Male Alcohol Use Research Articles

Is the fertility treatment itself a risk factor for early pregnancy loss?

This longitudinal multicentre cohort study aimed to identify the role of the conception mode in infertile couples with an early pregnancy loss (EPL). All couples referred to the fertility clinic for the first time in the period 2002-2006 because of infertility were followed up to their first clinical pregnancy (n=1809). EPL was the outcome of 286 (15.8%) pregnancies. EPL rates for the different conception modes were as follows: spontaneous 14.5% (125/864), ovulation induction 15.8% (42/266), intrauterine insemination 25.0% (5/20), intrauterine insemination combined with ovarian stimulation 18.2% (37/203), IVF 16.3% (31/190), intracytoplasmic sperm injection (ICSI) 14.9% (30/202) and frozen embryo transfer (FET) 26.2% (16/61). After adjusting for female age, male age, hospital, obstetric history, female smoking habit, male alcohol use, menstrual cycle type and infertility diagnosis, the EPL rate after FET was significantly increased (odds ratio 2.2, 95% CI 1.14-4.19) compared with spontaneous conception. Embryo quality was comparable in fresh and frozen embryos. Other fertility treatments showed no increased miscarriage rate. Therefore, it is concluded that even after adjustment for confounding factors conception through FET remained an independent risk factor for EPL. Other modes of conception were not related with EPL.

Outcomes of tuberculosis treatment: a retrospective cohort analysis of smoking versus non-smoking patients in Penang, Malaysia

The association between tobacco smoking and tuberculosis (TB) is increasingly coming to light and the literature is laden with the evidence of this association. However, only a few observational studies specifically investigated the association between smoking and TB treatment outcomes. The present study aims to determine the prevalence of smoking among TB patients in Penang and to compare the treatment outcomes between smoking and non-smoking TB patients. A retrospective estimate of smoking prevalence among patients with TB and a retrospective cohort study comparing smoking and non-smoking TB patients with regards to treatment outcomes was conducted. The data were extracted from medical records of newly diagnosed TB patients who registered at a chest clinic at a tertiary care hospital in the state of Penang, Malaysia from January 2006 to June 2008. The prevalence of ever-smoking among TB patients was 53.4%. Smoking was significantly associated with male gender, alcohol use, and intravenous drug use (IVDU). Ever smokers had increased likelihood of treatment failure (OR 7.48), default (OR 7.17) and were less likely to be cured (OR 0.34). After controlling for the effects of confounders using multivariate logistic regression, ever smokers were still less likely to be cured (aOR 0.31) and more likely to default treatment (aOR 3.24). Dying from TB did not reach statistical significance. Prevalence of smoking was high among TB patients in Malaysia. This study further reaffirms that smoking is an independent predictor of poor TB treatment outcomes and prognosis.

Adolescent Fighting: Racial/Ethnic Disparities and the Importance of Families and Schools

Objective To identify factors associated with fighting among African American, Asian/Pacific Islander, Latino, and white youth, with a focus on family and school connectedness. Methods Subjects were 4010 adolescents (12–17 years old) from the 2003 California Health Interview Survey. Stratified logistic regression examined whether fighting in the past year was associated with various risk and protective factors among African American, Asian/Pacific Islander, Latino, and white youth subsamples. Results Fighting was reported by 27% of African American, 24% of Latino, 16% of white, and 6% of Asian/Pacific Islander youth. Male gender, alcohol use, and smoking were associated with higher odds of fighting among whites and Latinos. Poverty was associated with higher odds of fighting among whites and African Americans, as was depression among Latinos. Higher family support was associated with decreased odds of fighting for white youth. Higher school support was associated with decreased odds of fighting for Latino youth. Conclusions A higher proportion of African American and Latino youth report fighting than do whites and Asians/Pacific Islanders. There is, however, important variation in racial/ethnic disparities in risk and protective factors associated with fighting. Family and school factors may be protective against fighting. Prevention and intervention efforts to decrease youth violence might benefit from tailoring to communities' racial/ethnic composition and paying greater attention to family and community influences on adolescent fighting.

