Alcohol Smoking Research Articles

Predictors of cardiovascular disease risk: findings from the National Survey of Health and Development Cohort

Abstract Background Cardiovascular disease (CVD) remains a significant cause of mortality and morbidity within the UK. CVDs and all-cause mortality can be predicted with varying levels of certainty with different models. Purpose This study aimed to explore the incremental effect of risk factors and respective biomarkers on CVD events risk estimation models. Methods The National Survey for Health and Development (NSHD) birth cohort study, including 2547 women 2815 men, was used to model relationships between conventional and emerging risk factors and cardiometabolic and vascular outcomes, including myocardial infarction and stroke between 1999 and 2009. Logistic regression or XGBoost (eXtreme Gradient Boosting) models were used to predict the outcomes (myocardial infarction and strokes). Model fit was assessed by comparing predicted and known incident events in a two-by-two error matrix for binary outcomes. Results In a model including both sex and smoking alcohol intake (β = -0.029g; p < 0.05), body mass index (BMI) (β = 0.095 kg/m2; p < 0.05), glycated haemoglobin (HbA1c) (β = 0.033 mmol/mol; p < 0.01) and total cholesterol/high density lipoprotein (TC/HDL) ratio (β = 0.459 mg/dL; p < 0.0001) waist-to-hip ratio (β = 5.632cm; p = 0.05) and waist circumference (β = 0.031cm; p < 0.01) were significant predictors of myocardial infarction. A lower risk was observed among those with higher average alcohol intake, whereas higher risk being observed among those with higher BMI, HbA1c levels, total cholesterol/HDL ratio, waist-to-hip ratio and waist circumference. For stroke, exercising 5+ times (β = -1.47; p < 0.01), systolic blood pressure (SBP) (β = 0.040mmHg; p < 0.001), diastolic blood pressure (DBP) (β = 0.027mmHg; p < 0.001), pulse pressure (β = 0.033mmHg; p < 0.01), triglycerides (β = 0.388; p < 0.05) and total cholesterol/HDL ratio (β = 0.419; p < 0.01) were all significant predictors of stroke. We found that higher values of SBP, DBP, pulse pressure, triglycerides and total cholesterol/HDL ratio were associated with higher risk of stroke, whereas higher levels of physical activity were associated with a lower risk. Additionally, by combining BMI, HbA1c and total cholesterol/HDL ratio to the baseline model it provided the greatest F1 score of all models (0.123) and the greatest precision (6.7%), with a recall of 72.4%. With XGBoost we observed a reduced F1 score from 0.123 to 0.079, although adding information on alcohol intake and waist to hip ratio to this model, as previous analysis indicated great improvements in prediction, the F1 score obtained using the XGBoost increased from to 0.079 to 0.103. Conclusion This research shows that clinical and laboratory measurements play a potentially powerful role in predicting health outcomes when using evidence-based risk calculators. Using large cohorts allows for real-life long-term associations to be explored and quantified with a higher level of certainty for replicability across other populations.

Chronic oral disease burden at the first 1000 days: Intergenerational risk factors, BRISA cohort

AbstractObjectiveTo analyze multiple‐causal models, including socioeconomic, obesity, sugar consumption, alcohol smoking, caries, and periodontitis variables in pregnant women with early sugar exposure, obesity, and the Chronic Oral Disease Burden in their offspring around the first 1000 days of life.MethodsThe BRISA cohort study, Brazil, had two assessments: at the 22nd–25th gestational weeks and during the child's second year (n = 1141). We proposed a theoretical model exploring the association between socioeconomic and pregnancy factors (age, smoking, alcohol, sugars, obesity, periodontitis, and caries) and child's variables (sugars and overweight) with the outcome, Chronic Oral Disease Burden (latent variable deduced from visible plaque, gingivitis, and tooth decay), using structural equation modeling.ResultsCaries and periodontitis were correlated in pregnant women. Addictive behaviors in the gestational period were correlated. Obesity (Standardized coefficient ‐ SC = 0.081; p = 0.047) and added sugar consumption (SC = 0.142; p = 0.041) were observed intergenerationally in the pregnant woman‐child dyads. Sugar consumption by the children (SC = 0.210; p = 0.041) increased the Chronic Oral Disease Burden.ConclusionsPoor caries and periodontal indicators were correlated in pregnant women and their offspring. Obesity and sugar consumption act intergenerationally. Oral health in early life may change life trajectory since the worst oral conditions predict main NCDs.

