Formal Alcohol Research Articles

Outcomes following liver transplantation for patients with alcohol- versus nonalcohol-induced liver disease.

To document and compare the outcomes of adult patients who received liver transplants for alcohol- and nonalcohol-induced liver diseases who attended a liver transplantation follow-up clinic in an urban, nontransplantation centre at a time when no formal alcohol abuse program for transplant candidates and/or recipients was offered. The study population comprised 10 alcoholic patients and 48 nonalcoholic patients followed for an average of 41 months (range five to 79 months) and 46 months (range two to 116 months), respectively. Primary outcome variables included rates of recidivism, duration of abstinence after transplantation and compliance with post-transplant medical follow-up visits. Time to discharge after transplantation, episodes of graft rejection, liver and renal biochemical abnormalities, diabetes, hypertension, sepsis, strictures, complications unrelated to transplantation and changes in psychosocial status were secondary outcome variables. Significant differences were found with respect to a higher incidence of recidivism (50% for alcoholic patients compared with 2% for nonalcoholic patients, P<0.0001), a shorter period of abstinence after transplantation (14.7+/-17.2 months for alcoholic patients compared with 26.3+/-23.0 months for nonalcoholic patients, P<0.05) and more missed office visits (2.7+/-3.5 for alcoholic patients compared with 1.0+/-1.9 for nonalcoholic patients, P=0.05) in the alcoholic group. The alcoholic group also had a lower incidence of rejection episodes (10% for alcoholic patients compared with 44% for nonalcoholic patients, P<0.05) but higher rates of post-transplantation diabetes (40% for alcoholic patients compared with 2% for nonalcoholic patients, P<0.05), more nontransplantation-related complications (20% for alcoholic patients compared with 0% for nonalcoholic patients, P<0.05), and higher serum creatinine but lower bilirubin and cyclosporine A levels (P<0.05, respectively). Marital separations were also more common in the alcoholic group (20% for alcoholic patients compared with 0% for nonalcoholic patients, P<0.05). In the absence of formal alcohol abuse programs, the post-transplantation outcome in alcoholic patients generally does not compare well with that of patients who undergo transplantation for nonalcohol-related liver diseases.

Age, ethnicity, and comorbidity in a national sample of hospitalized alcohol-dependent women veterans.

Treatment patterns in a national sample of hospitalized women veterans diagnosed with alcohol dependence were identified with the goal of improving health services to women veterans with alcohol-related disorders. Information from VA's patient treatment file for fiscal year 1993 was used to identify 854 women veterans diagnosed with alcohol dependence. Of that group, 546 received a primary diagnosis of alcohol dependence, and 308 received a secondary diagnosis of alcohol dependence after they sought treatment for other health problems. Chi square tests and multivariate logistic regression analyses were used to examine relationships between the sociodemographic profiles of these women and the types of services they received. The study population's largest age group (49 percent) was 30 to 39 years old. Fifty-two percent of the women were divorced or separated, and 62 percent were Caucasian. The overwhelming majority of comorbid diagnoses were of psychiatric disorders. Overall, only 47 percent of the 854 patients received formal treatment for their alcohol disorder, and only 34 percent completed alcohol treatment. Women over age 60 were significantly less likely than women in other age groups to enter or complete formal treatment. Native-American women were significantly more likely than Caucasians or African Americans to receive formal alcohol treatment services. The results indicate a need for targeting interventions more effectively in certain groups of women veterans diagnosed with alcoholism. Low completion rates also suggest a need for greater incentives for patients to complete treatment programs.

Efficacy of the alcohol use disorders identification test as a screening tool for hazardous alcohol intake and related disorders in primary care: a validity study

Objective: To determine the properties of the alcohol use disorders identification test in screening primary care attenders for alcohol problems.Design: A validity study among consecutive primary care attenders aged 18-65...

Alcohol use and abuse in the frail, homebound elderly: a clinical analysis of 103 persons

We studied alcohol use and abuse in 103 frail, homebound elderly individuals cared for in a long-term home health care program from July 1991 to February 1992. Their average age was 80.63 years. Eighty-four percent were abstinent at the time of the study, including 25 (25%) past heavy drinkers. Two persons were current heavy drinkers and 14 continued to drink socially. Previous alcohol use or abuse was associated with a history of smoking, cardiovascular morbidity, social isolation, and anxiety or agitation. Current social drinking was associated with sedative-hypnotic use as well as smoking. Twenty-three of 25 past heavy drinkers remained sober on our programs without the use of formal alcohol treatment. Abstinence is known to increase with age, appears to be fostered by the homebound setting, is feasible for homebound elderly persons and is often accepted.

Viscoelasticity of cellulose polymers and mucociliary transport on frog palates

The viscoelastic propertied of model polymer, hydroxypropylmethylcellulose (HPMC), in ternary solvent mixtures and the variation of viscoelastic properties under dilution with water were investigated. HPMC was dispersed in mixtures of glycerol formal (GF) or ethyl alcohol, propylene glycol (PG), and water. Each polymeric sample was oscillated at different frequencies with fixed stress amplitude and the changes in elastic modulus, viscous modulus, and apparent viscosity were measured at 30°C. The moisture absorption rate of HPMC in PG:GF solvent mixtures in a 94% relative humidified environment was also studied. A linear relationship between the elastic modulus or viscous modulus and polymer concentration was observed for the HPMC samples. The relative mucociliary transport rate tested on the non-depleted frog palate model revealed a curvilinear correlation with the loss tangent (a ratio of the viscous modulus to the elastic modulus) of the polymeric solution. Using GF as a solvent for HPMC resulted in a formation of a rigid gel with the highest elastic modulus and viscous modulus among solvents selected. A higher affinity for water was found for HPMC in the PG:GF 90:10 mixture compared with HPMC in the PG:GF 70:30 mixture. However, the elastic modulus and viscous modulus were much higher for HPMC in the PG:GF 70:30 mixture.