Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism最新文献

{"title":"Interrelationship between alcohol intake, hepatitis C, liver cirrhosis, and hepatocellular carcinoma.","authors":"H Yoshihara,&nbsp;K Noda,&nbsp;T Kamada","doi":"10.1007/0-306-47148-5_23","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_23","url":null,"abstract":"<p><p>The discovery of a cDNA clone of hepatitis C virus (HCV) genome in 1989 has resulted in numerous reports of high rates of the prevalence of HCV antibody in patients with alcoholic liver disease, in particular, alcoholic liver cirrhosis and hepatocellular carcinoma. Thus, the interaction between alcohol intake and HCV infection has become of great importance. In terms of the effect of alcohol on HCV-RNA levels, the data are controversial; in some reports, alcohol increases HCV-RNA levels, and in the other reports it does not. There are several reports suggesting the possibility of an elevated quasi-species of hypervariable region 1 in the HCV genome caused by alcohol drinking. Recent studies have documented that alcohol intake exaggerates the responsiveness of interferon therapy for chronic hepatitis C; however, its mechanism is still obscure. Several studies have suggested the promoting effect of alcohol on the development of hepatocellular carcinoma in type C liver cirrhosis, which has been similarly observed in type B chronic liver disease, whereas its mechanism is limited to speculations.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"457-69"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_23","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol and the pancreas.","authors":"S Schenker,&nbsp;R Montalvo","doi":"10.1007/0-306-47148-5_3","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_3","url":null,"abstract":"<p><p>Alcoholic pancreatitis may be one of the most serious adverse consequences of alcohol abuse. Its diagnosis, as it has for many years, depends primarily on clinical acumen in interpreting properly the symptoms and signs of abdominal distress, buttressed by elevated pancreatic enzymes (amylase and lipase). More recently, the use of computerized tomography (CT) in selected situations has been both of confirmatory and prognostic value. Severity of abnormality by CT correlates reasonably well with a variety of clinical-laboratory clusters (APACHE system, Ranson's criteria, etc.) and aids in therapy. The pathogenesis of alcoholic pancreatitis is not fully defined. The ultimate picture is one of tissue autolysis by activated proteolytic enzymes. The triggers for such activation, however, are still not known. They are represented by three main theories: (1) large duct obstruction and/or increased permeability relative to pancreatic secretion, (2) small duct obstruction due to proteinaceous precipitates, and (3) a direct toxic-metabolic effect of ethanol on pancreatic acinar cells. While not mutually exclusive, we favor the last hypothesis as being most consistent with the effects of ethanol on other organ systems. The direct effects of ethanol and/or its metabolites may be mediated, at least in part, via oxidative stress or the generation of fatty acid ethyl esters. Autolysis (regardless of proximate mechanism(s)) leads to inflammation likely mediated via release of various cytokines. It also should be appreciated that \"acute\" pancreatitis (the topic of this chapter) likely represents an acute process within a chronic pancreatic exposure and injury from alcoholic abuse. The key question of why pancreatitis develops in only a small number of alcohol abusers is not resolved. Therapy depends on the severity of alcoholic pancreatitis, which is defined by clinical-laboratory and often CT criteria. Mild pancreatitis usually resolves acutely with alcohol abstention and supportive therapy. Severe pancreatitis has a significant morbidity and mortality, mainly related to the degree of pancreatic necrosis and infection. It requires meticulous combined medical-surgical care.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"41-65"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20666342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Executive cognitive functioning in alcohol use disorders.","authors":"P R Giancola,&nbsp;H B Moss","doi":"10.1007/0-306-47148-5_10","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_10","url":null,"abstract":"<p><p>Executive cognitive functioning (ECF) has been identified as an important determinant in the etiology of alcoholism. ECF represents a \"higher-order\" cognitive construct involved in the self-regulation of goal-directed behavior. The prefrontal cortex and its subcortical connections represent the primary neurological substrate that subserves ECF. Both alcoholics and individuals at high risk for alcoholism exhibit a mild dysfunction in ECF. However, this deficit appears to be significantly stronger in alcoholics with a comorbid diagnosis of an antisocial personality disorder. Individuals with other disorders that are also highly comorbid with alcoholism, such as attention deficit hyperactivity disorder and conduct disorder, also demonstrate deficits in ECF. As such, compromised ECF may not be specific to alcoholism, but instead, might be a potential underlying etiologic substrate for a number of disorders of behavioral excess-disinhibition. Subsequent to reviewing the literature implicating ECF deficits in alcoholism and comorbid disorders, the authors present a heuristic cognitive-neurobehavioral model of alcoholism implicating the frontostriatal system. Finally, recommendations for the prevention and treatment of alcoholism, based on this model, are discussed.