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The disease theory of alcoholism, and by extension, of addiction, forms the theoretical basis of an expansive scientific industry, one which musters tremendous resources in the service of research, rehab clinics, and government programs. Revisiting the early work on the disease theory of alcoholism, this paper analyzes the apperance of the disease theory of alcoholism in the eighteenth/nineteenth century works of Rush, Trotter, and Brühl-Cramer as emergent of a theoretical tension within the Brunonian system of medicine, that of stimulus dependence. Establishing both the shared Brunonianism of these figures and the concept of stimulus dependence, I argue it is here that one finds the nascent formulation of the modern dependence model of addiction, pushing out alternative models, such as Hufeland's toxin theory., Competing Interests: Declaration of competing interest The author has no conflicts of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: There have been few large-scale nationally representative studies on the prevalence of substance use among doctors. In addition, the association of different medical specialties with the use of different substances requires further research., Aims: To investigate how the use of alcohol, tobacco and illicit drugs varied between junior doctors enrolled in different specialty training programmes., Methods: A secondary analysis was conducted on a national survey of 12 252 Australian doctors. The population of interest was junior doctors currently enrolled in a specialty training programme, termed vocational trainees (VT; n = 1890; 15.4% of the overall sample). Self-report prevalence of current alcohol, tobacco and illicit drug use were assessed and hazardous alcohol use was assessed using the Alcohol Use Disorders Identification Test. Logistic regression was used to examine the association between specialty and substance use, adjusting for demographic characteristics when required., Results: One in six VT reported hazardous levels of alcohol use (n = 268; 17.3%). After adjusting for confounders, the association between the prevalence of alcohol use and the specialties of emergency medicine/intensive care unit (odds ratio (OR) 2.15; 95% confidence interval (CI) 1.40-3.32; P < 0.001), anaesthetics (OR 2.53; 95% CI 1.35-4.76; P = 0.004) and obstetrics/gynaecology (OR 1.89; 95% CI 1.19-3.02; P = 0.007) remained significant. No significant associations were found between tobacco use/illicit drug use/hazardous alcohol use and medical specialty., Conclusions: While rates of substance use and hazardous alcohol use in VT are similar, if not lower, than the general population, it poses a concern that there are higher rates of alcohol use in certain medical specialties., (© 2022 Royal Australasian College of Physicians.)

Abstract Background External causes of death, such as accidents, substance use, and suicide, contribute substantially to mortality during adolescence and early adulthood and show marked sex differences. Individuals born preterm are at increased risk of mental disorders, and impaired cognitive and executive functions, potentially increasing their vulnerability to death from external causes. We investigated sex-specific associations between gestational age at birth and mortality from external causes during late adolescence and early adulthood. Methods Individual level data from national health registries in Denmark (1978–2001), Finland (1987–2003), Norway (1967–2002), and Sweden (1974–2001) were linked to form nationwide cohorts. In total, 6,924,697 participants were followed from age 15 years to a maximum of 50 years in 2016–2018. Gestational age was categorized as “very/moderately preterm” (23–33 weeks), “late preterm” (34–36 weeks), “early term” (37–38 weeks), “full term” (39–41 weeks), and “post term” (42–44 weeks). Outcomes were mortality from external causes overall and from the largest subgroups transport accidents, suicide, and drugs or alcohol. We estimated sex-specific hazard ratios (HRs), with full term as the reference, and pooled each country’s estimates in meta-analyses. Results Across gestational ages mortality was higher for males than females. Individuals born very/moderately preterm had higher mortality from external causes, with HRs 1.11 (95% confidence interval [CI] 0.99–1.24) for males and 1.55 (95% CI 1.28–1.88) for females. Corresponding estimates for late preterm born were 1.11 (95% CI 1.04–1.18) and 1.15 (95% CI 1.02–1.29), respectively. Those born very/moderately preterm had higher mortality from transport accidents, but precision was low. For females, suicide mortality was higher following very/moderately preterm birth (HR 1.76, 95% CI 1.34–2.32), but not for males. Mortality from drugs or alcohol was higher in very/moderately and late preterm born males (HRs 1.23 [95% CI 0.99–1.53] and 1.29 [95% CI 1.16–1.45], respectively) and females (HRs 1.53 [95% CI 0.97–2.41] and 1.35 [95% CI 1.07–1.71], respectively, with some heterogeneity across countries). Conclusions Mortality from external causes overall was higher in preterm than full term born among both males and females. A clear sex difference was seen for suicide, where preterm birth was a risk factor in females, but not in males.

Abstract Background Epigenome‐wide association studies have identified multiple DNA methylation sites (CpGs) associated with alcohol consumption, an important lifestyle risk factor for cardiovascular diseases. This study aimed to test the hypothesis that an alcohol consumption epigenetic risk score (ERS) is associated with blood pressure (BP) traits. Results We implemented an ERS based on a previously reported epigenetic signature of 144 alcohol-associated CpGs in meta-analysis of participants of European ancestry. We found a one-unit increment of ERS was associated with eleven drinks of alcohol consumed per day, on average, across several cohorts (p

Abstract The prevalence of alcohol use disorder was found 75% higher among amphetamine dependent patients. Alcohol and amphetamine alone have nephrotoxicity and hepatoxicity. But, the degree of risk with coabuse of alcohol and amphetamine is unknown. The objective of this study was to assess toxic effects of amphetamine-alcohol co-abuse on the liver and kidney. he present study was a cross-sectional study conducted et al. Amal Hospital for Mental Health, Qassim region, KSA and include one hundred participants. Seventy-five participants were patients hospitalized for the treatment of abuse, and twenty-five participants, were healthy voluntaries, have no history of abuse. An experienced psychiatrist conducted patient interviews and assessed the patients using the DSM-5 criteria. The data from healthy participants were considered as a control. The abuse group was paired with the control group by age and lifestyle. Participants were split into: Group I: Control group (n = 25); Group II: Amphetamine (AMP) abuser group (n = 25); Group III: Alcohol abuser group (n = 25) and Group IV: Combined drug abuser group (AMP and alcohol) (n = 25). The socio-demographic data was collected. Complete medical examination, Body Mass Index and samples of blood and urine were collected from all participants for analytical tests; determination of alcohol and AMP levels, kidney functions and liver functions. The mean BMI values in groups II, III, and IV showed no significant change from the control group. The serum level of albumin and alkaline phosphatase showed significant decrease in all abuser groups. While, alanine transaminase (ALT), Aspartate transaminase (AST) and osteopontin levels showed significant increase in all abuser groups. Fasting blood sugar values showed significant increase in alcohol abusers. On the other hand, it revealed no significant change in AMP and combined groups. The mean values of urea showed no significant change in AMP and alcohol abusers and significant increase in combined drug abuser group. The serum creatinine and all abuser groups showed significant increase in Cystatin C. The alteration in the most of studied biochemical parameters were more than two folds in combined group compared with that of AMP or alcohol groups. Study reveals synergistic liver and kidney toxicity. Amphetamine-alcohol co-abuse significantly heightens kidney and liver toxicity.

Abstract This study aimed to determine whether punitive state alcohol policies targeting pregnant women who drink alcohol are associated with decreased alcohol consumption among pregnant women over time. This study used data from the Pregnancy Risk Assessment Monitoring System (15 states) between 1990 and 2015. A difference-in-difference (DiD) approach was employed to determine whether passage of state laws changed alcohol consumption rates among pregnant women, while controlling for state and time fixed effects. The study specifically examined punitive state alcohol policies that clarify the admissibility of evidence in child welfare proceedings related to prenatal alcohol exposure, focusing on allegations of child abuse, child neglect, child deprivation, or child dependence, as well as proceedings seeking termination of parental rights. Punitive state alcohol policies were not significantly associated with decreased rates of alcohol consumption among pregnant women (+ 1.54%, 95% CI, -1.47-4.55), within 3 years of implementation. State alcohol policies that adopted a punitive stance toward pregnant women who drink alcohol did not result in the reduction of drinking during pregnancy. Given that punitive policies may not effectively reduce alcohol consumption during pregnancy, our findings highlight the need for reevaluation and potential reform to better address maternal/child health outcomes.

