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oai:open-archive.highwire.org:alcalc:33/4/3172015-05-19HighWireOUPalcalc:33:4
B VITAMIN DEFICIENCY AND NEUROPSYCHIATRIC SYNDROMES IN ALCOHOL MISUSE
COOK, CHRISTOPHER C. H.
HALLWOOD, PHILLIP M.
THOMSON, ALLAN D.
INVITED REVIEW
Alcohol misuse and alcohol withdrawal are associated with a variety of neuropsychiatric syndromes, some of which are associated with significant morbidity and mortality B vitamin deficiency is known to contribute to the aetiology of a number of these syndromes, and B vitamin supplementation thus plays a significant part in prophylaxis and treatment. In particular, the Wernicke-Korsakoff syndrome (WKS), due to thiamine deficiency, is a common condition in association with alcohol misuse, and is associated with high morbidity and mortality. Nicotinamide deficiency may result in a rarer condition, alcoholic pellagra encephalopathy, which often has a similar clinical presentation to WKS. This review considers the role of B vitamins in the aetiology and treatment of neuropsychiatric syndromes associated with alcohol misuse, with particular emphasis on WKS.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/317
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008400
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3372015-05-19HighWireOUPalcalc:33:4
DOWN THE ROAD TO DEREGULATION
CHENET, LAURENT
MCKEE, MARTIN
INVITED COMMENTARY
A recent preliminary ruling by the European Court of Justice, that would have ended the Swedish state retail alcohol monopoly on grounds of European law on free movement of goods, highlights the international pressure on countries to deregulate further their alcohol markets. However, those countries that have recently taken the road to deregulation have not been able to prevent the alcohol industry encouraging people to drink more and they are experiencing increased alcohol-related problems. The international debates about tradable commodities rarely take account of the consequences for public health. Alcohol is one such commodity that is also an important cause of premature death. It is essential that this is not overlooked in the race to promote free trade.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/337
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008401
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3412015-05-19HighWireOUPalcalc:33:4
THE INFLUENCE OF CHRONIC MODERATE ETHANOL ADMINISTRATION ON NADPH-DIAPHORASE (NITRIC OXIDE SYNTHASE) ACTIVITY IN RAT BRAIN
ZIMA, T.
DRUGA, R.
STÍPEK, S.
ORIGINAL ARTICLES
Nitric oxide synthase (NOS), the enzyme with reduced nicotinamide-adenine dinucleoude phosphate (NADPH)-diaphorase activity, generates nitric oxide (NO) which is an important bioregulatory molecule in the nervous, immune, and cardiovascular systems. NOS is linked to non-adrenergic non-cholinergic (NANC) neuronal pathways and modulation of the <it>N</it>-methyl-D-aspartate receptors, yet its modification by ethanol has been little explored. A possible modification by chronic ethanol administration of activity and*or localization of NADPH-diaphorase (NO-synthase) in rat brain may thus provide the pathogenic basis of alcohol-induced brain injury. When female Wistar rats were treated chronically with ethanol for 50 days, the NADPH-diaphorase staining of granular neurons and neurons located in the molecular layer of the cerebral cortex was significantly reduced. Chronic ethanol consumption led to a significant reduction in NADPH-diaphorase staining in the superficial layers of the superior colliculus. The number of NADPH-diaphorase-positive neurons was significantly reduced (<it>P</it> < 0.001) in the stratum zonale and stratum griseum superficiale (by 42 3–65 6% of control values). This could alter synaptic processes in the highly organized structures involved in oculomotor and somatic motor coordination and thus contribute to the motor disturbances which are associated with alcohol abuse.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/341
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008402
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3472015-05-19HighWireOUPalcalc:33:4
A NEW ORAL LOW-CARBOHYDRATE ALCOHOL LIQUID DIET PRODUCING LIVER LESIONS: A PRELIMINARY ACCOUNT
LINDROS, KAI O.
JÄRVELÄINEN, HARRI A.
