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Liao J, Li X, Wang L, Chen M, Quan F, Xi Z. Clinical characteristics of heavy alcohol consumption in young and middle-aged acute cerebral infarction: A 12-month follow-up study. Heliyon 2024; 10:e30416. [PMID: 38726157 PMCID: PMC11079088 DOI: 10.1016/j.heliyon.2024.e30416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
Objective To investigate the clinical characteristics and prognosis of heavy alcohol consumption among young and middle-aged patients with acute cerebral infarction (ACI). Methods A total of 263 young and middle-aged ACI patients were included in the study from June 2018 to December 2020 and classified into heavy drinkers and non-heavy drinkers. Multivariate logistic regression analysis was conducted to assess the association between ACI and heavy alcohol consumption, considering clinical characteristics and one-year post-discharge prognosis. Results Among the patients, 78 were heavy drinkers. Heavy drinkers were more likely to consume alcohol 24 h before ACI onset (OR 4.03, 95 % CI 2.26-7.20), especially in the form of liquor (OR 3.83, 95 % CI 1.59-9.20), and had a higher risk of diastolic blood pressure ≥90 mmHg upon admission (OR 2.02, 95 % CI 1.12-3.64). In the one-year post-discharge prognosis, heavy drinkers had a greater likelihood of poor prognosis at 3 months (OR 2.31, 95 % CI 1.01-5.25), were less likely to quit drinking after discharge (OR 0.36, 95 % CI 0.19-0.66), and had a higher risk of recurrent cerebral infarction (OR 2.79, 95 % CI 1.14-6.84). Conclusions Over the 12-month follow-up, young and middle-aged ACI patients with heavy alcohol consumption exhibited worse short-term prognosis. Controlling alcohol consumption levels may improve the prognosis of these patients.
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Affiliation(s)
- Jia Liao
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Nursing, Chongqing Medical University, Chongqing, China
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Li
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Ling Wang
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Mingfen Chen
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Nursing, Chongqing Medical University, Chongqing, China
| | - Fengying Quan
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiqin Xi
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Burton R, Sharpe C, Bhuptani S, Jecks M, Henn C, Pearce-Smith N, Knight S, Regan M, Sheron N. The relationship between the price and demand of alcohol, tobacco, unhealthy food, sugar-sweetened beverages, and gambling: an umbrella review of systematic reviews. BMC Public Health 2024; 24:1286. [PMID: 38730332 PMCID: PMC11088175 DOI: 10.1186/s12889-024-18599-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The WHO highlight alcohol, tobacco, unhealthy food, and sugar-sweetened beverage (SSB) taxes as one of the most effective policies for preventing and reducing the burden of non-communicable diseases. This umbrella review aimed to identify and summarise evidence from systematic reviews that report the relationship between price and demand or price and disease/death for alcohol, tobacco, unhealthy food, and SSBs. Given the recent recognition as gambling as a public health problem, we also included gambling. METHODS The protocol for this umbrella review was pre-registered (PROSPERO CRD42023447429). Seven electronic databases were searched between 2000-2023. Eligible systematic reviews were those published in any country, including adults or children, and which quantitatively examined the relationship between alcohol, tobacco, gambling, unhealthy food, or SSB price/tax and demand (sales/consumption) or disease/death. Two researchers undertook screening, eligibility, data extraction, and risk of bias assessment using the ROBIS tool. RESULTS We identified 50 reviews from 5,185 records, of which 31 reported on unhealthy food or SSBs, nine reported on tobacco, nine on alcohol, and one on multiple outcomes (alcohol, tobacco, unhealthy food, and SSBs). We did not identify any reviews on gambling. Higher prices were consistently associated with lower demand, notwithstanding variation in the size of effect across commodities or populations. Reductions in demand were large enough to be considered meaningful for policy. CONCLUSIONS Increases in the price of alcohol, tobacco, unhealthy food, and SSBs are consistently associated with decreases in demand. Moreover, increasing taxes can be expected to increase tax revenue. There may be potential in joining up approaches to taxation across the harm-causing commodities.