Background: Alcohol and tobacco use are among the major risk factors for causing hypertension in the adult population globally as well as in India. India being a religious country harbor’s large number of Hindu temples which are conventionally managed by a dedicated population of Hindu priests. The prevalence of alcohol and tobacco use in this special population of priests in India is not well established along with the associated risk of hypertension. Aims and Objectives: First, to study the pattern of use of habit-forming substances; tobacco, alcohol, and cannabis derivatives among priests in central India. Second, to find the relationship between the use of tobacco smoking, chewing, and alcohol with hypertension. Materials and Methods: The current study is a cross-sectional survey on Hindu priests of registered temples of a Pilgrimage city in Central India. The study utilizes a pre-tested semi-structured questionnaire for interviewing 440 study participants. It included a sociodemographic profile, history of use of habit-forming substances, the presence of known hypertension, and measurement of blood pressure. Results: Out of 440 study participants; 280 (63.6%) were currently using habit-forming substances, whereas 160 (36.4%) number of participants had never used it. The current study found the prevalence of hypertension to be 31.9%. A statistically significant relationship of hypertension with the use of alcohol (χ2=44.2), tobacco chewing (χ2=106.1), and smoking (χ2=74.3) was found. Conclusion: The current study concludes that the use of Habit-forming substances, especially alcohol, tobacco chewing, and smoking, are prevalent among priests which are known risk factors for hypertension in the general population. Hence all screening/interventions applicable for these risk factors should be applied to this special population of priests.

Background Stroke, as a major chronic non-communicable disease, seriously affects the health of the nation and imposes a heavy burden on patients, families and society. Alcohol consumption is common in China, and there is a close relationship between alcohol intake and stroke incidence, but the relationship between alcohol intake and stroke incidence is still controversial. Objective To investigate the relationship between alcohol intake and risk of stroke. Methods PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, Wanfang Data, and SinoMed were searched for prospective cohort studies on the relationship between alcohol intake and risk of stroke from inception to December 2023. Literature screening, data extraction, and literature quality evaluation were performed independently by 2 researchers. Stata/MP 17.0 was used for dose-response meta-analysis. Results A total of 16 papers with 548 595 study subjects were included. Meta-analysis results showed that alcohol intake was associated with the risk of stroke (RR=1.17, 95%CI=1.10-1.26, P40 g increased the risk of stroke by 35% (RR=1.35, 95%CI=1.23-1.49, P

(1) Background: The aim of this review was to identify and summarize adverse cardiovascular health events associated with the simultaneous consumption of energy drinks (ED) and alcohol. Potential prevention strategies and the implementation of research toward the underlying mechanisms for these pathologies were highlighted to emphasize the need for further investigation and to encourage more attention to this field. (2) Methods: The PubMed database was searched for case reports linked with adverse cardiovascular events after simultaneous ED and alcohol consumption. Inclusion criteria were: the reported age of the patient is between 16 and 35 years and confirmed co-consumption of EDs and alcohol. All relevant articles that met the inclusion criteria were fully read and all relevant data was extracted. The extracted data was summarized and presented in this review of cases. (3) Results: In total, 10 cases were identified. The analysis showed that mainly young adults (median age = 24.5 years), in particular men (80%) were affected. The three parts of the cardiovascular system affected were heart rhythm (42%), myocardial function (33%), and coronary arteries (25%). In 3 cases the outcome was fatal. Moreover, preexisting health conditions and/or potential trigger factors were present in 60% of selected cases. (4) Conclusions: This review of case reports suggests that the simultaneous consumption of EDs and alcohol can lead to adverse cardiovascular health events and even incidents with fatal outcomes were reported. Potential trigger factors and preexisting health conditions seem to increase the probability of adverse cardiovascular health events. Consumers should be informed about the potential risks and follow responsible consumption behavior to prevent future health events. More systematic studies are needed to determine the acute effects on the cardiovascular system in young adults.

Background: Consumption of alcohol by secondary school students is a major public health concern globally, but its prevalence is not known in secondary schools in Port Harcourt. Objective: To determine the prevalence and factors associated with alcohol use among secondary school students in Port Harcourt. Methods: This was a cross sectional school based study conducted in Port Harcourt in March 2014. A 20 itemed structured, self -administered questionnaire was distributed to 1080 senior secondary 1 to 3 students from 10 public secondary schools selected through Multistage Sampling technique. Questions asked covered drinking of alcohol, frequency of drinking and being drunk in the past 30 days before the survey. Other behaviours sought were smoking of cigarette, use of cocaine and going out in the evening for fun. Sociodemographic was also sought. Data was analyzed using SPSS version 20. Results: 1080 students participated in the study, mean age 16.09±6SD and male to female ratio of 0.9: 1. Prevalence of current drinking of alcohol was 30.6% and 38.1% of current drinkers were also drunk in the past 30 days, with 17.2 % being very frequently drunk. The behaviour which showed a strong association with drinking of alcohol, being drunk and the frequency of being drunk was going out in the evening for fun and recreation. Gender showed a positive association with drinking of alcohol, as more males drank alcohol with in the past 30 days compared to the females (p=0.000). Smoking of cigarette in the past 30 days and truancy were positively associated with being drunk, while academic grades showed an inverse relationship with consumption of alcohol. Majority of those who drank alcohol (42.6%) were experimenting with alcohol, though 5.4% drank due to addiction. Majority (39.3%) bought their drinks from stores and supermarkets. The most Common problems experienced by the drinkers were fatigue, alcohol made them behave in ways they later regretted and it hurt their relationships. Conclusion: Alcoholism is a serious problem with secondary school students in Port Harcourt. It is linked with truancy, poor academic achievement and other substances use. The most serious health and social problem experienced by the drinkers is addiction.

Abstract Korean dramas (K-dramas), with their unique characteristics, often encourage binge-watching. Moreover, the cultural norms and rituals surrounding alcohol, prevalent in South Korea, are mirrored in K-dramas that have gained global audiences in recent years. The present study aimed to examine problematic K-drama series watching, and the potential associations with alcohol consumption among global adult audiences from Israel and Indonesia. An online questionnaire was distributed to a non-probability convenience sample of 638 adult viewers of K-drama, of whom 383 (60%) were Indonesian and 255 (40%) were Israeli. Fifteen percent of the audiences were identified as displaying problematic K-drama series watching, 36% reported ever drinking Soju (the traditional unique Korean drink), 41% reported drinking alcohol in the past 3 months, and 24% reported binge drinking in the past 12 months. Participants who were higher in problematic K-drama series watching were more likely to be involved with drinking Soju, drinking alcohol in the past 3 months, and binge drinking in the last year. Indonesians and Israelis have significantly different viewing patterns and alcohol consumption. 21.2% of Israelis identified as problematic K-drama series watching compared to 10.7% of Indonesians. Greater percentage of the Israelis have reported consumption of alcohol than Indonesians. Multiple linear regression for problematic K-drama series watching revealed that Israeli audiences, younger age, being defined as a fan, being a member of a K-drama social network, higher number of weekly hours spent watching, and greater number of dramas being watched per month were associated with more problematic K-drama series watching. Series binge-watching may entail potentially negative health and social consequences and professionals should pay more attention to this type of problematic behavior. The identification of problematic K-drama series watching and its association with increased alcohol consumption, suggests the need for health policymakers to consider cultural influences on media alcohol messages consumption.

Abstract Background Aldehyde dehydrogenase 2 (ALDH2) is critical for alcohol metabolism by converting acetaldehyde to acetic acid. In East Asian descendants, an inactive genetic variant in ALDH2, rs671, triggers an alcohol flushing response due to acetaldehyde accumulation. As alcohol flushing is not exclusive to those of East Asian descent, we questioned whether additional ALDH2 genetic variants can drive facial flushing and inefficient acetaldehyde metabolism using human testing and biochemical assays. Methods After IRB approval, human subjects were given an alcohol challenge (0.25 g/kg) while quantifying acetaldehyde levels and the physiological response (heart rate and skin temperature) to alcohol. Further, by employing biochemical techniques including human purified ALDH2 proteins and transiently transfected NIH 3T3 cells, we characterized two newly identified ALDH2 variants for ALDH2 enzymatic activity, ALDH2 dimer/tetramer formation, and reactive oxygen species production after alcohol treatment. Results Humans heterozygous for rs747096195 (R101G) or rs190764869 (R114W) had facial flushing and a 2-fold increase in acetaldehyde levels, while rs671 (E504K) had facial flushing and a 6-fold increase in acetaldehyde levels relative to wild type ALDH2 carriers. In vitro studies with recombinant R101G and R114W ALDH2 enzyme showed a reduced efficiency in acetaldehyde metabolism that is unique when compared to E504K or wild-type ALDH2. The effect is caused by a lack of functional dimer/tetramer formation for R101G and decreased Vmax for both R101G and R114W. Transiently transfected NIH-3T3 cells with R101G and R114W also had a reduced enzymatic activity by ~ 50% relative to transfected wild-type ALDH2 and when subjected to alcohol, the R101G and R114W variants had a 2-3-fold increase in reactive oxygen species formation with respect to wild type ALDH2. Conclusions We identified two additional ALDH2 variants in humans causing facial flushing and acetaldehyde accumulation after alcohol consumption. As alcohol use is associated with a several-fold higher risk for esophageal cancer for the E504K variant, the methodology developed here to characterize ALDH2 genetic variant response to alcohol can lead the way precision medicine strategies to further understand the interplay of alcohol consumption, ALDH2 genetics, and cancer.

