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International Commission for Protection against Environmental Mutagens and Carcinogens. ICPEMC Working Paper No. 15/3. Human acetaldehyde levels: aspects of current interest.

The determination of acetaldehyde levels in blood and other tissues is a difficult task, and depends on the method used. Different methods and their pros and cons are discussed in detail. Quantitative results are shown for endogenous acetaldehyde levels and for acetaldehyde levels during alcohol intoxication. One article pertains to acetaldehyde bound to blood and tissue proteins.

Acetaldehyde↗

Patterns of alcohol, cigarette and illicit drug use in English adolescents.

AIMS: The aim of this study was to describe associations between alcohol, tobacco and illicit drug use in adolescents and demographic factors associated with substance use. DESIGN, SETTING, SUBJECTS: The study was a classroom survey of the total population of pupils (n = 5383, ages 11-16) in six schools selected from different locations around England. MEASURES: Respondents were asked confidentially about their use and extent of use of alcohol, cigarettes and illegal drugs. FINDINGS: The prevalence of regular substance use within the sample rose from 30.4% at age 11 to 83.9% at age 16. The prevalence of alcohol use did not differ between girls and boys, but smoking was more prevalent in girls and illegal drug use was more prevalent in boys. Alcohol was used more frequently than any other substance, or combination of substances, and alcohol use almost invariably accompanied the use of other substances: exclusive use of cigarettes or illegal drugs was negligible. In addition, high levels of alcohol intoxication were associated with increased use of both illegal drugs and cigarettes. Overall, around half the drinkers (46.8%) preferred alcopops to other types of alcoholic drink; this figure was greater in girls (56.4%) than in boys (37.1%), but fell sharply with age (62.9% at age 11; 37.7% at age 16), particularly in boys. Preference for spirits increased with age, and was particularly marked in girls (28.4% in girls vs. 18.5% in boys at age 16). Spirits drinkers were more likely to use cigarettes and drugs, and had been more frequently drunk, than either beer/wine or alcopops drinkers; these measures also tended to be higher in alcopop drinkers than in beer/wine drinkers, particularly among 11-13-year-old girls. CONCLUSION: The use of both tobacco and illicit drugs appears to be strongly associated with alcohol use, which is more prevalent, and the risk of smoking and illicit drug use is particularly high in adolescents who report high levels of drunkenness. Our results are consistent with a simple threshold model of substance abuse in which alcohol occupies a low threshold position relative to the higher threshold of cigarettes and illegal drugs. Smoking, drug use and drunkenness were lowest in beer/wine drinkers, intermediate in alcopop drinkers, and highest in spirits drinkers.

Adolescent↗

Alcohol use and HIV risk behaviors among rural adolescents in Khanh Hoa Province Viet Nam.

Research suggests that youth are consuming more alcohol and at younger ages than in the past. Data also indicate that alcohol consumption is associated with participation in other risk behaviors including aggression and sexual behaviors. As part of a randomized control effectiveness trial for an HIV prevention program, 480 Vietnamese youth (15-20 years old) living in eight rural communes in Khanh Hoa Province were administered a paper and pencil baseline evaluation. The evaluation included items for actual and intended alcohol use, perceptions of peers' alcohol consumption, and attitudinal questions regarding alcohol. The tool included questions on engagement and intention to engage in sexual behaviors. In addition, 96 randomly selected youth participated in qualitative interviews on similar topics. Among the 480 surveyed youth, 29.2% had consumed alcohol. Among those youth, 17.6% reported intoxication in the past 6 months. While young men were significantly more likely to drink than young women (P < 0.00), those young women who did drink were as likely to report intoxication. Alcohol use was significantly associated with engagement in sexual behaviors (P < 0.00) and intention to engage in sexual behaviors (P < 0.02). The qualitative data provided information on the social contexts of drinking behaviors and more in-depth findings regarding associated risk behaviors. With limited information about alcohol consumption among Vietnamese youth, these findings suggest that there is a need for more extensive research on alcohol use and associated risk behaviors among this population, and for targeted alcohol prevention and harm-reduction programs.

Adolescent↗

Rate of Distribution of Eethanol into the Total Body Water.

