Easy Ways To Quit Alcohol

Alcohol Free Forever

This powerful guide walks you step-by-step through exactly what you need to do to free yourself from your alcohol addiction without going through AA meetings or expensive sessions. There are three main types of relaxation techniques you can practice when you feel upset and stressed. If you practice regularly, they will become part of your lifestyle and you may find yourself habitually more relaxed as a result. Part 2 will exercise Neuro Linguistic Programming to release thoughts and a technique of progressive muscle relaxation also negative situations. Because of the mind body connection, exercises to relax the body will also flow through the mind. Much of the stress we feel is because of our resistance to certain feelings or emotions. Alcohol Free Forever is a lifesaver ebook. This guide was extremely eye-opening and the daily emails make it extremely easy to quit and to establish a routine that did not involve alcohol. Read more...

Alcohol Free Forever Summary


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Author: Mark Smith
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Moderate Alcohol Intake

Alcohol use can either harm or protect your memory, depending on how much you consume. There is no question that heavy drinking contributes to memory loss. Excessive alcohol consumption is toxic to neurons and is the leading risk factor for Kor-sakoff's syndrome, a disorder caused by thiamine deficiency and characterized by sudden and usually permanent memory loss. On the other hand, research suggests that moderate alcohol consumption (one or two drinks per day) may help prevent dementia. If you have been drinking heavily, discontinuing or sharply reducing your alcohol consumption can help prevent further memory loss and may permit the restoration of whatever loss you have already suffered. If you do not drink, I wouldn't recommend that you start to do so. Your memory won't suffer if you avoid alcohol, especially if you follow the other measures for maintaining optimal memory.

Treatment of alcoholism the role of serendipity

One means of treatment for alcoholism is to give the addict a sedative relaxant drug such as diazepam for about seven days. After this time the worst of the unpleasant withdrawal symptoms will have receded. The patient still has to be kept away from alcohol and weaned off it, but the drug helps to reduce the craving. There are other newer drugs that also do this by increasing the substance GABA (see box above), they inhibit the activity of nerves in the brain that would otherwise increase when there is no alcohol present. so that the breakdown of the toxic acetaldehyde is inhibited, which then accumulates, producing the unpleasant symptoms of nausea, vomiting, and headache, even after a single drink. The drug used for this, antabuse, was discovered by chance. The chemical disulphiram was used in industry, and it was noticed that those working with it suffered unpleasant effects when they drank alcohol. In the 1940s two Danish scientists who were looking for a new drug treatment for...

How Alcohol Affects the Brain

Habitual drinkers experience a tolerance for alcohol so that nerve cells in the brain become less and less responsive to a given amount of alcohol. Paradoxically, however, after years of drinking, many alcoholics experience a reduced tolerance. One theory is that long-term alcohol abuse damages the right frontal lobe of the cerebral cortex, which is responsible for spatial skills and perception. This could be the reason why verbal skills (controlled mainly by the left side of the cortex) are relatively unharmed.

American Society for Stereotactic and Functional

Amnesia following an injury (such as a concussion) in areas of the brain concerned with memory function is known as traumatic amnesia. Degenerative disorders such as Alzheimer's disease or other types of dementia may also cause amnesia, as can infections such as encephalitis or a thiamine deficiency in alcoholics. Amnesia could also be caused by a brain tumor, a stroke or a subarachnoid hemorrhage, or certain types of mental illness for which there is no apparent physical damage.

Work Related Conditions and Health

European researchers and, to a somewhat more limited extent, U.S. researchers. Although longitudinal studies of European populations have demonstrated a significant relationship between unemployment and higher standardized mortality ratios (SMRs), even after adjusting for age and social status (Moser et al., 1984, 1986, 1987 Costa and Segnan, 1987 Iversen et al., 1987 Martikainen, 1990 Kasl and Jones, 2000 Stefansson, 1991), U.S. data based on the U.S. National Longitudinal Mortality Study (Sorlie and Rogot, 1990) have shown no significant association between age, education, and income-adjusted SMRs and unemployment for either men or women. However, other U.S. epidemiological findings associate unemployment or risk of job loss with health conditions such as depression and engagement in negative health behaviors such as substance abuse, poor diet, and inactivity (Dooley et al., 1996). Analysis of panel data from the U.S. Epidemiologic Catchment Area study suggested that the 1-year...

Clinical thiamin deficiency

In Wernicke's disease, failure of energy metabolism predominantly affects neurons and their functions in selected areas of the central nervous system. Biochemical lesions that affect TKL and nucleic acid metabolism may cause glial changes. Membranous structures are visibly altered and secondary demyelination follows (Tanphaichitr, 1999). Prolonged alcohol consumption is associated with a variety of neuropsychiatric conditions, including the dense amnesic disorder known as Korsakoff's syndrome. Korsakoff's syndrome is frequently diagnosed in alcoholics after an episode of acute thiamin deficiency. The accepted view within the medical literature is that the etiology of this disorder lies in thiamin deficiency or Wernicke's encephalopathy. However, examination of the published reports of pure thiamin deficiency unaccompanied by chronic and excessive consumption of alcohol shows that, in this group of patients, the rate of progression to Korsakoff's syndrome is low. This result suggests...

Chlorpromazine Trade name Thorazine A

Still other studies have suggested that egg yolk (a dietary source of choline) may be useful to patients suffering from memory problems and seem to show an improvement in alcoholics and drug addicts. The major dietary source of choline is lecithin foods rich in lecithin include eggs (average size), salmon, and lean beef. While some researchers dismiss the idea that eating these foods can significantly improve memory, other scientists note at least that a normal level of lecithin in the diet may not be enough as people age.

Causes of decreased folate status

Dietary folate deficiency has been previously associated with poor socio-economic groups but now is thought to exist in 5-10 of the population of most communities. Intestinal absorption is impaired in those with coeliac disease or tropical sprue which if left untreated can lead to folate deficiency (Scott, 2000) (see also section 3.33). Pregnancy is associated with increased folate catabolism, particularly in the second and third trimesters, when it exceeds intake. Women who enter pregnancy with adequate stores or receive prophylaxis during pregnancy will avoid deficiency. Haemolytic anaemia, a condition with increased cell division, can also lead to folate deficiency (Scott, 2000). Anticonvulsant drug therapy is associated with folate deficiency but the mechanism is not known (Scott, 2000). It was suggested that the drugs cause folate malabsorption or excretion of folate through hepatic enzyme induction but this theory has now been discarded. Chronic alcoholics usually have folate...

The Treatment of Focal Syndromes

The treatment of patients with isolated memory impairments (amnestic syndrome) includes searching for an etiology and ensuring safety. If alcohol abuse or thiamine deficiency is possible, the physician should prescribe thiamine, 100 mg im followed by 100 mg po qd. If alcohol abuse or thiamine deficiency is unlikely, cerebrovascular disease may be present and, if identified, should be treated appropriately. About 50 percent of patients who present with isolated memory impairment progress to a dementia syndrome within two years. Patients with aphasia should be referred for speech therapy. Otherwise, patients with focal syndromes should be treated using the general principles described under the treatment of dementia.

Diet and physical activity

There is some evidence to suggest that diet and physical activity also may have an effect on insulin resistance and the metabolic syndrome that is independent of obesity. In the Framingham Offspring Study, wholegrain intake (mainly from cereal fibre) was found to be associated with a lower prevalence of the metabolic syndrome whereas dietary glycaemic index was positively associated with prevalence of the metabolic syndrome after adjustment for confounding lifestyle and dietary factors other than BMI (gender, age, cigarette dose, total energy intake, alcohol intake, percentage of saturated and polyunsaturated fat, multivitamin use and physical activity) (McKeown etal., 2004). In the same report from the Framingham Offspring Study the authors also reported that insulin resistance as assessed using the homeostatic model assessment of insulin resistance (fasting insulin x fasting glucose 22.5) was inversely associated with wholegrain foods, dietary fibre, cereal and fruit fibre and...

Phase Ii Metabolizing Enzymes Glutathione Stransferases

In one of the most recent studies, Verlaan et al. investigated whether polymorphisms in the GSTM1, GSTT1, and GSTP1 genes modify the risk for chronic pancreatitis.69 In this study, the rates of GSTT1 and GSTP1 genotypes did not differ between chronic pancreatitis patients and healthy controls. GSTM1 null genotypes, on the other hand, were significantly less common in patients with chronic pancreatitis induced by alcohol as compared to alcoholics without pancreatitis and normal controls. The authors concluded that GSTM1 null alcohol users are less susceptible to chronic pancreatitis.

