Alcohol and obesity: A new look at high blood pressure and stroke

Summary An investigation of the staff of a car assembly plant (3,351 persons) revealed a similarity between the change in relative body weight and diastolic blood pressure with age. There is a good temporal correlation between the course of alcohol consumption during life and the change of the relative body weight. German women had significantly less blood pressure for the same relative body weight than German men, and foreign employees had lower blood pressure than Germans In both cases the main cause is the difference in alcohol consumption. Besides obesity and hereditary factors, alcohol is the main cause of essential hypertension today. Epidemiological and experimental data indicate that there are two ways from alcohol to high blood pressure, a more direct one and an indirect one via obesity. Alcohol causes obesity via a change in metabolism (hyperinsulinism) rather than by higher caloric intake. In both ways alcohol is an important cause of stroke. To reduce body weight and blood pressure, a reduction of alcohol consumption should be recommended in addition to reduced caloric intake and increased physical activity as means of preventive neurology.     

Dexamethasone suppression and multiple hormonal responses (TSH,prolactin and growth hormone) to TRH in some psychiatric disorders

Summary Baseline and TRH-induced changes of thyroid stimulating hormone (TSH), prolactin (PRL), and growth hormone (GH) were measured in 15 healthy control subjects and 63 psychiatric inpatients with DSM-III diagnoses of major depression (n = 19), schizophrenic disorder (n = 20), alcohol dependence (n = 10), and adjustment disorder (n = 14); baseline and postdexamethasone cortisol (CS) were also determined 3–6 days after the TRH-challenge. All patients and controls were women of similar mean age, weight, height, and they were free from interfering illness or drugs.Baseline TSH and PRL were lower in depression, TRH-induced TSH and PRL responses were lower in the whole patient group, but most markedly in depression and alcohol dependence. Postdexamethasone CS was significantly higher in depression, schizophrenia and alcohol dependence. Basal GH did not differentiate the subgroups; TRH-induced pathological GH responses were sometimes found in the patient groups. The differences were most marked quantitatively in major depression: a multivariate analysis of variance showed that TSH, postdexamethasone CS and PRL were the most important variables in separating patients from controls. A discriminant function derived from these variables classified all controls and 18 of 19 depressed patients correctly; however, 25 of the 44 other patients were also classified with depression.It was confirmed that psychiatric patients show significantly more endocrine disturbances than controls, and this was seen not only in major depression but also in at least three other conditions. Further work is needed to identify other neuroendocrine patterns more specific to depressive disorder.     

Bladder cancer and the consumption of alcoholic beverages in Spain

The relationship between bladder cancer and alcohol consumption was investigated in a case-control study conducted in 546 patients (453 males and 53 females) with diagnoses of papillary urothelial carcinoma during 1978–1982 at La Paz hospital (Madrid), and an equal number of controls matched for age, sex and date of admission to the hospital. The results showed that the risk of bladder cancer does not increase with the intake of beer, wine and spirit beverages. However, a high risk of bladder cancer was associated with consumption of wine mixed with gaseosa (a refreshment beverage consisiting of carbonated water plus artificial sweeteners).     

Attenuation of ethanol tolerance by a novel stimulus

A Pavlovian conditioning model of tolerance emphasizes that an association between predrug cues and the systemic effects of the drug contributes to tolerance. On the basis of this model, established tolerance should be attenuated by external inhibition, i.e., by presentation of a novel, extraneous stimulus. This prediction was evaluated in the present experiment. Rats that were so tolerant to the hypothermic effect of ethanol that they evidenced no drug-induced decrease in temperature were presented with a bright strobe light following ethanol administration. The light precipitated a large decrease in temperature in these rats. These results provide further evidence that tolerance to the hypothermic effect of ethanol is, in part, mediated by learning.     

