Alcohol Disorders Research Articles

Sarcopenic Obesity in People with Alcoholic Use Disorder: Relation with Inflammation, Vascular Risk Factors and Serum Vitamin D Levels.

In recent years, the terms sarcopenia, sarcopenic obesity, and osteosarcopenic obesity (OSO) were coined to define a situation in elderly people strongly associated with frailty and increased mortality. Possibly, a complex interplay of several hormones and cytokines are involved in its development. Ongoing research detected that OSO may occur at any age and in several conditions. The prevalence of OSO in alcoholism was poorly analyzed. The aim of this study was to analyze the prevalence of OSO in alcoholism and its relationship with proinflammatory cytokines and/or common complications of alcoholism, such as cirrhosis, cancer, or vascular disease. We included 115 patients with alcoholic use disorder. Body composition analysis was performed by double X-ray absorptiometry. Handgrip strength was recorded using a dynamometer. We assessed liver function according to Child's classification, and determined serum levels of proinflammatory cytokines (TNF-α, IL-6, IL-8), routine laboratory variables, and vitamin D. People with alcoholic use disorder showed a high prevalence of OSO, especially regarding OSO obesity (60%), OSO osteopenia (55.65%), and OSO lean mass (60.17%). OSO handgrip was closely, independently, related to the presence of vascular calcification (χ2 = 17.00; p < 0.001). OSO handgrip was related to several proinflammatory cytokines and vitamin D. Vitamin D deficiency kept a close correlation with OSO handgrip (rho = -0.54, p < 0.001). Therefore, among people with alcohol use disorder, OSO prevalence was high. OSO handgrip is related to serum proinflammatory cytokine levels supporting the possible pathogenetic role of these cytokines on OSO development. Vitamin D deficiency is related to OSO handgrip suggesting its pathogenetic involvement in sarcopenia in patients with alcohol use disorder. The close association between OSO handgrip and vascular calcification is clinically relevant and suggests that OSO handgrip may constitute a prognostic tool in these patients.

Harnessing the potential of probiotics in the treatment of alcoholic liver disorders.

In the current scenario, prolonged consumption of alcohol across the globe is upsurging an appreciable number of patients with the risk of alcohol-associated liver diseases. According to the recent report, the gut-liver axis is crucial in the progression of alcohol-induced liver diseases, including steatosis, steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Despite several factors associated with alcoholic liver diseases, the complexity of the gut microflora and its great interaction with the liver have become a fascinating area for researchers due to the high exposure of the liver to free radicals, bacterial endotoxins, lipopolysaccharides, inflammatory markers, etc. Undoubtedly, alcohol-induced gut microbiota imbalance stimulates dysbiosis, disrupts the intestinal barrier function, and trigger immune as well as inflammatory responses which further aggravate hepatic injury. Since currently available drugs to mitigate liver disorders have significant side effects, hence, probiotics have been widely researched to alleviate alcohol-associated liver diseases and to improve liver health. A broad range of probiotic bacteria like Lactobacillus, Bifidobacteria, Escherichia coli, Sacchromyces, and Lactococcus are used to reduce or halt the progression of alcohol-associated liver diseases. Several underlying mechanisms, including alteration of the gut microbiome, modulation of intestinal barrier function and immune response, reduction in the level of endotoxins, and bacterial translocation, have been implicated through which probiotics can effectively suppress the occurrence of alcohol-induced liver disorders. This review addresses the therapeutic applications of probiotics in the treatment of alcohol-associated liver diseases. Novel insights into the mechanisms by which probiotics prevent alcohol-associated liver diseases have also been elaborated.

Genetic Underpinnings of the Transition From Alcohol Consumption to Alcohol Use Disorder: Shared and Unique Genetic Architectures in a Cross-Ancestry Sample.