Abstract Sugarcane is a central crop for sugar and ethanol production. Investing in sustainable practices can enhance productivity, technological quality, mitigate impacts, and contribute to a cleaner energy future. Among the factors that help increase the productivity of sugarcane, the physical, chemical and biological parameters of the soil are amongst the most important. The use of poultry litter has been an important alternative for soil improvement, as it acts as a soil conditioner. Therefore, this work aimed to verify the best doses of poultry litter for the vegetative, reproductive and technological components of sugarcane. The experiment was carried out at Usina Denusa Destilaria Nova União S/A in the municipality of Jandaia, GO. The experimental design used was a complete randomized block design with four replications: 5 × 4, totaling 20 experimental units. The evaluated factor consisted of four doses of poultry litter plus the control (0 (control), 2, 4, 6 and 8 t ha−1). In this study, were evaluated the number of tillers, lower stem diameter, average stem diameter, upper stem diameter, plant height, stem weight and productivity. The technological variables of total recoverable sugar, recoverable sugar, Brix, fiber, purity and percentage of oligosaccharides were also evaluated. It was observed, within the conditions of this experiment, that the insertion of poultry litter did not interfere significantly in most biometric, productive and technological variables of the sugarcane. But it can also be inferred that there was a statistical trend toward better results when the sugarcane was cultivated with 4 t ha-1 of poultry litter.

Signs, including pictograms, present in public space are intended to enforce a specific behavior. Due to their simplicity and unambiguity of the message, they can be an effective tool of public healthcare. The aim of this study was to assess the knowledge referred to the meaning of the sign prohibiting alcohol consumption during pregnancy among first-year medical students who do not have vast knowledge at present level in this field. The study was conducted among academic youth in Poland, and assumed a 5% risk of error, hence, for p

Introduction. Over the past 20 years, opioid consumption in the world has reached epidemic proportions, which has led to an increase in premature mortality and significantly changed the epidemiology of liver diseases. Aim. The study of features of liver injury with combined consumption of opioid drugs and alcohol. Materials and methods. A retrospective analysis of the medical data of 1,540 patients with the diagnoses of "Acute narcotic poisoning" and "Acute methadone poisoning" (ICD-10:Т40.0-Т40.3); 42 acts of forensic medical and forensic histological examination of death cases associated with illegal methadone and alcohol were considered. Clinical, biochemical, and pathohistological studies were used. Histological samples were examined using an Olympus CX 41 microscope in transmitted light, at magnifications of 100, 200, and 400 times. The SPSS Statistics 29.0.0.0 program was used, Pearson's correlation analysis was used, p≤0.05. Results. According to the results of forensic and histological studies, pronounced infiltration of the liver tissue by small lymphocytes (r=0.471, р=0.002) was found in persons with a long history of illegal methadone and alcohol consumption, which was combined with portal fibrosis (r=0.333, р=0.021) and, in some cases, moderate proliferation of bile ducts (r=0.203, p=0.047). Morphometric analysis of liver biopsies revealed sinusoidal dilatation, inflammatory and fibrotic changes of the terminal hepatic venules (r=0.501, p=0.017); sclerotic changes were noted from the expansion of the portal tracts due to fibrosis and to the initial signs of a partial structure violation, which indicates the transition to cirrhosis. Conclusions. The progressive spread of the practice of combined consumption of opioid drugs on the example of methadone and alcohol increases the risk of hepatotoxic effects, in particular, accelerating the development of fibrosis and cirrhosis.

Abstract Objective The objective of the study was to understand the role of self-reported drinking behavior on liver health after achieving sustained viral response (SVR) among HCV patients. Results The study was conducted in HCV treatment provider clinics in three cities in Georgia: Tbilisi, Batumi, and Telavi. Face-to-face interviews were conducted using a questionnaire developed specifically for this study. 9.5% considered themselves heavy drinkers, while 94.2% were aware that heavy alcohol consumption can progress liver fibrosis. During treatment, 97.8% abstained from alcohol, while 76.6% reported resuming drinking after achieving SVR. Additionally, 52.1% believed that moderate alcohol intake is normal for individuals with low fibrosis scores. Liver fibrosis improvement was more prevalent among individuals who abstained from alcohol after HCV diagnosis (85.4% vs. 71.4%, p

Abstract Observational studies have shown controversial associations between alcohol intake and radiographic osteoarthritis (OA). This study investigated whether this association was causal using a Mendelian randomization (MR) study in a population-based cohort in Korean. The study enrolled 2429 subjects (1058 men, 1371 women) from the Dong-gu Study. X-rays of the hand and knee joints were scored using a semi-quantitative grading system to calculate the total score of the hand and knee joints. ALDH2 rs671 genotyping was performed by high-resolution melting analysis. MR instrumental variable analysis and observational multivariable regression analysis were used to estimate the association between genetically predicted alcohol intake and the radiographic severity of OA. Subjects with the G/G genotype had a higher current alcohol intake than those with the G/A and A/A genotypes in both men and women (all P

IntroductionExcessive alcohol consumption is a leading global risk factor for ill-health and premature death. Digital alcohol interventions can be effective at reducing alcohol consumption, but their widespread adoption is lagging behind. This study aimed to identify factors promoting or inhibiting the implementation of a digital alcohol intervention in Norwegian primary care, by using Normalization Process Theory (NPT).MethodsA mixed methods feasibility study combining quantitative and qualitative methods. A digital alcohol intervention called “Endre” was implemented across four GP practices in Stavanger and Oslo. Usage of the intervention was logged on the digital platform. General practitioners (GPs) reported their perceived uptake of the intervention via a web-based survey. The Normalization MeAsure Development (NoMAD) survey was used to measure support staff's perceived normalization of the intervention. Qualitative data were analyzed using the NPT framework, with quantitative data analyzed descriptively and using χ2 and Wilcoxon signed-rank test for differences in current and future normalization.ResultsThirty-seven GPs worked in the clinics and could recruit patients for the digital intervention. Thirty-six patients registered for the intervention. Nine patients dropped out early and 25 completed the intervention as intended. Low normalization scores at follow-up (n = 27) indicated that Endre did not become fully embedded in and across practices. Nonetheless, staff felt somewhat confident about their use of Endre and thought it may become a more integral part of their work in the future. Findings from six semi-structured group interviews suggested that limited implementation success may have been due to a lack of tailored implementation support, staff's lack of involvement, their diminished trust in Endre, and a lack of feedback on intervention usage. The outbreak of the Covid-19 pandemic further limited opportunities for GPs to use Endre.ConclusionThis study investigated the real-world challenges of implementing a digital alcohol intervention in routine clinical practice. Future research should involve support staff in both the development and implementation of digital solutions to maximize compatibility with professional workflows and needs. Integration of digital solutions may further be improved by including features such as dashboards that enable clinicians to access and monitor patient progress and self-reported outcomes.

Objective: We aim to study the “golden youth” hypothesis, which suggests that risky behaviors might be prevalent among affluent adolescents in post-Communist countries of Europe (PCCE) with high income inequality. Methods: We included 71,119 adolescents aged 11–15 from 14 PCCE participating in the Health Behavior in School-aged Children survey 2017/18. A K-means cluster analysis was conducted to group adolescents based on risky behavior. Generalized linear mixed models were fitted. Results: The proportion of high-SEP adolescents in Cluster 2, characterized by frequent alcohol consumption but moderate frequency of drunkenness, was greater than that of low-SEP adolescents (14.3 % vs. 10.7 %). The prevalence of risky behaviors was similar for high and low-SEP adolescents in Cluster 3 (high smoking, frequent alcohol use, drunkenness, and moderate bullying) (8.0 % vs. 8.2 %) and Cluster 4 (high bullying perpetration) (6.7 % vs. 7.2 %). Countries with higher Gini index were at greater risk of reporting risky behaviors. High-SEP adolescents were more likely to engage in risky behaviors in countries with high income inequality. The odds ratios comparing high- vs. low-SEP adolescents ranged from 0.89 in the least unequal to 1.67 in the most unequal countries for multiple risky behaviors (Cluster 3: P-interaction = 0.042) and from 0.61 to 1.19 for bullying perpetration (Cluster 4: P-interaction = 0.030). Conclusions: High-SEP adolescents in PCCE might be at increased risk for unhealthy and vicious behaviors, especially in countries with high income inequality. Redistributive policies decreasing the gap between rich and poor are needed to ensure the health and well-being of adolescents in PCCE.

