Bottle Of Vodka Research Articles

Alcohol availability and affordability in three constituent entities of the Russian Federation

Aim. To analyze availability and affordability of alcoholic beverages in Russian cities.Material and methods. We assessed the actual state of urban infrastructure in the Arkhangelsk, Tver and Sverdlovsk regions. Data were collected in three districts of Arkhangelsk, three districts of Tver, three districts of Yekaterinburg and Revda, where participants of the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study (2021) lived. The study objects were elements of the city infrastructure where alcoholic beverages were sold. To assess the infrastructure, special software was developed to collect and analyze the necessary data using Open Street Maps. Data were collected from January to March 2022.Results. In total, 1180 alcohol-selling outlets were identified in the study areas: in Arkhangelsk — 450, in Yekaterinburg and Revda — 444, and in Tver — 286. Mainly alcoholic beverages in Sverdlovsk and Tver regions can be purchased in the alcohol section of a grocery store (n=260, 58,6% and n=185, 41,4%, respectively), and in the Arkhangelsk region — in a specialized liquor stores (n=263, 58,4%). The median number of alcohol stores located within a radius of 1000 m from the place of residence of the ESSE-RF3 participant was 33, and within a radius of 400 meters — 8. In Arkhangelsk, the alcohol was sold in a grocery store located in the same building as the college branch. In the Sverdlovsk region, the nearest alcohol store was located at a distance of 50 m from the kindergarten, in the Tver region — 44 m from the college. A 0,5 liter bottle of vodka was sold below the price floor in 55,1% of specialized liquor stores in the Sverdlovsk region and in 66,8% of such liquor stores in the Tver region.Conclusion. As a result of the study, availability and affordability of alcoholic beverages in Arkhangelsk, Tver, Yekaterinburg and Revda was assessed. The findings reflect the high availability of alcohol and indicate the need for interventions at both the national and local government levels. The used method of collecting and analyzing data demonstrated sufficient research effectiveness and can be recommended for wider use.

Lithuanian Postcard in the struggle against Imperial Russia

The article is devoted to a peculiar episode of the struggle of Lithuanians against the policy of persecution based on nationality which was pursued by Imperial Russia between 1864 and 1904. Its participants were representatives of the parts of the Lithuanian nation separated by the border between Germany and the Russian Empire – Martynas Jankus (1858–1946), a German citizen, a Lithuanian of East Prussia, the owner of a printing office in Tilsit (Lith. Tilžė, currently Sovetsk, a town in Kaliningrad Oblast, the Russian Federation) and a group of Lithuanian young people who were operating illegally, a group of citizens of the Russian Empire. The time under discussion is the 1890s. During that period, the Lithuanian national movement was rapidly developing and strengthening while striving to bring together both parts of the nation and the USA-based Lithuanian diaspora community. One of the most important measures of the common struggle was the distribution of publications printed in Latin characters in the Lithuanian language which were banned to be published in the territory of Russia but were legally printed in East Prussia and smuggled across the border into Lithuania. From there, the publications were sent to Lithuanian communities all over the Russian Empire. This struggle resulted in victory: the ban was lifted by Order of the Cabinet of Ministers of Russia issued in 1904.
 To strengthen the political opposition, Lithuanian intellectuals printed not only books, brochures and newspapers but also various minor publications – political leaflets. Students of Russian universities and Lithuanian intellectuals graduates of these higher education institutions prepared texts and sent funds intended for their publication to the printing offices of Lithuanians and Germans in East Prussia. The number of such leaflets surviving to the present day is very small. One of these publications was an anonymous card of the size of a standard German postcard (95 x 140 mm). Thus far, three of them have been found in Lithuanian libraries and archives, and one has been discovered in the National Library of Russia in Saint Petersburg. A composition of two illustrations is printed on one side of the card: a Lithuanian countrywoman and a Cossack standing in front of her with a raised whip and a bottle of vodka as a gift for obedience. This symbolised a spread of orthodoxy and the deportation of Lithuanians from their native land. The following exclamation of the Cossack is printed: Are you a Lithuanian? Go to Russia! The explanation of the content of the illustration and the encouragement (first of all, to Catholic believers) to oppose the plans of the authorities are printed in small characters. They are related to the colonisation of Siberia. The statements are well-grounded, the exposition of the subject is logical and written in the correct Lithuanian language. Most probably, it was created by the graduate of the Faculty of Law of the University of Moscow Vladas Mačys (1867–1936).
 Vaclovas Biržiška, Professor of Law at the University of Lithuania in Kaunas and Director of the University Library, was the first to describe this publication bibliographically. The author regarded this publication as a postcard, attributed it to Martynas Jankus’ printing office and dated it ‘1892’. A more precise description was publicised in the fundamental work of Lithuanian national bibliography Lietuvos TSR bibliografija. Serija A: Knygos lietuvių kalba (Bibliography of the Lithuanian SSR. Series A: Books in the Lithuanian Language; vol. 2: 1862–1904. Book 2 (Vilnius, 1988, p. 401, No. 4065). It was compiled in the Soviet era, and the only available copy stored in Mikhail J. Saltykov-Shchedrin State Public Library (currently renamed the Russian National Library in Sankt Petersburg) served as the basis for it. The present author amended the publication date of the postcard (1891) and specified the circumstances of its distribution, while also ascertaining that the artist of the illustrations was the lithographer of Tilsit Johann Mai.

