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PubMed1997

The relationship between drinking and heart disease morbidity in the United States: results from the National Health Interview Survey.

This study, based on data drawn from the responses of 18,323 males and 25,440 females to the 1988 National Health Interview Survey, a nationally representative, multistage probability sample of the United States, attempts to define more precisely the level of drinking at which the relationship between heart disease and alcohol consumption is a protective one. Its attempt at precision derives from (1) using drinking categories that represent various points within the range of moderate drinking (1-6 drinks) defined in the literature as protective; (2) adjusting for underreporting that commonly occurs in population surveys by using consumption at time of heaviest drinking; and (3) controlling for age, body mass, smoking, former drinker, and former smoker status, duration of drinking, and sociodemographic factors. It also examines whether the relationship derived from these levels conforms to the U-shaped curve that demonstrates the protective effect of moderate drinking when abstainers are not used as the reference group. Relative to infrequent drinkers (less than 1 drink per day), men report more heart disease at the level of more than five drinks per day. However, black men also report more heart disease, relative to infrequent drinkers, at the greater than two drinks per day level; and women report more heart disease at the level of more than two drinks per day at the time of their heaviest drinking. Former drinkers of both genders, considered as an independent variable in the regression analysis, were more likely to report having heart disease. Abstainers, light drinkers, and infrequent drinkers were not significantly different in their reports of heart disease. Our results are consistent with studies that suggest protection from heart disease occurs only at lower levels of drinking.

Adolescent↗

PubMed1998

Screening for problem drinking: does a single question work?

BACKGROUND: Brief interventions with problem drinkers have been shown to be effective, but physicians often do not ask about alcohol use. If a single question could effectively screen for problem drinking, it might facilitate intervention with problem drinkers. METHODS: A cross-sectional study was undertaken to address the clinical utility of the question, "On any single occasion during the past 3 months, have you had more than 5 drinks containing alcohol?" Placing it between questions about tobacco and seat-belt use, we presented the three questions in writing to 1435 patients; 95.3% answered them. With a systematic sample of 101 patients who answered yes and 99 who answered no, we administered the Alcohol Use Disorders Identification Test in writing followed by two gold-standard interview instruments: (1) a calendar-based review of drinking, with at-risk drinking defined as drinking more than 4 drinks on one occasion or more than 14 drinks per week for men, and more than 3 drinks on one occasion or 7 per week for women; and (2) the alcohol questions in the Composite International Diagnostic Interview, with alcohol-use disorders defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. We defined problem drinking as either at-risk drinking in the previous month or an alcohol-use disorder in the past 12 months. RESULTS: The single question had a positive predictive value of 74% and negative predictive value of 88% for problem drinking, with a sensitivity of 62% and a specificity of 93%. The question's utility was similar for detecting at-risk drinking and current alcohol-use disorders; it correctly identified all 29 patients who had both. CONCLUSIONS: A single question about alcohol can detect at-risk drinking and current alcohol-use disorders with clinically useful positive and negative predictive values.

Adult↗

PubMed2005

Properties and modification of soft drinks in relation to their erosive potential in vitro.

OBJECTIVES: The objective was three-fold; (1) to test the erosive potential (EP) of various soft drinks, (2) to determine properties related to the soft drinks that were important for EP, and (3) to test possibilities of reducing the EP of soft drinks by modification. METHODS: Sixteen soft drinks from the Icelandic market including three modified soft drinks were used. The pH, calcium, phosphorus, and titratable acid (TA) to pH 5.5, 7.0, and 10.0 were determined in each drink. From these results the buffer capacity (beta) at pH 4.5, 6.3, and 8.5, degree of saturation with respect to hydroxyapatite (DS(HAP)), and critical pH (DS(HAP)=1) were calculated. One orange juice was modified by addition of various concentrations of calcium and phosphate. EP was determined as weight loss from tooth pieces after immersion into the soft drinks for 24 and 72 h as well as calcium increase in the soft drink upon immersion. RESULTS: EP of the drinks varied from 0-10% weight loss and 0-31 mmol calcium increase. The pH in carbonated and sport drinks was lower than in fruit juices, whereas TA and beta was considerably higher in fruit juices. Significant correlations were obtained between EP and TA, beta, pH, and DS(HAP) (r(s)=0.69-0.90). Addition of calcium and phosphate to the experimental drinks considerably decreased their EP. CONCLUSION: We conclude that several properties related to soft drinks have an impact on their EP upon long exposure time to teeth and that moderate modification could be a helpful measure to reduce the EP of soft drinks.

