Daily Alcohol Consumption Research Articles

Effect of alcohol abuse on selected markers of inflammation, hemostasis, and endothelial function.

Alcohol consumption, even in moderate amounts, is associated with complex changes in blood biochemistry, involving abnormalities of many markers affecting cardiovascular risk. A total of 100 patients with documented alcohol abuse were included in the study. Demographic data and information on alcohol consumption were collected using a standardized questionnaire. All patients underwent biochemical tests. The following parameters were evaluated: PAI-1, vWF, TNF-α, VCAM-1, adiponectin, fibrinogen, lipid profile, and hsCRP. The results were compared with a control group of 25 healthy subjects. A significant adverse effect of alcohol abuse was observed for markers such as PAI-1, TNF-α, VCAM-1, adiponectin, and fibrinogen. Moreover, most of the subjects showed elevated TC, LDL-C, and TG levels. There was a significant relationship between vWF and average daily alcohol consumption, a positive relationship between adiponectin levels and age, and between fibrinogen and the number of cigarettes smoked. No significant correlations were observed between the other markers and age, gender, place of residence, daily alcohol consumption, and total time of alcohol abuse. Several abnormalities in most of the analyzed markers were observed in persons abusing alcohol, with no significant correlation with the daily amount of alcohol consumed and the total time of alcohol abuse, which may indicate permanent and irreversible damage to many tissues and organs as a result of chronic alcohol consumption. Further studies in this area with a larger group of patients are necessary to clarify the mechanisms leading to cardiovascular damage in the course of alcohol abuse.

12511 Rhabdomyolysis Related Acute Kidney Injury Presenting as First Manifestation of Autoimmune Hypothyroidism: A Case Report

Abstract Disclosure: A. Tiwari: None. S. Mantravadi: None. N. Doshi: None. A. Dabaja: None. C. Saad: None. Introduction: Autoimmune thyroiditis is the predominant cause of primary hypothyroidism, with an incidence of estimated 0.3-1.5 cases per 1000 people, with female to male predominance of 7-10[1]. Hypothyroid myopathy affects 79 % of the affected population. Its common presentation is fatigue and cramp but in rare instances rhabdomyolysis can occur with trivial triggers like alcohol, exercise2, Case Presentation: A 32-year-old male with no significant medical history, presented with generalized weakness, myalgia, and facial puffiness for last three months. The patient engaged in regular-intensity workouts and reported consuming 12 beers several times a week for past 5 years. Physical examination revealed facial puffiness and proximal muscle weakness. Initial Laboratory findings showed elevated creatinine (1.68 mg/dL, baseline 1.0 mg/dL in April 2020), CK (8113 U/L), AST (260 U/L), ALT (129 U/L). Urinalysis revealed hematuria and mild proteinuria. Serum electrolytes were unremarkable. Abdominal ultrasound showed diffuse hepatic steatosis with normal kidney appearance. This could not explain the reason for the Acute Kidney Injury and further workup showed TSH (>150 mIU/L) and TPO antibodies (197.9 U/mL). Autoimmune panel was unremarkable. Thyroid ultrasound done subsequently revealed a markedly heterogeneous gland. Treatment included parenteral crystalloids, low-dose prednisone which was empirically added for suspected autoimmune myositis and was later discontinued once the autoimmune panel was negative, and Levothyroxine at the recommended dose. At the time of discharge, his creatinine was reduced to 1.33 mg/dL and CK to 2,298 U/L. Discussion: Severe rhabdomyolysis is a rare but significant complication of autoimmune thyroiditis, potentially leading to acute kidney injury (AKI) if not promptly diagnosed and treated. Resident physicians often attribute symptoms like myalgia and generalized weakness in males to clear evident rhabdomyolysis if they find a cause like alcohol consumption and exercise, potentially overlooking the actual etiology. We recommend thyroid workup in such patients to promptly detect and manage underlying etiology predisposing to muscle damage and subsequent kidney injury. Our patient never had any Physician encounter as his prior medical history was unremarkable, however we suggest thorough family history and thyroid profile should be a part of outpatient workup as well for patients who show other risk factors for rhabdomyolysis like daily alcohol consumption, vigorous workout, consume medications like HMG CoA inhibitors, antipsychotics etc. Presentation: 6/3/2024

