OSTEOPENIA IN ALCOHOLICS AFTER TIBIA SHAFT FRACTURES

A marked reduction of 40–70% in regional bone mineraldensity (BMD) has been reported after fractures of long bones,and this post-traumatic osteopenia may to some extent persistfor several years, perhaps lifelong. In this cross-sectionalstudy, we investigated whether prolonged alcohol abuse had anyeffect on the degree of post-traumatic osteopenia after isolatedtibia shaft fractures, the rationale for such a suspicion beingthe deranged bone metabolism found in alcoholics. We also wantedto investigate whether dual energy X-ray absorptiometry (DEXA)or quantitative ultrasound technique could detect differencesbetween abusers and non-abusers in post-traumatic bone loss.We measured the BMD in 61 male patients with isolated tibiashaft fractures (1984–94) with the Lunar DPX-L^® andthe Lunar Achilles^®. Twenty-four of the patients were verifiedto be high consumers of alcohol. After correction for differencesin age and the time elapsed since the fracture event, we foundsignificantly lower (11%; P=0.017) BMD in the femoral neck ofthe fractured leg in abusers when utilizing the DEXA technique.No differences between abusers and non-abusers in BMD were detectablewhen using the ultrasound technique. We found a fair correlation(r=0.63–0.81) between the DEXA and the ultrasound techniquesin regions with spongious bone. Our findings suggest that alcoholabuse has some, albeit a limited, effect on the degree of post-traumaticosteopenia and that ultrasound measurements in the calcaneusare of little use in detecting an increased post-traumatic osteopeniain this patient group.     

Brain substrates of craving to alcohol cues in subjects with alcohol use disorder

AIMS: This study's purpose was to identify the neural substrates and mechanisms responsible for craving among subjects with alcohol use disorders (AUDs) using functional magnetic resonance imaging (fMRI). METHODS: Alcohol abusers with AUD (n = 9) and demographically similar non-abusers (n = 9) participated in this study. After given 5 cc of alcohol, subjects were exposed to different types of stimuli [i.e. alcohol, non-alcoholic beverage, and visual control pictures and one rest (cross-hair)]. Craving levels were rated through self-report on a Likert scale immediately after the presentation of visual cues. RESULTS: Brain activations in the fusiform gyri, temporal gyri, parahippocampal gyrus, uncus, frontal gyri, and precuneus were correlated with the level of craving among subjects with AUD in response to alcohol cues. CONCLUSIONS: In conclusion, specific brain regions were identified that are associated with craving among subjects with AUD.     

EFFECT OF ACUTE ALCOHOL INGESTION ON MINERAL METABOLISM AND OSTEOBLASTIC FUNCTION

Alcohol abuse can induce osteopenia in some subjects. In orderto study the effect of a single dose of alcohol on mineral metabolismand osteoblastic function, we have measured calcium, phosphate,parathyroid hormone midmolecule (PTHm), parathyroid hormoneintact molecule (PTHi) and bone-gla-protein (BGP) in serum of8 healthy men after the ingestion of a single dose of alcohol(0.6g/kg body weight). Urinary calcium and magnesium were alsomeasured. After alcohol intake, both serum PTHm and PTHi weredecreased, as well as serum BGP. Serum phosphate and urinarycalcium and magnesium were increased. An inverse significantcorrelation was found between PTHi and serum phosphate (r =0.42; P < 0.02). Our data show that acute alcohol ingestionlowers serum PTH and BGP in humans, suggesting an inhibitoryeffect on parathyroid and osteoblastic function. These changesand the alcohol-induced transient hypercalciuria could contributeto the development of bone disease associated with chronic alcoholabuse.     

Alcohol abuse in cancer patients: a shadow side in the oncological field and research

This article aims to foreground alcohol abuse by cancer patients and explore how alcohol abuse functions as a biographic master motive and at the same time is a shadow side in the oncological field and research. The research is based on a single case study which draws on empirical material from interviews, field notes and staff policy, with analysis using Bourdieu’s concepts of trajectory of life and habitus. The findings show that the cancer patient’s alcohol abuse is an important part of the trajectory of his private life and spare time. In social life with family and friends alcohol is given and normal and acts as a socialisator. Alcohol abuse provides both stability and instability in the cancer patient’s life. When cancer results in work breaks and retirement, and spare time often is used as drinking time, then all daily life becomes drinking time for the cancer patient. Alcohol is often a hidden abuse at the working place and in the oncological field. In meetings with healthcare professionals, the patient chooses not to speak about his alcohol abuse to avoid further medicalisation. The challenge for the healthcare professionals is to see and accept alcohol abusers with cancer and their social lives without always trying to change their ‘unhealthy’ lifestyles.     