Acids↗

PubMed2002

Comparative chronic toxicity and carcinogenicity of acrylonitrile by drinking water and oral intubation to Spartan Sprague-Dawley rats.

Groups of 100 male and 100 female Spartan Sprague-Dawley rats were administered lifetime oral doses of Acrylonitrile (AN) by one of two routes of dosing, either at 0.1 or 10 mg/kg per day, 7 day per week by intubation or continually at 1 or 100 ppm AN in their drinking water. The doses selected were designed to approximate the same daily intake of AN in each of two separate studies, whether by a single bolus dose (intubation) or a more continuous dosing regimen in drinking water. Each study had its own untreated control group of 100 rats per sex. In the drinking water study, the equivalent mean dosage of AN administered to males and females were 0, 0.09, and 0.15 mg/kg per day, respectively, at the 1 ppm level, and 0, 8.0 and 10.7 mg/kg per day, respectively, for 100 ppm dose groups. In both studies, groups of ten rats per sex were sacrificed at 6, 12 and 18 months and at study term. Ophthalmoscopic, hematological, clinical biochemistry, urinalysis and full histopathological exams were performed on control and high dose groups of rats in each study. Similar tests were done in lower dose groups, as required, to define dose-responses of observed effects. All animals were necropsied and underwent microscopic examination of target tissues, including brain, ear canal, stomach, spinal cord and any observable tissue masses. High dose male and female rats in both studies exhibited statistically decreased body weights. Food consumption and water intake were reduced only in the drinking water study. Due to increased deaths in groups of high dose rats of both studies receiving AN, all intubation test groups were terminated after 20 months of treatment. Surviving males and females in the drinking water study were terminated after 22 and 19 months, respectively. Small, sometimes statistically significant, reductions in hemoglobin, hematocrit and erythrocyte count were observed in male and female rats in both high dose (10 mg/kg per day intubation and 100 ppm drinking water) groups from both studies. There were increases in absolute or relative organ weight ratios for liver and adrenal in the high dose intubation study groups, but could not be correlated with AN toxicity in the absence of adverse clinical biochemistry or microscopic findings. Similar organ weight findings were not observed in the drinking water study. Again, there were no changes in clinical biochemistry or microscopic findings in these tissues. Absolute kidney weights were increased in high dose male and female rats in the intubation study and high dose female rats only in the drinking water study. Male and female rats from high dose groups in each study had a higher incidence of palpable masses of the head and the nonglandular stomach and, in females only, the mammary region. In both sexes, treatment-related tumors of the central nervous system (brain, spinal cord), ear canal, and gastrointestinal tract, and in females only, the mammary gland (intubation only) were observed in rats administered either 10 mg/kg per day by intubation or 100 ppm in drinking water. Animals from the intubation study had a substantially higher incidence of AN-related site-specific tumors than did their drinking water study counterparts. While a similar spectrum of tumors was produced by both oral dosing regimens, there were some notable differences in organ-specific incidence of tumors. Astrocytomas of the brain and spinal cord were found at a higher incidence in those rats exposed continuously to AN administered in the drinking water versus bolus dosing by intubation. Conversely, a higher incidence of squamous cell carcinomas/papillomas of the forestomach and adenocarcinomas of the intestine and, in females only, carcinomas of the mammary gland were observed in high dose rats receiving AN by intubation. An increase in the degree of severity of forestomach hyperplasia was observed in all high dose groups of animals, irrespective of mode of administration. These effects were more pronounced, were correlated with a much higher incidence of forestomach tumors, and were identified earlier (12 months) in the intubation study in which there was direct tissue contact with a more concentrated AN solution. Elevations in epidermal cysts in high dose males and females in the intubation study and renal hyperplasia in high dose animals of both sexes in both studies may have a treatment relationship. All other clinical and microscopic findings were considered unremarkable. There were no discernable non-neoplastic effects attributable to treatment in groups of low dose male and female rats given AN by intubation at 0.1 mg/kg per day or 1 ppm in drinking water. The results of this study indicate a consistent spectrum of neoplastic and non-neoplastic effects produced by AN in the same rat strain, whether administered orally by bolus or by continuous dosing in the drinking water. While the spectrum of tumors and target organ toxicity produced was similar, bolus dosing clearly increased tumors associated with the gastrointestinal tract. Neoplasms found in several other tissues were most prominently displayed in groups of more continuously dosed rats.