When fibrosis intersect: Association and risk factors between Peyronie's and Dupuytren's diseases

IntroductionPeyronie's and Dupuytren's diseases are benign but are source of significant functional impairment leading to considerable suffering. In this study, the aim is to investigate the association between Peyronie's and Dupuytren's diseases as well as their common and specific risk factors. Material and methodsFrom July 2022 to March 2024, we conducted a multicentric observational study on 450 patients. Patients followed up for Peyronie's and/or Dupuytren's disease were given a questionnaire that included a consent form, in order to screen one or the other associated disease and explore all risk factors. ResultsAmong the 278 patients followed for Dupuytren's disease, 35 (12.3%) had Peyronie's disease. Of the 172 patients with initial Peyronie's disease, 50 (29.1%) were diagnosed with Dupuytren's disease. Eventually, 85 patients had both pathologies (18.9%). High blood pressure was significantly more prevalent in patients with both diseases, compared to subjects with Peyronie's disease only (37.7% vs. 38.4% vs. 24.4%; P=0.02). The same observation was made regarding smoking (62.3% vs. 60.7% vs. 48.8%; P=0.05) and daily alcohol consumption (52.9% vs. 41.7% vs. 35.8%; P=0.04). Patients diagnosed with isolated Dupuytren's disease were more likely to be diabetic (13.6% vs. 9.41%; P=0.42). Blue eyes and family history were significantly more often reported in Dupuytren's patients (33.9% vs. 22.8%; P=0.03; P<0.001). Ledderhose disease was significantly more prevalent in patients with both diseases or isolated Dupuytren's disease (21.2% vs. 12.4% vs. 3.3%; P=0.0003). ConclusionThis study confirms the association between Peyronie and Dupuytren diseases. Smoking, alcohol daily consumption and hypertension are more prevalent in case of associated diseases. Blue eyes and family history are significantly more frequently found in case of Dupuytren's contracture. More powerful studies including a control group are necessary. Level of evidenceNot stated.

Tightening Blocks in Complementary Analyses of Observational Studies: Optimization Algorithm and Examples

An observational block design has I blocks matched for covariates and J individuals per block, but treatments were not randomly assigned to individuals within blocks, as would have been done in an experiment. Tightening an observational block design means selecting J ′ < J individuals from each block, and possibly I ′ ≤ I blocks, to construct a new observational block design that, in some way, addresses unmeasured biases from nonrandom treatment assignment. Tightening must preserve covariate balance while altering the design to achieve some additional objective. An optimization algorithm is introduced that achieves this while maintaining the block structure by finely balancing covariates across blocks and through optimal subset matching. An example is considered in detail, both to motivate and illustrate the tightening of an observational block design. Two tightened designs are built from a study of light daily alcohol consumption and its possible effects on HDL cholesterol. One tightened design adjusts for an outcome tentatively presuming it was unaffected by the treatment. The second tightened design uses a differential effect to remove bias from an unobserved general disposition that promotes several treatments. An R package tightenBlock implements the method, contains the data, and in that package the help-file for the function tighten reproduces the example.

Risk factor profile for non-communicable diseases: findings of a STEPS survey among the support staff at the University of Pretoria, South Africa

Background: Non-communicable diseases (NCDs) are an important problem in South Africa; they account for 60% of all deaths. Early screening could help lower NCD incidences and long-term consequences. Objective: The study aimed to profile NCD risk factors among insourced support staff at the University of Pretoria in 2018. Design: A cross-sectional, descriptive study was conducted at the University of Pretoria, Hatfield Campus. The World Health Organization (WHO) STEPwise approach to chronic disease risk factor surveillance (STEPS) questionnaire was administered to collect data in three steps. The participants’ behavioural risk profiles were gathered using the face-to-face interview technique (STEP I), followed by their physical risk profile using anthropometric and blood pressure measurements (STEP II). Last was the biochemical risk profile, including finger-prick blood glucose and cholesterol measurement (STEP III). Data were analysed using Epi-Info, version 3.54. Subjects: A convenient sample of participants aged 18–64 years from the Departments of Industrial Hygiene and Building Services, Landscape Services, Sports Fields Management, and Security Services (n = 146, 60% were females) took part in the study. Results: Most participants (97.8%) had low daily fruit and vegetable intake. Some 80% of the study population always or often added salt to their food when cooking. Daily alcohol consumption was reported by a quarter of the sample. More than two-thirds of all the participants were overweight or obese and 61% had central obesity. Conclusion: The study identified a high prevalence of several NCD risk factors. Tailored nutrition education and monitoring are needed to lower the elevated risk.