At Times I Didn't Drown

At Times I Didn't Drown

S1668 Pancreaticoportal Vein Fistula: A Very Rare Complication of Pancreatitis

Introduction: Pancreatic pseudocyst formation is a well-known complication of pancreatitis. Fistualization between a pancreatic pseudocyst and the portal system is a very rare complication of pancreatitis. Presentation varies from vague abdominal pain and elevated LFTs to systemic lipolysis, septic shock and death. It carries a high mortality risk if not identified promptly and managed. Case Description/Methods: 52-year-old male with a history of lymphoma s/p chemotherapy and splenectomy and HTN presented with 3 days of abdominal pain, decreased PO intake, and bilious emesis. He drinks half a bottle of vodka daily. His labs were notable for a significantly elevated lipase, lactic acidosis, severe AKI and elevated LFTs. CT abdomen was performed which was consistent with acute pancreatitis. He was admitted and treated conservatively. RUQ US revealed no gallstones. Pancreatitis was likely secondary to alcohol use. During this hospitalization he developed leukocytosis, fever, and worsening nausea and pain. An MRCP was obtained which revealed acute pancreatitis without definite focal pancreatic lesion, no cholelithiasis or choledocholithiasis. An MRI abdomen with contrast was obtained which revealed acute pancreatitis with necrosis in the pancreatic neck. There was no discrete abscess identified. He did not require surgical intervention. His course was complicated by C. difficile which was treated with oral vancomycin. The patient clinically improved and was discharged in stable condition after 11 days. About 1 month later the patient again presented with abdominal pain and "bulging" of his stomach. A CT and MRI of the abdomen revealed a massive pancreatic pseudocyst with communication with the porta hepatis. He was started on broad spectrum IV antibiotics and underwent a robotic cystgastrostomy. It was noted the pseudocyst was mostly fluid filled with small necroma component. Intraoperative cultures of the necroma remained without growth. The remainder of his hospital course was complicated by fever, leukocytosis and a pleural effusion with LLL collapse. The effusion was drained via chest tube. Pleural fluid cultures were negative. He was discharged in stable condition on IV antibiotics. Discussion: PPVF carries a high mortality risk and should be identified promptly. MRI/MRCP and ERCP aid in the diagnosis of PPVF. Treatment options include supportive medical management, surgical or endoscopic drainage of pseudocysts, fistula embolization, or partial pancreatectomy.Figure 1.: Multiloculated pseudocyst with fingerlike extensions into the porta hepatis.

Articulations of displacement and dissonance from Compton: Kendrick Lamar in the twenty-first century

Kendrick Lamar’s lyrics and subject matter often require repeated listens that reveal perspectives ranging from his upbringing in Compton, his parents’ migration from Chicago to California and broader questions of identity, place, displacement, belonging and home. A self-described Southern California ‘80s baby’, Lamar’s music nevertheless imagines Black self-identification in a broader and global sense. His work reflects rootlessness among continental and diasporic Africans across time and space. Utilizing approaches of British Cultural Studies and African diaspora studies, this article analyses Lamar’s critically acclaimed album To Pimp a Butterfly (2015). The pursuit of home as a response to the unbound nature of diasporic existence – connected to histories of transatlantic slavery, the Middle Passage and the plantation enterprise in the United States, the Caribbean and South America – reverberates for Lamar as an African American millennial yet also situate him within a continuum of Afro-Atlantic artistic innovators. In places as varied as Chicago, Compton, Jamaica, South Africa and London, Black people reckon with the meanings of home and Lamar offers his unique Afro-diasporic perspective. Lamar’s ruminations on intra-national migrations within the United States allow for a theorization of various iterations of home that include specific communities, families, cities, nations, gangs and the comforts of a bottle of vodka. Lamar’s lyrical confessions embrace identification as process, a brilliant and probing strategy that references histories of movement in the United States as well as ethnic tensions in South Africa, post-independence political economic realities in Jamaica and the history of migration from the Caribbean to metropolitan Britain. I suggest that Lamar introduces a particularized twenty-first-century Black racialized humanism where his own position vacillates between predator and victim. Who Lamar is and who he is said or seen to be recurs and reflects the specific conditions he and contemporary diasporans negotiate across the globe.

A refreshing change.