Recent genome-wide association studies (GWASs) of alcohol-related phenotypes have uncovered key differences in the underlying genetic architectures of alcohol consumption and alcohol use disorder (AUD), with the two traits having opposite genetic correlations with psychiatric disorders. Understanding the genetic factors that underlie the transition from heavy drinking to AUD has important theoretical and clinical implications. The authors used longitudinal data from the cross-ancestry Million Veteran Program sample to identify 1) novel loci associated with AUD and alcohol consumption (measured by the score on the consumption subscale of the Alcohol Use Disorders Identification Test [AUDIT-C]), 2) the impact of phenotypic variation on genetic discovery, and 3) genetic variants with direct effects on AUD that are not mediated through alcohol consumption. The authors identified 26 loci associated with AUD and 22 loci associated with AUDIT-C score, including ancestry-specific and novel loci. In secondary GWASs that excluded individuals who report abstinence, the authors identified seven additional loci for AUD and eight additional loci for AUDIT-C score. Although the heterogeneity of the abstinent group biases the GWAS findings, unique variance between alcohol consumption and disorder remained after the abstinent group was excluded. Finally, using mediation analysis, the authors identified a set of variants with effects on AUD that are not mediated through alcohol consumption. Differences in genetic architecture between alcohol consumption and AUD are consistent with their having different biological contributions. Genetic variants with direct effects on AUD are potentially relevant to understanding the transition from heavy alcohol consumption to AUD and may be targets for translational prevention and treatment efforts.

0193 Sleep profiles of drinking and non-drinking college students

Abstract Introduction Alcohol use and insufficient sleep are prevalent in American college students and studies suggest that these behaviors are reciprocally interrelated. However, there is limited information about the relationship between sleep and alcohol use in college students without sleep or alcohol disorders. This study aimed to characterize the relationship between sleep and alcohol use in healthy college students by considering the effects of using alcohol on same-day nocturnal sleep, next-day nocturnal sleep, and napping. Methods Thirty-one college students (n=12 consumed alcohol during the study, n=19 did not) completed twice-daily online diary reports and wore a wrist-actigraphy device across two weeks. Linear mixed models examined person-specific (e.g., drinker or non-drinker) and event-specific (e.g., drinking or non-drinking night; school or free night) effects of alcohol use on subjective and objective sleep outcomes. Results When averaged across all nights, sleep behavior did not differ between drinkers and non-drinkers (ps&amp;gt;0.05). On drinking nights, participants went to bed later (p&amp;lt; 0.05) but woke up at similar times compared to non-drinking nights, resulting in significantly shorter sleep durations on drinking nights (p&amp;lt; 0.05). There were no effects of alcohol use on subjective sleep quality or daytime sleepiness (ps&amp;gt;0.05) or on next-day nocturnal sleep variables (ps&amp;gt;0.05). Daytime sleep (i.e., napping) was observed in 25 (81%) participants. The proportion of nappers and number of naps per participant did not significantly differ by drinking status (ps&amp;gt;0.05). There were also no differences in actigraphy-derived daytime sleep variables between drinkers and non-drinkers (ps&amp;gt;0.05). Among drinkers who napped (n=9), naps were taken on 27% of days following drinking nights and on 17% of days following non-drinking nights (p&amp;gt;0.05). Conclusion This study bolsters prior reports that insufficient nocturnal sleep and daytime napping are common in college by validating self-reported sleep behaviors with objective actigraphy data. Efforts to convey the importance of proper sleep are still needed in the college context. Future research should examine consequences of layering acute bouts of excessive alcohol consumption onto insufficient nocturnal sleep. Support (if any) This work was supported by the NIH NIAAA grant R01AA028286 to JB and AS.

Characteristics of amplitude of low-frequency fluctuations in the resting-state functional magnetic resonance imaging of alcohol-dependent patients with depression.

The high comorbidity of alcohol use disorder and depressive disorder is associated with poor patient prognosis. The mechanisms underlying this comorbidity, however, are largely unknown. By applying the amplitude of low-frequency fluctuations parameter in resting-state functional magnetic resonance imaging, this study investigated changes in the brain functioning of alcohol-dependent patients with and without depression. Alcohol-dependent patients (n = 48) and healthy controls (n = 31) were recruited. The alcohol-dependent patients were divided into those with and without depression, according to Patients Health Questionnaire-9 scores. Amplitude of low-frequency fluctuations in resting-state brain images were compared among the alcohol-dependent patients with depression, alcohol-dependent patients without depression, and healthy controls groups. We further examined associations between amplitude of low-frequency fluctuations alterations, alcohol-dependence severity, and depressive levels (assessed with scales). Compared with the healthy controls group, both alcohol groups showed amplitude of low-frequency fluctuations enhancement in the right cerebellum and amplitude of low-frequency fluctuations abatement in the posterior central gyrus. The alcohol-dependent patients with depression group had higher amplitude of low-frequency fluctuations in the right cerebellum than the alcohol-dependent patients without depression group. Additionally, we observed a positive correlation between amplitude of low-frequency fluctuations value and Patients Health Questionnaire-9 score in the right superior temporal gyrus in the alcohol-dependent patients with depression group. Alcohol-dependent subjects showed abnormally increased spontaneous neural activity in the right cerebellum, which was more significant in alcohol-dependent patients with depression. These findings may support a targeted intervention in this brain location for alcohol and depressive disorder comorbidity.