Differential impact of emotional and social loneliness on daily alcohol consumption in individuals with alcohol use disorder

BackgroundLoneliness is a predisposing and maintaining factor of alcohol use behavior. Several studies have linked loneliness to daily drinking and elevated alcohol use disorder (AUD) risk; however, operationalizations of both loneliness and drinking have varied greatly. MethodsThe current study adopted a multidimensional framework of loneliness (i.e., emotional and social subtypes) to examine daily prospective relations between loneliness and drinking among non-treatment seeking individuals with AUD. Participants (N= 60) reported on current loneliness and drinking twice daily for 14-days. Scores on emotional and social loneliness were disaggregated into within- and between-person predictors, and a multilevel hurdle model proxy was fitted with drinking likelihood (logistic) and quantity (zero truncated negative binomial) specified as separate outcomes. ResultsEmotional loneliness (within-person) was associated with increased drinking likelihood (OR=1.05, 95 % BCI [1.01, 1.10]) and quantity (IRR=1.05, 95 % BCI [1.02, 1.09]), while social loneliness (within-person) was associated with decreases in both drinking likelihood (OR=.94, 95 % BCI [.89,.99]) and quantity (IRR=.96, 95 % BCI [.93,.99]). Between-person loneliness scores were unrelated to both outcomes. ConclusionsThese discrepant findings by loneliness subtype may be ascribed to differences in subjective manifestations, in that emotional loneliness is a more severe form of loneliness that overlaps significantly with other negative affective states and promotes a coping response, while social loneliness may be readily alleviated by adaptive behavioral strategies for some, and social withdrawal for others. These findings offer insight into the nuances of loneliness-drinking relations and their clinical implications.

Racial and ethnic disparities in the natural history of alcohol-associated liver disease in the United States.

Outcomes in alcohol-associated liver disease (ALD) are influenced by several race and ethnic factors, yet its natural history across the continuum of patients in different stages of the disease is unknown. We conducted a retrospective cohort study of U.S. adults from 2011 to 2018, using three nationally representative databases to examine potential disparities in relevant outcomes among racial and ethnic groups. Our analysis included logistic and linear regressions, along with competing risk analysis. Black individuals had the highest daily alcohol consumption (12.6 g/day) while Hispanic participants had the largest prevalence of heavy episodic drinking (33.5%). In a multivariable-adjusted model, Hispanic and Asian participants were independently associated with a higher ALD prevalence compared to Non-Hispanic White interviewees (OR: 1.4, 95% CI: 1.1-1.8 and OR: 1.5 95% CI:1.1-2.0, respectively), while Blacks participants had a lower ALD prevalence (OR: .7 95% CI: .6-.9), and a lower risk of mortality during hospitalization due to ALD (OR: .83 95% CI: .73-.94). Finally, a multivariate competing-risk analysis showed that Hispanic ethnicity had a decreased probability of liver transplantation if waitlisted for ALD (SHR: .7, 95% CI: .6-.8) along with female Asian population (HR: .40, 95% CI: .26-.62). After accounting for key social and biological health determinants, the Hispanic population showed an increased risk of ALD prevalence, even with lower alcohol consumption. Additionally, Hispanic and Asian female patients had reduced access to liver transplantation compared to other enlisted patients.

Prevalence of Non-communicable Disease Risk Factors Among Adults in a Rural Field Practice Area of a Tertiary Care Medical Center in Karnataka.