Impact of Treatment Related Side Effects in Quality of Life of Patients with Head and Neck Cancer

Cancer is the leading cause of death in all parts of the world. Head and neck cancer (HNC) comprises a unique group of aero-digestive tract malignancies that include the seventh most common cancer in the world. As patients receiving chemotherapy would usually experience many side effects and these can affect their quality of life captiously. So that this study can be used in amelioration of the Quality of life of patients with head and neck cancer. By understanding the quality of life status, therapy could be optimized accordingly or take precautionary measures to avoid that specific effect. A Cross-sectional study was carried out among 25 samples in the Department of Oncology, ESI PGIMSR, Rajajinagar of Bengaluru. The data was collected by using EORTC QLQ C 30 and HNC 35 questionnaires and responses were recorded. All information was processed and analyzed by using Microsoft Excel. The majority of the subjects included in the study were males (23, 92%) followed by females (8, 8%) The highest number of subjects included in the study belonged to the 50-59 years age group (9, 36%) followed by 60-69 age group (8, 32%). Out of 25 study subjects, 15 patients had social habits of smoking (37%) Alcohol consumption (15,39%), tobacco chewing (5,13%) and No habits (4,11%). The Quality-of-Life score obtained from the 25 study subjects who were undergoing any treatment was found to have a neutral to good quality of life (not excellent). The average raw score and the respective linear score were found to be 4.16,52.66 for global health status, the Functional scale was found to have 1.76,74.8 and the Symptom scale was found to be 1.88,29.29. The correlation was done in SPSS software and found a negative value which interpreted as the increasing Side Effects is leading to the decline in quality of life.

Primary oto-rhino-laryngological cancers: Epidemiological, clinical and therapeutic aspects about 231 cases in Senegal

Objective: establish the epidemiological, clinical and therapeutic profile of primary cancers of the oto-rhino-laryngological (ENT) sphere in a reference oncology service in Senegal. Methods: This is a retrospective descriptive study, conducted at the Joliot Curie Institute of Aristide le Dantec hospital over a 30 months period from January 1, 2020 to June 30, 2022. Results: 231 ENT cancers were collected in our study, with a mean age of 51 years [11; 93]. Females predominated with a sex ratio of 0.88. Alcoholism was noted in 15.1% of cases. Smoking was noted in 23.8%. Alcohol smoking predominated in laryngeal cancer. The oral cavity was the most frequent site (44.6%). The histological nature of the cancers was dominated by squamous cell carcinoma (93.5%). Stages III and IV were in the majority: 62.8% and 23.8% of cases respectively. Neoadjuvant surgery was performed in 11.9% of cases. Chemotherapy was used in 65.1% of cases (including 90.2% for induction). Radiotherapy was used in 42.9% of cases and associated with chemotherapy in 90.7% of cases. Conclusion: ENT cancers are common in Senegal and diagnosed at all ages. Females predominate. The most common cancers are those of the oral cavity. They are discovered at a locally advanced stage and are treated with induction chemotherapy followed by concomitant chemoradiotherapy.

Using the Alcohol, Smoking and Substance Involvement Screening Test to predict substance-related hospitalisation after release from prison: A cohort study.