Treatment and Monitoring

Treating the patient diagnosed with osteoporosis takes a multipronged approach that includes an assessment of additional risk factors that the patient can control or modify. Unless the patient has a history of renal stones or hypercalcemia, one of the first steps is to encourage increased calcium and vitamin D intake through diet or supplementation. Habits that are known to correlate with increased bone loss, such as smoking or excessive alcohol consumption, are discouraged. Exercise, particularly weight-bearing exercise, improves bone density and is encouraged.

Incidence of Mental Illness

In 1996, a large-scale nationwide mental health and substance abuse epidemiological study was conducted by researchers from the University of Antioquia and the University CES of Medellin. Funded by the Ministry of Health and working with a national team of more than 100 interviewers, the researchers interviewed a random sample of 15,046 individuals older than 12 years of age across the country, using the Clinical Diagnostic Inventory II questionnaire, which is based on the DSM-IV classification. This is the most comprehensive mental health study ever conducted in Colombia. The lifetime prevalence of diagnosable disorders was as follows nicotine dependency, 28 major depression, 19.3 alcohol abuse and dependency (combined), 16.6 posttraumatic stress disorder, 4.5 somatization, 4.3 generalized anxiety, 3.8 and schizophrenia, 1.4 . The lifetime use of marijuana was 7.8 and of cocaine 2.5 (Torres and Montoya 1997). Suicide is also a public health problem in 1995, a total of 58,830 suicides...

Suicide and Psychiatric Disorders

Clinical and community studies reveal that patients with psychiatric disorders have a remarkably high lifetime risk of completed suicide. Major depression has been associated with a 15-20 percent rate of completed suicide in follow-up of hospitalized patients (who are at higher risk for suicide because suicidal thought and self-injurious behavior are strong indications for hospitalization). Individuals with depression diagnosed in community surveys have a 5 percent lifetime risk of completed suicide (about 500 times the general population rate in the United States). Alcoholism and schizophrenia are associated with lifetime suicide rates in the 15-20 percent range.

Memory Myth Alcohol Destroys Memory

This doesn't mean that you should start drinking if you're opposed to using alcohol there are many other ways to protect your memory. But if you do drink, holding your alcohol intake to one or two beverages per day could keep your brain healthy. I advise patients to limit their use of alcohol one or two drinks a day seems to be a sensible amount for protecting memory and optimizing other health concerns. In terms of alcohol equivalency, one drink equals twelve ounces of beer, five ounces of wine, or one and a half ounces of distilled spirits. This doesn't mean that nondrinkers should start drinking, but this benefit is worth noting if you do drink alcohol.

Suicide and Medical Disorders

Medical disorders associated with an elevated risk of suicide are AIDS, cancer (especially head and neck), Huntington disease, multiple sclerosis, peptic ulcer disease, end-stage renal disease, spinal cord injury, and systemic lupus erythematosus. Any serious medical illness can raise the risk of suicide in elderly Caucasian men. In most cases, suicide in the context of a medical disorder occurs in conjunction with a depressive disorder or a history of alcohol abuse, or both.

Acculturation and Mental Health Symptoms

As the result of migration, some Colombian families tend to present marital conflicts, difficulties in communication with their teenage children, and symptoms of posttraumatic stress disorder. Alcoholism tends to be common in males depression occurs frequently in women (Leon 1993). Colombians also show frequent symptoms of somatization, resulting from postmigration stress. Escobar (1987 Escobar et al. 1983) documented higher somatization indexes among Colombian patients with major depression compared to North American patients.

The Nature of Causality

Material cause stems from the presence of some physical substance that is needed for a particular outcome. Aristotle suggested that bronze is an essential factor in the making of a bronze statue, but the concept is more general. Obesity in the United States, for example, is materially caused by the overproduction of corn (maize), just as Russian alcoholism is materially caused by the abundance of vodka.

Singlecase Studies Of Recovery Of Memory Function

Benson & Geschwind (1967), in a widely cited article, brought the phenomenon of shrinkage of retrograde amnesia into the realm of clinical neuroscience, even though the paper was primarily a descriptive report with minimal, formal neuropsychological testing. The patient had a history of occasional alcohol abuse, and although it was assumed that he had drunk heavily before his admission to hospital, there was clear clinical evidence to suggest that he had incurred a severe head injury. On admission, he was stuporous with a mild right hemiparesis. An EEG was abnormal and considered to be compatible with a subdural haematoma. One week after admission, the initial neurological state had improved, but the patient was noted to have a fluent dysphasia, abnormal behaviour and topographical disorientation in the hospital. When assessed 1 month after his admission, he appeared to have a marked anterograde and retrograde amnesia, giving the year as several years previous to the current one,...

Alcohol and Substance

Cuban Americans' socioeconomic conditions have permitted them to do well with respect to access to health and mental health services (Ruiz 1994 Ruiz et al. 1995). It has been found that the incidence of psychiatric illness among Cuban Americans does not differ from its incidence among other Hispanic-American subgroups, with the exception of substance abuse and alcoholism. Ruiz and Langrod (1982) found differences in the use of alcohol, marijuana, and cocaine among Cuban Americans, Mexican Americans, and Puerto Ricans. They found that 59.8 of Cuban Americans abstain from alcohol consumption, compared with 50.3 of Mexican Americans and 59.6 of Puerto Ricans. Cuban Americans also drink at a lower rate compared with the other two groups. The rate of cocaine use is much lower among Cuban Americans (9.2 ) than among Mexican Americans (11.1 ) or Puerto Ricans (21.5 ). Similarly, the rate of marijuana use is lower among Cuban Americans (20.1 ) than among Mexican Americans (41.6 ) or Puerto...

Davids Memory Treatment Plan

We then reviewed the effect of excessive and continuous stress on cardiovascular health, emotional well-being, and brain function. I pointed out that he had relinquished many of the activities that used to provide him with opportunities for recreation and stress release. He understood how time away from his work could paradoxically result in greater professional productivity. He promised to resume his workout routine and get back on schedule for weekly tennis matches with his oldest son. Without needing a lecture from me, he indicated his intention to reduce his alcohol consumption by regaining his discipline during his business lunches.

The Acquisition of Increased Tolerance

Patients with a high tolerance to alcohol, for example, readily develop similar tolerance to benzodiazepines, barbiturates, and anesthetic agents. A relationship exists between alcohol and opioids such that acetaldehyde, alcohols first metabolite, has been linked to increased production of endogenous opiates in the brain, which may explain the increased affinity for opioids observed among alcoholic persons and the frequency with which chronic pain patients develop alcoholism. Not all cross-tolerance is complete, however a fact with important implications for the treatment of withdrawal states.

The Awareness of a Compulsion to

The repeated urge to use can be experienced as a craving, which is readily acknowledged by most cocaine and heroin addicts. Patients dependent on alcohol may deny craving when asked about it directly but usually admit to a taste for beer that leads them to consume five or more in a single sitting. Patients often admit to self-imposed measures to resist further use (e.g., keeping busy, not permitting alcohol in the home, restricting access to ready cash for the purchase of drugs).

Specific Hepatic Toxins

The role of alcohol in the whole process is interesting. Alcohol induces the P450 oxidase system enzymes. Therefore, a relatively larger quantity of the acetaminophen will take the metabolic pathway to NAPQI. Alcoholics have suffered acetaminophen overdose on as little as 4 acetaminophen tablets per day.

Epidemiology Of Alcoholic Chronic Pancreatitis

A large number of studies have shown that alcohol consumption is the leading cause of chronic pancreatitis in industrialized countries. Based on these studies, approximately 70 of all cases of chronic pancreatitis can be attributed to this etiologic factor in industrialized countries with a variation from 38 to 94 in different investigations.1-8 However, the proportion of patients with alcoholic chronic pancreatitis varies considerably between the different studies. For an adequate interpretation of these results, several aspects have to be taken into account Precise information regarding alcohol consumption is frequently difficult to obtain. Furthermore, the amount of alcohol consumption that was used to define the disease as alcoholic pancreatitis was variable in the different investigations. The indistinguishable clinical picture of alcoholic and nonalcoholic chronic pancreatitis contributes to a potentially incorrect diagnosis. Of note, the International Classification of Diseases...