Oral squamous cell carcinoma and cultural oral risk habits in Vietnam

In South-Central Asia, 80% of head and neck cancers are found in the oral cavity and oropharynx. In Vietnam, oral cancer is often not being detected until people experience debilitating circumstances to normal oral function. The aims of the study were to explore the patterns of oral squamous cell carcinoma (OSCC) and its risk indicators, the structure of oral health care in Vietnam and trends in prevalence of cultural risk habits in southern Vietnamese patients. A retrospective clinical study was performed from 1 July 2005 to 1 April 2006 at Ho Chi Minh City Oncology hospital in Vietnam. Of the 161 cases, 147 subjects were diagnosed with OSCC, including 100 male and 47 female adults aged 24-85 years. Data were collected by a structured interview and clinical examination. Over 40% of the women with OSCC reported chewing betel quid and the most prevalent risk habit in males was smoking (91.0%). Daily alcohol use was reported by 79.0% of males and 2.1% of females. Two-thirds of the cases of OSCC were diagnosed at the 2nd and 3rd stage of cancer. The more advanced stages of cancer were observed in males than in females. The prevalence of tobacco and alcohol use in males with OSCC was higher in this study than in the previous Vietnamese studies. High frequency of risk habits in both genders was reported in OSCC Vietnamese patients. A trend of increased tobacco and alcohol use was observed in male OSCC patients. A lower prevalence of later staging in Vietnam was observed in this study than in earlier studies.

Stroke and Sleep Specialists: An Opportunity to Intervene?

Stroke and Sleep Specialists: An Opportunity to Intervene?

What is the latent structure of alcohol use disorders? A taxometric analysis of the Personality Assessment Inventory Alcohol Problems Scale in male and female prison inmates.

Three indicators derived from the Personality Assessment Inventory (PAI) Alcohol Problems scale (ALC)-tolerance/high consumption, loss of control, and negative social and psychological consequences-were subjected to taxometric analysis-mean above minus below a cut (MAMBAC), maximum covariance (MAXCOV), and latent mode factor analysis (L-Mode)-in 1,374 federal prison inmates (905 males, 469 females). Whereas the total sample yielded ambiguous results, the male subsample produced dimensional results, and the female subsample produced taxonic results. Interpreting these findings in light of previous taxometric research on alcohol abuse and dependence it is speculated that while alcohol use disorders may be taxonic in female offenders, they are probably both taxonic and dimensional in male offenders. Two models of male alcohol use disorder in males are considered, one in which the diagnostic features are categorical and the severity of symptomatology is dimensional, and one in which some diagnostic features (e.g., withdrawal) are taxonic and other features (e.g., social problems) are dimensional.

Caffeine, Alcohol, and Psychological Stress and In Vitro Fetilization

There has been an astounding explosion in the number of clinics offering ART techniques- 426 program in the US and 600 in Europe. Despite enormous advances regarding the technical aspects of the IVF procedure, the parents’ contribution has virtually been ignored. What is reassuring for patients is that lifestyle habits are within the patient’s control, and when modified, could lead to healthy babies. The focus of this paper will be on the current state of knowledge about the effects of female and male caffeine and alcohol use, and psychological stress on the reproductive endpoints of IVF. There is currently only one study on the effects of caffeine on IVF. In this study, caffeine intake by women had a profound effect on: 1) Miscarriages, 2) Not achieving a live birth and 3) Infant gestational age. The findings of this study require further confirmation. Success rates may be further affected by alcohol consumption. Female alcohol use was associated with: 1) A decrease in number of oocytes aspirated, 2) Not achieving a pregnancy, and 3) Increased risk of miscarriage. Male alcohol use was associated with: 1) Spontaneous miscarriages, and 2) Not achieving a live birth, particularly if consuming beer. Stress also has an impact on IVF success rates. There are several statistically significant studies on baseline and procedural depression, anxiety, stress, and mood, as well as stress hormones that all negatively affected pregnancy rates after IVF. However, the literature on stress and ART was devoid of an instrument that captures the female and male experience of going through ART. Thus, an instrument was developed that rated concern levels about anesthesia, surgery, pain, recovery time, side-effects, finances, missing work, insufficient information and delivering a healthy baby. At baseline, women who were concerned about the medical aspects of the procedure had fewer oocytes retrieved and fertilized. For women concerned about missing work, they had over twice the risk of not achieving a pregnancy, while women extremely concerned about finances had a very high risk of no live birth. Understanding both the independent and combined effects of stress, alcohol, and caffeine on ART may ultimately lead to effective interventions that will decrease adverse outcomes and in turn, produce healthy babies that mature into healthy children and adults.

