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Sample records for alcohol-related cirrhosis mediated

  1. The reliability of alcoholism history in patients with alcohol-related cirrhosis.

    Science.gov (United States)

    Yates, W R; Labrecque, D R; Pfab, D

    1998-01-01

    Alcoholic liver disease is considered an indication for liver transplantation when a candidate is felt to have a high likelihood of abstinence following transplantation. Historical variables such as duration of sobriety, duration and quantity of drinking, and treatment history are commonly used to estimate alcoholism prognosis, yet their reliability and validity in patients with alcoholic cirrhosis has received limited study. Fifty subjects (9 women and 41 men) with alcoholic cirrhosis underwent an alcoholism history interview. Each subject had a collateral source (usually a spouse) who was interviewed by a second interviewer blind to the subject's alcoholism history. The two histories were compared for duration of abstinence in months and estimated alcoholism relapse risk was calculated using the High-risk Alcoholism Relapse scale (HRAR). Duration of sobriety correlated highly between subject and collateral source (Spearman r= 0.96, P = 0.0001) as did HRAR total score (Spearman r = 0.72, P = 0.0001). Categorical assignments also showed high correlations with duration of sobriety (kappa = 0.97) and HRAR category (kappa = 0.63). When disagreements were present, collateral sources tended to underestimate severity of alcoholism. We conclude that patients with alcoholic liver disease provide a reliable history for alcoholism variables when compared with a collateral source, and that, when disagreements are present, subjects tend to report a more acute or severe alcohol problem. The results support the clinical use of patient history information in making decisions about medical interventions for alcoholic liver disease.

  2. Discrimination and alcohol-related problems among college students: a prospective examination of mediating effects.

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    Hatzenbuehler, Mark L; Corbin, William R; Fromme, Kim

    2011-06-01

    Discrimination is a risk factor for health-risk behaviors, including alcohol abuse. Far less is known about the mechanisms through which discrimination leads to alcohol-related problems, particularly during high-risk developmental periods such as young adulthood. The present study tested a mediation model using prospective data from a large, diverse sample of 1539 college students. This model hypothesized that discrimination would be associated with established cognitive (positive alcohol expectancies) and affective (negative affect and coping motives) risk factors for alcohol-related problems, which would account for the prospective association between discrimination and alcohol problems. Structural equation modeling indicated that discrimination was associated cross-sectionally with negative affect and more coping motives for drinking, but not with greater alcohol expectancies. Coping motives mediated the prospective relationship between discrimination and alcohol-related problems. Additionally, results indicated significant indirect effects from discrimination to alcohol-related problems through negative affect and coping motives. These associations were evident for multiple groups confronting status-based discrimination, including women, racial/ethnic minorities, and lesbian/gay/bisexual individuals. This study identified potential affective mechanisms linking discrimination to alcohol-related problems. Results suggest several avenues for prevention and intervention efforts with individuals from socially disadvantaged groups. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Social anxiety and alcohol-related negative consequences among college drinkers: do protective behavioral strategies mediate the association?

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    Villarosa, Margo C; Moorer, Kayla D; Madson, Michael B; Zeigler-Hill, Virgil; Noble, Jeremy J

    2014-09-01

    The link between social anxiety and alcohol-related negative consequences among college students has been well documented. Protective behavioral strategies are cognitive-behavioral strategies that college students use in an effort to reduce harm while they are drinking. In the current study we examined the mediating role of the 2 categories of protective behavioral strategies (i.e., controlled consumption and serious harm reduction) in the relationship that social anxiety symptoms have with alcohol-related negative consequences. Participants were 572 undergraduates who completed measures of social anxiety, alcohol use, negative consequences of alcohol use, and protective behavioral strategy use. Only serious harm reduction strategies emerged as a mediator of the association that social anxiety symptoms had with alcohol-related negative consequences. Clinical and research implications are discussed.

  4. Genetic Contribution to Alcohol Dependence: Investigation of a Heterogeneous German Sample of Individuals with Alcohol Dependence, Chronic Alcoholic Pancreatitis, and Alcohol-Related Cirrhosis

    Directory of Open Access Journals (Sweden)

    Jens Treutlein

    2017-07-01

    Full Text Available The present study investigated the genetic contribution to alcohol dependence (AD using genome-wide association data from three German samples. These comprised patients with: (i AD; (ii chronic alcoholic pancreatitis (ACP; and (iii alcohol-related liver cirrhosis (ALC. Single marker, gene-based, and pathway analyses were conducted. A significant association was detected for the ADH1B locus in a gene-based approach (puncorrected = 1.2 × 10−6; pcorrected = 0.020. This was driven by the AD subsample. No association with ADH1B was found in the combined ACP + ALC sample. On first inspection, this seems surprising, since ADH1B is a robustly replicated risk gene for AD and may therefore be expected to be associated also with subgroups of AD patients. The negative finding in the ACP + ALC sample, however, may reflect genetic stratification as well as random fluctuation of allele frequencies in the cases and controls, demonstrating the importance of large samples in which the phenotype is well assessed.

  5. Genetic Contribution to Alcohol Dependence: Investigation of a Heterogeneous German Sample of Individuals with Alcohol Dependence, Chronic Alcoholic Pancreatitis, and Alcohol-Related Cirrhosis

    Science.gov (United States)

    Treutlein, Jens; Streit, Fabian; Juraeva, Dilafruz; Degenhardt, Franziska; Rietschel, Liz; Forstner, Andreas J.; Ridinger, Monika; Dukal, Helene; Foo, Jerome C.; Soyka, Michael; Maier, Wolfgang; Gaebel, Wolfgang; Dahmen, Norbert; Scherbaum, Norbert; Müller-Myhsok, Bertram; Lucae, Susanne; Ising, Marcus; Stickel, Felix; Berg, Thomas; Roggenbuck, Ulla; Jöckel, Karl-Heinz; Scholz, Henrike; Zimmermann, Ulrich S.; Buch, Stephan; Sommer, Wolfgang H.; Spanagel, Rainer; Brors, Benedikt; Cichon, Sven; Mann, Karl; Kiefer, Falk; Hampe, Jochen; Rosendahl, Jonas; Nöthen, Markus M.; Rietschel, Marcella

    2017-01-01

    The present study investigated the genetic contribution to alcohol dependence (AD) using genome-wide association data from three German samples. These comprised patients with: (i) AD; (ii) chronic alcoholic pancreatitis (ACP); and (iii) alcohol-related liver cirrhosis (ALC). Single marker, gene-based, and pathway analyses were conducted. A significant association was detected for the ADH1B locus in a gene-based approach (puncorrected = 1.2 × 10−6; pcorrected = 0.020). This was driven by the AD subsample. No association with ADH1B was found in the combined ACP + ALC sample. On first inspection, this seems surprising, since ADH1B is a robustly replicated risk gene for AD and may therefore be expected to be associated also with subgroups of AD patients. The negative finding in the ACP + ALC sample, however, may reflect genetic stratification as well as random fluctuation of allele frequencies in the cases and controls, demonstrating the importance of large samples in which the phenotype is well assessed. PMID:28714907

  6. Gender-specific mediational links between parenting styles, parental monitoring, impulsiveness, drinking control, and alcohol-related problems.

    Science.gov (United States)

    Patock-Peckham, Julie A; King, Kevin M; Morgan-Lopez, Antonio A; Ulloa, Emilio C; Moses, Jennifer M Filson

    2011-03-01

    Recently, it has been suggested that traits may dynamically change as conditions change. One possible mechanism that may influence impulsiveness is parental monitoring. Parental monitoring reflects a knowledge regarding one's offspring's whereabouts and social connections. The aim of this investigation was to examine potential gender-specific parental influences to impulsiveness (general behavioral control), control over one's own drinking (specific behavioral control), and alcohol-related problems among individuals in a period of emerging adulthood. Direct and mediational links between parenting styles (permissive, authoritarian, and authoritative), parental monitoring, impulsiveness, drinking control, and alcohol-related problems were investigated. A multiple-group, SEM model with (316 women, 265 men) university students was examined. In general, the overall pattern among male and female respondents was distinct. For daughters, perceptions of a permissive father were indirectly linked to more alcohol-related problems through lower levels of monitoring by fathers and more impulsive symptoms. Perceptions of an authoritative father were also indirectly linked to fewer impulsive symptoms through higher levels of monitoring by fathers among daughters. For men, perceptions of a permissive mother were indirectly linked to more alcohol-related problems through lower levels of monitoring by mothers and more impulsive symptoms. For sons, perceptions of mother authoritativeness were indirectly linked to fewer alcohol-related problems through more monitoring by mothers and fewer impulsive symptoms. Monitoring by an opposite-gender parent mediated the link between parenting styles (i.e., permissive, authoritative) on impulsiveness.

  7. Stress and coping mediate relationships between contingent and global self-esteem and alcohol-related problems among college drinkers.

    Science.gov (United States)

    Tomaka, Joe; Morales-Monks, Stormy; Shamaley, Angelee Gigi

    2013-08-01

    This study examined the hypotheses that contingent self-esteem would be positively associated with alcohol-related problems and that global self-esteem would be negatively associated with such problems. It also examined the hypothesis that high stress and maladaptive coping would mediate these relationships. A sample of college students (n = 399) who were predominantly Hispanic (89%) completed measures of global and contingent self-esteem; stress and coping; and alcohol-related problems. Correlational and latent variable analyses indicated that contingent self-esteem positively related to alcohol-related problems, with maladaptive coping mediating this relationship. In contrast, global self-esteem negatively related to such problems, a relationship that was also mediated by maladaptive coping and stress. Overall, the results highlight the potentially harmful consequences of contingent self-worth and the adaptive nature of non-contingent self-esteem. They also demonstrate the important role that coping plays in mediating self-esteem's associations with alcohol-related problems. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Agreeableness and alcohol-related aggression: the mediating effect of trait aggressivity.

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    Miller, Cameron A; Parrott, Dominic J; Giancola, Peter R

    2009-12-01

    This study investigated the mediating effect of trait aggressivity on the relation between agreeableness and alcohol-related aggression in a laboratory setting. Participants were 116 healthy male social drinkers between 21 and 30 years of age. Agreeableness and trait aggressivity were measured using the Big Five Inventory and the Buss-Perry Aggression Questionnaire, respectively. Following the consumption of an alcohol or no-alcohol control beverage, participants completed a modified version of the Taylor Aggression Paradigm, in which electric shocks were received from and administered to a fictitious opponent during a competitive task. Aggression was operationalized as the proportion of the most extreme shocks delivered to the fictitious opponent under conditions of low and high provocation. Results indicated that lower levels of agreeableness were associated with higher levels of trait aggressivity. In turn, higher levels of trait aggressivity predicted extreme aggression in intoxicated, but not sober, participants under low, but not high, provocation. Findings highlight the importance of examining determinants of intoxicated aggression within a broader theoretical framework of personality.

  9. Friends' Alcohol-Related Social Networking Site Activity Predicts Escalations in Adolescent Drinking: Mediation by Peer Norms.

    Science.gov (United States)

    Nesi, Jacqueline; Rothenberg, W Andrew; Hussong, Andrea M; Jackson, Kristina M

    2017-06-01

    Adolescents' increased use of social networking sites (SNS) coincides with a developmental period of heightened risk for alcohol use initiation. However, little is known regarding associations between adolescents' SNS use and drinking initiation nor the mechanisms of this association. This study examined longitudinal associations among adolescents' exposure to friends' alcohol-related SNS postings, alcohol-favorable peer injunctive norms, and initiation of drinking behaviors. Participants were 658 high-school students who reported on posting of alcohol-related SNS content by self and friends, alcohol-related injunctive norms, and other developmental risk factors for alcohol use at two time points, 1 year apart. Participants also reported on initiation of three drinking behaviors: consuming a full drink, becoming drunk, and heavy episodic drinking (three or more drinks per occasion). Probit regression analyses were used to predict initiation of drinking behaviors from exposure to alcohol-related SNS content. Path analyses examined mediation of this association by peer injunctive norms. Exposure to friends' alcohol-related SNS content predicted adolescents' initiation of drinking and heavy episodic drinking 1 year later, controlling for demographic and known developmental risk factors for alcohol use (i.e., parental monitoring and peer orientation). In addition, alcohol-favorable peer injunctive norms statistically mediated the relationship between alcohol-related SNS exposure and each drinking milestone. Results suggest that social media plays a unique role in contributing to peer influence processes surrounding alcohol use and highlight the need for future investigative and preventive efforts to account for adolescents' changing social environments. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  10. Protective behavioral strategies as a mediator and moderator of the relationship between self-regulation and alcohol-related consequences in first-year college students.

    Science.gov (United States)

    D'Lima, Gabrielle Maria; Pearson, Matthew R; Kelley, Michelle L

    2012-06-01

    This study examined protective behavioral strategies (PBS) as a potential mediator and moderator of the relationship between self-regulation and alcohol-related consequences. Participants were 249 first-year undergraduate men and women. The use of PBS partially mediated the relationship between self-regulation and alcohol-related problems (i.e., supporting the "self-control equals drinking control" hypothesis). However, use of PBS appeared more important for those with poorer self-regulation abilities (supporting the "PBS protect the impaired" hypothesis). Because both mediation and moderation were supported, a moderated mediation model was tested. The moderated mediation model demonstrated that the negative relationship between self-regulation and alcohol-related consequences could be explained by use of PBS for individuals with poor-to-average self-regulation but not for individuals with above-average, self-regulation abilities. Implications of the study's findings are discussed.

  11. College drinking behaviors: mediational links between parenting styles, impulse control, and alcohol-related outcomes.

    Science.gov (United States)

    Patock-Peckham, Julie A; Morgan-Lopez, Antonio A

    2006-06-01

    Mediational links between parenting styles (authoritative, authoritarian, permissive), impulsiveness (general control), drinking control (specific control), and alcohol use and abuse were tested. A pattern-mixture approach (for modeling non-ignorable missing data) with multiple-group structural equation models with 421 (206 female, 215 male) college students was used. Gender was examined as a potential moderator of parenting styles on control processes related to drinking. Specifically, the parent-child gender match was found to have implications for increased levels of impulsiveness (a significant mediator of parenting effects on drinking control). These findings suggest that a parent with a permissive parenting style who is the same gender as the respondent can directly influence control processes and indirectly influence alcohol use and abuse.

  12. Mediational links among parenting styles, perceptions of parental confidence, self-esteem, and depression on alcohol-related problems in emerging adulthood.

    Science.gov (United States)

    Patock-Peckham, Julie A; Morgan-Lopez, Antonio A

    2009-03-01

    Depression is often found to be comorbid with alcohol-related problems. Parental overprotection, which may be of particular importance during emerging adulthood, has been linked to internalizing symptoms in offspring. This article evaluates the impact of parenting styles and parental confidence in their offspring on an internalizing pathway to alcohol-related problems through self-esteem and depression. Mediational links were tested among parenting styles (authoritative, authoritarian, permissive), parental confidence (overprotection, autonomy), self-esteem, depression, and alcohol-related problems. A two-group, multiple indicator multiple-cause structural equation model with 441 (216 female, 225 male) college students was examined. Overall, having a father who was confident in his child's ability to make autonomous decisions was protective against depression for both genders. Perceptions of paternal autonomy mediated the impact of the fathers' parenting styles (authoritative, permissive) on depression for both genders. For men, parental overprotection mediated the impact of an authoritarian father on self-esteem, and self-esteem mediated the impact of parental overprotection on depression. Moreover, among men, perceptions of maternal autonomy mediated the impact of the mothers' parenting styles (authoritative, permissive) on self-esteem, and self-esteem mediated the impact of maternal autonomy on depression. The current pattern of findings is distinct from pathways through behavioral undercontrol with influences from the same-sex parent for both genders. These findings indicate that parenting may have differential influences on internalizing pathways to alcohol-related problems.

  13. Mediational Links Among Parenting Styles, Perceptions of Parental Confidence, Self-Esteem, and Depression on Alcohol-Related Problems in Emerging Adulthood*

    Science.gov (United States)

    Patock-Peckham, Julie A.; Morgan-Lopez, Antonio A.

    2009-01-01

    Objective: Depression is often found to be comorbid with alcohol-related problems. Parental overprotection, which may be of particular importance during emerging adulthood, has been linked to internalizing symptoms in offspring. This article evaluates the impact of parenting styles and parental confidence in their offspring on an internalizing pathway to alcohol-related problems through self-esteem and depression. Method: Mediational links were tested among parenting styles (authoritative, authoritarian, permissive), parental confidence (overprotection, autonomy), self-esteem, depression, and alcohol-related problems. A two-group, multiple indicator multiple-cause structural equation model with 441 (216 female, 225 male) college students was examined. Results: Overall, having a father who was confident in his child's ability to make autonomous decisions was protective against depression for both genders. Perceptions of paternal autonomy mediated the impact of the fathers' parenting styles (authoritative, permissive) on depression for both genders. For men, parental overprotection mediated the impact of an authoritarian father on self-esteem, and self-esteem mediated the impact of parental overprotection on depression. Moreover, among men, perceptions of maternal autonomy mediated the impact of the mothers' parenting styles (authoritative, permissive) on self-esteem, and self-esteem mediated the impact of maternal autonomy on depression. Conclusions: The current pattern of findings is distinct from pathways through behavioral undercontrol with influences from the same-sex parent for both genders. These findings indicate that parenting may have differential influences on internalizing pathways to alcohol-related problems. PMID:19261233

  14. Predictive Effects of Good Self-Control and Poor Regulation on Alcohol-Related Outcomes: Do Protective Behavioral Strategies Mediate?

    Science.gov (United States)

    Pearson, Matthew R.; Kite, Benjamin A.; Henson, James M.

    2016-01-01

    In the present study, we examined whether use of protective behavioral strategies mediated the relationship between self-control constructs and alcohol-related outcomes. According to the two-mode model of self-control, good self-control (planfulness; measured with Future Time Perspective, Problem Solving, and Self-Reinforcement) and poor regulation (impulsivity; measured with Present Time Perspective, Poor Delay of Gratification, Distractibility) are theorized to be relatively independent constructs rather than opposite ends of a single continuum. The analytic sample consisted of 278 college student drinkers (68% women) who responded to a battery of surveys at a single time point. Using a structural equation model based on the two-mode model of self-control, we found that good self-control predicted increased use of three types of protective behavioral strategies (Manner of Drinking, Limiting/Stopping Drinking, and Serious Harm Reduction). Poor regulation was unrelated to use of protective behavioral strategies, but had direct effects on alcohol use and alcohol problems. Further, protective behavioral strategies mediated the relationship between good self-control and alcohol use. The clinical implications of these findings are discussed. PMID:22663345

  15. Alcohol-specific parenting, adolescent alcohol use and the mediating effect of adolescent alcohol-related cognitions

    NARCIS (Netherlands)

    Mares, S.H.W.; Lichtwarck-Aschoff, A.; Engels, R.C.M.E.

    2013-01-01

    Objectives : Previous research indicated that alcohol-specific parenting is an important precursor of adolescent alcohol use, but failed to define the underlying mechanism. Based on social cognitive theory, alcohol-related cognitions such as alcohol refusal self-efficacy and alcohol-related

  16. The gender specific mediational pathways between parenting styles, neuroticism, pathological reasons for drinking, and alcohol-related problems in emerging adulthood.

    Science.gov (United States)

    Patock-Peckham, Julie A; Morgan-Lopez, Antonio A

    2009-03-01

    Mediational links between parenting styles, neuroticism, pathological reasons for drinking, alcohol use and alcohol-related problems were tested. A two-group SEM path model with 441 (216 female, 225 male) college students was examined. In general, pathological reasons for drinking mediated the impact of neuroticism on alcohol use and alcohol-related problems. A different pattern of relationships was found for each of the two genders. Perceptions of having an authoritarian father were positively linked to higher levels of neuroticism among males but this pattern was not found among females. For males, neuroticism mediated the impact of having an authoritarian father on pathological reasons for drinking with pathological reasons for drinking mediating the impact of neuroticism on alcohol-related problems. Perceptions of having a permissive father were linked to lower levels of neuroticism in females (but have been found as a consistent risk factor for other pathways to alcohol use elsewhere). Compared with other work in this area, these findings indicate parental influences regarding vulnerabilities for alcohol use may be specific to parent-child gender matches for some pathways and specific to one parent (irrespective of child gender) for other pathways.

  17. Alcohol Expectancies Mediate and Moderate the Associations between Big Five Personality Traits and Adolescent Alcohol Consumption and Alcohol-Related Problems.

    Science.gov (United States)

    Ibáñez, Manuel I; Camacho, Laura; Mezquita, Laura; Villa, Helena; Moya-Higueras, Jorge; Ortet, Generós

    2015-01-01

    Personality and expectancies are relevant psychological factors for the development of adolescent alcohol use and misuse. The present study examined their direct, mediated and moderated effects on different drinking behaviors in adolescence. Personality domains of the five-factor model, positive and negative alcohol expectancies (AEs), alcohol use during the week and the weekend, and alcohol-related problems were assessed in a sample of 361 adolescents. Different personality dimensions were directly associated with specific alcohol outcomes: Extraversion, low Conscientiousness and low Openness were associated with weekend alcohol use; low Agreeableness was related to weekday use; whereas low Agreeableness, low Conscientiousness and Extraversion were associated with alcohol-related problems. In addition, positive AEs mediated the relationship between Extraversion and alcohol use, whereas both positive and negative expectancies mediated the association between Neuroticism and alcohol consumption and alcohol-related problems. Finally, both types of expectancies interacted with Extraversion to predict alcohol problems. Our results highlight the importance of examining the complex interplay of comprehensive personality models and AEs to gain a better understanding of the development of different alcohol use and misuse patterns in adolescence.

  18. Chronic alcoholism-mediated impairment in the medulla oblongata: a mechanism of alcohol-related mortality in traumatic brain injury?

    Science.gov (United States)

    Lai, Xiao-ping; Yu, Xiao-jun; Qian, Hong; Wei, Lai; Lv, Jun-yao; Xu, Xiao-hu

    2013-01-01

    Alcohol-related traumatic brain injury (TBI) is a common condition in medical and forensic practice, and results in high prehospital mortality. We investigated the mechanism of chronic alcoholism-related mortality by examining the effects of alcohol on the synapses of the medulla oblongata in a rat model of TBI. Seventy adult male Sprague-Dawley rats were randomly assigned to either ethanol (EtOH) group, EtOH-TBI group, or control groups (water group, water-TBI group). To establish chronic alcoholism model, rats in the EtOH group were given EtOH twice daily (4 g/kg for 2 weeks and 6 g/kg for another 2 weeks). The rats also received a minor strike on the occipital tuberosity with an iron pendulum. Histopathologic and ultrastructure changes and the numerical density of the synapses in the medulla oblongata were examined. Expression of postsynaptic density-95 (PSD-95) in the medulla oblongata was measured by ELISA. Compared with rats in the control group, rats in the chronic alcoholism group showed: (1) minor axonal degeneration; (2) a significant decrease in the numerical density of synapses (p Chronic alcoholism induces significant synapse loss and axonal impairment in the medulla oblongata and renders the brain more susceptible to TBI. The combined effects of chronic alcoholism and TBI induce significant synapse and axon impairment and result in high mortality.

  19. Hyperammonemia in cirrhosis induces transcriptional regulation of myostatin by an NF-κB–mediated mechanism

    Science.gov (United States)

    Qiu, Jia; Thapaliya, Samjhana; Runkana, Ashok; Yang, Yu; Tsien, Cynthia; Mohan, Maradumane L.; Narayanan, Arvind; Eghtesad, Bijan; Mozdziak, Paul E.; McDonald, Christine; Stark, George R.; Welle, Stephen; Naga Prasad, Sathyamangla V.; Dasarathy, Srinivasan

    2013-01-01

    Loss of muscle mass, or sarcopenia, is nearly universal in cirrhosis and adversely affects patient outcome. The underlying cross-talk between the liver and skeletal muscle mediating sarcopenia is not well understood. Hyperammonemia is a consistent abnormality in cirrhosis due to impaired hepatic detoxification to urea. We observed elevated levels of ammonia in both plasma samples and skeletal muscle biopsies from cirrhotic patients compared with healthy controls. Furthermore, skeletal muscle from cirrhotics had increased expression of myostatin, a known inhibitor of skeletal muscle accretion and growth. In vivo studies in mice showed that hyperammonemia reduced muscle mass and strength and increased myostatin expression in wild-type compared with postdevelopmental myostatin knockout mice. We postulated that hyperammonemia is an underlying link between hepatic dysfunction in cirrhosis and skeletal muscle loss. Therefore, murine C2C12 myotubes were treated with ammonium acetate resulting in intracellular concentrations similar to those in cirrhotic muscle. In this system, we demonstrate that hyperammonemia stimulated myostatin expression in a NF-κB–dependent manner. This finding was also observed in primary murine muscle cell cultures. Hyperammonemia triggered activation of IκB kinase, NF-κB nuclear translocation, binding of the NF-κB p65 subunit to specific sites within the myostatin promoter, and stimulation of myostatin gene transcription. Pharmacologic inhibition or gene silencing of NF-κB abolished myostatin up-regulation under conditions of hyperammonemia. Our work provides unique insights into hyperammonemia-induced myostatin expression and suggests a mechanism by which sarcopenia develops in cirrhotic patients. PMID:24145431

  20. Normative Beliefs, Expectancies, and Alcohol-Related Problems among College Students; Implications for Theory and Practice.

    Science.gov (United States)

    Fearnow-Kenny, Melodie D.; Wyrick, David L.; Hansen, William B.; Dyreg, Doug; Beau, Dan B.

    2001-01-01

    Investigation (1) examined interrelations among normative beliefs, alcohol expectancies, and alcohol-related problems, and (2) investigated whether alcohol-related expectancies mediate associations between normative beliefs and alcohol-related problems. Analyses revealed that alcohol expectancies mediate the relationship between normative beliefs…

  1. Management of decompensated cirrhosis.

    Science.gov (United States)

    Mansour, Dina; McPherson, Stuart

    2018-04-01

    Decompensated cirrhosis is a common reason for admission to the acute medical unit, and such patients typically have complex medical needs and are at high risk of in-hospital death. It is therefore vital that these patients receive appropriate investigations and management as early as possible in their patient journey. Typical presenting clinical features include jaundice, ascites, hepatic encephalopathy, hepato-renal syndrome or variceal haemorrhage. A careful history, examination and investigations can help identify the precipitating cause (infections, gastrointestinal bleeding, high alcohol intake / alcohol-related hepatitis or drug-induced liver injury), so appropriate treatment can be given. A 'care bundle' that has been endorsed by the British Society of Gastroenterology is available to help guide the management of patients with decompensated cirrhosis for the first 24 hours and ensure all aspects are addressed. Specific management of complications, such as infections, gastrointestinal bleeding, hepatic encephalopathy and hepatorenal syndrome, are discussed. © Royal College of Physicians 2018. All rights reserved.

  2. Pronounced Coronary Arteriosclerosis in Cirrhosis

    DEFF Research Database (Denmark)

    Danielsen, Karen V; Wiese, Signe; Hove, Jens

    2018-01-01

    factors including smoking, type 2 diabetes, hypertension, gender, or hypercholesterolemia. Coronary artery calcium-score was associated with diastolic dysfunction, lateral e´ (p = 0.025), but not with other markers of cardiac dysfunction. During a median follow-up of 25 months 12 patients (21%) died......BACKGROUND: The relation between excessive alcohol consumption and coronary arteriosclerosis has remained controversial. The etiology of cirrhosis has been considered a substantial risk factor for development of arteriosclerotic lesions. The coronary artery calcium-score derived from coronary CT...... and women: 136 vs. 0 HU; p alcohol-related cirrhosis was significantly higher than in nonalcohol-related cirrhosis (362 vs. 46 HU, p 

  3. Temporal distribution of alcohol related facial fractures.

    Science.gov (United States)

    Lee, Kai H; Qiu, Michael; Sun, Jiandong

    2017-11-01

    This study aimed to address 2 important aspects of temporal pattern in alcohol-related facial fractures: (1) comparison of temporal pattern of alcohol-related facial fracture (alcohol group) presentation with non-alcohol-related fracture (non-alcohol group) presentation; (2) temporal pattern of patient demographic characteristics, injury characteristics, and surgical management in the alcohol group presentation. This study retrospectively examined the Victorian admitted episodes data set (VAED) for the years 2010 to 2013. VAED is a standardized set of data collected during all hospital presentations in Victoria. The study found higher incidence of alcohol-related facial fracture presentations during weekends and during the summer and spring months compared with non-alcohol-related fractures (statistically significant). Alcohol-related facial fractures are more likely to involve male patients in the 20- to 29-year age group, occur as a result of interpersonal violence, and require shorter hospital stays during weekend admissions (statistically significant). No statistically significant relationship has been observed in seasonal variation across all variables. This study found distinct characteristics in temporal distribution of alcohol-related facial fractures. These characteristics are, in particular, significant in weekend trauma admissions. Such information is important in workforce planning, resource distribution, and implementation of injury prevention programs. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. An empirical analysis of the relationship between the consumption of alcohol and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    The question whether intake of alcohol is associated with liver cirrhosis mortality is analyzed using aggregate data for alcohol consumption, alcohol related diseases and alcohol policies of 16 European countries. The empirical analysis gives support to a close association between cirrhosis morta...... mortality and intake of alcohol - and the latter also concerns each of the specific beverages, i.e. spirits, wine and beer, where other studies usually only find evidence of spirits and wine related to liver cirrhosis mortality.  ...

  5. Effect of biliary cirrhosis on nonadrenergic noncholinergic-mediated relaxation of rat corpus cavernosum: Role of nitric oxide pathway and endocannabinoid system

    Directory of Open Access Journals (Sweden)

    Dehpour A.R.

    2008-06-01

    Full Text Available Background: Relaxation of the corpus cavernosum plays a major role in penile erection. Nitric oxide (NO is known to be the most important factor mediating relaxation of corpus cavernosum, which is mainly derived from nonadrenergic noncholinergic (NANC nerves. The aim of the present study was to investigate the effect of biliary cirrhosis on nonadrenergic noncholinergic (NANC-mediated relaxation of rat corpus cavernosum as well as the possible relevant roles of endocannabinoid and nitric oxide systems.Methods: Corporal strips from sham-operated and biliary cirrhotic rats were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate (5 µM and atropine (1 µM to induce adrenergic and cholinergic blockade. The strips were precontracted with phenylephrine hydrochloride (7.5 µM and electrical field stimulation was applied at different frequencies (2, 5, 10, 15 Hz to obtain NANC-mediated relaxation. In separate precontracted strips of the sham and cirrhotic groups, the concentration-dependent relaxant responses to sodium nitroprusside (10 nM-1mM, as an NO donor, were assessed.  Results: The NANC-mediated relaxation was significantly enhanced in cirrhotic animals (P<0.01. Anandamide potentiated the relaxations in both groups (P<0.05. The cannabinoid CB1 receptor antagonist AM251 (10 µM and the vanilloid receptor antagonist capsazepine (10 µM each significantly prevented the enhanced relaxations in cirrhotic rats (P<0.01. The CB2 receptor antagonist AM630 had no effect on relaxations in the cirrhotic group. In a concentration-dependent manner, L-NAME (30-1000 nM inhibited relaxations in both the sham and cirrhotic groups, although cirrhotic groups were more resistant to the inhibitory effects of L-NAME. The degree of relaxation induced by sodium nitroprusside (10 nM-1 mM was similar in the two groups.Conclusions: Biliary cirrhosis enhances the neurogenic relaxation in rat corpus cavernosum probably via the NO pathway and

  6. Impact of Alcohol Tax Increase on Maryland College Students' Alcohol-Related Outcomes.

    Science.gov (United States)

    Smart, Mieka J; Yearwood, Safiya S; Hwang, Seungyoung; Thorpe, Roland J; Furr-Holden, C Debra

    2018-05-12

    This study A) assessed whether levels of alcohol-related disciplinary actions on college campuses changed among MD college students after the 2011 Maryland (MD) state alcohol tax increase from 6% to 9%, and B) determined which school-level factors impacted the magnitude of changes detected. A quasi-experimental interrupted time series (ITS) analysis of panel data containing alcohol-related disciplinary actions on 33 MD college campuses in years 2006-2013. Negative binomial regression models were used to examine whether there was a statistically significant difference in counts of alcohol-related disciplinary actions comparing time before and after the tax increase. The ITS anaysis showed an insignificant relationship between alcohol-related disciplinary actions and tax implementation (β = -.27; p =.257) but indicated that alcohol-related disciplinary actions decreased significantly over the time under study (β = -.05; p =.022). Alcohol related disciplinary actions did decrease over time in the years of study, and this relationship was correlated with several school-level characteristics, including school price, school funding type, types of degrees awarded, and specialty. School price may serve as a proxy mediator or confounder of the effect of time on disciplinary actions.

  7. Kupffer cell depletion attenuates leptin-mediated methoxamine-stimulated portal perfusion pressure and thromboxane A2 release in a rodent model of NASH-cirrhosis.

    Science.gov (United States)

    Yang, Ying-Ying; Huang, Yi-Tsau; Tsai, Tung-Hu; Hou, Ming-Chih; Lee, Fa-Yauh; Lee, Shou-Dong; Lin, Han-Chieh

    2012-12-01

    Cirrhotic portal hypertension is characterized by increased hepatic oxidative stress, AA (arachidonic acid)-derived TXA(2) (thromboxane A(2)) release and exaggerated hepatic response to the α-adrenergic agonist MTX (methoxamine). Besides promoting hepatic fibrosis, the role of hyperleptinaemia in the modulation of vascular response in NASH (non-alcoholic steatohepatitis) rat livers remains unknown. The aim of the present study was to explore the possible links between hyperleptinaemia and the disarrangement in the hepatic microcirculation. NASH-cirrhosis with hyperleptinaemia was induced in lean rats by feeding with an HF/MCD (high-fat/methionine-choline-deficient) diet. Portal haemodynamics, various substances, protein and mRNA expression and PUFA (polyunsaturated fatty acid) composition were measured. Finally, the effects of leptin pre-infusion on TXA(2) release and concentration-PPP (portal perfusion pressure) curves in response to MTX were evaluated by simultaneously pre-treatment with the Kupffer cell inactivators GdCl(3) (gadolinium chloride) or EC (encapsulated clodronate), the TXS (TXA(2) synthase) inhibitor furegrelate, the TP receptor (TXA(2) receptor) antagonist SQ29548 and the dual TXS/TP receptor antagonist BM567. In HF/MCD+leptin-lean rats, cirrhosis-induced PPP and MTX hyper-responsiveness were associated with increased hepatic TXA(2) production, TBARS (thiobarbituric acid-reacting substances) levels and the AA (arachidonic acid)/n-3 PUFA ratio, and up-regulation of hepatic leptin, FAS (fatty acid synthase), NADPH oxidase subunits, TXS, TP receptor, TGFβ(1) (transforming growth factor β(1)) proteins and mRNAs. Pre-infusion of leptin significantly enhanced MTX-stimulated PPP elevation and TXA(2) release, which were attenuated by GdCl(3) and EC pre-treatment. Concomitantly pre-incubation with BM567, but not furegrelate or SQ29548, significantly abolished the leptin-enhanced MTX-stimulated increase in PPP in NASH-cirrhotic rats. Hyperleptinaemia

  8. HEV and cirrhosis: methods

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. HEV and cirrhosis: methods. Study group. Patients with cirrhosis and recent jaundice for <30 d. Controls. Patients with liver cirrhosis but no recent worsening. Exclusions. Significant alcohol consumption. Recent hepatotoxic drugs. Recent antiviral therapy. Recent ...

  9. PPARgamma-PGC-1alpha activity is determinant of alcohol related breast cancer

    DEFF Research Database (Denmark)

    Koefoed Petersen, Rasmus; Benzon Larsen, Signe; Jensen, Ditte Marie

    2012-01-01

    Alcohol is a risk factor for postmenopausal breast cancer. One of several proposed mechanisms is that alcohol-related breast cancer is caused by increased sex hormone levels. PPARγ inhibits aromatase transcription in breast adipocytes. We reproduced previously found allele-specific effects...... of the wildtype Pro-allele of PPARG Pro12Ala in alcohol related breast cancer. In transiently transfected cells, transcriptional activation by PPARγ and the PPARγ-PGC-1α complex was inhibited by ethanol. PPARγ 12Ala-mediated transcription activation was not enhanced by PGC-1α, resulting in allele......-specific transcription activation by the PPARγ 12Pro-PGC-1α complex. Our results suggest that PPARγ and PGC-1α activity is an important determinant of alcohol related breast cancer....

  10. The green eyed monster in the bottle: Relationship contingent self-esteem, romantic jealousy, and alcohol-related problems.

    Science.gov (United States)

    DiBello, Angelo M; Rodriguez, Lindsey M; Hadden, Benjamin W; Neighbors, Clayton

    2015-10-01

    Previous research suggests that both jealousy and relationship contingent self-esteem (RCSE) are related to alcohol use and alcohol-related problems. No work, however, has examined these two constructs together as they relate to motives for alcohol use and alcohol-related problems. The current study aims to build upon emerging literature examining different types of jealousy (i.e., emotional, cognitive, and behavioral), relationship quality (i.e., satisfaction, commitment, closeness), RCSE, and alcohol use. More specifically, the current study aimed to examine the associations between RCSE and drinking to cope and RCSE and alcohol-related problems, in the context of the different types of jealousy. Moreover, the current study aimed to assess whether the associations between RCSE, jealousy, and drinking outcomes vary as a function of relationship quality. Two hundred and seventy seven individuals (87% female) at a large southern university participated in the study. They completed measures of RCSE, relationship satisfaction, commitment, closeness, and jealousy as well as alcohol-related outcomes. Using PROCESS, moderated mediational analyses were used to evaluate different types of jealousy as mediators of the association between RCSE and drinking to cope/alcohol-related problems. Further, we aimed to examine whether relationship quality moderated the association between RCSE and jealousy in predicting alcohol-related variables. Results indicated that cognitive jealousy mediated the association between both RCSE and drinking to cope and RCSE and alcohol-related problems. Further, relationship satisfaction, commitment, and closeness were all found to moderate the association between RSCE and cognitive jealousy such that at lower, but not higher levels of satisfaction, commitment, and closeness, cognitive jealousy mediated the association between RCSE and drinking to cope and RCSE and alcohol-related problems. Copyright © 2015. Published by Elsevier Ltd.

  11. PTSD Symptoms, Emotion Dysregulation, and Alcohol-Related Consequences Among College Students With a Trauma History.

    Science.gov (United States)

    Tripp, Jessica C; McDevitt-Murphy, Meghan E; Avery, Megan L; Bracken, Katherine L

    2015-01-01

    Posttraumatic stress disorder (PTSD), alcohol use, and alcohol-related consequences have been linked to emotion dysregulation. Sex differences exist in both emotion regulation dimensions and alcohol use patterns. This investigation examined facets of emotion dysregulation as potential mediators of the relationship between PTSD symptoms and alcohol-related consequences and whether differences may exist across sexes. Participants were 240 college students with a trauma history who reported using alcohol within the past three months and completed measures of PTSD symptoms, emotion dysregulation, alcohol consumption, alcohol-related consequences, and negative affect. The six facets of emotion dysregulation were examined as mediators of the relationship between PTSD symptoms and alcohol-related consequences in the full sample and by sex. There were differences in sexes on several variables, with women reporting higher PTSD scores and lack of emotional awareness. Men reported significantly more drinks per week in a typical week and a heavy week. There were significant associations between the variables for the full sample, with PTSD showing associations with five facets of emotion dysregulation subscales: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, lack of emotional clarity, and limited access to emotion regulation strategies. Alcohol-related consequences were associated with four aspects of emotion dysregulation: impulse control difficulties when upset, difficulties engaging in goal-directed behavior, nonacceptance of emotional responses, and limited access to emotion regulation strategies. Two aspects of emotion regulation, impulse control difficulties and difficulties engaging in goal directed behavior, mediated the relationship between PTSD symptoms and alcohol-related consequences in the full sample, even after adjusting for the effects of negative affect. When examined separately by

  12. Heavy drinking and alcohol-related injuries in college students

    Directory of Open Access Journals (Sweden)

    Lucía Moure-Rodríguez

    2014-09-01

    Conclusion: We can conclude that heavy drinking leads to an increase of alcohol-related injuries. This shows a new dimension on the consequences of this public concern already related with a variety of health and social problems. Furthermore, our results allow us to suggest that about half of alcohol-related injuries could be avoided by removing this consumption pattern.

  13. Alcohol-Related Problems And High Risk Sexual Behaviour In ...

    African Journals Online (AJOL)

    There was a significant association between alcohol-related problems and risky sexual behavior. Alcohol-related problems are fairly common in people already infected with HIV/AIDS and are associated with high-risk sexual behavior. Thus, screening and treatment should be part of an effective HIV intervention program.

  14. Constitutional and functional genetics of human alcohol-related hepatocellular carcinoma.

    Science.gov (United States)

    Nahon, Pierre; Nault, Jean-Charles

    2017-11-01

    Exploration of the constitutional genetics of hepatocellular carcinoma (HCC) has identified numerous variants associated with a higher risk of liver cancer in alcoholic cirrhotic patients. Although Genome-Wide Association studies have not been carried out in the field of alcohol-related HCC, common single nucleotide polymorphisms conferring a small increase in the risk of liver cancer risk have been identified and shown to modulate ethanol metabolism, inflammation, oxidative stress, iron or lipid metabolism. Specific patterns of gene mutations including CTNNB1, TERT, ARID1A and SMARCA2 exist in alcohol-related HCC. Moreover, a specific mutational process observed at the nucleotide level by next generation sequencing has revealed cooperation between alcohol and tobacco in the development of HCC. Combining this genetic information with epidemiological and clinical data that might define specific HCC risk classes and refine surveillance strategies needs to be assessed in large prospective cohorts of patients with alcoholic cirrhosis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Exposure to alcohol advertisements and teenage alcohol-related problems.

    Science.gov (United States)

    Grenard, Jerry L; Dent, Clyde W; Stacy, Alan W

    2013-02-01

    This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents' jobs, and parents' education. Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade. Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence.

  16. Exposure to Alcohol Advertisements and Teenage Alcohol-Related Problems

    Science.gov (United States)

    Dent, Clyde W.; Stacy, Alan W.

    2013-01-01

    OBJECTIVE: This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. METHODS: A total of 3890 students were surveyed once per year across 4 years from the 7th through the 10th grades. Assessments included several measures of exposure to alcohol advertising, alcohol use, problems related to alcohol use, and a range of covariates, such as age, drinking by peers, drinking by close adults, playing sports, general TV watching, acculturation, parents’ jobs, and parents’ education. RESULTS: Structural equation modeling of alcohol consumption showed that exposure to alcohol ads and/or liking of those ads in seventh grade were predictive of the latent growth factors for alcohol use (past 30 days and past 6 months) after controlling for covariates. In addition, there was a significant total effect for boys and a significant mediated effect for girls of exposure to alcohol ads and liking of those ads in 7th grade through latent growth factors for alcohol use on alcohol-related problems in 10th grade. CONCLUSIONS: Younger adolescents appear to be susceptible to the persuasive messages contained in alcohol commercials broadcast on TV, which sometimes results in a positive affective reaction to the ads. Alcohol ad exposure and the affective reaction to those ads influence some youth to drink more and experience drinking-related problems later in adolescence. PMID:23359585

  17. Kidney injury in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Krag, Aleksander; Bendtsen, Flemming

    2014-01-01

    Acute kidney injury (AKI) is frequent in patients with cirrhosis. AKI and hyponatraemia are major determinants of the poor prognosis in advanced cirrhosis. The hepatorenal syndrome (HRS) denotes a functional and potential reversible impairment of renal function. Type 1 HRS, a special type of AKI...

  18. Alcohol-related interpretation bias in alcohol-dependent patients

    NARCIS (Netherlands)

    Woud, M.L.; Pawelczack, S.; Rinck, M.; Lindenmeyer, J.; Souren, P.M.; Wiers, R.W.H.J.; Becker, E.S.

    2014-01-01

    Background Models of addictive behaviors postulate that implicit alcohol-related memory associations and biased interpretation processes contribute to the development and maintenance of alcohol misuse and abuse. The present study examined whether alcohol-dependent patients (AP) show an

  19. Alcohol-Related Knowledge and Alcohol-Related Norms in 4- to 6-Year-Olds-Evidence from the Dutch Electronic Appropriate Beverage Task

    NARCIS (Netherlands)

    Voogt, Carmen; Otten, Roy; Kleinjan, Marloes; Engels, Rutger; Kuntsche, Emmanuel

    BACKGROUND: Limited research is available on children's alcohol-related knowledge and alcohol-related norms, yet a better comprehension of these factors may be crucial in explaining alcohol use later in life. This study provides insights into alcohol-related knowledge and alcohol-related norms in 4-

  20. Alcohol-related knowledge and alcohol-related norms in 4- to 6-year-olds: Evidence from the Dutch electronic Appropriate Beverage Task

    NARCIS (Netherlands)

    Voogt, C.V.; Otten, R.; Kleinjan, M.; Engels, R.C.M.E.; Kuntsche, E.N.

    2017-01-01

    Background: Limited research is available on children's alcohol-related knowledge and alcohol-related norms, yet a better comprehension of these factors may be crucial in explaining alcohol use later in life. This study provides insights into alcohol-related knowledge and alcohol-related norms in

  1. Influence of gastrointestinal factors on glucose metabolism in patients with cirrhosis

    DEFF Research Database (Denmark)

    Junker, Anders E; Gluud, Lise L; Holst, Jens Juul

    2015-01-01

    BACKGROUND AND AIMS: The impaired glucose tolerance in cirrhosis is poorly understood. We evaluated the influence of gastrointestinal-mediated glucose disposal and incretin effect in patients with cirrhosis. METHODS: Non-diabetic patients with Child Pugh A or B cirrhosis (n = 10) and matched...... of intravenous glucose in patients with cirrhosis compared to 24 ± 10 g in healthy controls (P = 0.003). The gastrointestinal-mediated glucose disposal was markedly lower in patients with cirrhosis (30 ± 23 vs. 52 ± 20%; P = 0.003). Despite higher levels of the incretin hormones glucagon-like peptide-1 (GLP-1......) and glucose-dependent insulinotropic peptide (GIP) patients with cirrhosis had reduced incretin effect (35 ± 44 vs. 55 ± 30%; P = 0.008). CONCLUSIONS: Impaired gastrointestinal-mediated glucose disposal and reduced incretin effect may contribute to the glucose intolerance seen in patients with cirrhosis....

  2. What Is Decompensated Cirrhosis?

    Science.gov (United States)

    ... is decompensated cirrhosis? Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans and the Public Home Hepatitis A Hepatitis B Hepatitis C Hepatitis C Home Getting ...

  3. Alcohol and Cirrhosis

    Science.gov (United States)

    ... Alcohol and Cirrhosis Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans and the Public Home Hepatitis A Hepatitis B Hepatitis C Hepatitis C Home Getting ...

  4. Normative perceptions of alcohol-related consequences among college students.

    Science.gov (United States)

    Brett, Emma I; Leavens, Eleanor L; Miller, Mary Beth; Lombardi, Nathaniel; Leffingwell, Thad R

    2016-07-01

    College students in the U.S. continue to drink in hazardous ways and experience a range of alcohol-related consequences. Personalized feedback interventions (PFIs), which often include normative components comparing personal drinking to that of similar peers, have been effective in reducing alcohol outcomes among college students. Though normative perceptions of the quantity and frequency of alcohol use have been examined in many studies, norms for alcohol-related consequences have received less attention. The current study examined self-other discrepancies (SODs) for alcohol-related consequences among college students. Participants overestimated how often alcohol-related consequences are experienced by other same-sex students on campus and rated consequences as more acceptable for others to experience than themselves. No differences in SODs were found between those who did and did not report alcohol use. Future studies should examine the efficacy of PFIs that incorporate normative feedback on alcohol-related consequences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Emotion dysregulation and peer drinking norms uniquely predict alcohol-related problems via motives.

    Science.gov (United States)

    Simons, Raluca M; Hahn, Austin M; Simons, Jeffrey S; Murase, Hanako

    2017-08-01

    This study examined the relationships between emotion dysregulation, peer drinking norms, drinking motives, and alcohol-related outcomes among 435 college students. We examined the mediating roles of drinking motives when predicting alcohol consumption and related problems from the subscales of the Difficulties in Emotion Regulation Scale (DERS; Gratz and Roemer, 2004) via negative and positive reinforcement models. First, we hypothesized that individuals who lack in emotion regulation strategies or have difficulties in accepting negative emotions are more likely to drink to cope. Additionally, we hypothesized that individuals who act impulsively or become distracted when upset as well as those with higher peer drinking norms are more likely to drink for social and enhancement motives. The results of the path model indicated that limited access to emotion regulation strategies significantly predicted alcohol-related problems via both depression and anxiety coping motives, but did not predict alcohol consumption. Nonacceptance of emotional responses was not significantly associated with coping motives. Impulsivity had a significant direct relationship with alcohol problems. Difficulty in engaging in goal-directed behaviors predicted both enhancement and social motives, but only enhancement motives in turn predicted consumption. Norms indirectly predicted problems via enhancement motives and consumption. The results indicated that using alcohol to reduce negative or to increase positive emotions increases alcohol consumption and alcohol-related problems. Overall, results advance our understanding of the mechanisms of increased alcohol use and problems among college students. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. Exploring college students' use of general and alcohol-related social media and their associations with alcohol-related behaviors.

    Science.gov (United States)

    Hoffman, Eric W; Pinkleton, Bruce E; Weintraub Austin, Erica; Reyes-Velázquez, Wanda

    2014-01-01

    Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students' use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors. Public and private university students (N = 637) participated November and December 2011 and April 2012. College students completed online surveys to measure their exposure to social and online media generally, as well as their alcohol-related digital media use and alcohol use. Use of social media related to alcohol marketing predicted alcohol consumption and engaging in risky behaviors, whereas the use of social media more generally did not. Students' use of alcohol-related social media-marketing content associates with their problem drinking. Results have implications for alcohol abuse reduction efforts targeted at college students and suggest the importance of considering social, cultural, and cognitive factors in campaign planning and design.

  7. Adipokines in Liver Cirrhosis.

    Science.gov (United States)

    Buechler, Christa; Haberl, Elisabeth M; Rein-Fischboeck, Lisa; Aslanidis, Charalampos

    2017-06-29

    Liver fibrosis can progress to cirrhosis, which is considered a serious disease. The Child-Pugh score and the model of end-stage liver disease score have been established to assess residual liver function in patients with liver cirrhosis. The development of portal hypertension contributes to ascites, variceal bleeding and further complications in these patients. A transjugular intrahepatic portosystemic shunt (TIPS) is used to lower portal pressure, which represents a major improvement in the treatment of patients. Adipokines are proteins released from adipose tissue and modulate hepatic fibrogenesis. These proteins affect various biological processes that are involved in liver function, including angiogenesis, vasodilation, inflammation and deposition of extracellular matrix proteins. The best studied adipokines are adiponectin and leptin. Adiponectin protects against hepatic inflammation and fibrogenesis, and leptin functions as a profibrogenic factor. These and other adipokines are supposed to modulate disease severity in patients with liver cirrhosis. Consequently, circulating levels of these proteins have been analyzed to identify associations with parameters of hepatic function, portal hypertension and its associated complications in patients with liver cirrhosis. This review article briefly addresses the role of adipokines in hepatitis and liver fibrosis. Here, studies having analyzed these proteins in systemic blood in cirrhotic patients are listed to identify adipokines that are comparably changed in the different cohorts of patients with liver cirrhosis. Some studies measured these proteins in systemic, hepatic and portal vein blood or after TIPS to specify the tissues contributing to circulating levels of these proteins and the effect of portal hypertension, respectively.

  8. TPH2 polymorphisms and alcohol-related suicide.

    Science.gov (United States)

    Zupanc, Tomaž; Pregelj, Peter; Tomori, Martina; Komel, Radovan; Paska, Alja Videtič

    2011-02-18

    Substantial evidence from family, twin, and adoption studies corroborates implication of genetic and environmental factors, as well as their interactions, on suicidal behavior and alcoholism risk. Serotonergic disfunction seems to be involved in the pathophysiology of substance abuse, and has also an important role in suicidal behavior. Recent studies of the tryptophan hydroxylase 2 showed mild or no association with suicide and alcohol-related suicide. We performed SNP and alcohol analysis on 388 suicide victims and 227 controls. The results showed association between suicide (Pχ²=0.043) and alcohol-related suicide (Pχ²=0.021) for SNP Rs1843809. A tendency for association was determined also for polymorphism Rs1386493 (Pχ²=0.055) and alcohol-related suicide. Data acquired from psychological autopsies in a subsample of suicide victims (n=79) determined more impulsive behavior (Pχ²=0.016) and verbal aggressive behavior (Pχ²=0.025) in the subgroup with alcohol misuse or dependency. In conclusion, our results suggest implication of polymorphisms in suicide and alcohol-related suicide, but further studies are needed to clarify the interplay among serotonergic system disfunction, suicide, alcohol dependence, impulsivity and the role of TPH2 enzyme. © 2010 Elsevier Ireland Ltd. All rights reserved.

  9. Alcohol-related morbidity and mortality within siblings

    DEFF Research Database (Denmark)

    Søndergaard, Grethe; Osler, Merete; Andersen, Anne-Marie Nybo

    2015-01-01

    AIMS: To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals. DESIGN: Cohort study. SETTING: Denmark. PARTICIPANTS: Approximately 1.4 million full siblings born in De...

  10. [Alcohol-related cognitive impairment and the DSM-5

    NARCIS (Netherlands)

    Walvoort, S.J.; Wester, A.J.; Doorakkers, M.C.; Kessels, R.P.C.; Egger, J.I.

    2016-01-01

    BACKGROUND: It is evident from the dsm-iv-tr that alcohol-related impairment is extremely difficult to classify accurately. As a result, cognitive deficits can easily be overlooked. The dsm-5, however, incorporates a new category, namely 'neurocognitive disorders', which may lead to significant

  11. Bezafibrate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2012-01-01

    Treatment of primary biliary cirrhosis is complicated. There are studies suggesting that bezafibrate, alone or in combination with ursodeoxycholic acid (UDCA), is effective in the treatment of primary biliary cirrhosis, but no systematic review has summarised the evidence yet....

  12. [Diabetes in liver cirrhosis].

    Science.gov (United States)

    García-Compeán, Diego; Jáquez-Quintana, Joel O; González-González, José A; Lavalle-González, Fernando J; Villarreal-Pérez, Jesús Z; Maldonado-Garza, Hector J

    2013-01-01

    The prevalence of overt diabetes mellitus (DM) in liver cirrhosis is about 30%. However, DM or impaired glucose tolerance can be observed in 90% after an oral glucose tolerance test in patients with normal fasting plasma glucose. Type 2 DM may produce cirrhosis, whereas DM may be a complication of cirrhosis. The latter is known as «hepatogenous diabetes». Overt and subclinical DM is associated with liver complications and death in cirrhotic patients. Treating diabetes is difficult in cirrhotic patients because of the metabolic impairments due to liver disease and because the most appropriate pharmacologic treatment has not been defined. It is also unknown if glycemic control with hypoglycemic agents has any impact on the course of the liver disease. Copyright © 2013 Elsevier España, S.L. y AEEH y AEG. All rights reserved.

  13. Alcohol-related dementia: an update of the evidence

    Science.gov (United States)

    2013-01-01

    The characteristics of dementia relating to excessive alcohol use have received increased research interest in recent times. In this paper, the neuropathology, nosology, epidemiology, clinical features, and neuropsychology of alcohol-related dementia (ARD) and alcohol-induced persisting amnestic syndrome (Wernicke-Korsakoff syndrome, or WKS) are reviewed. Neuropathological and imaging studies suggest that excessive and prolonged use of alcohol may lead to structural and functional damage that is permanent in nature; however, there is debate about the relative contributions of the direct toxic effect of alcohol (neurotoxicity hypothesis), and the impact of thiamine deficiency, to lasting damage. Investigation of alcohol-related cognitive impairment has been further complicated by differing definitions of patterns of alcohol use and associated lifestyle factors related to the abuse of alcohol. Present diagnostic systems identify two main syndromes of alcohol-related cognitive impairment: ARD and WKS. However, 'alcohol-related brain damage' is increasingly used as an umbrella term to encompass the heterogeneity of these disorders. It is unclear what level of drinking may pose a risk for the development of brain damage or, in fact, whether lower levels of alcohol may protect against other forms of dementia. Epidemiological studies suggest that individuals with ARD typically have a younger age of onset than those with other forms of dementia, are more likely to be male, and often are socially isolated. The cognitive profile of ARD appears to involve both cortical and subcortical pathology, and deficits are most frequently observed on tasks of visuospatial function as well as memory and higher-order (executive) tasks. The WKS appears more heterogeneous in nature than originally documented, and deficits on executive tasks commonly are reported in conjunction with characteristic memory deficits. Individuals with alcohol-related disorders have the potential to at least

  14. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Henriksen, Jens Henrik Sahl

    2008-01-01

    Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction and electrophysi......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed....

  15. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E

    1998-01-01

    characteristics. PATIENTS: One hundred and forty two patients with cirrhosis without significant hepatic encephalopathy (grades 0-I) (41 patients in Child class A, 57 in class B, and 44 in class C) and 21 patients with hepatic encephalopathy. RESULTS: Mean Po2 in kPa was 11.3 in Child class A, 10.8 in class B, 10...... resistance, and a low indocyanine green clearance (p hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing.......6 in class C, and 10.6 in patients with encephalopathy (p C, and in patients with encephalopathy (p

  16. CCl4 cirrhosis in rats

    DEFF Research Database (Denmark)

    Fischer-Nielsen, A; Poulsen, H E; Hansen, B A

    1991-01-01

    Cirrhosis of the rat liver was induced by a 12 week individualized CCl4/phenobarbital treatment. After treatment, all surviving animals (81%) showed cirrhosis of the liver. The cirrhosis induced was irreversible when evaluated 24 weeks after cessation of treatment. Quantitative liver function...

  17. Problem Drinking, Alcohol-Related Violence, and Homelessness among Youth Living in the Slums of Kampala, Uganda

    Directory of Open Access Journals (Sweden)

    Monica H. Swahn

    2018-05-01

    Full Text Available This paper examines problem drinking, alcohol-related violence, and homelessness among youth living in the slums of Kampala—an understudied population at high-risk for both alcohol use and violence. This study is based on a cross-sectional survey conducted in 2014 with youth living in the slums and streets of Kampala, Uganda (n = 1134, who were attending Uganda Youth Development Link drop-in centers. The analyses for this paper were restricted to youth who reported current alcohol consumption (n = 346. Problem drinking patterns were assessed among youth involved in alcohol-related violence. Mediation analyses were conducted to examine the impact of homelessness on alcohol-related violence through different measures of problem drinking. Nearly 46% of youth who consumed alcohol were involved in alcohol-related violence. Problem drinkers were more likely to report getting in an accident (χ2 = 6.8, df = 1, p = 0.009, having serious problems with parents (χ2 = 21.1, df = 1, p < 0.0001 and friends (χ2 = 18.2, df = 1, p < 0.0001, being a victim of robbery (χ2 = 8.8, df = 1, p = 0.003, and going to a hospital (χ2 = 15.6, df = 1, p < 0.0001. For the mediation analyses, statistically significant models were observed for frequent drinking, heavy drinking, and drunkenness. Interventions should focus on delaying and reducing alcohol use in this high-risk population.

  18. Exploring College Students' Use of General and Alcohol-Related Social Media and Their Associations with Alcohol-Related Behaviors

    Science.gov (United States)

    Hoffman, Eric W.; Pinkleton, Bruce E.; Weintraub Austin, Erica; Reyes-Velázquez, Wanda

    2014-01-01

    Objective: Alcohol marketers have increasingly moved their advertising efforts into digital and social media venues. As a result, the purpose of this study is to investigate associations between students' use of social media, their exposure to alcohol marketing messages through social media, and their alcohol-related beliefs and behaviors.…

  19. Diastolic dysfunction in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Wiese, Signe Skovgaard; Halgreen, Hanne

    2016-01-01

    volumes, and DD is a predictor of poorer survival in these patients. Future studies should aim at disclosing pathophysiological mechanisms behind the developing of DD in cirrhosis in relation to patient characteristics, development of complications, treatment, and risk associated with interventional...

  20. Osteodystrophy in liver cirrhosis

    International Nuclear Information System (INIS)

    Sezai, Shu-ichi; Ishizawa, Suguru; Yoshino, Katsumasa

    1987-01-01

    In order to investigate the osteodystrophy in liver cirrhosis, 21 liver cirrhotic patients having no malignancy and normal renal function were examined by 99m Tc Methylene Diphosphonate (MDP) bone scintigraphy. The cirrhotic subjects consisted of 14 males and 7 females. Their age was 31 - 80, average 55.7 years. The causes of their cirrhotic damage were 1 primary biliary cirrhosis, 9 alcoholic, 2 HB viral and 9 cryptogenic. The contents of their illness showed 9 cases in A, 4 in B and 8 in C of Child's classification. Abnormal hot spot(s) on bone in the cirrhotics could be observed very frequently in 99m Tc MDP bone scintigraphy (47.6 %; 10/21 cases). Those spots were seen more frequently in female and advanced stage of cirrhosis. The number of spot(s) increased also in advanced liver cirrhosis. Serum Ca, P and PTH were in normal range. All of three vitamin D 3 fractions decreased and especially 1,25 (OH) 2 D 3 was depressed more in scinti-positive cases. Metacarpal bone X-p with an alumimum step wedge as a reference was analyzed by a microdensitometry (MD) method (Inoue T et al) and the pattern of osteopathy (i.e. porosis, malacia and poromalacia) was examined according to Sumi Y et al. MD method was not known yet if there was any definite correlation with bone scintigraphy and the osteopathic pattern belonged to border categories. In conclusion, more attension on hepatic osteodystrophy will be significantly necessary due to the fact that it has been found very frequently in liver cirrhosis. 99m Tc MDP bone scintigraphy is a good means for detection of the hepatic osteodystrophy. (author)

  1. Experimental Alcohol-Related Peripheral Neuropathy: Role of Insulin/IGF Resistance

    Directory of Open Access Journals (Sweden)

    James Gilchrist

    2012-08-01

    Full Text Available The mechanisms of alcohol-related peripheral neuropathy (ALPN are poorly understood. We hypothesize that, like alcohol-related liver and brain degeneration, ALPN may be mediated by combined effects of insulin/IGF resistance and oxidative stress. Adult male Long Evans rats were chronically pair-fed with diets containing 0% or 37% ethanol (caloric, and subjected to nerve conduction studies. Chronic ethanol feeding slowed nerve conduction in the tibial (p = 0.0021 motor nerve, and not plantar sensory nerve, but it did not affect amplitude. Histological studies of the sciatic nerve revealed reduced nerve fiber diameters with increased regenerative sprouts, and denervation myopathy in ethanol-fed rats. qRT-PCR analysis demonstrated reduced mRNA levels of insulin, IGF-1, and IGF-2 polypeptides, IGF-1 receptor, and IRS2, and ELISAs revealed reduced immunoreactivity for insulin and IGF-1 receptors, IRS-1, IRS-4, myelin-associated glycoprotein, and tau in sciatic nerves of ethanol-fed rats (all p < 0.05 or better. The findings suggest that ALPN is characterized by (1 slowed conduction velocity with demyelination, and a small component of axonal degeneration; (2 impaired trophic factor signaling due to insulin and IGF resistance; and (3 degeneration of myelin and axonal cytoskeletal proteins. Therefore, ALPN is likely mediated by molecular and signal transduction abnormalities similar to those identified in alcoholic liver and brain degeneration.

  2. Bullying perpetration and victimization as externalizing and internalizing pathways: A retrospective study linking parenting styles and self-esteem to depression, alcohol use, and alcohol-related problems

    Science.gov (United States)

    Patock-Peckham, Julie A; Medina, Mia; Terrell, Nathan; Belton, Daniel; King, Kevin M

    2016-01-01

    Emerging research suggests significant positive associations between bullying and substance use behaviors. However, these studies typically focused either on the link between substance use and bullying perpetration or victimization, and few have conceptualized bullying perpetration and/or victimization as mediators. In this study, we simultaneously tested past bullying perpetration and victimization as mediational pathways from retrospective report of parenting styles and global self-esteem to current depressive symptoms, alcohol use and alcohol-related problems. Data were collected from a college sample of 419 drinkers. Mediation effects were conducted using a bias-corrected bootstrap technique in structural equation modeling. Two-path mediation analyses indicated that mother and father authoritativeness were protective against bully victimization and depression through higher self-esteem. Conversely, having a permissive or authoritarian mother was positively linked to bullying perpetration, which in turn was associated with increased alcohol use, and to a lesser degree, more alcohol-related problems. Mother authoritarianism was associated with alcohol-related problems through depressive symptoms. Three-path mediation analyses suggested a trend in which individuals with higher self-esteem were less likely to report alcohol-related problems through lower levels of bullying victimization and depression. Results suggested that bullying perpetration and victimization may respectively serve as externalizing and internalizing pathways through which parenting styles and self-esteem are linked to depression and alcohol-related outcomes. The present study identified multiple modifiable precursors of, and mediational pathways to, alcohol-related problems which could guide the development and implementation of prevention programs targeting problematic alcohol use. PMID:26757486

  3. Bullying Perpetration and Victimization as Externalizing and Internalizing Pathways: A Retrospective Study Linking Parenting Styles and Self-Esteem to Depression, Alcohol Use, and Alcohol-Related Problems.

    Science.gov (United States)

    Luk, Jeremy W; Patock-Peckham, Julie A; Medina, Mia; Terrell, Nathan; Belton, Daniel; King, Kevin M

    2016-01-02

    Emerging research suggests significant positive associations between bullying and substance use behaviors. However, these studies typically focused either on the link between substance use and bullying perpetration or victimization, and few have conceptualized bullying perpetration and/or victimization as mediators. In this study, we simultaneously tested past bullying perpetration and victimization as mediational pathways from retrospective report of parenting styles and global self-esteem to current depressive symptoms, alcohol use, and alcohol-related problems. Data were collected from a college sample of 419 drinkers. Mediation effects were conducted using a bias-corrected bootstrap technique within a structural equation modeling framework. Two-path mediation analyses indicated that mother and father authoritativeness were protective against bully victimization and depression through higher self-esteem. Conversely, having a permissive or authoritarian mother was positively linked to bullying perpetration, which in turn, was associated with increased alcohol use, and to a lesser degree, more alcohol-related problems. Mother authoritarianism was associated with alcohol-related problems through depressive symptoms. Three-path mediation analyses suggested a trend in which individuals with higher self-esteem were less likely to report alcohol-related problems through lower levels of bullying victimization and depression. Results suggested that bullying perpetration and victimization may, respectively, serve as externalizing and internalizing pathways through which parenting styles and self-esteem are linked to depression and alcohol-related outcomes. The present study identified multiple modifiable precursors of, and mediational pathways to, alcohol-related problems which could guide the development and implementation of prevention programs targeting problematic alcohol use.