Background: The use of tobacco, alcohol and other drugs has considerable health consequences. Substance histories are often only incompletely taken in everyday clinical practice. When learning to take a medical history in medical school, one of the learning objectives is to inquire about consumption behavior. The aim of this exploratory study was therefore to examine the content and language of substance histories taken by medical students.Methods: From a simulation training of a first working day in hospital, 91 video films of medical histories were available, which advanced medical students had conducted with six patients with different consumer behavior. These interviews were verbatim transcribed and analyzed using content-structuring qualitative content analysis according to Kuckartz. For all substances, the reasons for the questions and the depth of the respective substance use were categorized and errors in the questions were examined. In addition, a linguistic analysis of the verbal ways in which the substances were inquired about was carried out.Results: The students most frequently asked about smoking (73.3%). In only 15.4% of the interviews were all substances asked about, in none were all substances asked about completely. A total of 112 protocol questions and 21 occasion-related questions were identified. Logical errors and double questions were found. Most of the questions were asked in a factual manner. However, questions in the categories “evasive” and “stigmatizing” were also found.Conclusion: The content-related and linguistic deficits of medical students in the collection of substance histories identified in this study should be addressed in communication courses at an early stage of undergraduate medical studies.

Alcohol consumption in pregnancy can affect genome regulation in the developing offspring but results have been contradictory. We employed a physiologically relevant murine model of short-term moderate prenatal alcohol exposure (PAE) resembling common patterns of alcohol consumption in pregnancy in humans. Early moderate PAE was sufficient to affect site-specific DNA methylation in newborn pups without altering behavioural outcomes in adult littermates. Whole-genome bisulfite sequencing of neonatal brain and liver revealed stochastic influence on DNA methylation that was mostly tissue-specific, with some perturbations likely originating as early as gastrulation. DNA methylation differences were enriched in non-coding genomic regions with regulatory potential indicative of broad effects of alcohol on genome regulation. Replication studies in human cohorts with fetal alcohol spectrum disorder suggested some effects were metastable at genes linked to disease-relevant traits including facial morphology, intelligence, educational attainment, autism, and schizophrenia. In our murine model, a maternal diet high in folate and choline protected against some of the damaging effects of early moderate PAE on DNA methylation. Our studies demonstrate that early moderate exposure is sufficient to affect fetal genome regulation even in the absence of overt phenotypic changes and highlight a role for preventative maternal dietary interventions.

Background: Studies of alcohol analgesia often assume that changes in pain sensitivity reflect the negative reinforcing effects of alcohol in pain self-management. However, factors that may influence perceived pain relief due to alcohol use remain incompletely characterized. Thus, the primary aim of this study was to identify which factors are most strongly related to self-reported pain relief in individuals with and without chronic pain after alcohol consumption. Methods: This study combined data from two studies of alcohol analgesia in individuals who regularly consume alcohol with and without chronic pain. Alcohol analgesia expectancies were assessed during screening. In laboratory sessions, participants received an alcohol-containing (.08 g/dL target BrAC) or placebo beverage and rated subjective intoxication and subjective response (positive/negative aspects of stimulation/sedation). Participants underwent quantitative sensory testing to measure pain intensity, pain threshold, and relief. Paired sample t-tests determined effects of alcohol on pain measures. Hierarchical linear models determined factors associated with pain relief ratings in the alcohol condition. Results: Pain relief and pain threshold were higher in the alcohol session relative to placebo, but pain intensity did not differ. In a 4-step hierarchical linear model, expectancy of pain relief, subjective intoxication, and high positive affect, but not pain threshold or pain intensity, were significantly and uniquely associated with perceived relief. Conclusions: Taken together, results suggest the negative-reinforcing effects of alcohol for pain-management are not completely reflected by changes in pain sensitivity in a laboratory setting. Expectancies and subjective response may be important in determining an individual’s evaluation of alcohol’s efficacy for pain self-management.

Alcohol consumption is an important risk factor for traumatic brain injury (TBI), and it has a great impact on its incidence and severity. However, studies suggest potential beneficial effects of alcohol during hospitalization and in the prognosis of moderate or severe TBI, with conflicting results. The objective of the present study was to associate alcohol consumption and helmet use in TBI patients, as well as the prognostic variables and patterns of injuries secondary to TBI. We analyzed 109 medical records of patients who suffered TBI due to a motorcycle accident. We evaluated data on alcohol consumption, helmet use, TBI severity, and tomographic findings on admission. The subjects with moderate or severe TBI were evaluated regarding hospitalization, mortality and prognosis variables. Patients who wore a helmet at the time of trauma had lower rates of skull fracture and extradural hematoma (EDH), but an increased incidence of subarachnoid hemorrhage (SAH). Furthermore, patients with moderate or severe TBI who were those under alcohol intoxication had a greater need for Intensive Care Unit (ICU) admission and a tendency to have a lower in-hospital mortality rate and a higher score on the Glasgow Prognostic Score (GPS). Thus, although the consumption of alcohol has an impact on the incidence and severity of TBI at admission, it seems to be related to a lower in-hospital mortality rate and a better prognosis. In addition, helmet use is essential to prevent injuries from direct head-to-shield impact, but no similar reduction in the incidence of injuries caused by indirect forces was observed.

Abstract People consume alcohol for multiple reasons. Negative motives are often associated with alcohol-related problems. These problems might be explained by negative effects of high alcohol consumption on empathy. Past studies have associated alcohol use disorder (AUD) with reduced cognitive and affective empathy. Few studies have focused on non-clinical samples and considered behavioral empathy. We examined the links between alcohol consumption and multiple aspects of empathy, and if these links were moderated by negative drinking motives. We collected online data of 520 unselected individuals. All completed the AUD Identification Test (AUDIT) and a Drinking Motives Questionnaire. Affective and cognitive empathy were assessed using the Empathy Quotient. Behavioral empathy was assessed by asking participants how likely they would help the person in each of 24 scenarios involving pain. Helping others in pain was positively predicted by affective and cognitive empathy. Higher AUDIT scores were associated with helping others less, particularly among participants who scored higher on drinking to cope with negative affect. People who drink more and do so to cope with negative affect appear to have less behavioral empathy. This supports the view that negative drinking motives contribute to AUD risk.

Marchiafava-Bignami Disease (MBD) is an unusual neurological illness caused by prolonged alcoholism that is distinguished by demyelination of the corpus callosum. Clinicians encounter a wide range of alcohol-related diseases in their practice, and MBD is a rare condition that requires a high clinical suspicion due to its potential to mimic withdrawal symptoms, Wernicke’s-Korsakoff’s Psychosis, and various other neurological conditions, leading to confusion in diagnosis. It is a toxic-demyelinating syndrome that typically affects chronic alcoholics, but it has been described in rare instances in chronically malnourished teetotalers. The symptoms and warning signs are diffuse, and the onset could be abrupt or gradual. This is a case of a 54-year-old chronic alcoholic who presented with neurological symptoms. Magnetic Resonance Imaging (MRI) of the brain revealed typical features of MBD. The patient was treated with high doses of thiamine along with folic acid and other symptomatic treatments, after which significant improvement was observed. This case report reviews past reported cases to shed light on the varied presentation features of the disease. It adds to the limited corpus of MBD literature and highlights the intricate diagnostic process and management complexities associated with this condition. By integrating clinical observations, neuroimaging findings, and treatment outcomes, this report underscores the importance of maintaining a high clinical suspicion in cases involving alcohol abuse and the significance of tailored therapeutic strategies. As MBD continues to present diagnostic challenges, this report contributes valuable insights into its presentation, progression, and potential pathways to recovery. Therefore, it requires a high clinical suspicion for both clinical and radiological diagnosis.

