AUDIT Questionnaire Research Articles

Binge drinking at time of bariatric surgery is associated with liver disease, suicides, and increases long-term mortality.

Alcohol use disorder has been reported in patients undergoing bariatric procedures, but the pattern of alcohol consumption has not been evaluated. We investigated the prevalence, risk factors, and impact of binge drinking (BD) at the time of surgery and during follow-up. A prospective, longitudinal study of subjects undergoing bariatric surgery was included in the LABS-2 registry between 2006 and 2009. Participants with AUDIT questionnaire at the time of surgery and a minimum of 12 months follow-up were included. BD was defined as consuming ≥5 drinks on at least 1 occasion in the previous month. Liver biopsies were obtained during bariatric procedures in not all cases. Survival analysis was performed with the adjusted Cox regression model and competing risk. A total of 2257 subjects were included, with a median follow-up of 79 months. The prevalence of BD at time of surgery was 12%, and it raised up to 23% during follow-up. Patients with BD predominantly had a binge eating disorder (OR=1.35 [95% CI: 1.04-1.76]), regularly consumed fast food [OR=1.4 (95% CI: 1.07-1.85)] and used other drugs (OR=2.65 [95% CI: 1.74-4.04]). Within liver biopsies evaluation, BD showed higher hepatic iron deposits (OR=3.00 [95% CI: 1.25-7.21]). BD at the time of surgery was associated with a higher risk of BD during follow-up (OR=10.49 [95% CI: 7.86-14.00]) and long-term mortality (HR: 3.21 [95% CI: 1.67-6.18]). Specific causes of death in these patients with BD were liver disease (p=0.020), suicide (p=0.015), neoplasms (p=0.034), and respiratory (p=0.025). The prevalence of BD in patients undergoing bariatric surgery is high and increases the risk of postoperative liver disease, suicides, and long-term mortality.

Combined Use of Phosphatidylethanol and the Audit Test for Detecting of Alcohol Abuse

Aim: To estimate the prevalence of alcohol abuse among men by using combined the direct biochemical marker phosphatidylethanol (PEth) and the AUDIT questionnaire (Alcohol Use Disorders Identification Test). Subjects and Methods: The concentration of PEth was determined in 136 blood samples of men aged 15 - 65 years. The blood was obtained from the laboratory of the medical advisory centre, where it was submitted for routine biochemical analysis. Immediately before blood sampling, clients were asked to complete the AUDIT questionnaire. Determination of the concentration of PEth was carried out using the method of high performance liquid chromatography - tandem mass spectrometry (HPLC - MS). Statistical data processing was carried out using the Statistica 10.0 program. Results: Discrimination by the level of alcohol consumption using the concentration of PEth showed that the proportion of abstinents (practically not drinking alcohol) among men was 20.6 %; the proportion of moderate drinkers was 63.1 %; the proportion of alcohol abusers was 16.3 %. The highest average concentration of PEth, as well as the proportion of those who abuse alcohol, was observed in the age groups of 50 - 59 and 60+ years. The distribution by level of alcohol consumption according to the total score of the AUDIT test was as follows: abstinents - 17.9 %; moderate drinkers - 69.6 %; alcohol abusers - 12.5 %. The highest average test score, as well as the highest share of alcohol abusers, was observed in the age group 50 - 59 years. Correlation analysis did not reveal any relationship between the concentration of PEth in the blood and the total score of the AUDIT test in any of the age groups of men. Conclusion: The results indicate a fairly high prevalence of alcohol abuse among men. Alcohol-related problems are especially high among middle-aged men. The outcomes suggest a low concordance between the concentration of PEth in the blood and the AUDIT score.

