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Digestive and Liver Disease : Official... Nov 2022The COVID-19 pandemic is having substantial impacts on the health status of individuals with alcohol use disorder (AUD) and alcohol-associated liver disease (ALD). AUD... (Review)
Review
The COVID-19 pandemic is having substantial impacts on the health status of individuals with alcohol use disorder (AUD) and alcohol-associated liver disease (ALD). AUD and ALD have both been impacted throughout the pandemic, with increases in alcohol use during the early stages of the pandemic, reduced access to treatment during the mid-pandemic, and challenges in managing the downstream effects in the post-COVID era. This review will focus on how the COVID-19 pandemic has impacted AUD and ALD epidemiology and access to treatment, and will discuss to address this rising AUD and ALD disease burden.
Topics: Humans; COVID-19; Pandemics; Liver Diseases, Alcoholic; Alcoholism; Alcohol Drinking
PubMed: 35933291
DOI: 10.1016/j.dld.2022.07.007 -
American Family Physician Mar 2000Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later... (Review)
Review
Alcohol abuse and alcoholism are common but underrecognized problems among older adults. One third of older alcoholic persons develop a problem with alcohol in later life, while the other two thirds grow older with the medical and psychosocial sequelae of early-onset alcoholism. The common definitions of alcohol abuse and dependence may not apply as readily to older persons who have retired or have few social contacts. Screening instruments can be used by family physicians to identify older patients who have problems related to alcohol. The effects of alcohol may be increased in elderly patients because of pharmacologic changes associated with aging. Interactions between alcohol and drugs, prescription and over-the-counter, may also be more serious in elderly persons. Physiologic changes related to aging can alter the presentation of medical complications of alcoholism. Management of alcohol withdrawal in elderly persons should be closely supervised by a health care professional. Alcohol treatment programs with an elder-specific focus may improve outcomes in some patients.
Topics: Aged; Aging; Alcohol-Related Disorders; Alcoholism; Brain; Cognition; Diagnosis, Differential; Ethanol; Humans; Surveys and Questionnaires
PubMed: 10750878
DOI: No ID Found -
Seminars in Liver Disease Feb 2023Alcohol-associated liver disease is a leading cause of mortality and morbidity worldwide. Patients with alcohol-associated liver disease are often diagnosed at advanced... (Review)
Review
Alcohol-associated liver disease is a leading cause of mortality and morbidity worldwide. Patients with alcohol-associated liver disease are often diagnosed at advanced stage and disease spectrum including alcoholic hepatitis, a severe manifestation with a high short-term mortality. Corticosteroid, recommended first-line treatment for patients with alcoholic hepatitis, is a very suboptimal treatment. Although the use of early liver transplantation has increased with consistent benefit in select patients with alcoholic hepatitis, its use remains heterogeneous worldwide due to lack of uniform selection criteria. Over the last decade, several therapeutic targets have evolved of promise with ongoing clinical trials in patients with cirrhosis and alcoholic hepatitis. Even with availability of effective medical therapies for alcohol-associated liver disease, long-term outcome depends on abstinence from alcohol use in any spectrum of alcohol-associated liver disease. However, alcohol use disorder treatment remains underutilized due to several barriers even in patients with advanced disease. There is an urgent unmet need to implement and promote integrated multidisciplinary care model with hepatologists and addiction experts to provide comprehensive management for these patients. In this review, we will discuss newer therapies targeting liver disease and therapies targeting alcohol use disorder in patients with alcohol-associated liver disease.
Topics: Humans; Hepatitis, Alcoholic; Alcoholism; Liver Diseases, Alcoholic; Alcohol Drinking; Treatment Outcome
PubMed: 36572032
DOI: 10.1055/s-0042-1759614 -
Alcohol (Fayetteville, N.Y.) May 2017Chronic alcohol exposure produces widespread neuroadaptations and alterations in gene expression in human alcoholics and animal models. Technological advances in the... (Review)
Review
Chronic alcohol exposure produces widespread neuroadaptations and alterations in gene expression in human alcoholics and animal models. Technological advances in the past decade have increasingly highlighted the role of non-protein-coding RNAs (ncRNAs) in the regulation of gene expression and function. These recently characterized molecules were discovered to mediate diverse processes in the central nervous system, from normal development and physiology to regulation of disease, including alcoholism and other psychiatric disorders. This review will investigate the recent studies in human alcoholics and rodent models that have profiled different classes of ncRNAs and their dynamic alcohol-dependent regulation in brain.
