Chronic Alcohol Abuse Research Articles

Neoplastic Effects of Endogenous Alcohol in Carcinogenesis Process of Hepatocarcinoma

Introduction: Based on the grim statistics, the mortality of alcoholic liver disease was in last years the high in the undeveloped countries but and in developed countries in the statistic compared with last years.
 Aim: Scope of this work was to discover the patients diagnosed with alcoholic cirrhosis which in time was transformed in Hepatocellular Carcinoma, (HCT) by continue abuse alcohol and which presented, at a previous medical control, with the diagnosis of steatohepatitis after the chronic abuse of alcohol.
 Methodology: The retrospective study consisted of 180 patients, adult men (mean age 55 years) and females (mean age = 48) hospitalized and investigated for alcoholic liver diseases. From total cases investigated, 54 cases (30% from of cases admitted in hospital, meaning 27 men and 17 women), which were diagnosed with alcoholic liver cirrhosis in last 5-7 years but in next medical controls were discovered liver cancers in the 6.1% percent.
 Results: The majority of patients with uncompensated liver cirrhosis, (70%), have had elevated AST in average 66 U/L value, (N= 5-38U/L). Also, they have had an AST/ALT ratio 1.36, (N = 1.33) and ratio TGP/TGO = 0.95. In the liver carcinogenesis process the report AST/ALT increased in 2.64 value and ratio TGP/TGO decreased in 0.67 value.
 Conclusions: The active and rational lifestyle is an essential element in preventing the process of carcinogenesis. Liver disease it's not just how much you drink, but how and when you drink. The treatment of severe alcoholic hepatitis will be necessary in all alcoholic liver diseases centers to prevent hepatic cancer disease.

Protective Effects of Glochidion wallichianum Mull. Arg. on Ethanol-induced Liver Injury in Rats

Chronic ethanol consumption leads to the development of liver disease. In the present study, the effects of Glochidion wallichianum Mull. Arg. ethanol extract (GWE) on chronic ethanol-induced liver injury in rats were evaluated. Total phenolic and flavonoid contents and in vitro antioxidant activities were determined. In the in vivo experiment, male Wistar rats were divided into 5 groups: Control, ethanol, ethanol plus low and high doses of GWE (ethanol+GWE300 and ethanol+GWE600, respectively) and GWE alone (GWE600). All treatments were administered orally for 28 days. Serum biochemical profiles, hepatic malondialdehyde (MDA) levels, antioxidant enzyme activities, cytochrome P450 2E1 (CYP2E1) expression, and liver histopathology were assessed. GWE contained high concentrations of total phenols and total flavonoids and exhibited inhibition of 2,2-diphenyl-1-picrylhydrazyl free radical. The GWE treatment significantly decreased alanine aminotransferase (ALT) levels, reduced hepatic MDA levels, increased catalase (CAT) activity, and improved histopathological alterations. However, compared with the control condition, GWE alone induced a low level of necrosis. The expression of the CYP2E1 mRNA was not different among the groups (p > 0.05). Based on these findings, GWE exerts a protective effect on ethanol-induced liver injury in rats through its antioxidant activity.
 HIGHLIGHTS
 
 Chronic alcohol abuse causes liver injury which leads to alcohol liver disease
 Administration of Glochidion wallichianum Mull. Arg. ethanol extract declined oxidative stress marker in hepatic tissue, improved hepatic antioxidant enzyme on chronic ethanol-induced liver injury in rats
 Glochidion wallichianum Mull. Arg. possibly serves as supplement to attenuate ethanol-induced liver injury
 