Primary squamous cell carcinoma of the oral cavity at presentation in Pakistan

e17002 Background: Squamous cell carcinoma of oral cavity (SCCOC) is characterized by marked geographical differences in frequency and site distribution. Pakistan is situated within the high risk zone on the global oral cancer map. However, no reliable data exists on oral cancer in this area. Our aim was to determine clinicopathological features and patterns at presentation of primary SCCOC in a comprehensive cancer centre in Pakistan. Methods: Demographic, risk factors, pathological and AJCC staging data for SCCOC treated at Shaukat Khanum Memorial Hospital for the period November 2003-October 2008 were obtained from the head and neck unit database. Results: The database identified 666 patients with biopsy proven primary SCCOC. Mean age was 53 years (range 12 - 90 years). Male (428): Female (238) ratio was M64%:F36%. The occurrence of major risk factors for oral cancer specifically smoking, betel quid chewing, naswar (smokeless tobacco) and alcohol use in males (428) was 45% (193), 28% (118), 29% (126), 3% (13), and in females (238) was 8% (20), 29% (68), 13% (30), 0% (0), respectively. Thirty-eight percent (411/666) had no association with tobacco, betel quid or alcohol use. Subsite within oral cavity; anterior tongue 41.1% (274), buccal mucosa 26.6% (177), lower gingival and alveolus 19.5% (130), upper gingival and alveolus 4.1% (27), lips 3.6% (24), retromolar trigone 2.9% (19), hard palate 1.7% (11), and floor mouth 0.6 (4). Broder's/World Health Organization histological grade; grade I 52% (334), grade II 34% (226), grade III 7% (49), and unknown 5% (36). According to AJCC 2002 system 0.2% (1), 10.8% (72), 12.2% (81), 13.2% (88), and 63.7% (420) had stage 0, I, II, III, and IV, respectively. Conclusions: Approximately 80% of patients with primary SCCOC present with stage III or IV disease with anterior tongue as the most common subsite in our hospital. While tobacco and betel quid chewing can be attributed to development of SCCOC in a significant proportion of patients, nearly 38% are unlinked to typical risks factors suggesting other environmental and genetic agents as etiological factors in this region. No significant financial relationships to disclose.

Male alcohol use and unprotected sex with non-regular partners: Evidence from wine shops in Chennai, India

Background In India, heterosexual transmission accounts for approximately 80% of the spread of HIV, the virus that causes AIDS. Male alcohol use and its putative association with sexual risk are explored to inform HIV prevention interventions. Methods A survey of 1196 male patrons of wine shops or bars was conducted from August 2002–January 2003 as part of an ongoing HIV prevention trial in Chennai city in south India. In the analysis, we explored associations between covariates related to sexual behavior and alcohol use and our outcome of unprotected sexual intercourse with non-regular partners among men. Results Nearly half (43%) of the respondents reported any unprotected sex with non-regular partners and 24% had four or more recent sexual partners. Over 85% reported using alcohol at least 10 days a month (17% reported drinking everyday). During a typical drinking day, 49% reported consuming five or more drinks. Alcohol use before sex was reported by 89% of respondents. Unprotected sex with non-regular partners was significantly higher among unmarried men (OR =3.25), those who reported irregular income (OR = 1.38), who used alcohol before sex (OR = 1.75) and who had higher numbers of sexual partners (OR = 14.5). Conclusions Our findings suggest that future HIV prevention interventions in India might consider discussing responsible alcohol use and its possible role in sexual risk. These interventions should particularly consider involving unmarried men and weigh the role of structural factors such as access to income in developing prevention messages.

What African-American Middle School Youth Report About Risk-taking Behaviors

Introduction African-American youth represent the heaviest burden for HIV in all U.S. ethnic groups. The risk assessment was conducted with a group of suburban and urban African-American middle school children prior to the implementation of a faith-based substance abuse and HIV prevention program. The purpose of the study on risk-taking was to examine the sample’s level and predictors of social adaptation and risk-taking processes and to examine their ideas about risk and risk-taking behavior. Methods A correlation design was used to determine relationships between risky behaviors and scores for risk taking and social adaptation. A descriptive design guided open-ended questions about risk and risk-taking behaviors. Data were collected in two youth ministries. The nonprobability sample consisted of 45 male and female subjects in the suburban pre-intervention group and 39 male and female subjects in the urban comparison group. Results Findings include a statistically significant relationship between male gender and alcohol use and risk-taking scores in the suburban pre-intervention group; in addition, sexual activity and drug use were predictive of higher risk-taking scores in the urban comparison group. The urban comparison group also reported significantly higher risk-taking behaviors than did the suburban group. Discussion Data from this study suggest the need for substance abuse and HIV prevention programs for middle school youth before problem behaviors become established.

