Secondary Causes of Hypertriglyceridemia are Prevalent Among Patients Presenting With Hypertriglyceridemia Induced Acute Pancreatitis

BackgroundHypertriglyceridemia induced acute pancreatitis (HIAP) is the third common cause of acute pancreatitis. HIAP can result in recurrent attacks of severe AP with significant morbidity and mortality. Hypertriglyceridemia (HTG) could be primary or secondary. Although genetic causes of HTG are well studied, the prevalence of secondary causes of HTG in patients presenting with HIAP is not well characterized. This study aimed to identify the prevalence of risk factors for secondary hypertriglyceridemia among patients presenting with HIAP in a tertiary referral center in a large metropolitan area.MethodsThis is a retrospective analysis of all patients admitted with AP from August 2012–2017. A subgroup of patients with triglycerides >880 mg/dl were included for analysis. Secondary causes of HTG were identified. Secondary analysis evaluating the severity of pancreatitis was performed.ResultsThere were 3,746 patients admitted for AP of which 57 patients had AP and HTG. Of these 57 patients, 70.2% had history of diabetes mellitus, 26.3% had history of heavy alcohol use, 22.8% had chronic kidney disease, 47.3% with obesity, and 21.1% with metabolic syndrome. Two patients were classified as unexplained HTG. Secondary analysis showed a total of 45.6% of patients requiring ICU admission. 26.3% of patients with severe inflammatory pancreatitis and 17.5% of patients with severe necrotizing pancreatitis.ConclusionsIn our cohort of HIAP, 55 out of 57 patients had secondary causes for HTG. Identifying secondary causes of HTG during acute hospitalization is important to tailor outpatient treatment in order to prevent future admissions with HIAP.     

Understanding college student spring break drinking: Demographic considerations,perceived norms and travel characteristics

Research has documented normative perceptions of others' alcohol use and how these related to increased rates of drinking and related problems among college students. Recently, research has expanded this concept to specific events (21st birthday drinking and tailgating). No studies to date examine the construct of normative perceptions of alcohol use for spring break (SB). SB is a known time of risk for increased alcohol use, and understanding whether students overestimate SB drinking norms, variables that influence norms perceptions (gender, ethnicity and travel) and whether SB norms relate to one's own drinking can inform future prevention and intervention efforts. We extend the literature by examining SB normative perceptions: (1) whether or not these perceptions are accurate and (2) the relationship to students' own drinking and related consequences. A random sample (N?=?1583) of students were asked about their SB drinking, consequences and norm perceptions. Students' SB drinking in this study was lower than their perception of typical student SB drinking (p?<?0.001), and women's perceptions were higher than men's (p?<?0.001). After adjusting for demographics and typical drinking, SB norms were significantly associated with SB drinking among those taking a trip over SB (p?<?0.001). After controlling for SB drinking, SB drinking norms were unrelated to consequences. Similar misperceptions exist for SB drinking. Prevention and intervention efforts aimed at reducing SB drinking and consequences, particularly for those planning a trip, may incorporate SB specific social norms education.     

高职生久坐行为测量及其与抑郁水平关系

目的:高职生过长的久坐行为如电脑前看视频、玩游戏、坐着玩手机等已经成为高校学生工作不可忽视的课题。较可靠的测量工具是评估久坐行为水平及其对健康的危害的前提。方法:本研究主要采用开放式问卷测量、结构式问卷调查以及数据处理与分析等方法,初步考察了某一高职院校学生久坐行为自编问卷的信效度及其与抑郁及各因子的关联性。结果:开放式调查、久坐行为自编问卷与国际体力活动问卷久坐行为条目所测的平均时间分别为412.58分钟/天、549.92分钟/天和466.99分钟/天;同时,久坐行为与抑郁量表人际因子的简单相关系数有统计学意义(r=0.306,P0.05)。结论:高职生久坐行为自编问卷具有较好的可靠性,他们的久坐行为时间普遍过长并且提示久坐行为与抑郁水平存在一定的关联。     

Association of the ADH2 genotypes with skin responses after ethanol exposure in Japanese male university students

