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Management of postmenopausal hot flushes with venlafaxine hydrochloride: a randomized, controlled trial.

OBJECTIVE: To examine the efficacy of extended-release venlafaxine for the treatment of postmenopausal hot flushes. METHODS: Eighty postmenopausal women with more than 14 hot flushes per week were randomized to receive treatment with extended-release venlafaxine or placebo. Participants received 37.5 mg daily for 1 week, followed by 75 mg daily for 11 weeks. Daily hot flush severity scores and adverse effects were recorded by subjects. Baseline and monthly follow-up questionnaires assessed patient-perceived hot flush score, quality of life, and sexual function. Participants were treated for 12 weeks. RESULTS: Of the 80 subjects who enrolled in the study, 40 were in the treatment group and 40 in the control group. Of these, 61 completed the study (treatment, n = 29; control, n = 32). Subjective assessment at monthly visits of the effects of hot flush symptoms on daily living were significantly improved in the treatment group (P < .001). Hot flush severity scores based on daily diaries were somewhat lower in the treatment group, but the between-group difference did not reach statistical significance (P = .25). Three side effects, dry mouth, sleeplessness, and decreased appetite, were significantly more frequent in the venlafaxine group, but others, including dizziness, tremors, anxiety, diarrhea, and rash, were significantly less frequent. Ninety-three percent of participants in the venlafaxine group chose to continue treatment at the conclusion of the study. CONCLUSION: Extended-release venlafaxine, 75 mg per day, is an effective treatment for postmenopausal hot flushes in otherwise healthy women, based on a significant decrease in patient-perceived hot flush score.

Antidepressive Agents↗

Effect of oral gamolenic acid from evening primrose oil on menopausal flushing.

OBJECTIVE: To evaluate the efficacy of gamolenic acid provided by evening primrose oil in treating hot flushes and sweating associated with the menopause. DESIGN: Randomised, double blind, placebo controlled study. SETTING: District general hospital and teaching hospital. SUBJECTS: 56 menopausal women suffering hot flushes at least three times a day. INTERVENTION: Four capsules twice a day of 500 mg evening primrose oil with 10 mg natural vitamin E or 500 mg liquid paraffin for six months. MAIN OUTCOME MEASURES: Change in the number of hot flushes or sweating episodes a month. RESULTS: 56 diaries were analysed, 28 from women taking gamolenic acid and 28 from those taking placebo. Only 18 women given gamolenic acid and 17 given placebo completed the trial. The mean (SE) improvement in the number of flushes in the last available treatment cycle compared with the control cycle was 1.9 (0.4) (P < 0.001) for daytime flushes and 0.7 (0.3) (P < 0.05) for night time flushes in women taking placebo; the corresponding values for women taking gamolenic acid were 0.5 (0.4) and 0.5 (0.3). In women taking gamolenic acid the only significant improvement was a reduction in the maximum number of night time flushes (1.4 (0.6); P < 0.05). CONCLUSION: Gamolenic acid offers no benefit over placebo in treating menopausal flushing.

Administration, Oral↗

Flushing and altrenogest affect litter traits in gilts.

Gilts (n = 267) were allotted to flushing (1.55 kg/d additional grain sorghum), altrenogest (15 mg.gilt-1.d-1) and control treatments in a 2 x 2 factorial arrangement. Altrenogest was fed for 14 d. Flushing began on d 9 of the altrenogest treatment and continued until first observed estrus; 209 gilts (78%) were detected in estrus. The interval from the last day of altrenogest feeding to estrus was shorter (P less than .05) with the altrenogest + flushing treatment (6.6 +/- .2 d) than with flushing alone (7.6 + .3 d). Ovulation rates (no. of corpora lutea) were higher (P less than .05) in all flushed gilts (14.5 +/- .4 vs 13.4 +/- .4), whether or not they received altrenogest. Flushing also increased the total number of pigs farrowed (.9 pigs/litter; P = .06) and total litter weight (1.43 kg/litter; P = .01), independent of altrenogest treatment. Number of pigs born alive and weight of live pigs were higher for gilts treated with altrenogest + flushing and inseminated at their pubertal estrus than for gilts in all other treatment combinations. In contrast, gilts receiving only altrenogest had greater live litter weight and more live pigs born when inseminated at a postpubertal estrus than when inseminated at pubertal estrus. We conclude that flushing increased litter size and litter weight, particularly for gilts that were inseminated at their pubertal estrus. Increased litter size resulted from increased ovulation rates, which, in nonflushed gilts, limited litter size at first farrowing.