Absenteeism Due to Mental Disorders in Agents Fighting Endemic Diseases in Ceará/Northeast Brazil.

The purpose of this study is to quantify the days away from work by mental disorders (MDs) in endemic fighting agents (EFAs) in the state in Northeast Brazil. This is a historical cohort carried out from the survey of 584 expert medical records of EFA. The association measures were performed using Poisson regression models. The days away from work increased over time. Endemic fighting agents who have been on sick leaves by mood disorders ([cumulative incidence like relative risk (IRR)], 21.37; 95% CI, 12.36-36.93), alcoholism (IRR, 17.12; 95% CI, 10.04-29.34), and stress-related disorders (IRR, 10.32; 95% CI, 6.05-17.63) have a higher risk of absenteeism longer than 15 days. This study reinforces the importance of actions for coping with MD in EFA.

Etiopathogenesis of Yakruth Vriddi w.s.r ALD

Yakruth plays an important role in the Chayapachay and Ranjana of Rasa Dhatu. Yakruth and Pleeha are formed by the Raktadhatu. Yakruth is situated at the Dakshina bhaga and Pleeha at the Vaama bahga. Yakruth and Pleeha are the Moola Sthana of the Raktavaha Srothas. Madya is considered as alcohol it’s having qualities of Amla Usha laghu Tikshna, Sukshma, Vyavayi Ruksha Vikasi and Vishada. Madya vitiates Pitta as well as Rakta and that leads to Yakruth Vriddi. Rakta is one of the main Dushyas in Yakruth Vriddi. Diet and lifestyle are major factors that influence susceptibility to liver disorders. Alcohol use is quite common in India. According to recent data published by NHPI 74% of men and 48% of women are alcoholics. Alcohol disorders cover the spectrum of disorders beginning from the fatty liver, jaundice, hepatomegaly, ascites, and cirrhosis advanced and irreversible forms of liver injury related to the consumption of alcohol. There are three histopathological stages of alcoholic liver disease alcoholic fatty liver, alcoholic hepatitis, and, alcoholic cirrhosis. These alcoholic liver disorders’ pathogenesis can be understood in Ayurveda with the help of Kamala, Yakruth Vriddhi, Shchutha, and Ashchutha Yakruthodara. Hence an attempt is made to understand the etiopathogenesis of ALD w.s.r Yakruth Vriddi.

Alcohol and the death of Ludwig van Beethoven: comparison of general biographies to the medical literature.

Beethoven's autopsy findings of cirrhosis may have been due to alcoholism. This condition may have been underemphasized historically, given its stigma and the incongruence with the often heroic portrayal of Beethoven. We therefore aimed to compare how medical experts and biographers writing for anon-medical audience describe his final illness in the context of alcoholism. English-language biographies were identified using asurvey of biographies of Beethoven and supplemented by the authors. English-language medical publications were identified by searching for "Beethoven" in the PubMed® MEDLINE database. We included studies that mentioned Beethoven's final illness and death. We recorded statements regarding alcohol consumption, alcoholism, or alcohol use disorder, and the role of alcohol in Beethoven's death. The most commonly cited final illness was liver disease. Alcohol use was more frequently mentioned in biographies, but alcoholism less so. Alcohol use was invoked as apossible cause of final illness more frequently by medical publications.

Psychedelic therapies are returning to psychiatry

Psychedelic therapies are returning to psychiatry Professor Erika Dyck, Canada Research Chair in History of Health &amp; Social Justice at the University of Saskatchewan argues that psychedelic drugs and therapies, whether conducted in ceremonial settings or clinical ones, are being touted as life-changing moments for their capacity to efficiently transform an individual's perspective on themselves. The number of people who suffer from mental illness has grown steadily, with the WHO now reporting that 1 in 5 people in the world lives with mental illness. Due to this, numerous psychedelic therapies have also emerged on this landscape as a potential treatment that may improve individual lives while also transforming the way we diagnose and treat mental illness around the world – labelled a "psychedelic renaissance". Initiatives to legalize, decriminalize, and/or regulate psychedelics have taken different legal forms – as the legal landscape is changing quickly – but there are undeniable and unprecedented successes in treating alcoholism and trauma-based disorders with psychedelic therapies, which Professor Dyck recommends to be explored in more depth.

