Cessation Of Alcohol Consumption Research Articles

Impact of addressing modifiable risk factors on the 10-year risk of cardiovascular disease in individuals with familial hypercholesterolemia: a causal analysis utilising UK biobank

Abstract Background Familial hypercholesterolemia (FH) is a prevalent autosomal dominant disorder characterised by elevated low-density lipoprotein cholesterol (LDL-C) levels from birth. These elevated LDL-C levels significantly amplify the lifetime risk of cardiovascular disease (CVD). While the impact of early and effective initiation of lipid-lowering medication (LLM) on CVD risk is well documented in genetically confirmed FH, the additional impact of addressing modifiable lifestyle risk factors (MLRF) in that patient population remains largely unquantified. Methods This study quantified the potential effects of successfully managing 4 MLRF (smoking, obesity, alcohol consumption, and low physical activity) on the 10-year incidence of a first CVD diagnosis in adults with genetically confirmed FH treated with LLM within the UK Biobank. The synthesised causal estimates of these 4 MLF were obtained using two recent causal analysis frameworks, namely the doWhy causal calculus framework and the Causal Forest Double Machine Learning Method. Results In 660 FH individuals (mean age 56±8 years; 60.15% women), smoking cessation and reducing body mass index below 30 kg/m2 delivered the most substantial risk reductions (pooled estimates, adjusted for the 3 other MLRF: -6.5% and -3.2%, respectively; both p<0.001), followed by initiating moderate or high physical activity (-1.7%; p<0.001; Figure). Notably, cessation of alcohol consumption significantly increased CVD risk (+2.5%; p<0.001), aligning with existing literature. Conclusion In over 10 years, reductions in CVD risk ranging from 1.7% to 6.5% were achievable through smoking cessation, BMI reduction, and enhanced physical activity in FH individuals. Leveraging causal inference methodologies facilitates the discernment of which risk factors offer the most pronounced additional benefits beyond lipid-lowering interventions in this high-risk population.Forest Plot of Causal Effect Estimates

Benefits of exercise on cognitive impairment in alcohol use disorder following alcohol withdrawal.

Although most cognitive impairments induced by prolonged alcohol consumption tend to improve within the initial months of abstinence, there is evidence suggesting certain cognitive deficits may persist. This study aimed to investigate the impact of aerobic exercise on learning and memory in alcohol use disorder (AUD) mice following a period of abstinence from alcohol. We also sought to assess the levels of monoamine neurotransmitters in the hippocampus. To this end, we established an AUD mouse model through a two-bottle choice (sucrose fading mode and normal mode) and chronic intermittent alcohol vapor (combined with intraperitoneal injection) and randomly allocated mice into exercise groups to undergo treadmill training. Learning and memory abilities were assessed through the Morris water maze test and spontaneous activity was evaluated using the open field test. The levels of dopamine, norepinephrine, serotonin, and brain-derived neurotrophic factor in the hippocampus were quantified using enzyme-linked immunoassay (ELISA) kits. The findings reveal that after cessation of alcohol consumption, learning and memory abilities in AUD mice did not completely return to normal levels. The observed enhancement of cognitive functions in AUD mice through aerobic exercise may be attributed to restoring levels of monoamine neurotransmitters in the hippocampus, boosting brain-derived neurotrophic factor (BDNF) concentrations, and facilitating an increase in hippocampal mass. These results offer empirical evidence to support aerobic exercise as a viable therapeutic strategy to alleviate cognitive deficits associated with AUD.

The effect of C60 fullerenes on the recovery of muscle soleus contraction dynamics in rats after chronic alcoholization

