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Wall H, Hansson H, Zetterlind U, Kvillemo P, Elgán TH. Effectiveness of a Web-Based Individual Coping and Alcohol Intervention Program for Children of Parents With Alcohol Use Problems: Randomized Controlled Trial. J Med Internet Res 2024; 26:e52118. [PMID: 38598286 PMCID: PMC11043930 DOI: 10.2196/52118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 02/08/2024] [Accepted: 02/27/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Children whose parents have alcohol use problems are at an increased risk of several negative consequences, such as poor school performance, an earlier onset of substance use, and poor mental health. Many would benefit from support programs, but the figures reveal that only a small proportion is reached by existing support. Digital interventions can provide readily accessible support and potentially reach a large number of children. Research on digital interventions aimed at this target group is scarce. We have developed a novel digital therapist-assisted self-management intervention targeting adolescents whose parents had alcohol use problems. This program aims to strengthen coping behaviors, improve mental health, and decrease alcohol consumption in adolescents. OBJECTIVE This study aims to examine the effectiveness of a novel web-based therapist-assisted self-management intervention for adolescents whose parents have alcohol use problems. METHODS Participants were recruited on the internet from social media and websites containing health-related information about adolescents. Possible participants were screened using the short version of the Children of Alcoholics Screening Test-6. Eligible participants were randomly allocated to either the intervention group (n=101) or the waitlist control group (n=103), and they were unblinded to the condition. The assessments, all self-assessed, consisted of a baseline and 2 follow-ups after 2 and 6 months. The primary outcome was the Coping With Parents Abuse Questionnaire (CPAQ), and secondary outcomes were the Center for Epidemiological Studies Depression Scale, Alcohol Use Disorders Identification Test (AUDIT-C), and Ladder of Life (LoL). RESULTS For the primary outcome, CPAQ, a small but inconclusive treatment effect was observed (Cohen d=-0.05 at both follow-up time points). The intervention group scored 38% and 46% lower than the control group on the continuous part of the AUDIT-C at the 2- and 6-month follow-up, respectively. All other between-group comparisons were inconclusive at either follow-up time point. Adherence was low, as only 24% (24/101) of the participants in the intervention group completed the intervention. CONCLUSIONS The findings were inconclusive for the primary outcome but demonstrate that a digital therapist-assisted self-management intervention may contribute to a reduction in alcohol consumption. These results highlight the potential for digital interventions to reach a vulnerable, hard-to-reach group of adolescents but underscore the need to develop more engaging support interventions to increase adherence. TRIAL REGISTRATION ISRCTN Registry ISRCTN41545712; https://www.isrctn.com/ISRCTN41545712?q=ISRCTN41545712. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/1471-2458-12-35.
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Affiliation(s)
- Håkan Wall
- Stockholm Prevents Alcohol and Drug Problems, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Helena Hansson
- School of Social Work, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Ulla Zetterlind
- Clinical Health Promotion Centre, Department of Health Sciences, Lund University, Lund, Sweden
| | - Pia Kvillemo
- Stockholm Prevents Alcohol and Drug Problems, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
| | - Tobias H Elgán
- Stockholm Prevents Alcohol and Drug Problems, Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Stockholm, Sweden
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Hoang YTT, Nguyen YT, Vu LT, Bui HTT, Nguyen QV, Vu NP, Nguyen TD, Nguyen HH. Association of ADH1B rs1229984, ADH1C rs698, and ALDH2 rs671 with Alcohol abuse and Alcoholic Cirrhosis in People Living in Northeast Vietnam. Asian Pac J Cancer Prev 2023; 24:2073-2082. [PMID: 37378938 PMCID: PMC10505894 DOI: 10.31557/apjcp.2023.24.6.2073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/22/2023] [Indexed: 06/29/2023] Open
Abstract
OBJECTIVE Alcohol abuse can cause developing cirrhosis, even liver cancer. Several single nucleotide polymorphisms (SNPs) of ADH1B, ADH1C, and ALDH2 genes have been reported to be associated with alcohol abuse and alcoholic cirrhosis (ALC). This study investigated the association between three SNPs of ADH1B rs1229984, ADH1C rs698, and ALDH2 rs671 with alcohol abuse and ALC in people living in the Northeast region of Vietnam. METHODS 306 male participants were recruited including 206 alcoholics (106 ALC, 100 without ALC) and 100 healthy non-alcoholics. Clinical characteristics were collected by clinicians. Genotypes were identified by Sanger sequencing. Chi-Square (χ2) and Fisher-exact tests were used to assess the differences in age and clinical characteristics, Child-Pugh score, frequencies of alleles and genotypes. RESULT Our data showed that the frequency of ALDH2*1 was significantly higher in alcoholics (88.59%) and ALC groups (93.40%) than that of healthy non-alcoholics (78.50%) with p=0.0009 and non-ALC group (83.50%) with p=0.002, respectively. We detected opposite results when examined ALDH2*2. Frequency of combined genotypes with high acetaldehyde accumulation were significantly lower in alcoholics and ALC group than those of control groups with p=0.005 and p=0.008, respectively. Meanwhile, the proportion of combined genotypes with non-acetaldehyde accumulation were significantly two times higher in the ALC group (19.98%) than those of the non-ALC group (8%) with p=0.035. These combined genotypes showed a decreasing trend in the Child-Pugh score from likely phenotype causing risk for non-acetaldehyde accumulation to high acetaldehyde accumulation. CONCLUSION The ALDH2*1 allele was found as a risk factor for alcohol abuse and ALC, and combined genotypes of ADH1B rs1229984, ADH1C rs698, and ALDH2 rs671 with non-acetaldehyde accumulation increase ALC risk. In contrast, ALDH2*2 and the genotype combinations related to high acetaldehyde accumulation were protective factors against alcohol abuse and ALC.
