Management of alcohol use disorder: a gastroenterology and hepatology-focused perspective

˜The œLancet. Gastroenterology & hepatology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 1, 2025

Language: Английский

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Harmonization of alcohol use data and mortality across a multi‐national HIV cohort collaboration

Alcohol Clinical and Experimental Research, Journal Year: 2025, Volume and Issue: 49(2), P. 407 - 417

Published: Jan. 8, 2025

Alcohol use is measured in diverse ways across settings. Harmonization of measures necessary to assess effects alcohol multi-cohort collaborations, such as studies people with HIV (PWH). Data were combined from 14 cohort (nine European, five North American) participating the Antiretroviral Therapy Cohort Collaboration. We analyzed data on adult PWH at any time 6 months before starting antiretroviral therapy. Five cohorts AUDIT-C and others used cohort-specific measures. harmonized grams/day, calculated using country-level definitions a standard drink. For Use Disorders Identification Test (AUDIT-C), we Items 1 (frequency) 2 (number drinks typical day). Where was categories, mid-point calculate grams/day. multivariable Cox models estimate associations mortality. available for 83,424 PWH, 22,447 (27%) had 60,977 (73%) recorded number drinks/units per week/day. Of sample, 19,150 (23%) female, 54,006 (65%) White ethnicity, median age 42 years. Median 0.3 g/day (interquartile range [IQR] 0-4.8) 0 (IQR 0-20) those without AUDIT-C. There J-shaped relationship between grams/day mortality, higher mortality reporting no (adjusted hazard ratio [aHR] 1.46; 95% CI: 1.23-1.72) heavier (>61.0 g/day) (aHR 1.92; 1.41-2.59) compared 0.1-5.5 among Associations similar non-AUDIT-C Grams/day useful metric harmonize use. Magnitudes may differ by setting measurement method. Higher strengthens case interventions reduce drinking.

Language: Английский

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Genetics, primary care records and lifestyle factors for short-term dynamic risk prediction of colorectal cancer: prospective study of asymptomatic and symptomatic UK Biobank participants

BMJ Oncology, Journal Year: 2025, Volume and Issue: 4(1), P. e000336 - e000336

Published: Feb. 1, 2025

To quantify the contributions of polygenic scores, primary care records (presenting symptoms, medical history and common blood tests) lifestyle factors, for short-term risk prediction colorectal cancer (CRC) in general symptomatic individuals. This prospective cohort study used data from UK Biobank with follow-up until 2018. It included 160 507 participants linked a subcohort 42 782 recent CRC-related symptoms. The outcome was first-recorded CRC diagnosis within 2 years. Dynamic models time-varying predictors were derived using super-landmark framework. Model discrimination assessed through Harrel's C-index, predictor to model evaluated inclusion-order-agnostic Shapley values. C-indices (95% CIs) 0.73 (0.72 0.73) 0.69 (0.68 0.70) participants, respectively. core (eg, age, sex) 33% (25% 42%) (symptomatic: 34% (9% 75%)), scores 16% (8% 26%) (-21% 35%)), tests 32% (19% 43%) (41% (16% 73%)), 11% (4% 17%) (-25% 37%)), factors 6% (0% 11%) (-5% (-32% 13.4%)) symptoms 3% (-2% 7%) (13% (-19% 41%)). Polygenic contribute substantially both populations; however, contribution information (including presenting is greater. Lifestyle not routinely collected minimally.

Language: Английский

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Europe and Northern Asia

Oxford University Press eBooks, Journal Year: 2025, Volume and Issue: unknown, P. 162 - 174

Published: Feb. 1, 2025

Abstract This chapter describes the problems and challenges in mental healthcare Europe North Asia: difficulties diagnosing depression, data on suicidal ideation suicide rates Europe, care for patients with dementia, concerns about rise of alcohol use disorders near future older people, that need to be addressed context loneliness people. The results 2023 study people Belarus, Kazakhstan, Russia. indicate prevalence adults diverges significantly region, demonstrated relevance non-psychotic affective dementia. As population Northern Asia continues grow, proportion health related this group may increasing, more research is needed. requires policymakers take urgent action ensure living have a good quality life adequate accessible care. It advisable develop unified system assessing socio-demographic characteristics structure (aged 65+). Another important task organizing qualified region provision training principles (cognitive) taking into account changes diagnostic approaches ICD-11.