Poor substance use-related health outcomes after release from prison are common. Identifying people at greatest risk of substance use and related harms post-release would help to target support at those most in need. The Alcohol Smoking and Substance Involvement Screening Test (ASSIST) is a validated substance use screener, but its utility in predicting substance-related hospitalisation post-release is unestablished. We measured whether screening for moderate/high-risk substance use on the ASSIST was associated with increased risk of substance-related hospitalisation. A prospective cohort study. Prisons in Queensland and Western Australia. Participants were incarcerated and within 6weeks of expected release when recruited. A total of 2585 participants were followed up for a median of 873 days. Baseline survey data were combined with linked unit record administrative hospital data. We used the ASSIST to assess participants for moderate/high-risk cannabis, methamphetamine and heroin use in the 3months prior to incarceration. We used International Classification of Diseases (ICD) codes to identify substance-related hospitalisations during follow-up. We compared rates of substance-related hospitalisation between those classified as low/no-risk and moderate/high-risk on the ASSIST for each substance. We estimated adjusted hazard ratios (aHR) by ASSIST risk group for each substance using Weibull regression survival analysis allowing for multiple failures. During follow-up, 158 (6%) participants had cannabis-related, 178 (7%) had opioid-related and 266 (10%) had methamphetamine-related hospitalisation. The hazard rates of substance-related hospitalisation after prison were significantly higher among those who screened moderate/high-risk compared with those screening low risk on the ASSIST for cannabis (aHR 2.38, 95% confidence interval [CI] 1.74, 3.24), methamphetamine (aHR 2.23, 95%CI 1.75, 2.84) and heroin (aHR 5.79, 95%CI 4.41, 7.60). Incarcerated people with an Alcohol Smoking and Substance Involvement Screening Test (ASSIST) screening of moderate/high-risk substance use appear to have a significantly higher risk of post-release substance-related hospitalisation than those with low risk. Administering the ASSIST during incarceration may inform who has the greatest need for substance use treatment and harm reduction services in prison and after release from prison.

Isopropyl alcohol inhalation versus 5-HT3 antagonists for treatment of nausea: a meta-analysis of randomised controlled trials

PurposeNausea is a common and unpleasant sensation for which current therapies such as serotonin (5-HT3) antagonists are often ineffective, while also conferring a risk of potential adverse events. Isopropyl alcohol (IPA) has been proposed as a treatment for nausea. We aimed to compare IPA with 5-HT3 antagonists for the treatment of nausea across all clinical settings.MethodsMEDLINE, EMBASE, PubMed, CENTRAL and CINAHL were searched from inception to 17 July 2023 for randomised controlled trials (RCTs) comparing inhaled IPA and a 5-HT3 antagonist for treatment of nausea. Severity and duration of nausea, rescue antiemetic use, adverse events and patient satisfaction were the outcomes sought. Risk of bias (RoB) was assessed using Cochrane RoB 2. Random-effects model was used for meta-analysis. Combination of meta-analyses and narrative review was used to synthesise findings. The evidence was appraised using GRADE.ResultsFrom 1242 records, 4 RCTs were included with 382 participants. Participants receiving IPA had a significantly lower mean time to 50% reduction in nausea (MD − 20.06; 95% CI − 26.26, − 13.85). Nausea score reduction at 30 min was significantly greater in the IPA group (MD 21.47; 95% CI 15.47, 27.47). IPA led to significantly reduced requirement for rescue antiemetics (OR 0.60; 95% CI 0.37, 0.95; p = 0.03). IPA led to no significant difference in patient satisfaction when compared with a 5-HT3 antagonist. The overall GRADE assessment of evidence quality ranged from very low to low.ConclusionIPA may provide rapid, effective relief of nausea when compared with 5-HT3 antagonists.

Isopropyl alcohol inhalation for the treatment of nausea in adult emergency department patients: a systematic review and meta-analysis

BackgroundNausea and vomiting is a common ED chief complaint. However, randomised trials comparing antiemetic agents to placebo have not demonstrated superiority. This systematic review investigates the efficacy of inhaled isopropyl...

Adapting a substance use screening and brief intervention for peer-delivery and for youth in Kenya

BackgroundSubstance use is a major problem among youth in sub-Saharan Africa, yet interventions that address this problem are scarce within the region. Screening and brief intervention is a cost-effective, efficacious, and easy to scale public health approach to addressing substance use problems. We conducted a pilot study to evaluate the feasibility of implementing a peer delivered screening and brief intervention program for youth in Kenya. The goal of this paper is to report on the process of adapting the Alcohol Smoking and Substance Involvement Screening Test for Youth-linked Brief Intervention (ASSIST-Y-linked BI) program for peer delivery and for the Kenyan context prior to the pilot. MethodsThe adaptation process was led by a multi-disciplinary team comprised of psychiatrists, pediatricians, and psychologists. We utilized the ADAPT-ITT framework to adapt the ASSIST-Y-linked BI. The ADAPT-ITT framework consists of 8 phases including Assessment, Decision making, Adaptation, Production, Topical Experts, Integration, Training, and Testing the evidence-based intervention. Here, we report on phases 1–7 of the framework. The results of the pilot testing will be out in 2023. ResultsOverall, we made surface level adaptations to the ASSIST-Y-linked BI program such as simplifying the language to enhance understandability. We maintained the core components of the program i.e., Feedback, Responsibility, Advice, Menu of Options, Empathy, Self-efficacy (FRAMES). ConclusionsOur paper provides information which other stakeholders planning to implement the ASSIST-Y-linked BI for youth in sub-Saharan Africa, could use to adapt the intervention.

