Heavy Alcohol Intake Research Articles

Replication of factors related to blackout incidence in U.S. high school students: A brief report

Alcohol-related blackouts are a common, yet serious consequence that can result from heavy alcohol intake. This study tested a model examining whether factors identified in related samples (i.e., adolescents residing in the U.K. and U.S. college students) predicted blackouts in community-dwelling U.S. high school youth. Participants from a Northeastern U.S. high school with prior alcohol use (Mage = 16.0 years; 48.2% male, 78.0% White) completed a paper-and-pencil assessment including measures of demographics, alcohol and other substance use, externalizing behaviors, and injunctive norms about risky drinking behaviors. Hierarchical logistic regression examined which factors identified for U.K. residing adolescents (Block 1) replicated in the U.S. sample, and whether factors identified in samples of U.S. college students added additional explained variance (Block 2). Blackouts were reported by 35.6% of students. Regression results indicated that two variables previously identified in adolescents, female gender (OR = 3.26) and increased alcohol use (OR = 1.27) were associated with blackouts. College student risk factors of drinking game (DG) participation and, to a lesser degree injunctive norms for passing out, emerged as additional risk factors (ORs = 2.85 and 1.32, respectively), with the final model explaining 39% of the variance in blackouts. This study advances our understanding of blackouts in younger drinkers and identifies the importance of addressing blackouts within the context of intervention programming that addresses cognitions and high risk drinking practices like DGs.

A Review on Gouty Arthritis

Gout is the inflammatory disease which is characterised by the deposition of the Mono Sodium Urate in joints. The joint infection is quickly reassured by Non-Steroidal Anti-inflammatory Drugs. The most common symptoms are pain, redness, and swelling. Gout is primarily detected by recognition of the signs and symptoms of Mono Sodium Urate crystals clumps together in the joints especially in phalanges. The major risk factor occurs in young people because of heavy alcohol intake and they may cause the major symptoms. Metabolism of purine in the liver can produce acute as well as chronic conditions of gout. Hence it is considered by repeated; throbbing attacks of severe arthritis the treatment for gouty arthritis are classified into by their types chronic and acute. The prevalence of gout is over comes around 1000 persons. When compared to woman, the action of gout is high in men. Chronicity might be an aspect of inflammatory disease. It produce unrelieved swelling that follows continual attacks of inflammatory disease. Acute gouty arthritis can be managed by using NSAID's and physical exercise and chronic gout can be managed by physician advisable drugs. Pharmacological management of hyper-uricemia in arthritis is mostly terribly successful. Main cause for the treatment malfunction is due to the reduced actions, and patient education improves observance.

NUTRITIONAL ADEQUACY AND ORAL NUTRITIONAL SUPPLEMENTATION IN OLDER COMMUNITY-DWELLING ADULTS

Background: Older adults (65 years and older) comprise a high-risk group that are susceptible to the development of malnutrition. Dietary intake and diet quality represent key modifiable risk factors to help prevent and to treat declines in nutrition status, with oral nutritional supplements (ONS) often being a cost-effective therapy for many to increase protein and caloric intake. The DETERMINE Checklist offers a series of questions capable of mapping the initial landscape of contextual factors that influence the dietary patterns of the at-risk populations. Objectives: To examine independent predictors of inadequate dietary intake and poor diet quality amongst a multi-ethnic sample of urban community-dwelling older adults in an effort to identify target groups of participants that could benefit most from an ONS intervention. Design: Cross-sectional. Participants: Chicago, Illinois, United States urban residents greater than 55 years of age who self-reported to be non-Hispanic White, non-Hispanic Black, or Hispanic. Methods: Telephone surveys were conducted to obtain basic demographic information. The DETERMINE Checklist was administered to (1) characterize participants’ nutritional risk, and (2) identify participants with inadequate intake and/or poor diet quality. Predictors of inadequate intake, defined as any participant who reported either to eat less than two meals per day and/or poor diet quality, defined as any participant who reported to eat few fruits, vegetables or dairy were used to identify groups of participants who could benefit most from ONS consumption. Mantel-Hanzel chi square, Breslow-day tests, and logistic regressions were conducted. Results: 1001 ethnically diverse participants were interviewed (37% non-Hispanic White, 37% non-Hispanic Black, and 26% Hispanic). Respondents were predominantly female (69%) with a mean age of 66.9 (± 6.4) years. The majority were found to be at either moderate or high nutrition risk (78.7%). Domains of the DETERMINE Checklist that predicted either inadequate dietary intake or poor diet quality included social isolation, lower levels of educational attainment, food insecurity, limitations in activities of daily living (ADL), polypharmacy, or three or more alcoholic drinks per day. Of the participants who met the criteria as those who would benefit from ONS, less than 50% had reported consuming ONS in the past six months. Conclusion: Older community-dwelling adults living in an urban setting, especially those with social isolation, lower levels of education, food insecurity, limitations with ADLs, polypharmacy, and those reporting heavy alcohol intake represent a population who could benefit from consuming ONS. Efforts should be made towards further understanding these contextual factors and providing nutrition education along with an ONS intervention that could be beneficial to supplement dietary inadequacies in this population.