#1452 Halting the progression of chronic kidney disease; an audit of the use of renin-angiotensin-aldosterone blockers and SGLT-2 inhibitors

Abstract Background and Aims Sodium-glucose cotransporters-2 inhibitors (SGLT2i) were initially developed for the treatment of type 2 diabetes. Multiple studies have demonstrated the renoprotective effect of SGLT2i, with the capacity to slow diabetic kidney disease and non-diabetic proteinuric chronic kidney disease progression. More recently, the EMPA-KIDNEY trial demonstrated a benefit in patients with chronic kidney disease with a wider range of albuminuria and glomerular filtration rate. We aim to identify the proportion of patients on renin-angiotensin aldosterone system blockade (RAASb) such as angiotensin converting enzyme inhibitor (ACEi), and angiotensin II receptor blocker (ARB), and sodium-glucose transporter-2 inhibitor (SGLT2i) in our Nephrology outpatients clinic. We also aim to encourage awareness and prescribing of RAASb and SGLT2i in eligible patients with CKD. Method A prospective audit was performed in Galway University Hospital (GUH) from September 2023 to October 2023. The audit questionnaire was completed by doctors reviewing patients in OPD. The use of ACEi/ARB/SGLT2i was recorded during the consultation. Results 165 patients were included in the audit with a mean (±SD) age of 62.1 ± 18.6 years. The 3 most common primary renal diagnoses were diabetic kidney disease; 20/165 (12.1%), hypertensive renal disease; 18/165 (10.9%) and IgA nephropathy; 15/165 (9.1%). The mean estimated glomerular filtration rate (eGFR) was 46.8 ± 24.5 ml/min/1.73 m². At baseline, 94/165 (57%) were already on RAASb, none on dual RAASb agents. 20/165 (12.1%) were already on SGLT2i, amongst these, 15/20 (75%) were also on RAASb at the time of the OPD consultation. 13/165 (7.9%) patients were maximised on RAASb and 4/165 (2.4%) commenced an SGLT2i at the clinic visit. Guideline directed medical therapy according to the EMPA-Kidney and UK Kidney Association Clinical Practice Guidelines would suggest missed opportunity on therapeutic optimisation with RAASb and SGLT2i in 66/83 (79.5%) patients; 26/66 (39.4%) were neither on RAASb or SGLT2i, 34/66 (51.5%) were on RAASb but not on SGLT2i, 3/66 (4.5%) were on SGLT2i but not on RAASb, and 3/66 (4.5%) were on sub-maximal RAASb with an SGLT2i. Conclusion There is new evidence to support the use of SGLT2i, in those with chronic kidney disease with a wide range of albuminuria. SGLT2i use is underutilised in our clinic. Ideally, these patients should be initiated on an SGLT2i after being established on a RAASb early in their diagnosis to ensure the optimal renoprotective effects of SGLT2i.

Relationship between risky alcohol consumption and academic performance in students in the health area at a Chilean University

Introduction: the phenomenon of alcohol consumption among university students, particularly in the field of health, is the subject of growing concern due to its potential impact on public health and academic performance.Objective: analyze the relationship between risky alcohol consumption and the academic performance of students studying in the health area at a Chilean university in the second semester of 2023.Methods: the study with a descriptive and transversal quantitative approach, with a sample of 361 students who responded to the AUDIT questionnaire. Academic performance was characterized using the university's grading system.Results: regarding alcohol consumption, 81,7 % (295 participants) showed low-risk consumption, 16,3 % (59 participants) high-risk consumption, and the remaining 1,9 % a possible consumption or dependence problem. Furthermore, a trend is observed in which students with problematic consumption are distributed between the categories of "good" (note 5) and "very good" (note 6), while risk and low-risk consumption are distributed between the categories of "very good", "good" and "sufficient".Conclusions: the findings of this study show that, in general, alcohol consumption does not appear to have a significant negative impact on the academic performance of health students. Although approximately 20 % of those surveyed reported problematic or risky consumption

