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Biomedical subjects

J G Rankin

Publications and source records attributed to J G Rankin.

At least 37 records · Page 2Linked to original sources
PubMed1986

Risk of fatty infiltration or cirrhosis of the liver in relation to ethanol consumption: a case-control study.

A case-control study was conducted to investigate the risk of either fatty infiltration of the liver or cirrhosis, in males and females, in relation to varying levels of ethanol consumption. Male and female cases of fatty infiltration of the liver (47 males and 43 females) and male and female cases of cirrhosis (85 males and 66 females) were identified during 1981-1982 as part of a liver biopsy study in 6 teaching hospitals in Toronto. All cases were confirmed by biopsy. Male and female controls (394 males and 225 females) were obtained from 7 different local industries during the same period as part of a study for the early detection of liver disease. Cases and controls were interviewed by a nurse practitioner using a standard questionnaire designed to elicit data on daily and cumulative alcohol consumption. In both males and females, a dose-response effect between increasing levels of both daily and cumulative alcohol consumption and increasing risk of either fatty liver or cirrhosis was demonstrated and was independent of effects of age and duration of consumption. In males, risk for fatty liver was 1.37 (95% CL = 0.47, 4.0) for those consuming 40-59 g absolute alcohol/day compared to males consuming less than 40 g/day, rising to 50 (95% CL = 15.0, 170.7) for males consuming 80 or more g/day. In females, risk for fatty liver appeared at lower levels and was 2.82 (95% CL = 1.02, 7.82) for females consuming 20-59 g/day compared to females consuming less than 20 g/day, rising to 8.53 (95% CL = 2.12, 34.31) for females consuming 60 or more g/day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

Cerebral atrophy and functional deficits in alcoholics without clinically apparent liver disease.

Ninety-seven chronic alcoholics, both impaired and unimpaired, without clinically evident liver disease, showed significantly more cerebral atrophy on computed tomography than age-matched neurologic controls. Age was the variable most highly correlated with cerebral atrophy measurements, and it accounted for most of the correlations between atrophy and functional impairment, except in the Wernicke-amnesic group. Analysis of the slopes of atrophy scores versus age showed a more rapid "rate" of development of cerebral atrophy in alcoholics compared with controls. There were no correlations between liver biopsy scores (51 cases), drinking history (47 cases), or dietary intake (39 cases) and cerebral atrophy measurements.

Adult↗
PubMed1981

Morbidity patterns in hazardous drinkers: relevance of demographic, sociologic, drinking, and drug use characteristics.

A profile of the demographic, sociologic, drug use, and drinking characteristics of a large group of inpatient alcoholics has been constructed as background for discussion of the clinical significance of these factors as determinants of physical morbidity in hazardous drinkers. Factors specifically considered include sex, skid row status, social class, and abnormal use of drugs of dependence, the amount of alcohol consumed and duration of drinking, drinking pattern, and type of beverage. While heavy drinking is of primary importance, the physical disease profile found in hazardous drinkers is modified by certain host and environmental characteristics. The implications for treatment planning and preventive programs are considered.

Adolescent↗
PubMed1979

Alcohol consumption and hypertension--the evidence from hazardous drinking and alcoholic populations.

To provide an enhanced perspective to observations of an association between moderate alcohol consumption and hypertension, information on the frequency of hypertension in heavy drinking and alcoholic populations was reviewed. Hypertension was found more often in ambulatory heavy drinkers and alcoholics than in more moderate drinkers and abstainers. This hypertensive state appeared to be at least partially reversible upon cessation of drinking. Additional investigation is needed to define the level of consumption associated with an increased risk of hypertension, the dose response pattern, and the determinants of irreversibility. Alcohol-related hypertension may constitute a risk factor for cardiovascular disease, thus contributing to the excess mortality experienced by heavy drinking populations. In view of the steady increase in per capita alcohol consumption which characterizes many affluent societies further clarification of this relationship is an urgent public health research priority.