Abstract TP215: Prenatal Alcohol Exposure Impairs Long-term Behavioral Recovery Following Ischemic Stroke In Sprague Dawley Rats

Background and Purpose: Early life adversity is an important risk factor for cardiometabolic diseases in adulthood. There is very little information on prenatal insults and adult stroke outcomes. The present study tested the hypothesis that prenatal alcohol exposure (PAE) impedes long-term recovery from ischemic stroke in rats. Methods: Pregnant Sprague Dawley rats (in-house bred) were exposed to 10% alcohol or air, for 1 hour from gestational day 8 through 18 using the rodent alcohol inhalation system. Adult offspring (5-6 mo old) were subjected to endothelin-1 induced MCAo and outcomes were evaluated after 180 days. Long-term cognitive outcomes were determined using the Barnes maze and fear conditioning/extinction test. Results: In the Barnes maze test, control males showed shorter latency to reach the goal box over 3-day learning period (p=0.002), as assessed by the slope of the curve (-27.66, significantly different from 0; p=0.005). In contrast, the latency over the 3-day learning period did not improve in PAE males (-9.674, not significantly different from 0; p=0.22). In females, the latency to escape box during the learning trials was not different between the control and PAE. The fear conditioning data indicate that percent freezing over trials was similar in control and PAE-males. However, the PAE females exhibited a diminished freezing response as compared to control females (p=0.01). In the context of fear extinction, control males showed a reduction in freezing response to repeated tones over the trial blocks (p=0.004) compared to PAE-males. The control and PAE females showed similar freezing responses with repeated tones. Conclusions: The present findings support the hypothesis that PAE modifies long-term cognitive changes after stroke, and further show that different cognitive domains are affected by PAE in males and females.

Evaluating psychometric properties of the Thai-version Alcohol Smoking and Substance Involvement Screening Test (ASSIST)

ABSTRACT Background Alcohol use disorders and illicit drug use disorder are important causes of mortality and disability in adolescents. This study evaluated psychometric properties of the Thai-version Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Two subscales were tested, including the Tobacco and Alcohol. Method 624 participants from three high schools in Bangkok and Nakornpathom province, Thailand were recruited. Research instruments included self-reported questionnaire of demographic data and the ASSIST Thai-version. The construct validity and concurrent of the scale was test using structural equation modeling with AMOS 23.0. Internal consistency reliability was tested by using reliability analyses. Results Results showed that the ASSIST Thai-version displayed one-factor solution for both assessment of Tobacco and Alcohol. Factor loadings for Tobacco ranged from .40 to .96 and for Alcohol those were in the range of .28 - .82. Construct and concurrent validity of the instrument were supported by the results from this study. Cronbach’s alpha was .82 for Tobacco and .73 for Alcohol, indicating good and acceptably reliability. Conclusion The results showed adequate psychometric properties of the Thai version ASSIST. Thus, this scale is appropriate to use for screening specifically in Tobacco and Alcohol use among Thai adolescents.

Inhalation of Isopropyl Alcohol for the Management of Nausea and Vomiting: A Systematic Review.