Alcohol consumption and hospitalization burden in an adult Italian population: prospective results from the Moli-sani study.

Epidemiological evidence on the impact of different alcohol drinking patterns on health-care systems or hospitalizations is sparse. We investigated how the different average volumes of alcohol consumed relate to all-cause and cause-specific hospitalizations. Prospective cohort study (baseline 2005-10) linked to a registry of hospital discharge records to identify hospitalizations at follow-up (December 2013). Molise region, Italy. A total of 20 682 individuals (48% men, age≥35years) who participated in the Moli-sani Study and were free from cardiovascular disease or cancer at baseline. The alcohol volume consumed in the year before enrolment was classified as: life-time abstainers, former drinkers, occasional drinkers and current drinkers who drank 1-12 (referent), 12.1-24, 24.1-48 and>48 g/day of alcohol. Cause-specific hospitalizations were assigned by Italian Diagnosis Related Groups classification or by ICD-9 code of main admission diagnoses. Incidence rate ratios (IRR) of hospitalization were estimated by Poisson regression, taking into account the total number of admissions that occurred during the follow-up per person. During a median follow-up of 6.3years, 12 996 multiple hospital admissions occurred. In multivariable analyses, life-time abstainers and former drinkers had higher rates of all-cause [IRR=1.11, 95% confidence interval (CI)=1.05-1.17 and IRR=1.19, 95% CI=1.02-1.31, respectively] and vascular (IRR=1.14, 95% CI=1.02-1.27 and IRR=1.48, 95% CI=1.24-1.76, respectively) hospitalizations compared with light alcohol consumers. Alcohol consumption >48 g/day was associated with a higher rate of hospitalization for both alcohol-related diseases (IRR=1.74, 95% CI=1.32-2.29) and cancer (IRR=1.36, 95% CI=1.12-1.65). The magnitude of the association between heavier alcohol intake and hospitalization tended to be greater in smokers than non-smokers. No associations were observed with hospitalization for trauma or neurodegenerative diseases. Moderate alcohol consumption appears to have a modest but complex impact on global hospitalization burden. Heavier drinkers have a higher rate of hospitalization for all causes, including alcohol-related diseases and cancer, a risk that appears to be further magnified by concurrent smoking.

Genetic testing for Mendelian stroke due to cerebrovascular anomalies and other syndromes

Abstract Stroke is defined as a focal or at times global neurological impairment of sudden onset and presumed vascular origin. 85% of strokes are due to cerebral ischemia and the other 15% to primary intracerebral hemorrhage. Ischemic stroke (IS) is characterized by complete or partial obstruction of a vessel in the brain, resulting in lack of blood supply and death of brain tissue. The most common causes of IS are atherosclerosis, cardioembolism and small-vessel disease (lacunar stroke). Genetic factors play important role. Incidence rates for IS in the 15- to 45-year age range are ≈10 per 100,000 person years. Hemorrhagic stroke (HS) is the least treatable and the most fatal form of cerebrovascular disease. Genetic mechanisms play a role in its development. Occurrence depends on many risk factors, including hypertension, heavy alcohol intake and anticoagulant treatment. According to the World Health Organization, 15 million people suffer stroke worldwide each year. The overall incidence of spontaneous HS worldwide is 24.6 per 100,000 person years. Strokes are the third most common cause of death and the most common cause of disability in developed countries. This Utility Gene Test was developed on the basis of an analysis of the literature and existing diagnostic protocols. It is useful for confirming diagnosis, as well as for differential diagnosis, couple risk assessment and access to clinical trials.