  4. Different pathways explain alcohol related problems in female and male college students

    Science.gov (United States)

    Pedrelli, P.; Collado, A.; Shapero, B. G.; Brill, C.; MacPherson, L.

    2016-01-01

    Objectives Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARP) and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs. Results Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males. Conclusions Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption. PMID:27219280

  5. Adolescent alcohol-related risk cognitions: the roles of social norms and social networking sites.

    Science.gov (United States)

    Litt, Dana M; Stock, Michelle L

    2011-12-01

    The present study examined the impact of socially based descriptive norms on willingness to drink alcohol, drinker prototype favorability, affective alcohol attitudes, and perceived vulnerability for alcohol-related consequences within the Prototype Willingness model. Descriptive norms were manipulated by having 189 young adolescents view experimenter-created profile pages from the social networking site Facebook, which either showed older peers drinking or not. The results provided evidence that descriptive norms for alcohol use, as portrayed by Facebook profiles, significantly impact willingness to use, prototypes, attitudes toward use, and perceived vulnerability. A multiple mediation analysis indicated that prototypes, attitudes, and perceptions of use mediated the relationship between the content of the Facebook profile and willingness. These results indicate that adolescents who perceive that alcohol use is normative, as evidenced by Facebook profiles, are at higher risk for cognitions shown to predict alcohol use than adolescents who do not see alcohol use portrayed as frequently on Facebook.

  6. Immune dysfunction in cirrhosis

    Science.gov (United States)

    Sipeki, Nora; Antal-Szalmas, Peter; Lakatos, Peter L; Papp, Maria

    2014-01-01

    Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, is a major component of cirrhosis, and plays a pivotal role in the pathogenesis of both the acute and chronic worsening of liver function. During the evolution of the disease, acute decompensation events associated with organ failure(s), so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and also development of disease specific complications, comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and increased occurrence of systemic bacterial infections have substantial impacts on both clinical situations. Acute and chronic exposure to bacteria and/or their products, however, can result in variable clinical consequences. The immune status of patients is not constant during the illness; consequently, alterations of the balance between pro- and anti-inflammatory processes result in very different dynamic courses. In this review we give a detailed overview of acquired immune dysfunction and its consequences for cirrhosis. We demonstrate the substantial influence of inherited innate immune dysfunction on acute and chronic inflammatory processes in cirrhosis caused by the pre-existing acquired immune dysfunction with limited compensatory mechanisms. Moreover, we highlight the current facts and future perspectives of how the assessment of immune dysfunction can assist clinicians in everyday practical decision-making when establishing treatment and care strategies for the patients with end-stage liver disease. Early and efficient recognition of inappropriate performance of the immune system is essential for overcoming complications, delaying progression and reducing mortality. PMID:24627592

  7. Bile acids and cardiovascular function in cirrhosis

    DEFF Research Database (Denmark)

    Voiosu, Andrei; Wiese, Signe; Voiosu, Theodor

    2017-01-01

    Cirrhotic cardiomyopathy and the hyperdynamic syndrome are clinically important complications of cirrhosis, but their exact pathogenesis is still partly unknown. Experimental models have proven the cardiotoxic effects of bile acids and recent studies of their varied receptor-mediated functions...... offer new insight into their involvement in cardiovascular dysfunction in cirrhosis. Bile acid receptors such as farnesoid X-activated receptor and TGR5 are currently under investigation as potential therapeutic targets in a variety of pathological conditions. These receptors have also recently been...... identified in cardiomyocytes, vascular endothelial cells and smooth muscle cells where they seem to play an important role in cellular metabolism. Chronic cholestasis leading to abnormal levels of circulating bile acids alters the normal signalling pathways and contributes to the development of profound...

  8. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  9. Social impressions while drinking account for the relationship between alcohol-related problems and social anxiety.

    Science.gov (United States)

    Buckner, Julia D; Matthews, Russell A

    2012-04-01

    Individuals with elevated social anxiety appear particularly vulnerable to experiencing alcohol-related problems; yet we know little about factors that may account for this relationship. One possibility is that socially anxious individuals hold beliefs about the impressions they make on others while drinking and these beliefs play an important role in their drinking behaviors. The present study used exploratory factor analysis among participants with clinically elevated social anxiety (n=166) to develop a measure, the Social Impressions while Drinking Scale (SIDS), to assess beliefs regarding others' impressions of drinking behaviors that may be particularly relevant to socially anxious individuals. A valuations scale was also developed to assess the importance of each belief. Empirically-derived subscales were identified with adequate reliability. Among socially anxious participants, the Gregarious and Sexual Facilitation subscales were uniquely related to drinking problems and frequency respectively. Individuals with clinically meaningful social anxiety achieved higher scores on all SIDS subscales compared to those with lower social anxiety (n=166). Several SIDS scales mediated the relations between social anxiety group status and drinking problems (Interaction Fears, Observation Fears, Aggression, Gregariousness). Results highlight the importance of examining beliefs specific to high-risk populations in assessing their alcohol-related behaviors. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Physiologic and laboratory correlates of depression, anxiety, and poor sleep in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Ko Fang-Yuan

    2013-01-01

    Full Text Available Abstract Background Studies have shown psychological distress in patients with cirrhosis, yet no studies have evaluated the laboratory and physiologic correlates of psychological symptoms in cirrhosis. This study therefore measured both biochemistry data and heart rate variability (HRV analyses, and aimed to identify the physiologic correlates of depression, anxiety, and poor sleep in cirrhosis. Methods A total of 125 patients with cirrhosis and 55 healthy subjects were recruited. Each subject was assessed through routine biochemistry, 5-minutes ECG monitoring, and psychological ratings of depression, anxiety, and sleep. HRV analysis were used to evaluate autonomic functions. The relationship between depression, sleep, and physiologic correlates was assessed using a multiple regression analysis and stepwise method, controlling for age, duration of illness, and severity of cirrhosis. Results Reduced vagal-related HRV was found in patients with severe liver cirrhosis. Severity of cirrhosis measured by the Child-Pugh score was not correlated with depression or anxiety, and only had a weak correlation with poor sleep. The psychological distress in cirrhosis such as depression, anxiety, and insomnia were correlated specifically to increased levels of aspartate aminotransferase (AST, increased ratios of low frequency to high frequency power, or reduced nonlinear properties of HRV (α1 exponent of detrended fluctuation analysis. Conclusions Increased serum AST and abnormal autonomic nervous activities by HRV analysis were associated with psychological distress in cirrhosis. Because AST is an important mediator of inflammatory process, further research is needed to delineate the role of inflammation in the cirrhosis comorbid with depression.

  11. Hepatorenal syndrome in cirrhosis

    DEFF Research Database (Denmark)

    Busk, Troels M; Bendtsen, Flemming; Møller, Søren

    2016-01-01

    , diagnosis, including biomarkers, and pathophysiology, will also be covered through a comprehensive, critical reading of the latest literature, encompassing the most recent, updated, international guidelines, reviews and high-impact original literature. Expert commentary: The advances made...... in the understanding of the pathophysiology of HRS and other complications of cirrhosis within the recent decades, have provided the basis for improved diagnostic criteria and the development of treatments that have substantially increased survival rates in cirrhotic patients suffering from these conditions. Focus...... should, in the nearest future, be on continuing this positive development, thus further improving prognosis for cirrhotic patients with HRS....

  12. Periodontal disease and liver cirrhosis

    DEFF Research Database (Denmark)

    Grønkjær, Lea Ladegaard

    2015-01-01

    and liver cirrhosis and to identify opportunities and directions for future research in this area. METHODS: A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral...

  13. Methotrexate for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Giljaca, Vanja; Poropat, Goran; Stimac, Davor

    2010-01-01

    Methotrexate has been used to treat patients with primary biliary cirrhosis as it possesses immunosuppressive properties. The previously prepared version of this review from 2005 showed that methotrexate seemed to significantly increase mortality in patients with primary biliary cirrhosis. Since...... that last review version, follow-up data of the included trials have been published....

  14. Psychiatric morbidity in spouses of patients with alcohol related disorders

    Directory of Open Access Journals (Sweden)

    Aruna Dandu

    2017-01-01

    Full Text Available Context: Alcohol dependence is on rise world over, especially in developing countries such as India. According to the World Health Organization, about 30% of Indians consume alcohol, out of which 4%–13% are daily consumers and up to 50% of them, fall under the category of hazardous drinking. Another worrying trend from India is that the average age of initiation of alcohol use has reduced from 28 years during the 1980s to 17 years in 2007. In India, alcohol abuse also amounts to huge annual losses due to alcohol-related problems in workplaces. This was a cross-sectional, noninterventional study which was carried out at the Department of Psychiatry, Sri Venkateswara Ramnaraian Ruia Government General Hospital (SVRRGGH, Tirupati, Andhra Pradesh. Aim: The aim of this study was to determine the frequency and nature of psychiatric morbidity in spouses of patients with alcohol-related disorders (ARDs. Methods: Study design - Hospital-based cross-sectional study. Study setting - Psychiatry Department of SVRRGGH, Sri Venkateswara Medical College, Tirupati. Study period - October 1, 2014 to September 30, 2015. Study units - the spouses of adult patients attending the Department of Psychiatry, with a diagnosis of ARDs. After the ethical clearance from the Institutional Ethical Committee, the spouses of adult patients attending the Department of Psychiatry with a diagnosis of ARDs according to the International Classification of Diseases-10 classification of mental and behavioral disorders constitute the population for the investigation. After obtaining written informed consent from each of the concerned subjects, demographic details and history of psychiatric illness were noted as per the structured pro forma. Results: The age of the alcohol-dependent men and spouses of men with ADS ranged from 23 to 67 years (mean ± standard deviation [SD] 41.24 ± 10.101 and 21–60 years (mean ± SD 35.04 ± 8.98, respectively. Among the study population, 36.6% of

  15. Violence- and alcohol-related acute healthcare visits in Greenland

    DEFF Research Database (Denmark)

    Nexøe, Jørgen; Wilche, Julie Præst; Niclasen, Birgit

    2013-01-01

    for presentation were mental or social problems, attempted suicide, accidents, or violence, 24, 50, 15, and 59% respectively were intoxicated. Alcohol intoxication was statistically significantly more often associated with advanced treatment (e.g. evacuation, hospitalisation, or follow up by doctor or nurse...... by simple means. Methods: Registration of all emergencies presented in 15 out of 17 of Greenland's health districts in the period 21 May to 7 June 2010. Results: In the 17-day registration period, 2403 emergencies were registered. In 10% of cases the patients were clinically alcohol intoxicated. When reason......). Conclusions: This study confirms that violence- and alcohol-related emergencies put a considerable strain on Greenland's healthcare system. Due to the short observation period, we have not been able to describe the actual extent of the problem in detail, nor was it possible to estimate whether this problem...

  16. Energy drinks and alcohol-related risk among young adults.

    Science.gov (United States)

    Caviness, Celeste M; Anderson, Bradley J; Stein, Michael D

    2017-01-01

    Energy drink consumption, with or without concurrent alcohol use, is common among young adults. This study sought to clarify risk for negative alcohol outcomes related to the timing of energy drink use. The authors interviewed a community sample of 481 young adults, aged 18-25, who drank alcohol in the last month. Past-30-day energy drink use was operationalized as no-use, use without concurrent alcohol, and concurrent use of energy drinks with alcohol ("within a couple of hours"). Negative alcohol outcomes included past-30-day binge drinking, past-30-day alcohol use disorder, and drinking-related consequences. Just over half (50.5%) reported no use of energy drinks,18.3% reported using energy drinks without concurrent alcohol use, and 31.2% reported concurrent use of energy drinks and alcohol. Relative to those who reported concurrent use of energy drinks with alcohol, and controlling for background characteristics and frequency of alcohol consumption, those who didn't use energy drinks and those who used without concurrent alcohol use had significantly lower binge drinking, negative consequences, and rates of alcohol use disorder (P energy drink without concurrent alcohol groups on any alcohol-related measure (P > .10 for all outcomes). Concurrent energy drink and alcohol use is associated with increased risk for negative alcohol consequences in young adults. Clinicians providing care to young adults could consider asking patients about concurrent energy drink and alcohol use as a way to begin a conversation about risky alcohol consumption while addressing 2 substances commonly used by this population.

  17. New vasoactive peptides in cirrhosis

    DEFF Research Database (Denmark)

    Kimer, Nina; Goetze, Jens Peter; Bendtsen, Flemming

    2014-01-01

    BACKGROUND: Patients with cirrhosis have substantial circulatory imbalance between vasoconstrictive and vasodilating forces. The study of circulatory vasoactive peptides may provide important pathophysiological information. This study aimed to assess concentrations, organ extraction and relations...... to haemodynamic changes in the pro-peptides copeptin, proadrenomedullin and pro-atrial natriuretic peptide (proANP) in patients with cirrhosis. MATERIALS AND METHODS: Fifty-four cirrhotic patients and 15 controls were characterized haemodynamically during a liver vein catheterization. Copeptin, proadrenomedullin...... pressure (R=0·32, P0·31, Ppeptide is elevated in cirrhosis. Copeptin, proadrenomedullin and proANP are related to portal pressure and seem associated with systemic haemodynamics. These propeptides may...

  18. Impaired Follistatin Secretion in Cirrhosis

    DEFF Research Database (Denmark)

    Rinnov, Anders Rasmussen; Plomgaard, Peter; Pedersen, Bente Klarlund

    2016-01-01

    compared to healthy control participants. DESIGN, SETTING, AND PARTICIPANTS: To experimentally increase the glucagon-insulin ratio (mimicking the hormonal effect of exercise), we infused glucagon/somatostatin (to inhibit insulin secretion) and compared the acute follistatin increase in eight male cirrhosis...... controls (27.6 ± 3.8 vs 34.5 ± 2.9%, respectively; P = .001). CONCLUSIONS: Patients with cirrhosis show impaired capacity to acutely secrete follistatin. The decrease in acute follistatin release may contribute to the loss of muscle mass in liver cirrhosis....

  19. Impaired Insulin/IGF Signaling in Experimental Alcohol-Related Myopathy

    Directory of Open Access Journals (Sweden)

    Elizabeth Silbermann

    2012-08-01

    Full Text Available Alcohol-related myopathy (Alc-M is highly prevalent among heavy drinkers, although its pathogenesis is not well understood. We hypothesize that Alc-M is mediated by combined effects of insulin/IGF resistance and oxidative stress, similar to the effects of ethanol on liver and brain. We tested this hypothesis using an established model in which adult rats were pair-fed for 8 weeks with isocaloric diets containing 0% (N = 8 or 35.5% (N = 13 ethanol by caloric content. Gastrocnemius muscles were examined by histology, morphometrics, qRT-PCR analysis, and ELISAs. Chronic ethanol feeding reduced myofiber size and mRNA expression of IGF-1 polypeptide, insulin, IGF-1, and IGF-2 receptors, IRS-1, and IRS-2. Multiplex ELISAs demonstrated ethanol-associated inhibition of insulin, IRS-1, Akt, and p70S6K signaling, and increased activation of GSK-3β. In addition, ethanol-exposed muscles had increased 4-hydroxy-2-nonenal immunoreactivity, reflecting lipid peroxidation, and reduced levels of mitochondrial Complex IV, Complex V, and acetylcholinesterase. These results demonstrate that experimental Alc-M is associated with inhibition of insulin/IGF/IRS and downstream signaling that mediates metabolism and cell survival, similar to findings in alcoholic liver and brain degeneration. Moreover, the increased oxidative stress, which could be mediated by mitochondrial dysfunction, may have led to inhibition of acetylcholinesterase, which itself is sufficient to cause myofiber atrophy and degeneration.

  20. Parents know best, but are they accurate? Parental normative misperceptions and their relationship to students' alcohol-related outcomes.

    Science.gov (United States)

    LaBrie, Joseph W; Hummer, Justin F; Lac, Andrew; Ehret, Phillip J; Kenney, Shannon R

    2011-07-01

    Parents often look to other parents for guidance, but how accurate are their perceptions? Expanding on existing normative literature to include parents of college students, this study first sought to determine whether parents accurately estimated the attitudes of other parents concerning their college student's alcohol-related behaviors. The effect of these (mis)perceived injunctive norms on the alcohol-related attitudes and behaviors of the parents' own children was then examined. Participants were 270 college student-parent dyadic pairs who completed independent online surveys. The student sample was 59% female; the parent sample was 78% female. A structural equation model demonstrated that parents significantly overestimated other parents' approval of alcohol use by their respective child and, further, that these misperceptions strongly influenced parental attitudes toward their own child's drinking. Parental attitudes were subsequently found to be significantly associated with their child's attitudes toward drinking but were only marginally associated with the child's actual drinking, thereby underscoring the mediational effect of the child's attitudes. This is the first study to document the influence of parental normative misperceptions regarding alcohol use by their college-age children, reinforcing the importance of parental attitudes on children's alcohol-related attitudes and behaviors in college. These findings support the need to complement student-based interventions with parent-based interventions aimed at increasing parental awareness and involvement. Further, the current findings indicate that normative interventions targeting parents offer a promising avenue by which to indirectly and positively influence college students' alcohol use.

  1. Direct and indirect links between parenting styles, self-concealment (secrets), impaired control over drinking and alcohol-related outcomes.

    Science.gov (United States)

    Hartman, Jessica D; Patock-Peckham, Julie A; Corbin, William R; Gates, Jonathan R; Leeman, Robert F; Luk, Jeremy W; King, Kevin M

    2015-01-01

    Self-concealment reflects uncomfortable feelings, thoughts, and information people have about themselves that they avoid telling others (Larson & Chastain, 1990). According to Larson and Chastain (1990) these secrets range from the slightly embarrassing to the very distressing with an individual's most traumatic experiences often concealed. Parental attitudes including those involving self-disclosure are thought to be expressed in their choice of parenting style (Brand, Hatzinger, Beck, & Holsboer-Trachsler, 2009). The specific aim of this investigation was to examine the direct and indirect influences of parenting styles on self-concealment, impaired control over drinking (i.e. the inability to stop drinking when intended), alcohol use (quantity/frequency), and alcohol-related problems. A structural equation model with 419 (223 men, 196 women) university students was examined. Two and three path mediated effects were examined with the bias corrected bootstrap technique in Mplus. Having an authoritarian mother was directly linked to more self-concealment, while having an authoritative father was directly linked to less self-concealment. Higher levels of mother authoritarianism were indirectly linked to both increased alcohol use and alcohol-related problems through more self-concealment and more impaired control over drinking. Moreover, higher levels of father authoritativeness were indirectly linked to less alcohol use and alcohol-related problems through less self-concealment and less impaired control over drinking. These findings suggest that parenting styles influence vulnerabilities such as self-concealment in the impaired control over the drinking pathway to alcohol use and alcohol-related problems. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren

    2006-01-01

    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...

  3. Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences

    OpenAIRE

    Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. METHODS: In the present study, 573 undergraduate students (M(age) = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) ...

  4. Meta-Analysis of the Association of Alcohol-Related Social Media Use with Alcohol Consumption and Alcohol-Related Problems in Adolescents and Young Adults.

    Science.gov (United States)

    Curtis, Brenda L; Lookatch, Samantha J; Ramo, Danielle E; McKay, James R; Feinn, Richard S; Kranzler, Henry R

    2018-06-01

    Despite the pervasive use of social media by young adults, there is comparatively little known about whether, and how, engagement in social media influences this group's drinking patterns and risk of alcohol-related problems. We examined the relations between young adults' alcohol-related social media engagement (defined as the posting, liking, commenting, and viewing of alcohol-related social media content) and their drinking behavior and problems. We conducted a systematic review and meta-analysis of studies evaluating the association of alcohol consumption and alcohol-related problems with alcohol-related social media engagement. Summary baseline variables regarding the social media platform used (e.g., Facebook and Twitter), social media measures assessed (e.g., number of alcohol photographs posted), alcohol measures (e.g., Alcohol Use Disorders Identification Test and Timeline Follow back Interview), and the number of time points at which data were collected were extracted from each published study. We used the Q statistic to examine heterogeneity in the correlations between alcohol-related social media engagement and both drinking behavior and alcohol-related problems. Because there was significant heterogeneity, we used a random-effects model to evaluate the difference from zero of the weighted aggregate correlations. We used metaregression with study characteristics as moderators to test for moderators of the observed heterogeneity. Following screening, 19 articles met inclusion criteria for the meta-analysis. The primary findings indicated a statistically significant relationship and moderate effect sizes between alcohol-related social media engagement and both alcohol consumption (r = 0.36, 95% CI: 0.29 to 0.44, p social media engagement and drinking behavior or these were measured on different occasions and (ii) whether measurements were taken by self-report or observation of social media engagement. We found moderate-sized effects across the 19

  5. Alcohol-Related Blackouts, Negative Alcohol-Related Consequences, and Motivations for Drinking Reported by Newly Matriculating Transgender College Students.

    Science.gov (United States)

    Tupler, Larry A; Zapp, Daniel; DeJong, William; Ali, Maryam; O'Rourke, Sarah; Looney, John; Swartzwelder, H Scott

    2017-05-01

    Many transgender college students struggle with identity formation and other emotional, social, and developmental challenges associated with emerging adulthood. A potential maladaptive coping strategy employed by such students is heavy drinking. Prior literature has suggested greater consumption and negative alcohol-related consequences (ARCs) in transgender students compared with their cisgender peers, but little is known about their differing experiences with alcohol-related blackouts (ARBs). We examined the level of alcohol consumption, the frequency of ARBs and other ARCs, and motivations for drinking reported by the largest sample of transgender college students to date. A Web survey from an alcohol-prevention program, AlcoholEdu for College™, assessed student demographics and drinking-related behaviors, experiences, and motivations of newly matriculating first-year college students. A self-reported drinking calendar was used to examine each of the following measures over the previous 14 days: number of drinking days, total number of drinks, and maximum number of drinks on any single day. A 7-point Likert scale was used to measure ARCs, ARBs, and drinking motivations. Transgender students of both sexes were compared with their cisgender peers. A total of 989 of 422,906 students (0.2%) identified as transgender. Over a 14-day period, transgender compared with cisgender students were more likely to consume alcohol over more days, more total drinks, and a greater number of maximum drinks on a single day. Transgender students (36%) were more likely to report an ARB than cisgender students (25%) as well as more negative academic, confrontation-related, social, and sexual ARCs. Transgender respondents more often cited stress reduction, social anxiety, self-esteem issues, and the inherent properties of alcohol as motivations for drinking. For nearly all measures, higher values were yielded by male-to-female than female-to-male transgender students. Transgender

  6. A cultural and social cognitive model of differences in acculturation orientations, alcohol expectancies, and alcohol-related risk behaviors among Hispanic college students.

    Science.gov (United States)

    Des Rosiers, Sabrina E; Schwartz, Seth J; Zamboanga, Byron L; Ham, Lindsay S; Huang, Shi

    2013-04-01

    The present study used a cultural and social cognitive conceptual framework to investigate whether alcohol expectancies and valuations would mediate the associations between specific acculturation orientations and alcohol-related risk behaviors. The sample comprised 1,527 Hispanic students attending colleges and universities in diverse regions of the United States. Respondents completed self-report measures of Hispanic and American cultural practices; alcohol expectancies and valuations; and self-reported frequency of hazardous alcohol use, binge drinking, sexual activity under the influence of alcohol, driving under the influence of alcohol, and riding with a drunk driver. Latent class analysis was used to classify participants into acculturation orientations. Results indicated that acculturation orientations were differentially associated with alcohol-related risk outcomes, with separated bicultural and low bicultural orientations inversely related to all of the alcohol-related risk behaviors except for riding with a drunk driver. Negative expectancy valuations were positively associated with endorsement of binge drinking and drunk driving and negative expectancies were negatively associated with binge drinking, drunk driving, and riding with a drunk driver. With the exception of sexual activity under the influence of alcohol, the associations between acculturation orientations and alcohol-related risk behaviors were partially mediated by positive alcohol expectancies. Our findings provided relevant data that are informative for preventing alcohol and related risk behaviors among Hispanic college students. © 2012 Wiley Periodicals, Inc.

  7. Different digital paths to the keg? How exposure to peers' alcohol-related social media content influences drinking among male and female first-year college students.

    Science.gov (United States)

    Boyle, Sarah C; LaBrie, Joseph W; Froidevaux, Nicole M; Witkovic, Yong D

    2016-06-01

    Despite speculation that peers' alcohol-related content on social media sites (SMS) may influence the alcohol use behaviors of SMS frequenting college students, this relationship has not been investigated longitudinally. The current prospective study assesses the relationship between exposure to peers' alcohol-related SMS content and later-drinking among first-year college students. Among 408 first-year students, total exposure to peers' alcohol-related content on Facebook, Instagram, and Snapchat during the initial 6 weeks of college predicted alcohol consumption 6 months later. The rather robust relationship persisted even after students' and close friends drinking were accounted for, indicating that alcohol references on SMS do not simply reflect alcohol use behaviors that would otherwise be observed in the absence of SMS and be predictive of later alcohol use. Findings also illuminate important gender differences in the degree to which peers' alcohol-related SMS content influenced later drinking behavior as well as psychological mediators of this relationship. Among females, enhancement drinking motives and beliefs about the role of alcohol in the college experience fully mediated the relationship between SMS alcohol exposure and later drinking. Males, however, evidenced a much stronger predictive relationship between SMS alcohol exposure and second semester drinking, with this relationship only partially explained by perceptions of drinking norms, enhancement drinking motives, and beliefs about the role of alcohol in the college experience. Implications of these findings for college drinking prevention efforts and directions for future research are discussed. Copyright © 2016. Published by Elsevier Ltd.

  8. Different digital paths to the keg? How exposure to peers’ alcohol-related social media content influences drinking among male and female first-year college students

    Science.gov (United States)

    Boyle, Sarah C.; LaBrie, Joseph W.; Froidevaux, Nicole M.; Witkovic, Yong D.

    2016-01-01

    Despite speculation that peers’ alcohol-related content on social media sites (SMS) may influence the alcohol use behaviors of SMS frequenting college students, this relationship has not been investigated longitudinally. The current prospective study assesses the relationship between exposure to peers’ alcohol-related SMS content and later-drinking among first-year college students. Among 408 first-year students, total exposure to peers’ alcohol-related content on Facebook, Instagram, and Snapchat during the initial 6 weeks of college predicted alcohol consumption 6 months later. The rather robust relationship persisted even after students’ and close friends drinking were accounted for, indicating that alcohol references on SMS do not simply reflect alcohol use behaviors that would otherwise be observed in the absence of SMS and be predictive of later alcohol use. Findings also illuminate important gender differences in the degree to which peers’ alcohol-related SMS content influenced later drinking behavior as well as psychological mediators of this relationship. Among females, enhancement drinking motives and beliefs about the role of alcohol in the college experience fully mediated the relationship between SMS alcohol exposure and later drinking. Males, however, evidenced a much stronger predictive relationship between SMS alcohol exposure and second semester drinking, with this relationship only partially explained by perceptions of drinking norms, enhancement drinking motives, and beliefs about the role of alcohol in the college experience. Implications of these findings for college drinking prevention efforts and directions for future research are discussed. PMID:26835604

  9. Clinical profile of patients with nascent alcohol related seizures

    Directory of Open Access Journals (Sweden)

    P Sandeep

    2013-01-01

    Full Text Available Aim: The aim of this study is to characterize the clinical profile of patients with alcohol related seizures (ARS and to identify the prevalence of idiopathic generalized epilepsy (IGE in the same. Materials and Methods: 100 consecutive male patients presenting to a tertiary care center in South India with new onset ARS were analyzed with alcohol use disorders identification test (AUDIT score. All underwent 19 channel digital scalp electroencephalography (EEG and at least computed tomography (CT scan. Results: A total of 27 patients (27% who had cortical atrophy on CT had a mean duration of alcohol intake of 23.62 years compared with 14.55 years in patients with no cortical atrophy (P < 0.001. Twenty-two patients (22% had clustering in the current episode of whom 18 had cortical atrophy. Nearly, 88% patients had generalized tonic clonic seizures while 12% who had partial seizures underwent magnetic resonance imaging (MRI, which identified frontal focal cortical dysplasia in one. Mean lifetime duration of alcohol intake in patients presenting with seizures within 6 hours (6H-gp of intake of alcohol was significantly lower (P = 0.029. One patient in the 6H-gp with no withdrawal symptoms had EEG evidence for IGE and had a lower AUDIT score compared with the rest. Conclusion: CT evidence of cortical atrophy is related to the duration of alcohol intake and portends an increased risk for clustering. Partial seizures can be a presenting feature of ARS and those patients may benefit from MRI to identify underlying symptomatic localization related epilepsy (8.3% of partial seizures. IGE is more likely in patients presenting with ARS within first 6 hours especially if they do not have alcohol withdrawal symptoms and scalp EEG is helpful to identify this small subgroup (~1% who may require long-term anti-epileptic medication.

  10. Skin Immunization Obviates Alcohol-Related Immune Dysfunction

    Directory of Open Access Journals (Sweden)

    Rhonda M. Brand

    2015-11-01

    Full Text Available Alcoholics suffer from immune dysfunction that can impede vaccine efficacy. If ethanol (EtOH-induced immune impairment is in part a result of direct exposure of immune cells to EtOH, then reduced levels of exposure could result in less immune dysfunction. As alcohol ingestion results in lower alcohol levels in skin than blood, we hypothesized that the skin immune network may be relatively preserved, enabling skin-targeted immunizations to obviate the immune inhibitory effects of alcohol consumption on conventional vaccines. We employed the two most common chronic EtOH mouse feeding models, the liver-damaging Lieber-DeCarli (LD and liver-sparing Meadows-Cook (MC diets, to examine the roles of EtOH and/or EtOH-induced liver dysfunction on alcohol related immunosuppression. Pair-fed mice were immunized against the model antigen ovalbumin (OVA by DNA immunization or against flu by administering the protein-based influenza vaccine either systemically (IV, IM, directly to liver (hydrodynamic, or cutaneously (biolistic, ID. We measured resulting tissue EtOH levels, liver stress, regulatory T cell (Treg, and myeloid-derived suppressor cell (MDSC populations. We compared immune responsiveness by measuring delayed-type hypersensitivity (DTH, antigen-specific cytotoxic T lymphocyte (CTL, and antibody induction as a function of delivery route and feeding model. We found that, as expected, and independent of the feeding model, EtOH ingestion inhibits DTH, CTL lysis, and antigen-specific total IgG induced by traditional systemic vaccines. On the other hand, skin-targeted vaccines were equally immunogenic in alcohol-exposed and non-exposed subjects, suggesting that cutaneous immunization may result in more efficacious vaccination in alcohol-ingesting subjects.

  11. Seasonality of alcohol-related phenomena in Estonia

    Science.gov (United States)

    Silm, Siiri; Ahas, Rein

    2005-03-01

    We studied alcohol consumption and its consequences as a seasonal phenomenon in Estonia and analysed the social and environmental factors that may cause its seasonal rhythm. There are two important questions when researching the seasonality of human activities: (1) whether it is caused by natural or social factors, and (2) whether the impact of the factors is direct or indirect. Often the seasonality of social phenomena is caused by social factors, but the triggering mechanisms are related to environmental factors like temperature, precipitation, and radiation via the circannual calendar. The indicators of alcohol consumption in the current paper are grouped as: (1) pre-consumption phenomena, i.e. production, tax and excise, sales (beer, wine and vodka are analysed separately), and (2) post-consumption phenomena, i.e. alcohol-related crime and traffic accidents and the number of people detained in lockups and admitted to alcohol treatment clinics. In addition, seasonal variability in the amount of alcohol advertising has been studied, and a survey has been carried out among 87 students of Tartu University. The analysis shows that different phenomena related to alcohol have a clear seasonal rhythm in Estonia. The peak period of phenomena related to beer is in the summer, from June to August and the low point is during the first months of the year. Beer consumption correlates well with air temperature. The consumption of vodka increases sharply at the end of the year and in June; the production of vodka does not have a significant correlation with negative temperatures. The consumption of wine increases during summer and in December. The consequences of alcohol consumption, expressed as the rate of traffic accidents or the frequency of medical treatment, also show seasonal variability. Seasonal variability of alcohol consumption in Estonia is influenced by natural factors (temperature, humidity, etc.) and by social factors (celebrations, vacations, etc.). However

  12. Alcohol-Related Posts from Young People on Social Networking Sites : Content and Motivations

    NARCIS (Netherlands)

    Hendriks, H.; Gebhardt, W.A.; van den Putte, B.

    Many young people place alcohol-related posts on social networking sites (SNS) which can result in undesirable effects. Although several recent studies have investigated the occurrence of alcohol-related SNS use, it is neither clear (a) what type of alcohol posts are placed on SNS, (b) the

  13. Alcohol-related presentations to emergency departments in Ireland: a descriptive prevalence study

    LENUS (Irish Health Repository)

    McNicholl, Brian

    2018-05-24

    To determine the prevalence of alcohol-related presentations in all 29 emergency departments (EDs) in Ireland and compare with non-alcohol-related presentations in order to identify opportunities for improvements in the quality of patient care and related data collection.

  14. 'Getting into the spirit': Alcohol-related interpretation bias in heavy-drinking students

    NARCIS (Netherlands)

    Woud, M.L.; Fitzgerald, D.A.; Wiers, R.W.; Rinck, M.; Becker, E.S.

    2012-01-01

    Alcohol misuse is characterized by patterns of selective information processing. The present study investigated whether heavy- compared with light-drinking students, show evidence of an alcohol-related interpretation bias to ambiguous, alcohol-related cues. Toward this aim, participants were asked

  15. Subjective Evaluations of Alcohol-Related Consequences among College Students: Experience with Consequences Matters

    Science.gov (United States)

    Leavens, Eleanor L.; Leffingwell, Thad R.; Miller, Mary Beth; Brett, Emma I.; Lombardi, Nathaniel

    2017-01-01

    Objective: Research suggests college students rate some alcohol-related consequences less negatively than others, yet it is unclear how or when these differences in perception develop. The current study compared college students' subjective evaluations of alcohol-related consequences that they had and had not experienced in order to test the…

  16. Alcohol-Related Consequences among Intercollegiate Student Athletes: The Role of Drinking Motives

    Science.gov (United States)

    Doumas, Diana M.

    2013-01-01

    This study examined drinking motives as predictors of alcohol-related consequences among student athletes and nonathletes. Results indicated that the highest level of alcohol-related consequences was reported by student athletes with high levels of both coping and conformity motives. (Contains 2 tables and 2 figures.)

  17. Social anxiety and alcohol-related sexual victimization: A longitudinal pilot study of college women.

    Science.gov (United States)

    Schry, Amie R; Maddox, Brenna B; White, Susan W

    2016-10-01

    We sought to examine social anxiety as a risk factor for alcohol-related sexual victimization among college women. Women (Time 1: n = 574; Time 2: n = 88) who reported consuming alcohol at least once during the assessment timeframe participated. Social anxiety, alcohol use, alcohol-related consequences, and sexual victimization were assessed twice, approximately two months apart. Logistic regressions were used to examine social anxiety as a risk factor for alcohol-related sexual victimization at both time points. Longitudinally, women high in social anxiety were approximately three times more likely to endorse unwanted alcohol-related sexual experiences compared to women with low to moderate social anxiety. This study suggests social anxiety, a modifiable construct, increases risk for alcohol-related sexual victimization among college women. Implications for clinicians and risk-reduction program developers are discussed. Published by Elsevier Ltd.

  18. Emotional reactions to alcohol-related words: Differences between low- and high-risk drinkers.

    Science.gov (United States)

    Gantiva, Carlos; Delgado, Rafael; Romo-González, Tania

    2015-11-01

    Research that has examined responses to alcohol-related words in drinkers has mostly linked such responses to memory, attentional, and perceptual bias. However, studies of emotional processing in alcoholics have not received much attention. The main goal of the present study was to identify the features and differences of emotional responses to alcohol-related words in low- and high-risk drinkers. A total of 149 low-risk drinkers and 125 high-risk drinkers evaluated five alcohol-related words and 15 words from the Affective Norms for English Words in the dimensions of valence, arousal, and dominance using the Self-Assessment Manikin. The results indicated that high-risk drinkers evaluated alcohol-related words as more appetitive and arousing. These results, together with findings in the attention and memory research literature, suggest that alcohol-related words can serve as conditioned cues in alcohol consumption. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Sharing of Alcohol-Related Content on Social Networking Sites: Frequency, Content, and Correlates.

    Science.gov (United States)

    Erevik, Eilin K; Torsheim, Torbjørn; Vedaa, Øystein; Andreassen, Cecilie S; Pallesen, Ståle

    2017-05-01

    The present study aimed to explore students' reports of their sharing of alcohol-related content on different social networking sites (i.e., frequency of sharing and connotations of alcohol-related posts), and to identify indicators of such posting. Students at the four largest institutions for higher education in Bergen, Norway, were invited to participate in an Internet-based survey. The sample size was 11,236 (a 39.4% response rate). The survey included questions about disclosure of alcohol-related content on social networking sites, alcohol use (using the Alcohol Use Disorders Identification Test), personality factors (using the Mini-IPIP), and demographic characteristics. Binary logistic regressions were used to analyze indicators of frequent sharing of alcohol-related content depicting positive and negative aspects of alcohol use. A majority of the students had posted alcohol-related content (71.0%), although few reported having done so frequently. Positive aspects of alcohol use (e.g., enjoyment or social community) were most frequently shared. Young, single, and extroverted students with high alcohol consumption were more likely to report frequent sharing of alcohol-related content. Positive attitudes toward posting alcohol-related content and reports of exposure to such content particularly increased the likelihood of one's own posting of alcohol-related content. Positive aspects of alcohol use seem to be emphasized on social networking sites. Sharing of alcohol-related content is associated with heightened alcohol use, which implies that such sites can be relevant for prevention agents. Social influence from social networking sites, such as exposure to others' alcohol-related content, is associated with one's own sharing of similar content.

  20. Autonomic dysfunction in cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Dümcke, Christine Winkler; Møller, Søren

    2008-01-01

    Liver cirrhosis and portal hypertension are frequently associated with signs of circulatory dysfunction and peripheral polyneuropathy, which includes defects of the autonomic nervous system. Autonomic dysfunction, which is seen in both alcoholic and non-alcoholic liver cirrhosis and increases...

  1. Muscle GLUT4 in cirrhosis

    DEFF Research Database (Denmark)

    Holland-Fischer, Peter; Andersen, Per Heden; Lund, Sten

    2007-01-01

    test and later a muscle biopsy. Levels of GLUT4 total protein and mRNA content were determined in muscle biopsies by polyclonal antibody labelling and RT-PCR, respectively. RESULTS: GLUT4 protein content in the cirrhosis group was not different from that of the controls, but at variance......: In cirrhosis GLUT4 protein content was quantitatively intact, while limiting glucose tolerance. This indicates loss of redundancy of the major glucose transport system, possibly related to the markedly decreased expression of its gene. Hyper-insulinemia may be a primary event. Our findings implicate...

  2. An Unusual Case of Cirrhosis

    Directory of Open Access Journals (Sweden)

    Ahmad Alkaddour

    2014-01-01

    Full Text Available 49-year-old white female with remote h/o sarcoidosis was referred to GI when her liver was noted to be nodular. Physical examination revealed normal vital signs and no icterus, spider nevi, clubbing, ascites, hepatosplenomegaly, or ankle edema. LFTs, hepatitis serologies, ANA, AMA, ASMA, Ferritin, Ceruloplasmin, and α1-AT, level were unremarkable. Liver biopsy showed cirrhosis. She developed worsening of baseline SOB and was hospitalized. She was eventually diagnosed with constrictive pericarditis. A diagnosis of cardiac cirrhosis was made.

  3. Smoking and risk of liver cirrhosis

    DEFF Research Database (Denmark)

    Dam, Marie Kamstrup; Flensborg-Madsen, Trine; Eliasen, Marie

    2013-01-01

    Alcohol is the most acknowledged risk factor for liver cirrhosis. Smoking is rarely considered to be a cause of liver cirrhosis even though a few studies have suggested the opposite. The aim of this study was to assess the independent effect of smoking on alcoholic liver cirrhosis and liver...

  4. A community-based intervention to reduce alcohol-related accidents and violence in 9th grade students in southern Sweden: the example of the Trelleborg project.

    Science.gov (United States)

    Stafström, Martin; Ostergren, Per-Olof

    2008-05-01

    The purpose of the present study was to analyse if a community-based intervention has led to a decrease in alcohol-related accidents and violence, and whether this was mediated by a reduction in excessive drinking and frequency of distilled spirits consumption. We applied logistic regression analyses on cross-sectional, non-repeated data, which was collected from a questionnaire distributed in classrooms to all 9th graders from 1999 to 2001, and in 2003 (n=1376, 724 boys and 652 girls; response rate=92.3%). All alcohol abstainers (n=330) were excluded from the analyses, making the sample 1046 individuals. The odds ratio for alcohol-related accidents was significantly lower, comparing the baseline year (1999) with 2003 (OR 0.5, 95% CI 0.27-0.76). There was also an indication that self-reported alcohol-related violence had decreased between 1999 and 2003 (OR 0.7, 95% CI 0.43-1.01). When controlling these estimates for excessive drinking and frequency of distilled spirits consumption, the differences between survey years were substantially reduced or even deleted. In conclusion, the decrease in alcohol-related accidents and violence among 15-16-year-olds in Trelleborg, between 1999 and 2002, is likely to be attributed to the identified reduction in excessive drinking and frequency of distilled spirits consumption.

  5. Antidepressant sales and the risk for alcohol-related and non-alcohol-related suicide in Finland--an individual-level population study.

    Science.gov (United States)

    Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

    2014-01-01

    A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly

  6. Fatal alcohol-related traffic crashes increase subsequent to changes to and from daylight savings time.

    Science.gov (United States)

    Hicks, G J; Davis, J W; Hicks, R A

    1998-06-01

    On the hypothesis that sleepiness and alcohol interact to increase the risk of alcohol-related traffic fatalities, the percentages of alcohol-related fatal traffic crashes were assessed for the entire state of New Mexico for the years 1989-1992, for each of the seven days that preceded the changes to and from Daylight Savings Time and for each of the 14 days which followed the changes to and from Daylight Savings Time. Consistent with our hypothesis the percentage of alcohol-related fatal crashes increased significantly during the first seven days after these changes in Daylight Savings Time.

  7. Management options in decompensated cirrhosis

    Directory of Open Access Journals (Sweden)

    Shah NL

    2015-07-01

    Full Text Available Neeral L Shah,1 Yasmin Pourkazemi Banaei,2 Kristen L Hojnowski,2 Scott L Cornella3 1Division of Gastroenterology and Hepatology, 2School of Medicine, 3Department of Medicine, University of Virginia, Charlottesville, VA, USA Abstract: Chronic injury to the liver from a variety of different sources can result in irreversible scarring of the liver, known as cirrhosis. Cirrhosis is a major cause of morbidity and mortality in the USA, and according to the Centers for Disease Control and Prevention was responsible for 31,903 deaths in 2010 alone. It is thus of the utmost importance to appropriately manage these patients in the inpatient and outpatient setting to improve morbidity and mortality. In this review, we address four major areas of cirrhosis management: outpatient management of portal hypertension with decompensation, hepatic encephalopathy, hepatorenal syndrome, and bleeding/coagulation issues. Outpatient management covers recommendations for health care maintenance and screening. Hepatic encephalopathy encompasses a brief review of pathophysiology, treatment in the acute setting, and long-term prevention. Hepatorenal syndrome is discussed in regards to pathophysiology and treatment in the hospital setting. Finally, a discussion of the assessment of coagulation profiles in cirrhosis and recommendations for bleeding and thrombosis complications is included. These topics are not all encompassing with regard to this complicated population, but rather an overview of a few medical problems that are commonly encountered in their care. Keywords: portal hypertension, hepatic encephalopathy, hepatorenal, coagulation

  8. Relationship between retinopathy and cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Colakoglu Onder; Taskiran Bengur; Dayi Selcuk; Sozmen Bulent; Unsal Belkis; Maden Ahmet; Pasa Eser; Aslan S. Leyla

    2005-01-01

    AIM: To evaluate ophthalmic disorders with special attention to retinopathy in cirrhotic patients. Vitamin A deficiency-related ophthalmopathy, xerophthalmia, and color blindness may be documented in cirrhosis due to various etiologies. Retinopathy is an obscure feature of cirrhosis. METHODS: Thirty-two cirrhotic patients, who were followed up by Clinics of Gastroenterology, Izmir Ataturk Teaching and Research Hospital, were enrolled to the study. Associated systemic diseases such as diabetes mellitus and hypertension were excluded. Thirty-two healthy volunteers took part as the control subjects. All participants had ophthalmologic examination in the same hospital. RESULTS: Five (15.6%) of the cirrhotic subjects had soft exudate in the retina. None of the control subjects had retinopathy (P<0.05). Intraocular pressure (IOP) measured for both eyes were also significantly lower in the cirrhotics (P<0.05 vs P = 0.01). There were no statistically significant differences between the two groups in terms of other ophthalmic pathologies. The ophthalmic findings did not show up any differences according to the etiology of cirrhosis. CONCLUSION: Soft exudates may develop in cirrhotic patients probably due to loss of synthetic function of liver and hemodynamic effects of portal hypertension. Retinopathy must be sought in cirrhosis because of its severe morbidity.

  9. Questionnaire Based Assessment of Risk Factors for Primary Biliary Cirrhosis

    Science.gov (United States)

    Lammert, Craig; Nguyen, Douglas L.; Juran, Brian D.; Schlicht, Erik; Larson, Joseph J.; Atkinson, Elizabeth J.; Lazaridis, Konstantinos N.

    2013-01-01

    Background Primary Biliary Cirrhosis is a cholestatic liver disease characterized by immune-mediated destruction of bile ducts. Its pathogenesis is largely unknown, although complex interactions between environment and genetic predisposition are proposed. Aims Identify disease risk factors using a detailed patient questionnaire and compare study findings to 3 published reports. Methods Questionnaire data were prospectively collected from 522 cases and 616 controls of the Mayo Clinic Primary Biliary Cirrhosis Genetic Epidemiology Registry. Case and control responses were compared using logistic regression, adjusting for recruitment age, sex, and education level. Results Cases reported ever regularly smoking cigarettes more frequently than controls (P < 0.001). History of urinary tract infection (UTI) was similar between groups; however, cases reported multiple UTIs more commonly than controls (P < 0.001). Frequency of other autoimmune disease was higher in cases than controls (P < 0.001). As well, prevalence of primary biliary cirrhosis among first-degree relatives was higher in case families than control families (P < 0.001). Conclusions Our study confirms prior reported risk factors associated with disease risk. Given the potential importance of gene and environment interactions, further examination of environmental risk factors considering genetic background may provide new insight into primary biliary cirrhosis pathogenesis. PMID:23490343

  10. Interactive and Indirect Effects of Anxiety and Negative Urgency on Alcohol-Related Problems

    Science.gov (United States)

    Menary, Kyle R.; Corbin, William R.; Leeman, Robert F.; Fucito, Lisa M.; Toll, Benjamin A.; DeMartini, Kelly; O’Malley, Stephanie S.

    2015-01-01

    Background Although drinking for tension reduction has long been posited as a risk factor for alcohol-related problems, studies investigating anxiety in relation to risk for alcohol problems have returned inconsistent results, leading researchers to search for potential moderators. Negative urgency (the tendency to become behaviorally dysregulated when experiencing negative affect) is a potential moderator of theoretical interest because it may increase risk for alcohol problems among those high in negative affect. The present study tested a cross-sectional mediated moderation hypothesis whereby an interactive effect of anxiety and negative urgency on alcohol problems is mediated through coping-related drinking motives. Method The study utilized baseline data from a hazardously drinking sample of young adults (N = 193) evaluated for participation in a randomized controlled trial of naltrexone and motivational interviewing for drinking reduction. Results The direct effect of anxiety on physiological dependence symptoms was moderated by negative urgency such that the positive association between anxiety and physiological dependence symptoms became stronger as negative urgency increased. Indirect effects of anxiety and negative urgency on alcohol problems (operating through coping motives) were also observed. Conclusions Although results of the current cross-sectional study require replication using longitudinal data, the findings suggest that the simultaneous presence of anxiety and negative urgency may be an important indicator of risk for AUDs via both direct interactive effects and indirect additive effects operating through coping motives. These findings have potentially important implications for prevention/intervention efforts for individuals who become disinhibited in the context of negative emotional states. PMID:26031346

  11. Social outcomes associated with alcohol-related diagnoses: a population-based analysis using linked administrative data

    Directory of Open Access Journals (Sweden)

    Nathan Nickel

    2017-04-01

    Receiving an alcohol-related diagnosis is associated with subsequent increased use of social services and contacts with the justice system. Upstream efforts to reduce alcohol-related diagnoses may result in reduced use of social services and justice contacts.

  12. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark?

    DEFF Research Database (Denmark)

    Kedir, Abdu; Berg-Beckhoff, Gabriele; Stock, Christiane

    2018-01-01

    Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n=5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p

  13. Is proximity to alcohol outlets associated with alcohol consumption and alcohol-related harm in Denmark?

    DEFF Research Database (Denmark)

    Seid, Abdu K.; Berg-Beckhoff, Gabriele; Stock, Christiane

    2018-01-01

    Background: This study examined the associations between distance from residence to the nearest alcohol outlet with alcohol consumption as well as with alcohol-related harm. Methods: Data on alcohol consumption, alcohol-related harm and sociodemographics were obtained from the 2011 Danish Drug...... and Alcohol Survey (n = 5133) with respondents aged 15–79 years. The information on distances from residence to the nearest alcohol outlets was obtained from Statistics Denmark. Multiple logistic and linear regressions were used to examine the association between distances to outlets and alcohol consumption...... whereas alcohol-related harm was analysed using negative binomial regression. Results: Among women it was found that those living closer to alcohol outlets were more likely to report alcohol-related harm (p

  14. Alcohol-related hot-spot analysis and prediction : final report.

    Science.gov (United States)

    2017-05-01

    This project developed methods to more accurately identify alcohol-related crash hot spots, ultimately allowing for more effective and efficient enforcement and safety campaigns. Advancements in accuracy came from improving the calculation of spatial...

  15. Joint effect of alcohol consumption and educational level on alcohol-related medical events

    DEFF Research Database (Denmark)

    Nordahl Christensen, Helene; Diderichsen, Finn; Hvidtfeldt, Ulla Arthur

    2017-01-01

    alcohol consumption at baseline using self-administrated questionnaires. Information on highest attained education 1 year before study entry and hospital and mortality data on alcohol-related medical events were obtained through linkage to nationwide registries. We performed analyses using the Aalen...... may also play a role. We investigated the joint effect of alcohol consumption and educational level on the rate of alcohol-related medical events.Methods: We pooled seven prospective cohorts from Denmark that enrolled 74,278 men and women age 30–70 years (study period, 1981 to 2009). We measured...... additive hazards model.Results: During follow-up (1,085,049 person-years), a total of 1718 alcohol-related events occurred. The joint effect of very high alcohol consumption (>21 [>28] drinks per week in women [men]) and low education on alcohol-related events exceeded the sum of their separate effects...

  16. Alcohol-related Injuries at an Emergency Department in Eastern Taiwan

    Directory of Open Access Journals (Sweden)

    Yin-Ming Li

    2006-01-01

    Conclusion: Injuries were alcohol related in one out of seven patients this study from an emergency department in eastern Taiwan. Ongoing epidemiologic monitoring of the prevalence and nature of alcohol abuse among patients visiting the ED are urgently needed.

  17. Brand preferences of underage drinkers who report alcohol-related fights and injuries.

    Science.gov (United States)

    Roberts, Sarah P; Siegel, Michael B; DeJong, William; Naimi, Timothy S; Jernigan, David H

    2015-04-01

    A significant body of research has demonstrated an association between adolescent alcohol consumption and subsequent fights and injuries. To date, however, no research has identified which brands are associated with alcohol-related fights and injuries among underage drinkers. We aimed to: (1) report the prevalence of alcohol-related fights and injuries among a national sample of underage drinkers in the U.S. and (2) describe the relationship between specific alcohol brand consumption and these alcohol-related negative consequences. We recruited 1,031 self-reported drinkers (ages 13-20 years) via an internet panel maintained by Knowledge Networks to complete an online survey. Respondents reported their past-month overall and brand-specific alcohol consumption, risky drinking behavior, and past-year alcohol-related fights and injuries. Over one-quarter of the respondents (26.7%, N = 232) reported at least one alcohol-related fight or injury in the past year. Heavy episodic drinkers were over six times more likely to report one of these negative alcohol-related consequences (AOR: 6.4, 95% CI: 4.1-9.9). Respondents of black race and those from higher-income households were also significantly more likely to report that experience (AOR: 2.2, 95% CI: 1.3-3.7; AOR: 1.8, 95% CI: 1.1-3.0 and 1.1-3.2, respectively). We identified eight alcohol brands that were significantly associated with alcohol-related fights and injuries. CONCLUSIONS/IMPORTANCE: Alcohol-related fights and injuries were frequently reported by adolescent respondents. Eight alcohol brands were significantly more popular among drinkers who experienced these adverse consequences. These results point to the need for further research on brand-specific correlates of underage drinking and negative health outcomes.

  18. The manipulation of alcohol-related interpretation biases by means of Cognitive Bias Modification - Interpretation (CBM-I)

    NARCIS (Netherlands)

    Woud, M.L.; Hutschemaekers, M.H.M.; Rinck, M.; Becker, E.S.

    2015-01-01

    Background and objectives: There is a large body of evidence demonstrating that alcohol abuse and misuse is characterized by alcohol-related interpretation biases (IBs). The present study tested whether alcohol-related IBs can be trained, and whether this has an effect on alcohol-related

  19. Gender matters: the relationship between social anxiety and alcohol-related consequences.

    Science.gov (United States)

    Schry, Amie R; Norberg, Melissa M; Maddox, Brenna B; White, Susan W

    2014-01-01

    Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. In the present study, 573 undergraduate students (M(age) = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.

  20. Gender matters: the relationship between social anxiety and alcohol-related consequences.

    Directory of Open Access Journals (Sweden)

    Amie R Schry

    Full Text Available BACKGROUND AND OBJECTIVES: Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. METHODS: In the present study, 573 undergraduate students (M(age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role. Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. RESULTS: After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. DISCUSSION AND CONCLUSIONS: These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. SCIENTIFIC SIGNIFICANCE: This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences.

  1. Alcohol consumption, masculinity, and alcohol-related violence and anti-social behaviour in sportspeople.

    Science.gov (United States)

    O'Brien, Kerry S; Forrest, Walter; Greenlees, Iain; Rhind, Daniel; Jowett, Sophia; Pinsky, Ilana; Espelt, Albert; Bosque-Prous, Marina; Sonderlund, Anders Larrabee; Vergani, Matteo; Iqbal, Muhammad

    2018-04-01

    There is no research examining alcohol-related aggression and anti-social behaviour in UK or European sportspeople (athletes), and no research has examined relationships between masculinity, alcohol consumption, and alcohol-related aggression and antisocial behaviour in sportspeople (athletes). This study addresses this gap. Cross-sectional. A sample (N=2048; women=892, 44%) of in season sportspeople enrolled at UK universities (response 83%), completed measures of masculinity, alcohol consumption, within-sport (on-field) violence, and having been the perpetrator and/or victim of alcohol-related violent/aggressive and antisocial behaviour (e.g., hit/assaulted, vandalism, sexual assault). Logistic regressions examined predictors of alcohol-related violence/aggression and anti-social behaviours. Significant bivariate relationships between masculinity, within-sport violence, alcohol consumption, and alcohol-related aggression and anti-social behaviour were found for both men and women (p'smasculinity and alcohol consumption in men and women were related to an increased odds of having conducted an aggressive, violent and/or anti-social act in the past 12 months when intoxicated. Odds ratios were largest for relationships between masculinity, alcohol consumption, within-sport violence, and interpersonal violence/aggression (p'smasculinity and excessive drinking. Interventions that reduce excessive alcohol consumption, masculine norms and associated within-sport violence, could be effective in reducing alcohol-related aggression and antisocial behaviour in UK sportspeople. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  2. A Hard Road: Driving Local Action against Alcohol Related Problems in a Rural Town

    Directory of Open Access Journals (Sweden)

    Julaine Allan

    2012-12-01

    Full Text Available Context is important in developing strategies to address alcohol related violence. Knowledge of local conditions is critical to action in rural areas. The aim of this study was to gather information about context specific alcohol related problems experienced by frontline workers in a regional centre to inform the local alcohol action plan. Frontline workers were invited to participate in one of five focus group discussions that investigated problems experienced as a result of other people’s alcohol use. Alcohol related problems were more frequently associated with time periods than any single group in the community. Social media was used to incite arguments between groups in different venues during the lock-out periods. The focus groups identified that the location of licensed premises and a taxi rank; and previous relationships between protagonists were the key contextual factors causing alcohol related problems. A second taxi rank was identified as a useful local management strategy. Supply reduction was suggested as a key factor in long term solutions to alcohol related problems in rural towns. The local liquor accord did not want to reduce supply of alcohol by closing late night venues earlier. Local action to reduce alcohol related problems will be limited to pragmatic solutions because supply reduction is unacceptable to those in the business of selling alcohol.

  3. Gender Matters: The Relationship between Social Anxiety and Alcohol-Related Consequences

    Science.gov (United States)

    Schry, Amie R.; Norberg, Melissa M.; Maddox, Brenna B.; White, Susan W.

    2014-01-01

    Background and Objectives Identification of risk factors for alcohol-related consequences is an important public health concern. Both gender and social anxiety have been associated with alcohol-related consequences broadly, but it is unknown whether these variables are differentially related to specific types of alcohol-related consequences for American college students. Methods In the present study, 573 undergraduate students (M age = 19.86 years, SD = 1.40; range 18 to 25; 68.9% female) completed an on-line assessment of social anxiety, alcohol use, and four types of alcohol-related consequences (personal, social, physical, and role). Poisson regressions were run to examine social anxiety, gender, and the interaction between social anxiety and gender as predictors of each type of alcohol-related consequences. Results After controlling for alcohol use, social anxiety was positively associated with all four types of consequences, and females endorsed higher rates of physical, personal, and role consequences. The interaction between social anxiety and gender was statistically significant only for physical consequences, with social anxiety having a stronger effect for males. Discussion and Conclusions These findings, which diverge somewhat from those of a prior study with Australian college students, are discussed in the context of a biopsychosocial model of social anxiety and substance use problems. Scientific Significance This study highlights the importance of further investigating cultural differences in the relationships among social anxiety, gender, and alcohol-related consequences. PMID:25541722

  4. Alcohol-related crime in city entertainment precincts: Public perception and experience of alcohol-related crime and support for strategies to reduce such crime.

    Science.gov (United States)

    Tindall, Jenny; Groombridge, Daniel; Wiggers, John; Gillham, Karen; Palmer, Darren; Clinton-McHarg, Tara; Lecathelinais, Christophe; Miller, Peter

    2016-05-01

    Bars, pubs and taverns in cities are often concentrated in entertainment precincts that are associated with higher rates of alcohol-related crime. This study assessed public perception and experiences of such crime in two city entertainment precincts, and support for alcohol-related crime reduction strategies. A cross-sectional household telephone survey in two Australian regions assessed: perception and experiences of crime; support for crime reduction strategies; and differences in such perceptions and support. Six hundred ninety-four people completed the survey (32%). Most agreed that alcohol was a problem in their entertainment precinct (90%) with violence the most common alcohol-related problem reported (97%). Almost all crime reduction strategies were supported by more than 50% of participants, including visitors to the entertainment precincts, with the latter being slightly less likely to support earlier closing and restrictions on premises density. Participants in one region were more likely to support earlier closing and lock-out times. Those at-risk of acute alcohol harm were less likely to support more restrictive policies. High levels of community concern and support for alcohol harm-reduction strategies, including restrictive strategies, provide policy makers with a basis for implementing evidence-based strategies to reduce such harms in city entertainment precincts. [Tindall J, Groombridge D, Wiggers J, Gillham K, Palmer D, Clinton-McHarg T, Lecathelinais C, Miller P. Alcohol-related crime in city entertainment precincts: Public perception and experience of alcohol-related crime and support for strategies to reduce such crime. Drug Alcohol Rev 2016;35:263-272]. © 2015 The Authors. Drug and Alcohol Review published by Wiley Publishing Asia Pty Ltd on behalf of Australasian Professional Society on Alcohol and other Drugs.

  5. Ursodeoxycholic acid for primary biliary cirrhosis.

    Science.gov (United States)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N; Bjelakovic, Goran; Gluud, Christian

    2012-12-12

    Ursodeoxycholic acid is administered to patients with primary biliary cirrhosis, a chronic progressive inflammatory autoimmune-mediated liver disease with unknown aetiology. Despite its controversial effects, the U.S. Food and Drug Administration has approved its usage for primary biliary cirrhosis. To assess the beneficial and harmful effects of ursodeoxycholic acid in patients with primary biliary cirrhosis. We searched for eligible randomised trials in The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index Expanded, LILACS, Clinicaltrials.gov, and the WHO International Clinical Trials Registry Platform. The literature search was performed until January 2012. Randomised clinical trials assessing the beneficial and harmful effects of ursodeoxycholic acid versus placebo or 'no intervention' in patients with primary biliary cirrhosis. Two authors independently extracted data. Continuous data were analysed using mean difference (MD) and standardised mean difference (SMD). Dichotomous data were analysed using risk ratio (RR). Meta-analyses were conducted using both a random-effects model and a fixed-effect model, with 95% confidence intervals (CI). Random-effects model meta-regression was used to assess the effects of covariates across the trials. Trial sequential analysis was used to assess risk of random errors (play of chance). Risks of bias (systematic error) in the included trials were assessed according to Cochrane methodology bias domains. Sixteen randomised clinical trials with 1447 patients with primary biliary cirrhosis were included. One trial had low risk of bias, and the remaining fifteen had high risk of bias. Fourteen trials compared ursodeoxycholic acid with placebo and two trials compared ursodeoxycholic acid with 'no intervention'. The percentage of patients with advanced primary biliary cirrhosis at baseline varied

  6. Primary biliary cirrhosis: natural history.

    Science.gov (United States)

    Tornay, A S

    1980-03-01

    All patients seen with primary biliary cirrhosis during this decade were reviewed. Sixty per cent were diagnosed during the earliest asymptomatic stage of this illness and only 20% progressed symptomatically during a mean follow-up period of 52 months. Those patients presenting with persistent jaundice followed a classic downhill course. These data establish the previously predicted trend toward earlier diagnosis and raise questions about the concept of universal progression of this disease and its time course.

  7. Arrhythmia risk in liver cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Ioana Mozos

    2015-01-01

    Interactions between the functioning of the heart andthe liver have been described, with heart diseasesaffecting the liver, liver diseases affecting the heart,and conditions that simultaneously affect both. Theheart is one of the most adversely affected organs inpatients with liver cirrhosis. For example, arrhythmiasand electrocardiographic changes are observed inpatients with liver cirrhosis. The risk for arrhythmia isinfluenced by factors such as cirrhotic cardiomyopathy,cardiac ion channel remodeling, electrolyte imbalances,impaired autonomic function, hepatorenal syndrome, metabolic abnormalities, advanced age, inflammatory syndrome, stressful events, impaired drug metabolism and comorbidities. Close monitoring of cirrhotic patients is needed for arrhythmias, particularly when QT intervalprolonging drugs are given, or if electrolyte imbalances or hepatorenal syndrome appear. Arrhythmia risk may persist after liver transplantation due to possible QT interval prolongation, persistence of the parasympathetic impairment, post-transplant reperfusion and chronic immunosuppression, as well as consideration of the fact that the transplant itself is a stressful event for the cardiovascular system. The aims of the present article were to provide a review of the most important data regarding the epidemiology, pathophysiology, and biomarkers of arrhythmia risk in patients with liver cirrhosis, to elucidate the association with long-term outcome, and to propose future research directions.

  8. Antidepressant Sales and the Risk for Alcohol-Related and Non-Alcohol-Related Suicide in Finland—An Individual-Level Population Study

    Science.gov (United States)

    Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

    2014-01-01

    Objectives A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. Methods We followed a nationally representative sample of 950,158 Finnish adults in 1995–2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. Results The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976–0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. Conclusion We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995–2007. However, the rise in the proportion of antidepressant

  9. Scintigraphic features of cirrhosis of the liver

    Energy Technology Data Exchange (ETDEWEB)

    Bell, E; Biersack, H J; Altland, H; Albrecht, M; Winkler, C

    1980-09-01

    A retrospective study of 101 patients with histologically confirmed cirrhosis of the liver and portal hypertension was carried out in order to evaluate the accepted scintigraphic criteria. In only 20% were all the essential criteria present. The absence of generally accepted important scintigraphic signs does not exclude the diagnosis of cirrhosis of the liver. Specificity of liver scintigraphy in cirrhosis of the liver is fairly low, but sensitivity of the method is almost 100%.

  10. The cardiorenal link in advanced cirrhosis

    DEFF Research Database (Denmark)

    Krag, Aleksander; Bendtsen, Flemming; Burroughs, Andrew K

    2012-01-01

    A considerable number of patients with advanced cirrhosis develop a hepatorenal syndrome. The pathogenesis involves liver dysfunction, splanchnic vasodilatation, and activation of vasoconstrictive systems. There are now several observations that indicate a relation between the renal failure...... and impaired cardiac function in patients with advanced cirrhosis. Cirrhotic cardiomyopathy has been described as a condition with impaired contractile responsiveness to stress and altered diastolic relaxation. We propose a cardiorenal interaction in patients with advanced cirrhosis and renal dysfunction...

  11. Recurring alcohol-related care between 1998 and 2007 among people treated for an alcohol-related disorder in 1997: A register study in Stockholm County

    Directory of Open Access Journals (Sweden)

    Kåreholt Ingemar

    2011-07-01

    Full Text Available Abstract Background Inpatient care for alcohol intoxication is increasing in Sweden, especially among young women. Since it is well known that alcohol disorder is a chronic relapsing illness, this study examines the extent to which people return for more care. Method All inpatients with alcohol-related diagnoses in Stockholm County during 1997 were followed prospectively to 2007 through registers. The proportion reappearing for the same diagnosis, other alcohol-related inpatient, or outpatient care each year after baseline, as well as the number of years the inpatients reappeared were calculated (n = 2735. Three diagnoses were examined separately; alcohol dependence, harmful use of alcohol, and alcohol intoxication. Results Three out of five inpatients with an alcohol diagnoses reappeared for more alcohol-related inpatient care during the following decade. The proportion returning was largest the year after baseline and then decreased curvilinearly over time. The inclusion of outpatient care increased proportions, but did not change patterns. Of those with an alcohol dependence diagnosis at baseline 42 percent returned for more alcohol-related inpatient care the first, 28 percent the fifth, and 25 percent the tenth year. Corresponding proportions for harmful use and intoxication were smaller. One in five among those with an alcohol dependence returned for more than five of the ten years. Ordered logistic regressions confirmed that besides diagnosis, age and gender were independently related to the number of years returning to care. Conclusions While middle-aged males with alcohol dependence were in a revolving door, young female inpatients with intoxication diagnosis returned to a comparably lower degree.