Acrylonitrile↗

PubMed1999

Effect on plaque pH of fruit drinks with reduced carbohydrate content.

OBJECTIVES: To assess the acidogenic response in dental plaque after challenge with four fruit drinks, including two blackcurrant drinks newly formulated, with low levels of carbohydrate. METHODS: 24 adult volunteers rinsed, in randomised order, with each of two new formulations of a blackcurrant drink (7% juice with 0.49% and 10% juice with 0.65% carbohydrate concentration respectively), an apple and blackcurrant drink with no added sugar (0.8%), and a mixed citrus fruit drink with a higher carbohydrate concentration (4.5% w/v). Solutions of 10% sucrose and 10% sorbitol were used as controls. Plaque pH was assessed, in vivo, before and after the acidogenic challenge using the plaque-harvesting technique. RESULTS: Results showed that the minimum plaque pH after the subjects rinsed with the new blackcurrant drinks was higher as compared with all the other test products and significantly so compared with the mixed citrus drink (P = 0.0001). It was also found that with the 7% blackcurrant juice drink none of the subjects and with 10% blackcurrant juice drink only one subject recorded a pH drop below the pH of 5.7. Ten minutes after consumption, both the new formulation blackcurrant drinks produced significantly higher plaque pH than the mixed citrus drink. In addition, overall change in the hydrogen ion concentration over the study period (sigma delta cH) was significantly less with both new blackcurrant drinks compared with the mixed citrus drink. CONCLUSIONS: It was concluded that the two new formulations with low levels of carbohydrate had a low acidogenic potential and did not depress the plaque pH below the critical level and their consumption could not be considered to pose a significant risk for enamel demineralisation.

Adolescent↗

PubMed1992

Effects of desoxycorticosterone acetate (DOCA) plus saline drinking on gentamicin-mediated nephropathy in rats.

Studies were performed to examine the effect of desoxycorticosterone acetate (DOCA) treatment plus isotonic saline drinking on gentamicin (GM)-mediated nephropathy in rats. GM, 40 mg/kg/day, was subcutaneously injected for 13 days following a 5-week treatment with water drinking or DOCA (10 mg/kg/week) plus saline drinking. Twenty-four hours after the last injection of GM, renal blood flow (RBF) and Cin decreased to approximately 69% and 52% of the control values in water-drinking GM-treated rats, respectively, but was well maintained in DOCA plus saline-drinking GM-treated animals. There was no significant difference in morphologic tubular injury or the renal cortical GM content between GM-treated groups. Saline drinking alone (1% saline, 5 weeks) lessened neither GM-induced reduction in GFR nor tubular damage. Body weight loss occurred following GM injection in the water-drinking group but not in the DOCA plus saline-drinking and saline-drinking-alone groups. DOCA plus saline drinking significantly suppressed the plasma renin activity (PRA) but saline drinking alone did not. A significant inverse correlation was found between PRA and Cin in water-drinking GM-treated and untreated rats. The data suggest that the beneficial effect of DOCA plus saline drinking is associated with renin-angiotensin suppression rather than with the renal GM content or well-maintained hydration.