ORIGINAL ARTICLES
Male Wistar rats were administered a modified, but nutritionally adequate, ethanol liquid diet with a low content of carbohydrate (5.5% of energy). The high daily intake of ethanol (mean 12.9 g/kg body wt) resulted in consistently sustained elevation of diurnal blood ethanol levels (mean 40.3 ± 14.9 mmol/l, corresponding to 180 mg/dl). Marked micro- and macrovesicular panlobular steatosis, occasional inflammatory foci and a threefold elevation of serum alanine aminotransferase activity developed in 6 weeks. In livers from rats on regular 11% carbohydrate diet, lesions beyond periportally located steatosis were race. These observations suggest that oral administration of a low-carbohydrate liquid ethanol diet may provide an affordable alternative to the technically demanding intragastric feeding model for experimental studies of alcoholic liver disease.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/347
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008403
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3542015-05-19HighWireOUPalcalc:33:4
PERCEPTIONS OF ALCOHOL-RELATED ATTENDANCES IN ACCIDENT AND EMERGENCY DEPARTMENTS IN ENGLAND: A NATIONAL SURVEY
WALLER, S.
THOM, B.
HARRIS, S.
KELLY, M.
ORIGINAL ARTICLES
The results from a survey, conducted in February and March 1997, of all Accident and Emergency (A&E) departments in England are presented. The survey examined staff perceptions of the preventive role of A&E departments in screening and intervention in alcohol-related attendances. Perceptions of the prevalence of alcohol-related attendances were also included. Attitudes towards developing a preventive response were positive. Few departments currently screen or offer intervention and considerable barriers to the implementation of a preventive response were reported.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/354
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008404
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3622015-05-19HighWireOUPalcalc:33:4
ADJUVANT TRAZODONE IN THE TREATMENT OF ALCOHOLISM: AN OPEN STUDY
JANIRI, L.
HADJICHRISTOS, A.
BUONANNO, A.
RAGO, R.
MANNELLI, P.
DE RISIO, S.
ORIGINAL ARTICLES
Serotonergic drugs have been proven to be helpful to alcoholics in maintaining abstinence. In this open study, we report that the atypical antidepressant trazodone at low doses was able to significandy decrease craving for alcohol, depressive, and anxious symptoms in a number (25) of detoxified alcohol-dependent subjects after 3 months of treatment. Trazodone may, therefore, be an adjuvant in the therapy of alcoholism.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/362
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008405
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3662015-05-19HighWireOUPalcalc:33:4
DETERMINATION OF PLASMA {alpha}-GLUTATHIONE-S-TRANSFERASES IN CHRONIC ALCOHOL ABUSERS: RELATIONSHIP WITH ALCOHOL INTAKE AND LIVER INVOLVEMENT
LOGUERCIO, C.
DE GIROLAMO, V.
CUOMO, A.
ARGENZIO, F.
IANNOTTA, C.
DISALVO, D.
GRELLA, A.