Midway through grad school, a friend asked me to volunteer as a barback—a bartender's assistant—at the opening gala for a film festival. I was hesitant at first, having never worked behind a bar. But I said yes, lured by the offer of free tickets to the festival. I spent an evening running around like a chicken with its head cut off: slicing fruit, replacing liquor bottles, and doing other menial tasks. By the end of the night, I was tired and sweaty and I'd dropped an expensive bottle of vodka. But I felt incredible—in awe of how much fun I had—and I went home and slept better than I had in years. The event forced me to reflect on what brings me happiness and a clear state of mind. It was a turning point in my grad school experience. ![][1] ILLUSTRATION: ROBERT NEUBECKER > “The demands of the job were exactly what I was missing from my Ph.D. program.” I got into my doctoral program on a technicality. On my application, I'd checked the box for “Ph.D.” not knowing that a master's degree was a prerequisite. My adviser—who interviewed me over the phone—misread my undergraduate record and thought I had a graduate degree under my belt, so I was admitted to the Ph.D. program. He welcomed me into his lab even after finding out about the error. But it left me feeling like I had a lot to prove. I got off to a running start. My adviser had 3 years of funding to cover my stipend and tuition. I threw myself into reading every paper I could find and thinking about how to test scientific questions no one had yet delved into. And I was awarded a grant to help fund some expensive genetics labwork. But 4 years later, I felt lost. I barely passed my qualifying exam. A manuscript I spent a year working on was rejected outright, without peer review, and I was running out of funding. My mood was in the gutter. I told my therapist at the time, “The more people are interested in what I study, the angrier I am that they care and I don't.” I dreamed about quitting my program, moving back home, and working at the bike shop that had employed me during college. Then came the barback gig. After we finished cleaning up the bar that night, I was handed festival tickets and an envelope with my cut of the tips—close to $40. It felt wrong to be compensated while having so much fun. I grinned as we snuck upstairs to watch the gala attendees finish their drinks and to steal shrimp from the serving bowls. The next day, I tried to figure out why I loved this short-lived experience so much. I realized it was because the demands of the job were exactly what I was missing from my Ph.D. program. It was physically exhausting, the tasks I was responsible for were simple and could be completed in a short time, and I knew without a doubt when I succeeded and when I failed. My mind was blissfully blank all night. At that point, I had not had a break from thinking as hard as I possibly could for 4 years. I had never come up for air, and I was completely unaware of the toll it was taking on my mental health. Since then, I've tried to give my mind more breaks. When I start to feel overwhelmed—when an experiment fails, a mistake sets me back a month, or funding falls through—I make a point of doing things that allow me to feel successful in other ways. I learn how to play a new song on the piano. I go for a run. I volunteer for an organization that I care deeply about, performing basic tasks such as stapling papers and shredding documents. The simplicity of these activities brings a peace of mind that I never find in academia. They help clear my head, preparing me to dive back into the graduate work that both excites and exhausts me. I don't think I'll ever be a professional barback. But I'll never forget the lessons I learned that night. Graduate school takes a lot of work and skill, but it doesn't exercise all the muscles of your brain, body, or spirit. Sometimes it's OK—even necessary—to find other, decidedly unscientific, ways to fill your cup. [1]: /embed/graphic-1.gif

3036 Alcohol Consumption Increases Risk of Pancreatitis in Celiac Disease: A Case Report

INTRODUCTION: Celiac disease is an autoimmune disorder of small intestine that improves significantly with gluten free diet. It is reported that patients with celiac disease are associated with increased risk of hepatobiliary and pancreatic diseases. In patients with celiac disease, alcohol further increases the risk of pancreatitis. CASE DESCRIPTION/METHODS: 35 year old female with history of celiac disease and alcohol abuse presented to us with abdominal pain, nausea and vomiting for 1 week. Pain was generalized, characterized as sharp and stabbing. She admitted drinking half a bottle of vodka daily for pevious few weeks and has been dealing with alcohol abuse for many years. Initial labs showed hyponatremia 125, Hypokalemia 2.4, Ethanol 280 and lipase 500. CT Abdomen was unremarkable. Patient IGA was elevated with Tissue transglutaminase IgA level more than 250. Patient was diagnosed with acute pancreatitis and was treated with supportive management. Patient previous pathology showed villous blunting and intraepithelial lymphocytes suspected for non-compliance with gluten free diet. Patient symptoms and labs improved significantly during hospitalization and was discharged home. Unfortunately, patient was admitted within a week with similar symptoms of abdominal pain with hyponatremia, hypokalemia, and elevated lipase but Ethanol level was less than 10. Patient was again treated conservatively for recurrent pancreatitis and discharged home with counselling for gluten free diet and alcohol cessation. DISCUSSION: Celiac disease is an autoimmune disease with abnormal response of the small intestine to the gluten, widely present in our diet. Patient may present with vomiting, abdominal pain, nausea, flatulence, weight loss or diarrhea. It has been reported that almost 20% of the patients with celiac disease are associated with pancreatitis and pancreatic inflammation. It is believed that impaired release of pancreatic stimulating hormones from the pancreas due to inflammed proximal small bowel may be responsible. However, it has also been reported that papillary stenosis may be responsible for the pancreatic inflammation present in the celiac disease. Alcoholic patients with celiac disease have several fold increased risk of development of pancreatitis and pancreatic inflammation and are counselled to avoid or reduce the alcohol intake.