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Affiliation(s)
- Yen Thi Thu Hoang
- Department of Genetics and Molecular Biology, Faculty of Biotechnology, Thai Nguyen University of Sciences, Thai Nguyen University, Thai Nguyen province, Vietnam.
| | - Yen Thi Nguyen
- Department of Genetics and Molecular Biology, Faculty of Biotechnology, Thai Nguyen University of Sciences, Thai Nguyen University, Thai Nguyen province, Vietnam.
| | - Lan Thi Vu
- Department of Genetics and Molecular Biology, Faculty of Biotechnology, Thai Nguyen University of Sciences, Thai Nguyen University, Thai Nguyen province, Vietnam.
| | - Huong Thi Thu Bui
- Department of Biochemistry, Faculty of Foundation Medicine, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen University, Thai Nguyen province, Vietnam.
| | - Quang Viet Nguyen
- Department of Occupational Health and Environmental Health, Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen University, Thai Nguyen province, Vietnam.
| | - Nhung Phuong Vu
- Genome Analysis Laboratory, Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.
| | - Ton Dang Nguyen
- Genome Analysis Laboratory, Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.
| | - Ha Hai Nguyen
- Genome Analysis Laboratory, Institute of Genome Research, Vietnam Academy of Science and Technology, Hanoi, Vietnam.
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Souza ABDS, De Souza JN, Oliveira CDL, Barreto NMPV, Costa WA, Oliveira RR, Teixeira MCA, Soares NM. Modulation of circulating cytokine production in alcoholic patients infected with Strongyloides stercoralis. Parasite Immunol 2023; 45:e12977. [PMID: 36883337 DOI: 10.1111/pim.12977] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 02/23/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
Strongyloidiasis control is associated with a Th2 immune response. However, alcohol ingestion plays an important role in modulating the immune system. The aim of this study is to evaluate the occurrence of Strongyloides stercoralis infection in alcoholic patients, the levels of circulating cytokines (IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-15 and IL-17), and its correlation with modulation of parasitic load in alcoholic individuals infected with S. stercoralis. A total of 336 alcoholic patients, treated at the Alcoholic Care and Treatment Center were included in this study. The cytokine levels were measured by a commercial ELISA in 80 sera divided into four groups with 20 individuals each: alcoholics infected (ASs+) and not infected (ASs-) with S. stercoralis and non-alcoholics infected (NASs+) and not infected (NASs-) with the helminth. S. stercoralis frequency in alcoholic patients was 16.1% (54/336). The parasitic load varied from 1 to 546 larvae/g of faeces, median and interquartile range (IQR) of 9 and 1.0-62.5 larvae/g of faeces, while in non-alcoholic individuals the parasitic load was less than 10 larvae/g of faeces. Levels of circulating IL-4 were significantly higher in ASs+ when compared with NASs- group (p < .05). An inverse correlation between serum levels of IFN-γ and parasitic load in alcoholic patients infected with S. stercoralis was observed (r = -601; p < 0.01). These results suggest that modulation of IFN-γ production occurs in alcoholic individuals with high parasitic burden.
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Affiliation(s)
| | | | | | | | | | - Ricardo Riccio Oliveira
- Laboratório de Patologia Experimental, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador, Brazil
| | | | - Neci Matos Soares
- Faculdade de Farmácia, Universidade Federal da Bahia (UFBA), Salvador, Brazil
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Nikkola A, Mäkelä KA, Herzig KH, Mutt SJ, Prasannan A, Seppänen H, Lehtimäki T, Kähönen M, Raitakari O, Seppälä I, Pakkanen P, Nordback I, Sand J, Laukkarinen J. Pancreatic Secretory Trypsin Inhibitor (SPINK1) Gene Mutation in Patients with Acute Alcohol Pancreatitis (AAP) Compared to Healthy Controls and Heavy Alcohol Users without Pancreatitis. Int J Mol Sci 2022; 23:ijms232415726. [PMID: 36555366 PMCID: PMC9778821 DOI: 10.3390/ijms232415726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/27/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Only 3-5% of heavy alcohol users develop acute alcohol pancreatitis (AAP). This suggests that additional triggers are required to initiate the inflammatory process. Genetic susceptibility contributes to the development of AAP, and SPINK1 mutation is a documented risk factor. We investigated the prevalence of the SPINK1(N34S) mutation in patients with AAP compared to heavy alcohol users who had never suffered an episode of pancreatitis. Blood samples for the mutational analysis from patients with first episode (n = 60) and recurrent AAP (n = 43) and from heavy alcohol users without a history of AAP (n = 98) as well as from a control population (n = 1914) were obtained. SPINK1 mutation was found in 8.7% of the patients with AAP. The prevalence was significantly lower in healthy controls (3.4%, OR 2.72; 1.32-5.64) and very low in alcoholics without pancreatitis (1.0%, OR 9.29; 1.15-74.74). In a comparison adjusted for potential cofounders between AAP patients and alcoholics, SPINK1 was found to be an independent marker for AAP. The prevalence of the SPINK1 mutation is overrepresented in AAP patients and very low in alcoholics without pancreatitis. This finding may play a role in understanding the variable susceptibility to AAP found in heavy alcohol users.
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Affiliation(s)
- Anssi Nikkola
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33520 Tampere, Finland; (A.N.); (J.S.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
| | - Kari Antero Mäkelä
- Research Unit of Biomedicine, Oulu University, 90220 Oulu, Finland; (K.A.M.); (K.-H.H.); (S.J.M.); (A.P.)
| | - Karl-Heinz Herzig
- Research Unit of Biomedicine, Oulu University, 90220 Oulu, Finland; (K.A.M.); (K.-H.H.); (S.J.M.); (A.P.)
