Male Alcoholics Research Articles

Women and Alcohol Consumption in Fascist Italy

AbstractThis article examines discourses and practices around women's drinking in Fascist Italy. The history of alcohol production and consumption in Italy during the fascist dictatorship has only recently received attention; alcohol's gendered dimensions, especially women's drinking, have been hitherto overlooked. While the production of legislation, rhetoric and propaganda on alcohol consumption was dominated by men, women were identified as key constituents whose alcohol‐related practices could make or break the causes of fascist propagandists, ‘anti‐alcohol’ campaigners and alcohol industry associations. The article explains how Italian women were imagined and addressed by regime propagandists, alcohol industry producers and temperance campaigners as (a) simultaneously the principal victims of and responsibility bearers for male excess alcohol consumption, (b) potential ‘crisis‐women’ whose unpatriotic drinking choices (whether English tea, French champagne or American cocktails) denoted their prioritising of fashion over fascist values and (c) gatekeepers of family alcohol consumer practices and consumers of alcohol in their own right. It then moves to examine sources left by interwar Italian women to explore what, how and when they drank. Ultimately, it argues that despite attempts to construct women's drinking in archly nationalistic terms, the discourses and actual practices of Italian women around alcohol consumption operated within profoundly transnational frames.

A combination of support vector machine and voxel-based morphometry in adult male alcohol use disorder patients with cognitive deficits

Cognitive performance deteriorates with drinking. However, the neural basis of cognitive deficits in alcohol use disorder (AUD) is still incompletely understood. Here we examined the relationship between overall drinking, brain structural alterations and cognitive deficits in AUD. A total of 40 middle-aged AUD males and 40 healthy controls (HC) underwent high-resolution anatomical imaging scans, and the data were analyzed using voxel-based morphometry, support vector machine (SVM) classification and mediation analysis. The AUD patients demonstrated reduced gray matter (GM) volumes that included left amygdala, thalamus, hippocampus, precentral gyrus, cerebellum, calcarine, right supplementary motor area and bilateral superior temporal gyri (voxel-wise p < 0.05, FWE corrected). The SVM results could distinguish AUD from HC with satisfactory classification results (0.8275). GM volumes in the bilateral cerebellum and thalamus, left anterior medial temporal lobe, left nucleus ambiguus + parahippocampus gyrus, left fusiform gyrus, left lingual gyrus, left hippocampus, and right nucleus accumbens had positive correlations with the Montreal Cognitive Assessment (MoCA) scores. Further mediation analysis showed that left cerebellum crus 1 partially mediated the relationship between overall drinking and MoCA scores (standardized beta coefficient = −0.0973, SE = 0.0002, 95% CI = (−0.0006, 0.0000)). Our findings showed widespread GM atrophies and many of these atrophies also mirrored cognitive deficits and were robustly distinguishable. Critically, the left cerebellum crus 1 partially mediated the relationship betweem overall drinking and MoCA scores, suggesting a pathway by which alcohol abuse impairs cognition and accelerates brain ageing in middle-aged AUD males.

Moderator effects in a randomized controlled trial of the Common Elements Treatment Approach (CETA) for intimate partner violence and hazardous alcohol use in Zambia

BackgroundIntimate partner violence (IPV) and hazardous alcohol use are prevalent and co-occurring problems in low- and middle-income countries (LMICs). While limited evidence suggests that cognitive behavioral therapy (CBT) interventions can help address these problems, few randomized trials in LMICs have investigated moderators of treatment effectiveness. This study explores moderating factors impacting responsiveness to a CBT-based intervention for IPV and hazardous alcohol use among couples in Zambia. MethodsData were obtained from a completed randomized trial of a CBT-based intervention, the Common Elements Treatment Approach (CETA), among 248 couples in Lusaka. Female experiences of IPV and male alcohol use were measured at baseline and 12 months post-baseline. Mixed effects regression models were used to evaluate each moderator: age, educational attainment, employment status, marital status, physical disability, HIV status, trauma exposure, depression, post-traumatic stress disorder, alcohol use disorder, and substance use. ResultsTreatment effectiveness for male alcohol use was moderated by female substance use, with greater reductions among men whose partners reported using non-alcohol substances (e.g., cannabis) (p < 0.01). Other marginally significant moderators (p < 0.15) of change in male alcohol use included female education and male depression, substance use, and moderate-to-severe alcohol use at baseline. Female HIV status and depression were marginally significant moderators of change in IPV. ConclusionsThis study suggests that CETA may be especially effective for highly symptomatic individuals with comorbid mental and behavioral health problems, a promising finding given that such comorbidity is widespread in LMICs. Psychotherapeutic treatments that can flexibly and simultaneously address co-occurring problems are needed.