Animal Feed↗

Estrous and litter traits in gilts altered by altrenogest, flushing and pubertal status.

Influences of estrous synchronization with altrenogest and flushing on reproductive traits in gilts were evaluated in three experiments on two farms. Crossbred gilts were fed altrenogest or altrenogest and an additional 1.55 kg ground sorghum grain for at least 10 d before breeding (flushing), or served as controls. Additional grain for the flushing treatment was provided to gilts from the eighth day of altrenogest treatment until they were detected in estrus. The combination of altrenogest and flushing (on Farm A) increased (P less than .05) litter size when compared with gilts treated only with altrenogest and controls that received neither altrenogest nor flushing. This response was entirely among gilts inseminated at their pubertal estrus. For pubertal gilts fed altrenogest and the flushing treatment, litter traits were similar to other treated or control gilts inseminated at a postpubertal estrus. No treatment effects on litter size were detected for gilts inseminated at a postpubertal estrus. Gilts on Farm B responded differently, with larger litter sizes (P = .08) for those treated with altrenogest and flushing plus altrenogest than for control gilts. Reasons for farm differences might be unidentified genetic or management factors or different seasons of the year when gilts were treated on Farm B (summer) vs Farm A (fall, winter and spring). Our results indicate a marked potential for increasing litter size in gilts mated at their pubertal estrus because their unstimulated ovulation rate (no altrenogest or flushing) did not challenge adequately the biological capacity of their uteri.

Animal Nutritional Physiological Phenomena↗

Alpha 2-adrenergic mechanism in menopausal hot flushes.

It has been hypothesized that hot flushes are triggered within the hypothalamus by alpha 2-adrenergic receptors on noradrenergic neurons. We administered intravenous clonidine (an alpha 2-adrenergic agonist) and yohimbine (an alpha 2-adrenergic antagonist) to nine menopausal women with hot flushes and to an asymptomatic comparison group. Hot flushes were defined objectively by skin conductance responses recorded from the sternum; finger temperature recordings and symptom reports were also evaluated. The subjects were prescreened using ambulatory skin conductance monitoring. A significantly greater number of hot flushes occurred during yohimbine sessions than in corresponding placebo sessions (six versus zero). Clonidine significantly increased the amount of peripheral heating needed to provoke a hot flush (40.6 versus 33.6 minutes) and reduced the number of hot flushes that did occur (two versus eight). No hot flushes occurred in the asymptomatic women. These findings support the role of a central alpha 2-adrenergic mechanism in the initiation of hot flushes.

Adult↗

Studies on the duration of ovum transport by the human oviduct. III. Time interval between the luteinizing hormone peak and recovery of ova by transcervical flushing of the uterus in normal women.

This article deals with attempts to time the onset and duration of the ovum's sojourn in the endometrial cavity of women. Recovery of the ovum from the uterus was attempted by means of transcervical flushing of the cavity 48 to 216 hours after the luteinizing hormone (LH) peak in plasma. A single flushing or repetitive flushings done at 24-hour intervals in the same cycle were performed in different subjects. With both modalities, the adverse effects were mild and few. Of 132 flushings done in 76 subjects, 90 were considered to be technically adequate from the point of view of recovering over 50% of the flushing volume. Twenty ova were recovered. Technically adequate flushings and adequate timing of the LH peak were accomplished in 39 cycles. In this group, 13 ova were recovered between 96 and 168 hours after the LH peak. The highest yield of ova per flushing was obtained from 120 to 168 hours with an average of 37% and a range of 25% to 50%. Limitations of the technique are discussed. Some uncertainties persist which prevent the drawing of definitive conclusions about how soon after the LH peak the egg enters the uterine cavity, how long it stays there, and what is the extent of individual variation. However, recovery rates at various times after ovulation agree with previous data derived from transfundal flushing and indicate that the ovum is usually transferred to the uterus between 96 and 120 hours after the LH peak is retained there for several days.

Adult↗

Liver transplantation from non-heart beating donors in rats: influence of viscosity and temperature of initial flushing solutions on graft function.

