Andrew Nick
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Excessive alcohol use is an important component of a persons risk for drug overdose death But alcohols contribution to overdose death risk has not been well quantified We aimed to quantify the role of excessive alcohol use particularly as defined by a blood alcohol concentration BAC 008 gdL in drug overdose deaths in New Mexico NM The study was conducted in 2018 We abstracted death records scene investigation toxicology pathology for all drug overdose deaths in NM during 20152016 information on BAC other indications of alcohol risk factors comorbidities and drug type and linked this information with demographic characteristics on death certificates A Poisson regression model was used to determine independent associations between decedents characteristics and alcohol involvement among drug overdose decedents Approximately 18 n 170 of the 946 drug overdose decedents in this study had a BAC 008 gdL After adjustment drug overdose decedents who were American IndianAlaska Native or had a history of alcohol use disorder were more likely to have had a BAC 008 gdL at the time of death However decedents who had methamphetamine involved in their death or who had a history of diabetes mental illness or chronic pain were less likely to have a BAC 008 gdL at the time of death Nearly 1 in 5 overdose decedents had a BAC 008 gdL at the time of death suggesting that evidencebased alcohol prevention strategies eg increasing alcohol taxes regulating alcohol outlet density could reduce the risk of drug overdose death Nearly 1 in 5 overdose decedents had a BAC 008 gdL at the time of death suggesting that evidencebased alcohol prevention strategies eg increasing alcohol taxes regulating alcohol outlet density could reduce the risk of drug overdose death Human immunodeficiency virus HIVassociated neurocognitive disorders persist in the era of antiretroviral therapy One factor that is elevated among persons with HIV PWH and independently associated with neurocognitive impairment is methamphetamine dependence METH Such dependence may further increase cognitive impairment among PWH by delaying HIV diagnosis and thus antiretroviral therapy initiation which has been posited to account for persistent cognitive impairment among PWH despite subsequent treatmentrelated viral load suppression VLS 50 copies of the virus per milliliter in plasma or cerebrospinal fluid This study examined the main and interactive additive versus synergistic effects of HIV and history of METH on the sustained attention and vigilance cognitive domain while controlling for VLS Participants included 205 median age 44 years 77 males HIVMETH n 67 HIVMETH n 49 HIVMETH n 36 HIVMETH n 53 individuals enrolled in the Translational Methamnitiation of antiretroviral therapy and METH use interventions Parents frequently supply alcohol to their children often only sips We investigated whether supply of sips and whole drinks from parents and other sources are differentially associated with subsequent drinking outcomes A cohort of 1910 adolescents mean age 129yrs were surveyed annually over seven years from 201011 We examined prospective adjusted associations between the quantity of supply from parental and nonparental sources in the preceding 12 months and five outcomes in the subsequent year over several consecutive years binge drinking alcoholrelated harms symptoms of alcohol abuse dependence and alcohol use disorder AUD In early waves most parental supply comprised sips while supply of whole drinks increased in later waves Among those not receiving alcohol from other sources parental supply of sips was associated with increased odds of binge drinking OR 185 995 CI 117291 and alcoholrelated harms OR 170 995 CI 120242 but not with reporting symptoms of alcohol abuse dependence or AUD compared with no supply Relative to no supply supply of sips from other sources was associated with increased odds of binge drinking OR 204 995 CI 114367 only Compared with supply of sips supply of whole drinks by parents or others had higher odds of binge drinking alcoholrelated harms symptoms of dependence and of AUD Secondary analysis demonstrated that supply of larger quantities was associated with an increased risk of all outcomes Parental provision of sips is associated with increased risks and the supply of greater quantities was associated with an increasing risk of adverse outcomes ClinicalTrialsgov NCT02280551 ClinicalTrialsgov NCT02280551 Hazardous drinking is widespread among people with HIV PWH PWH are also vulnerable to depression due to HIVrelated social stigma and social support can play an important role in improving mental health for this population No studies have explored whether social support modifies the association of hazardous drinking and depressive symptoms among PWH We used baseline data from a randomized controlled trial of two evidencebased alcohol reduction interventions among antiretroviral therapy clients in Vietnam Hazardous alcohol use was defined as having a score 8 for men and 7 for women on the Alcohol Use Disorders Identification Test The presence of depression symptoms was defined as a score 5 on the Patient Health Questionnaire9 Social support was measured with a 5question modified version of the Medical Outcomes Study Social Support Instrument Crude CPRs and adjusted prevalence ratios aPRs of the association were presented Hazardous drinking was significantly associated with increase to support mental health among those with lower levels of social support Lymph node metastasis occurs in a subset of papillary microcarcinoma patients We aimed to analyze the differences between metastatic and nonmetastatic papillary microcarcinomas in order to identify a highrisk subgroup that is likely to require more aggressive treatment 126 thyroidectomies with lymph node dissections central lateral diagnosed as papillary microcarcinoma were reviewed Mean age of 126 patients FM 33 was 42 years Mean size of the largest tumor was 7 mm Classical was the most frequently 89 encountered subtype Multiple histologic subtypes cooccurred in 19 Lymphovascular invasion was present in 16 n 20 55 44 and 71 56 cases were unifocal and multifocal respectively 90 cases 71 were nonencapsulated with overall infiltrative tumor borders whereas in 36 cases 29 the tumor had a welldefined capsule Among those 23 64 had tumor capsule invasion 47 37 cases had metastasis in lymph nodes selleck kinase inhibitor In univariate analysis metastasis was associated with tumor size of 5 mm p 0