Diseases of the cardiovascular system (hypertension, coronary heart disease, and heart failure) occupy leading places in the overall pathology structure. A specific feature is a growing share of young people who suffer from cardiovascular diseases (CVDs) in the total population. This is facilitated by physical inactivity, unhealthy diets, elevated stress levels as well as genetic predisposition. Identification of leading risk factors at the latent stage can make for timely diagnostics of cardiovascular pathology in young people. This, in its turn, allows implementing relevant prevention as well as adjusting therapies thereby improving quality of life of each individual patient. Given that, the aim of this study was to assess risk factors causing CVDs in medical university students; to determine severity of existing cardiovascular disorders as well as their relationships with factors that may have caused them. Eight hundred and seventeen students participated in the study. They all took part in a survey to identify risks of developing CVDs with certain adjustments made to an applied questionnaire to adapt it for use among students. Also, the study involved assessing basic anthropometric parameters (height, weight, and body mass index (BMI)), hypertension in family case history, physical activity, time spent with gadgets (use of smartphone), and alcohol consumption. The study revealed that 30 % of the examined people had overweight; more than 54 % abused alcohol; 53 % of the respondents mentioned elevated stress levels. All this creates significantly elevated risks of cardiovascular diseases as well as their complications for young and middle-aged people. The study results clearly indicate elevated risks of cardiovascular pathology and this requires correction of risk factors at an early stage.

Abstract Use of alcohol and other substances remains a major health concern among higher learning institutions. This study aimed at assessing the prevalence of alcohol and other substance use among students at Busitema University in Eastern Uganda. A cross sectional survey was conducted among 658 undergraduate students using a questionnaire consisting of Alcohol, Smoking and Substance Involvement Screening Tool and participant sociodemographic and clinical factors. Logistic regression was used to explore the associations. Two hundred sixty-five (40.3%) students reported ever using alcohol and 158 (24.0%) had used in last 3 months. Seventy-four (11.2%) students reported ever use of other substances including tobacco, cannabis, cocaine, stimulants sedatives and hallucinogens and 36 (5.5%) had used within the recent 3 months. After controlling for potential confounders, recent alcohol use was associated with engaging in romantic relationship (odd ratio (OR) = 1.9, P value (P) = 0.045) while having chronic medical conditions was protective (OR = 0.3, P = 0.031). On the other hand, recent use of other substances was 7 times higher among males (OR = 7.0, P = 0.008) compared to females while fourth year of study was protective (OR = 0.05, P = 0.011). Although alcohol use is a worsening challenge among university students, use of other substances is also highly prevalent after COVID-19 lockdown. There is need for universities to identify students with above factors and design interventions to address them in order to prevent the likely undesirable outcomes of alcohol and substance use.

Impulsivity has well-documented associations with risky alcohol use. Little evidence exists on the causal mechanisms, but emerging experimental evidence suggests a role for reward-related impulsivity. Recent work experimentally increased reward-related impulsivity to increase drinking using standardised reward-cue stimuli. The present study piloted participant-generated reward-cue stimuli to increase laboratory alcohol consumption. Sixteen participants (56.3 % male; Mage = 20.13, SD = 1.78) attended two laboratory sessions (experimental and control). In the experimental session, the Individualised Reward-seeking Induction Schedule (IRIS) had participants re-experience an intense, vivid memory of an approach motivational state (control session: no induction) before completing a laboratory drinking task. Self-reported reward-seeking, positive, and negative affect were measured. IRIS significantly increased alcohol consumption by 53.65 ml (SE = 29.11, p

How does alcohol consumption alter synaptic transmission across time, and do these alcohol-induced neuroadaptations occur similarly in both male and female mice? Previously we identified that anterior insular cortex (AIC) projections to the dorsolateral striatum (DLS) are uniquely sensitive to alcohol-induced neuroadaptations in male, but not female mice, and play a role in governing binge alcohol consumption in male mice (Haggerty et al., 2022). Here, by using high-resolution behavior data paired with in-vivo fiber photometry, we show how similar levels of alcohol intake are achieved via different behavioral strategies across sexes, and how inter-drinking session thirst states predict future alcohol intakes in females, but not males. Furthermore, we show how presynaptic calcium activity recorded from AIC synaptic inputs in the DLS across 3 weeks of water consumption followed by 3 weeks of binge alcohol consumption changes across, fluid, time, sex, and brain circuit lateralization. By time-locking presynaptic calcium activity from AIC inputs to the DLS to peri-initiation of drinking events we also show that AIC inputs into the left DLS robustly encode binge alcohol intake behaviors relative to water consumption. These findings suggest a fluid-, sex-, and lateralization-dependent role for the engagement of AIC inputs into the DLS that encode binge alcohol consumption behaviors and further contextualize alcohol-induced neuroadaptations at AIC inputs to the DLS.

Key Clinical Message Standardized alcohol withdrawal treatments, such as the phenobarbital taper protocol, are effective in the management of alcohol withdrawal syndromes associated with surrogate alcohols including witch hazel toner. Abstract Ingestion of alcohol not intended for consumption, also known as surrogate alcohols, is well‐documented in patients with alcohol use disorder. Ingestion of surrogate alcohols may lead to higher morbidity and mortality than standard alcohol consumption alone. However, management of complications such as withdrawal syndromes in individuals consuming surrogate alcohols has received little attention in the literature. We present the case of a patient with alcohol use disorder who required medically supervised withdrawal following ingestion of witch hazel toner as a surrogate alcohol. Review of patient's history revealed routine ingestion of witch hazel toner as a substitute to traditional alcohols. Witch hazel toner is a non‐FDA regulated product designed for topical use; it is commonly sold in a steam distilled formulation containing 13%–15% ethanol and small amounts of essential oil components, such as carvacrol and eugenol. During hospitalization the patient received treatment of alcohol withdrawal with a phenobarbital taper protocol and was discharged in stable condition. He also received resources for alcohol use disorder to follow‐up in the outpatient setting. To our knowledge this is the first reported case of a patient requiring medically supervised withdrawal following ingestion of witch hazel toner and sheds light on the potential complications and management of patients who present following ingestion.

Abstract Background Sex is an important factor in the progression and treatment of alcohol addiction, and therapeutic approaches may have to be tailored to potential sex differences. This highlights the importance of understanding sex differences in behaviors that reflect key elements of clinical alcohol addiction, such as continued use despite negative consequences (“compulsive use”). Studies in experimental animals can help provide an understanding of the role sex plays to influence these behaviors. Methods Large populations of genetically heterogeneous male and female Wistar rats were tested in an established model of compulsive alcohol self-administration, operationalized as alcohol responding despite contingent foot shock punishment. We also tested baseline (fixed ratio, unpunished) operant alcohol self-administration, motivation to self-administer alcohol (progressive ratio), and temporal discounting for alcohol reward. In search of predictors of compulsivity, animals were screened for novelty-induced place preference, anxiety-like behavior, pain sensitivity and corticosterone levels. The estrous cycle was monitored throughout the study. Results Unpunished self-administration of alcohol did not differ between males and females when alcohol intake was corrected for body weight. Overall, females showed higher levels of compulsive responding for alcohol. Compulsive response rates showed bimodal distributions in male but not in female rats when intermediate shock intensities were used (0.2 and 0.25 mA); at higher shock intensities, responding was uniformly suppressed in both males and females. We also found less steep discounting in females when alcohol was devalued by delaying its delivery. Males exhibited a stronger motivation to obtain alcohol under unpunished conditions, while females showed higher corticosterone levels at baseline. Factor analysis showed that an underlying dimension related to stress and pain predicted compulsivity in females, while compulsivity in males was predicted by a reward factor. We did not find differences in alcohol-related behaviors throughout the various stages of the estrous cycle. Conclusions Our results suggest that mechanisms promoting compulsivity, a key feature of alcohol addiction, likely differ between males and females. This underscores the importance of considering sex as a biological variable in both preclinical and clinical research, and has potential treatment implications in alcohol addiction.

Abstract Objective In the EU, which has the highest drinking levels worldwide, cancer is the primary cause of alcohol-attributable deaths. Existing studies show gaps in public knowledge, but there is lack of systematic appraisal. The report presents original data from a cross-sectional survey conducted within the framework of an online experimental study in 14 European countries, which among other things assessed baseline knowledge of the alcohol-NCD link, particularly cancer. Methods Online questionnaire among adults who consume alcohol conducted in 14 countries in 2022–2023 using different recruitment strategies and applying population weights for the final sample. Baseline assessments measured participants’ knowledge of alcohol-attributable health issues (with a specific focus on cancer). Results Baseline knowledge assessment showed that 90% indicated a causal role of alcohol for liver disease, 68% for heart diseases, and only 53% for cancer. Knowledge of specific alcohol-attributable cancer types was lower, with 39% aware of the link between alcohol use and colon cancer, 28% regarding oral cancer, and only 15% regarding female breast cancer. Knowledge levels varied across different countries and population groups. Conclusion Most Europeans do not know which cancers can be caused by alcohol use and knowledge is low specifically for female breast cancer. More awareness raising and prevention efforts are needed, such as the placement of cancer-specific health warnings on alcohol container labels.

