Alcohol Abuse Research Articles

Advances in research on medications for the treatment of alcohol use disorders: A review.

Alcohol use disorder (AUD) has become a global public health challenge, with the social and economic costs of alcohol abuse escalating, drawing widespread attention from healthcare professionals and the public worldwide. Particularly in recent years, the COVID-19 pandemic and associated lockdown measures have led to a significant increase in global alcohol consumption, further exacerbating the risk of AUD and sparking in-depth discussions on its prevention and treatment methods. Given that the current mainstay of AUD treatment relies on pharmacotherapy, the aim of this article is to review the progress of existing drug research for the treatment of AUD, and at the same time to focus on drug classes that have not yet been applied to the clinic, but have been shown in recent studies to be potentially exploitable for the treatment of AUD, in order to provide new ideas and directions for future drug research and development efforts.

From sleep to sip? Examining a daily model of sleep and trauma-related drinking among sexual violence survivors.

Alcohol misuse is common among women who have experienced sexual violence and is often attributed to the self-medication model of alcohol use to alleviate posttraumatic stress disorder (PTSD) symptoms. Despite the proximal theorized role of PTSD symptoms, less attention has been given to daily associations between PTSD symptoms, trauma-related drinking to cope (TRD) motives, and ensuing alcohol use by survivors. Moreover, despite indications that poor sleep impacts affective functioning and may exacerbate daily PTSD symptoms, the role of sleep duration and quality in drinking to cope with PTSD symptoms is not well understood. This study examined an integrated model testing whether shorter sleep duration and poorer sleep quality predict greater daily PTSD symptoms and, in turn, greater alcohol use later that day through TRD motives. Participants were 82 cisgender women (Mage = 22.8, 73.2% White, 13.4% Hispanic/Latina, 56.1% heterosexual, 30.5% bisexual) who had experienced sexual violence. Participants completed ecological momentary assessment measures and wore actigraphs for 3 weeks. Contrary to hypotheses, shorter-than-usual sleep duration did not predict greater alcohol use quantity via daily PTSD symptoms and TRD motives. However, poorer-than-usual sleep quality predicted greater PTSD symptoms that day, which in turn predicted greater same-day TRD motives. Findings underscore the importance of sleep quality in heightened PTSD symptoms but suggest survivors did not drink more to alleviate trauma-related distress. Future research should examine other drinking motives among survivors to inform proximal interventions to prevent alcohol misuse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adverse Childhood Experiences (ACEs) in 252 Board-Certified Plastic Surgeons: Prevalences, ACE Clustering, and Effects on Adult Health and Behaviors, Including Self-Defined Depression, Work Addiction, and Burnout.

The CDC/Kaiser Adverse Childhood Experiences (ACE) study documented that ACEs predict adult health and self-harming behaviors. ACEs have been documented in physicians and are higher in physicians treated for problematic behavior. Plastic surgeons have never been assayed. Might ACE prevalences in plastic surgeons predict their adult health and/or behavior? 252 ABPS-certified plastic surgeons (72% men, 28% women, ) completed the 10-question CDC/Kaiser ACE survey by de-identified email. Data was collected on adult health and behaviors previously associated with ACEs in the literature. 42% of plastic surgeons had 1 or more ACEs; 9.9% had 4 or more. Emotional abuse was 2 times higher than the control CDC/Kaiser population, though other ACEs were lower. Gender differences existed: women suffered more sexual abuse (17% vs. 8%), physical neglect (7% vs. 1%), violence against their mothers (7% vs. 2%), and self-defined burnout (32% vs. 17%). ACEs occurred in clusters. Total ACEs predicted autoimmune disorders, chronic pain/fatigue, self-defined depression, irritable bowel, antidepressant/anxiolytic use, alcohol abuse, >3 marriages, >10 sexual partners, sex and work addiction, eating disorders, and self-defined burnout (all p< 0.020). Emotional abuse predicted alcohol abuse. Sexual abuse predicted sex addiction. Emotional neglect predicted autoimmune disease, antidepressant/anxiolytic use, eating disorder, and work addiction. Physical neglect predicted chronic fatigue/chronic pain, depression, and burnout (all p< 0.001 or less). Adverse childhood experiences occurred in 42% of our 252-member plastic surgeon cohort and predicted 13 adult illnesses and self-harming behaviors that can impair surgeons' lives and performances. Recognition may facilitate their recognition and treatment.