Language: Английский

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MetALD: New Perspectives on an Old Overlooked Disease

Liver International, Journal Year: 2025, Volume and Issue: 45(5)

Published: April 3, 2025

ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) and alcohol‐associated (ALD) are the major contributors to burden globally. The rise in these conditions is linked obesity, type 2 diabetes, metabolic syndrome increased alcohol consumption. MASLD ALD share risk factors, pathophysiology histological features but differ their thresholds for use, definition does not require presence of dysfunction. A recent multi‐society consensus overhauled nomenclature steatosis introduced term MetALD describe patients with dysfunction who drink more than those less ALD. This new terminology aims enhance understanding management poses challenges, such as need accurately measure consumption research clinical practice settings. Recent studies show that has significant implications patient management, it associated mortality risks severe outcomes compared alone. face progression, cancer cardiovascular disease. diagnosis involves adequate quantification use through standardised questionnaires and/or biomarkers well proper assessment stage progression using non‐invasive tools including serologic markers, imaging, elastography techniques genetic testing. Effective requires addressing both alcohol‐related factors improve outcomes. review intends provide a comprehensive overview MetALD, covering pathogenesis, potential diagnostic approaches, strategies emerging therapies.

Language: Английский

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Magnitude and determinants of alcohol use disorder among adult population in East Asian countries: A systematic review and meta-analysis

Frontiers in Public Health, Journal Year: 2023, Volume and Issue: 11

Published: Feb. 28, 2023

Alcohol use disorder is a medical condition characterized by an impaired ability to control or stop alcohol despite adverse health outcomes. Despite several studies that have analyzed the prevalence and determinants, their results been equivocal, reasons for differences in rates determinants of AUD across nationalities are unknown. Hence, this study estimated pooled its determinant among adults East Asian countries.Articles were searched from PubMed, Web Science, EMBASE, PsycINFO, Scopus. All observational designs fulfilled predefined criteria included study. The findings reported following Preferred Reporting Items Systematic Reviews Meta-Analysis (PRISMA). quality heterogeneity articles assessed using new castle-Ottawa scale (NOS) I2, respectively. Additionally, publication bias was checked through funnel plot Egger's regression test.A total 14 with 93, 161 participants considered Of which 9 meta-analysis 1-year disorder, 6 lifetime, abuse, 8 dependency. Consequently, overall one-year 8.88% (95% CI: 6.32, 11.44), lifetime 13.41% (95%CI: 8.48, 18.34), abuse 5.4% 2.66, 8.13), dependency 4.47% 6.27). In subgroup analysis country, highest observed Korea at 9.78% CI:4.40, 15.15) 16.73% 15.31, 18.16), Besides, smoking (OR: 3.99; 95% 1.65, 6.33) male gender 5.9; 3.3, 8.51) significant disorder.The magnitude high countries. Smoking key disorders.

Language: Английский

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Adolescent Alcohol and the Spectrum of Cognitive Dysfunction in Aging

Advances in experimental medicine and biology, Journal Year: 2025, Volume and Issue: unknown, P. 257 - 298

Published: Jan. 1, 2025

Language: Английский

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Pooled analysis of the association between mental health and violence against women: evidence from five settings in the Global South

