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1.

Background

High alcohol intake is associated with increased mortality. We aimed to identify factors affecting mortality in people drinking extreme amounts of alcohol.

Methods

We obtained information from the UK Biobank on approximately 500,000 participants aged 40–70 years at baseline assessment in 2006–2010. Habitual alcohol intake, lifestyle and physiological data, laboratory test results, and hospital diagnoses and death certificate data (to June 2020) for 5136 men (2.20% of male participants) and 1504 women (0.60%) who reported consuming ≥80 or ≥50 g/day, respectively, were used in survival analysis.

Results

Mortality hazard ratios for these excessive drinkers, compared to all other participants, were 2.02 (95% CI 1.89–2.17) for all causes, 1.89 (1.69–2.12) for any cancer, 1.87 (1.61–2.17) for any circulatory disease, and 9.40 (7.00–12.64) for any liver disease. Liver disease diagnosis or abnormal liver function tests predicted not only deaths attributed to liver disease but also those from cancers or circulatory diseases. Mortality among excessive drinkers was also associated with quantitative alcohol intake; diagnosed alcohol dependence, harmful use, or withdrawal syndrome; and current smoking at assessment.

Conclusions

People with chronic excessive alcohol intake experience decreased average survival, but there is substantial variation in their mortality, with liver abnormality and alcohol dependence or other alcohol use disorders associated with a worse prognosis. Clinically, patients with these risk factors and high alcohol intake should be considered for early or intensive management. Research can usefully focus on the factors predisposing to dependence or liver abnormality.  相似文献   
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张怡然 《天津护理》2022,30(5):556-559
目的:调查冠心病合并糖尿病患者护理依赖性情况,并分析其影响因素。方法:采用便利抽样法选择142例冠心病合并糖尿病患者为研究对象,使用护理依赖性量表(CDS)对患者的护理依赖性进行调查。结果:冠心病合并糖尿病患者CDS 总分为(44.85 ± 16.47)分,护理依赖发生率为 64.79%。文化程度、服药种类、是否了解病情、是否合并其他慢性疾病、是否行介入手术影响患者的护理依赖程度(P<0.05)。结论:冠心病合并糖尿病患者的护理依赖性发生率偏高,在护理过程中多关注文化程度低、服药种类多、不了解病情、合并其他慢性疾病及接受介入手术治疗的患者,制定合理的护理计划,实行有效的护理干预措施,以降低冠心病合并糖尿病患者的护理依赖性。  相似文献   
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IntroductionComputed tomography (CT) numbers are used in radiological diagnosis, attenuation correction and radiotherapy treatment planning. Modern CT scanners use iterative reconstruction methods instead of the traditional filtered back projection (FBP). Hence, the investigation of CT number accuracy with image reconstruction techniques and X-ray tube potential (kVp) used in CT is warranted. The aim of this study is to evaluate the effect of Sinogram Affirmed Iterative Reconstruction (SAFIRE) Technique and image acquisition at different tube potentials on CT numbers of different tissue equivalent materials.MethodsImages of the Computerised Imaging Reference System Model 062M Electron Density Phantom were acquired at different tube potentials and reconstructed using FBP and different strengths of SAFIRE. Average CT numbers, in circular regions of interest, and their standard deviations were used to investigate any dependence of CT numbers on tube potentials and/or image reconstruction technique using non-parametric statistical tests with p-values set at 0.05.ResultsStatistically significant differences in CT numbers were not observed (p > 0.091) between the different image reconstruction techniques. CT number of bone equivalent materials increased significantly (p < 0.015), by up to 400 Hounsfield Units, when tube potential was decreased. Such extent of CT number change over the tube potentials range used in this study may influence diagnostic outcomes in lung nodule, contrast enhanced and calcium score studies. For all other tissue equivalent materials, the CT number did not change significantly for different tube potentials. Linear relationship was observed