Rising hospital admissions for alcohol-related cirrhosis and the impact of sex and comorbidity - a data linkage study.

OBJECTIVES: International studies have shown shifting demographic data and rising hospitalizations for alcohol-related cirrhosis (ARC), with a paucity of data from Australia. We examined hospitalizations, mortality and demographic data for people admitted with ARC over the last decade in Queensland, Australia. STUDY DESIGN: Data linkage study. METHODS: A retrospective analysis of adults hospitalized with ARC during 2008-2019 was performed using state-wide admissions data. International Classification of Diseases, 10th revision, codes identified admissions with the principal diagnosis of ARC based on validated algorithms. Comorbidity was assessed using the Charlson Comorbidity Index. RESULTS: A total of 7152 individuals had 24,342 hospital admissions with ARC (16,388 were for ARC). There was a predominance of males (72.6%) and age ≥50 years (80.4%) at index admission. Females were admitted at a significantly younger age than men (59% of women and 43% of men were aged <60 years, P < 0.001). Comorbidities were common, with 45.1% of people having at least one comorbidity. More than half (54.6%) of the patients died over the study period (median follow-up time was 5.1 years; interquartile range 2.4-8.6). Women had significantly lower mortality, with 47.6% (95% confidence interval [CI] 45.0-50.2) probability of 5-year survival, compared with 40.1% (95% CI 38.5-41.6) in men. In multivariable analysis, this was attributable to significantly lower age and comorbidity burden in women. Significantly lower survival was seen in people with higher comorbidity burden. Overall, the number of admissions for ARC increased 2.2-fold from 869 admissions in 2008 to 1932 in 2019. CONCLUSIONS: Hospital admissions for ARC have risen substantially in the last decade. Females were admitted at a younger age, with fewer comorbidities and had lower mortality compared with males. The association between greater comorbidity burden and higher mortality has important clinical implications, as comorbidity-directed interventions may reduce mortality.

Climatology of atmospheric circulation patterns of Arabian dust in western Iran.

Being in vicinity of vast deserts, the west and southwest of Iran are characterized by high levels of dust events, which have adverse consequences on human health, ecosystems, and environment. Using ground based dataset of dust events in western Iran and NCEP/NCAR reanalysis data, the atmospheric circulation patterns of dust events in the Arabian region and west of Iran are identified. The atmospheric circulation patterns which lead to dust events in the Arabian region and western Iran were classified into two main categories: the Shamal dust events that occurs in warm period of year and the frontal dust events as cold period pattern. In frontal dust events, the western trough or blocking pattern at mid-level leads to frontogenesis, instability, and air uplift at lower levels of troposphere in the southwest of Asia. Non-frontal is other pattern of dust event in the cold period and dust generation are due to the regional circulation systems at the lower level of troposphere. In Shamal wind pattern, the Saudi Arabian anticyclone, Turkmenistan anticyclone, and Zagros thermal low play the key roles in formation of this pattern. Summer and transitional patterns are two sub-categories of summer Shamal wind pattern. In summer trough pattern, the mid-tropospheric trough leads to intensify the surface thermal systems in the Middle East and causes instability and rising of wind speed in the region. In synthetic pattern of Shamal wind and summer trough, dust is created by the impact of a trough in mid-levels of troposphere as well as existing the mentioned regional systems which are contributed in formation of summer Shamal wind pattern.

Long-bone fractures in persons with spinal cord injury.

STUDY DESIGN: Retrospective data analysis. OBJECTIVES: To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI). SETTING: Rehabilitation centre for SCI individuals. METHOD: Patients' records were reviewed. Patients with traumatic SCI and extremity fractures that had occurred after SCI were included. Patient characteristics, fractured bone, fracture localisation, severity and management (operative/conservative), and fracture-related complications were extracted. RESULTS: A total of 156 long-bone fractures in 107 SCI patients (34 women and 73 men) were identified. The majority of patients were paraplegics (77.6%) and classified as American Spinal Injury Association Impairment Scale A (86.0%). Only the lower extremities were affected, whereby the femur (60.9% of all fractures) was fractured more frequently than the lower leg (39.1%). A total of 70 patients (65.4%) had one fracture, whereas 37 patients (34.6%) had two or more fractures. Simple or extraarticular fractures were most common (75.0%). Overall, 130 (83.3%) fractures were managed operatively. Approximately half of the femur fractures (48.2%) were treated with locking compression plates. In the lower leg, fractures were mainly managed with external fixation (48.8%). Conservative fracture management was applied in 16.7% of the cases and consisted of braces or a well-padded soft cast. Fracture-associated complications were present in 13.5% of the cases but did not differ significantly between operative (13.1%) and conservative (15.4%) fracture management. CONCLUSION: SCI was associated with simple or extraarticular fractures of the distal femur and the lower leg. Fractures were mainly managed operatively with a low complication rate.

Factors associated with timely initiation of breastfeeding in Al-Hassa province, Saudi Arabia.

The World Health Organization recommends early initiation of breastfeeding (within 1 hour of giving birth). This study assessed the prevalence of timely initiation of breastfeeding by mothers of neonates in Al-Hassa province, Saudi Arabia. Mothers attending for birth registration at primary health care centres were interviewed and various sociodemographic, obstetric and health service related variables as well as breast problems were assessed for any influence on timely breastfeeding rates. While 91.9% of the 906 neonates studied were breastfed (8.1% were never breastfed), only 11.4% were given timely breastfeeding (within 1 hour after birth). Logistic regression revealed that the independent predictors of timely breastfeeding were: not giving prelacteal feed (OR 13.7), rural/hegar residence (OR 4.2), absence of breast problems (OR 3.4), parity 2 or 3 (OR 2.9) and parity 4+ (OR 2.4). Mothers at risk of delayed breastfeeding initiation should be the target of breastfeeding promotion during prenatal care.

Factors associated with timely initiation of breastfeeding in AI-Hassa province, Saudi Arabia

The World Health Organization recommends early initiation of breastfeeding [within 1 hour of giving birth]. This study assessed the prevalence of timely initiation of breastfeeding by mothers of neonates in AI-Hassa province, Saudi Arabia. Mothers attendingfor birth registration at primary health care centres were interviewed and various sociodemographic, obstetric and health service related variables as well as breast problems were assessed for any influence on timely breastfeeding rates. While 91.9% of the 906 neonates studied were breastfed [8.1% were never breastfed], only 11.4% were given timely breastfeeding [within 1 hour after birth]. Logistic regression revealed that the independent predictors of timely breastfeeding were: not giving prelacteal feed [OR 13.7], rura\\\\/hegar residence [OR 4.2], absence of breast problems [OR3.4], parity 2 or 3 [OR2.9] and parity 4+ [OR 2.4]. Mothers at risk of delayed breastfeeding initiation should be the target of breastfeeding promotion during prenatal care