Topics: Alcohol Drinking; Alcoholism; Animals; Brain; Gene Expression Regulation; Humans; MicroRNAs; RNA, Long Noncoding
PubMed: 28438526
DOI: 10.1016/j.alcohol.2017.01.004 -
Alcohol Research & Health : the Journal... 2003Electroencephalography (EEG), the recording of electrical signals from the brain, provides a noninvasive measure of brain function as it is happening. Research using... (Review)
Review
Electroencephalography (EEG), the recording of electrical signals from the brain, provides a noninvasive measure of brain function as it is happening. Research using EEG, as well as event-related potentials (ERPs) and event-related oscillations (EROs), which measure brain activity in response to a specific stimulus, have shown that the brain activity of alcoholics and nonalcoholics differs in some characteristic ways. These differences are consistent with an imbalance between excitation and inhibition processes in the brains of alcoholics.
Topics: Alcoholism; Electroencephalography; Electrophysiology; Evoked Potentials; Humans
PubMed: 15303626
DOI: No ID Found -
Lakartidningen Oct 2017Alcoholic ketoacidosis - a review A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem in the emergency room. Over and above... (Review)
Review
Alcoholic ketoacidosis - a review A chronic alcoholic with severe metabolic acidosis presents a difficult diagnostic problem in the emergency room. Over and above methanol- and ethylene glycol intoxication, alcoholic ketoacidosis is a common but less recognized etiology. The disorder occurs in alcoholics who have had a recent binge drinking followed by the abrupt cessation of alcohol consumption because of abdominal pain and vomiting, with resulting dehydration, starvation, and then a β-hydroxybutyrate dominated ketoacidosis. Laboratory results may be misleading as the common urine-ketone tests may be negative or only weakly positive, since they only respond to acetoacetate. The short-term prognosis is good if treatment including replacement of fluid, electrolytes, glucose and thiamine is provided. However, recent studies have indicated that alcoholic ketoacidosis may be a significant cause of mortality in patients with alcohol dependence.
Topics: Alcoholism; Disease Management; Humans; Ketones; Ketosis
PubMed: 28994854
DOI: No ID Found -
California Medicine Aug 1958"Hidden alcoholics"-those who drink surreptitiously to keep their addiction secret-far out-number the overt habitues of skid rows. The former rather than the latter...
"Hidden alcoholics"-those who drink surreptitiously to keep their addiction secret-far out-number the overt habitues of skid rows. The former rather than the latter should be considered "typical" alcoholics. Even though they have severe problems, they maintain fairly good employment stability and stability in marriage. Yet they steadily deteriorate. Often "hidden" alcoholics go to physicians because of symptoms referable to alcoholism but contrive to conceal their addiction and so make diagnosis difficult. Hence, physicians observing certain kinds of symptoms that cannot be attributed to a readily observable or demonstrable pathologic change should make searching inquiry as to the patient's drinking habits. For not until the proper diagnosis is made in such cases can there be hope of effective treatment.
Topics: Alcoholics; Alcoholism; Humans; Treatment Outcome
PubMed: 13561127
DOI: No ID Found -
The Western Journal of Medicine Sep 1994Alcoholism, a worldwide disorder, is the cause of a variety of neurologic disorders. In this article we discuss the cellular pathophysiology of ethanol addition and... (Review)
Review
Alcoholism, a worldwide disorder, is the cause of a variety of neurologic disorders. In this article we discuss the cellular pathophysiology of ethanol addition and abuse as well as evidence supporting and refuting the role of inheritance in alcoholism. A genetic marker for alcoholism has not been identified, but neurophysiologic studies may be promising. Some neurologic disorders related to longterm alcoholism are due predominantly to inadequate nutrition (the thiamine deficiency that causes Wernicke's encephalopathy), but others appear to involve the neurotoxicity of ethanol on brain (alcohol withdrawal syndrome and dementia) and peripheral nerves (alcoholic neuropathy and myopathy).