Association between oral health and colorectal adenoma in a screening population.

Although periodontal disease and gastrointestinal tract health are closely associated, few studies have investigated whether periodontitis is a risk factor for colorectal adenoma. The aim of this study was to investigate whether there is an association between periodontitis and the risk of colorectal adenoma in asymptomatic healthy people.From January 2013 to October 2015, we retrospectively enrolled 42,871 patients who underwent health screening at Kangbuk Samsung Hospital in South Korea. Demographic and clinical data were collected before colonoscopy. We calculated the odds ratio (OR) for adenoma in these patients.The median age was 39.3 ± 8.7 years and 70.4% of the patients were men; 32.5% had a body mass index (BMI) 25.0 kg/m2. The frequency of adenoma was 12% (n = 5136). A higher risk of adenoma was associated with the following factors: BMI 25.0 kg/m2 (OR 1.51, 95% confidence interval [CI]: 1.42–1.61), current smoker (OR 1.51, 95% CI: 1.42–1.61), former smoker (OR 1.28, 95% CI: 1.19–1.37), periodontitis (OR 1.95, 95% CI: 1.82–2.0), moderate alcohol intake (OR 1.8, 95% CI: 1.69–1.93), and heavy alcohol intake (OR 2.67, 95% CI: 2.24–3.18).Being male or a former or current smoker, alcohol intake above the moderate level, and periodontitis increase the risk of colorectal adenoma. These findings suggest that controlling oral disease is important to the prevention and management of colorectal adenoma. The findings of this study could be applied to risk stratification and colorectal cancer prevention programs, including screening guidelines.

Etiology of hepatocellular carcinoma and treatment through medicinal plants: a comprehensive review

Liver is a power house of the body for many components such as vitamins, minerals, iron and glycogen and play role in biotransformation. Some ingredients of our diet (foodstuffs may contain with aflatoxin B1, vinyl chloride, tobacco, heavy alcohol intake, fried meat, coffee and oral contraceptives),when metabolized become tremendous for liver and leads toward hepatocellular carcinoma (HCC). HCC occurs through cyclical liver injury due to inflammation and DNA damaging as a result of oxidative stress. Phytochemicals of medicinal plants have curative potential against liver cancer due to presence of linalool, eucalyptol, borneol, thujone, camphor, 4-terpineol, monoterpenes and α-cadinol, sophytotherapies have several advantages over conventional chemotherapies. According to literature survey Acanthus ilicifolius, Allium sativum, Artemisiaprinceps, Artemisia vulgaris, Amorphophallus campanulatus, Brucea javanica, Broussonetia luzonica, Dracocephalum kotschyi, Graptopetalum paraguayense, Nigella sativa, Petasites japonicas, Silybum marianum, Bergenia ciliata, Cassia fistula and Picrorhiza scrophularilora have vital bioactive compounds used against hepatocellular carcinoma.

Double trouble: The effect of obesity and alcohol consumption on serum GGT in Irish middle-aged adults

Background Obesity and excessive alcohol consumption are increasingly pervasive public health issues due to their profound health impacts and high prevalence throughout the world. Both obesity and alcohol consumption induce liver injury, as reflected by raised GGT levels. However, these can be overlapping phenomena, potentially placing obese individuals who consume alcohol at higher risk of liver damage. Aim The aim of this research was to investigate the association between obesity and alcohol consumption, and the subsequent impact on serum GGT levels in Irish middle-aged adults. Methods This research involved secondary analysis of the baseline wave of data from the Mitchelstown Cohort Study, a large community-based prospective cohort study of 2047 men and women aged 50–69 years. Results In total, 30.24% of females and 16.90% of males had raised GGT levels. Most of these individuals (∼ 87%) were overweight or obese and were moderate or heavy drinkers. Multivariate logistic regression analysis was carried out for females with high serum GGT with BMI, alcohol, physical activity and education as predictor variables. The results showed that as BMI increased females were almost twice as likely to have high serum GGT (OR: 1.9, P 14 units of alcohol per week (P Conclusion There is evidence of interaction between obesity, alcohol and gender. Obese males with heavy alcohol intake are a high-risk group for liver injury. Targeted health promotion campaigns aimed at increasing awareness of the dangers of combining these modifiable risk factors are required.

