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Cureus May 2024Background Cancer is the leading cause of death globally. Information on cancer patterns and survival is essential for the effective planning and implementation of...
Background Cancer is the leading cause of death globally. Information on cancer patterns and survival is essential for the effective planning and implementation of cancer control interventions. Objective This study aimed to identify various factors associated with the survival estimates of common cancers. Methods A community-based ambispective study was conducted in a rural population. Data were collected from individuals diagnosed with cancer or relatives of individuals who died of cancer. The total population covered was 82,983. All cancer cases diagnosed since 2005 and followed until the year 2020 were included. Survival analysis and five-year survival rates were estimated. A Cox proportional hazard model was used. Results A total of 146 cancer patients were included in the study. Five-year survival estimates for breast cancer, head and neck cancer, and GI cancer were 72%, 28%, and 0%, respectively. The median survival time was lowest for GI cancers (1 year), and for head and neck and breast cancers, it was 3 and 6 years, respectively. Multivariate Cox regression was performed, adjusting for age, type of hospital, alcohol use, tobacco use, opium use, gender, treatment sought, GI cancer, frequency of changing hospitals, and frequency of follow-up. After adjustment, changing hospitals ≥3 times, being lost to follow-up, receiving no treatment, tobacco abuse, and the presence of GI cancers were significantly associated with survival estimates. Conclusions The five-year survival estimate for GI cancers was the lowest compared to other cancers. Study participants who were lost to follow-up or who took no treatment were significantly associated with lower survival estimates.
PubMed: 38854348
DOI: 10.7759/cureus.59990 -
Cureus May 2024Long-standing overt ventriculomegaly in adults (LOVA) is a kind of chronic hydrocephalus that has been reported to have started in infancy and is characterized by...
Long-standing overt ventriculomegaly in adults (LOVA) is a kind of chronic hydrocephalus that has been reported to have started in infancy and is characterized by severe ventriculomegaly and macrocephaly. It often manifests clinically in later adulthood. We describe the case of a 34-year-old male patient who had a history of chronic alcoholism and who had been complaining of headaches, disturbed gait, and frequent falls for three months when he arrived in a stupor at the emergency room. Massive ventriculomegaly with Evans' index of 0.40 was found during a head magnetic resonance imaging (MRI). The MRI results were more severe than the clinical manifestations. He was diagnosed with LOVA and treated with conservative hyperosmolar drugs, neuroprotective agents, and intravenous (IV) thiamine. The patient was discharged and consented to follow-up after a hospital stay of seven days.
PubMed: 38854239
DOI: 10.7759/cureus.59973 -
BioRxiv : the Preprint Server For... Jun 2024Preclinical and human studies indicate psilocybin may reduce perseverant maladaptive behaviors, including nicotine and alcohol seeking. Such studies in the opioid field...
Preclinical and human studies indicate psilocybin may reduce perseverant maladaptive behaviors, including nicotine and alcohol seeking. Such studies in the opioid field are lacking, though opioids are involved in more >50% of overdose deaths. Psilocybin is an agonist at the serotonin 2A receptor (5-HTR), a well-documented target for modulation of drug seeking, and evidence suggests 5-HTR agonists may dampen motivation for opioids. We sought to investigate the therapeutic efficacy of psilocybin in mediating cessation of opioid use and maintenance of long-lasting abstinence from opioid seeking behavior in a rat model of heroin self-administration (SA). Psilocybin or 5-HTR antagonists ketanserin and volinanserin were administered systemically to rats prior to SA of 0.075 mg/kg/infusion of heroin, or relapse following forced abstinence. Psilocybin did not alter heroin taking, but a single exposure to 3.0 mg/kg psilocybin 4-24 hours prior to a relapse test blunted cue-induced heroin seeking. Conversely, 5-HTR antagonists exacerbated heroin relapse. To begin to elucidate mechanisms of psilocybin, drug-naïve rats received psilocybin and/or ketanserin, and tissue was collected from the prefrontal cortex (PFC), a region critical for drug seeking and responsive to psilocybin, 24 hours later for RNA-sequencing. 3.0 mg/kg psilocybin regulated ~2-fold more genes in the PFC than 1.0 mg/kg, including genes involved in the cytoskeleton and cytokine signaling. Ketanserin blocked >90% of psilocybin-regulated genes, including the IL-17a cytokine receptor, . Psychedelic compounds have reported anti-inflammatory properties, and therefore we performed a gene expression array to measure chemokine/cytokine molecules in the PFC of animals that displayed psilocybin-mediated inhibition of heroin seeking. Psilocybin regulated 4 genes, including , and a subset of genes correlated with relapse behavior. Selective inhibition of PFC IL-17a was sufficient to reduce heroin relapse. We conclude that psilocybin reduces heroin relapse and highlight IL-17a signaling as a potential downstream pathway of psilocybin that also reduces heroin seeking.