Background. It has been shown that the available therapeutic agents do not eliminate the consequences of miotic pathologies in chronic alcoholism, the most significant of which are disturbances in the dynamics of muscle contraction. A positive effect of biocompatible water-soluble C60 fullerenes on the contraction parameters of damaged muscles has been established. In addition, administration of C60 fullerene aqueous solution during chronic alcoholization of rats protects muscle tissue from damage caused by oxidative stress. Materials and Methods. Biomechanical parameters such as the values of the minimum and maximum contraction force and the muscle force impulse were evaluated using tensometry. The blood levels of creatine phosphokinase and lactate dehydrogenase, creatinine and lactate as well as the level of oxidative processes in muscle tissue of experimental animals (content of hydrogen peroxide, activity of catalase, glutathione peroxidase and superoxide dismutase) as markers of muscle damage were determined using methods of biochemical analysis. Results. The C60 fullerene aqueous solution effect on the skeletal muscle contraction dynamics in rats after chronic alcoholization for 9 months and cessation of alcohol consumption for 1 month was investigated. It was established that water-soluble C60 fullerenes (daily dose of 1 mg/kg) reduce the effects of chronic alcoholization by 35–40±2 % on the studied biomechanical parameters and by 20±1 % on the studied biochemical parameters compared to the group of alcoholized animals, thus increasing the energy capabilities of the muscular system. Conclusions. The obtained data indicate a pronounced protective effect of C60 fullerenes on the muscle soleus contraction dynamics during the development of alcoholic myopathy, which opens up the potential possibility of their use for the prevention and correction of miotic damage.

Dietary Patterns and Lifestyle Factors Associated with the Risk of Colorectal Cancer: A Hospital-Based Case-Control Study among Malaysians.

This study aimed to examine the association between dietary patterns, lifestyle factors, and colorectal cancer (CRC) risk among the Malaysian population. We recruited 100 patients and 100 controls from two selected government hospitals. Principal component analysis was used to identify dietary patterns using a 123-item semiquantitative food frequency questionnaire. Tobacco smoking and alcohol consumption questionnaires were modified from the WHO STEPS Survey questionnaire. Physical activity levels were assessed using the revised Global Physical Activity questionnaire. Associations between dietary patterns, lifestyle factors and CRC risk were assessed using logistic regression with SPSS version 24.0. Three dietary patterns were derived from factor analysis: i) vegetables; ii) meat, seafood and processed food; and iii) grains and legumes. High vegetable diet intake was independently and significantly associated with an 81% decreased risk of CRC (odds ratio [OR]: 0.19; 95% confidence interval [CI]: 0.08, 0.46). Both recreational-related physical activity (OR: 2.04; 95% CI: 1.14, 3.64) and vigorous physical activity (OR: 2.06; 95% CI: 1.13, 3.74) are significantly associated with decreased risk of CRC. Increasing the number of cigarettes smoked (≥ 16 cigarettes) per day significantly increased the odds of developing CRC (OR: 2.58; 95% CI: 1.95, 6.75). The duration of alcohol consumption cessation was inversely associated with CRC risk (OR: 2.52; 95% CI: 2.30, 10.57). The protective effects of a fruit and vegetable diet, and a healthy lifestyle can be used to develop interventions that help reduce the risk of CRC in the Malaysian population.

Heart Transplantation and Thromboembolic Risk In Patients With Percutaneous Aortic Valve Prosthesis and Left Ventricular Assist Device: A Case Report

Transcatheter aortic valve replacements have become a good option for patients with aortic valve disease and high surgical risk. Thromboembolism is reported as a relatively common complication of Transcatheter aortic valve replacement. This risk may be increased in patients who have left ventricular assist devices, as valve motion is drastically reduced. We present the case of a 65-year-old man with a history of alcoholism and valvular cardiomyopathy (severe chronic aortic insufficiency) with severe left ventricular dysfunction. Improvement in ventricular function followed the cessation of alcohol consumption, but still in poor clinical condition. Due to his high surgical risk, it was decided to implant a percutaneous aortic valve to treat the valve deficiency. Two months later, he suffered from a first episode of embolic stroke, which he successfully recovered. Despite the treatment, his clinical status did not improve (INTERMACS 3-4), and he was referred for heart transplantation. A left ventricular assist device was implanted as a bridge to the transplant. While on the waiting list, he suffered from other 3 episodes of stroke, 2 of them requiring mechanical thrombectomy. Finally, his transplant was performed with a favorable postoperative clinical course. Heart transplantation may be feasible in patients with multiple intracardiac devices in left chambers, although we must be aware of the increased thromboembolic risk, especially when used in combination.

Association between tobacco smoking and alcohol consumption with arterial stiffness.

