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Zalavadiya R, Bhatt JH, Nagori I, Kagathara N, Neupane S. An unusual case of Zieve's syndrome in a 36-year-old male with latent autoimmune diabetes of adult and disseminated intravascular coagulation. Clin Case Rep 2024; 12:e8445. [PMID: 38292231 PMCID: PMC10823546 DOI: 10.1002/ccr3.8445] [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: 10/19/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 02/01/2024] Open
Abstract
Zieve's syndrome, associated with chronic alcoholism, manifests as hemolytic anemia, transient hyperlipidemia, and cholestatic jaundice. Key symptoms comprise nausea, abdominal pain, and jaundice. Diagnosis relies on recognizing the triad in those with an alcohol use history. Supportive management includes blood transfusions and alcohol cessation. The exact pathophysiology remains uncertain, with hypotheses ranging from alcohol-induced liver damage to autoimmune processes. The report emphasizes diagnostic complexities, particularly when concurrent with autoimmune disorders such as latent autoimmune diabetes of adults or complicated by disseminated intravascular coagulation (DIC). A 36-year-old male with latent autoimmune diabetes of adults and an 18-year history of chronic alcoholism presented with yellowish skin discoloration, abdominal pain, and distension. Physical examination revealed signs of anemia, jaundice, pedal edema, hepatomegaly, splenomegaly, and abdominal tenderness. Over eight admissions, multiple tests revealed severe anemia, thrombocytopenia, elevated bilirubin, and positive autoantibodies. Treatment for suspected autoimmune hepatitis showed no improvement. Subsequent examinations indicated DIC, altered liver function, and cirrhosis progression. A confirmed diagnosis of Zieve's syndrome was made. Upper gastrointestinal endoscopy was done to check for esophageal varices which were banded. The patient was subsequently managed on supportive treatment with multiple blood transfusions and abstinence from alcohol. Prompt recognition of Zieve's syndrome is crucial to avoid unnecessary interventions. Alcohol cessation is the keystone of treatment, emphasizing the need to raise awareness among practitioners. This case points toward the importance of comprehensive evaluation, serial investigations, and multidisciplinary collaboration for accurate diagnosis and management. Further research is needed to enhance understanding and optimize therapeutic strategies.
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Affiliation(s)
- Rushit Zalavadiya
- Department of Internal MedicineGMERS Medical College GotriVadodaraIndia
| | - Jugal Hiren Bhatt
- Department of Internal MedicineGMERS Medical College GotriVadodaraIndia
| | - Irfan Nagori
- Department of Internal MedicineGMERS Medical College GotriVadodaraIndia
| | - Nency Kagathara
- Department of Internal MedicineZydus Medical College and HospitalDahodIndia
| | - Srijana Neupane
- Chormara Public Health CenterMadhyabindu MunicipalityNawalpurNepal
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2
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Sousou JM, Griffith EM, Marsalisi C, Reddy P. Pyridoxine Deficiency and Neurologic Dysfunction: An Unlikely Association. Cureus 2023; 15:e47647. [PMID: 38021490 PMCID: PMC10668619 DOI: 10.7759/cureus.47647] [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: 08/31/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Pyridoxine deficiency is a prevalent condition in the United States that primarily affects patients with alcohol use disorder. The presentation of this condition is very nonspecific and commonly presents with a constellation of symptoms including peripheral neuropathy, stomatitis, dermatitis, confusion, depression, encephalopathy, and seizures. Over half of these patients have associated alcohol use disorder, which causes pyridoxine deficiency due to the breakdown of pyridoxal phosphate during ethanol metabolism in the liver. As an important cofactor in the synthesis of γ-aminobutyric acid (GABA), deficient levels of pyridoxine may lower the seizure threshold due to reduced GABA-mediated inhibition. This case details a 57-year-old male with chronic alcoholism and a history of seizures who developed episodes of myoclonic jerks, tremors, anxiety, and neuropathy whose symptoms persisted even while on anti-epileptic medication. He was found to have pyridoxine deficiency and had full resolution of symptoms shortly after the administration of vitamin B6 supplementation. Pyridoxine deficiency may lead to severe neurologic disorders such as encephalopathy and seizures. Hence, it is important to consider pyridoxine deficiency in the workup of neurologic complaints, especially in high-risk patients.
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Affiliation(s)
- John M Sousou
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Emma M Griffith
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Christopher Marsalisi
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Pramod Reddy
- Internal Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
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3
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Navari Y, Bagheri A, Foreback J. A Rare Case of Pellagra in a Chronic Alcoholic. Cureus 2023; 15:e47909. [PMID: 38034227 PMCID: PMC10683836 DOI: 10.7759/cureus.47909] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2023] [Indexed: 12/02/2023] Open
Abstract
This case report documents a rare occurrence of pellagra in a chronic alcoholic individual, characterized by a pruritic rash and gastrointestinal symptoms. The patient, a Caucasian male in his 60s, with a history of alcohol use disorder, presented with worsening skin lesions and non-bloody diarrhea. Laboratory findings revealed significant deficiencies in niacin and related metabolites, confirming the diagnosis. Prompt initiation of niacin supplementation, dietary adjustments, and supportive care led to notable improvements. This case shows the critical importance of recognizing pellagra in chronic alcoholism, emphasizing the triad of symptoms - rash, diarrhea, and malnutrition - as key diagnostic markers. Early intervention holds the potential to significantly enhance the patient's well-being and prevent disease progression.
