Direct Antiglobulin Tests (DAT) as well as a number of immunological parameters (immunoglobulin levels, latex fixation, VDRL) were studied in 168 narcotic-addicted patients. Of these, 94 were untreated narcotic addicts (Group I), 61 were methadone maintained patients (Group II), and 13 had completed successful detoxification with methadone and were drug-free (Group III). Weakly positive DAT were detected in 2.1 per cent of individuals in Group I, 18 per cent in Group II, and 15 per cent in Group III. The reactions were usually transient. A number of other immunological aberrations were also present in individuals of all three groups, but there was no correlation between these parameters and the positive direct antiglobulin reactions.

Adolescent↗

PubMedDate not supplied

Postgraduate substance abuse teaching: cognitive knowledge before and long after a required course.

Explore the source record for details and available documents.

Family Practice↗

PubMedDate not supplied

Biochemical markers for alcoholism: sensitivity problems.

A panel of blood tests, purportedly markers for alcohol abuse, were examined in 543 relatively healthy alcoholics entering ambulatory rehabilitation treatment. Individual tests were too low in sensitivity: gamma-glutamyl transpeptidase was abnormally high in only 49%, then mean corpuscular volume (45%), high density lipoprotein cholesterol (HDLC) (25%), serum glutamic oxaloacetic transaminase (SGOT) (28%), and blood alcohol (21%). HDLC was of low sensitivity, generally unaffected by liver disease, and related to quantitation of recent alcohol consumed. Combining seven markers, 82% of males and 71% females had at least one abnormally high value. Histories of heavy recent drinking, positive blood alcohol levels on admission, and manifest liver disease on physical examination or by hyperbilirubinemia were associated with high sensitivities of individual and pooled markers. The biochemical markers studied can be useful to suggest alcohol abuse, especially in some populations of drivers. In other populations of alcoholics, especially with intermittent alcohol or recent abstinence, their sensitivities were so low as to discourage extensive reliance on their use. The diagnosis of alcoholism continues to depend on clinical history of alcohol-related problems, including social, familial, legal, medical, psychological, and economic.

Alanine Transaminase↗

PubMedDate not supplied

Alcohol withdrawal syndromes: clinical management with lofexidine.

Sixty-three mainly male alcoholics were randomly assigned to placebo or lofexidine treatment for 48 hr shortly after admission to the hospital. Their starting points were similar regarding their semiquantitative estimates of alcohol withdrawal symptoms (AWS). Their demographics, histories of past alcohol use, physical findings, and laboratory abnormalities usually associated with alcoholism were similar. Starting 3 hr after 0.4 mg of oral lofexidine, which was given every 6 hr as eight doses, the AWS scores were significantly lower than those of the placebo group. Hypotension was the strongest finding. Six placebo recipients had to be prematurely interrupted due to increasing or intolerable alcohol withdrawal symptoms and switched to a benzodiazepine. Only one lofexidine recipient was prematurely interrupted, due to transient hallucinations. The study has a large placebo effect, as both groups of patients rated the treatment process very highly. Lofexidine, an alpha 2-adrenergic agonist, was superior to placebo in alcohol withdrawal. This drug, as with its analogue clonidine, may represent a new and important pharmacological treatment for alcohol withdrawal symptoms.

Adult↗

PubMedDate not supplied

Alcohol: high density lipoproteins, apolipoproteins.

Plasma lipids, including high density lipoproteins (HDL) components, were studied in 26 healthy male alcohol abusers. Age- and gender-matched controls denied the use of substances or behaviors associated with increased HDL. On admission to abstinence treatment, the alcohol abusers' total cholesterol and triglycerides were usually normal. Their HDL-cholesterol levels were high, and fell to normal within 2 weeks of sobriety. Apolipoprotein (APO) AI and AII were high initially and also became normal in 2 weeks. APO A I and II to HDL-cholesterol ratios appeared to change during abstinence, while APO AI/AII did not. APO CIII, high initially, fell during treatment, but was still high after 4 weeks of sobriety. Therefore, alcohol seems to affect several components of HDL and these HDL changes move toward normal at different rates. If alcohol is protective against some cardiovascular disease, it remains to be established whether HDL is involved and which HDL component is most important.

Adult↗

PubMedDate not supplied

Lithium treatment of depressed and nondepressed alcoholics.

We assessed the efficacy of lithium carbonate in the treatment of 457 male alcoholics in a double-blind, placebo-controlled Department of Veterans Affairs Cooperative Study. Alcoholics either without depression or with a history of major depression, current major depression, or dysthymic disorder were studied. Two hundred eighty-six alcoholics without depression and 171 alcoholics with depression began the 52-week outpatient study; 172 alcoholics (60.1%) without depression and 108 alcoholics (63.2%) with depression completed the study. Among both all alcoholics who began the study and a subgroup who completed the study, no significant differences between alcoholics who took lithium and those who took placebo were found for the following outcome measures:number of alcoholics abstinent, number of days of drinking, number of alcohol-related hospitalizations, changes in rating of severity of alcoholism, and change in severity of depression. Similarly, no significant differences were found when only the 82 alcoholics compliant in taking lithium and the 89 alcoholics compliant in taking placebo were considered. In our study, lithium treatment did not affect the course of alcoholism in either depressed or nondepressed alcoholics.

Adult↗