BACKGROUND: We evaluated the effect of warm (37 degrees C) versus cold (4 degrees C) solutions as the initial flush for liver preservation from non-heart beating donors in rats. METHODS: An initial flush was performed just before donor hepatectomy with cold or warm University of Wisconsin solution (UW), UW without hydroxyethyl starch, sodium lactobionate sucrose solution, or lactated Ringer's solution as the control group. A separate group also used as control received no initial flushing. Liver transplantation was performed, and the graft function was determined by survival and assessment of enzyme release. The viscosity of each solution and the vascular resistance of the graft were measured. RESULTS: The 7-day survival rate was 83% and 100% in the warm and cold sodium lactobionate sucrose solution groups and 60% and 50% in the warm and cold lactated Ringer's solution groups, respectively. In the no-initial-flush group, rats did not survive. The 7-day survival rate was 67% and 0% in the warm and cold UW groups, respectively. Eliminating the hydroxyethyl starch from the cold UW improved the survival to 67%. Serum alanine aminotransferase levels 1 day after transplantation in the no-initial-flush and the cold UW groups were significantly higher than those of the remaining groups. At 4 degrees C the viscosity was higher in the UW (86.2 cp) compared to hydroxyethyl starch-free UW solution (30.9 cp), lactated Ringer's solution (24.5 cp), and sodium lactobionate sucrose solution (32.7 cp). The viscosity of UW at 37 degrees C was 34.7 cp. Vascular resistance correlated well with the viscosity. Livers flushed with solutions with a low viscosity showed lower vascular resistance than those flushed with cold UW and led to better survival. CONCLUSIONS: These data suggest that the viscosity of the initial flushing solution may play an important role in determining the outcome of organ procurement from non-heart beating donors.

Adenosine↗

A comparison of the University of Wisconsin solution and the modified Kawakami solution for initial flush and coronary perfusion in long-term canine heart preservation.

BACKGROUND: We compared two different solutions, the University of Wisconsin (UW) solution (intracellular-like) and the modified Kawakami (mK) solution (extracellular-like), for initial flush of coronary vascular beds before simple storage and following coronary perfusion. METHODS: After a right thoracotomy in the 4th intercostal space, the donor heart was isolated by ligating the azygos vein and venae cavae, and cross-clamping the aorta. Cardiac arrest was then obtained with a cold GIK solution. Following initial flush of coronary vascular beds, the donor heart was resected, stored utilizing a combination of simple immersion and coronary perfusion, and then transplanted. A total of 48 mongrel dogs was divided into three groups each using different solutions for the initial flush of coronary vascular beds and for coronary perfusion. In group I (n=10) the UW solution was used for both initial flush and coronary perfusion. In group II (n=7) the mK solution was used for both initial flush and coronary perfusion, and in group III (n=7) the UW solution was used for initial flush and the mK solution for coronary perfusion. Intracellular high-energy phosphate was surveyed by 31P-nuclear magnetic resonance spectroscopy. RESULTS: After 12-hour simple immersion and 1-hour coronary perfusion, phosphocreatine and adenosine triphosphate were significantly (p<0.05) higher in group III than in groups I and II. The high-energy phosphate levels of the graft tissue were better in groups I and III than in group II. Orthotopic transplantation was then performed using 10 preserved grafts in group I and seven preserved grafts of group III. After transplantation, left ventricular (LV) pressure of group I animals recovered to 82.3% and group III recovered to 95.8% of the control values. LV dp/dt of group I and III animals recovered to 76.5% and 96.7% of the control values, respectively. CONCLUSIONS: The UW solution, which is acceptable for both initial flush and simple storage, is not suitable for continuous coronary perfusion even for a short period due to its high viscosity. A combination of the UW solution both for initial flush and the following cold simple immersion and the mK solution for continuous coronary perfusion is appropriate for long-term preservation of the canine heart.

Adenosine↗

Effect of a long-acting somatostatin analogue (octreotide) on circulating tachykinins and the pentagastrin-induced carcinoid flush.