Childhood adversity, emergent psychopathology, and adolescent-to-parent violence: Process mining trajectories from police and health service administrative data

AimTo discover developmental risk trajectories for emerging mental health problems among a sample of adolescent family violence offenders to inform service delivery focused on early preventative interventions with children and their families.DesignA retrospective case-series design employing data linkage.SettingAn Australian regional location.ParticipantsAdolescents (born between 1994 and 2006) issued a legal action by the NSW Police Force for an adolescent-to-parent family violence offense (n = 775).ProcedureDiscrete routinely collected episode data in police and health service electronic records for children, and police data for parents, were linked and transformed into longitudinal person-based records from birth to 19 years to identify trajectories for mental health problems.ResultsSixty-three percent (n = 489) of adolescents had contact with a mental health service before age 19. The majority of these adolescents received a diagnosis for a stress or anxiety disorder (n = 200). Trajectory analysis found childhood exposure to parental intimate partner violence and parental drug and/or alcohol use were dominant events in the pathway to receiving a mental health diagnosis. Being a victim of a sexual offense was found to increase the odds of adolescents having a diagnosis for each of the main mental health categories (with the exception of drug or alcohol disorders).ConclusionsPathways to mental health problems were characterized by inter-related adverse childhood events and poly-victimization for many adolescents. Early identification of at-risk children must be a continued focus of child health services in order to reduce and identify early emerging mental health problems.

The risk of infection in open distal tibial fracture: the DANGER score.

Open fractures of the distal tibia can be functionally devastating, and they remain one of the most challenging injuries treated by trauma surgeons usually burdened with a high rate of complications, including surgical site infections (SSI). Our aim is to analyze the most significant risk factors of SSI and propose a new scoring system-called the DANGER scale-potentially able to predict reliably and quantify the infection risk in distal tibia open fractures. We identified six variables summarized in the acronym DANGER where D stands for Diabetes, A for Antibiotic, N for Nature of trauma (high- or low-energy trauma), G represents Grade of fracture following the AO/OTA classification, E indicates Exposure of the fracture according to the Gustilo-Anderson classification, and R represents Relative risk of patient, including use of tobacco, alcoholism, and psychiatric disorders. Therefore, total score ranged from 1 to 14, with a lower score indicating less risk to develop SSI. A total of 103 patients with open distal tibial fractures were enrolled, 12 patients (11.6%) developed SSI. Regarding DANGER score, a rating of 8.2 was calculated in SSI group and 4.8 in non-SSI group. Based on Fisher's test, diabetes (odds = 31.8 p < 0.05), grade of articular involvement (p < 0.05), severity of open fracture (p < 0.05), and dangerous behavior such as use of tobacco, alcoholism, and psychiatric disorders (p < 0.05) were significantly correlated with infection. Significant difference between total DANGER scores in SSI and non-SSI groups was found (p < 0.001). ROC curve was calculated founding a potential threshold of 7.5 (p < 0.001). Based on the above well-accepted risk factors, DANGER scale represents an advantageous and practical tool in order to readily estimate the risk of surgical site infection of open distal tibial fractures.

Modern aspects of seeking drug treatment for alcohol-associated diseases: expert assessment of practitioners

The use of the method of expert assessments is an indispensable element of the search for reserves to improve the quality and safety of medical activities for the realization of strategic tasks in the field of population conservation and improvement of health indicators of the Russian population.The purpose of the study was to assess the factors influencing the appeal for drug treatment of alcohol–associated diseases in state medical organizations on the model of a large agro-industrial region.Materials and methods. Anonymous sociological survey was conducted in 2022. 135 doctorsspecialist in the field of “Psychiatry-narcology” working in outpatient or inpatient units of the public health system of the Krasnodar region. The following methods were applied in this study: sociological, statistical, content analysis, expert assessments.Results. The representative group of experts was characterized by a predominance of female doctors (57,0 %), persons aged 40–49 years (25.2 %) with a qualification category (76.3 %), with more than 15 years of work experience in the specialty “Psychiatry-narcology” (58.5 %). The organization of drug treatment in outpatient settings was rated “good” and “excellent” by 54.8 % of respondents, in inpatient – 71.1 %. According to experts, the factors of legal restrictions, public censure, as well as defects in the self-assessment of the nosological status of patients and the lack of general medical literacy of the population had the greatest impact on the decrease in the incidence of drug treatment for alcohol-related pathology.Conclusion. The potential aspects of possible directions for selective influence in order to increase the appeal of the population with addictive alcohol disorders to specialized professionals and the preservation of human resources were identified.

