Alcoholic Hepatitis

We are seeing an increased volume of alcoholic liver disease due to the COVID pandemic. Previously admissions to ICU for alcoholic hepatitis were rare, but these are now occurring with regularity.

IBCC – Alcoholic hepatitis — https://emcrit.org/pulmcrit/alcoholic-hepatitis/

Duh.

Updated benzodiazepine boxed warning: What you need to know

“I took the medication only as prescribed,” Bobbi said. After her benzodiazepine was stopped abruptly, she suffered multiple disabling neurological symptoms, including seizures, cognitive and visual impairment, difficulty walking, and hand contractures, leaving her unable to work. Bobbi is one of many patients my advocacy organization helped report their harm to the FDA. Our goal was to raise awareness of the adverse effects of benzodiazepines and advocate for stronger warning labels.

Thus, I was pleasantly surprised last September to see the FDA’s drug safety communication announcing an update to the boxed warning for benzodiazepines “to address the serious risks of abuse, addiction, physical dependence, and withdrawal reactions.” Curious, I filed a FOIA request for the FDA’s 175-page report on benzodiazepines. Many of the document’s conclusions raise the same concerns benzodiazepine safety advocates have had for decades.

updated benzodiazepine boxed warning: What you need to know — https://www.kevinmd.com/blog/2021/03/the-updated-benzodiazepine-boxed-warning-what-you-need-to-know.html

I downloaded the FDA report for future reference.

The report should be fun weekend reading.

Midlife Crisis? Just Another U Shaped Curve

Subsequent research discovered that this age-related U-shape in job satisfaction is part of a much broader phenomenon. A similar midlife nadir is detectable in measures of people’s overall life satisfaction and has been found in more than 50 countries. On average, life satisfaction is high when people are young, then starts to decline in the early 30s, bottoming out between the mid-40s and mid-50s before increasing again to levels as high as during young adulthood. And this U-curve occurs across the entire socio-economic spectrum, hitting senior-level executives as well as blue-collar workers and stay-at-home parents. It affects childless couples as well as single people or parents of four. In short, a mid-career crisis does not discriminate.

Why So Many of Us Experience a Midlife Crisis Harvard Business Review Hannes Schwandt — https://getpocket.com/explore/item/why-so-many-of-us-experience-a-midlife-crisis?utm_source=pocket-newtab

This post originally appeared on Harvard Business Review and was published April 20, 2015. A link popped up on my browser webpage.

U shaped curves are everywhere.

The Boy Who Drew Cats — BREVITY’s Nonfiction Blog

By Jesse Lee Kercheval Outside there is a pandemic and I am in lockdown in Montevideo, Uruguay, far from my daughter and son also locked down, but in Kanazawa, in Ishikawa Prefecture, Japan, and I am inside drawing, drawing, drawing, filling sheets of paper, pages drifting to the floor, as if I were the boy […]

The Boy Who Drew Cats — BREVITY’s Nonfiction Blog

The Pandemic Life through the eyes and words of a writer.

Why PTSD May Plague Many Hospitalized Covid-19 Survivors — Smithsonian Magazine

Scientists warn about the likelihood of post-traumatic stress disorder for patients discharged from the intensive care unit.

Covid-19 isn’t the first epidemic to cause a domino effect of persisting psychiatric health problems across a population. The current pandemic has been compared to the severe adult respiratory syndrome (SARS) outbreak in 2003 and the Middle East respiratory syndrome (MERS) outbreak in 2014 in Saudi Arabia—both diseases caused by coronaviruses. In an analysis of international studies from the SARS and MERS outbreaks, researchers found that among recovered patients, the prevalence of PTSD was 32.2 percent, depression was 14.9 percent and anxiety disorders was 14.8 percent.

Why PTSD May Plague Many Hospitalized Covid-19 Survivors — Science | Smithsonian Magazine

The entire article is worth reading. And from The BMJ probable PTSD in hospital workers too.

Nearly half of intensive care unit (ICU) and anaesthetic staff surveyed for a study reported symptoms consistent with a probable diagnosis of post-traumatic stress disorder (PTSD), severe depression, anxiety, or problem drinking.1

The preprint, produced by researchers at King’s College London, aimed to get a picture of the rates of probable mental health disorders in ICU and anaesthetic staff in six English hospitals during June and July 2020.

BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n108 (Published 13 January 2021) BMJ 2021;372:n108

Every Day is an Emergency – Psychiatric Bed Shortages Nationwide

The pandemic and the parallel economic crisis have fueled new concern about access to mental health care. An estimated 40% of American adults are have a condition involving mental illness or substance abuse. In June, federal health officials reported nearly 11% percent of adults surveyed seriously considered suicide during the past 30 days.

‘Every day is an emergency’: The pandemic is worsening psychiatric bed shortages nationwide — https://www.statnews.com/2020/12/23/mental-health-covid19-psychiatric-beds/?utm_campaign=rss

We are just ten months into the Great Pandemic and I fear conditions will get worse before they get better.

Diet modifications (including more wine and cheese) May Help Reduce Cognitive Decline

Participants also answered questions about their food and alcohol consumption at baseline and through two follow-up assessments. The Food Frequency Questionnaire asked participants about their intake of fresh fruit, dried fruit, raw vegetables and salad, cooked vegetables, oily fish, lean fish, processed meat, poultry, beef, lamb, pork, cheese, bread, cereal, tea and coffee, beer and cider, red wine, white wine and Champaign and liquor.

Here are four of the most significant findings from the study:

Cheese, by far, was shown to be the most protective food against age-related cognitive problems, even late into life;

The daily consumption of alcohol, particularly red wine, was related to improvements in cognitive function;

Weekly consumption of lamb, but not other red meats, was shown to improve long-term cognitive prowess; and

Excessive consumption of salt is bad, but only individuals already at risk for Alzheimer’s Disease may need to watch their intake to avoid cognitive problems over time.