You Owe Me a Murder by Eileen Cook

Reviewed by: You Owe Me a Murder by Eileen Cook Karen Coats Cook, Eileen You Owe Me a Murder. Houghton Mifflin Harcourt, 2019 [352p] Trade ed. ISBN 978-1-328-51902-3 $17.99 E-book ed. ISBN 978-1-328-63003-2 $9.99] Reviewed from galleys R Gr. 9-12 Kim goes a little off the deep end emotionally when Connor dumps her, but her parents won’t let her out of the study-abroad trip that she had planned to share with him before the breakup. Stuck witnessing him snuggled up with his new girlfriend, Kim is relieved when a strange girl named Nicki befriends her in the airport. Before their flight, Nicki dares Kim to steal a bottle of vodka; on the plane to London, she then prods a drunken Kim into a bargain that Kim takes to be a joke: Nicki will kill Connor if Kim kills Nicki’s alcoholic mom. Things look up when Nicki disappears and Kim immediately hits it off with another boy, Alex, but then plummet when Connor tumbles off a platform in the Underground and is hit by a train. Though everyone thinks it was either suicide or an accident, Kim knows better, and soon Nicki shows back up, fully expecting Kim to kill her mother in return. While the woman-scorned motive for murder may be past its freshness date, the taut suspense, surprising twists, a trip through London, and a truly sinister villain keep pages turning as readers learn that Kim isn’t as smart or as reliable a narrator as she appears. Copyright © 2019 The Board of Trustees of the University of Illinois

ON-THE TITLE OF THE ESSAY OF «THE EARTH UNDER WHITE WINGS»

The article discusses on-the title of the essay by Vladimir Karatkevich “The Earth under white wings”. This title is the crown, the seed from which it grows, is born the idea of the piece. We identified the characteristics according to their semantic-stylistic and aesthetic features in waznym the text. Wide open the image of the stork. For sublimely magnificent manivanna our homeland of Belarus as a state, Vladimir Karatkevich has created a descriptive expression of the land under white wings, who named his popular not only in Belarus essay addressed to the first students of the brotherly Ukraine.Every Belarusian knows that the stork is very typical for Belarus, most migratory bird with long straight red beak and red high feet. In the people since Colacevich then the storks metaphorically referred to as a high a bottle of vodka. Thus, V. Korotkevich, putting in bblank great symbolic meaning, prompted Udomlya the reader that Belarus is a country which, averguenza this God’s bird, and we, Belarusians, go under the care and protection of God himself. When describing positive in the works V. Karatkevich and other writers of this celeronm (white) very productive, frequent, symbolically filled. On grammatical structure, as traced by linguists, this title – a difficult phrase, which used three independent and one function word. Token the earth, which, according to the researchers replaced the words of the country in the structure bblonde, stands as a synonym for such units as country, state. In works of fiction, journalism, the word is widely used in the structure Tapani called with the grandly-elevated connotation: opening of the new land archipelago, country, island, pioneers identified them rhetorically-majestic: the Sannikov Land, the Earth Frantsa-Joseph, New land, such periphrase-phrases identified in the literature: the Land of Cervantes, Land Kupala and Yakub Kolas, etc. Adjective-celeronm white (white) hapatitis sense is a symbol of infinity, eternity, the universe, in the traditional culture of the Belarusians, he is one of the most advanced. Along with the red and black, he is the main range of the color symbolism in the mythopoetic model of the world. The essence of most bblonde elaborates the writer himself, often written using the people explanations, naive etymology, adding data from scientific sources, chronicles, etc.

A Case of Altered Mental Status in the Setting of Bromethalin Toxicity

Bromethalin is one of four different types of rodenticide ingredients. Accidental or intentional ingestion of that poison can cause serious symptoms and signs that would require hospitalization and might lead to death. It works by depleting ATP from brain and liver mitochondria by uncoupling of oxidative phosphorylation process which leads to disruption of the function of sodium/potassium ion pumps in those organs causing cerebral edema with intracranial hypertension. Our case presented with altered mental status after patient was found down in his car with green discoloration around mouth and holding Tomcat rat poison in one hand and a bottle of Vodka on the other hand. Patient was intubated and admitted to ICU. Supportive care was started and later on was weaned off mechanical ventilation and improved over the course of his hospital stay.