Acute Kidney Injury↗

PubMed2005

Microbiological quality of sous and tamarind, traditional drinks consumed in Jordan.

This study was conducted to evaluate the microbiological quality of sous (a drink prepared by extracting dried roots of Glycyrrhiza glabra) and tamarind (a drink prepared by infusing Tamarindus indica dried pulp), traditional drinks consumed in Jordan. Twenty-one samples of sous and 44 samples of tamarind were collected from the local market in Amman, Jordan. Water is the major component of the drinks. Sous drink is characterized by having an alkaline pH (range, 6.6 to 9.9; mean, 8.6), whereas tamarind drink has an acidic pH (range, 1.8 to 3.7; mean, 2.8). The drinks are not processed for safety before serving, and at some vendors drinks are not properly refrigerated. The mean counts for aerobic bacteria, lactic acid bacteria, and yeasts in sous drink samples were 5.9, 5.0, and 3.8 log CFU/ml, respectively; those in tamarind drink samples were 4.0, <1, and 5.8 log CFU/ml, respectively. The lactic acid bacteria isolated were Enterococcus raffinosus, Enterococcus hirae, Enterococcus durans, Lactobacillus acidophilus, and Lactobacillus buchneri. The yeast isolates in sous drink were from the genera Candida, Filobasidium, Hanseniaspora, Lodderomyces, Pichia, and Williopsis, and those in tamarind drink were from Arthroascus, Brettanomyces, Candida, Debaromyces, Filobasidiella, Hanseniaspora, Klavispora, Lodderomyces, Pichia, Saccharomycodes, Trichosporon, and Zygosaccharomyces. Enterobacteriaceae were detected in two sous samples and were identified as Enterobacter sakazakii and Erwinia sp., and in two tamarind samples and were identified as Citrobacter freundii and Klebsiella pneumoniae. Salmonella was detected in one sous and one tamarind sample. Pseudomonas aeruginosa was detected in only one sous sample. These findings highlight the importance of application of hygienic practices throughout preparation and vending of drinks, starting with raw ingredients and continuing through preparation, storage, display, and serving.

Bacteria↗

PubMed2000

Preschool children's consumption of drinks: implications for dental health.

OBJECTIVE: To examine drinking patterns in pre-school children and their relationship to percentage of energy intake from non-milk extrinsic sugars. DESIGN: Secondary analysis of data from the national diet and nutrition survey (NDNS) relating to the dietary intakes of a representative sample of pre-school children in the UK. SUBJECTS: 1,675 children aged 1.5 to 4.5 years surveyed between July 1992 and June 1993. OUTCOME MEASURES: Proportion of consumers, average daily frequency of consumption and estimated seven day volume of consumption of different drinks. Percentage of average daily energy intake obtained from non-milk extrinsic sugars (NMES). RESULTS: Soft drinks were the most commonly consumed drinks followed by whole milk and diet or low sugar varieties of soft drinks. Half the sample were estimated to consume more than 1.5 litres of soft drinks and whole milk and over a litre of diet or low-sugar soft drinks per seven days. Fifty-six per cent of the children consumed soft drinks more than once a day. The youngest children (1.5-2.5 years) were more likely to consume whole milk and less likely to consume diet, soft drinks and skimmed milk than other age groups. Children from manual home backgrounds consumed more tea and coffee and were less likely to consume fruit juice than those from non-manual backgrounds. Drinks contributed 23% to total energy intake and 39% of NMES intake. Consumption of soft drinks, fruit juice and whole and semi-skimmed milk accounted for 59% of variance in percentage of energy from NMES. CONCLUSIONS: A large proportion of pre-school children consume considerable quantifies of soft drinks which have little or no nutritional value and are high in cariogenic non-milk extrinsic sugars. This has implications for children's dental and general health. Recommendations for drinks consumption should be included in food policy guidelines for pre-school children.