BACKGROUND: A contribution of the alcohol dehydrogenase-2 (ADH2) polymorphism to alcohol sensitivity and alcohol drinking behavior is still controversial. In this study, we examined the effects of the ADH2 genotypes on skin reactions to ethanol and habitual alcohol intake among Japanese male university students, controlling for the effects of the low Km aldehyde dehydrogenase (ALDH2) genotype, as an extension of our previous study. METHODS: The study subjects were 357 Japanese male students [average age (mean +/- SD) was 23.7 +/- 3.0 years] in a medical university. The subjects completed a questionnaire regarding self-reported alcohol-associated symptoms and alcohol-drinking behavior. The ADH2 and ALDH2 genotypes were determined through digestion of polymerase chain reaction products by restriction enzymes. All subjects participated in the ethanol patch test. We observed skin responses at 0, 5, 15, and 20 min after removal of the tape. RESULTS: Among the ALDH2*1/*1 genotypes, only some subjects with ADH2*1/*2 or ADH2*2/*2 exhibited a positive response, which increased with increasing time after the removal. However, none of comparisons between the different ADH2 genotypes reached statistical significance. Among the ALDH2*1/*2 genotypes, those with ADH2*1/*2 or ADH2*2/*2 showed a significant increase in response with increasing time after the removal and revealed a significantly higher positivity rate at 15 min than those with ADH2*1/*1. In those with the ALDH2*1/*2 genotype, the positive rate of facial flushing with one glass of beer was higher in those with ADH2*1/*2 and ADH2*2/*2 than those with ADH2*1/*1, although this was not significant. However, the ADH2 genotype did not seem to influence drinking frequency or amounts of alcohol intake in each ALDH2 genotype. CONCLUSIONS: This study finds further evidence for a contribution of the ADH2 polymorphism to skin reactions after either local or systemic ethanol exposure in Asian people. However, the effects of the ADH2 polymorphism may be mild because this polymorphism does not seem to influence alcohol drinking behavior in these study subjects.     

Antimicrobial susceptibility of common pathogens isolated from postoperative intra-abdominal infections in Japan

The principle of empirical therapy for patients with intra-abdominal infections (IAI) should include antibiotics with activity against Enterobacteriaceae and Bacteroides fragilis group species. Coverage of Pseudomonas aeruginosa, Enterobacter cloacae, and Enterococcus faecalis is also recommended for hospital-associated IAI. A nationwide survey was conducted to investigate the antimicrobial susceptibility of pathogens isolated from postoperative IAI. All 504 isolates were collected at 26 institutions and referred to a central laboratory for susceptibility testing. Lower susceptibility rates to ciprofloxacin and cefepime were demonstrated in Escherichia coli. Among E. coli, 24.1% of strains produced extended-spectrum β-lactamase (ESBL). Carbapenems, piperacillin/tazobactam, cephamycins/oxacephem, aminoglycosides, and tigecycline had high activity against E. coli, including ESBL-producing isolates. Among E. cloacae, low susceptibility rates to ceftazidime were demonstrated, whereas cefepime retained its activity. P. aeruginosa revealed high susceptibility rates to all antimicrobials tested except for imipenem. Among B. fragilis group species, low levels of susceptibility were observed for cefoxitin, moxifloxacin, and clindamycin, and high susceptibility rates were observed for piperacillin/tazobactam, meropenem, and metronidazole. Ampicillin, piperacillin, and glycopeptides had good activity against E. faecalis. Imipenem had the highest activity against E. faecalis among carbapenems. In conclusion, we suggested the empirical use of antimicrobials with the specific intent of covering the main organisms isolated from postoperative IAI. Piperacillin/tazobactam, meropenem, or doripenem, are appropriate in critically ill patients. Combination therapy of cefepime (aztreonam in patients with β-lactam allergy) plus metronidazole plus glycopeptides, imipenem/cilastatin or cephamycins/oxacephem plus ciprofloxacin plus metronidazole are potential therapeutic options.     

An analysis of blood donation barriers experienced by North American and Caribbean university students in Grenada,West Indies

Objectives

To estimate the associations of nationality, university program, donation history and gender, with blood donation barriers experienced by non-donating students on the day of a campus blood drive. This project focused particularly on nationality and the effect of the different blood donation cultures in the students' countries of origin.