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"227-51"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_10","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of price on the consequences of alcohol use and abuse.","authors":"F J Chaloupka,&nbsp;M Grossman,&nbsp;H Saffer","doi":"10.1007/0-306-47148-5_15","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_15","url":null,"abstract":"<p><p>Economists have examined the impact of alcohol prices on various outcomes related to alcohol consumption, including nonfatal and fatal motor vehicle accidents, other accidents, liver cirrhosis, and other alcohol-related mortality, crime, and education attainment. Price, in the context of this research, includes not only the monetary price of alcoholic beverages, but also a wide variety of other \"costs\" of drinking and heavy drinking, including the time spent obtaining alcoholic beverages and the legal costs associated with drinking and related behavior. This research clearly demonstrates that increases in the monetary prices of alcoholic beverages, which could be achieved by increasing taxes on alcohol, can significantly reduce many of the problems associated with alcohol use and abuse. In addition, control policies that raise other \"costs\" of drinking, including reduced availability of alcoholic beverages, higher legal drinking ages, and others, are also effective in reducing the consequences of alcohol use and abuse.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"331-46"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_15","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolism of ethanol and some associated adverse effects on the liver and the stomach.","authors":"C S Lieber,&nbsp;M A Leo","doi":"10.1007/0-306-47148-5_2","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_2","url":null,"abstract":"<p><p>Current knowledge of alcohol oxidation and its effects on hepatic metabolism and its toxicity are summarized. This includes an evaluation of the relationship of the level of consumption to its interaction with nutrients (especially retinoids, carotenoids, and folate) and the development of various stages of liver disease. Ethanol metabolism in the stomach and its link to pathology and Helicobacter pylori is reviewed. Promising therapeutic approaches evolving from newly gained insight in the pathogenesis of medical complications of alcoholism are outlined. At present, the established approach for the prevention and treatment of alcoholism are outlined. At present, the established approach for the prevention and treatment of alcoholic liver injury is to control alcohol abuse, with the judicial application of selective antioxidant therapy, instituted at early stages, prior to the social or medical disintegration of the patient, and associated with antiinflammatory agents at the acute phase of alcoholic hepatitis. In addition, effective antifibrotic therapy may soon become available.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"7-40"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20666341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular effects of alcohol.","authors":"H S Friedman","doi":"10.1007/0-306-47148-5_6","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_6","url":null,"abstract":"<p><p>The ingestion of one or two alcoholic drinks can affect heart rate, blood pressure, cardiac output, myocardial contractility, and regional blood flow. These actions generally are not clinically important. In the presence of cardiovascular disease, however, even such small quantities of alcohol might result in transient unfavorable hemodynamic changes. Moreover, alcohol abuse can produce cardiac arrhythmias, hypertension, cardiomyopathy, stroke, and even sudden death. In contrast, moderate alcohol use produces changes that have an overall favorable effect on atherosclerotic-related vascular diseases. Because cardiovascular disease due to atherosclerosis is the leading cause of death in Western society, this desirable effect of alcohol use outweighs its detrimental actions, resulting in favorable findings in population studies. Nevertheless, the body of evidence argues against encouraging alcohol use for its cardiovascular effects.