  12. Patterns of 'at-home' alcohol-related injury presentations to emergency departments.

    Science.gov (United States)

    Bunker, Naomi; Woods, Cindy; Conway, Jane; Barker, Ruth; Usher, Kim

    2017-01-01

    This study aimed to establish the scale of alcohol-related injuries originating in the home. Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. A retrospective observational study. Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of domestic violence by spouse or partner (n = 510), 59·5% occurred 'at home'. This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. © 2016 John Wiley & Sons Ltd.

  13. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2006-01-01

    hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...... of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status......OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...

  14. Ethnic group variations in alcohol-related hospital admissions in England: does place matter?

    Science.gov (United States)

    Barry, Eleanor; Laverty, Anthony A; Majeed, Azeem; Millett, Christopher

    2015-01-01

    The health burden of alcohol use is socially and geographically patterned in many countries. Less is known about variations in this burden between ethnic groups and whether this differs across place of residence. National cross-sectional study using hospital admission data in England. Alcohol-related admission rates, where an alcohol-related condition was either the primary diagnosis (considered as the reason for admission) or a comorbidity, were calculated using ethnic group specific rates for English regions. In 2010/11 there were a total of 264,870 alcohol-related admissions in England. Admission rates were higher in the North of England than elsewhere (e.g. for primary diagnosis 161 per 100,000 population in the North vs. 62 per 100,000 in the South). These patterns were not uniform across ethnic groups however. For example, admission rates for alcohol-related comorbidity were four times higher among White Irish in London compared with those in the South of England (306 to 76 per 100,000) and four times higher in Indians living in the Midlands compared with those in the South of England (128 to 29 per 100,000). These patterns were similar for admissions with a comorbid alcohol-related condition. Geographical location may be an important determinant of within and between ethnic group variations in alcohol-related hospital admissions in England. While a number of factors were not examined here, this descriptive analysis suggests that this heterogeneity should be taken into account when planning interventions and services for the prevention and management of alcohol misuse.

  15. The gendered trouble with alcohol: young people managing alcohol related violence.

    Science.gov (United States)

    Lindsay, Jo

    2012-05-01

    Alcohol related violence is a troubling backdrop to the social lives and relationships of many young people in post-industrial societies. The development of the night-time economy where young people are encouraged to drink heavily in entertainment precincts has increased the risk of violence. This paper reports on 60 individual structured in-depth interviews about the drinking biographies of young people (aged 20-24) living in Victoria, Australia. Twenty-six males and 34 females participated in the research. The participants discussed their experiences with alcohol over their life course to date. The material on alcohol related violence is analysed in this paper. Just over half of the participants (33/60) recounted negative experiences with alcohol related violence. The findings demonstrate the continuing gendered nature of experiences of perpetration and victimization. Participants reported that aggression and violence perpetrated by some men was fuelled by alcohol consumption and required ongoing management. Experiences of violence were also spatialized. Men were more likely to report managing and avoiding violence in particular public settings whilst more women than men discussed managing violence in domestic settings. The central argument of this paper is that incidents of alcohol related violence and reactions to it are specific gender performances that occur in specific socio-cultural contexts. In contrast to research which has found some young people enjoy the adventure and excitement of alcohol related violence the mainstream participants in this study saw violence as a negative force to be managed and preferably avoided. Understanding violence as a dynamic gender performance complicates the development of policy measures designed to minimize harm but also offers a more holistic approach to developing effective policy in this domain. There is a need for greater acknowledgement that alcohol related violence in public venues and in families is primarily about

  16. The location of late night bars and alcohol-related crashes in Houston, Texas.

    Science.gov (United States)

    Levine, Ned

    2017-10-01

    A study in the City of Houston, Texas, related the location of establishments primarily serving alcohol ("bars") after midnight to late night alcohol-related motor vehicle crashes. There were three data sets for 2007-09: 1) 764bars that were open after midnight; 2) 1660 alcohol-related crashes that occurred within the City of Houston between midnight and 6 am; and 3) 4689 modeling network road segments to which bars and alcohol-related crashes were assigned. Forty-five percent of the late night alcohol-related crashes were within a quarter mile of a late night bar. The bars were highly concentrated in 17 small bar clusters. Using the modeling network, Poisson-Gamma-CAR and Poisson-Lognormal-CAR spatial regression models showed a positive exponential relationship between late night alcohol-related crashes and the number of late nights bars and bar clusters, and a negative exponential relationship to distance to the nearest late night bar controlling for the type of road segment (freeway, principal arterial, minor arterial). A more general model dropped the bar cluster variable. Further, the Poisson-Gamma-CAR model appeared to produce a better representation than the Poisson-Lognormal-CAR model though the errors were different. The general Poisson-Gamma-CAR model showed that each late night bar increased the frequency of alcohol-related crashes on a segment by approximately 190%. For each mile closer a segment was to a late night bar, the likelihood increased by 42%. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Heavy episodic drinking and alcohol-related injuries: An open cohort study among college students.

    Science.gov (United States)

    Caamaño-Isorna, Francisco; Moure-Rodríguez, Lucía; Doallo, Sonia; Corral, Montserrat; Rodriguez Holguín, Socorro; Cadaveira, Fernando

    2017-03-01

    The objective of this study is to assess the effects of Heavy Episodic Drinking (HED) on the incidence of alcohol-related injuries among university students in Spain, taking sex into consideration. We carried out an open cohort study among college students in Spain (992 women and 371 men). HED and alcohol-related injuries were measured by question 3rd and 9th of Alcohol Use Disorders Identification Test to every participant at the ages of 18, 20, 22, 24 and 27. For data analysis we used a Multilevel Logistic Regression for repeated measures adjusting for alcohol and cannabis use. The incidence rate of alcohol-related injuries was 0.028year -1 for females and 0.036year -1 for males. The multivariate analysis showed that among females a high frequency of HED and use of cannabis are risk factors for alcohol-related injuries (Odds Ratio [OR]=2.64 and OR=3.68), while being more than 23 is a protective factor (OR=0.34). For males, bivariate analysis also showed HED like risk factor (OR=4.69 and OR=2.51). Finally, the population attributable fraction for HED among females was 37.12%. HED leads to an increase of alcohol-related injuries in both sexes and being over 23 years old acts as a protective factor among women. Our results suggest that about one third of alcohol-related injuries among women could be avoided by removing HED. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs.

    Science.gov (United States)

    Mundt, Marlon P; Zakletskaia, Larissa I; Shoham, David A; Tuan, Wen-Jan; Carayon, Pascale

    2015-10-01

    Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes. Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs. Between May 2013 and December 2013, a total of 155 healthcare employees at 6 primary care clinics participated in a survey on team communication. Three-level hierarchical modeling evaluated the link between connectedness within the care team and the number of alcohol-related emergency department visits, hospital days, and associated medical care costs in the past 12 months for each team's primary care patient panel. Teams (n = 31) whose registered nurses displayed more strong (at least daily) face-to-face ties and strong (at least daily) electronic communication ties had 10% fewer alcohol-related hospital days (rate ratio [RR] = 0.90; 95% confidence interval [CI]: 0.84, 0.97). Furthermore, in an average team size of 19, each additional team member with strong interaction ties across the whole team was associated with $1,030 (95% CI: -$1,819, -$241) lower alcohol-related patient healthcare costs per 1,000 team patients in the past 12 months. Conversely, teams whose primary care practitioner (PCP) had more strong face-to-face communication ties and more weak (weekly or several times a week) electronic communication ties had 12% more alcohol-related hospital days (RR = 1.12; 95% CI: 1.03, 1.23) and $1,428 (95% CI: $378, $2,478) higher alcohol-related healthcare costs per 1,000 patients in the past 12 months. The analyses controlled for patient age, gender, insurance, and comorbidity diagnoses. Excessive alcohol-using patients may fair better if cared for by teams whose

  19. Impacts of licensed premises trading hour policies on alcohol-related harms.

    Science.gov (United States)

    Atkinson, Jo-An; Prodan, Ante; Livingston, Michael; Knowles, Dylan; O'Donnell, Eloise; Room, Robin; Indig, Devon; Page, Andrew; McDonnell, Geoff; Wiggers, John

    2018-07-01

    Evaluations of alcohol policy changes demonstrate that restriction of trading hours of both 'on'- and 'off'-licence venues can be an effective means of reducing rates of alcohol-related harm. Despite this, the effects of different trading hour policy options over time, accounting for different contexts and demographic characteristics, and the common co-occurrence of other harm reduction strategies in trading hour policy initiatives, are difficult to estimate. The aim of this study was to use dynamic simulation modelling to compare estimated impacts over time of a range of trading hour policy options on various indicators of acute alcohol-related harm. An agent-based model of alcohol consumption in New South Wales, Australia was developed using existing research evidence, analysis of available data and a structured approach to incorporating expert opinion. Five policy scenarios were simulated, including restrictions to trading hours of on-licence venues and extensions to trading hours of bottle shops. The impact of the scenarios on four measures of alcohol-related harm were considered: total acute harms, alcohol-related violence, emergency department (ED) presentations and hospitalizations. Simulation of a 3 a.m. (rather than 5 a.m.) closing time resulted in an estimated 12.3 ± 2.4% reduction in total acute alcohol-related harms, a 7.9 ± 0.8% reduction in violence, an 11.9 ± 2.1% reduction in ED presentations and a 9.5 ± 1.8% reduction in hospitalizations. Further reductions were achieved simulating a 1 a.m. closing time, including a 17.5 ± 1.1% reduction in alcohol-related violence. Simulated extensions to bottle shop trading hours resulted in increases in rates of all four measures of harm, although most of the effects came from increasing operating hours from 10 p.m. to 11 p.m. An agent-based simulation model suggests that restricting trading hours of licensed venues reduces rates of alcohol-related harm and extending trading hours of bottle

  20. The role of the health services in the prevention of alcohol-related facial injury.

    LENUS (Irish Health Repository)

    McHugh, E E

    2009-10-01

    This paper outlines the preventive health strategic measures that are currently in place and it endeavours to consider how improvements can be made to our national preventive strategy with the goal of reducing alcohol-related facial injuries. It is based on a review of the literature sourced through PubMed, Ovid Medline and the Cochrane database. The main findings are that increased funding, legislative amendment and media involvement are key to improving the work of the health services in their struggle to limit the ever increasing alcohol-related incidents that are experienced by society today.

  1. Cholecystectomy in Patients with Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Jonas Strömberg

    2015-01-01

    Full Text Available Background. The aim of this population-based study was to describe characteristics of patients with liver cirrhosis undergoing cholecystectomy and evaluate the risk for perioperative and postoperative complications during the 30-day postoperative period. Method. All laparoscopic and open cholecystectomy procedures registered between 2006 and 2011 in the Swedish Registry for Gallstone Surgery and ERCP (GallRiks were included. Patients with liver cirrhosis were identified by linking data to the Swedish National Patient Registry (NPR. Results. Of 62,488 patients undergoing cholecystectomy, 77 (0.12% had cirrhosis, of which 29 patients (37.7% had decompensated cirrhosis. Patients with cirrhosis were older and had more often gallstone complications at the time for surgery. Postoperative complications were registered in 13 (16.9% patients with liver cirrhosis and in 5,738 (9.2% patients in the noncirrhotic group (P1 day (OR = 2.3, CI 1.11–4.84, P<0.05 than noncirrhotic patients. Conclusion. Patients with cirrhosis undergoing cholecystectomy have a higher incidence of postoperative complications than patients without cirrhosis. However, cholecystectomy is safe and if presented with adequate indication, surgery should not be delayed due to fears of surgical complications.

  2. Physical exercise for people with cirrhosis

    DEFF Research Database (Denmark)

    Aamann, Luise; Dam, Gitte; Rinnov, Anders

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of physical exercise versus no intervention for people with cirrhosis.......This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the beneficial and harmful effects of physical exercise versus no intervention for people with cirrhosis....

  3. Pharmacokinetics of paroxetine in patients with cirrhosis

    DEFF Research Database (Denmark)

    Dalhoff, K; Almdal, T P; Bjerrum, K

    1991-01-01

    with cirrhosis experienced nausea during the first two or three days after the first dose, while none of the controls had this symptom. The study showed slower elimination of paroxetine and consequently higher plasma levels in patients with cirrhosis, suggesting that in the latter the dose of paroxetine should...

  4. Primary biliary cirrhosis: Diagnostic and therapeutic aspects

    NARCIS (Netherlands)

    E.M.M. Kuiper (Edith)

    2010-01-01

    textabstractPrimary Biliary Cirrhosis (PBC) is a relatively rare cholestatic liver disease. The first case was described by Addison and Gull in 1851. The name PBC is generally accepted, however in fact this is a misnomer since cirrhosis is found in a minority of patients. PBC is one of the most

  5. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    on the relationship between liver cirrhosis mortality and alcohol consumption is included. The conclusion is that the total level of alcohol consumption as well as the specific beverages - beer, wine and spirits - contributes to liver cirrhosis mortality, but the present study also reveals that directly addressing...

  6. Severe periodontitis and higher cirrhosis mortality

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Holmstrup, Palle; Schou, Søren

    2018-01-01

    Background Periodontitis and edentulism are prevalent in patients with cirrhosis, but their clinical significance is largely unknown. Objective The objective of this article is to determine the association of severe periodontitis and edentulism with mortality in patients with cirrhosis. Methods...... A total of 184 cirrhosis patients underwent an oral examination. All-cause and cirrhosis-related mortality was recorded. The associations of periodontitis and edentulism with mortality were explored by Kaplan–Meier survival plots and Cox proportional hazards regression adjusted for age, gender, cirrhosis...... etiology, Child–Pugh score, Model for End-Stage Liver Disease score, smoker status, present alcohol use, comorbidity, and nutritional risk score. Results The total follow-up time was 74,197 days (203.14 years). At entry, 44% of the patients had severe periodontitis and 18% were edentulous. Forty...

  7. Diastolic and autonomic dysfunction in early cirrhosis

    DEFF Research Database (Denmark)

    Dahl, Emilie Kristine; Møller, Søren; Kjær, Andreas

    2014-01-01

    OBJECTIVE. Presence of cardiac dysfunction in patients with advanced cirrhosis is widely accepted, but data in early stages of cirrhosis are limited. Systolic and diastolic functions, dynamics of QT-interval, and pro-atrial natriuretic peptide (pro-ANP) are investigated in patients with early stage...... cirrhosis during maximal β-adrenergic drive. MATERIAL AND METHODS. Nineteen patients with Child A (n = 12) and Child B cirrhosis (n = 7) and seven matched controls were studied during cardiac stress induced by increasing dosages of dobutamine and atropine. RESULTS. Pharmacological responsiveness was similar...... indicate that patients with early stage cirrhosis exhibit early diastolic and autonomic dysfunction as well as elevated pro-ANP. However, the cardiac chronotropic and inotropic responses to dobutamine stress were normal. The dynamics of ventricular repolarization appears normal in patients with early stage...

  8. Hemostatic abnormalities in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Kendal YALÇIN

    2009-06-01

    Full Text Available In this study, 44 patients with liver cirrhosis were investigated for hemostatic parameters. Patients with spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome and cholestatic liver diseases were excluded. Patients were classified by Child-Pugh criterion and according to this 4 patients were in Class A, 20 in Class B and 20 in C. Regarding to these results, it was aimed to investigate the haematological disturbances in liver cirrhotic patients.In the result there was a correlation between activated partial thromboplastin time, serum iron, ferritin, transferrin, haptoglobin and Child-Pugh classification. Besides there was no correlation between prothrombin time, factor 8 and 9, protein C and S, anti-thrombin 3, fibrinogen, fibrin degradation products, serum iron binding capacity, hemoglobin, leukocyte, mean corpuscular volume and Child-Pugh classification.There were significant difference, in terms of AST, ferritin, haptoglobulin, sex and presence of ascites between groups (p0.05. In the summary, we have found correlation between hemostatic abnormalities and disease activity and clinical prognosis in patients with liver cirrhosis which is important in the management of these patients. This is also important for identification of liver transplant candidiates earlier.

  9. The stress-response dampening hypothesis: how self-esteem and stress act as mechanisms between negative parental bonds and alcohol-related problems in emerging adulthood.

    Science.gov (United States)

    Backer-Fulghum, Lindsey M; Patock-Peckham, Julie A; King, Kevin M; Roufa, Lindsay; Hagen, Leslie

    2012-04-01

    The stress dampening model (Marlatt, 1987; Sayette, 1993; Sher, 1987) suggests certain individuals may use alcohol to escape from their negative life experiences. Pathological reasons for drinking (e.g., using alcohol as a means to cope) reflect the degree to which individuals are motivated to use alcohol in order to dampen or alleviate the stress they are experiencing (Johnson, Schwitters, Wilson, Nagoshi, & McClearn, 1985). Direct and mediational links among parental bonds (rejection, care, overprotection, autonomy, and neglect), self-esteem, stress, pathological reasons for drinking, and alcohol-related problems were explored. A Structural Equation Model with (405 students; 164 women, 241 men) college students was examined. Three path mediational analyses revealed several mediated pathways. Greater feelings of perceived father/mother neglectfulness (i.e., offspring feeling parents do not show up for them) were indirectly linked to more alcohol-related problems (e.g., indicative of alcohol use or dependence in emerging adulthood) through increased stress and pathological reasons for drinking. Furthermore, higher levels of father rejection (i.e., perception of feeling unwanted) were indirectly linked to more pathological reasons for drinking through low self-esteem and increased stress. However, greater feelings of mother care (affectionate and attentive) were indirectly linked to fewer pathological reasons for drinking through higher self-esteem and lower levels of stress. Moreover, high self-esteem was found to be indirectly linked to fewer alcohol-related problems through decreased stress and pathological reasons for drinking. These findings suggest several specific pathways for using alcohol to self-medicate (i.e., consume alcohol for a specific purpose) or dampen feelings of stress. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Cirrhosis

    Science.gov (United States)

    ... a change in alertness, or it gets worse Rectal bleeding, vomiting blood, or blood in the urine ... Copyright 1997-2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing ...

  11. Cirrhosis

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Hepatitis (Viral) What Is Viral Hepatitis? Hepatitis A Hepatitis B ... diseases and conditions. Related Conditions & Diseases Autoimmune Hepatitis Hepatitis (Viral) Hepatitis C Nonalcoholic Fatty Liver Disease (NAFLD) & Nonalcoholic ...

  12. A family history of alcoholism relates to alexithymia in substance use disorder patients

    NARCIS (Netherlands)

    de Haan, Hein A.; Joosten, Evelien A.G.; de Haan, Lydia; Schellekens, Arnt F.A.; Buitelaar, Jan K.; van der Palen, Jacobus Adrianus Maria; de Jong, Cor A.J.

    2013-01-01

    Objectives Previous research identified alexithymia as a potential risk factor for substance use disorders (SUD). More insight into the relation between alexithymia and SUD is needed in order to treat SUD effectively. Therefore, we investigated whether a familial vulnerability to alcoholism relates

  13. Genderedness of Bar Drinking Culture and Alcohol-Related Harms: A Multi-Country Study

    Science.gov (United States)

    Roberts, Sarah C. M.; Bond, Jason; Korcha, Rachael; Greenfield, Thomas K.

    2013-01-01

    This study explores whether associations between consuming alcohol in bars and alcohol-related harms are consistent across countries and whether country-level characteristics modify associations. We hypothesized that genderedness of bar drinking modifies associations, such that odds of harms associated with bar drinking increase more rapidly in…

  14. Alcohol-Related Posts from Young People on Social Networking Sites: Content and Motivations.

    Science.gov (United States)

    Hendriks, Hanneke; Gebhardt, Winifred A; van den Putte, Bas

    2017-07-01

    Many young people place alcohol-related posts on social networking sites (SNS) which can result in undesirable effects. Although several recent studies have investigated the occurrence of alcohol-related SNS use, it is neither clear (a) what type of alcohol posts are placed on SNS, (b) the motivations to place alcohol posts, nor (c) which young people are most likely to place alcohol posts. This study addressed these three goals. A large cross-sectional study among young participants (12-30 years; N = 561) assessed the posting of different types of alcohol posts, the motivations to (not) post these posts, and potential differences in posting between subgroups (i.e., in terms of age, gender, and religion). Participants reported that they most often placed moderate, instead of more extreme, alcohol posts, in particular, when alcohol was present in the post "by chance". Furthermore, they indicated to post alcohol-related content mostly for entertainment reasons. Finally, we found differences in self-reported posting and motivations to post according to age, gender, and religion. These findings provide relevant implications for future interventions aiming to decrease alcohol posts, for example, by making participants aware of their posting behavior and by targeting specific at risk groups. Future research should explore the effectiveness of such intervention strategies and should investigate whether alcohol posts lead to an underestimation of alcohol-related risks.

  15. The Effects of Sleep Problems and Depression on Alcohol-Related Negative Consequences among College Students

    Science.gov (United States)

    Wattenmaker McGann, Amanda

    2013-01-01

    Previous literature provides an overview of the multiple relationships between alcohol use, protective behavioral strategies (PBS), alcohol-related negative consequences, depression, and sleep problems among college students, as well as differences by individual level characteristics, such as age, gender, and race/ethnicity. The purpose of this…

  16. Sexual orientation, treatment utilization, and barriers for alcohol related problems: Findings from a nationally representative sample.

    Science.gov (United States)

    Allen, Junior Lloyd; Mowbray, Orion

    2016-04-01

    Gay, lesbian, and bisexual (GLB) individuals appear to have an increased likelihood of alcohol use disorders and treatment utilization for alcohol related problems compared to heterosexual individuals. Despite this increase, treatment utilization rates among GLB individuals remain low. In an effort to address this, our paper examined whether or not GLB individuals encounter unique barriers when pursuing treatment for alcohol related problems. Using data from the National Epidemiologic Survey on Alcohol Related Conditions (NESARC), we examined service sector specific factors, some of which included (a) utilization rates, (b) self-reported treatment barriers, and (c) whether or not there were emergent differences among GLB individuals, after controlling for socio-demographic and clinical characteristics. Findings indicated that GLB individuals reported higher severity rates for alcohol use disorders when compared to heterosexual individuals, and were significantly more likely to utilize treatment services for alcohol related problems, however, not across all treatment sectors. While similar patterns were observed when examining barriers to treatment, bisexual individuals reported significantly more barriers than heterosexual and gay/lesbian individuals. These findings underscored the importance of identifying and developing interventions that addresses treatment barriers associated with alcohol use service utilization among GLB populations, and creating improved outreach and education programs to better address stigmas associated with substance use and sexuality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. I drink therefore I am: validating alcohol-related implicit association tests

    NARCIS (Netherlands)

    Lindgren, K.P.; Neighbors, C.; Teachman, B.A.; Wiers, R.W.; Westgate, E.; Greenwald, A.G.

    2013-01-01

    There is an imperative to predict hazardous drinking among college students. Implicit measures have been useful in predicting unique variance in drinking and alcohol-related problems. However, they have been developed to test different theories of drinking and have rarely been directly compared with

  18. Four Years of Reports of Alcohol-Related Harm to Pediatricians in the Netherlands

    NARCIS (Netherlands)

    van Hoof, Joris Jasper; van Zanten, Eva; van der Lely, Nicolaas

    2015-01-01

    Over the four years of the study, the number of adolescents treated with alcohol-related harm increased significantly (from 297 in 2007 to 684 in 2010), up to a total of 1,616. The dominant reason for hospitalization was “alcohol intoxication” (in total 1,350; 88% of all cases). The gender ratio did

  19. Alcohol-Related Emergency Department Visits Associated with Collegiate Football Games

    Science.gov (United States)

    Shook, Janice; Hiestand, Brian C.

    2011-01-01

    Objective: In 2003, after several post-college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors' city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing…

  20. An Exploration of Adlerian Lifestyle Themes and Alcohol-Related Behaviors among College Students

    Science.gov (United States)

    Lewis, Todd F.; Osborn, Cynthia J.

    2004-01-01

    The aim of this study was to investigate college student drinking through the lens of Adlerian theory. In a sample of 273 participants, multiple regression analyses confirmed that certain lifestyle themes were associated with alcohol-related behaviors and that men and women who engage in drinking differ in their convictions and goals as defined by…

  1. College law enforcement and security department responses to alcohol-related incidents: a national study.

    Science.gov (United States)

    Bernat, Debra H; Lenk, Kathleen M; Nelson, Toben F; Winters, Ken C; Toomey, Traci L

    2014-08-01

    Campus police and security personnel are often the first to respond to alcohol-related incidents on campus. The purpose of this study is to examine how campus law enforcement and security respond to alcohol-related incidents, and how consequences and communication differ based on characteristics of the incident. Directors of campus police/security from 343 colleges across the United States completed a survey regarding usual practice following serious, underage, and less serious alcohol incidents on and off campus. Campus law enforcement and security most commonly reported contacting campus officials. A minority reported issuing citations and referring students to the health center. Enforcement actions were more commonly reported for serious and underage incidents than for less serious incidents. Large (vs. small) colleges, public (vs. private) colleges, and those located in small (vs. large) towns more consistently reported taking actions against drinkers. Understanding how campus police and security respond to alcohol-related incidents is essential for reducing alcohol-related problems on college campuses. Copyright © 2014 by the Research Society on Alcoholism.

  2. Alcohol-related problems and life satisfaction predict motivation to change among mandated college students.

    Science.gov (United States)

    Diulio, Andrea R; Cero, Ian; Witte, Tracy K; Correia, Christopher J

    2014-04-01

    The present study investigated the role specific types of alcohol-related problems and life satisfaction play in predicting motivation to change alcohol use. Participants were 548 college students mandated to complete a brief intervention following an alcohol-related policy violation. Using hierarchical multiple regression, we tested for the presence of interaction and quadratic effects on baseline data collected prior to the intervention. A significant interaction indicated that the relationship between a respondent's personal consequences and his/her motivation to change differs depending upon the level of concurrent social consequences. Additionally quadratic effects for abuse/dependence symptoms and life satisfaction were found. The quadratic probes suggest that abuse/dependence symptoms and poor life satisfaction are both positively associated with motivation to change for a majority of the sample; however, the nature of these relationships changes for participants with more extreme scores. Results support the utility of using a multidimensional measure of alcohol related problems and assessing non-linear relationships when assessing predictors of motivation to change. The results also suggest that the best strategies for increasing motivation may vary depending on the types of alcohol-related problems and level of life satisfaction the student is experiencing and highlight potential directions for future research. Copyright © 2014. Published by Elsevier Ltd.

  3. Alcohol-related hand injuries: an unnecessary social and economic cost.

    OpenAIRE

    Marston, R. A.

    1992-01-01

    Severe hand injuries constitute the largest number of acute referrals to this plastic surgery unit, the admission of these patients often displacing routine admissions due to bed shortages, thus increasing waiting list time. This study showed that a high percentage of these injuries were alcohol-related and were therefore preventable. The economic cost to the unit is discussed.

  4. Resisting temptation: decreasing alcohol-related affect and drinking behavior by training response inhibition

    NARCIS (Netherlands)

    Houben, K.; Nederkoorn, C.; Wiers, R.W.; Jansen, A.

    2011-01-01

    According to dual-process models, excessive alcohol use emerges when response inhibition ability is insufficient to inhibit automatic impulses to drink alcohol. This study examined whether strengthening response inhibition for alcohol-related cues decreases alcohol intake. Fifty-two heavy drinking

  5. Implicit and explicit alcohol-related cognitions in heavy and light drinkers

    NARCIS (Netherlands)

    Wiers, RW; van Woerden, N; Smulders, FTY; de Jong, Peter

    2002-01-01

    Implicit and explicit alcohol-related cognitions were measured in 2 dimensions: positive-negative (valence) and arousal-sedation, with 2 versions of the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. Schwartz) and related explicit measures. Heavy drinkers (h 24) strongly

  6. A working memory bias for alcohol-related stimuli depends on drinking score.

    Science.gov (United States)

    Kessler, Klaus; Pajak, Katarzyna Malgorzata; Harkin, Ben; Jones, Barry

    2013-03-01

    We tested 44 participants with respect to their working memory (WM) performance on alcohol-related versus neutral visual stimuli. Previously an alcohol attentional bias (AAB) had been reported using these stimuli, where the attention of frequent drinkers was automatically drawn toward alcohol-related items (e.g., beer bottle). The present study set out to provide evidence for an alcohol memory bias (AMB) that would persist over longer time-scales than the AAB. The WM task we used required memorizing 4 stimuli in their correct locations and a visual interference task was administered during a 4-sec delay interval. A subsequent probe required participants to indicate whether a stimulus was shown in the correct or incorrect location. For each participant we calculated a drinking score based on 3 items derived from the Alcohol Use Questionnaire, and we observed that higher scorers better remembered alcohol-related images compared with lower scorers, particularly when these were presented in their correct locations upon recall. This provides first evidence for an AMB. It is important to highlight that this effect persisted over a 4-sec delay period including a visual interference task that erased iconic memories and diverted attention away from the encoded items, thus the AMB cannot be reduced to the previously reported AAB. Our finding calls for further investigation of alcohol-related cognitive biases in WM, and we propose a preliminary model that may guide future research. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

  7. The Impact of Reality Television on the Alcohol-Related Beliefs and Behaviors

    Science.gov (United States)

    Paredes, Valerie; Cantu, Vanessa C.; Graf, Noreen M.

    2013-01-01

    This study is designed to examine the effects of reality television and alcohol-related beliefs and behaviors of Hispanic college students (N = 285). Reality television is a new form of media that is gaining popularity and provides increased exposure to glamorized alcohol use. There is a lack of research studies focused on the impact that reality…

  8. An Examination of College Students' Receptiveness to Alcohol-Related Information and Advice

    Science.gov (United States)

    Leahy, Matthew M.; Jouriles, Ernest N.; Walters, Scott T.

    2013-01-01

    This project examined the reliability and validity of a newly developed measure of college students' receptiveness to alcohol related information and advice. Participants were 116 college students who reported having consumed alcohol at some point in their lifetime. Participants completed a measure of receptiveness to alcohol-related…

  9. Hospitalizations for Students with an Alcohol-Related Sanction: Gender and Pregaming as Risk Factors

    Science.gov (United States)

    Ahmed, Rimsha; Hustad, John T. P.; LaSalle, Linda; Borsari, Brian

    2014-01-01

    Objective: The purpose of this study is to investigate whether pregaming (ie, drinking prior to a social event) is a risk factor for hospitalization. Participants: Participants (N = 516) were undergraduate students with an alcohol-related sanction. Methods: Participants completed a survey about alcohol use, as well as behaviors and experiences,…

  10. Different Pathways Explain Alcohol-Related Problems in Female and Male College Students

    Science.gov (United States)

    Pedrelli, Paola; Collado, Anahi; Shapero, Benjamin G.; Brill, Charlotte; MacPherson, Laura

    2016-01-01

    Objectives: Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways. Methods: College students (N…

  11. Interpersonal Influence and Alcohol-Related Interventions in the College Environment.

    Science.gov (United States)

    Thomas, Richard W.; Seibold, David R.

    A study examined the interpersonal influence strategies reported by college students in two alcohol-related situations--a drunk driving intervention situation and a non-driving alcohol abuse situation. Subjects, 489 undergraduate students attending a large midwestern university, a large central midwestern university, or a mid-sized upper…

  12. A Duty of Care: Non-Drinkers and Alcohol Related Harm among an Australian University Sample

    Science.gov (United States)

    Mikhailovich, Katja; George, Amanda; Rickwood, Debra; Parker, Rhian

    2011-01-01

    Studies documenting the harm associated with excessive drinking amongst university students are numerous. Fewer studies have explored the experience of non-drinkers in the university setting. In 2008, 826 students aged 18-29 years responded to an online survey aiming to investigate alcohol use and alcohol related harm at an Australian university.…

  13. Homicide in Chicago from 1890 to 1930: prohibition and its impact on alcohol- and non-alcohol-related homicides.

    Science.gov (United States)

    Asbridge, Mark; Weerasinghe, Swarna

    2009-03-01

    The aim of the current paper is to examine the impact of the enactment of constitutional prohibition in the United States in 1920 on total homicides, alcohol-related homicides and non-alcohol-related homicides in Chicago. Data are drawn from the Chicago Historical Homicide Project, a data set chronicling 11 018 homicides in Chicago between 1870 and 1930. Interrupted time-series and autoregression integrated moving average (ARIMA) models are employed to examine the impact of prohibition on three separate population-adjusted homicide series. All models control for potential confounding from World War I demobilization and from trend data drawn from Wesley Skogan's Time-Series Data from Chicago. Total and non-alcohol-related homicide rates increased during prohibition by 21% and 11%, respectively, while alcohol-related homicides remained unchanged. For other covariates, alcohol-related homicides were related negatively to the size of the Chicago police force and positively to police expenditures and to the proportion of the Chicago population aged 21 years and younger. Non-alcohol-related homicides were related positively to police expenditures and negatively to the size of the Chicago police force. While total and non-alcohol-related homicides in the United States continued to rise during prohibition, a finding consistent with other studies, the rate of alcohol-related homicides remained unchanged. The divergent impact of prohibition on alcohol- and non-alcohol-related homicides is discussed in relation to previous studies of homicide in this era.

  14. Effectiveness of lockouts in reducing alcohol-related harm: Systematic review.

    Science.gov (United States)

    Nepal, Smriti; Kypri, Kypros; Pursey, Kirrilly; Attia, John; Chikritzhs, Tanya; Miller, Peter

    2018-05-01

    Australian jurisdictions have introduced lockouts to prevent alcohol-related violence. Lockouts prohibit patrons from entering licensed premises after a designated time while allowing sale and consumption of alcohol to continue. Their purposes include managing the movement of intoxicated patrons, and preventing violence and disorder by dispersing times that patrons leave premises. We sought to evaluate the effectiveness of lockouts in preventing alcohol-related harm. We systematically searched electronic databases and reference lists and asked authors to identify relevant studies published to 1 June 2017. We deemed studies eligible if they evaluated lockouts, and if outcome measures included: assault, emergency department attendances, alcohol-related disorders or drink-driving offences. Two reviewers independently extracted data. After screening 244 records, we identified five studies from electronic databases, two from reference lists search and one from a Google search (N = 8). Two studies showed a decline in assaults; a third study showed reductions occurred only inside licensed premises; two studies showed an increase in assaults; and three studies showed no association. The studies had significant design and other limitations. Lockouts have been implemented across Australian jurisdictions as a strategy to prevent alcohol-related harm, despite limited evidence. In this systematic review, we synthesised findings from studies that evaluated lockouts as stand-alone interventions, to help clarify debate on their utility as a harm prevention strategy. There is not good evidence that lockouts prevent alcohol-related harm, in contrast to what is known about stopping the sale of alcohol earlier, for which there is evidence of effectiveness. © 2018 Australasian Professional Society on Alcohol and other Drugs.

  15. Assessing the impacts of Saskatchewan's minimum alcohol pricing regulations on alcohol-related crime.

    Science.gov (United States)

    Stockwell, Tim; Zhao, Jinhui; Sherk, Adam; Callaghan, Russell C; Macdonald, Scott; Gatley, Jodi

    2017-07-01

    Saskatchewan's introduction in April 2010 of minimum prices graded by alcohol strength led to an average minimum price increase of 9.1% per Canadian standard drink (=13.45 g ethanol). This increase was shown to be associated with reduced consumption and switching to lower alcohol content beverages. Police also informally reported marked reductions in night-time alcohol-related crime. This study aims to assess the impacts of changes to Saskatchewan's minimum alcohol-pricing regulations between 2008 and 2012 on selected crime events often related to alcohol use. Data were obtained from Canada's Uniform Crime Reporting Survey. Auto-regressive integrated moving average time series models were used to test immediate and lagged associations between minimum price increases and rates of night-time and police identified alcohol-related crimes. Controls were included for simultaneous crime rates in the neighbouring province of Alberta, economic variables, linear trend, seasonality and autoregressive and/or moving-average effects. The introduction of increased minimum-alcohol prices was associated with an abrupt decrease in night-time alcohol-related traffic offences for men (-8.0%, P prices may contribute to reductions in alcohol-related traffic-related and violent crimes perpetrated by men. Observed lagged effects for violent incidents may be due to a delay in bars passing on increased prices to their customers, perhaps because of inventory stockpiling. [Stockwell T, Zhao J, Sherk A, Callaghan RC, Macdonald S, Gatley J. Assessing the impacts of Saskatchewan's minimum alcohol pricing regulations on alcohol-related crime. Drug Alcohol Rev 2017;36:492-501]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

  16. Pervasive, hard-wired and male: Qualitative study of how UK adolescents view alcohol-related aggression.

    Science.gov (United States)

    Whitaker, Lydia; Brown, Stephen L; Young, Bridget; Fereday, Richard; Coyne, Sarah M; Qualter, Pamela

    2018-01-01

    Laboratory studies of alcohol-inexperienced adolescents show that aggression can be primed by alcohol-related stimuli, suggesting that alcohol-related aggression is partly socially learned. Script theory proposes that alcohol-related aggression 'scripts' for social behaviors are culturally-available and learned by individuals. The purpose of the study was to understand the content and origins of alcohol-related aggression scripts learned by adolescents. This qualitative focus group study of 40 adolescents (ages 14-16 years) examined alcohol-related aggression scripts. Participants believed aggression and severe injury to be pervasive when young people drink. Viewed through a biological lens, participants described aggression as an 'instinctive' and 'hard-wired' male trait facilitated by intoxication. As such, alcohol-related aggression was not seen as intended or personally controllable and participants did not see it in moral terms. Females were largely viewed as either bystanders of inter-male aggression or potential victims of male sexual aggression. Participants attributed their views on the frequency and nature of alcohol-related aggression to current affairs and reality television, which they felt portrayed a reality of which they had little experience. The origins of the explicitly biological frameworks that participants used seemed to lie in pre-existing beliefs about the nature of gender differences. Perceptions of the pervasiveness of male alcohol-related aggression, and the consequent failure to view alcohol-related aggression in moral terms, could dispose some young people to alcohol-related aggression. Interventions could target (1) the beliefs that alcohol-related aggression is pervasive and uncontrollable in males, and (2) participants' dysfunctional views of masculinity that underpin those beliefs.

  17. Managing Sleep Disturbances in Cirrhosis

    Directory of Open Access Journals (Sweden)

    Xun Zhao

    2016-01-01

    Full Text Available Sleep disturbances, particularly daytime sleepiness and insomnia, are common problems reported by patients suffering from liver cirrhosis. Poor sleep negatively impacts patients’ quality of life and cognitive functions and increases mortality. Although sleep disturbances can be an early sign of hepatic encephalopathy (HE, many patients without HE still complain of poor quality sleep. The pathophysiology of these disturbances is not fully understood but is believed to be linked to impaired hepatic melatonin metabolism. This paper provides an overview for the clinician of common comorbidities contributing to poor sleep in patients with liver disease, mainly restless leg syndrome and obstructive sleep apnea. It discusses nondrug and pharmacologic treatment options in these patients, such as the use of light therapy and histamine (H1 blockers.

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

    Directory of Open Access Journals (Sweden)

    Michael Hamerle

    2018-06-01

    Full Text Available 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

  19. Mediatization

    DEFF Research Database (Denmark)

    Hjarvard, Stig

    2017-01-01

    Mediatization research shares media effects studies' ambition of answering the difficult questions with regard to whether and how media matter and influence contemporary culture and society. The two approaches nevertheless differ fundamentally in that mediatization research seeks answers...... to these general questions by distinguishing between two concepts: mediation and mediatization. The media effects tradition generally considers the effects of the media to be a result of individuals being exposed to media content, i.e. effects are seen as an outcome of mediated communication. Mediatization...... research is concerned with long-term structural changes involving media, culture, and society, i.e. the influences of the media are understood in relation to how media are implicated in social and cultural changes and how these processes come to create new conditions for human communication and interaction...

  20. Fatty liver disease in Sudan is not alcohol related | Nail | Sudan ...

    African Journals Online (AJOL)

    Background: The finding of fatty liver disease (FLD) has generally been assumed to be a consequence of ethanol ingestion. However, non- alcoholic fatty liver disease (NAFLD) was identified as a specific entity. Although FLD is generally nonprogressive or only slowly progressive, cirrhosis and HCC can develop.

  1. Study of pulmonary dysfunctions in liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Amr M. Helmy

    2014-10-01

    Conclusion: Liver cirrhosis is associated with unique pulmonary complications. The early identification of pulmonary dysfunctions in cirrhotic patients is crucial as it affects the prognosis and guides the future management by speeding up orthotopic liver transplantation (OLT recommendations.

  2. Bisphosphonates for osteoporosis in primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena; Giljaca, Vanja; Krstic, Miodrag N

    2011-01-01

    Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis...

  3. Ursodeoxycholic acid for primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Gong, Y.; Huang, Z.B.; Christensen, Erik

    2008-01-01

    , and the references of identified studies. The last search was performed in January 2007. SELECTION CRITERIA: Randomised clinical trials evaluating UDCA versus placebo or no intervention in patients with primary biliary cirrhosis. DATA COLLECTION AND ANALYSIS: The primary outcomes were mortality and mortality......, trial duration, and patient's severity of primary biliary cirrhosis. We also used Bayesian meta-analytic approach to estimate the UDCA effect as sensitivity analysis. MAIN RESULTS: Sixteen randomised clinical trials evaluating UDCA against placebo or no intervention were identified. Data from three......BACKGROUND: Primary biliary cirrhosis is an uncommon autoimmune liver disease with unknown aetiology. Ursodeoxycholic acid (UDCA) has been used for primary biliary cirrhosis, but the effects remain controversial. OBJECTIVES: To evaluate the benefits and harms of UDCA on patients with primary...

  4. Eating Tips for People with Cirrhosis

    Science.gov (United States)

    ... People with Cirrhosis Viral Hepatitis Menu Menu Viral Hepatitis Viral Hepatitis Home For Veterans and the Public Veterans and the Public Home Hepatitis A Hepatitis B Hepatitis C Hepatitis C Home Getting ...

  5. Intensive Care Management of Patients with Cirrhosis.

    Science.gov (United States)

    Olson, Jody C

    2018-06-01

    Cirrhosis is a major worldwide health problem which results in a high level of morbidity and mortality. Patients with cirrhosis who require intensive care support have high mortality rates of near 50%. The goal of this review is to address the management of common complications of cirrhosis in the ICU. Recent epidemiological studies have shown an increase in hospitalizations due to advanced liver disease with an associated increase in intensive care utilization. Given an increasing burden on the healthcare system, it is imperative that we strive to improve our management cirrhotic patients in the intensive care unit. Large studies evaluating the management of patients in the intensive care setting are lacking. To date, most recommendations are based on extrapolation of data from studies in cirrhosis outside of the ICU or by applying general critical care principles which may or may not be appropriate for the critically ill cirrhotic patient. Future research is required to answer important management questions.

  6. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik Lykke; Reinisch, June M

    2006-01-01

    OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...... conducted in a sample of 6,562 men and women, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The sample was divided into two categories based on duration of breast-feeding, as assessed by a physician interview with mothers at a 1-year examination. Psychiatric...... hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...

  7. Serelaxin as a potential treatment for renal dysfunction in cirrhosis: Preclinical evaluation and results of a randomized phase 2 trial.

    Directory of Open Access Journals (Sweden)

    Victoria K Snowdon

    2017-02-01

    Full Text Available Chronic liver scarring from any cause leads to cirrhosis, portal hypertension, and a progressive decline in renal blood flow and renal function. Extreme renal vasoconstriction characterizes hepatorenal syndrome, a functional and potentially reversible form of acute kidney injury in patients with advanced cirrhosis, but current therapy with systemic vasoconstrictors is ineffective in a substantial proportion of patients and is limited by ischemic adverse events. Serelaxin (recombinant human relaxin-2 is a peptide molecule with anti-fibrotic and vasoprotective properties that binds to relaxin family peptide receptor-1 (RXFP1 and has been shown to increase renal perfusion in healthy human volunteers. We hypothesized that serelaxin could ameliorate renal vasoconstriction and renal dysfunction in patients with cirrhosis and portal hypertension.To establish preclinical proof of concept, we developed two independent rat models of cirrhosis that were characterized by progressive reduction in renal blood flow and glomerular filtration rate and showed evidence of renal endothelial dysfunction. We then set out to further explore and validate our hypothesis in a phase 2 randomized open-label parallel-group study in male and female patients with alcohol-related cirrhosis and portal hypertension. Forty patients were randomized 1:1 to treatment with serelaxin intravenous (i.v. infusion (for 60 min at 80 μg/kg/d and then 60 min at 30 μg/kg/d or terlipressin (single 2-mg i.v. bolus, and the regional hemodynamic effects were quantified by phase contrast magnetic resonance angiography at baseline and after 120 min. The primary endpoint was the change from baseline in total renal artery blood flow. Therapeutic targeting of renal vasoconstriction with serelaxin in the rat models increased kidney perfusion, oxygenation, and function through reduction in renal vascular resistance, reversal of endothelial dysfunction, and increased activation of the AKT

  8. Serum iron parameters in liver cirrhosis

    Science.gov (United States)

    Siregar, G. A.; Maail, W.

    2018-03-01

    The liver plays a fundamental role in iron homeostasis. Iron parameters change, especially ferritin, need to be evaluated in patients with liver cirrhosis. Serum ferritin could predict the prognosis of patients with decompensated cirrhosis since it reflects immunemediated and infectious stimuli. Ferritin could express the severity of liver disease and possible subsequent complications. Finally, it might reflect an iron overload condition resulting in significant morbidity and early mortality. 70 patients with decompensated liver cirrhosis divided into three Child-Pugh subgroups. Serum iron parameters include serum iron (SI), total iron binding capacity (TIBC) and ferritin was measured in these groups. From these 70 patients, 30 (42.9%) with HbsAg positive, 26 (37.1%) with anti-HCV positive and 14 (20%) with both HbsAg and anti-HCV positive. Of the 70 patients, 14 (20%) had CTP Class A cirrhosis, 17 (24.3%) had CTP Class B cirrhosis, and 39 (55.7%) had CTP C cirrhosis. The median (range) value of serum iron was 36 (10-345) μg/dl, TIBC was 160 (59-520) μg/dl, Ferritin was 253.5 (8-6078) ng/ml and the transferrin saturation was 22.9 (3.65-216.98) %.We found a significant difference in serum ferritin level with CTP score. Ferritin levels increased as Child-Pugh class progressed (p<0.001).

  9. Alcohol-related expectancies in adults and adolescents: Similarities and disparities.

    Science.gov (United States)

    Monk, Rebecca L; Heim, Derek

    2016-03-02

    This study aimed to contrast student and not student outcome expectancies, and explore the diversity of alcohol-related cognitions within a wider student sample. Participants (n=549) were college students (higher education-typically aged 15-18 years), university students (further education-typically aged 18-22 years) and business people (white collar professionals <50 years) who completed questionnaires in their place of work or education. Overall positive expectancies were higher in the college students than in the business or university samples. However, not all expectancy subcategories followed this pattern. Participant groups of similar age were therefore alike in some aspects of their alcohol-related cognitions but different in others. Similarly, participant groups whom are divergent in age appeared to be alike in some of their alcohol-related cognitions, such as tension reduction expectancies. Research often homogenises students as a specific sub-set of the population, this paper hi-lights that this may be an over-simplification. Furthermore, the largely exclusive focus on student groups within research in this area may also be an oversight, given the diversity of the findings demonstrated between these groups.

  10. Sexual identity and alcohol-related outcomes: contributions of workplace harassment.

    Science.gov (United States)

    Nawyn, S J; Richman, J A; Rospenda, K M; Hughes, T L

    2000-01-01

    While workplace sexual harassment has received a great deal of attention in both the popular media and scientific literature, less attention has been directed to the differential occurrence of sexual harassment among lesbians, gay men, and heterosexual men and women, and the relationships between these experiences and alcohol-related outcomes. Additionally, the distribution of alcohol-related outcomes of non-sexual forms of workplace harassment among these groups have not been adequately explored. Using data from a university-based study of workplace harassment and alcohol use (N = 2492), we focus on exposure to workplace harassment and alcohol-related outcomes for lesbians, gay men, and bisexuals compared to heterosexual men and women. Lesbian/bisexual women did not differ significantly from heterosexual women in their experiences of workplace harassment. However, stronger linkages between harassment and increased alcohol consumption and problems were found for lesbian and bisexual women than for heterosexual women. Gay/bisexual men, on the other hand, experienced significantly more sexual harassment than heterosexual men, but did not report a corresponding increase in alcohol use and abuse. Implications for future research on sexual identity, alcohol use, and workplace harassment are discussed.

  11. Improving Survival in Decompensated Cirrhosis

    Directory of Open Access Journals (Sweden)

    Amar Nath Mukerji

    2012-01-01

    Full Text Available Mortality in cirrhosis is consequent of decompensation, only treatment being timely liver transplantation. Organ allocation is prioritized for the sickest patients based on Model for End Stage Liver Disease (MELD score. In order to improve survival in patients with high MELD score it is imperative to preserve them in suitable condition till transplantation. Here we examine means to prolong life in high MELD score patients till a suitable liver is available. We specially emphasize protection of airways by avoidance of sedatives, avoidance of Bilevel Positive Airway Pressure, elective intubation in grade III or higher encephalopathy, maintaining a low threshold for intubation with lesser grades of encephalopathy when undergoing upper endoscopy or colonoscopy as pre transplant evaluation or transferring patient to a transplant center. Consider post-pyloric tube feeding in encephalopathy to maintain muscle mass and minimize risk of aspiration. In non intubated and well controlled encephalopathy, frequent physical mobility by active and passive exercises are recommended. When renal replacement therapy is needed, night-time Continuous Veno-Venous Hemodialysis may be useful in keeping the daytime free for mobility. Sparing and judicious use of steroids needs to be borne in mind in treatment of ARDS and acute hepatitis from alcohol or autoimmune process.

  12. Alcohol-related blackouts among college students: impact of low level of response to alcohol, ethnicity, sex, and environmental characteristics

    Directory of Open Access Journals (Sweden)

    Priscila D. Gonçalves

    2017-08-01

    Full Text Available Objective: To explore how a genetically-influenced characteristic (the level of response to alcohol [LR], ethnicity, and sex relate to environmental and attitudinal characteristics (peer drinking [PEER], drinking to cope [COPE], and alcohol expectancies [EXPECT] regarding future alcohol-related blackouts (ARBs. Methods: Structural equation models (SEMs were used to evaluate how baseline variables related to ARB patterns in 462 college students over 55 weeks. Data were extracted from a longitudinal study of heavy drinking and its consequences at a U.S. university. Results: In the SEM analysis, female sex and Asian ethnicity directly predicted future ARBs (beta weights 0.10 and -0.11, respectively, while all other variables had indirect impacts on ARBs through alcohol quantities (beta weights ~ 0.23 for European American ethnicity and low LR, 0.21 for cannabis use and COPE, and 0.44 for PEER. Alcohol quantities then related to ARBs with beta = 0.44. The SEM explained 23% of the variance. Conclusion: These data may be useful in identifying college students who are more likely to experience future ARBs over a 1-year period. They enhance our understanding of whether the relationships of predictors to ARBs are direct or mediated through baseline drinking patterns, information that may be useful in prevention strategies for ARBs.

  13. The relationship between emotion regulation capacity, heart rate variability, and quality of life in individuals with alcohol-related brain damage

    Directory of Open Access Journals (Sweden)

    Steinmetz JP

    2016-08-01

    Full Text Available Jean-Paul Steinmetz,1,2 Claus Vögele,3,4 Christiane Theisen-Flies,5 Carine Federspiel,1,2 Stefan Sütterlin6,7 1Department of Research and Development, ZithaSenior, 2Centre for Memory and Mobility, ZithaSenior, 3Institute for Health and Behaviour, Integrative Research Unit on Social and Individual Development (INSIDE, University of Luxembourg, Luxembourg; 4Research Group Health Psychology, University of Leuven, Leuven, Belgium; 5Home St Joseph, ZithaSenior, Luxembourg; 6Department of Psychology, Lillehammer University College, Lillehammer, 7Division of Surgery and Clinical Neuroscience, Department of Psychosomatic Medicine, Oslo University Hospital – Rikshospitalet, Oslo, Norway Abstract: The reliable measurement of quality of life (QoL presents a challenge in individuals with alcohol-related brain damage. This study investigated vagally mediated heart rate variability (vmHRV as a physiological predictor of QoL. Self- and proxy ratings of QoL and dysexecutive symptoms were collected once, while vmHRV was repeatedly assessed over a 3-week period at weekly intervals in a sample of nine alcohol-related brain damaged patients. We provide robustness checks, bootstrapped correlations with confidence intervals, and standard errors for mean scores. We observed low to very low heart rate variability scores in our patients in comparison to norm values found in healthy populations. Proxy ratings of the QoL scale “subjective physical and mental performance” and everyday executive dysfunctions were strongly related to vmHRV. Better proxy-rated QoL and fewer dysexecutive symptoms were observed in those patients with higher vmHRV. Overall, patients showed low parasympathetic activation favoring the occurrence of dysfunctional emotion regulation strategies. Keywords: heart rate variability, emotion regulation, alcohol-related brain damage, quality of life

  14. Update on Primary Biliary Cirrhosis

    Directory of Open Access Journals (Sweden)

    Jenny Heathcote

    2000-01-01

    Full Text Available The diagnosis of primary biliary cirrhosis (PBC is most often made in the asymptomatic phase, sometimes before the development of abnormal liver biochemistry. The antimitochondrial antibody remains the predominant hallmark, although not all patients test positive, even when the most sensitive techniques are used. The etiology of PBC remains elusive; studies suggest that the interlobular bile duct destruction is immune based, and associated autoimmune diseases are common. There are no surrogate markers that predict outcome in asymptomatic patients, whose chance of survival is less than that of age- and sex-matched populations but much better than the median survival of eight years in patients with symptomatic PBC. Symptoms common in this disease are fatigue, pruritus and xanthelasma, as well as complications of portal hypertension and osteoporosis. Treatment includes symptomatic and preventive measures, as well as specific therapeutic measures. Immunosuppressive therapy has yielded disappointing results in the long term management of PBC, and the only therapy shown to improve survival is the hydrophobic dihydroxy bile acid ursodeoxycholic acid. Treatment at a dose of 13 to 15 mg/kg/day is optimal, given in separate doses or as a single dose at least 4 h from giving the oral anion exchange resin cholestyramine, which may be used to control pruritus. However, liver transplantation remains the only cure for this disease, and the best postoperative survival is seen in patients whose serum bilirubin does not exceed 180 µmol/L at the time of liver transplantation. Recurrence takes place but is rarely symptomatic and does not deter from the benefits of transplantation.

  15. Liver surgery in cirrhosis and portal hypertension.

    Science.gov (United States)

    Hackl, Christina; Schlitt, Hans J; Renner, Philipp; Lang, Sven A

    2016-03-07

    The prevalence of hepatic cirrhosis in Europe and the United States, currently 250 patients per 100000 inhabitants, is steadily increasing. Thus, we observe a significant increase in patients with cirrhosis and portal hypertension needing liver resections for primary or metastatic lesions. However, extended liver resections in patients with underlying hepatic cirrhosis and portal hypertension still represent a medical challenge in regard to perioperative morbidity, surgical management and postoperative outcome. The Barcelona Clinic Liver Cancer classification recommends to restrict curative liver resections for hepatocellular carcinoma in cirrhotic patients to early tumor stages in patients with Child A cirrhosis not showing portal hypertension. However, during the last two decades, relevant improvements in preoperative diagnostic, perioperative hepatologic and intensive care management as well as in surgical techniques during hepatic resections have rendered even extended liver resections in higher-degree cirrhotic patients with portal hypertension possible. However, there are few standard indications for hepatic resections in cirrhotic patients and risk stratifications have to be performed in an interdisciplinary setting for each individual patient. We here review the indications, the preoperative risk-stratifications, the morbidity and the mortality of extended resections for primary and metastatic lesions in cirrhotic livers. Furthermore, we provide a review of literature on perioperative management in cirrhotic patients needing extrahepatic abdominal surgery and an overview of surgical options in the treatment of hepatic cirrhosis.

  16. The PNPLA3 rs738409 148M/M genotype is a risk factor for liver cancer in alcoholic cirrhosis but shows no or weak association in hepatitis C cirrhosis.

    Directory of Open Access Journals (Sweden)

    Hans Dieter Nischalke

    Full Text Available BACKGROUND: An isoleucine>methionine mutation at position 148 in the PNPLA3 gene (p.I148M, rs738409 has recently been identified as a susceptibility factor for liver damage in steatohepatitis. Here, we studied whether the PNPLA3 rs738409 polymorphism also affects predisposition to hepatocellular carcinoma (HCC. METHODS: We compared distributions of PNPLA3 genotypes in 80 and 81 Caucasian patients with alcoholic and hepatitis C virus (HCV-associated HCC to 80 and 81 age- and sex-matched patients with alcohol-related and HCV-related cirrhosis without HCC, respectively. PNPLA3 genotypes in 190 healthy individuals from the same population served as reference. Potential confounders obesity, diabetes, HCV genotype and HBV co-infection were controlled by univariate and multivariate logistic regression with forward variable selection. RESULTS: PNPLA3 genotypes were in Hardy-Weinberg equilibrium for all study groups. The frequency of the 148M allele was significantly (p<0.001 increased in alcoholic cirrhosis with (53.7% and without HCC (36.2% but was not different between healthy controls (22.9% and patients with cirrhosis (25.3%; p = 0.545 and HCC (30.2%; p = 0.071 due to hepatitis C. HCC risk was highest in 148M/M homozygous patients with alcoholic liver disease (odds ratio (OR 16.8 versus healthy controls; 95% confidence interval (CI 6.68-42.43, p<0.001. Finally, multivariate regression confirmed 148M/M homozygosity (OR 2.8; 95%-CI: 1.24-6.42; p = 0.013 as HCC risk factor in alcoholic cirrhosis. In HCV-related cirrhosis only HCV genotype 1 was confirmed as a HCC risk factor (OR 4.2; 95%-CI: 1.50-11.52; p = 0.006. CONCLUSION: The PNPLA3 148M variant is a prominent risk factor for HCC in patients with alcoholic cirrhosis, while its effects are negligible in patients with cirrhosis due to HCV. This polymorphism provides an useful tool to identify individuals with particularly high HCC risk in patients with alcoholic liver disease that

  17. The impact of alcohol-related presentations on a New Zealand hospital emergency department.

    Science.gov (United States)

    Stewart, Rebecca; Das, Manidipa; Ardagh, Michael; Deely, Joanne M; Dodd, Stuart; Bartholomew, Nadia; Pearson, Scott; Spearing, Ruth; Williams, Tracey; Than, Martin

    2014-08-29

    To determine the impact of alcohol-related presentations on the Christchurch Hospital Emergency Department (ED). Over 42 8-hour shifts (2 weeks) between 15 November 2013 and 9 December 2013, patients attending the ED with recent alcohol consumption were classified as screen-positive (consumed alcohol in the 4 hours prior to presentation) or not. A subset of screen-positive patients was classified as impact-positive (alcohol consumption clearly contributed to the reason for presenting). Data were analysed in relation to days/shifts for gender, age, disruptive behaviour, medical reasons for presenting, and completeness of ED records. Of the 3619 patients screened in the study, 268 (7.4%) and 182 (5%) were screen-positive and impact-positive, respectively. Most patients attended the ED on the weekends (58%: 105/182), particularly on Saturday night (31%; 56/182). More males (118) than females (64) were impact-positive. Of the impact-positive males, most were 16-25 years old (37%; 44/118) or 41-61 years old (32%; 38/118), attended the ED on weekend night shifts (24%; 28/118), and sought treatment for non- interpersonal trauma (38%; 45/118) or interpersonal trauma due to violence (17%; 20/118). Of the female impact-positive patients, most were 16-25 years old (41%; 26/64) or 41-60 years old (33%; 21/64), and presented for deliberate self-harm (36%; 23/64) or non-interpersonal trauma (27%; 17/64). Of the 182 impact-positive patients, 86% (156) were recorded in the ED computer system. Alcohol-related presentations had a significant impact on the ED, particularly on weekends. Teenagers, young adults and middle-aged adults contributed to the alcohol-related patient impact on weekends. Male patients were a significant burden on Saturday evening and night shifts.

  18. Social Inequalities and Gender Differences in the Experience of Alcohol-Related Problems

    Science.gov (United States)

    Grittner, Ulrike; Kuntsche, Sandra; Graham, Kathryn; Bloomfield, Kim

    2012-01-01

    Aims: To examine the influence of country-level characteristics and individual socio-economic status (SES) on individual alcohol-related consequences. Methods: Data from 42,655 men and women collected by cross-sectional surveys in 25 countries of the Gender, Alcohol and Culture: An International Study study were used. The individual SES was measured by the highest attained educational level. Alcohol-related consequences were defined as the self-report of at least one internal or one external consequence in the last year. The relationship between individuals’ education and alcohol-related consequences was examined by meta-analysis. In a second step, the individual level data and country data were combined in multilevel models. As country-level indicators, we used the purchasing power parity of the gross national income (GNI), the Gini coefficient and the Gender Gap Index. Results: Lower educated men and women were more likely to report consequences than higher educated men and women even after controlling for drinking patterns. For men, this relation was significant for both internal and external problems. For women, it was only significant for external problems. The GNI was significantly associated with reporting external consequences for men such that in lower income countries men were more likely to report social problems. Conclusion: The fact that problems accrue more quickly for lower educated persons even if they drink in the same manner can be linked to the social or environmental dimension surrounding problems. That is, those of fewer resources are less protected from the experience of a problem or the impact of a stressful life event. PMID:22542707

  19. Social inequalities and gender differences in the experience of alcohol-related problems.

    Science.gov (United States)

    Grittner, Ulrike; Kuntsche, Sandra; Graham, Kathryn; Bloomfield, Kim

    2012-01-01

    To examine the influence of country-level characteristics and individual socio-economic status (SES) on individual alcohol-related consequences. Data from 42,655 men and women collected by cross-sectional surveys in 25 countries of the Gender, Alcohol and Culture: An International Study study were used. The individual SES was measured by the highest attained educational level. Alcohol-related consequences were defined as the self-report of at least one internal or one external consequence in the last year. The relationship between individuals' education and alcohol-related consequences was examined by meta-analysis. In a second step, the individual level data and country data were combined in multilevel models. As country-level indicators, we used the purchasing power parity of the gross national income (GNI), the Gini coefficient and the Gender Gap Index. Lower educated men and women were more likely to report consequences than higher educated men and women even after controlling for drinking patterns. For men, this relation was significant for both internal and external problems. For women, it was only significant for external problems. The GNI was significantly associated with reporting external consequences for men such that in lower income countries men were more likely to report social problems. The fact that problems accrue more quickly for lower educated persons even if they drink in the same manner can be linked to the social or environmental dimension surrounding problems. That is, those of fewer resources are less protected from the experience of a problem or the impact of a stressful life event.

  20. Still a difficult business? Negotiating alcohol-related problems in general practice consultations.

    Science.gov (United States)

    Rapley, Tim; May, Carl; Frances Kaner, Eileen

    2006-11-01

    This paper describes general practitioners' (GPs) experiences of detecting and managing alcohol and alcohol-related problems in consultations. We undertook qualitative research in two phases in the North-East of England. Initially, qualitative interviews with 29 GPs explored their everyday work with patients with alcohol-related issues. We then undertook group interviews--two with GPs and one with a primary care team--where they discussed and challenged findings of the interviews. The GPs reported routinely discussing alcohol with patients with a range of alcohol-related problems. GPs believed that this work is important, but felt that until patients were willing to accept that their alcohol consumption was problematic they could achieve very little. They tentatively introduced alcohol as a potential problem, re-introduced the topic periodically, and then waited until the patient decided to change their behaviour. They were aware that they could identify and manage more patients. A lack of time and having to work with the multiple problems that patients brought to consultations were the main factors that stopped GPs managing more risky drinkers. Centrally, we compared the results of our study with [Thom, B., & Tellez, C. (1986). A difficult business-Detecting and managing alcohol-problems in general-practice. British Journal of Addiction, 81, 405-418] seminal study that was undertaken 20 years ago. We show how the intellectual, moral, emotional and practical difficulties that GPs currently face are quite similar to those faced by GPs from 20 years ago. As the definition of what could constitute abnormal alcohol consumption has expanded, so the range of consultations that they may have to negotiate these difficulties in has also expanded.

  1. Long-Term Mortality of Patients with an Alcohol-Related Wernicke-Korsakoff Syndrome.

    Science.gov (United States)

    Sanvisens, Arantza; Zuluaga, Paola; Fuster, Daniel; Rivas, Inmaculada; Tor, Jordi; Marcos, Miguel; Chamorro, Antonio J; Muga, Roberto

    2017-07-01

    To characterize a series of contemporary patients with alcohol-related Wernicke's encephalopathy (WE) or Korsakoff's syndrome (KS) and to update the current prognosis of disease. Retrospective and prospective study of patients diagnosed with an alcohol-related WE or KS between 2002 and 2011 in a tertiary hospital. Socio-demographic, alcohol use characteristics, signs and symptoms, co-morbidity and blood parameters were obtained at admission. Patients were followed up until 2013 and causes of death were ascertained through the review of charts. Sixty-one patients were included (51 with WE and 10 with KS). Among patients with WE, 78% were men and age at diagnosis was 57 years (interquartile range (IQR): 49-66). Twenty-three percent fulfilled the classic WE triad. Regarding Caine's criteria for WE, 70.6% presented with at least two out of four signs or symptoms. Median follow-up of patients with WE syndrome was 5.3 years (IQR: 2.6-8.8), the cumulated mortality was 45% and death rate of 7.4 × 100 person-years (95% confidence interval (CI): 4.8-10.9). Overall, 50% of patients would be expected to die within 8 years of WE episode and main causes of death included serious bacterial infections (44.5%) and cancer (33.3%). Survival of patients with an alcohol-related Wernicke-Korsakoff syndrome is poor; pursuing treatment of alcohol use disorder and early diagnosis of thiamine deficiency is a priority for improving clinical outcomes. © The Author 2017. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  2. [Trans-Cultural Prevention of Alcohol-Related Disorders in Elderly Immigrants].

    Science.gov (United States)

    Bermejo, I; Frank, F

    2015-09-01

    In migrants alcohol-related problems increase with increasing age. This group, in particular, is hardly reached by alcohol-specific care offers. Thus our project aimed at the identification of target group-specific barriers to health-care use by means of a cross-sectional study (n=435). Based on these results a trans-cultural concept for alcohol prevention among elderly migrants was developed and evaluated in a cluster-randomised controlled trial (n=176). © Georg Thieme Verlag KG Stuttgart · New York.