Few investigations have been performed between tobacco smoking, alcohol, and arterial stiffness. The purpose of our study was to investigate the association between smoking use and alcohol with arterial stiffness index (ASI) in a middle-age population. Smoking pack-years and cigarettes per day were defined as alcohol consumption in units/day. Sex associations between smoking and alcohol with ASI were estimated using multiple linear regressions. Interactions and synergistic effects were investigating. 98039 individuals of the UK Biobank cohort were included (45457 men and 52582 women). ASI levels were higher in men than in women (9.91 vs. 8.71m/s, p<.001), and showed higher relationship to smoking tobacco in multiple linear regression models in women than in men (FDR logworth 78.4 vs. 52.7). The findings revealed that ASI was higher among current smokers than never smokers in both sex and after adjustment for all covariates (in men 10.4 vs. 9.6 and in women 9.5 vs. 8.5m/s, p<.001). Alcohol consumption per day was positively associated with higher levels of ASI in both sex, but with a less relationship (FDR logworth for men=2.8, for women=2.5). An interaction was observed between smoking information and alcohol in men but not in women. Synergistic effects were observed by adding smoking information on alcohol consumption models in men and women (p=.029, p<.001, respectively). Smoking and alcohol were associated with higher ASI in both sex but with a higher relationship among women. The findings suggest the importance of considering smoking and alcohol consumption cessation in cardiovascular diseases prevention.

Multifaceted case management during pregnancy is associated with better child outcomes and less fetal alcohol syndrome

Background Pregnant women participated in multifaceted case management (MCM) to prevent Fetal Alcohol Spectrum Disorders (FASD). Methods Women recruited from antenatal clinics for a longitudinal child development study were screened for alcohol use. Forty-four pregnant women were defined as high-risk drinkers on the Alcohol Use Disorder Identification Test (AUDIT) by an AUDIT score ≥8 and participated in 18 months of MCM to facilitate reduction or cessation of alcohol consumption. Forty-one women completed MCM. Fifty-five equally high-risk women who received standard antenatal care comprised the comparison/control group. Development in offspring was evaluated by a blinded interdisciplinary team of examiners through 5 years of age. Results At five years of age, more children (34%) of MCM participating women did not meet the criteria for FASD vs. non-MCM offspring (22%). Furthermore, a statistically significant (p = .01) lower proportion of MCM offspring (24%) was diagnosed with fetal alcohol syndrome (FAS) compared to controls (49%). Children of MCM participants had significantly (p < .05) better physical outcomes: lower total dysmorphology scores, larger head circumferences, longer palpebral fissures, and higher midfacial measurements. Neurodevelopment results showed mixed outcomes. While Bayley developmental scores indicated that MCM offspring were performing significantly worse on most domains through 18 months, group scores equalized and were not significantly different on Kaufman Assessment Battery neurobehavioral measures by five years. Regression analyses indicated that offspring of women who received standard antenatal care were associated with significantly more negative outcomes than MCM offspring: a diagnosis of FAS (OR = 3.2; 95% CI: 1.093–9.081), microcephaly (OR = 5.3; 95% CI: 2.1–13.5), head circumference ≤10th centile (OR = 4.3; 95%CI: 1.8–10.4), and short palpebral fissures (OR = 2.5; 95% CI: 1.0–5.8). Conclusion At age five, proportionally fewer children of MCM participants qualified for a diagnosis of FAS, and proportionally more had physical outcomes indicating better prenatal brain development. Neurobehavioral indicators were not significantly different from controls by age five. KEY MESSAGES Multifaceted Case Management (MCM) was designed and employed for 18 months during the prenatal and immediate postpartum period to successfully meet multiple needs of women who had proven to be very high risk for birthing children with fetal alcohol spectrum disorders (FASD). Offspring of the women who participated in MCM were followed up through age five years and were found to have significantly better physical outcomes on multiple variables associated with fetal alcohol syndrome (FAS) and FASD, such as larger head circumferences and fewer minor anomalies, than those children born to equally at-risk women not receiving MCM. Fewer children of women receiving MCM were diagnosed with FASD than the offspring of equally-at-risk controls, and significantly (p = .01) fewer MCM offspring had FAS, the most severe FASD diagnosis.

