further contact , who intentionally were not followed up or who lacked information about the intervention they received were excluded . A total of 46 287 smokers were included . Interventions Various real-life smoking cessation interventions were identified and compared : The Gold St and ard Programme , Come & Quit , crash courses , health promotion counselling ( brief intervention ) and other interventions . Main outcome Self-reported continuous abstinence for 6 months . Results Overall , 33 % ( 11 184 ) were continuously abstinent after 6 months ; this value was 24 % when non-respondents were considered smokers . The follow-up rate was 74 % . Women were less likely to remain abstinent , OR 0.83 ( CI 0.79 to 0.87 ) . Short interventions were more effective among men . After adjusting for confounders , the Gold St and ard Programme was the only intervention with significant results across sex , increasing the odds of abstinence by 69 % for men and 31 % for women . In particular , compliance , and to a lesser degree , mild smoking , older age and not being disadvantaged were associated with positive outcomes for both sexes . Compliance increased the odds of abstinence more than 3.5-fold . Conclusions Over time , Danish smoking cessation interventions have been effective in real life . Compliance is the main predictor of successful quitting . Interestingly , short programmes seem to have relatively strong effects among men , but the absolute numbers are very small . Only the comprehensive Gold St and ard Programme works across sexes Patients admitted to an emergency surgical ward were screened for alcohol problems and r and omized between an extensive alcohol counseling and a brief assessment followed by feedback of risky alcohol consumption . Some 165 patients were assessed for risk consumption and followed up 6 to 12 months , and it was found that patients in both interventions significantly reduced the amount they drank per occasion although they drank as often as before . The patients had also moved to a stage more ready to change . No differences in effect were found between the interventions . A brief assessment with feedback about risk consumption can be done on an emergency surgical ward by the surgical staff with a few hours of training and may reduce risky alcohol consumption significantly Background : Although alcohol use disorders ( AUDs ) have enormous public health consequences , the rate of diagnosis of AUDs remains unsatisfactorily low . The primary aim of this study was to compare the detection of AUDs by anesthesiologists in a large preoperative assessment clinic to that by computerized self- assessment of the Alcohol Use Disorder Identification Test . Secondary outcome measures were to compare the actions taken by anesthesiologists upon a finding of an AUD . Methods : One thous and five hundred fifty-six patients were included . Before preoperative assessment , patients were asked to complete the  Alcohol Use Disorder Identification Test  ( positive scores : men ≥ 8 , women ≥ 5 ) using a computer . The authors performed a retrospective chart analysis of the anesthesiologists ’ actions upon a finding of an AUD . The anesthesiologists were blinded to the results of the computer-based assessment and to the subsequent chart analysis . Results : The prevalence rate of AUDs determined by the anesthesiologists was 6.9 % ( 107 of 1,556 ) , whereas the proportion of patients positive for an AUD using the computerised Alcohol Use Disorder Identification Test was 18.1 % ( 282 of 1,556 ) ( P < 0.001 ) . The detection rate by the anesthesiologists of AUDs among men was significantly higher than among women ( P < 0.001 ) as well as in the elderly compared with younger patients ( P < 0.001 ) . Action taken by anesthesiologists was mainly based on evaluating quantity of alcohol consumption . Conclusion : The computer-based self- assessment  increases detection rates of AUDs in busy setting s such as a preoperative assessment clinic . Prevalence rates of AUDs are underestimated . Best- practice guidelines for detection of AUDs are not implemented in the daily clinical routine . Barrier analysis is urgently required Background : Preoperative alteration of T cell – mediated immunity as well as an altered immune response to surgical stress were found in long-term alcoholic 
    Output:
    
Results show differences between the three clinical studies regarding outcome measurement and intensity of the interventions .
Investigators describe more successful quitters at the end of the intervention programme than among controls .
Intensive alcohol cessation interventions offered for four to eight weeks to participants undergoing all types of surgical procedures to achieve complete alcohol cessation before surgery probably reduced the number of postoperative complications .
The included participants may represent a selective group , as they could have been more motivated and /or more interested in participating in clinical research or otherwise different , and effects may have been overestimated for both intervention and control groups in these studies .