Iowa State University. “Diet modifications — including more wine and cheese — may help reduce cognitive decline, study suggests.” ScienceDaily. http://www.sciencedaily.com/releases/2020/12/201210145850.htm (accessed December 13, 2020).

Journal Reference

  1. Brandon S. Klinedinst, Scott T. Le, Brittany Larsen, Colleen Pappas, Nathan J. Hoth, Amy Pollpeter, Qian Wang, Yueying Wang, Shan Yu, Li Wang, Karin Allenspach, Jonathan P. Mochel, David A. Bennett, Auriel A. Willette. Genetic Factors of Alzheimer’s Disease Modulate How Diet is Associated with Long-Term Cognitive Trajectories: A UK Biobank Study. Journal of Alzheimer’s Disease, 2020; 78 (3): 1245 DOI: 10.3233/JAD-201058

Finally some good news.

I Thought I Told You To Put That Phone Down!

Compared with participants who used less than 120 minutes per day of social media, for example, young adults who used more than 300 minutes per day were 2.8 times as likely to become depressed within six months.The study, which will be published online Dec. 10 and is scheduled for the February 2021 issue of the American Journal of Preventive Medicine, is the first large, national study to show a link between social media use and depression over time.

University of Arkansas. “Increased social media use linked to developing depression.” ScienceDaily. http://www.sciencedaily.com/releases/2020/12/201210074722.htm (accessed December 13, 2020).

Journal Reference

  1. Brian A. Primack, Ariel Shensa, Jaime E. Sidani, César G. Escobar-Viera, Michael J. Fine. Temporal Associations Between Social Media Use and Depression. American Journal of Preventive Medicine, 2020; DOI: 10.1016/j.amepre.2020.09.014

A few more posts for your reading pleasure.

Consistently Inconsistent With the Virus (as with life)

I’d thought long and hard about what I wanted to do when Will — and, soon after, his brother, Theo — returned home. The by-the-book Dr. Anthony Fauci approach would have been to have the boys keep on their masks, send them upstairs for a couple of weeks, and open all the windows in the house in the meantime.

But as the pandemic has taught us, there are things we value more than perfect protection from the virus. When it comes to them, we’re willing to puncture our bubbles, because without them, living feels like something less than being fully alive…

I admit that, at least to an outsider, my behavior seems inconsistent. But to me, it makes perfect sense. The risks I’m choosing to take are the ones where the payoff is biggest relative to the risk I perceive. (Yes, even the haircut! I love a good high-and-tight, and my barber is applying the clippers in his open-air home workshop.)

Before you argue with me, I get it. These aren’t the choices you would make. And that’s my point.We all have things we value. And risks we are willing to take for them. Neither of these two categories will be exactly the same for any one of us.

When it comes to the virus, we are all consistently inconsistent
Adam Cohen Published: Sun, December 13, 2020 1:07 AM Updated: Sun, December 13, 2020 1:36 AM — https://oklahoman.com/article/5678132/cohen-when-it-comes-to-the-virus-we-are-all-consistently-inconsistent

Exposed to grandchildren? Why take the chance?

reader comment

A reader’s comment above stopped me in my tracks. The past nine months have been spent mostly in the house with minimal forays out of the house for essentials like food and beer. I didn’t get a real haircut for months. The insides of a restaurant are now foreign to me. I cancelled my gym membership. So the comment made me think, why did I take the chance to spend time with Tiny Human Petri Dishes? When I stumbled upon the Cohen article I realized I was not alone. Nine months have disappeared and we all struggle with our own individual risk/reward scenarios.

The Grandchildren Bubble is unique. Risk was reduced to zero for six months. After six months all of the adults decided the Covid risk was minimal for several reasons. Two of the four adults (the most cautious and conservative ones) caught the virus. Thankfully both were fairly mild cases on the spectrum of asymptomatic to death and both have fully recovered. So two people have antibodies. The third adult is a front line HCW who deals with Covid each and every time he goes to work. The doctor has gotten tested multiple times all with negative results. One Tiny Human attends preschool and if a child has anything near a small sniffle they have to stay home and cannot rejoin the class until they have a negative Covid test. She recently received a negative test. Tiny Human Too just started crawling and doesn’t get out the house much. Not much to worry about here.

And for readers who have been counting that leaves yours truly. I lived with one of the infected before we knew she was infected. I tested negative the day before she got her test results. One of our neighbors asked if I left the house to live in a hotel. No I didn’t. Living apart while under the same roof was an interesting experience that I hope never to repeat. And despite having Covid in the house I didn’t catch it.

So I spent some time in my only trusted bubble mask less and I end up catching one or two non-Covid-19 coronaviruses. Next time I’m wearing a mask.

Personality Traits Linked to Toilet Paper Stockpiling

The most robust predictor of toilet paper stockpiling was the perceived threat posed by the pandemic; people who felt more threatened tended to stockpile more toilet paper. Around 20 percent of this effect was also based on the personality factor of emotionality — people who generally tend to worry a lot and feel anxious are most likely to feel threatened and stockpile toilet paper. The personality domain of conscientiousness — which includes traits of organization, diligence, perfectionism and prudence — was also a predictor of stockpiling.

Max Planck Institute for Evolutionary Anthropology. “Personality traits linked to toilet paper stockpiling: High levels of emotionality and conscientiousness are indicators for stockpiling behavior.” ScienceDaily. http://www.sciencedaily.com/releases/2020/06/200612172227.htm (accessed November 25, 2020).

In case you haven’t noticed it’s happening again. Where’s the toilet paper?