Comparison of profile and treatment outcomes between elderly and non-elderly tuberculosis patients in Puducherry and Tamil Nadu, South India.

The rising geriatric population and the increased susceptibility of this age group to tuberculosis (TB), the deadliest single infectious agent, is bothersome for India. This study tried to explore the demographic and treatment outcome differences between the elderly (aged 60 years and above) and non-elderly TB (<60 years) patients from South India. This study was part of a large ongoing cohort study under the RePORT India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included in this study. Pretested and standardized questionnaire and tools were used to collect data and were stored securely for the entire cohort. Required demographic, anthropometric and treatment related variables were extracted from this database and analyzed using Stata version 14.0. Prevalence of elderly TB was summarized as percentage with 95% confidence interval (CI). Generalized linear modelling was attempted to find the factors associated with elderly TB. A total of 1,259 eligible TB patients were included into this present study. Mean (SD) of the participants in the elderly and non-elderly group was 65.8 (6.2) and 40.2 (12.0) respectively. Prevalence of elderly TB was 15.6% (95%CI: 13.6%-17.6%) with nearly 71% belonging to 60–69 age category. Male sex, OBC caste, poor education, unemployment, marriage, alcohol consumption and unable to work as per Karnofsky score were found to be significantly associated with an increased prevalence of elderly TB. Unfavorable outcomes (12% vs 6.5%, p value: 0.018), including death (9.3% vs 3.4%, p value: 0.001) were significantly higher among the elderly group when compared to their non-elderly counterparts. The current TB programme should have strategies to maintain follow up with due attention to adverse effects, social support and outcomes. Additional research should focus on predictors for unfavorable outcomes among the elderly TB group and explore ways to handle the same. Rendering adequate social support from the health system side and family side would be a good start.

Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

ObjectiveThe effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help...

Alcohol drinking during early adolescence activates microglial cells and increases frontolimbic Interleukin-1 beta and Toll-like receptor 4 gene expression, with heightened sensitivity in male rats compared to females

Adolescent drinking is risky because neural circuits in the frontal lobes are undergoing maturational processes important for cognitive function and behavioral control in adulthood. Previous studies have shown that myelinated axons in the medial prefrontal cortex (mPFC) are particularly sensitive to alcohol drinking, especially in males. Pro-inflammatory mediators like toll-like receptor 4 (TLR4) and interleukin-1 beta (IL1b) have been implicated in alcohol induced-inflammation and demyelination; thus, herein we test the hypothesis that voluntary alcohol drinking early in adolescence elicits a pro-inflammatory state that is more pronounced in the brain of males compared to females. Adolescent male and female Wistar rats self-administered sweetened alcohol or sweetened water from postnatal days 28–42 and separate sets of brains were processed for 1) immunolabeling for ionized calcium-binding adapter molecule 1 to analyze microglial cell morphology, or 2) qPCR analysis of gene expression of pro-inflammatory mediators. Binge drinking alcohol activated microglia in the mPFC and hippocampus of both males and females, suggesting that voluntary alcohol exposure initiates an inflammatory response. Il1b mRNA was upregulated in the mPFC of both sexes. Conversely, Tlr4 mRNA levels were elevated after drinking only in males, which could explain more robust effects of alcohol on myelin in this region in developing males compared to females. Il1b mRNA changes were not observed in the hippocampus, but alcohol elevated Tlr4 mRNA in both sexes, highlighting regional specificity in inflammatory responses to alcohol. Overall, these findings give insight into potential mechanisms by which low-to-moderate voluntary alcohol intake impacts the developing brain.This article is part of the special Issue on ‘Vulnerabilities to Substance Abuse’.

The association between alcohol intake and fecundability during menstrual cycle phases.

