Alcohol Use and Alcohol Consumption–Related Problems in Rural Vietnam: An Epidemiological Survey Using AUDIT

This study aimed to assess alcohol use and alcohol consumption–related problems in different sociodemographic groups in a rural district in Vietnam. Interviews were completed between March 2004 and July 2004. The Alcohol Use Disorder Identification Test (AUDIT) was applied to interview 3423 people, who were randomly selected in a rural district (1695 men and 1728 women). People who had an AUDIT score greater than 7 (in men) or greater than 5 (in women) were identified as having alcohol consumption–related problems. Prevalences and adjusted odds ratios of alcohol use and alcohol consumption–related problems were estimated for different subgroups of the population. Weekly and daily “binge drinking” among men were 5.7 and 3.6%, while binge drinking in women was virtually nonexistent. The prevalence of alcohol consumption–related problems was 25.5% among men and 0.7% among women. The differences between sociodemographic groups were not strong, but women who were separated, divorced, or widowed as well as those with higher education had significantly higher rates of alcohol consumption–related problems than married women and those with lower education. This study indicates an urgent need for alcohol intervention programs focused on men. However, further monitoring of alcohol use and problems among women is important to follow-up changes in consumption pattern. The study's limitations are discussed.     

Alcohol and drug use among deaf and hard-of-hearing individuals: A secondary analysis of NHANES 2013–2014

Background: Within the field of behavioral health research, one of the most understudied populations is the US deaf and hard-of-hearing (D/HH) population—a diverse group of individuals with hearing loss that have varied language and communication preferences, community affiliations, and sociocultural norms. Recent research identified concerning behavioral health disparities experienced by the D/HH population; yet, little research has been conducted to extend these findings to the topic of substance use disorder. Methods: To begin to fill this gap, the authors conducted a secondary analysis of data from the 2013–2014 administration of the National Health and Nutrition Examination Survey, comparing alcohol and drug use between participants based on their reported hearing status, i.e., D/HH or hearing. Results: Findings suggest that the overall lifetime prevalence of alcohol and drug use does not differ based on hearing status, and that D/HH and hearing adolescents begin using cannabis on a similar timeline. However, findings also revealed that D/HH respondents were more likely to have been regular cannabis users and heavy alcohol users than hearing respondents. In other words, when D/HH individuals use substances, they tend to be heavy users. Conclusions: These findings stress the importance of directing resources to the prevention and treatment of heavy alcohol use in the D/HH population, given that binge drinking is associated with a number of health problems and social consequences. Additionally, the continuation of this empirical work is rather urgent given recent legislative changes regarding cannabis use. D/HH individuals possess a number of risk factors for substance use disorder and, as such, may be more greatly impacted by these legislative changes than individuals from the general US population. It is imperative that this impact be captured by future research efforts in order to inform the development of prevention and intervention efforts for the traditionally underserved D/HH population.     

Alcohol and tobacco co‐use in nondaily smokers: An inevitable phenomenon?

Introduction and Aims. Alcohol use has consistently been associated with smoking among nondaily smokers. However, this may not be an inevitable relationship that extends across all drinking sessions and/or all nondaily smokers. Recently, distinct subgroups of nondaily smokers have been identified, with one subgroup maintaining a stable pattern of nondaily smoking (long‐term occasional smokers; LOS), and others transitioning to nondaily smoking either from a non‐smoking status (early occasional smokers; EOS) or from a daily smoking status (former daily smokers; FDS). However, little is known about the extent to which these subgroups differ in their alcohol–tobacco co‐administration patterns. Design and Methods. 183 nondaily smokers (74 LOS; 55 EOS; 54 FDS) completed face‐to‐face interviews during which they provided details about their lifetime and past‐week tobacco and alcohol administration patterns. Results. EOS were more likely to report having used alcohol at the time of their first‐ever cigarette relative to the other subgroups (P ≤ 0.001), but there were no differences in past‐week co‐administration patterns between the subgroups. Overall, less than one‐third of all smoking sessions occurred when drinking, but these accounted for more than half of all cigarettes consumed during the previous week. Moreover, while only 42% of drinking sessions involved tobacco co‐administration, when drinking and smoking did co‐occur, significantly greater amounts of alcohol were consumed relative to drinking sessions where no tobacco was used (P < 0.01). Discussion and Conclusions. Findings suggest that alcohol use is not invariably related to smoking in EOS, FDS or LOS, but when it is, across all subgroups co‐administration is associated with mutual dose escalation.[Campbell ML, Bozec LJ, McGrath D, Barrett SP. Alcohol and tobacco co‐use in nondaily smokers: An inevitable phenomenon? Drug Alcohol Rev 2012;31:447–450]     