MASLD in persons with HIV is associated with high cardiometabolic risk as evidenced by altered advanced lipoprotein profiles and targeted metabolomics

BackgroundMetabolic dysfunction associated steatotic liver disease (MASLD) is associated with increased cardiovascular disease (CVD) risk in persons with HIV (PWH). The lipidomic and metabolomic alterations contributing to this risk are poorly understood. We aimed to characterize the advanced lipoprotein and targeted metabolomic profiles in PWH and assess if the presence and severity of MASLD influence these profiles.MethodsThis is a cross-sectional analysis of a prospectively enrolled multicenter cohort. PWH without alcohol abuse or known liver disease underwent vibration-controlled transient elastography for controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Lipidomic and metabolomic profiling was undertaken with nuclear magnetic resonance (NMR) spectroscopy. Hepatic steatosis was defined as CAP ≥ 263 dB/m and clinically significant fibrosis (CSF) as LSM ≥ 8 kPa. Logistic regression models assessed associations between MASLD, CSF and lipidomic and metabolic parameters.ResultsOf 190 participants (71% cisgender male, 96% on antiretroviral therapy), 58% had MASLD and 12% CSF. Mean (SD) age was 48.9 (12.1) years and body mass index (BMI) 29.9 (6.4) kg/m2. Compared to PWH without MASLD (controls), PWH with MASLD had lower HDL-C but higher total triglyceride, VLDL-C, branched-chain amino acids, GlycA, trimethylamine N-oxide levels, Lipoprotein-Insulin Resistance and Diabetes Risk Indices. There were no significant differences in these parameters between participants with MASLD with or without CSF. In a multivariable regression analysis, MASLD was independently associated with changes in most of these parameters after adjustment for age, gender, race/ethnicity, type 2 diabetes mellitus, BMI, and lipid lowering medications use.ConclusionsMASLD in PWH is independently associated with altered advanced lipoprotein and targeted metabolic profiles, indicating a higher CVD risk in this population.

How Do Health Information Scanning and Seeking Influence Excessive Alcohol Drinking Among Chinese Hypertensive Drinkers? A Moderated Mediation Analysis.

China has a longstanding tradition of alcohol consumption, yet excessive drinking poses significant health risks, particularly for individuals with cardiovascular conditions such as hypertension. While existing literature indicates that both health information scanning and seeking behaviors can impact health beliefs and actions, their effects on alcohol prevention remain understudied. Utilizing data from a national survey in China, this study investigates the influence of health information scanning and seeking on alcohol risk knowledge and the frequency of excessive drinking among hypertensive drinkers. Results demonstrate that both health information scanning (b = -.018, p < .05) and seeking (b = -.030, p < .001) are negatively associated with excessive alcohol consumption indirectly through heightened awareness of alcohol as a risk factor for cancer. However, health information scanning is positively linked to excessive drinking directly (b = .203, p < .01). Additionally, cancer information overload positively moderates the relationship between awareness of alcohol as a cancer risk factor and excessive drinking (b = .148, p < .001). Hypertensive drinkers who experience lower levels of cancer information overload are more inclined to reduce excessive alcohol consumption. These findings underscore the different roles of health information scanning and seeking on alcohol control. It is important to implement interventions aimed at encouraging active information seeking and mitigating information overload. Educational programs should be promoted to help high-risk groups accurately understand the risk of excessive drinking.

Music-Based Therapy for the Treatment of Perioperative Anxiety and Pain-A Randomized, Prospective Clinical Trial.

