Gut microbiome in alcohol use disorder:Implications for health outcomes and therapeutic strategies-a literature review

Alcohol use disorder(AUD)represents a major public health issue which affects millions of people globally and consist a chronic relapsing condition associated with substantial morbidity and mortality.The gut microbiome plays a crucial role in maintaining overall health and has emerged as a significant contributor to the pathophysiology of various psychiatric disorders.Recent evidence suggests that the gut microbiome is intimately linked to the development and progression of AUD,with alcohol consumption directly impacting its composition and function.This review article aims to explore the intricate relationship between the gut microbiome and AUD,focusing on the implications for mental health outcomes and potential therapeutic strategies.We discuss the bidirectional communication between the gut microbiome and the brain,highlighting the role of microbiotaderived metabolites in neuroinflammation,neurotransmission,and mood regulation.Furthermore,we examine the influence of AUD-related factors,such as alcohol-induced gut dysbiosis and increased intestinal permeability,on mental health outcomes.Finally,we explore emerging therapeutic avenues targeting the gut microbiome in the management of AUD,including prebiotics,probiotics,and fecal microbiota transplantation.Understanding the complex interplay between the gut microbiome and AUD holds promise for developing novel interventions that could improve mental health outcomes in individuals with AUD.

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components.Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte.The liver is the central organ in the metabolism of alcohol,a process that also involves other organs and tissues such as the brain,heart and muscles,but the most relevant organ is the liver.The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes,to cirrhosis and hepatocellular carcinoma.Alcohol abuse frequently leads to liver disease such as steatosis,steatohepatitis,fibrosis,cirrhosis,and tumors.Following the spread of coronavirus disease 2019(COVID-19),there was an increase in alcohol consumption,probably linked to the months of lockdown and smart working.It is known that social isolation leads to a considerable increase in stress,and it is also recognized that high levels of stress can result in an increase in alcohol intake.Cirrhotic patients or subjects with liver cancer are immunocompromised,so they may be more exposed to COVID-19 infection with a worse prognosis.This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

Alcohol Use Disorders and Associated Factors among an Elderly Community Sample in Nigeria: A Cross-Sectional Survey

Background: Alcohol Use Disorders (AUDs) in the elderly are associated with impairments in physical, psychological, social and cognitive functioning. Both the elderly men and women who drink alcohol are at a greater risk of social isolation and economic deprivation and the women in particular are in the danger of rapid development of dependence a phenomenon termed “telescoping” dependence. This study seeks to determine the prevalence of alcohol use disorders as well as their associated factors among the elderly in Jos South LGA, Plateau State, Nigeria. Methods: A community-based cross-sectional study of elderly (≥60 years) men and women. A total of 400 out of a total of 422 elderly community dwellers identified were interviewed with the aid of a composite questionnaire incorporating the socio-demography, Alcohol Smoking and Substance Involvement Screening Test (ASSIST), Mini International Neuropsychiatric Interview (MINI) and the 12-item General Health Questionnaire (GHQ-12). Results: The lifetime and current prevalence of alcohol use were 69.8% and 45.5% respectively. The prevalence of AUDs was (n = 52, 13.0%). AUDs was significantly associated with being male (OR = 2.57, 95%CI: 1.35 - 3.77, p < 0.01). Participants with AUDs were more likely to report difficulty ambulating (χ2 = 0.34, 0.56), cardiovascular (χ2 = 0.42, p = 0.52), respiratory (χ2 = 0.55, p = 0.46), and digestive (χ2 = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (χ2 = 2.35, p = 0.13) and chronic pain (χ2 = 0.52, p = 0.47). Conclusions: Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices.

The Differences in Alcohol Use between Urban and Rural Students of Inner Mongolia Medical University, China

Objective: The purpose of this study was to evaluate the difference in alcohol use between urban and rural students of Inner Mongolia Medical University. Methods: A cross-sectional census was conducted on medical students on campus in 2013. We use multivariate logistic regression models to assess the factors associated with alcohol use. We further use chi-square test assess on differences in alcohol use between urban and rural people among significance factors in logistic regression models. Results: The prevalence of alcohol use among students in rural area was higher than that in urban area (p = 0.016). Alcohol use was associated with Gender, monthly expenses, residence, ethnic and faculty. The odds of alcohol use for Mongolia students were 1.139 times higher than that for Han students. The prevalence of alcohol consumption among students from pharmacy or Traditional Chinese Medicine and Mongolian Medicine faculties in rural area was higher than that among student in urban area (p = 0.03;p = 0.001). The prevalence of alcohol use among female students in rural area was higher than that among female students in urban area (p < 0.043). The proportion of alcohol use among students with <600 in rural area was higher than that among students in urban area (p < 0.001). Conclusion: Considering the differences in the prevalence of alcohol use between rural area and urban area, university administrators aiming at students from various regions develop various approaches.