Diagnostika alkoholovej choroby pečene u gastroenterológa

Summary: The alarming rise in morbidity and mortality from liver diseases is the reason for searching ways to reverse this trend. The COVID-19 period was a time of increased consumption of spirits in Slovakia and associated morbidity and mortality. An effective tool for early detection of risky alcohol consumption is screening in the form of the AUDIT questionnaire followed by intervention and screening of liver disease in the form of laboratory and imaging methods, including ultrasonography and elastography using non-invasive fibrosis indices. Screening for risky alcohol consumption and advanced liver fibrosis in gastroenterologist, hepatologist and general practitioner outpatient offices will help to detect at-risk individuals early and start intervention. This paper presents a screening proposal in the context of the latest EASL and AASLD guidelines and available current reviews of screening worldwide. The goal is to reduce the adverse effects of alcohol in Slovakia. Key words: risk alcohol consumption – AUDIT test – elastography – screening

Risky alcohol use during youth: Impact on emotion, cognitive networks, and resting-state EEG activity

The identification of the risk factors of alcohol consumption in youths is crucial for early interventions focused on reducing harmful alcohol use. In our study, 82 college students (40 healthy control (CO group) and 42 with risky alcohol use (RAU group) determined by AUDIT questionnaire) between the ages of 18 and 25 years underwent a comprehensive neuropsychological assessment covering emotional and cognitive functioning. Their resting-state activity was also recorded with an EEG for 10 min with their eyes open (EO) and 10 min with their eyes closed (EC) and analyzed using the Fitting Oscillations & One-Over-F (FOOOF) paradigm. After adjusting for sex, those in the RAU group had higher emotional dysregulation and impulsivity traits. The RAU girls presented more emotional regulation problems, such as dysregulation and negative urgency compared with the RAU boys. The RAU youths had significantly worse functioning in several cognitive domains, such as sustained attention, verbal memory, and executive functions. Cognitive network analysis revealed a different pattern of connections in each group showing that in the RAU group, the verbal memory domain had the highest connection with other cognitive functions. The EEG analyses did not reveal any significant differences between the CO and the RAU groups. However, we observed only in the EO condition that boys the from the RAU group displayed a higher theta/beta ratio than the RAU girls, whereas these differences were not observed within the CO group. Our findings highlight the need to explore more deeply the emotional, cognitive and brain changes underlying the RAU in young people.

Obesity and harmful alcohol consumption are predictors for advanced liver disease in the disease management program for type 2 diabetes.

Type 2 diabetes mellitus (T2DM) is a major risk factor for advanced liver disease. The aim of this prospective cohort study was to assess the prevalence and associated risk factors of liver fibrosis and cirrhosis in primary care centers participating in the diabetes disease management program (DMP) in Germany. A total of 175 participants with the diagnosis of T2DM were enrolled in two primary care centers. Steatotic liver disease (SLD; hepatic steatosis, ≥275dB/m), fibrosis (≥8kPa), and cirrhosis (≥15kPa) were assessed non-invasively using vibration-controlled transient elastography. Multivariable logistic regression analysis was performed to identify clinical predictors of fibrosis and cirrhosis. The AUDIT questionnaire was used to screen for alcohol consumption, and a score ≥8 was considered harmful alcohol consumption. The majority of participants were male (62%), and the median age was 66years (interquartile range 59; 71). The median body mass index was 31.1kg/m2 , with 58.9% of the participants being obese. Harmful alcohol consumption was prevalent in 8.0% and 20.0% of the entire cohort and in those with cirrhosis, respectively. The prevalence of SLD, fibrosis, and cirrhosis was 77.1%, 42.3%, and 12.0%, respectively. In multivariable logistic regression analysis, obesity, and harmful alcohol consumption were associated with the highest odds of fibrosis (odds ratio [OR] 5.198, 95% confidence interval [CI] 2.269-11.908) and cirrhosis (OR 5.615, 95% CI 1.274-24.756), respectively. The prevalence of fibrosis and cirrhosis in patients seen in the diabetes DMP in Germany is high. Obesity and harmful alcohol consumption increase the risk of fibrosis and cirrhosis in people with T2DM. Screening for advanced liver disease and associated risk factors within the DMP program may reduce the liver disease burden in this high-risk population.