Abstract The association between personal habits and metabolic syndrome (MetS) remains controversial. This study aimed to assess the prevalence of MetS among youths and its association with cigarette, tobacco, opium, and alcohol consumption in the Rafsanjan Youth Cohort Study (RYCS). The current cross-sectional study was based on data from RYCS, as part of the Rafsanjan Cohort Study (RCS). RCS is a branch of the prospective epidemiological research studies in Iran (PERSIAN). In the present study, 2843 youths aged 15–35 were included. MetS was diagnosed using the international diabetes federation (International IDF), National Cholesterol Education Panel- Adult Treatment Panel III (NCEP-ATPIII), and Iranian criteria (IDF Iranian). Binary logistic regression models were performed to estimate odds ratios (ORs) and confidence intervals (CIs). The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS according to international IDF and Iranian IDF in the alcohol-drinking group in the last 12 months (OR: 1.51, 95%CI 1.02–2.21, OR: 1.66, 95%CI 1.11–2.48 respectively) were greater compared with the non-drinking group. The odds of having high TG in the alcohol-drinking group in the last 12 months was 1.53 times higher than the control group (OR = 1.53, 95% CI: 1.20–1.94). Furthermore, the odds of having high waist circumference (WC) according to IDF International was significantly higher in the tobacco-smoking group in the last 12 months and in the tobacco-smoking group in the last 12 months daily (OR: 1.23, 95%CI 1.01–1.49 and OR: 1.41, 95%CI 1.01–1.98 respectively) compared to the control groups. The prevalence of MetS was 7.67%, 7.14%, and 10.13% based on NCEP-ATPIII, IDF Iranian, and International IDF criteria respectively. The odds of MetS and high TG were greater in the alcohol-drinking group in the last 12 months compared with the non-drinking group. The odds of high WC in the last 12 months, were greater in the tobacco-smoking group compared with the non-smoking group. However, more longitudinal studies are needed to verify the associations observed in the current study.

Abstract The risk of having atrial fibrillation (AF) is associated with alcohol intake. However, it is not clear whether sudden cardiac arrest (SCA) and ventricular arrhythmia (VA) including ventricular tachycardia, flutter, or fibrillation have similar associations with alcohol. We aimed to evaluate the association of alcohol intake with all-cause death, new-onset AF, VA, and SCA using single cohort with a sufficient sample size. A total of 3,990,373 people without a prior history of AF, VAs, or SCA was enrolled in this study based on nationwide health check-up in 2009. We classified the participants into four groups according to weekly alcohol consumption, and evaluated the association of alcohol consumption with each outcome. We observed a significant association between mild (hazard ratio [HR] = 0.826; 95% confidence interval [CI] = 0.815–0.838) to moderate (HR = 0.930; 95% CI = 0.912–0.947) drinking with decreased risk of all-cause mortality. However heavy drinking (HR = 1.108; 95% CI = 1.087–1.129) was associated with increased all-cause death. The risk of new-onset AF was significantly associated with moderate (HR = 1.129; 95% CI = 1.097–1.161) and heavy (HR = 1.298; 95% CI = 1.261–1.337) drinking. However, the risk of SCA showed negative association with all degrees of alcohol intake: 20% (HR = 0.803; 95% CI = 0.769–0.839), 15% (HR = 0.853; 95% CI = 0.806–0.902), and 8% (HR = 0.918; 95% CI = 0.866–0.974) lower risk for mild, moderate, and heavy drinkers, respectively. Mild drinking was associated with reduced risk of VA with moderate and heavy drinking having no associations. In conclusion, the association between alcohol and various outcomes in this study were heterogeneous. Alcohol might have different influences on various cardiac disorders.

Background and Aim: Monitoring alcohol consumption in population is very important for planning public health and evaluation of the efficiency of intervention strategies. The aim of this study was to use wastewater-based epidemiology (WBE) to estimate alcohol consumption in a Kermanshah City and calculate risk assessment using the margin of exposure (MOE) approach. Materials and Methods: Raw composite wastewater samples (5 hours) were collected form the entrance of Kermanshah wastewater plant over a 30 days’ period. Ethyl sulfate metabolite was used to measure the alcohol content of the samples, which is excreted in the urine after consuming alcohol by humans and enters into the wastewater collection network. After centrifugation and filtration, the samples were directly injected into the liquid chromatography with tandem mass spectrometry LC-MS/MS for analysis. After calculation of alcohol consumption rate with back-calculation method, the results were used for risk assessment by MOE. Results: In general, the average amount of alcohol consumption during sampling in the society was 0.332 ml per person of equal age and over 15 years of age (adult) per day, which was equal to 0.121 liters of pure alcohol per person per year. We found no significant difference in the amount of alcohol consumption between the weekend and working days of the week, and also between sampling days in Ramadan and ordinary days. In 90% of the samples taken, the risk associated with alcohol consumption was higher than MOE=100 and only in 3 samples the MOE value was in the "risk" category. Conclusion: The results of this study showed that wastewater-based epidemiology can provide appropriate timely and transisional information on alcohol use and its associated exposure risks in the community. Also, the amount of alcohol consumption in the population in our study was much lower than those in the European and American countries.

Venom from a snake is extremely uncommonly consumed by humans. It can be administered in a variety of ways, including a direct bite on the tongue or other parts of the body, or it can be taken as a venom pill at rave parties. The belief is that upon consumption, it provides virility, a sense of elation, and excitement, among other effects. However, it is more often dangerous to the human body and can even be fatal. Only a very small number of cases have been described in publications. In the present case report, a 36-year-old male patient who was an alcoholic and had a history of psychiatric disease initially arrived with anxiety as a result of having consumed snake venom the day before. As for the patient’s vital signs, they were acceptable. For observation, the patient was admitted to the intensive care unit reserved for medicine. However, antisnake venom was not administered. After 24 hours, he was released from the hospital. This is an unusual case where the patient was relatively unharmed after the consumption and didn’t show any obvious lasting effects on the neurological or haematological systems. If the venom is not effectively broken down in the intestines and is absorbed as such, drinking snake venom can have deadly repercussions. The treatment is determined by the features that the patient presents. In the present case, antivenom was not administered, as the need was not justified. However, there may arise situations in other cases where it should be administered sparingly.

Introduction Oxidative and antioxidant pathways play essential roles in the development of alcohol-induced brain injury. The Nrf2 pathway is an endogenous antioxidant response pathway, but there has been little research on the role of Nrf2 in alcohol-related diseases. Thus, we examined the effects of alcohol and an Nrf2 agonist (TBHQ) on astrocyte function, mRNA expression, and metabolite content to further explore the protective mechanisms of Nrf2 agonists in astrocytes following alcohol exposure. Methods CTX TNA2 astrocytes were cultured with alcohol and TBHQ and then subjected to transcriptome sequencing, LC-MS/MS analysis, quantitative reverse transcription polymerase chain reaction (qRT-PCR), and malondialdehyde (MDA) and superoxide dismutase (SOD) activity assays. Results Alcohol exposure significantly increased malondialdehyde (MDA) levels while decreasing superoxide dismutase (SOD) levels in astrocytes. Treatment with TBHQ effectively reversed these effects, demonstrating its protective role against oxidative stress induced by alcohol. Transcriptome sequencing and qRT-PCR analysis revealed that TBHQ specifically upregulates genes involved in glutathione metabolism, including a notable increase in the expression of the glutathione S-transferase A5 (GSTA5) gene, which was suppressed by alcohol exposure. Additionally, metabolomic analysis showed that TBHQ regulates key components of ether lipid metabolism in alcohol-exposed astrocytes, with significant reductions in the levels of lysophosphatidylcholine (18:0) (LysoPC (18:0)) and 2-acetyl-1-alkyl-sn-glycero-3-phosphocholine, both of which are critical markers in the ether lipid metabolic pathway. Discussion The findings underscore the role of TBHQ as an Nrf2 agonist in mitigating alcohol-induced oxidative damage in astrocytes by modulating glutathione metabolism and ether lipid metabolism. The regulation of GSTA5 gene expression emerges as a key mechanism through which Nrf2 agonists confer neuroprotection against oxidative stress and lipid oxidation. These insights pave the way for potential therapeutic strategies targeting the Nrf2 pathway to protect astrocytes from alcohol-induced damage.