Low bone density in patients receiving methadone maintenance treatment

Aim To examine the frequency and severity of low bone mineral density (BMD) among patients enrolled in a methadone maintenance treatment (MMT) program and to ascertain risk factors for low BMD in this population. Design Cross-sectional. Measurements Data derived from standardized survey, medical record review, and dual energy X-ray densitometry (DXA). Results DXA results were below normal in 83% (76/92) of the study sample with T-scores <−2.5 (osteoporosis range) in 35% [32/92] and between −1.0 and −2.5 (osteopenia range) in 48% [44/92]. Risk factors for low BMD were common: tobacco use, 91%; heavy alcohol use, 52%; and HIV infection, 28%. Only 17% (16/92) were on medications that lower the risk of osteoporosis: estrogen ( n = 5), testosterone ( n = 4), calcium ( n = 4), and Vitamin D ( n = 2). None of the participants reported a known diagnosis of osteoporosis. In bivariate analyses, significant predictors of low BMD were: male gender ( p < 0.001), lower weight ( p = 0.009), and heavy alcohol use ( p = 0.02). Conclusion More than three quarters of this sample of patients in a MMT program had low BMD. Treatable conditions associated with low BMD were commonplace. Efforts to increase awareness of low BMD in MMT patients should be considered so that effective treatment may be employed to lower future fracture risk.

Cocaine and coronary calcification in young adults. The coronary artery risk development in young adults (cardia) study: Pletcher MJ, Kiefe DI, Sidney S, et al. Am Heart J 2005;150:921–6

This study examined the correlation between cocaine use and coronary calcification in participants enrolled in a longitudinal study of risk factors for coronary artery disease. At the 15-year evaluation of the CARDIA cohort, 3038 participants answered questions about cocaine use and underwent computed tomography (CT) to quantify coronary artery calcification. Before adjustment for age, sex, socioeconomic status, ethnicity, family history, smoking and alcohol use, cocaine exposure was strongly associated with coronary calcification. After adjustment for these factors, however, the correlation disappeared, with adjusted odds ratios for coronary calcification of 0.9 (95% confidence intervals [CI] 0.6–1.3) for 1 to 10 lifetime episodes, 1.2 (95% CI 0.8–1.7) for 11–99 episodes and 1.0 (95% CI 0.6–1.6) for ≥ 100 lifetime episodes of cocaine exposure. Male gender, alcohol and tobacco use were the three most important confounders, whereas systolic blood pressure, LCL-C, and HCL-C remained strong independent predictors of coronary calcification. The authors conclude that the increased rate of myocardial ischemia and infarction seen in cocaine users is due primarily to the acute effects of cocaine rather than accelerated atherogenesis.