Answers and Discussion

Q1. (Answer b) Adriamycin, in common with virtually all chemotherapeutic agents, has high potential toxicity. In the case of this drug, the limiting toxicity is cardiac. More drug might have been beneficial in attacking the tumor but it would likely have been cardiotoxic. There was no mention in his history of chemical abnormalities nor of myocardial infarction during his treatment for the angiosarcoma. Q2. (Answer c) Alcohol is responsible for a range of liver pathology. Heavy drinking causes fatty liver that may progress to hepatitis that may progress to cirrhosis. Some small number of alcoholics develop liver cancer. The specific pathology resulting from alcohol is not predictable but it is certain that alcoholism correlates with risk of hepatic cancer. A history of alcohol abuse puts this patient in a higher risk category. Whether this is merely additive to the risk that arises from vinyl chloride exposure or whether it is greater than the additive risk predicted from each factor...

Implementation of the Plan

A history of major withdrawal phenomena (e.g., delirium tremens, acute withdrawal hallucinosis, seizures) calls for inpatient detoxification. Fever or significant medical comorbidity (such as pneumonia or systemic infection, liver or other active gastrointestinal disease, a history of cardiac dysfunction, malnourishment, and recent trauma) is also an indication for inpatient detoxification. Patients with psychiatric disorders (such as major depression, mania, panic disorder, and schizophrenia) or who are using multiple psychoactive drugs are best detoxified on inpatient psychiatric units. Patients with histories of major alcohol withdrawal but who are otherwise healthy can sometimes be safely detoxified in residential treatment facilities that have 24-hour medical supervision. Detoxification in such facilities is indicated for patients who have failed outpatient detoxification, Outpatient detoxification should be attempted only once and only after the results of baseline...

Recommendations for Clinicians

It is important to recognize that as a result of the constant contact that Dominicans in the United States retain with the Dominican Republic, their acculturation may differ from that of other Hispanics in the United States. The remigration process puts Dominicans in double jeopardy, because they feel marginalized and unintegrated in both the United States and the Dominican Republic. Remigration may make the process of acculturation not only difficult but at times improbable, as exemplified by the significant levels of maladjustment (Cosgrove 1992). Unemployment and the lowering of occupational status, particularly in professional men, can cause significant stresses among family members, aggravating the possibility of domestic violence, alcoholism, and negative effects on both marital relationships and parent-child relationships.

Peripheral Nerve Disorders

The primary care physician should keep in mind two considerations. First, unlike the complete sensorimotor dysfunction resulting from complete transection, symmetric neuropathies often give partial abnormalities. Small-fiber neuropathies, as seen in diabetes or alcoholism, selectively impair pain and temperature sensation, leaving relatively intact vibratory sensation, reflexes, and motor power (all subserved by large nerve fibers). Second, most of the cranial nerves are peripheral nerves that happen to be in the head. They may be involved in focal or symmetric dysfunction, just like their counterparts in the arms and legs.

Marilyn A Davies Chiaoying Chang and Bryan L Roth

This chapter first describes the structural changes involved in genetic polymorphisms, mRNA editing, and alternative mRNA splicing of 5-hydroxytryptamine (5-HT) receptors. These structural changes lead to modifications in the production and characteristics of 5-HT receptors and affect protein expression. Functionally, they affect radioligand binding, signal transduction, and receptor sensitivity, thus affecting interindividual variation in responses to therapeutic agents, particularly antipsychotics and antidepressants. Studies indicate that genetic polymorphic and post-transcriptional modifications of 5-HT receptor structure contribute also to pathological processes related to irritable bowel syndrome, cardio-pulmonary problems, psychiatric illness (i.e., schizophrenia and mood disorders), Alzheimer's disease, problems involving increased food and alcohol intake, and behavioral problems such as impulsivity, self-harm, and aggression. In the second part of this chapter, the 5HT2A,...

Alcohol our favourite drug

Gin Lane, by Hogarth, depicts the ravages and evils of drinking alcohol (gin was especially popular at that time in the 18th Century). majority of people probably don't consider alcohol to be a drug or that, like most drugs, it is a potential poison. Alcohol is a drug in the sense that it has particular desirable effects on the body people drink it in order to experience its pleasurable effects. It can also be addictive, and has been responsible for more death, disease, and ill health than any other single drug, with the exception perhaps of nicotine tobacco. The deaths due to alcohol number in the thousands, whereas those due to ecstasy amount to a handful. It is far more of a problem than all the drugs of abuse we tend to worry about, such as heroin and cocaine, because it is accepted by society, having been used by humans for several thousand years. Perhaps society, and politicians in particular, should be as concerned about the drug alcohol as about illegal drugs. There is now...

Whats all this about units

Effectively alcohol is removed from the blood at a constant rate of about 14 ml per hour (slightly more than 1 unit). People who drink infrequently have much slower rates, while those who drink more regularly (including alcoholics) may have much faster rates (see below). This means that it is difficult to predict the effects of a certain amount of alcohol on different individuals and it can vary even in the same individual.

The effects of alcohol on the brain and addiction

Because alcoholics break down the alcohol more quickly than other people, they may appear to be sober even when they have had several drinks (that is, until they sustain liver damage, when they may be more affected than the average person). Can alcoholism be treated Apart from simple abstinence and drug treatment to alleviate the withdrawal symptoms, there is a drug, antabuse, which helps alcoholics to stop drinking by making the effects of the alcohol unpleasant.

The protective effects of alcoholic drinks

It seems clear that alcohol reduces the level of 'bad' cholesterol in the blood (known as LDL) while increasing the level of 'good' cholesterol (HDL). It dilates blood vessels and lowers blood pressure (but chronic alcohol intake increases it). A decrease in colon cancer and Alzheimer's disease have also been associated with moderate drinking. There is evidence, in particular, that one or perhaps two glasses of red wine a day may be beneficial. This is the so-called 'French paradox', for the level of heart disease in France is one of the lowest in the world despite a diet traditionally rich in animal fats. The French also drink more red wine than other countries, and evidence seems to suggest that components in the grapes, polyphenols such as resveratrol, may be partly responsible for the low level of heart disease. One theory put forward is that this is due to the antioxidant effects of the polyphenols. Antioxidants such as vitamins C and E can react with and remove reactive...

Variability in the effects of alcohol sex and race

Some people in Asia have inherited an aldehyde dehydrogenase with reduced activity, which means that they accumulate acetaldehyde and makes drinking alcohol unpleasant. The alcohol levels in the blood are higher and stay that way for longer. Some people, both Caucasian and Japanese, also have inherited alcohol dehydrogenase which breaks down alcohol at a greater rate than average. It has been suggested that this may be a factor in alcoholism. The removal (known as clearance) of alcohol from the blood can vary, between 8 mg per i00 ml of blood per hour in non-drinkers to 39 mg per i00 ml of blood per hour in alcoholics. This means that a non-drinker could take two to three hours to remove i unit of alcohol, whereas an alcoholic could do this in thirty to forty minutes. relation between alcohol intake and adverse health effects. Everyone is different and what may be a safe intake for one person may be a risk for another, just as it is for other drugs. Clear information from...

Common Causes of Amnesia

Korsakoff's syndrome (thiamine deficiency associated with chronic alcoholism) Diencephalic amnesia can be caused by Korsakoff's syndrome (the result of a thiamine deficiency associated with chronic alcoholism), as well as by other nutritional deficiencies, traumatic brain injury, stroke, or a tumor that damages the thalamus. This type of amnesia includes deficits in executive function and insight.

Learning Disabilities Association

Treatment for learning disabilities is extremely important if the child is to be successful. In fact, 35 percent of students with untreated learning disabilities do not finish high school. Most students with learning disabilities were not fully employed one year after graduating from high school. Adolescents with untreated learning disabilities are at higher risk for drug and alcohol abuse. One study showed that up to 60 percent of adolescents in treatment for substance abuse had learning disabilities.

Treatment for Amnesia

With other causes of amnesia, the prospects for improvement also depend on the severity of the problem. Once a patient with thiamine deficiency and chronic alcoholism has crossed the threshold into Korsakoff's syndrome, deficits tend to be enduring. However, people with alcohol-related memory impairment that has not progressed to Korsakoff's can regain a substantial degree of memory function if they stop consuming alcohol, improve their diet, and remediate vitamin deficiency.