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Affiliation(s)
- Yasaman Navari
- Internal Medicine, Michigan State University, Flint, USA
| | - AmirBehzad Bagheri
- Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, USA
| | - Jami Foreback
- Internal Medicine, Michigan State University at Hurley Medical Center, Flint, USA
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Lima BJP, de Oliveira GRL, Sousa TC, de Aquino AM, Hinokuma KD, Ricardo MLS, Scarano WR, Castilho ACDS, Pacagnelli FL, Martinez FE, Mendes LDO. Fractal analysis is a useful tool for evaluating prostate tissue remodeling caused by ethanol consumption and androgen therapy. Anim Reprod 2023; 20:e20230072. [PMID: 37795198 PMCID: PMC10546910 DOI: 10.1590/1984-3143-ar2023-0072] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/03/2023] [Indexed: 10/06/2023] Open
Abstract
Alcohol has been widely consumed for centuries and is linked to the aggravation of diseases. Several studies have shown that excessive consumption of ethanol results in morphophysiological changes in the male reproductive system. One of the effects of ethanol is the decrease in testosterone concentration and hormonal therapies are an alternative to minimize the changes resulting from chronic alcoholism. Qualitative studies were commonly carried out to evaluate the male histopathological alterations resulting from ethanol consumption, being necessary quantitative and non-subjective techniques. This study analyzes the importance of fractal analysis as a useful tool to identify and quantify tissue remodeling in rats submitted to ethanol consumption and hormone therapy with testosterone. Prostate of animals submitted to chronic ethanol consumption showed tissue disorganization, which was confirmed by an increasing of fractal dimension. Regarding the prostatic stroma, collagen fractal dimension and quantification revealed lower values in animals that were only submitted to androgen therapy. Thus, we can conclude that the fractal analysis was a useful tool to quantify tissue changes caused by ethanol consumption and androgen therapy.
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Affiliation(s)
- Bruna Jardim Pereira Lima
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
| | | | - Thainá Cavalleri Sousa
- Programa de Pós-Graduação em Ciência Animal, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
| | - Ariana Musa de Aquino
- Departmento de Biologia Estrutural e Funcional, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | | | - Maria Luiza Silva Ricardo
- Programa de Pós-Graduação em Ciência Animal, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
| | - Wellerson Rodrigo Scarano
- Departmento de Biologia Estrutural e Funcional, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | | | - Francis Lopes Pacagnelli
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
- Programa de Pós-Graduação em Ciência Animal, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
| | - Francisco Eduardo Martinez
- Departmento de Biologia Estrutural e Funcional, Instituto de Biociências de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - Leonardo de Oliveira Mendes
- Programa de Pós-Graduação em Ciências da Saúde, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
- Programa de Pós-Graduação em Ciência Animal, Universidade do Oeste Paulista, Presidente Prudente, SP, Brasil
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Almaguer J, Murray D, Murray M, Murray R. Biliary Outlet Obstruction Due to Pancreatic Calculi in a Post-cholecystectomy Patient. Cureus 2023; 15:e44328. [PMID: 37649927 PMCID: PMC10464916 DOI: 10.7759/cureus.44328] [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] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
Chronic pancreatitis has been shown to cause various pathologies, such as biliary strictures and pancreatic malignancies, which can in turn result in biliary outlet obstruction. However, a pancreatic calculus itself resulting in biliary obstruction has been far less observed. The patient in question had a documented history of chronic alcoholism and received a cholecystectomy decades prior to the onset of cholestatic symptoms. Cholangiography demonstrated no indication of biliary stricture formation, nor was there radiological evidence of pancreatic pseudocyst or malignant formation. CT evidence across a decade of time established a storyline of pancreatic calculi formation, migration, and resultant biliary obstruction. Subsequent endoscopic sphincterectomy, pancreatic calculi removal, and biliary tree stent placement resulted in laboratory value normalization and clinical symptom resolution.
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Affiliation(s)
- Joey Almaguer
- Department of Radiology, Texas Tech University Health Sciences Center School of Medicine, Amarillo, USA
| | - Dylan Murray
- Department of Surgery, University College Dublin, Dublin, IRL
| | - Matthew Murray
- Department of Surgery, Royal College of Surgeons, Dublin, IRL
| | - Richard Murray
- Department of Diagnostic and Interventional Radiology, Northwest Texas Healthcare System, Amarillo, USA
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Pentapati S, Caucci S, Balmuri S, Devarkonda V. Complete Remission of Advanced Hepatocellular Carcinoma in a Patient With Ulcerative Colitis Treated With Atezolizumab and Bevacizumab: A Case Report. Cureus 2023; 15:e39538. [PMID: 37366434 PMCID: PMC10290901 DOI: 10.7759/cureus.39538] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
In this case study, a 73-year-old man who had previously undergone colectomy had a history of ulcerative colitis and alcohol abuse and presented with fatigue, weight loss, and a liver lesion. After a biopsy, he was diagnosed with stage IV-A hepatocellular carcinoma with poor differentiation and cirrhotic architecture, and molecular testing revealed positivity for multiple genes. A combination of atezolizumab and bevacizumab was administered, resulting in complete remission lasting beyond 16 months, demonstrating the potential of these drugs as a treatment option for advanced hepatocellular carcinoma (HCC). The patient's history of autoimmune conditions could have contributed to his robust response to the treatment. The report highlights the sustained survival benefits of this treatment beyond month 16.
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Affiliation(s)
- Swetha Pentapati
- Hematology and Oncology, Michigan State University College of Human Medicine, Lansing, USA
| | - Stephen Caucci
- Internal Medicine, Michigan State University College of Human Medicine, Lansing, USA
| | - Shravya Balmuri
- Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Vishal Devarkonda
- Internal Medicine, Louisiana State University Health Sciences Center, Shreveport, USA
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Haider A, Gurjar H, Ghazanfar H, Singh H, Siddiqa A. A Reversible Cause of Cutaneous Rash in a Patient With Alcohol Consumption. Cureus 2023; 15:e35011. [PMID: 36938293 PMCID: PMC10021349 DOI: 10.7759/cureus.35011] [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] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
The most common cutaneous manifestations of alcoholism include urticarial reaction, flushing, porphyria cutanea tarda, psoriasis, rosacea, seborrheic dermatitis, and pruritus. Here, we present a case of a young male with a history of alcohol abuse who presented with non-blanching, petechial, and perifollicular macular rash secondary to vitamin C deficiency in view of poor oral intake. The rash improved significantly with vitamin C supplementation. Although rare in developed countries, clinicians should keep vitamin C deficiency as a differential diagnosis for skin rash in alcohol consumers.