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Affiliation(s)
- Robyn Burton
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England.
- Institute for Social Marketing and Health UK, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
| | - Casey Sharpe
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Saloni Bhuptani
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Mike Jecks
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Clive Henn
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nicola Pearce-Smith
- UK Health Security Agency (UKHSA), 10 South Colonnade, Canary Wharf, London, England
| | - Sandy Knight
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Marguerite Regan
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
| | - Nick Sheron
- Department of Health and Social Care, Office for Health Improvement and Disparities, 39 Victoria Street, London, England
- The Roger Williams Institute of Hepatology, Kings College London, London, England
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Searby A, Burr D, Redley B. The impact of COVID-19 on nurse alcohol consumption: A qualitative exploration. J Clin Nurs 2024; 33:368-380. [PMID: 35871283 PMCID: PMC9350011 DOI: 10.1111/jocn.16467] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore the long-term impact of the COVID-19 pandemic on nurse alcohol consumption. BACKGROUND The COVID-19 pandemic has caused immense disruption to healthcare services worldwide, and nurses have not been immune, experiencing burnout, declining mental health and ultimately, attrition from the profession. Increases in alcohol consumption have been reported across subsections of society, including those with pre-existing mental ill health and experiencing high stress, and exploring this phenomenon in nurses is essential for workforce well-being and sustainability. DESIGN Qualitative descriptive study design. METHODS Secondary analysis of individual, semi-structured interviews with nurses (N = 42) from diverse settings across Australia, including community, primary and hospital settings, conducted in July and August 2021. Data were analysed using structural coding and reported in accordance with the CORE-Q guidelines. FINDINGS Two key themes were found after analysis of the data: (1) factors influencing alcohol consumption (subthemes: workplace factors and external factors), and (2) the pandemic's influence on alcohol consumption (subthemes: increased consumption, moderation of consumption and alcohol as a reward). CONCLUSIONS Several participants described increased alcohol consumption because of the COVID-19 pandemic, particularly due to the stress of working in an environment where resources were scarce. Workplace factors such as overtime, missed breaks and heightened workload were all described as driving stress, and in turn increased alcohol consumption. RELEVANCE TO CLINICAL PRACTICE Increased alcohol consumption has been associated with burnout, absenteeism and intention to leave. The nursing profession is currently undergoing significant continuing stress providing care and management to patients with the SARS-CoV-2 virus, and increased alcohol consumption is a significant threat to personal and workforce well-being, workforce sustainability and quality nursing care.
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Affiliation(s)
- Adam Searby
- Deakin University, Institute for Health TransformationSchool of Nursing & MidwiferyGeelongAustralia
| | - Dianna Burr
- Deakin University, Institute for Health TransformationSchool of Nursing & MidwiferyGeelongAustralia
| | - Bernice Redley
- Deakin University, Institute for Health TransformationSchool of Nursing & MidwiferyGeelongAustralia
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4
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Jun S, Park H, Kim UJ, Choi EJ, Lee HA, Park B, Lee SY, Jee SH, Park H. Cancer risk based on alcohol consumption levels: a comprehensive systematic review and meta-analysis. Epidemiol Health 2023; 45:e2023092. [PMID: 37905315 PMCID: PMC10867516 DOI: 10.4178/epih.e2023092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/13/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES Alcohol consumption is a well-established risk factor for cancer. Despite extensive research into the relationship between alcohol consumption and cancer risk, the effect of light alcohol consumption on cancer risk remains a topic of debate. To contribute to this discourse, we conducted a comprehensive systematic review and meta-analysis. METHODS Our systematic review aimed to investigate the associations between different levels of alcohol consumption and the risk of several cancer types. We focused on analyzing prospective associations using data from 139 cohort studies. Among them, 106 studies were included in the meta-analysis after a quantitative synthesis. RESULTS Our analysis did not find a significant association between light alcohol consumption and all-cause cancer risk (relative risk, 1.02; 95% confidence interval, 0.99 to 1.04), but we observed a dose-response relationship. Light alcohol consumption was significantly associated with higher risks of esophageal, colorectal, and breast cancers. Light to moderate drinking was associated with elevated risks of esophageal, colorectal, laryngeal, and breast cancers. Heavy drinking was also found to contribute to the risk of stomach, liver, pancreas, and prostate cancers, thereby increasing the risk of almost all types of cancer. Additionally, females generally had lower cancer risks compared to males. CONCLUSIONS Our findings highlight that cancer risks extend beyond heavy alcohol consumption to include light alcohol consumption as well. These findings suggest that there is no safe level of alcohol consumption associated with cancer risk. Our results underscore the importance of public health interventions addressing alcohol consumption to mitigate cancer risks.