 GRAPHICAL ABSTRACT

Wernicke Encephalopathy: A case report

IntroductionWe report a case of a 56-year old woman with a history of depressive disorder between 2012 and 2017 achieving full remission after treatment with antidepressants and anxiolytics. In the year 2021 was presented to the emergency department manifesting alteration of behavioral patterns, ataxia, mental confusion and horizontal nystagmus. A chronic alcohol abuse was also discovered while interviewing. She also exhibited low mood, anterograde amnesia and confabulations that improved rapidly after following treatment with thiamine.ObjectivesReviewing clinical manifestations and treatment of Wernicke encephalopathy and the development of Korsakoff syndrome.MethodsWe systematically reviewed articles using PubMed.ResultsWernicke encephalopathy is a well-known complication of thiamine deficiency, mostly associated with alcohol use disorder. Classically, the syndrome comprises changes in mental status, gait ataxia and ophthalmoplegia. However, the full triad has been described in only 10-17 % of cases, which in our the case is report. After the diagnosis was established and was treated with thiamine, a rapid improvement in the patient´s clinical status was observed. Cognitive impairment was later identified, taking into account the possibility of a Korsakoff syndrome characterized by irreversible brain damage and subsequent loss of anterograde memory. In our patient, this specific diagnosis was dismissed due to the clinical improvement after thiamine treatment.ConclusionsIt is relevant to emphasize the importance of a precise diagnosis and treatment of patients with Wernicke Encephalopathy to avoid the development of a Korsakoff syndrome.DisclosureNo significant relationships.

Non-steroidal anti-inflammatory drugs (NSAIDs), pain and aging: Adjusting prescription to patient features.

A narrative review of papers published from January 2011 to December 2021, after a literature search in selected databases using the terms "pharmacokinetics", "ibuprofen", "diclofenac", "acemetacin", "naproxen", "etodolac" and "etoricoxib" was performed. From 828 articles identified, only eight met the inclusion criteria. Selective COX-2 inhibitors are associated with higher cardiovascular risk, while non-selective COX inhibitors are associated with higher gastrointestinal risk. NSAIDs with lower renal excretion with phase 2 metabolism are less likely to induce adverse effects and drug-drug interactions. Patients with frequent NSAID use needs, such as elderly patients and patients with cardiovascular disease or impaired renal function, will benefit from lower renal excretion (e.g. acemethacin, diclofenac, and etodolac) (level of evidence 3). Polymedicated patients, elderly patients, and patients with chronic alcohol abuse will be at a lower risk for adverse effects with NSAIDs that undergo phase 2 liver biotransformation, namely, acemethacin and diclofenac (level of evidence 3). Young patients, patients dealing with acute pain, or with active and/or chronic symptomatic gastritis, selective COX-2 inhibitors (celecoxib or etoricoxib) may be a better option (level of evidence 2). Knowing the individual characteristics of the patients, combined with knowledge on basic pharmacology, offers greater safety and better adherence to therapy. PERSPECTIVE: Although there are several NSAIDs options to treat pain, physicians usually take special care to its prescription regarding cardiovascular and gastrointestinal side effects, despite the age of the patient. In this paper, based on the best evidence, the authors present a review of the safest NSAIDs to use in the elderly.

Structural Basis of the Pancreatitis-Associated Autoproteolytic Failsafe Mechanism in Human Anionic Trypsin.

ObjectiveThe pathophysiological mechanisms underlying chronic pancreatitis (CP) are still poorly understood. Human cationic (TRY1) and anionic (TRY2) trypsins are the two major trypsin isoforms and their activities are tightly regulated within pancreatic acinar cells. Typically, they exist in a molar ratio of 2:1 (cationic:anionic). This ratio is reversed during chronic alcohol abuse, pancreatic cancer, or pancreatitis due to selectively upregulated expression of TRY2, causing anionic trypsin to become the predominant isoform. The involvement of TRY2 in pancreatitis is considered limited due to the absence of disease-causing mutations and its increased prevalence for autoproteolysis. However, exacerbated pancreatitis in TRY2 overexpressing mice was recently demonstrated. Here, we aim to elucidate the molecular structure of human anionic trypsin and obtain insights into the autoproteolytic regulation of tryptic activity.MethodsTrypsin isoforms were recombinantly expressed in E. coli, purified and refolded. Enzymatic activities of all trypsin isoforms were determined and crystals of TRY2 were grown using the vapor-diffusion method. The structure was solved by molecular replacement and refined to a resolution of 1.7 Å. Equilibration molecular dynamics simulations were used to generate the corresponding TRY1–TRY1 model.ResultsAll trypsin isoforms display similar kinetic properties. The crystal structure of TRY2 reveals that the enzyme crystallized in the autoproteolytic state with Arg122 placed in the S1 binding pocket and the corresponding loop cleaved. The TRY2–TRY2 dimer confirms a previously hypothesized autoinhibitory state with an unexpectedly large binding interface.ConclusionWe provide a structure of TRY2, which is the predominant trypsin isoform in chronic pancreatitis and pancreatic cancer. A proposed autoinhibition mode was confirmed and the structural basis of the autoproteolytic failsafe mechanism elucidated.

