Clinical presentation and hospitalisation duration of 201 coronavirus disease 2019 patients in Abuja, Nigeria

Background: Knowledge of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is unfolding. Insights from patient features in different environments are therefore vital to understanding the disease and improving outcomes.Aim: This study aimed to describe patient characteristics associated with symptomatic presentation and duration of hospitalisation in coronavirus disease 2019 (COVID-19) patients managed in Abuja.Setting: The study was conducted in Abuja, the Federal Capital Territory, Nigeria.Methods: This was a retrospective study of 201 COVID-19 patients hospitalised in the Asokoro District Hospital COVID-19 Isolation and Treatment Centre between April 2020 and July 2020. Demographic and clinical data were obtained and outcomes assessed were symptom presentation and duration of hospitalisation.Results: Patients’ median age was 39.3 years (interquartile range [IQR]: 26–52); 65.7% were male and 33.8% were health workers. Up to 49.2% of the patients were overweight or obese, 68.2% had mild COVID-19 at presentation and the most common symptoms were cough (38.3%) and fever (33.8%). Hypertension (22.9%) and diabetes mellitus (7.5%) were the most common comorbidities. The median duration of hospitalisation was 14.4 days (IQR: 9.5–19). Individuals with secondary and tertiary education had higher percentage symptoms presentation (8.5% and 34%, respectively), whilst a history of daily alcohol intake increased the length of hospital stay by 129.0%.Conclusion: Higher educational levels were linked with symptom presentation in COVID-19 patients and that daily alcohol intake was significantly associated with longer hospital stay. These findings highlight the importance of public education on COVID-19 for symptom recognition, early presentation and improved outcomes.

Visceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in 40–69-years subjects

Background Visceral fat obesity can be defined quantitatively by abdominal computed tomography, however, the usefulness of measuring visceral fat area to assess the etiology of gastrointestinal reflux disease has not been fully elucidated. Methods A total of 433 healthy subjects aged 40–69 years (234 men, 199 women) were included in the study. The relationship between obesity-related factors (total fat area, visceral fat area, subcutaneous fat area, waist circumference, and body mass index) and the incidence of reflux erosive esophagitis was investigated. Lifestyle factors and stomach conditions relevant to the onset of erosive esophagitis were also analyzed. Results The prevalence of reflux erosive esophagitis was 27.2% (118/433; 106 men, 12 women). Visceral fat area was higher in subjects with erosive esophagitis than in those without (116.6 cm2 vs. 64.9 cm2, respectively). The incidence of erosive esophagitis was higher in subjects with visceral fat obesity (visceral fat area ≥ 100 cm2) than in those without (61.2% vs. 12.8%, respectively). Visceral fat obesity had the highest odds ratio (OR) among obesity-related factors. Multivariate analysis showed that visceral fat area was associated with the incidence of erosive esophagitis (OR = 2.18), indicating that it is an independent risk factor for erosive esophagitis. In addition, daily alcohol intake (OR = 1.54), gastric atrophy open type (OR = 0.29), and never-smoking history (OR = 0.49) were also independently associated with the development of erosive esophagitis. Conclusions Visceral fat obesity is the key risk factor for the development of reflux erosive esophagitis in subjects aged 40–69 years.

Trends in Alcohol Consumption for Korean Adults from 1998 to 2018: Korea National Health and Nutritional Examination Survey

Drinking culture has been well developed in Korea. This research assessed trends in daily pure alcohol consumption over time and examined its trends regarding socio-demographic variables and alcoholic beverage types. We used data from the 1998–2018 Korea National Health and Nutrition Examination Survey. A total of 87,623 adults aged ≥ 19 years were included. Alcohol intake was assessed via 24-h dietary recall, and pure alcohol content was calculated according to alcoholic beverage type. Daily alcohol consumption increased from 8.37 g in 1998 to 14.98 g in 2016–2018 (p for trend < 0.001). The degree of the increasing trend was higher for women (2.09 g to 5.79 g) than men (14.78 g to 23.94 g) from 1998 to 2016–2018. Alcohol intake was highest in men aged 30–49 years and women aged 19–29 years. Moreover, the change of the rising trend in alcohol consumption according to high socioeconomic factors was more pronounced than the other variables. Lastly, the alcohol intake from soju and beer was dominant in alcohol consumption and escalated over time. The total daily alcohol intake increased about two times during 21 years in Korea, and the trends varied according to socio-demographic status.