Age Factors↗

PubMed2003

Drinking water contamination in Walkerton, Ontario: positive resolutions from a tragic event.

In May 2000, Escherichia coli O157:H7 and Campylobacter jejuni contaminated the drinking water supply in Walkerton, Ontario. Seven people died and over 2,000 were ill as a result. The Ontario Provincial Government set up a judicial Inquiry into the circumstances surrounding the outbreak and also moved quickly to introduce a new Drinking Water Regulation that incorporated some significant requirements for drinking water providers. The Inquiry itself was in three parts: (a) part 1 related to the events that occurred in Walkerton and why the water contamination occurred; (b) part 1A related specifically to the role of the Provincial Government in the event; and (c) part 2 related to the future of drinking water safety in Ontario with potential to influence regulation on a wider basis. A number of other actions were taken after Walkerton. In August 2000, the Ontario Government, through the Regulatory body, the Ontario Ministry of the Environment (MOE) (a) re-issued and revised the Ontario Drinking Water Objectives (ODWO) as the Ontario Drinking Water Standards (ODWS) and (b) introduced new regulations governing drinking water in Ontario--the Ontario Drinking Water Protection Regulation. One of the key features of the Drinking Water Protection Regulation was the requirement to produce an independent Engineers' Report on all water systems. This paper provides a unique perspective on the Walkerton tragedy and its aftermath. The author was active in many aspects of the resulting activity (Chair of the Ontario Water Works Association's (a section of the AWWA) Special Committee involved in Part 2 of the Walkerton Inquiry; author of several of the Engineers' Reports mandated by Regulation; reviewer on behalf of the Regulator of Engineers' Reports submitted by others). The Engineers' Reports were of interest because (1) the drinking water providers (mostly municipalities) were mandated by regulation to complete the Reports by specific dates and are paying for the Reports, (2) the work had to be done by a registered professional engineer who is not an employee of the owner or the operator if a different entity and (3) the engineer had to sign a declaration that the Regulator could rely on the accuracy of the Report. In other words, the Municipality retained the Engineer and paid them to produce the Report--the Engineer essentially carried the liability while the Regulator had the final say in the acceptability of the Report, a sort of eternal triangle of responsibilities. The paper will outline how the drinking water profession in North America worked together to provide the Walkerton Inquiry with the benefit of its experience and knowledge of best practices to the benefit of consumers and the drinking water providers. It will also outline the procedures adopted to produce the independent Engineers' Reports and how the findings are being applied to further improve drinking water safety in Ontario, across Canada and in similar situations around the world.

Campylobacter Infections↗

PubMed1988

Properties of aeromonads and their occurrence and hygienic significance in drinking water.