Alcohol associated liver disease and bariatric surgery:Current perspectives and future directions

Bariatric surgery is a routinely performed procedure and is associated with a reduction in all-cause mortality in patients with obesity.However,bariatric sur-gery has also been linked to increased alcohol use with up to 30%of these patients developing alcohol use disorder(AUD).The mechanism of AUD after bariatric surgery is multifactorial and includes anatomic,metabolic,and neurohumoral changes associated with post-surgical anatomy.These patients are at increased risk of alcohol associated liver disease and,in some cases,require liver trans-plantation.In this article,we provide a scoping review of epidemiology,patho-physiology,and clinical outcomes of alcohol-related health conditions after bariatric surgery.

Telehealth interventions for alcohol use disorder:A systematic review

Alcohol use disorder(AUD)is a worldwide problem for individuals of varying ages and backgrounds and is associated with the underlying cause of alcoholic liver disease,liver cirrhosis,liver cancer,or many other common diseases and health conditions.Existing treatments such as cognitive behavioral therapy(CBT)have been demonstrated as an evidence-based treatment to aid individuals struggling with AUD.However,these treatments have excessive costs and time demand with trained experts.In this paper,we examine the efficacy and long-term impacts of digitally delivered CBT and other online telehealth tools and apps for AUD patients.Results show the effectiveness in the ability of digitally delivered CBT to decrease alcohol use in AUD patients.The additional use of online technologies and smartphone apps for post-CBT care demonstrates that such computer-aided apps could have long-term effects when it is continually employed,which opens the door for AUD patients who were not seeking treatment elsewhere.Further longitudinal examination research is needed to evaluate the lasting effects in liver health and other chronic diseases associated with digitally delivered alcohol reduction for AUD patients.

Alcohol and drug use disorders in adult attentiondeficit/hyperactivity disorder:Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation

BACKGROUND High risk of alcohol and drug use disorders in people with attentiondeficit/hyperactivity disorder(ADHD)calls for exploratory research of relationships with clinical features of ADHD.AIM To estimate prevalence of alcohol/drug use disorders and associations with ADHD symptom severity and emotional dysregulation,in adults with ADHD.METHODS This observational cross-sectional clinical study consisted of patients admitted to a private psychiatric outpatient clinic in Oslo,Norway(2014-2018).Five-hundred and fifty-eight eligible patients diagnosed with ADHD(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM-5)criteria)agreed to participate.Alcohol and drug use disorders were diagnosed using the Mini International Neuropsychiatric Interview(MINI).Dependence and abuse were merged into“use”disorder as in MINI version 7.0/DSM-5.Questions were related both to lifetime and the past 12-mo.ADHD severity was assessed by the Adult ADHD Self Report Scale(ASRS).Subdivisions of the ASRS questionnaire as inattentive items and hyperactive/impulsivity items were recorded separately.Emotional dysregulation was assessed by the eight-item version of Barkley’s Current Behavior Scale-Self Report.RESULTS The 12-mo prevalence was 5.3%for alcohol use disorder and 13.7%for drug use disorder.The lifetime prevalence was 12.0%for alcohol use disorder and 27.7%for drug use disorder.Men had higher rates of both alcohol use disorder and drug use disorder compared to women.The prevalence of drug use disorder was more than twice that of alcohol use disorder for both sexes.The drugs most participants reported having used were(in descending order):Amphetamine(19.1%),cannabis(17.1%),cocaine or ecstasy(7.4%),benzodiazepines(7.4%),and heroin or other opioids(2.9%).Lifetime drug use disorder was significantly associated with both hyperactivity-impulsivity symptoms and emotional dysregulation symptom severity.Lifetime alcohol use disorder,on the other hand,was not significantly associated with ADHD symptoms or emotional dysregulation when adjusted for gender and age.CONCLUSION Patients with ADHD have a high lifetime prevalence of drug use disorder,which is associated with higher levels of hyperactivity-impulsivity symptoms and emotional dysregulation.