Alcohol and “bursts” of aggressive behavior: ethological analysis of individual differences in rats

A quantitative ethological analysis of rodent aggression was performed in order to characterize the aggression-heightening effects of alcohol in certain individuals. In dyadic confrontations, a resident rat pursues, threatens and attacks an intruder, who reacts with defensive, flight and submissive behaviors. The behavioral data from five series of experiments conducted from 1984 through 1989 were subjected to a lag sequential analysis that identified highly predictable sequences of aggressive behavior, and to interval analysis that delineated a burst pattern of aggressive behavior. These analyses revealed a distinct behavioral sequence of pursuit sideways threat attack bite aggressive posture that occurs in bursts with an inter-event interval of less than 6.6 s. In the total population, alcohol heightened attack behavior at low acute doses (0.1, 0.3, 1.0 g/kg) in 47% of the animals (n=44), suppressed reliably attack behavior in another 25% (0.1–3.0 g/kg;n=23) and had unreliable effects in the remaining 28% (n=24). The peak enhancement of aggressive behavior was seen over more than a log cycle of alcohol doses (0.1, 0.3 or 1.0 g/kg) in different individuals. In an additional group of rats (n=20), individuals were identified according to whether or not acute low alcohol doses enhanced or suppressed the frequency of attack bites. In the subgroup of five rats who doubled their attack frequency upon acute alcohol challenge, this aggression-heightening effect was confirmed on repeated occasions. The aggression-heightening effects of alcohol were seen during the high-rate interactions in the initial phase of the confrontation and particularly during the lower level of fighting later on. Regardless of alcohol dose and subgroup, the highly predictable sequence of pursuit sideways threat attack bite aggressive posture remained intact as long as the individual was able to fight. The present analysis identifies those individuals in whom low alcohol doses increase the frequency of attack behavior, the number of aggressive elements in bursts and particularly the time in burst. Alcohol produces these changes without altering the latency to initiate aggressive behavior, the rate of aggressive behavior within a burst or the number of bursts in an encounter. Alcohol may lengthen aggressive bursts by preventing termination of longer aggressive sequences rather than by altering the initiation of this behavior.We dedicate this paper to our friend Dr. Milos Krsiak, Professor of Pharmacology, Charles University, Prague, Czechoslovakia     

Alcohol use among abused and non-abused older persons aged 60–84 years: An European study

Aims: Describing alcohol use by abuse type (e.g. psychological) and considering other factors (e.g. depression).

Methods: The respondents were 4467 (2559 women, 57.3%) randomly selected elders (60–84 years) from seven European cities. The cross-sectional data were collected with scales covering various areas and examined with bivariate/multivariate methods.

Findings: Psychologically abused elders were more often alcohol users than non-users (21.7% vs. 16.3%) and the opposite regarding financially abused elders (4.8% vs. 3.5%). Psychologically abused elders also had more often three or more drinks containing alcohol in a drinking day (21.1% vs. 16.1%) and six or more drinks on one occasion (24.5% vs. 18.3%). Psychological abuse, demographics/socio-economics (e.g. education), smoking and leisure activities were positively associated alcohol use, and being from certain countries (e.g. Italy), age (e.g. 80–84 years), depression and financial abuse negatively.