Background: Music-based intervention has been advocated as a nonpharmacologic approach for the perioperative control of pain and anxiety in surgical patients. However, its impact on patients with preoperative anxiety has not been clearly established. Our study aimed to examine the impact of music-based intervention administered before, during, and after surgery on postoperative opioid consumption and pain levels, as well as preoperative anxiety, depression, and pain catastrophizing. We hypothesized that, compared to a control group, music-based intervention would be effective in reducing opioid requirements and mood disorders. Methods: This study was a single-center, prospective, single-blinded, randomized controlled trial. Inclusion criteria isame-day or observation surgery. Exclusion criteria included American Society of Anesthesiologists physical status IV, use of spinal anesthesia, PROMIS Anxiety T-scores ≤ 57.4 and ≥74.1, preoperative chronic opioid use, transgender surgery, and history of drug or alcohol abuse. Music-based intervention was developed by a certified music therapist. Each patient was randomized to receive standard of care (SC) or SC plus music-based intervention before, during, and after surgery. The primary end point was postoperative oral morphine equivalents (OMEs) over 5 days following surgery using the area under the curve (AUC)Secondary end points were PROMIS Anxiety, PROMIS Depression scores Pain Catastrophizing Scale scores, postoperative nausea and vomiting, time of hospital discharge, and patient satisfaction (0 = totally unsatisfied to 10 = completely satisfied). Results: A total of 75 patients were randomized to a music-based intervention (n = 33) or control (n = 42) group. Patients in the music-based intervention group consumed 56.7% less opioids than those in the control group (AUC was 2.8 in the music-based intervention group vs. 6.4 in the control group, absolute standardized mean difference (aSMD) = 0.34 (-0.17, 0.85)). No difference in pain scores was recorded between groups. Music-based intervention also reduced anxiety on postoperative day (POD)2 (aSMD = 0.38 (-0.16, 0.91)), depression on POD2 (aSMD = 0.31 (-0.23, 0.84)) and POD4 (aSMD = 0.24 (-0.29, 0.77)), and pain catastrophizing on POD1 (aSMD = 0.24 (-0.3, 0.77)). Conclusions: Our data support the use of music-based intervention to reduce postoperative opioid requirements. Music-based intervention may also reduce anxiety, depression, and pain catastrophizing.

Don’t forget to mind the mind: a prospective cohort study over 12 months on mental health symptoms in active professional male footballers

AimsWe examined the prevalence and incidence of mental health symptoms (MHS) in active professional male footballers over a 12-month period and investigated if MHS was associated with severe injuries or surgeries.Participants and methodsFootball Players Worldwide (FIFPRO) affiliated national unions invited active professional male football players to participate in the study. MHS was operationalised in symptoms of anxiety, disordered eating, depression, distress, sleep disturbance, alcohol misuse and drug misuse, all being assessed with validated questionnaires.ResultsOf the 101 participants enrolled, the prevalence of distress was 53% and MHS was between 6% for drug misuse and 48% for alcohol misuse. The incidence of distress was 29% and MHS ranged from 1% for anxiety to 11% for sleep disturbance. At baseline, players suffering from injury/surgery were more likely to report depression (OR 1.35; 95%CI 1.10–1.70) and disordered eating (OR 1.22; 95%CI 1.02–1.47). At follow-up, players who suffered injury or surgery were inclined to report distress (OR 2.15; 95%CI 1.26–4.31) and drug misuse (OR 2.05; 95%CI 1.01–4.04).ConclusionThere seems to be a greater prevalence of MHS in active professional male footballers than in the global population and other sports. After severe injury/surgery, the risk of developing MHS is increased, confirming that healthcare professionals should be aware of the mental health of injured players.

Adolescent mental health services in West Africa: a comparative analysis of Burkina Faso, Ghana, and Niger

BackgroundAdolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context.MethodsThe study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services.ResultsThe findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates.ConclusionThe study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.

Post-mortem human brain analysis of the ventral pallidum in alcohol use disorder

ObjectiveAlcohol use disorder (AUD) is characterised by cycles of alcohol misuse, abstinence, and relapse. The neurobiology of AUD strongly implicates the role of the ventral pallidum (VP) in a variety of drugs of abuse, including alcohol. Pre-clinical studies have demonstrated critical role of parvalbumin and calretinin neurons in the VP in modulating relapse, mood, and motivation. However, there are a limited studies examining the VP at the cellular level in AUD in humans. MethodPost-mortem human brain tissue of AUD (n = 11), remission (n = 6), and control brains (n = 12) were processed for immunohistochemistry to examine the presence and changes in parvalbumin and calretinin neurons in the VP. ResultsSimilar to pre-clinical rodent models, parvalbumin and calretinin neurons were present in the VP, although no significant difference was found in their number or morphology across all AUD, remission, and control brains. ConclusionThe presence of parvalbumin and calretinin neurons in the VP was confirmed across all groups. This is particularly important as it supports the translatability of previous animal studies regarding the role of parvalbumin and calretinin neurons in AUD, and thus further implicates the VP in the neurobiology of AUD in humans. As there are no distinctions in the number or morphology of these neurons, their significance likely lies in their activity. The presence of both parvalbumin and calretinin in humans, particularly in both control and AUD cases supports translational capacity from preclinical findings is more feasible.