Studies with {α 2}-adrenoceptor agonists and alcohol abstinence syndrome in rats

Various ₂-adrenoceptor agonists were assessed for their effects on alcohol abstinence syndrome in rats. In the first experimental model, groups of Wistar rats were made alcohol dependent by feeding alcohol together with sweetened milk for 15 days. The volume of fluid intake was measured every 12 h to determine daily ethanol consumption. Abstinence signs following abrupt alcohol withdrawal were observed in control as well as test groups receiving various ₂-adrenoceptor agonists. Clonidine, guanfacine and B-HT 920, in equimolar concentration (0.5 M/kg), effectively attenuated the various abstinence signs, which developed after alcohol withdrawal. In the other experimental model, rats were subjected to cold water immersion to induce wet shakes. The inhibitory action of ₂-adrenoceptor agonists was assessed in this test model. Clonidine, guanfacine and B-HT 920 markedly suppressed the cold water immersion-induced wet shakes and pretreatment with yohimbine (0.1 and 2.0 M/kg) reversed this inhibitory effect. The present data reveal the possible therapeutic potential of ₂-adrenoceptor agonists in alleviating alcohol abstinence syndrome, and suggest that the resultant reduced noradrenergic activity may be responsible for the beneficial action.     

双色谱柱双FID顶空气相色谱法测量乙醇 浓度的一致性评价

目的 研究双色谱柱双FID检测器顶空气相色谱法（双柱双检法）测量乙醇浓度的一致性,探讨不同一致性评价方法应用价值,为司法鉴定中涉嫌“醉驾”案件准确检测乙醇浓度提供理论依据。方法 配置浓度为80mg/100ml 乙醇溶液和4mg/100ml叔丁醇的混合样。使用自动进样器进样,然后用配备色谱柱和双FIDs的HS-GC分别分析样品。共进行了20次试验,分别计算FID-1和FID-2组的乙醇浓度。采用配对 t 检验、Pearson相关分析、组内相关系数、Bland- Altman 法、ATE/LER区域法等,对两组乙醇检测结果进行一致性评价。结果 FID-1组乙醇浓度为（79.57±1.65） mg/100ml,RSD为2.07%;FID-2组为（81.42±1.33） mg/100 ml,RSD为1.63%。配对 t 检验: t =-7.69（ P <0.001）;Pearson相关系数: r =0.757（ P <0.001）;组内相关系数: ICC =0.739（ P <0.001）;Bland-Altman 法显示,95%的点均落在一致性限内;ATE/LER区域法显示,100%点落在ATE区域,无点落在LER区域。结论 推荐联合使用Bland- Altman图分析法、ATE/LER区域法和组内相关系数作为双柱双检法检测样本中乙醇浓度的一致性评价方法。 双柱双检法测量乙醇浓度的一致性良好。但还应结合测量不确定度等方面对FID-1、FID-2的结果进一步研究。     

Dietary Intakes of Patients with Alcohol Use Disorder During a 4-Week Protocol on an Inpatient Treatment Unit Found to Meet Dietary Reference Intakes for Macronutrients,but Have Variability in Energy Balance and Adequacy of Micronutrient Intake

BackgroundDespite literature supporting the importance of diet during rehabilitation, minimal research quantifies dietary intake during treatment for alcohol use disorder (AUD).ObjectiveThe aim was to quantify dietary intake and energy balance of patients with AUD during inpatient treatment.DesignThis was a secondary analysis of data from a 4-week observational protocol. Participants self-selected food from a room service menu. Dietary intake was recorded by patients and reviewed by nutrition staff. To quantify nutrient and food group intake, data were coded into Nutrition Data Systems for Research software, versions 2016 and 2017. Daily average intake was calculated for all dietary variables.Participants/settingParticipants (n = 22) were adults seeking treatment for AUD at the National Institutes of Health Clinical Center (Bethesda, MD) between September 2016 and September 2017 and who were enrolled in a study examining the microbiome during AUD rehabilitation. Four participants discontinued protocol participation before study week 4 and were not included in analyses examining change over time.Main outcome measuresWeight change, daily energy, and macronutrient and select micronutrient intakes were the main outcome measures included.Statistical analyses performedMean differences in intake and weight were assessed using nonparametric tests.ResultsSixty-four percent of participants were male; mean ± SD age was 46.3 ± 13.0 years, mean ± SD body mass index (calculated as kg/m²) was 23.9 ± 2.5, and mean intake was 2,665 kcal/d (consisting of 45.9% carbohydrate, 34.9% fat, and 19.1% protein). Eighty percent or more of this sample met the Estimated Average Requirement for 10 of 16 micronutrients assessed. Male participants consumed more energy than estimated needs (P = .003) and gained a mean ± SD of 2.67 ± 1.84 kg (P = .006) when an outlier with weight loss and acute pancreatitis was removed from analysis. Female participants did not gain weight or consume more than estimated energy needs.ConclusionsOverall macronutrient intake was within recommended ranges, but intake of other dietary components and weight gain were variable, supporting the need for individualized nutrition care during AUD treatment.     

