Dropped head syndrome is a rare condition characterized by the inability to maintain an upright head posture. It is commonly associated with neuromuscular disorders and is more frequently observed among the elderly population. While the exact cause of dropped head syndrome can vary, one potential cause is electrolyte imbalance, specifically hypokalemia, which can be induced by chronic alcoholism. Chronic alcohol use disorder could be traced back from psychosocial factors which can be identified by using various family assessment tools.

This is a case of a 40-year-old male who presented with a sudden inability to lift his head after a two-week long alcoholic beverage intake.

The case highlights the importance of the biopsychosocial approach in primary care, which offers holistic management by addressing not only medical problems but also the psychosocial factors that contribute to the patient’s clinical presentation.

Human ; Male ; Adult: 25-44 Yrs Old ; Dropped Head Syndrome ; Alcohol Use Disorder ; Alcoholism

BACKGROUND: This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. METHODS: We conducted a cross-sectional study of 356 young adults (aged 18 to 24 years) living in Palau in 2013. The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. RESULTS: The proportion of current drinking was higher in people aged 21-24 than in those aged 18-20 (73.2% vs. 60.9%, p = 0.09 in men and 48.3% vs. 30.0%, p = 0.02 in women), while that of marijuana use did not differ between the age groups. The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities (current drinking: 70.6% vs. 40.6%, p = 0.005 in men and 38.8% vs. 16.6%, p = 0.04 in women; lifetime marijuana use: 80.0% vs. 52.9%, p = 0.02 in men and 56.1% vs. 30.6%, p = 0.09 in women). The proportion of frequent (3 times or more) marijuana users was higher for the lower educated than for the higher educated (62.5% vs. 32.1%, p < 0.001 in men and 33.9% vs. 24.4%, p = 0.12 in women). CONCLUSIONS Sex, age, ethnicity, and education were significant determinants of alcohol and marijuana use.
Age Factors ; Alcohol Drinking/ethnology* ; Cross-Sectional Studies ; Educational Status ; Female ; Humans ; Male ; Marijuana Use/ethnology* ; Palau/epidemiology* ; Prevalence ; Sex Factors ; Young Adult

Recently, fatal nicotine intoxications with electronic cigarette liquid have increased in Korea, but various kinds of cigarettes and smoking cessation aids may also cause fatal poisoning. We report cases of fatal nicotine intoxications involving causes other than the use of liquid nicotine. A 29-year-old woman (case 1) found dead in a hotel room with about 70 patches (21 mg dose) of nicotine on her body. Blood nicotine levels were 7.68 mg/L (heart) and 3.25 mg/L (femoral). A toxic level of zolpidem was also detected. A 28-year-old Uzbekistan man (case 2) was found dead in his uncle's room with his face covered with chewing tobacco. Blood nicotine levels were 7.3 mg/L (heart) and 4.6 mg/L (femoral). Blood alcohol level was 0.139%. A 55-year-old man (case 3) bit his tongue. As he was taken to the hospital, his wife put tobacco powders in his mouth for hemostasis, and he died of cardiac arrest. Blood nicotine levels were 2.01 mg/L (heart) and 0.96 mg/L (femoral). Nicotine-related deaths can be caused by various types of administration including transdermal and transmucosal routes, and relatively small doses may cause death, so meticulous investigation should be taken when such deaths are suspected.
Adult ; Blood Alcohol Content ; Electronic Cigarettes ; Female ; Heart Arrest ; Hemostasis ; Humans ; Korea ; Middle Aged ; Mouth ; Nicotine ; Poisoning ; Powders ; Smoking Cessation ; Spouses ; Tobacco ; Tobacco Products ; Tobacco Use Cessation Products ; Tobacco, Smokeless ; Tongue ; Uzbekistan

