The volume of the liver in patients correlates to body weight and alcohol consumption

The measurement of liver volume has gained practical use inrelation to liver transplantation (Kawasaki et al., 1993). Livervolume may also relate to the many metabolic processes in whichthe liver is engaged (Homeida et al., 1979; Marchesini et al.,1988; Murry et al., 1995; Reichel et al., 1997; Kwo et al.,1998; Andersen et al., 1999). The present study was undertakento measure liver . . . [Full Text of this Article]FOOTNOTESREFERENCES     

Determination of ethyl glucuronide in hair samples

Ethyl glucuronide (EtG) is a non-volatile, water-soluble, stable-upon-storage,direct metabolite of ethanol and can be detected in body fluidsand tissues (and also in post-mortem material) for an extendedtime period after the complete elimination of alcohol from thebody (Alt et al., 1997; Schmitt et al., 1997; Seidl et al.,1998; Wurst et al., 1999a,b). The aim of the present Letteris to emphasize . . . [Full Text of this Article]FOOTNOTESREFERENCES     

Thiamine administration in alcohol-dependent patients

Thiamine (vitamin B1) is a water-soluble vitamin that is involvedin the metabolism of glucose and lipids as well as in the productionof glucose-derived neurotransmitters (see Cook et al., 1998).Its deficiency leads to a variety of neurological and cardiovascularsymptoms and signs. Early symptoms may include fatigue, weaknessand emotional disturbance, whereas prolonged gradual deficiencymay lead to a form of polyneuritis (known as dry beriberi),cardiac failure or peripheral oedema (wet beriberi) (Thomson,2000). Severe thiamine deficiency (TD) may result in the     

REPLY: THE SBU EVALUATION OF THE EFFECT OF TREATMENT OF ALCOHOL AND DRUG PROBLEMS

I am happy that the authors (Berglund and Thelander, 2003) havefound several of my comments (Poikolainen, 2002) helpful and     

Alcohol exposure in utero and breast cancer risk later in life

Since the pioneering work of Hiatt and Bawol (1984), there hasamassed a considerable amount of evidence that moderate-to-heavyalcohol consumption increases risk of breast cancer in women(Willett et al., 1987; Longnecker, 1999). A plausible mechanismis by alcohol's effects on circulating hormone levels. Alcoholadministration has been reported to increase circulating oestradiollevels in pre-menopausal women (Reichman et al., 1993); theevidence is mixed in . . . [Full Text of this Article]FOOTNOTESREFERENCES     

Pragmatic trials and the ARES study

The ARES study (Kiritzé-Topor et al., 2004) addressesan important issue of the use of acamprosate in general practicepatients with alcohol dependence. The paper gives a stronglyargued advocacy for pragmatic trials in alcohol dependence.The authors have tried to ensure that the study closely mimicsclinical practice in almost all possible ways, thus increasingthe     

Gamma-hydroxybutyrate (GHB)-deficiency in alcohol-dependence?

I wish to propose a hypothesis that could help explain someof the effects of baclofen in alcohol dependence that are describedin Dr. Bucknam's case study (Bucknam, 2007) and in my self-casereport (Ameisen, 2005). At a behavioural     

Long-term abstinent alcoholics have a blunted blood glucose response to 2-deoxy-d-glucose

With regard to the article entitled as above by Umhau et al.(2002),     

One hundred alcoholic doctors: a 21-year follow-up

I read with great interest the article by Lloyd (2002) entitled‘One     

CUNNINGHAM CONCERNING 'REGRESSION TO THE MEAN: WHAT DOES IT MEAN?'

We agree that our interpretation of our results regarding acognitive behaviour alcohol programme compared with post-mailedminimal intervention (Johnsson and Berglund, 2006) is conservativein that we did     

Cyanamide or disulfiram in the treatment of adolescent alcohol misusers?

The Randomised Controlled Trial by Niederhofer et al.(2003)describing the successful use of cyanamide in a group of alcohol-misusingadolescents, is further and convincing evidence of the effectivenessof deterrent or antagonist medication in the management of sometypes of substance     

Disulfiram, cocaine, and alcohol: two outcomes for the price of one?

The concurrent abuse of cocaine and alcohol is a common phenomenon,and is increasingly recognized as a difficult clinical issue.Several effective pharmacotherapies for substance dependencedisorders have been identified, though the search for an effectivepharmacotherapy for cocaine dependence has proved difficult.However, it has been suggested that disulfiram may offer a promisingtreatment option. The randomized, placebo-controlled study of Carroll et al. (2004)provides some of the strongest evidence to date regarding theeffectiveness of disulfiram treatment in reducing cocaine use.In a large     

Regression to the mean: what does it mean?

To the Editor Johnsson and Berglund's recent article evaluating two interventionsfor high-risk drinking in university freshman could be regardedas a model of appropriately conservative interpretation of experimentalresults (Johnsson and Berglund, 2006). The authors found statisticallysignificant reductions in drinking from baseline to one-yearfollow-up but little evidence of differences     

Why build a health promotion evidence base about gender?