BMJ Open, Journal Year: 2023, Volume and Issue: 13(3), P. e063730 - e063730

Published: March 1, 2023

Objectives To describe associations between men’s poor mental health (depressive and post-traumatic stress symptomatology) their perpetration of intimate partner violence (IPV) non-partner sexual (NPSV), women’s experiences IPV NPSV in five settings the Global South. Design A pooled analysis data from baseline interviews with men women participating against girls prevention intervention evaluations. Setting Three sub-Saharan African countries (South Africa, Ghana Rwanda), one Middle Eastern country, occupied Palestinian territories. Participants 7021 4525 18+ years old a mix self-selecting randomly selected household surveys. Main outcome measures All studies measured depression symptomatology using Centre for Epidemiological Studies-Depression, Harvard Trauma Scale disorder (PTSD) symptoms among women. were items modified WHO domestic UN multicountry study to assess men, experience Findings Overall was associated increased odds perpetrating physical NPSV. Specifically, who had more depressive reporting (adjusted OR (aOR)=2.13; 95%CI 1.58 2.87) (aOR=1.62; 95% CI 0.97 2.71) compared those fewer symptoms. Men PTSD higher (aOR=1.87; 1.44 2.43) (aOR=2.13; 1.49 3.05) without PTSD. Women experienced (aOR=2.53; 2.18 2.94) (aOR=2.65; 2.02 3.46) experiencing not. Conclusions Interventions aimed at preventing must account as risk factor, experience.

Language: Английский

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Alcohol use is associated with intracranial hemorrhage in older emergency department head trauma patients

Journal of the American College of Emergency Physicians Open, Journal Year: 2024, Volume and Issue: 5(4)

Published: July 31, 2024

Abstract Objectives Falls are common in adults aged 65 years and older the leading cause of traumatic brain injuries this age group. Alcohol use may increase risk falls as well severity resultant injuries. The aim study was to examine association between self‐reported alcohol prevalence intracranial hemorrhage (ICH) patient Methods This a secondary analysis Geriatric Head Trauma Short Term Outcomes Project (GREAT STOP), with blunt head trauma from fall. We determined characteristics every fall event, including demographics medical history, clinical signs symptoms related trauma. Self‐reported categorized none, occasionally, weekly, or daily. defined ICH any acute detected by computed tomography scan. evaluated frequency ICH, adjusted for factors injury factors. Results Of 3128 participants, 18.2% ( n = 567) reported use: 10.3% occasional use, 1.9% weekly 6.0% daily use. more patients who used (20.5%, 22.0%, 25.1% occasional, users, respectively, vs. 12.0% non‐users, p < 0.001). independently associated odds ratios (with 95% confidence intervals) users increased 2.0 (1.5‒2.8) 2.1 (1.1‒4.1) 2.5 (1.7‒3.6), showed dose‒response effect. Conclusions adult emergency department is relatively common. appears be higher dose‐dependent fashion. Fall prevention strategies need consider mitigation modifiable factor.

Language: Английский

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The effects of age on the severity of problem drinking: Mediating effects of positive alcohol expectancy and neural correlates

Addiction Biology, Journal Year: 2023, Volume and Issue: 28(6)

Published: April 27, 2023

Abstract Aging is associated with reduction in the severity of alcohol misuse. However, psychological and neural mechanisms underlying age‐related changes remain unclear. Here, we tested hypothesis that diminution positive expectancy (AE) mediated effects age on problem drinking investigated correlates mediating effects. Ninety‐six drinkers 21–85 years age, including social those mild/moderate use disorder (AUD), were assessed for global (GP) AE drinking, each Alcohol Expectancy Questionnaire Use Disorders Identification Test (AUDIT), brain imaging during cue exposure. We processed data published routines; identified shared between whole‐brain regression against GP AUDIT scores; performed mediation path analyses to explore interrelationships clinical variables. The results showed was negatively correlated both scores, score completely correlation score. Lower higher responses bilateral parahippocampal gyrus left middle occipital cortex (PHG/OC). Further, scores rostral anterior cingulate caudate head (ACC/caudate). Path demonstrated models significant statistical fit PHG/OC ACC/caudate interrelating scores. These findings confirmed change as a mechanism mitigating misuse individuals highlighted processes cue‐reactivity severity.

Language: Английский

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