Objective: To study the relationship between blood pressure level and major risk factors for cardiovascular diseases in adults in China. Methods: A total of 179 347 adults aged ≥18 years were recruited from 298 surveillance points in 31 provinces in China in 2013 through complex multistage stratified sampling. The survey included face to face interview and physical examination to collect information about risk factors, such as smoking, drinking, diet pattern, physical activity, overweight or obesity, and the prevalence of hypertension. The blood pressure was classified into 6 levels (ideal blood pressure, normal blood pressure, normal high blood pressure and hypertension phase Ⅰ, Ⅱ and Ⅲ). The relationship between the prevalence or co-prevalence of risk factors for cardiovascular disease and blood pressure was analyzed. Results: The adults with ideal blood pressure, normal blood pressure, normal high pressure, hypertension phase Ⅰ, Ⅱ and Ⅲ accounted for 36.14%, 22.77%, 16.22%, 16.43%, 5.97% and 2.48%, respectively. Among them, the blood pressure was higher in men, people in Han ethnic group and those married, and the blood pressure was higher in those with older age, lower income level and lower education level, the differences were all significant (P<0.05). Whether taking antihypertensive drug or not, co-prevalence of risk factors influenced the blood pressure levels of both sexes (P<0.05), and the blood pressure levels of those taking no antihypertensive drug was influenced more by the co-prevalence of risk factors. Finally, multiple logistic analysis showed that the risks for high blood pressure in adults with 1, 2 and ≥3 risk factors were 1.36, 1.79 and 2.38 times higher, respectively, than that of the adults without risk factor. Conclusion: The more the risk factors for cardiovascular disease in adults, the higher their blood pressure were. It is necessary to conduct comprehensive behavior intervention targeting ≥ 2 risk factors for the better control of blood pressure in general population.
Adolescent ; Adult ; Alcohol Drinking/epidemiology* ; Antihypertensive Agents/therapeutic use* ; Blood Pressure/physiology* ; Cardiovascular Diseases/epidemiology* ; China/epidemiology* ; Diet ; Female ; Humans ; Hypertension/epidemiology* ; Male ; Obesity/epidemiology* ; Overweight ; Prevalence ; Risk Factors ; Smoking/epidemiology* ; Surveys and Questionnaires

Objective: To investigate the correlation of intermittent androgen-deprivation therapy (IADT) and continuous androgen-deprivation therapy (CADT) for advanced prostate cancer (PCa) with the risks of secondary diabetes mellitus (DM) and impaired glucose tolerance (IGT). METHODS: We conducted a retrospective case-control study of the advanced PCa patients treated by IADT or CADT in our hospital from January 2013 to December 2015. Based on the levels fasting blood glucose and 2-hour postprandial blood glucose, results of oral glucose tolerance test, and clinical symptoms of the patients, we statistically analyzed the IADT- or CADT-related risk factors for DM and IGT and the relationship of the body mass index (BMI), hypertension, smoking, and alcohol consumption with secondary DM and IGT. RESULTS: IADT was given to 53 (46.5%) of the patients, aged (69.1 ± 4.3) years, and CADT to 61 (53.5%), aged (70.2 ± 5.7) years. No statistically significant differences were observed in clinical characteristics between the two groups of patients (P > 0.05). BMI, blood pressure, smoking and drinking exhibited no significant influence on the development of DM or IGT either in the IADT (P > 0.05) or the CADT group. The incidence of IGT was significantly lower in the IADT than in the CADT group (P = 0.03), but that of DM showed no statistically significant difference between the two groups (P = 0.64). CONCLUSIONS Compared with CADT, IADT has a lower risk of IGT and a higher safety in the treatment of advanced prostate cancer.
Aged ; Alcohol Drinking ; adverse effects ; Androgen Antagonists ; adverse effects ; therapeutic use ; Blood Glucose ; metabolism ; Body Mass Index ; Case-Control Studies ; Diabetes Mellitus ; chemically induced ; Glucose Intolerance ; chemically induced ; Glucose Tolerance Test ; Humans ; Hypertension ; complications ; Male ; Prostatic Neoplasms ; drug therapy ; pathology ; Retrospective Studies ; Risk Factors ; Smoking ; adverse effects

