Marchiafava-Bignami disease: longitudinal MR imaging and MR spectroscopy study.
(25/893)
A case of Marchiafava-Bignami disease was serially evaluated with MR imaging and MR spectroscopy at 1, 2, 4, and 11 months after the onset of symptoms. The first MR imaging study showed extensive abnormal signal intensity of the corpus callosum without macroscopic changes; a diagnosis of Marchiafava-Bignami disease was made, and vitamin therapy was initiated. Follow-up studies showed progressive reduction of signal intensity abnormalities and residual callosal atrophy. MR spectroscopy revealed progressive reduction of the N-acetylaspartate:creatine ratio, with partial recovery in the last study, and a normalization of the choline:creatine ratio, which was initially slightly increased. Lactate was detectable during the subacute phase and was replaced by lipids after 4 months. This study confirmed the role of MR imaging in diagnosing Marchiafava-Bignami disease and particularly the value of MR spectroscopy in focusing the pathogenesis of the disease, monitoring its evolution and changes related to therapy. (+info)
Decreased risk of alcohol dependence and/or misuse in women with high self-assertiveness and leadership abilities.
(26/893)
AIMS: To analyse dimensions of gender identity and its association to psychiatric disorders and alcohol consumption. METHODS: The study was performed in two stages: an initial screening (n = 8335) for alcohol consumption, followed by a structured psychiatric interview (n = 1054). The Masculinity/Femininity-Questionnaire was used as an indicator of gender identity. The final study group included 836 women. RESULTS: Leadership, caring, self-assertiveness and emotionality were dimensions of gender identity found in a factor analysis. Low self-assertiveness, high emotionality and to some extent low leadership were associated with increased odds for having bipolar disorders, severe anxiety disorders and alcohol dependence and misuse. Low self-assertiveness and high emotionality were not only associated with alcohol dependence and misuse, but also with high episodic drinking. CONCLUSIONS: There was an association between some of the dimensions of gender identity and psychiatric disorders and alcohol consumption. Further attention is needed in both clinical work and research. (+info)
Alcohol dependence and misuse in elderly suicides.
(27/893)
AIMS: To assess suicide risk associated with alcohol use disorder in elderly men and women, and to examine the role of social stressors in elderly suicides with and without alcohol use disorders. METHODS: This retrospective case-control study included 85 suicide cases aged 65 years and above (46 men, 39 women) and 153 randomly selected population controls (84 men, 69 women). Interviews were carried out with control persons and with informants for the suicide cases. Mental disorders were diagnosed in accordance to DSM-IV. RESULTS: A history of alcohol dependence or misuse was observed in 35% of the elderly men who died by suicide and in 18% of the women. This disorder was uncommon among persons in the control group (2% of the men and 1% of the women). Alcohol use disorder remained an independent predictor of suicide risk in the regression models for both sexes. Among suicide cases, those with alcohol use disorders were younger and less likely to be suffering from severe physical illness (35 vs 63%) than those without this disorder. CONCLUSION: Alcohol use disorder is associated with suicide in elderly men and women. Prevention programmes need to target this important subgroup. (+info)
Motivational intervention to reduce alcohol-exposed pregnancies--Florida, Texas, and Virginia, 1997-2001.
(28/893)
Prenatal alcohol use is a threat to healthy pregnancy outcomes for many U.S. women. During 1999, approximately 500,000 pregnant women reported having one or more drinks during the preceding month, and approximately 130,000 reported having seven or more alcohol drinks per week or engaging in binge drinking (i.e., five or more drinks in a day). These heavier drinking patterns have been associated with fetal alcohol syndrome (FAS) and alcohol-related neurodevelopmental disorders (ARND). Lower levels of alcohol consumption (i.e., fewer than seven drinks per week) also have been associated with measurable effects on children's development and behavior. Although the majority of women reduce their alcohol use substantially when they realize they are pregnant, a large proportion do not realize they are pregnant until well into the first trimester and, therefore, might continue to drink alcohol during this critical period of fetal development. To reduce alcohol-exposed pregnancies, CDC initiated a multisite pilot study (phase I clinical trial) in 1997 to investigate the use of a dual intervention focused on both alcohol-use reduction and effective contraception among childbearing-aged women at high risk for an alcohol-exposed pregnancy (Project CHOICES). This report describes the association between baseline drinking measures and the success women have achieved in reducing their risk for an alcohol-exposed pregnancy. The analysis compares the impact of the motivational intervention at 6-month follow-up on women drinking at high-, medium-, and low-risk drinking levels. The findings indicate that although 69% of the women in the study reduced their risk for an alcohol-exposed pregnancy, women with the lowest baseline drinking measures achieved the highest rates of outcome success, primarily by choosing effective contraception and, secondarily, by reducing alcohol use. Women with higher baseline drinking measures chose both approaches equally but achieved lower success rates for reducing their risk for an alcohol-exposed pregnancy. A randomized controlled trial of the motivational intervention is under way to further investigate outcomes of the phase I study. (+info)
Influence of nutritional status on alcoholic myopathy.