Is increased alcohol intake in different phases of the menstrual cycle associated with fecundability in women? Heavy intake (>6 drinks/week) of alcoholic beverages in the luteal phase and ovulatory subphase was associated with reduced odds of conception; moderate intake (3-6 drinks/week) during the luteal phase was also associated with reduced fecundability. Despite strong indications for increased risk of infertility among drinking women with intention to conceive, inconsistencies in previous results point to possible residual confounding, and have not thoroughly investigated timing of drinking and other drinking patterns during the menstrual cycle. Participants in The Mount Sinai Study of Women Office Workers (MSSWOW), a prospective cohort study of fertility, were recruited and followed between 1990 and 1994, and completed daily diaries reporting their alcohol intake (type and number of drinks) for a maximum of 19 months of follow-up (N = 413). Participants were between 19 and 41 years of age. After completion of baseline surveys, they were asked to record their alcoholic beverage intake as number of drinks of beer, wine, and liquor per day, in addition to other exposures such as caffeine and smoking. Furthermore, they submitted urine samples each month to assess pregnancy. Menstrual cycle phases were calculated using the Knaus-Ognio approach. Discrete survival analysis methods were employed to estimate the association between categories of alcohol intake in each phase of menstrual cycle and fecundability. In the luteal phase, both moderate drinking (3-6 drinks/week, Fecundability Odds Ratio (FOR)=0.56, CI: 0.31, 0.98) and heavy drinking (>6 drinks/week, FOR = 0.51, CI: 0.29, 0.89) were associated with a reduction in fecundability, compared to non-drinkers. For the follicular phase, heavy drinking in the ovulatory sub-phase (FOR = 0.39, CI: 0.19, 0.72) was similarly associated with reduced fecundability, compared to non-drinkers. For the pre-ovulatory sub-phase, heavy drinking (>6 drinks/week, FOR = 0.54, CI: 0.29, 0.97) was associated with reduction in fecundability, but this association was inconsistent when subjected to sensitivity tests. Each extra day of binge drinking was associated with 19% (FOR = 0.81, CI: 0.63, 0.98), and 41% (FOR = 0.59, CI: 0.33, 0.93) reduction in fecundability for the luteal phase and ovulatory sub-phase respectively, but no association was observed in the pre-ovulatory sub-phase. No meaningful differences in fecundability between beverages were observed in any menstrual phase. Patterns of alcohol intake in this cohort suggest a lower average alcohol intake compared to more recent national averages for the same demographic group. Sample sizes were small for some subgroups, resulting in limited power to examine specific beverage types in different phases of the menstrual cycle, or to assess interaction. In addition, the influence of male partner alcohol intake was not assessed, the data relied on self-report, and residual confounding (e.g. unmeasured behaviors correlated with alcohol intake) is a possibility. Results suggest an inverse association between alcohol and fecundability, and support the relevance of menstrual cycle phases in this link. More specifically, moderate to heavy drinking during the luteal phase, and heavy drinking in the ovulatory window, could disturb the delicate sequence of hormonal events, affecting chances of a successful conception. Authors declare no conflict of interest. This work was supported by the National Institutes of Health grant, R01-HD24618. N/A.

Spontaneous Internal Pancreatic Fistulae Complicating Acute Pancreatitis.

Spontaneous pancreatic fistula (PF) is a rare but challenging complication of acute pancreatitis (AP). The fistulae could be internal (draining into another viscera or cavity, e.g., pancreaticocolonic, gastric, duodenal, jejunal, ileal, pleural, or bronchial) or external (draining to skin, i.e., pancreaticocutaneous). Internal fistulae constitute the majority of PF and will be discussed in this review. Male sex, alcohol abuse, severe AP, and infected necrosis are the major risk factors for development of internal PF. A high index of suspicion is required to diagnose PF. Broad availability of computed tomography makes it the initial test of choice. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography have higher sensitivity compared with computed tomography scan and also allow for assessment of pancreatic duct for leak or disconnection, which affects treatment approaches. Certain complications of PF including hemorrhage and sepsis could be life-threatening and require urgent intervention. In nonurgent/chronic cases, management of internal PF involves control of sepsis, which requires effective drainage of any residual pancreatic collection/necrosis, sometimes by enlarging the fistula. Decreasing fistula output with somatostatin analogs (in pancreaticopleural fistula) and decreasing intraductal pressure with endoscopic retrograde cholangiopancreatography or endoscopic ultrasound/interventional radiology-guided interventions or surgery are commonly used strategies for management of PF. More than 60% of the internal PF close with medical and nonsurgical interventions. Colonic fistula, medical refractory-PF, or PF associated with disconnected pancreatic duct can require surgical intervention including bowel resection or distal pancreatectomy. In conclusion, AP-induced spontaneous internal PF is a complex complication requiring multidisciplinary care for successful management.