  3. Change in alcohol outlet density and alcohol-related harm to population health (CHALICE

    Directory of Open Access Journals (Sweden)

    Fone David

    2012-06-01

    Full Text Available Abstract Background Excess alcohol consumption has serious adverse effects on health and violence-related harm. In the UK around 37% of men and 29% of women drink to excess and 20% and 13% report binge drinking. The potential impact on population health from a reduction in consumption is considerable. One proposed method to reduce consumption is to reduce availability through controls on alcohol outlet density. In this study we investigate the impact of a change in the density of alcohol outlets on alcohol consumption and alcohol-related harms to health in the community. Methods/Design A natural experiment of the effect of change in outlet density between 2005–09, in Wales, UK; population 2.4 million aged 16 years and over. Data on outlets are held by the 22 local authorities in Wales under The Licensing Act 2003. The study outcomes are change in (1 alcohol consumption using data from annual Welsh Health Surveys, (2 alcohol-related hospital admissions using the Patient Episode Database for Wales, (3 Accident & Emergency department attendances between midnight–6am, and (4 alcohol-related violent crime against the person, using Police data. The data will be anonymously record-linked within the Secure Anonymised Information Linkage Databank at individual and 2001 Census Lower Super Output Area levels. New methods of network analysis will be used to estimate outlet density. Longitudinal statistical analysis will use (1 multilevel ordinal models of consumption and logistic models of admissions and Accident & Emergency attendance as a function of change in individual outlet exposure, adjusting for confounding variables, and (2 spatial models of the change in counts/rates of each outcome measure and outlet density. We will assess the impact on health inequalities and will correct for population migration. Discussion This inter-disciplinary study requires expertise in epidemiology and public health, health informatics, medical statistics

  4. Amelioration of carbon tetrachloride-induced cirrhosis and portal hypertension in rat using adenoviral gene transfer of Akt.

    Science.gov (United States)

    Deng, Gang; Huang, Xiang-Jun; Luo, Hong-Wu; Huang, Fei-Zhou; Liu, Xun-Yang; Wang, Yong-Heng

    2013-01-01

    To investigate whether a virus constitutively expressing active Akt is useful to prevent cirrhosis induced by carbon tetrachloride (CCl4). Using cre-loxp technique, we created an Ad-myr-HA-Akt virus, in which Akt is labeled by a HA tag and its expression is driven by myr promoter. Further, through measuring enzyme levels and histological structure, we determined the efficacy of this Ad-myr-HA-Akt virus in inhibiting the development of cirrhosis induced by CCl4 in rats. Lastly, using western blotting, we examined the expression levels and/or phosphorylation status of Akt, apoptotic mediators, endothelial nitric oxide synthase (eNOS), and markers for hepatic stellate cells activation to understand the underlying mechanisms of protective role of this virus. The Ad-myr-HA-Akt virus was confirmed using polymerase chain reaction amplification of inserted Akt gene and sequencing for full length of inserted fragment, which was consistent with the sequence reported in the GenBank. The concentrations of Ad-myr-HA-Akt and adenoviral enhanced green fluorescent protein (Ad-EGFP) virus used in the current study were 5.5 × 10(11) vp/mL. The portal vein diameter, peak velocity of blood flow, portal blood flow and congestion index were significantly increased in untreated, saline and Ad-EGFP cirrhosis groups when compared to normal control after the virus was introduced to animal through tail veil injection. In contrast, these parameters in the Akt cirrhosis group were comparable to normal control group. Compared to the normal control, the liver function (Alanine aminotransferase, Aspartate aminotransferase and Albumin) was significantly impaired in the untreated, saline and Ad-EGFP cirrhosis groups. The Akt cirrhosis group showed significant improvement of liver function when compared to the untreated, saline and Ad-EGFP cirrhosis groups. The Hyp level and portal vein pressure in Akt cirrhosis groups were also significantly lower than other cirrhosis groups. The results of HE and

  5. Increased arterial compliance in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren; Schifter, S

    1999-01-01

    BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension...... of CGRP (r=0.34, pcompliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

  6. Increased arterial compliance in decompensated cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Møller, Søren; Schifter, S

    1999-01-01

    of the vasodilator, calcitonin gene-related peptide (CGRP) and mean arterial blood pressure (MAP). METHODS: Arterial compliance (COMPart=deltaV/deltaP) was determined as the stroke volume relative to pulse pressure (i.e. systolic minus diastolic blood pressure) during a haemodynamic evaluation of portal hypertension......BACKGROUND/AIMS: In patients with cirrhosis, the systemic circulation is hyperdynamic with low arterial blood pressure and reduced systemic vascular resistance. The present study was undertaken to estimate the compliance of the arterial tree in relation to severity of cirrhosis, circulating level...... of CGRP (r=0.34, parterial compliance in cirrhosis is directly related to the severity of the disease and to the elevated level of circulating vasodilator peptide CGRP, and inversely related...

  7. Alcohol-related cognitions in children (aged 2-10) and how they are shaped by parental alcohol use : A systematic review

    NARCIS (Netherlands)

    Voogt, Carmen; Beusink, Miriam; Kleinjan, Marloes; Otten, Roy; Engels, Rutger; Smit, Koen; Kuntsche, Emmanuel

    2017-01-01

    BACKGROUND: This systematic review aims to summarize the evidence of the impact of parental alcohol use on the acquisition of children's alcohol-related cognitions (alcohol-related knowledge, alcohol-related norms, alcohol expectancies) in the developmental period from age two to ten. METHODS: A

  8. Alcohol-related cognitions in children (aged 2-10) and how they are shaped by parental alcohol use: A systematic review

    NARCIS (Netherlands)

    Voogt, C.V.; Beusink, M.; Kleinjan, M.; Otten, R.; Engels, R.C.M.E.; Smit, K.; Kuntsche, E.N.

    2017-01-01

    Background: This systematic review aims to summarize the evidence of the impact of parental alcohol use on the acquisition of children's alcohol-related cognitions (alcohol-related knowledge, alcohol-related norms, alcohol expectancies) in the developmental period from age two to ten. Methods: A

  9. The relationship between exposure to alcohol-related content on Facebook and predictors of alcohol consumption among female emerging adults.

    Science.gov (United States)

    Miller, Joseph; Prichard, Ivanka; Hutchinson, Amanda; Wilson, Carlene

    2014-12-01

    Consuming an unhealthy level of alcohol is a significant problem for some young women. Potential determinants of excess consumption include perceptions of usual consumption among peers-perceptions of what is "normal." The present study examined whether perceptions of social normative endorsement of drinking, operationalized by measures of perceived alcohol consumption of close friends (proximal norms), the consumption of the "average student" (distal norms), and the extent of alcohol-related content posted by peers on Facebook were related to alcohol-related attitudes and self-reported consumption. Female university students (n=129; Mage=21.48 years, SD=3.00) completed an online questionnaire assessing Facebook use, perceived alcohol-related norms, and self-reported alcohol attitudes and consumption. Perceptions of the consumption of the average female student were a negative predictor of attitudes. Positive alcohol attitudes, extent of own alcohol-related photographic posts on Facebook, average female student alcohol consumption, and report of male close friend consumption predicted self-report of own alcohol consumption. Interestingly, female close friend norms failed to predict consumption, whereas male close friend norms predicted consumption but not attitudes, suggesting the possibility of separate cognitive pathways for alcohol-related attitudes and behavior. This study builds on existing research by casting new light on predictors of alcohol-related attitudes, as well as describing the potential role of social networking sites such as Facebook in the formation of social norms and the modulation of drinking behavior.

  10. TIMP-1 in patients with cirrhosis

    DEFF Research Database (Denmark)

    Busk, Troels M; Bendtsen, Flemming; Nielsen, Hans J

    2014-01-01

    OBJECTIVE: Cirrhotic portal hypertensive patients often develop hemodynamic complications and the diagnosis is often based on liver biopsy and measurements of the hepatic venous pressure gradient (HVPG). Potential noninvasive biomarkers for the severity of cirrhosis are the matrix metalloproteinase...... and their specific inhibitors such as tissue inhibitor of metalloproteinases-1 (TIMP-1). The aim of the study was to investigate TIMP-1 levels in cirrhosis in relation to the degree of liver dysfunction, portal hypertension, and hemodynamic changes. MATERIALS AND METHODS: We retrospectively studied 84 patients.......0001), HVPG (r = 0.40, p portal hypertension. CONCLUSIONS: TIMP-1 is significantly...

  11. Arterial hypoxaemia in cirrhosis: fact or fiction?

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, J; Christensen, E

    1998-01-01

    characteristics. PATIENTS: One hundred and forty two patients with cirrhosis without significant hepatic encephalopathy (grades 0-I) (41 patients in Child class A, 57 in class B, and 44 in class C) and 21 patients with hepatic encephalopathy. RESULTS: Mean Po2 in kPa was 11.3 in Child class A, 10.8 in class B, 10...... resistance, and a low indocyanine green clearance (p hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing.......6 in class C, and 10.6 in patients with encephalopathy (p C, and in patients with encephalopathy (p

  12. Reduced central blood volume in cirrhosis

    DEFF Research Database (Denmark)

    Bendtsen, F; Henriksen, Jens Henrik Sahl; Sørensen, T I

    1989-01-01

    than 0.0001). The lowest values (18 ml/kg) were found in patients with gross ascites and a reduced systemic vascular resistance. In patients with cirrhosis central blood volume was inversely correlated to the hepatic venous pressure gradient (r = -0.41, p less than 0.01), and the total blood volume...... was inversely correlated to the systemic vascular resistance (r = -0.49, p less than 0.001), the latter being significantly reduced in the patient group. Patients with cirrhosis apparently are unable to maintain a normal central blood volume. This may be due to arteriolar vasodilation, portosystemic collateral...

  13. Detection of novel biomarkers of liver cirrhosis by proteomic analysis

    DEFF Research Database (Denmark)

    Mölleken, Christian; Sitek, Barbara; Henkel, Corinna

    2009-01-01

    Hepatic cirrhosis is a life-threatening disease arising from different chronic liver disorders. One major cause for hepatic cirrhosis is chronic hepatitis C. Chronic hepatitis C is characterized by a highly variable clinical course, with at least 20% developing liver cirrhosis within 40 years. On...

  14. Marketing and alcohol-related traffic fatalities: impact of alcohol advertising targeting minors.

    Science.gov (United States)

    Smith, Ryan C; Geller, E Scott

    2009-10-01

    Alcohol-related youth traffic fatalities continue as a major public-health concern. While state and federal laws can be useful in tackling this problem, the efficacy of many laws has not been empirically demonstrated. We examined the impact of state laws prohibiting alcohol advertising to target minors. Using statistics obtained from the Fatality Analysis Reporting System (FARS), youth alcohol-related, single-vehicle, driver traffic fatalities were compared by state as a function of whether the state has a law prohibiting alcohol advertising that targets minors. Overall, states possessing this law experienced 32.9% fewer of the above specified traffic fatalities. DISCUSSION AND IMPACT ON INDUSTRY: The results suggest that not only are youth drinking rates affected by alcohol advertisements targeting youth, but also drink-driving behaviors. Indeed, we estimate that if this type of legislation were adopted in the 26 states that do not prohibit targeting of minors with alcohol advertising, then 400 youth lives could be saved annually.

  15. Using autopsy brain tissue to study alcohol-related brain damage in the genomic age.

    Science.gov (United States)

    Sutherland, Greg T; Sheedy, Donna; Kril, Jillian J

    2014-01-01

    The New South Wales Tissue Resource Centre at the University of Sydney, Australia, is one of the few human brain banks dedicated to the study of the effects of chronic alcoholism. The bank was affiliated in 1994 as a member of the National Network of Brain Banks and also focuses on schizophrenia and healthy control tissue. Alcohol abuse is a major problem worldwide, manifesting in such conditions as fetal alcohol syndrome, adolescent binge drinking, alcohol dependency, and alcoholic neurodegeneration. The latter is also referred to as alcohol-related brain damage (ARBD). The study of postmortem brain tissue is ideally suited to determining the effects of long-term alcohol abuse, but it also makes an important contribution to understanding pathogenesis across the spectrum of alcohol misuse disorders and potentially other neurodegenerative diseases. Tissue from the bank has contributed to 330 peer-reviewed journal articles including 120 related to alcohol research. Using the results of these articles, this review chronicles advances in alcohol-related brain research since 2003, the so-called genomic age. In particular, it concentrates on transcriptomic approaches to the pathogenesis of ARBD and builds on earlier reviews of structural changes (Harper et al. Prog Neuropsychopharmacol Biol Psychiatry 2003;27:951) and proteomics (Matsumoto et al. Expert Rev Proteomics 2007;4:539). Copyright © 2013 by the Research Society on Alcoholism.

  16. Social meaning of alcohol-related flushing among university students in China.

    Science.gov (United States)

    Newman, Ian M; Jinnai, Izumi; Zhao, Jie; Huang, Zhaoqing; Pu, Jia; Qian, Ling

    2013-09-01

    This study explored drinking patterns, alcohol-related flushing, and ways students themselves and other people respond to flushing in drinking situations. Of 1080 Chinese undergraduate university students given the survey questionnaire, 725 (67.1%) returned the completed surveys. Eighty percent of the students were drinkers (93% of males and 69% of females); 68% of the drinkers were flushers. Most of the students (59.3%) said flushing had no special meaning, that is, would ignore flushing; 54% of the flushers said they could keep drinking "but less" when they flush; 27% of the students said that a flushing person should stop drinking; however, if the flushing person is a girl, 89% of the students said the girl should drink less or stop. If the flushing person was a boy, 61% of students said he should drink less or stop. The data do suggest gender differences in the understanding of and social reaction to alcohol-related flushing, and these differences raise interesting questions as to how flushing acts as a potential protective factor against alcohol misuse.

  17. Gender orientation and alcohol-related weight control behavior among male and female college students.

    Science.gov (United States)

    Peralta, Robert L; Barr, Peter B

    2017-01-01

    We examine weight control behavior used to (a) compensate for caloric content of heavy alcohol use; and (b) enhance the psychoactive effects of alcohol among college students. We evaluate the role of gender orientation and sex. Participants completed an online survey (N = 651; 59.9% women; 40.1% men). Weight control behavior was assessed via the Compensatory-Eating-and-Behaviors-in Response-to-Alcohol-Consumption-Scale. Control variables included sex, race/ethnicity, age, and depressive symptoms. Gender orientation was measured by the Bem Sex Role Inventory. The prevalence and probability of alcohol-related weight control behavior using ordinal logistic regression are reported. Men and women do not significantly differ in compensatory-weight-control-behavior. However, regression models suggest that recent binge drinking, other substance use, and masculine orientation are positively associated with alcohol-related weight control behavior. Sex was not a robust predictor of weight control behavior. Masculine orientation should be considered a possible risk factor for these behaviors and considered when designing prevention and intervention strategies.

  18. A nonalcoholic fatty liver disease cirrhosis model in gerbil : the dynamic relationship between hepatic lipid metabolism and cirrhosis

    NARCIS (Netherlands)

    Li, Wei; Guan, Zheng; Brisset, Jean C.; Shi, Qiaojuan; Lou, Qi; Ma, Yue; Suriguga, Su; Ying, Huazhong; Sa, Xiaoying; Chen, Zhenwen; Quax, Wim J.; Chu, Xiaofeng

    2018-01-01

    Nonalcoholic fatty liver disease (NAFLD) usually takes decades to develop into cirrhosis, which limits the longitudinal study of NAFLD. This work aims at developing a NAFLD-caused cirrhosis model in gerbil and examining the dynamic relationship between hepatic lipid metabolism and cirrhosis. We fed

  19. Primary Biliary Cirrhosis Is a Generalized Autoimmune Epithelitis

    Directory of Open Access Journals (Sweden)

    Jun Gao

    2015-03-01

    Full Text Available Primary biliary cirrhosis (PBC is a chronic progressive autoimmune cholestatic liver disease characterized by highly specific antimitochondrial antibodies (AMAs and the specific immune-mediated injury of small intrahepatic bile ducts. Unique apoptotic feature of biliary epithelial cells (BECs may contribute to apotope presentation to the immune system, causing unique tissue damage in PBC. Perpetuation of inflammation may result in senescence of BECs, contributing to irreversible loss of bile duct. In addition to the classic liver manifestations, focal inflammation and tissue damage are also seen in salivary glands and urinary tract in a significant proportion of PBC patients. These findings provide potent support to the idea that molecular mimicry may be involved in the breakdown of autoimmune tolerance and mucosal immunity may lead to a systematic epithelitis in PBC patients. Thus, PBC is considered a generalized epithelitis in clinical practice.

  20. SERUM IRON PARAMETERS IN ALCOHOLIC CIRRHOSIS, CRYPTOGENIC CIRRHOSIS, CHRONIC HEPATITIS B AND CHRONIC HEPATITIS C

    Directory of Open Access Journals (Sweden)

    Sajeevan K. C

    2016-11-01

    Full Text Available BACKGROUND Regular monitoring of serum iron parameters is helpful for assessing the severity of alcoholic liver disease. Assessment of serum iron parameters are used for screening hereditary haemochromatosis in chronic liver disease. Serum iron parameters in chronic liver disease have not been clearly described in most of the studies. The aim of this study was to assess the serum iron, Total Iron Binding Capacity (TIBC, transferrin saturation and ferritin levels in common chronic liver disease like alcoholic cirrhosis, cryptogenic cirrhosis, chronic hepatitis C and chronic hepatitis B. MATERIALS AND METHODS 110 consecutive patients with chronic liver disease admitted to the Gastroenterology Department, Government Medical College, Kozhikode were selected for the study. The categories of chronic liver disease included in our study were alcoholic cirrhosis (Group I, n = 40, cryptogenic cirrhosis (Group II, n = 30, chronic hepatitis C (Group III, n = 20 and chronic hepatitis B (Group IV, n = 20. Serum iron, ferritin, total iron binding capacity and transferrin saturation were estimated in the fasting sample. Statistical Analysis- Analysis was performed using nonparametric Kruskal-Wallis and Bonferroni test to assess statistical significance of difference of continuous variables among and between groups, respectively. The results were considered statistically significant at the level of p <0.05. RESULTS The serum iron level was normal and total iron binding capacity was low in all the four groups of chronic liver disease. Serum ferritin and transferrin saturation were significantly higher in alcoholic cirrhosis in comparison with cryptogenic cirrhosis and chronic hepatitis B, but was not statistically significant in comparison with chronic hepatitis C. CONCLUSION We observed irregularities in iron status in patients with alcoholic cirrhosis, cryptogenic cirrhosis, chronic hepatitis C and chronic hepatitis B.

  1. Extrahepatic complications to cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens H; Bendtsen, Flemming

    2014-01-01

    In addition to complications relating to the liver, patients with cirrhosis and portal hypertension develop extrahepatic functional disturbances of multiple organ systems. This can be considered a multiple organ failure that involves the heart, lungs, kidneys, the immune systems, and other organ...

  2. Amiodarone-Induced Liver Injury and Cirrhosis.

    Science.gov (United States)

    Buggey, Jonathan; Kappus, Matthew; Lagoo, Anand S; Brady, Carla W

    2015-01-01

    We present a case report of an 80-year-old woman with volume overload thought initially to be secondary to heart failure, but determined to be amiodarone-induced acute and chronic liver injury leading to submassive necrosis and bridging fibrosis consistent with early cirrhosis. Her histopathology was uniquely absent of steatosis and phospholipidosis, which are commonly seen in AIC.

  3. Arterial pressure profile in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Fuglsang, Stefan; Bendtsen, Flemming

    2012-01-01

    Patients with cirrhosis have cardiovascular dysfunction and altered mechanical properties of large and small arteries. This study was undertaken in order to analyze the arterial pressure curve in relation to mean arterial pressure level, stroke volume, and severity of liver disease....

  4. [Dental management in patients with cirrhosis].

    Science.gov (United States)

    Rodríguez Martínez, Sandra; Talaván Serna, Julio; Silvestre, Francisco-Javier

    2016-03-01

    The present article makes a brief review about dental management of the patients with cirrhosis. It focus on problems related with infections, haemorrhagic events and treatment with drugs of common use in odontology. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  5. Evaluation of drinking patterns and their impact on alcohol-related aggression: a national survey of adolescent behaviours.

    Science.gov (United States)

    Siciliano, Valeria; Mezzasalma, Lorena; Lorenzoni, Valentina; Pieroni, Stefania; Molinaro, Sabrina

    2013-10-10

    Although there have been a wide range of epidemiological studies examining the impact of patterns of alcohol consumption among adolescents, there remains considerable variability in both defining these patterns and the ability to comprehensively evaluate their relationship to behavioural patterns. This study explores a new procedure for defining and evaluating drinking patterns and integrating well-established indicators. The composite measure is then used to estimate the impact of these patterns on alcohol-related aggressive behaviour among Italian adolescents. Data were collected as part of the 2011 European School Survey Project on Alcohol and other Drugs (ESPAD). A national sample of 14,199 students aged 15-19 years was collected using an anonymous, self-administered questionnaire completed in a classroom setting. Drinking patterns were established using principal component analysis. Alcohol-related aggression was analysed as to its relationship to patterns of drinking, behaviour of friends towards alcohol use, substance use/abuse, school performance, family relationships and leisure activities. Several specific drinking patterns were identified: "Drinking to Excess" (DE), "Drinking with Intoxication" (DI) and "Drinking but Not to Excess" (DNE). A higher percentage of males were involved in alcohol-related aggression compared with females. In males, the DE and DI patterns significantly increased the likelihood of alcohol-related aggression, whereas the DNE pattern was negatively associated. Similar results were found in females, although the DI pattern was not significantly associated with alcohol-related aggression. Overall, cigarette smoking, illegal drug use, truancy, limited parental monitoring, frequent evenings spent outside of the home and peer influence associated strongly with alcohol-related aggression. Our findings suggest that drinking patterns, as uniquely monitored with an integrated metric, can: 1) explain drinking habits better than commonly

  6. Trends in alcohol-related harms and offences in a liberalized alcohol environment.

    Science.gov (United States)

    Huckle, Taisia; Pledger, Megan; Casswell, Sally

    2006-02-01

    To assess alcohol-related harms and offences in New Zealand from 1990 to 2003, a period of alcohol policy liberalization, that included the lowering of the purchase age from 20 to 18 years in 1999. Time trend analyses were carried out on routinely collected data for prosecutions for driving with excess alcohol; alcohol-involved vehicle crashes (all and fatal) and prosecutions for disorder offences. These were carried out separately for those aged 14-15, 16-17, 18-19, 20-24 and 25 years and over. Rates of: prosecutions for driving with excess alcohol (1990-2003); rates of alcohol- involved vehicle crashes (all and fatal) (1990-2003); and rates of prosecutions for disorder offences (1994-2003). Effects of alcohol policy liberalization: positive trends were found in the rates of prosecutions for disorder in the 16-17, 18-19, 20-24 and 25 + age groups; with 18-19-year-olds and 16-17-year-olds having the largest rates and largest positive trend in rates. For 16-17-year-olds, there was a positive trend in the rates of prosecutions for excess breath alcohol. Negative trends in rates were found for alcohol-related crashes (all and fatal) among all age groups. Negative trends for those over 16-17 years were found for prosecutions for driving with excess breath alcohol (this was prior to the lowering of the purchase age). Effects of lowering the minimum purchase age: the lowering of minimum purchase age coincided with an increase in the trend of alcohol-related crashes for 18-19-year-olds; the next largest increase was among the 20-24-year-olds (all other age groups also increased but at a much lower rate). A similar result was found for driving with excess alcohol for those aged 18-19 (and those aged 20-24 years). An increase in the rates of prosecutions for disorder offences occurred for the 14-15-year-old group following the lowering of the purchase age. The liberalization of alcohol throughout the 1990s may have influenced younger people more, as reflected in increases

  7. Advanced transgenic approaches to understand alcohol-related phenotypes in animals.

    Science.gov (United States)

    Bilbao, Ainhoa

    2013-01-01

    During the past two decades, the use of genetically manipulated animal models in alcohol research has greatly improved the understanding of the mechanisms underlying alcohol addiction. In this chapter, we present an overview of the progress made in this field by summarizing findings obtained from studies of mice harboring global and conditional mutations in genes that influence alcohol-related phenotypes. The first part reviews behavioral paradigms for modeling the different phases of the alcohol addiction cycle and other alcohol-induced behavioral phenotypes in mice. The second part reviews the current data available using genetic models targeting the main neurotransmitter and neuropeptide systems involved in the reinforcement and stress pathways, focusing on the phenotypes modeling the alcohol addiction cycle. Finally, the third part will discuss the current findings and future directions, and proposes advanced transgenic mouse models for their potential use in alcohol research.

  8. Services for prisoners with alcohol-related problems: a survey of U.K. prisons.

    Science.gov (United States)

    McMurran, M; Baldwin, S

    1989-09-01

    Offenders have been identified as heavy drinkers who admit to a relationship between drinking and offending. Many prisoners express a desire to reduce their alcohol consumption. The extent of alcohol interventions in U.K. prisons was unknown and so a postal survey was conducted to gather basic information about current work. Of all responding establishments, 91% claimed to provide services for prisoners with alcohol-related problems and 58% gave details of these services. Services are provided mainly by probation officers/social workers, prison officers and Alcoholics Anonymous. Group and individual interventions are described. Service development has been haphazard, lacking central co-ordination. A case is made for appointment of a central facilitator responsible for staff training, establishing a communications network, encouraging new interventions to match clients' needs, encouraging closer links with community workers and guiding evaluative research.

  9. Alcohol-related predictors of adolescent driving: gender differences in crashes and offenses.

    Science.gov (United States)

    Shope, J T; Waller, P F; Lang, S W

    1996-11-01

    Demographic and alcohol-related data collected from eight-grade students (age 13 years) were used in logistic regression to predict subsequent first-year driving crashes and offenses (age 17 years). For young men's crashes and offenses, good-fitting models used living situation (both parents or not), parents' attitude about teen drinking (negative or neutral), and the interaction term. Young men who lived with both parents and reported negative parental attitudes regarding teen drinking were less likely to have crashes and offenses. For young women's crashes, a good-fitting model included friends' involvement with alcohol. Young women who reported that their friends were not involved with alcohol were least likely to have crashes. No model predicting young women's offenses emerged.

  10. Reported beverage consumed and alcohol-related diseases among male hospital inpatients with problem drinking.

    Science.gov (United States)

    Coder, Beate; Freyer-Adam, Jennis; Lau, Katharina; Riedel, Jeannette; Rumpf, Hans-Jürgen; Meyer, Christian; John, Ulrich; Hapke, Ulfert

    2009-01-01

    The aim of this study was to examine if problem drinkers have varying risks of having alcohol-related diseases according to their reported beverage consumed. In a cross-sectional study all consecutive inpatients aged 18- 64 years from four general hospitals of one catchment area were systematically screened for alcohol use. A total of 1011 men with problem drinking were used for this study. Routine treatment diagnoses for all participants were provided by hospital physicians and were classified into three categories according to their alcohol-attributable fractions (AAF; AAF = 0; AAF spirits drinkers, 26.0% mixed beer and spirits drinkers and 6.9% individuals drinking wine exclusively or in combination with one or two other beverages (mixed wine drinkers). Compared to spirits drinkers and controlling for possible confounders (i.e. alcohol-associated characteristics, demographic variables), multinomial regressions revealed that beer drinkers, mixed beer and spirits drinkers, and mixed wine drinkers had lower odds of having diseases with AAF = 1 than spirits drinkers (e.g. for AAF = 1: beer versus spirits drinkers: OR = 0.42, CI: 0.25-0.72). Beer drinkers and mixed wine drinkers also had lower odds of having diseases with AAF spirits drinkers (e.g. mixed wine versus spirits drinkers: OR = 0.36, CI: 0.18-0.72). These data suggest an association between the reported beverage consumed and alcohol-related diseases. Among hospitalized problem drinkers, spirits drinkers had the greatest risk of having diseases with AAF < 1 and with AAF = 1.

  11. Cirrhosis Diagnosis and Liver Fibrosis Staging: Transient Elastometry Versus Cirrhosis Blood Test.

    Science.gov (United States)

    Calès, Paul; Boursier, Jérôme; Oberti, Frédéric; Bardou, Derek; Zarski, Jean-Pierre; de Lédinghen, Victor

    2015-07-01

    Elastometry is more accurate than blood tests for cirrhosis diagnosis. However, blood tests were developed for significant fibrosis, with the exception of CirrhoMeter developed for cirrhosis. We compared the performance of Fibroscan and CirrhoMeter, and classic binary cirrhosis diagnosis versus new fibrosis staging for cirrhosis diagnosis. The diagnostic population included 679 patients with hepatitis C and liver biopsy (Metavir staging and morphometry), Fibroscan, and CirrhoMeter. The prognostic population included 1110 patients with chronic liver disease and both tests. Binary diagnosis: AUROCs for cirrhosis were: Fibroscan: 0.905; CirrhoMeter: 0.857; and P=0.041. Accuracy (Youden cutoff) was: Fibroscan: 85.4%; CirrhoMeter: 79.2%; and PFibrosis classification provided 6 classes (F0/1, F1/2, F2±1, F3±1, F3/4, and F4). Accuracy was: Fibroscan: 88.2%; CirrhoMeter: 88.8%; and P=0.77. A simplified fibrosis classification comprised 3 categories: discrete (F1±1), moderate (F2±1), and severe (F3/4) fibrosis. Using this simplified classification, CirrhoMeter predicted survival better than Fibroscan (respectively, χ=37.9 and 19.7 by log-rank test), but both predicted it well (Ptest). Comparison: binary diagnosis versus fibrosis classification, respectively, overall accuracy: CirrhoMeter: 79.2% versus 88.8% (PFibrosis classification should be preferred over binary diagnosis. A cirrhosis-specific blood test markedly attenuates the accuracy deficit for cirrhosis diagnosis of usual blood tests versus transient elastometry, and may offer better prognostication.

  12. Adding an alcohol-related risk score to an existing categorical risk classification for older adults: sensitivity to group differences.

    Science.gov (United States)

    Wilson, Sandra R; Fink, Arlene; Verghese, Shinu; Beck, John C; Nguyen, Khue; Lavori, Philip

    2007-03-01

    To evaluate a new alcohol-related risk score for research use. Using data from a previously reported trial of a screening and education system for older adults (Computerized Alcohol-Related Problems Survey), secondary analyses were conducted comparing the ability of two different measures of risk to detect post-intervention group differences: the original categorical outcome measure and a new, finely grained quantitative risk score based on the same research-based risk factors. Three primary care group practices in southern California. Six hundred sixty-five patients aged 65 and older. A previously calculated, three-level categorical classification of alcohol-related risk and a newly developed quantitative risk score. Mean post-intervention risk scores differed between the three experimental conditions: usual care, patient report, and combined report (Ptrinary risk classification. The additional clinical value of the risk score relative to the categorical measure needs to be determined.

  13. Hepatic erythropoietin response in cirrhosis

    DEFF Research Database (Denmark)

    Risør, Louise M; Fenger, Mogens; Olsen, Niels Vidiendal

    2016-01-01

    The main function of erythropoietin (EPO) is to maintain red blood cell mass, but in recent years, increasing evidence has suggested a wider biological role not solely related to erythropoiesis, e.g. angiogenesis and tissue protection. EPO is produced in the liver during fetal life, but the main...... production shifts to the kidney after birth. The liver maintains a production capacity of up to 10% of the total EPO synthesis in healthy controls, but can be up-regulated to 90-100%. However, the hepatic EPO synthesis has been shown not to be adequate for correction of anemia in the absence of renal......, which lead to arterial hypotension, hepatic nephropathy and anemia. An increase in EPO due to renal hypoperfusion, hypoxia and anemia or an EPO-mediated hepato-protective and regenerative mechanism is plausible. However, poor hepatic synthesis capacity, a decreasing co-factor level and inflammatory...

  14. Pharmacological interventions for alcoholic liver disease (alcohol-related liver disease)

    DEFF Research Database (Denmark)

    Buzzetti, Elena; Kalafateli, Maria; Thorburn, Douglas

    2017-01-01

    of the various pharmacological interventions compared with each other or with placebo or no intervention. Data collection and analysis: Two review authors independently identified trials and independently extracted data. We calculated the odds ratio (OR) and rate ratio with 95% confidence intervals (CIs) using...... cirrhosis, liver transplantation. None of the trials reported health-related quality of life or incidence of hepatocellular carcinoma. Severe alcoholic hepatitis Of the trials on alcoholic hepatitis, 19 trials (2545 participants) included exclusively participants with severe alcoholic hepatitis (Maddrey...... and follow-up of one to two years in order to compare the benefits and harms of different treatments in people with alcoholic hepatitis. Randomised clinical trials should include health-related quality of life and report serious adverse events separately from adverse events. Future randomised clinical trials...

  15. Cirrhosis: CT and MR imaging evaluation

    International Nuclear Information System (INIS)

    Brancatelli, Giuseppe; Federle, Michael P.; Ambrosini, Roberta; Lagalla, Roberto; Carriero, Alessandro; Midiri, Massimo; Vilgrain, Valerie

    2007-01-01

    In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and peribiliary cysts. We show different conditions causing liver morphology changes that can mimic cirrhosis, such as congenital hepatic fibrosis, 'pseudo-cirrhosis' due to breast metastases treated with chemotherapy, Budd-Chiari syndrome, sarcoidosis and cavernous transformation of the portal vein

  16. Nutritional therapy in cirrhosis or alcoholic hepatitis

    DEFF Research Database (Denmark)

    Dam Fialla, Annette; Israelsen, Mads; Hamberg, Ole

    2015-01-01

    BACKGROUND & AIMS: Patients with cirrhosis and alcoholic hepatitis are often malnourished and have a superimposed stress metabolism, which increases nutritional demands. We performed a systematic review on the effects of nutritional therapy vs. no intervention for patients with cirrhosis...... or alcoholic hepatitis. METHODS: We included trials on nutritional therapy designed to fulfil at least 75% of daily nutritional demand. Authors extracted data in an independent manner. Random-effects and fixed-effect meta-analyses were performed and the results expressed as risk ratios (RR) with 95% confidence...... with 329 allocated to enteral (nine trials) or intravenous (four trials) nutrition and 334 controls. All trials were classed as having a high risk of bias. Random-effects meta-analysis showed that nutritional therapy reduced mortality 0.80 (95% CI, 0.64 to 0.99). The result was not confirmed in sequential...

  17. Cirrhosis: CT and MR imaging evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Brancatelli, Giuseppe [Sezione di Radiologia, Ospedale Specializzato in Gastroenterologia, ' Saverio de Bellis' -IRCCS, 70013 Castellana Grotte (Bari) (Italy) and Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Universita di Palermo, Via del Vespro 127, 90127 Palermo (Italy) and Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, 15213 Pittsburgh, PA (United States)]. E-mail: gbranca@yahoo.com; Federle, Michael P. [Department of Radiology, University of Pittsburgh Medical Center, 200 Lothrop Street, 15213 Pittsburgh, PA (United States); Ambrosini, Roberta [Department of Diagnostic and Interventional Radiology, ' Maggiore della Carita' University Hospital, ' A.Avogadro' Eastern Piemonte University, Corso Mazzini 18, Novara (Italy); Lagalla, Roberto [Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Universita di Palermo, Via del Vespro 127, 90127 Palermo (Italy); Carriero, Alessandro [Department of Diagnostic and Interventional Radiology, ' Maggiore della Carita' University Hospital, ' A.Avogadro' Eastern Piemonte University, Corso Mazzini 18, Novara (Italy); Midiri, Massimo [Sezione di Scienze Radiologiche, Dipartimento di Biotecnologie Mediche e Medicina Legale, Universita di Palermo, Via del Vespro 127, 90127 Palermo (Italy); Vilgrain, Valerie [Service de Radiologie, Hopital Beaujon, 100 Boulevard du General Leclerc, 92118 Clichy (France)

    2007-01-15

    In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and peribiliary cysts. We show different conditions causing liver morphology changes that can mimic cirrhosis, such as congenital hepatic fibrosis, 'pseudo-cirrhosis' due to breast metastases treated with chemotherapy, Budd-Chiari syndrome, sarcoidosis and cavernous transformation of the portal vein.

  18. Malabsorption in cirrhosis of the liver

    Directory of Open Access Journals (Sweden)

    Patwardhan R

    1977-01-01

    Full Text Available Gastrointestinal function of absorption has been studied in twenty biopsy proved cases of cirrhosis of the liver. The gastro-intestinal function was assessed by means of glucose and lactose tolerance tests and by fecal fat, d-Xylose and Co 57 B 12 excretion tests. Steatorrhoea and lactose intolerance are common in cir-rhotics. The etiopathogenesis of this malabsorption in cirrhotics is discussed and appears multifactorial in origin.

  19. Immunologic, hemodynamic, and adrenal incompetence in cirrhosis

    DEFF Research Database (Denmark)

    Risør, Louise Madeleine; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    dysfunction, but is not responsive to volume expansion. Recent research indicates that development of hepatic nephropathy represents a continuous spectrum of functional and structural dysfunction and may be precipitated by the inherent immunologic, adrenal, and hemodynamic incompetence in cirrhosis. New...... research explores several new markers of renal dysfunction that may replace serum creatinine in the future and give new insight on the hepatic nephropathy. Our understanding of the pathophysiological mechanisms causing the immunologic, adrenal, and hemodynamic incompetence, and the impact on renal...

  20. Analysis of ultrasonographic findings in liver cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Wook; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

    1988-10-15

    The association of liver cirrhosis with high amplitude echoes is well recognized. In Korea, despite the common occurrence of liver cirrhosis, little has been written regarding its ultrasonographic features. Retrospective evaluation of abdominal sonograms in 122 patients with liver cirrhosis was made using Weill's classification. The results were as followings: 1. 122 cases consist of 23 cases with Type I, 37 cases with Type II, 33 cases with Type IIIa, 28 cases with Type IIIb, and 1 case with Type IV. 2. Neither clinical finding nor laboratory data discriminates remarkable difference between each type. 3. Liver size is not in direct proportion to ultrasonographic type although hepatic retraction was more frequent in Type III, IV than in Type I and II. 4. Ancillary findings such as splenomegaly, portal hypertension and ascites are seen in Type I, II as frequently as in Type III, IV. Therefore, these different patterns are considered to be related to morphological types rather than phases. 5. Area of diverse echogenicity was revealed as malignant transformation in cirrhotic liver by RI scan by cold area.

  1. Do students use contextual protective behaviors to reduce alcohol-related sexual risk? Examination of a dual-process decision-making model.

    Science.gov (United States)

    Scaglione, Nichole M; Hultgren, Brittney A; Reavy, Racheal; Mallett, Kimberly A; Turrisi, Rob; Cleveland, Michael J; Sell, Nichole M

    2015-09-01

    Recent studies suggest drinking protective behaviors (DPBs) and contextual protective behaviors (CPBs) can uniquely reduce alcohol-related sexual risk in college students. Few studies have examined CPBs independently, and even fewer have utilized theory to examine modifiable psychosocial predictors of students' decisions to use CPBs. The current study used a prospective design to examine (a) rational and reactive pathways and psychosocial constructs predictive of CPB use and (b) how gender might moderate these influences in a sample of college students. Students (n = 508) completed Web-based baseline (mid-Spring semester) and 1- and 6-month follow-up assessments of CPB use; psychosocial constructs (expectancies, normative beliefs, attitudes, and self-concept); and rational and reactive pathways (intentions and willingness). Regression was used to examine rational and reactive influences as proximal predictors of CPB use at the 6-month follow-up. Subsequent path analyses examined the effects of psychosocial constructs, as distal predictors of CPB use, mediated through the rational and reactive pathways. Both rational (intentions to use CPB) and reactive (willingness to use CPB) influences were significantly associated with increased CPB use. The examined distal predictors were found to effect CPB use differentially through the rational and reactive pathways. Gender did not significantly moderate any relationships within in the model. Findings suggest potential entry points for increasing CPB use that include both rational and reactive pathways. Overall, this study demonstrates the mechanisms underlying how to increase the use of CPBs in programs designed to reduce alcohol-related sexual consequences and victimization. (c) 2015 APA, all rights reserved).

  2. Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland.

    Science.gov (United States)

    Gilchrist, Elizabeth Allison; Ireland, Lana; Forsyth, Alasdair; Godwin, Jon; Laxton, Tim

    2017-01-01

    Scotland has a particular problem with alcohol, and the links between intimate partner abuse (IPA) and alcohol appear stronger here than elsewhere across Europe. This study explored differences in alcohol use, related aggression and relationship conflict across a number of groups: men convicted for intimate partner abuse, men convicted of general offences and men recruited from community sports teams. Participants (n = 64) completed three questionnaires exploring their experiences of alcohol use (Alcohol Use Disorders Identification Test, AUDIT); alcohol and aggression (Alcohol Related Aggression Questionnaire, ARAQ-28), and relationship conflict (Revised Conflict Tactics Scale, CTS-2). There were significant differences across the groups in terms of AUDIT and ARAQ-28 scores, IPA and general offenders scored higher than the community sample. CTS-2 scores showed significant differences: both offender groups reported more use of negotiation and psychological abuse, than the community men, and IPA offenders reported causing more physical harm than either general offenders or the community sample. ARAQ-28 scores correlated with psychological abuse for general offenders. Alcohol use was very high across all groups, but the community group did not endorse an aggression-precipitating view of alcohol and did not report high IPA. Discussed is the need for cross-cultural research to explore putative mediators and moderators in the relationship between alcohol, aggressiveness and IPA. [Gilchrist EA, Ireland L, Forsyth A, Godwin J, Laxton T. Alcohol use, alcohol-related aggression and intimate partner abuse: A cross-sectional survey of convicted versus general population men in Scotland. Drug Alcohol Rev 2017;36:20-23]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

  3. Alcohol-Related Facebook Activity Predicts Alcohol Use Patterns in College Students

    Science.gov (United States)

    Marczinski, Cecile A.; Hertzenberg, Heather; Goddard, Perilou; Maloney, Sarah F.; Stamates, Amy L.; O’Connor, Kathleen

    2016-01-01

    The purpose of this study was to determine if a brief 10-item alcohol-related Facebook® activity (ARFA) questionnaire would predict alcohol use patterns in college students (N = 146). During a single laboratory session, participants first privately logged on to their Facebook® profiles while they completed the ARFA measure, which queries past 30 day postings related to alcohol use and intoxication. Participants were then asked to complete five additional questionnaires: three measures of alcohol use (the Alcohol Use Disorders Identification Test [AUDIT], the Timeline Follow-Back [TLFB], and the Personal Drinking Habits Questionnaire [PDHQ]), the Barratt Impulsiveness Scale (BIS-11), and the Marlowe-Crowne Social Desirability Scale (MC-SDS). Regression analyses revealed that total ARFA scores were significant predictors of recent drinking behaviors, as assessed by the AUDIT, TLFB, and PDHQ measures. Moreover, impulsivity (BIS-11) and social desirability (MC-SDS) did not predict recent drinking behaviors when ARFA total scores were included in the regressions. The findings suggest that social media activity measured via the ARFA scale may be useful as a research tool for identifying risky alcohol use. PMID:28138317

  4. Population-level interventions to reduce alcohol-related harm: an overview of systematic reviews.

    Science.gov (United States)

    Martineau, Fred; Tyner, Elizabeth; Lorenc, Theo; Petticrew, Mark; Lock, Karen

    2013-10-01

    To analyse available review-level evidence on the effectiveness of population-level interventions in non-clinical settings to reduce alcohol consumption or related health or social harm. Health, social policy and specialist review databases between 2002 and 2012 were searched for systematic reviews of the effectiveness of population-level alcohol interventions on consumption or alcohol-related health or social outcomes. Data were extracted on review research aim, inclusion criteria, outcome indicators, results, conclusions and limitations. Reviews were quality-assessed using AMSTAR criteria. A narrative synthesis was conducted overall and by policy area. Fifty-two reviews were included from ten policy areas. There is good evidence for policies and interventions to limit alcohol sale availability, to reduce drink-driving, to increase alcohol price or taxation. There is mixed evidence for family- and community-level interventions, school-based interventions, and interventions in the alcohol server setting and the mass media. There is weak evidence for workplace interventions and for interventions targeting illicit alcohol sales. There is evidence of the ineffectiveness of interventions in higher education settings. There is a pattern of support from the evidence base for regulatory or statutory enforcement interventions over local non-regulatory approaches targeting specific population groups. © 2013.

  5. Changes in the perception of alcohol-related stigma in Germany over the last two decades.

    Science.gov (United States)

    Schomerus, Georg; Matschinger, Herbert; Lucht, Michael J; Angermeyer, Matthias C

    2014-10-01

    Alcohol dependence is a severely stigmatized disorder. Perceived stigma may deter help-seeking and is associated with higher co-morbidity and self-stigma in persons with alcohol dependence. We assess changes in the perception of alcohol-related stigma over 21 years in the general population. Two representative population surveys using identical methodology were conducted in Germany in 1990 and 2011 (n=1022 and n=967), eliciting the perceived discrimination and devaluation of someone with a history of alcohol problems as measured with an adoption of Link's Perceived Discrimination and Devaluation Scale (aPDDS), and perceived negative stereotypes of an "alcoholic." Both on item level and using factor scores, attitudes changed significantly between 1990 and 2011. Perceived discrimination and devaluation of someone with a history of alcohol dependence decreased considerably by 0.44 standard deviations (SD). Perceived negative stereotypes related to unpredictability of an "alcoholic" increased slightly by 0.15 SD, while perceived stereotypes related to strangeness decreased (-0.23 SD). Our findings suggest that particularly the image of someone who has received treatment for alcohol dependence has improved in Germany. This parallels increasing acceptance of professional treatment for alcohol dependence among the general population over the last twenty years, and contrasts with overall unchanged negative attitudes toward persons who actually suffer from alcohol problems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Study Protocol: Screening and Treatment of Alcohol-Related Trauma (START – a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Jayaraj Rama

    2012-10-01

    Full Text Available Abstract Background The incidence of mandibular fractures in the Northern Territory of Australia is very high, especially among Indigenous people. Alcohol intoxication is implicated in the majority of facial injuries, and substance use is therefore an important target for secondary prevention. The current study tests the efficacy of a brief therapy, Motivational Care Planning, in improving wellbeing and substance misuse in youth and adults hospitalised with alcohol-related facial trauma. Methods and design The study is a randomised controlled trial with 6 months of follow-up, to examine the effectiveness of a brief and culturally adapted intervention in improving outcomes for trauma patients with at-risk drinking admitted to the Royal Darwin Hospital maxillofacial surgery unit. Potential participants are identified using AUDIT-C questionnaire. Eligible participants are randomised to either Motivational Care Planning (MCP or Treatment as Usual (TAU. The outcome measures will include quantity and frequency of alcohol and other substance use by Timeline Followback. The recruitment target is 154 participants, which with 20% dropout, is hoped to provide 124 people receiving treatment and follow-up. Discussion This project introduces screening and brief interventions for high-risk drinkers admitted to the hospital with facial trauma. It introduces a practical approach to integrating brief interventions in the hospital setting, and has potential to demonstrate significant benefits for at-risk drinkers with facial trauma. Trial Registration The trial has been registered in Australian New Zealand Clinical Trials Registry (ANZCTR and Trial Registration: ACTRN12611000135910.

  7. Categorization abilities for emotional and nonemotional stimuli in patients with alcohol-related Korsakoff syndrome.

    Science.gov (United States)

    Labudda, Kirsten; von Rothkirch, Nadine; Pawlikowski, Mirko; Laier, Christian; Brand, Matthias

    2010-06-01

    To investigate whether patients with alcohol-related Korsakoff syndrome (KR) have emotion-specific or general deficits in multicategoric classification performance. Earlier studies have shown reduced performance in classifying stimuli according to their emotional valence in patients with KS. However, it is unclear whether such classification deficits are of emotion-specific nature or whether they can also occur when nonemotional classifications are demanded. In this study, we examined 35 patients with alcoholic KS and 35 healthy participants with the Emotional Picture Task (EPT) to assess valence classification performance, the Semantic Classification Task (SCT) to assess nonemotional categorizations, and an extensive neuropsychologic test battery. KS patients exhibited lower classification performance in both tasks compared with the healthy participants. EPT and SCT performance were related to each other. EPT and SCT performance correlated with general knowledge and EPT performance in addition with executive functions. Our results indicate a common underlying mechanism of the patients' reductions in emotional and nonemotional classification performance. These deficits are most probably based on problems in retrieving object and category knowledge and, partially, on executive functioning.

  8. Chemosensory Dysfunction in Alcohol-Related Disorders: A Joint Exploration of Olfaction and Taste.

    Science.gov (United States)

    Brion, Mélanie; de Timary, Philippe; Vander Stappen, Caroline; Guettat, Lamia; Lecomte, Benoît; Rombaux, Philippe; Maurage, Pierre

    2015-11-01

    Chemosensory (olfaction-taste) dysfunctions are considered as reliable biomarkers in many neurological and psychiatric states. However, experimental measures of chemosensory abilities are lacking in alcohol-dependence (AD) and Korsakoff Syndrome (KS, a neurological complication of AD), despite the role played by alcohol-related odors and taste in the emergence and maintenance of AD. This study thus investigated chemosensory impairments in AD and KS. Olfactory-gustatory measures were taken among 20 KS, 20 AD, and 20 control participants. Olfaction (odor detection-discrimination-identification) was assessed using the "Sniffin Sticks" battery and taste was measured using the "Taste Strips" task. Impairments were found for high-level olfaction in AD (odor discrimination) and KS (odor discrimination-identification), even after controlling for psychopathological comorbidities. Gustatory deficits were also observed in both groups, indexing a global deficit for chemosensory perception. Finally, the gradient of impairment between the successive disease stages for odor identification suggests that the hypothesis of a continuum between AD and KS regarding cognitive deficits can be generalized to chemosensory perception. AD and KS are thus characterized by deficits in chemosensory abilities, which could constitute a marker of the AD-KS transition. In view of its deleterious influence on everyday life, chemosensory dysfunction should also be taken into account in clinical settings. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Alcohol-Related Consequences among First-Year University Students: Effectiveness of a Web-Based Personalized Feedback Program

    Science.gov (United States)

    Doumas, Diana M.; Nelson, Kinsey; DeYoung, Amanda; Renteria, Camryn Conrad

    2014-01-01

    This study evaluated the effectiveness of a web-based personalized feedback program using an objective measure of alcohol-related consequences. Participants were assigned to either the intervention group or an assessment-only control group during university orientation. Sanctions received for campus alcohol policy violations were tracked over the…

  10. Alcohol-related memory associations in positive and negative affect situations: Drinking motives, working memory capacity, and prospective drinking

    NARCIS (Netherlands)

    Salemink, E.; Wiers, R.W.

    2014-01-01

    Although studies on explicit alcohol cognitions have identified positive and negative reinforcing drinking motives that are differentially related to drinking indices, such a distinction has received less attention in studies on implicit cognitions. An alcohol-related Word-Sentence Association Task

  11. Exploring the Relationship between Experiential Avoidance, Alcohol Use Disorders, and Alcohol-Related Problems among First-Year College Students

    Science.gov (United States)

    Levin, Michael E.; Lillis, Jason; Seeley, John; Hayes, Steven C.; Pistorello, Jacqueline; Biglan, Anthony

    2012-01-01

    Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in…

  12. Does increasing community and liquor licensees' awareness, police activity, and feedback reduce alcohol-related violent crime? A benefit-cost analysis.

    Science.gov (United States)

    Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M; Petrie, Dennis J

    2013-10-28

    Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees' awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

  13. Does Increasing Community and Liquor Licensees’ Awareness, Police Activity, and Feedback Reduce Alcohol-Related Violent Crime? A Benefit-Cost Analysis

    Science.gov (United States)

    Navarro, Héctor José; Shakeshaft, Anthony; Doran, Christopher M.; Petrie, Dennis J.

    2013-01-01

    Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees’ awareness, police activity, and feedback) on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions. PMID:24169411

  14. Does Increasing Community and Liquor Licensees’ Awareness, Police Activity, and Feedback Reduce Alcohol-Related Violent Crime? A Benefit-Cost Analysis

    Directory of Open Access Journals (Sweden)

    Dennis J. Petrie

    2013-10-01

    Full Text Available Approximately half of all alcohol-related crime is violent crime associated with heavy episodic drinking. Multi-component interventions are highly acceptable to communities and may be effective in reducing alcohol-related crime generally, but their impact on alcohol-related violent crime has not been examined. This study evaluated the impact and benefit-cost of a multi-component intervention (increasing community and liquor licensees’ awareness, police activity, and feedback on crimes typically associated with alcohol-related violence. The intervention was tailored to weekends identified as historically problematic in 10 experimental communities in NSW, Australia, relative to 10 control ones. There was no effect on alcohol-related assaults and a small, but statistically significant and cost-beneficial, effect on alcohol-related sexual assaults: a 64% reduction in in the experimental relative to control communities, equivalent to five fewer alcohol-related sexual assaults, with a net social benefit estimated as AUD$3,938,218. The positive benefit-cost ratio was primarily a function of the value that communities placed on reducing alcohol-related harm: the intervention would need to be more than twice as effective for its economic benefits to be comparable to its costs. It is most likely that greater reductions in crimes associated with alcohol-related violence would be achieved by a combination of complementary legislative and community-based interventions.

  15. Provincial alcohol index and its relationship to alcohol-related harm in Thailand: implications for subnational alcohol policy development

    Directory of Open Access Journals (Sweden)

    Surasak Chaiyasong

    2016-07-01

    Full Text Available Abstract Background The Provincial Alcohol Index (PAI is one of the efforts to develop a composite measurement to operationalize the situation of alcohol consumption and related risk behaviors. The index offers a means for national and subnational alcohol control committees to address alcohol-related problems in their responsible jurisdiction areas. The objective of this study is to assess the relationship between PAI scores and alcohol-related problems using Thailand as an example. Methods Cross-sectional analyses of PAI scores based on the 2007 National Cigarette Smoking and Alcohol Drinking Behavior Survey (CSAD and the National Statistical Office data were conducted. CSAD data were collected from 168,285 Thai residents aged 15 years and above in 76 provinces of Thailand (population range 180,787 to 5,716,248. The PAI scores were generated using three different methods based on five indicators: 1 prevalence of adult (≥15 years drinkers, 2 prevalence of underage drinkers, 3 proportion of regular drinkers, 4 proportion of binge drinkers and 5 proportion of drink-drivers. Alcohol-related injuries and violent events together with provincial level covariates (age, gender, income and region were assessed. Correlational and linear regression analyses were performed to examine the relationship between PAI scores and alcohol-related problems. Results The PAI scores generated from the three methods were significantly correlated with one another (r > 0.7, p < 0.05 and significantly related to alcohol-related problems after adjusting for the provincial level covariates. Based on the normalized method, PAI scores had a significant and positive relationship with prevalence of alcohol-related injuries (beta = 562 cases per million population, p = 0.027 and violence (beta = 451 events per million population, p = 0.013. PAI scores were highest in the north and lowest in the south of the country. Conclusions The findings of this

  16. Regional alcohol consumption and alcohol-related mortality in Great Britain: novel insights using retail sales data.

    Science.gov (United States)

    Robinson, Mark; Shipton, Deborah; Walsh, David; Whyte, Bruce; McCartney, Gerry

    2015-01-07

    Regional differences in population levels of alcohol-related harm exist across Great Britain, but these are not entirely consistent with differences in population levels of alcohol consumption. This incongruence may be due to the use of self-report surveys to estimate consumption. Survey data are subject to various biases and typically produce consumption estimates much lower than those based on objective alcohol sales data. However, sales data have never been used to estimate regional consumption within Great Britain (GB). This ecological study uses alcohol retail sales data to provide novel insights into regional alcohol consumption in GB, and to explore the relationship between alcohol consumption and alcohol-related mortality. Alcohol sales estimates derived from electronic sales, delivery records and retail outlet sampling were obtained. The volume of pure alcohol sold was used to estimate per adult consumption, by market sector and drink type, across eleven GB regions in 2010-11. Alcohol-related mortality rates were calculated for the same regions and a cross-sectional correlation analysis between consumption and mortality was performed. Per adult consumption in northern England was above the GB average and characterised by high beer sales. A high level of consumption in South West England was driven by on-trade sales of cider and spirits and off-trade wine sales. Scottish regions had substantially higher spirits sales than elsewhere in GB, particularly through the off-trade. London had the lowest per adult consumption, attributable to lower off-trade sales across most drink types. Alcohol-related mortality was generally higher in regions with higher per adult consumption. The relationship was weakened by the South West and Central Scotland regions, which had the highest consumption levels, but discordantly low and very high alcohol-related mortality rates, respectively. This study provides support for the ecological relationship between alcohol-related

  17. The impact of policies regulating alcohol trading hours and days on specific alcohol-related harms: a systematic review.

    Science.gov (United States)

    Sanchez-Ramirez, Diana C; Voaklander, Donald

    2018-02-01

    Evidence supports the expectation that changes in time of alcohol sales associate with changes in alcohol-related harm in both directions. However, to the best of our knowledge, no comprehensive systematic reviews had examined the effect of policies restricting time of alcohol trading on specific alcohol-related harms. To compile existing evidence related to the impact of policies regulating alcohol trading hours/days of on specific harm outcomes such as: assault/violence, motor vehicle crashes/fatalities, injury, visits to the emergency department/hospital, murder/homicides and crime. Systematic review of literature studying the impact of policies regulation alcohol trading times in alcohol-related harm, published between January 2000 and October 2016 in English language. Results support the premise that policies regulating times of alcohol trading and consumption can contribute to reduce injuries, alcohol-related hospitalisations/emergency department visits, homicides and crime. Although the impact of alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is also positive, these associations seem to be more complex and require further study. Evidence suggests a potential direct effect of policies that regulate alcohol trading times in the prevention of injuries, alcohol-related hospitalisations, homicides and crime. The impact of these alcohol trading policies in assault/violence and motor vehicle crashes/fatalities is less compelling. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. The Angel and the Devil on your shoulder: Friends mitigate and exacerbate 21st birthday alcohol-related consequences.

    Science.gov (United States)

    Fillo, Jennifer; Rodriguez, Lindsey M; Anthenien, Amber M; Neighbors, Clayton; Lee, Christine M

    2017-11-01

    Twenty-first birthdays are associated with heavier drinking and more negative consequences than any other high-risk drinking event. Friends are the strongest social influence on young adult drinking; however, previous research on college students' drinking has often only examined individuals' perceptions of "friends" generally. Unfortunately, this may obscure the positive influence of some friends and the negative influence of others. Using data drawn from a larger intervention study aimed at reducing 21st birthday drinking, this research examined how specific friends (N = 166) who were present at 21st birthday celebrations may have exacerbated or mitigated celebrants' (N = 166) experience of alcohol-related consequences, as well as how characteristics of that friendship moderate these effects. Controlling for sex, alcohol consumption, and friend prointoxication intentions for the celebrants' 21st birthday drinking, higher friend prosafety/support intentions predicted the celebrants experiencing fewer alcohol-related consequences. Higher prosafety/support intentions also buffered participants from the negative influence of friend prointoxication intentions. Furthermore, the closeness of the friendship moderated this effect. At high levels of closeness, having a friend with lower prosafety/support intentions was associated with more alcohol-related consequences for the celebrant. Post hoc analyses revealed that this effect may have been driven by discrepancies between celebrants' and friends' reports of friendship closeness; celebrants' perception of closeness that was higher than the friends' perception was associated with the celebrant experiencing more alcohol-related consequences. Results demonstrate the ways that specific friends can both mitigate and exacerbate 21st birthday alcohol-related consequences. The implications of the present findings for incorporating specific friends into drinking-related interventions are discussed. (PsycINFO Database Record (c

  19. Changes in Patient-Reported Alcohol-Related Advice Following Veterans Health Administration Implementation of Brief Alcohol Interventions.

    Science.gov (United States)

    Chavez, Laura J; Williams, Emily C; Lapham, Gwen T; Rubinsky, Anna D; Kivlahan, Daniel R; Bradley, Katharine A

    2016-05-01

    Brief alcohol interventions are recommended for primary care patients who screen positive for alcohol misuse, but implementation is challenging. The U.S. Veterans Health Administration (Veterans Affairs [VA]) implemented brief interventions for patients with alcohol misuse in 2008, and rates of brief interventions documented in the electronic medical record increased from 24% to 78% (2008-2011). This study examined whether an independent measure of brief interventions-patient-reported alcohol-related advice-also increased among VA outpatients who screened positive for alcohol misuse on a mailed survey. This retrospective cross-sectional study included VA outpatient respondents to the VA's Survey of Healthcare Experiences of Patients (SHEP; 2007-2011) who reported past-year alcohol use and answered a question about alcohol-related advice. Alcohol-related advice was defined as a report of past-year advice from a VA clinician to abstain from or reduce drinking. The adjusted prevalence of alcoholrelated advice among patients who screened positive for alcohol misuse (SHEP AUDIT-C ≥ 5) was estimated for each year. Among patients with alcohol misuse (n = 61,843), the adjusted prevalence of alcohol-related advice increased from 40.4% (95% CI [39.3%, 41.5%]) in 2007 to 55.5% (95% CI [53.3%, 57.8%]) in 2011. Rates of alcoholrelated advice increased significantly each year except the last. The VA's efforts to implement brief interventions were associated with increased patient-reported alcohol-related advice over time, with a majority of patients with alcohol misuse reporting its receipt. Other systems considering similar approaches to implementation may benefit from collecting patient-reported measures of brief interventions for an additional perspective on implementation.

  20. Could the high level of cirrhosis in central and eastern Europe be due partly to the quality of alcohol consumed? An exploratory investigation.

    Science.gov (United States)

    Szucs, Sándor; Sárváry, Attila; McKee, Martin; Adány, Róza

    2005-04-01

    The burden of alcohol-related diseases differs widely among countries. Since the 1980s, a band of countries in Central and Eastern Europe have experienced a steep rise in deaths from chronic liver diseases and cirrhosis. A possible risk factor is the consumption of illegally produced home-made spirits in these countries containing varying amounts of aliphatic alcohols and which may be hepatotoxic. However, little is known about the composition of such beverages. To compare the concentration of short-chain aliphatic alcohols in spirits from illegal and legal sources in Hungary. Samples taken from commercial retailers and illegal sources were collected and their aliphatic patterns and alcohol concentrations were determined by gas chromatographic/mass spectrometric (GC/MS) analysis. The concentrations of methanol, isobutanol, 1-propanol, 1-butanol, 2-butanol and isoamyl alcohol were significantly higher in home-made spirits than those of from commercial sources. The results suggest that the consumption of home-made spirits is an additional risk factor for the development of alcohol-induced cirrhosis and may have contributed to high level of liver cirrhosis mortality in Central and Eastern Europe. Restrictions on supply and sale of alcohol from illicit sources are needed urgently to reduce significantly the mortality from chronic liver disease.

  1. Circulating microRNAs as a Fingerprint for Liver Cirrhosis.

    Directory of Open Access Journals (Sweden)

    Yan-Jie Chen

    Full Text Available Sensitive and specific detection of liver cirrhosis is an urgent need for optimal individualized management of disease activity. Substantial studies have identified circulation miRNAs as biomarkers for diverse diseases including chronic liver diseases. In this study, we investigated the plasma miRNA signature to serve as a potential diagnostic biomarker for silent liver cirrhosis.A genome-wide miRNA microarray was first performed in 80 plasma specimens. Six candidate miRNAs were selected and then trained in CHB-related cirrhosis and controls by qPCR. A classifier, miR-106b and miR-181b, was validated finally in two independent cohorts including CHB-related silent cirrhosis and controls, as well as non-CHB-related cirrhosis and controls as validation sets, respectively.A profile of 2 miRNAs (miR-106b and miR-181b was identified as liver cirrhosis biomarkers irrespective of etiology. The classifier constructed by the two miRNAs provided a high diagnostic accuracy for cirrhosis (AUC = 0.882 for CHB-related cirrhosis in the training set, 0.774 for CHB-related silent cirrhosis in one validation set, and 0.915 for non-CHB-related cirrhosis in another validation set.Our study demonstrated that the combined detection of miR-106b and miR-181b has a considerable clinical value to diagnose patients with liver cirrhosis, especially those at early stage.

  2. Multiple infarcted regenerative nodules in liver cirrhosis after decompensation of cirrhosis: a case series

    Directory of Open Access Journals (Sweden)

    Müllhaupt Beat

    2010-11-01

    Full Text Available Abstract Introduction Liver cirrhosis is a common disease with many known complications. Cirrhosis represents a clinical spectrum, ranging from asymptomatic liver disease to hepatic decompensation. Manifestations of hepatic decompensation include variceal bleeding, ascites, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, portopulmonary hypertension and hepatocellular carcinoma. There are reports about infarcted regenerative nodules in cirrhotic livers after gastrointestinal hemorrhage. Case presentation We report three Caucasian patients (one female and two male patients; ages: 52, 54 and 60 years with decompensated liver cirrhosis, who showed newly infarcted regenerative nodules at necropsy. Two of them suffered from gastric variceal bleeding. Histopathology showed extensive infarction in all three cases. Hemorrhage and inflammatory changes were also observed around the infarcted regenerative nodules. Conclusion These patients showed focal liver lesions, to be considered in the differential diagnosis of cirrhotic livers. Infarcted regenerative nodules may be underdiagnosed in patients with decompensation of cirrhosis. In order to differentiate these lesions from malignant tumors, serial imaging seems to be helpful. However, the main differential diagnosis should be an abscess. It is important to know the wide spectrum of image appearances of these lesions. Hypotension can lead to a reduction of portal and arterial liver flow. Since variceal bleeding or septic shock can induce hypotension - as observed in our patients - we conclude that this leads to infarction of such nodules.

  3. Under-Researched Demographics: Heavy Episodic Drinking and Alcohol-Related Problems Among Asian Americans.

    Science.gov (United States)

    Iwamoto, Derek Kenji; Kaya, Aylin; Grivel, Margaux; Clinton, Lauren

    2016-01-01

    , traditional norms that may directly pertain to hyperfemininzed Asian-American women, including modesty and sexual fidelity, may protect against heavy episodic drinking (Young et al. 2005). Conversely, the risk for heavy episodic drinking may be enhanced in men who strive to demonstrate traditional notions of masculinity through risk-taking and endorsement of playboy norms (Iwamoto et al. 2010). Although this review has illustrated the contemporary state of research on alcohol use among Asian Americans, it also highlights the significant limitations in this literature. Many of the studies reviewed here have used cross-sectional data, which do not allow researchers to infer causality between the various sociocultural factors and problematic alcohol use. One way of addressing this gap in the existing literature may be to implement longitudinal designs to further understand how the temporal relationship between sociocultural factors, including acculturation and gender norms, may impact alcohol use and alcohol-related problem trajectories. There also is a pressing need to develop greater understanding of within-group differences among U.S.-born and foreign-born Asian Americans as well as among as specific ethnic groups. To date, epidemiological research has largely neglected to examine these significant discrepancies. Given the growing prevalence of alcohol use and alcohol-related problems among Asian-American women (Grant et al. 2004; Iwamoto et al. 2010), studies also should focus on this group and explore how the intersection of gender and culture may influence alcohol use. Finally, the majority of research on this population has been conducted in college samples; therefore, it is important to also examine community samples, including U.S.-born young adults who are not attending college and older adult Asian-American populations.

