Alcohol-Related Dementia: Rethink How Much You Drink

People have consumed alcohol for centuries. Most clinicians who work with people who have dementia acknowledge that alcohol may cause or exacerbate dementia's symptoms. Alcohol-related dementia (ARD) has been recognized since the 1960s, but clinicians rarely use this diagnosis. Regardless, it is common and develops pursuant to long-term excessive alcohol consumption. It may, in some cases, evolve into Wernicke-Korsakoff syndrome. Diagnosis can be obscured if patients are not truthful about their alcohol consumption. Often, friends or family provide a better picture of the patient's alcohol history than patients do themselves. Thiamine treatment may prevent or improve symptoms. Abstinence from alcohol is critical, but it is difficult for older people with long histories of heavy drinking. Consultant pharmacists can help the heath care team develop nuanced care plans for patients who have ARD.

Alcohol-Related Dementia: Rethink How Much You Drink

People have consumed alcohol for centuries. Most clinicians who work with people who have dementia acknowledge that alcohol may cause or exacerbate dementia’s symptoms. Alcohol-related dementia (ARD) has been recognized since the 1960s, but clinicians rarely use this diagnosis. Regardless, it is common and develops pursuant to long-term excessive alcohol consumption. It may, in some cases, evolve into Wernicke-Korsakoff syndrome. Diagnosis can be obscured if patients are not truthful about their alcohol consumption. Often, friends or family provide a better picture of the patient’s alcohol history than patients do themselves. Thiamine treatment may prevent or improve symptoms. Abstinence from alcohol is critical, but it is difficult for older people with long histories of heavy drinking. Consultant pharmacists can help the heath care team develop nuanced care plans for patients who have ARD.

EVALUATE THE EFFECTIVENESS OF MOTIVATIONAL PACKAGE ON ENHANCING SELF-ESTEEM AND MAINTAIN ABSTINENCE, IN ALCOHOL DEPENDENT ADULTS IN A SELECTED DE-ADDITION CENTRE: A PILOT STUDY

ABSTRACT Alcohol dependence is a major health problem in every society, and in both developed and developing countries. It is usually referred to as the third most serious public health problem. Alcohol is a dangerous drug, which has been domesticated by traditionsthat predate history. It is intimate with our social life. Alcohol is a major public health problem today. In last three decades, many surveys have been carried out in India to assess the prevalence and co-morbidity of alcohol and drug uses. Important finding of these studies is that alcohol was the commonest substance used, i.e., 60-98%. The research design used for the study was quasi-experimental research design. Total of 60 alcohol dependent adults, who met inclusion sampling criteria, were selected and randomly allocated 30 to experimental group and 30 to control group with the help of computer-generated random sequence numbers. Level of self – esteem and maintaining abstinence from alcohol among the alcohol dependent adults was assessed by using Rosenberg Self-Esteem Scale and URICA Scale respectively. The participants of experimental group administered motivational package in 6 sessions, each day one session. Outcome variables were measured at three points in time; before intervention, 7th day after intervention, and one month after intervention. Effects of the intervention were analyzed by repeated-measures ANOVA. Results shows the that Motivational Package was effective in enhancing Self-Esteem and maintaining abstinence, in alcohol dependent adults in a selected de-addition centre. A significant positive correlation (r = 0.0888) was found between post intervention level of self-esteem and maintaining abstinence from alcohol among adults in the experimental group and a significant negative correlation between (r = -0.487) was found between post intervention level of self-esteem and maintaining abstinence from alcohol among adults in the control group. The study concludes that Motiv

Trends of Healthy Lifestyles Among Adolescents: An Analysis of More Than Half a Million Participants From 32 Countries Between 2006 and 2014

The purpose of this study was to provide data regarding the prevalence and trends of adolescents' healthy lifestyles from 32 countries between 2006 and 2014 by sex and age interval. The data used in the present study were derived from the Health Behavior in School-aged Children (HBSC) 2006, 2010, and 2014 international database. Healthy lifestyle was assessed using the combination of daily physical activity, daily fruit and vegetable consumption, <2 h daily on screen-based behaviors, abstinence from alcohol, and abstinence from tobacco products. Healthy lifestyle measures were based on self-report. The final sample comprised 519,371 adolescents (aged between 10 and 16 years old). The prevalence of healthy lifestyle behaviors increased between 2006 and 2014. The healthy lifestyle score worsened with advancing age for boys and girls. Comparing countries, for boys, the highest values were observed in adolescents from Ireland (5.2%, 95% CI: 3.9, 6.4), and for girls, the highest values were observed in adolescents from Iceland (4.2%, 95% CI: 3.6, 4.7). The present study showed a slight trend to an improved healthy lifestyle among adolescents, although much more has to be done. A joint effort from multiple areas of knowledge must be made to improve adolescent health policies, since lifestyles in adolescence play an important role for the development of vulnerability and health in later life.