Examining problem gambling, substance use disorders and cluster B personality traits among incarcerated individuals

Prison populations face heightened rates of addictive behaviors and significant stressors, including health challenges and social disparities. Although problem gambling is prevalent in criminal justice settings, its distinctiveness compared to other addictions among incarcerated individuals remains uncertain. This study examines risk factors associated with problem gambling in Finnish prisoners and explores differences compared to other forms of addiction.Covariates from a questionnaire (N = 527) included gender, age, education, offender status, involvement in theft or property crime, Trauma Screening Questionnaire (TSQ), Depression Scale (DEPS), and lifetime abuse experiences. Of the 527 participants, 330 were interviewed using the Structured Clinical Interview (SCID-II) to assess personality disorders. Multiple logistic regression models were utilized, with separate models for problem gambling (PG), lifetime substance use disorder, and lifetime alcohol disorder.Crime type was not significantly associated with alcohol or substance use problems, but PG was associated with property crime or theft convictions. Borderline personality traits were linked to probable PG, while antisocial traits were linked to drug use, and both traits predicted alcohol misuse. Age and gender were significant only in relation to alcohol use problems, with older age and male gender indicating higher risk.The association between problem gambling and criminal behavior underscores the vulnerability of incarcerated individuals across various domains. Detailed assessments, considering the nature of criminal activity and personality disorders, especially borderline traits and comorbid conditions, are crucial for tailoring rehabilitation and treatment strategies to prevent recidivism. These findings provide valuable insights for clinicians managing addiction and mental health issues within correctional settings.

Co-abuse of amphetamine and alcohol harms kidney and liver.

The prevalence of alcohol use disorder was found 75% higher among amphetamine dependent patients. Alcohol and amphetamine alone have nephrotoxicity and hepatoxicity. But, the degree of risk with coabuse of alcohol and amphetamine is unknown. The objective of this study was to assess toxic effects of amphetamine-alcohol co-abuse on the liver and kidney. he present study was a cross-sectional study conducted et al. Amal Hospital for Mental Health, Qassim region, KSA and include one hundred participants. Seventy-five participants were patients hospitalized for the treatment of abuse, and twenty-five participants, were healthy voluntaries, have no history of abuse. An experienced psychiatrist conducted patient interviews and assessed the patients using the DSM-5 criteria. The data from healthy participants were considered as a control. The abuse group was paired with the control group by age and lifestyle. Participants were split into: Group I: Control group (n = 25); Group II: Amphetamine (AMP) abuser group (n = 25); Group III: Alcohol abuser group (n = 25) and Group IV: Combined drug abuser group (AMP and alcohol) (n = 25). The socio-demographic data was collected. Complete medical examination, Body Mass Index and samples of blood and urine were collected from all participants for analytical tests; determination of alcohol and AMP levels, kidney functions and liver functions. The mean BMI values in groups II, III, and IV showed no significant change from the control group. The serum level of albumin and alkaline phosphatase showed significant decrease in all abuser groups. While, alanine transaminase (ALT), Aspartate transaminase (AST) and osteopontin levels showed significant increase in all abuser groups. Fasting blood sugar values showed significant increase in alcohol abusers. On the other hand, it revealed no significant change in AMP and combined groups. The mean values of urea showed no significant change in AMP and alcohol abusers and significant increase in combined drug abuser group. The serum creatinine and all abuser groups showed significant increase in Cystatin C. The alteration in the most of studied biochemical parameters were more than two folds in combined group compared with that of AMP or alcohol groups. Study reveals synergistic liver and kidney toxicity. Amphetamine-alcohol co-abuse significantly heightens kidney and liver toxicity.

The effect of probiotic supplementation on non-alcoholic fatty liver disease (NAFLD) fibrosis score in patients attending a tertiary hospital clinic in Cairo, Egypt.

Non-alcoholic fatty liver disease (NAFLD) is characterized by hepatic fat accumulation (> 5% of liver tissue) in the absence of alcohol abuse or other chronic liver diseases. NAFLD can progress to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). This study aimed to assess the efficacy of probiotic (lactobacillus) supplementation on NAFLD fibrosis score. A double-arm randomized controlled trial was conducted in the family medicine clinic of a tertiary hospital, enrolling patients with sonographic evidence of NAFLD. Fifty patients were divided into two groups: the Probiotic group received lifestyle modification instructions along with daily probiotic supplementation for twelve weeks, with regular monthly follow-up visits. The Standard Treatment group received low-fat diet and lifestyle modification instructions only. The mean age of participants was 46.10 years (SD 10.11), with 70% females and 30% males. The study found a statistically significant difference in liver enzymes (ALT and AST) and BMI in the probiotic group before and after intervention. However, there was no significant difference in NAFLD fibrosis score between the two groups. Short-term probiotic treatment resulted in improvements in ALT, AST, and BMI in the probiotic group, but did not significantly affect NAFLD fibrosis score. Further research with larger sample sizes and longer follow-up periods is warranted. The clinical trial was registered at Protocol Registration and Results System with number NCT06074094 (12/09/2021).