Efficacy of Self-Administered Intranasal Oxytocin on Alcohol Use and Craving After Detoxification in Patients With Alcohol Dependence. A Double-Blind Placebo-Controlled Trial

Aims The aim of this study was to assess the efficacy of self-administered intranasal oxytocin on alcohol dependence after detoxification. Methods In a double-blind, randomized, placebo-controlled trial, 38 patients fulfilling the criteria for ICD-10 diagnosis of alcohol dependence received either 8 IU oxytocin or placebo at their own discretion up to thrice daily for 4 weeks, after completing detoxification. Primary outcome was alcohol intake specified as the amount of alcohol consumed, the number of days to relapse into alcohol use and the proportion of subjects relapsing. Secondary outcomes were self-reported symptoms of craving, sleep and mental distress. Results There were no significant differences between the oxytocin group and the placebo group in daily alcohol intake in total (mean 1.3 ± 2.9 vs. 2.0 ± 5.0 units; P = 0.63) or on drinking days (mean 8.4 ± 2.7 vs. 7.7 ± 6.0 units; P = 0.76), in the number of days until relapse (P = 0.91) or in the proportion of subjects relapsing (37.5 vs. 41.2%; P = 0.84). Neither were there any statistically significant differences in any other outcomes, except a larger decrease in self-reported nervousness in the oxytocin group (P = 0.022). Conclusion The results were inconclusive as to whether intranasal oxytocin reduced the time to relapse, degree of craving or total amount of alcohol consumed after detoxification. However, the oxytocin group had a larger decrease in self-reported nervousness.

Heavy drinking habits are associated with worse in-hospital outcomes in patients with acute coronary syndrome

Introduction The association between alcohol consumption and the occurrence of coronary heart disease is well described in literature. Data regarding the impact of regular alcohol consumption on in-hospital outcomes in the setting of acute coronary syndrome (ACS) are lacking. Purpose We aimed to evaluate the impact of self-reported alcohol consumption on in-hospital outcomes in patients with ACS. Methods Data derived from patients enrolled between 2007 and 2019 in the Acute Myocardial Infarction in Switzerland (AMIS) Plus registry were retrospectively analyzed. The primary endpoint was all-cause in-hospital mortality, while secondary endpoints were set as incidence of major adverse cardiac and cerebrovascular events (MACCEs). Outcomes comparisons according to quantity of daily alcohol intake were also performed. Results Records concerning alcohol consumption were available in 25707 patients; 5298 of them (21%) fulfilled the criteria of regular alcohol consumption. Daily alcohol intake was reported in 4059 (77%), of these patients (regular drinkers) with 2640 light drinkers (≤2 drinks/day) and 1419 heavy drinkers (&gt;2 drinks/day). Regular drinkers were predominantly male, younger, smokers, more comorbid and with a worse clinical presentation as compared to abstainers/occasional drinkers. In-hospital mortality and MACCEs of heavy drinkers were significantly higher compared to light drinkers (5.4% vs. 3.3% and 7.0% vs. 4.4%, both p=0.001). When tested together with GRACE risk score parameters, heavy alcohol consumption was independently associated to in-hospital mortality (p=0.004). Conclusions Heavy alcohol consumption is an additional independent predictor of in-hospital mortality in patients presenting with ACS. Figure 1. Study flowchart. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Swiss Heart Foundation

Daily alcohol intake triggers aberrant synaptic pruning leading to synapse loss and anxiety-like behavior