Background: The use of inhaled isopropyl alcohol (IPA) has been proposed as a therapeutic intervention for the relief of nausea in various settings. The objective of this systematic review was to evaluate the existing evidence for the use of inhaled IPA in the management of nausea and vomiting. Methods: We performed a literature search on Medline, EMBASE, Web of Science, Scopus, CINAHL, PsycInfo, and Cochrane Library databases before November 2021. The following concepts were searched using subject headings and keywords as needed "aromatherapy," "alcohol," "ethylic alcohol," "ethanol," "isopropyl alcohol," "emesis," "chemotherapy-induced," "pregnancy," "hyperemesis gravidarum," "motion sickness," "emetics," "antiemetics," "inhalation," and "inhale." Searches were not limited to a specific language. The bibliographies of identified articles were also manually searched. Two authors independently assessed the included studies for risk of bias. Results: Thirteen randomized controlled trials out of 158 studies identified met the inclusion criteria, with a total of 1253 participants. Twelve studies were conducted in the postoperative anesthesia care unit and two studies were performed in the emergency department setting. Four studies were double blinded, one was single blind, and eight were open label. Three studies assessed the use of inhaled IPA for prevention, whereas 10 studies evaluated its use in the treatment of nausea and vomiting. Seven studies reported IPA to be more effective, four studies reported no difference, and two studies reported IPA to be ineffective. Participant satisfaction was high overall, regardless of intervention received. No adverse effects were reported. The overall quality of evidence was low. Conclusion: There is a lack of strong evidence to support the use of inhaled IPA in the management of nausea and vomiting. Additional trials are warranted to confirm this finding and to further explore the use of inhaled IPA in various populations and settings.

Highly Selective Wearable Alcohol Homologue Sensors Derived from Pt-Coated Truncated Octahedron Au.

Unhealthy alcohol inhalation is among the top 10 causes of preventable death. However, the present alcohol sensors show poor selectivity among alcohol homologues. Herein, Pt-coated truncated octahedron Au (Ptm@Auto) as the electrocatalyst for a highly selective electrochemical sensor toward alcohol homologues has been designed. The alcohol sensor is realized by distinguishing the electro-oxidation behavior of methanol (MeOH), ethanol (EtOH), or isopropanol (2-propanol). Intermediates from alcohols are further oxidized to CO2 by Ptm@Auto, resulting in different oxidation peaks in cyclic voltammograms and successful distinction of alcohols. Ptm@Auto is then modified on wearable glove-based sensors for monitoring actual alcohol samples (MeOH fuel, vodka, and 2-propanol hand sanitizer), with good mechanical performance and repeatability. The exploration of the Ptm@Auto-based wearable alcohol sensor is expected to be suitable for environmental measurement with high selectivity for alcohol homologues or volatile organic compounds.

Alcohol and drug use in a sample of Brazilian Army soldiers

Objective: To identify the pattern of use of alcohol and other drugs and its related sociodemographic variables in a sample of Brazilian Army soldiers. Materials and method: Cross-sectional study conducted with 229 soldiers from an infantry battalion at the Brazilian Army. Data were collected in 2019 with the application of a sociodemographic and employment instrument, the Alcohol Smoking and Substance Involvement Screening Test (ASSIST), and the Pearson correlation test. Results: The prevalence of alcohol use was present in more than half of the studied sample, followed by tobacco and cannabis sativa. Regarding the pattern of use, alcohol (22.2%), tobacco (31%), and cannabis sativa (9.7%) reported significant results. The sociodemographic variables of the individuals in the sample, their educational level (years of schooling), and economic-related issues were the main variables associated to alcohol and drug use. Conclusions: The consumption of alcohol and other drugs by the military is lower than that identified for the general population in the Brazilian territory. The use of psychoactive substances in the military context is often part of an attempt to deal with stress. Therefore, it is necessary to implement strategies aimed at preventing alcohol and drug use and promoting mental health among this population.

Novel Implementation Strategy to Electronically Screen and Signpost Patients to Health Behavior Apps: Mixed Methods Implementation Study (OptiMine Study).