Associative memory in alcohol-related contexts: An fMRI study with young binge drinkers.

Alcohol-related cues are known to influence craving levels, a hallmark of alcohol misuse. Binge drinking (BD), a pattern of heavy alcohol use, has been associated with cognitive and neurofunctional alterations, including alcohol attentional bias, memory impairments, as well as disrupted activity in prefrontal- and reward-related regions. However, literature is yet to explore how memories associated with alcohol-related cues are processed by BDs, and how the recall of this information may influence their reward processing. The present functional magnetic resonance imaging (fMRI) study aimed to investigate the neurofunctional signatures of BD during an associative memory task. In all, 36 university students, 20 BDs and 16 alcohol abstainers, were asked to memorize neutral objects paired with either alcohol or non-alcohol-related contexts. Subsequently, neutral stimuli were presented, and participants were asked to classify them as being previously paired with alcohol- or non-alcohol-related contexts. While behavioral performance was similar in both groups, during the recall of alcohol-related cues, BDs showed increased brain activation in two clusters including the thalamus, globus pallidus and dorsal striatum, and cerebellum and occipital fusiform gyrus, respectively. These findings suggest that BDs display augmented brain activity in areas responsible for mental imagery and reward processing when trying to recall alcohol-related cues, which might ultimately contribute to alcohol craving, even without being directly exposed to an alcohol-related context. These results highlight the importance of considering how alcohol-related contexts may influence alcohol-seeking behavior and, consequently, the maintenance or increase in alcohol use.

Paternal perinatal depression: underestimation of the disorder, its clinical and classificatory entanglements, and therapeutic alternatives

In the perinatal period, fathers may also suffer from depression, referred to as paternal perinatal depression. Studies have shown that the prevalence of paternal perinatal depression is considerably higher than in the general adult population. For example, a meta-analysis showed that the prevalence of depression among fathers was 9.76% during the prenatal period and 8.75% during the postpartum year.1 Paternal perinatal depression can deteriorate the marital relationship and generate psychosocial and behavioral problems in the offspring (Ramchandani et al., 2021).2 However, paternal perinatal depression has received comparatively little clinical attention. A review of the literature on this subject will list the biological, psychological and social risk factors for this condition, which include a history of depression or anxiety disorders, lack of social support, conflicts in the couple's relationship, economic and labor problems. The clinical characteristics of depression share similarities with depressions in other periods of life, and there are differential clinical features, such as anger, aggressiveness, somatic symptoms and greater comorbidity with substance abuse disorder. Early detection with scales such as the Edinburgh, Gotland and PAPA and the appropriate approach are fundamental to mitigate the effects of paternal perinatal depression. Psychotherapeutic support, psychoeducation of the disorder, and self-care tools can be part of a comprehensive approach to help parents experiencing this condition. In conclusion, the proposal to include this disorder within the parental perinatal affective disorders, as proposed by the author Baldoni,3 given the level of overlap that it usually has with other comorbid conditions (anxiety, alcohol abuse, impulse control disorders) and high frequency of masked symptoms, goes in the direction to give the attention it deserves for early detection and provide adequate support and treatment.

Outpatient Upper Extremity Fracture Surgery Is Associated with Increased Post-operative Emergency Department Visits.