Neuroimmune interactions with binge alcohol drinking in the cerebellum of IL-6 transgenic mice

The neuroimmune system of the brain, which is comprised primarily of astrocytes and microglia, regulates a variety of homeostatic mechanisms that underlie normal brain function. Numerous conditions, including alcohol consumption, can disrupt this regulatory process by altering brain levels of neuroimmune factors. Alcohol and neuroimmune factors, such as proinflammatory cytokines IL-6 and TNF-alpha, act at similar targets in the brain, including excitatory and inhibitory synaptic transmission. Thus, alcohol-induced production of IL-6 and/or TNF-alpha could be important contributing factors to the effects of alcohol on the brain. Recent studies indicate that IL-6 plays a role in alcohol drinking and the effects of alcohol on the brain activity following the cessation of alcohol consumption (post-alcohol period), however information on these topics is limited. Here we used homozygous and heterozygous female and male transgenic mice with increased astrocyte expression of IL-6 to examined further the interactions between alcohol and IL-6 with respect to voluntary alcohol drinking, brain activity during the post-alcohol period, IL-6 signal transduction, and expression of synaptic proteins. Wildtype littermates (WT) served as controls. The transgenic mice model brain neuroimmune status with respect to IL-6 in subjects with a history of persistent alcohol use. Results showed a genotype dependent reduction in voluntary alcohol consumption in the Drinking in the Dark protocol and in frequency-dependent relationships between brain activity in EEG recordings during the post-alcohol period and alcohol consumption. IL-6, TNF-alpha, IL-6 signal transduction partners pSTAT3 and c/EBP beta, and synaptic proteins were shown to play a role in these genotypic effects.

A new method for predicting alcohol relapse in patients undergoing liver transplantation for alcohol-related liver failure: Barratt scale.

Alcohol-induced liver disease has become one of the major causes of chronic liver disease worldwide with the increasing use of alcohol in society. The most important step in treatment is cessation of alcohol consumption. In patients with advanced liver disease, the most effective treatment is liver transplantation. Careful evaluation of patients with alcoholic liver disease before transplantation can help identify those at high risk of relapsing. Of a total of 42 patients who underwent liver transplantation for alcohol-related liver failure in our hospital between 2011 and 2022, 26 surviving patients were included in the study. Patient data were analyzed retrospectively. Demographic data, MELD score, history of alcohol consumption, alcohol treatment, post-transplant prognosis and survival were analyzed. The Barratt Impulsivity Scale-11 Short Form (BIS-11 SF) was applied to the surviving patients for impulsivity analysis to predict the possibility of relapse. Of the 26 patients who were included in the study, all were male. The mean age at transplantation was 53 (31-71) years. Mean MELD score was 22.31 (9-36). 12 patients (46.2%) received living donor liver transplantation and 14 patients (53.8%) received cadaveric liver transplantation. 25 patients (96.2%) had no post-transplant dependence, while 1 patient (3.8%) had post-transplant dependence. 5 patients (19.2%) continued to consume alcohol after transplantation. In our study, we observed that patients with high motor impulsivity tendency according to BSI-11 SF had alcohol relapse. We believe that revising this scale with more detailed questions for alcohol-dependent liver patients and applying it to patients before transplantation will be effective in better selection for transplantation and guiding patients to appropriate therapy and thus preventing relapse after transplantation.

Systemic Activin Is Elevated in Patients With Severe Alcoholic Hepatitis.

Systemic Activin Is Elevated in Patients With Severe Alcoholic Hepatitis.

Holiday heart syndrome: influence of alcohol on heart rhythm

The impact of alcohol on human health is widely known. There is a large body of research about positive (the “French paradox”) and negative effects of alcohol consumption. The relationship between excessive alcohol consumption and cardiac arrhythmias was first described in the 1970s in people who consumed alcohol heavily, mainly on weekends or holidays, but also in those who drank little or did not consume any alcohol. The term “holiday heart syndrome” was used for the first time by Philip Ettinger with reference to healthy people without cardiovascular disease. Excessive alcohol consumption can cause arrhythmias, most often in the form of atrial fibrillation. Ethanol and its metabolites have a toxic impact on cardiac myocytes; moreover, alcoholic cardiomyopathy accounts for one-third of all cases of non‐ischaemic dilated cardiomyopathy. It is possible to restore normal heart function through early diagnosis and cessation of alcohol consumption. The prevalence of holiday heart syndrome depends on the drinking habits of the study population. Holiday heart syndrome should be considered especially in patients without overt heart disease with a new onset of atrial fibrillation. Although relapses do occur, the clinical course is mild and specific antiarrhythmic therapy is usually not warranted. People diagnosed with cardiovascular disease benefit from minimising the amount of alcohol consumption. There is no safe amount of alcohol to drink and especially those with alcoholic cardiomyopathy should strive for abstinence in order to optimise treatment.