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Affiliation(s)
- Asim Haider
- Internal Medicine, BronxCare Health System, New York, USA
| | - Hitesh Gurjar
- Internal Medicine, BronxCare Health System, New York, USA
| | | | | | - Ayesha Siddiqa
- Infectious Diseases, NewYork-Presbyterian Queens Hospital, New York, USA
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8
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Castro I, Cardoso J, Esteves C, Figueiredo A. Marchiafava-Bignami Disease: Report of a Subacute Case. Cureus 2023; 15:e34692. [PMID: 36909031 PMCID: PMC9995083 DOI: 10.7759/cureus.34692] [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] [Accepted: 02/06/2023] [Indexed: 02/09/2023] Open
Abstract
Marchiafava-Bignami disease (MBD) is rare and often associated with chronic alcohol consumption; however, cases have been described in non-alcoholic patients with nutritional deficits. This disease manifests itself through an array of neurological signs and symptoms, from mild dysarthria or mild confusion to coma and death, and can present acutely, subacutely, or chronically, depending on their severity. The evolution of imaging technology makes magnetic resonance imaging (MRI) the gold standard for the diagnosis of this disease, although computed tomography (CT) scan is usually in the first line owing to its greater availability. The main feature for the diagnosis of MBD by brain MRI is the identification of areas of demyelination and necrosis of the corpus callosum. We report a 55-year-old male with subacute neurological deterioration whose MRI demonstrated atrophy and demyelination of the corpus callosum.
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Affiliation(s)
- Ivo Castro
- Department of Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT
| | - João Cardoso
- Department of Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT
| | - Cristina Esteves
- Department of Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT
| | - Adelaide Figueiredo
- Department of Internal Medicine, Hospital Distrital de Santarém, Santarém, PRT
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9
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Adhikari P, Shukla PK, Alharthi F, Rao R, Pradhan P. Photonic technique to study the effects of probiotics on chronic alcoholic brain cells by quantifying their molecular specific structural alterations via confocal imaging. J Biophotonics 2022; 15:e202100247. [PMID: 34786860 DOI: 10.1002/jbio.202100247] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
Molecular specific photonics localization method, the inverse participation ratio (IPR) technique, is a powerful procedure to probe the nano- to submicron scales structural alterations in cells/tissues in their abnormalities due to chronic alcoholism using confocal imaging. Chronic alcoholism introduces abnormalities in brain cells/tissue at the nanoscale level that results in behavioural and psychological disorders which are not well understood. On the other hand, probiotics such as Lactobacillus plantarum enhances brain functions in chronic alcoholism. Using the IPR technique, we probe the molecular specific spatial structural alterations in glial brain cells astrocytes and microglia, as well as in chromatins in the nuclei of cortex brain cells, with or without probiotic treatments in chronic alcoholism. The results show chronic alcoholism alone harms brain cells and the probiotic treatment in chronic alcoholism reverses alcoholic damage in the brain cells/tissues toward normalcy.
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Affiliation(s)
- Prakash Adhikari
- Department of Physics and Astronomy, Mississippi State University, Mississippi State, Mississippi, USA
| | - Pradeep K Shukla
- Department of Physiology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Fatemah Alharthi
- Department of Physics and Astronomy, Mississippi State University, Mississippi State, Mississippi, USA
| | - Radhakrishna Rao
- Department of Physiology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Prabhakar Pradhan
- Department of Physics and Astronomy, Mississippi State University, Mississippi State, Mississippi, USA
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Abstract
Wernicke encephalopathy (WE) is the most common neurological complication of thiamine deficiency in patients who have a background of chronic alcohol use disorder. WE is characterized by acute onset of confusion, gait ataxia, and oculomotor dysfunction. Prompt treatment with parenteral thiamine leads to improvement. Untreated WE has mortality rates of up to 20% and many cases progress to the more chronic Korsakoff syndrome. Cases of untreated WE in which symptoms last beyond the acute phase and become chronic are rarely found in the literature. Here, we present a case of a 64-year-old female having a background of chronic alcohol use disorder presenting with symptoms of gait ataxia, recurrent falls, and decreased concentration. These symptoms had progressed over a period of nine months. The patient was seen by her family physician and several specialists undergoing many diagnostic studies with inconclusive results. Ultimately, with a high index of suspicion for thiamine deficiency, she was admitted for IV thiamine treatment. Upon follow-up in the clinic, the patient reported improvement in her balance and concentration further confirming the initial suspicion of WE with thiamine deficiency as the cause of her symptoms. This case corroborates the existence of WE as a chronic phenomenon in addition to the more commonly reported acute WE. Furthermore, this case highlights the importance of recognizing WE as a potential cause of chronic neurological symptoms in people with alcohol-related disorders and the role of IV thiamine in treatment.
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Affiliation(s)
- Hina Bagash
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Assad Marwat
- Internal Medicine, Shifa Tameer-E-Millat University, Shifa College of Medicine, Islamabad, PAK
| | - Asghar Marwat
- Internal Medicine, Prairie Ridge Health, Sun Prairie, USA.,Internal Medicine, Conemaugh Memorial Medical Center, Johnstown, USA
| | - Bruce Kraus
- Internal Medicine, Prairie Ridge Health, Columbus, USA
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Jain N, Smirnovs M, Strojeva S, Murovska M, Skuja S. Chronic Alcoholism and HHV-6 Infection Synergistically Promote Neuroinflammatory Microglial Phenotypes in the Substantia Nigra of the Adult Human Brain. Biomedicines 2021; 9:biomedicines9091216. [PMID: 34572401 PMCID: PMC8472392 DOI: 10.3390/biomedicines9091216] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 12/25/2022] Open
Abstract
Both chronic alcoholism and human herpesvirus-6 (HHV-6) infection have been identified as promoters of neuroinflammation and known to cause movement-related disorders. Substantia Nigra (SN), the dopaminergic neuron-rich region of the basal ganglia, is involved in regulating motor function and the reward system. Hence, we hypothesize the presence of possible synergism between alcoholism and HHV-6 infection in the SN region and report a comprehensive quantification and characterization of microglial functions and morphology in postmortem brain tissue from 44 healthy, age-matched alcoholics and chronic alcoholics. A decrease in the perivascular CD68+ microglia in alcoholics was noted in both the gray and white matter. Additionally, the CD68+/Iba1− microglial subpopulation was found to be the dominant type in the controls. Conversely, in alcoholics, dystrophic changes in microglia were seen with a significant increase in Iba1 expression and perivascular to diffuse migration. An increase in CD11b expression was noted in alcoholics, with the Iba1+/CD11b− subtype promoting inflammation. All the controls were found to be negative for HHV-6 whilst the alcoholics demonstrated HHV-6 positivity in both gray and white matter. Amongst HHV-6 positive alcoholics, all the above-mentioned changes were found to be heightened when compared with HHV-6 negative alcoholics, thereby highlighting the compounding relationship between alcoholism and HHV-6 infection that promotes microglia-mediated neuroinflammation.