BLANCO, C. DEL VECCHIO
ORIGINAL ARTICLES
α-Gluthathione-S-transferascs (α-GSTs) are enzymes involved in the cellular detoxifying processes; elevated circulating α-GSTs activity is considered to be an early index of liver damage. Glutathione (GSH) is the substrate for α-GST action. The aims of our study were: (1) to evaluate plasma GSH levels and α-GST activity in chronic alcohol abusers with or without liver cirrhosis; (2) to define the relationship between these two biochemical parameters; (3) to establish their clinical relevance in patients with alcohol abuse and/or liver damage. We studied 69 subjects (18 healthy subjects and 51 chronic alcohol abusers: 29 without liver cirrhosis and 22 with). Plasma α-GST activity was determined on baseline samples and every following day for a total of 10 days in five alcoholics by HEPKIT (Alpha-Biotech, Biotrin International, Dublin, Ireland). GSH was determined on all subjects' baseline samples by fluorescent high-performance liquid chromatography. Alcohol intake was evaluated in all patients by determining blood-alcohol concentrations. Significant increases in plasma α-GSTs were observed in 9/29 (31%) alcoholics and 3/22 (13.6%) cirrhotics irrespective of their alcohol intake. GSH was significantly lower than normal values (<it>P</it> < 0.001) in all alcoholics with or without cirrhosis (controls 10.4 ± 4.8; alcoholics without cirrhosis 3.9 ± 1.4; alcoholics with cirrhosis 3.3 ± 1.6). No correlation was observed between plasma α-GST and GSH levels. Our data indicate that: (1) α-GST activity does not correlate with GSH levels in the plasma; (2) α-GSTs do not have clinical relevance as markers of recent alcohol intake; (3) in cirrhotics, α-GST does not provide more information than other liver function tests. However, plasma α-GST determination may be useful in selecting a subgroup of alcoholics in whom routine biochemical markers of liver damage are within reference ranges.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/366
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008406
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3732015-05-19HighWireOUPalcalc:33:4
ALCOHOL ABUSE AND HEALING COMPLICATIONS AFTER CERVICAL HIP FRACTURES
NYQUIST, FREDRIK
OVERGAARD, ANGELICA
DÜPPE, HENRIK
OBRANT, KARL J.
ORIGINAL ARTICLES
Osteonecrosis of the femoral head following femoral neck fractures is a common condition. Spontaneous osteonecrosis, is, however, a rare disorder, which is observed with increased frequency in alcohol abusers. In this retrospective study, we followed 512 consecutive male patients who had sustained femoral neck fractures between 1984 and 1992; 82 of these 512 patients (16%) had earlier been registered at the Department of Alcohol Diseases as high consumers of alcohol. The aim of the study was to determine the relationship between the rate of healing complications and alcohol consumption. No differences were observed in the degree of fracture dislocation, frequency of femoral head necrosis, and pseudoarthrosis among the abusers. Furthermore, no differences were found in causative events, primary operative treatment, post-operative complications, and the number of secondary operations. The abusers were significantly younger, had a higher rate of early retirement, and had an increased death rate. Our study suggests that alcohol complicates the healing process to a lesser extent than earlier thought, and that osteonecrosis of the femoral head after femoral neck fractures is equally conimon in non-abusers as in abusers.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/373
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008407
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3812015-05-19HighWireOUPalcalc:33:4
META-ANALYSIS OF ALCOHOL INTAKE IN RELATION TO RISK OF LIVER CIRRHOSIS
CORRAO, GIOVANNI
BAGNARDI, VINCENZO
ZAMBON, ANTONELLA
TORCHIO, PIERFEDERICO
ORIGINAL ARTICLES
The heterogeneity in the results of observational studies that investigated the association between alcohol consumption and risk of liver cirrhosis was ana]ysed by means of a meta-analysis that included 15 articles published from 1978 to 1997. Relative risks associated with low levels of alcohol intake (25 g/day) ranged from 1.5 [95% confidence interval (CI): 1 4–1.5] for a linear model fitting the results of the six studies performed in Mediterranean areas, to 3.6 (95% CI 3.1–4.3) for a quadratic model fitting the results of the nine studies performed in other areas. A strong indication of heterogeneity was observed when combining all studies. Quadratic term of alcohol intake, quality of the study and area in which the study was performed explained most of this heterogeneity. Efforts should be made to explain the strong heterogeneity in the trend estimates. Reproducible methods to collect relevant and valid information on alcohol intake should be developed and the role of drinking patterns and viral and nutritional factors in modifying the effect of alcohol on the risk of liver cirrhosis should be investigated.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/381