PubMed: 38854027
DOI: 10.1101/2024.05.28.596205 -
Industrial Psychiatry Journal 2024Alcohol dependence syndrome is a major public health problem, and it impacts the social, psychological, medical, economic, and religious spheres of our existence....
BACKGROUND
Alcohol dependence syndrome is a major public health problem, and it impacts the social, psychological, medical, economic, and religious spheres of our existence. Persistent alcohol abuse impacts sexual functioning negatively and leads to the onset of sexual dysfunction.
AIM
This study was conducted to determine erectile dysfunction in males diagnosed with alcohol dependence syndrome and its association with the severity of alcohol dependence.
MATERIALS AND METHODS
The descriptive, non-interventional, cross-sectional study was conducted at the Department of Psychiatry in a tertiary care hospital where 78 subjects diagnosed with alcohol dependence syndrome were assessed for severity of dependence with the Severity of Alcohol Dependence Questionnaire (SADQ-C). Erectile dysfunction in these subjects was assessed with the International Index of Erectile Function scale (IIEF) and the severity of the same was correlated with the severity of alcohol dependence.
RESULTS
The results of our study indicated that erectile dysfunction was common in individuals having alcohol dependence syndrome and its severity was positively correlated with the severity of alcohol dependence. Unidentified sexual dysfunction may perpetuate alcohol dependence with poor response to deaddiction therapy. This information about sexual dysfunction due to alcohol dependence can also be used in motivational counseling of heavy drinkers to provide an impetus for change.
CONCLUSIONS
The prevalence of erectile dysfunction was significantly higher than that of the general population. The same was significantly elevated in patients with severe alcohol dependence as compared to those with mild/moderate alcohol dependence.
PubMed: 38853789
DOI: 10.4103/ipj.ipj_69_23 -
Psychiatria Polska Feb 2024To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war.
OBJECTIVES
To depict overall psychological well-being of a large group of students of different universities in Ukraine three months after the emerge of the full-scale war.
METHODS
A total of 1,142 participants were asked to measure their psychological well-being on a 0-10 scale before and after the onset of full-scale war. Mental health symptoms were measured with questionnaires targeting depression (PHQ-9), anxiety (GAD-7), sleep problems (ISI), eating disorders (SCOFF), alcohol abuse (CAGE), and PTSD symptoms (PC-PTSD-5). To evaluate the connection between variables a χ2 was conducted. Phi and Cramer's V coefficient were stated to demonstrate the power of the relationships. Additionally, machine learning (the XGBoost regression model) was used to build a predictive model for depressive symptoms.
RESULTS
Of all respondents, 66% screened positive for PTSD symptoms, 45% - moderate and severe anxiety symptoms, 47% - moderate and severe depressive symptoms. Regarding sleep, alcohol use and eating behavior, 19% of surveyed students had signs of moderate and severe insomnia, 15% reported alcohol abuse and 31% disordered eating. The severity of the aforementioned disorders varied depending on gender, year of study, social status, etc. According to the predictive model, lower initial psychological well-being, female gender, younger age, first years of study and any traumatic experience, including multiple trauma, predicted increases in depression score. Return to home after relocation was a protective factor.
CONCLUSIONS
The study demonstrated the high prevalence of mental health symptoms among university students in Ukraine during the first months of the full-scale war. The psychological well-being pre-war was the strongest predictor of depressive symptoms in the model.
Topics: Humans; Female; Ukraine; Male; Students; Adult; Stress Disorders, Post-Traumatic; Young Adult; Mental Health; Depression; Anxiety; Surveys and Questionnaires; Psychological Well-Being
PubMed: 38852187
DOI: 10.12740/PP/177073 -
Psychiatria Polska Feb 2024To perform an adaptation and psychometric validation of the Polish version of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen version in a clinical sample of...
OBJECTIVES
To perform an adaptation and psychometric validation of the Polish version of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen version in a clinical sample of patients admitted to the psychiatric hospital.