Ayurvedic Management of Alcohol Use Disorder - A Case Series

Alcohol Use Disorder (AUD) is a medical condition characterized by impaired ability to stop or control alcohol use despite the adverse social, occupational, or health consequences which ranges from mild to severe. AUD includes symptoms of alcohol intoxication, withdrawal as well as dependence. Etiological perspective applies a bio psychosocial framework that emphasizes the interplay of genetics, neurobiology, psychology and individual’s societal context. Globally around 1.4% of the population have AUD and 3 million deaths result from harmful alcohol use each year. Contemporary management includes medical intervention, counselling, outpatient program, or a residential inpatient stay, but the relapse rate is high. Hence the medical world is focusing on indigenous medicine and its probable outcome in the management of AUD. Objectives: In Ayurveda, the context of Madatyaya refers to conditions resultant from improper and excessive usage of alcohol and even other substance use. Every patient is being examined thoroughly as per Ayurveda parameters and based on the observations as well as the severity; individualized protocols are being framed. The case series includes 4 cases of AUD which was managed with a protocol including withdrawal management with Nasya, Sirodhara as well as internal medicines. This was followed by Snehapana, Vamana or Virechana, therapeutic yoga, family counselling as well as administration of Rasayana so as to address the dependence. The treatment protocol was finalised as per the assessment of Doshas, based on the clinical presentation. The outcome was assessed with CIWA-Ar, AUDIT, and SADQ Questionnaire. Result: Such a protocol is capable of addressing the bio-psychosocial factors of AUD and was observed as effective. Symptomatic improvement was noticed after the treatment in all the four cases and there was improvement in scores of assessment. The result was promising as well.

Audit on Practices of Endotracheal Suctioning in Intensive Care Unit Patients among Health Care Workers (HCWs).

Endotracheal suctioning (ETS) is one of the most frequently performed invasive procedures in intensive care units (ICUs). This audit was aimed at studying current practices and knowledge regarding ETS in the Indian critical care setup, with the background aim of raising awareness regarding correct practices as per current recommendations in critically ill patients. After registering the trial with the clinical trial registry, India, a structured audit questionnaire containing 20 questions pertaining to ETS was distributed through electronic media among resident doctors working in the ICUs across India. Responses received were statistically analyzed. The questionnaire was sent to 530 clinicians, of which only 200 (37.73%) responded. The audit revealed that only 22% respondents set the maximum negative pressure every time before suctioning, on the suction apparatus and only 32% said they would choose a catheter size of less than half the internal diameter of the endotracheal tube (ETT). About 90% of the respondents did not routinely do any form of documentation of the ETS. Almost 72% of the responders opined that closed suction systems reduce the chances of developing ventilator-associated pneumonia (VAP). Only 46% of respondents thought that no solution should be routinely instilled in ETT during ETS. There is lack of awareness regarding frequency and technique of ETS, infection control and monitoring required during ETS. Institutional protocols should be in place to follow correct guidelines for performing ETS. Singh R, Bhalotra AR, Sharma S. Audit on Practices of Endotracheal Suctioning in Intensive Care Unit Patients among Health Care Workers (HCWs). Indian J Crit Care Med 2024;28(1):58-65.

Theory-based implementation of an enhanced recovery protocol for cranial surgery.