Alcohol intake and the risk of intracerebral hemorrhage in the elderly: The MUCH-Italy.

To investigate the role of alcohol as a causal factor for intracerebral hemorrhage (ICH) and whether its effects might vary according to the pathogenic mechanisms underlying cerebral bleeding. We performed a case-control analysis, comparing a cohort of consecutive white patients with ICH aged 55 years and older with a group of age- and sex-matched stroke-free controls, enrolled in the setting of the Multicenter Study on Cerebral Haemorrhage in Italy (MUCH-Italy) between 2002 and 2014. Participants were dichotomized into excessive drinkers (>45 g of alcohol) and light to moderate drinkers or nondrinkers. To isolate the unconfounded effect of alcohol on ICH, we used causal directed acyclic graphs and the back-door criterion to select a minimal sufficient adjustment set(s) of variables for multivariable analyses. Analyses were performed on the whole group as well as separately for lobar and deep ICH. We analyzed 3,173 patients (1,471 lobar ICH and 1,702 deep ICH) and 3,155 controls. After adjusting for the preselected variables in the minimal sufficient adjustments, heavy alcohol intake was associated with deep ICH risk (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.36-2.09) as well as with the overall risk of ICH (OR, 1.38; 95% CI, 1.17-1.63), whereas no effect was found for lobar ICH (OR, 1.01; 95% CI, 0.77-1.32). In white people aged 55 years and older, high alcohol intake might exert a causal effect on ICH, with a prominent role in the vascular pathologies underlying deep ICH.

Alcohol Use and Alcohol-Related Seizures in Patients With Epilepsy.

Purpose: This study aimed to assess alcohol consumption and the occurrence of alcohol-related seizures in patients with epilepsy within the last 12 months.Methods: In an epilepsy outpatient clinic, a standardized questionnaire was used to collect data retrospectively from consecutive adult epilepsy patients who had been suffering from the disease for at least 1 year. Logistic regression analyses were performed to identify independent predictors.Results: A total of 310 patients with epilepsy were included. Of these, 204 subjects (65.8%) consumed alcohol within the last 12 months. Independent predictors for alcohol use were antiepileptic drug monotherapy (OR 1.901) and physicians' advice that a light alcohol intake is harmless (OR 4.102). Seizure worsening related to alcohol consumption was reported by 37 of the 204 patients (18.1%) who had used alcohol. All 37 subjects had consumed large quantities of alcohol prior to the occurrence of alcohol-related seizures regardless of their usual alcohol-drinking behavior. The amount of alcohol intake prior to alcohol-related seizures was at least 7 standard drinks, which is equivalent to 1.4 L of beer or 0.7 L of wine. In 95% of cases, alcohol-related seizures occurred within 12 h after cessation of alcohol intake. Independent predictors for alcohol-related seizures were generalized genetic epilepsy (OR 5.792) and chronic heavier alcohol use (OR 8.955).Conclusions: Two-thirds of interviewed subjects had consumed alcohol within the last 12 months. This finding may be an underestimate due to patients' self-reporting and recall error. In all cases, the occurrence of alcohol related-seizures was associated with timely consumption of considerably large amounts of alcohol. Thus, a responsible alcohol intake seems to be safe for most patients with epilepsy. However, subjects with epilepsy and especially those with generalized genetic epilepsy should be made aware of an increased risk for seizures related to heavy alcohol consumption. Factors accompanying acute heavy alcohol intake such as altered sleep architecture, impaired adherence to antiepileptic medication, and metabolic disturbances may further facilitate the occurrence of seizures.

Association between alcohol consumption and bone mineral density in elderly Korean men and women.