In the Netherlands, aeromonads in drinking water have attracted much attention in recent years. This development was caused by a sudden increase of the Aeromonas density in the drinking water of the municipal Dune Waterworks of The Hague and reports about the possible health significance of these organisms in drinking water. Literature data indicate that representatives of the motile Aeromonas species A. hydrophila, A. sobria and A. caviae generally have been observed in larger percentages of diarrheal feces than in normal stools, with isolation rates ranging from less than 1% to more than 20%. These data and the virulence properties of the aeromonads, viz. hemolytic activity, cytotoxicity and enterotoxicity, as tested in the suckling mouse assay or the rabbit ileal loop, strongly suggest that these aeromonads are potential enteric pathogens for susceptible hosts, including young children and immunocompromised persons. Aeromonads are ubiquitously present in fresh water environments, with densities depending on pollution with sewage, trophic state and temperature. About 100 years ago, bacteria identical with Aeromonas spp. have already been isolated from drinking water. Depletion of free chlorine residuals in drinking water generally results in increasing Aeromonas densities, particularly in the summer months. Investigations in the Netherlands have shown that Aeromonas densities in drinking water increase with increasing residence time. Furthermore, the aeromonads constitute a minor fraction of the heterotrophic bacterial population in drinking water. Growth measurements with pure cultures of A. hydrophila revealed that certain compounds, e.g. oleate as present in soft soap, promote the growth of the organism at substrate concentrations of a few micrograms per liter. Based on a number of surveys on the presence of aeromonads in drinking water, the health authorities in the Netherlands have defined so-called indicative maximum values for Aeromonas densities in drinking water i.e. 20 CFU/100 ml in drinking water at the production plant and 200 CFU/100 ml in drinking water during distribution. Further research is necessary (i) to elucidate the health significance of aeromonads in drinking water and (ii) to define measures for limiting Aeromonas densities in drinking water.

Aeromonas↗

PubMed1995

Screening for drinking problems by patient self-report. Even 'safe' levels may indicate a problem.

BACKGROUND: Physicians often screen their ambulatory patients for serious drinking problems by asking questions related to the quantity of alcohol that they consume. Never previously reported is whether this "quantitative" approach to screening can be used to effectively screen ambulatory patients for the presence of a serious drinking problem. METHODS: The project interviewed 510 patients attending an inner city general medicine practice with the alcohol module of the Diagnostic Interview Schedule, revised for the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition. Collected data also included reported quantity, frequency, and recency of drinking. We then calculated the sensitivity, specificity, positive predictive values, and receiver operating characteristic curve for zero to two, three to five, six to 11, 12 to 23, and 24 or more standard drinks as reported by 155 patients who reported drinking within 30 days of their visit. RESULTS: Forty-eight of 155 active drinkers met the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition criteria for alcohol dependence or abuse. Only five patients with an active diagnosis failed to report drinking within 30 days of their visit. The calculated area under the receiver operating characteristic curve for reported quantity was 0.81. The sensitivities of reported consumption decline with increasing drinking, while the specificities and positive predictive values rise. The report of drinking between six and 12 drinks per week was associated with a positive predictive value of 0.54 for an active Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, diagnosis. CONCLUSIONS: Patient self-report of drinking can be used to screen actively drinking outpatients on the general medicine service for serious drinking problems. Further, in an urban general medicine outpatient population, even federally recommended levels of drinking may indicate a problem. Our data suggest that physicians' recommendations be adjusted for the setting in which they practice.

Alcoholism↗

PubMed1994

Are men or women more likely to stop drinking because of alcohol problems?

Using a national population sample of adults who had ever consumed at least 12 drinks per year, men and women were compared in terms of the proportions who had stopped drinking because of alcohol problems. Overall, 24% of the male drinkers and 31% of the female drinkers had stopped drinking as of the time of interview, but men were more likely than women to have stopped drinking because of alcohol-related problems (4.3 vs. 2.3%). After using survival techniques to adjust for women's greater competing risk of stopping drinking for other reasons and men's greater exposure time due to their earlier initiation of drinking, the conditional probabilities of having stopped drinking because of alcohol problems were almost identical for men and women during the first 15 years of their drinking histories. Thereafter, the conditional probabilities were about 50% higher for men than for women. The observed durations of drinking history were about five years longer for men than women. After controlling for sociodemographic characteristics, family history of alcoholism, and patterns of alcohol consumption, there was no gender difference in the hazard of stopping drinking because of alcohol problems among persons who drank alcohol on less than a daily basis during their period of heaviest consumption. However, among daily drinkers, the hazard of stopping drinking because of alcohol problems was greater for women than men, by a factor of 1.5 to 3, depending on quantity of consumption and interval since first drink.

Adolescent↗

PubMed1992

Problem drinking among college freshmen.