There is growing evidence for the use of enhanced recovery protocols (ERPs) in cranial surgery. As they become widespread, successful implementation of these complex interventions will become a challenge for neurosurgical teams owing to the need for multidisciplinary engagement. Here, the authors describe the novel use of an implementation framework (normalization process theory [NPT]) to promote the incorporation of a cranial surgery ERP into routine neuro-oncology practice. A baseline audit was conducted to determine the degree of implementation of the ERP into practice. The Normalization MeAsure Development (NoMAD) questionnaire was circulated among 6 groups of stakeholders (neurosurgeons, anesthetists, intensivists, recovery nurses, preoperative assessment nurses, and neurosurgery ward staff) to examine barriers to implementation. Based on these findings, a theory-guided implementation intervention was delivered. A repeat audit and NoMAD questionnaire were conducted to assess the impact of the intervention on the uptake of the ERP. The baseline audit (n = 24) demonstrated limited delivery of the ERP elements. The NoMAD questionnaire (n = 32) identified 4 subconstructs of the NPT as barriers to implementation: communal specification, contextual integration, skill set workability, and relational integration. These guided an implementation intervention that included the following: 1) teamwork-focused training; 2) ERP promotion; and 3) procedure simplification. The reaudit (n = 21) demonstrated significant increases in the delivery of 5 protocol elements: scalp block (12.5% of patients before intervention vs 76.2% of patients after intervention, p < 0.00001), recommended analgesia (25.0% vs 100.0%, p < 0.00001) and antiemetics (12.5% vs 100.0%, p < 0.00001), trial without catheter (13.6% vs 88.9%, p < 0.00001), and mobilization on the 1st postoperative day (45.5% vs 94.4%, p < 0.00001). There was a significant reduction in the mean hospital length of stay from 6.3 ± 3.4 to 4.2 ± 1.7 days (p = 0.022). Two months after implementation, a repeat NoMAD survey demonstrated significant improvement in communal specification. Here, the authors have demonstrated the successful implementation of a cranial surgery ERP by using a systematic theory-based approach.

Centre of pressure changes during stance but not during gait in young women after alcohol intoxication.

Women are underrepresented in research focused on alcohol (e.g., Brighton, Moxham & Traynor, 2016; DOI 10.1097/JAN.0000000000000136) despite the changing patterns of alcohol consumption, which has been increasing in women in recent decades. The purpose of this study was to analyse the relationship between habitual alcohol consumption and centre of pressure (CoP) parameters during stance and gait while intoxicated by alcohol. Thirty women (24.39 ±2.93 years) participated in this study. All participants were asked to answer the AUDIT questionnaire. Stance and gait analysis were repeated under two conditions on a Zebris platform (FDM GmbH; Munich, Germany): when the participants were sober (0.00% breath alcohol concentration, BrAC) and when they were in an intoxicated state (0.11% BrAC). Participants were divided by their AUDIT score into a low-risk alcohol consumption group (n=15; AUDIT score: 3 to 6) and a hazardous alcohol consumption group (n=15; AUDIT score: 7 to 13). No statistical difference was observed in stance and gait parameters when comparing the low-risk and hazardous groups under 0.00% BrAC and 0.11% BrAC conditions. A statistically significant difference was observed when comparing 0.00% BrAC and 0.11% BrAC conditions within each group. This significant difference was found in CoP path length and CoP average velocity during quiet stance. However, no statistically significant differences were observed in CoP parameters during gait. An alcohol intoxication of 0.11% BrAC was not sufficient to cause statistically significant impairments in butterfly parameters of gait.

Effects of Maternal HIV Infection and Alcohol Use in Pregnancy on Birth Outcomes in Uganda.

Alcohol use and HIV infection are prevalent in sub-Saharan Africa (sSA), and both are associated with low birth weight. Yet, few studies have evaluated the combined effects of maternal HIV infection and alcohol use on birth outcomes. We analyzed data from a prospective cohort study of HIV-related placental changes in Ugandan women. We defined alcohol use as self-reported alcohol use within the last year, using the AUDIT questionnaire and used linear and logistic regression to measure associations between maternal alcohol use, HIV serostatus, and birth weight. In a subsample, we measured alcohol exposure using phosphatidylethanol (PEth) in neonatal heelstick dried blood spots to confirm maternal alcohol use. Of 352 participants, 176 (50%) were women with HIV (WHIV). Three of 176 (2%) HIVuninfected women and 17/176 (10%) of WHIV self-reported alcohol use (P = 0.002). Maternal HIV infection was associated with lower birth weight (β = -0.12, 95% CI [-0.20, -0.02], P = 0.02), but self-reported alcohol use was not (β = 0.06, 95% CI [-0.15, 0.26], P = 0.54), and the interaction between HIV serostatus and alcohol use was not significant (P = 0.13). Among the PEth subsample, neither HIV status nor PEthconfirmed alcohol use were associated with low birth weight. Maternal HIV infection was associated with lower birth weight, but alcohol use was not, and there was no significant interaction between maternal HIV infection and alcohol use. Alcohol use was more prevalent in WHIV and under-reporting was common. A larger study of the effects of laboratory-confirmed alcohol and HIV exposure on birth outcomes is warranted.