  4. Queensland Alcohol-related violence and Night Time Economy Monitoring project (QUANTEM): a study protocol.

    Science.gov (United States)

    Miller, Peter G; Ferris, Jason; Coomber, Kerri; Zahnow, Renee; Carah, Nicholas; Jiang, Heng; Kypri, Kypros; Chikritzhs, Tanya; Clough, Alan; Livingston, Michael; de Andrade, Dominique; Room, Robin; Callinan, Sarah; Curtis, Ashlee; Mayshak, Richelle; Droste, Nicolas; Lloyd, Belinda; Matthews, Sharon; Taylor, Nicholas; Crane, Meredythe; Thorn, Michael; Najman, Jake

    2017-10-05

    Alcohol-related harm is a substantial burden on the community in Australia and internationally, particularly harm related to risky drinking practices of young people in the night-time economy. This protocol paper describes a study that will report on the changes in a wide range of health and justice outcome measures associated with major policy changes in the state of Queensland, Australia. A key element includes trading hours restrictions for licensed premises to 2 am for the state and 3 am in Safe Night Precincts (SNPs). Other measures introduced include drinks restrictions after midnight, increased patron banning measures for repeat offenders, mandatory ID scanning of patrons in late-night venues, and education campaigns. The primary aim of the study is to evaluate change in the levels of harm due to these policy changes using administrative data (e.g., police, hospital, ambulance, and court data). Other study elements will investigate the impact of the Policy by measuring foot traffic volume in SNPs, using ID scanner data to quantify the volume of people entering venues and measure the effectiveness of banning notices, using patron interviews to quantify the levels of pre-drinking, intoxication and illicit drug use within night-time economy districts, and to explore the impacts of the Policy on business and live music, and costs to the community. The information gathered through this project aims to evaluate the effectiveness of the Policy and to draw on these findings to inform future prevention and enforcement approaches by policy makers, police, and venue staff.

  5. Alcohol and public health in Africa: can we prevent alcohol-related harm from increasing?

    Science.gov (United States)

    Ferreira-Borges, Carina; Dias, Sonia; Babor, Thomas; Esser, Marissa B; Parry, Charles D H

    2015-09-01

    According to the World Health Organization (WHO), the total amount of alcohol consumed in the African region is expected to increase due to the growth of new alcohol consumers, especially young people and women. With the changing alcohol environment, increases in the alcohol-attributable burden of disease are inevitable. To our knowledge, there has not been a comprehensive analysis of the factors that could be driving those increases. The objective of this study was to examine the evidence from peer reviewed literature regarding the factors that could be instrumental in this process, in order to inform strategic policy-related decisions. A narrative review was conducted using a thematic analysis approach. We searched papers published between January 2000 and July 2014 in PubMed, the WHO's Global Health Library and African Journals Online. Our analysis identified seven factors (demographics, rapid urbanization, economic development, increased availability, corporate targeting, weak policy infrastructure and trade agreements) which are potentially tied to changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these various factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality. To address the emerging risk factors associated with increased alcohol consumption, African governments need to take a more active role in protecting the public's health. In particular, important strategic shifts are needed to increase implementation of intersectoral strategies, community involvement in the policy dialogue, health services re-orientation and better regulation of the alcohol beverage industry. © 2015 Society for the Study of Addiction.

  6. Under-diagnosis of alcohol-related problems and depression in a family practice in Japan

    Directory of Open Access Journals (Sweden)

    Yamada Kenshi

    2008-09-01

    Full Text Available Abstract Aim The aim of this survey was to assess the accuracy of a family physician's diagnosis of depression and alcoholism. Methods Consecutive new adult patients attending a family practice in Japan between April 2004 and August 2006 were enrolled. Excluded were those with dementia or visual disturbance, and emergency cases. Participants completed a questionnaire regarding their complaints and socio-demographics. A research nurse conducted the Japanese version of the Mini-International Neuropsychiatric Interview (J-MINI in the interview room. The doctor independently performed usual practice and recorded his own clinical diagnoses. A researcher listed the clinical diagnoses and complaints, including J-MINI or clinically-diagnosed alcoholism and depression, using the International Classifications for Primary Care, Second Edition (ICPC-2 and calculated kappa statistics between the J-MINI and clinical diagnoses. Results Of the 120 adult first-visit patients attending the clinics, 112 patients consented to participate in the survey and were enrolled. Fifty-one subjects were male and 61 female, and the average age was 40.7 ± 13.2 years. Eight alcohol-related disorders and five major depressions were diagnosed using the J-MINI, whereas no cases of alcoholism and eight depressions were diagnosed by the physician. Clinically overlooked patients tended to have acute illnesses like a common cold. Concordance between the clinical and research diagnosis was achieved only for three episodes of Major depression, resulting in a kappa statistic of 0.43. Conclusion Although almost half of the major depressions were identified, all alcoholism was missed. A mental health screening instrument might be beneficial in family practice, especially to detect alcoholism.

  7. Predictors of risky alcohol consumption in schoolchildren and their implications for preventing alcohol-related harm

    Directory of Open Access Journals (Sweden)

    Allen Tony

    2007-05-01

    Full Text Available Abstract Background While alcohol-related health and social problems amongst youths are increasing internationally, both consumption and associated harms are particularly high in British youth. Youth drinking patterns, including bingeing, frequent drinking and drinking in public spaces, are associated with increased risks of acute (e.g. violence and long-term (e.g. alcohol-dependence health problems. Here we examine economic, behavioural and demographic factors that predict these risky drinking behaviours among 15–16 year old schoolchildren who consume alcohol. A cross-sectional survey was conducted among schoolchildren in North West England (n = 10,271 using an anonymous questionnaire delivered in school settings. Analysis utilised logistic regression to identify independent predictors of risky drinking behaviour. Results Of all respondents, 87.9% drank alcohol. Of drinkers, 38.0% usually binged when drinking, 24.4% were frequent drinkers and 49.8% drank in public spaces. Binge, frequent and public drinking were strongly related to expendable income and to individuals buying their own alcohol. Obtaining alcohol from friends, older siblings and adults outside shops were also predictors of risky drinking amongst drinkers. However, being bought alcohol by parents was associated with both lower bingeing and drinking in public places. Membership of youth groups/teams was in general protective despite some association with bingeing. Conclusion Although previous studies have examined predictors of risky drinking, our analyses of access to alcohol and youth income have highlighted eradicating underage alcohol sales and increased understanding of children's spending as key considerations in reducing risky alcohol use. Parental provision of alcohol to children in a family environment may also be important in establishing child-parent dialogues on alcohol and moderating youth consumption. However, this will require supporting parents to ensure they

  8. A comparison of contributing factors between alcohol related single vehicle motorcycle and car crashes.

    Science.gov (United States)

    Maistros, Alexander; Schneider, William H; Savolainen, Peter T

    2014-06-01

    Alcohol related crashes have accounted for approximately 35% of fatal crashes per year since 1994 nationwide, with approximately 30% involving impairment over the legal blood alcohol content limit of 0.08%. Educational campaigns and law enforcement efforts are two components of multi-faceted programs aimed toward reducing impaired driving. It is crucial that further research be conducted to guide the implementation of enforcement and educational programs. This research attempts to provide such guidance by examining differences in alcohol-involved crashes involving motorcycles and passenger cars. Prior safety research has shown that motorcyclists follow a significantly different culture than the average passenger car operator. These cultural differences may be reflected by differences in the contributing factors affecting crashes and the severity of the resulting injuries sustained by the driver or motorcyclist. This research is focused on single-vehicle crashes only, in order to isolate modal effects from the contribution of additional vehicles. The crash data provided for this study are from the Ohio Department of Public Safety from 2009 through 2012. The injury severity data are analysed through the development of two mixed logit models, one for motorcyclists and one for passenger car drivers. The models quantify the effects of various factors, including horizontal curves, speeds, seatbelt use, and helmet use, which indicate that the required motor skills and balance needed for proper motorcycle operation compounded with a lack of mechanical protection make motorcyclists more prone to severe injuries, particularly on curves and in collisions with roadside objects. The findings of this study have been incorporated into combined motorcycle and sober driving educational safety campaigns. The results have shown to be favorable in supporting national campaign messages with local justification and backing. Copyright © 2014 Elsevier Ltd. All rights reserved.

  9. Queensland Alcohol-related violence and Night Time Economy Monitoring project (QUANTEM: a study protocol

    Directory of Open Access Journals (Sweden)

    Peter G. Miller

    2017-10-01

    Full Text Available Abstract Background Alcohol-related harm is a substantial burden on the community in Australia and internationally, particularly harm related to risky drinking practices of young people in the night-time economy. This protocol paper describes a study that will report on the changes in a wide range of health and justice outcome measures associated with major policy changes in the state of Queensland, Australia. A key element includes trading hours restrictions for licensed premises to 2 am for the state and 3 am in Safe Night Precincts (SNPs. Other measures introduced include drinks restrictions after midnight, increased patron banning measures for repeat offenders, mandatory ID scanning of patrons in late-night venues, and education campaigns. Methods The primary aim of the study is to evaluate change in the levels of harm due to these policy changes using administrative data (e.g., police, hospital, ambulance, and court data. Other study elements will investigate the impact of the Policy by measuring foot traffic volume in SNPs, using ID scanner data to quantify the volume of people entering venues and measure the effectiveness of banning notices, using patron interviews to quantify the levels of pre-drinking, intoxication and illicit drug use within night-time economy districts, and to explore the impacts of the Policy on business and live music, and costs to the community. Discussion The information gathered through this project aims to evaluate the effectiveness of the Policy and to draw on these findings to inform future prevention and enforcement approaches by policy makers, police, and venue staff.

  10. A Qualitative Study of Service Provision for Alcohol Related Health Issues in Mid to Later Life.

    Directory of Open Access Journals (Sweden)

    Catherine Haighton

    Full Text Available Epidemiological surveys over the last 20 years show a steady increase in the amount of alcohol consumed by older age groups. Physiological changes and an increased likelihood of health problems and medication use make older people more likely than younger age groups to suffer negative consequences of alcohol consumption, often at lower levels. However, health services targeting excessive drinking tend to be aimed at younger age groups. The aim of this study was to gain an in-depth understanding of experiences of, and attitudes towards, support for alcohol related health issues in people aged 50 and over.Qualitative interviews (n = 24, 12 male/12 female, ages 51-90 years and focus groups (n = 27, 6 male/21 female, ages 50-95 years were carried out with a purposive sample of participants who consumed alcohol or had been dependent.Participants' alcohol misuse was often covert, isolated and carefully regulated. Participants tended to look first to their General Practitioner for help with alcohol. Detoxification courses had been found effective for dependent participants but only in the short term; rehabilitation facilities were appreciated but seen as difficult to access. Activities, informal groups and drop-in centres were endorsed. It was seen as difficult to secure treatment for alcohol and mental health problems together. Barriers to seeking help included functioning at a high level, concern about losing positive aspects of drinking, perceived stigma, service orientation to younger people, and fatalistic attitudes to help-seeking. Facilitators included concern about risk of fatal illness or pressure from significant people.Primary care professionals need training on improving the detection and treatment of alcohol problems among older people. There is also a compelling need to ensure that aftercare is in place to prevent relapse. Strong preferences were expressed for support to be provided by those who had experienced alcohol problems themselves.

  11. Alcohol, drinking pattern and all-cause, cardiovascular and alcohol-related mortality in Eastern Europe.

    Science.gov (United States)

    Bobak, Martin; Malyutina, Sofia; Horvat, Pia; Pajak, Andrzej; Tamosiunas, Abdonas; Kubinova, Ruzena; Simonova, Galina; Topor-Madry, Roman; Peasey, Anne; Pikhart, Hynek; Marmot, Michael G

    2016-01-01

    Alcohol has been implicated in the high mortality in Central and Eastern Europe but the magnitude of its effect, and whether it is due to regular high intake or episodic binge drinking remain unclear. The aim of this paper was to estimate the contribution of alcohol to mortality in four Central and Eastern European countries. We used data from the Health, Alcohol and Psychosocial factors in Eastern Europe is a prospective multi-centre cohort study in Novosibirsk (Russia), Krakow (Poland), Kaunas (Lithuania) and six Czech towns. Random population samples of 34,304 men and women aged 45-69 years in 2002-2005 were followed up for a median 7 years. Drinking volume, frequency and pattern were estimated from the graduated frequency questionnaire. Deaths were ascertained using mortality registers. In 230,246 person-years of follow-up, 2895 participants died from all causes, 1222 from cardiovascular diseases (CVD), 672 from coronary heart disease (CHD) and 489 from pre-defined alcohol-related causes (ARD). In fully-adjusted models, abstainers had 30-50% increased mortality risk compared to light-to-moderate drinkers. Adjusted hazard ratios (HR) in men drinking on average ≥60 g of ethanol/day (3% of men) were 1.23 (95% CI 0.95-1.59) for all-cause, 1.38 (0.95-2.02) for CVD, 1.64 (1.02-2.64) for CHD and 2.03 (1.28-3.23) for ARD mortality. Corresponding HRs in women drinking on average ≥20 g/day (2% of women) were 1.92 (1.25-2.93), 1.74 (0.76-3.99), 1.39 (0.34-5.76) and 3.00 (1.26-7.10). Binge drinking increased ARD mortality in men only. Mortality was associated with high average alcohol intake but not binge drinking, except for ARD in men.

  12. CT of the liver in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Baert, A L; Wilms, G; Marchal, G; de Somer, F; de Maeyer, P; Ponette, E

    1980-07-01

    Of the diseases causing diffuse hepatic parenchyma alterations, CT will demonstrate most typically fatty replacement and hemochromatosis. Cirrhosis of the liver will be detected by CT in only a minority of the patients by virtue of changes in size and contour. Changes in attenuation coefficient in cirrhotic livers are described by some authors but not confirmed on a large scale until now. CT is useful for demonstrating associated anomalies such as signs of portal hypertension (splenomegaly, venous collaterals and ascites) and for studying the permeability of the portal vein.

  13. CT of the liver in cirrhosis

    International Nuclear Information System (INIS)

    Baert, A.L.; Wilms, G.; Marchal, G.; Somer, F. de; Maeyer, P. de; Ponette, E.

    1980-01-01

    Of the diseases causing diffuse hepatic parenchyma alterations, CT will demonstrate most typically fatty replacement and hemochromatosis. Cirrhosis of the liver will be detected by CT in only a minority of the patients by virtue of changes in size and contour. Changes in attenuation coefficient in cirrhotic livers are described by some authors but not confirmed on a large scale until now. CT is useful for demonstrating associated anomalies such as signs of portal hypertension (splenomegaly, venous collaterals and ascites) and for studying the permeability of the portal vein. (orig.) [de

  14. Complications of cirrhosis. A 50 years flashback

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming

    2015-01-01

    In patients with cirrhosis and portal hypertension, it is largely the frequency and severity of complications relating to the diseased liver, degree of portal hypertension and hemodynamic derangement that determine the prognosis. It can be considered as a multiple organ failure that apart from...... the liver involves the heart, lungs, kidneys, the immune systems and other organ systems. Progressive fibrosis of the liver and subsequent metabolic impairment leads to a systemic and splanchnic arteriolar vasodilatation. With the progression of the disease development of portal hypertension leads...

  15. Thioacetamide-induced cirrhosis in selenium-adequate mice displays rapid and persistent abnormity of hepatic selenoenzymes which are mute to selenium supplementation

    International Nuclear Information System (INIS)

    Zhang Jinsong; Wang Huali; Yu Hanqing

    2007-01-01

    Selenium reduction in cirrhosis is frequently reported. The known beneficial effect of selenium supplementation on cirrhosis is probably obtained from nutritionally selenium-deficient subjects. Whether selenium supplementation truly improves cirrhosis in general needs additional experimental investigation. Thioacetamide was used to induce cirrhosis in selenium-adequate and -deficient mice. Selenoenzyme activity and selenium content were measured and the influence of selenium supplementation was evaluated. In Se-adequate mice, thioacetamide-mediated rapid onset of hepatic oxidative stress resulted in an increase in thioredoxin reductase activity and a decrease in both glutathione peroxidase activity and selenium content. The inverse activity of selenoenzymes (i.e. TrxR activity goes up and GPx activity goes down) was persistent and mute to selenium supplementation during the progress of cirrhosis; accordingly, cirrhosis was not improved by selenium supplementation in any period. On the other hand, selenium supplementation to selenium-deficient mice always more efficiently increased hepatic glutathione peroxidase activity and selenium content compared with those treated with thioacetamide, indicating that thioacetamide impairs the liver bioavailability of selenium. Although thioacetamide profoundly affects hepatic selenium status in selenium-adequate mice, selenium supplementation does not modify the changes. Selenium supplementation to cirrhotic subjects with a background of nutritional selenium deficiency can improve selenium status but cannot restore hepatic glutathione peroxidase and selenium to normal levels

  16. Osteoporosis and FRAX risk in patients with liver cirrhosis

    Directory of Open Access Journals (Sweden)

    Azucena I. Casanova-Lara

    2014-10-01

    Conclusions: The frequency of osteoporosis or osteopenia is 90.4% in Mexican patients with liver cirrhosis of different etiologies. The decreased levels of bone alkaline phosphatase and 25-hydroxyvitamin-D were correlated with the risk of bone disease in patients with liver cirrhosis.

  17. High burden of coronary atherosclerosis in patients with cirrhosis

    DEFF Research Database (Denmark)

    Kazankov, Konstantin; Munk, Kim; Ovrehus, Kristian Altern

    2017-01-01

    Background Population studies report increased cardiovascular mortality in patients with cirrhosis. Coronary artery disease may be a trait of end-stage liver disease, but whether it is frequent or extensive in cirrhosis in general is unknown. Thus, we aimed to assess the prevalence and extent of ...

  18. Primary biliary cirrhosis and scleroderma complicated by Barrett's ...

    African Journals Online (AJOL)

    1991-04-06

    Apr 6, 1991 ... primary biliary cirrhosis, CREST syndrome, and chronic pancreatitis. Thorax. 1983; 38: 316-317. 9. Okano Y, Nisbikai M, Sato A. Scleroderma, primary biliary cirrhosis, and. Sjogren's syndrome after cosmetic breast augmentation with silicone injec- tion: a case reporfof possible human adjuvant disease.

  19. Autonomic dysfunction and impaired cerebral autoregulation in cirrhosis

    DEFF Research Database (Denmark)

    Frøkjaer, Vibe G; Strauss, Gitte I; Mehlsen, Jesper

    2006-01-01

    .0+/-2.0 bpm) compared to the controls (21.7+/-2.2 bpm, p=0.001, Tukey' test). Systolic blood pressure fell during head-up tilt only in patients with severe cirrhosis. Our results imply that cerebral autoregulation was impaired in the most severe cases of liver cirrhosis, and that those with impaired cerebral...

  20. High prevalence of diabetes mellitus in patients with liver cirrhosis

    NARCIS (Netherlands)

    Wlazlo, N.; Beijers, H. J. B. H.; Schoon, E. J.; Sauerwein, H. P.; Stehouwer, C. D. A.; Bravenboer, B.

    2010-01-01

    The reported prevalence of Type 2 diabetes mellitus in patients with liver cirrhosis is five times higher than in the general population. However, these data were never adjusted for classical risk factors for Type 2 diabetes. We therefore investigated the association between cirrhosis and Type 2

  1. Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts

    Directory of Open Access Journals (Sweden)

    Kerri Coomber

    2017-01-01

    Full Text Available This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews (n = 4016 were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC, pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

  2. Demographic and Substance Use Factors Associated with Non-Violent Alcohol-Related Injuries among Patrons of Australian Night-Time Entertainment Districts.

    Science.gov (United States)

    Coomber, Kerri; Mayshak, Richelle; Hyder, Shannon; Droste, Nicolas; Curtis, Ashlee; Pennay, Amy; Gilmore, William; Lam, Tina; Chikritzhs, Tanya; Miller, Peter G

    2017-01-12

    This study examined the relationship between patron demographics, substance use, and experience of recent alcohol-related accidents and injuries that were not due to interpersonal violence in night-time entertainment districts. Cross-sectional interviews ( n = 4016) were conducted around licensed venues in entertainment districts of five Australian cities. Demographic factors associated with non-violent alcohol-related injuries were examined, including gender, age, and occupation. The association between substance use on the night of interview; blood alcohol concentration (BAC), pre-drinking, energy drink consumption, and illicit drug use; and experience of injury was also explored. Thirteen percent of participants reported an alcohol-related injury within the past three months. Respondents aged younger than 25 years were significantly more likely to report an alcohol-related injury. Further, a significant occupation effect was found indicating the rate of alcohol-related injury was lower in managers/professionals compared to non-office workers. The likelihood of prior alcohol-related injury significantly increased with BAC, and self-reported pre-drinking, energy drink, or illicit drug consumption on the night of interview. These findings provide an indication of the demographic and substance use-related associations with alcohol-related injuries and, therefore, potential avenues of population-level policy intervention. Policy responses to alcohol-related harm must also account for an assessment and costing of non-violent injuries.

  3. Red blood cell sodium transport in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Ulrik Lütken; Kiszka-Kanowitz, Marianne; Bendtsen, Flemming

    2016-01-01

    Patients with advanced cirrhosis have abnormal sodium homoeostasis. The study was undertaken to quantify the sodium transport across the plasma membrane of red blood cells (RBC) in patients with cirrhosis. RBC efflux and influx of sodium were studied in vitro with tracer (22) Na(+) according...... to linear kinetics in 24 patients with cirrhosis and 14 healthy controls. The sodium efflux was modified by ouabain (O), furosemide (F) and a combination of O and F (O + F). RBC sodium was significantly decreased (4·6 versus control 6·3 mmol l(-1) , Psodium (r = 0·57, P......sodium efflux was higher in patients with cirrhosis (+46%, Psodium buffers showed that the F-insensitive sodium efflux was twice as high in cirrhosis as in controls (P = 0...

  4. Alcohol and cirrhosis: dose--response or threshold effect?

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Grønbaek, Morten; Tolstrup, Janne

    2004-01-01

    BACKGROUND/AIMS: General population studies have shown a strong association between alcohol intake and death from alcoholic cirrhosis, but whether this is a dose-response or a threshold effect remains unknown, and the relation among alcohol misusers has not been studied. METHODS: A cohort of 6152...... alcohol misusing men and women aged 15-83 were interviewed about drinking pattern and social issues and followed for 84,257 person-years. Outcome was alcoholic cirrhosis mortality. Data was analyzed by means of Cox-regression models. RESULTS: In this large prospective cohort study of alcohol misusers...... there was a 27 fold increased mortality from alcoholic cirrhosis in men and a 35 fold increased mortality from alcoholic cirrhosis in women compared to the Danish population. Number of drinks per day was not significantly associated with death from alcoholic cirrhosis, since there was no additional risk of death...

  5. Alcohol drinking pattern and risk of alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Askgaard, Gro; Grønbæk, Morten; Kjær, Mette S

    2015-01-01

    BACKGROUND & AIMS: Alcohol is the main contributing factor of alcoholic cirrhosis, but less is known about the significance of drinking pattern. METHODS: We investigated the risk of alcoholic cirrhosis among 55,917 participants (aged 50-64years) in the Danish Cancer, Diet, and Health study (1993......-2011). Baseline information on alcohol intake, drinking pattern, and confounders was obtained from a questionnaire. Follow-up information came from national registers. We calculated hazard ratios (HRs) for alcoholic cirrhosis in relation to drinking frequency, lifetime alcohol amount, and beverage type. RESULTS......: We observed 257 and 85 incident cases of alcoholic cirrhosis among men and women, respectively, none among lifetime abstainers. In men, HR for alcoholic cirrhosis among daily drinkers was 3.65 (95% CI: 2.39; 5.55) compared to drinking 2-4days/week. Alcohol amount in recent age periods (40-49 and 50...

  6. Establishment of animal model with half-liver cirrhosis

    International Nuclear Information System (INIS)

    Yang Zhenghan; Zhou Cheng; Chen Min; Xie Jingxia; Zhang Yuewu; Hu Bifang; Mo Hongbo; Wu Xiao

    2003-01-01

    Objective: To establish a new cirrhosis model suitable for imaging study. Methods: Via a 4 F catheter, 50-100 μl of carbon tetrachloride was injected into the left or right hepatic artery of 12 dogs fortnightly. Liver functional test, imaging study, and pathological examination were performed in these dogs regularly. Results: As the times of injection increased, necrosis of hepatocytes, fibrosis, and cirrhosis of the liver aggravated. In each dog, cirrhosis was more serious in the half liver with carbon tetrachloride injection than in the other half liver without carbon tetrachloride injection. With this model, it was convenient to perform the imaging study of liver cirrhosis. Conclusion: Animal model with half-liver cirrhosis can be established by combining catheter technique and traditional method

  7. Alcoholic Cirrhosis Increases Risk for Autoimmune Diseases

    DEFF Research Database (Denmark)

    Grønbæk, Lisbet; Vilstrup, Hendrik; Deleuran, Bent

    2015-01-01

    IRR, 1.56; 95% CI, 1.26-1.92), celiac disease (aIRR, 5.12; 95% CI, 2.58-10.16), pernicious anemia (aIRR, 2.35; 95% CI, 1.50-3.68), and psoriasis (aIRR, 4.06; 95% CI, 3.32-4.97). There was no increase in the incidence rate for rheumatoid arthritis (aIRR, 0.89; 95% CI, 0.69-1.15); the incidence rate......BACKGROUND & AIMS: Alcoholic cirrhosis is associated with hyperactivation and dysregulation of the immune system. In addition to its ability to increase risk for infections, it also may increase the risk for autoimmune diseases. We studied the incidence of autoimmune diseases among patients...... (controls) of the same sex and age. The incidence rates of various autoimmune diseases were compared between patients with cirrhosis and controls and adjusted for the number of hospitalizations in the previous year (a marker for the frequency of clinical examination). RESULTS: Of the 24,679 patients...

  8. Alcohol-related memory associations in positive and negative affect situations: drinking motives, working memory capacity, and prospective drinking.

    Science.gov (United States)

    Salemink, Elske; Wiers, Reinout W

    2014-03-01

    Although studies on explicit alcohol cognitions have identified positive and negative reinforcing drinking motives that are differentially related to drinking indices, such a distinction has received less attention in studies on implicit cognitions. An alcohol-related Word-Sentence Association Task was used to assess implicit alcohol-related memory associations in positive and negative affect situations in 92 participants. Results revealed that enhancement motives were specifically associated with the endorsement of alcohol words in positive affect situations and coping motives were associated with the endorsement of alcohol words in negative affect situations. Furthermore, alcohol associations in positive affect situations predicted prospective alcohol use and number of binges, depending on levels of working memory capacity. The current findings shed more light on the underpinnings of alcohol use and suggest that implicit memory processes and working memory capacity might be important targets for intervention.

  9. Alcohol consumption and liver cirrhosis mortality

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Smith, Valdemar

    Since the 1960s wine consumption has decreased dramatically in especially the Southern European countries whereas the countries in the northern parts of Europe have experienced a substitution from beer and spirits toward wines. In this sense there has been a process of convergence taking place...... regarding per capita consumption of wine among the European countries. Also for the total consumption of alcohol, i.e. the per capita consumption of beer, wine and spirits, the hypothesis of convergence seems to hold. In the same time span the number of alcohol related diseases as e.g. liver diseases, have...... changed significantly in the same direction as the developments in alcohol consumption. The changes in the consumption levels of alcohol in general -- and wine in particular -- are influenced by many factors of which health arguments may have played a crucial role. The alcohol policies of the European...

  10. Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study.

    Directory of Open Access Journals (Sweden)

    Karl Gauffin

    Full Text Available The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912, which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

  11. Relationship between alcohol-related expectancies and anterior brain functioning in young men at risk for developing alcoholism.

    Science.gov (United States)

    Deckel, A W; Hesselbrock, V; Bauer, L

    1995-04-01

    This experiment examined the relationship between anterior brain functioning and alcohol-related expectancies. Ninety-one young men at risk for developing alcoholism were assessed on the Alcohol Expectancy Questionnaire (AEQ) and administered neuropsychological and EEG tests. Three of the scales on the AEQ, including the "Enhanced Sexual Functioning" scale, the "Increased Social Assertiveness" scale, and items from the "Global/Positive Change scale," were used, because each of these scales has been found to discriminate alcohol-based expectancies adequately by at least two separate sets of investigators. Regression analysis found that anterior neuropsychological tests (including the Wisconsin Card Sorting test, the Porteus Maze test, the Controlled Oral Word Fluency test, and the Luria-Nebraska motor functioning tests) were predictive of the AEQ scale scores on regression analysis. One of the AEQ scales, "Enhanced Sexual Functioning," was also predicted by WAIS-R-Verbal scales, whereas the "Global/Positive" AEQ scale was predicted by the WAIS-R Performance scales. Regression analysis using EEG power as predictors found that left versus right hemisphere "difference" scores obtained from frontal EEG leads were predictive of the three AEQ scales. Conversely, parietal EEG power did not significantly predict any of the expectancy scales. It is concluded that anterior brain any of the expectancy scales. It is concluded that anterior brain functioning is associated with alcohol-related expectancies. These findings suggest that alcohol-related expectancy may be, in part, biologically determined by frontal/prefrontal systems, and that dysfunctioning in these systems may serve as a risk factor for the development of alcohol-related behaviors.

  12. Gender differences in alcohol-related non-consensual sex; cross-sectional analysis of a student population

    Directory of Open Access Journals (Sweden)

    Gunby Clare

    2012-03-01

    Full Text Available Abstract Background Sexual offences are a global public health concern. Recent changes in the law in England and Wales have dramatically altered the legal landscape of sexual offences, but sexual assaults where the victim is voluntarily intoxicated by alcohol continue to have low conviction rates. Worldwide, students are high consumers of alcohol. This research aimed to compare male and female students in relation to their knowledge and attitudes about alcohol and sexual activity and to identify factors associated with being the victim of alcohol-related non-consensual sex. Methods 1,110 students completed an online questionnaire. Drinking levels were measured using the Alcohol Use Disorder Identification Test. Non-consensual sexual experiences were measured using the Sexual Experience Survey. Univariate and multivariate analyses were undertaken using chi square and backwards stepwise logistic regression respectively. Results A third of respondents had experienced alcohol-related non-consensual sex. Male and female students differed in the importance they gave to cues in deciding if a person wished to have sex with them and their understanding of the law of consent. 82.2% of women who had experienced alcohol-related non-consensual sex were hazardous drinkers compared to 62.9% who drank at lower levels (P Conclusions Alcohol-related coerced sexual activity is a significant occurrence among students; attitudinal and knowledge differences between males and females may explain this. Educational messages that focus upon what is deemed acceptable sexual behaviour, the law and rape myths are needed but are set against a backdrop where drunkenness is commonplace.

  13. The Relationship Between Collective Self-Esteem, Acculturation, and Alcohol-Related Consequences Among Asian American Young Adults

    OpenAIRE

    PEDERSEN, ERIC R.; HSU, SHARON HSIN; NEIGHBORS, CLAYTON; LEE, CHRISTINE M.; LARIMER, MARY E.

    2013-01-01

    We examined the relationship between collective self-esteem (i.e., the value one places on being part of a collective group), acculturation, and alcohol-related consequences in a sample of 442 Asian American young adults. We found that membership self-esteem and public collective self-esteem interacted with acculturation such that low levels of both predicted greater rates of consequences. Participants with lower acculturation and greater private collective self-esteem experienced more alcoho...

  14. Neural correlates of instrumental responding in the context of alcohol-related cues index disorder severity and relapse risk.

    Science.gov (United States)

    Schad, Daniel J; Garbusow, Maria; Friedel, Eva; Sommer, Christian; Sebold, Miriam; Hägele, Claudia; Bernhardt, Nadine; Nebe, Stephan; Kuitunen-Paul, Sören; Liu, Shuyan; Eichmann, Uta; Beck, Anne; Wittchen, Hans-Ulrich; Walter, Henrik; Sterzer, Philipp; Zimmermann, Ulrich S; Smolka, Michael N; Schlagenhauf, Florian; Huys, Quentin J M; Heinz, Andreas; Rapp, Michael A

    2018-01-08

    The influence of Pavlovian conditioned stimuli on ongoing behavior may contribute to explaining how alcohol cues stimulate drug seeking and intake. Using a Pavlovian-instrumental transfer task, we investigated the effects of alcohol-related cues on approach behavior (i.e., instrumental response behavior) and its neural correlates, and related both to the relapse after detoxification in alcohol-dependent patients. Thirty-one recently detoxified alcohol-dependent patients and 24 healthy controls underwent instrumental training, where approach or non-approach towards initially neutral stimuli was reinforced by monetary incentives. Approach behavior was tested during extinction with either alcohol-related or neutral stimuli (as Pavlovian cues) presented in the background during functional magnetic resonance imaging (fMRI). Patients were subsequently followed up for 6 months. We observed that alcohol-related background stimuli inhibited the approach behavior in detoxified alcohol-dependent patients (t = - 3.86, p < .001), but not in healthy controls (t = - 0.92, p = .36). This behavioral inhibition was associated with neural activation in the nucleus accumbens (NAcc) (t (30)  = 2.06, p < .05). Interestingly, both the effects were only present in subsequent abstainers, but not relapsers and in those with mild but not severe dependence. Our data show that alcohol-related cues can acquire inhibitory behavioral features typical of aversive stimuli despite being accompanied by a stronger NAcc activation, suggesting salience attribution. The fact that these findings are restricted to abstinence and milder illness suggests that they may be potential resilience factors. LeAD study, http://www.lead-studie.de , NCT01679145.

  15. A systematic review: effectiveness of mass media campaigns for reducing alcohol-impaired driving and alcohol-related crashes.

    Science.gov (United States)

    Yadav, Rajendra-Prasad; Kobayashi, Miwako

    2015-09-04

    Mass media campaigns have long been used as a tool for promoting public health. In the past decade, the growth of social media has allowed more diverse options for mass media campaigns. This systematic review was conducted to assess newer evidence from quantitative studies on the effectiveness of mass media campaigns for reducing alcohol-impaired driving (AID) and alcohol-related crashes, particularly after the paper that Elder et al. published in 2004. This review focused on English language studies that evaluated the effect of mass media campaigns for reducing AID and alcohol-related crashes, with or without enforcement efforts. A systematic search was conducted for studies published between January 1, 2002 and December 31, 2013. Studies from the review by Elder et al. were added as well. A total of 19 studies met the inclusion criteria for the systematic review, including three studies from the review by Elder et al. Nine of them had concomitant enforcement measures and did not evaluate the impact of media campaigns independently. Studies that evaluated the impact of mass media independently showed reduction more consistently (median -15.1%, range -28.8 to 0%), whereas results of studies that had concomitant enforcement activities were more variable (median -8.6%, range -36.4 to +14.6%). Summary effects calculated from seven studies showed no evidence of media campaigns reducing the risk of alcohol-related injuries or fatalities (RR 1.00, 95% CI = 0.94 to 1.06). Despite additional decade of evidence, reviewed studies were heterogeneous in their approaches; therefore, we could not conclude that media campaigns reduced the risk of alcohol-related injuries or crashes. More studies are needed, including studies evaluating newly emerging media and cost-effectiveness of media campaigns.

  16. Responsibility without legal authority? Tackling alcohol-related health harms through licensing and planning policy in local government.

    Science.gov (United States)

    Martineau, F P; Graff, H; Mitchell, C; Lock, K

    2014-09-01

    The power to influence many social determinants of health lies within local government sectors that are outside public health's traditional remit. We analyse the challenges of achieving health gains through local government alcohol control policies, where legal and professional practice frameworks appear to conflict with public health action. Current legislation governing local alcohol control in England and Wales is reviewed and analysed for barriers and opportunities to implement effective population-level health interventions. Case studies of local government alcohol control practices are described. Addressing alcohol-related health harms is constrained by the absence of a specific legal health licensing objective and differences between public health and legal assessments of the relevance of health evidence to a specific place. Local governments can, however, implement health-relevant policies by developing local evidence for alcohol-related health harms; addressing cumulative impact in licensing policy statements and through other non-legislative approaches such as health and non-health sector partnerships. Innovative local initiatives-for example, minimum unit pricing licensing conditions-can serve as test cases for wider national implementation. By combining the powers available to the many local government sectors involved in alcohol control, alcohol-related health and social harms can be tackled through existing local mechanisms. © The Author 2013. Published by Oxford University Press on behalf of Faculty of Public Health.

  17. Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students.

    Science.gov (United States)

    Dennhardt, Ashley A; Murphy, James G

    2011-12-01

    Although levels of heavy drinking and alcohol-related problems are high in college students, there is significant variability in the number and type of problems experienced, even among students who drink heavily. African American students drink less and experience fewer alcohol-related problems than European American students, but are still at risk, and little research has investigated the potentially unique patterns and predictors of problems among these students. Depression, distress tolerance, and delay discounting have been implicated in adult substance abuse and may be important predictors of alcohol problem severity among college students. We examined the relationship between these variables and alcohol-related problems among African American and European American students (N = 206; 53% female; 68% European American; 28% African American) who reported recent heavy drinking. In regression models that controlled for drinking level, depression, distress tolerance, and delay discounting were associated with alcohol problems among African American students, but only depression was associated with alcohol problems among European American students. These results suggest that negative affect is a key risk factor for alcohol problems among college student drinkers. For African American students, the inability to tolerate negative emotions and to organize their behavior around future outcomes may also be especially relevant risk factors.

  18. An application of deviance regulation theory to reduce alcohol-related problems among college women during spring break.

    Science.gov (United States)

    Dvorak, Robert D; Kramer, Matthew P; Stevenson, Brittany L; Sargent, Emily M; Kilwein, Tess M

    2017-05-01

    Spring break (SB) can lead to heavy episodic drinking and increased alcohol-related risks. This may be especially relevant for women. The current study utilized deviance regulation theory to increase the use of protective behavioral strategies (PBSs) among female college students on SB. Female college students going on SB (n = 62) completed a screening, a pre-SB intervention (where they were randomly assigned to receive either a positively or negatively framed message about individuals who do or do not use PBS), and a post-SB assessment that provided alcohol and PBS use data for each day of SB (n = 620 person-days). Data were analyzed using a multilevel structural equation model. In the negative frame, SB PBS use was higher among those who perceived SB PBS norms to be more common on SB relative to non-SB. In the positive frame, SB PBS use was higher among those who perceived SB PBS norms to be less common on SB relative to non-SB. These associations did not result in lower alcohol consumption, but did result in a lower likelihood of experiencing alcohol-related problems during SB. These results suggest that a brief online intervention, that utilizes targeted messages based on normative perceptions of SB PBS use, could be an effective strategy for reducing alcohol-related consequences among college student women during SB. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Characteristics of cirrhosis undiagnosed during life: a comparative analysis of 73 undiagnosed cases and 149 diagnosed cases of cirrhosis, detected in 4929 consecutive autopsies

    DEFF Research Database (Denmark)

    Graudal, Niels; Leth, Peter Mygind; Mårbjerg, Lone

    1991-01-01

    In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty-three of ......In 4929 consecutive autopsies performed during a period of 4 years, 222 cases (4.5%) of cirrhosis were found, of which 149 (3%) were detected while the patients were alive (diagnosed cirrhosis) and 73 (1.5%) were not detected while the patients were living (undiagnosed cirrhosis). Fifty......-three of the 73 undiagnosed patients appeared to be completely without signs of cirrhosis (silent cirrhosis). In the diagnosed group, 70% of patients died from hepatic causes, in contrast to 16% in the undiagnosed group. At autopsy, the following complications of cirrhosis were found more frequently...

  20. DIABETES MELLITUS IN PATIENTS WITH LIVER CIRRHOSIS: NEW TREATMENT OPTIONS

    Directory of Open Access Journals (Sweden)

    L. Yu. Morgunov

    2017-01-01

    Full Text Available In economically developed countries, cirrhosis is one of the six leading causes of death at the age of 35–60 years and ranges from 14 to 30 cases per 100000 population. In the world 40 million people die of cirrhosis each year. At 6% of the population of the Russian Federation there is a diabetes mellitus. The combination of diabetes mellitus in patients with cirrhosis of the liver is a common comorbid pathology. Diabetes mellitusis a risk factor for the development of liver cirrhosis, and the incidence of combination of both diseases is quite high, although the frequency of occurrence varies. About 80% of patients with LC may have impaired glucose metabolism, and 30% have diabetes mellitus. Prospective studies have shown that diabetes is associated with an increased risk of developing hepatic complications and death in patients with cirrhosis of the liver. Diabetes mellitus increases the risk of complications of liver cirrhosis of any etiology (varicose veins of the esophagus, hepatic encephalopathy, hepatic-cell insufficiency and subsequent survival. The incidence, frequency of hospitalizations and mortality from this combined pathology are very high. There are common mechanisms that provoke metabolic and autoimmune disorders in the development of chronic hepatitis and cirrhosis, leading to steatosis, insulin resistance, impaired glucose tolerance and the development of diabetes mellitus. There are certain features of the evaluation of the compensation of carbohydrate metabolism in patients with cirrhosis of the liver, anemia and impaired protein metabolism. Effective control of glycemia can have a beneficial effect on the treatment of these patients. However, few studies have evaluated the efficacy and safety of antidiabetic drugs and the effect of diabetes treatment on morbidity and mortality in patients with cirrhosis. Previously it was believed that in the presence of cirrhosis the only treatment remains insulin. At present, in

  1. Periodontal disease and liver cirrhosis: A systematic review.

    Science.gov (United States)

    Grønkjær, Lea Ladegaard

    2015-01-01

    Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including 'liver cirrhosis', 'end-stage liver disease', 'liver diseases', 'oral health', 'periodontal disease', 'mouth disease', 'gingivitis', and 'periodontitis'. Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%-79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed.

  2. [Use of medroxyprogesterone in human hepatic cirrhosis].

    Science.gov (United States)

    Kremer, A; Ríos, B; Bruno, M; Heinrichs, G

    1985-01-01

    The effect of medroxyprogesterone in 14 patients with hepatic cirrhosis demonstrated with histological technics was studied. Eight of the 14 patients were controlled over a period of one year and three months. Six of this eight patients presented subjective clinical improvement and the ascitis disappeared in 5/7 cases, so that the doses of lactona could be diminished. Three of the male patients recovered their sexual potency although all were in alcoholic abstinence for more than one year. Histologically 5/6 patients presented a diminishing fibrosis in the control biopsy and the 3 patients controlled with hemodynamic studies presented lower portal pression. We didn't found secondary effects, except obesity in 3 cases. We concluded that it would be important to continue this experience with a greater number of patients and adding appropriate biochemical controls.

  3. Oral health in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Vilstrup, Hendrik

    2015-01-01

    frequently (P=0.001), more rarely brushed teeth (P=0.001) and had problems with oral dryness (68 vs. 14%, P=0.0001). The patients’ mean OHIP score was 5.21±7.2, with the most commonly reported problems being related to taste and food intake. An association was observed between the OHIP score and the patients...... Services Research report on the Danish population’s dental status. Results: One hundred and seven patients participated. Their oral care habits and self-perceived oral health were poorer than the Danish population; the patients had fewer teeth (on average 19 vs. 26, P=0.0001), attended the dentist less...... importance. Our results emphasize the need for measures to protect and improve the oral health of cirrhosis patients....

  4. How to detect hepatocellular carcinoma in cirrhosis

    Energy Technology Data Exchange (ETDEWEB)

    Ward, Janice; Robinson, Philip J. [Department of Clinical Radiology, St. James' s University Hospital, Beckett Street, Leeds LS9 7TF (United Kingdom)

    2002-09-01

    Cirrhosis predisposes to hepatocellular carcinoma (HCC) which develops by sequential steps of de-differentiation of hepatocytes from regenerative nodules via borderline (dysplastic) nodules to frankly malignant HCC. Effective treatment depends on early recognition of HCC, so the key tasks for imaging are firstly recognising the presence of a suspicious lesion, and secondly differentiating between benign, borderline and malignant nodules. Screening of high-risk cirrhotic patients with sonography and measurement of alpha fetoprotein (AFP) is helpful but will not reliably differentiate small HCC from benign or dysplastic nodules. Large HCCs can usually be recognised by their characteristic morphology on imaging, but the appearances of smaller benign and malignant nodules show considerable overlap on unenhanced sonography, CT and MRI. Increasing degrees of histological malignancy are associated with increasing arterialisation and loss of portal blood supply, so the recognition of HCC requires the use of dynamic imaging with contrast-enhanced CT or T1-weighted MRI with gadolinium enhancement. Sonography with microbubble contrast media now offers another method for detecting arterialised nodules; however, some non-malignant nodules show arterial hypervascularity and a minority of HCCs are hypovascular, so the assessment of perfusion does not conclusively distinguish benign from malignant lesions. Kupffer cell function is another attribute of liver tissue which can be explored using MRI with superparamagnetic iron oxide particles (SPIO). Experience thus far suggests that uptake of SPIO is an effective discriminator between benign and malignant nodules. The combination of SPIO with gadolinium-enhanced MRI offers the opportunity for imaging characterisation of cirrhotic nodules by cellular function as well as by blood supply, and this approach is now proposed as the examination of choice for detecting HCC in cirrhosis. (orig.)

  5. Review article: volume expansion in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Kiszka-Kanowitz, Marianne; Bendtsen, Flemming

    2002-01-01

    with low systemic vascular resistance, increased whole-body vascular compliance, and increased arterial compliance. The effectiveness and temporal relations of plasma/blood volume expansion depend highly on the type of load (water, saline, oncotic material, red blood cells). Patients with cirrhosis respond...... in advanced cirrhosis is qualitatively and quantitatively different from that of healthy subjects, and in those with early cirrhosis. Timely handling is essential, but difficult as it is a balance between the risks of excess extravascular volume loading and further circulatory dysfunction in these patients...

  6. Review article: volume expansion in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Kiszka-Kanowitz, Marianne; Bendtsen, Flemming

    2002-01-01

    Adequate size and distribution of the circulating medium are important for cardiovascular function, tissue oxygenation, and fluid homoeostasis. Patients with cirrhosis have cardiovascular dysfunction with a hyperkinetic systemic circulation, abnormal distribution of the blood volume, vasodilation...

  7. Hypertrophic osteoarthropathy associated with alcoholic liver disease without cirrhosis.

    Science.gov (United States)

    Varju, T; Lesch, M; Adorján, A

    1986-01-01

    Two cases of secondary hypertrophic osteoarthropathy associated with alcoholic liver disease without cirrhosis are reported. Conditions which can be associated with hypertrophic osteoarthropathy and theoretical factors which can play a role in its pathomechanism are briefly discussed.

  8. Hormone replacement for osteoporosis in women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

    2011-01-01

    Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

  9. Autonomic dysfunction and impaired cerebral autoregulation in cirrhosis

    DEFF Research Database (Denmark)

    Frøkjaer, Vibe G; Strauss, Gitte I; Mehlsen, Jesper

    2006-01-01

    Cerebral blood flow autoregulation is lost in patients with severe liver cirrhosis. The cause of this is unknown. We determined whether autonomic dysfunction was related to impaired cerebral autoregulation in patients with cirrhosis. Fourteen patients with liver cirrhosis and 11 healthy volunteers...... were recruited. Autonomic function was assessed in response to deep breathing, head-up tilt and during 24-h Holter monitoring. Cerebral autoregulation was assessed by determining the change in mean cerebral blood flow velocity (MCAVm, transcranial Doppler) during an increase in blood pressure induced...... by norepinephrine infusion (NE). The severity of liver disease was assessed using the Child-Pugh scale (class A, mild; class B, moderate; class C, severe liver dysfunction).NE increased blood pressure similarly in the controls (27 (24-32) mmHg) and patients with the most severe liver cirrhosis (Child-Pugh C, 31 (26...

  10. Risk of primary biliary cirrhosis in patients with coeliac disease

    DEFF Research Database (Denmark)

    Sørensen, Henrik Toft; Thulstrup, Ane Marie; Blomqvist, P

    1999-01-01

    BACKGROUND: Several case reports, but only a few studies, have examined the coexistence of coeliac disease and primary biliary cirrhosis. AIM: To estimate the risk of primary biliary cirrhosis in two national cohorts of patients with coeliac disease in Denmark and Sweden. METHODS: Through record...... linkage all Danish patients hospitalised with coeliac disease were followed for possible occurrence of primary biliary cirrhosis from 1 January 1977 until 31 December 1992. All patients hospitalised with coeliac disease in Sweden from 1987 to 1996 were also followed in a separate analysis. RESULTS......: A total of 896 patients with coeliac disease were identified in Denmark with a median follow up period of 9.1 years for a total of 8040 person-years at risk. Two cases of primary biliary cirrhosis were observed where 0.07 were expected, giving a standardised incidence ratio of 27.6 (95% confidence...

  11. Evaluating Personalized Feedback Intervention Framing with a Randomized Controlled Trial to Reduce Young Adult Alcohol-Related Sexual Risk Taking.

    Science.gov (United States)

    Lewis, Melissa A; Rhew, Isaac C; Fairlie, Anne M; Swanson, Alex; Anderson, Judyth; Kaysen, Debra

    2018-03-06

    The purpose of this study was to evaluate personalized feedback intervention (PFI) framing with two web-delivered PFIs aimed to reduce young adult alcohol-related risky sexual behavior (RSB). Combined PFIs typically use an additive approach whereby independent components on drinking and components on RSB are presented without the discussion of the influence of alcohol on RSB. In contrast, an integrated PFI highlights the RSB-alcohol connection by presenting integrated alcohol and RSB components that focus on the role of intoxication as a barrier to risk reduction in sexual situations. In a randomized controlled trial, 402 (53.98% female) sexually active young adults aged 18-25 were randomly assigned to a combined PFI, an integrated PFI, or attention control. All assessment and intervention procedures were web-based. At the 1-month follow-up, those randomly assigned to the integrated condition had a lower likelihood of having any casual sex partners compared to those in the control group. At the 6-month follow-up, the combined condition had a lower likelihood of having any casual sex partners compared to those in the control group. When examining alcohol-related RSB, at the 1-month follow-up, both interventions showed a lower likelihood of any drinking prior to sex compared to the control group. When examining alcohol-related sexual consequences, results showed a reduction in the non-zero count of consequences in the integrated condition compared to the control at the 1-month follow-up. For typical drinks per week, those in the combined condition showed a greater reduction in the non-zero count of drinks than those in the control condition at the 1-month follow-up. While there were no significant differences between the two interventions, the current findings highlight the utility of two efficacious web-based alcohol and RSB interventions among a national sample of at-risk young adults.

  12. Cue-induced alcohol-seeking behaviour is reduced by disrupting the reconsolidation of alcohol-related memories.

    Science.gov (United States)

    von der Goltz, Christoph; Vengeliene, Valentina; Bilbao, Ainhoa; Perreau-Lenz, Stephanie; Pawlak, Cornelius R; Kiefer, Falk; Spanagel, Rainer

    2009-08-01

    In humans, the retrieval of memories associated with an alcohol-related experience frequently evokes alcohol-seeking behaviour. The reconsolidation hypothesis states that a consolidated memory could again become labile and susceptible to disruption after memory retrieval. The aim of our study was to examine whether retrieval of alcohol-related memories undergoes a reconsolidation process. For this purpose, male Wistar rats were trained to self-administer ethanol in the presence of specific conditioned stimuli. Thereafter, animals were left undisturbed in their home cages for the following 21 days. Memory retrieval was performed in a single 5-min exposure to all alcohol-associated stimuli. The protein synthesis inhibitor anisomycin, the non-competitive N-methyl-D: -aspartate (NMDA) receptor antagonist MK-801 and acamprosate, a clinically used drug known to reduce a hyper-glutamatergic state, were given immediately after retrieval of alcohol-related memories. The impact of drug treatment on cue-induced alcohol-seeking behaviour was measured on the following day and 7 days later. Administration of both anisomycin and MK-801 reduced cue-induced alcohol-seeking behaviour, showing that memory reconsolidation was disrupted by these compounds. However, acamprosate had no effect on the reconsolidation process, suggesting that this process is not dependent on a hyper-glutamatergic state but is more related to protein synthesis and NMDA receptor activity. Pharmacological disruption of reconsolidation of alcohol-associated memories can be achieved by the use of NMDA antagonists and protein synthesis inhibitors and may thus provide a potential new therapeutic strategy for the prevention of relapse in alcohol addiction.

  13. Social anxiety and drinking refusal self-efficacy moderate the relationship between drinking game participation and alcohol-related consequences.

    Science.gov (United States)

    Kenney, Shannon R; Napper, Lucy E; LaBrie, Joseph W

    2014-09-01

    Participation in drinking games is associated with excessive drinking and alcohol risks. Despite the growing literature documenting the ubiquity and consequences of drinking games, limited research has examined the influence of psychosocial factors on the experience of negative consequences as the result of drinking game participation. The current event-level study examined the relationships among drinking game participation, social anxiety, drinking refusal self-efficacy (DRSE) and alcohol-related consequences in a sample of college students. Participants (n = 976) reported on their most recent drinking occasion in the past month in which they did not preparty. After controlling for sex, age, and typical drinking, higher levels of social anxiety, lower levels of DRSE, and playing drinking games predicted greater alcohol-related consequences. Moreover, two-way interactions (Social Anxiety × Drinking Games, DRSE × Drinking Games) demonstrated that social anxiety and DRSE each moderated the relationship between drinking game participation and alcohol-related consequences. Participation in drinking games resulted in more alcohol problems for students with high social anxiety, but not low social anxiety. Students with low DRSE experienced high levels of consequences regardless of whether they participated in drinking games; however, drinking game participation was associated with more consequences for students confident in their ability to resist drinking. Findings highlight the important role that social anxiety and DRSE play in drinking game-related risk, and hence provide valuable implications for screening at-risk students and designing targeted harm reduction interventions that address social anxiety and drink refusal in the context of drinking games.

  14. Are energy drinks unique mixers in terms of their effects on alcohol consumption and negative alcohol-related consequences?

    Science.gov (United States)

    Johnson, Sean J; Alford, Chris; Stewart, Karina; Verster, Joris C

    2018-01-01

    Previous research has suggested that consuming alcohol mixed with energy drinks (AMED) increases overall alcohol consumption. However, there is limited research examining whether energy drinks are unique in their effects when mixed with alcohol, when compared with alcohol mixed with other caffeinated mixers (AOCM). Therefore, the aim of this survey was to investigate alcohol consumption on AMED occasions, to that on other occasions when the same individuals consumed AOCM or alcohol only (AO). A UK-wide online student survey collected data on the frequency of alcohol consumption and quantity consumed, as well as the number of negative alcohol-related consequences reported on AO, AMED and AOCM occasions (N=250). Within-subjects analysis revealed that there were no significant differences in the number of alcoholic drinks consumed on a standard and a heavy drinking session between AMED and AOCM drinking occasions. However, the number of standard mixers typically consumed was significantly lower on AMED occasions compared with AOCM occasions. In addition, when consuming AMED, students reported significantly fewer days consuming 5 or more alcohol drinks, fewer days mixing drinks, and fewer days being drunk, compared with when consuming AOCM. There were no significant differences in the number of reported negative alcohol-related consequences on AMED occasions to AOCM occasions. Of importance, alcohol consumption and negative alcohol-related consequences were significantly less on both AMED and AOCM occasions compared with AO occasions. The findings that heavy alcohol consumption occurs significantly less often on AMED occasions compared with AOCM occasions is in opposition to some earlier claims implying that greatest alcohol consumption occurs with AMED. The overall greatest alcohol consumption and associated negative consequences were clearly associated with AO occasions. Negative consequences for AMED and AOCM drinking occasions were similar, suggesting that energy

  15. Alcohol-related biases in selective attention and action tendency make distinct contributions to dysregulated drinking behaviour.

    Science.gov (United States)

    Sharbanee, Jason M; Stritzke, Werner G K; Wiers, Reinout W; MacLeod, Colin

    2013-10-01

    To assess whether alcohol-related biases in selective-attention and action tendency uniquely or concurrently predict the ability to regulate alcohol consumption. Two groups of undergraduate social drinkers (total n = 55) who differed in their ability to regulate their alcohol consumption completed a novel Selective-Attention/Action-Tendency Task (SA/ATT), which assessed separately alcohol-related biases in selective attention and action tendency. University of Western Australia, Australia. Dysregulated drinking was operationalized as a self-reported high level of alcohol consumption on the Alcohol Consumption Questionnaire, and a high desire to reduce consumption on the Brief Readiness to Change Algorithm. Selective attention and action tendency were assessed using the SA/ATT, working memory was assessed using the operation-span task and participant characteristics were assessed using the Alcohol Use Disorders Identification Test (AUDIT) and Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES). Results indicated that (i) there was no significant association between alcohol-related biases in selective attention and action tendency, r = 0.16, P = 0.274, and (ii) biases towards alcohol, in both selective attention, β = 1.01, odds ratio = 2.74, P = 0.022, and action tendency, β = 1.24, odds ratio = 3.45, P = 0.015, predicted independent variance in dysregulated-drinker status. Biases in selective attention and action tendency appear to be distinct mechanisms that contribute independently to difficulty regulating alcohol consumption. Treatment components that could be combined to target both mechanisms could enhance treatment outcomes for alcohol-use disorders. © 2013 Society for the Study of Addiction.

  16. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

    Directory of Open Access Journals (Sweden)

    Walvoort SJW

    2016-07-01

    Full Text Available Serge JW Walvoort,1–3 Paul T van der Heijden,3,4 Roy PC Kessels,1,2,5 Jos IM Egger1–3,6 1Centre of Excellence for Korsakoff and Alcohol-Related Cognitive Disorders, Vincent van Gogh Institute for Psychiatry, Venray, 2Donders Institute for Brain, Cognition and Behaviour, 3Behavioural Science Institute, Radboud University, Nijmegen, 4Reinier van Arkel Mental Health Institute, ‘s-Hertogenbosch, 5Department of Medical Psychology, Radboud University Medical Center, Nijmegen, 6Centre of Excellence for Neuropsychiatry, Vincent van Gogh Institute for Psychiatry, Venray, the Netherlands Aim: Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8 was investigated in patients with Korsakoff’s syndrome (KS and in alcohol use disorder (AUD patients with mild neurocognitive deficits. Methods: First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results: Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73. The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion: The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction. Keywords: illness insight, anosognosia, alcohol use disorder, Korsakoff

  17. Triglyceride concentration and waist circumference influence alcohol-related plasminogen activator inhibitor-1 activity increase in black South Africans.

    Science.gov (United States)

    Pieters, Marlien; de Lange, Zelda; Hoekstra, Tiny; Ellis, Suria M; Kruger, Annamarie

    2010-12-01

    We investigated the association between alcohol consumption and plasminogen activator inhibitor-1 activity (PAI-1act) and fibrinogen concentration in a black South African population presenting with lower PAI-1act and higher fibrinogen than what is typically observed in white populations. We, furthermore, wanted to investigate the effect of urbanization, sex, central obesity, increased triglycerides, 4G/5G polymorphism (PAI-1 only) and BMI on the association of alcohol with PAI-1act and fibrinogen. Data from 2010 apparently healthy, randomly collected black South African volunteers from the Prospective Urban and Rural Epidemiological (PURE) study were cross-sectionally analyzed. Alcohol consumption was recorded using quantitative food frequency questionnaires and fasting blood samples were collected for biochemical analysis including PAI-1act and fibrinogen. Heavy alcohol consumption is associated with significantly increased PAI-1act, in the total population as well as in the women separately, and tended to be so in men. This alcohol-related PAI-1act increase was observed in volunteers with increased triglycerides and central obesity but not in volunteers with normal levels and waist circumference. Urbanization, the 4G/5G polymorphism and BMI did not affect the association of alcohol with PAI-1act. Moderate alcohol consumption is associated with decreased fibrinogen concentration. Sex and level of urbanization did not affect the association of alcohol with fibrinogen. Fibrinogen decreased in normal and overweight volunteers but not in obese and centrally obese volunteers following moderate alcohol consumption. Triglyceride levels and waist circumference influence alcohol-related PAI-1act increase potentially through modulating adipocyte and triglyceride-induced PAI-1 production. Obesity prevented alcohol-related fibrinogen decrease possibly by counteracting the anti-inflammatory effect of moderate alcohol consumption.

  18. Effects of Specific Alcohol Control Policy Measures on Alcohol-Related Mortality in Russia from 1998 to 2013.

    Science.gov (United States)

    Khaltourina, Daria; Korotayev, Andrey

    2015-09-01

    To elucidate the possible effects of alcohol control policy measures on alcohol-related mortality in Russia between 1998 and 2013. Trends in mortality, alcohol production and sales were analyzed in conjunction with alcohol control legislative measures. Correlation analysis of health and alcohol market indicators was performed. Ethyl alcohol production was the strongest correlate of alcohol-related mortality, which is probably due to the fact that ethyl alcohol is used for both recorded and unrecorded alcohol production. Measures producing greatest mortality reduction effect included provisions which reduced ethyl alcohol production (introduction of minimum authorized capital for ethyl alcohol and liquor producers in 2006 and the requirement for distillery dreg processing), as well as measures to tax and denaturize ethanol-containing liquids in 2006. Liquor tax decrease in real terms was associated with rising mortality in 1998-1999, while excise tax increase was associated with mortality reduction in 2004 and since 2012. Conventional alcohol control measures may also have played a moderately positive role. Countries with high alcohol-related mortality should aim for a reduction in spirits consumption as a major health policy. Alcohol market centralization and reduction of the number of producers can have immediate strong effects on mortality. These measures should be combined with an increase in alcohol taxes and prices, as well as other established alcohol policy measures. In 2015 in Russia, this is not being implemented. In Russia, legislation enforcement including excise tax collection remains the major challenge. Another challenge will be the integration into the Eurasian Economic Union. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  19. Renal Impairment in Cirrhosis Unrelated to Hepatorenal Syndrome

    Directory of Open Access Journals (Sweden)

    Gavin Low

    2015-01-01

    Full Text Available Renal impairment is common in liver disease and may occur as a consequence of the pathophysiological changes that underpin cirrhosis or secondary to a pre-existing unrelated insult. Nevertheless, the onset of renal impairment often portends a worsening prognosis. Hepatorenal syndrome remains one of the most recognized and reported causes of renal impairment in cirrhosis. However, other causes of renal impairment occur and can be classified into prerenal, intrinsic or postrenal, which are the subjects of the present review.

  20. Acid-base disturbance in patients with cirrhosis

    DEFF Research Database (Denmark)

    Henriksen, Jens H; Bendtsen, Flemming; Møller, Søren

    2015-01-01

    (r=-0.25, Psodium (r=-0.38, Preduced standard base excess in all patients (P...PURPOSE: Acid-base disturbances were investigated in patients with cirrhosis in relation to hemodynamic derangement to analyze the hyperventilatory effects and the metabolic compensation. METHODS: A total of 66 patients with cirrhosis and 44 controls were investigated during a hemodynamic study......, and effects of unidentified ions (all P

  1. Periodontal disease and liver cirrhosis: A systematic review

    Science.gov (United States)

    2015-01-01

    Objectives: Studies suggest that periodontal disease, a source of subclinical and persistent infection, may be associated with various systemic conditions, including liver cirrhosis. The aim of this study was to examine the literature and determine the relationship between periodontal disease and liver cirrhosis and to identify opportunities and directions for future research in this area. Methods: A systematic review of English articles in the PubMed, EMBASE, and Scopus databases was conducted using search terms including ‘liver cirrhosis’, ‘end-stage liver disease’, ‘liver diseases’, ‘oral health’, ‘periodontal disease’, ‘mouth disease’, ‘gingivitis’, and ‘periodontitis’. Results: Thirteen studies published between 1981 and 2014 were found to include data on oral health and periodontal disease in cirrhotic patients. Studies indicated an increased incidence of periodontal disease in patients with liver cirrhosis, measured with several different periodontal indices. The reported prevalence of periodontal disease in cirrhosis patients ranged from 25.0% to 68.75% in four studies and apical periodontitis was found in 49%–79% of the patients. One study found that mortality was lower among patients who underwent dental treatment versus non-treated patients. Another study suggested an association between periodontal disease and the progression of liver cirrhosis, but data are sparse and conflicting as to whether periodontal disease is correlated to cirrhosis aetiology and severity. Conclusion: Despite the clinical reality of periodontal disease in liver cirrhosis patients, there are few published studies. Before clinical implications can be addressed, more data on the prevalence of and correlation between periodontal disease and liver cirrhosis aetiology, duration, and progression are needed. PMID:26770799

  2. Variation of left heart function and thyroid hormone in cirrhosis

    International Nuclear Information System (INIS)

    Liu Junchi; Du Sujun; Mao Shaorong; Lu Jun; Tang Xiaoling

    1996-01-01

    The observation of 52 cases of cirrhosis left heart function indices traced with 113 In m in quiet and motion, and the combining determination of thyroid hormone serum levels with RIA are described. The cirrhosis to the function of liver damage increased, the indices of left heart function has great change. Moreover, the serum levels of T 3 , FT 3 in thyroid hormone are decreased obviously and the serum level of rT 3 is also increased significantly

  3. Khat chewing and cirrhosis in Somaliland: Case series

    Directory of Open Access Journals (Sweden)

    Hawa D. Mahamoud

    2016-07-01

    Results: Eight Somali men aged 27–70 years living in Somaliland were identified with cirrhosis of otherwise unknown cause. All chewed khat habitually for many years (15–128 bundles per day times years of use. A liver biopsy of one man was consistent with khat hepatotoxicity. Four of the eight men died during the study period.Conclusion: Khat chewing may be associated with health consequences including severe hepatotoxicity with cirrhosis.

  4. Ethnic Variations in Liver- and Alcohol-Related Disease Hospitalisations and Mortality: The Scottish Health and Ethnicity Linkage Study.

    Science.gov (United States)

    Bhala, Neeraj; Cézard, Genevieve; Ward, Hester J T; Bansal, Narinder; Bhopal, Raj

    2016-09-01

    Preventing alcohol-related harms, including those causing liver disease, is a public health priority in the UK, especially in Scotland, but the effects of ethnicity are not known. We assessed liver- and alcohol-related events (hospitalisations and deaths) in Scotland using self-reported measures of ethnicity. Linking Scottish NHS hospital admissions and mortality to the Scottish Census 2001, we explored ethnic differences in hospitalisations and mortality (2001-2010) of all liver diseases, alcoholic liver disease (ALD) and specific alcohol-related diseases (ARD). Risk ratios (RR) were calculated using Poisson regression with robust variance, by sex, adjusted for age, country of birth and the Scottish Index of Multiple Deprivation (SIMD) presented below. The White Scottish population was the standard reference population with 95% confidence intervals (CI) calculated to enable comparison (multiplied by 100 for results). For all liver diseases, Chinese had around 50% higher risks for men (RR 162; 95% CI 127-207) and women (141; 109-184), as did Other South Asian men (144; 104-201) and Pakistani women (140; 116-168). Lower risks for all liver diseases occurred in African origin men (42; 24-74), other White British men (72; 63-82) and women (80; 70-90) and other White women (80; 67-94). For ALD, White Irish had a 75% higher risk for men (175; 107-287). Other White British men had about a third lower risk of ALD (63; 50-78), as did Pakistani men (65; 42-99). For ARD, almost 2-fold higher risks existed for White Irish men (182; 161-206) and Any Mixed Background women (199; 152-261). Lower risks of ARD existed in Pakistani men (67; 55-80) and women (48; 33-70), and Chinese men (55; 41-73) and women (54; 32-90). Substantial variations by ethnicity exist for both alcohol-related and liver disease hospitalisations and deaths in Scotland: these exist in subgroups of both White and non-White populations and practical actions are required to ameliorate these differences. © The

  5. The relationship between collective self-esteem, acculturation, and alcohol-related consequences among Asian American young adults.