DISSEMINATED TB IN AN IMMUNOCOMPETENT PATIENT

TYPE: Case Report TOPIC: Chest Infections INTRODUCTION: Disseminated tuberculosis (TB) is a rare presentation, more common in patients with HIV, chronic liver disease or alcohol abuse and associated with high rates of treatment failure. CASE PRESENTATION: A 28 years-old male, with history of asthma, started complains of cough, sputum production and asthenia . Despite inhaled steroids, he continued to deteriorate. Skin ulcerations on the right wrist, elbow and leg appeared 4 months later. Fourteen months after the first symptoms, there was purulent drainage in the ulcers and a right knee edema which prevented the patient from walking. The patient presented to the hospital with extreme weight loss (20Kg). HIV screening was negative. CT scan with peri broncho-vascular opacities, tree-in-bud, cavitary lesions and pneumomediastinum. PCR for Mycobacterium tuberculosis was positive on sputum and knee pus. The patient started antibiotics (Clindamycin) and anti-TB drugs. A drain was placed on the right knee. Bone MRI revealed osteomyelitis in the knee, femur and cervical-dorsal spine, with need for surgical cleaning. DISCUSSION: A long evolution of symptoms was probably responsible for the exuberant presentation in this case of disseminated TB. The antibiotics and surgical strategies to treat the skin lesions were very challenging due to different microbiologic isolates and recurrence after drainage. The extension of lesions to the bone led to leg and arm movement impairment. Due to this, a multidisciplinary evaluation and decision to perform surgery were essential to prevent permanent disability. CONCLUSIONS: This case highlights the challenges in the management of thoracic complications of cavitary lesions, cutaneous ulceration and osteomyelitis due to TB. DISCLOSURE: Nothing to declare. KEYWORD: disseminated tuberculosis

Fenretinide Reduces Intestinal Mucin-2-Positive Goblet Cells in Chronic Alcohol Abuse

Introduction: Alcohol-induced thickening of the gut mucosal layer and increased expression of goblet cell gel-forming mucins, such as mucin-2 (MUC2) are associated with disruptions to the gut barrier in alcoholic liver disease (ALD). Interest in drugs that can target gut mucins in ALD has grown; however to date, no studies have examined the properties of drugs on expression of gut mucins in models of ALD. We previously demonstrated that at 10 mg/kg/day, the drug fenretinide (N-[4-hydroxyphenyl] retinamide [Fen]), a synthetic retinoid, mitigates alcohol-associated damage to the gut barrier and liver injury in a murine model of ALD. Methods: In this study, we specifically sought to examine the effects of Fen on gut goblet cells, and expression of mucins, including MUC2 using a 25-day Lieber-DeCarli model of chronic alcohol intake. Results: Our results show that chronic alcohol intake increased gut-mucosal thickening, goblet cell numbers, and mRNA and protein expression of MUC2 in both the ileum and colon. Alcohol intake was associated with marked decreases in ileal and colonic Notch signaling, levels of Notch ligands Dll1 and Dll4, and increases in the expression of Notch-associated genes indispensable for goblet cell specification, including Math1 and Spdef. Interestingly, ileal and colonic expression of KLF4, which is involved in terminal differentiation of goblet cells, was reduced in mice chronically fed alcohol. Coadministration of alcohol with Fen at 10 mg/kg/day significantly reduced alcohol-associated increases in ileal and colonic mucosal thickening, ileal Muc2, colonic Muc2, Muc5ac and Muc6 mRNAs, and goblet cell numbers. We also found that Fen strongly prevented alcohol-mediated suppression of the Notch ligand Dll1, Notch signaling, and alcohol-induced increases in expression of Notch-associated goblet cell specification genes in both the ileum and colon. In the absence of alcohol, Fen treatments alone at 10 mg/kg/day had no effects on any of the goblet cell-related endpoints. Conclusion: These data show for the first time that the drug Fen possesses mucosal layer-modulating properties in response to chronic alcohol abuse. These data warrant further preclinical examination of Fen given the need for anti-ALD drugs and emerging evidence of a role for intestinal goblet cell mucins in the progression of ALD.