The impact of alcohol on the male reproductive system

Although alcohol has been consumed by humans for centuries, its effect on reproductive function is still not fully understood. Numerous studies have examined the effects of alcohol on ejaculate parameters and male fertility. This article provides an overview of the main preclinical and clinical studies. Studies in experimental animals have shown that ethanol-rich diets cause spermatogenesis abnormalities, a variety of abnormalities involving different parts of the reproductive tract, and a decreased frequency of fertilization in murine oocytes. These effects quickly disappeared with the cessation of alcohol use. Most of the studies examining the effects of alcohol on men have shown a negative effect on ejaculate parameters. An association of hypogonadism and low or elevated gonadotropin levels has been reported, suggesting a combined central and peripheral damaging effect of ethanol. Thus, alcohol consumption has a pronounced negative effect on ejaculate parameters, which can be reversible upon cessation of alcohol consumption.

A longitudinal examination of alcohol cessation and academic outcomes among a sample of Canadian secondary school students

IntroductionThe negative effects of alcohol consumption on learning ability and intellectual development of youth may be recovered after cessation. This study explored to what extent reduction or complete cessation of alcohol consumption affects school performance of secondary school students. MethodsAlcohol use was self-reported by 37,223 grade 9–12 students attending 89 secondary schools across Ontario (n = 79) and Alberta (n = 10), Canada, participating in the COMPASS study over four years (school years 2013–14 to 2016–17). Measures included past-year frequency of drinking and frequency of binge drinking. A first-order autoregressive multinomial logistic regression was used to establish the impact of reduction or cessation of alcohol use on school performance. ResultsDuring follow-up, 1465 (6.4%) reductions and 1903 (8.3%) cessations in alcohol consumption, and 1447 (10.1%) reductions and 2147 (14.9%) cessations of binge drinking were reported. Male students reported more cessation in both drinking (9.7% male vs 7.1% female) and binge drinking (15.6% male vs 14.4% female), though female students had higher rates of reductions. Students who quit or reduced their drinking or binge drinking were less likely to skip classes, leave their homework incomplete, or expect to get or to aspire to educational qualifications above a high school diploma compared to those who continued their alcohol use. ConclusionsAside from health benefits, reduction or cessation of alcohol use may improve students’ academic rigor. Prioritising school-based alcohol prevention efforts may therefore be beneficial for aspects of academic performance.

Adherence to Drinking Guidelines and Reasons for Alcohol Consumption Cessation in the Southern Cone of Latin America - Findings from the CESCAS Study.

Introduction:Alcohol consumption is a risk factor for morbidity and mortality globally. Consumption levels in Southern Latin America are among the highest in the world.Objectives:To describe consumption patterns and adherence to guidelines in the general adult population of Southern Latin America, as well as exploration of reasons for alcohol cessation and the advising role of the health worker in this decision.Methods:In 7,520 participants from the Centro de Excelencia en Salud Cardiovascular para el America del Sur (CESCAS) cohort, consumption patterns were described and the proportion excessive drinkers (i.e. >7 units/week for women and >14 for men or binge drinking: >4 (women) or >5 (men) units at a single occasion) was calculated. Former drinkers were asked if they had quit alcohol consumption on the advice of a health worker and/or because of health reasons. Furthermore, among former drinkers, multivariable logistic regression analysis was performed to assess which participant characteristics were independently associated with the chance of quitting consumption on a health worker’s advice.Results:Mean age was 54.8 years (SD = 10.8), 42% was male. Current drinking was reported by 44.6%, excessive drinking by 8.5% of the population. In former drinkers, 23% had quit alcohol consumption because of health reasons, half of them had additionally quit on the advice of a health worker. The majority of former drinkers however had other, unknown, reasons. When alcohol cessation was based on a health worker’s advice, sex, country of residence, educational status and frequency of visiting a physician were independent predictors.Conclusion:In this Southern American population-based sample, most participants adhered to the alcohol consumption guidelines. The advising role of the health worker in quitting alcohol consumption was only modest and the motivation for the majority of former drinkers remains unknown. A more detailed assessment of actual advice rates and exploration of additional reasons for alcohol cessation might be valuable for alcohol policy making.