- Medical Research Center Oulu, Oulu University, Oulu University Hospital, 90220 Oulu, Finland
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, 60-572 Poznan, Poland
| | - Shivaprakash Jagalur Mutt
- Research Unit of Biomedicine, Oulu University, 90220 Oulu, Finland; (K.A.M.); (K.-H.H.); (S.J.M.); (A.P.)
| | - Aishwarya Prasannan
- Research Unit of Biomedicine, Oulu University, 90220 Oulu, Finland; (K.A.M.); (K.-H.H.); (S.J.M.); (A.P.)
| | - Hanna Seppänen
- Department of Surgery, Helsinki University Hospital, 00260 Helsinki, Finland;
| | - Terho Lehtimäki
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
- Fimlab Laboratories, Department of Clinical Chemistry, 33520 Tampere, Finland;
- Finnish Cardiovascular Research Center, 33520 Tampere, Finland
| | - Mika Kähönen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
- Finnish Cardiovascular Research Center, 33520 Tampere, Finland
- Department of Clinical Physiology, Tampere University Hospital, 33520 Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, 20521 Turku, Finland;
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, 20014 Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, 20521 Turku, Finland
| | - Ilkka Seppälä
- Fimlab Laboratories, Department of Clinical Chemistry, 33520 Tampere, Finland;
| | - Pihla Pakkanen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Helsinki University Hospital, 00260 Helsinki, Finland
| | - Isto Nordback
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
| | - Juhani Sand
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33520 Tampere, Finland; (A.N.); (J.S.)
| | - Johanna Laukkarinen
- Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, 33520 Tampere, Finland; (A.N.); (J.S.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland; (T.L.); (M.K.); (P.P.); (I.N.)
- Correspondence: ; Tel.:+358-3-311-64314
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Johannessen A, Tevik K, Engedal K, Tjelta T, Helvik AS. Family' members experiences of their older relative's alcohol and substance misuse. Int J Qual Stud Health Well-being 2022; 17:2094059. [PMID: 35786387 PMCID: PMC9255228 DOI: 10.1080/17482631.2022.2094059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Alcohol consumption in Norway and much of the western world has increased during the past decades, in particular among older adults (> 65 years). Although living with a family member's alcohol misuse has been shown to have a significant deleterious health impact, research on this topic is both lacking and urgently needed to develop targeted health services. AIM To generate knowledge of how family members are affected by their older relatives' alcohol and other substance misuse problems. METHOD In 2020, 17 individual interviews were carried out with the wives and adult children of older adults with alcohol and other substance misuse problems. Data were analysed using content analysis. FINDINGS Analyses revealed two main themes; the impact of living with psychological stress over time, and the impact over time on family relationships and functioning. Both included four subthemes, representing different dimensions of participants' experiences of the impact of their older relative's alcohol and substance misuse. CONCLUSION The challenges family members experienced through ongoing exposure to their relatives' alcohol and/or other substance misuse increased over time. These experiences had significant negative consequences for their health and life situation.
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Affiliation(s)
- Aud Johannessen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway,CONTACT Aud Johannessen The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, P.O. Box 2136 NO-3103, Tønsberg, Norway
| | - Kjerstin Tevik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Knut Engedal
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Thomas Tjelta
- Faculty of Health and Social Science, University of South-Eastern Norway, Kongsberg, Norway
| | - Anne-Sofie Helvik
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Martinez FE, Cassettaria LL, Nicolaua NC, de Barros Camargoa VM, de Almeida Chuffaa LG, Pinheiroa PFF, Padovania CR, Martinez M. Ageing decreases the healing of wounds in the skin of alcohol-preferring rats. J Wound Care 2022; 31:872-881. [PMID: 36240793 DOI: 10.12968/jowc.2022.31.10.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Alcohol consumption combined with ageing alters the healing process of the skin. We evaluated whether ageing decreases the healing of incisional wounds in the skin of Wistar rats of Universidade de Chile of variety B (UChB). METHOD A total of 20 adult rats and 20 older UChB rats, divided into two groups which underwent surgical aggression in the anterior region of the abdomen, were used: G1, adult rats (100 days old, control) with water and 10% ethanol; G2, aged rats (540 days old, experimental) with water and 10% ethanol; evaluated at 4, 7, 14 and 21 days after surgery. RESULTS Ageing did not alter the rupture force and collagen elasticity and resistance. There were increases in telomerase with the implementation of cellular senescence, in interleukin 1-alpha (IL-1α) at 14 days of healing, in epidermal growth factor (EGF) at 14 and 21 days of healing with delayed growth and development of keratinocytes, also an increase of IL-β at 4 days, and decrease in tumour necrosis factor (TNFα) at 7 days, associated with chronic scarring. There was an increase in vascular endothelial growth factor (VEGF) at 4 and 7 days, responsible for the early vessels re-establishment. There was a decrease in transforming growth factor 2-beta (TGFβ2) and β3 at 4 and 7 days of healing respectively, and estradiol at 4 days. CONCLUSION Ageing decreases the skin healing in incisional wounds in alcohol-preferring rats.