Alcohol Increases Lung Angiotensin-Converting Enzyme 2 Expression and Exacerbates Severe Acute Respiratory Syndrome Coronavirus 2 Spike Protein Subunit 1–Induced Acute Lung Injury in K18-hACE2 Transgenic Mice

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, alcohol consumption increased markedly. Nearly one in four adults reported drinking more alcohol to cope with stress. Chronic alcohol abuse is now recognized as a factor complicating the course of acute respiratory distress syndrome and increasing mortality. To investigate the mechanisms behind this interaction, a combined acute respiratory distress syndrome and chronic alcohol abuse mouse model was developed by intratracheally instilling the subunit 1 (S1) of SARS-CoV-2 spike protein (S1SP) in K18–human angiotensin-converting enzyme 2 (ACE2) transgenic mice that express the human ACE2 receptor for SARS-CoV-2 and were kept on an ethanol diet. Seventy-two hours after S1SP instillation, mice on an ethanol diet showed a strong decrease in body weight, a dramatic increase in white blood cell content of bronchoalveolar lavage fluid, and an augmented cytokine storm, compared with S1SP-treated mice on a control diet. Histologic examination of lung tissue showed abnormal recruitment of immune cells in the alveolar space, abnormal parenchymal architecture, and worsening Ashcroft score in S1SP- and alcohol-treated animals. Along with the activation of proinflammatory biomarkers [NF-κB, STAT3, NLR family pyrin domain-containing protein 3 (NLRP3) inflammasome], lung tissue homogenates from mice on an alcohol diet showed overexpression of ACE2 compared with mice on a control diet. This model could be useful for the development of therapeutic approaches against alcohol-exacerbated coronavirus disease 2019.

Neoplastic Effects of Endogenous Alcohol in Carcinogenesis Process of Hepatocarcinoma

Introduce: Based on the grim statistics, the mortality of alcoholic liver disease was in last years the high in the undeveloped countries but and in developed countries in the statistic compared with last years. Aim: Scope of this work was to discover the patients diagnosed with alcoholic cirrhosis which in time was transformed in Hepatocellular Carcinoma, (HCT) by continue abuse alcohol and which presented, at a previous medical control, with the diagnosis of steatohepatitis after the chronic abuse of alcohol. Methodology: The retrospective study consisted of 180 patients, adult men (mean age 55 years) and females (mean age = 48) hospitalized and investigated for alcoholic liver diseases. From total cases investigated, 54 cases (30% from of cases admitted in hospital, meaning 27 men and 17 women), which were diagnosed with alcoholic liver cirrhosis in last 5-7 years but in next medical controls were discovered liver cancers in the 6.1% percent. Results: The majority of patients with uncompensated liver cirrhosis, (70%), have had elevated AST in average 66 U/L value, (N= 5-38U/L). Also, they have had an AST/ALT ratio 1.36, (N = 1.33) and ratio TGP/TGO = 0.95. In the liver carcinogenesis process the report AST/ALT increased in 2.64 value and ratio TGP/TGO decreased in 0.67 value. Conclusions: The active and rational lifestyle is an essential element in preventing the process of carcinogenesis. Liver disease it’s not just how much you drink, but how and when you drink. The treatment of severe alcoholic hepatitis will be necessary in all alcoholic liver diseases centers to prevent hepatic cancer disease.