Genetic Classification Assists Risk Estimation

So far, the complex issues of interaction between genotype and environment are understood for only a small fraction of genetic diseases. This can make it difficult to sort out the genetic components of many traits that involve phe-nocopies or that may be conditional upon environmental effects, especially if there are many different genes and environmental factors that can affect the trait. Through the studies of geneticists, epidemiologists, and others, the complex interplay of genes and environment is gradually coming into focus. Will this eventually let us pinpoint who will become alcoholics if they take up drinking, or who it is that will develop lung cancer if they take up smoking The goal is to end up being able to offer estimates of altered risk in the presence of environmental effects. Those risk estimates will tell us who has susceptibilities that should lead to more medical monitoring, different treatments, or advice on how we should change our diets or other behavior...

Audit of volunteer screening procedures

On the basis of information from GPs, four volunteers were rejected for depressive illness, 18 for alcohol dependency, four for drug dependency, and six for neurological disorders (including one case of epilepsy and four of recent head injuries, two of whom had been prescribed prophylactic anti-convulsant drugs). The understated conclusion of the authors is 'Application to the GP for medical information on potential volunteers is an important step in the screening of volunteer subjects for clinical research'.

Lessons and challenges of study of ethnicity in terms of disease risk

There is marked heterogeneity within racial and ethnic groups. Thus, for example, South Asians are not a homogenous group but are made up of Indians, Pakistanis, Bangladeshis and Sri Lankans, and within these subgroups there are Hindus, Muslims, Christians and followers of other religions, with different lifestyle behaviours such as smoking habit (Sikhs are forbidden to smoke) and alcohol consumption (Muslims are forbidden to drink alcohol). However, it is now clear that people from the Indian

Prevention and Proaction The Path to Optimal Memory

No matter how old you are, it's not too late to take steps to prevent memory loss. In this chapter, I review thirteen strategies for achieving and maintaining optimal memory. Some are good health habits that can reduce the risk of illnesses that might impair your memory as well as the likelihood that you'll need medications with memory-related side effects. Others are strategies that appear to strengthen the brain and enhance cognitive function. Best of all, they're neither expensive nor difficult to carry out. Obtain regular exercise Put out the cigarettes Take vitamins Involve yourself with others Maintain healthful nutrition Aim for a good night's sleep Learn something new Moderate alcohol intake Engage in life Manage stress

Some Traits May Require A Threshold Number Of Deleterious Alleles

If all of this seems less solid or more confusing than simple Mendelian inheritance, it is. The understanding of polygenic traits and of genotype-environment interactions is becoming an increasingly interesting and profitable avenue of inquiry in human genetics. Multifactorial inheritance presumably underlies some of the more clinically important human traits, such as susceptibility to several major diseases or illnesses (e.g., heart disease, stroke, diabetes, schizophrenia). Some data also support the notion that alcoholism may involve multifactorial inheritance. It is also possible, as noted earlier, that this type of inheritance might play a role in establishing some crucial aspects of personality, as well. Thus it is worth considering just how one would recognize multifactorial inheritance in a pedigree.

Genetic Predisposition In Alcoholic Pancreatitis

There is good evidence that alcohol remains one of the most important toxic risk factors that are associated with CP (see Chapter 6 and Chapter 15). The risk for CP clearly has been shown to correlate with alcohol consumption in different parts of the world. In industrialized countries, long-term alcohol abuse accounts for approximately 70 of CP whereas in 25 , the cause remains generally unknown. Although acute pancreatitis is in approximately 50 of cases caused by events unrelated to alcohol, alcohol-related pancreatitis presents in most cases as a chronic disease state, even though the clinical course is not uniform and may vary. Recurrent episodes of acute inflammatory conditions may lead over time to chronic inflammation and fibrosis. Other observations suggest that CP may also arise independent of acute disease recurrences. Interestingly, the correlation between alcohol abuse and CP is not strict, as it appears that less than 5 of alcoholics develop pancreatitis as a consequence...

Elevated Triglycerides

If you have high triglyceride levels but normal levels of HDL and LDL, one of two things can be to blame a genetic abnormality or unhealthy lifestyle choices. More commonly, it's the latter. Normal triglyceride levels are less than 150. Levels of 200-1,000 can be caused by having uncontrolled diabetes, being significantly overweight, drinking too much alcohol, or taking certain medications. Medications that affect triglyceride levels include estrogen (either in hormonal replacement regimens or as part of an oral ,175

When the acceptable daily intake was too high

At one time, cobalt chloride, a salt of the metal cobalt, was added to beer in the USA as a foam stabilizer. Such salts had been used to treat people with anaemia at doses of 300 mg per day without any apparent problems. However, heavy beer drinkers, who drank about 10 litres per day, suffered effects on the heart, known as cardiomyopathy, a degeneration of the heart muscle, which was eventually ascribed to the cobalt. It transpired that, while cobalt alone was apparently not toxic to the heart, even at single doses many times higher than the exposure from the additive in beer, in the exceptionally heavy drinkers the toxic effects of cobalt were greatly increased. It turned out that the victims were malnourished individuals and deficient in particular amino acids, which was an important factor in increasing the toxicity of the cobalt. Furthermore, the excessive alcohol intake was itself an additional factor. The potentiation of the toxicity of cobalt was unexpected and so had not been...

Kochs postulates revisited

The design of the studies is very important, and control subjects should be of the same sex as the exposed subjects and as similar as possible in age and lifestyle. Those who set up and interpret epidemiological studies must be aware of sources of bias and any confounding factors, for example smoking or alcohol consumption by members of the population studied, especially when evaluating the incidence of certain diseases (for example, cancer or liver disease).

Reflections On Mental Illness And Psychiatry

Despite this shift in focus to biological models, prejudice and discrimination against the mentally ill persist, no matter the type of disease. Some people mistakenly believe that mental illness is caused by personal weakness, poor upbringing, or a defect in character. They think that sufferers of psychiatric disorders should just snap out of it. Yet the agitated homeless man talking to himself on the street and the chronic alcoholic who cannot quit drinking both suffer from pathophysiologic derangements. Just like mainstream conditions such as diabetes or high blood pressure, psychiatric disorders are biochemically based and require long-term treatment. Many colleagues in medicine who do not look highly upon psychiatry consider its treatments less effective than those in other areas of medicine. The evidence seemingly refutes this misperception. With its wide array of powerful drugs, treatment in modern psychiatry surpasses conventional therapies found in other areas of medicine. In...

The Line That Cant Be Crossed

People have substantial differences in what they can tolerate, different limits beyond which they cannot go. Some hit their limit when faced with terminating a pregnancy. Others hit their limit when faced with watching their baby die a long, slow painful death. Some hit a limit when faced with raising a child whose needs they know they cannot meet in a society that too often fails to live up to the ideal of offering a loving alternative home for such a child. So many factors contribute, including financial status, presence or absence of a social safety net to help a family cope, mental illness, alcoholism, and the presence of other family members who are desperately ill. A diagnosis of Duchenne muscular dystrophy in a child might well mean one thing to a young, happy, healthy, financially secure couple going through their first pregnancy in the context of a very supportive extended family but mean something quite different to a couple struggling with unrelated heath problems in the...

Sensory integration dysfunction 447

Many studies indicate that children with learning disabilities are at risk for later delinquency, criminal behavior, alcoholism, and drug abuse because of repeated failure in school. By interrupting the vicious cycle of failure, intervention to help children with sensory integration and learning problems may also prevent serious social problems later in life.

Mental Illness and Substance Abuse

Latina patterns of alcohol use have been studied in Mexicans, Puerto Ricans, and Cubans. The trends described in the 1984 Hispanic Health and Nutrition Examination Survey (HHANES) data indicated that Latina women drink less than men do and that traditional sanctions against women drinking appear to exist (Aguirre-Molina and Caetano 1994). However, according to more recent studies, acculturation and education appear to weaken the injunctions against drinking in Latinas. Female single heads of household appear to drink more than married females. Flores-Ortiz (1994) found that Latinas attending high school and college have considerable difficulty moderating alcohol consumption in the context of courting and sexual situations and that in spite of knowledge, information, and high levels of perceived self-efficacy, few actually have changed high-risk behaviors. For example, few young women understood that alcohol consumption increased their risk of sexually transmitted diseases, including...