Conclusions: Across countries, 64.2% of the elders were drinkers. Some variables (e.g. psychological abuse) were positively related to alcohol use and others (e.g. depression) negatively. Many of the elders were exposed to abuse. Our findings may be useful to prevent/manage drinking and abuse among elders. However, alcohol use was influenced by various factors that need to be further elucidated, particularly the relation between abuse and drinking.     

Alcohol and Femininity in Sweden c. 1830–1922: An Investigation of the Emergence of Separate Drinking Standards for Men and Women

This paper discusses changing views about gender and drinking in Sweden c. 1830–1922. The author posits that the emergence of bourgeois morals in the 19th century were associated with a decline in the tolerance for female alcohol consumption, and also shows how the values, norms, and activities of the temperance movement interconnected with religion and notions of purity. Yet, in spite of hardening attitudes against women's drinking, alcohol remained integral in Swedish upper-class women's lives. The results are based on a qualitative study of Swedish women's diaries. The study was financed by the Swedish Research Council, 2009–2012. Study limitations are also noted.     

Crystal methamphetamine: A source of added sexual risk for Hispanic men who have sex with men?

OBJECTIVES: To determine whether use of crystal methamphetamine increases HIV risk behaviors beyond the risk associated with use of other recreational drugs among Hispanic men who have sex with men (HMSM). DESIGN: We compared the sexual behaviors and psychosocial characteristics of non-recreational drug users (non-users), recreational drug users who did not use crystal (non-crystal drug users), and recreational drug users who used crystal (crystal users). METHODS: We recruited 294 HMSM from Internet and 272 from community venues. Eligible men completed an ACASI to assess socio-demographic factors, drug use, sexual behaviors and psychosocial factors and received 50 dollars. RESULTS: In the multivariate model, crystal users were more likely than non-crystal drug users to have lower Hispanicism, higher attachment to the gay community, and history of suicide attempts. Crystal users were not significantly different from non-crystal drug users in number of sex partners; however, differences in unprotected receptive anal sex approached significance. CONCLUSIONS: The additional risk of crystal above that of other recreational drugs needs to be disentangled from those associated with poly-drug use. Our data suggest that it may depend on how one defines risky sexual behavior and is influenced by psychological, physiologic and social factors.     

The Neuroeconomics of Alcohol Demand: An Initial Investigation of the Neural Correlates of Alcohol Cost–Benefit Decision Making in Heavy Drinking Men

Neuroeconomics integrates concepts and methods from psychology, economics, and cognitive neuroscience to understand how the brain makes decisions. In economics, demand refers to the relationship between a commodity''s consumption and its cost, and, in behavioral studies, high alcohol demand has been consistently associated with greater alcohol misuse. Relatively little is known about how the brain processes demand decision making, and the current study is an initial investigation of the neural correlates of alcohol demand among heavy drinkers. Using an event-related functional magnetic resonance imaging (fMRI) paradigm, participants (N=24) selected how much they would drink under varying levels of price. These choices determined access to alcohol during a subsequent bar laboratory self-administration period. During decisions to drink in general, greater activity was present in multiple distinct subunits of the prefrontal and parietal cortices. In contrast, during decisions to drink that were demonstrably affected by the cost of alcohol, significantly greater activation was evident in frontostriatal regions, suggesting an active interplay between cognitive deliberation and subjective reward value. These choices were also characterized by significant deactivation in default mode network regions, suggesting suppression resulting from greater cognitive load. Across choice types, the anterior insula was notably recruited in diverse roles, further implicating the importance of interoceptive processing in decision-making behavior. These findings reveal the neural signatures subserving alcohol cost–benefit decision making, providing a foundation for future clinical applications of this paradigm and extending this approach to understanding the neural correlates of demand for other addictive commodities.     