ВЛИЯНИЕ ПОТРЕБЛЕНИЯ АЛКОГОЛЯ НА УРОВНИ БЕЛКОВ СУРФАКТАНТА SP-A И SP-D КРОВИ У МУЖЧИН И ЖЕНЩИН Г. НОВОСИБИРСКА

Introduction. Currently, there are a few experimental data on the effect of alcohol consumption on the surfactant proteins SP-A and SP-D, while these aspects remain unexplored in humans. In view of the high social significance of the problem of alcohol abuse, and also due to the fact that the lungs are one of the "target organs" in excessive alcohol consumption, the study of the effect of alcohol consumption on the levels of surfactant proteins SP-A and SP-D in men and women is undoubtedly topical direction of modern medical science. The aim of the work is to determine the effect of alcohol consumption on the levels of surfactant proteins SP-A and SP-D in men and women in Novosibirsk. Materials and methods. On the basis of the NIITPM-branch of the Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, in 2022, 174 people (87 men and 87 women), aged 45 to 69 years, randomly selected from the residents of Novosibirsk, were examined. Alcohol consumption was assessed using the AUDIT questionnaire. The content of surfactant proteins SP-A and SP-D in blood serum was determined by enzyme immunoassay using standard ELISA kits. Statistical analysis used parametric and non-parametric methods of descriptive statistics, correlation analysis was carried out using the Spearman test, and multivariate analysis using binary logistic regression. ROC-analysis was used to assess the diagnostic significance of variables with the determination of sensitivity and specificity. In all procedures of statistical analysis, the critical significance level of the null statistical hypothesis (p) was taken equal to 0.05. Results. In the general sample of men and women aged 45-69 years, it was determined that the usual single dose of alcohol consumed equal to 7-9 alcohol units is inversely associated with SP-A (r=-0.154, p=0.043). Using ROC analysis, it was found that SP-A is a marker (the area under the ROC curve is 71.2%) of alcohol intake in a typical single dose of alcohol consumed equal to 7-9 alcohol units. With an SP-A level of no more than 921 pg / ml, its sensitivity in relation to the determination of alcohol consumption in a typical single dose of 7-9 alcohol units is 68.7%, and the specificity is 87.5%. Using regression analysis, it was determined that the variable "usual single dose of alcohol consumed equal to 7-9 alcohol units" directly affects the presence of SP-A no more than 921 pg / ml (Exp (B) = 13.0; 95% CI = 1, 5; 111.0, p=0.019) regardless of age and male sex. Conclusion. Thus, it has been established that in men and women of Novosibirsk aged 45-69 years, a high single dose of alcohol consumed equal to 7-9 alcohol units is an independent factor that directly affects the presence of SP-A levels in the blood that do not exceed 921 pg/ml .

Alcohol consumption and academic performance in nursing students

Introduction: currently, the consumption of alcoholic beverages is considered a global public health problem that requires immediate and effective actions, and this problem has extended to the educational field. The main objective of this research was to analyze alcohol consumption and academic performance in students from the first to the seventh semesters of the nursing career in a public university in Ecuador.Methods: a quantitative, correlational, non-experimental and cross-sectional research was conducted. The sample consisted of 252 students. The MEDMAR and AUDIT questionnaires were applied. The SPSS and Excel statistical package was used for the processing and analysis of the information collected. Confidentiality and informed consent were guaranteed.Results: 11 students (4,4 %) are in the probable addiction group with very good academic performance, 20 (7,9 %) of the high-risk group of alcohol consumption have very good academic performance. It is evident that alcohol consumption has not affected academic performance.Conclusions: there is no significant relationship between alcohol consumption and academic performance in nursing students at the public university of Ecuador. The results show that students with high risk of alcohol consumption and even those with probable addiction have very good and good performance

General health and its relation to the quality of life and alcohol consumption in a Polish cohort of medical students - preliminary results of POLLEK survey.