Specific Types of Tremor

Everyone has a slight tremor of the outstretched hands that is usually not apparent. But under certain circumstances, this physiologic tremor may become symptomatic, or enhanced (Table 14.1). Such enhancement is normal after carrying a heavy bag of groceries or when nervous, hungry, cold, or febrile. These short-lived, situational tremors rarely come to medical attention. A similar tremor is often seen in the setting of drug and alcohol withdrawal or accompanying acute metabolic derangements such as hypo-glycemia or hyponatremia, and it disappears when the offending insult is resolved.

Weaknesses and Strengths in the LTM Performance of MR Individuals

The first reports of dissociable performance in MR individuals on LTM tasks supposed to tap theoretically distinguishable memory processes date back to the late 1980s. Ellis and co-workers (Ellis & Allison, 1988 Ellis et al., 1989 Katz & Ellis, 1991) reported a series of experiments contrasting the performance of MR and chronological age-matched individuals on memory tasks intended to investigate effortful or automatic memory processes in the context of an influential theoretical framework proposed by Hasher & Zacks (1979, 1984). According to these latter authors, critical differences between effortful memory tasks (e.g. the traditional free recall and recognition procedures) and automatic memory tasks (e.g. tests of frequency judgement and spatial location) reside in the amount of attentional resources and elaborative encoding implicated, which are maximal for the first type of memory task and minimal for the second. Hasher & Zacks (1979, 1984) theoretically argued (and...

Contrasting LTM Performance in Distinct Aetiological Groups of MR

A last aetiological group of studies concerns individuals with a maternal history of alcohol abuse during pregnancy. Animal models suggest a particular vulnerability of the hippocampus to gestational alcohol exposure (Abel et al., 1983), leading to particularly poor performance of these on spatial learning tasks (Blanchard et al., 1987). Uecker & Nadel (1996, 1998) hypothesized that there is more severe spatial than verbal and visual memory impairment in individuals with fetal alcohol syndrome. Consistent with the hypothesis, these individuals scored at the same level as chronological age-matched normal controls on the free recall of verbalizable pictures, but were significantly poorer than controls when requested to indicate the location in which each picture had been originally studied (Uecker & Nadel, 1996, 1998). However, further work, possibly correlating neuropsychological data with morphometric analysis of cerebral structures, is clearly needed.

Tumor necrosis factor TNF inhibitor Drugs that work to inhibit tumor necrosis factor

12-step program A self-help program to achieve a goal, usually sobriety, organized in a set number of stages (often but not always 12). These programs are carried out by members of such groups as Alcoholics Anonymous (AA the original 12-step program), Narcotics Anonymous (NA), Overeaters Anonymous (OA), and so forth. In most, the focus is on a mind-body-spirit approach to a behavioral problem.

David H Farb Janine L Steiger Stella C Martin Maria C Gravielle Terrell T Gibbs and Shelley J Russek

The y-aminobutyric acid (GABA) neurotransmitter acting through ionotropic and metabotropic receptor classes exerts the major inhibitory control in the central nervous system. Therapeutic agents targeting GABA receptors (GABA-R), such as benzodiazepines and baclofen, are used to treat many nervous system conditions, including anxiety and spasticity. The subunit composition of GABA-Rs at the cell surface plays a critical role in determining their physiological and pharmacological properties, and alteration of GABA-R subunit expression has been associated with a number of diseases including schizophrenia, temporal lobe epilepsy, and alcoholism. The ionotropic type A GABA receptor (GABAaR) and type C GABA receptor (GABACR) are pentameric complexes that comprise a ligand gated chloride channel. The metabotropic type B GABA receptor (GABABR) is a heterodimer that couples G protein-signaling to GABA binding. There are eight classes of ionotropic receptor subunits and only two metabotropic...

Definition and Classification

Hyperuricemia (serum urate > 7.0 mg dL) is a common laboratory finding, occurring in over 5 of adults on at least one occasion. Risk factors for hyperuricemia include increased body weight or mass index, elevated serum creatinine or urea nitrogen, alcohol intake, and male gender. Hyperuricemia leads to gout in a minority of instances. The majority of patients with asymptomatic hyperuricemia remain gout-free, but the greater the degree or duration of hyperuricemia, the more likely that gout will develop. The prevalence of clinical gout was estimated to be 13.6 per 1000 men and 6.4 per 1000 women in a 1986 study, but evidence suggests that the prevalence of disease is rising. The peak incidence occurs in middle-aged males.

Principles of Substance Abuse Treatment

As stated earlier in the chapter, Hispanic women may underreport their alcohol use because of the austere cultural proscriptions they face when drinking. Clinicians must stress to all Hispanic female drinkers of childbearing age, whether known to be pregnant or not, that there is no known safe level of alcohol consumption during pregnancy and that they should abstain completely if possible. Some are tragically unaware that although they may deliver apparently healthy babies without physical signs of fetal alcohol syndrome, myriad neuropsychiatric problems are attributable to gestational alcohol intake, such as speech and language delays, learning disabilities, and emotional instability, which sometimes do not become evident until well after birth. It is helpful for clinicians to present balanced points of view to their Hispanic patients when the media sensationalize a particular drug issue. For example, the past media reports of low to moderate alcohol ingestion reducing cholesterol...

Where Did the Red Cells Go

A 60-year-old man complained of progressive dyspnea over two weeks. Review of systems was negative for productive cough, chest pain, fever, myalgias, arthralgias, weight loss, change in bowl habits, or signs of gastrointestinal or genitourinary tract bleeding. He smoked two packs of cigarettes a day, and had stopped drinking alcohol five years ago on the advice of his physician. He was not taking any prescribed medicines, over-the-counter drugs, or natural health aids. No abnormalities were noted on physical exam other than a resting tachycardia (pulse 96 bpm), pale conjunctiva, and a 2 6 systolic ejection murmur. The following tests were performed in his doctor's office urine dip stick, negative stool occult blood test, negative spun hematocrit, 25 . A CBC performed three months ago as part of a routine evaluation was normal. The patient was admitted to the hospital. Upper endoscopy and colonoscopy were immediately performed, and both studies were normal.

Personal Orientation Inventory

Everett Shostrom (1964) reported that his inventoiy distinguished between groups nominated by clinicians to be self-actualized or not self-actualized and that meaningful changes in scores occurred during the course of psychotherapy. Several studies have validated the POI through criterion group studies that is, groups thought to be more self-actualized score higher than those assumed to be less self-actualized (Hattie & Cooksey, 1984). For example, medical patients score higher than alcoholics, who score higher

Mistaken Styles of Life

Ruling types seek to dominate others. They may actively confront life's problems in a selfish way, becoming delinquents, tyrants, sadists (Ansbacher & Ansbacher, 1956, p. 168). Adler (1998) described, for example, a school girl who acted sarcastically and arrogantly toward her peers, seeking satisfaction there because she was unable to do her schoolwork. Or, if less active, ruling types may attack others indirectly through suicide, drug addiction, or alcoholism, according to Adler. Not all people of this type are despicable. Some, with talent and hard work, are high achievers, but they are vain and

Prevention and Health Screening

Lored to meet the specific needs of Latino subgroups and to make full use of the community's resources, including the skills and commitment of its people. Improvement of modifiable risk factors such as nutritional habits, alcohol consumption, cigarette smoking, sedentary lifestyle, obtaining health care screenings, and environmental exposures need to be addressed by linguistically, culturally, and educationally appropriate methods. Largely preventable diseases such as invasive cervical cancer, cirrhosis, and lung cancer can be greatly reduced through reductions in associated risk behaviors. In 1998, 11 of Latinos reported an interval of greater than 3 years since their last health care contact compared with 5.0 of whites (National Center for Health Statistics 2000). Among children younger than 18 years, 19.5 of Latinos reported no health care visits within the past 12 months compared with 10.7 of white children (National Center for Health Statistics 2000). Thus, increased access to...

Viral load test See viral load

Natural sources of riboflavin (B2) include dairy products, meat, fish, and green leafy vegetables. whole grain cereals are also good sources, as are egg whites. Vitamin B2 is broken down by heat, so exposure during cooking (by broiling, for instance) can deplete it. Vitamin B2 is given to alcoholics to reduce delirium tremens (DTs).