Alcohol is a risk factor of osteoporosis but previous studies on its effect on bone health has been controversial. The aim of this study was to evaluate the association between alcohol intake and bone mineral density in Korean elderly men and women. Based on the Fourth and Fifth Korean National Health and Nutrition Examination Surveys (KNHANES), 2657 men and 2080 women 50 to 79years of age were included. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Alcohol consumption was determined by self-administered questionnaires and classified into four groups according to sex: non-drinkers (0g/day), light drinking (1-19g/day men, 1-9g/day women), moderate drinking (20-39g/day men, 10-29g/day women), and heavy drinking (≥ 40g/day men, ≥ 20g/day women). The adjusted mean values calculated by linear regression analysis for BMD were determined according to the amount of alcohol consumed. Light drinkers had the highest whole-body BMD for both men (mean 1.164, SD 0.047-1.281) and women (mean 1.046, SD 0.912-1.180). Among men, mean whole-body BMD for heavy drinkers was significantly lower than that among light drinkers (P = 0.031). Among women, BMD for light drinkers was significantly higher in the whole body, lumbar, and total femur than that for non-drinkers (P < 0.001, P = 0.026, P = 0.040, respectively). Heavy alcohol intake may be associated with lower BMD in men while light alcohol intake may associate with higher BMD among women. Future longitudinal studies investigating the effect of alcohol consumption on bone mineral density are needed to validate the findings of this study.

Grey matter dysmyelination during abstinence in ethanol dependence

White matter atrophy/demyelination observed in heavy alcohol users is often reported as reduced fractional anisotropy (FA) and increased mean and radial diffusivity (MD and RD, respectively) quantified using diffusion tensor imaging (DTI). Several lines of research suggest that neurobehavioral impairments in grey matter areas like the medial prefrontal cortex (mPFC) are critical components of alcohol dependence and relapse vulnerability. Previous research revealed that homeostatic imbalance in myelinating cells in mPFC of a rat model of alcoholism was associated with increased risk of relapse-like behavior during protracted abstinence. Therefore, we investigated the demyelination in the mPFC at several time points during protracted abstinence from heavy alcohol exposure. Adult male rats underwent chronic intermittent ethanol exposure (CIE), where rats breathed air containing ethanol vapor for 14 hours/day to elicit blood alcohol levels (125–250 mg/dl), and neurobehavioral deficits mirroring moderate-severe alcohol use disorder. Myelination was investigated first using DTI in vivo, followed by post-mortem immunoblotting analyses of myelin-associated proteins in mPFC after various durations of ethanol abstinence (1 day; 1d, 7d, 21d, and 42d) in CIE rats and in age-matched ethanol-naive controls (n = 6–10/group). In the corpus callosum (white matter), we observed a transient decrease in FA (to ~ 90% of controls) and increase in RD (~ 180%) at 7d that normalized later (21–42d; ps < 0.05). These white-matter microstructural data indicate demyelination followed by recovery in the CIE model, which mirrors the results obtained from neuroimaging in human alcoholics. In the mPFC (grey matter), increased MD and RD (both ~160%), and surprisingly, increased FA (~105%) was observed at 7d (ps < 0.05). Concurrently, increased expression of myelin basic protein and myelin oligodendrocyte glycoprotein in the mPFC were observed at 7d (ps < 0.05). All changes in DTI measures and protein expression were normalized by 21–42d (ps < 0.05). These results suggest microstructural damage that is inconsistent qualitatively, with both demyelination and hypermyelination. Electron microscopic analysis was conducted in 7d abstinent and control rats (n = 4–5/group) to determine ultrastructural characteristics of mPFC neurons at this critical interval. Results revealed damaged myelinated axons in the mPFC, such that more fibers were flayed (~160%), and these flays occupied a greater portion of the axonal perimeter (~160%) in rats with a history of CIE compared to naïve controls (ps < 0.05). The flayed damage is consistent with demyelination suggested by the increased MD and RD. The increased FA may reflect the accumulation of myelin-associated proteins due to reduced turnover and compensatory de novo protein synthesis. Taken together, these results suggest transient dysmyelination in the mPFC of rats with a history of CIE; future studies should investigate its functional implications. DTI measures observed in white matter area (corpus callosum) of the rat model was translationally valid, therefore providing credence to the translational relevance of the observed grey matter (mPFC) DTI changes. Thus, the current model may provide valuable insights into the causal link between heavy alcohol intake, mPFC myelin neuropathology, and relapse and thereby may be developed into a diagnostic indicator for future risk for relapse during abstinence. Support or Funding Information Funding: AA020098, AA06420 and DA034140All research reported has been conducted in conformance with the FASEB Statement of Principles for the use of Animals in Research and Education. Damaged (flayed) myelin in mPFC of alcohol abstinent subject This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Abstract P236: Association Between Alcohol and Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis

Introduction: Alcohol intake is associated with cardiovascular disease (CVD), with moderate drinkers having a decreased CVD risk compared to non- and heavy drinkers. However, this association is yet to be examined using the AHA Life’s Simple 7 (LS7) metrics as a proxy for cardiovascular health (CVH). We explored associations between alcohol intake and CVH in a multi-ethnic population. Methods: Our cross-sectional analyses included 6,506 MESA participants, free of CVD, aged 45 to 84 years. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each scored 0-2, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. Total LS7 score ranged from 0-14. Alcohol data was obtained from personal history and food frequency questionnaires. Participants were classified as never, former or current drinkers. Current drinkers were categorized as &lt;1 (light), 1-2 (moderate) and &gt;2 (heavy) drinks/day. Multinomial logistic regression models assessed associations between alcohol intake and CVH, adjusted for age, sex, race/ethnicity, education, income and health insurance. Results: Mean (SD) age was 62 (10) years, 53% were women; 20% were never, 24% former and 56% current drinkers. Among current drinkers, 44% had &lt;1, 9% 1-2 and 3% &gt;2 drinks/day. Additionally, 47% had inadequate LS7 scores, 33% average and 20% optimal. Compared to never drinkers, those who drank &lt;1 drink/day were more likely to have average and optimal scores, although most of the associations were not significant. Women with 1-2 drinks/day were more likely than men to have optimal scores. Overall and in men, those who drank &gt;2 drinks/day were less likely to have average or optimal scores. Whites and Hispanics with &gt;2 drinks/day were less likely to have optimal and average scores, respectively (Table). Conclusion: Light alcohol intake tended to show favorable CVH, whereas heavy alcohol intake was unfavorable. For moderate alcohol intake, the associations with CVH varied by sex and race/ethnicity.

Determination of blood phosphatidylethanol by liquid chromatography tandem mass spectrometry

Objective To establish a method for measuring blood phosphatidylethanol by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), which can be applied for objective and quantitative of alcohol intake. Methods Whole blood samples were treated with isopropanol to precipitate protein, and phosphopropanol (16∶0/16∶0) was used as the standard.After centrifugation, the supernatants were transferred and evaporated under a stream of nitrogen until dryness.Then the residuals were analyzed by LC-MS/MS.Various methodological parameters, including linearity, limit of detection (LOD), limit of quantitation (LOQ), recovery, and precision, were investigated.Finally, blood samples from 40 Chinese individuals with more than one year of regular drinking habits were analyzed, and distributions of phosphatidylethanol were evaluated. Results The correlation coefficients were higher than 0.9992.The LOD and LOQ were lower than 0.74 and 2.48 ng/ml, respectively.The inter- and total assay coefficient of variations were 0.77%-3.18% and 2.30%-6.95%, respectively, with recoveries ranged from 96.88% to 102.99%.The relationship between phosphatidylethanol level and self-reported alcohol consumption was significantly and positively correlated (r=0.769, P<0.001). Furthermore, Kruskal-Wallis analysis showed a significant difference in total phosphatidylethanol levels among individuals with different levels of alcohol intake (χ2=18.850, P<0.001). Conclusions An LC-MS/MS method for whole blood phosphatidylethanol detection has been developed. This method is simple, sensitive and accurate and can effectively reflect light, moderate and heavy alcohol intake. The method will be applied to the assessment of alcohol consumption and its association with the risks of drinking related diseases.(Chin J Lab Med, 2018, 41: 103-108) Key words: Glycerophospholipids; Chromatography, liquid; Tandem mass spectrometry; Alcohol drinking; Ethanol

Alcohol intake and brain white matter in middle aged men: Microscopic and macroscopic differences.