Our study aimed to establish the relationship between the number of depressive symptoms and the clinical characteristics of major depressive disorder (MDD). This would enable us to predict the clinical significance of the number of depressive symptoms in MDD patients. Using data from the Clinical Research Center for Depression (CRESCEND) study in Korea, 853 patients with DSM-IV MDD were recruited. The baseline and clinical characteristics of groups with different numbers of depressive symptoms were compared using the χ2 test for discrete variables and covariance (ANCOVA) for continuous variables. In addition, the scores of these groups on the measurement tools were compared by ANCOVA after adjusting the potential effects of confounding variables. After adjusting the effects of monthly income and history of depression, a larger number of depressive symptoms indicated higher overall severity of depression (F [4, 756] = 21.458, P < 0.001) and higher levels of depressive symptoms (F [4, 767] = 19.145, P < 0.001), anxiety symptoms (F [4, 765] = 12.890, P < 0.001) and suicidal ideation (F [4, 653] = 6.970, P < 0.001). It also indicated lower levels of social function (F [4, 760] = 13.343, P < 0.001), and quality of life (F [4, 656] = 11.975, P < 0.001). However, there were no significant differences in alcohol consumption (F [4, 656] = 11.975, P < 0.001). The number of depressive symptoms can be used as an index of greater illness burden in clinical psychiatry.
Adult ; Alcohol Drinking ; Analysis of Variance ; Antidepressive Agents/therapeutic use ; Anxiety ; *Depression ; Depressive Disorder, Major/drug therapy/*pathology/psychology ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Severity of Illness Index ; Sex Factors ; Suicidal Ideation

OBJECTIVES: This study investigated the relationship between depression, attachment and addiction problems in runaway youths. METHODS: We sent a questionnaire package to 187 runaway youths in 18 adolescent shelters. The questionnaire package collected their sociodemographic data and included the Patient Health Questionnaire-9, Inventory of Parent Attachment (IPA), Korean Internet Addiction Self-Scale (K-Scale), Korean version of Alcohol Use Disorders Identification Test, and Korean version of the Fagerström Test for Nicotine Dependence. RESULTS: The percentage of youth with depression was 28.8% (N=54). In the depression group, there were significantly more problematic alcohol users (53.06%, p=.0199) and significantly lower IPA scores (p=.0064). There was a significant negative correlation between depression and a IPA, and significant positive correlation between depression and the K-Scale. CONCLUSION: These results suggest that runaway youths with depression have more problematic alcohol drinking and attachment problems.
Adolescent* ; Alcohol Drinking ; Child ; Depression* ; Homeless Youth* ; Humans ; Internet ; Parents ; Tobacco Use Disorder

BACKGROUND: The purpose of this study is to examine the effect of the spiritual well-being on social nicotine dependence, alcohol consumption, use of internet and gambling among medical students (n=271). METHODS: A cross-sectional survey was conducted on 271 medical students using self-administered questionnaires including the spiritual well-being scale, KTSND score, the alcohol use disorder identification test, the internet addiction test, and the Canadian problem gambling index (Korean Version). RESULTS: There were significant negative relationships between spiritual well being and addictive behaviors such as social nicotine dependence (r=-0.160, P<0.05), alcohol consumption (r=-0.357, P<0.001), internet overuse (r=-0.156, P<0.01). High social nicotine dependence was related with high alcohol consumption (r=0.317, P<0.01), as well as internet overuse with gambling (r=0.165, P<0.01). Spiritual well being on was significantly related to alcohol consumption (beta=-0.244, P<0.01) and use of internet (beta=-0.136, P<0.01). This suggests the higher spiritual well being score the student has, the lower possibility of alcohol or internet overuse he or she tends to have. On the other hand, the impact of spiritual well being on social nicotine dependence or gambling were not significant. CONCLUSIONS: The milestone of the current study is to provide the importance of better understanding of spiritual background of an individual, and to address the necessity of its holistic approach. Moreover, new spiritual counseling model and its healing program should be developed and validated before application.
Alcohol Drinking* ; Behavior, Addictive ; Counseling ; Cross-Sectional Studies ; Gambling* ; Hand ; Humans ; Internet* ; Nicotine* ; Students, Medical* ; Tobacco Use Disorder*