Cutaneous flushing was provoked in seven patients with metastatic carcinoid tumours and the carcinoid syndrome by an intravenous injection of pentagastrin (0.6 micrograms.kg-1 body weight). The patients were studied before and 1 h after a subcutaneous injection of the long-acting somatostatin analogue octreotide 50 micrograms (Sandostatin). The severity of the carcinoid flush in all the patients was reduced by administration of the analogue. The rise in facial temperature was 1.3 (0.3) degree C before and 0.8 (0.2) degree C after octreotide. Six patients responded to pentagastrin with a rise in the circulating neurokinin A-like immunoreactivity (NKA-LI) and five patients with a rise in circulating substance P-like immunoreactivity (SP-LI). No cutaneous flushing or rise in tachykinin concentration was observed in healthy subjects (n = 6) after injection of pentagastrin. The rise in NKA-LI in the patients was decreased by 61 (14)% and the rise in SP-LI by 54 (13)% after octreotide. Although flushing still occurred, the tachykinin response in two patients was completely abolished. The data demonstrate that the release of tachykinins from carcinoid tumours during pentagastrin-induced flushing is subject to partial inhibition by octreotide. However, the occurrence of a flush in some patients in the absence of a detectable rise in circulating tachykinins indicates that the latter peptides cannot be the sole causative agent of the carcinoid flush.

Aged↗

The role of gustatory flushing in Frey's syndrome and its treatment with botulinum toxin type A.

After parotid surgery, gustatory sweating and flushing occur more frequently, the former reportedly in 15-100% of cases, while no reliable data are available for the latter. Although botulinum toxin (BoNT) is effective in controlling sweating, little is known about its effect on flushing. In 17 patients suffering from Frey's syndrome after parotid surgery, we studied the gustatory flushing phenomenon as compared to gustatory sweating, analyzing their frequency, area, type of stimulus and response to BoNT administration. Cutaneous blood flow (CBF) was monitored by laser Doppler flowmetry (LDF) on affected and unaffected areas of the cheek in basal conditions and after meals, before and then 1 month after starting the BoNT injections. The Minor test was used to identify the sweating area. Flushing was observed in 7 of 17 patients after masticatory activity, spicy meals or citrus fruits. No clinical data correlated with any presence of flushing. Flushing regressed completely after BoNT administration and CBF reached similar values in the affected and unaffected sites. No adverse effects were observed. BoNT administration proved an effective and safe treatment for gustatory sweating and flushing in patients with Frey's syndrome.

Adult↗

The incidence of flushing on induction of anaesthesia in patients who blush easily.

Flushing (reddening and blotching of the skin) is seen frequently at induction of anaesthesia, is associated with anaesthetic agents such as thiopental and muscle relaxants, and is attributed to histamine release. The changes are generally confined to the neck and upper chest (the blush area). In conscious subjects, the mechanisms responsible for blushing in the same skin distribution are well defined and neurally mediated. We investigated the relationship between a history of blushing easily and flushing after intravenous induction o f anaesthesia. We interviewed 898 patients about to undergo general anaesthesia and asked them if they blushed easily. Anaesthesia was induced with thiopental followed by suxamethonium and/or alcuronium. We noted skin colour and the presence of a flush every 5 min for 20 min. Women reported blushing more than men (47% of women, compared with 33% of men, p < 0.001), and blushing was more common in young people (p < 0.001). In those women with a history of blushing, 32% flushed on induction of anaesthesia, compared with 6% of those who did not blush. In men, a flush was seen in 22% of those who blushed, and in 0.2% of those who did not. These differences in the frequency of flushing were significant (p < 0.001). In conclusion, flushing after induction of anaesthesia appears to be related to individual predisposition and may be neurally mediated.

Adolescent↗

The role of endogenous opioids in the chlorpropamide alcohol flush.

The response of plasma immunoreactive met-enkephalin (IR-met-enkephalin) to ethanol (8 g by mouth) after chlorpropamide (250 mg daily for 14 d) was studied in three groups of non-insulin dependent diabetics (a) six diabetics who showed chlorpropamide alcohol flush (CPAF) and in whom the reaction could be blocked by indomethacin, (b) five diabetics who showed CPAF but in whom the flush could not be blocked by indomethacin and (c) five diabetics who did not show CPAF. A rise in plasma IR-met-enkephalin was observed in all three groups. When the two groups of flushers were re-tested with the addition of an infusion of naloxone a rise in plasma IR-met-enkephalin was still demonstrated in both groups regardless of whether the flush was blocked by naloxone. Naloxone blocked the flush only in those six subjects whose flush could be blocked by indomethacin. In five subjects, all flushers, CPAF was tested using intravenous and oral ethanol in doses producing similar plasma ethanol levels. A facial flush was induced by both intravenous and oral ethanol. In three flushers, plasma IR-met-enkephalin levels were measured during CPAF testing with both intravenous and oral ethanol. None showed a rise in plasma IR-met-enkephalin after intravenous ethanol, despite the appearance of a facial flush, whereas all showed a rise after oral ethanol. We therefore conclude that CPAF is unlikely to be caused by a rise in plasma IR-met-enkephalin.