METHODS
This was a single-center, observational and cross-sectional study. A total of 318 consecutive patients completed a set of questionnaires upon their admission to acute psychiatric units. The set comprised C-SSRS screener and the reference measures: the Suicidal Behaviors Questionnaire - Revised (SBQ-R), the Suicidal Ideation Attributes Scale (SIDAS), the Center of Epidemiological Studies Depression Scale - Revised (CESD-R), the Scale of Psychache, the Purpose in Life scale (PIL), and alcohol misuse screen test (CAGE).
RESULTS
Cronbach's α of the C-SSRS was 0.89. Two latent components were identified in the factor analysis: (1) suicidal thoughts, intentions and plans, and (2) history of suicidal attempts. There were differences in the mean scores of all the utilized questionnaires (namely, SBQ-R, the Psychache scale, CAGE, SIDAS, PIL and CESD-R) between the C-SSRS risk groups (p=0.01). The C-SSRS risk group was associated with the category of the primary psychiatric diagnosis (p<0.001).
CONCLUSIONS
The Polish version of the Columbia-Suicide Severity Rating Scale screener is a questionnaire with good psychometric features to assess the suicidal risk among psychiatric in-patients. It can be used for the purposes of a routine assessment of suicidal risk among hospitalized patients.
PubMed: 38852178
DOI: 10.12740/PP/OnlineFirst/174591 -
Child Abuse & Neglect Jun 2024Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help...
BACKGROUND
Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts.
OBJECTIVE
The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents.
PARTICIPANTS AND SETTING
A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey.
METHODS
Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems.
RESULTS
CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives.
CONCLUSIONS
The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.
PubMed: 38850749
DOI: 10.1016/j.chiabu.2024.106885 -
JAMA Network Open Jun 2024Alcohol use disorder (AUD) is present in nearly half of individuals with bipolar disorder (BD) and is associated with markedly worsening outcomes. Yet, the concurrent...
IMPORTANCE
Alcohol use disorder (AUD) is present in nearly half of individuals with bipolar disorder (BD) and is associated with markedly worsening outcomes. Yet, the concurrent treatment of BD and AUD remains neglected in both research and clinical care; characterizing their dynamic interplay is crucial in improving outcomes.
OBJECTIVE
To characterize the longitudinal alcohol use patterns in BD and examine the temporal associations among alcohol use, mood, anxiety, and functioning over time.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study selected participants and analyzed data from the Prechter Longitudinal Study of Bipolar Disorder (PLS-BD), an ongoing cohort study that recruits through psychiatric clinics, mental health centers, and community outreach events across Michigan and collects repeated phenotypic data. Participants selected for the present study were those with a diagnosis of BD type I (BDI) or type II (BDII) who had been in the study for at least 5 years. Data used were extracted from February 2006 to April 2022, and follow-up ranged from 5 to 16 years.
MAIN OUTCOMES AND MEASURES
Alcohol use was measured using the Alcohol Use Disorders Identification Test. Depression, mania or hypomania, anxiety, and functioning were measured using the 9-Item Patient Health Questionnaire, the Altman Self-Rating Mania Scale, the 7-item Generalized Anxiety Disorder assessment scale, and the Life Functioning Questionnaire, respectively.
RESULTS
A total of 584 individuals (386 females (66.1%); mean [SD] age, 40 [13.6] years) were included. These participants had a BDI (445 [76.2%]) or BDII (139 [23.8%]) diagnosis, with or without a lifetime diagnosis of AUD, and a median (IQR) follow-up of 9 (0-16) years. More problematic alcohol use was associated with worse depressive (β = 0.04; 95% credibility interval [CrI], 0.01-0.07) and manic or hypomanic symptoms (β = 0.04; 95% CrI, 0.01-0.07) as well as lower workplace functioning (β = 0.03; 95% CrI, 0.00-0.06) over the next 6 months, but increased depressive and manic or hypomanic symptoms were not associated with greater subsequent alcohol use. These latter 2 associations were more pronounced in BDII than BDI (mania or hypomania: β = 0.16 [95% CrI, 0.02-0.30]; workplace functioning: β = 0.26 [95% CrI, 0.06-0.45]). Alcohol use was not associated with anxiety over time.
CONCLUSIONS AND RELEVANCE
This study found that alcohol use, regardless of diagnostic status, was associated with mood instability and poorer work functioning in BD, but increased mood symptoms were not associated with subsequent alcohol use. Given its prevalence and repercussions, dimensional and longitudinal assessment and management of alcohol use are necessary and should be integrated into research and standard treatment of BD.