The Prevalence and Pattern of Use of Alcohol among Undergraduate Students in Jos Plateau State, Nigeria

Introduction: Alcohol abuse is a recognized phenomenon among university students in Nigeria and harms the education and performance of students. This may include disruption of interpersonal relationships, especially within the family, criminal behaviour, academic failure, vocational failure, and a lack of commensurate achievement. Methodology: A cross-sectional descriptive study aimed at assessing the Prevalence and Pattern of Use of Alcohol Among Undergraduate Students In Jos Plateau State, Nigeria. It involved 290 Undergraduates selected using the Multistage sampling method. Results: The prevalence of current use of alcohol was 33.7% while two-thirds were not taking alcohol. There was a statistically significant association between current use of alcohol and sex (χ2 = 12.168, p ≤ 0.001), where more males than females use alcohol. Most (44.4%) undergraduates use alcohol weekly, 11.1% use it daily, and 14.3% Two times weekly. A majority (52.4%) take it after lectures and 27.0% take whenever they like. There was a statistically significant association between alcohol use and the level/year of study (χ2 = 27.258, p ≤ 0.001). More students in higher classes (5th year and 4th year) are taking alcohol when compared with new students and lower classes (1st year and 2nd year). A significant association was also found between alcohol use and respondent's Cumulative Grade Point Average-CGPA (χ2 = 22.809, p ≤ 0.001), as the majority of students using alcohol had a low CGPA (1.1 to 2.0) when compared to those with higher. Conclusion: The University and government should collaborate with students to establish peer support groups and programs that discourage the use of alcohol during school hours and while studying.

Advances in neuroimaging studies of alcohol use disorder(AUD)

Alcohol use disorder(AUD)is a worldwide problem and themost common substance use disorder.Chronic alcohol consumptionmay have negative effects on the body,the mind,the family,and even society.With the progress of current neuroimaging methods,an increasing number of imaging techniques are being used to objectively detect brain impairment induced by alcoholism and serve a vital role in the diagnosis,prognosis,and treatment assessment of AUD.This article organizes and analyzes the research on alcohol dependence concerning the main noninvasive neuroimaging methods,structural magnetic resonance imaging,functional magnetic resonance imaging,and electroencephalography,as well as the most common noninvasive brain stimulation-transcranial magnetic stimulation,and intersperses the article with joint intra-and intergroup studies,providing an outlook on future research directions.

Construction and evaluation of an alcohol vapor chamber system

An increasing number of studies demonstrated that alcohol vapor chamber is an effective way to model physical signs of alcohol use disorders. Although researchers are developing different vapor chambers to study chronic alcohol exposure model worldwide, few studies build and modify their own vapor chambers in China.Here, we designed and established an alcohol vapor chamber system for small animals. We described a paradigm showing how to control and monitor alcohol concentration in whole system. The vapor chamber system with several advantages including accommodating up to ten standard mouse cages. Furthermore, the system was tested by evaluating the blood alcohol concentration and neuron injury in mice. Importantly, the alcohol withdrawal after vapor exposure caused motor coordination impairment, anxiolytic-and depression-like behavior. Finally, the Nmethyl-D-aspartate receptor(NMDAR)-mediated glutamatergic transmissions in the medial prefrontal cortex was changed after alcohol vapor exposure-induced behaviors. The frequency and amplitude of spontaneous excitatory postsynaptic currents between control and alcohol groups were not different, suggesting that alcohol exposureinduced behaviors are associated with the change in NMDAR response. Taken together, the new alcohol vapor chamber system was constructed, which would help to research the relationship between the stable alcohol exposure and withdrawal behaviors and to study chronic alcohol exposure-induced disorders in China.

Alcohol,inflammation,and gut-liver-brain interactions in tissue damage and disease development

Chronic inflammation is often associated with alcoholrelated medical conditions. The key inducer of such inflammation, and also the best understood, is gut microflora-derived lipopolysaccharide (LPS). Alcohol can significantly increase the translocation of LPS from the gut. In healthy individuals, the adverse effects of LPS are kept in check by the actions and interactions of multiple organs. The liver plays a central role in detoxifying LPS and producing a balanced cytokine milieu. The central nervous system contributes to anti-inflammatory regulation through neuroimmunoendocrine actions. Chronic alcohol use impairs not only gut and liver functions, but also multi-organ interactions, leading to persistent systemic inflammation and ultimately, to organ damage. The study of these interactions may provide potential new targets for therapeutic intervention.