Nonequilibrium distribution of ethanol in the total body water (TBW) has implications for understanding gross intoxication seen after rapid consumption of alcohol and for certain new clinical monitoring methods where ethanol is used as a tracer. We studied the rate of distribution of ethanol into the TBW from the concentration--time profiles in whole blood after 0.4 g kg(minus sign1) of ethanol was given by intravenous over 15, 30, 45, and 60 min to six female volunteers. We also gave these females 0.6 g kg(minus sign1) over 30 min, and five young males 0.4 g kg(minus sign1) over 30 min. The results suggest that the blood ethanol concentration after rapid infusion can be described by a two-compartment model with first-order distribution kinetics and zero-order (saturated Michaelis--Menten) elimination. Distribution of ethanol occurred with a half-time of 6.6 plus minus 2.6 min (mean plus minus SD). Alcohol intoxication was more pronounced when ethanol was given rapidly. We conclude that predictable differences in the concentration of ethanol between the blood and the peripheral tissues during rapid supplementation of ethanol causes higher concentrations in blood and a more pronounced intoxication.

Journal Article↗

Traffic accidents involving psychiatric patients. Characteristics of accidents involving drivers who have been admitted to Danish psychiatric departments.

A nationwide study of psychiatric in-patients driving motor vehicles and involved in accidents causing bodily injury in the years 1972--74 was undertaken. Compared with drivers in general involved in accidents causing bodily injury, drivers with a psychiatric record were characterized by an over-representation of women. A preponderance of psychiatric drivers in the age group 25--54 was observed. About 3% of drivers with a psychiatric record were involved in two or more accidents during the period studied. A greater proportion of the psychiatrically diseased group drove stolen vehicles, without valid licences, and were found not to have used safety belts at the time of the accident. Occurrence of injury was more frequent among the diseased drivers. They were more frequently alcohol intoxicated and with a higher blood alcohol level. The most commonly encountered diagnostic groups were personality disorder and transitory reactions.

Accidents, Traffic↗

Effect of alcohol ingestion on bone and mineral metabolism in rats.

Chronic ethanol administration to growing rats for 56 days resulted in circulating levels of 140 mg/dl, approximating concentrations that characterize alcoholic intoxication in man. This degree of alcohol ingestion, although without gross or histological effect on the liver or testicles, was attended by decreased trabecular bone volume despite a normal rate of skeletal mineralization as measured by time-spaced tetracycline labeling. Concomitant serum levels of calcium, phosphate, magnesium, creatinine, glutamic oxalacetic transaminase, alkaline phosphatase, testosterone, and 25-hydroxyvitamin D were normal. Although alcohol treatment was associated with a significant decrease in urinary calcium excretion, it had no effect on phosphate excretion nor on its renal tubular reabsorption. The data reveal that circulating levels of alcohol that do not result in hepatic or testicular injury are toxic for bone.

Alcohol Drinking↗

Modification of alcohol withdrawal by the A9 allele of the dopamine transporter gene.

OBJECTIVE: Determinants of individual vulnerability to alcohol withdrawal symptoms are largely unknown. Because of the substantial role of monoaminergic transporters in limiting time and space effects of synaptic neurotransmission, the dopamine transporter gene (DAT1; locus symbol: SLC6A3) was studied as a candidate gene possibly related to symptoms of uncomplicated alcohol withdrawal. METHOD: In 48 chronically intoxicated alcoholics (diagnosed according to ICD-10), withdrawal symptoms were examined and the presence of a variable-number tandem repeat in the 3' untranslated region of the DAT1 gene was determined. RESULTS: Withdrawal syndromes were more pronounced in the 22 patients carrying the nine-copy repeat than in the 26 patients without this variant. Multiple regression analysis revealed that 4% of the variance of withdrawal was explained by this genotype, whereas 16% was due to the amount of alcohol the patients reported having consumed in the month before detoxification. CONCLUSIONS: The A9 allele of the dopamine transporter gene is associated with more severe effects of alcohol withdrawal, possibly because of modifications of the brain's capacity to compensate for long-term effects of ethanol on cerebral function.

Adult↗

Effect of resveratrol on alcohol-induced mortality and liver lesions in mice.

BACKGROUND: Resveratrol is a polyphenol with important antiinflammatory and antioxidant properties. We investigated the effect of resveratrol on alcohol-induced mortality and liver lesions in mice. METHODS: Mice were randomly distributed into four groups (control, resveratrol-treated control, alcohol and resveratrol-treated alcohol). Chronic alcohol intoxication was induced by progressively administering alcohol in drinking water up to 40% v/v. The mice administered resveratrol received 10 mg/ml in drinking water. The animals had free access to standard diet. Blood levels were determined for transaminases, IL-1 and TNF-alpha. A histological evaluation was made of liver damage, and survival among the animals was recorded. RESULTS: Transaminase concentration was significantly higher in the alcohol group than in the rest of the groups (p < 0.05). IL-1 levels were significantly reduced in the alcohol plus resveratrol group compared with the alcohol group (p < 0.05). TNF-alpha was not detected in any group. Histologically, the liver lesions were more severe in the alcohol group, though no significant differences between groups were observed. Mortality in the alcohol group was 78% in the seventh week, versus 22% in the alcohol plus resveratrol group (p < 0.001). All mice in the alcohol group died before the ninth week. CONCLUSION: The results obtained suggest that resveratrol reduces mortality and liver damage in mice.