Alcohol use as a mediator of the effect of two alcohol reduction interventions on mental health symptoms of ART clients in Vietnam

ABSTRACT We aimed to examine the mediating role of alcohol use in the pathway from the interventions to depression and anxiety symptoms using data from a randomized controlled trial among people living with HIV (PWH) with hazardous alcohol use (n = 440) in Thai Nguyen, Vietnam. Participants were randomized into either a combined intervention (CoI), a brief intervention (BI) and a standard of care arm. Both interventions were based on cognitive behavioral therapy and motivational enhancement therapy. Alcohol use was measured as the percentage of days abstinent from alcohol in the last 30 days. Symptoms of depression and anxiety were measured with the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Alcohol use was a significant mediator of the effects of two alcohol interventions on depression symptoms, but not anxiety symptoms. There were significant indirect effects via alcohol use of both interventions on depression symptoms at 12 months (CoI: mean difference (MD) = −0.134; 95%CI: −0.251, −0.035); (BI: MD = −0.141; 95%CI: −0.261, −0.038). There were no significant direct or total effects of the interventions on either symptoms at 12 months. Interventions with a dual focus on mental health and alcohol disorders are needed to determine optimal ways to tackle these common comorbidities among PWH.

Network analysis of reasons for and against changing alcohol use among veterans engaged in a web-based intervention for hazardous drinking and PTSD symptoms

Better understanding of reasons for and against change may be an effective strategy for supporting drinking reduction or abstinence among Iraq and Afghanistan veterans. The current study explored connections between reasons for and against changing hazardous alcohol use, as well as the relative importance of a given reason. Data from 366 veterans (86% male, 77% White) between the ages of 21 and 56 (M = 31.8, SD = 7.3) were obtained from a nationwide web-based alcohol and posttraumatic stress disorder randomized clinical trial. Participant-generated reasons for and against change were used to estimate two separate network models. The network of motives for changing alcohol use was generally well connected with predominately positive associations. Veterans reporting motivation to change alcohol use to improve functioning, enhance self-worth, and decrease alcohol-related consequences tended to have higher than average motivation to reduce or abstain from alcohol use. Alternatively, the network structure of motives against changing alcohol use demonstrated a nearly equal number of positive and negative associations. Whereas reasons to cope and sleep may imply higher than average motivation to continue drinking the same, veterans reporting reasons to reduce anxiety and have fun tended to have lower than average motivation to continue drinking. The current study may inform content modifications to self-help tools to more quickly and effectively target users’ motivations from the beginning. Capitalizing on intervention users’ motivations early may promote sustained engagement or improve therapeutic impact among those who only use the intervention for a short period of time.

Malnutrition and its association with the mortality in liver cirrhosis; a prospective nutritional assessment in two referral centers in Iran

Liver cirrhosis is a chronic condition caused by different conditions including viral infection, alcoholism, and autoimmune disorders. Malnutrition is one of the complications of liver cirrhosis that is associated with poor outcomes. This study aimed to determine the association of malnutrition with mortality in liver cirrhosis patients. This prospective cross-sectional study was conducted on liver cirrhosis patients who were referred to two referral centers for liver disease in Tehran, Iran. Patients' information including demographics (age, gender, etiology of cirrhosis, alcohol and smoking history) in addition to triceps skinfold (TSF), mid-arm circumference (MAC), Child-Pugh score and Model for End-Stage Liver Disease (MELD) score were recorded in all patients. Patients were classified into A, B, and C categories based on the Subjective Global Assessment (SGA) questionnaire. Among 121 participants (68.6%) were males and the mean age was 54.78. Viral infections were the most common etiology and 65 patients (56.2%) were in the classification A of Child-Pugh Score. TSF (P=0.001) and MAC (P=0.003) were significantly lower in SGA class C. The survival rate in SGA class C was significantly lower than other groups (P<0.001; log-rank test). The risk of mortality in patients with SGA class A and B was 85% (HR value: 0.15; 95% CI: 0.02-0.87; P=0.03) and 76% (HR value: 0.24; 95% CI: 0.06-0.83; P=0.02) lower than those with SGA class C. Anthropometric and SGA measure are two easy and accessible methods for assessing malnutrition and mortality in liver cirrhosis patients.