Antidepressants,sex steroids and pituitary–adrenal response in sheep

Rationale The importance of sex differences in major affective diseases such as depression is providing a new focus for investigating the interactions between sex, sex steroids and antidepressants.Objectives In this study, we examined the acute effects of sertraline, a selective serotonin reuptake inhibitor (SSRI) and imipramine, a tricyclic antidepressant (TCA) on the endocrine endpoints, adrenocorticotropin (ACTH) and cortisol secretion in gonadectomised male and female sheep.Methods Each sheep was treated with an acute subcutaneous (SC) injection containing vehicle, sertraline (5 and 10 mg/kg), or imipramine (10 mg/kg) in the presence and absence of sex steroid replacement. In males, SSRI treatment consisted of testosterone (2×200 mg SC pellets), and in females, estradiol (1 cm SC implant) plus an intravaginal controlled internal drug release device containing 0.3 g progesterone. ACTH and cortisol were measured in jugular blood.Results Female sheep responded to sertraline treatment with dose-dependent ACTH and cortisol increases that were unchanged by sex steroid replacement. In castrated males, however, only the highest dose of sertraline increased ACTH and cortisol, and this increase was abolished in the presence of testosterone replacement. Imipramine affected neither ACTH nor cortisol secretion in either the sex or sex steroid condition.Conclusions We conclude that the sex and sex steroid-related differences in the male and female responses to sertraline treatment may reflect sex and sex steroid dependent differences in serotonergic activation of the HPA axis. This highlights the potential significance of sex and circulating sex steroids in modulating neuroendocrine responses to antidepressants, and may have an impact on our understanding of the actions of these drugs in men and women.Parts of this work were presented at the meeting of the Endocrinology Society, Philadelphia, Pa., USA in June 2003, and at the annual meeting of the Endocrine Society of Australia, Melbourne, September, 2003.     

Alcohol Consumption and Harm among Adolescents in Sweden: Is Smuggled Alcohol More Harmful?

As a consequence of Sweden joining the European Union, privately imported alcohol is increasingly sold within illegal contexts (i.e., smuggled alcohol). One implication of the smuggled alcohol is that alcohol becomes more available to underage drinkers. In the Swedish debate, smuggled alcohol has been formulated as a youth problem. The aim of this article is to examine the relationship between consumption of smuggled alcohol and alcohol-related harm among adolescents in Sweden. Data on consumption of smuggled alcohol were obtained from monthly surveys, and data on harm originates from the National Board of Health and Welfare. The analysis was made by means of time-series analysis (ARIMA models). The results highlight the importance of overall consumption per se and not the type of alcohol (illegal or not) consumed.     

Adolescent sexual activity and cancer risk: physicians’ duty to inform?

Yearly, 33,000 cancer diagnoses in the US are attributed to human papillomavirus (HPV), with cervical cancer the most common. HPV is transmitted through sexual contact; HPV types 16 and 18 cause the majority of ano-genital cancers in men and women. HPV causes ～100% of cervical cancers, ～90% of anal cancers, and ～50% of vaginal, vulvar, and penile cancers. HPV is also involved in ～70% of oropharyngeal cancers (OPCs) in the US. The CDC recommends routine administration to all female (bivalent or quadrivalent vaccine) and male (quadrivalent vaccine) patients at 11–12 years of age; the series may be started as early as 9 years of age. Recent evidence suggests physicians do not universally recommend the vaccine to all adolescents. Additionally, parents may refuse the vaccine due to safety concerns as well as religious and moral beliefs related to onset of sexual debut. It has been suggested physicians should consider discussing HPV vaccine as a cancer prevention tool only, with less focus on the fact that transmission is caused by sexual activity. In this commentary we suggest physicians have a duty to warn parents and adolescents that OPCs may be transmitted through oral sex, which is often perceived as not constituting sexual activity.     