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008408
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/3932015-05-19HighWireOUPalcalc:33:4
ATAXIA OF STANCE IN DIFFERENT TYPES OF ALCOHOL DEPENDENCE -- A POSTUROGRAPHIC STUDY
WÖBER, CHRISTIAN
WÖBER-BINGÖL, ÇIÇEK
KARWAUTZ, ANDREAS
NIMMERRICHTER, AMANDA
WALTER, HENRIETTE
DEECKE, LÜDER
ORIGINAL ARTICLES
The aim of this study was to assess the prevalence of ataxia of stance in different types of alcohol-dependent patients. Posturographic measurements were performed in 82 abstinent alcohol- dependent patients and 54 healthy controls in order to analyse postural control According to Lesch and co-workers, alcohol dependence was classified as total abstinence (Type I), drinking without loss of control (Type II), fluctuating course (Type III), and persistent severe drinking (Type IV). The mechanisms of alcohol dependence in these subtypes can be summarized as follows: Type I patients drink alcohol to counteract symptoms of alcohol withdrawal; Type 11 patients use alcohol as an agent for solving conflicts; Type III patients drink alcohol to ‘treat’ an affective disorder, and Type IV patients have a history of pre-alcoholic neurological and/or psychiatric disorders. The neurological examination showed pathological findings in 39%, whereas posturographic measurements uncovered impaired postural control in 61% (<it>x</it>2 = 8.8, <it>P</it> = 0.003). Comparing the different study groups revealed that ataxia of stance was most common in alcohol-dependent patients classified as Type IV (τ = 0.24, <it>P</it> = 0.005). In conclusion, posturographic measurements are superior to the clinical examination in detecting postural imbalance in alcohol-dependent patients. The prevalence of postural imbalance is highest in patients classified by Lesch as Type IV. Consequently, this type of alcohol dependence — characterized by pre-alcoholic neurological and/or psychiatric disorders, bears the highest risk of developing ataxia of stance.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/393
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008409
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4032015-05-19HighWireOUPalcalc:33:4
MODERATE DOSES OF ALCOHOLIC BEVERAGES WITH DINNER AND POSTPRANDIAL HIGH DENSITY LIPOPROTEIN COMPOSITION
HENDRIKS, HENK F. J.
VEENSTRA, JAN
VAN TOL, ARIE
GROENER, JOHANNA E. M.
SCHAAFSMA, GERTJAN
ORIGINAL ARTICLES
Moderate alcohol consumption is associated with a reduced risk of coronary heart disease. In this study, postprandial changes in plasma lipids, high-density lipoprotein (HDL) composition and cholesteryl ester transfer protein (CETP) and lecithin: cholesterol acyltransferase (LCAT) activity levels were investigated in response to moderate alcohol consumption. A dose of 40 g of alcohol was consumed as beer, wine or spints by eight healthy middle-aged men before and during dinner thus simulating social drinking. Lipid parameters were studied before, and at 1, 3, 5, 9, and 13 h after dinner. An alcohol- induced elevation of plasma triglycerides was observed at 3 and 5 h after dinner, but total plasma cholesterol and apolipoprotein B were hardly affected. HDL lipids changed during the postprandial phase after alcohol consumption, HDL triglycerides were elevated at 5 and 9 h, RDL phospholipids were elevated at 9 and 13 h, and HDL cholesterol was elevated at 13 h. A 6% increase in the concentration of apolipoprotein A-II was observed at 13 h. Plasma LCAT activity was slightly increased 9 h after dinner, but CETP activity levels were not affected. The LCAT changes appeared similar for all three alcoholic beverages. It is concluded that moderate alcohol consumption with dinner affects plasma triglyceride concentration as well as HDL composition.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/403
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008410
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4112015-05-19HighWireOUPalcalc:33:4
PREVENTION OF ALCOHOL ABUSE-RELATED BIRTH EFFECTS -- I. PUBLIC EDUCATION EFFORTS
ABEL, ERNEST L.