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Affiliation(s)
- Seunghee Jun
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyunjin Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ui-Jeong Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Bomi Park
- Department of Preventive Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- Graduate Program in System Health Science and Engineering, Ewha Womans University College of Medicine, Seoul, Korea
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Harrison F, Mortby ME, Mather KA, Sachdev PS, Brodaty H. Apathy as a determinant of health behaviors in older adults: Implications for dementia risk reduction. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12505. [PMID: 38026759 PMCID: PMC10668002 DOI: 10.1002/dad2.12505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 08/04/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Long-term improvements in physical inactivity and other behavioral risk factors are integral to dementia risk reduction; however, sustained behavior change is challenging. Apathy, depression, and fatigue may impact engagement in health behaviors, but their presentation overlaps. This study investigates whether these symptoms are differentially associated with multiple health behaviors. METHODS In 1037 community-dwelling older adults without dementia (aged 70-90, 55% women), regression analyses examined apathy, depression, and fatigue as predictors of health behaviors (physical activity, diet, alcohol, smoking) and a behavioral risk index. RESULTS Apathy was associated with reduced physical activity and alcohol use, and one or multiple behavioral risk factors. No or inconsistent relations were found between depression or fatigue and health behaviors. DISCUSSION Apathy is relevant to multiple health behaviors and should be considered when designing health promotion for older adults, including interventions for dementia risk reduction. Findings highlight the importance of distinguishing apathy from comorbid symptoms. Highlights Novel theory-based perspective on behavioural risk factors for dementia.Higher apathy predicted less physical activity and alcohol use, and increased odds of lifestyle risk factors.Depressive symptoms were not associated with any health behavior.Apathy may be a determinant of multiple health behaviors in older adults, distinct from depression and fatigue.Considering apathy in precision prevention of dementia appears warranted.
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Affiliation(s)
- Fleur Harrison
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
| | - Moyra E. Mortby
- School of Psychology, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- UNSW Ageing Futures Institute, UNSW SydneySydneyNew South WalesAustralia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- NeuroPsychiatric InstitutePrince of Wales HospitalRandwickNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry & Mental HealthFaculty of Medicine & Health, UNSW SydneySydneyNew South WalesAustralia
- Older People's Mental Health ServicePrince of Wales HospitalRandwickNew South WalesAustralia
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Hu K, Cassimatis M, Nguyen M, Girgis CM. Ethnic determinants of skeletal health in female patients with fragility fracture in a culturally diverse population. Bone Rep 2023; 18:101677. [PMID: 37101568 PMCID: PMC10123337 DOI: 10.1016/j.bonr.2023.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 04/02/2023] [Accepted: 04/04/2023] [Indexed: 04/28/2023] Open
Abstract
Background Low bone density leads to fragility fracture, with significant impact on morbidity and mortality. While ethnic differences in bone density have been observed in healthy subjects, this has not yet been explored in fragility fracture patients. Aims To assess if ethnicity is associated with bone mineral density and serum markers of bone health in female patients who experience fragility fractures. Methods 219 female patients presenting with at least one fragility fracture at a major tertiary hospital in Western Sydney Australia were studied. Western Sydney is a region with great cultural diversity, comprising people from over 170 ethnicities. Within this cohort, the three largest broad ethnic groups were Caucasians (62.1 %), Asians (22.8 %), and Middle Eastern patients (15.1 %). Location and nature of the presenting fracture and other relevant past medical history were obtained. Bone mineral density, measured by dual-energy X-ray absorptiometry, and bone-related serum markers were compared between ethnicities. Covariates (age, height, weight, diabetes, smoking, and at-risk drinking) were adjusted in multiple linear regression model. Results Although Asian ethnicity was associated with lower bone mineral density at the lumbar spine in fragility fracture patients, this association was no longer significant after adjustment for weight. Ethnicity (Asian or Middle Eastern) was not a determinant of bone mineral density at any other skeletal site. Caucasians had lower estimated glomerular filtration rate compared to Asian and Middle Eastern subjects. Serum parathyroid hormone concentrations were significantly lower in Asians compared to other ethnicities. Conclusion Asian ethnicity and Middle Eastern ethnicity were not major determinants of bone mineral density at the lumbar spine, femoral neck, or total hip.
