Mortality post inpatient alcohol detoxification: a descriptive case series

<br>Background: Individuals with alcohol dependence often die prematurely. Scotland in particular has high rates of alcohol misuse compared to the rest of the UK and Europe. Although there is some evidence that rates of alcoholrelated harm and alcohol-related deaths are reducing in Europe, there is little evidence of this trend occurring in Scotland. Inpatient detoxification is an important, but expensive, option in the management of alcohol dependence. Little work has been done with regard possible clinical characteristics associated with mortality post discharge in this cohort of patients.</br> <br>Methods: Retrospective electronic records were used to identify patients admitted electively for alcohol detoxification into a psychiatric ward in a district general hospital under the care of a single consultant addiction psychiatrist between 1/1/05 and 31/12/07 inclusively. Demographic and clinical factors were recorded. 5-year mortality data was obtained by linkage to the National Records of Scotland.</br> <br>Results: 25.2% of patients admitted for elective alcohol detoxification died during the 5-year follow up period. 42.9% of deaths (n=12) were due to alcoholic liver disease, one death (3.6%) was of undetermined intent. A higher proportion of the deceased cohort was likely to have continued disulfiram (93% vs. 80%) and acamprosate (81% vs. 60%) than those surviving. There was no statistically significant difference in survival between individuals on medication and those not on medications in our cohort. The average consumption of units of alcohol per week in the deceased cohort was significantly higher than that calculated for the surviving cohort (298.8 units vs. 233.3 units p=0.0137).</br> <br>Conclusion: Inpatient detoxification was associated with significant mortality at 5-year follow up post- discharge. The majority of deaths were due to liver disease while deaths due to accidents and of undetermined intent were relatively infrequent. Increased education and practical strategies such as “space and pace” aimed both at an individual and societal level to reduce alcohol consumption may help to reduce mortality associated with alcohol dependence post inpatient detoxification.</br&gt

Screening for health risks: A social science perspective

Health screening promises to reduce risks to individuals via probabilistic sifting of populations for medical conditions. The categorisation and selection of 'conditions' such as cardiovascular events, dementia and depression for screening itself requires prior interpretive labour which usually remains unexamined. Screening systems can take diverse organisational forms and varying relationships to health status, as when purported disease precursors, for example 'pre-cancerous' polyps, or supposed risk factors, such as high cholesterol themselves, become targets for screening. Screening at best yields small, although not necessarily unworthwhile, net population health gains. It also creates new risks, leaving some individuals worse-off than if they had been left alone. The difficulties associated with attempting to measure small net gains through randomised controlled trials are sometimes underestimated. Despite endemic doubts about its clinical utility, bibliometric analysis of published papers shows that responses to health risks are coming to be increasingly thought about in terms of screening. This shift is superimposed on a strengthening tendency to view health through the lens of risk. It merits further scrutiny as a societal phenomenon

Commercially Available Capsaicin Supplement Fails to Enhance Time-to-Exhaustion During Cycling

International Journal of Exercise Science 13(2): 225-233, 2020. This study examined whether a commercially available low-dose (1.2 mg), chewable capsaicin supplement could enhance endurance cycling performance. Thirteen young (8M/5F), recreationally active individuals (age = 24.2 ± 2.9 yrs, body fat = 21.2 ± 6.1%) participated in the study. The study consisted of three visits, beginning with an initial evaluation of cardiorespiratory fitness (37.1 ± 5.5 ml/kg/min). During the second and third study visits, participants completed time-to-exhaustion (TTE) tests on a cycle ergometer at a workload eliciting ~90% VO2max, 45 minutes after ingesting either a 139 kcal capsaicin fruit gummy, or eucaloric placebo. Heart rate and rating of perceived exertion (RPE) were recorded every two minutes throughout the TTE sessions. Time-to-exhaustion was not significantly different (p\u3e 0.05; d= 0.13) between placebo (487.8 ± 187.7 sec) and capsaicin (517.5 ± 258.4 sec) trials. Furthermore, heart rate responses and ratings of perceived exertion were similar (p\u3e 0.05) between trials. These findings suggest that pre-exercise ingestion of a commercially available low-dose (1.2 mg), chewable capsaicin supplement fails to provide ergogenic benefits for time-to-exhaustion during cycling exercise. Higher doses may be necessary to elicit the performance-enhancing benefits observed during alternative exercise modalities (i.e., running) of comparable intensity

Mustapha and the host: Some reflections on inferences in religious language

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45785/1/11153_2004_Article_BF00143432.pd

Effect of a Commercially Available Low-Dose Capsaicin Supplement on Knee Extensor Contractile Function

International Journal of Exercise Science 13(2): 312-318, 2020. Capsaicin, the active pungent ingredient in chili peppers and various spicy foods, is demonstrated to influence a variety of physiological systems including skeletal muscle. The purpose of this study was to examine if a chewable capsaicin supplement (1.2 mg) could enhance isokinetic knee extensor contractile performance. Nine young, recreationally active individuals (5 females/4 males; 23.6 ± 1.5 yrs; 24.2 ± 3.3 kg/m2) participated in this randomized, single-blind crossover study. Following a familiarization session, participants completed two isokinetic knee extensor contractile function assessments, 45 minutes after ingesting either a capsaicin fruit gummy or eucaloric placebo, the order of which was randomized. Knee extensor peak torque (strength), summed torque (endurance) and fatigue index (fatigue) were compared between trials. Knee extensor peak torque was significantly greater (p \u3c 0.05; d= 0.80) in the capsaicin (126.0 ± 40.4 N⋅m-1) than the placebo (118.8 ± 41.3 N⋅m-1) trial. No significant differences (p \u3e 0.05) were found for summed torque (8012 ± 2771 vs. 7823 ± 2611 N⋅m-1; d= 0.45) or fatigue index (56.0 ± 17.1 vs. 48.7 ± 21.0 %; d= 0.46) between capsaicin and placebo trials, respectively. These findings, in a relatively modest and mixed-gender sample, suggest that pre-exercise capsaicin ingestion may benefit knee extensor muscle strength but does not appear to affect parameters of skeletal muscle endurance or fatigue