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Abstract
Alcohol is often cited to be a common cause of cardiomyopathy and heart failure. However, in most available population-based studies, a modest-to-moderate alcohol consumption has been associated with favorable effects on the cardiovascular system, including a lowered risk of heart failure, compared with no alcohol consumption. Available genetic epidemiological data have not supported a causal association between alcohol consumption and heart failure risk, suggesting that alcohol may not be a common cause of heart failure in the community. Data linking alcohol intake with cardiomyopathy risk are sparse, and the concept of alcoholic cardiomyopathy stems mainly from case series of selected patients with dilated cardiomyopathy, where a large proportion reported a history of excessive alcohol intake. This state-of-the-art paper addresses the current knowledge of the epidemiology of alcoholic cardiomyopathy and the role of alcohol intake in patients with non-alcohol-related heart failure. It also offers directions to future research in the area. The review questions the validity of current clinical teaching in the area. It is not well known how much alcohol is needed to cause disease, and the epidemiological pathways linking alcohol consumption to cardiomyopathy and heart failure are not well understood. Until more evidence becomes available, caution is warranted before labeling patients as having alcoholic cardiomyopathy due to a risk of neglecting other contributors, such as genetic causes of cardiomyopathy. In non-alcohol-related heart failure, it is unknown whether total abstinence is improving outcomes (compared with moderate drinking). Ideally, randomized clinical trials are needed to answer this question.
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Affiliation(s)
- Charlotte Andersson
- Department of Medicine, Section of Cardiovascular Medicine, Boston Medical Center, Boston University, MA (C.A.)
| | - Morten Schou
- Department of Cardiology, Herlev and Gentofte Hospital (M.S.), University of Copenhagen, Denmark
| | - Finn Gustafsson
- The Heart Centre, Rigshospitalet (F.G.), University of Copenhagen, Denmark
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Chen Y, Liu H, Yu Z, Yang Y, Huang Q, Deng C, Rao H, Wu H. ALDH2 Polymorphism rs671 *1/*2 Genotype is a Risk Factor for the Development of Alcoholic Liver Cirrhosis in Hakka Alcoholics. Int J Gen Med 2022; 15:4067-4077. [PMID: 35450031 PMCID: PMC9017692 DOI: 10.2147/ijgm.s356761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/05/2022] [Indexed: 01/19/2023] Open
Abstract
Background Alcoholics are prone to alcoholic cirrhosis (ALC). Aldehyde dehydrogenase 2 (ALDH2) is involved in alcohol metabolism. Herein, the relationship between ALDH2 genotypes and ALC was analyzed among Hakka alcoholics in southern China. Methods A total of 213 alcoholics and 214 non-alcoholics were included in the study. The ALDH2 gene rs671 polymorphism was analyzed, life history, disease history, and auxiliary examination results of these participants were collected. Results The alcoholics had higher level of total serum protein, and serum globulin, lower level of serum albumin, serum albumin/globulin ratio, serum prealbumin, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) than non-alcoholics. In the 213 alcoholics, 180 developed ALC. There were 206 non-ALC persons in the 214 non-alcoholics. The proportion of the ALDH2 rs671 G/G homozygous (*1/*1) was significantly lower in ALC patients (83.3%) than that of other groups (100.0% in non-ALC in alcoholics, 95.6% in non-ALC in non-alcoholics), while the proportion of the G/A heterozygous (*1/*2) was significantly higher in ALC patients (16.7%) than that of other groups (0% in non-ALC in alcoholics, 4.4% in non-ALC in non-alcoholics). Logistic regression analysis indicated that participants with low level of NLR (adjusted OR 5.543, 95% CI 2.964–10.368, P<0.001), LMR (adjusted OR 9.256, 95% CI 4.740–18.076, P<0.001), and PLR (adjusted OR 6.047, 95% CI 3.372–10.845, P<0.001), and ALDH2 G/A genotype (adjusted OR 6.323, 95% CI 2.477–16.140, P<0.001) had a significantly higher risk of ALC. Conclusion ALDH2 polymorphism rs671 *1/*2 genotype is a potential risk factor for the development of ALC among Hakka alcoholics.
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Affiliation(s)
- Yijin Chen
- Department of Gastroenterology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Hongtao Liu
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Department of Gastrointestinal Surgery, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Zhikang Yu
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Yang Yang
- Department of Gastroenterology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Qingyan Huang
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Changqing Deng
- Department of Gastroenterology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Hui Rao
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Heming Wu
- Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China.,Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
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Adachi M, Tamakoshi K, Watai I. Hospital organizational structure factors related to discharge planning activities for alcoholics by nurses in Japan. Jpn J Nurs Sci 2022; 19:e12473. [PMID: 35112492 DOI: 10.1111/jjns.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/13/2021] [Accepted: 12/06/2021] [Indexed: 10/19/2022]
Abstract
AIM Nurses play a significant role in providing discharge support for alcoholics. We aimed to explore the organizational structures of hospitals that are related to effective discharge planning activities provided by nurses. METHODS We conducted a cross-sectional survey of Japanese hospitals with psychiatric wards that accept alcoholics. The survey questionnaire was administered to one nurse per hospital from August to September 2019. The Discharge Planning Scale for Ward Nurses (DPWN) was used to assess the actual status of the hospital nurse teams' discharge planning activities. The DPWN consists of four subscales: subscale I, "collect information from patients and their families"; subscale II, "supports for decision-making for the patients and families"; subscale III, "utilization of social resources"; and subscale IV, "discharge guidance by cooperating with community support teams and multidisciplinary teams." RESULTS From the valid responses of 116 hospitals, scores on subscale IV were significantly lower than scores on subscales I, II, and III, indicating that medical care guidance through multidisciplinary collaboration between hospitals and the community was inadequate. In addition, multiple regression analysis showed that "hospital management and administrators understanding about nurses' discharge support activities," and "planning discharge schedules, such as using clinical paths" were significantly and independently related to the total DPWN and each of subscale scores, regardless of the hospital's establishment body and size. "Multidisciplinary discharge support" was significantly related to subscale II. CONCLUSIONS These findings have implications for the management of discharge planning activities provided by nurses for alcoholics through multidisciplinary collaboration.