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Affiliation(s)
- Nityanand Jain
- Joint Laboratory of Electron Microscopy, Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia;
- Correspondence: (N.J.); (S.S.); Tel.: +371-673-204-21 (N.J. & S.S.)
| | - Marks Smirnovs
- Joint Laboratory of Electron Microscopy, Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia;
| | - Samanta Strojeva
- Institute of Microbiology and Virology, Rīga Stradiņš University, LV-1067 Riga, Latvia; (S.S.); (M.M.)
| | - Modra Murovska
- Institute of Microbiology and Virology, Rīga Stradiņš University, LV-1067 Riga, Latvia; (S.S.); (M.M.)
| | - Sandra Skuja
- Joint Laboratory of Electron Microscopy, Institute of Anatomy and Anthropology, Rīga Stradiņš University, LV-1010 Riga, Latvia;
- Correspondence: (N.J.); (S.S.); Tel.: +371-673-204-21 (N.J. & S.S.)
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Oh SS, Lee S, Jang SI, Park EC. Chronic alcoholism and all-cause mortality among disabled individuals: Findings from the Korea National Health Insurance Service-National Sample Cohort. Alcohol 2020; 89:57-62. [PMID: 32860858 DOI: 10.1016/j.alcohol.2020.08.006] [Citation(s) in RCA: 2] [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] [Received: 03/24/2020] [Revised: 07/27/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alcohol use among adults with mild to severe disability is an under-researched topic in the literature. Few studies have attempted to assess the impact of alcohol misuse, abuse, and chronic alcoholism among this target group. Thus, we investigated the association between chronic alcoholism and mortality among disabled individuals in South Korea. METHODS We used data from the National Health Insurance Service National Sample Cohort (NHIS-NSC) for the years 2003-2013, which included data on 61,013 disabled individuals. Among these patients, a multivariate Cox proportional hazards model was used to estimate the hazard ratio of mortality associated with chronic alcoholism. RESULTS A total of 800 individuals died during the study period. Individuals who had medical claims for chronic alcoholism following their disability diagnosis had greater risk of mortality than individuals without chronic alcoholism (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 1.06-2.31, p = 0.0244). Individuals with a physical disability (HR: 2.30, 95% CI: 1.06-4.95, p = 0.0342), brain lesion (HR: 1.96, 95% CI: 1.03-3.74, p = 0.0405), and/or kidney failure (HR: 4.98, 95% CI: 1.07-23.25, p = 0.0411) had greatest mortality risk when diagnosed with chronic alcoholism, compared to individuals who were not diagnosed with chronic alcoholism. CONCLUSIONS Chronic alcoholism following disability diagnosis was associated with greater mortality risk in a nationally representative population of disabled individuals, especially among individuals with a physical disability, brain lesion, and/or kidney failure. Such findings reveal that certain social and political measures must be implemented to help disabled individuals suffering from alcoholism, especially according to disability diagnosis.
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Lajtai A, Lakatos Á, Kuzma M, Mayer M, Miseta A. Tragic consequences of paracetamol therapy in chronic liver disease. Orv Hetil 2020; 161:1720-1723. [PMID: 33011708 DOI: 10.1556/650.2020.31752] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Abstract
Absztrakt:
Az őszi és téli meghűléses időszakban sokan vásárolnak különböző, vény nélkül
kapható, megfázás elleni készítményeket, ezen belül is nagy számban paracetamol-
(más néven acetaminofén-) tartalmú szereket. A paracetamol különböző típusú
fájdalmak (fejfájás, migrén, meghűlés-láz okozta fájdalom, fogfájás,
menstruációs fájdalom stb.) enyhítésére szolgáló, igen népszerű, a nemopioid
típusú analgetikumok közé sorolható hatóanyag, amely többek között tabletta, kúp
és oldat formájában is elérhető a gyógyszertárakban. Magyarországon 2020-ban 86,
törzskönyvezett paracetamoltartalmú készítmény van forgalomban. A paracetamol
alkalmazása biztonságos és hatékony, amennyiben az előírásnak megfelelően
használják. Közleményünkben három olyan esetet mutatunk be, amelyben a beteg
halála összefüggésbe hozható a paracetamol alkalmazásával. Mindhárom, krónikus
alkoholizmusban szenvedő beteg (34, 42 és 51 évesek) rövid idővel a kórházba
kerülés után elhunyt. Vizsgálataink során három betegből származó, összesen
kilenc szérumminta került feldolgozásra. A paracetamolnak és metabolitjainak
együttes meghatározása enzimatikus módszerrel (Roche assay) történt, míg a
paracetamol specifikus mérésére tandem-tömegspektrométerrel kapcsolt
szuperkritikus folyadékkromatográfot (SFC–MS/MS) alkalmaztunk. Enzimatikus
meghatározással mindegyik mintában terápiás koncentrációt mutattunk ki.
SFC–MS/MS módszerrel történt meghatározás esetén egy betegtől származó négy
mintában a terápiás tartománynál alacsonyabb paracetamolkoncentrációkat mértünk.