BackgroundBehavior change apps have the potential to provide individual support on a population scale at low cost, but they face numerous barriers to implementation. Electronic health records (EHRs) in acute care hospitals provide a valuable resource for identifying patients at risk, who may benefit from behavior change apps. A novel, emerging implementation strategy is to use digital technologies not only for providing support to help-seeking individuals but also for signposting patients at risk to support services (also called proactive referral in the United States).ObjectiveThe OptiMine study aimed to increase the reach of behavior change apps by implementing electronic signposting for smoking cessation and alcohol reduction in a large, at-risk population that was identified through an acute care hospital EHR.MethodsThis 3-phase, mixed methods implementation study assessed the acceptability, feasibility, and reach of electronic signposting to behavior change apps by using a hospital’s EHR system to identify patients who are at risk. Phase 1 explored the acceptability of the implementation strategy among the patients and staff through focus groups. Phase 2 investigated the feasibility of using the hospital EHR to identify patients with target risk behaviors and contact them via SMS text message, email, or patient portal. Phase 3 assessed the impact of SMS text messages sent to patients who were identified as smokers or risky drinkers, which signposted them to behavior change apps. The primary outcome was the proportion of participants who clicked on the embedded link in the SMS text message to access information about the apps. The acceptability of the SMS text messages among the patients who had received them was also explored in a web-based survey.ResultsOur electronic signposting strategy—using SMS text messages to promote health behavior change apps to patients at risk—was found to be acceptable and feasible and had good reach. The hospital sent 1526 SMS text messages, signposting patients to either the National Health Service Smokefree or Drink Free Days apps. A total of 13.56% (207/1526) of the patients clicked on the embedded link to the apps, which exceeded our 5% a priori success criterion. Patients and staff contributed to the SMS text message content and delivery approach, which were perceived as acceptable before and after the delivery of the SMS text messages. The feasibility of the SMS text message format was determined and the target population was identified by mining the EHR.ConclusionsThe OptiMine study demonstrated the proof of concept for this novel implementation strategy, which used SMS text messages to signpost at-risk individuals to behavior change apps at scale. The level of reach exceeded our a priori success criterion in a non–help-seeking population of patients receiving unsolicited SMS text messages, disconnected from hospital visits.International Registered Report Identifier (IRRID)RR2-10.2196/23669

The implementation of a smoking cessation and alcohol abstinence intervention for people experiencing homelessness

BackgroundIn the United States, eighty percent of the adult homeless population smokes cigarettes compared to 15 percent of the general population. In 2017 Power to Quit 2 (PTQ2), a randomized clinical trial, was implemented in two urban homeless shelters in the Upper Midwest to address concurrent smoking cessation and alcohol treatment among people experiencing homelessness. A subset of this study population were interviewed to assess their experiences of study intervention. The objective of this study was to use participants’ experiences with the intervention to inform future implementation efforts of combined smoking cessation and alcohol abstinence interventions, guided by the Consolidated Framework for Implementation Research (CFIR).MethodsQualitative semi-structured interviews were conducted with 40 PTQ2 participants between 2016–2017 and analyzed in 2019. Interviews were audio-recorded, transcribed, and analyzed using a socially constructivist approach to grounded theory.ResultsParticipants described the PTQ2 intervention in positive terms. Participants valued the opportunity to obtain both counseling and nicotine-replacement therapy products (intervention characteristics) and described forming a bond with the PTQ2 staff and reliance on them for emotional support and encouragement (characteristics of individuals). However, the culture of alcohol use and cigarette smoking around the shelter environment presented a serious challenge (outer setting). The study setting and the multiple competing needs of participants were reported as the most challenging barriers to implementation (implementation process).ConclusionThere are unique challenges in addressing smoking cessation with people experiencing homelessness. For those in shelters there can be the difficulty of pro-smoking norms in and around the shelter itself. Considering pairing cessation with policy level interventions targeting smoke-free spaces, or pairing cessation with housing support efforts may be worthwhile.. Participants described a discord in their personal goals of reduction compared with the study goals of complete abstinence, which may pose a challenge to the ways in which success is defined for people experiencing homelessness.Trial registrationClinicaltrials.gov, NCT01932996, registered 08/30/2013.

Investigating the association between infertility and psychological distress using Australian Longitudinal Study on Women's Health (ALSWH)