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Affiliation(s)
- Madoka Adachi
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Izumi Watai
- Faculty of Nursing, Hamamatsu University School of Medicine, Hamamatsu, Japan
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Yang J, Kim S. Effects of a nonviolent communication-based training program for inpatient alcoholics in South Korea. Perspect Psychiatr Care 2021; 57:1187-1194. [PMID: 33135195 DOI: 10.1111/ppc.12673] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to evaluate a communication skills program based on nonviolent communication targeted on inpatient alcoholics at the alcoholics specialized ward. DESIGN AND METHODS The sample for this mixed methods quasi-experimental study comprised 47 patients who were hospitalized in the alcoholic wards of two psychiatric hospitals in South Korea. FINDINGS The program effectively improved participants' empathy, anger expression, communication competence, and alcohol abstinence self-efficacy (p < .001). PRACTICE IMPLICATIONS This program could be implemented in community-based alcoholic care with the aim of preventing relapse and serve as the basis for developing similar programs for family members.
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Affiliation(s)
- Jeongwoon Yang
- Department of Nursing, Kyungbok University, Namyangju, Geyonggi, South Korea
| | - Sungjae Kim
- Department of Alcoholism Specialized Ward, College of Nursing, The Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
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Lee JY, An JS, Suh KH. The Double Mediating Effect of Social Isolation and Emotional Support on Feelings of Entrapment and Motivation for Recovery among Korean Alcoholic Inpatients. Int J Environ Res Public Health 2021; 18:4710. [PMID: 33925128 DOI: 10.3390/ijerph18094710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/12/2021] [Accepted: 04/22/2021] [Indexed: 12/04/2022]
Abstract
This study identified the relationship between feeling of entrapment and motivation for change among hospitalized alcoholic patients and examined the double mediating effect model of social isolation and emotional support on this relationship. The study participants were 101 male and female alcoholic patients hospitalized at C hospital, which specializes in alcohol treatment at I city in Korea. PROCESS Macro 3.5 Model 6 was used for analyses of double mediating effects. The results revealed that entrapment and social isolation were negatively correlated with motivation for recovery of alcoholic inpatients, whereas emotional support was positively correlated with it. In a sequential double mediation model for motivation to change in alcoholic inpatients, the direct effects of social isolation and entrapment were not significant. However, the sequential indirect effect of social isolation and emotional support on entrapment and motivation for recovery among alcoholic inpatients was significant. These results suggest that making alcoholic inpatients not feel socially isolated by providing them with emotional support or through other means of assistance by practitioners or family members is important for their recovery from alcohol use disorder.
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12
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Lloyd B, Oudman E, Altgassen M, Walvoort SJW, Kessels RPC, Postma A. Episodic future thinking together with observational learning benefits prospective memory in high-functioning Korsakoff's syndrome patients. Br J Clin Psychol 2020; 59:369-383. [PMID: 32420647 PMCID: PMC7496103 DOI: 10.1111/bjc.12251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 04/02/2020] [Indexed: 11/29/2022]
Abstract
Objective Patients with Korsakoff’s syndrome (KS) have difficulty carrying out tasks which rely on prospective memory (PM). Since remembering to carry out an action in the future is crucial for living independently, it is of primary interest to develop strategies that improve PM performance in KS patients. Design The study employed a computer categorization task as an ongoing activity into which a PM task was embedded. We included episodic future thinking (EFT) and observational learning (Experiment 2) to boost PM. Methods Experiment 1 evaluated the efficacy of EFT following written PM task instructions in ten KS patients. Due to floor‐level PM performance in Experiment 1, Experiment 2 included an instructional video demonstrating the PM intention. In Experiment 2, twenty‐six KS patients performed both conditions (EFT and no‐EFT) at least 1 week apart, while twelve controls with alcohol use disorder without KS performed the no‐EFT condition. In Experiment 2, the PM instructions were also shown through video (observational learning component). Mild cognitive impairment was assessed in a short test battery. Results Experiment 1 showed overall floor performance in both conditions. Experiment 2 showed that KS patients performed PM tasks less accurately than the control group in the no‐EFT condition. In Experiment 2, where the observational learning component was included, EFT improved PM performance in KS patients. This effect was driven by a sub‐group of high‐functioning KS patients. Conclusions This study showed the value of an observational learning component together with EFT in improving PM performance, in relatively high‐functioning KS patients. Practitioner points KS patients performed the PM task less accurately than non‐KS controls with alcohol use disorder, confirming PM impairment in this patient population. Controls with alcohol use disorder performed the PM task at ceiling level. Showing an instructional video demonstrating the PM intention improved PM performance and later recall of PM task instructions in KS patients. Episodic future thinking strategy improved PM performance in KS patients with relatively intact cognitive functioning.