    Science.gov (United States)

    Pedersen, Eric R; Hsu, Sharon Hsin; Neighbors, Clayton; Lee, Christine M; Larimer, Mary E

    2013-01-01

    We examined the relationship between collective self-esteem (i.e., the value one places on being part of a collective group), acculturation, and alcohol-related consequences in a sample of 442 Asian American young adults. We found that membership self-esteem and public collective self-esteem interacted with acculturation such that low levels of both predicted greater rates of consequences. Participants with lower acculturation and greater private collective self-esteem experienced more alcohol consequences. This study suggests that differential aspects of collective self-esteem may serve as protective or risk factors for Asian American young adults depending on degree of acculturation.

  6. Work stressors, sleep quality, and alcohol-related problems across deployment: A parallel process latent growth modeling approach among Navy members.

    Science.gov (United States)

    Bravo, Adrian J; Kelley, Michelle L; Hollis, Brittany F

    2017-10-01

    This study examined how work stressors were associated with sleep quality and alcohol-related problems among U.S. Navy members over the course of deployment. Participants were 101 U.S. Navy members assigned to an Arleigh Burke-class destroyer who experienced an 8-month deployment after Operational Enduring Freedom/Operation Iraqi Freedom. Approximately 6 weeks prior to deployment, 6 weeks after deployment, and 6 months reintegration, participants completed measures that assessed work stressors, sleep quality, and alcohol-related problems. A piecewise latent growth model was conducted in which the structural paths assessed if work stressors influenced sleep quality or its growth over time, and in turn if sleep quality influenced alcohol-related problems intercepts or growth over time. A significant indirect effect was found such that increases in work stressors from pre- to postdeployment predicted decreases in sleep quality, which in turn were associated with increases in alcohol-related problems from pre- to postdeployment. These effects were maintained from postdeployment through the 6-month reintegration. Findings suggest that work stressors may have important implications for sleep quality and alcohol-related problems. Positive methods of addressing stress and techniques to improve sleep quality are needed as both may be associated with alcohol-related problems among current Navy members. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Hepatopulmonary syndrome in a patient with AIDS and virus C cirrhosis (viral cirrhosis type C)

    International Nuclear Information System (INIS)

    Ferreira, Maria Angelica; Gazzana, Marcelo Basso; Barreto, Sergio Saldanha Menna; Knorst, Marli Maria

    2001-01-01

    Hepatopulmonary syndrome is characterized by a triad consisting of liver disorder, pulmonary vascular dilatation, and hypoxaemia. No case of hepatopulmonary syndrome associated with AIDS has been reported so far. In this study, the authors report the case of a 43-year woman with AIDS and virus C cirrhosis taking prophylactic cotrimoxazole for pneumocystosis and retroviral therapy. Upon admission, the patient presented dyspnoea, cyanosis, digital clubbing, vascular spiders, and normal chest examination. Chest X-ray revealed bilateral interstitial infiltration and evidenced increased alveolar-arterial gradient and liver function impairment. Intrapulmonary shunt was evidenced by contrast-enhanced echocardiography and radionuclide perfusion scanning, thus confirming hepatopulmonary syndrome. (author)

  8. Nutritional assessment in patients with cirrhosis

    Directory of Open Access Journals (Sweden)

    Sabrina Alves Fernandes

    2012-03-01

    Full Text Available CONTEXT: Malnutrition in cirrhotic patients with end-stage disease is common, and the degree of nutritional debilitation can play an important role in the pathogenesis of complications and cause a negative impact on prognosis. However, it involves difficulties and controversies regarding the identification of the best nutritional assessment method. OBJECTIVE: To identify a method that provides a safe and effective nutritional diagnosis. METHODS: Cross-sectional study with 129 cirrhotic patients. Anthropometric measurements, subjective global assessment, hand grip strength and bioelectrical impedance. RESULTS: Through phase angle of bioelectrical impedance analysis (BIA method, significant associations with Child-Pugh (P = 0.008, age group and gender were observed. The ROC (receiver operator characteristic curve was generated to determine the best cutoff point of the phase angle of cirrhotic patients, serving as one of the reference parameters for the nutritional assessment with bioimpedance in this study, considering the classification through Child-Pugh score as the reference standard for the clinical conditions of patients with cirrhosis. CONCLUSIONS: The assessment through bioelectrical impedance presented a statistically significant correlation with Child-Pugh score. The identification of phase angle of 5.44º is the new parameter suggested for the classification of the nutritional conditions of cirrhotic patients.

  9. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours.

    Science.gov (United States)

    Wintemute, Garen J

    2011-12-01

    Alcohol use and firearm ownership are risk factors for violent injury and death. To determine whether firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours, the author conducted a cross-sectional study using Behavioral Risk Factor Surveillance System data for eight states in the USA from 1996 to 1997 (the most recent data available). Altogether, 15 474 respondents provided information on firearm exposure. After adjustment for demographics and state of residence, firearm owners were more likely than those with no firearms at home to have ≥5 drinks on one occasion (OR 1.32; 95% CI 1.16 to 1.50), to drink and drive (OR 1.79; 95% CI 1.34 to 2.39) and to have ≥60 drinks per month (OR 1.45; 95% CI 1.14 to 1.83). Heavy alcohol use was most common among firearm owners who also engaged in behaviours such as carrying a firearm for protection against other people and keeping a firearm at home that was both loaded and not locked away. The author concludes that firearm ownership and specific firearm-related behaviours are associated with alcohol-related risk behaviours.

  10. Nature of events and alcohol-related content in marketing materials at a university freshers' fair: a summative content analysis.

    Science.gov (United States)

    Fuller, A; Fleming, K M; Szatkowski, L; Bains, M

    2017-12-15

    The transition to university is a potentially influential time upon students' drinking behaviour. This study explored the nature of activities and alcohol-related content in marketing materials from student-led societies and local businesses provided to students, at a university freshers' fair in the UK. All marketing materials handed out at the fair were collected across the 5-day event in September 2015. Written and visual content was analysed using a summative qualitative content analysis. Most student-led societies promoted social events they were hosting (n = 530), most of which took place in a drinking venue or referred to drinking (n = 335). Only four explicitly alcohol-free events were promoted. Student-led societies also promoted activities relating to their interest, e.g. sports training (n = 519), a small proportion of which had references to drinking and drinking venues (n = 54). Three societies provided promotional handouts from local bars or nightclubs. Local bars, pubs and nightclubs promoted events they hosted (n = 81) as well as alcoholic drink promotions (n = 79) and alcohol branded advertising (n = 22), albeit infrequently for the latter. In the first week of university, students are exposed to alcohol-related events, promotions and advertising, which may act as an incentive to participate in drinking. © The Author(s) 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. An Examination of the Relationship between Consequence-Specific Normative Belief Patterns and Alcohol-Related Consequences among College Students

    Science.gov (United States)

    Reavy, Racheal; Cleveland, Michael J.; Mallett, Kimberly A.; Scaglione, Nichole M.; Sell, Nichole M.; Turrisi, Rob

    2016-01-01

    Background Research has previously identified a high-risk subgroup of college students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). The purpose of this study was to examine the association between consequence-specific normative influences and experiencing multiple and repeated drinking-related consequences using a person-centered approach. Normative subgroups were identified using latent profile analysis (LPA), which were then used to predict MRC group status at 6-month follow-up. Methods First-year college student drinkers (N=2024) at a large northeastern university completed online surveys during the fall and spring semesters of their freshman year. Retention was high with 92% of invited participants completing T2, of which the MRC group accounted for 27%. Results Three student profiles were identified from LPA on T1 data: Non Permissive Parents (77%), Positive Peer and Parent Norms (20%), and Permissive Parents (3%). Logistic regression revealed that both the Positive Peer and Parent Norms and Permissive Parents profiles had significantly higher odds of MRC group membership at follow-up (1.81 and 2.78 times greater, respectively). Conclusions The results suggest value in prevention efforts that include normative beliefs about alcohol-related consequences. Further, parental norms in particular have the potential to enhance interventions, especially through direct communication of disapproval for experiencing consequences. PMID:27805274

  12. Disruption of long-term alcohol-related memory reconsolidation: Role of β-adrenoceptors and NMDA receptors

    Directory of Open Access Journals (Sweden)

    Jelte A Wouda

    2010-11-01

    Full Text Available Disrupting reconsolidation of drug-related memories may be effective in reducing the incidence of relapse. In the current study we examine whether alcohol- related memories are prone to disruption by the β -adrenergicreceptor antagonist propranolol (10 mg/kg and the NMDA receptor antagonist MK801 (0.1 mg/kg following their reactivation. In operant chambers, male Wistar rats were trained to self-administer a 12% alcohol solution. After 3 weeks of abstinence, the animals were placed in the self-administration cages and were reexposed to the alcohol-associated cues for a 20-min retrieval period, immediately followed by a systemic injection of either propranolol, MK801 or saline. Rats were tested for cue-induced alcohol seeking on the following day. Retrieval session, injection and test were repeated on 2 further occasions at weekly intervals. Both propranolol and MK801 administration upon reactivation did not reduce alcohol seeking after the first reactivation test. However, a significant reduction of alcohol seeking was observed over three post-training tests in propranolol treated animals, and MK801 treated animals showed a strong tendency towards reduced alcohol seeking (p=0.06. Our data indicate that reconsolidation of alcohol-related memories can be disrupted after a long post-training interval and that particularly β-adrenergic receptors may represent novel targets for pharmacotherapy of alcoholism, in combination with cue-exposure therapies.

  13. Reducing alcohol-related aggression: Effects of a self-awareness manipulation and locus of control in heavy drinking males.

    Science.gov (United States)

    Purvis, Danielle M; Gallagher, Kathryn E; Parrott, Dominic J

    2016-07-01

    Alcohol Myopia Theory (AMT; Steele & Josephs, 1990) purports that alcohol facilitates aggression by narrowing attentional focus onto salient and instigatory cues common to conflict situations. However, few tests of its counterintuitive prediction - that alcohol may decrease aggression when inhibitory cues are most salient - have been conducted. The present study examined whether an AMT-inspired self-awareness intervention manipulation would reduce heavy drinking men's intoxicated aggression toward women and also examined whether a relevant individual variable, locus of control, would moderate this effect. Participants were 102 intoxicated male heavy drinkers who completed a self-report measure of locus of control and completed the Taylor Aggression Paradigm (Taylor, 1967). In this task, participants administered electric shocks to, and received electric shocks from, a fictitious female opponent while exposed to an environment saturated with or devoid of self-awareness cues. Results indicated that the self-awareness manipulation was associated with less alcohol-related aggression toward the female confederate for men who reported an internal, but not an external, locus of control. Findings support AMT as a theoretical framework to inform preventative interventions for alcohol-related aggression and highlight the importance of individual differences in receptivity to such interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. The acceptability to Aboriginal Australians of a family-based intervention to reduce alcohol-related harms.

    Science.gov (United States)

    Calabria, Bianca; Clifford, Anton; Shakeshaft, Anthony; Allan, Julaine; Bliss, Donna; Doran, Christopher

    2013-05-01

    Cognitive-behavioural interventions that use familial and community reinforcers in an individual's environment are effective for reducing alcohol-related harms. Such interventions have considerable potential to reduce the disproportionately high burden of alcohol-related harm among Aboriginal Australians if they can be successfully tailored to their specific needs and circumstances. The overall aim of this paper is to describe the perceived acceptability of two cognitive-behavioural interventions, the Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT), to a sample of Aboriginal people. Descriptive survey was administered to 116 Aboriginal people recruited through an Aboriginal Community Controlled Health Service and a community-based drug and alcohol treatment agency in rural New South Wales, Australia. Participants perceived CRA and CRAFT to be highly acceptable for delivery in their local Aboriginal community. Women were more likely than men to perceive CRAFT as highly acceptable. Participants expressed a preference for counsellors to be someone they knew and trusted, and who has experience working in their local community. CRA was deemed most acceptable for delivery to individuals after alcohol withdrawal and CRAFT for people who want to help a relative/friend start alcohol treatment. There was a preference for five or more detailed sessions. Findings of this study suggest that CRA and CRAFT are likely to be acceptable for delivery to some rural Aboriginal Australians, and that there is potential to tailor these interventions to specific communities. © 2012 Australasian Professional Society on Alcohol and other Drugs.

  15. How do NHS general hospitals in England deal with patients with alcohol-related problems? A questionnaire survey.

    Science.gov (United States)

    Owens, Lynn; Gilmore, Ian T; Pirmohamed, Munir

    2005-01-01

    Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses. Two postal surveys of all NHS general hospital Trusts in England, the first in 2000 (n = 138; 54% response rate) and the second in 2003 after the publication of the Royal College of Physicians (RCP) report on alcohol in secondary care (n = 164; 75% response rate). Between the two surveys, there was a significant increase (P = 0.005) in the number of dedicated alcohol nurses employed by general hospital trusts; however, the numbers remain low (n = 21). Additionally, the availability of prescribing guidelines for the management of alcohol withdrawal increased significantly (P = 0.0001). The survey indicates that most general hospitals do not have appropriate services in place to deal with such patients. Although there is a need and willingness to develop alcohol services in general hospitals, which is one of the key recommendations of the RCP report, the lack of funding is going to act as a major barrier.

  16. Prevention of Alcohol-Related Crime and Trauma (PACT: brief interventions in routine care pathway – a study protocol

    Directory of Open Access Journals (Sweden)

    Jayaraj Rama

    2013-01-01

    Full Text Available Abstract Background Globally, alcohol-related injuries cause millions of deaths and huge economic loss each year . The incidence of facial (jawbone fractures in the Northern Territory of Australia is second only to Greenland, due to a strong involvement of alcohol in its aetiology, and high levels of alcohol consumption. The highest incidences of alcohol-related trauma in the Territory are observed amongst patients in the Maxillofacial Surgery Unit of the Royal Darwin Hospital. Accordingly, this project aims to introduce screening and brief interventions into this unit, with the aims of changing health service provider practice, improving access to care, and improving patient outcomes. Methods Establishment of Project Governance: The project governance team includes a project manager, project leader, an Indigenous Reference Group (IRG and an Expert Reference Group (ERG. Development of a best practice pathway: PACT project researchers collaborate with clinical staff to develop a best practice pathway suited to the setting of the surgical unit. The pathway provides clear guidelines for screening, assessment, intervention and referral. Implementation: The developed pathway is introduced to the unit through staff training workshops and associate resources and adapted in response to staff feedback. Evaluation: File audits, post workshop questionnaires and semi-structured interviews are administered. Discussion This project allows direct transfer of research findings into clinical practice and can inform future hospital-based injury prevention strategies.

  17. Measuring illness insight in patients with alcohol-related cognitive dysfunction using the Q8 questionnaire: a validation study

    Science.gov (United States)

    Walvoort, Serge JW; van der Heijden, Paul T; Kessels, Roy PC; Egger, Jos IM

    2016-01-01

    Aim Impaired illness insight may hamper treatment outcome in patients with alcohol-related cognitive deficits. In this study, a short questionnaire for the assessment of illness insight (eg, the Q8) was investigated in patients with Korsakoff’s syndrome (KS) and in alcohol use disorder (AUD) patients with mild neurocognitive deficits. Methods First, reliability coefficients were computed and internal structure was investigated. Then, comparisons were made between patients with KS and patients with AUD. Furthermore, correlations with the Dysexecutive Questionnaire (DEX) were investigated. Finally, Q8 total scores were correlated with neuropsychological tests for processing speed, memory, and executive function. Results Internal consistency of the Q8 was acceptable (ie, Cronbach’s α =0.73). The Q8 items represent one factor, and scores differ significantly between AUD and KS patients. The Q8 total score, related to the DEX discrepancy score and scores on neuropsychological tests as was hypothesized, indicates that a higher degree of illness insight is associated with a higher level of cognitive functioning. Conclusion The Q8 is a short, valid, and easy-to-administer questionnaire to reliably assess illness insight in patients with moderate-to-severe alcohol-related cognitive dysfunction. PMID:27445476

  18. Liver cirrhosis as a result of chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    A. A. Sukhoruk

    2014-01-01

    Full Text Available The incidence of chronic hepatitis C in St. Petersburg is 124.4 per 100 000 population. The number of patients with liver cirrhosis is significant.Aim of this study: to examine the demographic, clinical and epidemiological characteristics of patients with cirrhosis in the results of chronic hepatitis C.Materials and methods: 100 patients with cirrhosis due to chronic hepatitis C in age 31–70 years were included. Patients with infection hepatitis viruses A and B, HIV, alcohol abuse, drug addicts, previously received antiviral therapy were excluded. Liver cirrhosis was diagnosed on the basis clinical, laboratory and instrumental investigations.Results: most patients (86,2% male and 81,7% female are socially adapted. In 23,2% of patients antibodies to hepatitis C virus were first detected simultaneously with the diagnosis of cirrhosis. Medical procedures were the most common route of infection (25,6% male and 57,1% female. Genotype 1 was dominant (65.7%. Viral load over 800 000 IU/ml was detected in 36,7% of patients. ALT activity was normal or not more than 2 upper limit of normal in 59% of patients, AST – 47%. Normal levels of total bilirubin were recorded in 37% of cases.Conclusions: the first detection of antibodies to hepatitis C virus at the stage of cirrhosis, absence of jaundice, normal or low cytolytic activity once again confirms the need for screening for markers of hepatitis C virus. Dominance of genotype 1 is probably due on the one hand with features routes of transmission, and the other – with the speed of transformation chronic hepatitis to cirrhosis.

  19. Clinico-hemato-biochemical profile of dogs with liver cirrhosis

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    M. A. Elhiblu

    2015-04-01

    Full Text Available Aim: The aim of this study was to determine the relevant tools in the diagnosis of liver cirrhosis in dogs. Material and Methods: A total of 140 dogs presented at Veterinary Teaching Hospital, Guru Angad Dev Veterinary and Animal Sciences University, Ludhiana, showing clinical signs of hepatic insufficiency were subjected to clinico-hemato biochemical, urological, ultrasonographic (USG, and USG guided fine-needle biopsy examinations by standard methods. On the basis of these results, 6 dogs out of 140 dogs were found to be suffering from liver cirrhosis. Six clinically healthy dogs constituted the control group. Results: The dogs suffering from liver cirrhosis manifested inappetence, halitosis, abdominal distension, weight loss, melena, icterus, anemia, and neutrophilic leukocytosis with the left shift. Levels of hemoglobin, lymphocytes, packed cell volume, mean corpuscular volume, mean corpuscular Hb (MCH, and platelet count were significantly lower in liver cirrhosis group than control group while total leukocyte count, neutrophils, and MCH concentration were significantly higher. Glucose, total protein, albumin, A/G ratio, and fibrinogen were significantly lower, and creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, prothrombin time, and APTT were significantly higher than the control values. Ultrasound revealed diffuse increase in echogenicity with rounded and irregular liver margins. Cytological examination of the ascitic fluid and fine-needle aspiration biopsy of liver was not fruitful in the diagnosis of liver cirrhosis. Conclusions: Liver cirrhosis causes clinical and hemo-biochemical alterations, which require special consideration when treating diseased animals. USG, diffuse increase in echogenicity of liver, rounding and irregularity of liver margins and microhepatica were the consistent findings. It is suggested that USG along with hemo-biochemical alterations may be used as a diagnostic tool for

  20. Orphan drugs in development for primary biliary cirrhosis: challenges and progress

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    Ali AH

    2015-09-01

    Full Text Available Ahmad H Ali,1 Thomas J Byrne,1 Keith D Lindor1,21Division of Gastroenterology and Hepatology, Mayo Clinic, 2College of Health Solutions, Arizona State University, Phoenix, AZ, USAAbstract: Primary biliary cirrhosis (PBC is a chronic progressive liver disease that often leads to fibrosis, cirrhosis, and end-stage liver disease. The diagnosis is made when there is evidence of cholestasis and reactivity to the antimitochondrial antibody. The etiology of PBC is poorly understood; however, several lines of evidence suggest an environmental factor that triggers a series of immune-mediated inflammatory reactions in the bile ducts in a genetically susceptible individual. Fatigue and pruritus are the most common symptoms of PBC; however, many patients are diagnosed with PBC only based on laboratory abnormalities. The only pharmacological treatment approved for PBC is ursodeoxycholic acid (UDCA. Several controlled studies have shown that UDCA improves liver biochemistries and prolongs transplant-free survival in PBC patients. Nearly 40% of PBC patients do not respond to UDCA, and those patients are at high risk of serious adverse events, such as the development of liver failure. Therefore, newer alternative therapeutic options for PBC are needed. Obeticholic acid is a first-in-class farnesoid X receptor agonist that has been recently evaluated in PBC patients with inadequate response to UDCA, and demonstrated beneficial results in improving liver biochemistries. Several other agents (fibrates and glucocorticoids have been previously examined in PBC patients with inadequate response to UDCA, and preliminary results showed biochemical improvement. However, large-scale controlled clinical trials are needed to determine the long-term effects of fibrates and glucocorticoids on the clinical outcomes of PBC. Clinical trials of NGM282 (a fibroblast growth factor-19 analog and Abatacept (a fusion protein composed of the Fc portion of immunoglobulin G1 fused to

  1. Association between Excessive Alcohol Use and Alcohol-Related Injuries in College Students: A Multi-Center Cross-Sectional Study in Japan.

    Science.gov (United States)

    Yoshimoto, Hisashi; Takayashiki, Ayumi; Goto, Ryohei; Saito, Go; Kawaida, Kyoko; Hieda, Rika; Kataoka, Yoshihiro; Aramaki, Maie; Sakamoto, Naoto; Maeno, Tetsuhiro; Kobayashi, Yoshinao; Takemura, Yousuke C

    2017-06-01

    Alcohol-related injuries in college students are a major public health problem worldwide. We clarified the association between excessive drinking and alcohol-related injuries in Japanese college students. This was a cross-sectional study with a self-administered questionnaire. From January to March 2013, we sampled all college students and graduate students aged 20 years or older during annual health examinations at three colleges in Mie Prefecture in Japan. The questionnaire assessed the frequency of alcohol drinking, amount of alcohol consumed per day, binge drinking during the past year, alcohol-related injuries during the past year, and demographic data. Logistic regression analysis was conducted on the association between excessive alcohol use and alcohol-related injuries. A total of 2,842 students underwent health examinations, of whom 2,177 (76.6%) completed the questionnaire. Subjects included 1,219 men (56.0%) and 958 women (44.0%). Eighty-eight men (7.2%) and 93 women (9.7%) were classified as excessive weekly drinkers, while 693 men (56.8%) and 458 women (47.8%) were determined to be binge drinkers. Eighty-one men (6.6%) and 26 women (2.7%) had experienced alcohol-related injuries during the past year. In the logistic regression analysis, binge drinkers (odds ratio 25.6 [8.05-81.4]) and excessive weekly drinkers (odds ratio 3.83 [2.41-6.09]) had a history of significantly more alcohol-related injuries, even after adjusting for age and sex. In conclusion, alcohol-related injuries in college students in Japan were strongly associated with excessive drinking. As a strategy for preventing such injuries in this population, an interventional study is required to identify effective methods for reducing excessive alcohol use.

  2. Mesenchymal Stem Cells Mitigate Cirrhosis through BMP7

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    Bing Li

    2015-01-01

    Full Text Available Background/Aims: Transplantation of mesenchymal stem cells (MSCs has therapeutic effects on various diseases, while its effect on developing cirrhosis as well as the underlying mechanism remained largely unknown. Methods: Twenty C57BL/6 mice were randomly separated into 2 groups of ten each. One group received transplantation of MSCs, while the other group received saline as control. The mice then received intraperitoneal injection of carbon tetrachloride (CCl4 twice per week for 8 weeks to develop cirrhosis. After another 4 weeks, the levels of cirrhosis in these mice were evaluated by liver fibrosis area, portal pressure, sodium balance and excretion. Transcripts of transforming growth factor β 1 (TGFβ1 and bone morphogenic protein 7 (BMP7 in the mouse livers were quantified by RT-qPCR. BMP7-depleted MSCs were prepared and applied in this model, and compared to MSCs. Results: Liver fibrosis, portal hypertension and sodium retention that were developed by CCl4, were all significantly alleviated by MSCs transplantation, which decreased TGFβ1 levels and increased BMP7 levels in the injured liver. MSCs were found to express extremely high levels of BMP7. Knockdown of BMP7 in MSCs completely abolished the protective effect of MSCs against CCl4-induced cirrhosis. Conclusions: MSCs mitigate cirrhosis through their production of BMP7 against the fibrogenic effect of TGFβ1 in the injured liver.

  3. Oxidative Stress and Pulmonary Changes in Experimental Liver Cirrhosis

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    Renata Salatti Ferrari

    2012-01-01

    Full Text Available The use of carbon tetrachloride (CCl4 in rats is an experimental model of hepatic tissue damage; which leads to fibrosis, and at the long term, cirrhosis. Cirrhosis is the consequence of progressive continued liver damage, it may be reversible when the damaging noxae have been withdrawn. The aim of this study is to evaluate the changes caused by cirrhosis in lung and liver, through the experimental model of intraperitoneal CCI4 administration. We used 18 male Wistar rats divided into three groups: control (CO and two groups divided by the time of cirrhosis induction by CCI4: G1 (11 weeks, G2 (16 weeks. We found significant increase of transaminase levels and lipid peroxidation (TBARS in liver and lung tissue and also increased antioxidant enzymes SOD and CAT, as well as the expression of TNF-α and IL-1β in the lung of cirrhotic animals. We observed changes in gas exchange in both cirrhotic groups. We can conclude that our model reproduces a model of liver cirrhosis, which causes alterations in the pulmonary system that leads to changes in gas exchange and size of pulmonary vessels.

  4. Implications of alcoholic cirrhosis in atherosclerosis of autopsied patients

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    Luciano Alves Matias da Silveira

    Full Text Available Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals with liver cirrhosis, observing macroscopic and microscopic changes in lipid and collagen deposits and in the liver. We also aimed to verify the association of lipid and collagen fiber deposits with gender, age and body mass index, and to relate alcoholism, liver cirrhosis and atherosclerosis. Method: We performed a study based on autopsy reports of patients with alcoholic liver cirrhosis, with analysis of aorta and liver fragments to verify the occurrence and degree of atherosclerosis, as well as collagen contents. Results: Microscopic atherosclerosis was higher in young subjects (early injury and in patients with alcoholic liver cirrhosis. The macroscopic analysis of atherosclerosis in aortas showed that patients in more advanced age groups presented more severe classifications. Atherosclerosis, both micro and macroscopically, and the percentage of fibrosis in the liver and aorta were more expressive in females. Conclusion: Cirrhotic patients presented a higher percentage of fibrosis and lipidosis, and may represent a group susceptible to the accelerated progression of cardiovascular diseases. Investigative studies contribute to targeting health-promoting interventions, reducing the mortality and costs of treating cardiovascular disease.

  5. BIOCHEMICAL NUTRITIONAL PROFILE OF LIVER CIRRHOSIS PATIENTS WITH HEPATOCELLULAR CARCINOMA

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    Gabriela Zanatta PORT

    2014-03-01

    Full Text Available Context Liver cirrhosis patients with hepatocellular carcinoma present nutritional alterations and metabolic disorders that negatively impact the prognosis. Objective The objective is to identify alterations in the metabolism of macro and micronutrients among liver cirrhosis patients with and without hepatocellular carcinoma and their relation to the Child-Turcote-Pugh score and Barcelona Clinic Liver Cancer staging. Methods Analytical transversal study, with 31 hepatocellular carcinoma patients and 48 liver cirrhosis patients. Laboratorial exams were carried out. The existence of an association between the biochemical parameters and the disease severity as well as the presence of hepatocellular carcinoma was assessed. Results The metabolic-nutritional profile of liver cirrhosis patients caused by the hepatitis C virus and hepatocellular carcinoma showed alterations, specifically the lipid (total cholesterol, HDL and triglycerides, protein (albumin, creatinine and uric acid, iron (transferrin, iron and ferritin saturation, hematocrit and hemoglobin, zinc and B12 vitamin profiles. There is a relation between nutritional biochemical markers and the Child-Turcote-Pugh, as well as Barcelona Clinic Liver Cancer staging. Conclusions Considering the existence of alterations in the metabolism of nutrients in liver cirrhosis patients with and without hepatocellular carcinoma, and also that conventional nutritional assessment methods present limitations for this population, the biochemical laboratorial exams are valid to complement the diagnosis of the nutritional state in a quick and practical manner.

  6. The moderating role of social networks in the relationship between alcohol consumption and treatment utilization for alcohol-related problems

    Science.gov (United States)

    Mowbray, Orion

    2014-01-01

    Many individuals wait until alcohol use becomes severe before treatment is sought. However, social networks, or the number of social groups an individual belongs to, may play a moderating role in this relationship. Logistic regression examined the interaction of alcohol consumption and social networks as a predictor of treatment utilization while adjusting for sociodemographic and clinical variables among 1,433 lifetime alcohol-dependent respondents from wave 2 of the National Epidemiologic Survey on Alcohol Related Conditions (NESARC). Results showed that social networks moderate the relationship between alcohol consumption and treatment utilization such that for individuals with few network ties, the relationship between alcohol consumption and treatment utilization was diminished, compared to the relationship between alcohol consumption and treatment utilization for individuals with many network ties. Findings offer insight into how social networks, at times, can influence individuals to pursue treatment, while at other times, influence individuals to stay out of treatment, or seek treatment substitutes. PMID:24462223

  7. #WaysToRelax: developing an online alcohol-related health promotion animation for people aged 55 and older.

    Science.gov (United States)

    Ferguson, Nyssa; Savic, Michael; Manning, Victoria; Lubman, Daniel

    2017-04-27

    Alcohol use among middle-aged and older adults (55 years and older) is increasingly becoming a public health concern. Despite this, there is relatively little research on the experiences of alcohol use and related concerns among people aged 55 and older to inform tailored and engaging health promotion activities. To address this gap, we aimed to develop an engaging alcohol-related health promotion resource for people aged 55 and older. We drew on a research-into-action approach, which involved: 1) thematic analysis of alcohol-related concerns in online counselling transcripts of 70 people aged 55 and older, 2) a review of health promotion literature, and 3) consultation with consumers of alcohol and other drug services, and carers. The research phase highlighted that people aged 55 and older were concerned that their reliance on alcohol use to manage stress had become a habit they wanted to shift. Alongside this, the literature showed that people aged 55 and older were often dismissive of conventional health promotion activities, and pointed to the benefits of conveying health promotion messages through animation. In response, we developed an animation to stimulate reflection and thought about other ways to relax and manage stress. We drew on health promotion principles to ensure that the animation had a positive message and was engaging without being ageist or paternalistic. It was further refined with input from consumers and carers, who thought the animation was appropriate, appealing and useful. Future activities will include further dissemination and evaluation of the animation and associated activities.

  8. Effects of caffeine on alcohol-related changes in behavioural control and perceived intoxication in light caffeine consumers.

    Science.gov (United States)

    Attwood, Angela S; Rogers, Peter J; Ataya, Alia F; Adams, Sally; Munafò, Marcus R

    2012-06-01

    Caffeinated alcoholic beverages have been associated with increased risk of alcohol-related harms. However, few studies have examined these combined effects on behavioural control, which is believed to underlie many of the negative effects of alcohol consumption. In addition, studies have often omitted subjective measures, and none have directly assessed the role of caffeine consumer history. To examine the combined effects of alcohol and caffeine on measures of behavioural control and perceived intoxication in abstinent, light caffeine consumers. Participants (n = 28; 50% male) attended four sessions at which they consumed one of the following beverages in a randomised order: placebo, alcohol alone (0.6 g/kg), caffeine alone (2.0 mg/kg), and alcohol/caffeine. They completed measures of mood, intoxication, anxiety and alcohol craving before and after a task battery comprising measures of behavioural control and reaction time performance. Caffeine attenuated alcohol-related performance deficits on stop-signal accuracy, had no effect on go-no-go performance deficits, and worsened accuracy on the Stroop task. Caffeine did not influence absolute changes in perceived intoxication but there was suggestion that caffeine may have changed the nature of intoxication with increases in stimulation. Caffeine appears to have mixed effects on alcohol intoxication that are task-dependent. We found increased stimulation in the alcohol/caffeine condition, supporting the contention that caffeinated alcoholic beverages enable an individual to drink for longer. Future research should model real world drinking behaviour by examining how these effects change across multiple drink administrations.

  9. Perpetration of Alcohol-Related Aggression by Male and Female College Students: An Examination of Overt and Relational Aggression.

    Science.gov (United States)

    Robertson, Kirsten; Forbes, Sarah; Thyne, Maree

    2017-03-01

    Existing literature exemplifies the relationship between alcohol and overt aggression, especially for adult males. Less clear is the relationship between alcohol and aggression among male and female college students, in particular, the nature of this aggression and the co-occurrence of drinking and aggression on the same day (temporal proximity). This study examines the chronic and temporal nature of males' and females' alcohol-related aggression among college students. Two hundred fourteen students completed a web-based 7-day event-level survey measuring alcohol consumption and perpetration of physical aggression, verbal aggression, anger, and relational aggression over 4 weeks, resulting in 4,256 observations (days). The global analysis revealed students who are heavy drinkers are more likely to perpetrate all four forms of aggression, whereas the event-level analysis revealed that specific forms of aggression are associated with drinking at the time, while other forms were not linked to drinking occasions. Cross-tabulation revealed males and females were more likely to use verbal and physical aggression when drinking. For females, drinking was also associated with relational aggression and anger. Despite often being overlooked in research on aggression during emerging adulthood, relational aggression was prevalent. Discrepancies between the global and temporal analysis revealed factors other than alcohol might explain the relationship between chronic alcohol consumption and specific forms of aggression. This is one of the first event-level studies to show the temporal relationship between alcohol and relational aggression. The distinctions in the current study, exemplifying the diversity of alcohol-related aggression, are critical for understanding aggressive behavior, potential gender differences, and for developing interventions. The temporal relationship between alcohol and aggression suggests health interventions should target drinking and aggression

  10. Description and predictors of positive and negative alcohol-related consequences in the first year of college.

    Science.gov (United States)

    Barnett, Nancy P; Clerkin, Elise M; Wood, Mark; Monti, Peter M; O'Leary Tevyaw, Tracy; Corriveau, Donald; Fingeret, Allan; Kahler, Christopher W

    2014-01-01

    The purpose of this study was to establish the frequency of positive and negative alcohol-related consequences during the first year of college and to evaluate gender, race/ethnicity, time of year, alcohol use, and intoxication as predictors of consequences using frequent assessments. Participants (N = 1,053; 57.5% female) completed biweekly assessments of alcohol use and positive and negative alcohol-related consequences throughout the year. The majority of drinkers reported both positive and negative consequences. Having a good time and feeling less stressed were the most commonly reported positive consequences. Blackouts and getting physically sick were the most commonly endorsed negative consequences. At the weekly level, number of drinking days, drinks per drinking day, and estimated blood alcohol concentration (eBAC, reflecting intoxication) were significantly related to all consequences after controlling for demographics and time of year. Negative consequences had stronger associations with number of drinks and eBAC than positive consequences did. With each additional drink consumed on a drinking day, the incidence of negative consequences more than doubled (incidence rate ratio [IRR] = 2.34, 95% CI [2.19, 2.50]), whereas the incidence of positive consequences increased by about half (IRR = 1.51, 95% CI [1.47, 1.56]). The consequence with the largest gender difference was regretted sex, with women reporting it more often. Few racial/ethnic differences were found in report of negative consequences. Greater positive and negative consequences were endorsed at the beginning of both academic semesters. As number of drinks and eBAC increase, the relative odds of a negative consequence are higher than that of a positive consequence. Alcohol interventions could promote greater awareness of the likelihood of specific consequences and could highlight that positive consequences are associated with lower levels of drinking.

  11. #WaysToRelax: developing an online alcohol-related health promotion animation for people aged 55 and older

    Directory of Open Access Journals (Sweden)

    Nyssa Ferguson

    2017-04-01

    Full Text Available Alcohol use among middle-aged and older adults (55 years and older is increasingly becoming a public health concern. Despite this, there is relatively little research on the experiences of alcohol use and related concerns among people aged 55 and older to inform tailored and engaging health promotion activities. To address this gap, we aimed to develop an engaging alcohol-related health promotion resource for people aged 55 and older. We drew on a research-into-action approach, which involved: 1 thematic analysis of alcohol-related concerns in online counselling transcripts of 70 people aged 55 and older, 2 a review of health promotion literature, and 3 consultation with consumers of alcohol and other drug services, and carers. The research phase highlighted that people aged 55 and older were concerned that their reliance on alcohol use to manage stress had become a habit they wanted to shift. Alongside this, the literature showed that people aged 55 and older were often dismissive of conventional health promotion activities, and pointed to the benefits of conveying health promotion messages through animation. In response, we developed an animation to stimulate reflection and thought about other ways to relax and manage stress. We drew on health promotion principles to ensure that the animation had a positive message and was engaging without being ageist or paternalistic. It was further refined with input from consumers and carers, who thought the animation was appropriate, appealing and useful. Future activities will include further dissemination and evaluation of the animation and associated activities.

  12. Temporal Patterns of Alcohol Consumption and Alcohol-Related Road Accidents in Young Swiss Men: Seasonal, Weekday and Public Holiday Effects.

    Science.gov (United States)

    Foster, Simon; Gmel, Gerhard; Estévez, Natalia; Bähler, Caroline; Mohler-Kuo, Meichun

    2015-09-01

    To assess seasonal, weekday, and public holiday effects on alcohol-related road accidents and drinking diaries among young Swiss men. Federal road accident data (35,485 accidents) from Switzerland and drinking diary data from a large cohort of young Swiss men (11,930 subjects) were analysed for temporal effects by calendar week, weekday and public holiday (Christmas, New Years, National Day). Alcohol-related accidents were analysed using rate ratios for observed versus expected numbers of accidents and proportions of alcohol-related accidents relative to the total number. Drinking diaries were analysed for the proportion of drinkers, median number of drinks consumed, and the 90th percentile's number of drinks consumed. Several parallel peaks were identified in alcohol-related accidents and drinking diaries. These included increases on Fridays and Saturdays, with Saturday drinking extending until early Sunday morning, an increase during the summer on workdays but not weekends, an increase at the end of the year, and increases on public holidays and the evening before. Our results suggest specific time-windows that are associated with increases in drinking and alcohol-related harm. Established prevention measures should be enforced during these time-windows to reduce associated peaks. © The Author 2015. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  13. A time series analysis of presentations to Queensland health facilities for alcohol-related conditions, following the increase in 'alcopops' tax.

    Science.gov (United States)

    Kisely, Steve; Crowe, Elizabeth; Lawrence, David; White, Angela; Connor, Jason

    2013-08-01

    In response to concerns about the health consequences of high-risk drinking by young people, the Australian Government increased the tax on pre-mixed alcoholic beverages ('alcopops') favoured by this demographic. We measured changes in admissions for alcohol-related harm to health throughout Queensland, before and after the tax increase in April 2008. We used data from the Queensland Trauma Register, Hospitals Admitted Patients Data Collection, and the Emergency Department Information System to calculate alcohol-related admission rates per 100,000 people, for 15 - 29 year-olds. We analysed data over 3 years (April 2006 - April 2009), using interrupted time-series analyses. This covered 2 years before, and 1 year after, the tax increase. We investigated both mental and behavioural consequences (via F10 codes), and intentional/unintentional injuries (S and T codes). We fitted an auto-regressive integrated moving average (ARIMA) model, to test for any changes following the increased tax. There was no decrease in alcohol-related admissions in 15 - 29 year-olds. We found similar results for males and females, as well as definitions of alcohol-related harms that were narrow (F10 codes only) and broad (F10, S and T codes). The increased tax on 'alcopops' was not associated with any reduction in hospital admissions for alcohol-related harms in Queensland 15 - 29 year-olds.

  14. Impact of Microbes on the Pathogenesis of Primary Biliary Cirrhosis (PBC and Primary Sclerosing Cholangitis (PSC

    Directory of Open Access Journals (Sweden)

    Jochen Mattner

    2016-11-01

    Full Text Available Primary biliary cirrhosis (PBC and primary sclerosing cholangitis (PSC represent the major clinical entities of chronic cholestatic liver diseases. Both disorders are characterized by portal inflammation and slowly progress to obliterative fibrosis and eventually liver cirrhosis. Although immune-pathogenic mechanisms have been implicated in the pathogenesis of PBC and PSC, neither disorder is considered to be a classical autoimmune disease, as PSC and PBC patients do not respond to immune-suppressants. Furthermore, the decreased bile flow resulting from the immune-mediated tissue assault and the subsequent accumulation of toxic bile products in PBC and PSC not only perpetuates biliary epithelial damage, but also alters the composition of the intestinal and biliary microbiota and its mutual interactions with the host. Consistent with the close association of PSC and inflammatory bowel disease (IBD, the polyclonal hyper IgM response in PBC and (auto-antibodies which cross-react to microbial antigens in both diseases, an expansion of individual microbes leads to shifts in the composition of the intestinal or biliary microbiota and a subsequent altered integrity of epithelial layers, promoting microbial translocation. These changes have been implicated in the pathogenesis of both devastating disorders. Thus, we will discuss here these recent findings in the context of novel and alternative therapeutic options.

  15. Bone Marrow–Derived Stromal Cell Therapy in Cirrhosis: Clinical Evidence, Cellular Mechanisms, and Implications for the Treatment of Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Vainshtein, Jeffrey M. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kabarriti, Rafi; Mehta, Keyur J. [Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Roy-Chowdhury, Jayanta [Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Department of Genetics, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Guha, Chandan, E-mail: cguhamd@gmail.com [Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States); Department of Pathology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York (United States)

    2014-07-15

    Current treatment options for hepatocellular carcinoma (HCC) are often limited by the presence of underlying liver disease. In patients with liver cirrhosis, surgery, chemotherapy, and radiation therapy all carry a high risk of hepatic complications, ranging from ascites to fulminant liver failure. For patients receiving radiation therapy, cirrhosis dramatically reduces the already limited radiation tolerance of the liver and represents the most important clinical risk factor for the development of radiation-induced liver disease. Although improvements in conformal radiation delivery techniques have improved our ability to safely irradiate confined areas of the liver to increasingly higher doses with excellent local disease control, patients with moderate-to-severe liver cirrhosis continue to face a shortage of treatment options for HCC. In recent years, evidence has emerged supporting the use of bone marrow–derived stromal cells (BMSCs) as a promising treatment for liver cirrhosis, with several clinical studies demonstrating sustained improvement in clinical parameters of liver function after autologous BMSC infusion. Three predominant populations of BMSCs, namely hematopoietic stem cells, mesenchymal stem cells, and endothelial progenitor cells, seem to have therapeutic potential in liver injury and cirrhosis. Preclinical studies of BMSC transplantation have identified a range of mechanisms through which these cells mediate their therapeutic effects, including hepatocyte transdifferentiation and fusion, paracrine stimulation of hepatocyte proliferation, inhibition of activated hepatic stellate cells, enhancement of fibrolytic matrix metalloproteinase activity, and neovascularization of regenerating liver. By bolstering liver function in patients with underlying Child's B or C cirrhosis, autologous BMSC infusion holds great promise as a therapy to improve the safety, efficacy, and utility of surgery, chemotherapy, and hepatic radiation therapy in the

  16. Cardiac Function in Patients with Early Cirrhosis during Maximal Beta-Adrenergic Drive

    DEFF Research Database (Denmark)

    Krag, Aleksander; Bendtsen, Flemming; Dahl, Emilie Kristine

    2014-01-01

    BACKGROUND AND AIM: Cardiac dysfunction in patients with early cirrhosis is debated. We investigated potential cardiac dysfunction by assessing left ventricular systolic performance during a dobutamine stress test in patients with early cirrhosis. PATIENTS AND METHODS: Nineteen patients with Chil...

  17. Tc-99 m-GSA liver scintigraphy in alcoholic liver cirrhosis

    International Nuclear Information System (INIS)

    Itano, Satoshi; Harada, Masaru; Nagamatsu, Hiroaki

    2003-01-01

    We compared 15 alcoholic liver cirrhosis patients with 10 viral liver cirrhosis patients using technetium-99 m-galactosyl human serum albumin (Tc-99 m-GSA) liver scintigraphy and could clinically reveal the disorder of metabolism of asialoglycoprotein in alcoholic liver cirrhosis. Receptor index (LHL 15 = liver count divided by the sum of liver and heart counts at 15 minutes) was significantly (p <0.01) lower in patients with alcoholic cirrhosis (median: 0.821), compared with patients with viral cirrhosis (0.915). Grading score, which was an index showed by the difference in the isotope uptake patterns between liver and heart, was significantly (p <0.01) worse in patients with alcoholic cirrhosis, compared with patients with viral cirrhosis. These results suggested that alcoholic liver cirrhosis had a specific disorder of a metabolic function for asialoglycoprotein. (author)

  18. Effect of splenectomy on liver cirrhosis and related surgical issues

    Directory of Open Access Journals (Sweden)

    KONG Degang

    2016-12-01

    Full Text Available Patients with liver fibrosis and cirrhosis experience certain changes in spleen morphology and function, and there is always a controversy over whether to perform splenectomy in patients with liver cirrhosis. As a surgical treatment of recurrent portal hypertension complicated by esophagogastric variceal bleeding, splenectomy can reduce portal venous pressure, reduce the possibility of gastrointestinal bleeding, and correct the reduced white blood cell count and platelet count. It can also protect the liver by improving liver function, promoting regeneration of hepatocytes, and inhibiting the progression of liver fibrosis. With reference to available clinical and laboratory data, this article reviews the effect of splenectomy on the cirrhotic liver and related issues such as selection of surgical procedures and prevention and treatment of postoperative complications, in order to promote splenectomy in patients with liver cirrhosis.

  19. Carbohydrate deficient transferrin (CDT) in alcoholic cirrhosis: a kinetic study

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Grønbaek, M; Møller, Søren

    1997-01-01

    BACKGROUND/AIMS: Carbohydrate deficient transferrin has been introduced as a marker of excessive alcohol intake. The present study was undertaken in order to measure the circulating level of carbohydrate deficient transferrin in patients with alcoholic cirrhosis and to assess arteriovenous kinetics...... of carbohydrate deficient transferrin in liver and kidney. METHODS/RESULTS: The median value of serum carbohydrate deficient transferrin was 16.0 U/l in patients with alcoholic cirrhosis (n = 41), and this value was not significantly different from that of a normal control group (median 17.4 U/l, n = 55, ns......). Carbohydrate deficient transferrin was significantly higher in patients with cirrhosis and high current alcohol intake than in abstaining patients (20 vs. 14 U/l, p 50 g/day) had a significantly higher carbohydrate deficient transferrin...

  20. Autoantibodies and immunoglobulins in alcoholic steatosis and cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Tage-Jensen, Ulrik Viggo

    1983-01-01

    increased (p less than 0.005) concentrations of immunoglobulins G, A, and M when compared to patients with steatosis. These results indicate that the degree of liver damage has more effect than chronic alcoholism on the humoral immune system. Whether this influence is direct or indirect remains......Antinuclear antibodies were significantly more prevalent (p less than 0.01) in 143 patients with alcoholic cirrhosis than in 64 patients with alcoholic steatosis and in 94 controls. Smooth muscle antibodies were significantly more prevalent (p less than 0.05) in patients with alcoholic steatosis...... and cirrhosis than in controls. The prevalence of antimitochondrial antibodies and IgG liver membrane antibodies did not differ significantly between the three groups. Immunoglobulin G, A, and M concentrations were only occasionally increased in patients with steatosis. Patients with cirrhosis had significantly...

  1. Factors predicting hyperkalemia in patients with cirrhosis receiving spironolactone

    International Nuclear Information System (INIS)

    Abbas, Z.; Mumtaz, K.; Salam, A.; Jafri, W.

    2003-01-01

    Objective: To evaluate the factors leading to hyperkalemia in patients with cirrhosis receiving spironolactone. Results: Patients with hyperkalemia (K>5 mmol/l) had higher blood urea nitrogen, serum creatinine and bilirubin levels (p=0.004, 0.001 and 0.044 respectively). Their serum sodium and albumin levels were lower (p=0.000 and 0.017 respectively). They had advanced cirrhosis with high Pugh score (p=0.003). These patients were on higher dose of spironolactone (p=0.001). Multivariate analysis showed that dose of spironolactone > 100 mg/day, serum creatinine >1.3 mg/dl, persistence of ascites and edema, and female gender were important predictors of development of hyperkalemia. Conclusion: Patients with cirrhosis receiving high dose of the diuretic, having edema, ascites and high serum creatinine are at the greater risk of developing hyperkalemia during spironolactone therapy. (author)

  2. ROC analysis in gammagraphic diagnosis of hepatic cirrhosis

    International Nuclear Information System (INIS)

    Hdez-Armas, J.; Allende, A.; Alarco, R.; Panero, J.; Oton, C.

    1982-01-01

    An application of the ROC statistical method is described on a sample of 161 patients who underwent hepatic gammagraphy and biopsies obtained by laparsocopy, and of whom 90 were found to have hepatic cirrhosis according to pathological anatomy. Five decision thresholds have been established in the elaboration of the gammagraphic diagnosis of cirrhosis. The true positive fraction (TPF) and false positive fraction (FPF) of these five thresholds are shown on an ordinate axis and an ROC curve is obtained. By means of a simplified cost-benefit analysis the optimal point of operation for this type of diagnosis is determined on this curve, according to which the diagnosis of cirrhosis should be considered positive when alterations in the size of the liver and distribution of the isotope in the liver are found simultaneously with splenomegaly. (orig.)

  3. Gastrointestinal Motility Disorders and Their Clinical Implications in Cirrhosis

    Directory of Open Access Journals (Sweden)

    Eleni Theocharidou

    2017-01-01

    Full Text Available Gastrointestinal motility is impaired in a substantial proportion of patients with cirrhosis. Cirrhosis-related autonomic neuropathy, increased nitric oxide production, and gut hormonal changes have been implicated. Oesophageal dysmotility has been associated with increased frequency of abnormal gastro-oesophageal reflux. Impaired gastric emptying and accommodation may result in early satiety and may have an impact on the nutritional status of these patients. Small intestinal dysmotility might be implicated in small intestinal bacterial overgrowth and increased bacterial translocation. The latter has been implicated in the pathophysiology of hepatic encephalopathy and spontaneous bacterial peritonitis. Enhanced colonic motility is usually associated with the use of lactulose. Pharmacological interventions aiming to alter gastrointestinal motility in cirrhosis could potentially have a beneficial effect reducing the risk of hepatic decompensation and improving prognosis.

  4. Altered doppler flow patterns in cirrhosis patients: An overview

    Energy Technology Data Exchange (ETDEWEB)

    Iranpour, Pooya; Lall, Chandana; Houshyar, Roozbeh; Helmy, Mohammad; Yang, Albert; Ward, Garrett; Goodwin, Scott C. [Dept. of Radiology, University of California Irvine, Orange (United States); Choi, Joon Il [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-01-15

    Doppler ultrasonography of the hepatic vasculature is an integral part of evaluating precirrhotic and cirrhotic patients. While the reversal of the portal venous flow is a well-recognized phenomenon, other flow patterns, although not as easily understood, may play an important role in assessing the disease status. This article discusses the different characteristic flow patterns observed from the portal vein, hepatic artery, and hepatic vein in patients with liver cirrhosis or related complications and procedures. Knowledge of these different flow patterns provides additional information that may reinforce the diagnosis of cirrhosis, help in staging, and offer prognostic information for determining the direction of therapy. Doppler ultrasonography is invaluable when liver transplantation is being considered and aids in the diagnosis of cirrhosis and portal hypertension.

  5. Early diagnosis and empiric therapy for cirrhosis associated with infection

    Directory of Open Access Journals (Sweden)

    NAN Yuemin

    2015-03-01

    Full Text Available Infection is a frequent complication of cirrhosis, which often occurs in the lungs, chest, abdomen, biliary tract, urinary tract, soft tissue, and skin, and occasionally causes spontaneous bacteremia in patients. This paper reviews the risk factors and common types of infection in cirrhosis associated with infection, and the early diagnosis and symptomatic treatment of different types of infection. Moreover, this paper points out that cirrhosis associated with infection is a key factor for disease progression and the early diagnosis and treatment are essential for successful treatment. The third-generation cephalosporins are the first-line antibiotic agents. Drug-resistant bacteria should be treated with antibiotic compound containing β-lactamase inhibitors or carbapenems. Methicillin-resistant Staphylococcus aureus should be treated with glycopeptide antibiotics or combination therapies. Pulmonary mycoses are mainly treated with caspofungin or voriconazole. Antibiotics combined with supportive therapies including the administration of albumin can improve the treatment outcome and prognosis.

  6. Serum-thyroglobulin in women with cirrhosis of the liver

    International Nuclear Information System (INIS)

    Gruen, R.; Kopp, L.; Kaffarnik, H.

    1985-01-01

    In 68 women with liver cirrhosis of different origin (alcoholic n=34, cryptogenetic n=18, post hepatitic B n=9, PBC n=5, Morbus Wilson n=2) the median concentration of serum thyroglobulin (TG) was slightly but significantly elevated (31,7 ng/ml versus 22,1 ng/ml in controls). No difference could be found between TG levels in alcoholic and non alcoholic cirrhosis. The TG-concentrations overlapped to a large extent with the data of a control group and showed no significant correlation to other parameters of thyroid function (T 4 , T 3 , TBG, T 4 /TBG-quotient, TSH). The missing correlation to the concentrations of estradiol and estrone argues against a significant influence of estrogen concentrations on TG-concentrations. The increase in serum TG was highest in the subgroup with decompensated liver cirrhosis and is possibly caused by the reduced metabolic capacity of the liver. (orig.) [de

  7. Fibronectin as predictor of cirrhosis in men who abuse alcohol

    DEFF Research Database (Denmark)

    Junge, Jette; Bentsen, K D; Christoffersen, P

    1988-01-01

    In a study of 142 male alcohol abusers without evidence of cirrhosis the presence of intralobular fibronectin in the liver was investigated in relation to the subsequent development of the disease. All 142 initial biopsy samples showed preserved architecture. During a follow up period of 10-13 ye...... increased amounts later developed the disease (p less than 0.005). Semiquantitative assessment of the amount of parenchymal fibronectin at an early stage of alcoholic liver disease is of definite predictive value for the development of cirrhosis.......In a study of 142 male alcohol abusers without evidence of cirrhosis the presence of intralobular fibronectin in the liver was investigated in relation to the subsequent development of the disease. All 142 initial biopsy samples showed preserved architecture. During a follow up period of 10...

  8. Serum zinc level in patients with liver cirrhosis

    International Nuclear Information System (INIS)

    Soomro, A.A.; Devrajani, B.R.; Shaikh, K.; Shah, S.Z.A.; Devrajani, T.; Bibi, I.

    2009-01-01

    Objective: To determine the serum zinc level in patients with liver cirrhosis. Methodology: This descriptive cross sectional study was conducted at Liaquat University Hospital Hyderabad Sindh, Pakistan. All patients above 12 years of age, of either gender and known (diagnosed) cases of liver cirrhosis were further evaluated for their serum zinc level. The data was analyzed in statistical software (SPSS) and the p value <0.05 was considered as statistically significant. Result: One hundred twenty seven cirrhotic patients with means age 42.7559 +- 15.8894 were evaluated and assessed. The serum zinc was low in 69% patients. According to Child-Pugh classification 72% zinc deficient cirrhotic subjects were in class C, 16% in class B and 12% in class A. 94% subjects had hepatitis C virus infection, 4% had hepatitis B virus infection and 2% had history of alcoholism. Conclusion: The serum zinc level was low in patients with liver cirrhosis. (author)

  9. Lower risk for alcohol-induced cirrhosis in wine drinkers

    DEFF Research Database (Denmark)

    Becker, Ulrik; Grønbaek, Morten; Johansen, Ditte

    2002-01-01

    Although there is a well-known relationship between total alcohol intake and future risk for cirrhosis, other factors such as the type of alcohol consumed are sparsely studied. The aim of this study was to assess the effects of wine compared with other types of alcoholic beverages on risk...... for alcohol-induced cirrhosis. In 3 prospective studies, 30,630 participants from the Copenhagen area were followed-up for a total observation time of 417,325 person-years. Information on weekly intake of beer, wine, and spirits, and sex, age, body mass index, smoking habits, and education was obtained from...... with increasing alcohol intake. Individuals who drank more than 5 drinks per day had a relative risk of 14 to 20 for developing cirrhosis compared with non- or light drinkers. However, compared with individuals who drank no wine (relative risk set at 1.0), individuals drinking 16% to 30% wine of their total...

  10. Wartime Paris, cirrhosis mortality, and the ceteris paribus assumption.

    Science.gov (United States)

    Fillmore, Kaye Middleton; Roizen, Ron; Farrell, Michael; Kerr, William; Lemmens, Paul

    2002-07-01

    This article critiques the ceteris paribus assumption, which tacitly sustains the epidemiologic literature's inference that the sharp decline in cirrhosis mortality observed in Paris during the Second World War derived from a sharp constriction in wine consumption. Paris's wartime circumstances deviate substantially from the "all else being equal" assumption, and at least three other hypotheses for the cirrhosis decline may be contemplated. Historical and statistical review. Wartime Paris underwent tumultuous changes. Wine consumption did decline, but there were, as well, a myriad of other changes in diet and life experience, many involving new or heightened hardships, nutritional, experiential, institutional, health and mortality risks. Three competing hypotheses are presented: (1) A fraction of the candidates for cirrhosis mortality may have fallen to more sudden forms of death; (2) alcoholics, heavy drinkers and Paris's clochard subpopulation may have been differentially likely to become removed from the city's wartime population, whether by self-initiated departure, arrest and deportation, or death from other causes, even murder; and (3) there was mismeasurement in the cirrhosis mortality decline. The alcohol-cirrhosis connection provided the template for the alcohol research effort (now more than 20 years old) aimed at re-establishing scientific recognition of alcohol's direct alcohol-problems-generating associations and causal responsibilities. In a time given to reports of weaker associations of the alcohol-cirrhosis connection, the place and importance of the Paris curve in the wider literature, as regards that connection, remains. For this reason, the Paris findings should be subjected to as much research scrutiny as they undoubtedly deserve.

  11. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

    OpenAIRE

    DARA, Naghi; SAYYARI, Ali-Akbar; IMANZADEH, Farid

    2014-01-01

    How to Cite This Article: Dara N, Sayyari AA, Imanzadeh F. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis. Iran J Child Neurol. 2014 Winter; 8(1):1-11.ObjectiveAs acute liver failure (ALF) and chronic liver disease (cirrhosis) continue to increase in prevalence, we will see more cases of hepatic encephalopathy.Primary care physician are often the first to suspect it, since they are familiar with the patient’s usual physical and mental status. This serious complic...

  12. Leptin receptor blockade reduces intrahepatic vascular resistance and portal pressure in an experimental model of rat liver cirrhosis.

    Science.gov (United States)

    Delgado, María Gabriela; Gracia-Sancho, Jordi; Marrone, Giusi; Rodríguez-Vilarrupla, Aina; Deulofeu, Ramon; Abraldes, Juan G; Bosch, Jaume; García-Pagán, Juan Carlos

    2013-10-01

    Increased hepatic vascular resistance mainly due to elevated vascular tone and to fibrosis is the primary factor in the development of portal hypertension in cirrhosis. Leptin, a hormone associated with reduction in nitric oxide bioavailability, vascular dysfunction, and liver fibrosis, is increased in patients with cirrhosis. We aimed at evaluating whether leptin influences the increased hepatic resistance in portal hypertension. CCl4-cirrhotic rats received the leptin receptor-blocker ObR antibody, or its vehicle, every other day for 1 wk. Hepatic and systemic hemodynamics were measured in both groups. Hepatic nitric oxide production and bioavailability, together with oxidative stress, nitrotyrosinated proteins, and liver fibrosis, were evaluated. In cirrhotic rats, leptin-receptor blockade significantly reduced portal pressure without modifying portal blood flow, suggesting a reduction in the intrahepatic resistance. Portal pressure reduction was associated with increased nitric oxide bioavailability and with decreased O2(-) levels and nitrotyrosinated proteins. No changes in systemic hemodynamics and liver fibrosis were observed. In conclusion, the present study shows that blockade of the leptin signaling pathway in cirrhosis significantly reduces portal pressure. This effect is probably due to a nitric oxide-mediated reduction in the hepatic vascular tone.

  13. What "likes" have got to do with it: Exposure to peers' alcohol-related posts and perceptions of injunctive drinking norms.

    Science.gov (United States)

    Boyle, Sarah C; Smith, Daniel J; Earle, Andrew M; LaBrie, Joseph W

    2018-01-01

    Examine 1) whether observed social reinforcements (i.e., "likes") received by peers' alcohol-related social media posts are related to first-year college students' perceptions of peer approval for risky drinking behaviors; and 2) whether associations are moderated by students' alcohol use status. First-year university students (N = 296) completed an online survey in September, 2014. Participants reported their own alcohol use, friends' alcohol use, perceptions of the typical student's approval for risky drinking, and ranked 10 types of social media posts in terms of the relative numbers of "likes" received when posted by peers. Observed social reinforcement (i.e., "likes") for peers' alcohol-related posts predicted perceptions of peer approval for risky drinking behaviors among non-drinking students, but not drinking students. For first-year college students who have not yet initiated drinking, observing peers' alcohol-related posts to receive abundant "likes" may increase perceptions of peer approval for risky drinking.

  14. Relationship of attention-deficit/hyperactivity disorder symptom severity with severity of alcohol-related problems in a sample of inpatients with alcohol use disorder

    Directory of Open Access Journals (Sweden)

    Bozkurt M

    2016-07-01

    Full Text Available Muge Bozkurt,1 Cuneyt Evren,1 Gokhan Umut,1 Bilge Evren2 1Research, Treatment and Training Center for Alcohol and Substance Dependence, Bakirkoy Prof Dr Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 2Department of Psychiatry, Baltalimani State Hospital for Muskuloskeletal Disorders, Istanbul, Turkey Purpose: Attention-deficit/hyperactivity disorder (ADHD has been shown to be related to a higher risk of developing psychiatric problems such as depressive disorders, substance use disorder, and impulsivity. Adults who have comorbid ADHD and alcohol use disorder (AUD are at greater risk of negative outcomes. Thus, it is important to evaluate the relationship of ADHD symptoms and the severity of alcohol-related problems among patients with AUD. The aim of the present study was to evaluate the effect of ADHD symptoms on severity of alcohol-related problems, while controlling the effects of depression and impulsivity in a sample of inpatients with AUD. Patients and methods: Participants (n=190 were evaluated with the Beck Depression Inventory, the Short Form Barratt Impulsiveness Scale, the Michigan Alcohol Screening Test, and the Adult ADHD Self-Report Scale. Results: Severity of the scale scores was positively correlated with each other. Although severity of depression and impulsivity (particularly non-planning impulsivity predicted the severity of alcohol-related problems in a linear regression model, when severity of ADHD symptoms was included in the analysis, the inattentive subscale score, in particular, predicted the severity of alcohol-related problems together with non-planning impulsivity, whereas depression was no longer a predictor. Conclusion: These findings suggest that, together with non-planning impulsivity, symptoms of ADHD (particularly inattentive factor are an important factor that predict alcohol-related problems, while controlling the severity of depressive symptoms among inpatients

  15. The effect of alcohol outlets, sales and trading hours on alcohol-related injuries presenting at emergency departments in Perth, Australia, from 2002 to 2010.

    Science.gov (United States)

    Hobday, Michelle; Chikritzhs, Tanya; Liang, Wenbin; Meuleners, Lynn

    2015-12-01

    Few studies have investigated the combined effects of alcohol sales, outlet numbers and trading hours on alcohol-related harms. This study aimed to test whether associations: (i) exist between alcohol-related emergency department (ED) injuries and alcohol sales and counts of outlets; (ii) vary between on- and off-premises outlets; and (iii) vary by trading hours conditions [extended trading permits (ETP) versus standard hours]. Panel study using 117 postcodes over 8 years (2002-10): 936 data points. Perth, Australia. ED injury presentations, aggregated to postcode-level. Alcohol-related injuries were identified using time-based surrogate measures: night injuries (n=51,241) and weekend night injuries (n=30,682). Measures of alcohol availability included number of outlets with standard and extended trading hours and mean sales per postcode. Negative binomial regression modelling with random effects was used to examine associations between availability and alcohol-related injury, controlling for socio-demographic characteristics. (i) Night injuries were associated significantly with counts of on-premises outlets [incident rate ratio (IRR)=1.046; 95% confidence interval (CI)=1.014-1.078] and sales per off-premises outlet (IRR=1.019; 95% CI=1.004-1.035); (ii) counts of on-premises outlets were positively associated with alcohol-related injury while counts of off-premises outlets indicated a negative association; and (iii) weekend night injuries increased by about 5% per on-premises outlet with an ETP (IRR=1.049; 95% CI=1.015-1.084) and by less than 1% for outlets with standard trading hours (IRR=1.008; 95% CI=1.004-1.013). Regions of Perth, Australia with greater off-premises alcohol sales and counts of on-premises alcohol outlets, particularly those with extended trading hours, appear to have higher levels of alcohol-related injuries. © 2015 Society for the Study of Addiction.

  16. Polygenic risk for alcohol consumption and its association with alcohol-related phenotypes: Do stress and life satisfaction moderate these relationships?

    Science.gov (United States)

    Mies, Gabry W; Verweij, Karin J H; Treur, Jorien L; Ligthart, Lannie; Fedko, Iryna O; Hottenga, Jouke Jan; Willemsen, Gonneke; Bartels, Meike; Boomsma, Dorret I; Vink, Jacqueline M

    2018-02-01

    Genetic and environmental factors contribute about equally to alcohol-related phenotypes in adulthood. In the present study, we examined whether more stress at home or low satisfaction with life might be associated with heavier drinking or more alcohol-related problems in individuals with a high genetic susceptibility to alcohol use. Information on polygenic scores and drinking behavior was available in 6705 adults (65% female; 18-83 years) registered with the Netherlands Twin Register. Polygenic risk scores (PRSs) were constructed for all subjects based on the summary statistics of a large genome-wide association meta-analysis on alcohol consumption (grams per day). Outcome measures were quantity of alcohol consumption and alcohol-related problems assessed with the Alcohol Use Disorders Identification Test (AUDIT). Stress at home and life satisfaction were moderating variables whose significance was tested by Generalized Estimating Equation analyses taking familial relatedness, age and sex into account. PRSs for alcohol were significantly associated with quantity of alcohol consumption and alcohol-related problems in the past year (R 2 =0.11% and 0.10% respectively). Participants who reported to have experienced more stress in the past year and lower life satisfaction, scored higher on alcohol-related problems (R 2 =0.27% and 0.29 respectively), but not on alcohol consumption. Stress and life satisfaction did not moderate the association between PRSs and the alcohol outcome measures. There were significant main effects of polygenic scores and of stress and life satisfaction on drinking behavior, but there was no support for PRS-by-stress or PRS-by-life satisfaction interactions on alcohol consumption and alcohol-related problems. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. An Exploration of the Associations of Alcohol-Related Social Media Use and Message Interpretation Outcomes to Problem Drinking Among College Students.

