Kinetics of ethanol and methanol in alcoholics during detoxification.

We investigated the kinetics of ethanol and methanol in 20 dependent alcoholics (16 men and four women) during the first 24 hr after admission to hospital for detoxification. The blood-ethanol concentration (BEC) on admission ranged from 238 to 489 mg/dl (mean 386 mg/dl). The mean rate of ethanol disappearance from the blood was 23 mg/dl/hr with a spread from 13 to 36 mg/dl/hr. The concentrations of methanol in blood at the start of detoxification ranged from 0.16 to 2.8 mg/dl (mean 1.15 mg/dl) and these levels remained more or less unchanged until the BEC had dropped below 30 mg/dl. The concentrations of ethanol and methanol in blood at the start of detoxification were not correlated (r = 0.032, P > 0.05). The results of this study do not support the notion that the metabolism of methanol in chronic alcoholics proceeds independently of the prevailing BEC. We found a three-fold difference in the rate of disappearance of ethanol from blood in alcohol-dependent subjects.     

Relative kindling effect of detoxification and non-detoxification admissions in alcoholics

We reviewed the histories of 340 men and 60 women who were admitted for alcohol detoxification to determine if hospitalizations unrelated to detoxification increased the prevalence of seizures observed in these patients. Previous investigations on this cohort suggested that recurrent detoxification admissions increased the probability of seizure histories. Detoxification and non-detoxification hospitalizations were calculated from patient reports and chart reviews on patients admitted for alcohol detoxification. Discriminant analysis of each type of hospitalization and total hospitalizations for each sex revealed an increased risk of seizure activity correlating with non-detoxification hospitalizations, but the correlation was weaker than that observed for detoxification admissions and for total admissions. This correlation between hospitalizations and seizure prevalence supports the hypothesis that recurrent alcohol withdrawal may have a kindling effect.     

Superoxide dismutase SodB is a protective antigen against Campylobacter jejuni colonisation in chickens

Campylobacter is the leading cause of foodborne diarrhoeal illness in the developed world and consumption or handling of contaminated poultry meat is the principal source of infection. Strategies to control Campylobacter in broilers prior to slaughter are urgently required and are predicted to limit the incidence of human campylobacteriosis. Towards this aim, a purified recombinant subunit vaccine based on the superoxide dismutase (SodB) protein of C. jejuni M1 was developed and tested in White Leghorn birds. Birds were vaccinated on the day of hatch and 14 days later with SodB fused to glutathione S-transferase (GST) or purified GST alone. Birds were challenged with C. jejuni M1 at 28 days of age and caecal Campylobacter counts determined at weekly intervals. Across three independent trials, the vaccine induced a statistically significant 1 log₁₀ reduction in caecal Campylobacter numbers in vaccinated birds compared to age-matched GST-vaccinated controls. Significant induction of antigen-specific serum IgY was detected in all vaccinated birds, however the magnitude and timing of SodB-specific IgY did not correlate with lower numbers of C. jejuni. Antibodies from SodB-vaccinated chickens detected the protein in the periplasm and not membrane fractions or on the bacterial surface, suggesting that the protection observed may not be strictly antibody-mediated. SodB may be useful as a constituent of vaccines for control of C. jejuni infection in broiler birds, however modest protection was observed late relative to the life of broiler birds and further studies are required to potentiate the magnitude and timing of protection.     

微量元素镉 硒对NIH小鼠超氧化物歧化酶的影响

目的 :了解镉、硒对NIH小鼠超氧化物歧化酶 (SOD)活性变化的作用。方法 :采用Oyanagui和贺锐的方法测定Cu—ZnSOD和Mn—SOD活性。结果和结论 :镉能使NIH小鼠内脏组织细胞的Cu—ZnSOD活性降低 ,Mn—SOD活性相应增高 ,硒能拮抗这种作用 ,从酶角度阐明了镉的致癌机理     

Changes in psychological symptoms during ambulant detoxification

Reports suggest a high prevalence of psychological symptomsin alcohol-dependent patients, but there are difficulties inevaluating their significance. To elucidate these relationships,the effect of withdrawal from alcohol on psychological symptomsin men and women detoxifying on an ambulant basis was examined.A prospective study of 65 patients was carried out using a standardizedinterview which included sociodemographic indices, measuresof alcohol dependence and problems. Psychological symptoms weremeasured using the General Health Questionnaire at three differenttime points. The majority of alcohol-dependent patients presentedfor treatment with co-existing psychological symptoms, but,for both men and women, these decreased rapidly after a 10-daydetoxification period. For patients who remained abstinent overthe next 6 weeks there was a further decline in psychologicalsymptoms to almost asymptomatic levels. For those who resumeddrinking, no such improvement was apparent. The clinical implicationis that treatment for what may at first appear to be an independentco-morbid disorder may not be necessary once the patient hasbeen withdrawn from alcohol and has achieved a period of abstinence.     