Severe Intimate Partner Violence and Alcohol Use among Female Trauma Patients

The lifetime prevalence of intimate partner violence (IPV) among women in the United States is reported to be between 18 and 50%. One-third of female homicide victims are killed by an intimate partner and alcohol is often involved. Despite these figures, 77% of women have never been screened for IPV. Substance abuse in male partners is known to place women at risk. We examined the role of female alcohol use on rates of severe IPV. Our hypotheses were: (1) the prevalence of IPV among women seen in trauma centers is greater than that found in national surveys; (2) alcohol problems among abused women and their partners are greater than those among non-abused women; (3) females and their partners alcohol problems are each independently associated with IPV; and (4) female trauma center patients support domestic violence screening. An in-person survey was administered to 95 consecutive adult female trauma patients admitted to a Level I Trauma Center. The survey included questions about past-year and lifetime severe IPV, female and male partner alcohol use, and willingness to participate in IPV screening and referral. The multivariate associations of female and partner alcohol use with past-year severe IPV were assessed with logistic regression. Nearly one-half (46.3%) of women reported a lifetime history of severe IPV, with 26% experiencing severe IPV in the past year. Past-year IPV was identified in 59.1% of women screening positive for drinking problems, but in only 12.7% of those screening negative for drinking problems (p = 0.001). Similarly, past-year IPV prevalence was 55.2% when the partner was a problem drinker versus 8.3% when he was not (p = 0.001). Multivariate analysis showed that female problem drinking (odds ratio [OR] = 5.8) and partner problem drinking (OR=8.9) were independent predictors of past-year severe IPV. The majority of women (90.5%) felt that it was appropriate for health care professionals to screen for IPV; 90% of women with a history of IPV thought screening was important and 71% wished a previous healthcare provider had asked them about it. Female trauma patients demonstrate a higher prevalence of severe IPV than the general population. IPV rates appear to be related to both female and partner alcohol misuse. Female trauma patients endorsed IPV screening and thus should be screened for alcohol use and IPV in a way that minimizes future violence risk. Further research is needed to elucidate whether intervention for alcohol misuse has an impact on rates of IPV in this population.

Asking semi-literate adolescents about sexual behaviour: the validity of assisted self-completion questionnaire (ASCQ) data in rural Tanzania.

To develop and test a sexual behaviour survey method for semi-literate populations, combining the privacy of a self-completion questionnaire (SCQ) with the clarity of a face-to-face questionnaire (FFQ). In 1998, 6079 Tanzanian primary school students (mean age 15.1 years) were surveyed using an innovative assisted self-completion questionnaire (ASCQ). The format of the questionnaire was simple, all responses were closed, and conceptually complex questions such as those involving ranking or multiple answers were avoided. The ASCQ was administered to groups of 20 by a research assistant who read questions and answers aloud in two languages so pupils could tick or write responses independently. A total of 4958 of respondents from the 1998 ASCQ Cohort also participated in a 1998 FFQ interview and, in 2000, 4424 again completed an ASCQ. In the 1998 ASCQ survey, 55.0% of males and 21.1% of females reported they had had vaginal intercourse, of whom 71.5% and 66.0%, respectively reported their first sexual relationship lasted for a week or less, and 49.5% and 59.6%, respectively reported they had had sex in the last 4 weeks. After adjustment for age, reported sex was associated with alcohol use in both males (OR = 1.57) and females (OR = 1.69), earning money for males (OR = 1.32) and not living with a mother for females (OR = 0.77). The vast majority of respondents did not appear to have difficulty completing the ASCQ, but 7.4% of 1998 respondents and 2.9% of 2000 respondents selected all first or all last answers in a section for which this was inconsistent. This bias was associated with female, less educated and more geographically remote respondents. Of those respondents who reported sex in the 1998 ASCQ survey, 32.1% reported fewer total partners in the 2000 ASCQ survey, 25.2% reported having had sex fewer times than originally reported, and 61.9% of those who reported having used a condom in 1998 reported never having used one in 2000. While the proportions reporting sex were very similar in the 1998 ASCQ and FFQ surveys, 37.9% of males and 59.2% of females reporting sex only did so on one of the two questionnaires. Higher proportions of respondents reported sensitive information in the ASCQ than the FFQ, although in some cases this may have related to answer order bias. The results suggest that an ASCQ may be useful in assessing sexual behaviour in African adolescents, particularly for older, male and/or educated respondents. However, triangulation with data from other surveys raises questions about the validity of self-reported sexual behaviour in general.

Parental monitoring, negotiated unsupervised time, and parental trust: the role of perceived parenting practices in adolescent health risk behaviors

Purpose To compare two different parenting practices (parental monitoring and negotiated unsupervised time) and perceived parental trust in the reporting of health risk behaviors among adolescents. Methods Data were derived from 692 adolescents in 9th and 10th grades (x̄ = 15.7 years) enrolled in health education classes in six urban high schools. Students completed a self-administered paper-based survey that assessed adolescents’ perceptions of the degree to which their parents monitor their whereabouts, are permitted to negotiate unsupervised time with their friends and trust them to make decisions. Using gender-specific multivariate logistic regression analyses, we examined the relative importance of parental monitoring, negotiated unsupervised time with peers, and parental trust in predicting reported sexual activity, sex-related protective actions (e.g., condom use, carrying protection) and substance use (alcohol, tobacco, and marijuana). Results For males and females, increased negotiated unsupervised time was strongly associated with increased risk behavior (e.g., sexual activity, alcohol and marijuana use) but also sex-related protective actions. In males, high parental monitoring was associated with less alcohol use and consistent condom use. Parental monitoring had no affect on female behavior. Perceived parental trust served as a protective factor against sexual activity, tobacco, and marijuana use in females, and alcohol use in males. Conclusions Although monitoring is an important practice for parents of older adolescents, managing their behavior through negotiation of unsupervised time may have mixed results leading to increased experimentation with sexuality and substances, but perhaps in a more responsible way. Trust established between an adolescent female and her parents continues to be a strong deterrent for risky behaviors but appears to have little effect on behaviors of adolescent males.