Alanine Transaminase↗

Diagnosis of depression in alcohol dependence: changes in prevalence with drinking status.

BACKGROUND: Depression and alcohol dependence are frequently found to co-exist but the relationship between these disorders requires further elucidation. This study tested several hypotheses related to the relevance of whether the diagnosis of depression was made before admission or after detoxification in the current episode for those with alcohol dependence. METHOD: The Schedule for Affective Disorders and Schizophrenia (SADS) was administered to obtain Research Diagnostic Criteria (RDC) on 82 randomly selected alcohol dependent in-patients. Alcohol-related (Severity of Alcohol Dependence Questionnaire (SADQ), alcohol consumption and alcohol-related problems), socio-demographic variables and treatment for depression were assessed. RESULTS: For the episode of drinking which led to admission, a diagnosis of major depression was found in the majority of patients (67%). Once detoxification from alcohol took place, only the minority (13%) met criteria for major depression. CONCLUSIONS: It is suggested that depression is largely associated with the episode of drinking which led to admission in patients who are dependent on alcohol and may be due to the effect of chronic alcohol intoxication. Socio-demographic and alcohol-related characteristics appear to bear little relation to the presence of depression. Clinicians exercise appropriate judgement in not prescribing antidepressant treatments to patients whose depression may remit with abstinence from alcohol.

Adult↗

Human immunodeficiency virus and hepatitis B virus infections in a New York City alcoholic population.

Alcoholics have previously been reported to have an increased susceptibility to hepatitis B virus (HBV) infection. Since human immunodeficiency virus (HIV) is transmitted in a similar fashion, we studied 143 consecutive in- and outpatient alcoholics residing in New York City for HIV and HBV prevalence and associated risk factors. Of these alcoholics, 19 (13%) individuals were HIV positive, 57 (40%) were hepatitis B seropositive. Intravenous drug use and sexual contact with an IV drug user were the most important risk behaviors for HIV acquisition, with large numbers of partners and anal heterosexual intercourse being lesser factors. The only significant risk behavior determined for hepatitis B infection was IV drug use. These high-risk behaviors did not appear to be related to episodes of alcoholic intoxication. However, it is conceivable that alcoholism may, in other ways, affect susceptibility to HIV infection.

Adult↗

Repeated instillation of a limited volume of ethanol for the treatment of symptomatic hepatic cysts.

BACKGROUND/AIMS: In the past, various treatments for symptomatic hepatic cysts have been reported. In recent years, sclerosis therapy seems to be most common. In the present study, repeated instillation of a limited volume of ethanol was evaluated. METHODOLOGY: Six patients who had one or more hepatic cysts underwent percutaneous alcohol sclerosis therapy. Of the six patients, five had epigastric discomfort, and one had back pain. A 7.0-French pigtail polyethylene catheter was inserted into the cyst. The fluid was aspirated and it was demonstrated by radiograph that there were no communications between the cysts and the intrahepatic duct or hepatic vessels. Six hepatic cysts were instilled with 99% sterile ethanol, which was allowed to remain in place for 5 minutes, and then removed. Ethanol instillation was repeated every day or every other day in all patients. It was performed two to five. Ethanol volume of a single instillation varied from 10mL to 100mL. In all cases, the ethanol volume of first instil lation was limited to 20mL or less to prevent severe complications. RESULTS: The diameters of the initial cysts ranged from 7.8 to 13.2cm (mean, 10.4cm) and aspirated fluid volume varied from 70 to 1000mL (mean, 455mL). All patients had slight alcohol intoxication for a few hours after alcohol instillation, two had moderate abdominal pain at the time of alcohol instillation. In five of six patients, subtotal or total regression of the hepatic cysts was observed within eight months following treatment. In one case, the hepatic cyst was reduced from 13x11 to 7.8x7.5cm in size after seven months, but further regression was not obtained thereafter. All patients became symptom-free. CONCLUSIONS: It is concluded that repeated instillation of a limited volume of ethanol is effective for the treatment of symptomatic hepatic cysts and potentially reduces the incidence of complications.

Abdominal Pain↗

Alcohol and trauma.