Infertility affects millions of people globally. Although an estimated 1 in 6 couples in Australia are unable to conceive without medical intervention, little is known about the mental health impacts of infertility. This study investigated how infertility impacts the mental health of women. The study used nationally representative Australian Longitudinal Study on Women's Health (ALSWH) data. We analysed data from survey periods 2–8 conducted every three years between 2000 and 2018 for 6582 women born in 1973–78. We used a Generalised Equation Modelling (GEE) method to investigate the association of primary, secondary and resolved fertility status and psychological distress over time. Multiple measures were used to measure psychological distress: the (1) the mental health index subscale of the 36-item short form survey (SF-36), (2) the Center for Epidemiological Studies Depression Scale (CESD-10), (3) the Goldberg Anxiety and Depression Scale (GADanx) anxiety subscale; and a (4) composite psychological distress variable. About a third (30%) of women reported infertility at any of the survey rounds; a steady increase over 18 years from 1.7% at round 2 to 19.3% at round 8. Half of the women reporting primary or secondary infertility reported psychological distress, with the odds of having psychological distress was higher in women reporting primary (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.06–1.45), secondary (OR 1.27, 95% CI 1.10–1.46) or resolved infertility (OR 1.15, 95% CI 1.05–1.26) compared to women reporting normal fertility status. Women with partners, underweight or higher BMI, smoking, and high-risk alcohol use had higher odds of psychological distress, whereas women in paid work had significantly lower odds of psychological distress (p < 0.001). Diabetes, high blood pressure, asthma, and other chronic physical illness were independently associated with higher odds of psychological distress. Infertility has a significant impact on mental health even after it is resolved. Frequent mental health assessment and a holistic approach to address the lifestyle factors should be undertaken during the treatment of infertility.

Exposure to Electronic Media, Smoking and Alcohol Drinking Among Guyanese Adults.

Use of electronic media has been shown to be associated with tobacco and alcohol consumption behavior among adult population. Currently, not much is known about the risk factors of tobacco and alcohol consumption in Guyana. The present study aimed to explore the association between exposure to electronic media and tobacco and alcohol consumption by adjusting for the sociodemographic correlates.MethodsData were obtained from the sixth round of Guyana Multiple Indicator Cluster Survey (MICS 2019–20). Sample population were 2,208 men and 5,872 women aged between 15 and 49 years. Outcome variables were self-reported lifetime use of tobacco and alcohol, and the main explanatory variables were the use of electronic media such as internet, television and radio. Data were analyzed using descriptive and multivariable regression analysis in Stata version 17.ResultsOverall, 55.5% (95% CI = 53.4, 57.6) men and 44.5% (95% CI = 42.4, 46.6) women reported ever smoking tobacco, while the percentage of ever drinking alcohol was 34.2% (95% CI = 32.9, 35.4) and 65.8% (95% CI = 64.6, 67.1) among men and women, respectively. Internet users had significantly higher odds of ever consuming tobacco and alcohol, however, the association was not uniform across the sociodemographic variables. For smoking, the positive association with internet use was observed for women only (OR = 1.32, 95% CI = 1.09, 1.59), whereas, for alcohol consumption the association with internet use was significantly positive among both men (OR = 1.82, 95% CI = 1.58, 2.09) and women (OR = 1.84, 95% CI = 1.22, 2.70). Men and women who ever tried alcohol drinking had (OR = 4.64, 95% CI = 3.16, 6.82) and (OR = 10.62, 95% CI = 7.83, 14.40) times higher odds of trying tobacco smoking.ConclusionCurrent findings indicate over a quarter of the participants reported ever smoking tobacco and more than three-fifths ever drinking alcohol. Electronic media use, especially that of internet, is a strong predictor of tobacco and alcohol consumption among Guyanese adults. Results also revealed a strong interrelation between alcohol and tobacco smoking, and suggesting that strengthening the tobacco prevention programs may reduce the prevalence of alcohol drinking as well.