Late Onset of Abiraterone Severe Hypokalemia Due to Unsuspected ACTH-Secreting NEC

Clinical Case: 68-year-old male, Active smoker (30-40 packs/year), and moderate alcohol drinker. An increase in urinary frequency, nocturia, and a PSA of 116 µg/L led to the diagnosis of disseminated castration-sensitive prostate cancer (CSPC), advanced Gleason score (3 + 4 pT2), with bone and retroperitoneal metastases (CT). By 02/2018, he started androgen deprivation therapy (ADT) with Abiraterone (AB) 1000 mg, prednisone, and LHRH agonist. 15 months later, PSA levels decreased to 0.75 ng/ml without side effects and normal K+(3.7 mEq/L), when a CT scan revealed both liver and bone metastasis. During the progression study, two months later, the patient was admitted to the hospital for severe hypoK+ (1.7 mEq / L), normal renal function and metabolic alkalosis. Although abiraterone was discontinued, up to 460 mEq iv per day of K+ and spironolactone were required to maintain serum K+ above 2.5. 3 days later, the hormonal study revealed TSH 1.13 mU /L, ACTH 162 pmol/L, cortisol 258 nmol/L, aldosterone 105 pmol/L, renin (protein) 0.7 µU/mL and deoxycorticosterone 507 pmol/L. 11 days later, plasma cortisol was 967 nmol/L, ACTH 132pmol/L, and cortisoluria 1456 nmol/d. The suppression test with 1 mg of DXM for cortisol was 1162,5 nmol/L. DHEAS was < 407 nmol/L. Liver biopsy showed a small cell neuroendocrine carcinoma (NEC), chromogranin (+), synaptophysin (+), CD56 (+), TTF-1 (+), PSA (-), Ki-67 90% and the granular cytoplasmic ACTH (+). The octreotide scan (+) revealed pathological uptake in L4, multiple uptakes in the liver, and in the axial skeleton. Treatment with Carboplatin plus Paclitaxel for NEC was started, completing 3 weekly doses with good tolerance and clinical benefit, but with the persistence of severe hypoK+ (2.5 mEq/L). Treatment with lanreotide 120 mg every 4 weeks was added, following a feeling of clinical improvement, the disappearance of edema, asthenia, and normalization of plasma K+ (3,4mEq/L). The patient died two months later from respiratory sepsis. Discussion: Several clinical trials have demonstrated that the combination of AB plus ADT prolongs overall survival in DCSPC. The CYP17 inhibition by AB increases ACTH leading to early secondary mineralocorticoid excess with hypokalemia and hypertension while the cortisol levels remain normal or low. Cortisol serum levels increased after AB was discontinued, whereas aldosterone serum levels remained low due to K+ regulatory feedback. The hormonal profile and the pathological and radiological studies revealed an ACTH-producing small cell NEC. In this patient, the previous treatment with BA has masked the clinical and hormonal profile of an ectopic Cushing syndrome. Therefore, Cyp17 inhibitors can mask adrenal or extra-adrenal processes characterized by alterations in steroid metabolism. This case has suggested a more thorough assessment of the adrenal hormonal profile including ACTH during BA treatment.

Drug use as a coping style to social isolation by COVID-19 pandemic and its effects on the adherence to safety guidelines in Mexico

Introduction: in response to the pandemic originated by COVID-19, governments placed in practice a series of safety guidelines recommended by the World Health Organization (WHO). In Mexico, one of the decisive actions to prevent the disease's spread was social isolation or lockdown. These rigorous proceedings could increase stress experience or other mental health disorders. One of the coping mechanisms used to avoid stress includes drug use. Objective: the study's goal was to evaluate the relationship between drug use (alcohol, tobacco, and cannabis) and adherence to safety guidelines. Method: the association between the variables was assessed with a series of surveys indicating adherence to safety guidelines and drug use, 475 Mexican participants (56.5% females and 43.4% males) completed the study. Results: the results suggest that most participants had low drug abuse levels before and during social isolation. There was a significant decrease in tobacco, alcohol, and cannabis use in both females and males. Upon analyzing guideline adherence, low alcohol use correlated with the safety behavior scale, while tobacco and cannabis correlated with the preventive behavior scale. Discussion: the current Mexican sample had not used drugs to cope during social isolation.

