Alcohol Overconsumption Research Articles

α1Antitrypsin Deficiency and Liver Cirrhosis in Adults

alpha 1-Antitrypsin (AAT) deficiency in adults predisposes to lung and liver disease, but its natural history is incompletely known. To better characterize the liver disease, all known deceased adult Swedish patients known to us with homozygous (PiZZ) AAT-deficiency, who had undergone autopsy during the 20-year period 1963-82 were reviewed. Of 94 such patients, 35 had cirrhosis (27 males and eight females) with a mean age at death of 65.5 +/- 10.5 (SD) years compared to 53.6 +/- 12.8 years (p less than 0.01) for the 59 non-cirrhotic patients. The longer survival suggests less severe lung disease in the cirrhotic group. Clinically these patients most frequently presented with ascites or other signs of portal hypertension. Evidence of alcohol overconsumption, chronic viral hepatitis, or autoimmune disease was rare. Aside from low plasma AAT levels, laboratory and other clinical features were indistinguishable from those of decompensated cirrhosis of any etiology. The prognosis was generally grave with a mean survival of two years after diagnosis. Fourteen of the 35 cirrhotics (10 males and four females) had primary liver cancer (PLC) at autopsy. We conclude that cirrhosis and PLC are more frequent complications in elderly patients with AAT-deficiency than was previously known. These complications had a marked male predominance.

Studying drinking problems rather than alcoholism.

This chapter focuses primarily on the implications of quantitative, nonclinical studies of drinking practices and problems in planning primary prevention programs. The discussion utilizes the findings of the national probability surveys, directed by the author and his colleagues over the last 20 years, to illustrate how vastly different the survey findings are from studies of clinical alcoholics in terms of prevalence among various age and subcultural groups, and how longitudinal studies have cast question on much of the predictive utility of the disease concept of alcoholism. In closing, the chapter draws attention to the importance of cross-cultural surveys, conducted at intervals, in achieving greater success in primary prevention of severe physical and social problems associated with overconsumption of alcohol.

Vaernepligtige - håndethed og social baggrund

Examined by questionnaire for handedness and social-psychiatric background were 179 conscripts hospitalized in the Department of Militarypsychiatry University Hospital of Copenhagen. Those belonging to the control group consisted of 191 drafted for national service. No difference in handedness was observed between the two groups. On the other hand, a significant difference was found between the groups as regards years of childhood separated from parents, duration of schooling, education in special classes, number of people with education after school and unemployment. There were more participants in the conscript group than those belonging to the control group who had an overconsumption of alcohol, abuse of hashish, consumption of psychotherapeutic drugs or had consulted a psychiatrist or psychologist. 25% of the participants and 10% of the control group had volunteered for duty because of unemployment. This investigation indicates that problems during national service break out particularly in individual...

Failure of long-term acclimatization in smokers moving to high altitude.

It was found that several foreign experts recruited for an irrigation project in southern Peru could not cope with their work at an altitude of 3 200 m. When we analyzed the haematological acclimatization to high altitude in 109 adult males, we found that the moderate differences in haematocrit level (0.9) and haemoglobin concentration (0.2 g/100 ml) between male smokers and non-smokers at low altitude were almost quadrupled at 3 200 m height. The haemoglobin concentration increased in both groups during the first month, after which it remained constant. Of 51 Swedish employees, 25 smokers and 26 non-smokers, 14 were obliged to terminate their contracts. All 10 who had failed to cope with their work for other than purely medical reasons were smokers. This group of smoking men also had an overconsumption of alcohol. We therefore conclude that life style determines long-term acclimatization to high altitude.

Bone Morphometry in Alcoholics

The osteoclast activity (number of osteoclasts per surface bone section) and the osteoid abundance (percentage of trabecular bone surface covered with osteoid) were measured in iliac crest biopsies from 38 men with alcoholism. These patients had histories of decades of over-consumption of alcohol and repeated injuries, as well as medical complications. In older individuals, the bone mineral content of the forearms decreased so that the reduction in relation to age was comparable to that of women rather than men. Osteoid seams increased in thickness only in alcoholics who had previously undergone gastric resection. Otherwise, there were no differences in osteoid seams in alcoholics and control nonalcoholism patients. Osteoclasts, however, were more abundant in the iliac crest biopsies from alcoholics than from the nonalcoholic group. Osteoclasts were also more numerous in alcoholics who had undergone gastric resection although, in the other cases, there were also significant increases above normal. In any case, the nutritional effects of alcoholism on the skeleton were relatively slight inasmuch as there was no case of advanced osteomalacia. Nevertheless, alcoholism causes bone changes, both systemic (possibly hormonal) and local in nature, and is characterized by bone resorption.

Lipoprotein lipase activity of human adipose tissue in health and in some diseases with hyperlipidemia as a common feature.

Abstract Adipose tissue lipoprotein lipase activity (LPLA), serum triglycerides, cholesterol and free fatty acids (FFA), blood glucose and aceto‐acetate have been determined in groups of 50 healthy men and 50 healthy women. Groups of subjects with atherosclerotic disease, diabetes and impaired glucose tolerance, high alcohol consumption, uremia and some patients with myxedema, nephrosis and insuloma have been studied in the same way. In comparison with a majority of normo‐ and hyperlipidemic subjects the relation between LPLA and serum lipids did not seem to be modified by either atherosclerotic disease or different degrees of glucose intolerance. On the contrary, in subjects with alcohol overconsumption LPLA was normal or high, in spite of a high incidence of hyperlipidemia. Thirty uremic subjects were characterized by low LPLA, increased levels of serum triglycerides, cholesterol and blood aceto‐acetate, while serum FFA was low.

Alcohol and heart disease

A summary was given of the effect on the heart of severe chronic over-consumption of alcohol in 170 individuals on whom a medico-legal post-mortem examination was carried out. The findings in this series appeared to indicate that alcoholism caused the disappearance of, or prevented development of, coronary atherosclerosis, but only at the price of severe damage to the heart in the shape of alcoholic cardiomyopathy. In the microscopic picture of full-blown alcoholic cardiomyopathy the myocardium both of the right ventricle and the left ventricle showed wasting admixed with hypertrophy of individual fibres; there was much fibro-fatty interstitial change and patchy fatty degeneration; and there was fibrosis both in the right and the left ventricles. This fibrosis differed in distribution from that seen in coronary ischaemic damage and also was different in character, having a 'whorled' appearance.