Mental health and substance use disorders in young adults with spina bifida.

Although medical advances have allowed most patients with spina bifida (SB) to survive into adulthood, these patients may have physical impairments, urological complications, infections, and neurocognitive deficits. These factors can cause psychological distress and impact the transition from pediatric to adult care. There remains limited research on mental health disorders (MHDs) and substance use disorders (SUDs) in SB patients during this vulnerable transition period. This study aimed to investigate the 10-year incidence of MHDs and SUDs in 18- to 25-year-old patients with SB. TriNetX, a federated de-identified database, was retrospectively queried to identify 18- to 25-year-old patients with SB. The presence of MHDs and SUDs based on ICD-10 codes in SB patients (cohort 1) was analyzed and compared with those of patients without SB (cohort 2). Subgroup analysis was performed on SB patients with hydrocephalus and neurogenic bladder (NB). SB patients were further compared to patients with a spinal cord injury (SCI). After propensity score matching, the authors identified 1494 patients in each cohort. SB patients were more likely to have depression (OR 1.949, 95% CI 1.64-2.317), anxiety (OR 1.603, 95% CI 1.359-1.891), somatoform disorders (OR 2.102, 95% CI 1.052-4.199), and suicidal ideations or attempts and self-harm (OR 1.424, 95% CI 1.014-1.999). The prevalence of attention-deficit/hyperactivity disorder (ADHD) and eating disorders were comparable between cohorts. SB patients also had increased rates of nicotine dependence (OR 1.546, 95% CI 1.22-1.959) but not of alcohol or opioid disorders. In SB patients, the presence of hydrocephalus and NB was not associated with significantly increased rates of any measured MHDs or SUDs. When compared with SCI patients, SB patients were more likely to have anxiety (OR 1.377, 95% CI 1.028-1.845) and ADHD (OR 1.875, 95% CI 1.084-3.242). However, SB patients had lower rates of nicotine dependence (OR 0.682, 95% CI 0.482-0.963) and opioid-related disorders (OR 0.434, 95% CI 0.223-0.845). SB and SCI patients shared similar rates of depression, suicidal ideations or attempts and self-harm, and alcohol-related disorders. Young adults with SB have higher prevalence rates of MHDs and SUDs compared with the general population. Therefore, incorporation of mental health and substance use management is critical to facilitate transition to adulthood.

Does the Integration of Primary Reflex Schemas According to Masgutovas Neurosensorimotor Reflex Integration Improve Functioning and Quality of Life Among Children with Spectrum of Foetal Alcohol Disorders?

Introduction: Foetal Alcohol Disorder Spectrum (FASD) is an incurable, non-genetic disorder that can occur in children whose mothers consumed alcohol during pregnancy. Patients with FASD are characterised by extensive damage to the central nervous system, neurological disorders, delays in physical and mental development, as well as difficulties in emotional regulation and behavioural disturbances. Neurosensory Integration of Reflexes by S. Masgutova is a holistic rehabilitation and therapeutic programme focused on the diagnosis and integration of primary reflex mechanisms. Intrauterine exposure of the foetus to alcohol affects the lack of proper reflex mechanism integration, which constitutes the foundation of harmonious psychomotor, cognitive, emotional and social development.The aim: The aim of this study is to present the role of primary reflex integration disorders according to MNRI in children with the Spectrum of Foetal Alcohol Disorders (FASD), as well as to discuss the impact of integrating primary reflex disorders according to MNRI on the functioning of FASD in children.Methods: The therapy comprised 103 patients (44 girls and 59 boys) aged 1-13 years with FASD, diagnosed according to the criteria of ICD-10 (Q 86.0). The mean age of the patients was 7.13 years (SD 3.26). Each participant took active participation in 2 rehabilitation interventions according to MNRI, the average interval between the stays was 4 months and 1 week (17 weeks).Results: In patients with FASD, the biomechanics of reflex patterns, such as: Babkin's, ATOS, hand support, paralyzing fear, Galant, grasping hands and Babinski, improved after MNRI therapy.Conclusions: Our research allows to indicate that the rehabilitated FASD patients following MNRI therapy could hug their caregivers more easily, thumb-sucking activity decreased, coordination improved, sleep quality significantly improved while psychomotor hyperactivity decreased.

