Influence of ethanol concentration in the phagocytic function of neutrophils against Klebsiella pneumoniae isolates in an experimental model

Background/Purpose

Although the prevalence of pneumonia or other extrapulmonary infections is higher in people with alcoholism or acute alcohol intoxication, the possible relationship of acute alcohol intoxication to phagocytic function has not been investigated. Our aim was to determine whether acute alcohol intoxication suppresses phagocytic function in human neutrophils.

A Survey of Oregon Emergency Physicians to Assess Mandatory Reporting Knowledge and Reporting Patterns Regarding Intoxicated Drivers in the State of Oregon

Objectives: To assess emergency physician reporting patterns in Oregon before and after the passage of a mandatory intoxicated driving reporting law. Methods: A one‐page survey was mailed to 504 emergency physicians in Oregon in April 2004. Data on reporting frequency were collected using a four‐point ordinal scale regarding motor vehicle crash–involved drivers (MIDs) and intoxicated persons attempting to drive away from the emergency department (DAEDs). Paired observations were assessed for a stated increase in reporting activity following passage of the law using the Wilcoxon signed‐rank test. Associations of postlaw reporting and demographic and knowledge factors were sought using Spearman rank correlation analysis. Results: Of the 504 surveys mailed, 298 (59%) were adequate for analysis. Many respondents (57%) were already aware of the law. Most (92%) agreed that physicians should be mandated to report some crimes. MIDs were always reported by 18% of physicians before the law and by 47% afterward, whereas DAEDs were always reported by 56% of physicians before the law and by 69% afterward. Emergency medicine–trained physicians, higher emergency department census, and increased years of experience were associated with a significantly higher increase in reporting pattern after passage of the law for both MIDs and DAEDs. Conclusions: Although 44% of responding emergency physicians in Oregon were unaware of a mandated reporting law for intoxicated drivers presenting to the ED, most physicians stated an increase in their reporting practice.     

Genome‐wide and digital polymerase chain reaction epigenetic assessments of alcohol consumption

The lack of readily employable biomarkers of alcohol consumption is a problem for clinicians and researchers. In 2014, we published a preliminary DNA methylation signature of heavy alcohol consumption that remits as a function of abstinence. Herein, we present new genome‐wide methylation findings from a cohort of additional subjects and a meta‐analysis of the data. Using DNA from 47 consecutive heavy drinkers admitted for alcohol detoxification in the context of alcohol treatment and 47 abstinent controls, we replicate the 2014 results and show that 21,221 CpG residues are differentially methylated in active heavy drinkers. Meta‐analysis of all data from the 448,058 probes common to the two methylation platforms shows a similarly profound signature with confirmation of findings from other groups. Principal components analyses show that genome‐wide methylation changes in response to alcohol consumption load on two major factors with one component accounting at least 50% of the total variance in both smokers and nonsmoking alcoholics. Using data from the arrays, we derive a panel of five methylation probes that classifies use status with a receiver operator characteristic area under the curve (AUC) of 0.97. Finally, using droplet digital polymerase chain reaction (PCR), we convert these array‐based findings to two marker assays with an AUC of 0.95 and a four marker set AUC of 0.98. We conclude that DNA methylation assessments are capable of quantifying alcohol use status and suggest that readily employable digital PCR approaches for substance consumption may find widespread use in alcohol‐related research and patient care.     

不同量乙醇对家兔血液流变指标的影响

目的观察不同量乙醇对家兔血液流变指标的影响。方法静注乙醇,按每公斤体重累加注入500mL.L-1浓度乙醇0.5g/kg、1.0g/kg、1.5g/kg三个实验组,造成不同量乙醇注入的动物模型,注入乙醇15min后颈静脉抽血,分别测定其血液流变指标变化情况。结果随着乙醇量的加大,高切还原粘度降低,低切还原粘度降低,红细胞刚性指数降低,血沉稍变慢。红细胞聚集指数、血沉方程K值和血浆粘度值基本不变。结论不同乙醇量对血液流变指标有不同程度的改变。     

Adaptation in families raising children with fetal alcohol spectrum disorder. Part I: What has helped

Background There is limited research investigating the lived experiences of parents raising children with fetal alcohol spectrum disorder (FASD). The aim of this paper is to use qualitative analysis to identify how parents have adapted to the experience of raising their child with FASD.