A paracetamolterápia alkalmazása krónikus alkoholizmusban szenvedő betegek
esetén fokozott kockázatot jelent. A klinikai toxikológiai gyakorlatban a
paracetamol meghatározására használt enzimatikus módszer eredményét a máj- és
vesefunkciós paraméterekkel együttesen szükséges értékelni, mert krónikus
alkoholizmusban szenvedő betegek esetén az enzimatikus módszerrel kapott
terápiás tartományba eső koncentráció nem zárja ki a paracetamoltoxicitást. Orv
Hetil. 2020; 161(40): 1720–1723.
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Affiliation(s)
- Anikó Lajtai
- 1 Általános Orvostudományi Kar, Klinikai Központ, Laboratóriumi Medicina Intézet, Pécsi Tudományegyetem, Pécs, Ifjúság út 13., 7624
| | - Ágnes Lakatos
- 1 Általános Orvostudományi Kar, Klinikai Központ, Laboratóriumi Medicina Intézet, Pécsi Tudományegyetem, Pécs, Ifjúság út 13., 7624
| | - Mónika Kuzma
- 2 Általános Orvostudományi Kar, Igazságügyi Orvostani Intézet, Pécsi Tudományegyetem, Pécs
| | - Mátyás Mayer
- 2 Általános Orvostudományi Kar, Igazságügyi Orvostani Intézet, Pécsi Tudományegyetem, Pécs
| | - Attila Miseta
- 1 Általános Orvostudományi Kar, Klinikai Központ, Laboratóriumi Medicina Intézet, Pécsi Tudományegyetem, Pécs, Ifjúság út 13., 7624
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Yao LX, Han JX, Wei PY, Hou SB, He XJ, Zhang RL, DU AL. [Effects of butylphthalide on H 2S/CBS pathway in hippocampal and amygdala and learning and memory ability in chronic alcoholism rats]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2020; 36:138-42. [PMID: 32744007 DOI: 10.12047/j.cjap.5902.2020.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the effects of butylphthalide (NBP) on learning and memory related ability, hydrogen sulfide (H2S) content in hippocampus and amygdala, cystathionine-β-synthase (CBS) expression and mitochondrial ATPase activity in rats with chronic alcoholism. Methods: Ninety SD male rats were randomly divided into three groups: normal control group (NC), model group (M) and butylphthalide remedy group (BR). Except for the control group, the water solution containing 6% (v/v) alcohol was used as the sole source of drinking water in the other two groups. After 14 days of feeding, the butylphthalide remedy group was injected with NBP intraperitoneally at the dose of 5 mg/kg once a day for 14 consecutive days, and the remaining two groups were injected with the same dose of normal saline. The control group subsequently used the Morris water maze method to observe and record the animals after entering the water. The time required for the underwater platform, their strategies and their swimming trajectories could analyze and infer the animal's ability to learn and remember. H2S concentration, CBS expression and mitochondrial ATPase activity in hippocampus and amygdale were dectected. Results: Compared with NC group, the latency period and swimming distance of M group were increased, the content of H2S and the mean optical density of CBS in hippocampus and amygdala were increased, and the activity of mitochondrial ATPase in hippocampus and amygdala was decreased significantly (P<0. 01) . Compared with the M group, the latency period and swimming distance of learning and memory performance of BR group were decreased, the content of H2S and the mean optical density of CBS in hippocampus and amygdala were decreased, and the activity of mitochondrial ATPase in hippocampus and amygdala was increased significantly (P<0. 01) . Conclusion: NBP can alleviate the effect of ethanol on learning and memory in rats, which may be related to the effect of NBP on the concentration of H2S and the expression of CBS in the amygdala of hippocampus and the increase of ATPase activity.
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Stoica SI, Tănase I, Ciobanu V, Onose G. Initial researches on neuro-functional status and evolution in chronic ethanol consumers with recent traumatic spinal cord injury. J Med Life 2019; 12:97-112. [PMID: 31406510 PMCID: PMC6685305 DOI: 10.25122/jml-2019-0026] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
We found differences related to the neuro-functional deficiency and clinical progress, among non-consumers and chronic consumers of ethanol, with recent traumatic spinal cord injury (SCI). We present a synthesis of related data on lesion mechanisms in post-traumatic myelogenous disorders, namely some of the alcohols and their actions on the nervous system, with details on the influences exerted, in such afflictions, by the chronic consumption of ethanol. The subject is not frequently approached – according to a literature review with systematic elements, which we have done before – thus constituting a niche that deserves to be further explored. The applicative component of the article highlights statistical data resulted from a retrospective study regarding the specialized casuistry from the Neuromuscular Recovery Clinic of the “Bagdasar Arseni” Emergency Clinical Hospital, following the comparative analysis of two groups of patients with recent SCI: non-consumers – the control group (n=780) – and chronic ethanol consumers – the study group (n=225) – with the addition of a prospective pilot component. Data processing has been achieved with SPSS 24. The American Spinal Injury Association Impairment Scale (AIS) mean motor scores differ significantly (tests: Mann-Whitney and t) between the control and study group in favor of the second, both at admission (p<0.001) and at discharge (p<0.001). AIS mean sensitive scores differ between the two lots, and also in favor of the study, but statistically significant only at discharge (p=0.048); the difference at admission is not significant (p=0.51) – possibly because of alcoholic-nutritional polyneuropathy. These findings, with numerous related details, later presented in the text, are surprising, which requires further studies and attempts of understanding.