Alcohol, Inflammation, and Microbiota in Alcoholic Liver Disease

Alcoholic liver disease (ALD) is a consequence of excessive alcohol use. According to many studies, alcohol represents a significant socioeconomic and health risk factor in today's population. According to data from the World Health Organization, there are about 75 million people who have alcohol disorders, and it is well known that its use leads to serious health problems. ALD is a multimodality spectrum that includes alcoholic fatty liver disease (AFL) and alcoholic steatohepatitis (ASH), consequently leading to liver fibrosis and cirrhosis. In addition, the rapid progression of alcoholic liver disease can lead to alcoholic hepatitis (AH). Alcohol metabolism produces toxic metabolites that lead to tissue and organ damage through an inflammatory cascade that includes numerous cytokines, chemokines, and reactive oxygen species (ROS). In the process of inflammation, mediators are cells of the immune system, but also resident cells of the liver, such as hepatocytes, hepatic stellate cells, and Kupffer cells. These cells are activated by exogenous and endogenous antigens, which are called pathogen and damage-associated molecular patterns (PAMPs, DAMPs). Both are recognized by Toll-like receptors (TLRs), which activation triggers the inflammatory pathways. It has been proven that intestinal dysbiosis and disturbed integrity of the intestinal barrier perform a role in the promotion of inflammatory liver damage. These phenomena are also found in chronic excessive use of alcohol. The intestinal microbiota has an important role in maintaining the homeostasis of the organism, and its role in the treatment of ALD has been widely investigated. Prebiotics, probiotics, postbiotics, and symbiotics represent therapeutic interventions that can have a significant effect on the prevention and treatment of ALD.

Development and cross-validation of a veterans mental health risk factor screen.

VA primary care patients are routinely screened for current symptoms of PTSD, depression, and alcohol disorders, but many who screen positive do not engage in care. In addition to stigma about mental disorders and a high value on autonomy, some veterans may not seek care because of uncertainty about whether they need treatment to recover. A screen for mental health risk could provide an alternative motivation for patients to engage in care. Data from samples of veterans and traumatic injury survivors were analyzed to identify mental health risk factors that are characteristics of individuals or stressors or of post-trauma, post-deployment, or post-military service resources, experiences, or responses. Twelve risk factors were strongly related to PTSD (r > .50): current PTSD, depression, dissociation, negative thinking, and emotional lability symptoms, life stress, relationship stress, social constraints, and deployment experiences of a difficult environment, concerns about life and family, perceived threat, and moral injury. Items assessing each of these risk factors were selected and their validity to prospectively predict PTSD and/or depression 6 months later was assessed in a new sample of 232 VA primary care patients. Twelve items assessing dissociation, emotional lability, life stress, and moral injury correctly classified 86% of those who later had elevated PTSD and/or depression symptoms (sensitivity) and 75% of those whose later symptoms were not elevated (specificity). Performance was also very good for 110 veterans who identified as members of ethnic/racial minorities. Mental health status was prospectively predicted in VA primary care patients with high accuracy using a screen that is brief, easy to administer, score, and interpret, and fits well into VA's integrated primary care. When care is readily accessible, appealing to veterans, and not perceived as stigmatizing, information about mental health risk may result in higher rates of engagement than information about current mental disorder status.

Hepatic artery disorders associated with alcoholism.

We aimed to characterize the relationship between severe chronic alcoholism and hepatic arterial wall disorders in humans. We obtained hepatic arteries from 165 patients undergoing liver transplantation who were placed into two etiological groups: an Alcoholism group and a Non-alcoholism group. We compared the age, sex, lipid profile, and histologic characteristics of the hepatic arteries (normal, reduction in luminal diameter of ≤10%, or atherosclerosis) of the participants in the two groups using multifactor analyses. The Alcoholism group comprised 58 men and 40 women and the Non-alcoholism group comprised 63 men and 4 women. The mean ages of the groups were 52.5 ± 9.6 years and 44.2 ± 13.8 years, respectively. There were no circulating lipid abnormalities in any of the participants. In women, arterial disorders were found at a younger age than in men. Hepatic arterial disorders were more frequent in the non-alcoholic participants, and women with alcoholism showed less arterial narrowing. The heavy consumption of alcoholic beverages is associated with a lower incidence of atherosclerosis of the hepatic artery in humans.