    Science.gov (United States)

    Hoffman, Eric W; Austin, Erica Weintraub; Pinkleton, Bruce E; Austin, Bruce W

    2017-07-01

    College students' use of digital communication technology has led to a rapid expansion of digital alcohol marketing efforts. Two surveys (total usable n = 637) were conducted to explore college students' experiences with alcohol-related social media, their decision making related to alcohol use, and their problematic drinking behaviors. Study results indicated that students' use of alcohol-related social media predicted their problem drinking behaviors. In addition, students' wishful identification, perceived desirability, perceived similarity, and normative beliefs predicted their expectancies for drinking alcohol. Finally, students' expectancies for drinking alcohol predicted their problematic drinking behaviors.

  18. Effect of propranolol on survival in patients with decompensated cirrhosis

    DEFF Research Database (Denmark)

    Bang, Ulrich C; Benfield, Thomas; Hyldstrup, Lars

    2016-01-01

    BACKGROUND & AIMS: We assessed the impact of propranolol on death, risk of hepatorenal syndrome and peritonitis in patients with cirrhosis. METHODS: This study was a retrospective observational study and data were retrieved from Danish databases. We used our own criteria to stratify the patients...

  19. Aquaporin-2 excretion in hospitalized patients with cirrhosis

    DEFF Research Database (Denmark)

    Busk, Troels M; Møller, Søren; Pedersen, Erling B.

    2017-01-01

    Background and Aim: Urinary aquaporin-2 (AQP2) is a parameter of water transport in the principal cells in the distal part of the nephron and involved in water retention in cirrhosis and may be a marker of renal function. The aim of the study was to evaluate AQP2 as a predictor of renal insuffici...

  20. Petechiae and vasculitis in asymptomatic primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Diederichsen, H; Sørensen, P G; Mickley, H

    1985-01-01

    Recurrent petechiae of the lower legs and signs of asymptomatic primary biliary cirrhosis have been found in three women. Large immune complexes were identified in the serum of three and cryoglobulin/cryofibrinogen in two. Histological examination of skin biopsies revealed a leukocytoclastic vasc...

  1. BCAA-enriched snack improves nutritional state of cirrhosis.

    Science.gov (United States)

    Nakaya, Yutaka; Okita, Kiwamu; Suzuki, Kazuyuki; Moriwaki, Hisataka; Kato, Akinobu; Miwa, Yoshiyuki; Shiraishi, Koichi; Okuda, Hiroaki; Onji, Morikazu; Kanazawa, Hidenori; Tsubouchi, Hirohito; Kato, Shinzo; Kaito, Masahiko; Watanabe, Akiharu; Habu, Daiki; Ito, Susumu; Ishikawa, Tomohisa; Kawamura, Naohiro; Arakawa, Yasuyuki

    2007-02-01

    A late evening snack improves the catabolic state in patients with advanced liver cirrhosis. We tested whether long-term (3 mo) late evening snacking that included a branched-chain amino acid (BCAA)-enriched nutrient mixture produces a better nutritional state and better quality of life than ordinary food in patients with hepatitis C virus-positive liver cirrhosis. In a multicenter, randomized study, 48 patients with liver cirrhosis received late-evening supplementation with the BCAA-enriched nutrient mixture or ordinary food, such as a rice ball or bread, for 3 mo. During the study period, each patient was instructed on energy and protein intake. Blood biochemical data, nitrogen balance, respiratory quotient, and health-related quality of life (Short Form 36 questionnaire) were evaluated at baseline and at the end of the study. Total and late-evening energy intakes were similar in the two groups at 3 mo. Serum albumin level, nitrogen balance, and respiratory quotient were significantly improved by the BCAA mixture but not by ordinary food. The parameters of the Short Form 36 did not statistically significantly improve over 3 mo in either group. Long-term oral supplementation with a BCAA mixture is better than ordinary food in a late evening snack at improving the serum albumin level and the energy metabolism in patients with cirrhosis.

  2. Cirrhosis related chylous ascites successfully treated with TIPS.

    Science.gov (United States)

    de Vries, G J; Ryan, B M; de Bièvre, M; Driessen, A; Stockbrugger, R W; Koek, G H

    2005-04-01

    We describe a patient with chylous ascites, who was extensively investigated for the cause. No malignant or lymphatic disease could be found, but a liver biopsy revealed liver cirrhosis. The chylous ascites was unsuccessfully treated with a sodium restriction diet, diuretics and a medium chain triglyceride diet. After the placement of a transjugular intrahepatic portosystemic shunt the ascites disappeared.

  3. Pulmonary dysfunction and hepatopulmonary syndrome in cirrhosis and portal hypertension

    DEFF Research Database (Denmark)

    Møller, Søren; Krag, Aleksander; Madsen, Jan L

    2009-01-01

    BACKGROUND: Pulmonary dysfunction including the hepatopulmonary syndrome (HPS) is an important complication to cirrhosis and portal hypertension. However, the precise relation to liver dysfunction and the prevalence of HPS are unclear. AIMS: We therefore aimed to assess (i) the prevalence of HPS......, Pportal hypertension (post-sinusoidal resistance, P

  4. Bacterial infections in alcoholic and nonalcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Sargenti, Konstantina; Prytz, Hanne; Bertilsson, Sara

    2015-01-01

    .001), this relationship was not significant after adjustment for confounders in Cox regression analysis (P=0.056). Resistance to piperacilin-tazobactam and carbapenems was more common in infections occurring in alcoholic versus nonalcoholic cirrhosis (13 vs. 5%, P=0.057 and 12 vs. 2%, P=0.009). Alcoholic etiology...

  5. Fibronectin as predictor of cirrhosis in men who abuse alcohol

    DEFF Research Database (Denmark)

    Junge, Jette; Bentsen, K D; Christoffersen, P

    1988-01-01

    In a study of 142 male alcohol abusers without evidence of cirrhosis the presence of intralobular fibronectin in the liver was investigated in relation to the subsequent development of the disease. All 142 initial biopsy samples showed preserved architecture. During a follow up period of 10...

  6. Hepatoadrenal syndrome in Egyptian children with liver cirrhosis ...

    African Journals Online (AJOL)

    This pilot study was designed to evaluate adrenal function for 24 children with liver cirrhosis of various etiologies by measuring basal cortisol level and measuring the peak level after 30 min of short low dose ACTH stimulation test. They were categorized in two groups; group 1 included 12 patients with sepsis and group 2 ...

  7. Indian Childhood Cirrhosis: Case Report and Pediatric Diagnostic Challenges

    Directory of Open Access Journals (Sweden)

    Jaivinder Yadav

    2015-08-01

    Full Text Available Introduction: Indian childhood cirrhosis is a chronic liver disease usually seen in paediatric age group and is unique to the Indian subcontinent. The definitive causative factor for the disease is not found till now but excess copper ingestion has been associated with it.Case presentation: An Indian origin one and half year old premorbidly normal male child presented with history of gradual distension of abdomen for 6 months and jaundice, generalized body swelling, high colour urine for 20 days. There was no history of any bleeding or feature suggestive of hepatic encephalopathy. On physical examination child was icteric, pale and had anasarca, massive hepatosplenomegaly and ascites. The child was evaluated for various causes of hepatic failure in pediatric age group including infective, metabolic and autoimmune etiologies. Unfortunately the child succumbed to the illness. The post-mortem liver biopsy and copper estimation cleared the air, revealing Indian childhood cirrhosis as the underlying etiology.Conclusion: Though Indian childhood cirrhosis is a rare entity and reported less frequently in literature, the treating pediatrician should keep this as a differential in case of pediatric hepatic failure. The liver biopsy and hepatic copper estimation are the gold standard diagnostic tests for diagnosing Indian Childhood cirrhosis.

  8. liver cirrhosis from autoimmune hepatitis in a nigerian woman

    African Journals Online (AJOL)

    like autoimmune thyroiditis, celiac disease and ulcerative colitis, with about 25% having cirrhosis at ... to immunosuppressive therapy. Keywords: Autoimmune hepatitis, Autoimmune liver disease, Chronic liver disease, Nigeria ... who is also exposed to environmental triggering factors.2,5,8 Subsequently, the autoimmune.

  9. Antibiotics can ameliorate circulatory complications of liver cirrhosis

    DEFF Research Database (Denmark)

    Madsen, Bjørn Stæhr; Schaffalitzky de Muckadell, Ove B

    2011-01-01

    . This review focuses on how broad spectrum antibiotics can ameliorate the haemodynamic consequences of bacterial translocation. It is possible that the use of broad spectrum antibiotics in the future may be used to prevent other complications of liver cirrhosis than spontaneous bacterial peritonitis...

  10. Primary biliary cirrhosis following lactobacillus vaccination for recurrent vaginitis

    NARCIS (Netherlands)

    Bogdanos, Dimitrios; Pusl, Thomas; Rust, Christian; Vergani, Diego; Beuers, Ulrich

    2008-01-01

    Background/Aims:Antimitochondrial antibodies directed against the E2 subunit of the pyruvate dehydrogenase complex, PDC-E2, and other mitochondrial 2-oxoacid dehydrogenases (AMA-M2) are the hallmark for diagnosis (of primary biliary cirrhosis (PBC). AMA-M2 formation as an early step in the

  11. Decompensated cirrhosis-related admissions in a large urban ...

    African Journals Online (AJOL)

    EB

    Background: Cirrhosis-related complications are a major cause of morbidity and mortality in areas where its risk factors are endemic. ... prevalence of risk factors. .... Collateral veins. 39 (45.9%). Splenomegaly. 37 (43.5%). Variceal bleeding. 31 (36.5%). Encephalopathy. Grade 1 and 2. 15 (17.6%). Grade 3 and 4. 5 (5.9%).

  12. Aetiological and Histopathological correlates of liver cirrhosis in ...

    African Journals Online (AJOL)

    The slides and paraffin embedded blocks were retrieved and re-examined. The diagnoses were reviewed if found different from the initial sign-out. Cases were then classified according to pathological concept of disease present. Cases of cirrhosis were further evaluated. Results: Two hundred and one liver biopsies were ...

  13. Changes in Renal Resistive lndex in Patients with Liver Cirrhosis

    International Nuclear Information System (INIS)

    Kim, Won Ho; Kim, Sung Woo; Yang, Geun Seok; Kim, Tae Hun; Lee, Yang Il

    1995-01-01

    The purpose of this study was to determine wheter duplex ultrasonography can allow early detection of renal functional impairment identity the patients under high risk for renal failure among thore with liver cirrhosis. We measured the intrarenal resistive index by using duplex ultrasonography in 26 patients of liver cirrhosis with normal renal function test. For statistical comparison, we measured the intrarenal resistive index of 10 adults with normal liver and kidneys. We evaluated the relationships between theseverity of liver cirrhosis and intrarenal resistive index. We also calculated the difference in intrarenalresistive index between the patients with ascites and those without ascites. The intrarenal resistive index in cirrhotic patients group(0.67±0.065) was significantly higher than that in control group(0.56±0.007).The intrarenal resistive index of patients with ascites (0.70±0.052) was also higher than that of those without ascites (0.60±0.033). The intrarenal resistive index of the patients with Child class C disease (0.73±0.036) was higher than the resistive index of those with Child class A disease (0.60±0.043) and those with Child class B(0.64±0.037). Renal resistive index measurement by non-invasive duplex ultrasonography can detect subtle derangement of renal hemodynamics in liver cirrhosis and may be useful for identification of patients with higher risk of renal failure and to guide the therapeutic approach

  14. CIRRHOSIS INDUCES APOPTOSIS IN RENAL TISSUE THROUGH INTRACELLULAR OXIDATIVE STRESS

    Directory of Open Access Journals (Sweden)

    Keli Cristina Simões da SILVEIRA

    2015-03-01

    Full Text Available Background Renal failure is a frequent and serious complication in patients with decompensated cirrhosis. Objectives We aimed to evaluate the renal oxidative stress, cell damage and impaired cell function in animal model of cirrhosis. Methods Secondary biliary cirrhosis was induced in rats by ligation of the common bile duct. We measured TBARS, ROS and mitochondrial membrane potential in kidney as markers of oxidative stress, and activities of the antioxidant enzymes. Relative cell viability was determined by trypan blue dye-exclusion assay. Annexin V-PE was used with a vital dye, 7-AAD, to distinguish apoptotic from necrotic cells and comet assay was used for determined DNA integrity in single cells. Results In bile duct ligation animals there was significant increase in the kidney lipoperoxidation and an increase of the level of intracellular ROS. There was too an increase in the activity of all antioxidant enzymes evaluated in the kidney. The percentage viability was above 90% in the control group and in bile duct ligation was 64.66% and the dominant cell death type was apoptosis. DNA damage was observed in the bile duct ligation. There was a decreased in the mitochondrial membrane potential from 71.40% ± 6.35% to 34.48% ± 11.40% in bile duct ligation. Conclusions These results indicate that intracellular increase of ROS cause damage in the DNA and apoptosis getting worse the renal function in cirrhosis.

  15. ACUTE KIDNEY INJURY IN PATIENTS WITH CIRRHOSIS- CAUSES AND OUTCOME

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    Amit Hanmant Shejal

    2017-06-01

    Full Text Available BACKGROUND Acute Kidney Injury (AKI is a common complication in patients with cirrhosis leading to high mortality. Creatinine-based criteria for defining AKI are validated in general hospitalised patients, but their application to cirrhotic patients is less certain. This study was undertaken to evaluate current definition of AKI by International Club of Ascites (ICA and assess clinical course of hospitalised cirrhosis patients with AKI and to study the impact of AKI on mortality. MATERIALS AND METHODS We prospectively studied patients with AKI and cirrhosis for a period of 1 year and assessed the association between AKI severity and progression with complications, including death. RESULTS 48 cirrhotic patients with AKI were enrolled in the study period. Mean age of patients was 56.81 ± 9.78 years. The aetiology of cirrhosis included alcohol (52.1%, HBV (2.2%, HCV (4.2%, NASH (27.1% and cryptogenic (14.6%. 13 patients (27.1% had mortality while 35 patients (72.9% survived. 39 patients (81.25% had AKI at admission while 9 patients (18.75% developed later after admission. Patients achieved a peak severity of AKI stage 1, 10.41%; stage 2, 60.41%; and stage 3, 37.5%. The incidence of mortality, increased with severity of AKI in stepwise manner with peak AKI stage 1 has no mortality; stage 2 has 4 (30.76%; stage 3, 9 (69.23%. SIRS was present in 17 patients (35.4% and was significantly associated with mortality. CONCLUSION AKI, as defined by new ICA criteria, in patients with cirrhosis is associated with mortality in a stage-dependent fashion. Early intervention and preventing progression by timely and specific treatment may improve outcomes.

  16. Endocrine-Manifestations of Cirrhosis and Liver Disease

    Directory of Open Access Journals (Sweden)

    M Khalili

    2014-04-01

    Full Text Available The liver is involved in the synthesis and metabolism of many kinds of hormones, various abnormalities hormone levels are found in advanced liver disease. For example the liver is, extremely sensitive to changes in insulin or glucagon levels. The liver is the primary organ of iron storage is frequently involved, diabetes is common in patients with iron overload and may be seen in cirrhosis. Chronic infection with HCV is associated with insulin resistance. Thyroid disease often accompanies chronic hepatitis C infection .Anti thyroid autoantibodies are also found in chronic HCV infection. Nonalcoholic liver disease (NAFLDas a most common cause of chronic liver disease in western world ,as well accompanied by Type 2 diabetes and hyperlipidemia. Hypopituitarism and hypothyroidism also have been in NAFLD.The patients with NAFLD and Hypopituitarism may be susceptible to central obesity, dyslipidemia and insulin resistance leading to disease progression. Hepatic cirrhosis as the end stage of chronic liver disease is also associated with hypogonadism and signs of feminization. The peripheral metabolism of steroids is altered in many of hypogonadism, low testosterone level decreased libido, infertility, reduced secondary sex hair and gynecomastia, reduced spermatogenesis and peritubular fibrosis are found in men with cirrhosis .The normal function of the hypothalamic-pituitary gonadal axis is affected in liver disease. In cirrhotic patients the estrogen/androgen ratio is usually increased, the level of testosterone and dihydroepiandosteron are reduced while the estradiol level are normal or slightly elevated, these alterations are dependent on the severity of the liver disease.Succsesfull orthotropic liver transplantation  leads to improvement of the sex hormone disturbances. The pathogenesis of gynecomastia is due to the loss of equilibrium between estrogen and androgen caused by a feminizing state but it is due to increased estrogen precursor in

  17. Patterns of blood component use in cirrhosis: a nationwide study.

    Science.gov (United States)

    Desborough, Michael J R; Hockley, Brian; Sekhar, Mallika; Burroughs, Andrew K; Stanworth, Simon J; Jairath, Vipul

    2016-04-01

    Cirrhosis is a complex acquired disorder of coagulation and frequent indication for transfusion of blood components. We characterised blood component use in patients with cirrhosis and compared this to transfusion guidelines. All National Health Service trusts with representation on the British Society of Gastroenterology membership list were invited to take part. Data were collected prospectively on consecutive, unselected, hospitalised admissions with cirrhosis over 28 days. Detailed information was recorded for patients receiving blood components including indication (for bleeding or prophylaxis), type of component, laboratory indices triggering transfusion, complications, thromboembolic events and clinical outcome to day 28. Data on 1313 consecutive patients with cirrhosis were collected from 85 hospitals. A total of 391/1313 (30%) were transfused a blood component; in 238/391 (61%), this was for treatment of bleeding and in 153/391 (39%) for prophylaxis of bleeding. In 48/185 (26%) cases with bleeding, the haemoglobin threshold was >80 g/L prior to red blood cell transfusion. In the prophylaxis group, 238/391 (61%) received transfusion in response to an abnormal haematological value in the absence of any planned procedure. In patients transfused for procedural prophylaxis, 10/34 (29%) received fresh frozen plasma at an International Normalised Ratio lower than the threshold where a benefit would be anticipated. An in-patient thromboembolic event was recorded in 3% (35/1313) and 10% (138/1313) died by day 28. One-third of hospitalised patients with cirrhosis were transfused. Strategies for Patient Blood Management should include ensuring transfusion practice is consistent with guidelines and greater emphasis on alternatives to transfusion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. Clostridium difficile colonization and infection in patients with hepatic cirrhosis.

    Science.gov (United States)

    Yan, Dong; Chen, Yunbo; Lv, Tao; Huang, Yandi; Yang, Jiezuan; Li, Yongtao; Huang, Jianrong; Li, Lanjuan

    2017-10-01

    The aim of this study was to investigate the toxigenic Clostridium difficile colonization (CDC, colonization with toxigenic C. difficile but without symptoms) and C. difficile infection (CDI, active C. difficile infection resulting in disease symptoms) in hepatic cirrhosis patients, identify the risk factors of CDC, and determine the correlation between CDC and CDI. The strains of toxigenic C. difficile were isolated from patients with hepatic cirrhosis within 48 h after admission, followed by multilocus sequence typing (MLST). Patients were divided into toxigenic CDC group and noncolonized (NC) group according to the colonization. Logistic regression analysis was performed to analyse the risk factors for the CDC. Besides, the CDI incidence was compared between the two groups. Colonization of toxigenic C. difficile was identified in 104 cases (19.8 %). Eighteen sequence types (STs) were identified, among which ST-3, ST-54, ST-35 and ST-37 were the predominant types. Child-Pugh class C(relative risk, RR, 3.025; 95 % CI: 1.410-6.488), decrease of prothrombin time activity (PTA) (RR 2.180; 95 % CI: 1.368-3.476), decrease of platelet (RR 2.746; 95 % CI: 0.931-8.103) and concurrent hepatic encephalopathy (RR 1.740; 95 % CI: 1.012-2.990) were identified as the risk factors for the hepatic cirrhosis patients with CDC. The CDI incidence in the CDC group was also significantly higher than that of the NC group (26.0 % vs 1.7 %, Pdifficile colonization. Child's class C, decrease of PTA and platelet, and concurrent hepatic encephalopathy were the risk factors for the hepatic cirrhosis patients with C. difficile colonization. Hepatic cirrhosis patients with C. difficile colonization were more susceptible to CDI.

  19. Predictors of alcohol-related negative consequences in adolescents: A systematic review of the literature and implications for future research.

    Science.gov (United States)

    Grigsby, Timothy J; Forster, Myriam; Unger, Jennifer B; Sussman, Steve

    2016-04-01

    To conduct a systematic review of the literature examining risk and protective factors of alcohol related negative consequences (ARNCs) among adolescents. We conducted a systematic search of original empirical articles published between January 1, 1990 and June 1, 2015. The qualitative synthesis was performed using the Theory of Triadic Influence as a framework. Fifty-two studies were reviewed. Intrapersonal (e.g., personality traits, drinking motives and expectancies, depression), interpersonal (e.g., parental and peer alcohol use, violence exposure) and attitudinal factors (e.g., media exposure to alcohol, religiosity) influence ARNCs. Emerging evidence of new trends contributing to ARNCs include ready mixed alcohol drinks and childhood trauma and abuse. Risk factors from all domains of influence were observed. More research is needed on protective factors and how alcohol use interacts with preventive factors in predicting ARNCs. The conceptualization of negative consequences varies significantly between studies and may impact the external validity of previous research. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  20. Development and Validation of a Video Measure for Assessing Women’s Risk Perception for Alcohol-Related Sexual Assault

    Science.gov (United States)

    Parks, Kathleen A.; Levonyan-Radloff, Kristine; Dearing, Ronda L.; Hequembourg, Amy; Testa, Maria

    2016-01-01

    Objective Using an iterative process, a series of three video scenarios were developed for use as a standardized measure for assessing women’s perception of risks for alcohol-related sexual assault (SA). The videos included ambiguous and clear behavioral and environmental risk cues. Method Focus group discussions with young, female heavy drinkers (N = 42) were used to develop three videos at different risk levels (low, moderate, and high) in Study 1. Realism, reliability, and validity of the videos were assessed using multiple methods in Studies 2 and 3. One hundred-four women were used to compare differences in risk perception across the video risk level in Study 2. In Study 3 (N = 60), we assessed women’s perceptions of the low and high risk videos under conditions of no alcohol and alcohol. Results The realism and reliability of the videos were good. Women who viewed the low risk video compared to women who viewed the moderate and high risk videos perceived less risk for SA. We found an interaction between alcohol and risk perception such that, women in the alcohol condition were less likely to perceive risk when watching the high risk video. Conclusions As the video risk level increased, women’s perception of risk increased. These findings provide convergent evidence for the validity of the video measure. Given the limited number of standardized scenarios for assessing risk perception for sexual assault, our findings suggest that these videos may provide a needed standardized measure. PMID:27747131

  1. Vulnerability to alcohol-related problems: a policy brief with implications for the regulation of alcohol marketing.

    Science.gov (United States)

    Babor, Thomas F; Robaina, Katherine; Noel, Jonathan K; Ritson, E Bruce

    2017-01-01

    The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. © 2016 Society for the Study of Addiction.

  2. A facebook survey to obtain alcohol-related information by young people and adolescents. An Italian study.

    Science.gov (United States)

    Zulli, C; Federico, A; Gaeta, L; Del Prete, A; Iadevaia, M; Gravina, A G; Romano, M; Loguercio, C

    2014-03-01

    Alcohol consumption by adolescents and young adults is an issue of significant public concern. Internet-based Social Networking sites, such as Facebook, are potential avenues to reach young people easily. to underline the innovation in proposing surveys to collect health-related information regarding young people alcohol consumption and other substances abuse by using Social Networking Websites, particularly Facebook. A questionnaire investigating modalities of alcohol consumption, drinking patterns' risk behaviors and other substances abuse was proposed through a "Facebook event" to young Italian Facebook users aged between 16 and 32. Each Facebook user invited to the event was free to participate, to answer to the questionnaire and to invite his "Facebook friends". During the 89 days of permanence on the Social Network, 1846 Facebook users participated the event and 732 of them decided spontaneously to answer the questionnaire. The frequency of answering was 8.2 people per day. About 200 users wrote a positive comment to the initiative on the wall of the event. Sixty% of subjects participating the survey were females. Ninety-one% of people answering the questionnaire were alcohol consumers. More than 50% of alcohol consumers were also smokers. Approximately 50% of subjects were binge drinkers. Illegal drugs were used by the 22.2% of the interviewed people. Facebook resulted an efficient and rapid tool to reach young people from all over Italy and to propose surveys in order to investigate alcohol consumption and alcohol-related health problems in the youth.

  3. Effects of Acute Alcohol Consumption on the Processing of Emotion in Faces: Implications for Understanding Alcohol-Related Aggression

    Science.gov (United States)

    Attwood, Angela S.; Munafò, Marcus R.

    2016-01-01

    The negative consequences of chronic alcohol abuse are well known, but heavy episodic consumption ("binge drinking") is also associated with significant personal and societal harms. Aggressive tendencies are increased after alcohol but the mechanisms underlying these changes are not fully understood. While effects on behavioural control are likely to be important, other effects may be involved given the widespread action of alcohol. Altered processing of social signals is associated with changes in social behaviours, including aggression, but until recently there has been little research investigating the effects of acute alcohol consumption on these outcomes. Recent work investigating the effects of acute alcohol on emotional face processing has suggested reduced sensitivity to submissive signals (sad faces) and increased perceptual bias towards provocative signals (angry faces) after alcohol consumption, which may play a role in alcohol-related aggression. Here we discuss a putative mechanism that may explain how alcohol consumption influences emotional processing and subsequent aggressive responding, via disruption of OFC-amygdala connectivity. While the importance of emotional processing on social behaviours is well established, research into acute alcohol consumption and emotional processing is still in its infancy. Further research is needed and we outline a research agenda to address gaps in the literature. PMID:24920135

  4. Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients

    Directory of Open Access Journals (Sweden)

    Justina Slavinskienė

    2014-01-01

    Conclusions: Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients’ different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior.

  5. Assessment of Alcohol-related Memory Deficits: A Comparison between the Rivermead Behavioural Memory Test and the California Verbal Learning Test

    NARCIS (Netherlands)

    Wester, A.J.; Roelofs, R.L.; Egger, J.I.M.; Kessels, R.P.C.

    2014-01-01

    Objectives: Neuropsychological assessment of memory disorders is an important prerequisite in the treatment of patients with alcohol-related cognitive disorders. Although many memory tests are available in clinical practice, a question remains regarding which test is most appropriate for this

  6. "Man-ing" up and getting drunk: the role of masculine norms, alcohol intoxication and alcohol-related problems among college men.

    Science.gov (United States)

    Iwamoto, Derek Kenji; Cheng, Alice; Lee, Christina S; Takamatsu, Stephanie; Gordon, Derrick

    2011-09-01

    Compared to college women, college men face elevated risks for problematic drinking and negative alcohol-related consequences. These risks highlight the critical need to investigate gender issues and risk factors contributing to intoxication and related problems among men. Theoretical models suggest that conforming to masculine norms or the beliefs and expectations of what it means to be a man, may help explain patterns of problematic drinking among men. The current study advances the literature by investigating the association between masculine norms, drinking to intoxication, and alcohol-related consequences among 776 undergraduate males after taking into account the importance of fraternity status and perceived peer norms. Results indicate that fraternity status and higher perceived peer norms regarding drinking increased the risks of getting drunk and experiencing alcohol-related consequences. Specifically, the masculine norms of being a "playboy", risk-taking, and winning were risk factors of drinking to intoxication; while, being a "playboy", risk-taking, and self-reliance increased the risks of alcohol-related problems. Primacy of work and heterosexual presentation were two masculine norms that were protective of drinking to intoxication. Our findings contribute to important future considerations for prevention, clinical interventions, and public-health implications in college settings. Copyright © 2011 Elsevier Ltd. All rights reserved.

  7. “Man-ing” up and Getting Drunk: The Role of Masculine Norms, Alcohol Intoxication and Alcohol-Related Problems among College Men

    Science.gov (United States)

    Iwamoto, Derek Kenji; Cheng, Alice; Lee, Christina S.; Takamatsu, Stephanie; Gordon, Derrick

    2011-01-01

    Compared to college women, college men face elevated risks for problematic drinking and negative alcohol-related consequences. These risks highlight the critical need to investigate gender issues and risk factors contributing to intoxication and related problems among men. Theoretical models suggest that conforming to masculine norms or the beliefs and expectations of what it means to be a man, may help explain patterns of problematic drinking among men. The current study advances the literature by investigating the association between masculine norms, drinking to intoxication, and alcohol-related consequences among 776 undergraduate males after taking into account the importance of fraternity status and perceived peer norms. Results indicate that fraternity status and higher perceived peer norms regarding drinking increased the risks of getting drunk and experiencing alcohol-related consequences. Specifically, the masculine norms of being a “playboy”, risk-taking, and winning were risk factors of drinking to intoxication; while, being a “playboy”, risk-taking, and self-reliance increased the risks of alcohol-related problems. Primacy of work and heterosexual presentation were two masculine norms that were protective of drinking to intoxication. Our findings contribute to important future considerations for prevention, clinical interventions, and public-health implications in college settings. PMID:21620570

  8. Effectiveness of an email-based intervention helping parents to enhance alcohol-related parenting skills and reduce their children's alcohol consumption: A randomised controlled trial

    NARCIS (Netherlands)

    Wurdak, M.; Kuntsche, E.N.; Wolstein, J.

    2017-01-01

    Aims: Developing and evaluating an email-based intervention (EBI) to enhance alcohol-related parenting skills and reduce alcohol consumption among adolescents. Methods: Over four weeks, participating parents received a weekly email containing scientific findings, practical advice and exercises in

  9. Prescription for antidepressant in reducing future alcohol-related readmission in patients suffering from depression and alcohol use disorder: a retrospective medical record review.

    Science.gov (United States)

    Chan, Patrick; Yomen, Katie; Turcios, Jennifer; Richman, Mark

    2015-12-21

    Patients suffering from major depressive disorder are more likely to suffer from alcohol use disorder. The data is inconclusive for the effectiveness of antidepressant treatment of patients suffering from both illnesses in regards to improving sobriety and reducing alcohol-related healthcare expenses such as hospitalizations. The objective of this study is to determine if a new prescription of an antidepressant upon inpatient discharge is associated with a reduction in the number of future acute alcohol-related hospital readmissions to the same institution in patients suffering from major depressive disorder and alcohol-use disorder. A retrospective, medical record review study was conducted at a publicly-supported hospital in Sylmar, CA. A query was performed for adult patients admitted between 1/1/2005-12/31/2013 who had ICD-9 codes for both alcohol-use disorder and depression. Index admission was the first hospitalization in which the patient was currently consuming alcohol and had depression as identified by physician documentation as a problem. Acute alcohol-related admissions were those for alcohol intoxication or withdrawal (indicating current alcohol use). Patients were excluded if they were receiving an antidepressant on index admission, depressive disorder with a prescription for an antidepressant is not associated with a reduction in future readmissions, nor significantly increase the number of days to readmission. The study does not support the concept of antidepressants in reducing acute alcohol-related readmissions.

  10. The whole spectrum of alcohol-related changes in the CNS. Practical MR and CT imaging guidelines for daily clinical use

    International Nuclear Information System (INIS)

    Keil, V.C.; Greschus, S.; Hadizadeh, D.R.; Schild, H.H.; Schneider, C.

    2015-01-01

    Alcohol addiction is the most common drug addiction. Alcohol passes both the placenta as well as the blood-brain barrier and is in multiple ways neurotoxic. Liver diseases and other systemic alcohol-related diseases cause secondary damage to the CNS. Especially in adolescents, even a single episode of severe alcohol intoxication (''binge drinking'') may result in life-threatening neurological consequences. Alcohol-related brain and spinal cord diseases derive from multiple causes including impairment of the cellular metabolism, often aggravated by hypovitaminosis, altered neurotransmission, myelination and synaptogenesis as well as alterations in gene expression. Modern radiological diagnostics, MRI in particular, can detect the resulting alterations in the CNS with a high sensitivity. Morphological aspects often strongly correlate with clinical symptoms of the patient. It is less commonly known that many diseases considered as ''typically alcohol-related'', such as Wernicke's encephalopathy, are to a large extent not alcohol-induced. Visible CNS alterations are thus non-pathognomonic and demand careful evaluation of differential diagnoses. This review article elucidates the pathogenesis, clinical aspects and radiological image features of the most common alcohol-related CNS diseases and their differential diagnoses.

  11. I didn’t feel like drinking but I don’t know why: the effects of evaluative conditioning on alcohol-related attitudes, craving and behavior

    NARCIS (Netherlands)

    Houben, K.; Schoenmaker, T.M.; Wiers, R.W.

    2010-01-01

    The goal of the present research was to test the value of evaluative conditioning (EC) to unobtrusively change alcohol-related attitudes and drinking behavior. In the EC paradigm, participants had to spot an irrelevant target picture in a series of trials in which many different stimuli were

  12. Training First-Year College Students to Intervene in Alcohol-Related Emergencies: Addressing Bystander Beliefs and Perceived Consequences of Intervening

    Science.gov (United States)

    Anthenien, Amber M.; Neighbors, Clayton; Rosa, Juliana

    2017-01-01

    A bystander program to increase knowledge and self-efficacy for intervening in alcohol-related emergencies, and increase the ratio of perceived benefits to barriers for intervening, was evaluated. Incoming first-year students participated in small group motivational interviewing sessions. Surveys were emailed two weeks before scheduled…

  13. Estimating alcohol-related premature mortality in san francisco: use of population-attributable fractions from the global burden of disease study

    Directory of Open Access Journals (Sweden)

    Reiter Randy B

    2010-11-01

    Full Text Available Abstract Background In recent years, national and global mortality data have been characterized in terms of well-established risk factors. In this regard, alcohol consumption has been called the third leading "actual cause of death" (modifiable behavioral risk factor in the United States, after tobacco use and the combination of poor diet and physical inactivity. Globally and in various regions of the world, alcohol use has been established as a leading contributor to the overall burden of disease and as a major determinant of health disparities, but, to our knowledge, no one has characterized alcohol-related harm in such broad terms at the local level. We asked how alcohol-related premature mortality in San Francisco, measured in years of life lost (YLLs, compares with other well-known causes of premature mortality, such as ischemic heart disease or HIV/AIDS. Methods We applied sex- and cause-specific population-attributable fractions (PAFs of years of life lost (YLLs from the Global Burden of Disease Study to 17 comparable outcomes among San Francisco males and females during 2004-2007. We did this in three ways: Method 1 assumed that all San Franciscans drink like populations in developed economies. These estimates were limited to alcohol-related harm. Method 2 modified these estimates by including several beneficial effects. Method 3 assumed that Latino and Asian San Franciscans drink alcohol like populations in the global regions related to their ethnicity. Results By any of these three methods, alcohol-related premature mortality accounts for roughly a tenth of all YLLs among males. Alcohol-related YLLs among males are comparable to YLLs for leading causes such as ischemic heart disease and HIV/AIDS, in some instances exceeding them. Latino and black males bear a disproportionate burden of harm. Among females, for whom estimates differed more by method and were smaller than those for males, alcohol-related YLLs are comparable to leading

  14. Proton MR spectroscopic features of chronic hepatitis and liver cirrhosis

    International Nuclear Information System (INIS)

    Cho, Soon Gu; Chung, Won Kyun; Kim, Young Soo; Choi, Won; Shin, Seok Hwan; Kim, Hyung Jin; Suh, Chang Hae

    2000-01-01

    The purpose of this study was to evaluate change in the proton MR spectroscopic ( 1 H-MRS) features of the liver according to changes in the severity of the chronic hepatitis spectrum (normal-chronic hepatitis-liver cirrhosis), and to determine the possibility of replacing liver biopsy by 1 H-MRS. Sixty profiles of 1 H-MRS features from 15 normal volunteers, 30 cases of chronic hepatitis, and 15 of liver cirrhosis were evaluated. All cases of chronic hepatitis and liver cirrhosis were confirmed by biopsy, and histopathologic disease severity was categorized according to Ludwig's classification. Using the STEAM (STimulated Echo-Aquisition Mode) sequence, 1 H-MRS was performed. The ratios of peak areas of (glutamate + glutamine)/lipid, phosphomonoesters/lipid, (glycogen + glucose)/lipid, and (3.9-4.1 ppm unknown peak)/lipid and their mean and standard deviation were calculated in normal, chronic hepatitis stages I and II, and early and late liver cirrhosis groups and the results were compared between these groups. One-way variable analysis was applied to the statistics. Mean and standard deviation of phosphomonoesters/lipid in the normal, chronic hepatitis grades I and II, and early and late liver cirrhosis groups were 0.0146±0.0090, 0.0222±0.0170, 0.0341±0.0276, 0.0698±0.0360, and 0.0881±0.0276, respectively, and (glycogen + glucose)/lipid were 0.0403±0.0267, 0.0922±0.0377, 0.1230±0.0364, 0.1853±0.0667, 0.2325±0.1071, respectively. These results implied that the ratio of the above metabolites to lipid content increased according to increasing disease severity (p less than 0.05). For (glutamate + glutamine)/lipid however, the ratios for each group were 0.0204±0.0067, 0.0117±0.0078, 0.0409±0.0167, 0.0212±0.0103, and 0.0693±0.0371, respectively, and there was no correlation with disease severity. In the chronic hepatitis grades I and II, and early and late liver cirrhosis groups, the ratios for (3.9-4.1 ppm unknown peak)/lipid were 0.0302±0.0087, 0

  15. The Effects of the 2004 Reduction in the Price of Alcohol on Alcohol-Related Harm in Finland – a Natural Experiment Based on Register Data

    Directory of Open Access Journals (Sweden)

    Kimmo Herttua

    2010-01-01

    Full Text Available Changes in alcohol pricing have been documented as inversely associated with changes in consumption and alcohol-related problems. Evidence of the association between price changes and health problems is nevertheless patchy and is based to a large extent on cross-sectional state-level data, or time series of such cross-sectional analyses. Natural experimental studies have been called for. There was a substantial reduction in the price of alcohol in Finland in 2004 due to a reduction in alcohol taxes of one third, on average, and the abolition of duty-free allowances for travellers from the EU. These changes in the Finnish alcohol policy could be considered a natural experiment, which offered a good opportunity to study what happens with regard to alcohol-related problems when prices go down. The present study investigated the effects of this reduction in alcohol prices on (1 alcohol-related and all-cause mortality, and mortality due to cardiovascular diseases, (2 alcohol-related morbidity in terms of hospitalisation, (3 socioeconomic differentials in alcohol-related mortality, and (4 small-area differences in interpersonal violence in the Helsinki Metropolitan area. Differential trends in alcohol-related mortality prior to the price reduction were also analysed.  A variety of population-based register data was used in the study. Time-series intervention analysis modelling was applied to monthly aggregations of deaths and hospitalisation for the period 1996-2006. These and other mortality analyses were carried out for men and women aged 15 years and over. Socioeconomic differentials in alcohol-related mortality were assessed on a before/after basis, mortality being followed up in 2001-2003 (before the price reduction and 2004-2005 (after. Alcohol-related mortality was defined in all the studies on mortality on the basis of information on both underlying and contributory causes of death. Hospitalisation related to alcohol meant that there was a

  16. Prevalence of cirrhosis in patients with thrombocytopenia who receive bone marrow biopsy.

    Science.gov (United States)

    Sheikh, Muhammad Y; Raoufi, Rahim; Atla, Pradeep R; Riaz, Muhammad; Oberer, Chad; Moffett, Michael J

    2012-01-01

    Thrombocytopenia is a common finding in patients with cirrhosis and may lead to unnecessary referral for bone marrow (BM) biopsy. To date, the prevalence of cirrhosis in patients with thrombocytopenia who receive BM biopsy is largely unknown. Between fiscal years 2006-2010, 744 patients (≥18 years) who underwent BM biopsies for thrombocytopenia at our hospital were identified retrospectively. 541 patients were excluded who had hematologic malignancies and received chemotherapy. Remaining 203 patients with predominant isolated thrombocytopenia were included in the study. Of 203 patients, 136 (67%) had a normal and 67 (33%) had an abnormal BM examination. Prevalence of cirrhosis in the study population was 35% (95% CI: 28.4-41.9). 51% patients with normal BM were found to have cirrhosis compared to 3% of patients with abnormal BM exam (P < 0.0001). Common causes of cirrhosis were nonalcoholic steatohepatitis (NASH) (47%), followed by alcohol and Hepatitis C virus infection. Idiopathic thrombocytopenia and myelodysplastic syndrome were most frequent causes of thrombocytopenia in patients without cirrhosis. Patients with NASH had higher body mass index (BMI) (33.4 vs. 25.8, P < 0.001) and lower MELD scores (11.1 vs. 16, P = 0.028) when compared to non-NASH patients with cirrhosis. Approximately, one third (35%) of patients with cirrhosis induced thrombocytopenia may undergo unwarranted BM biopsies. Clinical diagnosis of cirrhosis is still a challenge for many physicians, particularly with underlying NASH. We propose cirrhosis to be the prime cause of isolated thrombocytopenia.

  17. Occurrence of hepatocellular carcinoma and decompensation in western European patients with cirrhosis type B. The EUROHEP Study Group on Hepatitis B Virus and Cirrhosis

    DEFF Research Database (Denmark)

    Fattovich, G; Giustina, G; Schalm, S W

    1995-01-01

    To examine the morbidity of compensated cirrhosis type B, a cohort of 349 Western European, white patients (86% men; mean age, 44 years) with biopsy-proven cirrhosis was followed up for a mean period of 73 months and was studied for occurrence of hepatocellular carcinoma (HCC) and decompensation...

  18. Childhood adversity moderates the effect of ADH1B on risk for alcohol-related phenotypes in Jewish Israeli drinkers.

    Science.gov (United States)

    Meyers, Jacquelyn L; Shmulewitz, Dvora; Wall, Melanie M; Keyes, Katherine M; Aharonovich, Efrat; Spivak, Baruch; Weizman, Abraham; Frisch, Amos; Edenberg, Howard J; Gelernter, Joel; Grant, Bridget F; Hasin, Deborah

    2015-01-01

    Childhood adversity and genetic variant ADH1B-rs1229984 have each been shown to influence heavy alcohol consumption and disorders. However, little is known about how these factors jointly influence these outcomes. We assessed the main and additive interactive effects of childhood adversity (abuse, neglect and parental divorce) and the ADH1B-rs1229984 on the quantitative phenotypes 'maximum drinks in a day' (Maxdrinks) and DSM-Alcohol Use Disorder (AUD) severity, adjusting for demographic variables, in an Israeli sample of adult household residents (n = 1143) evaluated between 2007 and 2009. Childhood adversity and absence of the protective ADH1B-rs1229984 A allele were associated with greater mean Maxdrinks (mean differences: 1.50; 1.13, respectively) and AUD severity (mean ratios: 0.71; 0.27, respectively). In addition, childhood adversity moderated the ADH1B-rs1229984 effect on Maxdrinks (P < 0.01) and AUD severity (P < 0.05), in that there was a stronger effect of ADH1B-rs1229984 genotype on Maxdrinks and AUD severity among those who had experienced childhood adversity compared with those who had not. ADH1B-rs1229984 impacts alcohol metabolism. Therefore, among those at risk for greater consumption, e.g. those who experienced childhood adversity, ADH1B-rs1229984 appears to have a stronger effect on alcohol consumption and consequently on risk for AUD symptom severity. Evidence for the interaction of genetic vulnerability and early life adversity on alcohol-related phenotypes provides further insight into the complex relationships between genetic and environmental risk factors. © 2013 Society for the Study of Addiction.

  19. Alcohol-related cancers and genetic susceptibility in Europe: the ARCAGE project: study samples and data collection.

    LENUS (Irish Health Repository)

    Lagiou, Pagona

    2009-02-01

    Cancers of the upper aerodigestive tract (UADT) include those of the oral cavity, pharynx (other than nasopharynx), larynx, and esophagus. Tobacco smoking and consumption of alcoholic beverages are established causes of UADT cancers, whereas reduced intake of vegetables and fruits are likely causes. The role of genetic predisposition and possible interactions of genetic with exogenous factors, however, have not been adequately studied. Moreover, the role of pattern of smoking and drinking, as well as the exact nature of the implicated dietary variables, has not been clarified. To address these issues, the International Agency for Research on Cancer initiated in 2002 the alcohol-related cancers and genetic susceptibility (ARCAGE) in Europe project, with the participation of 15 centers in 11 European countries. Information and biological data from a total of 2304 cases and 2227 controls have been collected and will be used in a series of analyses. A total of 166 single nucleotide polymorphisms of 76 genes are being studied for genetic associations with UADT cancers. We report here the methodology of the ARCAGE project, main demographic and lifestyle characteristics of the cases and controls, as well as the distribution of cases by histology and subsite. About 80% of cases were males and fewer than 20% of all cases occurred before the age of 50 years. Overall, the most common subsite was larynx, followed by oral cavity, oropharynx, esophagus and hypopharynx. Close to 90% of UADT cancers were squamous cell carcinomas. A clear preponderance of smokers and alcohol drinkers among UADT cases compared with controls was observed.

  20. Post-9/11 drug- and alcohol- related hospitalizations among World Trade Center Health Registry enrollees, 2003-2010.

    Science.gov (United States)

    Hirst, Andrew; Miller-Archie, Sara A; Welch, Alice E; Li, Jiehui; Brackbill, Robert M

    2018-06-01

    To describe patterns of drug- and alcohol-related hospitalizations among persons exposed to the 2001 World Trade Center (WTC) terrorist attacks and to assess whether 9/11-related exposures or post-9/11 post-traumatic stress disorder (PTSD) were associated with increased odds of hospitalization. Data for adult enrollees in the WTC Health Registry, a prospective cohort study, were linked to New York State (NYS) administrative hospitalization data to identify alcohol- and drug-related hospitalizations from enrollment to December 31, 2010. Logistic regression was used to analyze the associations between substance use-related hospitalization, 9/11-related exposure and PTSD. Of 41,176 NYS resident enrollees, we identified 626 (1.5%) who had at least one alcohol- or drug-related hospitalization; 53.4% (n = 591) of these hospitalizations were for alcohol only diagnoses and 46.6% (n = 515) were drug-related. Witnessing ≥3 traumatic events on 9/11 was significantly associated with having a drug-related hospitalization (AOR 1.4, 95% CI = [1.1, 1.9]). PTSD was significantly associated with both having a drug-related hospitalization as well as an alcohol only-related hospitalization. (AOR 2.6, 95% CI = [2.0, 3.3], AOR 1.8, 95% CI = [1.4, 2.3], respectively). Witnessing traumatic events and having PTSD were independently associated with substance use-related hospitalizations. Targeting people who witnessed traumatic events on 9/11 and/or who have PTSD for substance use- treatment could reduce alcohol and drug-related hospitalizations connected to 9/11. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

    International Nuclear Information System (INIS)

    Khodzhibekov, M.Kh.; Rikhsieva, L.Eh.; Nazyrov, F.G.

    1988-01-01

    Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis

  2. Radionuclide and ultrasonic investigations in liver cirrhosis with portal hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Khodzhibekov, M Kh; Rikhsieva, L Eh; Nazyrov, F G

    1988-08-01

    Combined radionuclide and ultrasonic investigations (UNI) were performed in 95 patients with liver cirrhosis complicated by portal hypertension. Liver and splenic shape structure and the presence of fluid in the abdominal cavity were assessed in USI. Radionuclide methods of investigation of the hepatic blood flow, assessment of the shape, size and structure of RP distribution in the liver and spleen, and for calculation of the hepatosplenic index. The most significant signs of differentiation of stages of portal hypertension were the presence and amount of fluid in the abdominal cavity and a hepatic blood flow value reflecting the gravity of portal hypertension. Combined radionuclide and ultrasonic investigations permitted a differentiated approach to staging of portal hypertension and assessment of liver and splenic morphofunctional state that could play an important role in the choice of tactics of surgery of liver cirrhosis.

  3. Beta-blockers in cirrhosis and refractory ascites

    DEFF Research Database (Denmark)

    Kimer, Nina; Feineis, Martin; Møller, Søren

    2015-01-01

    OBJECTIVE: It is currently discussed if beta-blockers exert harmful effects and increase mortality in patients with cirrhosis and refractory ascites. In this study, we provide an overview of the available literature in this field in combination with a retrospective analysis of 61 patients...... trials (9 trials on propranolol, 1 case-control study and 4 retrospective analyses) were identified. One trial suggested an increased mortality in patients treated with beta-blockers and refractory ascites. The results of the remaining trials were inconclusive. No increase in mortality among beta-blocker......-treated patients was found in the present retrospective analysis. CONCLUSIONS: Treatment with beta-blockers may increase mortality in patients with cirrhosis and refractory ascites. However, the current evidence is sparse and high-quality studies are warranted to clarify the matter....

  4. Markers of immunity and bacterial translocation in cirrhosis

    DEFF Research Database (Denmark)

    Mortensen, Christian

    2015-01-01

    to be correlated to portal hypertension, a clinically relevant haemodynamic alteration, and appeared to be associated with increased mortality. To assess the consequences of BT on immunity, we developed an assay for the detection of bacterial DNA (bDNA), a novel marker of BT. Using the assay in the second study......Bacterial translocation (BT), the migration of enteric bacteria to extraintestinal sites, is related to immune stimulation and haemodynamic changes in experimental cirrhosis. These changes may be highly relevant to patients with cirrhosis, where changes in the circulation cause serious......, in 38 patients with ascites, we found no association between bDNA and immunity, in contrast to some previous findings. In the final paper, exploring one possible translocation route, we hypothesized a difference in bDNA levels between the blood from the veins draining the gut on one hand and the liver...

  5. Hyperammonemia: A Report of Maternal Biliary Cirrhosis and Neonatal Outcome

    Directory of Open Access Journals (Sweden)

    Deana J. Hussamy

    2013-01-01

    Full Text Available Although uncommon during pregnancy, cirrhosis results in multiple medical complications impacting both mother and fetus. Previous reports suggest liver dysfunction in pregnancy causes accumulation of neurotoxins within the maternal compartment that increases neonatal morbidity through placental transfer. We present a case of a 36-year-old G2P1 female with history of biliary cirrhosis presenting at 32-weeks' gestation with hepatic congestion progressing to hepatic encephalopathy prompting delivery. Umbilical cord sampling and postnatal infant testing demonstrated elevated ammonia levels which resolved by 12 hours of life without intervention. At discharge, the infant did not demonstrate evidence of neurologic deficit. We conclude that acute maternal hepatic encephalopathy and hyperammonemia due to chronic liver disease do not portend adverse neonatal outcomes, notably encephalopathy.

  6. The pathophysiology of arterial vasodilatation and hyperdynamic circulation in cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Bendtsen, Flemming

    2018-01-01

    transplantation and point to the pathophysiological significance of portal hypertension. In this paper we aimed to review current knowledge on the pathophysiology of arterial vasodilatation and the hyperdynamic circulation in cirrhosis. This article is protected by copyright. All rights reserved.......Patients with cirrhosis and portal hypertension often develop complications from a variety of organ systems leading to a multiple organ failure. The combination of liver failure and portal hypertension result in a hyperdynamic circulatory state partly owing to simultaneous splanchnic and peripheral...... arterial vasodilatation. Increases in circulatory vasodilators are believed to be due to portosystemic shunting and bacterial translocation leading to redistribution of the blood volume with central hypovolemia. Portal hypertension per se and increased splanchnic blood flow are mainly responsible...

  7. Targeting the gut-liver axis in cirrhosis

    DEFF Research Database (Denmark)

    Madsen, Bjørn S; Havelund, Troels; Krag, Aleksander

    2013-01-01

    The gut-liver axis in cirrhosis and portal hypertension is gaining increasing attention as a key pathophysiological mechanism responsible for progression of liver failure and development of complications such as spontaneous infections and hepatocellular carcinoma. Antibiotics and non-selective β......-blockers (NSBB) intercept this axis and each drug has proven efficacy in clinical trials. A synergistic effect is a hitherto unproven possibility. There is an increasing body of evidence supporting improved outcome with expanded use of NSBB and antibiotic therapy beyond current indications. This review addresses...... the issue of pharmacological treatment of cirrhosis and portal hypertension with antibiotics and NSBB. We discuss their mechanism of action and suggest that combining the two treatment modalities could potentially reduce the risk of complications....

  8. Influence of unrecorded alcohol consumption on liver cirrhosis mortality

    OpenAIRE

    Lachenmeier, Dirk W; Monakhova, Yulia B; Rehm, Jürgen

    2014-01-01

    Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unre...

  9. Implications of alcoholic cirrhosis in atherosclerosis of autopsied patients

    OpenAIRE

    Silveira, Luciano Alves Matias da; Torquato, Bianca Gonçalves Silva; Oliveira, Mariana Silva; Juliano, Guilherme Ribeiro; Oliveira, Lívia Ferreira; Cavellani, Camila Lourencini; Ramalho, Luciana Santos; Espindula, Ana Paula; Teixeira, Vicente de Paula Antunes; Ferraz, Mara Lúcia Fonseca

    2017-01-01

    Summary Introduction: Alcoholism is a major public health problem, which has a high social cost and affects many aspects of human activity. Liver disease is one of the first consequences of alcohol abuse, and steatosis, liver cirrhosis and hepatitis may occur. Other organs are also affected with pathological changes, such as pancreatitis, cardiomyopathies, dyslipidemias and atherosclerosis. Objective: To identify the occurrence and degree of atherosclerosis in alcohol-dependent individuals ...

  10. Explaining trends in alcohol-related harms in Scotland 1991-2011 (II): policy, social norms, the alcohol market, clinical changes and a synthesis.

    Science.gov (United States)

    McCartney, G; Bouttell, J; Craig, N; Craig, P; Graham, L; Lakha, F; Lewsey, J; McAdams, R; MacPherson, M; Minton, J; Parkinson, J; Robinson, M; Shipton, D; Taulbut, M; Walsh, D; Beeston, C

    2016-03-01

    To provide a basis for evaluating post-2007 alcohol policy in Scotland, this paper tests the extent to which pre-2007 policy, the alcohol market, culture or clinical changes might explain differences in the magnitude and trends in alcohol-related mortality outcomes in Scotland compared to England & Wales (E&W). Rapid literature reviews, descriptive analysis of routine data and narrative synthesis. We assessed the impact of pre-2007 Scottish policy and policy in the comparison areas in relation to the literature on effective alcohol policy. Rapid literature reviews were conducted to assess cultural changes and the potential role of substitution effects between alcohol and illicit drugs. The availability of alcohol was assessed by examining the trends in the number of alcohol outlets over time. The impact of clinical changes was assessed in consultation with key informants. The impact of all the identified factors were then summarised and synthesised narratively. The companion paper showed that part of the rise and fall in alcohol-related mortality in Scotland, and part of the differing trend to E&W, were predicted by a model linking income trends and alcohol-related mortality. Lagged effects from historical deindustrialisation and socio-economic changes exposures also remain plausible from the available data. This paper shows that policy differences or changes prior to 2007 are unlikely to have been important in explaining the trends. There is some evidence that aspects of alcohol culture in Scotland may be different (more concentrated and home drinking) but it seems unlikely that this has been an important driver of the trends or the differences with E&W other than through interaction with changing incomes and lagged socio-economic effects. Substitution effects with illicit drugs and clinical changes are unlikely to have substantially changed alcohol-related harms: however, the increase in alcohol availability across the UK is likely to partly explain the rise in

  11. Acute kidney injury in liver cirrhosis: new definition and application

    Directory of Open Access Journals (Sweden)

    Florence Wong

    2016-12-01

    Full Text Available The traditional diagnostic criteria of renal dysfunction in cirrhosis are a 50% increase in serum creatinine (SCr with a final value above 1.5 mg/dL. This means that patients with milder degrees of renal dysfunction are not being diagnosed, and therefore not offered timely treatment. The International Ascites Club in 2015 adapted the term acute kidney injury (AKI to represent acute renal dysfunction in cirrhosis, and defined it by an increase in SCr of 0.3 mg/dL (26.4 µmoL/L in <48 hours, or a 50% increase in SCr from a baseline within ≤3 months. The severity of AKI is described by stages, with stage 1 represented by these minimal changes, while stages 2 and 3 AKI by 2-fold and 3-fold increases in SCr respectively. Hepatorenal syndrome (HRS, renamed AKI-HRS, is defined by stage 2 or 3 AKI that fulfils all other diagnostic criteria of HRS. Various studies in the past few years have indicated that these new diagnostic criteria are valid in the prediction of prognosis for patients with cirrhosis and AKI. The future in AKI diagnosis may include further refinements such as inclusion of biomarkers that can identify susceptibility for AKI, differentiating the various prototypes of AKI, or track its progression.

  12. Improving Quality of Care in Patients with Liver Cirrhosis.

    Science.gov (United States)

    Saberifiroozi, Mehdi

    2017-10-01

    Liver cirrhosis is a major chronic disease in the field of digestive diseases. It causes more than one million deaths per year. Despite established evidence based guidelines, the adherence to standard of care or quality indicators are variable. Complete adherence to the recommendations of guidelines is less than 50%. To improve the quality of care in patients with cirrhosis, we need a more holistic view. Because of high rate of death due to cardiovascular disease and neoplasms, the care of comorbid conditions and risk factors such as smoking, hypertension, high blood sugar or cholesterol, would be important in addition to the management of primary liver disease. Despite a holistic multidisciplinary approach for this goal, the management of such patients should be patient centered and individualized. The diagnosis of underlying etiology and its appropriate treatment is the most important step. Definition and customizing the quality indicators for quality measure in patients are needed. Because most suggested quality indicators are designed for measuring the quality of care in decompensated liver cirrhosis, we need special quality indicators for compensated and milder forms of chronic liver disease as well. Training the patients for participation in their own management, design of special clinics with dedicated health professionals in a form of chronic disease model, is suggested for improvement of quality of care in this group of patients. Special day care centers by a dedicated gastroenterologist and a trained nurse may be a practical model for better management of such patients.

  13. Sex hormones in postmenopausal women with primary biliary cirrhosis

    DEFF Research Database (Denmark)

    Becker, U; Almdal, Thomas Peter; Christensen, E

    1991-01-01

    To evaluate serum sex hormone profiles in nonalcoholic postmenopausal women with liver disease, 25 women with primary biliary cirrhosis (11 in cirrhotic stage) and 46 healthy controls were studied. The patients had significantly (p less than 0.05) elevated serum concentrations of estrone and andr......To evaluate serum sex hormone profiles in nonalcoholic postmenopausal women with liver disease, 25 women with primary biliary cirrhosis (11 in cirrhotic stage) and 46 healthy controls were studied. The patients had significantly (p less than 0.05) elevated serum concentrations of estrone...... and androstenedione and significantly (p less than 0.05) lower concentrations of estrone sulfate, dehydroepiandrosterone sulfate and 5 alpha-dihydrotestosterone compared with the 46 controls. Serum concentrations of sex hormone binding globulin, testosterone, non-sex hormone binding globulin-bound testosterone...... and non-protein-bound testosterone did not differ significantly (p greater than 0.05) between primary biliary cirrhosis patients and controls. Patients in the cirrhotic stage had significantly (p less than 0.05) higher concentrations of sex hormone binding globulin than did controls. Patients...

  14. Influence of unrecorded alcohol consumption on liver cirrhosis mortality.

    Science.gov (United States)

    Lachenmeier, Dirk W; Monakhova, Yulia B; Rehm, Jürgen

    2014-06-21

    Unrecorded alcohol includes illegally distributed alcohol as well as homemade or surrogate alcohol which is unintended for consumption by humans (e.g., cosmetics containing alcohol). The highest unrecorded alcohol consumption occurs in Eastern Europe and some of these countries have an over proportional liver cirrhosis mortality. Compounds besides ethanol have been hypothesized as being responsible for this observation. On the other hand, chemical investigations were unable to prove that unrecorded alcohol regularly contains contaminants above toxicological thresholds. However, illegally produced spirits regularly contain higher percentages of alcohol (above 45% by volume), but for considerably less costs compared with licit beverages, potentially causing more problematic patterns of drinking. In this review, it is investigated whether patterns of drinking rather than product composition can explain the liver cirrhosis mortality rates. Statistical examination of World Health Organization country data shows that the originally detected correlation of the percentage of unrecorded alcohol consumption and liver cirrhosis mortality rates disappears when the data is adjusted for the prevalence of heavy episodic drinking. It may be concluded that there is currently a lack of data to demonstrate causality between the composition of illicit spirits (e.g., higher levels of certain contaminants in home-produced products) and liver toxicity on a population scale. Exceptions may be cases of poisoning with antiseptic liquids containing compounds such as polyhexamethyleneguanidine, which were reported to be consumed as surrogate alcohol in Russia, leading to an outbreak of acute cholestatic liver injury, histologically different from conventional alcoholic liver disease.

  15. Intravascular volume in cirrhosis. Reassessment using improved methodology

    International Nuclear Information System (INIS)

    Rector, W.G. Jr.; Ibarra, F.

    1988-01-01

    Previous studies of blood volume (BV) in cirrhosis have either not adjusted BV properly for body size; determined plasma volume from the dilution of labeled albumin 10-20 min postinjection, when some extravascular redistribution has already occurred; and/or not used the correct whole body-peripheral hematocrit ratio (0.82) in calculating whole BV from plasma volume and the peripheral hematocrit. We measured BV with attention to these considerations in 19 patients with cirrhosis and reexamined the determinants of vascular volume and the relationship between vascular volume and sodium retention. BV was calculated as plasma volume (determined from extrapolated plasma activity of intravenously injected [ 131 I]+albumin at time 0) divided by (peripheral hematocrit X 0.82). The result was expressed per kilogram dry body weight, determined by subtracting the mass of ascites (measured by isotope dilution; 1 liter = 1 kg) from the actual body weight of nonedematous patients. Measured and expressed in this way, BV correlated strongly with esophageal variceal size (r = 0.87, P less than 0.05), although not with net portal, right atrial, inferior vena caval, or arterial pressure, and was significantly greater in patients with sodium retention as compared to patients without sodium retention. The principal modifier of vascular volume in cirrhosis is vascular capacity, which is probably mainly determined by the extent of the portasystemic collateral circulation. Increased vascular volume in patients with sodium retention as compared to patients without sodium retention supports the overflow theory of ascites formation

  16. Serum level of IL-6 in liver cirrhosis patients

    Science.gov (United States)

    Rey, I.; Effendi-YS, R.; Dairi, L. B.; Siregar, G. A.; Zain, L. H.

    2018-03-01

    Cytokines are polypeptides that have a wide spectrum of inflammatory, metabolic, hematopoietic and immunologic regulatory properties. The liver represents an important site of synthesis and clearance organ for several cytokines. This study aimed to evaluate serum IL-6 in liver cirrhosis with the type of underlying disease, child pugh group and various clinical and laboratory parameter. This cross-sectional study was at Adam Malik General Hospital and Pirngadi General Hospital from July - December 2016. We examine 75 patients with liver cirrhosis. The exclusion criteria were hepatoma, sepsis and renal impairment. There were 28 (37.3%), 8 (10.6%) and 39 (52%) for HBV-positive; HCV-positive and HBV- HCV negative liver cirrhosis patients, respectively were 14 (18.7 %), 15 (20 %) and 46 (61.3%) for Child- Pugh A, B and C respectively. There was no significant difference value of IL-6 between HBV positive, HCV positive, and HBV-HCV negative group (7.7/6.1/10.9). There was no significant difference value of IL-6 between child pugh A, B, and C group (4.2/11.0/7.9).

  17. Nutritional evaluation in cirrhosis: Emphasis on the phase angle.

    Science.gov (United States)

    Fernandes, Sabrina Alves; de Mattos, Angelo Alves; Tovo, Cristiane Valle; Marroni, Claudio Augusto

    2016-10-18

    Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients' overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.

  18. Pharmacology and safety of glycerol phenylbutyrate in healthy adults and adults with cirrhosis.

    Science.gov (United States)

    McGuire, Brendan M; Zupanets, Igor A; Lowe, Mark E; Xiao, Xunjun; Syplyviy, Vasyliy A; Monteleone, Jon; Gargosky, Sharron; Dickinson, Klara; Martinez, Antonia; Mokhtarani, Masoud; Scharschmidt, Bruce F

    2010-06-01

    Phenylbutyric acid (PBA), which is approved for treatment of urea cycle disorders (UCDs) as sodium phenylbutyrate (NaPBA), mediates waste nitrogen excretion via combination of PBA-derived phenylacetic acid with glutamine to form phenylactylglutamine (PAGN) that is excreted in urine. Glycerol phenylbutyrate (GPB), a liquid triglyceride pro-drug of PBA, containing no sodium and having favorable palatability, is being studied for treatment of hepatic encephalopathy (HE). In vitro and clinical studies have been performed to assess GPB digestion, safety, and pharmacology in healthy adults and individuals with cirrhosis. GPB hydrolysis was measured in vitro by way of pH titration. Twenty-four healthy adults underwent single-dose administration of GPB and NaPBA and eight healthy adults and 24 cirrhotic subjects underwent single-day and multiple-day dosing of GPB, with metabolites measured in blood and urine. Simulations were performed to assess GPB dosing at higher levels. GPB was hydrolyzed by human pancreatic triglyceride lipase, pancreatic lipase-related protein 2, and carboxyl-ester lipase. Clinical safety was satisfactory. Compared with NaPBA, peak metabolite blood levels with GPB occurred later and were lower; urinary PAGN excretion was similar but took longer. Steady state was achieved within 4 days for both NaPBA and GPB; intact GPB was not detected in blood or urine. Cirrhotic subjects converted GPB to PAGN similarly to healthy adults. Simulations suggest that GPB can be administered safely to cirrhotic subjects at levels equivalent to the highest approved NaPBA dose for UCDs. GPB exhibits delayed release characteristics, presumably reflecting gradual PBA release by pancreatic lipases, and is well tolerated in adults with cirrhosis, suggesting that further clinical testing for HE is warranted.

  19. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis

    DEFF Research Database (Denmark)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik

    2016-01-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare......,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk...... of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients....

  20. Severe abnormal Heart Rate Turbulence Onset is associated with deterioration of liver cirrhosis

    DEFF Research Database (Denmark)

    Jansen, Christian; Al-Kassou, Baravan; Lehmann, Jennifer

    2018-01-01

    BACKGROUND: In patients with liver cirrhosis, cardiac dysfunction is frequent and is associated with increased morbidity and mortality. Cardiac dysfunction in cirrhosis seems to be linked to autonomic dysfunction. This study investigates the role of autonomic dysfunction assessed by Heart Rate...... Turbulence (HRT) analyses in patients with liver cirrhosis. METHODS AND PATIENTS: Inclusion criteria was (1) diagnosis of cirrhosis by clinical, imaging or biopsy and (2) evaluation by standard 12-lead-ECG and 24h holter monitoring and (3) at least 3 premature ventricular contractions. The exclusion...... criterion was presence of cardiac diseases, independent of liver cirrhosis. Biochemical parameters were analysed using standard methods. HRT was assessed using Turbulence onset (TO) and slope (TS). The endpoint was deterioration of liver cirrhosis defined as increased MELD and readmission for complications...

  1. Computer tomographic findings in portal hypertension due to cirrhosis of the liver. Pt. 3

    International Nuclear Information System (INIS)

    Koester, O.; Fischer, P.; Lindecken, K.D.; Lackner, K.; Bonn Univ.