between CT numbers and electron densities.ConclusionThe study concludes that the CT numbers of all tissues did not change significantly with image reconstruction methods. However, the CT numbers of bone equivalent materials increased with decreasing tube potentials, which may result in misrepresentation of clinical information obtained.Implications for practiceWhen CT images are used to extract quantitative parameters such as calcium score, to characterise lung nodules and contrast enhanced structures, the kVp used for image acquisition should be carefully selected to avoid any misrepresentation of clinical information.  相似文献   
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目的:分析大学生体力活动水平与烟草依赖性之间的相关性,探讨不同体力活动水平对大学生烟草依赖性的影响。方法:以133名吸烟男性大学生为研究对象,运用国际体力活动问卷(IPAQ)和尼古丁依赖检验量表(FTND)等测量工具,分别评估体力活动水平和烟草依赖程度。采用Spearman相关分析的方法检验体力活动与烟草依赖的相关性,采用多独立样本非参数检验(Kruskal-Wallis单因素ANOVA)的方法,检验不同体力活动水平之间烟草依赖性的差异。结果:吸烟男大学生体力活动水平为5124.28±3381.43 MET-min/w,烟草依赖程度为2 (0~4)分,非参数相关分析Spearman’s rho=-0.21,P<0.05。与低体力活动水平组相比,高、中体力活动水平组大学生的烟草依赖性分别存在显著差异性[6(2.25~8)vs. 1(0~4),P<0.01;6(2.25~8)vs. 2(0~4),P<0.05]。高、中体力活动水平组大学生之间的烟草依赖性差异无统计学意义[1(0~4) vs.2(0~4),P>0.05]。结论:大学生体力活动水平与烟草依赖程度呈负相关。高、中体力活动水平大学生的烟草依赖程度较低,两组之间无显著差异。  相似文献   
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目的 探讨人口学因素和心理渴求对酒精依赖患者复发的影响。方法 采用前瞻性研究方法,选择2017年8月至2018年8月在3家精神专科医院招募符合《美国精神疾病诊断与统计手册》第4版(Diagnositic and Statistical Manual Disorder-Fourth Version, DSM-Ⅳ)酒精依赖诊断标准的住院治疗的男性患者158例,进行基线测查,并在基线后3个月进行随访,调查复饮情况。基线测查包括人口学资料、饮酒特征、临床机构酒精依赖戒断评估表(clinical institute withdrawal assessment-advanced revised, CIWA-Ar)、环境线索诱导及戒断期心理渴求视觉模拟标尺评分(visual analog scale,VAS)、密歇根酒精依赖筛查量表(Michigan alcoholism screening test, MAST)、焦虑自评量表(self-rating anxiety scale, SAS)、抑郁自评量表(self-rating depression scale, SDS)及饮酒促迫性量表(alcohol urge questionnaire, AUQ)。根据随访结果,将“复发”定义为在基线和随访之间任何时刻饮用含有乙醇的饮料,“复发时间”定义为首次饮酒距离基线的天数。是否复发和复发时间是主要结局指标,采用Cox比例风险回归模型分析影响酒精依赖复发的因素。结果酒精依赖患者3个月复发率为63.7%, 多因素Cox比例风险回归模型分析发现年龄(OR=0.975,P=0.030)及CIWA-Ar评分(OR=1.126,P=0.010)是影响酒精依赖复发的因素,两种环境下心理渴求与复饮差异无统计学意义(P > 0.05)。结论 年龄与住院期间酒精依赖戒断症状严重程度是酒精依赖复发的影响因素,其中年龄大是保护因素,戒断症状的严重程度重是危险因素,而线索诱导及戒断期心理渴求对酒精依赖患者复发的影响作用较小。  相似文献   
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Background: Resultant of engaging in behaviors outside of their value systems to maintain addiction, many people with substance use disorder (SUD) feel shame and guilt. Although shame, guilt, and pride do not represent traditional dependent measures in SUD research, experimental studies targeting these constructs are warranted. Objective: The purpose of this study was to determine the effects of a single songwriting intervention on state shame, guilt, and pride with adults with SUD on a detoxification unit. Method: Participants (N?=?118) were cluster-randomized to songwriting or control conditions. To avoid testing fatigue in this single-session study, experimental participants received a group-based blues songwriting protocol targeting state shame, guilt, and pride and then completed the questionnaire. Control participants completed the questionnaire before receiving an intervention. Results: While there was no significant between-group difference in state shame or guilt, there tended to be slightly lower mean scores in the experimental condition. There was a significant between-group difference in state pride (p = .012), with experimental participants having higher mean scores than control participants. Conclusion: Although only the state pride measure reached significance, shame, guilt, and pride represent consequential constructs for people with SUD. As addressing shame and guilt can be perceived as confrontational, group-based blues songwriting may represent a positive, engaging, and creative intervention to target these challenging but important topics. Implications for clinical practice, limitations, and suggestions for future research are provided.  相似文献   
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