This study aimed to determine if outpatient upper extremity fracture surgery was associated with increased post-operative ED visits and identify related risk factors. Design: Retrospective cohort. This multi-center study was conducted within a single academic institution, encompassing two level 1, two level 2, and one level 3 trauma center. All patients >18 years of age that underwent upper extremity fracture surgery from 2015-2021 were included. Risk factors for postoperative ED visit that were investigated included age, sex, tobacco use, alcohol abuse, psychiatric diagnosis, Elixhauser comorbidity score, race, location of upper extremity fracture, surgical setting (inpatient vs. outpatient), upper extremity block, surgical specialty, and Area Deprivation Index. Variables with a p<0.1 in bivariate analysis were included in a multivariable logistic regression to determine factors associated with a postoperative ED visit at 30 and 90-days. A total of 6,315 patients with an average age of 51±19 years were identified of which 52% were female and 65% had outpatient surgery. Post-operatively, 188 patients (3.0%) presented to the ED within 30 days and 304 (4.8%) presented within 90 days. Thirty-seven percent of ED visits were directly related to the procedure, most commonly for pain (20%), cast issues (4.3%), and swelling (3.9%). At 30 days postoperatively, 2.8% of patients who underwent surgery in an outpatient setting and 3.4% of those who underwent inpatient surgery returned to the ED, with these rates increasing to 4.4% and 5.6%, respectively, by 90 days. In multivariable analysis, outpatient surgery (OR:1.5, p=0.030), tobacco use (OR:2.1, p<0.001), higher Elixhauser Comorbidity scores (OR:1.2, p<0.001), non-White race (OR:1.9, p<0.001) elbow fractures (OR:1.8, p=0.016), and hand fractures (OR: 1.6, p=0.046) were associated with 30-day ED visits. Outpatient surgery was associated with increased rate of 30-day ED visits. Patients that smoke, had increased number of comorbidities or were non-White presented to the ED more frequently. III.

Risk Factors for In-Stent Stenosis After Flow Diverter Treatment of Intracranial Aneurysms: A Systematic Review and Meta-Analysis of 2350 Patients.

Recent advances in flow diverter (FD) therapy for intracranial aneurysms have highlighted the need to evaluate risk factors for in-stent stenosis (ISS), a potentially serious complication. This meta-analysis aims to identify risk factors associated with an increased risk of ISS after FD treatment. PubMed, Web of Science, Embase, and SCOPUS databases were systematically searched for studies reporting ISS rates and risk factors after FD therapy for intracranial aneurysms. Odds ratios were calculated using random-effects models to assess potential risk factors associated with ISS. Ten studies involving 2350 patients with 2441 aneurysms were included. Younger age (P = .006) and male sex (P = .003) were associated with higher ISS risk. Smoking also increased the risk (P = .02). Aneurysm location in the posterior circulation (P < .00001) and fusiform morphology (P < .00001) were significant risk factors for ISS, as were ruptured aneurysms (P = .05). Hypertension, hyperlipidemia, diabetes, allergies, and alcohol abuse, as well as aneurysm size, neck width, and parent artery diameter, did not affect ISS risk. Procedural factors like balloon angioplasty, multiple FDs, or FD/coil combinations were not significantly associated with ISS. This meta-analysis identified both nonmodifiable (younger age, male sex) and modifiable (smoking) patient factors, as well as high-risk aneurysm characteristics (posterior circulation, fusiform, ruptured), associated with an increased risk of ISS after FD treatment. These findings highlight the importance of tailored monitoring and management approaches for optimizing outcomes in FD therapy.

Adaptations in glutathione-based redox protein signaling pathways and alcohol drinking across species

Alcohol use disorder (AUD) is the most prevalent substance use disorder but there is incomplete knowledge of the underlying molecular etiology. Here, we examined the cytosolic proteome from the nucleus accumbens core (NAcC) of ethanol drinking rhesus macaques to identify ethanol-sensitive signaling proteins. The targets were subsequently investigated using bioinformatics, genetic, and pharmacological manipulations in mouse models of ethanol drinking. Of the 1000+ cytosolic proteins identified in our screen, 50 proteins differed significantly between control and ethanol drinking macaques. Gene Ontology analysis of the differentially expressed proteins identified enrichment in pathways regulating metabolic processes and proteasome activity. Because the family of Glutathione S-transferases (GSTs) was enriched in these pathways, validation studies targeted GSTs using bioinformatics and genetically diverse mouse models. Gstp1 and Gstm2 were identified in Quantitative Trait Loci and published gene sets for ethanol-related phenotypes (e.g., ethanol preference, conditioned taste aversion, differential expression), and recombinant inbred strains that inherited the C57BL/6J allele at the Gstp2 interval consumed higher amounts of ethanol than those that inherited the DBA/2J allele. Genetic deletion of Gstp1/2 led to increased ethanol consumption without altering ethanol metabolism or sucrose preference. Administration of the pharmacologic activator of Gstp1/2, carnosic acid, decreased voluntary ethanol drinking. Proteomic analysis of the NAcC cytosolic of heavy drinking macaques that were validated in mouse models indicate a role for glutathione-mediated redox regulation in ethanol-related neurobiology and the potential of pharmacological interventions targeting this system to modify excessive ethanol drinking.