Administration, Oral↗

Clinical evidence for use of acetyl salicylic acid in control of flushing related to nicotinic acid treatment.

Nicotinic acid (NA) is highly effective and widely used in the management of dyslipidaemia. For many patients, the side effect of flushing of the face and upper body leads to discontinuation. Flushing with NA is mediated by prostaglandins, and as acetyl salicylic acid (ASA, 'aspirin') is a highly effective inhibitor of prostaglandin synthesis, there is a rationale for its use to prevent or reduce the severity of NA-related flushing. This literature survey identified four studies specifically exploring the utility of ASA in preventing NA-related flushing in healthy volunteers. Twenty-three NA studies, where ASA was mandatory or optional within the protocol, and four studies, where background ASA therapy was reported in most participants, were also identified. Although the incidence of flushing in studies using ASA was often high, discontinuation rates due to flushing were low (mean 7.7%). This figure compares favourably with discontinuation rates with NA commonly reported in the literature (up to approximately 40%). There is good supportive evidence for the use of ASA in reducing the severity of NA-related flushing.

Aspirin↗

Flushing and haemodynamic responses to vasopressin peptides in the rhesus monkey.

1. The mechanism of the flushing, hypotension and tachycardia associated with i.v. administration of desGlyd(CH2)5D-Tyr(Et)VAVP (SK&F 101926; 25 micrograms kg-1) and the selective V2 antidiuretic agonist, desamino-8-D-arginine vasopressin (dDAVP; 3 micrograms kg-1) was studied in ketamine-anaesthetized rhesus monkeys. 2. The flushing associated with SK&F 101926 was reduced by pretreatment with a mast cell stabilizer and by repeated administration of peptide (within 2-4 weeks). A similar desensitization to dDAVP-associated flushing was observed on repeated administration. 3. Treatment with dDAVP also resulted in reduced SK&F 101926-associated flushing. 4. The hypotension associated with SK&F 101926 was not affected by pretreatment with a mast cell stabilizer. A similar degree of hypotension was observed with repeated administration of either SK&F 101926 or dDAVP. 5. The tachycardia associated with SK&F 101926 was reduced by pretreatment with a mast cell stabilizer or repeated administration of SK&F 101926. Repeated administration of dDAVP, however, resulted in an enhanced tachycardia. 6. Indomethacin (5 mg kg-1 i.v.) did not alter the flushing or the hypotension associated with the administration of either SK&F 101926 or dDAVP, but resulted in an enhanced tachycardia to SK&F 101926. 7. Administration of a selective V1 vasopressor antagonist did not result in flushing, hypotension or tachycardia. 8. It was concluded that the flushing response to vasopressin-like peptides in rhesus monkeys may be due to an action on mast cells, whereas the haemodynamic responses are not, but probably involve direct vasodilator actions.

Animals↗

Plasma substance-P in neuroendocrine tumors and idiopathic flushing: the value of pentagastrin stimulation tests and the effects of somatostatin analog.

We examined the role of the potent vasoactive kinin substance-P (SP) in flushing derived from various causes. SP was measured in plasma after acetone/ether extraction using an antiserum directed at the carboxy-terminal 5-11 amino acid region of undecapeptide SP. The antiserum had less than 1% cross-reaction with the other neurokinins, neurokinin-A and neuropeptide-K, that derive from the beta-preprotachykinin gene and share carboxy-terminal residues. Basal and pentagastrin-stimulated SP levels were measured in 22 healthy controls, 11 patients with histologically proven carcinoid tumors, 8 patients with tumors other than carcinoid, and 7 patients with idiopathic flushing (IF). Basal SP levels were less than 10 pg/mL in normal subjects. All patients with midgut carcinoid tumors had SP levels greater than 25 pg/mL, as did 7 of 8 patients with noncarcinoid tumors and 5 of 7 patients with IF. Using 50 pg/mL as the cutoff point, the sensitivity was 63% for detection of a tumor, and 100% of nontumor patients were excluded. Pentagastrin administration uniformly induced flushing and caused a rise in SP levels greater than 150 pg/mL in 5 of 10 patients with carcinoid tumors, 3 of 8 with noncarcinoid tumors, and 0 of 7 with IF, i.e. a SP rise of more than 100 pg/mL suggests a tumor. Administration of somatostatin (150 micrograms) 0.5 h before the pentagastrin abolished flushing in all carcinoid patients and reduced SP levels, but not into the normal range. Long term treatment with SMS significantly reduced flushing and lowered SP levels, but did not restore these to normal. We conclude that 90% of patients with carcinoid/noncarcinoid tumor have raised COOH-terminal SP levels. A basal level above 50 pg/mL or a pentagastrin-stimulated rise of more than 100 pg/mL distinguishes carcinoid from IF. The dissociation between SP concentrations and flushing suggests that SP may not be the only kinin involved in the flushing associated with carcinoid tumors.