Abstract 5892: Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women

Abstract Mammographic density is an important risk factor for breast cancer and is known to differ in women by characteristics such as age and race/ethnicity. Women who experience longitudinal decreases in breast density have a reduced risk of breast cancer; however, besides age, which correlates with decreases in breast density, it is unclear what other factors contribute to changes in breast density over time. Understanding factors associated with density changes may enable a better understanding of breast cancer risk and potential strategies for prevention. This study investigated factors associated with changes in mammographic density in a cohort of 3,392 postmenopausal women (mean age=61.3±8.8 years) with no history of breast cancer who had at least two mammograms spaced at least three months apart at a University of California, Irvine Health breast imaging facility between 2011-2017. Self-reported information on demographics, breast and reproductive history, and lifestyle factors, including body mass index (BMI), alcohol intake, smoking, and physical activity, was collected by an electronic intake form, and Breast Imaging Reporting and Database System (BI-RADS) mammographic density scores were obtained from electronic medical records. 7.9% of women exhibited a longitudinal decrease in mammographic density, 6.7% exhibited an increase, and 85.4% exhibited no change. Longitudinal changes in mammographic density were statistically significantly correlated with age, race/ethnicity, and age at menopause by univariate analysis using the Fisher’s exact test. Multivariate conditional logistic regression using baseline mammographic density as strata was performed to identify factors associated with a longitudinal increase or decrease in mammographic density. Variables were selected if they were nominally significant (p &amp;lt; 0.10) in the initial univariate analyses of women who exhibited a longitudinal change in mammographic density (race/ethnicity, age at baseline, menopause age) or were otherwise selected a priori based on previous literature showing an association with mammographic density (alcohol, physical activity, BMI). Asian women were more likely to exhibit a longitudinal increase in mammographic density (OR=1.78, 95% CI=1.02-3.09, p=0.04) and less likely to exhibit a decrease (OR = 0.58, 95% CI = 0.40-0.83, p=0.003) compared to white women. On the other hand, overweight and obese women were less likely to exhibit an increase compared to normal weight women (OR = 0.52, 95% CI = 0.31-0.87, p=0.01; OR = 0.41, 95% CI = 0.23-0.75, p=0.004, respectively). Other lifestyle factors (alcohol intake, smoking, and physical activity) were not associated with longitudinal changes in mammographic density. The potential interactions of Asian race and BMI with longitudinal breast density changes in influencing breast cancer risk should be further studied. Citation Format: Roza L. Kirmizi, Christie J. Lee, Hannah Lui Park, Argyrios Ziogas, Andrea Alvarez, Rachel M. Lucia, Deborah Goodman, Kathryn M. Larsen, Richard Kelly, Hoda Anton-Culver, Stephen A. Feig. Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5892.

Cauda Equina Syndrome Outcome: Early V/S Late Surgery

There is no reservation that the superlative result for Cauda Equina Syndrome (CES) requires decompression by surgery. Objective: The goal of our study was to determine the effect of surgical procedure, with relation to time, on bladder and bowel symptoms. Methods: A retrospective analysis of patients undergoing surgical decompression by CES was done. The subjects with persistent symptoms were surveyed for at least two-years. BASS criteria were applied to classify CES: painless urinary retention (CESR), incomplete (CESI) and CES suspicious (CESS). The resolution of presenting autonomic symptoms was assessed following surgery. Results: A total of 120 patients were confirmed with CES and referred for surgery. Surgical treatment included all cases of laminectomy or lumbar discectomy. 60 patients reported CESR, 24cases of CESI and 36 cases of CESS. No statistical alteration in sex, age, alcohol comorbidities score and smoking by the time of surgery was noted. All patients with CESR and CESI showed a positive response in bladder and bowel dysfunction following surgery. There was no substantial change in the recovery of autonomic dysfunction associated with the time of surgery. Conclusions: Surgical decompression is an operative method of treatment that suggestively alleviates the symptoms of CES involved autonomic system. Early decompression by surgery 24 hours after start of symptoms does not seems to improve resolving of bladder or bowel dysfunction significantly

The Presence of Smoking and Alcohol Imaginary in Popular Movies Available in Netflix Online Streaming Platform.

Exposure of tobacco and alcohol consumption in media and filmmaking has been related to promotion of smoking and drinking in adults. Current regulation aims to restrict tobacco and alcohol advertising in order to avoid alcohol consumption and smoking habits. We aimed to assess the impact of smoking and drinking habits in video-on-demand services. Three independent investigators watched the 50 most popular movies available in Netflix streaming platform, according to York Times and recorded incidence of smoking and drinking scenes for both primary and secondary actors. 45 movies were included in our analysis. Main characters appeared to smoke in 19 movies and to consume alcohol in 33 movies, while secondary characters in 32 movies with 121 scenes and consumed alcohol in 38 movies, respectively. First actors were males in 22 movies, females in 7 movies and both males and females in 6 movies. Movies' directors were males in 29 movies and females in 6 movies. Our analysis found increased content of smoking and drinking scenes in online movies and showed that recently released movies presented with increased incidence of drinking and smoking scenes, while era depicted in movies also affects smoking and drinking content.