ORIGINAL ARTICLES
Maternal alcohol abuse during pregnancy can result in a pattern of anomalies in children called ‘fetal alcohol syndrome’ (FAS) and more recently, ‘fetal alcohol abuse syndrome (FAAS)’. FAAS as well as individual alcohol-related anomalies, called ‘alcohol abuse-related birth effects’ (AARBEs), are widely considered to be totally preventable, because they stem from a behaviour that is presumably modifiable. However, current strategies to reduce their occurrence are more palliative than preventive, because their underlying premise, viz, that raising public awareness of the potential dangers of commonly used substances such as alcohol is enough to reduce their use, lacks empirical support. Moreover, in some cases they are also counter-productive. After considenng the relevant literature, this review contends that ‘universal’ public education efforts will only be effective in reducing FAAS and AARBEs if they focus on the cause of these disorders, which is alcohol abuse rather than the currently open-ended message that any amount of alcohol consumption during pregnancy constitutes a danger to an unborn child. This argument lays the ground work for an alternative and more pragmatic strategy set forth in the following paper for preventing FAAS and AARBEs.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/411
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008411
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4172015-05-19HighWireOUPalcalc:33:4
PREVENTION OF ALCOHOL ABUSE-RELATED BIRTH EFFECTS -- II. TARGETING AND PRICING
ABEL, ERNEST L.
ORIGINAL ARTICLES
Current public health measures to reduce the occurrence of fetal alcohol abuse syndrome (FAAS) and alcohol abuse-related birth effects (AARBEs) have been ineffective, because they target alcohol consumption, rather than alcohol abuse. The present discussion contends that the most effective public health strategy for reducing FAAS and AARBEs is a combination of more specific public health messages that target alcohol abuse, coupled with higher taxes on alcohol beverages. Although alcohol consumption by alcohol abusers has been thought to be inelastic to price changes, recent studies have found that both heavy drinking and binge drinking are sensitive to alcohol price changes, and price elasticities are relatively high for heavy drinkers who are aware of the consequences of their drinking. Although price increases may have a disproportionate impact on lower socioeconomic groups, this article concludes that they are justifiable from both a utilitarian and a categorical imperative perspective.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/417
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008412
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4212015-05-19HighWireOUPalcalc:33:4
IMPROVEMENT IN ALCOHOLICS MEASURED USING THE GENERAL HEALTH QUESTIONNAIRE
HOES, MELCHIOR J. A. J. M.
ZEIJPVELD, JOHAN H. B.
RUIJGROK, MAGGY
ORIGINAL ARTICLES
Over a 1-year study period all patients admitted to the department of psychiatry in a general hospital were asked to complete the General Health Questionnaire at admission, discharge, and first polyclinic (outpatient) follow-up contact. Seventeen per cent of admissions were alcoholics. Alcoholics improved rapidly after admission to the psychiatric department. This improvement was comparable to that of all the (psychiatric) patients admitted and continued after discharge.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/421
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008413
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4242015-05-19HighWireOUPalcalc:33:4
COMPARISON OF CAGE AND MAST WITH THE ALCOHOL MARKERS CDT, {gamma}-GT, ALAT, ASAT AND MCV
WETTERLING, TILMAN
KANITZ, ROLF-DIETER
RUMPF, HANS-JÜRGEN
HAPKE, ULFERT
FISCHER, DOROTHEA
ORIGINAL ARTICLES