ALCOHOL ABUSE AND HEALING COMPLICATIONS AFTER CERVICAL HIP FRACTURES

Osteonecrosis of the femoral head following femoral neck fracturesis a common condition. Spontaneous osteonecrosis, is, however,a rare disorder, which is observed with increased frequencyin alcohol abusers. In this retrospective study, we followed512 consecutive male patients who had sustained femoral neckfractures between 1984 and 1992; 82 of these 512 patients (16%)had earlier been registered at the Department of Alcohol Diseasesas high consumers of alcohol. The aim of the study was to determinethe relationship between the rate of healing complications andalcohol consumption. No differences were observed in the degreeof fracture dislocation, frequency of femoral head necrosis,and pseudoarthrosis among the abusers. Furthermore, no differenceswere found in causative events, primary operative treatment,post-operative complications, and the number of secondary operations.The abusers were significantly younger, had a higher rate ofearly retirement, and had an increased death rate. Our studysuggests that alcohol complicates the healing process to a lesserextent than earlier thought, and that osteonecrosis of the femoralhead after femoral neck fractures is equally conimon in non-abusersas in abusers.     

Alcohol drinking, mean corpuscular volume of erythrocytes, and alcohol metabolic genotypes in drunk drivers

Regular and irregular abuse of alcohol are global health priorities associated with diseases at multiple sites, including cancer. Mechanisms of diseases induced by alcohol are closely related to its metabolism. Among conventional markers of alcohol abuse, the mean corpuscular volume (MCV) of erythrocytes is prognostic of alcohol-related cancer and its predictivity increases when combined with functional polymorphisms of alcohol dehydrogenase (ADH1B [rs1229984] and ADH1C [rs698]) and the mitochondrial aldehyde dehydrogenase (ALDH2 [rs671]). Whether these genetic variants can influence abuse in alcohol drinking and MCV has never been examined in drunk-driving traffic offenders. We examined 149 drunk drivers, diagnosed as alcohol abusers according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition Text Revision (DSM-IV-TR) and enrolled in a probation program, and 257 social drinkers (controls), all Caucasian males. Alcohol intake was assessed according to self-reported drink-units/d and MCV unadjusted and adjusted for age, smoking, and body mass index. Multivariable models were used to compute MCV adjusted means. Genotype analyses were performed by PCR on DNA from blood. The adjusted MCV mean was higher in drunk-driving abusers than in controls (92 vs. 91 fL; P < .0001) and increased with the number of drink-units/d in both abusers and controls (P-trend = .0316 and .0089) already at intermediate quantities (0-1 vs. 2-4 drink-units/d: P = .054 and .024). Carriers of the common ADH1B*1/*1 (rs1229984) genotype were more likely to be drunk-driving abusers (P = .008), reported higher drink-units/d (P = .0126), and had larger MCV (P = .035). The rs698 ADH1C and rs671 ALDH2 polymorphisms were not associated with MCV. ADH1B*1/*1 polymorphism is significantly associated with being a drunk-driving abuser, higher alcohol drinking, and MCV enlargement. This suggests that drunk drivers with augmented MCV modulated by the alcohol metabolic ADH1B*1/*1 genotype may be at higher risk of driving incapability and of alcohol-related cancer.     

THE SECCAT SURVEY: II. THE ALCOHOL RELATED PROBLEIN QUESTIONNAIRE AS A PROXY FOR RESOURCE COSTS AND QUA OF LIFE IN ALCOHOLISM TREATMENT

An interview was obtained with 212 patients who had, at a point12 months previously, been in contact with an alcohol problemsclinic. Quality of life (SF-36) was measured and for the preceding6 months the cost of health and social service resource usewas estimated, together with the total abstinent (or controlleddrinking) days accrued. Alcohol related health, personal andsocial problems experienced during that period were elicitedusing a brief 11-item questionnaire, the Alcohol Related ProblemsQuestionnaire (ARPQ). The estimate of costs correlated morestrongly with the ARPQ score (r=-0.32, P=0.0001) than with abstinentdays (r=0.03, n.s.) or controlled drinking months (r=-0.21,P=0.002). The lack of relation of total abstinent days to costis partly because abstainers tended to use considerable alcoholproblems clinic resources. ARPQ scores indicating more problemswere associated with lower quality of life. The ARPQ can serveas a proxy for resource use and quality of life in alcoholismtreatment.     