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Affiliation(s)
- Katherine Hu
- Sydney Medical School, University of Sydney, Sydney, Australia
- Corresponding author.
| | - Maree Cassimatis
- Discipline of Exercise and Sports Science, Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Minh Nguyen
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, Australia
| | - Christian M. Girgis
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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7
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Gillies M, Tan K, Anthony L, Miller F. Effect of Psychosocial, Behavioral, and Disease Characteristics on Health-Related Quality of Life (HRQoL) After Breast Cancer Surgery: A Cross-Sectional Study of a Regional Australian Population. Cureus 2023; 15:e36054. [PMID: 36923016 PMCID: PMC10008704 DOI: 10.7759/cureus.36054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Increasing long-term breast cancer survivorship has highlighted the importance of patient-reported outcomes such as health-related quality of life (HRQoL) in addition to traditional outcomes that were used to define successful operative management. This study aimed to describe HRQoL in patients who underwent breast cancer resection in a regional Australian setting and identify the psychosocial, demographic, and operative characteristics associated with poor HRQoL. METHODS Consecutive patients who underwent breast cancer resection between 2015 and 2022 were included. Patients were asked to complete a survey instrument that included validated measures of HRQoL, emotional distress, fear of cancer recurrence (FCR), and social support. Demographic, disease, and operative data were collected from the medical record of the respondents. RESULTS Forty-six patients completed the survey (100% female, mean age = 62.68 years). Most HRQoL domains were significantly lower than an Australian reference population. HRQoL was more strongly associated with psychosocial factors (emotional distress, FCR, and social support) but was also associated with socioeconomic status, stage of cancer at presentation, and surgical complications. HRQoL was not related to breast conservation, management of the Axilla, or time since operation. CONCLUSION Long-term changes in HRQoL should be considered during the management and surveillance of breast cancer patients in regional Australia.
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Affiliation(s)
| | - Keith Tan
- Surgery, St. Vincent's Hospital Melbourne, Melbourne, AUS
| | | | - Francis Miller
- General Surgery, Goulburn Valley Health, Shepparton, AUS
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8
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Smith S, Buikstra E, Rubenach S, Preston-Thomas A, Hanson J. Limited Awareness of Melioidosis in High-risk Populations Despite an Increasing Incidence of the Disease in Far North Queensland, Australia. Am J Trop Med Hyg 2022; 107:1278-1280. [PMID: 35895342 PMCID: PMC9768265 DOI: 10.4269/ajtmh.22-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/17/2022] [Indexed: 12/30/2022] Open
Abstract
The incidence of melioidosis, an opportunistic infection caused by Burkholderia pseudomallei, has recently doubled in Far North Queensland (FNQ), Australia. This contrasts with the local burden of dengue, which is nearing elimination, and the stable incidence of leptospirosis. This questionnaire-based study assessed the awareness of melioidosis among people in FNQ with risk factors for the disease, using awareness of leptospirosis and dengue as comparators. There were 427 respondents; 361 (85%) reported one or more risk factors for melioidosis. Only 69 of 361 (19%) had heard of melioidosis compared with 301 of 361 (83%) who had heard of dengue (P < 0.001) and 137 of 361 (38%) who had heard of leptospirosis (P < 0.001). In FNQ, Australia, there is an increasing local incidence of melioidosis, but there is limited awareness of the disease among high-risk individuals. Greater community awareness of melioidosis is necessary to implement strategies to prevent disease and expedite the presentation of patients with this life-threatening infection.