BACKGROUND: Alcohol is traditionally known to have a relaxing effect. However, persons who consume alcohol in excessive amounts suffer from poor sleep quality and patients with alcohol use disorders commonly report insomnia. In this study, we aimed to evaluate the effects of alcohol use on sleep quality. METHODS: A questionnaire-based cross-sectional survey was conducted with 234 men and 159 women who had visited a general hospital. We used structured questionnaires, including Alcohol Use Disorder Identification Test-Korean revised version (AUDIT-KR) and the Pittsburgh Sleep Quality Index-Korean version (PSQI-K). We analyzed the association between scores for all subcategories of the PSQI-K and the AUDIT-KR and then analyzed the correlation between AUDIT-KR and global PSQI-K scores. RESULTS: The global PSQI-K score for men was positively correlated with the AUDIT-KR score (P=0.008) after adjusting for age, chronic disease, tobacco use, exercise, depression, and anxiety. The AUDIT-KR score was significantly associated with subjective sleep quality (P=0.005), sleep duration (P=0.047), and sleep disturbance (P=0.048); it was not associated with sleep latency, sleep efficiency, or daytime dysfunction. Sleep disturbances due to snoring were significantly associated with total AUDIT-KR score (P=0.008). There was no correlation between the global PSQI-K and AUDIT-KR scores for women (P=0.333). However, daytime dysfunction showed a significant association with total AUDIT-KR score (P=0.048). CONCLUSION: Men with higher AUDIT-KR scores tended to suffer from poor sleep quality. AUDIT-KR scores showed significant correlations with subjective sleep quality, sleep duration, and sleep disturbances in men.
Alcohol Drinking ; Anxiety ; Chronic Disease ; Cross-Sectional Studies ; Depression ; Female ; Hospitals, General ; Humans ; Male ; Sleep Wake Disorders ; Sleep Initiation and Maintenance Disorders ; Snoring ; Tobacco Use

INTRODUCTIONThis study assessed occupational differences in the prevalence of mental and physical disorders in an employed general population sample in Singapore and investigated the impact of these disorders on work productivity losses in terms of work-loss days and work-cutback days. The association of occupation with alcohol use disorders (AUD) and nicotine dependence (ND) was also investigated.

MATERIALS AND METHODSData from a population-based mental health survey of a representative sample of multi-ethnic residents aged 18 years and above were used. The World Health Organization's (WHO) Composite International Diagnostic Interview (CIDI) was administered to establish the lifetime diagnosis of key mental disorders. Self-report on sociodemographic characteristics, productivity loss, ND, and lifetime physical conditions were obtained. Nine occupational groups were included in this analysis.

RESULTSThe sample comprised 4361 participants with a mean (SD) age of 42.2 (11.9) years, ranging between 19 to 80 years. 'Associate professionals and technicians' (26.2%), 'Services and sales workers' (17.7%) and 'Professionals' (15.4%) were the 3 predominant occupational categories. Sociodemographic characteristics differed significantly across occupations (P <0.001). The lifetime prevalences of having 'any mental disorder' and 'any physical disorder' were 13.0% and 37.9%, respectively; major depressive disorder was the most prevalent mental disorder (5.9%) and hypertension was the most common physical disorder (15.6%). There were no significant differences in work productivity loss across occupations. Sociodemographic and occupational correlates for AUD and ND were identified.

CONCLUSIONSociodemographic and health disparities exist in the major occupational categories in Singapore. The strength of the associations between occupation and AUD and ND are significant, indicating the need for preventative measures in select occupations.

Adolescent ; Adult ; Aged ; Alcohol-Related Disorders ; epidemiology ; Chronic Disease ; epidemiology ; Depressive Disorder, Major ; epidemiology ; Female ; Health Surveys ; Humans ; Male ; Middle Aged ; Occupations ; Prevalence ; Singapore ; epidemiology ; Tobacco Use Disorder ; epidemiology ; Young Adult