A-051 Validation and Implementation of the Stanbio Beta-Hydroxybutyrate Assay on Roche c502 Analyzer

Abstract Background β-hydroxybutyrate (βOHB) serves as a crucial biomarker in assessing, managing, and monitoring ketosis in various clinical scenarios, such as diabetic ketoacidosis and instances of alcohol abuse combined with starvation. This study aimed to validate a βOHB assay (Stanbio Laboratory) conducted on a Roche Cobas c502 analyzer and establish performance specifications. Additionally, we conducted a method comparison for three assays: Randox D-3-Hydroxybutyrate (Ranbut) assay on Roche c501 analyzer, Abbott Freestyle Precision B-Ketone strip point-of-care test, and the Stanbio Laboratory β-Hydroxybutyrate LiquiColor assay on Roche c502 analyzer. Methods Precision, linearity, limit of quantification (LOQ), method comparison, and sample stability were determined according to Clinical and Laboratory Standards Institute (CLSI) guidelines, using commercial quality control materials (Randox Multisera) and residual patient samples (Lithium heparin anti-coagulated plasma). The reference interval was verified by residual samples from 20 healthy individuals (normal blood glucose, HbA1c, liver enzymes, and lipid panel results). Statistical analysis was performed by EP-Evaluator (v12). Results Intra-assay and total coefficient of variation (CV) were determined as 0% and 2.4% at 0.3 and 1.21 mmol/L, respectively. The linearity range of the assay was verified from 0.0 to 9.0 mmol/L. Using CV &amp;lt; 20% as criteria, the functional sensitivity (LOQ) was 0.10 mmol/L at least. Lithium heparin anti-coagulated plasma specimens were stable for 24 hours at room temperature or seven days at 4 - 8 ̊C. The manufacturer’s reference interval was verified as 0.00 - 0.40 mmol/L. The Stanbio βOHB assay on the Roche c502 analyzer demonstrated a strong agreement with the Randox D-3-Hydroxybutyrate assay on the Roche c501 analyzer with a slope of 1.053 (95% CI: 1.037, 1.070) and intercept of -0.005 (95% CI: -0.068, 0.059) (coefficient correlation R = 0.9992). A positive bias was observed compared to the Abbott Freestyle Precision B-Ketone strip POC test (mean bias = + 0.50 mmol/L; slope = 1.630, 95% CI: 1.404, 1.857; R = 0.9184), and this discrepancy occurred particularly at βOHB &amp;gt; 5.5 mmol/L measured by Abbott method. Conclusions The Standbio βOHB assay exhibited excellent precision and linearity across a brand range of concentrations. This assay strongly agrees with the Randox assay run on a similar instrument but discordance with Abbott’s POCT method at high βOHB concentration. Overall, the validated method provides a reliable and efficient means for measuring βOHB levels on a Roche chemistry analyzer, facilitating accurate diagnosis and monitoring of ketosis-related conditions in clinical settings.

B-260 Prevalence and Relative Distributions of Major Phosphatidylethanol (PEth) Homologs in a Large-Scale Clinical Study