First-year students of medicine are at higher risk of stress related to the new environment and study overload. Such factors can play a role and have an impact on their quality of life and general health status which can cause possible problems with alcohol use. The aim of the study is to assess the relationship between mentioned factors in the Polish cohort of first-year medical students. The quality of life has been assessed within the WHOQOL-BREF questionnaire, the general health status was assessed via GHQ28, and alcohol consumption was assessed the by AUDIT questionnaire. Due to the lack of signature informed consent and lack of data, 381 (72%) students out of 525 were included in the final analysis. The majority of the 1-year students were females 68%; (n = 259) vs. 32% (n = 122) males. Half of the students had lowered risk of distress. However, females had a higher risk of having higher scores in GHQ-28 than males. In relation to the assessment of the quality of life, the students with a lower level of distress (<32 points in GHQ-28) had better results in each WHOQOL domain. There was no association between general health status and alcohol use. For the students who had possible problems with alcohol use the OR was 1.15 95% CI (0.73-1.80) and for students who were probably addicted OR was 1.07 95% CI (0.33-3.41). The total quality of life in first-year Polish medical students is relatively high; however, half of them suffer because of distress and around 30% have some alcohol problems. Females are more likely to have higher GHQ-28 scores than males.

Editorial introductions.

Editorial introductions.

Analyzing the Relationship between Participation in Sports and Harmful Alcohol Drinking in Early Adolescence: Two-Year Prospective Analysis.

Alcohol drinking is an important health-related problem and one of the major risk factors for a wide array of non-communicable diseases, while there is a lack of studies investigating environment-specific associations between sports participation and alcohol drinking in adolescence. This study prospectively investigated the relationship between sports factors (i.e., participation in sports and competitive achievement), with the prevalence of harmful alcohol drinking (HD), and HD initiation in 14-to-16 years old adolescents from Bosnia and Herzegovina (n = 641, 337 females, 43% living in rural community). Participants were tested over 4-time points divided by approximately 6 months, from the beginning of high school to the end of the second grade. Variables included gender, factors related to sport participation, a community of residence (urban or rural), and outcome: alcohol consumption was assessed by the AUDIT questionnaire. Results evidenced that the prevalence of HD increased over the study period from 6 to 19%, with no significant differences between urban and rural youth. Logistic regression for HD as criterion evidenced adolescents who participated in sports and then quit as being at particular risk for drinking alcohol at the study baseline. Sports factors were not correlated with HD initiation in the period between 14 and 16 years of age. It seems that the problem of alcohol drinking should be preventively targeted in all youth, irrespective of living environment. Although sports participation was not evidenced as being a factor of influence on HD initiation, results highlight the necessity of developing targeted preventive campaigns against alcohol drinking for adolescents who quit sports.

Features of stomach and duodenum peptic ulcer in patients with mesenteric atherosclerosis