Effects of carnosine and related compounds on the stability and morphology of erythrocytes from alcoholics

The effects of carnosine and related compounds on erythrocytes from alcoholics were studied. In their presence, erythrocytes showed an increased ability to resist haemolysis and showed a more normal morphology, with carnosine and N-acetyl-carnosine being the most effective compounds. These beneficial properties of the dipeptides do not appear to be directly related to their antioxidant or buffering properties.     

Utilization of acute inpatient services for alcohol detoxification

This study indicates that the majority of patients admitted to VA hospital for medical detoxification could have those services provided on an outpatient or less intensive basis. However, inpatient medical detoxification services appear to be appropriate for those alcoholics at risk for potential life-threatening complications of withdrawal such as delirium tremens, or those with concurrent associated medical conditions such as pancreatitis, gastrointestinal bleeding, or complications of cirrhosis. Data were obtained from a national random sample of hospitalizations in Department of Veterans Affairs (VA) inpatient medical and surgical units. Medical records for 144 alcoholismrelated medical admissions to 35 VA medical centers were reviewed using the Appropriateness Evaluation Protocol (AEP), a clinically based utilization review instrument widely used in the private sector. The medical records for the admission and each day of medical/surgical inpatient stay were reviewed using clinical criteria for the appropriateness of acute inpatient care as opposed to lower levels of care. Opinions expressed in this article are those of the authors and do not reflect the views of the Department of Veterans Affairs, the University of Arkansas for Medical Sciences, Xavier University, or the University of Michigan.     

Estimated risk of hepatotoxicity after an acute acetaminophen overdose in alcoholics

A published logistic regression model based on the Canadian Acetaminophen Overdose Study registry was used to calculate the risk of hepatotoxicity after an acute acetaminophen overdose and to estimate a treatment threshold line for alcoholic patients who did not co-ingest alcohol (i.e., abstinent alcoholics) on the Rumack–Matthew nomogram. The risk of hepatotoxicity in nonalcoholic and abstinent alcoholic patients was calculated at the acetaminophen concentration of 150 μg/ml at 4 h (37.5 μg/ml at 12 h) treatment threshold line. This corresponds to the “possible risk” line on the Rumack–Matthew nomogram and represents a 1.6% risk of hepatotoxicity for nonalcoholic patients at or below this line. At or below this same 150 μg/ml at 4-h line, abstinent alcoholic patients have a hepatotoxicity risk of 10.7%. The risk of hepatotoxicity in abstinent alcoholics' equivalent to that of nonalcoholics (i.e., 1.6%) occurs at a lower acetaminophen concentrations treatment threshold line, that is, 104 μg/ml at 4 h (26 μg/ml at 12 h). Because of difficulties plotting this new line on the familiar Rumack–Matthew semilogarithmic scale, a line connecting 100 μg/ml at 4 h (25 μg/ml at 12 h) is proposed. This line equates to a 1.1% risk of hepatotoxicity in abstinent alcoholic patients. The analysis supports the observation that based on the published model abstinent alcoholics might have a greater risk of hepatotoxicity after an acute acetaminophen overdose. This proposed new risk line can be used in hypothesis generation for future clinical studies in this alcohol related problem.     

Steroid profiles in urine and plasma of alcoholics during withdrawal

Metabolic profiles of steroids in urine and plasma were analyzed in 14 male and four female alcoholics during withdrawal. The daily excretion of 30 conjugated steroids in urine and the concentration of 13 steroid sulfates in plasma were measured on days 1, 7 and 29 of the period of observation, which started on day 5-7 of abstinence. While the total excretion of cortisol metabolites was normal in most cases, the profiles of metabolites were changed in the alcoholics during the period of observation. The ratio between tetrahydrocortisol and tetrahydrocortisone exceeded the mean normal value by more than one standard deviation in 97% of the samples analyzed. The same was true of the ratio between 20-hydroxy and 20-oxosteroids in 90% of the samples. The differences between alcoholic and healthy subjects were statistically significant (p less than 0.001). The major change in plasma was a significantly increased concentration of 5-androstene-3 beta, 17 beta-diol disulfate on the first day of the study. The concentration decreased to normal values during the first month of withdrawal. The rate of excretion of this steroid in urine was increased in half of the patients and also decreased with time. The rate of excretion and the degree of fatty infiltration in liver biopsies were positively correlated. It is suggested that the ratios between cortisol metabolites in urine might be of value as biochemical markers in alcoholism, and that the absolute or relative concentrations of steroid disulfates in plasma might serve as an indicator of recent alcohol intake.     