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Affiliation(s)
- Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | | | - Sally Rubenach
- Tropical Public Health Services, Cairns, Queensland, Australia
| | | | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
- The Kirby Institute, New South Wales, Australia
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9
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Searby A, Burr D, Redley B. Alcohol guideline awareness and beliefs among Australian nurses: A mixed-methods study. Collegian 2022. [DOI: 10.1016/j.colegn.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Nejatian MM, Lan NSR, Yeap BB, Dwivedi G, Fegan PG, Ihdayhid AR. Characteristics and outcomes of patients with type 1 diabetes admitted with acute coronary syndromes. Diabetes Res Clin Pract 2022; 192:110093. [PMID: 36206818 DOI: 10.1016/j.diabres.2022.110093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/13/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022]
Abstract
AIMS This study explored characteristics and outcomes of patients with type 1 diabetes mellitus (T1DM) and acute coronary syndromes (ACS). METHODS A retrospective analysis of patients with T1DM admitted with ACS to an Australian hospital was conducted. Risk factor targets were defined by 2021 European Society of Cardiology Guidelines. Outcomes were defined as an adverse cardiovascular event (ACS, unplanned revascularisation, heart failure, stroke, or cardiovascular death) or all-cause mortality within six-months after discharge. RESULTS 61 patients were included [age 58.5 ± 12.8 years, 39 % female]. Dyslipidaemia (85 %), hypertension (75 %), smoking (28 %), prior coronary artery disease (CAD) (44 %), and microvascular complications (62 %) were common. HbA1c, low-density lipoprotein cholesterol, and blood pressure targets were attained in 12 %, 36 % and 47 %, respectively. ST-elevation myocardial infarction (65 % versus 7 %, p < 0.001) and revascularisation (77 % versus 41 %, p = 0.008) were more common in those without prior CAD. Peak inpatient blood glucose correlated directly with peak troponin (p = 0.011) and inversely with left ventricular ejection fraction (p = 0.027). Nineteen patients experienced an adverse six-month outcome, with peripheral neuropathy (p = 0.039) and in-hospital hypoglycaemia (p = 0.012) being independent predictors. CONCLUSIONS Patients with T1DM and ACS often do not meet guideline targets for cardiovascular risk factors, and frequently present with transmural infarctions. Dysglycemia and microvascular complications predict poorer outcomes.
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Affiliation(s)
| | - Nick S R Lan
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Girish Dwivedi
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Medical School, The University of Western Australia, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia
| | - P Gerry Fegan
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia; Curtin Medical School, Curtin University, Perth, Australia
| | - Abdul R Ihdayhid
- Department of Cardiology, Fiona Stanley Hospital, Perth, Australia; Harry Perkins Institute of Medical Research, Perth, Australia; Curtin Medical School, Curtin University, Perth, Australia.
