Drinking behavior among government employees in Changsha and its influencing factors / 中南大学学报(医学版)

OBJECTIVES@#To analyze the prevalence and influencing factors for drinking behavior and heavy drinking among government employees in Changsha and provide a basis for carrying out interventions for drinking behaviors and formulating public health promotion plans for government employees.@*METHODS@#Government employees were recruited consecutively from the Health Management Center of a general hospital in Changsha between December 2017 and December 2018. Information on sociodemograpic characteristics, drinking behaviors, life events, and psychosocial characteristics was collected using a standard set of questionnaire. Drinking behavior was defined as drinking once or more per week for the past 12 months. The differences in drinking rates and excessive drinking rates among groups with different characteristics were compared. Multivariate analysis was performed to analyze the associated factors of drinking behaviors and heavy drinking for government employees.@*RESULTS@#A total of 6 190 people completed this investigation. The overall drinking rate of government employees in Changsha was 21.9%, and the rate of drinking was higher in males than that in females (44.7% vs 4.0%, @*CONCLUSIONS@#The drinking and heavy drinking rates of government employees are high in Changsha. Marital status, physical exercise, and frequency of social intercourse are the common influencing factors of male drinking behavior and female drinking behavior. The life events stimulation is the influencing factor of heavy drinking.

Risk of fatty liver disease in alcoholics

Background: Fatty liver (FL) disease is commonly divided into non-alcoholic (NAFLD) and alcoholic (AFLD) FL disease categories. Although it has long been known that long-term heavy drinking is a cause of liver cirrhosis and liver cancer, the findings from recent observational studies have shown that light, moderate, and even heavier alcohol consumption may decrease the risk of FLD. This study aims to elucidate the quantity and pattern of alcohol consumption and fatty liver prevalence. We conducted a cross sectional study on semi urban population at our tertiary care centre Materials and methods: We performed a cross sectional observational study on male patients admitted for various ailments in medical wards of Government Omandurar Medical college during the period March 2018 to May 2018. Results: Among 100 cases fatty liver was present in 40% of cases and there is significant association between fatty liver and liver enzymes. The chances of fatty liver increase with duration of alcohol intake also there was significant association between fatty liver and BMI. Conclusion: In conclusion, this study demonstrates that the major risk factors for FL in alcoholic are factors related to adiposity, alcohol consumption, and that consistent consumption of alcohol for prolonged period may lead to FL. These results suggest that lifestyle modifications aimed at fighting central obesity and metabolic abnormalities should be the most important recommendations for the management of FL.

Perfil do consumo de álcool e prática do beber pesado episódico entre universitários brasileiros da área da saúde / Alcohol consumption and episodic heavy drinking among undergraduate students from the health area of a Brazilian university

RESUMO Objetivo Identificar entre os universitários da área da saúde de uma universidade brasileira a prevalência, o perfil do consumo de álcool e a prática do beber pesado episódico (BPE). Métodos Estudo transversal, quantitativo, com amostra randomizada dos universitários dos 12 cursos da saúde. Foram aplicados questionários individualizados, em formulário eletrônico, utilizando a escala AUDIT, após consentimento informado. Foi realizada análise estatística descritiva e inferencial. Resultados Entre os 619 estudantes selecionados, a prevalência de consumo de álcool foi de 85%, com perfil do consumo de baixo risco (77,1%). Consumo nocivo e provável dependência foram detectados em 2,7%. A prática do BPE foi de 51,6%, quase o dobro em comparação com outros estudos. As características que mais se associaram ao consumo de álcool foram: ser solteiro, do sexo masculino e frequentar festas semanalmente. Conclusão O consumo de álcool é elevado entre os estudantes avaliados, embora a maioria esteja no perfil de baixo risco. Contudo, fica evidente a necessidade de ações educativas para a promoção da saúde do estudante, visando à redução e ao consumo consciente de bebidas alcoólicas.

ABSTRACT Objective To identify among university students of the health area of a Brazilian university the prevalence, alcohol consumption profile and the practice of episodic heavy drinking (EHD). Methods A cross-sectional, quantitative study with a randomized sample of university students from 12 health courses. Individual questionnaires were used, in an electronic form, using the AUDIT scale, after informed consent. Descriptive and inferential statistical analysis were performed. Results Among the 619 students selected, the prevalence of alcohol consumption was 85%, profile of low risk consumption (77.1%). Harmful consumption and probable dependence were detected in 2.7%. The HDE practice was 51.6%, almost double when compared to other studies. The characteristics that were most associated with alcohol consumption were: being single, male and attending parties weekly. Conclusion Alcohol consumption is high among the students evaluated, although most are in the low risk profile. However, it is evident the need for educational actions to promote student health, aiming at the reduction and conscious consumption of alcoholic beverages.

Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease

BACKGROUND/AIMS: Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD. METHODS: We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms. RESULTS: Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005). CONCLUSIONS: Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.