Recovery of hippocampus-related functions in chronic alcoholics during monitored long-term abstinence

AIMS: The hippocampus (HC) is characterized by high vulnerability to noxious influence, but also by a considerable regenerative potential. Although deficits in HC-related functions are among the most commonly reported cognitive sequelae in alcoholism, little and conflicting information is available concerning regeneration upon abstinence. The present study has been designed to evaluate (i) the frequency of measurable dysfunction in so called HC tests and (ii) its predictive value for risk to relapse in a cohort of 50 severely affected chronic alcoholic patients and (iii) to monitor recovery of HC-related functions upon strict abstention from alcohol. METHODS: Patients underwent a 2-year neuropsychological follow-up including HC-associated tests (Verbal Learning Test, VLT; Nonverbal Learning Test, NVLT; 'City Map Test' of Learning and Memory Test, LGT-3), as well as tests of intelligence and attention in the framework of OLITA (Outpatient Long-Term Intensive Therapy for Alcoholics), a programme with careful abstinence monitoring. RESULTS: At study entry, 30/50 (60%) alcoholics had HC dysfunction which tended to predict a lower long-term abstinence probability (P = 0.058). Of the subgroup that could be followed under conditions of strictly monitored alcohol abstinence (n = 32; age 44.7 +/- 6.2 years; 23 men, 9 women), 53% (17/32) exhibited distinct HC dysfunction at inclusion which returned to normal after 2 years. Patients with initially normal HC function (9/32) and patients with additional brain damage of different aetiologies (6/32) failed to show improvement on HC-related tests. While the former displayed stably normal HC test performance, the latter remained on a performance level below normal. CONCLUSIONS: Demonstrating slow but remarkable regeneration of HC functions upon strict abstention from alcohol, our data strongly support abstinence-oriented long-term treatment of alcoholics. The absence of functional recovery in patients with additional causes of brain damage might be explained by the 'dual hit' exhausting the regenerative potential of the HC.     

Urinary enzyme output during detoxification of chronic alcoholic patients

The urinary excretion of N-acetylglucosaminidase, gamma-glutamyl transferase and lactate dehydrogenase was elevated by two to three fold in chronic alcoholic patients when compared to normal controls. After 4 weeks of alcohol abstention, the urinary excretion of these enzymes returned to control values. Increased urinary enzyme excretion was not related to malnutrition or pathological glomerular filtration and is due most probably to a direct effect of alcohol on the renal proximal tubule.     

Superoxide dismutase (EC 1.15.1.1), zinc status and ethanol consumption in maternal and foetal rat livers.

1. The activity of superoxide dismutase (EC 1.15.1.1) was not greatly affected by zinc deficiency in maternal or foetal (20 d) rat livers, although in the latter tissue it did appear to be slightly raised by Zn depletion when compared with pair-fed control animals. 2. Enzyme activity was significantly higher in livers from all foetuses after administration of aqueous ethanol at 100 or 200 ml/l to the dams during pregnancy. 3. Plasma Zn levels were significantly increased in Zn-deficient dams after ingestion of alcohol during pregnancy.     

The course of anxiety, depression and drinking behaviours after completed detoxification in alcoholics with and without comorbid anxiety and depressive disorders

We studied the associations between comorbid anxiety and depressive disorders in treated alcoholics, the course of current anxiety and depression during the early and late post-detoxification periods, and drinking behaviours after discharge. Lifetime psychiatric comorbidity was assessed in 100 alcoholics using the Composite International Diagnostic Interview (CIDI). Three subgroups defined as group DA (comorbid depressive and anxiety disorders, n = 15), group A (anxiety disorder only, n = 23), and group NO (no comorbid disorder, n = 62) were studied. Beginning 21 +/- 13 days after cessation of drinking, state anxiety (STAI-X1), trait anxiety (STAI-X2) and depression (BDI) were assessed once per week (t1 to t4) and once more 6 months after discharge (t5, n = 68). The severity of psychopathology decreased during the first 4 weeks after detoxification in all subgroups. However, trait anxiety remained at higher levels in both the comorbid subgroups from t1 to t4. In the follow-up sample, 60.5% of the non-comorbid subjects remained abstinent, but only 26.7% of all comorbid patients and only 12.5% of those with comorbid depressive disorder plus severe current trait anxiety or depression at t1. Independent of their comorbidity status, relapsers at t5 had already reported more trait anxiety than abstainers at t1. We conclude that severe trait anxiety persisting after 3 weeks of abstinence, comorbid depressive and/or anxiety disorders, and combinations of these with moderate or severe current anxiety and depressive states represent the greatest risks of relapse and therefore may indicate a treatment need.     

某餐馆诺如病毒暴发疫情中从业人员肠道排毒时间监测分析

目的 分析某餐馆诺如病毒暴发疫情中从业人员肠道排毒时间及其影响因素,为今后诺如病毒疫情的防控提供科学依据。方法 对2017年成都市某餐馆暴发诺如病毒疫情中的115名从业人员进行随访和采样检测,每隔3 d或7 d采集1次肛拭子进行核酸检测,对实验结果资料进行统计分析。结果 随访期餐馆从业人员第7、11、17、24天诺如病毒阳性率分别为14.78%、7.89%、3.51%、0.88%。阳性率呈现随时间推移而下降趋势,不同性别、工种间阳性率差异无统计学意义。从业人员感染率高达14.78%,其排毒期平均为14.94 d,最长28.00 d,且无症状携带者的排毒期较病例长。结论 诺如病毒暴发疫情中,食品从业人员存在无症状携带,其作为传染源在诺如病毒传播过程中所起的作用不容忽视,疫情处置中应加强从业人员的采样检测,对阳性检出者严格落实隔离措施。