Abstract Background Ethanol abuse remains a significant public health challenge in the United States. Detection of ethanol exposure is crucial for preventive, diagnostic, and therapeutic endeavors. Phosphatidylethanol (PEth) is a specific and direct ethanol biomarker. Compared to other metabolites, such as ethyl glucuronide and ethyl sulfate in urine (average 2-3 days), PEth in blood has a longer window of detection (average 1-2 weeks). Among the known 48 PEth homologs, PEth 16:0/18:1 (POPEth) and PEth 16:0/18:2 (PLPEth) are the most abundant species accounting for 37% to 46% and 26% to 28%, respectively. PLPEth is synthesized at a greater rate than POPEth, but POPEth has a longer half-life than PLPEth. The purpose of this study was to understand the prevalence and levels of POPEth and PLPEth in a large number of clinical specimens. Methods Briefly, lavender-top whole blood specimens were diluted with isotopically labeled internal standard (IS) in an organic buffer to precipitate proteins on an automated Hamilton platform. The mixture was centrifuged, and a supernatant portion isolated for injection onto a Sciex QTRAP 5500 liquid chromatography tandem mass spectrometry (LC-MS/MS) system using electrospray ionization (ESI) in negative mode. The assay was fully validated under CLIA regulations for lab developed tests: the analytical measurement range (AMR) was 10-400 ng/mL; the administrative reporting threshold for PEth positivity was 20 ng/mL based on clinical literature and a consensus among other United States laboratory methods. Results Precision of 4 QC levels was evaluated with between-run CV% (n=25) ranging from 1.6-6.3%, and accuracy across the AMR was achieved with 87-110%. No significant matrix effects were observed; variation in different whole blood specimens was corrected with IS normalization. No significant interferences were observed from 137 commonly seen prescription and nonprescription drugs and 6 other PEth homologs. Of the clinical specimens, most (20,833, 71.3%) were negative (&amp;lt;20 ng/mL) for both analytes. Meanwhile, 8,222 specimens (28.3%) were positive with either POPEth, or PLPEth or both ≥ 20ng/mL. There were 150 specimens excluded from the statistics due to interference challenges. Interestingly, 757 specimens (2.6%) were PLPEth negative and POPEth positive (mean value 40.1 ng/mL). Conversely, 62 specimens (0.2%) were POPEth negative and PLPEth positive (mean value 24.6 ng/mL). Among the specimens with both POPEth and PLPEth levels within the AMR, the average POPEth/PLPEth ratio was 1.4 supporting the overall prevalence of higher POPEth concentrations than PLPEth. However, the POPEth/PLPEth ratio varied widely, from 0.3 to 8.8, reflecting patient differences in PEth metabolism patterns. Conclusions To help verify probable ethanol abstinence, we have developed, validated, and deployed a high-throughput clinical assay for the major PEth homologs, POPEth and PLPEth. In a retrospective analysis of 29,205 clinical specimens: 71.3% of results were consistent with abstinence; 28.3% of the results were positive suggesting moderate alcohol consumption within the last 1-2 weeks. With POPEth most prevalent, yet variation observed, there were 62 specimens with PLPEth positive and negative for POPEth. This clinical PEth study including both POPEth and PLPEth provides greater sensitivity to identify ethanol exposure than only testing a single homolog.

Prevalence of HCV Infection Among People Experiencing Homelessness in Madrid, Spain

Hepatitis C virus (HCV) microelimination aims to detect and treat hidden infections, especially in at-risk groups, like people experiencing homelessness (PEH) with alcohol or drug use disorders. Point-of-care HCV RNA testing and peer support workers are crucial for identifying and preventing HCV infection among marginalized populations, contributing to overall elimination goals. To assess risk factors, prevalence, and trends of active HCV infection among PEH in Madrid, Spain (2019-2023). This cross-sectional study was conducted between 2019 and 2023 in PEH, defined as people who lacked a fixed, regular, and adequate night residence, screened on the street or in homeless shelters via mobile unit using rapid HCV antibody testing, followed by HCV-RNA testing in Madrid, Spain. Data were analyzed from January to June 2024. Active HCV infection among PEH was the main outcome. Risk factors analyzed included being born outside of Spain, alcohol misuse, lacking financial income, benzodiazepine use, injection drug use (IDU; including nonactive IDU and active IDU within the last year), opioid substitution therapy participation, and sexual behavior patterns. Data were analyzed using logistic regression. P values were adjusted for multiple testing using the false discovery rate (q-values). A total of 4741 individuals were screened for HCV infection, of whom 2709 (mean [SD] age, 42.2 [12.7]; 1953 [72.2%] men) were PEH and included in analysis. A total of 363 PEH (13.4%) had test results positive for HCV antibodies, of whom 172 (47.4%) had test results positive for HCV-RNA, and 148 of these (91.9%) started HCV treatment. Overall, active HCV infection prevalence was 6.3%, and the main risk factors associated with active HCV infection included IDU, encompassing both nonactive IDU (adjusted odds ratio [aOR], 10.9; 95% CI, 6.1-19.4; q < .001) and active IDU in the last year (aOR, 27.0; 95% CI, 15.2-48.0; q < .001); a lack of financial income (aOR, 1.8; 95% CI, 1.1-2.9; q = .03); and alcohol misuse (aOR, 1.8; 95% CI, 1.3-2.6; q = .008). There was a significant decrease between 2019 and 2023 in active HCV infection prevalence across the entire population, from 7.2% to 3.4% (P = .04). In this cross-sectional study of PEH in Madrid, IDU, lack of income, and alcohol misuse were primary risk factors associated with HCV infection. The significant decline in HCV rates observed across all risk groups during the study period suggests preventive policies were effective in reducing HCV prevalence among the homeless population.