Background: There is strong evidence that alcohol consumption is a significant risk factor for fatal road traffic accidents. It is estimated that the number of alcohol-related road accidents remains high in the past few years in Lithuania. This study aims to examine the prevalence of alcohol in blood samples collected from the autopsy results of road traffic accident victims. Materials and methods: A retrospective study of 136 road traffic accident victims was performed in State Forensic Medicine Service of Lithuania in the period of 2013 to 2023. We analyzed blood alcohol concentration (BAC) in relation to sex, age, road user type, place and time of the day at death. Results: 31% of the victims were under influence of alcohol at the time of death, with mean BAC 1.99 ± 0.92‰. The mean BAC was 2.16 ± 0.8‰ in male and 1.18 ± 1.12‰ in female group. By the type of road users, 23% of the pedestrians (mean BAC 2.45 ± 0.71‰), 32% of car drivers (mean BAC 2.13 ± 0.75‰), 41% of vehicle passengers (mean BAC of 1.73 ± 1.19‰), 37% of the motorcycle riders (mean BAC of 1.28 ± 0.53‰), 37% of the cyclists (mean BAC of 1.15 ± 0.75‰) were found to be intoxicated during the time of accident. Highest mean blood alcohol concentration was found during the night time hours (9 p. m. – 5 a. m.) 2.28 ± 0.91, comparing to in afternoon hours (12 p. m. – 5 p. m.) 1.49 ± 0.99, evening hours (5 p. m. – 9 p. m.) 2.10 ± 0.73 and morning hours (5 a. m. – 12 p. m.) 1.94 ± 1.00. The mean BAC in road traffic accidents during summer was 1.48 ± 0.71‰, spring 2.25 ± 0.76‰, autumn 2.12 ± 1‰, winter 2.42 ± 1‰. Conclusions: Alcohol consumption by road users is a significant contributing factor in road traffic accidents and their outcomes in Lithuania.

Introduction and purpose: Ethanol is still one of the most frequently consumed drugs worldwide and is a strong risk factor for more than 60 illnesses including alcoholic cardiomyopathy which is a specific heart muscle disease caused by long-term excessive alcohol consumption. The review aims to gather available data and summarize it to give better understanding of the disease, to help select patients with the condition to implement proper treatment, and to present possible future directions as the incidence of the disease is projected to persist in the future. Brief description of the state of knowledge: Alcoholic cardiomyopathy (ACM) is characterized by dilation, increased mass of the left ventricle, and reduced ejection fraction leading to end-stage heart failure. It is caused by ethanol’s direct toxicity on myocytes disturbing many different metabolic pathways. The result is a decrease in both systolic and diastolic function of the heart. The ACM development depends on factors such as genetics, gender, dietary factors and the dosage of ethanol consumption. The goal of the treatment is total alcohol abstinence, but the reduction of ethanol intake may also be beneficial. Patients should obtain a complete pharmacological treatment for heart failure. Summary: Ethanol overconsumption remains an unresolved problem, with the incidence of ACM projected to persist in the future, especially among patients with alcohol use disorder (AUD). Efforts for prevention, early detection, and effective treatment of ACM need to be established. A primary focus should be on treating AUD because it is the most effective way to halt the progression of the disease. Further research should focus on both asymptomatic and symptomatic patients with AUD to better define clinical manifestations, diagnostic approaches, and the most effective treatments for ACM.

BackgroundAlcohol and cannabis use constitutes the major public health problems in Greenland. Thus, it is important to assess if Allorfik, a new national outpatient addiction treatment service introduced in 2016, was implemented successfully and how it is perceived. Allorfik introduced local treatment centers offering a treatment methodology (motivational interviewing and cognitive therapy) new to addiction treatment in Greenland with limited evidence from Indigenous populations such as the Greenlandic. The present study investigates the implementation of Allorfik from the perspective of those engaged in the process and the field.MethodsData consisted of transcribed interviews with 23 individuals from both Allorfik and organizations collaborating with or supposed to collaborate with Allorfik. The theme of the interviews was their perspectives on the implementation process, enablers, and obstacles in the process and how Allorfik was performing at the time of the interview. The interview guide was informed by implementation theory. The transcribed material was analyzed using a general inductive approach.ResultsThe analysis resulted in three overall and interconnected themes, namely, implementation, collaborations, and challenges. The implementation was overall considered a success by the interviewees as all components were implemented as planned with a few adaptions, e.g., a treatment guideline update. The collaborations are considered challenging but important to all interviewees. Collaborations seem to rely on personal commitment as opposed to well-defined structures, making it unstable and vulnerable to changes in staff. One of the main challenges highlighted by the interviewees is the number of problems other than addiction among people in treatment, which makes addiction treatment and recovery difficult to achieve. Nevertheless, the high levels of other problems being treated in Allorfik highlights the need for easily accessible therapy as many find that Allorfik is the only place to turn to in times of crisis.ConclusionAllorfik seems to have been implemented in accordance with original intentions and plans for addiction treatment service but has also become more than just a service for addiction treatment with easy access in a country with vast distances and limited resources.

Background: Early use of alcohol and cannabis is associated with health and social problems. It is unclear how lifetime use changes for each additional year of age during adolescence, and whether this change varies by sex and race/ethnicity. This study characterized lifetime rates of alcohol and cannabis use by age among 12- to 17-year-old American youth and explored differential patterns by sex and race/ethnicity. Methods: Data were obtained from the 2019 National Survey on Drug Use and Health. Analyses were restricted to 12–17-year-olds who were non-Hispanic White, non-Hispanic Black, or Hispanic/Latino (n = 11,830). We estimated the increase in lifetime use of alcohol and cannabis by age for the full sample and stratified by sex and race/ethnicity. Slopes of the regression lines were compared to assess differential patterns across groups. Results: In these cross-sectional analyses, reported lifetime use increased substantially from age 12 to 17 for alcohol (6.4 % to 53.2 %) and cannabis (1.3 % to 35.9 %). The increase in lifetime alcohol use was slightly, but not significantly, steeper among girls than boys (F1,8 = 3.40, p = 0.09). White and Latino youth showed similar rates of increase in lifetime alcohol use, which was significantly flatter among Black youth (F2,12=21.26, p

Yellow phosphorus ingestion causing acute fulminant hepatic failure is a serious condition. The establishment of health measures to monitor and prevent yellow phosphorus poisoning is of utmost importance because there is no known cure for the condition. To prevent phosphorus poisoning, it is crucial to raise awareness among the general population about its potential fatality, educate primary care physicians about the delayed onset toxidrome, and take precautions to ensure careful monitoring and reporting. Herein, we present a case of case of a 33-year-old male who consumed 30 grams of rat poison {Yellow Phosphorus (YP)} while under the influence of alcohol. He presented to us on day 5 with icterus and bilateral subconjunctival haemorrhage. Laboratory investigations revealed severely deranged liver function tests and raised Prothrombin Time (PT)/International Normalised Ratio (INR), indicating acute fulminant hepatic failure. The patient was started on N-acetyl cysteine, vitamin K, and received fresh frozen plasma transfusion. Despite treatment, on day 3, the patient developed grade 4 Hepatic Encephalopathy (HE) and the laboratory parameters worsened. Close monitoring revealed further deterioration, leading to the decision for emergency orthotopic Liver Transplantation (LT) on day 7. Following the transplant, the patient's liver function tests showed improvement. The subconjunctival haemorrhage and icterus resolved completely on day 3 post-transplantation. The patient was extubated on day 3 and discharged on day 5 post-transplantation. Regular follow-up appointments were uneventful. In conclusion, the present case report highlights the successful management of a patient with acute fulminant hepatic failure through early hepatic transplantation. It emphasizes the importance of prompt recognition, appropriate treatment, and timely transplantation in improving patient outcomes.

The paper is devoted to wine as a cultural and historical phenomenon in the Middle Ages. People consumed wine all their lives, as it was considered to be a universal medicine and a health-promoting drink. Literature on healthy living and medicine has almost always dealt with the consumption of wine. The way wine is consumed also appears in the so-called princely mirrors, manuals for the upbringing of royal and aristocratic children. Wine also accompanied prominent persons after death, as it was used to embalm the bodies of the deceased. Wine was popularly consumed not only in aristocratic settings, but also in cities, as we demonstrate in this study with the example of the city of Bratislava, which was an important wine producer in the Middle Ages. However, excessive wine consumption was also reflected in crime and the commission of various offences, often leading to death or murder.