WHEN ALCOHOLICS DRINK AFTERSHAVE: A STUDY OF NONBEVERAGE ALCOHOL CONSUMERS

A one-year prospective study was conducted to describe nonbeveragealcohol (NBA) consumption (the use of substitutes for traditionalforms of ethanol) among alcoholics. It was found that 11% ofinpatient alcoholics at a veterans' hospital and 8.6% of alcoholicsat a community hospital had consumed NBA. Substances consumedranged from toiletries to organic solvents, often in quantitiesexceeding the theoretical lethal dose. ‘Ready availability’was cited as the primary reason for consumption. Social, demographicand psychiatric parameters were then compared between 48 VAalcoholics who used NBA and 48 nonusing alcoholics. No socialor demographic differences were found, but NBA drinkers drankmore alcohol (P < 0.0001), had higher global alcoholic severityscores (P < 0.0001), more severe withdrawal symptoms (P <0.0001), and a higher frequency of antisocial personality disorder(P = 0.009) and drug abuse (P = 0.005). When NBA drinkers weresubdivided by quantity of NBA consumption and recency of latestingestion, no social or psychological differences were foundbetween groups, except for more frequent and heavier illicitdrug use among ‘heavy’ NBA consumers (P < 0.0001).     

Assessing the general health of diagnostic orphans using the Short Form Health Survey (SF-12v2): a latent variable modelling approach

Aims: Research has demonstrated that diagnostic orphans (i.e.individuals who experience only one to two criteria of DSM-IValcohol dependence) can encounter significant health problems.Using the SF-12v2, this study examined the general health functioningof alcohol users, and in particular, diagnostic orphans. Methods:Current drinkers (n = 26,913) in the National EpidemiologicSurvey on Alcohol and Related Conditions were categorized intofive diagnosis groups: no alcohol use disorder (no-AUD), one-criterionorphans, two-criterion orphans, alcohol abuse and alcohol dependence.Latent variable modelling was used to assess the associationsbetween the physical and mental health factors of the SF-12v2and the diagnosis groups and a variety of background variables.Results: In terms of mental health, one-criterion orphans hadsignificantly better health than two-criterion orphans and thedependence group, but poorer health than the no-AUD group. Nosignificant differences were evident between the one-criterionorphan group and the alcohol abuse group. One-criterion orphanshad significantly poorer physical health when compared to theno-AUD group. One- and two-criterion orphans did not differin relation to physical health. Conclusion: Consistent withprevious research, diagnostic orphans in the current study appearto have experienced clinically relevant symptoms of alcoholdependence. The current findings suggest that diagnostic orphansmay form part of an alcohol use disorders spectrum severity.     

ALCOHOL-RELATED SEIZURES AND THE KINDLING EFFECT OF REPEATED DETOXIFICATIONS: THE INFLUENCE OF COCAINE

The purpose ol this study was to determine if individuals withconcurrent alcohol and cocaine use differ in regard to seizurerisk compared to individuals who abuse only alcohol, and toexplore the relationship between multiple dcto.xilications andseizure risk in the context ot concurrent cocaine use. In thisstudy, alcoholic cocaine users had a decreased risk of seizurecompared to alcoholics without cocaine use (P< 0. 005). Seizureswere rare in individuals who did not abuse alcohol. Alcoholiccocaine users reported a younger age at first seizure comparedto alcoholics without cocaine use (P< 0.04). Alcoholic patientswith seizures had significantly more previous detoxificationexperiences compared to matched alcoholic patients without seizures(P = 0.0001). Concurrent cocaine use did not appear to havean independent effect on the risk of seizure. The findings inthis study suggest that concurrent cocaine use may acceleratethe development of alcohol-related seizures in predisposed individualsbut docs not appear to substantially increase overall risk.Multiple previous dctoxilkations are associated with an increasedrisk of seizures in alcoholics both with and without concurrentcocaine use.     