Many alcoholics deny abuse. To screen greater samples for alcohol dependence, short questionnaires, e.g. the CAGE or MAST are often applied. Frequently laboratory parameters [i.e. ‘alcohol markers’, such as carbohydrate-deficient transfemn (CDT), γ-glutamyl transferase or mean corpuscular volume of erythrocytes] are used to support the diagnosis of long-standing heavy alcohol consumption. In this study, the self-ratings (CAGE and MAST) were compared with the above laboratory parameters in an unselected sample of 204 patients admitted to a general hospital. The sensitivities, specificities, and positive (PPV) as well as negative predictive values of the CAGE, the MAST, and the alcohol markers were calculated along with the reported alcohol consumption or the ICD-10 diagnosis as standard. According to recent harmful alcohol consumption levels (women > 225 g/week; men > 350g/week), the sensitivities and the PPVs were rather low in all tests (sensitivity < 60%; PPV < 50%). With the ICD-10 diagnosis as standard, the CAGE and MAST showed a rather high specificity (<95%) and PPV (about 90%). CDT revealed the best PPV of all alcohol markers (60%). However, the sensitivity of the CAGE, MAST, and the alcohol markers for the ICD-10 diagnosis was rather poor (<60%) This low sensitivity impedes the usefulness of these questionnaires and alcohol markers as screening tests for alcoholism in general hospitals.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/424
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008414
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4312015-05-19HighWireOUPalcalc:33:4
URINARY EXCRETION OF METHANOL AND 5-HYDROXYTRYPTOPHOL AS BIOCHEMICAL MARKERS OF RECENT DRINKING IN THE HANGOVER STATE
BENDTSEN, PREBEN
JONES, A. WAYNE
HELANDER, ANDERS
ORIGINAL ARTICLES
Twenty healthy social drinkers (9 women and 11 men) drank either 50 g of ethanol (mean intake 0.75 g/kg) or 80 g (mean 1.07 g/kg) according to choice as white wine or export beer in the evening over 2 h with a meal. After the end of drinking, at bedtime, in the following morning after waking-up, and on two further occasions during the morning and early afternoon, breath-alcohol tests were performed and samples of urine were collected for analysis of ethanol and methanol and the 5-hydroxytryptophol (5-HTOL) to 5-hydroxyindol-3-ylacetic acid (5-HIAA) ratio The participants were also asked to quantify the intensity of hangover symptoms (headache, nausea, anxiety, drowsiness, fatigue, muscle aches, vertigo) on a scale from 0 (no symptoms) to 5 (severe symptoms). The first morning urine void collected 6-11 h after bedtime as a rule contained measurable amounts of ethanol, being 0.09 ± 0.03 g/l (mean ± SD) after 50 g and 0.38 ± 0.1 g/l after 80 g ethanol. The corresponding breath-alcohol concentrations were zero, except for three individuals who registered 0.01–0.09 g/l. Ethanol was not measurable in urine samples collected later in the morning and early afternoon. The peak urinary methanol occurred in the first morning void, when the mean concentration after 80 g ethanol was {small tilde} 6-fold higher than pre-drinking values. This compares with a {small tilde} 50-fold increase for the 5-HTOL/5-HIAA ratio in the first morning void. Both methanol and the 5-HTOL/5-HIAA ratio remained elevated above pre-drinking baseline values in the second and sometimes even the third morning voids. Most subjects experienced only mild hangover symptoms after drinking 50 g ethanol (mean score 2.4 ± 2.6), but the scores were significantly higher after drinking 80g (78 ± 7.1). The most common symptoms were headache, drowsiness, and fatigue A highly significant correlation (<it>r</it> = 0.62–0.75, <it>P</it> <0.01) was found between the presence of headache, nausea, and vertigo and the urinary methanol concentration in the first and second morning voids, whereas 5-HTOL/5-HIAA correlated with headache and nausea. These results show that analysing urinary methanol and 5-HTOL furnishes a way to disclose recent drinking after alcohol has no longer been measurable by conventional breath-alcohol tests for at least 5–10 h. The results also support the notion that methanol may be an important factor in the aetiology of hangover.
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/431
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008415
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4392015-05-19HighWireOUPalcalc:33:4
CALENDAR
Calendar
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/439
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008416
en
Copyright (C) 1998, Medical Council on Alcohol
oai:open-archive.highwire.org:alcalc:33/4/4422015-05-19HighWireOUPalcalc:33:4
EUROPEAN SOCIETY FOR BIOMEDICAL RESEARCH ON ALCOHOLISM (ESBRA)
ESBRA
Oxford University Press
1998-07-01 00:00:00.0
TEXT
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http://alcalc.oxfordjournals.org/cgi/content/short/33/4/442
http://dx.doi.org/10.1093/oxfordjournals.alcalc.a008417
en
Copyright (C) 1998, Medical Council on Alcohol