Babies in the Water

Babies in the Water Molly Quinn (bio) Although it was May, the stone path leading up to Kim's childhood home was still glazed with ice. Green stubble poked through the crystalline snow on the front lawn. Kim had crossed the river to East Saint Paul to check on her mother, who was getting so confused she left the oven on and the taps running but refused to go to a nursing home. Kim saw her as little as possible and hadn't been to the house in more than a year. The only reason she'd come was because the personal care attendant had canceled, and her sister, Sharon, had begged Kim to help. Immediately, Kim said no. But then Sharon said maybe that was for the best, since Kim didn't know how to take care of anyone except herself, and she changed her mind. Kim took a swig from the bottle of vodka stashed in her purse before getting out of the car. When their mother was first diagnosed, Sharon had cleared the metropolis of liquor bottles from their parents' bar. Even Kim, steeped in anger and resentment as she was, thought this was unnecessarily cruel. She didn't see why her mother couldn't have a drink every now and then, just because she was confused. She stopped at the liquor store for both their sakes. Spite for Sharon wasn't the only force luring Kim up the walk: recently, her sister had told her it wouldn't be long before their mother didn't recognize them. If there was anything Kim wanted to say, it would have to be soon. The front door was unlocked. Kim walked through rooms that felt like dreams: the den with its wall of antlers; the tobacco-scented breezeway; the living room, dominated by a gleaming teak bar; and finally into the plastic-tiled kitchen, where her mother's feet were visible beneath the pantry doors, darting around in little high heels. She emerged wearing a cocktail dress with an apron tied over it. Her hair was the color of polished maple; her eyebrows were dyed to match. When she saw Kim, she smiled so hard the tendons in her neck stood out. "Kimmie!" [End Page 34] "Kim." She didn't know why she bothered to remind her. Her mother closed in with an odor of perfume that was meant to be floral but had the sharpness of bathroom sanitizer. She placed a hard pucker on Kim's cheek. "I'm glad you're here." "Really?" Kim said, annoyed by the hopeful rise in her own voice. "I made macaroni loaf for us. There's enough for Sharon too, if she stops by." "Sharon's at her kids' swimming lessons. It's just me tonight." "Yes, well. You never know when she might drop in." "Mom," Kim said, "aren't you surprised to see me?" "Surprised?" Kim searched her face, trying to figure out if her mother was confused about how long it had been since her last visit, or if, as usual, she was trying to avoid a conversation about what was really happening. Kim felt the power she'd accumulated with her distance draining away. "It's been awhile," she reminded her. "I suppose it has," her mother said absently. "Now, why do you think the children are swimming in the winter?" "It's spring now. But it doesn't matter—it's an indoor pool." Her mother put her hand over her heart. "I wish I could see them now, those babies in the water!" Kim had seen them at their swimming lessons. All four of them—Kim liked to remind her sister that four was enough to be considered a litter—bobbed along with confident strokes and breathed on both sides. Besides swimming, Sharon's children took tap and Irish dance lessons. The oldest played the viola, the other three the flute. All four were on the t-ball team. They would draw a picture and tell you all about it, chubby hands gesturing as they improvised stories in lisps. Kim knew that in her mother's eyes, there was no way to compete with the...

Informal Vows

In post-Soviet Kazakhstan, mobile pastoralism is now a task managed not by collective farms but by individual households: extended networks of kin band together to create flocks, and poor families trade labour for sustenance and a share of the flock’s live offspring. The success of these sheep-herding camps turns on their integrity as domestic units: the camp cannot function without the tasks customarily performed by women, yet relations of blood or marriage remain the only social institutions capable of mediating the exchange of domestic labour. This paper contrasts elaborate marriage ceremonies with more informal unions in which the primary desire is the presence of a woman’s labour. These marriages—unregistered, undertaken from necessity and celebrated by little more than a meal and perhaps a bottle of vodka for drinking toasts—index the conflicts and contradictions implicit in domestic labour being simultaneously fundamental to the household’s economic life and yet treated as a form of labour not to be honourably alienated from the family.