Light to Moderate Alcohol Consumption and Disability: Variable Benefits by Health Status

In adults, light to moderate alcohol consumption is associatedwith lower risks for heart disease, diabetes, and mortality.This study examined whether light to moderate alcohol use isalso associated with lower risk of incident physical disabilityover two 5-year periods in 4,276 noninstitutionalized adultsin the United States, aged 50 years or older, by using datafrom 3 waves of the National Health and Nutrition ExaminationSurvey Epidemiologic Follow-up Study surveys from 1982 to 1992.Light/moderate drinking (<15 drinks per week and <5 perdrinking day or 4 per drinking day for women) was associatedwith reduced risk for incident disability or death over 5 years,compared with abstention (adjusted odds ratio = 0.77; P = 0.008).Among survivors, light/moderate drinking was associated withlower risk for incident disability, compared with abstention(adjusted odds ratio = 0.75; P = 0.009). In stratified analyses,disability risk decreased with light/moderate drinking in adose-dependent fashion in men and women with good or betterself-reported health but not in men or women with fair or worseself-reported health. Alcohol consumption in moderation mightreduce the risk of developing physical disability in older adultsin good health but not in those in poor health. activities of daily living; alcohol drinking; longitudinal studies     

HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY IMPROVES DIAGNOSTIC EFFICIENCY OF CARBOHYDRATE-DEFICIENT TRANSFERRIN

Carbohydrate-deficient transferrin (CDT) is considered a usefulbiochemical marker of regular high alcohol intake. CDT was measuredin the sera of 51 alcohol abusers, 20 patients with nonalcoholicliver disease and 30 healthy controls with an alcohol intakeof <30g/day. The mean CDT levels of these three groups respectivelywere determined with high-performance liquid chromatography(HPLC; 4.6 ± 5.2%; 0.7 ± 0.2%; 0.7 ± 0.2%)and with a radioimmunoassay after microcolumn anion-exchangechromatography (MAEC/RIA; 34.2 ± 26.9 U/1; 16.9 ±3.8 U/1; 18.0 ± 5.7 U/1). CDT levels in patients withsevere alcohol abuse (161.6 ± 96.4g/day) were significantlyhigher than in the two other groups under investigation (P <0.0001). In heavily drinking subjects, the mean daily alcoholintake correlated with aspartate aminotransferase levels (ASAT)but not with the CDT levels determined either with HPLC or MAEC/RIA.With both methods, the CDT levels were slightly higher in patientswith an ASAT concentration >30 U/1, which may indicate anadvanced liver damage (P < 0.05). Analysis of receiver-operatingcharacteristic (ROC) plots demonstrated that the diagnosticaccuracy of the HPLC method, which determines the relative amountof CDT, was significantly higher than the established MAEC/RIAmethod, which measures the absolute amount of CDT (area underthe ROC curve: 0.95 ± 0.02 vs 0.73 ± 0.05; P <0.0001). At a specificity of >95%, the sensitivity of CDTdetermined with HPLC and MAEC/RIA was 80 and 47%, respectively.In addition, HPLC may be a useful and reliable method for thedetermination of this important biochemical marker, since theHPLC chromatogram is a visible document of the successful isotransferrinseparation and measurement.     

Transitions In and Out of Alcohol Use Disorders: Their Associations with Conditional Changes in Quality of Life Over a 3-Year Follow-Up Interval

Aims: The aim of this study was to investigate longitudinalchanges in quality of life (QOL) as a function of transitionsin alcohol use disorders (AUD) over a 3-year follow-up of ageneral US population sample. Methods: The analysis is basedon individuals who drank alcohol in the year preceding the Wave1 National Epidemiologic Survey on Alcohol and Related Conditionsand were reinterviewed at Wave 2 (n = 22,245). Using multiplelinear regression models, changes in SF-12 QOL were estimatedas a function of DSM-IV AUD transitions, controlling for baselineQOL and multiple potential confounders. Results: Onset and offsetof AUD were strongly associated with changes in mental/psychologicalfunctioning, with significant decreases in mental componentsummary (NBMCS) scores among individuals who developed dependenceand significant increases among those who achieved full andpartial remission from dependence. The increases in overallNBMCS and its social functioning, role emotional and mentalhealth components were equally great for abstinent and nonabstinentremission from dependence, but improvements in bodily pain andgeneral health were associated with nonabstinent remission only.Onset of abuse was unrelated to changes in QOL, and the increasein NBMCS associated with nonabstinent remission from abuse onlywas slight. Individuals with abuse only or no AUD who stoppeddrinking had significant declines in QOL. Conclusions: Theseresults suggest the possible importance of preventing and treatingAUD for maintaining and/or improving QOL. They are also consistentwith the sick quitter hypothesis and suggest that abuse is lessa mental disorder than a maladaptive pattern of behavior.     