Adolescent alcohol-use trajectories in the transition from high school.

A cohort of 3300 students from high schools across Victoria, Australia, were surveyed regarding their patterns of alcohol consumption from mid-1993 to 1995. The first wave of data was collected halfway through the students' final year of school (year 12). Students were then resurveyed 3 months following school completion and on two subsequent occasions, each separated by 6-month intervals. Analysis of the four waves of data indicated that five longitudinal patterns (trajectories) characterized temporal trends in male and female alcohol use through the transition from high school. Stable non-use trajectories were evident for 17% of males and 16% of females. Trajectories of less than weekly use characterized 45% of females and 46% of males, and showed little tendency to escalate toward harmful use. Among those using alcohol on a weekly or more frequent basis in high school, with few exceptions, use continued with at least the same frequency, but the quantity of alcohol consumed tended to escalate over time toward harmful levels. Overall, findings indicate that patterns of alcohol use tend to be stable over time, and more frequent alcohol use during the final year of high school tends to precede potentially harmful alcohol use following high school. Encouraging those high school students who consume alcohol once per week or more often to use alcohol on a less than weekly basis may be a valuable yet neglected harm minimization strategy.

Opportunistic screening for oral cancer and precancer in general dental practice: results of a demonstration study.

To demonstrate the feasibility of opportunistic oral cancer and precancer screening in general dental practice and to determine the prevalence of relevant lesions and risk habits in a population of general dental practice attenders. A prospective demonstration study, recruiting patients opportunistically. General dental practices. Eighteen general dental practitioners took part in this study. Each attended training sessions to be advised of the study protocol and the criteria of a positive and negative screen. Patients over the age of 35 years were prospectively and opportunistically recruited. Each patient was asked to complete a health questionnaire concerning age, gender, ethnicity, smoking and drinking habits. The dentist then examined the soft tissues and recorded the presence or absence of lesions independently on a second form. The forms were collated and data were analysed to determine prevalence of lesions and associations with risk habits. Data on 2,265 patients were available for analysis. Oral lesions were detected in 319 patients (14.1%). Ninety-four patients (4.2%) had lesions considered to be either malignant or potentially malignant. There was a significant association between positive lesions and male gender(IRR 1.86, 95% CI 1.22-2.82), heavy smoking (males: IRR 3.68, 95% Cl2.10-6.43: female; IRR 3.58, 954b CI 1.35-9.50) and heavy alcohol use in males (IRR 2.98, 95%q CI 1.06-3.47). The results suggest that patients attending general dental practices are representative of the general population both in terms of lesion prevalence and high risk habits such as smoking and drinking. This supports the view that opportunistic screening in a general dental practice setting may be a realistic alternative to population screening. Further research is needed to determine the cost effectiveness of this approach and to investigate the value of targeting high risk groups within this population. General dental practice is ideal for the evaluation of such systems prior to extending these studies to other healthcare settings.

Has the time come for opportunistic oral cancer screening?