Cognitive Predictors of Alcohol Involvement and Alcohol Consumption–Related Consequences in a Sample of Drunk-Driving Offenders

Motivational theories of alcohol involvement emphasize a wide range of cognitive factors as precursors to “heavy” or high-risk drinking. Central to this consideration has been expectancies, drinking urges, triggers, and situational cues, all of which can synergistically or independently stimulate drinking. Unfortunately, empirical studies have scrutinized low-level or moderate drinkers drawn from the general population, and less is known about the role of cognitive factors as precursors to high-risk drinking. The present study examines the unique contribution of several measures of cognitive motivation to harmful alcohol use in a sample of convicted drunk drivers. Confirmatory factor analysis indicated the psychometric soundness of a model positing four latent predictor constructs assessing drinking urges/triggers, situational cues, positive and negative expectancies and outcome constructs assessing harmful alcohol use and perceived consequences of harmful drinking. A structural equation model indicated that each motivational construct was associated uniquely with both drinking and perceived consequences, with the largest overall effect in both cases associated with situational cues. Results are discussed in terms of identifying prominent cognitive factors that may foster harmful drinking among high-risk populations and their implications for treatment.     

“An abnormal habit”: Alcohol policy and the control of methylated spirit drinking in England in the 1920s and 1930s

Abstract

This paper is a case-study analysis of methylated spirit drinking in England in the 1920s and 1930s, focussing in particular on moral panic about deviant consumption and the development of policy-making. During the interwar years there emerged a statistically minor, but socially significant, culture of drinking methylated spirit – an industrial denatured alcohol – in socio-economically deprived urban communities. In the wake of (often hyperbolic) discourse about the considerable physical damage caused by methylated spirit consumption, and associated concerns about the perceived moral deviancy of drinkers, policy-makers developed a variety of regulatory strategies aimed at curbing consumption. Overall, this paper reveals the complex matrix of legislative, judicial and administrative regulation which framed responses to this widely vilified form of alcohol consumption, and in doing so points to some of the varied pressures and influences which informed harm-reduction policy-making.     

Cyclooxygenase inhibition and rosuvastatin-induced vascular protection in the setting of ischemia–reperfusion: A human in vivo study

The 3-hydroxy-3-methylglutaryl coenzyme A (HMG Co-A) reductase inhibitors have preconditioning effects involving up-regulation of cyclooxygenase (COX)-2. We investigated the effect of selective and non-selective COX inhibition on rosuvastatin-mediated protection against ischemia–reperfusion (IR)-induced endothelial dysfunction in the human forearm. Healthy volunteers (n = 66) were allocated to placebo, acetylsalicylic acid (ASA) 81 mg daily, ASA 325 mg daily, celecoxib 200 mg twice daily or 400 mg ibuprofen four times daily, each administered for 5 to 7 days. On the last day of study drug therapy, subjects received a single dose of 40 mg rosuvastatin. Twenty-four hours later flow-mediated dilation (FMD) of the radial artery was evaluated before and after IR. In the placebo group, FMD was similar before and after IR (8.1 ± 1.0 vs 7.2 ± 0.8%; P = NS) indicating a significant protective effect of rosuvastatin. There was also no effect of IR on FMD in the ASA 81 mg group (6.7 ± 0.6 vs 6.1 ± 0.7%; P = NS). In contrast, following IR there was a significant decrease in FMD in the ASA 325 mg group (7.2 ± 0.8 vs 3.3 ± 0.7%, P < 0.001), the celecoxib group (7.3 ± 1.5 vs 2.6 ± 1.5%, P < 0.01) as well as the ibuprofen group (6.8 ± 0.7 vs 2.6 ± 0.8%; P < 0.01). Therefore, nonselective COX inhibition with ASA 325 mg and ibuprofen completely inhibit the protective effects of rosuvastatin in the setting of IR injury, as does therapy with the specific COX-2 antagonist celecoxib. In contrast, therapy with low dose ASA (81 mg daily) does not have such inhibitory effects.     