Acute Diseases of the Esophagus - Esophagitis

Acute Diseases of the Esopagus - Esophagitis Abstract. Inflammation of the esophagus can be caused by various conditions including gastroesophageal reflux (GERD), immunosuppression, infections, allergens, or distinct medications. GERD will be covered in a separate article. Clinical symptoms include heartburn, retrosternal pain, dysphagia, or fetor ex ore. Bleeding, strictures, or stenoses can occur as local complications. Besides a detailed medical history, diagnostic tools are usually an accurate physical examination and flexible endoscopy including histological and microbiological sampling. Immunosuppressive drugs, HIV, malignancies, and chronic alcohol abuse are often associated with candida esophagitis which is typically treated with fluconazole. History of allergies is especially relevant for eosinophilic esophagitis (EoE) which mostly affects young patients and can be treated with topical steroids. A rare but important differential diagnosis to EoE is esophageal lichen planus.

Characteristics of Nonelderly Adult Health Care Persistent Super Utilizers in Utah.

In the United States, the top 1% and top 5% of health care spenders account for 23% and 50% of total health care spending, respectively. These high spenders have been coined the term super utilizers (SU). The aim of this study was to identify the characteristics associated with these patients to aid in developing public health interventions aimed at transitioning patients out of the SU category and thus ultimately helping to control health care costs. The authors utilized the Utah All-Payer Claims Database and Utah Population Database from 2013 to 2015 to identify demographics, comorbid conditions, health care utilization, and cost characteristics of persistent super utilizers (PSU) (≥3 hospitalizations per year for 3 years) of health care compared with persistent nonsuper utilizers (PNSU) (<3 hospitalizations per year for 3 years). Multivariable logistic regression was utilized to identify the characteristics associated with PSU versus PNSU. Higher outpatient/Emergency Department/noninpatient (eg, visits with imaging and Centers for Medicare & Medicaid Services preventive visits) health care utilization and spending, and prevalence of comorbid disease and psychosocial conditions were associated with PSU. In multivariable analysis, factors such as heart disease, chronic kidney disease (CKD), diabetes, alcohol abuse, and depression were statistically significantly associated with higher odds of PSU, with the most noteworthy being CKD (odds ratio [OR] 6.85, 95% confidence interval [95% CI] 5.84-8.02; P < 0.001), alcohol abuse (OR 5.90, 95% CI 4.49-7.69; P < 0.001), and heart diseases (OR 4.41, 95% CI 3.74-5.18; P < 0.001). The annual health care cost of a PSU is about 11.5 times greater than a PNSU ($54,776 vs. $4801; P < 0.001).

Which Factors Predict 30-Day Readmission After Total Hip and Knee Replacement Surgery?

BackgroundThe Centers for Medicare and Medicaid Services enacted the Hospital Readmissions Reduction Program to impose penalties for diagnoses with high readmission rates. Despite several elective orthopedic procedures being included in this program, readmission rates have not declined, and associated costs have reached critical levels for total knee and total hip arthroplasty. Readmissions drastically impact patient outcomes. There are many known contributors to patient readmission rates, including infection, pain, and hematomas. However, evidence is inconclusive regarding other aspects, such as demographics, insurance, and discharge disposition. The purpose of this manuscript is to 1) measure hospital readmission rates for total knee and total hip arthroplasty, 2) evaluate the causes of readmissions, and 3) provide a predictive profile of risk factors associated with hospital readmissions.MethodsPatients who underwent total knee or total hip arthroplasty were identified through a retrospective database review. An electronic chart review extracted data concerning patient demographics, comorbidities, surgical information, 30-day outcomes, and reasons for 30-day readmissions. Continuous and categorical variables were assessed with the Wilcoxon rank-sum test and the Chi-square test, respectively.ResultsA total of 6,065 patients were included, with 269 (4.4%) having at least one surgery-related 30-day readmission. No differences in readmission were noted with age, sex, or ethnicity; however, differences were found in weight and body mass index. Statistically significant comorbidities were heart failure, chronic obstructive pulmonary disease, dialysis, and alcohol use or abuse.ConclusionOur research indicated that surgery type, length of stay, and heart failure most significantly impacted 30-day readmission rates. By assessing readmission rates, we can take steps to optimize care for non-elective surgeries that will improve patient outcomes and cost-effectiveness.