Method Eighty-four parents and caregivers of children with FASD in Ontario, Canada, participated in in-depth, semistructured interviews employing a basic interpretive approach.

Results Parents of children with FASD report a number of strategies, supports, and transformational outcomes. Using interpretative phenomenological analysis, 5 themes were identified: understanding FASD and advocating on their child's behalf, day-to-day adaptation, transformational outcomes, as well as the importance of informal and formal supports.

Conclusions Understanding what families do in order to facilitate adaptation is important when assisting families who may not be adapting as successfully. Continued research looking at the family experience of raising a child with a developmental disability, such as FASD, is necessary.     

纳洛酮对酒精戒断致震颤谵妄患者疗效及安全性对照研究

目的:探讨纳洛酮对酒精戒断所致震颤谵妄的疗效及安全性。方法:将68例震颤谵妄患者随机分为纳洛酮组和地西泮组,各34例;两组在常规对症支持治疗基础上分别静脉滴注纳洛酮和或地西泮,疗程1周。采用酒精戒断状态评定量表(CIWA-Ar)评定疗效,治疗中出现的症状量表(TESS)评定不良反应。结果:纳洛酮组意识恢复时间[(63.3±22.0)h]明显短于地西泮组[(99.8±24.8)h](P0.001);CIWA-Ar评分在治疗后1~4 d明显低于地西泮组(P0.05或P0.01);不良反应中嗜睡出现率明显少于地西泮组(P0.05)。结论:纳洛酮与地西泮治疗酒精戒断所致震颤谵疗效相当,但纳洛酮起效快、不良反应少。     

酒依赖患者自主神经及感觉功能的电生理研究

目的探讨酒依赖(AD)患者自主神经及感觉功能的电生理特征。方法对56例AD患者和30例健康对照者进行交感神经皮肤反应(SSR)体感诱发电位(SEP)及感觉神经传导速度(SCV)测定,分析SSR反应波及SEP上肢N20、下肢P40电位波幅、潜伏期和正中神经、胫神经感觉传导速度。于酒精戒断2个月时随访AD组患者的SSR。结果与正常对照组比较,AD组SSR异常率及反应波缺失率均显著升高(χ~2=7.860,P=0.005;χ~2=64.655,P=0.000)。与正常对照组比较,AD组入组时及酒精戒断后SSR波幅均显著降低,潜伏期显著延长(均P0.01)。与入组时比较,AD组酒精戒断后波幅、潜伏期差异无统计学意义(均P0.05)。AD组与正常对照组SEP上肢N20电位和下肢P40电位波幅、潜伏期及上肢正中神经、下肢胫神经SCV差异均无统计学意义(均P0.05)。AD患者酒依赖持续时间和日饮酒量分别与SSR潜伏期呈正相关(r=0.335,P=0.017;r=0.369,P=0.008),与SSR波幅呈负相关(r=-0.294,P=0.038;r=-0.310,P=0.028)。结论 AD患者存在周围神经损害,以C类交感神经节后纤维和传导痛温觉Aδ纤维功能障碍等小纤维损害为主,深感觉传导路尚无明显影响,SSR可为AD提供周围神经早期损害的客观指标。     

10年间酒精所致精神障碍住院患者流行病学变迁

目的探讨酒精所致精神障碍患者的流行病学及临床特征。方法对2005年1月-2014年12月在攀枝花市第三人民医院诊断为酒精所致精神障碍/酒相关障碍(符合ICD-10诊断标准)的住院病历档案进行回顾性调查分析。结果 10年间共收治酒精所致精神障碍患者986例,住院构成比10年增长约1.5倍,男性961例(97.46%),女性25例(2.54%),男女比例约为38:1,平均发病年龄(46.16±11.92)岁;农民285例(28.9%),工人337例(34.2%),二者占酒精所致精神障碍住院患者的63.1%;病理分型中依赖综合症占33%,精神病性症状占48.1%;伴发躯体疾病中,肝损害142例(14.4%),心血管系统疾病121例(12.3%);平均初饮年龄(25.31±11.07)岁,平均嗜酒年限(21.08±10.91)年。结论酒精中毒导致的精神和躯体障碍逐渐增加,已是一个日趋严重的社会问题,应提倡早期干预,酒精所致精神障碍患者宜尽早戒酒。