Universal problems during residency: abuse and harassment

Objectives Perceived abuse or harassment during residency has a negative impact on residents’ health and well‐being. This issue pertains not only to Western countries, but also to those in Asia. In order to launch strong international preventive measures against this problem, it is necessary to establish the generality and cultural specificity of this problem in different countries. Therefore, we investigated mistreatment among resident doctors in Japan. Methods In 2007, a multi‐institutional, cross‐sectional survey was conducted at 37 hospitals. A total of 619 residents (409 men, 210 women) were recruited. Prevalence of mistreatment in six categories was evaluated: verbal abuse; physical abuse; academic abuse; sexual harassment; gender discrimination, and alcohol‐associated harassment. In addition, alleged abusers, the emotional effects of abusive experiences, and reluctance to report the abuse to superiors were investigated. Male and female responses were statistically compared using chi‐square analysis. Results A total of 355 respondents (228 men, 127 women) returned a completed questionnaire (response rate 57.4%). Mistreatment was reported by 84.8% of respondents (n = 301). Verbal abuse was the most frequently experienced form of mistreatment (n = 256, 72.1%), followed by alcohol‐associated harassment (n = 184, 51.8%). Among women, sexual harassment was also often reported (n = 74, 58.3%). Doctors were most often reported as abusers (n = 124, 34.9%), followed by patients (n = 77, 21.7%) and nurses (n = 61, 17.2%). Abuse was reported to have occurred most frequently during surgical rotations (n = 98, 27.6%), followed by rotations in departments of internal medicine (n = 76, 21.4%), emergency medicine (n = 41, 11.5%) and anaesthesia (n = 40, 11.3%). Very few respondents reported their experiences of abuse to superiors (n = 36, 12.0%). The most frequent emotional response to experiences of abuse was anger (n = 84, 41.4%). Conclusions Mistreatment during residency is a universal phenomenon. Deliberation on the occurrence of this universally wrong tradition in medical culture will lead to the establishment of strong preventive methods against it. Current results indicate that alcohol‐associated harassment during residency is a Japanese culture‐specific problem and effective preventive measures against this are also urgently required.     

Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

Background

Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse.

Methods

This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females.

Results

A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females.

Conclusion

The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal.     

The role of alcohol in maxillofacial trauma—a comparative retrospective audit between the two centers

Alcohol abuse and maxillofacial trauma, particularly that due to interpersonal violence, have a well-established relationship in the literature. We present a retrospective audit comparing the role of alcohol in maxillofacial trauma between Selly Oak Hospital in Birmingham, United Kingdom and Westmead Hospital in Sydney, Australia, and the association between alcohol involvement and patient demographics, including age, sex, marital status, and employment status. Also presented are the differences between the two centers in terms of mechanisms and types of injuries and the locations where these injuries were sustained. Alcohol was involved in 34.78 and 30.77% of patients at Westmead and Birmingham, respectively. A multiple logistic regression analysis revealed a reduced likelihood of alcohol involvement in episodes of maxillofacial trauma where patients were unemployed (P = .04), and where injuries were sustained secondary to mechanisms other than assault (P < .001) and in locations other than pubs and nightclubs (P = .024). There appeared to be no statistically significant contribution to the likelihood of alcohol involvement by treating center, marital status, patient sex, or age. Alcohol continues to be a strong driving factor in cases of maxillofacial trauma, particularly those due to alleged assault, with a typical patient demographic of the gainfully employed frequenting drinking establishments being most at risk for alcohol-related trauma, most commonly sustaining their injuries secondary to assault. Identifying patient groups most at risk is a key step in developing public health strategies aimed at prevention, and our findings would appear to suggest this group of patients as being the most worthwhile to target with measures aimed at reducing alcohol-fueled maxillofacial trauma.     