Adult↗
PubMed1979

Collagenisation of the Disse space in alcoholic liver disease.

Collagenisation of the space of Disse was systematically assessed to determine its relationship to the clinical and histological manifestations of chronic alcoholic liver disease. Ninety-four chronic alcoholics who had been submitted to biopsy were assessed by clinical manifestations of hepatic dysfunction and by a 17-parameter Combined Clinical and Laboratory Index (CCLI). Liver biopsies were scored for light (LM) and electron-microscopy (EM) abnormalities using a universal scoring system for both. Thirty-five patients with normal liver histology (LM) had an average collagen score of 0.6 +/- 0.1. Twelve cirrhotic patients and 29 with fatty liver, both groups with mild clinical manifestations, did not differ significantly. In 18 cirrhotic patients and five with fatty liver, both groups having severe clinical manifestations, the mean scores were 2.1 +/- 0.8 (P less than 0.02) and 2.5 +/- 0.6 (P less than 0.01) respectively. Collagenisation also correlated with CCLI (P less than 0.001), serum bilirubin (P less than 0.001), serum aspartate transferase (SGOT) (P less than 0.003), and clinical evidence of portal hypertension and histological changes of necrosis, inflammation, and terminal hepatic vein sclerosis. These results suggest that collagenisation of the Disse space may be important in the pathogenesis of alcoholic liver disease.

Collagen↗
PubMed1979

Effect of short-term therapy with propylthiouracil in patients with alcoholic liver disease.

The effect of propylthiouracil (PTU; 300 mg/day) on alcoholic liver disease was evaluated in 133 patients in a short-term randomized double-blind trial. Severity of the disease was assessed by a composite clinical and laboratory index (CCLI). A normalization rate (NR) representing the rate of improvement in CCLI was calculated. Patients with alcoholic hepatitis, with and without cirrhosis, showed a significantly higher NR on PTU (43.6 +/- 4.6) than on placebo (19.8 +/- 3.3; P less than 0.001). A similar effect was observed in patients with abnormal prothrombin (no biopsy): NR was 32.9 +/- 6.9 on PTU and 2.6 +/- 3.7 on placebo (P less than 0.005). The effect of PTU on each clinical and laboratory component of the CCLI was also compared in these two groups. In 38 patients with alcoholic hepatitis and in 25 with abnormal prothrombin, those on PTU showed a greater improvement in 15 of 15 items (P less than 0.001) and 14 of 15 (P less than 0.01), respectively. When patients were divided according to the severity of the disease into those in the lower and upper halves of the CCLI range (81 and 52 patients, respectively), PTU was shown to have a significant effect only in the latter: The NR was 41.4 +/- 3.8 on PTU and 22.5 +/- 4.2 on placebo (P less than 0.005). PTU was ineffective in patients with inactive cirrhosis.

Double-Blind Method↗
PubMed1978

Alcoholic liver disease: the problem of diagnosis.

The objective of this article is to draw attention to the serious lack of correlation that exists between the detection and specific diagnosis of liver disease in alcoholic patients, based on clinical findings and investigations other than liver biopsy and histologic diagnosis established by that technique.

Adult↗
PubMed1977

Morbidity in alcoholics. Evidence for accelerated development of physical disease in women.

The physical disease profiles of 135 female and 736 male inpatient alcoholics, similar in age, social class, and referral pattern, were compared to further clarify the widespread clinical impression that female alcoholics are more illness-prone. Although the women had been drinking hazardously for fewer years, at admission the prevalence of most diseases was similar in men and women. There was, however, an excess of anemia in women and of fatty liver and chronic obstructive lung disease in men. Furthermore, the average duration of hazardous drinking before the first recorded occurrence of almost all illness events was shorter in women, the sex differences being statistically significant for fatty liver, hypertension, obesity, anemia, malnutrition, gastrointestinal hemorrhage, and an ulcer requiring surgery. These findings suggest that the development of physical morbidity in relation to hazardous drinking may be accelerated in women.