Smoking among patients followed at the department of psychiatry

IntroductionSmoking and nicotine dependence are particularly common in patients with a psychiatric disorder compared to the general population.ObjectivesTo study the prevalence of smoking in patients followed at the department of psychiatry and to assess their dependence on nicotine.MethodsThis was a cross-sectional, descriptive and analytical study. The study focused on patients followed at the department of psychiatry of the regional hospital of Gabes. Sociodemographic and clinical data were assessed. Fagerstrom questionnaire in its validated French version was used to assess the nicotine dependence. Data were analyzed using the software SPSS (20th edition).Results100 patients were included. They were male (60%) and single (50%) and with a mean age of 45.3 years [18-71]. The three most common pathologies were anxiety disorders (31%), schizophrenia (30%) and depression (29%). Among the patients surveyed 48% were smokers. Of which, 93.7% smoked cigarettes, 20.8% snorted chewing tobacco and 12.5% smoked hookah. The average number of pack-years was 11.6, with an average of 22.8 cigarettes per day. The mean duration of regular smoking was 19.1 years. Regarding nicotine dependence, 42% of patients were dependent. Regarding the degree of dependency, 43.7% were heavily dependent, 25% were weakly dependent and 18.8% were moderately dependent. Smoking was significantly associated with the male gender (p≤10-3), alcoholism (p=0.002) and schizophrenia (p=0.006).ConclusionsResults of our study show that smoking is frequent in patients followed at the psychiatry department. This aspect should be taken into account during the psychiatric evaluation, especially when therapeutic resistance occurs.

Pornography cyberaddiction and impulsivity among medical tunisian students

IntroductionMedical studies have always been considered as very stressful. Although these students are generally among the most academically successful students, they are not spared from developing both substance and behavioral addictions, particularly pornography cyberaddiction.ObjectivesTo evaluate the pornography cyberaddiction in a group of tunisian students, to study their impulsivity and determinate the link between these two entities.MethodsA descriptive and analytical cross-sectional study including 155 medical students. We used the S-IAT sex : to evaluate pornography cyberaddiction and Barrat bis 10 : to evaluate impulsivity.ResultsThe average age of students was 25.8 ±3.5 years old. The sex ratio (M/W) was 0,72. This medical students were single in 76.8%, had a high socio-economic status in 99.4% of case. They had a personal psychiatric history in 15.0%. They are smokers in 20%, consume alcohol in 30.3% and cannabis in 9% of case. The mean score of : the BIS 10 was 63.3 and the S-IAT was 15.6. The viewing of pornographic movies started around the age of 15 years old. Pornographic sites are the most frequently used tool (58.2%). The factors correlated with this addiction are: male sex (p=0.014), tobacco consumption (p=0.012), alcohol consumption (p=0.02) and impulsivity (p=0.03).ConclusionsIt resort from our study that medical students may suffer from pornography cyberaddiction. This increased use may be associated with impulsivity and substance use. Psychological support aimed specifically should be used to protect medical students.

Likely clinical depression and HIV-related decline in antiretroviral therapy untreated women who seroconverted during participation in microbicide trials in sub-Saharan Africa.

Depression worsens HIV outcomes in populations treated with antiretroviral therapy (ART) medications. Data are limited on the relationship between depression and HIV in untreated populations in sub-Saharan Africa. We aimed to identify associations between likely clinical depression, alcohol use, social support by partners, and HIV viral load (VL) among ART untreated women who recently became HIV positive and enrolled in the Microbicide Trials Network (MTN)-015 study. Analyses used cross-sectional data collected at baseline in MTN-015. Participants in this analysis (N = 190) enrolled from other MTN trials were not receiving ART and provided data on their HIV disclosure status to their husband or male partner and alcohol use behavior. The dependent variable, VL, was categorized as: low (≤400 RNA copies/mL; 9.1% of participants), medium (401-20,000 RNA copies/mL; 48.8%), and high (>20,000 RNA copies/mL; 42.0%). Depression was assessed using eight items from Hopkins Symptom Checklist; a cutoff of ≥1.75 indicated likely clinical depression. Independent variables with a significance of p ≤ 0.05 in unadjusted regressions were included in a regression adjusted for age, education, and time since seroconversion. Depressive symptoms were positively associated with high VL, in the adjusted regression (OR = 1.80; 95% CI = 1.07-3.01). Results suggest that likely having clinical depression may have a biological relationship with HIV disease progression.