Topics: Alcoholic Intoxication; Alcoholism; Brain; Ethanol; Humans; Nervous System Diseases; Peripheral Nerves
PubMed: 7975567
DOI: No ID Found -
Alcoholism, Clinical and Experimental... Aug 2017Alcoholism is a complex and dynamic disease, punctuated by periods of abstinence and relapse, and influenced by a multitude of vulnerability factors. Chronic excessive... (Review)
Review
Alcoholism is a complex and dynamic disease, punctuated by periods of abstinence and relapse, and influenced by a multitude of vulnerability factors. Chronic excessive alcohol consumption is associated with cognitive deficits, ranging from mild to severe, in executive functions, memory, and metacognitive abilities, with associated impairment in emotional processes and social cognition. These deficits can compromise efforts in initiating and sustaining abstinence by hampering efficacy of clinical treatment and can obstruct efforts in enabling good decision making success in interpersonal/social interactions, and awareness of cognitive and behavioral dysfunctions. Despite evidence for differences in recovery levels of selective cognitive processes, certain deficits can persist even with prolonged sobriety. Herein is presented a review of alcohol-related cognitive impairments affecting component processes of executive functioning, memory, and the recently investigated cognitive domains of metamemory, social cognition, and emotional processing; also considered are trajectories of cognitive recovery with abstinence. Finally, in the spirit of critical review, limitations of current knowledge are noted and avenues for new research efforts are proposed that focus on (i) the interaction among emotion-cognition processes and identification of vulnerability factors contributing to the development of emotional and social processing deficits and (ii) the time line of cognitive recovery by tracking alcoholism's dynamic course of sobriety and relapse. Knowledge about the heterochronicity of cognitive recovery in alcoholism has the potential of indicating at which points during recovery intervention may be most beneficial.
Topics: Alcoholism; Biomedical Research; Cognition Disorders; Executive Function; Forecasting; Humans; Memory; Memory Disorders; Recovery of Function; Social Behavior
PubMed: 28618018
DOI: 10.1111/acer.13431 -
World Journal of Gastroenterology Oct 2014Excessive ethanol consumption affects virtually any organ, both by indirect and direct mechanisms. Considerable research in the last two decades has widened the... (Review)
Review
Excessive ethanol consumption affects virtually any organ, both by indirect and direct mechanisms. Considerable research in the last two decades has widened the knowledge about the paramount importance of proinflammatory cytokines and oxidative damage in the pathogenesis of many of the systemic manifestations of alcoholism. These cytokines derive primarily from activated Kupffer cells exposed to Gram-negative intestinal bacteria, which reach the liver in supra-physiological amounts due to ethanol-mediated increased gut permeability. Reactive oxygen species (ROS) that enhance the inflammatory response are generated both by activation of Kupffer cells and by the direct metabolic effects of ethanol. The effects of this increased cytokine secretion and ROS generation lie far beyond liver damage. In addition to the classic consequences of endotoxemia associated with liver cirrhosis that were described several decades ago, important research in the last ten years has shown that cytokines may also induce damage in remote organs such as brain, bone, muscle, heart, lung, gonads, peripheral nerve, and pancreas. These effects are even seen in alcoholics without significant liver disease. Therefore, alcoholism can be viewed as an inflammatory condition, a concept which opens the possibility of using new therapeutic weapons to treat some of the complications of this devastating and frequent disease. In this review we examine some of the most outstanding consequences of the altered cytokine regulation that occurs in alcoholics in organs other than the liver.
Topics: Alcohol Drinking; Alcoholism; Animals; Cytokines; Ethanol; Humans; Inflammation; Inflammation Mediators; Liver; Liver Diseases, Alcoholic; Oxidative Stress; Prognosis; Reactive Oxygen Species; Risk Assessment; Risk Factors
PubMed: 25356029
DOI: 10.3748/wjg.v20.i40.14660