Diagnosis And Evaluation Of Lut Dysfunction

Botulinum Toxin Injection Anal Sphincter

A complete history and physical examination are crucial to the evaluation of LUT dysfunction. History should include a complete past medical history to evaluate for medical disease, surgical history, medications, and drug and alcohol intake that may contribute to urinary symptoms. In addition, a focused evaluation of urinary symptoms should be performed. For example, specific voiding symptoms should be detailed in an attempt to differentiate stress, urge, total, and mixed incontinence subtypes when applicable. The presence of frequency, urgency, and painful symptoms should also be addressed. Physical examination should include a routine survey, with specific focus on findings associated with neurological disease or previous surgery

Self Ideal Congruence and Mental Health

Higgins's theory has garnered much empirical attention since the mid-1980s. Some of the recent topics have ranged from alcohol consumption (Wolfe & Maisto, 2000), eating disorders (Veale, Kinderman, Riley, & Lambrou, 2003), procrastination (Orellana-Damacela, Thidale, & Suarez-Balcazar, 2000), and mental health hi general (Liao & Fan, 2003). For instance, Wendy Wolfe and Stephen Maisto (2000) tested the prediction that higher real-ideal self-discrepancy would be related to greater alcohol consumption in a sample of university students. Wolfe and Maisto reasoned that people who have large real-ideal self discrepancies look to relieve then negative affective states (anxiety, depression) by turning to alcohol. They went on to reason that this effect should be even stronger on those dimensions of self-concept that are particularly important and salient to the individual. In other words, they believed both the magnitude of the discrepancy and the salience of the discrepancy...

Fiingers Tridimensional Model

Cloninger's theory helps explain different types of alcohol abuse. Type I alcoholics are high in harm avoidance and reward dependence and low in novelty seeking, and become alcoholic in response to environmental stress. Type II alcoholics are high in novelty seeking and low in the other two traits, and are likely to begin drinking earlier (Cloninger, Sigvardsson, & Bohman, 1988 Wills, Windle, & Cleary, 1998). However, traits in the tridimensional model don't have a direct, automatic influence on people's lives. Experience matters. One of the most important experiences for predicting adolescent substance use is having friends who use drugs. The trait of novelty seeking, in Cloninger's model, predicts having such friends, but without them, novelty seeking alone does not lead to substance use (Wills, Windle, & Cleary, 1998).

How triorthocresyl phosphate caused jake leg

There were at least 35,000 victims in the ginger jake poisoning incident, and some estimates claim that as many as 50,000 people were affected. There seems to have been little sympathy or help for the victims, perhaps because they were thought to be alcoholics or down-and-outs. While the majority of victims were relatively poor, many were ordinary people who were using the preparation for a legitimate purpose. For example, a

Type Of Pancreatitis Initial Damage In The Pancreas And Fibrosis Pattern

Figure 16.2 Development of fibrosis in relapsing severe acute pancreatitis caused by alcohol abuse. A Interlobular fatty tissue necrosis demarcated from the adjacent preserved acinar tissue by inflammatory cells and a fibrotic band. B Cellular interlobular fibrosis developing adjacent to an area of old autodigestive fatty tissue necrosis (bottom left).

Tricyclic antidepressants 315

In addition, tremors may appear as a side effect of certain drugs (such as amphetamines, antipsychotics, ANTIDEPRESSANTS, CAFFEINE, or LITHIUM) or as a sign of withdrawal. Alcohol withdrawal also may trigger tremors, indicating the presence of alcohol dependence. These morning shakes occur as the blood alcohol level falls the tremors disappear when more alcohol is consumed. (See also INTERNATIONAL TREMOR FOUNDATION Appendix I.)

Myositis and Myopathy

Alcohol can cause acute and chronic muscle problems. Acute myopathy usually occurs in alcoholics after a heavy binge. It causes symptoms of muscle pain, weakness, and elevated enzyme levels. Most muscles are involved, enzyme levels are often very high, and rhabdomyolysis can occur. usually, unless rhabdomyolysis leads to kidney failure, recovery is complete. Alcohol can also cause muscle atrophy and a chronic, painless proximal myopathy. The onset of symptoms is gradual, and muscle enzymes are normal or elevated only a little. The cause of alcoholic myopathy is not known, but direct toxic effects of alcohol on the muscle combined with the effects of poor nutrition may contribute. Also, many alcoholics have diarrhea or vomiting and thus lose potassium and magnesium. This can increase the severity of muscle symptoms. Patients with chronic alcoholic myopathy are more likely to have alcohol-induced heart muscle disease (cardiomyopathy), a condition that can lead to heart failure and...

Perseverative Functional Autonomy

Allport (1961) listed other examples of perseverative functional autonomy that involve human rather than animal motivation. The first is an addiction to alcohol, tobacco, or other drugs when there is no physiological hunger for them. Alcoholics continue to drink although their current motivation is functionally independent from their original motive.

Population Perspective

Three realities are central to the development of effective population-based prevention strategies. First, disease risk is currently conceived of as a continuum rather than a dichotomy. There is no clear division between risk for disease and no risk for disease with regard to levels of blood pressure, cholesterol, alcohol consumption, tobacco consumption, physical activity, diet and weight, lead exposure, and other risk factors. In fact, recommended cutoff points for management or treatment of many of these risk factors have changed dramatically and in a downward direction over time (e.g., guidelines for control of hypertension and cholesterol), in acknowledgment of the increased risk associated with common moderately elevated levels of a given risk factor. This continuum of risk is also apparent for many social and environmental conditions as well (e.g., socioeconomic status, social isolation, work stress, and environmental exposures). Any population model of prevention should be...

Demyelinating disorders

Though there are some reversible cases of dementia, caused by head injury, pernicious anemia, encephalitis, myxedema, syphilis, brain tumor, or alcoholism), by far the majority of cases are more permanent, caused by cerebrovascular disease (including stroke), Parkinson's disease, and from Alzheimer's disease. While it may be possible to alleviate some dementia by treating high blood pressure or heart disease, gradual deterioration usually occurs. Alzheimer's disease is at present incurable.

The Recovered Memory Controversy

Two points are established beyond controversy Sexual abuse of children occurs all too frequently, and it has long-term negative effects on psychological functioning (Cahill, Llewelyn, & Pearson, 1991). David Finkelhor and his colleagues report a national survey of Americans in which 27 percent of the women and 16 percent of the men reported some type of sexual abuse when they were children. Overall, 13 percent of the women and 9 percent of the men reported a history of actual or attempted intercourse (Finkelhor et al., 1990). Those who have been sexually abused as children are at increased risk for a variety of disorders, including posttraumatic stress disorder, anxiety, depression, suicide, borderline personality disorder, multiple personality disorder, dissociation, drug and alcohol abuse, sexual victimization, difficulty in relationships, and poor self-esteem (Alter-Reid et al., 1986 Barnard & Hirsch, 1985 Browne & Finkelhor, 1986 Connors & Morse, 1993 deChesnay, 1985...

Effects Of Toxic Agents To The Exocrine Pancreas

The mechanism of pancreatic tissue injury may vary with the toxic agents. The effect of ethanol, however, is studied most extensively (see Chapter 15). The cause of pancreatic damage by alcohol may be due to premature activation of digestive enzyme in the acinar cells. It has been shown that alcohol increases the synthesis of digestive enzyme in the pancreas45 and increases the fragility of the zymogen granules46 and lysosomes.47 Premature activation of pancreatic protease by lysosomal cathepsin B may lead to the subsequent tissue damage. Long-term consumption of alcohol increases gene expression of pancreatic cholesterol esterase, ES-10 and fatty acid ethyl ester synthase III in rats48 that may be the cause of accumulation of cholesteryl esters and fatty acid ethyl esters (FAEEs), ethanol metabolites that increase the fragility of the lysosomes, in the pancreas.47,49 On the other hand, the fragility of zymogen granules is increased by alcohol through reduced synthesis of the granule...

Isoniazid genetic factors in toxicity

The severe liver dysfunction also seemed to be more common in slow metabolizers, and it was proposed that this due to a deficiency in detoxica-tion of a metabolite. Monitoring patients with liver function tests is one way to avoid this adverse effect. There may be other factors as well as the acetylator phenotype that are important, such as other drugs being taken at the same time. Excessive and sustained alcohol intake may also be a factor, as this is quite commonly associated with the occurrence of tuberculosis. Apart from weakening the liver it will also increase the amount of the enzyme that produces the toxic metabolite of isoniazid.