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Affiliation(s)
- Beth Lloyd
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Erik Oudman
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
| | - Mareike Altgassen
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Department of Psychology, Johannes Gutenberg-University Mainz, Germany
| | - Serge J W Walvoort
- Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
| | - Roy P C Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands.,Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands.,Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Albert Postma
- Helmholtz Institute, Experimental Psychology, Utrecht University, The Netherlands.,Slingedael Korsakoff Center, Rotterdam, The Netherlands
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Clark BJ, Jones J, Reed KD, Hodapp R, Douglas IS, Van Pelt D, Burnham EL, Moss M. The Experience of Patients with Alcohol Misuse after Surviving a Critical Illness. A Qualitative Study. Ann Am Thorac Soc 2017; 14:1154-61. [PMID: 28406727 DOI: 10.1513/AnnalsATS.201611-854OC] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
RATIONALE Alcohol misuse is common in patients admitted to the intensive care unit (ICU), but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months after hospital discharge to inform an alcohol-specific intervention for this unique population. METHODS We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test. Semistructured interviews were conducted 3 months after hospital discharge of patients. Patients were also allowed to nominate up to two friends or family members for enrollment to provide additional perspective on the patient's experience. RESULTS We enrolled 50 patients and 22 of their friends and/or family members. The average APACHE II score was 23, 80% of patients were male, and the average age was 50 years; 70% of patients and 77% of friends/family members completed the semistructured interview 3 months after hospital discharge. We identified three domains that could inform an alcohol-specific intervention, each with multiple themes: motivation with complications (anxiety and depression, critical illness as a catalyst, delirium and cognitive impairment); therapeutic alliance (autonomy, failure and opportunities to build a therapeutic alliance); and the return to the home milieu (lack of screening for depression and anxiety, social network support for drinking, social isolation, social network support for abstinence, lack of available and affordable treatment, and negative experiences with Alcoholics Anonymous). CONCLUSIONS An alcohol intervention for ICU survivors would account for the context in which patients are making a decision about their drinking and optimize the patient-provider interaction. Contrary to current paradigms that focus on addressing alcohol consumption only during a hospitalization, an intervention for ICU survivors should continue as patients transition from the hospital to home.
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Dabur R, Shirolkar A, Mishra V, Yadav BS. Non-invasive Qualitative Urinary Metabolomic Profiling Discriminates Gut Microbiota Derived Metabolites in the Moderate and Chronic Alcoholic Cohorts. Curr Pharm Biotechnol 2018. [PMID: 29521221 DOI: 10.2174/1389201019666180308093207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Excessive alcohol consumption damages the intestine and liver cells directly as well as through unbalancing the gut microbiota. OBJECTIVE The current study was undertaken to correlate the alcohol consumption and change in urinary metabolites profile linked with gut microbiota. METHOD Non-alcoholic (control) healthy (n=22) and moderate alcoholic (n=26) males with an average age of 39.3±1.83 years subjected to alcohol use disorders identification test (AUDIT) were considered for study. First pass urine and blood samples were collected in the morning. RESULTS Liver function test showed the increased levels of γGT, AST and ALT to 40.3 ± 2.3, 53.3 ± 0.7, and 38.9 ± 0.5 U/L, respectively. Urine samples were processed and subjected to HPLC-Q-TOFMS analysis in positive and negative ion polarity modes. Mass data were processed to align and filter out insignificant entities and subjected to One-way ANOVA with Bonferroni multiple testing corrections analysis. The analysis provided list of 211gut microbes specific metabolites with p>0.05 and fold change >1.5. All metabolites were identified using standards and referring to METALIN library of standard metabolites. Further analyses showed that alcohol intake disturbed more than ten metabolic pathways. Tryptophan, tyrosine, branched chain amino acids and short-chain fatty acids metabolism were the significantly disturbed pathways in alcoholics. CONCLUSION Correlation of various metabolites with gut microbiota showed that chronic and moderate dose intake of alcohol decreased the level of Bifidobacterium, Lactobacillus Ruminococcus and Faecalibacterium spp. and increased the levels of Proteobacteria, Alcaligenes and Clostridium.
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Affiliation(s)
- Rajesh Dabur
- Department of Biochemistry, Maharshi Dayanand University, Rohtak-124001, Haryana, India
| | - Amey Shirolkar
- Regional Research Institute of Basic Ayurvedic Sciences, (CCRAS), Nehru Garden, Kothrud, Pune, India
| | - Vijender Mishra
- Department of Basic & Applied Sciences, National Institute of Food Technology Entrepreneurship & Management (NIFTEM), Plot No. 97, Sector 56, HSIIDC Industrial Estate, Sonepat, Haryana, India
| | - Baljeet S Yadav
- Department of Food Technology, Maharshi Dayanand University, Rohtak-124001, Haryana, India
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Hong JY, Müller-Oehring EM, Pfefferbaum A, Sullivan EV, Kwon D, Schulte T. Aberrant blood-oxygen-level-dependent signal oscillations across frequency bands characterize the alcoholic brain. Addict Biol 2018; 23:824-835. [PMID: 28699704 DOI: 10.1111/adb.12532] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 04/20/2017] [Accepted: 05/29/2017] [Indexed: 11/26/2022]
Abstract
Chronic alcoholism is associated with widespread regional differences from controls in brain activity and connectivity dynamics measured by blood-oxygen-level-dependent (BOLD) signals. Identification of alcoholism-related neurofunctional power dynamics using functional magnetic resonance imaging (fMRI) that relate to cognition and behavior may serve as biomarkers of alcoholism. Previously, resting-state fMRI studies examined BOLD signals at a single low-frequency (LF) bandwidth. BOLD signals, however, oscillate systematically at different frequencies and are organized in a resting brain where LF oscillation facilitates long-distance communication between regions across cortical regions, whereas high-frequency (HF) oscillation occurs in closely localized, subcortical areas. Using a frequency power quantification approach, we investigated whether the organization of BOLD signal oscillations across all measured frequency bandwidths is altered in alcoholism and relates to cognitive performance. Frequency-dependent oscillation power differences between 56 sober alcoholics and 56 healthy controls occurred for all frequency bands. Alcoholics exhibited greater frequency oscillation power in the orbitofrontal cortex and less power in the posterior insula within the HF bandwidth than controls. Aberrant orbitofrontal HF power was associated with poorer memory performance and slower psychomotor speed in alcoholics. Middle-frequency and LF power proved sensitive in detecting altered frequency oscillation dynamics in parietal and postcentral cortical regions of alcoholics. This study is novel in identifying alcohol-related differences in BOLD oscillation power of the full fMRI frequency bandwidth. Specifically, HF power aberrations were associated with poorer cognitive functioning in alcoholism and may serve as a biomarker for identifying neural targets for repair.