Wake-up stroke: Clinical characteristics, sedentary lifestyle, and daytime sleepiness / Wake-up stroke: achados clínicos, sedentarismo e sonolência diurna

Summary Objective: Wake-up stroke (WUS) is defined when the exact time of the beginning of the symptoms cannot be determined, for the deficits are perceived upon awakening. Sleep alterations are important risk factors for stroke and cardiovascular diseases. This study evaluates the characteristics of patients with and without WUS, the presence of daytime sleepiness, and associated risk factors. Method: Patients with ischemic stroke were investigated about the presence of WUS. Clinical and demographic characteristics were evaluated. Stroke severity was studied by the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (MRS), and daytime sleepiness severity was studied by the Epworth Sleepiness Scale (ESS). Results: Seventy patients (57.1% men) aged from 32 to 80 years (58.5±13.3) were studied. WUS was observed in 24.3%. Arterial hypertension (67.1%), type 2 diabetes (27.1%), and hyperlipidemia (22.8%) were frequent. Type 2 diabetes and sedentary lifestyle were more common in patients with WUS (p<0.05). Overall, mild, moderate or very few symptoms of stroke (NIHSS<5) were predominant (62.3%). Among all cases, 20% had excessive daytime sleepiness (ESS>10). No differences were found between patients with and without WUS as regards stroke severity or excessive daytime sleepiness. Patients with excessive daytime sleepiness were younger and had more sedentary lifestyle (p<0.05). Individuals with previous history of heavy drinking had more daytime sleepiness (p=0.03). Conclusion: Wake-up stroke occurs in approximately 25% of stroke cases. In this study, patients with WUS had more diabetes and sedentary lifestyle. Daytime sleepiness is frequent and is associated with sedentary lifestyle and heavy drinking.

Resumo Objetivo: wake-up stroke (WUS) define o acidente vascular cerebral (AVC) que ocorre sem horário preciso de início, pois os sintomas manifestam-se ao despertar. Alterações do sono associam-se a maior risco de AVC e doenças cardíacas. Este estudo avalia as características dos pacientes com e sem WUS, a presença de sonolência diurna e os fatores de risco associados. Método: pacientes com AVC isquêmico foram identificados quanto à presença de WUS. Foram avaliadas as características clínico-demográficas, a gravidade do AVC pela National Institutes of Health Stroke Scale (NIHSS) e pela Modified Rankin Scale (MRS) e o grau de sonolência pela Epworth Sleepiness Scale (ESS). Resultados: setenta pacientes (57,1% homens) com idade entre 32 e 80 anos (58,5±13,3) foram estudados. Wake-up stroke foi observado em 24,3% dos casos. Hipertensão arterial sistêmica (67,1%), diabetes (27,1%) e distúrbio do metabolismo lipídico (22,8%) foram frequentes. Diabetes e hábitos sedentários foram mais comuns nos casos com WUS (p<0,05). Na amostra total, 62,3% dos casos apresentavam AVC leve, moderado ou com poucos sintomas (NIHSS<5). Sonolência excessiva diurna (SED) (ESS>10) foi identificada em 20% dos pacientes. Não houve diferença entre os grupos com e sem WUS quanto à gravidade do AVC e o grau de sonolência. Pacientes com SED eram mais jovens e mais sedentários (p<0,05). Os indivíduos com etilismo tinham maior grau de sonolência (p=0,03). Conclusão: wake-up stroke manifesta-se em 25% dos casos de AVC isquêmico. Neste estudo, os pacientes com WUS apresentaram mais diabetes e sedentarismo. Sonolência diurna é frequente e associa-se a hábitos sedentários e etilismo.

Usefulness of Biomarkers to Screen Heavy Drinking in Korean Females

BACKGROUND: The present study purposed to evaluate the clinical usefulness of biological indicators in identifying Korean female heavy drinkers. METHODS: Fifty five drinking women were selected among those who visited the Department of Family Medicine of Chungnam National University Hospital during the period from January to December 2006. We surveyed the alcohol intake during the recent one month. The correlation of alcohol intake with %CDT (carbohydrate- deficient transferrin), mean corpuscular volume (MCV), gamma glutamyl transferase (gammaGT), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) was examined. The sensitivity, specificity, positive predictive value, negative predictive value and ROC (receiver operating characteristic) curve of the biomarkers for heavy drinking (more than 7 drinks per week, one drink= 14 g of alcohol) were also investigated. RESULTS: The mean weekly alcohol intake showed a significant positive correlation with %CDT (r=0.583, P< 0.01), MCV (r=0.290, P<0.05) and AST (r=0.423, P<0.01). The sensitivity of %CDT, MCV, gammaGT, AST and ALT to heavy drinking were 66.7%, 13.3%, 40.0%, 26.7% and 26.7%, respectively, and the specificity 80.0%, 97.4%, 71.1%, 90.0% and 85.0%, respectively, and positive predictive values 55.6%, 66.6%, 35.3%, 50.0% and 40.0%, respectively, and negative predictive values 86.5%, 74.5%, 75.0%, 76.6% and 75.6%, respectively. The areas under the ROC curve (95% confidence interval) of %CDT, MCV, gammaGT, AST and ALT were 0.873 (0.780~0.966), 0.806 (0.668~0.944), 0.549 (0.372~0.725), 0.519 (0.328~0.710) and 0.479 (0.293~0.666), respectively. CONCLUSION: %CDT is considered as the most useful marker for identifying Korean female heavy drinkers.