Incidence and Risk Factors of Combined-Antiretroviral Therapy-Induced Hepatotoxicity among HIV Patients at the Bali District Hospital, Cameroon

Introduction: The incidence of hepatotoxicity is life-threatening and can result to an end-stage liver disease in long-term patients on combined antiretroviral therapy (cART). Our study sought to evaluate the incidence and predictors of cART-induced hepatotoxicity (CIH) among long term users on cART in a rural District hospital. Methods: This was a hospital-based cross-sectional study in the Bali District Hospital. Spectrophotometric method was use for the quantitative measurement of alanine-aminotransferase (ALT) and aspartate-aminotransferase (AST) levels. Patients with elevations of both ALT and AST were considered CIH. The Chi (χ2) square test, ANOVA and Kaplan Meier log-ranked/ survival analyses were used to analyses the data. Results: Of the 350 participants enrolled [156 (44.6%) males and 194 (55.4%) females], aged 43.87 ± 0.79 years (range 20 – 84 years) included in this analysis, 26 (4.4%) experienced moderate CIH. We observed 57 (16.3%), 62 (17.7%) and 238 (68%) elevated levels ALT + AST, ALT and AST respectively. Two independent predictive factors of CIH were the male sex and alcoholism during the study period. Conclusion: The prevalence of CIH in HIV-infected patients in Bali was lower than that observed in previous studies. The duration of therapy had no influence on the frequency of CIH. Alcoholism and smoking showed significant differences in the development of CIH.

The Effects of Life Stress on Men’s Alcohol Use: a Reassessment of Data from the 2012 China Family Panel Studies

Drinking alcohol is cited as a way for men to cope with stress, with most of the research emanating from western countries. However, in the East, limited scientific research has been conducted on the relationship between stress and alcohol consumption. Thus, this study aimed to explore the influence of life stress on alcohol use among Chinese men. Our data were drawn from the 2012 China Family Panel Studies that comprised representative samples of the Chinese population. In total, 15,373 Chinese men participated in this study, and their weekly alcohol intake and life stress were evaluated using computer-assisted personal interviews. It was found that the greater the overall life pressure experienced by the Chinese men, the less likely they were to engage in both general (OR = 0.977) and heavy drinking (OR = 0.975). Although severe life stress that interfered with daily life did not affect general drinking, it had a negative effect on heavy drinking. As for less severe life stresses, feeling down and sad had an inhibitory effect on male general and heavy drinking, and experiencing loneliness had a similar effect on general drinking but no effect on heavy drinking. Further, perceiving unfriendliness from others had no influence on male drinking behavior. Although feeling disliked by others had no effect on male drinking behavior, it had a significant, positive effect on male heavy drinking. This study found that in China, stress did not increase male alcohol consumption, but rather, inhibited it. Alcohol consumption is not a preferred strategy for Chinese men dealing with stress.

Intrinsic dialogues between the two hemispheres in middle-aged male alcoholics: a resting-state functional MRI study.

The purpose of this study was to investigate the interhemispheric intrinsic connectivity measured by resting-state functional MRI (R-fMRI) in middle-aged male alcoholics. Thirty male alcoholics (47.33 ± 8.30 years) and 30 healthy males (47.20 ± 6.17 years) were recruited and obtained R-fMRI data. Inter- and intrahemispheric coordination was performed by using voxel-mirrored homotopic connectivity (VMHC) and seed-based functional connectivity analysis. We found significantly decreased VMHC in a set of regions in male alcoholics patients, including lateral temporal, inferior frontal gyrus, insular/insulae operculum, precuneus/posterior cingulate gyrus, and pars triangularis (P < 0.05, corrected). Subsequent seed-based functional connectivity analysis demonstrated disrupted functional connectivity between the regions of local homotopic connectivity deficits and other areas of the brain, particularly the areas subserving the default, salience, primary somatomotor, and language systems. Middle-aged male alcoholic subjects demonstrated prominent reductions in inter- and intrahemispheric functional coherence. These abnormal changes may reflect degeneration of system/network integration, particularly the domains subserving default, linguistic processing, and salience integration.