Background Non-communicable diseases (NCDs), also referred to as chronic diseases, typically have a long duration and arise from a combination of genetic, physiological, environmental, and behavioral factors. Each year, 17 million people under the age of 70 die from non-communicable diseases (NCDs), with 86% of these premature deaths occurring in low- and middle-income countries. Objectives To estimate the prevalence of NCD risk factors among adults (18-65 years) in a rural population. Methods A cross-sectional study was conducted by selecting 200 participants from 200 households using convenience sampling. Participants aged 18-65 years were included, and locked households were excluded. Sociodemographic profiles were assessed using semi-structured questionnaires, and NCD risk factors were assessed using a Community-Based Assessment Checklist (CBAC). Descriptive statistics and associations were analyzed. Results The majority of participants were men (53.5%), married (89.5%), and belonged to the class 2 socioeconomic classification. The prevalence of NCD risk factors was 17%, with smoking (12.5%), alcohol consumption (6%), and waist circumference (1.8% for men and 27.9% for women) being the most common risk factors. Older age, lower educational attainment, unemployment, and lower-incomeclasses were associated with a higher risk of NCDs. Conclusion The study identifies key risk factors for non-communicable diseases (NCDs) as family history, waist circumference over 90 cm, daily alcohol consumption, and tobacco use, all significantly increasing the risk. Physical activity under 150 minutes per week and occupational exposure to crop residue showed no significant effect.

Risk factors of acute pancreatitis in young adults: a Nationwide population-based cohort study in South Korea.

This study aimed to identify the risk factors for acute pancreatitis (AP) in young adults in their 20s based on data from the nationwide cohort in South Korea. From the 2009 national health examination database of South Korea, total 471,098 individuals between the ages of 20 and 29 were analyzed. To identify the newly developed AP, the linked claims database was used. The incidence rates of AP were 18.8 and 9.8 per 100,000 person-years in male and female participants, respectively. Alcohol consumption and smoking were associated with the heightened risk of AP. The risk of AP development was increased as daily alcohol consumption increased. Also, ex-smokers and current smokers showed higher AP risk than never smokers. Hypertriglyceridemia and obesity were associated with the increased AP risk as well. Compared to female participants, male participants showed a higher risk of AP in univariate analysis, but showed a lower risk of AP in multivariate analysis. In the young adult population, alcohol consumption, smoking, hypertriglyceridemia, and obesity were associated with an elevated risk of developing AP. It is important to identify and manage the modifiable AP risk factors in young adults to minimize the socioeconomic burden of AP.

Assessing external exposome by implementing an Environmental Data Management System using Open Data

Due to the increasing importance of exposome in environmental epidemiology, feasibility and usefulness of an Environmental Data Management System (EDMS) using Open Data was evaluated. The EDMS includes data from 10 European cities (Celje (Slovenia), Łódź (Poland), Manchester (UK), Palermo (Italy), Paris (France), Porto (Portugal), Regensburg (Germany), Reus (Spain), Rijeka (Croatia), Thessaloniki (Greece)) about external non-specific and specific exposome factors at the city or country level (2017–2020). Findings showed that the highest values of life expectancy were in Reus females (86 years) and Palermo males (81 years). UK had the highest obesity rate (28%), Croatia the highest prescribed drug consumption (62%), Greece and Portugal the highest smoking rates (37%, 42%) and daily alcohol consumption (21%), respectively. The most polluted cities were Thessaloniki for PM10 (38 µg/m3), Łódź for PM2.5 (25 µg/m3), Porto for NO2 (62 µg/m3) and Rijeka for O3 (92 µg/m3). Thessaloniki had the highest grey space (98%) and Łódź the highest cumulative amount of pollen (39,041 p/m3). The highest daily noise levels ≥ 55 dB was in Reus (81% to traffic) and Regensburg (21% to railway). In drinking water, arsenic had the highest value in Thessaloniki (6.4 µg/L), boron in Celje (24 mg/L) and lead in Paris (46.7 µg/L). Portugal and Greece showed the highest pesticide residues in food (7%). In conclusion, utilizing open-access databases enables the translation of research findings into actionable strategies for public health interventions.