Gender has long been recognized as an important determinantof health service usage, but gender is increasingly importantin understanding how women and men experience and respond tohealth promotion programs and interventions and their outcomes.Gender frameworks are vital for understanding not just the differingeffects of the determinants of health on either women or men(Doyal, 1995; Krieger, 2000), but also how health programs shouldrespond in order to improve health outcomes for either womenor men. Much needs to be done to improve the evidence base inhealth promotion with respect to gender. Gender, as a determinant of health, refers to inter-relateddimensions of biological difference, psychological differenceand social experience. Biological     

Is daily single dosage of diazepam as effective as chlordiazepoxide in divided doses in alcohol withdrawal--a pilot study

We report on a pilot double-blind study on the effectivenessof divided doses of chlordiazepoxide and a single daily doseof diazepam in the treatment of the alcohol-withdrawal syndrome.While a variety of drugs (chlormethiazole, propranolol and clonidine)have been used for treatment of alcohol-withdrawal symptoms,benzodiazepines remain the drugs of choice for alcohol detoxification(Mayo-Smith, 1997). Diazepam and chlordiazepoxide are both . . . [Full Text of this Article]APPENDIXFOOTNOTESREFERENCES     

Intravenous injection of alcohol by drug injectors: report of three cases

The injection of psychoactive drugs, usually by the intravenousroute, has been recognized for more than a century, and hasbecome more widespread over recent decades (Golding, 1993; Derricotet al., 1999). We have been unable to identify any publishedexamples of the recreational injection of alcohol. We describehere three cases in which intravenous injection of alcohol isreported. Case 1 was a 29-year-old, single, unemployed and homeless man,admitted to hospital for alcohol and diazepam detoxification.He fulfilled ICD-10 criteria . . . [Full Text of this Article]FOOTNOTESREFERENCES     

Doctors' drinking and fitness to practise

Rosta and Aasland's paper (2005) ‘Female surgeons’alcohol use: A Study of a Nation-wide Sample of Norwegian Doctorsadds to the evidence that doctors are at increased risk of becomingdependent at some point in their career. The finding that detrimental drinking by surgeons was more prevalentthan might be expected may point to important fitness-to-practiseconsiderations. The questions ‘Who cares about doctors as individuals?’and ‘Who cares for doctors apart from family and friends?’seem still to be difficult to answer. A doctor's independence and ability to become immersed in apatient's plight are key components for     

Health and nature-new challenges for health promotion

The time is right for health promoters to take a close lookat the evidence of the impacts nature has on the health of individualsand communities. Why? Because we may actually be able to achievemore appropriate and sustainable conditions that support healththan if we only address interventions that focus on a particularhealth issue, e.g. poor diet, sedentary behaviour or drug misuse. The environment (and nature) have always featured as key componentsin health promotion models and concepts. Lalonde (Lalonde, 1974),Hancock and Perkins (Perkins, 1985), Kickbusch (Kickbusch, 1989)and many others incorporated ecological perspectives into theirconstructs of health. These models have been used to informthe development of health promotion practices and have beenlargely influential in the shaping of the extensive theoreticaldesigns and implementation strategies of the settings movement(e.g. healthy cities, health promoting schools, health     

DETERMINATION OF PLASMA {alpha}-GLUTATHIONE-S-TRANSFERASES IN CHRONIC ALCOHOL ABUSERS: RELATIONSHIP WITH ALCOHOL INTAKE AND LIVER INVOLVEMENT

-Gluthathione-S-transferascs (-GSTs) are enzymes involved inthe cellular detoxifying processes; elevated circulating -GSTsactivity is considered to be an early index of liver damage.Glutathione (GSH) is the substrate for -GST action. The aimsof our study were: (1) to evaluate plasma GSH levels and -GSTactivity in chronic alcohol abusers with or without liver cirrhosis;(2) to define the relationship between these two biochemicalparameters; (3) to establish their clinical relevance in patientswith alcohol abuse and/or liver damage. We studied 69 subjects(18 healthy subjects and 51 chronic alcohol abusers: 29 withoutliver cirrhosis and 22 with). Plasma -GST activity was determinedon baseline samples and every following day for a total of 10days in five alcoholics by HEPKIT (Alpha-Biotech, Biotrin International,Dublin, Ireland). GSH was determined on all subjects' baselinesamples by fluorescent high-performance liquid chromatography.Alcohol intake was evaluated in all patients by determiningblood-alcohol concentrations. Significant increases in plasma-GSTs were observed in 9/29 (31%) alcoholics and 3/22 (13.6%)cirrhotics irrespective of their alcohol intake. GSH was significantlylower than normal values (P < 0.001) in all alcoholics withor without cirrhosis (controls 10.4 ± 4.8; alcoholicswithout cirrhosis 3.9 ± 1.4; alcoholics with cirrhosis3.3 ± 1.6). No correlation was observed between plasma-GST and GSH levels. Our data indicate that: (1) -GST activitydoes not correlate with GSH levels in the plasma; (2) -GSTsdo not have clinical relevance as markers of recent alcoholintake; (3) in cirrhotics, -GST does not provide more informationthan other liver function tests. However, plasma -GST determinationmay be useful in selecting a subgroup of alcoholics in whomroutine biochemical markers of liver damage are within referenceranges.     

Prevalence of asthma in schoolchildren under-represents those from socially deprived areas

We were interested to read the excellent study by McCann etal. in the February edition of Health Education Research (McCannet al., 2002). We have recently conducted a similar, but smaller,study that sheds some light upon their results. Our study aimedto assess the impact of our local asthma health promotion schemefor schools [Asthma Friendly Schools (AFS) Initiative], whichhad been in place for 5 years and had been adopted by abouthalf of all Portsmouth schools. We