急性肺水肿不同湿化剂吸氧疗效的实验研究

目的通过对急性肺水肿不同湿化剂吸氧疗效的动物实验,筛选一种合适的湿化剂.方法复制急性肺水肿的动物模型,给予蒸馏水及不同浓度的乙醇、丁醇湿化吸氧,观察吸氧前后PaO2变化及支气管肺泡灌注液(BALF)中SOD及血浆NO变化情况.结果各组PaO2在吸氧后明显增高,尤以15%、25%乙醇组增高显著(P均<0.01),肺系数显著低于未吸氧组(P<0.01);15%乙醇组BALF中SOD显著高于其它各组(P<0.05),血浆NO在吸氧后亦明显升高,但与其它各组无显著性差异.结论①低浓度乙醇(15%～25%)为最佳湿化剂浓度,丁醇不适合作湿化剂;②不同湿化剂对肺水肿吸氧疗效的影响除与其消泡作用有关外,尚与水肿液成份及其它因素有关.     

Cirugía bariátrica y trastorno por abuso de alcohol y otras sustancias: una revisión sistemática

IntroductionBariatric surgery is a relatively safe surgical procedure with a high success rate. However, recent reports indicate a higher prevalence of alcohol or substance abuse disorder in this patient group. The purpose of this study was to review the related evidence to serve as a reference for multidisciplinary teams who treat these patients.MethodsWe searched the PubMed and CENTRAL databases. The odds ratios were extracted from the different articles, comparing the prevalence of the abuse of alcohol or other substances in the postoperative period versus preoperative levels. We also compared the prevalence of alcohol use disorder after different types of bariatric surgery.ResultsA total of 49 121 bariatric patients (80.8% female) were evaluated for alcohol use disorder. In general, bariatric surgery was found to be associated with an increase in the prevalence of alcohol abuse (4.58±5.3 vs. 1.58±10.7% in the preoperative period). We also found that the population of patients who underwent RYGB procedures had a higher prevalence of alcohol use disorder than patients who underwent another type of surgery (OR: 1.83; 95% CI: 1.51-2.21). The prevalence of substance abuse disorder (other than alcohol) after this procedure is less studied, although there appears to be an increased risk of abuse of certain substances.ConclusionsBariatric surgery is the best treatment for obesity and its complications. The evidence reviewed suggests that it correlates with a modest but consistent increase in the prevalence of abuse of alcohol and other substances. Medical teams who treat bariatric patients must be informed about this eventuality for its timely prevention, diagnosis and treatment.     

Effect of ethanol on dynamic visual acuity during vertical body oscillation in healthy volunteers

Visual orientation is the most important sensory input during locomotion (e.g. walking, driving a car, riding a bicycle). We investigated dynamic visual acuity (DVA) during vertical body-oscillations (amplitude 5 cm; frequency 1.5 Hz) in 12 healthy subjects before and twice after ethanol consumption. During oscillation, vertical eye movements were recorded under two test conditions: with eyes closed (EC) and during DVA testing. A significant increase in vertical eye-amplitude after ethanol ingestion occurred only during EC tests, as a possible sign of vestibular hyperreaction. During vestibular stimulation alone (EC), ethanol did not affect the phase shift between stimulus and eye movements. However, when the subjects were given an additional visual stimulus (DVA), the post-alcohol phase shift rose significantly. Surprisingly, the post-alcohol phase shift values for the two test conditions showed no significant differences. After ethanol ingestion we found no changes in static visual acuity but a significant loss of DVA. Volunteers with a change of DVA threshold (DVAT) showed significantly (P = 0.004) higher post-alcoholic changes in the phase shift. In summary, low doses of ethanol disturbed the visually guided oculomotor response during fixation of an earth-fixed target while the observer was subject to linear vertical acceleration. This effect led to an increasing delay between the beginning of body and eye movements. The consequence was an increasing phase shift and thus a decrease in DVA during whole-body oscillation which was comparable to movements during human locomotion. Received: 8 March 2000 / Accepted: 18 April 2000