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Affiliation(s)
- Simona Isabelle Stoica
- "Carol Davila" University of Medicine and Pharmacy (UMPCD), Bucharest, Romania.,Teaching Emergency Hospital "Bagdasar-Arseni" (TEHBA), Bucharest, Romania
| | - Ioana Tănase
- "Carol Davila" University of Medicine and Pharmacy (UMPCD), Bucharest, Romania.,Teaching Emergency Hospital "Bagdasar-Arseni" (TEHBA), Bucharest, Romania
| | - Vlad Ciobanu
- Politehnica University of Bucharest (PUB), Bucharest, Romania
| | - Gelu Onose
- "Carol Davila" University of Medicine and Pharmacy (UMPCD), Bucharest, Romania.,Teaching Emergency Hospital "Bagdasar-Arseni" (TEHBA), Bucharest, Romania
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Abstract
We herein report a case of Campylobacter fetus meningoencephalitis in a patient with chronic alcoholism. C. fetus is a rare cause of meningitis. The patient presented with hallucinations and monology, and alcohol withdrawal was initially suspected. After he was unsuccessfully treated for alcohol withdrawal delirium, we diagnosed C. fetus meningoencephalitis. Ampicillin monotherapy gradually improved his clinical status. A previous report stated that C. fetus infection is associated with chronic alcoholism. In patients with chronic alcoholism and disturbed consciousness, an atypical bacterial central nervous system infection, such as C. fetus meningoencephalitis, should be considered.
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Affiliation(s)
- Sho Tanabe
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Satoshi Kutsuna
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Motoyuki Tsuboi
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Nozomi Takeshita
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan
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Nie X, Wang W, Wang Q, Zhu D, Song H. Intranasal erythropoietin ameliorates neurological function impairments and neural pathology in mice with chronic alcoholism by regulating autophagy‑related Nrf2 degradation. Mol Med Rep 2018; 19:1139-1149. [PMID: 30535439 PMCID: PMC6323205 DOI: 10.3892/mmr.2018.9706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 04/05/2018] [Accepted: 11/01/2018] [Indexed: 12/22/2022] Open
Abstract
The neurological disorders and neural pathology brought about by chronic alcoholism are difficult to be reversed. Increasing evidence highlights the protective roles of erythropoietin (EPO) in neurodegenerative diseases and injuries of the central nervous system. In the present study, we investigated the therapeutic effects of EPO on the neurological function deficits and neural pathology caused by chronic alcoholism and the regulatory mechanisms. Using the canonical mouse model of chronic alcohol exposure designed to mimic the repeated cycles of heavy abuse typical of chronic alcoholism, it was found that EPO delivered via intranasal route effectively restored the alcohol-impaired motor cooperation in rotarod and beam walk tests, reversed alcoholic cognitive and emotional alterations in the novel location recognition task and open-filed test, and rescued alcohol-disrupted nervous conduction in the somatosensory-evoked potential (SSEP) test. Consistently, the intranasally administered EPO promoted the remyelination and synapse formation in chronic alcohol-affected neocortex and hippocampus as evidenced by immunofluorescence staining and transmission electron microscopy. Additionally, we discovered that the exogenous rhEPO, which entered the cerebrum through intranasal route, activated the erythropoietin receptor (EPOR) and the downstream ERKs and PI3K/AKT signaling, and suppressed autophagy-related degradation of nuclear factor, erythroid 2-like 2 (Nrf2). Furthermore, the intranasal EPO-exerted neuroprotection was almost abolished when the specific Nrf2 antagonist ATRA was administered intraperitoneally prior to intranasal EPO treatment. Collectively, our data demonstrated the repairing potential of EPO for the neurological disorders and neural pathology caused by chronic alcoholism, and identified the Nrf2 activity as the key mechanism mediating the protective effects of EPO.
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Affiliation(s)
- Xuedan Nie
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Wenbo Wang
- Intensive Care Unit, The Fifth Affiliated Hospital of Qiqihar Medical University (Daqing Longnan Hospital), Daqing, Heilongjiang 163453, P.R. China
| | - Qin Wang
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Dan Zhu
- Department of Nephrology, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Hongshan Song
- Department of Neurology, The Fifth Affiliated Hospital of Qiqihar Medical University (Daqing Longnan Hospital), Daqing, Heilongjiang 163453, P.R. China
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Qin HZ, Jiang HB, Dai X, Huang YD, Luo XQ, Zhang RL, Du AL. [Effects of aminooxyacetic acid on the learning and memory ability and its possible mechanism in rats with chronic alcoholism]. Zhongguo Ying Yong Sheng Li Xue Za Zhi 2018; 34:485-9. [PMID: 31032581 DOI: 10.12047/j.cjap.5662.2018.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effects of aminooxyacetic acid (AOAA) on learning and memory ability and possible mechanisms in rats with chronic alcoholism. METHODS Sixty SD male rats were randomly divided into three groups on average.The model group rats and the remedy group rats were fed with the water containing (v/v) 6% alcohol for 28 days.After 14 days, the remedy group rats were treated with AOAA (5 mg/kg·d) by intraperitoneal injection once a day for 14 days and the other two group rats were treated with the equal amount of saline by intraperitoneal injection every day.Five days before the end of the experiment, the water maze test was carried out to test the learning and memory ability of rats for 5 days.Subsequently, the content of H2S, the activity of ATP enzyme and the expression of 5-HT in hippocampus were measured. RESULTS Compared with the rats in the control group, the latency and the swimming distance of the 2nd to the 4th day, the content of H2S in hippocampus of rats in the model group were all increased, the mitochondrial ATP enzyme activity in hippocampus and the positive expression of 5-HT in hippocampus CA1 and CA3 of rats in the model group were decreased (P<0.01).Compared with the rats in the model group, the latency and the swimming distance of the 2nd to the 4th day, the content of H2S in hippocampus of the rats in the remedy group were decreased, the mitochondrial ATP enzyme activity in hippocampus and the positive expression of 5-HT in hippocampus CA1 and CA3 of rats in the model group were increased (P<0.01). CONCLUSIONS AOAA could alleviate the symptoms of chronic alcoholism rats, which may be related to the effects of AOAA on the content of H2S, the mitochondrial enzyme activity and the expression of 5-HT in hippocampus.