Differentiation of Positional Isomers of Propyl Alcohols Using Filament-Induced Fluorescence

We experimentally demonstrate the recognition of positional isomers of propyl alcohol vapor through nonlinear fluorescence induced by high-intensity femtosecond laser filaments in air. By measuring characteristic fluorescence of n-propyl and isopropyl alcohol vapors produced by femtosecond filament excitation, it is found that they show identical spectra, that is, those from molecular bands of CH, C2, Nit, OH and CN, while the relative intensities are different. By comparing the ratios of the CH and C2 signals, the two propyl alcohol isomers are differentiated. The different signal intensities are ascribed to different ionization potentials of the two isomer molecules, leading to different production efficiencies of fluorescing fragments.

Marchiafava-Bignami disease:A case report

Rationale:Clinicians encounter multiple alcohol-related illnesses in practice,and Marchiafava-Bignami disease is a rare and devastating entity among them.It is a toxic-demyelinating disease and seen in chronic alcoholics,although it may be occasionally observed in chronically malnourished teetotalers.The clinical presentations are diverse.The symptoms and signs are non-specific,and the onset can be acute or chronic.Patient’s concerns:A 45-year-old right-handed patient suffered from alcohol use disorder with multiple non-specific neuropsychiatric manifestations.Diagnosis:Marchiafava-Bignami disease.Interventions:Thiamine,folate,vitamin B12,and steroid therapy.Outcome:The patient’s behaviour was significantly improved but dysarthria and pyramidal signs persisted.He was left with permanent cognitive impairment.Lessons:Though prompt therapy may halt the demyelinating process in this disease,the treatment remains a challenge in clinical practice.The recognition of the neuro-radiologic features is crucial to establish an early diagnosis.

Perception and Attitude of Employers towards Employees with AUD in an Emerging Economy: A Qualitative Enquiry

Background: The disease, addiction to chemical substances or drugs such as alcohol (ethanol, C2H5OH) is still not accepted as a diagnostic nosology by many in Ghana. Many consider addiction as a moral challenge, rather than a medical condition. This perception is propagated even in the Ministry of Health’s Occupational Health and Safety (OHS) policy document which punishes symptoms of substance use disorders. This study seeks to explore the perception and attitude of employers towards employees with alcohol use disorders (AUD) and to ascertain the level at which employee assistance programs (EAPs) are implemented in organizations. Methods: To infer outcomes, the study adopted the qualitative approach. In-depth interviews and observations which describe the perceived attitudes of employers (using HR managers as proxy) towards employees with AUD of some selected hospitals (private and public) in the Greater-Accra Metropolis. The interview was conducted face-to-face using an interview guide, which included open-ended questions. The structure of the guide helped the researchers to observe the participants and the conversations were also audio-taped after seeking the consent of the participants. On average, the interview lasted between 45 and 60 minutes. Results: Findings from the 10 interviews revealed that a number of factors such as biological, environmental, social and psychological accounted for AUD among employees regardless of the nature of their work. Although the HR managers had knowledge on the possible causes of AUD, some of them explained that they could not identify alcohol use in their organisations. The few that admitted to AUD at their workplace reported that alcohol use did not have any effect on their productivity and most of these workers were temporal or causal workers, hence were not perceived as permanent staff. In spite of prevalence of AUD in some hospitals, it was interesting to know that majority of these facilities had no EAPs and the few that had policies on AUD were not implementing them. Conclusions: This paper focused on some aspect of HR managers’ perceived attitude toward an aspect of their employees’ mental wellbeing which is AUD in a work setting. However, there are other pertinent issues that are crucial to employee total wellbeing that can be addressed in future research.