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11
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Marzan M, Callinan S, Livingston M, Jiang H. Alcohol consumption, heavy episodic drinking and the perpetration of antisocial behaviours in Australia. Drug Alcohol Depend 2022; 235:109432. [PMID: 35405461 DOI: 10.1016/j.drugalcdep.2022.109432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/01/2022]
Abstract
AIMS This study aims to understand the dose-response relationship of the volume and patterns of alcohol consumption with alcohol-related antisocial behaviours (ASB) in the general population and assess whether these relationships are consistent across various sociodemographic subgroups. METHODS We used data from 30,275 respondents aged (14-69) from two waves (2013 and 2016) of the National Drug Strategy Household Survey (NDSHS). Average daily alcohol consumption and heavy episodic drinking (HED) frequencies were treated as the main independent variables and self-reported ASB perpetration as the dependent variable. Bivariable and multivariable logistic regression models predicting ASB with interaction terms between alcohol consumption and various sociodemographic variables were estimated. FINDINGS Compared with low-risk drinking (0.01-20 g of alcohol/day), respondents drinking at risky (20.01-40 g of alcohol/day) and high risk (>40 g of alcohol per day) levels had an increased prevalence of ASB perpetration with adjusted odds ratios of 3.63 (95% CI 2.98-4.42) and 8.07 (6.72-9.71). Increasing frequency of HED was also linked to increased self-report of ASB perpetration in bivariable and multivariable models. In our interaction models, we found higher probabilities of ASB perpetration among younger and unmarried respondents for a given level of drinking. DISCUSSION AND CONCLUSIONS Both average daily alcohol consumption and frequency of HED predict the probability of perpetrating alcohol-related ASB. Unsurprisingly, the risk of alcohol-specific ASB increased more quickly with consumption levels for younger and single respondents, suggesting interventions to reduce consumption among younger and unmarried persons will significantly impact ASB.
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Affiliation(s)
- Melvin Marzan
- Centre for Alcohol Policy Research (CAPR), School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Obstetrics and Gynaecology, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
| | - Sarah Callinan
- Centre for Alcohol Policy Research (CAPR), School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research (CAPR), School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden; National Drug Research Institute (NDRI), Curtin University, Perth, Australia
| | - Heng Jiang
- Centre for Alcohol Policy Research (CAPR), School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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12
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Sim BZ, Conway L, Smith LK, Fairhead L, Der YS, Payne L, Binotto E, Smith S, Hanson J. The aetiology and clinical characteristics of cryptococcal infections in Far North Queensland, tropical Australia. PLoS One 2022; 17:e0265739. [PMID: 35353860 PMCID: PMC8966997 DOI: 10.1371/journal.pone.0265739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/07/2022] [Indexed: 12/17/2022] Open
Abstract
Cryptococcal infections are an important cause of morbidity and mortality in tropical Australia. This retrospective audit was conducted to characterise the aetiology, temporospatial epidemiology, and clinical course of 49 cryptococcal infections in Far North Queensland between 1 January 1999 and 31 December 2019. Cryptococcus gattii was identified in 15/32 (47%) in whom it was possible to speciate the organism. Among these 15 patients, 13 (87%) had a rural residential address, 10 (67%) were Indigenous Australians and 11 (73%) presented during the May-November dry season. When compared to the 17 patients with Cryptococcus neoformans infection, patients with C. gattii were less likely to be immunocompromised (0/15 versus 8/17 (47%), p = 0.003). Neurosurgery was necessary in 5/15 C. gattii cases and 3/17 (18%) C. neoformans cases (p = 0.42). Outcomes were generally good with 42/49 (86%) cases—and 14/15 (93%) with C. gattii infection—surviving to hospital discharge. These positive outcomes are likely to be explained by the development of standardised treatment guidelines during the study period, low rates of comorbidity in the patients with C. gattii infection and access to liposomal amphotericin and neurosurgical support in the well-resourced Australian healthcare system.
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Affiliation(s)
- Beatrice Z. Sim
- Department of Medicine, Cairns Hospital, Cairns, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Luke Conway
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Laura K. Smith
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Lee Fairhead
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Yi Shan Der
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Lara Payne
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Enzo Binotto
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Australia
- Kirby Institute, University of New South Wales, Sydney, Australia
- * E-mail:
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