Inpatient outcomes of Dieulafoy’s lesions in the United States

Dieulafoy’s lesions are arguably underidentified rather than an infrequent cause of gastrointestinal bleeding. No population-based study exists regarding its inpatient outcomes in the United States. We evaluated the characteristics and inpatient outcomes for Dieulafoy’s lesions using the National Inpatient Sample from 2016 to 2019. We identified 30,015 weighted hospitalizations for Dieulafoy’s lesions. An initial diagnosis of Dieulafoy’s lesions was established for 53.85% of patients on admission. The mean age was 68.7 ± 0.04 years, with male (56%) and white race predominance (70%). The mean length of stay and hospital cost were 7.87 days and $111,914, respectively. Significant predictors of inpatient mortality included heart failure, cardiac arrhythmias, coagulopathy, protein-calorie malnutrition, and alcoholism (P < 0.001). During inpatient hospitalization, 78% of patients underwent endoscopies, and 11% had colonoscopies. Inpatient mortality was 4.65%. Common comorbidities in Dieulafoy’s lesions patients included heart failure (34%), cardiac arrhythmias (41%), hypertension (32%), chronic obstructive pulmonary disorders (25%), coagulopathic disorders (22%), and alcohol abuse (12%). Dieulafoy’s lesions have a significant effect on length of stay and hospital cost. Endoscopies were used substantially more than colonoscopies for Dieulafoy’s lesions, indicating a predominant presentation as upper gastrointestinal bleed. Cardiac disorders increase mortality in patients with Dieulafoy’s lesions.

Behavioral dysregulations by chronic alcohol abuse. Motivational enhancement therapy and cognitive behavioral therapy outcomes.

Patients with alcohol use disorder (AUD) do not manifest homogeneous clinical symptoms. Various studies described both cognitive impairments and psychiatric disorders among people with AUD. This disorder is one of the most frequent mental disorders in developed countries, due to excessive alcohol consumption. Alcohol is toxic as it increases the production of reactive oxygen species (ROS) and can cause dependence. This causes negative effects on brain development and cognitive functions that affect the individual's work, health, and social life. Current pharmacology treatment for alcohol addiction is based on direct action against the neurotransmitters involved in alcohol dependence. AUD patients without comorbid psychiatric disorders or severe cognitive deficits are defined as "pure alcoholics". To date, poor is known about effective treatments for this typology of AUD patients. Psychotherapy is largely used in resolving many psychiatric disorders, including substance use disorders. Motivational enhancement therapy (MET) and cognitive-behavioral therapy (CBT) are two psychotherapies used to achieve and maintain abstinence in patients affected by substance use disorders. This short review aims to describe two CBT and MET and to present the advantages and disadvantages of these two psychotherapies in the treatment of AUD.

Influence of alcohol abuse and / or HIV infection on morpho-functional condition of the uterine tube in women of reproductive age

The fallopian tubes are a key link in the relationship between the uterus and the ovary. The aim of our study was to determine the effect of alcohol abuse and / or HIV infection on the morpho-functional state of the fallopian tubes in women of reproductive age.&#x0D; Material and methods. The study included sectional material, which was selected from 100 women of reproductive age (20 to 40 years), who were divided into four groups. The first group included section material from 25 women who had been laboratory confirmed for HIV. The second group included sectional material selected from 25 women suffering from chronic alcoholism. The third group consisted of sectional material from HIV-positive women who also showed signs of alcohol abuse. The fourth group includes sectional material selected from HIV-negative women.&#x0D; Results. Gross pathological changes in the structure of the fallopian tube, due to both the impact of HIV infection and alcohol abuse was identified in each of the groups. Changes in morphometric parameters (length of the ampullary part, outer diameter of the tube at the junction of the isthmus in the ampullary part, the area of the lumen of the ampullary part) can cause severe complications of inflammation or lead to ectopic pregnancy. The study of the epithelial and muscular layer revealed destructive-sclerotic changes, which consist in reducing the height of the epithelium and increasing the proportion of connective tissue in the muscular layer of the tube.&#x0D; Conclusions. According to the study, HIV and alcohol abuse are diseases that affect all elements of the fallopian tube. Thus, HIV infection and chronic alcohol abuse can exacerbate each other's negative effects on the female reproductive system and cause morphometric changes that can form a substrate for the development of inflammatory processes and lead to ectopic pregnancy

Flow cytometric analysis of CD4 and T-lymphocytes of chronic amphetamine and alcohol abuse.