Epidemiology of children and adolescent eye injuries in British Columbia

AIM To quantify and characterize children and adolescent eye injuries treated in trauma department.METHODS A retrospective analysis was conducted of children and adolescent patients(0-19 years of age) with eye injuries using the British Columbia Trauma Registry(BCTR) data. BCTR data was obtained from January 1,2000 to December 31,2008. The BCTR provides the most detailed information on severe injuries throughout the province of BC. There are 12 trauma-receiving facilities in BC from which BCTR collects data.RESULTS A total of 162 patients with eye injuries were registered in BCTR during the data collection period. The highest number of injuries occurred in the 15-19 age group,followed by 10-14 and 5-9 age groups. Seventy-one point six percent of all patients were male. The mean age for all patients was 12.9(SD = 5.8) years. Vehicular crash was by far the most common mechanism of injury among all patients(42.0%) followed by blunt injury(14.2%) and cuts(12.3%). The child and adolescent eyeinjury data set we used for our study indicated that there were in total,50 patients that were tested for alcohol and drug use. The majority of them were 15-19 years of age(n = 38). Among the tested eye injury patients in the 15-19 age group,47%(18/38) tested positive for alcohol. There were approximately 30 cases of physical fighting(assault) and fighting-related injury among adolescents. Some injuries were caused by use of fire arms and knife during the assaults. Out of all patients,62(38%) were seen by an Ophthalmologist on admission,whereas 100(62%) patients were not seen by an eye specialist on admission. The most common injury diagnosis among the patients not consulted by ophthalmologist was conjunctiva injury(53%),whereas almost 9 out of 10 patients with ophthalmological consultation had laceration of cornea injury diagnoses. Using Glasgow Coma Scale(GCS)-based classification of brain injury severity,3.7% of all patients were classified with severe brain injury(GCS ≤ 8),while more than 64% had diagnosed with a mild brain injury(GCS ≥ 13).CONCLUSION This study suggests that most child and adolescent eye injuries in BC occur at street/highway locations followed by incidents at home. Vehicular crash was by far the most common mechanism of injury among all patients(42%). Sixty-four point two percent of child and adolescent eye injury patients also had mild brain injuries. Further,the child and adolescent eye injury data set we used for our study indicated that there were in total,50 patients tested for alcohol and drug use. There is an urgent need for a child and adolescent eye injury prevention plan in our province.

Current and emerging therapies for alcohol-associated hepatitis

Alcohol-related liver disease(ALD)encompasses a spectrum of diseases caused by excessive alcohol consumption.ALD includes hepatic steatosis,steatohepatitis,variable degrees of fibrosis,cirrhosis,and alcohol-associated hepatitis(AH),the latter being the most severe acute form of the disease.Severe AH is associated with high mortality(reaching up to 30%e50%)at 90 days.The cornerstone of ALD,and particularly AH,treatment continues to be abstinence,accompanied by support measures such as nutritional supplementation and management of alcohol withdrawal syndrome(AWS).In severe AH with model for end-stage liver disease(MELD)score21,corticosteroids can be used,especially MELD score between 25 and 39,where the highest benefit is achieved.Other key aspects of treatment include the early identification of infections and their associated management and the proper identification of potential candidates for liver transplantation.The development of new therapies based on the pathophysiology and mechanisms of liver injury are underway.This includes the modulation and management of the innate immune response,gut dysbiosis,bacterial translocation,and bacteria-derived products from the intestine.These hold promise for the future of AH treatment.

Burden of pancreatitis and associated risk factors in China,1990 to 2019:a systematic analysis for the Global Burden of Disease Study 2019

Background: Pancreatitis is a common disease of the digestive system. Acute pancreatitis is one of the most common reasons for gastrointestinal hospital admission, and chronic pancreatitis significantly reduces quality of life. However, national epidemiological data on pancreatitis in China are lacking. This study aimed to quantify the disease burden of pancreatitis in China from 1990 to 2019.Methods: This study was based on the Global Burden of Disease Study 2019 dataset. Age-standardized rates of incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (DALYs) were used to describe the disease burden of pancreatitis, and estimated annual percentage change (EAPC) was used to indicate the average change in age-standardized rates. We also described the trend of pancreatitis-related mortality and DALYs, which are attributable to alcohol use by age and sex.Results: From 1990 to 2019, the ASIR, ASPR, ASMR, and age-standardized DALYs of pancreatitis in China decreased by 10.90, 1.50, 0.49, and 15.54 per 100,000, respectively, with EAPCs of -1.35 (95% uncertainty interval [UI]: -1.67, -1.02) and -0.37 (95% UI: -0.43, -0.31), -2.01 (95% UI: -2.07, -1.94) and -2.32 (95% UI: -2.37, -2.28), respectively. Recently, the numbers of incident and prevalent cases have risen, with estimates of 380,018 (95% UI: 308,669-462,767) and 493,765 (95% UI: 416,705-578,675), respectively, in 2019. Among men, the disease burden of pancreatitis was more severe than among women, and with variances in the distribution among different age groups. Age-standardized DALYs caused by alcohol-related pancreatitis have gradually worsened in the past decade, accounting for 34.09% of the total in 2019.Conclusions: The disease burden of pancreatitis in China has declined in the past 30 years, but the exacerbation of population aging poses a challenge to prevention and control of pancreatitis. Alcohol use has gradually become an important factor in the disease burden of pancreatitis in recent years.