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Feng XM, Zhao T, Zhou CK, Liu JY. Psychiatric symptoms and limb tremors associated with central pontine myelinolysis: A case of alcoholism without hyponatremia. Exp Ther Med 2016; 12:3485-3487. [PMID: 27882183 DOI: 10.3892/etm.2016.3780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 08/26/2015] [Accepted: 09/01/2016] [Indexed: 12/23/2022] Open
Abstract
Central pontine myelinolysis (CPM), also known as osmotic demyelination syndrome, is a rare demyelinating disorder characterized by the loss of myelin in the center of the basis pontis. In this case report, an alcoholic patient with CPM and acquired demyelinating lesion of the basis pontis is described. The patient is a 70 year-old woman who presented with intermittent psychiatric symptoms and limb tremors following two months of alcohol abuse. During admission, magnetic resonance imaging (MRI) revealed hyperintensity on T2 weighted images and fluid-attenuated inversion-recovery imaging in the central pons without contrast enhancement. The patient's symptoms gradually improved following conservative treatment with vitamins B1 and B12. The one month follow-up MRI showed a significant reduction of the pontine injury.
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Affiliation(s)
- Xue-Min Feng
- Department of Neurology, The First Hospital, Jilin University, Changchun, Jilin 130031, P.R. China
| | - Teng Zhao
- Department of Neurology, The First Hospital, Jilin University, Changchun, Jilin 130031, P.R. China
| | - Chun-Kui Zhou
- Department of Neurology, The First Hospital, Jilin University, Changchun, Jilin 130031, P.R. China
| | - Jing-Yao Liu
- Department of Neurology, The First Hospital, Jilin University, Changchun, Jilin 130031, P.R. China
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Affiliation(s)
- Oki Nakano
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Science, Niigata University, Japan
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Li S, Wang SU, Guo ZG, Huang N, Zhao FR, Zhu ML, Ma LJ, Liang JY, Zhang YL, Huang ZL, Wan GR. Protective effect of Xingnaojia formulation on rats with brain and liver damage caused by chronic alcoholism. Exp Ther Med 2015; 10:1643-1652. [PMID: 26640531 PMCID: PMC4665616 DOI: 10.3892/etm.2015.2773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/31/2015] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to observe the effect of a formulation of traditional Chinese medicine extracts known as Xingnaojia (XNJ) on the liver function, learning ability and memory of rats with chronic alcoholism and to verify the mechanism by which it protects the brain and liver. A rat model of chronic alcoholism was used in the study. The spatial learning ability and memory of the rats were tested. The rats were then sacrificed and their brains and hepatic tissues were isolated. The activity of superoxide dismutase (SOD) and levels of glutamate (Glu), N-methyl D-aspartate receptor subtype 2B (NR2B), cyclin-dependent kinase 5 (CDK5) and cannabinoid receptor 1 (CB1) in the hippocampus were analyzed. The ultrastructure of the hepatic tissue was observed by electron microscopy. In addition, the activities of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) in serum were tested and the levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and total cholesterol (TCHOL) were analyzed. XNJ enhanced the learning and memory of rats with chronic alcoholism. Treatment with XNJ increased the activity of SOD, and decreased the expression levels of NR2B mRNA and NR2B, CB1 and CDK5 proteins in the brain tissues compared with those in the model rats. It also increased the activity of ALDH in the serum and liver, decreased the serum levels of LDL, TG and TCHOL and increased the serum level of HDL. These results indicate that XNJ exhibited a protective effect against brain and liver damage in rats with chronic alcoholism.
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Affiliation(s)
- Shuang Li
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - S U Wang
- College of Pharmacy, The Third Affiliated Hospital, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Zhi-Gang Guo
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Ning Huang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Fan-Rong Zhao
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Mo-Li Zhu
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Li-Juan Ma
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Jin-Ying Liang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Yu-Lin Zhang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Zhong-Lin Huang
- College of Pharmacy, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
| | - Guang-Rui Wan
- School of Basic Medical Sciences, Xinxiang Medical University, Xinxiang, Henan 453003, P.R. China
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Cui Y, Zheng L, Wang X, Zhang W, Yuan D, Wei Y. Marchiafava-Bignami disease with rare etiology: A case report. Exp Ther Med 2015; 9:1515-1517. [PMID: 25780461 PMCID: PMC4353765 DOI: 10.3892/etm.2015.2263] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/01/2014] [Accepted: 01/20/2015] [Indexed: 11/13/2022] Open
Abstract
A male, 62-year-old patient was admitted to hospital due to dizziness and gait disturbance for 10 days. The patient had fallen a few times due to the gait instability, which was associated with stiffness and memory loss. The patient had undergone cardiac carcinoma surgery three years previously and had no drinking history. Physical examination revealed that the patient was lucid when conscious but exhibited slurred speech, apathy and cognitive impairment. The finger-to-nose and rapid alternating movement tests showed the patient to be slightly clumsy. Magnetic resonance imaging revealed symmetric abnormal signals in the splenium of the corpus callosum, and the diagnosis was Marchiafava-Bignami disease (MBD). The patient recovered following the administration of vitamin B and other treatments. The patient had long-term appetite loss. A brain myelin metabolism disorder caused by long-term malnutrition and leading to demyelinating changes in the brain may have been the cause of the MBD of this patient. Clinicians should increase awareness of this disease and should not ignore the diagnosis of it, even when the patient lacks a drinking history. Early diagnosis and treatment can improve the prognosis of the patient.