Introduction. The high frequency of complicated forms of the stomach and duodenum peptic ulcer (PU) in patients with atherosclerosis requires the study of additional factors of ulcerogenesis in addition to infection withHelicobacter pylori(H. pylori) and the use of non-steroidal anti-inflammatory drugs (NSAIDs). Currently, there is no clear understanding of the role of mesenteric artery (MA) atherosclerosis in the development of gastroduodenal ulcers.The purpose of the study. To evaluate the contribution of MA atherosclerosis to the development of gastric and duodenal ulcer in patients with multifocal atherosclerosis.Material and methods. The study included 91 patients with atherosclerosis of two or more vascular beds in the period from 2019 to 2021. The examination included the determination of the gastrin-17, pepsinogen I, pepsinogen II and antibodies toH. pyloriIgG concentration in blood serum, as well as multispiral computed tomoangiography of the abdominal aortic branches and esophagogastroduodenoscopy with histological examination.Results. The patients were divided into two groups: group I – 36 (39.6%) patients with PU, group II – 55 (60.4%) patients without PU. A more frequent occurrence of hemodynamically significant stenosis of the MA and a higher percentage of the superior mesenteric artery (SMA) stenosis in group I were noted. A positive correlation was found between the severity of erosive and ulcerative lesions and the percentage of SMA stenosis, levels of pepsinogen I and pepsinogen II. The combination of PU and MA atherosclerosis is characterized by a lesser severity of abdominal pain syndrome (p = 0.049). Risk factors for PU were identified: MA atherosclerosis (OR 4.953; CI 1.571–15.608); more than 8 points on the HADS depression scale (OR 2.970; CI 1.062–8.320) and on the Audit questionnaire (OR 5.787; CI 1.348–24.837).Conclusions. Risk factors for PU in patients with multifocal atherosclerosis were identified: MA atherosclerosis, subclinical depression, and health-threatening alcohol consumption. PU in patients with multifocal atherosclerosis is characterized by asymptomatic course.

Influence of childhood trauma, HIV infection, alcohol use disorder, and resilience on health-related quality of life in adulthood

Experience of childhood trauma, especially physical, emotional, and sexual abuse, carries a risk for developing alcohol use disorder (AUD) and engaging in risky behaviors that can result in HIV infection. AUD and HIV are associated with compromised self-reported health-related quality of life (HRQoL) possibly intersecting with childhood trauma. To determine whether poor HRQoL is heightened by AUD, HIV, their comorbidity (AUD + HIV), number of trauma events, or poor resilience, 108 AUD, 45 HIV, 52 AUD + HIV, and 67 controls completed the SF-21 HRQoL, Brief Resilience Scale (BRS), Ego Resiliency Scale (ER-89), and an interview about childhood trauma. Of the 272 participants, 116 reported a trauma history before age 18. Participants had a blood draw, AUDIT questionnaire, and interview about lifetime alcohol consumption. AUD, HIV, and AUD + HIV had lower scores on HRQoL and resilience composite comprising the BRS and ER-89 than controls. Greater resilience was a significant predictor of better quality of life in all groups. HRQoL was differentially moderated in AUD and HIV: more childhood traumas predicted poorer quality of life in AUD and controls, whereas higher T-lymphocyte count contributed to better quality of life in HIV. This study is novel in revealing a detrimental impact on HRQoL from AUD, HIV, and their comorbidity, with differential negative contribution from trauma and beneficial effect of resilience to quality of life. Channeling positive effects of resilience and reducing the incidence and negative impact of childhood trauma may have beneficial effects on health-related quality of life in adulthood independent of diagnosis.

A study to assess the pattern of alcohol and tobacco usage in the rural field practice area of a medical college in Tamil Nadu

Background: Tobacco usage and alcohol consumption is a serious health issue to the society for ages. The consumption of alcohol and tobacco usage leads to medical and societal issues. An assessment of the pattern of tobacco usage and alcohol consumption in adult population is important to estimate the burden, and the risk factors associated with the same on the rural communities. There is a strong impact on the prevalence of NCDs by reduction in the usage of tobacco and alcohol products in the forthcoming decades. Methods: A community based cross-sectional study was conducted in the rural field practice area of a medical college, using pre-validated, semi-structured questionnaire amongst 275 study participants a rural area. The adults aged 18 years and above who were currently using tobacco products and consuming alcohol were selected by simple random sampling using the tobacco assessment and AUDIT questionnaire for alcohol consumption. Results: The results showed a significant association between all the socio-demographic variables (except for gender) in the usage of tobacco products; the study found higher literacy levels in using the products more frequently. The age distribution, family arrangement and socio-economic status were associated with alcohol consumption as well. In the multivariate regression the socio-economic class were associated with alcohol consumption. Conclusions: The interventions should be targeted at the family and community level. There is a need for health education programs and de-addiction camps.