Adverse childhood experiences and alcohol related negative consequence among college student drinkers.

OBJECTIVE: Despite increasing college campus prevention efforts, and identification of effective strategies to reduce drinking, reducing alcohol related negative consequences (ARNC, e.g., regrets, blackouts, self- and other- injury, law enforcement exposure, sexual assault, and considering suicide) continues to be a challenge. While college students with a history of adverse childhood experiences (ACE) are at greater risk for alcohol misuse, research regarding the association between ACE and ARNC remains limited. METHODS: Data are responses of currently drinking students on the American College Health Association-National College Health Assessment (ACHA-NCHA II) and College Student Health Survey (CSHS), administered in 2018 to students in California and Minnesota (N = 6,667). RESULTS: On average, students reported one ARNC (SD = 1.30) although 13 % experienced three or more different types of ARNC in the past year. Every ACE was associated with a 19 % to 41 % increase in the IRR of ARNC. Students with 1-3 ACE experienced significantly more types of ARNC events (IRR 1.55, 95 % CI: 1.44-1.67) than students with no ACE and students with ≥ 4 ACE experienced statistically significantly more types of ARNC events (IRR 2.04, 95 % CI: 1.82-2.31) than their peers with 1-3 or no ACE. The ACE-ARNC relationship did not vary by drinking frequency or binge drinking. CONCLUSIONS: The consistent ACE - ARNC relationship across drinking behaviors suggests alcohol consumption does not fully explain the association between ACE and ARNC and that early adversity heightens vulnerability for ARNC. Implications for future prevention and intervention efforts are discussed.

A case of pulmonary carcinoid in pregnancy and review of carcinoid tumours in pregnancy.

Carcinoid tumours are rare slow growing tumours which arise from primitive neuroendocrine cells. The effect of the pregnant state on carcinoid tumours and vice versa remains unclear, as does the optimal management of carcinoid tumours during the pregnancy including labour. We report the rare case of a 36 year old primigravida woman with large bilateral pulmonary carcinoid tumours. The patient's disease was minimally symptomatic with no clinical suspicion of carcinoid syndrome. Under close observation, the pregnancy progressed well and the patient proceeded to a spontaneous vaginal delivery of a healthy child. We conduct the the first literature review in 30 years of all reported cases in this area and make suggestions as to assessment and monitoring of cases of carcinoid during pregnancy.

Evaluation of therapeutic enoxaparin in a pregnant population at a tertiary hospital.

BACKGROUND: Therapeutic anticoagulation with enoxaparin in pregnancy is complex due to varying pharmacokinetics and the increasing prevalence of obesity. There is limited evidence to support current dosing and monitoring strategies of enoxaparin in this population. AIM: To describe the current practice in therapeutic anticoagulation in the pregnant population at a tertiary institution. METHODS: A retrospective study of pregnant women on therapeutic enoxaparin between January 2007 and December 2011. RESULTS: Forty-four pregnant women requiring therapeutic anticoagulation were identified and divided into two groups, monitored with anti-factor Xa (AXA) concentrations and unmonitored. Fifty-five percent of monitored women were initiated on the recommended 1 mg/kg twice a day (bd) enoxaparin dose-strategy. Eighty-two percent of women were monitored; however, there was variability regarding the timing, frequency and subsequent dose adjustments from monitoring. Overall, as pregnancies progressed, there was both increasing dose adjustments and increasing frequency of monitoring. Fourteen women had a BMI over 30 kg/m(2) , and 13 of these women were monitored. Nine monitored obese women required doses less than 1 mg/kg/bd to maintain a therapeutic AXA level. Management appeared to be individualised. There were small numbers of toxicity events. CONCLUSION: Variation exists in dosing and monitoring practices for therapeutic enoxaparin in the pregnant population. Dosing obese patients using 1 mg/kg twice daily can lead to toxic AXA concentrations, and dose reductions are required to maintain a therapeutic range. A larger prospective study reviewing dose, AXA concentrations and outcome data is necessary to make dosing recommendations in this group.

Insulin requirements in late pregnancy in women with type 1 diabetes mellitus: a retrospective review.