Heavy alcohol consumption is associated with deleterious changes in the brain but associations of moderate alcohol intake are not well understood. We examined the association of alcohol consumption with brain white matter health in 377 middle-aged men (56–66 years old; mean 61.8 ± 2.6 years) who were participants in the Vietnam Era Twin Study of Aging (VETSA). T1-, T2-, proton density-, and diffusion-weighted magnetic resonance images were obtained. Diffusion measures were quantified from 12 major white matter tracts. Global white matter lesion (WML) burden was also quantified. Mixed effects linear models examined differences in diffusivity and WMLs by amount of alcohol intake. Analyses adjusted for numerous demographic, health, and lifestyle variables. An inverted-U association was found between alcohol intake and fractional anisotropy (FA) in several tracts, including the inferior-frontal-occipital fasciculus, uncinate fasciculus, superior longitudinal fasciculus, the forceps minor and the anterior thalamic radiations. In these tracts, FA increased with increasing alcohol intake, peaking with moderate alcohol intake (9–28 drinks in 14 days), and declining with heavier intake. Associations remained significant after exclusion of individuals with diabetes or hypertension. There was a U-shaped association in WML burden with highest burden among never drinkers and heavy drinkers (>28 drinks in 14 days). This association was no longer significant after exclusion of individuals with hypertension, since WML burden among heavy drinkers no longer differed from that of other drinkers. This suggests that hypertension related to heavy alcohol intake may contribute to WML burden observed among heavy drinkers. Together, these correlational results suggest that among middle-aged men, moderate drinking may be associated with metrics of better white matter health, particularly microstructural measures, whereas drinking beyond recommended guidelines may be associated with both microstructural and macrostructural white matter damage.

Importance of hematological and biochemical findings in alcoholics admitted to emergency department

Background: Alcoholism represents one of the most serious worldwide socioeconomic and health problems. An alcoholic is a person who consumes an amount of alcohol capable of producing pathological changes. The amount of alcohol capable of producing disease depends on a variety of factors, including genetic predisposition, malnutrition and concomitant viral infections of the liver. The association of heavy alcohol intake with a significant increase of all cause and non-cardiovascular mortality rates especially by cirrhosis, cancer and violent deaths.Methods: This study was conducted on 500 patients who were taken from the emergency department over a period of one year, they were divided into two groups as none drinkers and heavy drinkers. 250 subjects were in each group. Frequency, quantity and type of alcohol were noted for each group. Patients presenting to emergency with known history of diabetes, anemia and hepatic encephalopathy were excluded.Results: In our study there was no significant difference in the bio chemical tests of heavy drinkers and non-drinkers with respect to Glucose, sodium, potassium, chloride, Total Protein, albumin, globulin. But in current study significant difference in the values of GGT, ALT, AST and alkaline phosphatase (P&gt;0.05) were noted among non-alcoholics and heavy drinkers.Conclusions: Some of the Hematological parameters(MCV) and biochemical parameters like GGT, AST, ALT and alkaline phosphatase could be used for the diagnosis and treatment of alcoholism along with clinical examination if history about alcohol is missing.

Neuroinflammation produced by heavy alcohol intake is due to loops of interactions between Toll-like 4 and TNF receptors, peroxisome proliferator-activated receptors and the central melanocortin system: A novel hypothesis and new therapeutic avenues

Excessive alcohol intake induces an inflammatory response in the brain, via TNFα, TLR4 and NF-κB signaling pathways. It has been proposed that neuroinflammation would play a very important role in the development of alcohol addiction. In addition to stimulating the synthesis of inflammatory mediators such as IL-6, IL-1β and TNFα, NF-κB is capable of reducing the anti-inflammatory activity of PPARα and PPARγ. Reciprocally, PPARα, PPARγ and melanocortin 4 receptor (MC4R) can decrease the proinflammatory activity of NF-κB, establishing an interplay of inactivations between such nuclear factors and receptors. In this review, we hypothesize that one of the mechanisms by which alcohol produces neuroinflammation is through NF-κB-mediated decrease in PPARα and PPARγ anti-inflammatory activities; in addition, ethanol negatively affects MC4R activity, decreasing the ability of this receptor to activate PPARγ. PPARα, PPARγ and MC4R can be pharmacologically activated by synthetic ligands (fibrates, thiazolidinediones and synthetic peptides, respectively); in this context, we propose that the administration of such ligands would decrease neuroinflammation produced by alcohol intake. The advantage of this approach is that fibrates and thiazolidinediones are FDA-approved drugs that have been used for years in other clinical conditions, and now may offer a new perspective for the treatment of alcoholism.