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Affiliation(s)
- Jui-Yang Hong
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
| | - Eva M. Müller-Oehring
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Adolf Pfefferbaum
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Edith V. Sullivan
- Department of Psychiatry & Behavioral Sciences; Stanford University; Stanford CA USA
| | - Dongjin Kwon
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
| | - Tilman Schulte
- Neuroscience Program, Center for Health Sciences; SRI International; Menlo Park CA USA
- Pacific Graduate School of Psychology; Palo Alto CA USA
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Abstract
Some philosophers and physicians have argued that alcoholic patients, who are responsible for their liver failure by virtue of alcoholism, ought to be given lower priority for a transplant when donated livers are being allocated to patients in need of a liver transplant. The primary argument for this proposal, known as the Responsibility Argument, is based on the more general idea that patients who require scarce medical resources should be given lower priority for those resources when they are responsible for needing them and when they are competing with patients who need the same resources through no fault of their own. Since alcoholic patients are responsible for needing a new liver and are in direct competition with other patients who need a new liver through no fault of their own, it follows that alcoholic patients ought to be given lower priority for a transplant. In this article, I argue against the Responsibility Argument by suggesting that in order for it to avoid the force of plausible counter examples, it must be revised to say that patients who are responsible for needing a scarce medical resource due to engaging in behavior that is not socially valuable ought to be given lower priority. I'll then argue that allocating organs according to social value is inconsistent or in tension with liberal neutrality on the good life. Thus, if one is committed to liberal neutrality, one ought to reject the Responsibility Argument.
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Oniszczenko W, Rybakowski JK, Dragan WŁ, Grzywacz A, Samochowiec J. The ADH gene cluster SNP rs1789891 and temperamental dimensions in patients with alcohol dependence and affective disorders. Scand J Psychol 2015; 56:420-7. [PMID: 26013422 DOI: 10.1111/sjop.12223] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 04/02/2015] [Indexed: 11/29/2022]
Abstract
This study had three objectives: (1) to assess the relationship between the single nucleotide polymorphism (SNP) rs1789891 in the alcohol dehydrogenase gene cluster and alcohol dependence and affective disorders; (2) to assess the differences in the Regulative Theory of Temperament (RTT) traits between an alcohol dependent group, an affective disorders group, and a healthy group; and (3) to assess the relationship between rs1789891 and temperament traits in a healthy group, taking into account the interaction of genotype and sex. The SNP rs1789891 was genotyped in a group of 194 alcohol dependent men, aged 21 to 71 years; 137 patients with affective disorders, including 51 males and 86 females, aged 19 to 85 years; and a group of 207 healthy individuals, including 89 males and 118 females, aged 18 to 71 years. Temperament traits (briskness, perseveration, sensory sensitivity, emotional reactivity, endurance, and activity) were assessed in all groups using the Formal Characteristics of Behaviour-Temperament Inventory. The comparative analysis of genotypic frequencies showed no significant differences between patients with alcoholism or affective disorders and those in the control group. Alcohol dependent men and the affective disorder group were characterised by higher levels of emotional reactivity (p-value 1.4e-5 and 9.84e-7, respectively) and lower levels of briskness, sensory sensitivity, endurance, and activity (p-value from 3.76e-8 to 0.012) when compared to the healthy group. The rs1789891 polymorphism was associated with briskness (p = 0.02), sensory sensitivity (p = 0.036), and activity (p = 0.049). None of the results were statistically significant after Bonferroni correction.
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Affiliation(s)
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznań University of Medical Sciences, Poznań, Poland
| | | | - Anna Grzywacz
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
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Trevejo-Nunez G, Kolls JK, de Wit M. Alcohol Use As a Risk Factor in Infections and Healing: A Clinician's Perspective. Alcohol Res 2015; 37:177-84. [PMID: 26695743 PMCID: PMC4590615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Physicians have recognized for more than a century that alcohol use is associated with infections and that alcoholics are especially at risk for pneumonia. Clear evidence now indicates that alcohol has a systemic effect on every organ. This review first presents a clinical case to describe a patient with immunity issues complicated by alcohol use-a setting familiar to many clinicians. This is followed by a description of the molecular mechanisms that explain the secondary immune deficiency produced by alcohol in the host, focusing mostly on the gut and lower respiratory mucosal immunity. The goal of this review is to increase awareness of the new mechanisms being investigated to understand how alcohol affects the human immune system and the development of new strategies to attenuate adverse outcomes in the affected population.
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Abstract
In the 21st century, alcoholism and the consequences of ethyl alcohol abuse are major public health concerns in the United States, affecting approximately 14 million people. Pertinent to the global impact of alcoholism is the World Health Organisation estimate that 140 million people worldwide suffer from alcohol dependence. Alcoholism and alcohol abuse are the third leading causes of preventable death in the United States. Alcohol dependence and alcohol abuse cost the United State an estimated US$220 billion in 2005, eclipsing the expense associated with cancer (US$196 billion) or obesity (US$133 billion). Orally ingested ethyl alcohol is absorbed rapidly without chemical change from the stomach and intestine, reaching maximum blood concentration in about an hour. Alcohol crosses capillary membranes by simple diffusion, affecting almost every organ system in the body by impacting a wide range of cellular functions. Alcohol causes metabolic derangements either directly, via its chemical by-product or secondarily through alcohol-induced disorders. Many of these alcohol-related metabolic disturbances are increased in severity by the malnutrition that is common in those with chronic alcoholism. This review focuses on the acute and chronic injurious consequences of alcohol ingestion on the kidney, as well as the fluid, electrolyte and acid-base abnormalities associated with acute and chronic ingestion of alcohol.