A smartphone app-based intervention combined with face-to-face sessions for alcohol dependence at internal medicine clinics: A randomized controlled trial

BackgroundAddressing the limited access to treatments for alcohol dependence, we developed ALM-002, a therapeutic application to be “prescribed” for non-abstinence-oriented treatment in internal medicine settings. Our objective was to preliminarily assess the efficacy and safety of ALM-002. MethodsIn a multicenter, open-label randomized controlled trial, participants aged ≥20 with alcohol dependence and daily alcohol consumption exceeding 60 g for men and 40 g for women, without severe complications, were randomly assigned to either the intervention group using ALM-002 or the treatment-as-usual control group. Participant in both groups received individual face-to-face sessions by physicians at weeks 0, 4, 8, and 12. The primary endpoint was the change in heavy drinking days (HDDs) from week 0 to week 12. A mixed model for repeated measures was employed. ResultsWe enrolled 43 participants: 22 in the intervention group and 21 in the control group. A significant reduction in HDDs every 4 weeks from week 0 to week 12 was observed, with a between-group difference of −6.99 days (95% CI: −12.4 to −1.6 days, standardized mean difference: −0.80). ConclusionsThese results indicate the potential of ALM-002 as a viable treatment for alcohol dependence. Further studies are needed to evaluate the clinical potential of ALM-002.

Industries, citizens, and non-governmental organizations’ positioning and arguments used in European Union initiatives for alcohol taxation and cross-border regulation

BackgroundThe European region has the highest daily alcohol consumption per capita and a high alcohol-related burden of disease. Policymaking at the European Union level is open to participation by interest groups, from public health organizations to alcohol industry representatives. This study aimed to map the interest groups present in the alcohol taxation and cross-border regulation initiatives and identify which arguments were used to support positions in favor or against them. MethodsWe used qualitative content analysis on the comments submitted on the official European Commission website during the 2017, 2018, 2020, and 2022 participation periods. Interest groups were characterized considering their positioning, and arguments were identified and compared by position and type of initiative. ResultsOpponents of changes to the structures of alcohol excise duties and cross-border regulations were mostly representatives of the alcohol and agricultural industries, and the proponents were mostly health-related nongovernmental organizations. Opponents of these initiatives used a wide variety of arguments, from economic and trade to health arguments, while proponents focused mainly on health arguments, such as the effectiveness of alcohol taxation in preventing alcohol-related morbidity and mortality. ConclusionThis study highlights the wide range of arguments used by opponents around alcohol control policies, contrasting with the health-centered arguments of proponents. It further shows that there is a lobbying network at the European Union level, combining national and international representatives of industry and non-governmental organizations. These findings provide an opportunity for better preparation for upcoming discussions on alcohol control at national and regional levels.

Associations between noticing public health education campaigns about cannabis and risk perceptions in the northern Canadian territories: a cross-sectional study.

This study investigated whether noticing cannabis education campaigns was associated with increased cannabis risk perceptions in Canada's three territories following non-medical cannabis legalization. Data were from the Cannabis Policy Study in the Territories, including 2452 participants, age ≥16years residing in Yukon, Northwest Territories and Nunavut. Poisson regression with robust standard errors were used to estimate associations between noticing cannabis education campaigns and moderate to very high risk perceptions of daily cannabis smoking, vaping, edible use and exposure to second-hand cannabis smoke, adjusting for sociodemographic characteristics and cannabis-use frequency. Results were compared with associations with risk perceptions of daily alcohol consumption and cigarette smoking, not included in cannabis education campaigns. Interactions were examined between noticing education campaigns and age group and cannabis-use frequency. Cannabis education campaigns were noticed by 40.4% of respondents, with lower awareness among those with lower education and income. Noticing campaigns was associated with higher risk perceptions of daily cannabis smoking [adjusted risk ratio (RRadj) = 1.09, 95% confidence interval (CI): 1.02-1.16] and vaping (RRadj = 1.09, 95%CI: 1.02-1.16). Significant interactions were not found with age group or cannabis-use frequency. Findings are consistent with modest effects of cannabis education campaigns. Approaches are needed to increase reach of cannabis education campaigns, including among groups with lower education and income.