Countermeasures to alcohol-related trauma are essential. The public perception that there is low risk of detection and punishment for alcohol-precipitated violence is being addressed. Current legislation is aimed at decreasing the availability of alcohol (e.g., adjusting legal drinking age, decreasing the serum alcohol intoxication limit, restricting the sale of alcoholic beverages at public events), increasing detection (e.g., greater driver surveillance, increased number of dedicated personnel), strengthening legal penalties for alcohol-related offenses, and mandating rehabilitative therapy. Physicians can intervene in the alcohol-trauma cycle. Unfortunately, they are notably poor in detecting the patient with alcohol-related injury. Moreover, physicians infrequently refer these patients to facilities and personnel that are expert in alcohol detoxification and rehabilitation. Recidivism can be positively impacted by physicians who are sensitive to and versed in the medical and social patterns of alcohol abuse.

Alcoholism↗

[Salsolinol, an endogenous molecule. Possible implications in alcoholism, Parkinson's disease and pain].

Salsolinol can be formed either by condensation of dopamine with acetaldehyde, or by condensation of dopamine with pyruvic acid followed by decarboxylation. Salsolinol has a complex pharmacologic profile. Its opium-like activity may be related to alcohol dependency and to the effectiveness of naloxone during acute alcohol intoxication. Because they had noticed that alcoholism and Parkinson's disease rarely coexist, the authors undertook a study to confirm this fact and attempt to explain it by implicating salsolinol. Urinary excretion of salsolinol was found to increase following ingestion of alcohol, as well as in Parkinson patients under L-dopa treatment. The authors also found that urinary salsolinol was very low in untreated patients with Parkinson's disease. Salsolinol was detected in a number of foods and beverages. Separate assays of enantiomeres showed that the S enantiomere predominates in some foods whereas the R enantiomere is more abundant in humans. Lastly, the antinociceptive effects of salsolinol and its enantiomeres were studied in mice and antidepressant effects were evidenced using predictive tests.

Aged↗

[The effect of laser hemotherapy on the acid glycosaminoglycan content of the liver and blood plasma in rats in the dynamics of an alcoholic coma].

The aim of the study was determination of the content of acid glycosaminoglicans (GAG) in hepatic tissue and blood plasma of rats in the course of alcoholic coma and in response to laser irradiation of venous blood. The alcoholic intoxication was achieved by introduction of 40% ethanol through a metal probe into the stomach. The content of acid GAG was defined according to Diche. Alcoholic coma caused reduction of GAG levels in hepatic tissue and an increase in blood plasma which were correlated with the severity of neurological state. Laser irradiation of venous blood promoted a trend to normalization of GAG content in the investigated tissues. A relative reduction in GAG plasma levels after laser hemotherapy indicates effectiveness of the conducted therapy.

Alcoholic Intoxication↗

Cardiac function after alcohol ingestion in patients with ischemic heart disease and cardiomyopathy: a controlled study.

Thirty male patients with ischemic heart disease and cardiomyopathy entered a controlled study of the acute effects of alcohol on cardiac function evaluated by right heart catheterization. Twenty patients, nine with angina pectoris and 11 with congestive heart failure, were studied during alcohol intoxication, and ten patients, five with angina pectoris and five with heart failure, served as a control group. The mean serum ethanol concentration in the alcohol group was 93 mg/100 ml (S.D. 17). The systemic arterial blood pressure was reduced by 6% in the alcohol group, P less than 0.05 compared with the control group. No significant changes occurred in the central venous pressure, the pulmonary artery pressure, the pulmonary capillary wedge pressure, or in cardiac output, stroke volume and total peripheral resistance. Alcohol intake in moderate doses has no measurable effect on pulmonary blood pressures or cardiac output in patients with ischemic heart disease and cardiomyopathy. Such an effect may, however, be masked by a reduction of afterload.

Aged↗

[Alcohol and hypertension in sudden cardiac death, features of the status of the renin-angiotensin-aldosterone system].

The activity of blood plasma renin and the renal cortical layer in persons who had suddenly died, was much lower in those with arterial hypertension than in those without it. A more pronounced increase in the activity of blood plasma renin and the renal cortex was noted in persons with hypertension who had died against a background of alcoholic intoxication as compared to persons without hypertension. In sudden cardiac death of persons without hypertension there was a positive correlation between plasma renin activity and alcohol concentration in the blood. Such a correlation was undetectable in the presence of hypertension. In small alcohol concentrations in the blood higher plasma renin activity values were noted in persons with hypertension than in those without it. Aldosterone concentration in the blood of patients with arterial hypertension and without it did not practically differ. The presence of alcohol in persons without hypertension resulted in a significant increase in aldosterone concentration in sudden cardiac death as compared to those with hypertension. A positive correlation between renin activity and aldosterone concentration was noted in all the groups under study.

Adult↗