A Six-Community Prevention Trial to Reduce Alcohol and Drug Use–Related Problems in Sweden: Planning and Early Findings

The objective of this study was to evaluate a research and development project to reduce alcohol and drug use–related problems, conducted during 2003–2005, in six urban and rural municipalities in Sweden, Umeå, Kramfors, Solna, Kalmar, Laholm, and Lund. The development of alcohol and drug use trends and patterns will be followed through 2008 in the six targeted intervention communities and in the six matched control communities. The evaluation includes archival data, survey data, observational data, as well as process measures. The six communities have gradually reoriented their thinking about prevention from a single focus on youth activities to a broader approach involving the whole population. The project's and the study's limitations are noted and future needed research is suggested.     

Detection of clenbuterol residues in beef sausages and its enantiomeric analysis using UHPLC–MS/MS: A risk of unintentional doping in sport field

Clenbuterol (Clb) can be present in Mexico often but not all over the world in animal tissues and organs, therefore, potentially is derived from animal sources as well. The aims of this study were to develop and validate a method for detecting traces of clenbuterol in beef sausages. A calibration curve showed linearity in the range of 20–500 pg ml⁻¹. The limit of detection (LOD) and lower limit of quantification (LLOQ) were 5 and 10 pg g⁻¹, respectively. The analyte recovery was from 95.70% to 100.40% with an intraday relative standard deviation (RSD%) of 0.99%–2.10% and an interday RSD% of 0.54%–2.34%, R² = 0.9998. The methodology developed was applied successfully in 15 samples of beef sausage, and 73.3% of the samples tested contained racemic clenbuterol in concentrations between 30 and 471 pg g⁻¹. The UHPLC–MS/MS method developed combines high sensitivity with good selectivity and short chromatographic run time. Additionally, the enantiomeric analysis of clenbuterol performed in beef sausages showed a 59% for R-(−)-Clb and 41% for S-(+)-Clb. The presence of clenbuterol in beef sausages could represent a risk of unintentional doping in sport field, because the clenbuterol is a banned substance included in the World Anti-Doping Agency's (WADA) list of prohibited substances.     

Incidence and risk of severe infections associated with aflibercept in cancer patients: a systematic review and meta‐analysis

Aims

Aflibercept is an engineered humanized vascular endothelial growth factor (VEGF)‐targeted agent. Severe infections are serious adverse event associated with aflibercept. However, the contribution of aflibercept to infection is still unknown. We thus conducted this meta‐analysis to investigate the overall incidence and risk of developing severe infections in cancer patients treated with aflibercept.

Methods

Electronic databases including PubMed, Embase and abstracts presented at American Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) meeting were searched. Eligible studies were phase II and III prospective clinical trials of aflibercept in cancer patients with toxicity profile on infections. Summary incidences, relative risk (RR), odds ratio (OR) and 95% confidence intervals (95% CIs) were calculated by using either random effects or fixed effect models according to the heterogeneity of included studies.

Results

A total of 4310 patients with a variety of solid tumours from 10 prospective clinical trials were included in the meta‐analysis. The incidence of high grade infections associated with aflibercept was 7.3% (95% CI 4.3, 12.0%), with a mortality of 2.2% (95% CI 1.5, 3.1%). In addition, patients treated with aflibercept had a significantly increased risk of developing high grade (RR 1.87, 95% CI 1.52, 2.30; P < 0.001) and fatal (OR 2.16, 95% CI 1.14, 4.11; P = 0.018) infections. No evidence of publication bias was observed. Furthermore, the risk of infections with aflibercept was substantially higher than bevacizumab.

Conclusions

Aflibercept is associated with a significant increased risk of developing severe infections in patients with solid tumours. Frequent clinical monitoring and appropriate management for infections should be emphasized during aflibercept treatment.