Impact of metabolic phenotype and alcohol consumption on mortality risk in metabolic dysfunction-associated fatty liver disease: a population-based cohort study

Patients with metabolic dysfunction-associated fatty liver disease (MAFLD) often present with concomitant metabolic dysregulation and alcohol consumption, potentially leading to distinct clinical outcomes. We analyzed data from 8043 participants with MAFLD in the Thai National Health Examination Survey with linked mortality records. According to the MAFLD criteria, 1432 individuals (17.2%) were categorized as having the diabetes phenotype, 5894 (71.0%) as the overweight/obesity phenotype, and 978 (11.8%) as the lean metabolic phenotype. Over 71,145 person-years, 916 participants died. Using Cox proportional hazard models adjusting for physiological, lifestyle, and comorbid factors, both diabetes (adjusted hazards ratio [aHR] 1.59, 95% CI 1.18–2.13) and lean metabolic phenotypes (aHR 1.28, 95% CI 1.01–1.64) exhibited significantly higher mortality risk compared to the overweight/obesity phenotype. A J-shaped relationship was observed between daily alcohol consumption and the risk of all-cause mortality. Daily alcohol intake exceeding 50 g for women and 60 g for men increased the all-cause mortality risk among MAFLD individuals with the lean metabolic phenotype (aHR 3.39, 95% CI 1.02–11.29). Our study found that metabolic phenotype and alcohol consumption have interactive effects on the risk of all-cause mortality in patients with MAFLD, indicating that evaluating both factors is crucial for determining prognostic outcomes and management strategies.

Effectiveness of genetic feedback on alcohol metabolism to reduce alcohol consumption in young adults: an open-label randomized controlled trial

BackgroundIt is unclear whether brief interventions using the combined classification of alcohol-metabolizing enzymes aldehyde dehydrogenase 2 (ALDH2) and alcohol dehydrogenase 1B (ADH1B) together with behavioral changes in alcohol use can reduce excessive alcohol consumption. This study aimed to examine the effects of a brief intervention based on the screening of ALDH2 and ADH1B gene polymorphisms on alcohol consumption in Japanese young adults.MethodsIn this open-label randomized controlled trial, we enrolled adults aged 20–30 years who had excessive drinking behavior (average amount of alcohol consumed: men, ≥ 4 drinks/per day and women, ≥ 2 drinks/per day; 1 drink = 10 g of pure alcohol equivalent). Participants were randomized into intervention or control group using a simple random number table. The intervention group underwent saliva-based genotyping of alcohol-metabolizing enzymes (ALDH2 and ADH1B), which were classified into five types. A 30-min in-person or online educational counseling was conducted approximately 1 month later based on genotyping test results and their own drinking records. The control group received traditional alcohol education. Average daily alcohol consumption was calculated based on the drinking diary, which was recorded at baseline and at 3 and 6 months of follow-up. The primary endpoint was average daily alcohol consumption, and the secondary endpoints were the alcohol-use disorder identification test for consumption (AUDIT-C) score and behavioral modification stages assessed using a transtheoretical model.ResultsParticipants were allocated to the intervention (n = 100) and control (n = 96) groups using simple randomization. Overall, 28 (29.2%) participants in the control group and 21 (21.0%) in the intervention group did not complete the follow-up. Average alcohol consumption decreased significantly from baseline to 3 and 6 months in the intervention group but not in the control group. The reduction from baseline alcohol consumption values and AUDIT-C score at 3 months were greater in the intervention group than in the control group (p < 0.001). In addition, the behavioral modification stages were significantly changed by the intervention (p < 0.001).ConclusionsGenetic testing for alcohol-metabolizing enzymes and health guidance on type-specific excessive drinking may be useful for reducing sustained average alcohol consumption associated with behavioral modification.Trial registrationR000050379, UMIN000044148, Registered on June 1, 2021.

Translation, adaptation, and validation of a Chinese version of the Hypertension Self-Care Activity Level effects (H-SCALE) for patients with hypertension.