Drug and alcohol abuse has significant negative impacts on individuals' life, health status and communities. They have also been implicated immunity system diseases. Therefore we aim to investigate the impact of chronic amphetamine abuse or co-abuse of alcohol with amphetamine on immunity, especially CD3 T cells, as well as the response of CD4 and CD8 T cells. A research sample comprising of 53 individuals younger than 40 years of age was employed to perform a retrospective case study within the setting of the Al-Amal Psychiatric Hospital. Individuals were distributed into 3 groups as the following: group (i) 17 patients abused amphetamine only for five years, group (ii) 17 patients' co-abused alcohol and amphetamine or five years, and group (iii) composed of 19 non-abusers of similar age and sex was selected as control. Flow cytometry was conducted for the collection and analysis of CD3+CD4+ and CD3+CD8+ monoclonal antibodies from blood samples. In contrast to the control group, amphetamine abuser patients showed a significantly decrease of the mean levels of CD3+CD4+ (#Event), CD3+CD8+ (#Event) and CD3+CD8+ (% Total). Meanwhile, levels of CD3+CD4+ (% Parent) was significantly higher in patients versus control (P = 0.001). furthermore, In the amphetamine abuse patient group, there were significant positive correlations between CD3+CD4+ (#Event) and CD3+CD4+ (% Total); CD3+CD8+ (#Event); Between CD3+CD4+ (% Parent) and CD3+CD8+ (% Parent) and CD3+CD8+ (% Total); Between CD3+CD4+ (% Total) and CD3+CD8+ (#Event); Between CD3+CD8+ % Parent) and CD3+CD8+ (% Total). The present work shed light on the reaction of CD4 and CD8 T cells to chronic amphetamine and alcohol abuse, which was found to induce changes in the systemic immune response. Interestingly, amphetamine abuse markedly changes the systemic immune as they diminished CD3+CD4+ and CD3+CD8+ T cells, and amphetamine and co-abuse alcohol affected CD3 cells significantly.

Co-relation between clinical parameters and histological parameters with outcome in severe alcoholic hepatitis patients

Background and Aim: Alcoholic hepatitis (AH) is characterized by recent onset of jaundice, with or without other signs of liver decompensation (ascites and/or encephalopathy), in patients with chronic alcohol abuse. Severe AH is defined by a modified Madey’s discriminant function of 32 or higher and has poor prognosis. Alcoholic hepatitis histologic score is a new approach which includes four histologic features (bridging fibrosis or cirrhosis, hepatocellular or canalicular/ductular bilirubinostasis, severe polymorphonuclear infiltration and megamitochonia) that allows patient classification into three groups with different risks of death within 90 days.In the present study,we aimed to correlate histologic and clinical parameters with outcomes in severe alcoholic hepatitis patients, which in turn will predict the prognosis of the patients.

The Benefits of Music-, Dance/Movement-, and Art Therapy on Improving and Retrieving Cognition and Memory with People Suffering from Korsakoff Syndrome: A Case Vignette Report