On Empson by Michael Wood

Reviewed by: On Empson by Michael Wood Andrew Motion (bio) Michael Wood, On Empson (Princeton University Press, 2017), 184pp. Near the beginning of this excellent short study of the criticism and poetry of William Empson, Michael Wood takes a leaf from his subject’s late book Using Biography; he reminisces about hearing Empson give the prestigious Clark Lectures at Cambridge, England, in 1974—“waving about a piece of paper on which he had some notes, not lecturing so much as commenting on what had come up in the office hours he had held the week before in Magdalen College.” Encouraged by Wood’s example, I’ll begin in the same way. I first heard Empson’s name in the spring of 1970, when I was seventeen years old, and my high school English teacher asked us to read and talk about the poem “To an Old Lady.” This tribute to his mother, which is haunted by other writings (King Lear at the opening: “Ripeness is all…,” Paradise Lost at the close: “. . . in darkness is she visible”), and dense with riddling ingenuities (“Bees sting their need, the keeper’s queen invader”), was immediately very attractive to me. I might fairly say that I fell half in love with its un-easeful life and energy. When I won the school poetry competition a few months later, I chose Empson’s Collected Poems as my prize. And although I was very often baffled by lines I then began to linger over, I never lost my deep liking and admiration for them. They seemed astoundingly witty—and they still do today. I still feel flattered as well as entertained by the intellectual demands they make on me, and I still feel enchanted by their music: elaborately formal but also direct and no-nonsense. Tough, as well as tricky. A couple of years after leaving school, when I was a student at Oxford, Empson came to give a reading, and of course I went to listen. It was [End Page 477] disappointing. Although I still remember the thrill of actually seeing him (that owlish face, that sweeping moustache, that extraordinary beard sprouting beneath the chin but not around the mouth), I couldn’t hear most of what he said. He delivered his poems in a quick-fire mumble. Five years later, when I was teaching English at the University of Hull, I went to listen again. This time he was introduced by Philip Larkin (whom I was sitting directly behind: I saw Larkin turn up—or possibly turn off—his hearing aid as proceedings got under way), and there was amplification. But it was another disappointment. Empson swayed in front of the microphone to such an extent that his words were continually bent out of shape, in a poetic version of the Doppler effect. But never mind. As far as I was concerned, having by now read the great critical works, Seven Types of Ambiguity (1930), Some Versions of Pastoral (193), The Structure of Complex Words (1951), and Milton’s God (1961) as well as the poems—which Empson had stopped writing in the mid-1940s —I was still watching one of the twentieth century’s giants. Which meant, when I went to work as poetry editor for his publisher Chatto and Windus in 1982, and discovered that no one from the firm had been in touch with him for a long time, I made it my business to see whether he had anything new that he wanted to publish. The (also recently-arrived) managing director Carmen Callil and I were duly invited for a drink at Empson’s house in Hampstead, north London. I was thirty years old and frankly a bit awe-struck. Empson, who often spoke (not that I knew it at the time) in his letters about the value of drink as a social lubricant, noticed this and perhaps took pity on me—or perhaps simply carried on as usual. Herding together four tall glasses on a kitchen work-surface (his wife Hetta was also there) he shook an open bottle of vodka roughly in the air above them all, until they were about half full, then did the same with...

Fatal Alcohol Poisonings and Traffic Accidents in Russia

IntroductionRoad traffic injuries are the eight leading cause of death globally, and the leading cause of death for children and young adults [1,2]. According to prognosis, the worldwide road traffic injuries rank among the causes of death will climb to the fifth place by 2030, resulting in an estimated 2.4 million fatalities each year [2]. It is estimated that in the European Union 1.3 million road traffic accidents occur each year, resulting in 1.7 million injuries and over 40 000 deaths annually [3]. The direct and indirect costs of these accidents sums up to 160 billion euro, equal to 2% of the gross national product of the EU [2].Alcohol has been identified as one of the most significant risk factors for road traffic crashes in many developed and developing countries of the world [4]. At the individual level, there is dose-response relationship between alcohol consumption and fatal road traffic accidents, with risk of death increas-. ing non-linearly with increasing alcohol consumption [3]. Zador estimated that each 0.02 increase in a driver's BAC nearly doubled the risk of fatal crash [5]. It has been also estimated that the likelihood of being a fatally injured driver was at least 9 times greater at BACs of 0.05 to 0.09% than at zero BAC [4].Several studies report the positive association between alcohol consumption and traffic fatalities at the aggregate level. Skog evaluated the effects of changes in aggregate alcohol consumption on fatal motor vehicle traffic accidents in 14 western European countries after 1950 [6]. For male traffic accidents, significant relationships were uncovered in central and southern Europe, but not in northern Europe. Among females the effect was significant only in central Europe [6]. A more recent time series analysis based on Belarusian data for the period from 1970 to 1999 reported a close link between vodka sales per capita and road traffic fatality rates [7].Russia has one of the world's highest road traffic fatality rates due to drunk driving, poor road conditions, an outdated vehicle fleet [8,9]. Each year, approximately 30 000 Russians die in road accidents - about the same as in the European Union [2]. Road safety has attracted attention at the top levels of Russian politics, receiving mention in Putin's 2006 Annual Address to the Federal Assembly and serves as the centerpiece of a national speech by Medvedev in August 2009 [9].There is common believe that high level of alcohol consumption in conjunction with binge drinking pattern is a major determinant of high violent mortality rates in Russia [7,10-12]. Over the past 10 years, almost 40 000 Russians have died in road accidents caused by drunk drivers [9]. A large retrospective case-control study in three Russian industrial cities found dose-response association between alcohol consumption and mortality from road accidents: drinking of three or more bottles of vodka per week was strongly associated with deaths from road accidents both among men (RR= 4.20; CI: 3.31-5.34) and women (RR= 4.48; CI: 3.385.96) [13]. Although drunk driving officially accounts for 7,2% of all road traffic crashes at the national level, its proportion increases to one-fifth in some federal regions [9]. Furthermore, the most recent individual-level estimates suggest that 46.1% of all deaths from road accidents (47.7% and 41.0% of deaths among men and women respectively) were attributable to alcohol consumption [14].In line with this evidence we assume that a combination of higher level of alcohol consumption per capita and binge drinking of vodka results in a close association between alcohol and mortality from road accidents in Russia. To test this hypothesis trends in mortality from road accidents and fatal alcohol poisoning rates from 1970 to 2013 in Russia were analyzed employing time-series analysis.Material and methodsDataThe data on sex-specific road traffic fatality and fatal alcohol poisoning rates per 1 000 000 of the population were taken from the Russian vital statistics registration system. …