UNLABELLED: Pregnancy in women with type 1 diabetes mellitus (T1DM) is generally associated with increased insulin requirements. AIMS: To determine the frequency and significance of declining insulin requirements in late gestation in women with T1DM. METHODS: We conducted a retrospective review of 54 women seen at our institution from 2006 to 2010 with a diagnosis of T1DM pre-pregnancy and presentation for antenatal care prior to 28 weeks. Information was collected regarding patient demographics, insulin dose and pregnancy outcome. A 15% difference in weight-adjusted basal insulin from 30 weeks gestation to delivery was considered significant. RESULTS: Five women (9.3%) had a fall of 15% or more and 23 (42.5%) had a rise of 15% or more rise in insulin requirements. There were fewer neonatal intensive care admissions but more infants with an APGAR <8 at 5 min in women with a fall in insulin requirements. These differences were not evident when the data were re-analysed by quartiles of change. CONCLUSIONS: In most women with T1DM, insulin requirements show little change from 30 weeks gestation until delivery. Almost 10% of women had a significant fall in insulin requirements which did not correlate with adverse neonatal outcome. These results require validation in a larger, prospective trial.

Smoking patterns, attitudes and motives: unique characteristics among 2-year versus 4-year college students.

Given the previously documented higher rates of smoking among 2-year college students in comparison with 4-year university students, this study compares smoking patterns, attitudes and motives among 2-year and 4-year college students. Two thousand two hundred and sixty-five undergraduate students aged 18-25 years at a 2-year college and a 4-year university completed an online survey in 2008. Current (past 30-day) smoking was reported by 43.5% of 2-year and 31.9% of 4-year college students, and daily smoking was reported by 19.9% of 2-year and 8.3% of 4-year college students. Attending a 2-year college was associated with higher rates of current smoking [odds ratio (OR) = 1.72] and daily smoking (OR = 2.84), and with less negative attitudes regarding smoking, controlling for age, gender, ethnicity and parental education. Also, compared with 4-year college student smokers, 2-year college smokers had lower motivation to smoke for social reasons, but more motivation to smoke for affect regulation, after controlling for age, gender, ethnicity and parental education. Two- and 4-year college students report different smoking patterns, attitudes and motives. These distinctions might inform tobacco control messages and interventions targeting these groups of young adults.

Management of labor in Eisenmenger syndrome with inhaled nitric oxide.

Administration of nitric oxide by means of inhalation during the labor of a woman with Eisenmenger's syndrome caused by an atrial septal defect resulted in improved oxygenation and initial pulmonary arterial pressure. She gave birth to a live infant at 34 weeks' gestation but died of worsening pulmonary hypertension and heart failure 21 days post partum.

Maternal intake of cruciferous vegetables and other foods and colic symptoms in exclusively breast-fed infants.

OBJECTIVE: We sought to assess relationships among components of maternal diet and the presence of colic symptoms among exclusively breast-fed infants aged < or = 4 months. DESIGN: Data were collected by means of a mailed questionnaire that solicited information on the presence of symptoms of colic in infants and maternal intake of 15 foods (including four cruciferous vegetables) during the week before completion of the questionnaire. SUBJECTS: Exclusively breast-feeding women (n = 272) and their 273 infants aged < or = 4 months. STATISTICAL ANALYSES PERFORMED: Dietary variables were analyzed categorically by logistic regression. Two-by-two tables were used to calculate relative risks. RESULTS: Relative risks (RRs) and 95% confidence intervals (CIs) for colic symptoms by food items the mothers consumed ranged from 0.7 (CI = 0.3 to 1.5) for beef to 2.0 (CI = 1.1 to 3.5) for cow's milk. Maternal intake of cabbage (RR = 1.3, CI = 1.1 to 1.5), cauliflower (RR = 1.2, CI = 1.0 to 1.4), broccoli (RR = 1.3, CI = 1.0 to 2.2), cow's milk (RR = 2.0, CI = 1.1 to 3.5), onion (RR = 1.7, CI = 1.1 to 2.5), and chocolate (RR = 1.5, CI = 1.0 to 2.2) were significantly related to colic symptoms. Maternal intake of more than one cruciferous vegetable was associated with an RR of 1.6 (CI = 1.1 to 2.4) for infants experiencing one or more colic symptoms. CONCLUSION: Results of this study provide initial evidence that maternal intake of cruciferous vegetables, cow's milk, onion, or chocolate during exclusive breast-feeding is associated with colic symptoms in young infants.

[Morbidity-mortality related to domestic accidents in Belgium: Epidemiology and strategy of prevention]. / Morbi-mortalité liée aux accidents domestiques en Belgique. Epidémiologie et stratégie de prévention.

Home accidents, especially those occurring in children in the younger age group, are a considerable concern to the public health authorities. In addition to the informations registered on the death certificates, the EHLASS-program, i.e. European Health and Leisure Accident Surveillance System, was organized since 1986 by the European Community in order to collect data on the morbidity related to this type of accidents. In Belgium, the collection of data started in 1987, and actually four hospitals provide information. Each year, several thousands of cases are reported. This poster will summarize the Belgian situation from the two sources of data. General strategies for prevention of home accidents are proposed, and some types of intervention are suggested.