Lifestyle modification is an essential component of prevention and management of hypertension. Existing instruments in Taiwan focus on assessing lifestyle modifications by evaluating medication adherence or confidence in controlling blood pressure. However, other self-care activities, such as diet, physical activity, weight management, smoking, and alcohol consumption are also important. The Hypertension Self-Care Activity Level Effects (H-SCALE) is one such instrument, but there are no similar tools available in Taiwan. This study aimed to translate the H-SCALE into Chinese and test its validity, and reliability in a sample of adults with hypertension. The English version of the 31-item H-SCALE was translated into Chinese using the forward-backward method. The content validity index (CVI) of the translated scale was determined by five experts in hypertension. Item analysis was conducted with a pilot sample of 20 patients with hypertension. Cronbach's α was used to establish the internal consistency reliability for the Chinese version of the H-SCALE (H-SCALE-C). Exploratory factor analysis (EFA) explored the structure of the H-SCALE-C. Additionally, construct validity was examined with confirmatory factor analysis (CFA). Patients with hypertension were recruited by convenience sampling from a cardiovascular outpatient clinic of a medical center in northern Taiwan. A total of 318 patients met the inclusion criteria and participated in factor analysis in the study. Pilot testing of the scale items indicated most patients could not accurately estimate the number of days of alcohol consumption for the previous week. Therefore, three alcohol-related items were removed. The adaptation resulted in a 28-item H-SCALE-C. EFA revealed a 4-factor solution with 13 items that explained 63.93% of the total variance. CFA indicated a good fit for a 4-factor model and construct validity was acceptable. Internal consistency reliability was acceptable (Cronbach's alpha for the four subscales ranged from 0.65 to 0.94). Convergent validity was acceptable, and discriminant validity was significant. The H-SCALE-C is a valid, reliable tool for promptly assessing life-style activities for patients with hypertension in Taiwan. The instrument is suitable for assisting healthcare providers in evaluating self-care activities, which could be used to facilitate lifestyle modifications for patients with hypertension.

Prevalence, sociodemographic, and clinical correlates of underweight in a sample of Chinese male alcohol-dependent patients.

Underweight is a significant symptom in alcohol-dependent patients, yet few studies have examined underweight in Chinese male patients. The current study aimed to identify the prevalence, sociodemographic, and clinical correlates of underweight in Chinese male patients with alcohol dependency. In this cross-sectional study, 405 male inpatients with alcohol dependence and 383 healthy male controls were recruited. Participants' demographic and clinical data, including anthropometric data, were collected. We first conducted univariate analysis to identify seven variables with significant differences between groups: smoking behavior, hospitalization, alcohol consumption, cerebral infarction, hypertension, Hamilton Depression Scale (HAMD) score, and Scale for Assessment of Negative Symptom (SANS) score. Then, binary logistic regression was used to assess their relationship with underweight, with a significance level of .05. The prevalence of underweight was significantly higher in the study population than in the control group (2.99% vs. 2.87%; P < .001). Patients with underweight had significantly higher rates of smoking behavior and cerebral infarction, as well as higher scores of SANS and HAMD than non-underweight patients. The non-underweight patients had higher daily alcohol consumption and times of hospitalization. Furthermore, logistic regression analysis showed that smoking behavior [odds ratio (OR) = 2.84, 95% confidence interval (CI) = 1.03-7.80, P = .043)], cerebral infarction (OR = 5.20, 95% CI = 1.13-23.85, P = .036), SANS score (OR = 1.22, 95% CI = 1.16-1.28, P < .001), and HAMD score (OR = 1.06, 95% CI = 1.02-1.11, P = .005) were associated with underweight. More than 20% of male alcohol-dependent patients in a Chinese sample were underweight. Some demographic and clinical variables independent correlates for underweight in alcohol-dependent patients. We need to focus on alcohol-dependent patients with smoking, cerebral infarction, depression, and more prominent negative symptoms.

Relationship between alcohol intake based on daily smartphone-reported consumption and PEth concentrations in healthy volunteers.