Entering college freshmen (n = 308) completed a questionnaire which assessed drinking behaviors and identified students at risk for problem drinking as defined by the CAGE (focuses on Cutting down on drinking, Annoyance by criticism by others about drinking, Guilty feelings about drinking, and the use of an Eye opener) questionnaire and Perceived-Benefit-of-Drinking Scale (PBDS). Students were 50% male with a mean age of 17.9 years. In the past month, 17% had drunk on 10 or more occasions, and 18% had binged on 6 or more occasions. CAGE scores of 2 or greater were obtained by 21% and PBDS scores of 3 or greater by 29%, reflecting high risk for problem drinking. High-risk CAGE and PBDS scores were associated with frequent drinking and binging. Student reports of parental problem drinking were not associated with high risk for problem drinking. Intent to join a fraternity or sorority (the Greek system) was associated with frequent drinking, binging, and high-risk CAGE and PBDS scores. Approaches to screening for problem drinking which emphasize attitudes and beliefs may be useful. The Greek system appears to be attractive to high-risk students and should be a focus of prevention programming.

Adolescent↗

PubMed2004

Excessive drinking in college: behavioral outcome, not binge, as a basis for prevention.

The dichotomous variable "binge drinking" and its associated outcomes may be insufficient for understanding the drinking phenomenon on college campuses. The current study examined the behavioral outcomes associated with different drinking nights (light, typical, and heavy) in an effort to more closely examine collegiate drinking behavior. Data were collected from 236 university students, including hourly drinking rate, estimated blood alcohol concentration (BAC) was computed, and outcomes for each drinking night. Students reported drinking behavior that ranged from weekly "light night" drinking (average: 2.85 drinks, 3.34 h, end of night BAC = 0.04%) to biweekly "heavy nights" (average: 9.91 drinks, 4.93 h, end of night BAC = 0.25%). Students report encountering the greatest number of negative outcomes during heavy drinking nights, while light nights were found to have the fewest associated negative outcomes. Positive outcomes were highest on "typical" nights, although effect sizes were small. These data suggest that prevention efforts may be more successful if types of drinking night and positive outcomes become a stronger focus. Limitations and directions for future programming and research are discussed.

Adolescent↗

PubMed2002

Water drinking as a treatment for orthostatic syndromes.

PURPOSE: Water drinking increases blood pressure in a substantial proportion of patients who have severe orthostatic hypotension due to autonomic failure. We tested the hypothesis that water drinking can be used as a practical treatment for patients with orthostatic and postprandial hypotension, as well as those with orthostatic tachycardia. SUBJECTS AND METHODS: We studied the effect of drinking water on seated and standing blood pressure and heart rate in 11 patients who had severe orthostatic hypotension due to autonomic failure and in 9 patients who had orthostatic tachycardia due to idiopathic orthostatic intolerance. We also tested the effect of water drinking on postprandial hypotension in 7 patients who had autonomic failure. Patients drank 480 mL of tap water at room temperature in less than 5 minutes. RESULTS: In patients with autonomic failure, mean (+/- SD) blood pressure after 1 minute of standing was 83 +/- 6/53 +/- 3.4 mm Hg at baseline, which increased to 114 +/- 30/66 +/- 18 mm Hg (P <0.01) 35 minutes after drinking. After a meal, blood pressure decreased by 43 +/- 36/20 +/- 13 mm Hg without water drinking, compared with 22 +/- 10/12 +/- 5 mm Hg with drinking (P <0.001). In patients with idiopathic orthostatic intolerance, water drinking attenuated orthostatic tachycardia (123 +/- 23 beats per minute) at baseline to 108 +/- 21 beats per minute after water drinking ( P <0.001). CONCLUSION: Water drinking elicits a rapid pressor response in patients with autonomic failure and can be used to treat orthostatic and postprandial hypotension. Water drinking moderately reduces orthostatic tachycardia in patients with idiopathic orthostatic intolerance. Thus, water drinking may serve as an adjunctive treatment in patients with impaired orthostatic tolerance.