Introduction The concept of “intestinal drinking” in this study refers to the continued absorption of alcohol in the gastrointestinal tract until adequate defecation occurs. Material and methods A longitudinal observation of hangover symptoms and alcohol metabolites in healthy humans following binge drinking was conducted. Results The hangover symptoms resulting from binge alcohol consumption were relieved by defecation. Following the defecation process, not only the blood ethanol levels, but also the concentrations of blood acetaldehyde, methanol, and iso-propanol, exhibited significant reductions. Conclusions This pilot study provides a different perspective for addressing hangovers and potentially mitigating the risks of alcoholic liver diseases.

Objectives: To explore the application of a model that integrates various factors that influence Dayak adolescents' intentions to consume alcohol in Sarawak, Malaysia. Methods: A cross-sectional quantitative study was conducted from September 2019 to February 2022. Through multistage stratified cluster sampling, 12 districts were selected from 12 divisions. Respondents were selected randomly and were interviewed using a questionnaire. Results: Structural equation modeling was used to test the Theory of Planned Behavior (TPB) and explore the relationship between various variables and respondents' intention to consume alcohol. The findings suggest that attitude (β=.22, p

Abstract Objective Lifestyle choices including physical inactivity, smoking, abuse of alcohol and drugs, unhealthy diet are common among traders and market women and these behavioural activities predispose individuals to ill-health conditions including cardiovascular diseases and chronic anaemia. We evaluated lifestyle choices such as alcohol intake, smoking and resorting to self-medication among traders in the Tamale Central market in Ghana. We then associated these lifestyle choices with anaemia. Results A total of 400 participants were recruited for this study. Haemoglobin (Hb) levels of participants were measured using Mission® Plus Hb meter and anaemia was diagnosed by Hb

Abstract Background Prenatal alcohol exposure (PAE) is a worldwide public health concern. While PAE is known to be associated with low birth weight, little is known about timing and quantity of PAE on fetal growth. This study investigated the association between periconceptional and prenatal alcohol exposure and longitudinal fetal growth, focusing on timing and quantity in a high exposure cohort. Methods The Safe Passage Study was a prospective cohort study, including 1698 pregnant women. Two-dimensional transabdominal ultrasound examinations were performed to measure fetal femur length, abdominal and head circumference, and biparietal diameter, at three time points during pregnancy. Estimated fetal weight and Z-scores of all parameters were calculated. Trimester-specific alcohol exposure was assessed using the Timeline Followback method. To investigate the associations of specific timing of PAE and fetal growth, two models were built. One with alcohol exposure as accumulative parameter over the course of pregnancy and one trimester specific model, in which PAE was separately analyzed. Linear mixed models adjusted for potential confounders were applied with repeated assessments of both alcohol exposure and fetal growth outcomes. Results This study demonstrated that periconceptional and prenatal alcohol exposure were associated with reduced fetal growth. Effect sizes are displayed as estimated differences (ED) in Z-score and corresponding 95% confidence intervals (95% CIs). When investigated as accumulative parameter, PAE was related to a smaller femur length (ED 30 ; − 0.13 (95% CI; − 0.22; − 0.04), ED 36 ; − 0.14 (95% CI; − 0.25; − 0.04)) and a smaller abdominal circumference (ED 36 ; − 0.09 (95% CI; − 0.18; − 0.01)). Periconceptional alcohol exposure was associated with a smaller abdominal circumference (ED 30 ; − 0.14 (95% CI; − 0.25; − 0.02), ED 36 ; − 0.22 (95% CI; − 0.37; − 0.06)) and a smaller estimated fetal weight (ED 36 ; − 0.22 (95% CI; − 0.38; − 0.05)). Second trimester alcohol exposure was associated with a smaller abdominal circumference (ED 30 ; − 0.49 (95% CI; − 0.86; − 0.12), ED 36 ; − 0.70 (95% CI; − 1.22; − 0.17)) and estimated fetal weight (ED 30 ; − 0.54 (95% CI; − 0.94; − 0.14), ED 36 ; − 0.69 (95% CI; − 1.25; − 0.14)). No additional association of binge drinking was found besides the already observed association of PAE and fetal growth. Conclusions This study demonstrated that PAE negatively affects fetal growth, in particular when exposed during the periconception period or in second trimester. Our results indicate that potential negative consequences of PAE are detectable already before birth. Therefore, healthcare providers should actively address and discourage alcohol use during pregnancy.

Abstract Background There is a paucity of information on alcohol adverts on alcohol consumption among early teenagers. The study aimed to examine the association between exposure to alcohol adverts and alcohol consumption. Methods A sample of 3833 early teenagers aged 12–14 years were extracted from the South African National HIV Prevalence, HIV Incidence, Behaviour and Communication Survey (SABSSM) 2017. Participants answered questions related to their exposure to alcohol adverts across television, Poster/billboard, events, and social media. Alcohol consumption was assessed on ever consumed alcohol and in the previous 12 months. Information on demographic characteristics was collected. Descriptive and inferential statistics were used to process the data. Result Exposure to alcohol adverts increases from 5.2% for Events to 77.0% on television. All alcohol media of adverts were associated with alcohol consumption by age. The results mirror studies that demonstrated that exposure to alcohol advertisements was associated with alcohol consumption. Conclusion The association between alcohol consumption, exposure to alcohol adverts, and demographic characteristics need the urgent attention of policymakers and interventionists. The focus of action should be on protecting these early teenagers from exposure to media of adverts and risk background factors.

Introduction: A community-based cross-sectional study was planned in urban slum area of a city to study risk factors of noncommunicable diseases. Material and Methods: WHO step protocol was used to assess the risk factors of noncommunicable diseases and data were entered in Google forms. In total, 1168 people participated in the study. Results: Eight hundred and forty people opted for random blood sugar test and only 569 people participated in physical examinations. A total of 3.5%, 2.7%, 0.5%, and 0.2% persons were found to be suffering from hypertension, diabetes, ischemic heart disease, and stroke, respectively. Smoking was found in 3.3% and alcohol in 4.3% individuals. In terms of physical activity, 56.8% males and 45.6% females were found to be physically active. Only 18.9% individuals were found to have blood pressure within normal range. Deranged random blood sugar, that is, >200 mg%, was found in 4.6% persons during time of survey. Conclusion: This study concludes increase in rapid industrialization and run for earning daily livelihood, putting people at risk of noncommunicable disease. People are not attentive about their health.

Introduction. Lifestyle factors, including smoking, alcohol (AU) and drug use (DU), can affect male fertility. The aim of the study was to investigate the frequency and characteristics of smoking, AU and DU in men from infertile couples, to identify the most significant associations of disorders of spermatogenesis and social risk factors.Material and methods. At the 1st stage of the study, the case histories of 1198 men from infertile couples were analyzed to determine the frequency of smoking, AU and DU, at the 2nd stage, a more detailed questionnaire of 239 patients from the general sample was conducted for detailed characteristics of smoking and/or AU and/or DU, at the 3rd stage, a comprehensive analysis of ejaculate from men who consumed strong alcohol, but did not smoke or use DU (n = 46) was performed in comparison with men without bad habits taken into account (n = 60).Results. In the general sample, the frequency of AU was 73 %, smoking – 41 %, DU –17 % (mostly in anamnesis). 47.9 % of AU men consumed beer (1.5 (1–2.5) liters per week, 25.6 % – strong alcohol (250 (100–500) ml per week), 7.6 % – champagne/wine (500 (250–725) ml per week); 92.7 % of smokers used cigarettes, 7.3 % – electronic cigarettes (smoking experience was 15 (10–20) years, the number of cigarettes per day was 15 (10–20) pieces); more than 90 % of DU men have a history of non-injection DU. Men who consumed only strong alcohol, but did not smoke and did not use drugs, increased sperm DNA fragmentation compared to men without bad habits taken into account: 16.0 (13.5–19.6) and 12.8 (8.8–19.4) %, respectively, p = 0.018.Conclusions. Among men from infertile couples, a high frequency of AU was revealed with the predominant use of beer or strong alcohol, the use of the latter increases sperm DNA fragmentation; smoking is characterized by a long experience; active DU is rare. Given the specifics of the requirements for the state of reproductive health of men applying to reproductive medicine centers, it is important to have knowledge about the frequency and severity of smoking, AU and DU among them, as well as about the relationship of risk factors of infertility with the parameters of ejaculate.