The doseresponse graph

The relationship between the level of exposure to a chemical and its harmful effects is very important in understanding how poisons work and whether they pose a risk. The typical graph can represent either a proportion of a group of individuals (humans or experimental animals) who have been given different doses of a substance and who show a particular effect (for example, the appearance of a slowing of reaction time after drinking alcohol), or the magnitude of the effect in a particular individual (for example, the extent by

Pancreatic Pathways Molecular Epidemiology And The Study Of Geneenvironment Interactions

CCK is a gastrointestinal hormone known to influence normal and malignant pancreatic growth and function (see also Chapter 6 and Chapter 14). A number of polymorphisms in genes for CCK and CCK receptors have been identified. Because of the importance of CCK in pancreatic growth and function, we hypothesized that a promoter polymorphism in CCK (-45 C T) might influence risk. Using data from our San Francisco Bay Area study, we found evidence for a moderate interaction between the promoter polymorphism in CCK (CT+TT) and tobacco smoking with the highest risk among smokers with variant genotypes (Duell and Holly, unpublished data). We observed weak interactions between CCK -45 genotypes and calorie-adjusted saturated fat intake. There were no major modifications in estimates of RRs for CCK -45 and pancreatic cancer by sex. We also observed a possible weak interaction between CCK -45 genotype (CT+TT) and average daily alcohol consumption. Interestingly, ORs for pancreatic cancer were...

Minamata Bay disaster

Was admitted to the Chisso Company's Minamata factory hospital she had been staggering around and talking incoherently. Within a few weeks her younger sister went down with the disease, as did others who lived in the same neighbourhood. On 1 May, Dr Hajime Hosokawa, the head of the Chisso factory hospital, reported these cases to the Minamata Public Health Department, saying that an unidentified disease of the central nervous system had broken out. That summer saw the first large scale outbreak of methyl mercury poisoning 52 people were badly affected and 21 of them died. As more and more people went down with the disease, an investigation of recent deaths in the area revealed many other cases that had been mis-diagnosed as due to other causes, such as encephalitis, syphilis, alcoholism, or hereditary deficiency.

Lifestyle management for atherogenic dyslipidemia

Cigarette smoking has also been shown to reduce insulin sensitivity and contribute to atherogenic dyslipidemia, adding to the myriad of reasons that smoking cessation should be encouraged. In addition, excessive alcohol intake will increase the TG concentration. Therefore, moderation (or cessation) of alcohol consumption should be encouraged if applicable (7).

Nonalcoholic Fatty Liver Disease NAFLD

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of histological changes in the liver in patients who drink < 20-30 g of alcohol per day, ranging from simple fatty infiltration (steatosis) to a pattern of injury characterized by inflammation, hepatocyte degeneration, and fibrosis, known as nonalcoholic steatohepatitis (NASH), and to frank cirrhosis. The histological changes in NAFLD are indistinguishable from those observed in alcoholic liver disease. Although the quantity of alcohol considered harmful is > 30 g day in men and > 20 g day in women, there is no consensus on the amount necessary to cause liver damage. Additionally, patients' self-reporting of alcohol consumption is frequently inaccurate.

Phase I Metabolizing Enzymes Cytochrome P450s

Maruyama et al. examined genotype patterns of CYP 2E1, together with two alcohol dehydrogenases (see below), in patients with chronic alcoholic pancreatitis who were diagnosed in general hospitals all over Japan in comparison with chronic nonalcoholic pancreatitis patients or in alcoholics with normal pancreatic function. Additionally, the relationship between pancreatic fibrosis or pancreatitis and genotypes of alcohol-metabolizing enzymes in autopsy cases of alcoholics was assessed.56,57 No significant differences in the distribution of genotypes of CYP 2E1, how

Natural Course Of Alcoholic Chronic Pancreatitis

The interval between the start of continuous alcohol abuse and the clinical manifestation of alcohol-induced chronic pancreatitis usually requires between 13 to 21 years.2,5 Then, the interval between onset of the disease and the occurrence of exocrine insufficiency and calcifications averages 4.8 + - 5.5 years in alcoholic chronic pancreatitis.16 Another study reported a median time of 13.1 years to pancreatic exocrine insufficiency after onset of the disease, whereas endocrine insufficiency was diagnosed after a median time of 19.8 years.6 Data regarding the progression of pancreatic insufficiency are conflicting. Several investigations did not show a progressive deterioration of exocrine pancreatic insufficiency or revealed even slight improvements in pancreatic insufficiency over time.6,17,18 In contrast, other reports show progressive deterioration of pancreatic function during a median follow-up of 10.4 years in patients with alcoholic chronic pancreatitis.19 The reasons for...

Social Connectedness and Health

Pathways related to health behaviors, health care, access to material resources such as jobs, and direct physiological responses leading to disease development and prognosis. For instance, evidence suggests that, in general, social network size or connectedness is inversely related to risk-related behaviors. People who are socially isolated are more likely to engage in such behaviors as tobacco and alcohol consumption, to be physically inactive, and to be overweight (Berkman and Glass, 2000). Behavioral pathways such as these do not appear to account for a large part of the association between social isolation and poor health, but they are important to consider. It is important to note that networks themselves have generally been shown to exert powerful influences on the behavior of both adolescents and adults, so that networks can either promote health or increase risk depending on the norms of the networks themselves.

Definition of Alcoholic Liver Disease

This case is classic for alcohol-induced cirrhosis with its three major complications ascites, portosystemic encephalopathy, and bleeding from esophageal varices. This patient suffered also from many of the other complications of persistent alcohol abuse acute alcoholic hepatitis, peripheral neuropathy, withdrawal syndrome, and spontaneous bacterial peritonitis. These manifestations in any patient further complicate management of the cirrhosis and darken the prognosis. Alcoholic liver disease (ALD) includes three conditions hepatic steatosis or fatty liver, alcoholic hepatitis, and cirrhosis.1,2 Heavy alcohol abuse, even for as little as few days can lead to hepatic steatosis, the earliest stage of ALD and the most common alcohol induced liver disorder. This condition can be reversed when alcohol consumption stops. Heavy use of alcohol for longer periods of time may lead to the development of the more severe and potentially lethal alcoholic hepatitis.3 Only 10-15 of abusers actually...

Cultural Issues in Substance Abuse Treatment

One of the most extensively studied of all cultural constructs of Hispanics is acculturation, which refers to the social and psychological process whereby immigrants and their offspring adopt the values, attitudes, and behaviors of the host culture. The relation of acculturation to substance abuse among His-panics has at times been unclear and dependent on the theoretical perspective used by researchers to define acculturation. Most research on acculturation (Garza and Gallegos 1995) has used simplistic, one-dimensional models that do not address the constellation of variables that affect the Hispanic individual in adjusting to United States society. The weight of the literature does suggest that higher levels of acculturation to United States society, as reflected by English language use, is associated with higher levels of drug use (Kail 1993). It has been postulated that Hispanic youth who are more acculturated than their parents may bond less to them, resulting in a less cohesive...

How alcohol is broken down and how it affects the liver

In addition to requiring an enzyme, the breakdown of alcohol requires a co-enzyme called NAD, which is converted into NADH when the alcohol is metabolized. The large increase in the level of NADH at the expense of NAD, and the lack of utilization of other sources of energy such as carbohydrate, leads to an increase in the production of fat, some of which accumulates in the liver after a heavy bout of drinking. This 'fatty liver', if maintained by regular and excessive drinking, seems to be a necessary stage in the eventual development of liver disease, like hepatitis and cirrhosis, which occurs in some alcoholics. The presence of the fat impairs the ability of the liver to function. The other effect of the change in the proportions of the coenzymes is that glucose is not produced, and this is made worse if the heavy drinker does not eat a normal diet from which glucose might be obtained. Blood glucose levels can therefore be dangerously low. If a person continues to drink excessively,...

The development of an antidote

Barbiturates and alcohol both increase the activity of (induce) the enzymes that metabolize paracetamol to the toxic product. A chronic alcoholic or someone who has been prescribed barbiturate drugs will be at greater risk when taking more than the recommended dose of paracetamol because a greater proportion of the dose will be converted into the toxic product. It would be equivalent to taking a larger dose. In the case of an alcoholic the liver may already be compromised by repeated and long-term alcohol abuse and so be more vulnerable and less able to detoxify paracetamol it may also have less protective substances like thiols.