Differential importance of nucleus accumbens Ox1Rs and AMPARs for female and male mouse binge alcohol drinking

Alcohol use disorder exhausts substantial social and economic costs, with recent dramatic increases in female problem drinking. Thus, it is critically important to understand signaling differences underlying alcohol consumption across the sexes. Orexin-1 receptors (Ox1Rs) can strongly promote motivated behavior, and we previously identified Ox1Rs within nucleus accumbens shell (shell) as crucial for driving binge intake in higher-drinking male mice. Here, shell Ox1R inhibition did not alter female mouse alcohol drinking, unlike in males. Also, lower dose systemic Ox1R inhibition reduced compulsion-like alcohol intake in both sexes, indicating that female Ox1Rs can drive some aspects of pathological consumption, and higher doses of systemic Ox1R inhibition (which might have more off-target effects) reduced binge drinking in both sexes. In contrast to shell Ox1Rs, inhibiting shell calcium-permeable AMPA receptors (CP-AMPARs) strongly reduced alcohol drinking in both sexes, which was specific to alcohol since this did not reduce saccharin intake in either sex. Our results together suggest that the shell critically regulates binge drinking in both sexes, with shell CP-AMPARs supporting intake in both sexes, while shell Ox1Rs drove drinking only in males. Our findings provide important new information about sex-specific and -general mechanisms that promote binge alcohol intake and possible targeted therapeutic interventions.

PREVALENCE OF SMOKING AND ALCOHOL CONSUMPTION AMONG RURAL POPULATION IN RUSSIA

Significance. Tobacco smoking and alcohol consumption are the major public health problem. These causes lead to the increased morbidity rates, excess mortality, decreased healthy life expectancy, lost health, deteriorated heredity and health of children, high health costs associated with prevention, diagnosis, treatment, and rehabilitation. Alcohol consumption and smoking among rural dwellers are important factors hindering effectiveness of programs aimed at demographic, infrastructural and socio-economic development of rural areas. Purpose. To analyze prevalence of bad habits (tobacco smoking and alcohol consumption) among rural dwellers both in dynamics (1994-2019) and by main socio-demographic groups. Material and methods. Results of the Russian Monitoring of Economic Situation and Health of the Higher School of Economics (RLMS-HSE) (1994—2019) served the study information basis. To meet the study purpose, a subsample of rural dwellers residing in settlements with population under 1000 people was developed. The subsample included men and women of five age groups: 1). under 18; 2). 18-25 years; 3). 26-45 years; 4). 46-60 years; and 5). over 60. The total subsample number equalled to 34 833 people, including 15 741 males (45.2%) and 19 942 females (54.8%). The analysis of multivariate distribution of the respondents' answers was carried out using the SPSS 17.0 statistical data processing package. Results. There was a gradual decrease in the share of smokers among rural males from the maximum of 67.4% in 2003 to 47.1% in 2019.The share of smokers among rural females reached its maximum in 2011 (11.9%) with a subsequent decline to 8.7% in 2019, with the share of female somokers increasing 2.8 times during the study period. A smooth upward trend in the share of women smoking in the active childbearing age of 26-45 years was identified (from 4.1% in 1994 to 21.1% in 2019). The average age of the smoking debut decreases with every new generation in both males and females. With age the share of smokers of "quality" tobacco (filtered) decreases with a proportional increase in the share of smokers of "low-quality" tobacco (unfiltered cigarettes, cigarettes, hand-rolled cigarettes). A detailed age-specific analysis of the number of cigarettes smoked shows that the smoking intensity in men decreases with age, while it increases in woman. Gender differences in the dynamics in alcohol consumption were revealed. From 1994 to 2005, a noticeable decrease in the share of alcohol consumers was registered among males (from 69.3% to 59.5%, respectively), while the share of alcohol consumers among females remained almost changed during this perios (42.0%-45.0%). The rise in consumption in 2006 was more pronounced among females (by 26.4%) compared to males (by 21.3%). As a result, the difference between the share of male and female alcohol consumers decreased during the study period (from 27.1% in 1994 to 13.3% in 2019). Increase in the share of alcohol consumers in 1994-2019 equalled to 2.9% in males and 16.7% in females. Among rural males aged 18-25, the share of alcohol consumers decreased by 26.4% in 1994-2019, while among females of the same age it increased by 17.2%. Decreased consumption was observed in the age group of 26-45 years, both among males (from 78.7% in 1994 to 65.1% in 2019) and females (by 4.3% compared to 1994). The trend in alcohol consumption in the 46-60 year group is of the utmost concern: the share of male alcohol consumers decreased from 68.4% to 61.0%, while it increased (by 19.3%) among females, resulting in a lower difference between the level of male and female alcohol consumption (from 38.6% in 1994 to 3.2% in 2019). Among rural dwellers over 60 the situation is similar: men began to drink less (by 13.3%), while women started to drink more (by 10.3%). Conclusion. The study has identified the increased tobacco and achohol consumption among rural females. With a lower tobacco consumption among females compared to males, negative growth trends have been noted in both the share of female smokers in rural areas and intensity of smoking. A trend towards a significant increase in alcohol consumption has been identified in both young females aged 18-25 and women over 45. In 1994-2019, tobacco consumption among rural males of all age groups, especially males under 18 and males aged 18-25 decreased. Alcohol consumption among males also significantly declined, especially in the youth cohort.