Mixed Messages

Mixed Messages

Can Wine and Moderate Alcohol Intake Work as Functional Food Nutraceuticals? A Tribute to Dr. Serge C. Renaud

Alcohol appears to be a double-edged sword because moderate alcohol intake is protective whereas drinking more than 10 drinks in a week appears to have adverse effects on morbidity and mortality. Recently, the exponential nature of the relation between average alcohol consumption and mortality has been demonstrated in Russia. This study revealed that substantial numbers of people report drinking three or more half-litre bottles of vodka per week. However, the exponential curves for dose-response relations between average volume of alcohol consumption and the mortality risk of various diseases is not fully explained. The variation in mortality may be due to presence of confounders such as physical activity, greater consumption of fish and salads which are rich sources of omega-3 fatty acids and polyphenolics. It is possible that patients with type 2 diabetes, moderate alcohol us-e, particularly wine consumption, is associated with reduced risks of cardiovascular events and all-cause mortality. Serge C. Renaud gave the definition of the French paradox and suggested that the inhibition of platelet reactivity by wine may be one explanation for protection from CAD in France. It is known that aging of alcohol also increases 1, 1-diphenyl-2-picrylhydrazyl radical scavenging activity and therefore moderate drinking of aged whisky and other alcoholic drinks in moderation may provide beneficial effects. Excess of alcohol intake causes decreases in vitamin B1, B6 and B12 as well as in folic acid, antioxidants vitamins A,E ,C and beta carotene, flavonoids, amino acids, coenzyme Q10, l-carnitine, omega-3 fatty acids as well as in minerals magnesium, potassium, calcium, copper, zinc, chromium and selenium. Alcoholism also has a direct adverse effects on cell membrane, mitochondria and genes. Alcoholic cirrhosis, fatty liver, cardiomyopathy, hypertriglyceridemia, hyperuricemia, oxidative stress and inflammation are well known adverse effects of alcoholism. It also damages the brain causing dementia, depression and psychosis. However, moderate alcohol intake up to 10 drinks per week may have beneficial effects on the risk of all these problems. Moderate alcohol intake increases HDL-C, and decreases C-reactive proteins, IL-6, TNF-alpha, Lp (a), plasminogen activator inhibiter-1, insulin resistance which are risk markers of CVDs, type 2 diabetes and cancer. These beneficial effects are enhanced by omega-3 fatty acids and polyphenolics that are rich in Mediterranean style diets. Vodka and spirits can be made healthly if enriched with fish oil or alpha- linolenic acid (rich source of w-3) and cocoa (flavanol) which can repair this deficiency. It is like a cleaning drink for the all the organs of the body. If standard Vodka is 40% alcohol, then we need +/- 1-g DHA per 500-ml bottle.

Drug scene, drug use and drug-related health consequences and responses in Kulob and Khorog, Tajikistan

BackgroundTajikistan and other Central Asian republics are facing intertwined epidemics of injecting drug use and HIV. This paper aims to examine drug scene, drug use, drug-related infectious diseases, drug treatment and other responses to health consequences of drug injecting in two Tajik cities of Kulob (Khatlon Region) and Khorog (Gorno-Badakhshan Autonomous Oblast). MethodsWe conducted 12 focus group discussions in Kulob and Khorog and analysed peer-reviewed literature, published and unpublished programme and country reports and other publications that focused on substance use and/or HIV/AIDS in Tajikistan and included the Khatlon and Gorno-Badakhshan regions. ResultsIn both Kulob and Khorog, heroin is used by the overwhelming majority of people who inject drugs (PWID), with one dose of heroin in Khorog costing less than a bottle of vodka. Opioid overdose among PWID in Tajikistan is a serious issue that appears to be substantially underestimated and inadequately addressed at the policy and practice levels. In integrated bio-behavioural surveys (IBBS), HIV and HCV prevalence in both Kulob and Khorog varied widely over a short period of time, raising questions over the quality and reliability of these data. Access to opioid substitution therapy (OST) and antiretroviral therapy (ART) by PWID is either lacking or inadequate. Very few women who inject drugs access needle and syringe programmes in Kulob and Khorog. HCV treatment cannot be afforded by the overwhelming majority of PWID due to high costs. ConclusionTajikistan IBBS data point to the potential problems in using composite national prevalence as an adequate reflection of the HIV epidemic among PWID in the country and highlight the importance of examining site-specific prevalence rates for better understanding of the dynamics of the epidemic over time as well as potential problems related to the reliability of data. Furthermore, our analysis highlights that in a country where almost all PWID inject opiates, agonist treatment should be an intervention of choice. Scaling-up both OST and ART coverage must be seen as the top priority for reducing HIV prevalence and incidence in Tajikistan. Naloxone distribution programmes need to be expanded and drug treatment, harm reduction and HIV services that meet the specific needs of female injecting drug users should be put in place.