Objectives To demonstrate the feasibility of opportunistic oral cancer and precancer screening in general dental practice and to determine the prevalence of relevant lesions and risk habits in a population of general dental practice attenders. Design, setting and methods A prospective demonstration study, recruiting patients opportunistically in general dental practices. Eighteen general dental practitioners took part in this study. Each attended training sessions to be advised of the study protocol and the criteria of a positive and negative screen. Patients over the age of 35 years were prospectively and opportunistically recruited. Each patient was asked to complete a health questionnaire concerning age, gender, ethnicity, smoking and drinking habits. The dentist then examined the soft tissues and recorded the presence or absence of lesions independently on a second form. The forms were collated and data were analysed to determine prevalence of lesions and associations with risk habits. Results Data on 2,265 patients were available for analysis. Oral lesions were detected in 319 patients (14.1%). Ninety-four patients (4.2%) had lesions considered to be either malignant or potentially malignant. There was a significant association between positive lesions and male gender (IRR 1.86, 95% CI 1.22–2.82), heavy smoking (males: IRR 3.68, 95% CI 2.10–6.43: female; IRR 3.58, 95% CI 1.35–9.50) and heavy alcohol use in males (IRR 2.98, 95% CI 1.06–3.47). Conclusions The results suggest that patients attending general dental practices are representative of the general population both in terms of lesion prevalence and high risk habits such as smoking and drinking. This supports the view that opportunistic screening in a general dental practice setting may be a realistic alternative to population screening. Further research is needed to determine the cost effectiveness of this approach and to investigate the value of targeting high risk groups within this population. General dental practice is ideal for the evaluation of such systems prior to extending these studies to other healthcare settings.

Effects of maternal and paternal alcohol consumption on the success rates of in vitro fertilization and gamete intrafallopian transfer

ObjectiveTo determine whether the amount and timing of female and male alcohol use during IVF and GIFT affect reproductive endpoints. DesignMulticenter prospective study. SettingClinics in southern California. Patient(s)Two hundred twenty-one couples with female infertility. Intervention(s)None. Main outcome measure(s)Egg retrieval, transfer, fertilization, pregnancy, miscarriage, live birth, and multiple gestations. Result(s)Female alcohol consumption was associated with: (1) a 13% decrease in the number of eggs aspirated (adjusted 95% confidence interval [CI]: −2% to −23%, for one additional drink per day, 1 year before the IVF or GIFT attempt); (2) an increase in risk of not achieving pregnancy by 2.86 times (0.99–8.24, 1 month prior); and (3) an increase in risk of miscarriage by 2.21 times (1.09–4.49, 1 week before the procedure).For men, one additional drink per day increased the risk of not achieving a live birth by 2.28 (1.08–4.80) to 8.32 (1.82–37.97) times, depending on the time period; beer also affected live births (ORs = 5.49–45.64). This outcome may be due partially to increased risk of miscarriage by 2.70 to 38.04 times for men who drank ≤1 month before and during IVF and GIFT. Conclusion(s)This is the first study to report an association between alcohol use and reproductive endpoints of IVF and GIFT. Because alcohol use is ubiquitous, modifying drinking habits may increase assisted reproductive technology success rates.

Alcohol dehydrogenase‐2 and aldehyde dehydrogenase‐2 genotypes and male alcohol use disorders in Khon Kaen, north‐east Thailand

A case-control study on the relationship between alcohol dehydrogenase-2 (ADH2), aldehyde dehydrogenase-2 (ALDH2) and male probable alcohol use disorders (AUD) was performed in Khon Kaen, north-east Thailand. One hundred and fifty-three paired cases (probable AUD) and controls (non-probable AUD) were sampled from villagers aged 18-65 years using the modified Michigan Alcoholism Screening Test - Thai version, controls being matched for gender, age (+/- 4 years) and village. All of the cases and 86.9% of the controls were current drinkers. The percentage of ADH2*1/1 among cases was 47.1%, being significantly larger than the 29.4% among controls, and yielding a univariate odds ratio (OR) of 2.421* (95% confidence interval (CI) = 1.419-4.132) for developing probable AUD. The ALDH2*1/1 proportion among cases, 92.8%, was comparable to the 92.2% among controls, yielding a univariate OR of 1.100 (95%CI = 0.757-1.599). Multivariate analysis based on a conditional logistic regression model and a hierarchically well-formulated model strategy revealed that: (i) the OR of developing probable AUD due to 1 g increment of daily ethanol drinking was 1.110* among farmers (95%CI = 1.054-1.170); (ii) OR due to 1 g increment of daily ethanol drinking was 1.329* among non-farmers (95%CI = 1.109-1.593); (iii) OR due to either ADH2*1/1 or ALDH2*1/1 was insignificant; and (iv) the daily amount of smoking is independently associated with probable AUD. The present findings suggest that one of the genetic factors that may be related to probable AUD among Thai males living in the north-east is the ADH2 gene.