    1984-01-01

    Contract injection for angio-CT shows kinetic changes in patients with portal hypertension due to cirrhosis of the liver when compared with normals. Contrast-duration diagrams show a higher aortic peak, low contrast and delayed contrast maximum in the liver and protal vein in patients with liver cirrhosis and portal hypertension. On these criteria it is possible to distinguish patients with cirrhosis (n = 18) from normals (n = 16). (orig.) [de

  2. Computer tomographic findings in portal hypertension due to cirrhosis of the liver. Pt. 3

    Energy Technology Data Exchange (ETDEWEB)

    Koester, O; Fischer, P; Lindecken, K D; Lackner, K

    1984-03-01

    Contract injection for angio-CT shows kinetic changes in patients with portal hypertension due to cirrhosis of the liver when compared with normals. Contrast-duration diagrams show a higher aortic peak, low contrast and delayed contrast maximum in the liver and protal vein in patients with liver cirrhosis and portal hypertension. On these criteria it is possible to distinguish patients with cirrhosis (n = 18) from normals (n = 16). 5 figs.

  3. The Risk of Fractures Among Patients With Cirrhosis or Chronic Pancreatitis

    DEFF Research Database (Denmark)

    Bang, Ulrich Christian; Benfield, Thomas; Bendtsen, Flemming

    2014-01-01

    BACKGROUND & AIMS: Cirrhosis and chronic pancreatitis (CP) are accompanied by inflammation and malnutrition. Both conditions can have negative effects on bone metabolism and promote fractures. We evaluated the risk of fractures among patients with CP or cirrhosis and determined the effect of fat...... individuals younger than 50 years old. Alcohol as an etiology was associated with an increased risk of fracture compared with patients with nonalcoholic cirrhosis (HR, 2.4 vs 1.5; P

  4. Social Drinking on Social Media: Content Analysis of the Social Aspects of Alcohol-Related Posts on Facebook and Instagram.

    Science.gov (United States)

    Hendriks, Hanneke; Van den Putte, Bas; Gebhardt, Winifred A; Moreno, Megan A

    2018-06-22

    Alcohol is often consumed in social contexts. An emerging social context in which alcohol is becoming increasingly apparent is social media. More and more young people display alcohol-related posts on social networking sites such as Facebook and Instagram. Considering the importance of the social aspects of alcohol consumption and social media use, this study investigated the social content of alcohol posts (ie, the evaluative social context and presence of people) and social processes (ie, the posting of and reactions to posts) involved with alcohol posts on social networking sites. Participants (N=192; mean age 20.64, SD 4.68 years, 132 women and 54 men) gave researchers access to their Facebook and/or Instagram profiles, and an extensive content analysis of these profiles was conducted. Coders were trained and then coded all screenshotted timelines in terms of evaluative social context, presence of people, and reactions to post. Alcohol posts of youth frequently depict alcohol in a positive social context (425/438, 97.0%) and display people holding drinks (277/412, 67.2%). In addition, alcohol posts were more often placed on participants' timelines by others (tagging; 238/439, 54.2%) than posted by participants themselves (201/439, 45.8%). Furthermore, it was revealed that such social posts received more likes (mean 35.50, SD 26.39) and comments than nonsocial posts (no people visible; mean 10.34, SD 13.19, P<.001). In terms of content and processes, alcohol posts on social media are social in nature and a part of young people's everyday social lives. Interventions aiming to decrease alcohol posts should therefore focus on the broad social context of individuals in which posting about alcohol takes place. Potential intervention strategies could involve making young people aware that when they post about social gatherings in which alcohol is visible and tag others, it may have unintended negative consequences and should be avoided. ©Hanneke Hendriks, Bas Van den

  5. University Students’ Willingness to Assist Fellow Students Who Experience Alcohol-Related Facial Flushing to Reduce Their Drinking

    Directory of Open Access Journals (Sweden)

    Lanyan Ding

    2018-04-01

    Full Text Available This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH, that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile

  6. Receptivity to and Recall of Alcohol Brand Appearances in U.S. Popular Music and Alcohol-Related Behaviors

    Science.gov (United States)

    Primack, Brian A.; McClure, Auden; Li, Zhigang; Sargent, James D.

    2014-01-01

    Background The average U.S. adolescent is exposed to about 2.5 hours of popular music per day and 8 mentions of alcohol brands every day. Alcohol brand mentions may function as advertising whether or not they are sanctioned by the alcohol industry. Our study aimed to determine associations between adolescents' involvement with music containing alcohol brand mentions and alcohol-related behaviors. Methods In 2010–2011 we conducted a random-digit-dial survey using national U.S. land line and cell phone frames. Through screening interviews, we identified 6,466 eligible households with subjects between 15 to 23 years of age, of whom 3422 (52%) completed the telephone survey. Of these, 2541 opted to participate in a subsequent Web-based component. Independent variables included a composite score indicating owning and liking popular songs with alcohol brand mentions and correct recall of alcohol brands in songs. Outcome measures included ever having consumed a complete drink, ever bingeing, bingeing at least monthly, and having experienced problems from alcohol use. Results Among the 2541 participants, compared with those in the lowest tertile on the receptivity scale, those in the highest tertile had higher odds of having had a complete drink (OR=3.4; 95% CI=2.2, 5.2) after adjusting for age, sex, race/ethnicity, socioeconomic status, sensation seeking, friend alcohol use, and parent alcohol use. Compared with those who did not identify at least one alcohol brand correctly, those who did had over twice the odds of having had a complete drink (OR=2.1; 95% CI=1.2, 3.8) after adjusting for all covariates. Results were also significant for the outcome of ever bingeing but not for bingeing at least monthly or having had problems due to drinking. Conclusions In a national sample of U.S. adolescents and young adults, there were independent associations between involvement with popular music containing alcohol brand mentions and both having ever had a complete drink and

  7. Receptivity to and recall of alcohol brand appearances in U.S. popular music and alcohol-related behaviors.

    Science.gov (United States)

    Primack, Brian A; McClure, Auden C; Li, Zhigang; Sargent, James D

    2014-06-01

    The average U.S. adolescent is exposed to about 2.5 hours of popular music and 8 mentions of alcohol brands every day. Alcohol brand mentions may function as advertising whether or not they are sanctioned by the alcohol industry. Our study aimed to determine associations between adolescents' involvement with music containing alcohol brand mentions and alcohol-related behaviors. In 2010 to 2011, we conducted a random-digit-dial survey using national U.S. land line and cell phone frames. Through screening interviews, we identified 6,466 eligible households with subjects between 15 and 23 years of age, of whom 3,422 (53%) completed the telephone survey. Of these, 2,541 opted to participate in a subsequent web-based component. Independent variables included a composite score indicating owning and liking popular songs with alcohol brand mentions and correct recall of alcohol brands in songs. Outcome measures included ever having consumed a complete drink, ever bingeing, bingeing at least monthly, and having experienced problems from alcohol use. Among the 2,541 participants, compared with those in the lowest tertile on the receptivity scale, those in the highest tertile had higher odds of having had a complete drink (OR = 3.4; 95% CI = 2.2, 5.2) after adjusting for age, sex, race/ethnicity, socioeconomic status, sensation seeking, friend alcohol use, and parent alcohol use. Compared with those who did not identify at least 1 alcohol brand correctly, those who did had over twice the odds of having had a complete drink (OR = 2.1; 95% CI = 1.2, 3.8) after adjusting for all covariates. Results were also significant for the outcome of ever bingeing, but not for bingeing at least monthly or having had problems due to drinking. In a national sample of U.S. adolescents and young adults, there were independent associations between involvement with popular music containing alcohol brand mentions and both having ever had a complete drink and having ever binged on alcohol

  8. Social class, social mobility and alcohol-related disorders in Swedish men and women: A study of four generations.

    Science.gov (United States)

    Sidorchuk, Anna; Goodman, Anna; Koupil, Ilona

    2018-01-01

    To investigate whether and how social class and social mobility in grandparents and parents predict alcohol-related disorders (ARDs) in males and females aged 12+ years, and whether intergenerational social prediction of ARDs varies across time periods. The study sample included four successive generations (G) of Swedish families from the Uppsala Birth Cohort Multigenerational Study: G0 born 1851-1912; G1 born 1915-1929; G2 born 1940-1964 and G3 born 1965-1989. Two study populations were created, each consisting of grandparents, parents and offspring: population I 'G0-G1-G2' (offspring n = 18 430) and population II 'G1-G2-G3' (offspring n = 26 469). Registers and archives provided data on ancestors' socio-demographic factors and ARD history, together with offspring ARD development between 1964-2008. Cox regression models examined the hazard of offspring ARD development according to grandparental social class and grandparental-to-parental social trajectories, controlling for offspring birth year, grandmother's and mother's marital status and parental ARDs. Disadvantaged grandparental social class predicted increased ARD risk in offspring in population I, although the effect attenuated and became non-significant in males after adjusting for parental characteristics (adjusted hazard ratio (HR) = 1.80 (95%CI; 1.07, 3.03) in females, HR = 1.32 (95%CI; 0.93, 1.89) in males). In population II, no increase in ARD risk by grandparental social was evident. In both populations, males were at the highest ARD risk if both parents and grandparents belonged to disadvantaged social class (population I: HR = 1.82 (95%CI; 1.22-2.72); population II: HR = 1.68 (95%CI; 1.02-2.76)). Intergenerational social patterning of ARDs appears to be time-contextual and gender-specific. The role of grandparental social class in developing ARDs in grandchildren seems to decline over time, while persistent grandparental-to-parental social disadvantage remains associated with higher ARD risk in males

  9. University Students' Willingness to Assist Fellow Students Who Experience Alcohol-Related Facial Flushing to Reduce Their Drinking.

    Science.gov (United States)

    Ding, Lanyan; Yuen, Lok-Wa; Newman, Ian M; Shell, Duane F

    2018-04-25

    This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational

  10. Process evaluation of an environmental health risk audit and action plan intervention to reduce alcohol related violence in licensed premises

    Directory of Open Access Journals (Sweden)

    Annie Williams

    2016-05-01

    Full Text Available Abstract Background Alcohol-related violence is associated with licensed premise environments and their management. There is a lack of evidence for effective interventions to address these, and there are significant barriers to implementation. This study aims to understand how development and implementation processes can facilitate intervention reach, fidelity and receipt and therefore provides key process data necessary to interpret the results of the randomised controlled trial conducted in parallel. Methods A process evaluation, embedded within a randomised controlled trial. Intervention development and implementation were assessed via focus groups (n = 2 and semi-structured interviews (n = 22 with Environmental Health Practitioners (EHPs. Reach and fidelity were assessed via routinely collected intervention data, which was was collected from 276 licenced premises across Wales, UK. Case study semi-structured interviews with licensed premises proprietors (n = 30 explored intervention receipt. Results Intervention co-production with senior EHPs facilitated organisational adoption and implementation. Training events for EHPs played an important role in addressing wider organisational concerns regarding partnership working and the contextual integration of the intervention. EHPs delivered the intervention to 98 % of intervention premises; 35 % of premises should have received a follow up enforcement visit, however EHP confidence in dealing with alcohol risk factors meant only 7 % of premises received one. Premises therefore received a similar intervention dose regardless of baseline risk. Intervention receipt appeared to be greatest in premises with an existing commitment to prevention and those in urban environments. Conclusions The study suggests that a collaborative approach to the development and diffusion of interventions is associated with high levels of organisational adoption, implementation and reach. However, the lack

  11. Visual search for feature conjunctions: an fMRI study comparing alcohol-related neurodevelopmental disorder (ARND) to ADHD.

    Science.gov (United States)

    O'Conaill, Carrie R; Malisza, Krisztina L; Buss, Joan L; Bolster, R Bruce; Clancy, Christine; de Gervai, Patricia Dreessen; Chudley, Albert E; Longstaffe, Sally

    2015-01-01

    Alcohol-related neurodevelopmental disorder (ARND) falls under the umbrella of fetal alcohol spectrum disorder (FASD). Diagnosis of ARND is difficult because individuals do not demonstrate the characteristic facial features associated with fetal alcohol syndrome (FAS). While attentional problems in ARND are similar to those found in attention-deficit/hyperactivity disorder (ADHD), the underlying impairment in attention pathways may be different. Functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) was conducted at 3 T. Sixty-three children aged 10 to 14 years diagnosed with ARND, ADHD, and typically developing (TD) controls performed a single-feature and a feature-conjunction visual search task. Dorsal and ventral attention pathways were activated during both attention tasks in all groups. Significantly greater activation was observed in ARND subjects during a single-feature search as compared to TD and ADHD groups, suggesting ARND subjects require greater neural recruitment to perform this simple task. ARND subjects appear unable to effectively use the very efficient automatic perceptual 'pop-out' mechanism employed by TD and ADHD groups during presentation of the disjunction array. By comparison, activation was lower in ARND compared to TD and ADHD subjects during the more difficult conjunction search task as compared to the single-feature search. Analysis of DTI data using tract-based spatial statistics (TBSS) showed areas of significantly lower fractional anisotropy (FA) and higher mean diffusivity (MD) in the right inferior longitudinal fasciculus (ILF) in ARND compared to TD subjects. Damage to the white matter of the ILF may compromise the ventral attention pathway and may require subjects to use the dorsal attention pathway, which is associated with effortful top-down processing, for tasks that should be automatic. Decreased functional activity in the right temporoparietal junction (TPJ) of ARND subjects may be due to a

  12. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: A registry study of Swedish mothers and fathers

    Directory of Open Access Journals (Sweden)

    Backhans Mona

    2008-09-01

    Full Text Available Abstract Background In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. Methods The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120. A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978–1979 and full-time work for mothers (1980. The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981–2001. Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. Results The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. Conclusion A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

  13. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: A registry study of Swedish mothers and fathers

    Science.gov (United States)

    Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

    2008-01-01

    Background In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. Methods The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978–1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981–2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. Results The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. Conclusion A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood. PMID:18793385

  14. “Man-ing” up and Getting Drunk: The Role of Masculine Norms, Alcohol Intoxication and Alcohol-Related Problems among College Men

    OpenAIRE

    Iwamoto, Derek Kenji; Cheng, Alice; Lee, Christina S.; Takamatsu, Stephanie; Gordon, Derrick

    2011-01-01

    Compared to college women, college men face elevated risks for problematic drinking and negative alcohol-related consequences. These risks highlight the critical need to investigate gender issues and risk factors contributing to intoxication and related problems among men. Theoretical models suggest that conforming to masculine norms or the beliefs and expectations of what it means to be a man, may help explain patterns of problematic drinking among men. The current study advances the literat...

  15. The relationship between a less gender-stereotypical parenthood and alcohol-related care and death: a registry study of Swedish mothers and fathers.

    Science.gov (United States)

    Månsdotter, Anna; Backhans, Mona; Hallqvist, Johan

    2008-09-15

    In general men tend to drink more alcohol and experience more alcohol-related sickness, injuries and mortality than women. In this paper, the overall hypothesis was that increased gender similarity in the division of parental duties would lead to convergence in alcohol-related harm. The aim was to analyse whether the risk of alcohol harm differs between parents who fit a gender-stereotypical versus those with a less gender-stereotypical division of childcare and paid work. The study sample was a retrospective registry-based cohort study of all Swedish couples who had their first child together in 1978 (N = 49,120). A less gender-stereotypical parenthood was indicated by paternity leave for fathers (1978-1979) and full-time work for mothers (1980). The outcome was inpatient care and/or death caused by alcohol psychosis, alcoholism, liver disease, or alcohol intoxication in the two decades following (1981-2001). Our main statistical method was multivariate logistic regression with odds ratios used to estimate relative risks. The main results show that fathers who took paternity leave had 18% lower risk of alcohol-related care and/or death than other fathers. Mothers who worked full-time about two years after having a child had 71% higher risk than mothers who were unemployed or worked part-time. A less gender-stereotypical division of duties between parents in early parenthood may contribute to a long-term decreased gender disparity regarding risky alcohol consumption and alcohol-related harm. In order to know more about the causal direction however, future research has to consider subjects' drinking patterns in the years prior to parenthood.

  16. Unrecorded Alcohol and Alcohol-Related Harm in Rural Sabah, Malaysia: A Socio-economically Deprived Region with Expensive Beer and Cheap Local Spirits.

    Science.gov (United States)

    Shoesmith, Wendy Diana; Oo Tha, Naing; Naing, Khin Saw; Abbas, Roslee Bin Haji; Abdullah, Ahmad Faris

    2016-11-01

    To investigate recorded and unrecorded alcohol and the relation to alcohol-related harm in a region with high taxation, economic deprivation and cultural use of alcohol. Two participants per household were systematically sampled from 12 different villages chosen using stratified random sampling in the North of Sabah, Malaysia. Participants were asked about each type and amount of drink consumed; price paid, whether tax was paid, number of days sick in the last year and whether they had experienced various health problems. A brief screen for mental disorders (PHQ) and an alcohol disorder screening test (AUDIT) were completed. Village heads were also interviewed about alcohol-related problems at village level. 470 people were interviewed. The most commonly drunk beverages were beer and Montoku (a local distilled beverage), which had average prices of RM3.85 and RM0.48 per standard drink respectively. Montoku was more likely to be drunk by problem drinkers. Only 3.1% of alcohol drunk was believed by respondents to be taxed. Men with an AUDIT score of more than 15 were more likely to have had a sick day in the last year and have a female household member with symptoms of mental disorder on PHQ. Change in the taxation structure needs to be considered to reduce alcohol-related harm. Most alcohol consumed in rural Sabah is smuggled or informal. The low price of local spirits is likely to be contributing to alcohol-related harm. Differential effects on minority populations need to be considered when designing alcohol policy. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  17. Distinct Classes of Negative Alcohol-Related Consequences in a National Sample of Incoming First-Year College Students: A Latent Class Analysis.

    Science.gov (United States)

    Rinker, Dipali Venkataraman; Diamond, Pamela M; Walters, Scott T; Wyatt, Todd M; DeJong, William

    2016-09-01

    : First-year college students are at particular risk for experiencing negative alcohol-related consequences that may set the stage for experiencing such consequences in later life. Latent class analysis is a person-centered approach that, based on observable indicator variables, divides a population into mutually exclusive and exhaustive groups ('classes'). To date, no studies have examined the latent class structure of negative alcohol-related consequences experienced by first-year college students just before entering college. The aims of this study were to (a) identify classes of first-year college students based on the patterns of negative alcohol-related consequences they experienced just before entering college, and (b) determine whether specific covariates were associated with class membership. Incoming freshmen from 148 colleges and universities (N = 54,435) completed a baseline questionnaire as part of an alcohol education program they completed just prior to their first year of college. Participants answered questions regarding demographics and other personal characteristics, their alcohol use in the past 2 weeks, and the negative alcohol-related consequences they had experienced during that time. Four distinct classes of students emerged: (a) No Problems, (b) Academic Problems, (c) Injured Self and (d) Severe Problems. Average number of drinks per drinking day, total number of drinking days, age of drinking initiation, intention to join a fraternity or sorority and family history of alcohol problems were associated with membership in all of the problem classes relative to the No Problems class. These results can inform future campus-based prevention efforts. © The Author 2016. Medical Council on Alcohol and Oxford University Press. All rights reserved.

  18. Cirrhosis is a risk factor for total hip arthroplasty for avascular necrosis.

    Science.gov (United States)

    Deleuran, Thomas; Overgaard, Søren; Vilstrup, Hendrik; Jepsen, Peter

    2016-06-01

    Background and purpose - There are limited data on risk factors for avascular necrosis of the hip, but cirrhosis has been proposed as a risk factor. We examined the association between cirrhosis and incidence of total hip arthroplasty for avascular necrosis. Methods - We used nationwide healthcare data to identify all Danish residents diagnosed with cirrhosis in 1994-2011, and matched them 1:5 by age and sex to non-cirrhotic reference individuals from the general population. We excluded people with a previous total hip arthroplasty, a previous hip fracture, or a previous diagnosis of avascular necrosis. We used stratified Cox regression to estimate the hazard ratio (HR) for cirrhosis patients relative to reference individuals, adjusting for potential confounders. We used the cumulative incidence function to compute 5-year risks. Results - We included 25,421 cirrhosis patients and 114,052 reference individuals. Their median age was 57 years, and 65% were men. 45 cirrhosis patients and 44 reference individuals underwent total hip arthroplasty for avascular necrosis. Cirrhosis patients' HR for a total hip arthroplasty for avascular necrosis was 10 (95% CI: 6-17), yet their 5-year risk of avascular necrosis was only 0.2%. For the reference individuals, the 5-year risk was 0.02%. Interpretation - Cirrhosis is a strong risk factor for avascular necrosis of the hip, but it is rare even in cirrhosis patients.

  19. Importance of alcohol-related expectations and emotional expressivity for prediction of motivation to refuse alcohol in alcohol-dependent patients.

    Science.gov (United States)

    Slavinskienė, Justina; Žardeckaitė-Matulaitienė, Kristina

    2014-01-01

    The aim of this study was to evaluate the importance of alcohol-dependent patients' emotional expressivity, alcohol-related expectations and socio-demographic factors for prediction of motivation to refuse alcohol consumption. The study sample consisted of 136 alcohol-dependent patients (100 men and 36 women) undergoing treatment in Kaunas center for addictive disorders. Only higher expression of negative alcohol-related expectations (std. beta=0.192, P=0.023), higher emotional impulse intensity (std. beta=0.229, P=0.021) and higher expression of positive emotional expressiveness (std. beta=0.021, P=0.020) as well as gender (std. beta=0.180, P=0.049), education (std. beta=-0.137, P=0.038) and alcohol dependency treatment conditions (members of support group after rehabilitation program) (std. beta=0.288, P=0.001; std. beta=0.608, P=0.001) were significant factors for predicting the different level of alcohol-dependent patients motivation to refuse alcohol consumption. Negative alcohol-related expectations, emotional impulse intensity and positive emotional expressiveness were significant even though quite weak triggers for alcohol-dependent patients' different level of motivation to refuse alcohol consumption. An assumption could be made that by changing these triggers it is possible to change addictive behavior. Copyright © 2014 Lithuanian University of Health Sciences. Production and hosting by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  20. Positive Drinking Consequences Are Associated With Alcohol Use and Alcohol-Related Problems Among Veterans Seeking Treatment for Alcohol Use Disorder.

    Science.gov (United States)

    Morean, Meghan E; Cooney, Judith L

    2015-01-01

    Military service is associated with increased rates of heavy drinking. Widely used clinical practices (e.g., motivational interviewing) indicate that addressing both negative and positive drinking consequences is essential to effective treatment. However, research on effectively assessing positive drinking consequences in a clinical population is absent. The current study (1) evaluated the utility of the Positive Drinking Consequences Questionnaire (PDCQ), a measure previously validated in an undergraduate sample, for use with treatment-seeking veterans, and (2) evaluated relationships between positive drinking consequences and alcohol expectancies, pre-treatment alcohol use, and alcohol-related problems. Ninety-seven veterans seeking treatment for alcohol problems completed an anonymous survey (97.9% male; mean age = 49.76[11.40], 67.0% Caucasian). The PDCQ evidenced a single factor latent structure and internal consistency (Cronbach's alpha = .90). Positive drinking consequences and expectancies were related yet distinct constructs. After controlling for demographic factors, experiencing more positive drinking consequences at program intake was associated with heavier pretreatment drinking (ηp(2) = .10, p = .003) and alcohol-related problems (ηp(2) = .18, p alcohol use (ηp(2) = .12, p = .002) and alcohol-related problems (ηp(2) = .11, p = .003) when expectancies also were included in the model. Positive drinking consequences are assessed reliably by the PDCQ in a clinical sample and appear to play an important role in the drinking behavior of veterans seeking alcohol treatment.

  1. Cirrhosis is Under-recognized in Patients Subsequently Diagnosed with Hepatocellular Cancer

    Science.gov (United States)

    Walker, Megan; El-Serag, Hashem B.; Sada, Yvonne; Mittal, Sahil; Ying, Jun; Duan, Zhigang; Richardson, Peter; Davila, Jessica A.; Kanwal, Fasiha

    2015-01-01

    Background Most clinical practice guidelines recommend screening for HCC in patients with cirrhosis. However, patients with compensated cirrhosis are often asymptomatic and may remain unrecognized for years. Aims To determine the extent to which cirrhosis is unrecognized in a US Veteran population with HCC and to evaluate the association between lack of cirrhosis recognition and stage of HCC at diagnosis. Methods We reviewed the electronic medical records of a random sample of HCC cases diagnosed in the national Veterans Affairs system between 2005 and 2011. We conducted multivariable analyses adjusting for patients’ demographics, comorbidity, etiology of underlying disease, and healthcare utilization including HCC surveillance. Results Of 1201 patients with HCC and cirrhosis, 24.6% had unrecognized cirrhosis prior to HCC diagnosis. Older patients (>65yr, odds ratio [OR] 2.32), African Americans (OR 1.93), patients with alcoholic or NAFLD liver disease (OR 1.69 and 4.77 respectively), HIV (OR 3.02), and fewer comorbidities (Deyo 0 vs. 3, OR 2.42) had significantly higher odds of having unrecognized cirrhosis than comparison groups. Furthermore, patients with unrecognized cirrhosis were 6.5 times more likely to have advanced stage HCC at diagnosis. The effect of cirrhosis recognition on HCC stage remained significant after adjusting for pre-specified covariates (OR 3.37). Conclusions In one fourth of patients, cirrhosis was unrecognized prior to HCC diagnosis, and this group was significantly more likely to have advanced stage HCC. These findings emphasize the importance of timely evaluation for cirrhosis in at-risk populations as a critical step to improving outcomes for HCC patients. PMID:26784271

  2. The Influence of Alcohol-Related Cognitions on Personality-Based Risk for Alcohol Use during Adolescence

    Science.gov (United States)

    Bekman, Nicole M.; Cummins, Kevin; Brown, Sandra A.

    2011-01-01

    This study examines whether expectancies about the impact of not drinking or reducing alcohol use and perceptions of peer alcohol use partially mediated risk incurred by sensation seeking for adolescent alcohol involvement. High school drinkers (N = 3,153) completed a survey assessing substance use, sensation seeking, perceived peer alcohol use,…

  3. Protein energy malnutrition predicts complications in liver cirrhosis.

    Science.gov (United States)

    Huisman, Ellen J; Trip, Evelien J; Siersema, Peter D; van Hoek, Bart; van Erpecum, Karel J

    2011-11-01

    Protein energy malnutrition frequently occurs in liver cirrhosis. Hand-grip strength according to Jamar is most reliable to predict protein energy malnutrition. We aimed to determine whether protein energy malnutrition affects complication risk. In 84 cirrhotics, baseline nutritional state was determined and subsequent complications prospectively assessed. Influence of potentially relevant factors including malnutrition (by Jamar hand-grip strength) on complication rates were evaluated with univariate analysis. Effect of malnutrition was subsequently evaluated by multivariate logistic regression with adjustment for possible confounders. Underlying causes of cirrhosis were viral hepatitis in 31%, alcohol in 26%, and other in 43%. Baseline Child-Pugh (CP) class was A, B, or C in 58, 35, and 7%, respectively. Energy and protein intake decreased significantly with increasing CP class, with shift from proteins to carbohydrates. At baseline, according to Jamar hand-grip strength, malnutrition occurred in 67% (n=56). Malnutrition was associated with older age and higher CP class (CP class A 57%, B 79%, C 100%) but not with underlying disease or comorbidity. Complications occurred in 18 and 48% in well-nourished and malnourished patients, respectively, (P=0.007) during 13 ± 6 months follow-up. In multivariate analysis, malnutrition was an independent predictor of complications, after correcting for comorbidity, age, and CP score (adjusted odds ratio 4.230; 95% confidence interval 1.090-16.422; P=0.037). In univariate analysis, mortality (4 vs. 18%; P=0.1) tended to be worse in malnourished patients, but this trend was lost in multivariate analysis. Malnutrition is an independent predictor of complications in cirrhosis.

  4. Tobacco and alcohol-related interventions for people with mild/moderate intellectual disabilities: a systematic review of the literature.

    Science.gov (United States)

    Kerr, S; Lawrence, M; Darbyshire, C; Middleton, A R; Fitzsimmons, L

    2013-05-01

    spanned a period of three weeks to one academic year. The studies highlighted a number of important issues linked to the appropriateness of interventions for this client group (e.g., use of pictures, quizzes, role play, incentives); however, in the majority of cases the interventions appeared to lack a theoretical framework (e.g., behaviour change theory). The appropriateness of the outcome measures for use with this client group was not tested. One study discussed feasibility (teachers delivering lessons on alcohol and tobacco) and only one was informative in terms of effectiveness, i.e., increasing knowledge of the health and social dangers of smoking and excessive alcohol consumption. This review is the first to systematically collate evidence on tobacco and alcohol-related interventions for people with ID. While there is currently little evidence to guide practice, the review delivers clear insights for the development of interventions and presents a strong case for more robust research methods. In particular there is a need to test the effectiveness of interventions in large-scale, well-designed trials and to ensure that outcome measures are developed/tailored appropriately for this client group. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

  5. Alcohol-related road traffic accidents before and after the passing of the Road Traffic Safety Act in Croatia.

    Science.gov (United States)

    Missoni, Eduard; Bozić, Boris; Missoni, Ivan

    2012-12-01

    The aim of this study was to gather enough data in order to formulate theory- and research-based recommendations to policy makers with the intention of decreasing the number of alcohol-related accidents and victims on Croatian roads. The data on the injured traffic participants and the share of participants under the influence of alcohol were collected from the police reports of the Traffic Police Department, Ministry of the Interior, written at the scene of the respective accidents. This documentation was then processed by descriptive epidemiology and analysed through a four-year period, before and after the passing of the New Road Traffic Safety Act in the Republic of Croatia, on 20 August 2004. In the first six months of 2005, after the passing of the Act, there were 3,275 accidents caused by the motorists under the influence of alcohol (12.5% of all the accidents), with 64 persons killed. Only 5 fatalities (8%) were caused by the drivers with measured blood alcohol concentration of up to 0.5 per thousand. As much as 27 fatalities (42%) were caused by the drivers with measured more than 1.5 per thousand, while half of the fatalities, 32 (50%), were caused by drivers with 0.5-1.5 per thousand. In this period, more than 451,000 violations were recorded, whereas in the same period of the previous year, the number of violations was about 519,000. A reduction of the total number of accidents is the result of the new regulation provision, according to which the incidents without human victims do not have to be reported to the police. The number of traffic accidents caused by drivers under the influence of alcohol had increased by some dozen per cents, namely: 2005 - 6,219 persons, 2006- 6,590 persons, noting that in 2006 one less person was killed (123) compared to 2005. In 2005, drivers with alcohol concentration of 0-0.5 per thousand caused 1,096 accidents, with 14 fatalities, whereas in 2006 there were 1,164 accidents with 9 fatalities. A total of 2,314 accidents

  6. Prognosis in patients with cirrhosis and mild portal hypertension

    DEFF Research Database (Denmark)

    Ytting, Henriette; Møller, Søren; Henriksen, Jens Henrik

    2006-01-01

    HVPG has been sparse. In this study, long-term survival and the risk of complications in mild portal hypertension were analysed. MATERIAL AND METHODS: Sixty-one patients with cirrhosis and HVPG below 10 mmHg were included in the study. Data were collected from medical files and National Patient...... with that in the background population. CONCLUSIONS: The frequency of complications in patients with mild portal hypertension is considerable, and guidelines for follow-up or medical prophylaxis are warranted. The risk of bleeding from oesophageal varices is low and bleeding-related deaths rare....

  7. Is ursodeoxycholic acid effective in primary biliary cirrhosis?

    Directory of Open Access Journals (Sweden)

    Gabriel Rada

    2014-09-01

    Full Text Available Ursodeoxycholic acid is considered as first line treatment in patients with primary biliary cirrhosis. Its mechanism of action in this disease is unknown and there is controversy about its clinical impact. Searching in Epistemonikos database, which is maintained by screening 19 databases, we identified four systematic reviews including 16 studies. We combined the evidence using tables with summary of findings following the GRADE approach and concluded ursodeoxycholic acid may not have any effect on pruritus, and there is uncertainty about its effect on mortality, need for liver transplantation or on any other important outcome for the patient.

  8. The outcome of critical illness in decompensated alcoholic liver cirrhosis

    DEFF Research Database (Denmark)

    Kavli, M; Strøm, T; Carlsson, M

    2012-01-01

    physiology and chronic health evaluation II (APACHE II) and simplified organ failure assessment (SOFA) in predicting outcome. We hypothesized that in a Scandinavian cohort of ICU patients, APACHE II, SOFA, and simplified acute physiology score (SAPS II) were superior to predict outcome compared...... with the Child-Pugh score. METHODS: A single-centre retrospective cohort analysis was conducted in a university-affiliated ICU. Eighty-seven adult patients with decompensated liver alcoholic cirrhosis were admitted from January 2007 to January 2010. RESULTS: The patients were severely ill with median scores...... alcoholic liver disease should be revised....

  9. No difference in portal and hepatic venous bacterial DNA in patients with cirrhosis undergoing transjugular intrahepatic portosystemic shunt insertion

    DEFF Research Database (Denmark)

    Mortensen, Christian; Karlsen, Stine; Grønbaek, Henning

    2013-01-01

    Bacterial translocation (BT) with immune activation may lead to hemodynamical alterations and poor outcomes in patients with cirrhosis.......Bacterial translocation (BT) with immune activation may lead to hemodynamical alterations and poor outcomes in patients with cirrhosis....

  10. A case of pneumonia and sepsis in cirrhosis as paradigm of the problems in the management of bacterial infections in cirrhosis and of the limitations of current knowledge

    Directory of Open Access Journals (Sweden)

    Manuel Tufoni

    2013-09-01

    Full Text Available Bacterial infections are a major problem in the management of liver cirrhosis. They represent the first precipitating cause of death since patients with cirrhosis carry an increased risk of sepsis, sepsis-induced organ failure and death. Although the clinical presentation is often misleading, the presence of bacterial infection should always be actively searched and ruled out with certainty whenever a cirrhotic patient is admitted to the hospital with an acute clinical deterioration. Major changes in the epidemiology of bacterial infections have also occurred in the last decade making the choice of empirical antibiotic therapy a challenge. We report a paradigmatic case of a 54-year old man with hepatitis C-related cirrhosis admitted to the hospital for worsening of his ascites and onset of hepatic encephalopathy, an excellent example for the difficulties of management of sepsis in cirrhosis and the limits of current knowledge.

  11. Elevated arterial compliance in patients with cirrhosis is not related to arterial endothelin-1

    DEFF Research Database (Denmark)

    Møller, Søren; Gülberg, V; Becker, U

    2002-01-01

    study was to investigate a potential relation between altered arterial compliance and arterial ET-1 in patients with cirrhosis. As ET-1 may be manipulated by somastostatin, the study includes infusion of octreotide in a subset of patients. METHODS: A total of 67 patients with cirrhosis and 27 controls...

  12. Recombinant factor VIIa for variceal bleeding in patients with advanced cirrhosis: A randomized, controlled trial

    DEFF Research Database (Denmark)

    Bosch, Jaime; Thabut, Dominique; Albillos, Agustín

    2008-01-01

    A beneficial effect of recombinant activated factor VII (rFVIIa) in Child-Pugh class B and C patients with cirrhosis who have variceal bleeding has been suggested. This randomized controlled trial assessed the efficacy and safety of rFVIIa in patients with advanced cirrhosis and active variceal...

  13. Increased circulating calcitonin in cirrhosis. Relation to severity of disease and calcitonin gene-related peptide

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik Sahl; Schifter, S; Møller, S

    2000-01-01

    circulating plasma concentrations of CT in patients with cirrhosis in relation to the severity of disease and the plasma level of CGRP. Moreover, the kinetics of CT was evaluated for different organ systems by determination of arteriovenous extraction. Thirty-nine patients with cirrhosis (Child...... system, lower extremities, or peripheral circulation, but there was a substantial rate of pulmonary disposal and clearance (P

  14. Risk for Alcoholic Liver Cirrhosis After an Initial Hospital Contact With Alcohol Problems

    DEFF Research Database (Denmark)

    Askgaard, Gro; Leon, David A.; Kjr, Mette S.

    2017-01-01

    cirrhosis in these patients relative to the general population. Age and alcohol diagnosis were significant predictors of alcoholic liver cirrhosis risk in men and women, whereas civil status, education, and type of hospital care were not. In men, the 15-year absolute risk was 0.7% (95% confidence interval...

  15. 28 CFR 79.36 - Indication of the presence of hepatitis B or cirrhosis.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Indication of the presence of hepatitis B or cirrhosis. 79.36 Section 79.36 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) CLAIMS... § 79.36 Indication of the presence of hepatitis B or cirrhosis. Possible indication of hepatitis B or...

  16. 28 CFR 79.27 - Indication of the presence of hepatitis B or cirrhosis.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Indication of the presence of hepatitis B... presence of hepatitis B or cirrhosis. (a)(1) If the claimant or eligible surviving beneficiary is claiming... possessed by the state cancer or tumor registries, indicates the presence of hepatitis B or cirrhosis, the...

  17. Sarcopenia in the prognosis of cirrhosis: Going beyond the MELD score

    Science.gov (United States)

    Kim, Hee Yeon; Jang, Jeong Won

    2015-01-01

    Estimating the prognosis of patients with cirrhosis remains challenging, because the natural history of cirrhosis varies according to the cause, presence of portal hypertension, liver synthetic function, and the reversibility of underlying disease. Conventional prognostic scoring systems, including the Child-Turcotte-Pugh score or model for end-stage liver diseases are widely used; however, revised models have been introduced to improve prognostic performance. Although sarcopenia is one of the most common complications related to survival of patients with cirrhosis, the newly proposed prognostic models lack a nutritional status evaluation of patients. This is reflected by the lack of an optimal index for sarcopenia in terms of objectivity, reproducibility, practicality, and prognostic performance, and of a consensus definition for sarcopenia in patients with cirrhosis in whom ascites and edema may interfere with body composition analysis. Quantifying skeletal muscle mass using cross-sectional abdominal imaging is a promising tool for assessing sarcopenia. As radiological imaging provides direct visualization of body composition, it is useful to evaluate sarcopenia in patients with cirrhosis whose body mass index, anthropometric measurements, or biochemical markers are inaccurate on a nutritional assessment. Sarcopenia defined by cross-sectional imaging-based muscular assessment is prevalent and predicts mortality in patients with cirrhosis. Sarcopenia alone or in combination with conventional prognostic systems shows promise for a cirrhosis prognosis. Including an objective assessment of sarcopenia with conventional scores to optimize the outcome prediction for patients with cirrhosis needs further research. PMID:26167066

  18. Benzodiazepines and risk for hepatic encephalopathy in patients with cirrhosis and ascites

    DEFF Research Database (Denmark)

    Grønbæk, Lisbet; Watson, Hugh; Vilstrup, Hendrik

    2018-01-01

    Background: There is limited evidence to support the belief that benzodiazepines increase cirrhosis patients’ risk of hepatic encephalopathy (HE). Objective: We aimed to examine the association between benzodiazepine use and HE development in cirrhosis patients. Methods: We used data on 865...

  19. Effect of Salvia miltiorrhiza Bge extract on liver cirrhosis in rats | Li ...

    African Journals Online (AJOL)

    Purpose: To explore the effects of Salvia miltiorrhiza Bge.extract(SMBE) on diethylnitrosamine(DEN)- induced liver cirrhosis in rats. Methods: SMBE was obtained by extracting dried Salvia miltiorrhiza Bge. in water. Liver cirrhosis was induced in Wistar rats by injecting diethylnitrosamine in abdominal cavity once a week for ...

  20. Delayed clearance of serum HBsAg in compensated cirrhosis B

    DEFF Research Database (Denmark)

    Fattovich, G; Giustina, G; Sanchez-Tapias, J

    1998-01-01

    The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B.......The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B....

  1. Hepatocellular Carcinoma in the Absence of Cirrhosis in US Veterans is Associated with Non-Alcoholic Fatty Liver Disease

    Science.gov (United States)

    Mittal, Sahil; El-Serag, Hashem B.; Sada, Yvonne H.; Kanwal, Fasiha; Duan, Zhigang; Temple, Sarah; May, Sarah B.; Kramer, Jennifer R.; Richardson, Peter A.; Davila, Jessica A.

    2015-01-01

    Background & Aims Hepatocellular carcinoma (HCC) can develop in individuals without cirrhosis. We investigated risk factors for development of HCC in the absence of cirrhosis in a US population. Methods We identified a national cohort of 1500 patients with verified HCC during 2005–2010 in the US Veterans Administration (VA), and reviewed their full VA medical records for evidence of cirrhosis and risk factors for HCC. Patients without cirrhosis were assigned to categories of level 1 evidence for no cirrhosis (very high probability) or level 2 evidence for no cirrhosis (high probability), based on findings from histologic analyses, laboratory test results, markers of fibrosis from non-invasive tests, and imaging features. Results A total of 43 (2.9%) of the 1500 patients with HCC had level 1 evidence for no cirrhosis and 151 (10.1%) had level 2 evidence for no cirrhosis; the remaining 1203 patients (80.1%) had confirmed cirrhosis. Compared to patients with HCC in presence of cirrhosis, greater proportions of patients with HCC without evidence of cirrhosis had metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), or no identifiable risk factors. Patients with HCC without evidence of cirrhosis were less likely to have abused alcohol or have HCV infection than patients with cirrhosis. Patients with HCC and NAFLD (unadjusted odds ratio, 5.4; 95% confidence interval, 3.4–8.5) or metabolic syndrome (unadjusted odds ratio, 5.0; 95% confidence interval, 3.1–7.8) had more than a 5-fold risk of having HCC in the absence of cirrhosis, compared to patients with HCV-related HCC. Conclusions Approximately 13% of patients with HCC in the VA system do not appear to have cirrhosis. NAFLD and metabolic syndrome are the main risk factors HCC in the absence of cirrhosis. PMID:26196445

  2. Outcomes of pregnancies complicated by liver cirrhosis, portal hypertension, or esophageal varices.

    Science.gov (United States)

    Puljic, Anela; Salati, Jennifer; Doss, Amy; Caughey, Aaron B

    2016-01-01

    To evaluate pregnancy outcomes in women with liver cirrhosis, portal hypertension, or esophageal varices. We analyzed a retrospective cohort of 2,284,218 pregnancies in 2005-2009 recorded in the California Birth Registry database. Utilizing ICD-9 codes we analyzed the following outcomes for liver cirrhosis, portal hypertension, or esophageal varices in pregnancy: preeclampsia (PET), preterm delivery (PTD; Portal hypertension in pregnancy was associated with PTD, LBW, NND, and PPH. Non-bleeding esophageal varices in pregnancy were not associated with the outcomes assessed in a statistically significant manner. One case of bleeding esophageal varices was observed, resulting in PTD with a LBW infant. There were three cases of concomitant portal hypertension or concomitant esophageal varices with cirrhosis in pregnancy. Pregnancy in women with concomitant liver cirrhosis, portal hypertension, or esophageal varices can be successful. However, pregnancy outcomes are worse and may warrant closer antenatal monitoring and patient counseling. Cirrhosis in pregnancy with concomitant portal hypertension or esophageal varices is rare.

  3. Pulmonary blood volume and transit time in cirrhosis: relation to lung function

    DEFF Research Database (Denmark)

    Møller, Søren; Burchardt, H; Øgard, CG

    2006-01-01

    BACKGROUND/AIMS: In cirrhosis a systemic vasodilatation leads to an abnormal distribution of the blood volume with a contracted central blood volume. In addition, the patients have a ventilation/perfusion imbalance with a low diffusing capacity. As the size of the pulmonary blood volume (PBV) has...... in cirrhosis. The relation between PBV and PTT and the low diffusing capacity suggests the pulmonary vascular compartment as an important element in the pathophysiology of the lung dysfunction in cirrhosis....... not been determined separately we assessed PBV and pulmonary transit time (PTT) in relation to lung function in patients with cirrhosis and in controls. METHODS: Pulmonary and cardiac haemodynamics and transit times were determined by radionuclide techniques in 22 patients with alcoholic cirrhosis...

  4. Serum Leptin Levels in Post-Hepatitis Band C Liver Cirrhosis

    International Nuclear Information System (INIS)

    Nosseir, N.M.; Abdel-Messeih, Ph.L.; Ismael, N.E.R.

    2010-01-01

    A healthy liver is able to regenerate most of its own cells when they become damaged, with the end stage cirrhosis the liver no longer replace damaged cells. Leptin is a hormone that plays a key role in regulating energy intake and expenditure including appetite and metabolism. This study was done to investigate serum Leptin level in liver cirrhosis (post hepatitis B and post-hepatitis C cirrhosis), as well as to determine its level in relation to liver functions in cirrhotic patients. In this study, serum Leptin level was significantly lower in post-hepatitis B cirrhosis than controls and insignificant changes were observed in patients with post-hepatitis C cirrhosis. Also a significant reduction in leptin level was observed as liver functions worsen as indicated by albumin decrease.

  5. Serum and Ascitic Fluid Superoxide Dismutase and Malondialdehyde Levels in Patients with Cirrhosis

    Directory of Open Access Journals (Sweden)

    Ugur Coskun

    2008-01-01

    Full Text Available Serum and ascitic fluid superoxide dismutase (SOD and malondialdehyde (MDA levels were measured in 43 patients with cirrhosis and in a 10 healthy control group. Compensated cirrhotic patients had no clinically detectable ascites, but decompensated patients had massive ascites. Cirrhotic patients were divided into three groups: patients with compensated cirrhosis (n = 16, patients with decompensated cirrhosis with Spontaneous bacterial peritonitis (SBP (n = 14, and patients with decompensated cirrhosis without SBP (n = 13. All cirrhotic patients in the experimental group had significantly higher serum SOD (p 0.05. These results suggest that the increase in serum SOD and MDA levels are not related to the presence of SBP and the status of liver cirrhosis. To sum up, clarifying the impact of increased serum SOD and MDA levels in cirrhotic patients needs further investigation.

  6. Mortality Rates in Patients With Chronic Hepatitis C and Cirrhosis Compared With the General Population

    DEFF Research Database (Denmark)

    Hallager, Sofie; Brehm Christensen, Peer; Ladelund, Steen

    2017-01-01

    Background: Knowledge about mortality rates (MRs) in patients with chronic hepatitis C (CHC) with cirrhosis is limited. This study aimed to estimate all-cause MRs among patients with CHC with or without cirrhosis in Denmark compared with the general population. Methods: Patients registered...... in the Danish Database for Hepatitis B and C with CHC and a liver fibrosis assessment were eligible for inclusion. Liver fibrosis was assessed by means of liver biopsy, transient elastography, and clinical cirrhosis. Up to 20 sex- and age-matched individuals per patient were identified in the general population....... Data were extracted from nationwide registries. Results: A total of 3410 patients with CHC (1014 with cirrhosis), and 67 315 matched individuals were included. Adjusted MR ratios (MRRs) between patients with or without cirrhosis and their comparison cohorts were 5.64 (95% confidence interval [CI], 4...

  7. Pulsatility index of renal artery in patients with liver cirrhosis

    International Nuclear Information System (INIS)

    Baik, Soon Koo; Kim, Kwan Hyun; Jeong, Yon Soo; Kim, Hyun Soo; Lee, Dong Ki; Kwon, Sang Ok

    2000-01-01

    As one of non-invasive methods evaluating disorders of renal perfusion using Doppler ultrasonography, PI represents the characteristics of the Doppler waveform more accurately than RI, and even when renal perfusion is severely impaired, objective estimation is possible because of using the mean velocity in its calculation. The purpose of this study is to find out the clinical usefulness of PI for evaluating disorder of renal function in patients with liver cirrhosis. The subjects were 167 patients including 89 of Child A and B groups, 39 of Child C group, and 39 of control group. We compared PI, RI, creatinine, serum renin activity and aldosterone level between each groups, and investigated the relationships of PI with creatinine clearance, serum renin activity, and aldosterone level. Meal PI was 1.00 ± 0.15 in control group, 1.17 ± 0.22 in Child A and B groups, and 1.30 ± 0.28 in Child C group, which showed significant difference between each groups (p<0.05). Also RI, creatinine clearance, serum renin activity and aldosterone level revealed significant difference between each groups (p<0.05). PI showed significant negative relationships with creatinine clearance (p=0.009), serum renin activity (p=0.06), and aldosterone level (p=0.001). Measurement of PI by Doppler ultrasonography is a useful non-invasive method for evaluation renal dysfunction in patients with liver cirrhosis.

  8. Cholangiocarcinoma in Cirrhosis: Value of Hepatocyte Specific Magnetic Resonance Imaging.

    Science.gov (United States)

    Piscaglia, Fabio; Iavarone, Massimo; Galassi, Marzia; Vavassori, Sara; Renzulli, Matteo; Forzenigo, Laura Virginia; Granito, Alessandro; Salvatore, Veronica; Sangiovanni, Angelo; Golfieri, Rita; Colombo, Massimo; Bolondi, Luigi

    2015-10-01

    The diagnosis of intrahepatic cholangiocellular carcinoma (ICC) remains elusive at imaging, which is a critical issue in cirrhotic patients in whom a diagnosis of hepatocellular carcinoma (HCC) can be established only by imaging. The aim of the study was to evaluate the potential of MRI in the diagnosis of ICC in cirrhosis using 'hepatocyte-specific' Gadolinium (Gd)-based contrast agents. Sixteen histologically proven and retrospectively identified ICCs on cirrhosis were investigated with hepatocyte-specific magnetic resonance contrast agents (6 in Bologna with Gd-EOB-DTPA and 10 in Milan with Gd-BOPTA). The control group consisted of 41 consecutively and prospectively collected nodules (31 HCCs) imaged with Gd-EOB-DTPA. Fifteen ICC nodules (94%) displayed hypointensity in the hepatobiliary phase, suggesting malignancy. Thirteen cholangiocarcinomas (81%) showed hyperenhancement in the venous phase. Only 2 cholangiocarcinoma nodules showed hypoenhancement in the venous phase, corresponding to washout, in both cases preceded by rim enhancement in arterial phase. All the hepatocarcinomas showed hypointensity in hepatobiliary phase, but was always preceded by hypointensity in the venous phase; arterial rim enhancement was never observed in any hepatocarcinoma or regenerative nodule. MRI with hepatocyte-specific Gd-based contrast agents showed a pattern of malignancy in almost all the ICCs, concurrently avoiding misdiagnosis with hepatocarcinoma. These findings suggest a greater diagnostic capacity for this technique compared with the results of MRI with conventional contrast agents reported in the literature in this setting. © 2015 S. Karger AG, Basel.

  9. Bariatric surgery in individuals with liver cirrhosis: A narrative review

    Directory of Open Access Journals (Sweden)

    Everton Cazzo

    Full Text Available Summary Introduction: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases. Objective: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis. Method: Narrative review performed by means of an online search in the MEDLINE and LILACS databases. Results: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension. Individuals with severe liver function impairment present significantly higher surgical morbidity and mortality. Among candidates to liver transplantation, surgery may be performed before, after and even during transplantation, and there is a predominant trend to perform it after. Vertical sleeve gastrectomy seems to be the most adequate technique in this group of subjects. Conclusion: Bariatric surgery is safe and effective in individuals with compensated cirrhosis without significant portal hypertension, but presents higher morbidity. Among candidates to liver transplantation and/or individuals with severe portal hypertension, morbidity and mortality are significantly higher.

  10. Natural history and management of primary biliary cirrhosis

    Directory of Open Access Journals (Sweden)

    Al-Harthy N

    2012-12-01

    Full Text Available Nadya Al-Harthy,1 Teru Kumagi21Gastroenterology and Hepatology, Royal Hospital, Muscat, Oman; 2Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, JapanAbstract: Primary biliary cirrhosis (PBC is a chronic inflammatory autoimmune disease that mainly targets the cholangiocytes of the interlobular bile ducts in the liver. It is a rare disease with prevalence of less than one in 2000. Its prevalence in developing countries is increasing presumably because of growth in recognition and knowledge of the disease. PBC is thought to result from a combination of multiple genetic factors and superimposed environmental triggers. The contribution of the genetic predisposition is evidenced by familial clustering. Several risk factors, including exposure to infectious agents and chemical xenobiotics, have been suggested. Common symptoms of the disease are fatigue and pruritus, but most patients are asymptomatic at first presentation. The prognosis of PBC has improved because of early diagnosis and use of ursodeoxycholic acid, the only established medical treatment for this disorder. When administered at adequate doses of 13–15 mg/kg/day, up to two out of three patients with PBC may have a normal life expectancy without additional therapeutic measures. However, some patients do not respond adequately to ursodeoxycholic acid and might need alternative therapeutic approaches.Keywords: primary biliary cirrhosis, natural history, long-term outcome, ursodeoxycholic acid, biochemical response, target therapy

  11. Radiographical findings in patients with liver cirrhosis and hepatic encephalopathy.

    Science.gov (United States)

    Elwir, Saleh; Hal, Hassan; Veith, Joshua; Schreibman, Ian; Kadry, Zakiyah; Riley, Thomas

    2016-08-01

    Hepatic encephalopathy is a common complication encountered in patients with liver cirrhosis. Hepatic encephalopathy is not reflected in the current liver transplant allocation system. Correlation was sought between hepatic encephalopathy with findings detected on radiographic imaging studies and the patient's clinical profile. A retrospective analysis was conducted of patients with cirrhosis, who presented for liver transplant evaluation in 2009 and 2010. Patients with hepatocellular carcinoma, ejection fraction less than 60% and who had a TIPS (transjugular intrahepatic portosystemic shunting) procedure or who did not complete the evaluation were excluded. Statistical analysis was performed and variables found to be significant on univariate analysis (P encephalopathy group (n = 58) and a control group (n = 59). Univariate analysis found that a smaller portal vein diameter, smaller liver antero-posterior diameter, liver nodularity and use of diuretics or centrally acting medications showed significant correlation with hepatic encephalopathy. This association was confirmed for smaller portal vein, use of diuretics and centrally acting medications in the multivariate analysis. A decrease in portal vein diameter was associated with increased risk of encephalopathy. Identifying patients with smaller portal vein diameter may warrant screening for encephalopathy by more advanced psychometric testing, and more aggressive control of constipation and other factors that may precipitate encephalopathy. © The Author(s) 2015. Published by Oxford University Press and the Digestive Science Publishing Co. Limited.

  12. [Gastric vascular lesions in cirrhosis: gastropathy and antral vascular ectasia].

    Science.gov (United States)

    Casas, Meritxell; Calvet, Xavier; Vergara, Mercedes; Bella, Maria Rosa; Junquera, Félix; Martinez-Bauer, Eva; Campo, Rafael

    2015-02-01

    Portal hypertensive gastropathy (GHP) is a complication of portal hypertension usually associated with liver cirrhosis. The pathogenesis is unclear but the presence of portal hypertension is an essential factor for its development. GHP may be asymptomatic or present as gastrointestinal bleeding or iron deficiency anemia. Endoscopic lesions vary from a mosaic pattern to diffuse red spots; the most common location is the fundus. Treatment is indicated when there is acute or chronic bleeding, as secondary prophylaxis. There is insufficient evidence to recommend primary prophylaxis in patients who have never bled. Drugs that decrease portal pressure, such as non-cardioselective beta-blockers, and/or endoscopic ablative treatments, such as argon-beam coagulation, may be used. The role of transarterial intrahepatic portosystemic shunt) or bypass surgery has been insufficiently analyzed. Antral vascular ectasia (EVA) is a rare entity in liver cirrhosis, whose pathophysiology is still unknown. Clinical presentation is similar to that of GHP and endoscopy usually shows red spots in the antrum. Biopsy is often required to differentiate EVA from GHP. There is no effective medical therapy, so endoscopic ablative therapy and, in severe cases, antrectomy are recommended. Copyright © 2014 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  13. Frequency of rectal varices in patients with cirrhosis

    International Nuclear Information System (INIS)

    Zuberi, F.F; Khan, M.A.; Zuberi, B.F.; Khan, M.H.

    2004-01-01

    Objective: To document the frequency of rectal varices in patients with cirrhosis of liver and compare it with that of oesophageal varices in liver and to compare the frequency of rectal varices with non-cirrhotic controls. Patients and Methods: All patients of confirmed cirrhosis of liver, presenting during the study period, were selected for initial workup. On the basis of upper gastrointestinal (GI) endoscopy, patients were segregated into those with oesophageal varices group-A) and those without them (Group-B). A matched control group (Group-C) was added, which consisted of patients of irritable bowel syndrome (IBS) who underwent sigmoidoscopic/colonoscopic examination during the study period. Fiberoptic sigmoidoscopy was done in all selected patients. Statistical analysis for continuous variables was done by student's 't' test while non-continuous variables were analyzed by Mann-Whitney-U test. Results: A total of 104 patients (males 61; females 43) were included. Hepatic encephalopathy grade was significantly lower in group-B (p < 0.0001). Grade-I varices were seen in 13 patients, Grade-II in 38 and Grade-III in 33 patients of Group-A. Rectal varices were present in 59.9% of patients in Group-A as compared to Group-B in which no one had them (p < 0.0001). Conclusion: Rectal varices are common in patients of portal hypertension. (author)

  14. Hepatic Encephalopathy: Early Diagnosis in Pediatric Patients With Cirrhosis

    Science.gov (United States)

    DARA, Naghi; SAYYARI, Ali-Akbar; IMANZADEH, Farid

    2014-01-01

    Objective As acute liver failure (ALF) and chronic liver disease (cirrhosis) continue to increase in prevalence, we will see more cases of hepatic encephalopathy. Primary care physician are often the first to suspect it, since they are familiar with the patient’s usual physical and mental status. This serious complication typically occurs in patients with severe comorbidities and needs multidisciplinary evaluation and care. Hepatic encephalopathy should be considered in any patient with acute liver failure and cirrhosis who presents with neuropsychiatric manifestations, decrease level of consciousness (coma), change of personality, intellectual and behavioral deterioration, speech and motor dysfunction. Every cirrhotic patient may be at risk; potential precipitating factors should be addressed in regular clinic visits. The encephalopathy of liver disease may be prominent, or can be present in subtle forms, such as decline of school performance, emotional outbursts, or depression. “Subtle form” of hepatic encephalopathy may not be obvious on clinical examination, but can be detected by neurophysiologic and neuropsychiatric testing. PMID:24665321

  15. [Treatment of nontumoral portal vein thrombosis in cirrhosis].

    Science.gov (United States)

    Bañares, Rafael; Catalina, María-Vega

    2014-07-01

    Portal vein thrombosis in cirrhosis is a relatively common complication associated with the presence of an accompanying prothrombotic phenotype of advanced cirrhosis. The consequences of portal vein thrombosis are relevant because it can be associated with impaired hepatic function, might contraindicate hepatic transplantation and could increase morbidity in the surgical procedure. There is controversy concerning the most effective treatment of portal vein thrombosis, which is based on information that is seldom robust and whose primary objective is to achieve a return to vessel patency. Various studies have suggested that starting anticoagulation therapy early is associated with portal vein repatency more frequently than without treatment and has a low rate of complications. There are no proven data on the type of anticoagulant (low-molecular-weight heparins or dicoumarin agents) and the treatment duration. The implementation of TIPS is technically feasible in thrombosis without cavernous transformation and is associated with portal vein recanalization in a significant proportion of cases. Thrombolytic therapy does not appear to present an adequate balance between efficacy and safety; its use is therefore not supported for this indication. The proper definition of treatment for portal vein thrombosis requires properly designed studies to delimit the efficacy and safety of the various alternatives. Copyright © 2014 Elsevier España, S.L. All rights reserved.

  16. Outreach screening of drug users for cirrhosis with transient elastography

    DEFF Research Database (Denmark)

    Moessner, Belinda K; Jørgensen, Tina R; Skamling, Merete

    2011-01-01

    Aims  Transient elastography (TE) is a non-invasive sensitive tool for diagnosing cirrhosis in hospital-based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users. Design  Cross-sectional study. Setting  All treatment centres in the county of Funen, Denmark....... Participants  Drug users attending treatment centres during the presence of the study team. Measurements  Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals...... with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy. Findings  Among 175 drug users negative for hepatitis C, 13% had LSM = 8-11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30...

  17. Clinical utility of red cell distribution width in alcoholic and non-alcoholic liver cirrhosis.

    Science.gov (United States)

    Milić, Sandra; Mikolasević, Ivana; Radić, Mladen; Hauser, Goran; Stimac, Davor

    2011-09-01

    Red blood cell distribution width (RDW) is a measure of the variation of red blood cell width that is reported as apart of standard complete blood count. Red blood cell distribution width results are often used together with mean corpuscular volume (MCV) results to figure out mixed anemia. The aim of our study was to compare the values of RDW in alcoholic and non-alcoholic liver cirrhosis and to determine if RDW follows the severity of disease according to Child-Pugh score. We retrospectively analyzed 241 patients (176 men and 65 women) with liver cirrhosis and anemia, defined as a hemoglobin value reference range is 11-15%. Alcoholic liver cirrhosis had 204 patients (85%) while non-alcoholic cirrhosis had 37 patients (15%). In group of alcoholic cirrhosis the average RDW was 16.8%. In relation to severity of disease the average RDW for Child-Pugh A was 16.80%, for Child-Pugh B was 16.92%, for Child-Pugh C was 17.10%. In the group of non-alcoholic cirrhosis the average RDW was 16.73% and in relation to severity of disease for Child-Pugh A was 16.25%, for Child-Pugh B 17.01% and for Child-Pugh C was 16.87%. We didn't find statistically significant difference of RDW between alcoholic and non alcoholic cirrhosis (p > 0.05) and we didn't proved any statistically significant increase of RDW in relation to severity of disease in group of alcoholic cirrhosis (p = 0.915) nor in group of patients with non-alcoholic cirrhosis (p = 0.697). Our study showed that RDW had not any clinical value in differentiation of anemia neither in alcoholic and non-alcoholic liver cirrhosis nor in severity of liver disease.

  18. Association between diabetes mellitus and cirrhosis mortality: the Singapore Chinese Health Study.

    Science.gov (United States)

    Goh, George Boon-Bee; Pan, An; Chow, Wan-Cheng; Yuan, Jian-Min; Koh, Woon-Puay

    2017-02-01

    Diabetes mellitus has been linked to cirrhosis-related mortality in Western populations, but less is known about this relationship in Asian populations. We studied the impact of diabetes on the risk of cirrhosis mortality in a population-based cohort among Chinese in Singapore. We used data collected and analysed from the Singapore Chinese Health Study, a prospective community-based cohort of 63 275 subjects aged 45-74 years during enrolment between 1993 and 1998. Information on diet, lifestyle and medical history was collected via structured questionnaire. Mortality cases from cirrhosis in the cohort were identified via linkage with nationwide death registry up to 31 December 2014. Cox proportional regression models were used to estimate the associations with adjustment for risk factors of cirrhosis. After a mean follow-up of 16.9 years, there were 133 deaths from cirrhosis. Diabetes was associated with an increased risk of cirrhosis mortality (hazard ratio [HR]: 2.80; 95% confidence interval [CI]: 2.04-3.83), and for both viral (HR: 2.20; 95% CI: 1.18-4.11) and non-viral hepatitis-related cirrhosis mortality (HR: 3.06; 95% CI: 2.13-4.41). The association between diabetes and non-viral hepatitis-related cirrhosis mortality was stronger among participants of body mass index (BMI) less than 23 kg/m 2 (HR: 7.11; 95% CI: 3.42-14.79) compared to heavier individuals (HR: 2.28; 95% CI: 1.20-4.35) (P interaction =0.02). Diabetes is a risk factor for cirrhosis mortality, especially for non-viral hepatitis-related cirrhosis in population with BMI considered low or normal in Asia. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Does Drinking Location Matter? Profiles of Risky Single-Occasion Drinking by Location and Alcohol-Related Harm among Young Men.

    Science.gov (United States)

    Bähler, Caroline; Dey, Michelle; Dermota, Petra; Foster, Simon; Gmel, Gerhard; Mohler-Kuo, Meichun

    2014-01-01

    In adolescents and young adults, acute consequences like injuries account for a substantial proportion of alcohol-related harm, especially in risky single-occasion (RSO) drinkers. The primary aim of the study was to characterize different drinking profiles in RSO drinkers according to drinking locations and their relationship to negative, alcohol-related consequences. The sample consisted of 2746 young men from the Cohort Study on Substance Use Risk Factors who had reported drinking six or more drinks on a single-occasion at least monthly over the preceding 12 months. Principal component analysis on the frequency and amount of drinking at 11 different locations was conducted, and 2 distinguishable components emerged: a non-party-dimension (loading high on theater/cinema, sport clubs, other clubs/societies, restaurants, and sport events) and a party-dimension (loading high on someone else's home, pubs/bars, discos/nightclubs, outdoor public places, special events, and home). Differential impacts of drinking location profiles were observed on severe negative alcohol-related consequences (SAC). Relative to those classified as low or intermediate in both dimensions, no significant difference experiencing SAC was found among those who were classified as high in the non-party-dimension only. However, those who were classified as high in the party-dimension alone or in both dimensions were more likely to experience SAC. These differential effects remained after adjusting for alcohol consumption (volume and risky single-occasion drinking), personality traits, and peer-influence [adjusted OR = 0.83 (0.68-1.02), 1.57 (1.27-1.96), and 1.72 (1.23-2.41), respectively], indicating independent effects of drinking location on SAC. The inclusion of sociodemographic factors did not alter this association. The fact that this cluster of party-dimension locations seems to predispose young men to experiencing SAC has important implications for alcohol control policies.

  20. Does drinking location matter? Profiles of risky single-occasion drinking by location and alcohol-related harm among young men

    Directory of Open Access Journals (Sweden)

    Caroline eBähler

    2014-06-01

    Full Text Available In adolescents and young adults, acute consequences like injuries account for a substantial proportion of alcohol-related harm, especially in risky single-occasion (RSO drinkers. The primary aim of the study was to characterize different drinking profiles in RSO drinkers according to drinking locations and their relationship to negative, alcohol-related consequences. The sample consisted of 2746 young men from the Cohort Study on Substance Use Risk Factors (C-SURF who had reported drinking 6 or more drinks on a single occasion at least monthly over the preceding 12 months. Principal component analysis on the frequency and amount of drinking at 11 different locations was conducted, and two distinguishable components emerged: a non-party-dimension (loading high on theatre/cinema, sport clubs, other clubs/societies, restaurants, and sport events and a party-dimension (loading high on someone else’s home, pubs/bars, discos/nightclubs, outdoor public places, special events, and home. Differential impacts of drinking location profiles were observed on severe negative alcohol-related consequences (SAC. Relative to those classified as low or intermediate in both dimensions, no significant difference experiencing SAC was found among those who were classified as high in the non-party-dimension only. However, those who were classified as high in the party-dimension alone or in both dimensions were more likely to experience SAC. These differential effects remained after adjusting for alcohol consumption (volume and RSOD, personality traits, and peer-influence (adjusted OR=0.83 [0.68-1.02], 1.57 [1.27-1.96] and 1.72 [1.23-2.41], respectively, indicating independent effects of drinking location on SAC. The inclusion of sociodemographic factors did not alter this association. The fact that this cluster of party-dimension locations seems to predispose young men to experiencing SAC has important implications for alcohol control policies.