Diagnosis of Iron Overload

Molecular testing is accomplished by searching for the two most common HFE gene mutations, C282Y and H63D. C282Y heterozygosity may contribute to iron overload when combined with other conditions such as chronic alcoholism or hepatitis, but it should not be considered the sole cause of iron overload and should not be considered diagnostic of hereditary hemochromatosis. At present, only homozygosity for C282Y and compound heterozygosity for C282Y H63D should be considered indicative of hereditary hemochromatosis. Cross-sectional population studies have shown that between 60 and 80 of those at genetic risk will develop biochemical penetrance in the form of abnormal ferritin and transferrin saturation. The use of DNA-based tests alone may fail to identify 2040 of Caucasian patients and most black patients with clinical evidence of hemochromatosis but without the C282Y mutation. Liver biopsy, to confirm iron overload and to evaluate for other types of hepatic disease, is recommended in...

About the Self Efficacy Scale

This may make it seem that self-efficacy is only relevant to the highly functioning, go-getters of the world, but a sense of self-efficacy is important to everyone, regardless of whether they head a major corporation or are struggling in psychotherapy to overcome a personal problem. Indeed, Bandura has found that a sense of self-efficacy does predict a good outcome for clients in psychotherapy. The Self-Efficacy Scale you just completed was constructed by Mark Sherer and James Maddux to be used by therapists to gauge the progress of treatment. As part of their work, they found that among veterans receiving treatment for alcoholism, those with a sense of self-efficacy had a more successful job history, had more education, and had achieved a higher military rank than their low-scoring peers. Self-efficacy is important to everyone, and those without it can improve their lot in life by working to develop this important trait.

Adult Male with New Onset Ascites

The patient stopped all alcohol intake. An esophagogastroduodenoscopy (EGD) was normal with no esophageal or gastric varices noted. Weekly to biweekly phlebotomies of 500 mL were begun. After 17 months, and removal of 45 units of blood, the patient's serum ferritin was 24 ng mL (24 mg L), his transferrin saturation was 27 , and his hematocrit had fallen to 37 (0.37). His AST and ALT returned to normal. Although his initial glucose had been high on presentation, he never developed overt diabetes, and a hemoglobin Aic was 5.7 . After several years of taking spironolactone (50mg day), the patient discontinued the drug. His ascites recurred, and a repeat paracentesis again showed a low leukocyte count with a wide SAAG. He responded to reinstitution of therapy but required larger doses. He continued to have therapeutic phlebotomies 3-5 times a year and has remained relatively stable with serum ferritins in the 30-50 ng mL range, eight years after his diagnosis was made. Unfortunately he...

Geneotypes And Environments

As in any area of science, investigators seek to reproduce interesting results of behavioral and other neurobiological experiments with laboratory animals in their own laboratory setting. This generalization of research findings is a crucial part of the scientific process in several ways. Repro-ducibility, in the broad sense, is taken as a sign of reliability. Failures to reproduce a finding can help to prune the literature of false-positive findings. Successful exportation of a finding to multiple laboratories can allow a scientific insight to be explored using diverse methods not available to the original reporter. In the specific case of studies with stable, reproducible genotypes, the accumulation of results across laboratories is both spatial and temporal. Thus, one of the most long-standing (and reproducible) findings in the modern history of studies with inbred mouse strains is the repeated finding that inbred mice of the C57BL lineage prefer to drink alcohol solutions over...

General Interview Questions

Drug and Alcohol Abuse Knowing about drug and alcohol abuse in the patient and other family members is important for many reasons. If there are abnormal ultrasound findings in a pregnancy, or a child has birth defects with or without mental retardation, there could be a maternal teratogenic etiology for the problems. The known and suspected human teratogens are list in Table 3.2. Neurological problems can also be related to, or exacerbated by, drug and alcohol use. Venezuelan equine encephalitis Maternal and metabolic factors Alcoholism

Florence Bravo 184678

Charles lived with his 29-year-old wife Florence in an imposing house, The Priory, on Bedford Hill Road, Balham, then on the fringes of south London. They had been married only five months when Charles was poisoned. He was Florence's second husband her first had been Captain Alexander Ricardo of the prestigious Grenadier Guards regiment and he had died of alcoholism in 1871 leaving his 25-year-old wife with a fortune of 40000 (equivalent to several million pounds today). During the course of that marriage, Florence had taken to heavy drinking and had even been on the water cure at Malvern in 1870 where she had been seems unlikely. It came to light later that Charles had bought a patent cure for alcoholism for Florence and that this consisted of powders, each containing 35 mg of tartar emetic, enough that when added to a drink would produce the desired effect of causing the drinker to vomit. The idea behind the cure was what later came to be known as aversion therapy. After a few such...

ADHD and Other Disorders

Some children may be depressed as a result of having ADHD, whereas others may have a mood disorder that exists independently of ADHD. Nearly half of all children with ADHD also have oppositional defiant disorder characterized by stubbornness, outbursts of temper, and defiance.

Mental Health of Hispanics in the United States

Showed that African Americans reported somewhat higher rates of any disorder, with substantially higher rates of phobias, schizophrenia, and cognitive impairment, than did other groups. Hispanics had very high scores on depression and alcohol abuse or dependence (Holzer et al. 1995). Table 1 -3 illustrates some of the differences in psychiatric disorders between whites, blacks, and Hispanics. High prevalence of major depression was similar to that of non-Hispanic whites. High rate of alcohol abuse and dependence was found. Few psychiatric epidemiologic studies of Hispanics have been done, and even fewer have compared Hispanics from different countries or origins in terms of prevalence rates for psychiatric disorders. Shrout and colleagues (1992) conducted a statistical analysis of comparable survey designs of psychiatric disorder prevalence. One study was of Puerto Ricans and the other of Mexican Americans (immigrants and United States natives) and non-Hispanic whites in the Los...

Counselling and Prozac

A BMJ editorial in 1993 noted that, even though 'many attempts to evaluate its effectiveness have shown little or no benefit', counselling had rapidly become established in general practice in Britain (Pringle, Laverty 1993). The authors noted that 'as well as its general indications in anxiety and depression, and problems with relationships', counselling had been advocated for 'smoking cessation, modification of diet, alcohol misuse, postnatal depression, addiction to tranquillisers, and high risk sexual behaviour'. The government-imposed GP contract in 1990 had encouraged the provision of counselling in general practice by agreeing to reimburse up to 70 per cent of the cost. The later growth of fundholding practices gave a further boost to the employment of counsellors in the surgery.

Symptoms of Alcoholic Liver Disease

Liver Function Tests in ALD Causes of jaundice in adults are numerous, among them, viral hepatitis, drug-induced hepatitis or cholestasis, biliary obstruction, or hemoly-tic anemia. With problems unrelated to the hepatobiliary systems, serum bilirubin is rarely > 7 mg dL (> 120 mmol L), and determination of conjugated (direct) bilirubin is unnecessary. Alcoholics presenting with jaundice should be promptly examined with ultrasonography of the right upper quadrant if biliary obstruction is present, aggressive therapy to decompress the biliary tract is necessary. Drug Sensitivity and Feminization in Men Patients with cirrhosis often have decreased activity of hepatic cytochromes P-450 and can be very sensitive to medications that require hepatic metabolism. This is especially true for certain sedatives, hypnotics, and psychoactive drugs. A good principle to follow is to avoid medication whenever possible when medication cannot be avoided, use discretion in choosing the drugs and...


Chronic drinking and alcoholism can cause a variety of neurological problems, including mental deterioration and muscle damage alcohol withdrawal can cause minor tremors to delirium TREMENs (DTs), a potentially fatal syndrome characterized by extreme agitation, hallucinations, and a very high fever. Alcoholism is one of the most serious and prevalent medical problems in the United States at least 12 to 15 percent of the population may be alcoholics. As many as 70 percent of known alcoholics display neurological abnormalities, according to the National council on Alcoholism and Drug Dependence, Inc., a nonprofit educational organization.

Genetic Link

Research suggests that some individuals seem predisposed to become alcoholics the inherited trait appears to be a decreased reaction to the effects of drinking during the first three to five drinks. Because the person's brain does not quickly indicate drunkenness, the drinker consumes more alcohol. Asians and Native Americans are genetically inclined to experience drunkenness earlier and more powerfully than drinkers of other races it is unclear whether this puts them at higher risk for alcoholism.

Beat The Battle With The Bottle

Beat The Battle With The Bottle

Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.

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