Influence of socioeconomic and cultural factors in the etiology of cirrhosis of the liver

Introduction and aimCirrhosis of the liver is a serious public health problem worldwide, with regional variations determined by cultural factors and economic development. AimTo know the characteristics of the social, cultural, and economic factors of the patients with cirrhosis of the liver in Veracruz. Materials and methodsA multicenter, retrolective, relational research study was conducted on patients with cirrhosis of the liver at 5 healthcare institutions in Veracruz. The variables analyzed were etiology, age, sex, civil status, educational level, occupation, and income. Descriptive and inferential statistics were utilized, and statistical significance was set at a p < 0.05. The Windows IBM-SPSS version 25.0 program was employed. ResultsA total of 182 case records of patients with cirrhosis of the liver were included. The etiologic factors were chronic alcohol consumption (47.8%), viral disease (28.5%), nonalcoholic fatty liver disease (NAFLD) (8.79%), autoimmune liver disease (4.4%), cholestasis (1.64%), and cryptogenic liver disease (8.8%). Mean patient age was 66.14 ± 13.91, with a predominance of men (58.79%). In comparing the socioeconomic and cultural factors related to etiology, secondary and tertiary education and singleness were statistically significant in male alcoholics (p < 0.05), viral diseases and NAFLD were significantly associated with women with no income (p < 0.05), cryptogenic liver disease was significantly associated with women (p < 0.05), and cholestasis and autoimmune liver disease were not significantly associated with any of the factors. ConclusionsThe study results revealed the influence of socioeconomic and cultural factors related to the different causes of cirrhosis of the liver in our environment.

Occurrence of male depression symptoms, suicidal behaviors, alcohol and tobacco use and level of personal resources in three male groups

Background and objective: The study was to compare the severity of male depression symptoms, suicidal behaviors, the use of psychoactive substances (alcohol, nicotine), and evaluate personal resources (self-efficacy, coping strategies and resilience) among men from three different groups. Material and methods: The clinical group contained men with depression disorders diagnosed by psychiatrists and treated in psychiatric hospitals (n = 197). The control groups contained men with physical disorders treated in general hospitals in Warsaw, Poland (n = 198) and men who self-evaluated themselves as healthy without physical or mental disorders (n = 203). Several tests were used for evaluation: a test with sociodemographic variables, the AUDIT Test, the Fagerstrom Test, the Generalized Self-Efficacy Scale (GSES), the MINI-COPE Questionnaire, the Resilience Evaluation Questionnaire (KOP-26), the Suicide Behaviors Questionnaire-Revised by Osman (SBQ-R) and the Gotland Male Depression Scale (GMDS). Results: Most of the men with depression disorders presented non-typical symptoms of depression which are not included in diagnostic criteria. It allows us to assume that a large percentage of men who suffer from depression are not properly being diagnosed. Moreover, we found that men with any type of physical disorder have the greatest severity of male depression symptoms than healthy men. Men with depression disorders have suicidal thoughts and have made efforts in the past more often, as well as having higher alcohol and nicotine addictions. Patients who overuse or are addicted to alcohol or nicotine should be additionally screened for the possible occurrence of depressive disorders, and substance usage should be treated as a symptom of male depression. Men with depression present low resilience and low self-efficacy. They also use negative strategies in dealing with stress. Conclusion: There is a need to plan and implement effective prevention actions that will take the conditioning of these groups into account.