Alcohol Consumption Reduction and Clinical Outcomes of Catheter Ablation for Atrial Fibrillation

Background - Abstinence from alcohol is effective for reduction of atrial fibrillation (AF) burden. However, effects of alcohol abstinence on clinical outcomes of catheter ablation for AF remain unknown. We sought to assess association of alcohol consumption reduction with clinical outcomes of catheter ablation for AF. Methods - In this multicenter prospective observational study, consecutive patients undergoing catheter ablation for AF were enrolled. All patients were requested to limit alcohol consumption to <20g per week after the ablation. The primary endpoint was AF/atrial tachycardia (AT) recurrence-free survival without antiarrhythmic drugs beyond a 3-month blanking period. Percent reduction of alcohol consumption from baseline to 1-year post-ablation, if freed from AF/AT for 1-year, or to AF/AT recurrence was assessed. Univariate and multivariate Cox regression analyses were performed to assess the association of the percent reduction of alcohol consumption with AF/AT recurrence-free survival as well as to determine the cutoff value for the percent reduction of alcohol consumption that yielded the largest difference in AF/AT recurrence-free survival. Results - Of 3474 patients enrolled in this study, analysis was performed in 1720 patients who consumed alcohol regularly before ablation (64&10 years, male 88%, paroxysmal AF 55.9%, persistent AF 31.6%, longstanding persistent AF 12.5%). Median baseline alcohol consumption was 140g per week (interquartile range [IQR]: 70-280g). Alcohol consumption during 1-year follow-up decreased to a median of 70g (IQR: 13-162g, p<0.0001). Multivariate Cox regression analysis demonstrated that alcohol reduction of ≥1% from baseline to 1-year follow-up (median reduction: 75%, [IQR: 45-100%]) was associated with lower risk of AF/AT recurrence (hazard ratio: 0.630, [95% confidence interval: 0.518-0.768], p <0.001), compared to alcohol reduction of <1% (median: 0%, [IQR: -20%-0%]). Conclusions - This study suggests that abstinence from alcohol improves clinical outcomes of catheter ablation for AF.

Mathematical Analysis of the Effect of Control on the Dynamics of Diabetes Mellitus and Its Complications

Diabetes is a disorder in which the body becomes unable to control the amount of sugar in the blood. The pancreas (beta-cells) is not functioning normally, resulting in a partial or total lack of insulin which is the key to the mechanism converting sugar to energy. In this study, mathematical model for the dynamics of diabetes mellitus and its complications incorporating control is developed and analyzed. Positive lifestyle, which includes abstinence from alcohol, smoking and glutoning, and effective management of diabetes condition are incorporated as controls. The analytical solution of the model equations is obtained using Homotopy Perturbation Method. Numerical simulation of the model solution was done using Maple 18 Mathematical software. The parameters are varied and their effects on the model dynamics are presented graphically. The results showed that the two control measures can effectively be used to reduce the evolution of incidence of diabetes and occurrence of complications of diabetes thereby reducing the rate of morbidity and mortality due to diabetes complications.

Health Beliefs, Behavior, Spiritual Growth, and Salvation in a Global Population of Seventh-day Adventists

Background The Seventh-day Adventist Church is a growing global denomination with strict substance use abstinence and recommended dietary requirements that together are called the “Health Message.” Abstinence from alcohol and tobacco is a requirement of membership and a plant-based diet is strongly advised. Purpose While a wide variety of research has reported the Adventist health advantage, very little research has been conducted on Adventist members’ attitudes toward and adherence to the Health Message. This research examines members views, from a global survey, about the health message, personal adherence, and belief that adherence ensures salvation. Methods The survey was conducted in 2017/2018 with a total N of 63,756. The questionnaire was translated into about 60 languages and then back translated into English for improved accuracy. Results Over 80% of the respondents reported that they agreed the Adventist health message was wholisitic, core to Adventist beliefs, supported by science, and increased the probability of a longer life. There were very few differences by global regions. About 80% also agreed that they should abstain from tobacco and alcohol and follow a healthy diet. However, about 45% believed that they could pick and choose which parts to follow with only a little over one-third reporting that they followed the Health Message a great deal. Strict adherence appeared to be in abstinence from alcohol (91%) and tobacco (97%). Only about 19% reported being vegetarian or vegan. Over 47%, mostly in the Southern Hemisphere, reported the belief that if they kept the Health Message completely, they would be assured of salvation, though this is at odds with formal doctrine. Conclusions and Implications The data suggest that church leadership has been successful in obtaining global acceptance of the Health Message, convincing members of its scientific basis, and to abstain from tobacco and alcohol use. However, the data also show almost half of members believe that they can pick and choose elements to follow. In addition, these data have major implications for church leadership in disentangling the implications and expectations of the Health Message from the Church’s fundamental belief that salvation is only through faith in Christ.

Renal replacement therapy as bridging-to-recovery in refractory hepatorenal syndrome

A 50-year-old female patient with cirrhosis due to alcoholic steatohepatitis was referred to our department because of recurrent hepatorenal syndrome (HRS) and hepatic hydrothorax. Clinically, severe anasarca was the leading problem. In contrast to previous episodes, HRS did not respond to standard treatment including terlipressin.Given the severe, refractory hyperhydration, we finally initiated renal replacement therapy (RRT). Subsequently, RRT was performed without severe side effects for more than 100 days. In the meantime, liver function remarkably improved, most probably due to the prolonged abstinence from alcohol. Finally, RRT could be stopped. Since then, our patient has remained in good clinical condition for more than 6 months, with well-compensated Child-Pugh stage A cirrhosis and only mild chronic kidney disease stage III.In conclusion, this case highlights that RRT may be considered in individual cases as bridging therapy in refractory HRS until the liver regenerates due to the absence of damaging mechanisms.