(29/893)
BACKGROUND: Muscle weakness and structural changes in striated skeletal muscle are common in persons with chronic alcoholism. OBJECTIVE: The objective of the study was to assess the role of malnutrition in the development of chronic alcoholic myopathy. DESIGN: We prospectively evaluated 146 men who reported an intake >/=100 g ethanol/d for the previous 5 y and 73 well-nourished control subjects. Alcohol consumption, energy and protein nutritional status, and deltoid muscle strength were determined. Deltoid muscle tissue specimens were taken from alcoholics and from 14 control subjects for histochemical studies and morphometric measurements of the fibers. RESULTS: Deltoid muscle strength was less in alcoholics than in control subjects (P < 0.001). Muscle strength correlated with lifetime consumption of ethanol (r = -0.56, P < 0.001), and a decrease in muscle strength was significantly greater in the presence of energy malnutrition. Using logistic regression analysis, we observed that alcoholics with muscle strength < 18 kg had the independent risk factors of an arm muscle area < 50 cm(2) (odds ratio: 5.4; 95% CI: 2.3, 12.3), consumption of > 1600 kg ethanol throughout their lives (odds ratio: 4.5; 95% CI: 2.0, 10.1), and protein malnutrition (odds ratio: 4.2; 95% CI: 1.4, 12.7). Protein malnutrition was also associated with muscle inefficiency (P < 0.001). Histologic myopathy was present in 58% of alcoholics, was related to lifetime ethanol consumption (P = 0.001), and was more severe in the presence of protein malnutrition (P = 0.01). CONCLUSION: Malnutrition is an additional developmental factor in the functional and structural muscle damage induced by chronic ethanol consumption. (+info)
Cumulative social class and mortality from various causes of adult men.
(30/893)
STUDY OBJECTIVE: It is possible that circumstances over the lifecourse contribute to social inequalities in mortality in adulthood. The aim of this study is to assess the cumulative effect of social class at childhood and adulthood on mortality from various causes of death in young adult men. DESIGN: The data consist of census records for all Finnish men born in 1956-60 (112,735 persons and 895,001 person years), and death records (1834 deaths) by cause of death for 1991-98. MAIN RESULTS: Mortality from each cause of death increased from the stable non-manual group to mobile groups, and further to the stable manual group. However, mortality in the downwardly mobile group was 150% higher than in the upwardly mobile group. Furthermore, analyses show that mortality was mainly related to current adult social class, though, within each adult social class men with a manual parental background showed slightly increased mortality from cardiovascular disease and from alcohol related causes. CONCLUSIONS: In these data the effects of adult social class were stronger than childhood class for all causes of death. It is more useful to differentiate between childhood and adulthood effects than to use a combined measure of social class to assess the contribution of social class at different stages of life on mortality. (+info)
Alcohol use in China.
(31/893)
AIMS: Over recent decades there has been a striking increase in alcohol consumption and related problems in China. As China holds over 22% of the world's population this has a significant potential impact on world health. Here we review English- and Chinese-language publications on the prevalence of alcohol consumption and related problems in China, and treatment and control measures to reduce these. METHODS: Medline search 1976-2002 and search of the China National Knowledge Infrastructure database 1996-2002. RESULTS: While alcohol is a traditional part of Chinese life, commercial alcohol production in China has increased more than 50-fold per capita since 1952. In parallel there is evidence of a marked increase in prevalence of alcohol dependence, which has moved from the ninth to the third most prevalent mental illness. The public health response to increase in alcohol-related disorders has commenced but is in need of further development. CONCLUSIONS: There is a need for increased policies and public health programmes to reduce alcohol related harm, and evaluation of outpatient treatment potential. (+info)
Correlates of externalizing symptoms in children from families of alcoholics and controls.
(32/893)
AIMS: This paper describes a new stage in the ongoing evaluation of the original families of sons of alcoholics and controls where we now focus on the relationships among relevant domains of functioning in their young sons and daughters. METHODS: The data were gathered from the 15-year follow-up of the families of the original probands (the fathers of these offspring) who had been selected from among students and non-academic staff at a university at approximately age 20. At the 15-year evaluation of these families, a structured interview and the Child Behavioral Checklist (CBCL) questionnaire were administered to a parent, usually the mother, of 145 offspring age seven through 17. The eight domains evaluated here included the extended family histories of alcohol use disorders, parental alcoholism, independent mood or anxiety disorders in the grandparents and parents, the history of potential brain insults early in life, the absence of a biological parent in the home, and scores for internalizing symptoms, with externalizing symptoms as the dependent variable. RESULTS: Correlations among the domains were all in the predicted direction, a structural equation model revealed empirical results with an R(2) of 0.26, and there were high goodness of fit characteristics for hypothesized and empirical models. The results were similar for boys and girls and older versus younger offspring. CONCLUSIONS: An understanding of the relationships among characteristics in the offspring of the original probands offers the opportunity of establishing levels of functioning in relevant domains before the onset of alcohol-related problems or related disorders. The data presented here represent a baseline upon which future follow-ups will evaluate substance-related problems and disorders as this population matures. (+info)