Adult↗
PubMed1976

Alcohol and acetaldehyde metabolism in Caucasians, Chinese and Amerinds.

Ethanol (0.4 to 0.8 g/kg in 30 minutes) was given by mouth to 102 healthy young volunteers (37 Caucasian men, 21 Caucasian women, 20 Chinese men and 24 Ojibwa men). Venous blood concentrations of ethanol and acetaldehyde 60, 90, 120 and 150 minutes after the end of drinking were measured by gas chromatography. The calculated rates of ethanol metabolism in the Caucasian men and women did not differ, but the overall group means for subgroups of Caucasians (103.6 mg/kg-h), Chinese (136.6 mg/kg-h) and Ojibwa (182.7 mg/kg-h) with decreasing postabsorption values differed significantly from each other. Mean acetaldehyde values paralleled the rates of ethanol metabolism: Ojibwa, 14.6 mug/ml; Chinese, 10.0 mug/ml; and Caucasians, 9.4 mug/ml. The high rate of ethanol metabolism in Amerind subjects differs from previous findings. Habitual level of alcohol consumption, proportion of body fat and genetic factors appear to account for most of the group differences.

Acetaldehyde↗
PubMed1976

A role for prostaglandins in the regulation of the placental blood flows.

A model is proposed for the regulation of the placental blood flows to the near-term pregnancy. The model has three features. 1) The maternal uterine and fetal placental tissues can synthesize constrictor and dilator prostaglandins. 2) Prostaglandins can cross the placenta. 3) There must exist a prostaglandin which has a vascodilating action in one of the placental circulations and a vasoconstricting action in the other circulation. Evidence is provided to indicate that the sheep, prostaglandin E2 (PGE2) can cross the placenta and has a vasodilating action in the uterine placental circulation and a vasoconstricting action in the umbilical placental circulation. The placenta and the lung are compared and PGE2 is shown to have similar actions in each of these organs.

Animals↗
PubMed1976

Social class and morbidity in clinically treated alcoholics.

The lifetime physical disease profiles of 122 lower and 724 middle class non-skid row alcoholics admitted to an inpatient treatment facility were compared to further clarify the significance of social class as a determinant of morbidity in alcoholics. The overall severity of physical disease and the frequency of all recorded lifetime illness diagnoses were greater in the lower than in the middle class. The former experienced more trauma, genitourinary disorders, venereal disease and malnutrition, as well as small excesses of respiratory and nervous system disorders. There were no class differences in the lifetime frequencies of liver and biliary tract, gastrointestinal, cardiovascular, endocrine and metabolic, integumentary, locomotor and haemopoietic disorders, or in the incidences of a number of disease entities including acute brain syndromes and chronic brain damage. The drinking patterns of the classes were similar, but the average duration of hazardous drinking was longer and the average current consumption was greater in the lower class. There were no class differences, however, in the average duration of hazardous drinking before the first occurrence of certain diseases. The referral sources of the classes were significantly different. Possible explanations for the differences between the findings of this and earlier studies are discussed.

Adult↗
PubMed1976

Skid row alcoholism. A distinct sociomedical entity.

The physical-disease charcteristics of 125 skid row and 736 non-skid row male alcoholics were compared in detail to determine whether skid row alcoholism is characterized by a distinct medical, as well as a social, profile. Trauma, tuberculosis, venereal disease, and malnutrition were more common in the skid row alcoholics. Epilepsy, peripheral neuritis, acute brain syndromes, chronic brain disease, and lifetime recordings of all nervous system illnesses also occurred more frequently in the skid row group, as did gastritis, gastrointestinal hemorrhage, ulcer surgery, and postgastrectomy syndrome. Fatty liver, hypertension, ischemic heart disease, cardiomyopathy, and cardiovascular illnesses of all kinds, however, were less common. The skid row medical profile is, in part, the product of a unique sociologic environment. Thus, skid row alcoholism may be viewed as a distinct sociomedical entity.

Adult↗