Topics: Humans; Bipolar Disorder; Female; Male; Adult; Longitudinal Studies; Middle Aged; Alcohol Drinking; Alcoholism; Affect; Michigan; Anxiety
PubMed: 38848066
DOI: 10.1001/jamanetworkopen.2024.15295 -
Cureus May 2024is a Gram-negative bacterium, commonly found as a commensal germ in the oral cavity of dogs and cats. It is an opportunistic pathogen, but, in specific situations, it...
is a Gram-negative bacterium, commonly found as a commensal germ in the oral cavity of dogs and cats. It is an opportunistic pathogen, but, in specific situations, it can cause very severe diseases, including arthritis, pleuritis, endocarditis, sepsis, and, in extremely rare cases, meningoencephalitis. The predisposing situations include immunosuppression, liver cirrhosis, splenectomy, hemochromatosis, beta thalassemia major (Cooley's anemia), and alcohol abuse. In this report, we describe the case of a 48-year-old male patient, with a medical history of several predisposing conditions, who developed a severe case of meningoencephalitis caused by , following a dog bite on his hand. The patient was successfully treated for his meningitis, but subsequently he developed a hospital-acquired septic shock from , which was treated with targeted antibiotic therapy and sequential extracorporeal blood purification therapies using Oxiris™ and Toraymyxin™ hemofilters.
PubMed: 38846194
DOI: 10.7759/cureus.59841 -
BMC Public Health Jun 2024Access to data concerning mental health, particularly alcohol use disorders (AUD), in sub-Saharan Africa is very limited. This study aimed to estimate AUD prevalence and...
INTRODUCTION
Access to data concerning mental health, particularly alcohol use disorders (AUD), in sub-Saharan Africa is very limited. This study aimed to estimate AUD prevalence and identify the associated factors in Togo and Benin.
METHODS
A cross-sectional study was conducted between April and May 2022, targeting individuals aged 18 years and above in the Yoto commune of Togo and the Lalo commune of Benin. Subjects were recruited using a multi-stage random sampling technique. AUD diagnoses were made using the MINI adapted to DSM-5 criteria. Our study collected sociodemographic information, data on psychiatric comorbidities, stigmatization, and assessed cravings, using a series of scales. The association between AUD and various factors was analyzed using multivariable logistic regression.
RESULTS
In Togo, 55 of the 445 people investigated had AUD (12.4%; [95% CI: 9.5-15.7%]). Among them, 39 (70.9%) had severe AUD and the main associated comorbidities were suicidal risk (36.4%), and major depressive disorder (16.4%). Associated factors with AUD were male gender (aOR: 11.3; [95% CI: 4.8-26.7]), a higher Hamilton Depression Rating Scale (HDRS) score (aOR: 1.2; [95% CI: 1.1-1.3]) and a lower Stigma score measured by the Explanatory Model Interview Catalogue (EMIC) (aOR: 0.9; [95% CI: 0.8-0.9). The stigma scores reflect perceived societal stigma towards individuals with AUD. In Benin, 38 of the 435 people investigated had AUD (8.7%; [95% CI: 6.4-11.7]), and the main associated comorbidities were suicidal risk (18.4%), tobacco use disorder (13.2%) and major depressive episode (16.4%). Associated factors with AUD were male gender (aOR: 6.4; [95% CI: 2.4-17.0]), major depressive disorder (aOR: 21.0; [95% CI: 1.5-289.8]), suicidal risk (aOR: 3.7; [95% CI: 1.2-11.3]), a lower Frontal Assessment Battery (FAB) score (aOR:0.8; [95% CI: 0.8-0.9]) and a lower perceived stigma score (by EMIC )(aOR: 0.9; [95% CI: 0.8-0.9]).
CONCLUSION
In these communes of Togo and Benin, AUD prevalence is notably high. A deeper understanding of the disease and its local determinants, paired with effective prevention campaigns, could mitigate its impact on both countries.
Topics: Humans; Male; Female; Benin; Togo; Adult; Cross-Sectional Studies; Middle Aged; Prevalence; Young Adult; Alcoholism; Adolescent; Risk Factors; Comorbidity; Aged; Depressive Disorder, Major
PubMed: 38844918
DOI: 10.1186/s12889-024-19032-5