Adult↗

Familial transmission of alcohol consumption and the flushing response to alcohol in three Oriental groups.

Multivariate path analysis was used to examine the etiologies of variation and covariation of flushing after alcohol use in nuclear families of Korean, Taiwanese, Japanese and Caucasian ancestries. Phenotypic variances and covariances were partitioned into familial (additive genetic and common family environment) and environmental components. Although alcohol consumption and flushing varied greatly among the different groups, familialities, estimated from components of mother, father and at least one child, were remarkably similar. The familialities for flushing were 0.48 for Japanese, 0.56 for Koreans and 0.35 for Taiwanese; flushing is infrequent in Caucasians and thus was not analyzed. Familialities were lower for consumption, but like flushing, were consistent across ethnic groups (Japanese, 0.27; Koreans, 0.24; Taiwanese, 0.15; Caucasians, 0.28). The genetic correlation between flushing and alcohol consumption was high. Thus, to the extent that flushing influences alcohol consumption, the covariance is most likely genetic.

Adolescent↗

The association between fast-flushing response and alcohol use among Japanese Americans.

This study investigated the association between the flushing response and alcohol use among Japanese Americans in the greater Los Angeles area. Epidemiolocial data collected through a telephone survey and a mail survey were utilized to test the flushing-alcohol use relationship in the Japanese population, and to explore the effects of socioenvironmental variables. Results showed that, as predicted, those Japanese Americans who exhibited the fast flushing response tended to drink less than those who did not flush, in the general community sample, but the relationship was weaker in the college student sample. Logistic regression analysis identified several covariates that predicted alcohol use among the general community residents: being a male, being single and being of the third/fourth generation. A separate logistic regression analysis with the college students only revealed a moderately significant interaction effect of flushing response and "Greek" affiliation (membership in a campus fraternity or sorority) on alcohol use (i.e., 6 drinks or more in a 24-hour period), indicating that the social context appeared to have a moderating effect on the relationship between the flushing response and alcohol use among Japanese Americans. Eighty out of 300 individuals completely abstained from alcohol consumption and therefore did not know if they possessed the fast-flushing response. Results were discussed with respect to further investigation of the role played by ALDH-I deficiency in varying social situations in the Japanese population.

Adult↗

An examination of ALDH2 genotypes, alcohol metabolism and the flushing response in Native Americans.

OBJECTIVE: The study was designed to examine the relationship between aldehyde dehydrogenase (ALDH2) genotype and the flushing response in a population of Native Americans. METHOD: Objective measures of the flushing response were obtained by monitoring skin temperature, heart rate, blood pressure, as well as blood alcohol concentrations, in flushing and nonflushing Native Americans (n = 105) as well as in Oriental (n = 15) and white (n = 15) control subjects following a dose of alcohol (0.2 or 0.4 gm/kg). ALDH genotypes were determined via polymerase chain reaction followed by hybridization to 32P or biotin-labeled allele-specific oligonucleotide probes. RESULTS: There were no ALDH2 mutations detectable in Native Americans reporting the flushing response, nor any objective evidence of an Oriental-like response to alcohol. The rate of alcohol metabolism was shown to be the same among whites, Native flushers and Native nonflushers. CONCLUSIONS: The results demonstrate that the flushing reaction experienced by Native Americans appears to be milder and less unpleasant than the "Oriental" flushing reaction, with little effect on drinking frequency and amount. In addition, the flushing is not mediated by the ALDH2 mutation or elevated blood acetaldehyde. A critical analysis of the discrepancies in the literature regarding alcohol metabolism in Native Americans is provided.

Adult↗