Natural Recovery by the Liver and Other Organs after Chronic Alcohol Use.

Chronic, heavy alcohol consumption disrupts normal organ function and causes structural damage in virtually every tissue of the body. Current diagnostic terminology states that a person who drinks alcohol excessively has alcohol use disorder. The liver is especially susceptible to alcohol-induced damage. This review summarizes and describes the effects of chronic alcohol use not only on the liver, but also on other selected organs and systems affected by continual heavy drinking—including the gastrointestinal tract, pancreas, heart, and bone. Most significantly, the recovery process after cessation of alcohol consumption (abstinence) is explored. Depending on the organ and whether there is relapse, functional recovery is possible. Even after years of heavy alcohol use, the liver has a remarkable regenerative capacity and, following alcohol removal, can recover a significant portion of its original mass and function. Other organs show recovery after abstinence as well. Data on studies of both heavy alcohol use among humans and animal models of chronic ethanol feeding are discussed. This review describes how (or whether) each organ/tissue metabolizes ethanol, as metabolism influences the organ’s degree of injury. Damage sustained by the organ/tissue is reviewed, and evidence for recovery during abstinence is presented.

Early diagnosis and treatment of diabetic and alcoholic polyneuropathy in outpatient practice

Diabetes mellitus (DM) and chronic alcoholism (CA) are diseases that damage many organs and systems of the body and, in particular, lead to peripheral neuropathies. The pathogenesis of peripheral neuropathies caused by diabetes mellitus (DM) and CA is complex and diverse. Different types of peripheral neuropathies develop according to the leading pathogenetic mechanism. The most common type of peripheral neuropathy in DM is diabetic distal symmetric polyneuropathy (DSPN) and that in CA is alcoholic polyneuropathy (APN). The principles of diagnosis and treatment of DSPN and APN are considered. Treatment of DSPN and APN is complex, which is aimed at treating the underlying disease and includes non-drug and drug treatments. The mainstay of DSPN treatment is achievement of the optimal blood glucose level, maintenance of a healthy lifestyle (diet, daily activity), and correction of cardiovascular comorbidities (if any) with symptomatic pharmacotherapy for neuropathic pain (if any) with antidepressants or anticonvulsants. Antioxidants, such as B group vitamins (B1, B6 and B12) and alpha-lipoic acid (ALA), are widely used to treat DSPN in clinical practice. APN treatment involves cessation of alcohol consumption, physical and mental rehabilitation, and intake of B group vitamins (B1, B2, B6 and B12). The use of ALA in DSPN and APN is discussed.

A new model for the HPA axis explains dysregulation of stress hormones on the timescale of weeks.

Stress activates a complex network of hormones known as the hypothalamic–pituitary–adrenal (HPA) axis. The HPA axis is dysregulated in chronic stress and psychiatric disorders, but the origin of this dysregulation is unclear and cannot be explained by current HPA models. To address this, we developed a mathematical model for the HPA axis that incorporates changes in the total functional mass of the HPA hormone‐secreting glands. The mass changes are caused by HPA hormones which act as growth factors for the glands in the axis. We find that the HPA axis shows the property of dynamical compensation, where gland masses adjust over weeks to buffer variation in physiological parameters. These mass changes explain the experimental findings on dysregulation of cortisol and ACTH dynamics in alcoholism, anorexia, and postpartum. Dysregulation occurs for a wide range of parameters and is exacerbated by impaired glucocorticoid receptor (GR) feedback, providing an explanation for the implication of GR in mood disorders. These findings suggest that gland‐mass dynamics may play an important role in the pathophysiology of stress‐related disorders.