To investigate the association between alcohol consumption registered daily with a digital smartphone-based diary and concentration of phosphatidylethanol (PEth) 16:0/18:1 in a population without a known alcohol use disorder (AUD), and evaluate whether prospective registration of alcohol consumption is better than retrospective registration and if the association between alcohol intake and PEth was affected by sex or body mass index (BMI). A total of 41 women and 21 men without AUD-diagnosis registered their alcohol consumption prospectively with a digital diary for 14days, and retrospectively with the Timeline Followback method in the same time interval. PEth was measured before and after the registration period. The correlation between alcohol consumption and PEth varied from 0.65 to 0.87. It did not depend significantly on the reporting method, and was not influenced by sex or BMI. Based on the regression coefficient, a reduction of alcohol consumption by two alcohol units (26g of pure ethanol) per day would lead to a reduction of the PEth concentration of about 0.1μmol/l, and vice versa. There was a good correlation between PEth concentration and alcohol consumption, both when alcohol consumption was reported prospectively and retrospectively. The preferred cut-off for PEth should be adjusted to the level of alcohol consumption considered harmful and a purposeful trade-off between sensitivity and specificity. In order to identify persons with a daily alcohol consumption of more than two or threeunits of alcohol with a sensitivity of 80% or 90%, we suggest a cut-off of around 0.1μmol/l.

Independent and combined effects of smoking, drinking and depression on periodontal disease

BackgroundPeriodontitis is a complex chronic inflammatory disease that is particularly associated with health-related conditions such as smoking, excessive drinking and depression. This research aimed to investigate the interaction between these lifestyles factors on periodontitis risk.MethodsThis study included participants who participated in the National Health and Nutrition Examination Survey in the United States between 2009 and 2014. They had completed oral health-periodontal examination, Smoking-Cigarette Use Questionnaire, Alcohol Use Questionnaire, and Patient Health Questionnaire. Periodontal clinical attachment loss (CAL) of 3 mm or more and Patient Health Questionnaire-9 (PHQ-9) of 10 scores or more were used to identify periodontitis and depression, respectively. Daily alcohol consumption in the past year was classified into three levels: low (1 drink or less), moderate (between 1 and 3 drinks), and heavy drinking (4 drinks or more), while smoking was defined as having smoked at least 100 cigarettes in one's lifetime. Then, the logistic regression combined with interaction models were used to analyze the independent and combined effects of smoking, drinking and depression on periodontitis risk.ResultsThe results indicated a statistically significant multiplicative interaction between smoking and depression in relation to the development of periodontitis, both in the overall population (P = 0.03) and among male participants (P = 0.03). Furthermore, among individuals experiencing depression, smoking was found to significantly increase the prevalence of periodontitis by 129% in the younger age group compared to non-smokers (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.10 to 4.76). However, the interaction between smoking and alcohol consumption was only significant among females (P < 0.05). There was a dose-dependent relationship between drinking frequency and smoking on periodontitis prevalence. In the smoking population, occasional drinking (OR: 1.70; 95% CI: 1.22 to 2.37) and regular drinking (OR: 2.28; 95% CI: 1.68 to 3.11) significantly increased the prevalence of periodontitis compared to individuals without these two factors.ConclusionThese results suggested that there were interactive effects between smoking, drinking and depression on periodontitis risk and policies aimed at healthy behaviours and mental health may be beneficial for our oral health.

Influence of lifestyle on academic performance in basic cycle medical students

Objective: To investigate the influence of lifestyle on academic performance in basic cycle medical students. Methods: The study involved applying two instruments to 51 medical students to identify cognitive function and lifestyle habits, as well as the level of physical activity through an international questionnaire. Results: No direct correlations were found between cognitive function and physical activity. Significant correlations were identified between participants' age and average correct answers in the Dissertation Cognitive Assessment (DCA) (r=0.4, p=0.01), extracurricular study days and average correct answers in the DCA (r=0.4, p=0.006), out-of-class study hours and average correct answers in the DCA (r=0.4, p=0.006), and between hours of sleep and days of alcohol consumption in the month (r=-0.6, p=0.000). Conclusion: The findings suggest that older students and those who spend more time studying outside the classroom exhibit better academic performance. Furthermore, a lifestyle with higher frequency of alcohol consumption is associated with reduced hours of sleep. These elements are fundamental to understanding and improving learning strategies and well-being of medical students.