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"135-66"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of the effects of moderate alcohol intake on psychiatric and sleep disorders.","authors":"R Castaneda,&nbsp;N Sussman,&nbsp;R Levy,&nbsp;M O'Malley,&nbsp;L Westreich","doi":"10.1007/0-306-47148-5_9","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_9","url":null,"abstract":"<p><p>In this chapter we discuss the effects of moderate ethanol consumption on the treatment of psychiatric and sleep disorders. A review of the literature on the interactions of ethanol with neurotransmitters and psychotropic medications suggests that although ethanol affects the clinical course of psychiatric and sleep disorders by different mechanisms, it does so principally through perturbations it causes in the balance of central nervous system neurotransmitter systems, which may modify the clinical course of primary psychiatric and sleep disorders and undermine the therapeutic response to psychotropic medications. Neurotransmitter responses may also be manifested clinically by rebound phenomena, akin to a subsyndromal withdrawal, which affect sleep and precipitate anxiety and mood symptoms. In addition, ethanol also modifies the clearance and disposition of a variety of psychotropic metabolites and interferes with their clinical effectiveness. We recommend that most psychiatric patients, and all patients with sleep disorders, should abstain from even moderate ethanol use, as this may adversely affect their clinical course and response to treatment.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"197-226"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with the alcohol use disorders identification test (AUDIT) in Mexico.","authors":"E Medina-Mora,&nbsp;S Carreño,&nbsp;J R De la Fuente","doi":"10.1007/0-306-47148-5_19","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_19","url":null,"abstract":"<p><p>This chapter describes the development of the Alcohol Use Disorders Identification Test (AUDIT) among various Mexican populations, the evaluations that followed the World Health Organization international research project from where this screening instrument was derived, its use in nonclinical settings, modifications introduced in its wording, the development of a short version, and validity and reliability tests. It also describes rates of hazardous, harmful, and dependent drinkers and biobehavioral consequences of abuse among various Mexican populations. Data drawn from different samples showed adequate levels of specificity and sensitivity. Findings from general population samples confirmed previous observations in general practice: That the AUDIT could capture not only regular consumption at hazardous levels, but also episodic heavy drinking. Data from an International Labor Office/World Health Organization project on model programs for alcohol prevention in the workplace showed that it was possible to derive a short version, easily used for intervention programs, that differentiated categories of drinkers at various risk levels. Rates of problem drinkers in clinical samples varied between 28 and 43% for males and 3.6 and 4.8% among females. Hazardous drinking varied between 0.7 and 15.5% among males and females in general populations and reached 44% in a sample of male workers; in clinical settings, harmful drinking ranged from 7 to 16% among males and dependence from 3 to 10%.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"383-96"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_19","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of severe mental illness related to alcohol and drug use disorders.","authors":"R E Drake,&nbsp;M F Brunette","doi":"10.1007/0-306-47148-5_12","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_12","url":null,"abstract":"<p><p>In this chapter we review research on the relationships between substance use disorder and 11 domains of adjustment for people with severe mental illness. Studies are divided into correlational research and prospective, longitudinal research, with greater weight given to those in the latter category. The weight of the evidence indicates that substance abuse severely complicates severe mental illness in the following domains: relapse of psychiatric illness, hospitalization, disruptive behavior, familial problems, residential instability, decreased functional status, HIV infection, and medication noncompliance. We discuss the limits of causal inference in these studies and the possible mechanisms that relate substance abuse to various complications.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"285-99"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_12","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drinking, problem drinking, and productivity.","authors":"J Mullahy,&nbsp;J L Sindelar","doi":"10.1007/0-306-47148-5_16","DOIUrl":"https://doi.org/10.1007/0-306-47148-5_16","url":null,"abstract":"<p><p>This chapter surveys and critiques the recent economic literature dealing with the relationships between labor market productivity and alcohol use and misuse. The focus here is twofold. First is to present and discuss the relevant conceptual issues that must be appreciated in assessing such relationships. Second is to summarize and assess the empirical findings that have been offered in the literature.</p>","PeriodicalId":77344,"journal":{"name":"Recent developments in alcoholism : an official publication of the American Medical Society on Alcoholism, the Research Society on Alcoholism, and the National Council on Alcoholism","volume":"14 ","pages":"347-59"},"PeriodicalIF":0.0,"publicationDate":"1998-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/0-306-47148-5_16","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20665534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}