This article reports about the beneficial effects of creative arts therapy on memory and cognition for patients with Korsakoff Syndrome, residing in a long term care facility specialized in the care of people with Korsakoff. Creative arts therapy is an umbrella term for healthcare professions who use the creative and expressive process of art-making to improve and enhance the psychological and social well-being of individuals of all ages and health conditions. It is a non-pharmaceutical intervention, using the power of the experience by doing rather than by speaking about the struggles in daily life. There is still little knowledge on how creative arts therapy may contribute to improving the quality of life of patients with Korsakoff, or reducing the impairments they suffer. In this article several case examples from the field of creative arts therapy, specifically music therapy, arts therapy and dance/movement-therapy, are described. These case examples portrait different persons with Kosakoff who benefit greatly from creative arts therapy while they are struggling with their physical and mental problems. Typical characteristics of persons suffering from Korsakoff are memory impairment, confabulation and problems with executive functions, caused by their chronic alcohol abuse which led to developing Korsakoff. The aim of this article is to provide greater insight into how to treat patients with Korsakoff through creative arts therapy. The different case vignettes, describing the authors lived experiences, give the reader insight in the real-world context in which creative arts therapy is practiced. By giving the patients a face and a voice and showing their artistic skills, we hope to break the stigma that is chasing them: the low-life-drunks who made a big mess of their life.

Histomorphological Changes in Pancreas and Liver among Chronic AlcoholicsAn Autopsy Study

Introduction: The clinical and pathological association between pancreatitis and alcohol abuse is well recognised, however the concurrence of prevalence of alcoholic related pancreatitis and liver disease is less well studied. Aim: To evaluate frequency of histomorphological changes in pancreas and liver among patients with history of alcohol abuse and observe the prevalence of coexistence between chronic pancreatitis and liver cirrhosis. Materials and Methods: This was observational cross-sectional study conducted in Department of Pathology at Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India, from July 2013 to July 2018. The study included 1917 autopsies and 107 cases with a documented history of chronic alcohol abuse. Haematoxylin and Eosin (H&amp;E) staining was done on all sections and special stain like Masson’s trichrome was performed as per indication. Gross and microscopy were studied under variable defined parameters. Data was entered in Microsoft Excel sheets. Results: Histomorphologically, 12 cases (11.21%) were diagnosed as pancreatitis; 10 cases (9.34%) were of acute pancreatitis and two cases (1.86%) were of chronic pancreatitis. Total 21 cases were diagnosed as liver cirrhosis. The most dominant pattern of fibrosis seen in pancreatitis was perilobular and interlobular periductal fibrosis. The frequency of pancreatitis (14.28%) and pancreatic fibrosis (38.09%) was found to be more in cirrhotics. Chronic pancreatitis was commonly seen in cirrhotics than in non cirrhotics. Similarly, liver cirrhosis was more commonly observed in cases of chronic pancreatitis. Conclusion: The frequency of histomorphological changes seen in pancreas and liver was observed considerably among patients giving history of alcohol abuse. The prevalence of co-existence of chronic pancreatitis and liver cirrhosis was 50%.

Activity of chaperones in the endometrium in chronic alcoholism

Alcohol abuse among Ukrainian women has been a medical and social problem for a long time. The pathogenesis of changes in the endometrium has not been established. Heat shock proteins (Hsp) appear to be one of the promising factors from the point of view of detecting early tissue transformations. The main function of these proteins is in the adaptive response to stress factors arising in the process of inflammation. The aim of our study was to determine the activity of heat shock proteins in the endometrium of women suffering from chronic alcoholism. Two groups of 25 cases of deceased women of reproductive age 20–40 years, with an autopsy performed were formed: a group with verified chronic alcoholism (based on catamnesis data and the presence of alcoholic cirrhosis of the liver) and a comparison group (women who died from accidental causes and not showing signs of alcoholism). As a result of the conducted immunohistochemical study, it was found that the content of Hsp90 in the tissues of the cervix is characterized by cytoplasmic and nuclear localization in different ratios. Positively stained structures are present both in the lamina propria of the mucous membrane and in the epithelium of the cervix. The degree of severity of the reaction in the group of dead women with chronic alcoholism was estimated as (1.73±0.11) according for Hsp70 and (1.61±0.17) for Hsp90. In the intact group, these indicators were (1.14±0.13) for Hsp70 (p&lt;0.05) and (0.77±0.06) for Hsp90 (p&lt;0.05). Keywords: Hsp70, Hsp90, transformation, uterus, chronic alcohol abuse.