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Biomedical subjects

E Gordis

Publications and source records attributed to E Gordis.

At least 37 records · Page 2Linked to original sources
PubMed1992

Alcohol and the elderly.

Moderate drinking for the elderly of both genders is no more than one drink per day, where a drink is defined as 12 oz of beer, 5 oz of wine, or 1.5 oz of spirits. Age does not affect the rate of absorption or elimination of alcohol. Lean body mass decreases and adipose tissue increases with age, however, resulting in a corresponding decrease in the volume of total body water. With a smaller volume of distribution, an alcohol dose identical to that administered to a younger individual of the same size and gender will produce a higher blood alcohol concentration in the elderly. Low-dose alcohol stimulates appetite and promoters regular bowel function. In the well-nourished nonalcoholic elderly, the negative impact of alcohol consumption on nutrition is minimal. Alcohol consumption improves mood by increasing feelings of happiness and freedom from care while lessening inhibitions, stress, tension, and depression. Although in the laboratory low-dose alcohol improves certain types of cognitive function in young men, in other types of task performance, alcohol induces impairment, which worsens with age. The effects of alcohol on sleep are primarily detrimental, worsening both insomnia and breathing disturbances during sleep. Although the role of alcohol consumption in mortality from heart disease has not been investigated in the elderly, moderate drinking appears safe. Under some circumstances low-dose alcohol may produce analgesia whereas in others it may worsen pain. The elderly use a significant proportion of both prescription and over-the-counter medication, a large variety of which interact with alcohol. Alcoholic beverage consumption may exacerbate cognitive impairment and dementias of other etiology. Although some studies suggest that moderate use of alcohol by institutionalized senior citizens appears to produce benefits including improved socialization, separation of the effects of the social situation from those specifically attributable to alcohol remains to be accomplished. Older individuals who want to drink, have no medical contraindications, and take no drugs (prescription or over-the-counter) that interact with alcohol, may consider one drink a day to be a prudent level of alcohol consumption. Patients should be counseled to avoid alcohol consumption immediately prior to going to bed in order to avoid sleep disturbances. They also should be cautioned against potential drug-alcohol interactions and told to avoid alcohol ingestion prior to activities such as driving. The decision to recommend a particular level of alcohol consumption in any given patient must, however, be carefully tailored not only to that individual's specific medical needs but to his or her social and environmental circumstances as well.

Affect↗
PubMed1991

Alcohol intake in relation to diet and obesity in women and men.

We studied relations between alcohol intake, body mass index, and diet in 89,538 women and 48,493 men in two cohort studies. Total energy increased with alcohol consumption (partial r = 0.11, P less than 0.001), and carbohydrate intake decreased from 153 g/d in abstainers to 131 g/d in women drinking 2.5.0-49.9 g alcohol/d. The decrease in carbohydrate intake was due mainly to decreased sugar consumption with higher alcohol intake (partial r = -0.05, P less than 0.001), reflecting decreased energy consumption from sources excluding alcohol. In men total energy increased with alcohol consumption (partial r = 0.19, P less than 0.001), from 7575.6 (abstainers) to 9821.5 kJ/d (greater than 50 g alcohol/d). Energy intake excluding alcohol varied little with alcohol intake (partial r = 0.003, P = 0.48) but sucrose intake decreased with higher alcohol intake. These data suggest that calories from alcohol were added to energy intake from other sources in men, and that in women, energy from alcohol intake displaced sucrose. The consumption of candy and sugar is inversely related to alcohol intake, raising the possibility that it is related to appetite for alcohol.

Adult↗
PubMed1991

Science and social policy problems: resolution of some, creation of others.

The scientist has two jobs: to do good science, and to be a spokesperson for science in the creation of rational social policy. Three categories of interaction between science and policy are described and examples given. The first is where science has provided data that were decisive in causing policy to be enacted. The second is where science is capable of resolving equity issues that have arisen from problems that science itself created. The third is where the issues are ultimately resolved by extra-scientific considerations. Two major issues where it is hoped that science can make a significant contribution include outcomes analysis, a new approach to dealing with health care costs and variations in clinical practice; and the disease concept of alcoholism, with questions it raises of volition, personal responsibility, and punishment. However, science alone is never the dominant force in the shaping of policy, which is determined by the interaction of many social forces, such as morals, values, politics, and economics.

Adult↗
PubMed1988

Validity of self-report in alcoholism research: results of a Veterans Administration Cooperative Study.

The validity of self-report in alcoholism treatment research is controversial. Our recently completed Veterans Administration Cooperative Study evaluating the efficacy of disulfiram treatment for alcoholism provided an opportunity to assess the validity of self-report. To assess treatment response, patients and household contacts were interviewed at seven scheduled points during the 1 year of follow-up. Blood specimens also were obtained from the patients at these times and were analyzed for ethanol. Eighty-eight percent of the patient and/or collateral interviews were obtained at 6 months and 90% at 1 year. The mean number of blood and urine specimens collected per patient was 4.3 and 14.4, respectively. Outcome criteria included continuous abstinence during the year and total number of drinking days. Continuous abstinence: If we had had only the patients' self reports, we would have significantly underestimated the percentage of men who drank. By self-report 58.7% (355/605) relapsed whereas the combination of self report, collaterals' reports, and laboratory tests indicated that 72.4% (438/605) drank (p less than 0.001). Using Bayes' theorem, the conditional probability that a patient is continuously abstinent for 1 year when he so claims is 65%. Total drinking days: Of the 213 patient-collateral pairs each of whom provided all seven scheduled interviews, 46.9% (100/213) agreed on the total number of drinking days during the year.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1987

The diabetic alcoholic: characteristics and treatment outcome.

We had previously found a correlation between a recovering alcoholic's propensity to choose free sugar in his diet and his ability to remain sober. To determine if chronic hyperglycemia in itself is a predictor of sobriety, we examined the outcome of alcoholism treatment in 138 diabetics we could identify among 9000 alcoholism treatment outpatients. In general, the diabetics did no better or worse in alcoholism treatment than the whole clinic population, but a subset of the diabetics, those whose diabetes resulted from pancreatitis or pancreatectomy, did very badly. The implications of these findings for future research are discussed.

Adult↗
PubMed1986

Mandatory supervised antabuse therapy in an outpatient alcoholism program: a pilot study.

We instituted a program of mandatory supervised antabuse therapy in an outpatient alcoholism clinic for patients who wish to remain connected to the clinic but who have continued to drink repeatedly. Almost 60% of 68 patients who agreed to this regimen achieved significant periods of sobriety. These preliminary findings suggest that a controlled trial of this approach is warranted.

Adult↗