Improvement of Readiness to Change in Heavy Drinkers by Group Drinking Education

BACKGROUND: This study was designed to evaluate the effectiveness of brief group education on improvement of readiness to change in heavy drinkers. METHODS: We selected 37 heavy drinkers categoriged in the state of precontemplation and contemplation stage according to readiness to change questionnaire (RTCQ). The readiness to change was re-evaluated after 4 sessions of drinking education. RESULTS: The mean (+/-SD) frequency of participation in group education was 3.5 (+/-0.6). According to the stage of readiness to change, the subjects were distributed into 11 (29.7%) in the stage of precontemplation and 26 (70.3%) in contemplation before participation in the program. After completion of educational program, the readiness to change in the subjects was significantly (P<0.001) changed into 1 drinker (2.7%) in the stage of precontemplation, 16 (43.2%) in contemplation and 20 (54.1%) in action. The influential factors associated with the improvement of the status of readiness to change was family APGAR score (odd ratio 1.75, 95% CI 1.02-3.03). CONCLUSION: Above results suggested that the readiness to change in heavy drinkers can be improved by brief group education program.

The Effect of Brief Intervention on Heavy Drinking Patients in Primary Care

BACKGROUND: The management of problem drinking is very important in family practice and primary care. This research was de signed to evaluate the effect of brief intervention on heavy drinking patients in family practice. METHODS: The subjects were composed of 34 Korean males who had findings of alcoholic liver disease in the general health examination. About 5 to 10 minute outpatient interventions consisting of brief advice on drinking problems were delivered in the mean (+/-SD) f requency of 3.5 (+/-1.4) times during the 12 weeks.The effect of brief intervention was evaluated by the number of drinking days per week and drinks per drinking day during the 4 weeks before brief intervention and 12 weeks later.The result was compared with the control group (24 males)who had the same condition but did not receive the brief intervention. RESULTS: The mean (+/-SD)drinking days per week were significantly (P<0.001)decreased from 3.5 (+/-1.7) to 2.0 (+/-2.1) days and the mean (+/-SD) drinks per drinking day were significantly (P<0.001) decreased from 9.5 (+/-3.5) to 5.1 (+/-4.3) drinks.The degree of decrease in the subjects was significantly higher than the control group in both drinking days per week (P=0.001) and drinks per drinking day (P<0.005). CONCLUSION: The brief intervention by family physicians is an effective clinical method in the management of heavy drinking patients.

Drinking Problems of Hepatitis B Virus Healthy Carriers in Korean Population

BACKGROUND: Heavy drinking may be a cause of serious health problems in hepatitis B virus carriers. The aim of this study was to reveal the degree of drinking problems in the Korean hepatitis B virus healthy carriers. METHODS: The subjects were 218 hepatitis B virus healthy carriers (124 males and 94 females) recruited from those who visited the Health Promotion Center of Chungnam National University Hospital for a general health check-up. Drinking problems of the subjects were evaluated by the AUDIT (Alcohol Use Disorders Identification Test) questionnaire. RESULTS: The AUDIT scores (mean+/-SD) of the male subjects (9.6+/-7.9) were significantly (P <0.001) higher than those of the female subjects (2.7+/-5.2). The individuals with heavy drinking (more than 14 drinks in males and 7 drinks in females per week) are 24 (19.4%) in males and 5 (5.3%) in females. Alcohol use disorders were suspected in 36 (29.0%) males and 4 (4.3%) females. CONCLUSION: It is suggested that, in Korea, clinical attention in primary health care should be focused on reducing the alcohol consumption among the hepatitis B virus carriers, considering a large proportion have drinking problems and the possible harmful effect on their health by heavy drinking.

Patient Education for Moderate Drinking

A brief advice by a physician to problem drinkers are known to be very effective in reducing alcohol consumption, health care utilization, motor vehicle events, and its related costs. This article is to provide the definition of moderate drinking and screening methods for alcohol problems in the context of primary care. Various individualized strategies of education can be applied to the patients based on their drinking habits on each visit. Regular programs of group education for problem drinkers and their families are also considered to be useful methods in both ambulatory and hospital settings. From preventive perspectives, public health educations should be focused on the establishment of a culture of moderate drinking in the community.