Adult↗

PubMedDate not supplied

The Inventory of Drinking Situations (IDS) in current drinkers with different degrees of alcohol problems.

The Inventory of Drinking Situations (IDS) is a questionnaire developed to characterize the situations where alcoholics in treatment drank excessively. The purpose of the present study was to extend the understanding of this instrument as a research and diagnostic tool by applying it to drinking situations in individuals who have never been diagnosed as alcoholics, but who may have problems due to alcohol. Seventy-three current drinkers (32.1 +/- 9.98 years) were examined with a version of the IDS suitable for nonalcoholic individuals. Using the CAGE test we categorized the subjects in five groups according to their score. Correlational analysis revealed that the IDS subscale scores increased significantly with the severity of drinking problems. The CAGE score, the factor-derived scale Negative Situations, being male, and a preference for drinking alone were also correlated with the amount of alcohol consumed, while age was correlated with none of the variables of interest. To facilitate the analysis of the profiles of drinking situations, the IDS subscales underwent a factor analysis that rendered two factor-derived scales, suggesting that drinking occurs both in positive and in negative situations. In persons with more alcohol problems, according to their high CAGE scores, there was more drinking in negative situations that in positive ones. Accordingly, we confirmed that the profiles of drinking situations seen in problem drinkers indicated that situations related to negative emotions are more important determinants to drink. Implications of a shift from drinking in positive to drinking in negative emotional situations are discussed. We further substantiated the value of this test instrument for studies on drinking situations and for studies in nonalcoholic individuals.

Adult↗

PubMed1981

Dissonance and alcohol: drinking your troubles away.

Based on recent evidence supporting the assumption that cognitive dissonance is experienced as an unpleasant emotional state, and further evidence pertaining to the effects of drinking alcohol, it was predicted that among social drinkers, dissonance arousal would increase the amount of drinking and that drinking, in turn, would reduce dissonance and subsequent attitude change. This hypothesis was tested in the first two experiments by having subjects taste rate different brands of an alcoholic beverage--ostensibly to test taste discrimination but in fact to measure the amount of drinking--immediately after dissonance was aroused by having them write a counterattitudinal essay. The effect of drinking on dissonance reduction was assessed by measuring subjects' postattitudes immediately after the drinking task. Both experiments found that although dissonance arousal had little effect on the amount of drinking, whatever drinking occurred was sufficient to eliminate dissonance-reducing attitude change. The second experiment further established that these results occurred for light as well as heavy social drinkers. Evidence that the dissonance-reducing effect of drinking resulted form some effect of drinking alcohol was provided by the finding, in the second and third experiments, that neither water or coffee drinking was sufficient to eliminate attitude change in this paradigm. Both the practical and theoretical implications are discussed. The practical implication is that some forms of alcohol abuse may evolve through the reinforcement of drinking as a means of reducing dissonance; the theoretical implication is that dissonance may be frequently reduced through behaviors that ameliorate the feelings of dissonance without involving cognitive change.

Adult↗

PubMed2003

Peer and partner drinking and the transition to marriage: a longitudinal examination of selection and influence processes.

This study examined the longitudinal relationships among adult drinking, partner drinking, and peer drinking over the transition to marriage. Newlywed couples were assessed with respect to alcohol involvement, peer drinking, and risk factors and reassessed at their 1st anniversary. Husbands' premarital drinking was predictive of wives' drinking at the 1st anniversary, indicating partner influence. The results did not support a peer-influence hypothesis in that peer drinking at marriage was not predictive of husbands' or wives' drinking at the 1st anniversary. There was evidence, however, for a peer-selection effect with husbands' premarital drinking predicting peer drinking for both husbands and wives. Wives' premarital drinking was unrelated to the subsequent drinking of their peers or their husbands' peers.

Adult↗