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Affiliation(s)
- Adebayo Adewale
- Department of Medicine, Kingsbrook Jewish Medical Center, Brooklyn, USA
| | - Onyekachi Ifudu
- Division of Nephrology, St. John's Episcopal Hospital, Southshore, New York, USA
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Smith PC, Schmidt SM, Allensworth-Davies D, Saitz R. Primary care validation of a single-question alcohol screening test. J Gen Intern Med 2009; 24:783-8. [PMID: 19247718 PMCID: PMC2695521 DOI: 10.1007/s11606-009-0928-6] [Citation(s) in RCA: 258] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2008] [Revised: 01/14/2009] [Accepted: 01/23/2009] [Indexed: 12/16/2022]
Abstract
BACKGROUND Unhealthy alcohol use is prevalent but under-diagnosed in primary care settings. OBJECTIVE To validate, in primary care, a single-item screening test for unhealthy alcohol use recommended by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). DESIGN Cross-sectional study. PARTICIPANTS Adult English-speaking patients recruited from primary care waiting rooms. MEASUREMENTS Participants were asked the single screening question, “How many times in the past year have you had X or more drinks in a day?”, where X is 5 for men and 4 for women, and a response of 1 or greater [corrected] is considered positive. Unhealthy alcohol use was defined as the presence of an alcohol use disorder, as determined by a standardized diagnostic interview, or risky consumption, as determined using a validated 30-day calendar method. MAIN RESULTS Of 394 eligible primary care patients, 286 (73%) completed the interview. The single-question screen was 81.8% sensitive (95% confidence interval (CI) 72.5% to 88.5%) and 79.3% specific (95% CI 73.1% to 84.4%) for the detection of unhealthy alcohol use. It was slightly more sensitive (87.9%, 95% CI 72.7% to 95.2%) but was less specific (66.8%, 95% CI 60.8% to 72.3%) for the detection of a current alcohol use disorder. Test characteristics were similar to that of a commonly used three-item screen, and were affected very little by subject demographic characteristics. CONCLUSIONS The single screening question recommended by the NIAAA accurately identified unhealthy alcohol use in this sample of primary care patients. These findings support the use of this brief screen in primary care.
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Affiliation(s)
- Peter C Smith
- Section of General Internal Medicine, Department of Medicine, Boston Medical Center and Boston University School of Medicine, Boston, MA 02118, USA.
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Padmini E, Sundari BT. Erythrocyte glutathione depletion impairs resistance to haemolysis in women consuming alcohol. J Clin Biochem Nutr 2008; 42:14-20. [PMID: 18231625 PMCID: PMC2212343 DOI: 10.3164/jcbn.2008003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2006] [Accepted: 01/28/2007] [Indexed: 11/22/2022] Open
Abstract
Alcohol abuse is known to cause an array of ethanol induced abnormalities in men but very few reports are available on the effect of alcohol in women. None of them discuss the effect of ethanol consumption on erythrocyte membrane. In the present study, erythrocytes in women who consume alcohol showed significant decrease in their ability to resist haemolysis with HPLC studies. Erythrocyte membrane indicates decreased phospholipid (p<0.05) levels, which increased the cholesterol/phospholipid ratio significantly (p<0.01) in women who consume alcohol. This can decrease the fluidity of membrane, which appears to be related to the effect of ethanol on erythrocyte membrane. Also the protection against exogenous and endogenous peroxides in the erythrocytes of alcoholic women is considerably affected due to decreased (p<0.05) activity of catalase, glucose-6-phosphate dehydrogenase, protein-SH group and glutathione (GSH). Enhanced free radical generation induced oxidation of oxyHb to metHb in alcoholics. Increased methemoglobin leads to significant reduction in membrane GSH, which may cause protein thiol oxidation. Thus peroxidative damage to membrane lipids and oxidation of membrane protein thiols potentially harmful to membrane fluidity and flexibility is responsible for decreased resistance to haemolysis as demonstrated in women who consume alcohol.
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Affiliation(s)
- Ekambaram Padmini
- P.G and Research Department Of Biochemistry, Bharathi Women’s College, Affiliated to the University of Madras, Chennai-600 108, Tamilnadu, India
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Sengupta S, Ray R, Desai N, Shetty KT. A study of serum prolactin and plasma human growth hormone in male alcoholics. Indian J Psychiatry 1997; 39:29-33. [PMID: 21584040 PMCID: PMC2967078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Serum levels of prolactin (PRL) and Human Growth Hormone (HGH) were assayed in 38 male alcoholics and 24 male control subjects using radioimmunoassay (RIA) technique. Biochemical parameters of hepatic function and severity of withdrawal state were also assessed. Significantly elevated values of plasma HGH were found in alcoholics as a group. Nineteen percent and eight percent of the patient had elevated serum PRL and HGH levels respectively. Evidence of advanced liver disease was scant and withdrawal symptoms were by and large mild. The findings indicate a dysfunction in hypothalamic adenohypophyseal axis in a subgroup of alcoholics.
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Affiliation(s)
- S Sengupta
- SOMNATH SENGUPTA, M.D., Associate Professor, Department of Psychiatry, Kasturba Medical College, Manipal-576 119, Karnataka
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