Alcohol abuse adversely affects the lives of millions of people worldwide. Deficits in synaptic transmission and in microglial function are commonly found in human alcohol abusers and in animal models of alcohol intoxication. Here, we found that a protocol simulating chronic binge drinking in male mice resulted in aberrant synaptic pruning and substantial loss of excitatory synapses in the prefrontal cortex, which resulted in increased anxiety-like behavior. Mechanistically, alcohol intake increased the engulfment capacity of microglia in a manner dependent on the kinase Src, the subsequent activation of the transcription factor NF-κB, and the consequent production of the proinflammatory cytokine TNF. Pharmacological blockade of Src activation or of TNF production in microglia, genetic ablation of Tnf, or conditional ablation of microglia attenuated aberrant synaptic pruning, thereby preventing the neuronal and behavioral effects of the alcohol. Our data suggest that aberrant pruning of excitatory synapses by microglia may disrupt synaptic transmission in response to alcohol abuse.

Examination of the daily drinking patterns and their relationships with alcohol dependence symptoms among adult users in Burkina Faso

Background: The alcohol consumption level is rising in Burkina Faso, which has the highest prevalence of heavy drinking in West Africa. This study used daily alcohol intake levels to explore drinking behaviors in regard to the days of the week and associations with dependence signs.Methods: We operated variables from the past 12-month drinkers reported by the 2013 Stepwise survey, which provided information on daily drinking and symptoms of alcohol dependence. We performed student tests, principal component analyses and logistic regression.Results: Data from 1,139 past 12-month drinkers was analyzed, and 15.9% (95%; CI: 13.8–18.1) of users had at least one sign of alcohol dependence. Both drinkers without and with dependence symptoms had a common behavior for higher intake on Thursday, Saturday and Sunday, while lower intake behavior was observed on Tuesday. Only drinkers with dependence signs had high intake behavior, especially on Monday and Friday. In multivariate analysis, alcohol dependence signs were associated with increased drinking only on Monday [adjusted odds ratio (aOR) =1.24, p=0.0001)] or Friday (aOR=1.15, p=0.003).Conclusion: For drinkers without any dependence sympoms, behaviors for higher intake were limited to Thursday, Saturday and Sunday in accordance with the “social events schedule” and the “weekly administrative time-off”, but those with dependence signs extended this kind of behavior to Monday or Friday, likely due to the increased and persistent craving triggered by the high intake the previous day.

Alcohol-Dependent Inpatients in Northern Vietnam : A Follow-Up Study on Relapse and Co-Occurring Psychiatric Disorders

Background: The prevalence of alcohol dependence has been increasing in several countries in the world as well as in Vietnam. This study aims to describe relapse among alcohol-dependent inpatients in Northern Vietnam and some co-occurring psychiatric disorders in these patients. Methods: This study followed 53 alcohol-dependent patients who were treated for six months at the Vietnam National Institute of Mental Health. At the point of one month, three months, and six months after being discharged from the hospital, the patients were monitored for their alcohol consumption, relapse into alcohol dependence, and co-occurring psychiatric disorders by clinical psychiatrists, using the International Classification of Diseases, the 10th edition, Hamilton depression rating scale, Hamilton anxiety rating scale, Pittsburgh Sleep Quality Index, and the EQ-5D-5L Life Quality Assessment. Results: The prevalence of relapse into alcohol dependence was 81.1%. The highest relapse rate was found in the first month after alcohol withdrawal (46.5%), then it decreased gradually. 53.9% of the relapsed patients had at least four alcohol withdrawals; they mainly used home-brewed alcohol. The average daily alcohol intake was fairly high: 14.4 ± 8.5 standard drinks. Mental disorders such as depression, anxiety, and sleep disorder were very prevalent among patients with relapsed alcohol dependence. Conclusions: The rate of relapsed alcohol dependence in Northern Vietnam was very high. It is important to detect and treat psychiatric disorders simultaneously with alcohol dependence to achieve better treatment effectiveness and reduce relapse rates.