Back From the Brink

Back From the Brink

Image Diagnosis: Spontaneous Hematoma from Scurvy

A 58-year-old alcoholic man presented with pain, swelling, and bruising of his right leg. He had no history of trauma or injury. His medical history was significant for frequent spontane ous hematomas in his legs (Figure 1), the first and most dramatic of which was a large thigh hematoma occurring 4 years earlier. This area became infected, developing necrotizing fasciitis that required emergency surgery. On physical examination, he had hyperplastic gums and no teeth. He had no body hair below his head. The calf of his right leg was enlarged and tender, with more swelling medially than laterally. Dependent bruising was noted in the popliteal fossa initially as his leg was elevated; several days later, when he started ambulating, bruising became apparent around his ankle. His initial blood alcohol level was 0.28%, and his Aspartate Aminotransferase and Alanine Aminotransferase levels were 90 and 61 international units/microliter, respectively. His platelet count and coagulation studies were normal. His body mass index was 30 kg/m 2 . Color flow Doppler ultrasound of his right leg was performed, and no deep venous thrombosis was identified. Imaging of his leg by a contrast-enhanced computerized tomography scan (Figure 2) showed a large hematoma in the right calf (white arrows), measuring 7.5 x 3.5 x 12.6 cm (anterior-posterior, transverse, and caudal-cranial dimensions, respectively). Extravasation of intravenous contrast was seen, indicating active bleeding (black arrowhead). There were no aneurysms or other vascular malformations in or near the hematoma. This patient drank a 1.75-liter bottle of vodka daily and smoked cigarettes. He ate mostly precooked hash brown potatoes, pasta, and occasional canned tuna. He did not eat fresh vegetables and rarely ate fruit.

Alcohol and mortality in Russia: prospective observational study of 151 000 adults

SummaryBackgroundRussian adults have extraordinarily high rates of premature death. Retrospective enquiries to the families of about 50 000 deceased Russians had found excess vodka use among those dying from external causes (accident, suicide, violence) and eight particular disease groupings. We now seek prospective evidence of these associations.MethodsIn three Russian cities (Barnaul, Byisk, and Tomsk), we interviewed 200 000 adults during 1999–2008 (with 12 000 re-interviewed some years later) and followed them until 2010 for cause-specific mortality. In 151 000 with no previous disease and some follow-up at ages 35–74 years, Poisson regression (adjusted for age at risk, amount smoked, education, and city) was used to calculate the relative risks associating vodka consumption with mortality. We have combined these relative risks with age-specific death rates to get 20-year absolute risks.FindingsAmong 57 361 male smokers with no previous disease, the estimated 20-year risks of death at ages 35–54 years were 16% (95% CI 15–17) for those who reported consuming less than a bottle of vodka per week at baseline, 20% (18–22) for those consuming 1–2·9 bottles per week, and 35% (31–39) for those consuming three or more bottles per week; trend p<0·0001. The corresponding risks of death at ages 55–74 years were 50% (48–52) for those who reported consuming less than a bottle of vodka per week at baseline, 54% (51–57) for those consuming 1–2·9 bottles per week, and 64% (59–69) for those consuming three or more bottles per week; trend p<0·0001. In both age ranges most of the excess mortality in heavier drinkers was from external causes or the eight disease groupings strongly associated with alcohol in the retrospective enquiries. Self-reported drinking fluctuated; of the men who reported drinking three or more bottles of vodka per week who were reinterviewed a few years later, about half (185 of 321) then reported drinking less than one bottle per week. Such fluctuations must have substantially attenuated the apparent hazards of heavy drinking in this study, yet self-reported vodka use at baseline still strongly predicted risk. Among male non-smokers and among females, self-reported heavy drinking was uncommon, but seemed to involve similar absolute excess risks.InterpretationThis large prospective study strongly reinforces other evidence that vodka is a major cause of the high risk of premature death in Russian adults.FundingUK Medical Research Council, British Heart Foundation, Cancer Research UK, European Union, WHO International Agency for Research on Cancer.