EFFECTS OF ALCOHOL ON BLASTOCYST IMPLANTATION SITE BLOOD FLOW IN THE RAT

The effect of alcohol on blood flow at sites of blastocyst implantationversus adjacent intersites was measured in conscious unrestrainedrats on day 5 of pregnancy Alcohol (0.75 ml of 100% ethanoldiluted 1:2, v/v) was injected into the femoral vein (1 g/kgbody wt); controls received an equivalent volume of vehicle(physiological saline). Implantation sites were rendered visibleby intravenous injection of Evans Blue dye. Blood flow was measuredat 15 min after alcohol injection by the ⁸⁶Rb fractionationmethod. In controls, blood flow was significantly greater (P<005) at implantation sites (0.77±0.04 ml/min/g) than atintersites (0.43±0.03 ml/min/g). Alcohol markedly increased(P<0.05) perfusion at both sites (2.17±0.22 ml/min/g)and intersites (1.74±0.15 ml/min/g) vs respective controls.Blood alcohol levels exceeded 100mg/dl at 10 min post-injection.Mean cardiac output and haematocrit values did not differ significantlybetween control and treated rats. The data indicate that alcoholenhances uterine vascular perfusion and that the vascular bedof implantation sites is susceptible to the haemodynamic effectsof alcohol. Enhanced uterine blood flow may contribute to thealcohol-induced changes in embryo development, blastocyst implantationand endometnal deciduahzation observed in the rat.     

INCREASED RATE OF ETHANOL ELIMINATION AND ELEVATED BLOOD ACETATE IN ASTHMATICS ON CORTICOSTEROID, BETA-2-SYMPATHICOMIMETIC AND THEOPHYLLINE TREATMENT

The rate of ethanol elimination and blood acetate concentrationsafter a peroral dose of alcohol were measured in eight asthmaticpatients receiving high-dose corticosteroid, sustained releasetheophylline and beta-2-sympathicomimetic treatment and in eightnonalcoholic, healthy controls. Mean ethanol elimination rate(ER) and mean blood acetate concentration (AC) were significantly(P<0.01) higher in asthmatics (ER=134.8 ± 12.9 mg/kg/hr,AC = 1.13± 0.25 mM) than in controls (ER = 100.2 ±12.3 mg/kg/hr, AC = 0.64 ± 0.10 mM). In the asthmaticsthere was a significant negative correlation between the ageand the rate of ethanol elimination (r = –0.890, P <0.01); in the control group, however, this correlation was oflower degree (r = –0.423) and did not achieve statisticalsignificance. Enhanced ethanol metabolism in asthmatics is possiblydue to the effect of drugs. Our results suggest that ethanolelimination rate is increased in asthmatics receiving medicationand that the effect is most significant in younger age groups.     

Personality risk factors for cocaine abuse.

To evaluate the role of personality in cocaine abuse, 59 adults meeting DSM-III criteria for cocaine abuse were compared to similar-aged non-cocaine alcohol abusers and community controls on a DSM-III measure of personality. Cocaine abusers were more likely than non-cocaine alcohol abusers to display narcissistic personality traits (Odds ratio 6.86, 95% CI = 4.52, 15.60). (Am J Public Health 1989; 79:891-892.     

Characteristics of alcohol abusers among incidental primary health clinic attenders in an Israeli development town

BACKGROUND: The belief that alcoholism is rare among Jews appears to be tenable no longer. High rates of alcohol abuse are being reported in subgroups of the population and in socially disadvantageously placed persons. The main objective of this study was to search for etiologic clues for alcohol abuse in different ethnic groups in a development town in southern Israel. METHODS: A structured questionnaire was answered by 152 randomly selected incidental attenders at a primary health care clinic. Alcohol abuse was determined using the CAGE questionnaire. RESULTS: The rate of present-time alcohol abuse was 17% and 20% among male Indian and non-Indian clinic attenders, respectively, while life-time abuse was 37% and 25%, respectively. These findings were considerably higher than the reported national rates of 2-3%. Differences were found between alcohol abusers in the various ethnic groups. Non-Indian life-time abusers were characterized by more frequent use of medical services, more reported physical and mental symptoms, more use of psychotropic drugs, and higher rates of unemployment. CONCLUSIONS: These differences suggest that the non-Indians may include symptomatic drinkers, while the Indians, we propose, may be alcohol abusers for cultural reasons. The extent of the alcohol abuse problem detected in this survey indicates that a major public health issue may exist in development town populations.