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Affiliation(s)
- Yongjian Cui
- The Second Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
| | - Lei Zheng
- Central Laboratory, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
| | - Xiaoli Wang
- The Second Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
| | - Weiwen Zhang
- The Second Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
| | - Dongcai Yuan
- The Second Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
| | - Yan Wei
- The Second Department of Neurology, Harrison International Peace Hospital, Hengshui, Hebei 053000, P.R. China
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Shayakhmetova GM, Bondarenko LB, Matvienko AV, Kovalenko VM. Chronic alcoholism-mediated metabolic disorders in albino rat testes. Interdiscip Toxicol 2014; 7:165-72. [PMID: 26109895 PMCID: PMC4434111 DOI: 10.2478/intox-2014-0023] [Citation(s) in RCA: 5] [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: 09/03/2014] [Revised: 09/13/2014] [Accepted: 09/14/2014] [Indexed: 12/17/2022] Open
Abstract
There is good evidence for impairment of spermatogenesis and reductions in sperm counts and testosterone levels in chronic alcoholics. The mechanisms for these effects have not yet been studied in detail. The consequences of chronic alcohol consumption on the structure and/or metabolism of testis cell macromolecules require to be intensively investigated. The present work reports the effects of chronic alcoholism on contents of free amino acids, levels of cytochrome P450 3A2 (CYP3A2) mRNA expression and DNA fragmentation, as well as on contents of different cholesterol fractions and protein thiol groups in rat testes. Wistar albino male rats were divided into two groups: I - control (intact animals), II - chronic alcoholism (15% ethanol self-administration during 150 days). Following 150 days of alcohol consumption, testicular free amino acid content was found to be significantly changed as compared with control. The most profound changes were registered for contents of lysine (-53%) and methionine (+133%). The intensity of DNA fragmentation in alcohol-treated rat testes was considerably increased, on the contrary CYP3A2 mRNA expression in testis cells was inhibited, testicular contents of total and etherified cholesterol increased by 25% and 45% respectively, and protein SH-groups decreased by 13%. Multidirectional changes of the activities of testicular dehydrogenases were detected. We thus obtained complex assessment of chronic alcoholism effects in male gonads, affecting especially amino acid, protein, ATP and NADPH metabolism. Our results demonstrated profound changes in testes on the level of proteome and genome. We suggest that the revealed metabolic disorders can have negative implication on cellular regulation of spermatogenesis under long-term ethanol exposure.
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Affiliation(s)
- Ganna M Shayakhmetova
- General Toxicology Department, SI "Institute of Pharmacology & Toxicology", National Academy of Medical Sciences of Ukraine, Kyiv, 03680, Ukraine
| | - Larysa B Bondarenko
- General Toxicology Department, SI "Institute of Pharmacology & Toxicology", National Academy of Medical Sciences of Ukraine, Kyiv, 03680, Ukraine
| | - Anatoliy V Matvienko
- General Toxicology Department, SI "Institute of Pharmacology & Toxicology", National Academy of Medical Sciences of Ukraine, Kyiv, 03680, Ukraine
| | - Valentina M Kovalenko
- General Toxicology Department, SI "Institute of Pharmacology & Toxicology", National Academy of Medical Sciences of Ukraine, Kyiv, 03680, Ukraine
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Abstract
Chronic alcoholism can damage the cytoskeleton and aggravate neurological deficits. However, the effect of chronic alcoholism on hippocampal neurons remains unclear. In this study, a model of chronic alcoholism was established in rats that were fed with 6% alcohol for 42 days. Endogenous hydrogen sulfide content and cystathionine-beta-synthase activity in the hippocampus of rats with chronic alcoholism were significantly increased, while F-actin expression was decreased. Hippocampal neurons in rats with chronic alcoholism appeared to have a fuzzy nuclear membrane, mitochondrial edema, and ruptured mitochondrial crista. These findings suggest that chronic alcoholism can cause learning and memory decline in rats, which may be associated with the hydrogen sulfide/cystathionine-beta-synthase system, mitochondrial damage and reduced expression of F-actin.
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Affiliation(s)
- Ailin Du
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Hongbo Jiang
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Neurology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Lei Xu
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Na An
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Hui Liu
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Neurology, the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Yinsheng Li
- Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China
| | - Ruiling Zhang
- Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan Province, China ; Department of Physiology and Neurobiology, Xinxiang Medical University, Xinxiang, Henan Province, China ; Henan Provincial Key Laboratory of Bio-psychiatry, Xinxiang, Henan Province, China
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25
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Fama R, Rosenbloom MJ, Sassoon SA, Thompson MA, Pfefferbaum A, Sullivan EV. Remote semantic memory for public figures in HIV infection, alcoholism, and their comorbidity. Alcohol Clin Exp Res 2011; 35:265-76. [PMID: 21121935 PMCID: PMC3058901 DOI: 10.1111/j.1530-0277.2010.01342.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Impairments in component processes of working and episodic memory mark both HIV infection and chronic alcoholism, with compounded deficits often observed in individuals comorbid for these conditions. Remote semantic memory processes, however, have only seldom been studied in these diagnostic groups. Examination of remote semantic memory could provide insight into the underlying processes associated with storage and retrieval of learned information over extended time periods while elucidating spared and impaired cognitive functions in these clinical groups. METHODS We examined component processes of remote semantic memory in HIV infection and chronic alcoholism in 4 subject groups (HIV, ALC, HIV + ALC, and age-matched healthy adults) using a modified version of the Presidents Test. Free recall, recognition, and sequencing of presidential candidates and election dates were assessed. In addition, component processes of working, episodic, and semantic memory were assessed with ancillary cognitive tests. RESULTS The comorbid group (HIV + ALC) was significantly impaired on sequencing of remote semantic information compared with age-matched healthy adults. Free recall of remote semantic information was also modestly impaired in the HIV + ALC group, but normal performance for recognition of this information was observed. Few differences were observed between the single diagnosis groups (HIV, ALC) and healthy adults, although examination of the component processes underlying remote semantic memory scores elicited differences between the HIV and ALC groups. Selective remote memory processes were related to lifetime alcohol consumption in the ALC group and to viral load and depression level in the HIV group. Hepatitis C diagnosis was associated with lower remote semantic memory scores in all 3 clinical groups. Education level did not account for group differences reported. CONCLUSIONS This study provides behavioral support for the existence of adverse effects associated with the comorbidity of HIV infection and chronic alcoholism on selective component processes of memory function, with untoward effects exacerbated by Hepatitis C infection. The pattern of remote semantic memory function in HIV + ALC is consistent with those observed in neurological conditions primarily affecting frontostriatal pathways and suggests that remote memory dysfunction in HIV + ALC may be a result of impaired retrieval processes rather than loss of remote semantic information per se.
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Affiliation(s)
- Rosemary Fama
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Neuroscience Program, SRI International, Menlo Park, CA
| | - Margaret J. Rosenbloom
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Neuroscience Program, SRI International, Menlo Park, CA
| | | | | | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
- Neuroscience Program, SRI International, Menlo Park, CA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
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