Metabolic Acidosis

Metabolic acidosis is a common clinical entity that can arise from a variety of disease states, medications, and toxic ingestions. This review covers the pathophysiology, diagnosis, and management of common presentations of metabolic acidosis. We have differentiated various causes of metabolic acidosis based on the presence of a normal or elevated anion gap (AG), the sum of serum anions unaccounted for by the measurement of plasma sodium, bicarbonate, and chloride levels. Normal AG metabolic acidosis, or non-AG metabolic acidosis, arises when there is excessive loss of bicarbonate from the gastrointestinal tract or in the urine. This review covers the development and diagnosis of non-AG metabolic acidosis, including a discussion of the spectrum of renal tubular acidosis subtypes. The treatment of non-AG metabolic acidosis is reviewed. Metabolic acidosis with an elevated AG, also called AG metabolic acidosis, develops when exogenous or endogenous nonchloride acid accumulates in the body. The most common causes of AG metabolic acidosis are lactic acidosis and ketoacidosis from starvation, heavy alcohol intake, or diabetes with total body insulin depletion. Medications, toxic substances, and uremia can also lead to AG acidosis. The mechanisms and management of these causes of metabolic acidosis with high AG are covered in detail. Key words: anion-gap acidosis, diabetic ketoacidosis, lactic acidosis, non–anion gap acidosis

Does Moderate Drinking Increase the Risk of Atrial Fibrillation? The Norwegian HUNT (Nord-Trøndelag Health) Study.

BackgroundCompelling evidence suggests that excessive alcohol consumption increases the risk of atrial fibrillation (AF), but the effect of light‐moderate alcohol consumption is less certain. We investigated the association between alcohol consumption within recommended limits and AF risk in a light‐drinking population.Methods and ResultsAmong 47 002 participants with information on alcohol consumption in a population‐based cohort study in Norway, conducted from October 2006 to June 2008, 1697 validated AF diagnoses were registered during the 8 years of follow‐up. We used Cox proportional hazard models with fractional polynomials to analyze the association between alcohol intake and AF. Population attributable risk for drinking within the recommended limit (ie, at most 1 drink per day for women and 2 drinks per day for men without risky drinking) compared with nondrinking was also calculated. The average alcohol intake was 3.8±4.8 g/d. The adjusted hazard ratio for AF was 1.38 (95% confidence interval, 1.06–1.80) when we compared participants consuming >7 drinks per week with abstainers. When we modeled the quantity of alcohol intake as a continuous variable, the risk increased in a curvilinear manner. It was higher with heavier alcohol intake, but there was virtually no association at <1 drink per day for women and <2 drinks per day for men in the absence of risky drinking. The population attributable risk among nonrisky drinkers was 0.07% (95% confidence interval, −0.01% to 0.13%).ConclusionsAlthough alcohol consumption was associated with a curvilinearly increasing risk of AF in general, the attributable risk of alcohol consumption within recommended limits among participants without binge or problem drinking was negligible in this population.

Severe hypertriglyceridemia in Japan: Differences in causes and therapeutic responses

Severe hypertriglyceridemia (>1000mg/dL) has a variety of causes and frequently leads to life-threating acute pancreatitis. However, the origins of this disorder are unclear for many patients. We aimed to characterize the causes of and responses to therapy in rare cases of severe hypertriglyceridemia in a group of Japanese patients. We enrolled 121 patients from a series of case studies that spanned 30years. Subjects were divided into 3 groups: (1) primary (genetic causes); (2) secondary (acquired); and (3) disorders of uncertain causes. In the last group, we focused on 3 possible risks factors for hypertriglyceridemia: obesity, diabetes mellitus, and heavy alcohol intake. Group A (n=20) included 13 patients with familial lipoprotein lipase deficiency, 3 patients with apolipoprotein CII deficiency, and other genetic disorders in the rest of the group. Group B patients (n=15) had various metabolic and endocrine diseases. In Group C (uncertain causes; n=86), there was conspicuous gender imbalance (79 males, 3 females) and most male subjects were heavy alcohol drinkers. In addition, 18 of 105 adult patients (17%) had histories of acute pancreatitis. The cause of severe hypertriglyceridemia is uncertain in many patients. In primary genetic forms of severe hypertriglyceridemia, genetic diversity between populations is unknown. In the acquired forms, we found fewer cases of estrogen-induced hypertriglyceridemia than in Western countries. In our clinical experience, the cause of most hypertriglyceridemia is uncertain. Our work suggests that genetic factors for plasma triglyceride sensitivity to alcohol should be explored.