Diminuição no uso de bebidas alcoólicas e a violência pelo parceiro íntimo

Introdução: A violência praticada por parceiro íntimo refere-se ao comportamento de parceiros ou ex-parceiros íntimos que resulta em dano físico, sexual ou psicológico, incluindo agressão física, coerção sexual, abuso psicológico e comportamento controlador. Sabe-se que o etilismo está associado ao aumento de tal violência. Objetivo: Analisar se a acompanhante do paciente em abstinência alcoólica referia menor índice de violência nesse período em relação ao tempo em que o mesmo fazia abuso de álcool. Métodos: Estudo observacional transversal no qual foram selecionados homens ex-etilistas atendidos no CAPSad de Maringá e suas parceiras. Foi utilizado um questionário para violência contra parceiro (HITS) composto de 4 perguntas objetivas, cuja pontuação varia de 4 até 20. Valores iguais ou superiores a 10 indicam violência. Resultados: Foram entrevistadas 53 mulheres de diversas faixas etárias e escolaridades. Desse total, 84,9% das participantes apresentaram pontuações menores no teste com o parceiro em abstinência em relação ao período em que o mesmo estava em uso/abuso de álcool. Das mulheres 15,1% não notaram diferença no nível de violência do acompanhante, estivesse ele em uso ou em abstinência alcoólica. Conclusões: Demonstrou-se claramente que o fato de cessar o consumo de bebidas alcoólicas reduziu o índice de violência infligida pelo parceiro.

Peripheral polyneuropathy after acute methanol poisoning: Six-year prospective cohort study

BackgroundMethanol is a widely used industrial short-chain aliphatic alcohol with known neurotoxic properties. Mass poisoning outbreaks due to the consumption of methanol-adulterated alcoholic drinks present a challenge to healthcare providers due to the high mortality and serious central nervous system (CNS) damage in survivors. However, the impact of methanol exposure on the peripheral nervous system is unknown. ObjectivesTo investigate the role of acute methanol exposure in the development of peripheral polyneuropathy (PNP) during the years following discharge from the hospital. MethodsA total of 55 patients with confirmed methanol poisoning (mean age of 47.9 ± 3.6 years; 9 females) were examined 4 times within a 6-year prospective longitudinal cohort study. The program included neurological and electromyographic examinations, visual evoked potentials, ocular examinations with retinal nerve fibre layer thickness measurements, brain magnetic resonance imaging, and a series of biochemical and toxicological tests. ResultsPNP was observed in 20/55 (36 %) patients, which, in most of the cases, was mild axonal sensorimotor neuropathy. In 8/55 (15 %) patients, worsening of electromyographic findings was registered during the follow-up period, including 5 cases with newly diagnosed PNP and 3 cases of PNP progression. In one subject, complete reversal of PNP was registered after cessation of alcohol intake. The patients with PNP were significantly older (57.3 ± 5.3 versus 42.5 ± 3.9 years; p < 0.001), with higher blood glucose (5.93 ± 0.97 versus 4.81 ± 0.32 mmol/L; p = 0.035) and lower vitamin B1 (45.5 ± 7.4 versus 57.5 ± 5.2 ug/L; p = 0.015) concentrations. The number of chronic alcohol abusers was significantly higher in the PNP group (17/20 versus 20/35; p = 0.034). No associations between PNP prevalence/ dynamics and acute parameters of poisoning severity, arterial blood pH (7.26 ± 0.07 with PNP versus 7.18 ± 0.09 without PNP; p = 0.150), or serum methanol (1320.0 ± 700.0 with PNP versus 1430.0 ± 510.0 mg/L without PNP; p = 0.813) and ethanol (460.0 ± 560.0 with PNP versus 340.0 ± 230.0 mg/L without PNP; p = 0.675) concentrations at admission were found. No difference in the number of patients with visual (9/20 with PNP versus 12/35 patients without PNP; p = 0.431) and CNS sequelae (9/20 with PNP versus 15/35 patients without PNP; p = 0.877) of poisoning was present. DiscussionDespite the relatively high number of PNP cases, no association was found between the severity of acute methanol poisoning and the prevalence of PNP and its dynamics during six years of observation. We did not find an association between methanol-induced visual/ brain damage and the prevalence of PNP in survivors of poisoning. A high prevalence of PNP and its progression might be attributed to other causes, mainly a history of chronic alcohol abuse and insufficiently treated diabetes mellitus. Our results highlight the importance of complete cessation of alcohol consumption and better control of glycaemia in diabetic patients in the prevention and treatment of peripheral PNP.

Delirium tremens: early diagnosis and intensive care guidelines. Review

Alcoholic delirium is a formidable complication of severe alcohol withdrawal syndrome. It is often formed in patients of hospitals and departments of anesthesiology and intensive care, as a result of the forced cessation of alcohol consumption. Its formation is associated with an increase in the length of hospital stay and mortality. The review discusses modern approaches to the diagnosis, especially early, of this condition, its intensive care and methods of non-drug correction.