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Increased Mortality Risk in Children with Fetal Alcohol Spectrum Disorders: A Scoping Review
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作者 Devin Evavold Tyler Mueller +2 位作者 Erika Johnson Marilyn G. Klug Larry Burd 《Open Journal of Pediatrics》 2024年第4期754-766,共13页
Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around ... Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiagnosed, lifelong developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around seven years of age. The most severe outcome in cases of FASD is mortality. The purpose of this scoping review is to 1) use a systematic review to provide an estimated mortality proportion for children with FASD, and 2) update a study published in 2014 by reviewing published reports of mortality in individuals diagnosed with FASD. Method: A search of PubMed, CINAHL, and Google Scholar for reports published between 2013 and 2023 on mortality in individuals with FASD. Results: Three population-based studies have reported on all-cause mortality rates, finding a combined mortality rate of 10.9%, a 2.63 fold (95% CI: 2.61 to 2.65) increase in mortality risk over the general population. Since 2016, this review identified only eight new cases meeting the study inclusion criteria. The reported causes of death were five cases of pneumonia, and one case each of failure to thrive and dehydration, intestinal dilatation and asphyxiation caused by overeating due to pica, and acute gastric volvulus. Discussion: While current research suggests a diagnosis of FASD is associated with a 2.6-fold increase in mortality risk, this is likely an underestimation, as most cases of FASD-related mortality go unreported. Globally, about 1 new case is reported every 15 months. However, in the United States alone, between 1752 to 4400 FASD related deaths occur annually. Our review suggests that FASD is rarely identified as a causal or contributing factor in deaths of children and adolescents, resulting in a substantial undercount of FASD-related deaths. Increased attention to the role of FASD in infant and child mortality case reviews, child death review committee reports, and mortality reviews is needed. 展开更多
关键词 Fetal alcohol Spectrum disorders MORTALITY Birth Defects DEATH EXPOSURE PNEUMONIA
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Alcohol associated liver disease and bariatric surgery:Current perspectives and future directions
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作者 Katherine M Cooper Alessandro Colletta +1 位作者 Nicholas Hebda Deepika Devuni 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第3期650-657,共8页
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 ... 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. 展开更多
关键词 Obesity medicine alcohol use disorder Roux-en-Y gastric bypass Vertical sleeve gastrectomy Liver transplant Simultaneous liver transplant and bariatric surgery
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Distinct and Additive Effects of Alcohol and Thiamine Deficiency in the Developing Brain: Relevance to Fetal Alcohol Spectrum Disorder
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作者 Suzanne M. de la Monte Elizabeth Silbermann Ming Tong 《Journal of Behavioral and Brain Science》 2024年第6期161-186,共26页
Background: Neurodevelopmental abnormalities in fetal alcohol spectrum disorder (FASD) are linked to brain insulin resistance and oxidative stress. However, the role of thiamine deficiency as a distinct or additive fa... Background: Neurodevelopmental abnormalities in fetal alcohol spectrum disorder (FASD) are linked to brain insulin resistance and oxidative stress. However, the role of thiamine deficiency as a distinct or additive factor in the pathogenesis of the neurodevelopmental and metabolic derangements in FASD has not been determined. Methods: Control and ethanol-exposed human PNET2 cerebellar neuronal cells and rat cerebellar slice cultures were treated with vehicle or pyrithiamine (Pyr) to assess independent and additive effects of thiamine deficiency on ethanol-mediated neurotoxicity, mitochondrial dysfunction, insulin resistance, inhibition of neuronal and glial genes, and oxidative stress. Results: Pyr treatments (0 - 200 µM) caused dose-dependent cell loss (Crystal Violet assay) and reduced mitochondrial function (MTT assay) in PNET2 neuronal cultures. Ethanol alone (100 mM) significantly reduced PNET2 neuronal viability, MTT activity, and ATP production. Over the broad dose range of Pyr treatment, ethanol significantly reduced ATP content and cell number and increased mitochondrial mass (MitoTracker Green). Ex vivo cerebellar slice culture studies revealed ethanol-induced developmental architectural disruption that was substantially worsened by Pyr. The adverse effects of ethanol were linked to increased lipid peroxidation and inhibition of asparatyl-asparaginyl-β-hydroxylase (ASPH) expression. The independent and additive effects of Pyr were associated with increased cytotoxicity, lipid peroxidation, Caspase 3 activation, and Tau accumulation. Conclusions: During development, alcohol exposure and thiamine deficiency exert distinct but overlapping molecular pathologies that ultimately impair the structure and function of cerebellar neurons. While both insults drive cell loss and mitochondrial dysfunction with increased lipid peroxidation, ethanol’s additional inhibitory effects on ASPH reflect impairments in insulin and IGF signaling. In contrast, Pyr’s main adverse effects were likely due to neurotoxicity and the activation of apoptosis cascades. The findings suggest that FASD severity may be reduced by thiamine supplementation, but without additional support for insulin/IGF signaling networks, FASD would not be prevented. 展开更多
关键词 Fetal alcohol Spectrum Disorder Thiamine Deficiency CEREBELLUM Slice Culture PYRITHIAMINE
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Is a Mini-Screen for Fetal Alcohol Spectrum Disorder Feasible?
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作者 Tyler Mueller Devin Evavold +2 位作者 June-Yung Kim Marilyn G. Klug Larry Burd 《Open Journal of Pediatrics》 2024年第4期767-781,共15页
Background: Fetal Alcohol Spectrum Disorders (FASDs) are a global public health concern with lifelong consequences for affected individuals. Recent prevalence studies suggest FASD prevalence rates range from 1-5% amon... Background: Fetal Alcohol Spectrum Disorders (FASDs) are a global public health concern with lifelong consequences for affected individuals. Recent prevalence studies suggest FASD prevalence rates range from 1-5% among school age children. Most people with FASD are not correctly diagnosed and inadequate screening to identify patients with increased risk may contribute to under-diagnosis. This study developed a 10-item screening tool for FASD and examined its feasibility. Methods: The sample consisted of 355 children who had been evaluated at an FASD clinic. Data from the 33-item Alcohol Related Neurodevelopmental Disorder Behavioral Checklist was used to develop a brief FASD screen by comparing the changes in Cronbach’s alpha for different combinations of items. The validity of the brief scale was then further examined using receiving operating characteristic analyses. Results: The 10-item screen demonstrated acceptable sensitivity, specificity, and accuracy to identify children at high risk for FASD. The percentage correctly classified was 91.3 and the area under the receiving operating characteristic curve was 0.971. Conclusions: This feasibility study demonstrated that a screen for FASD consisting of 10 items with yes or no responses can be completed in 3 - 4 minutes. The tool is brief, with a low administration burden and has acceptable epidemiologic performance characteristics including accuracy. Future research should examine the performance of this tool when used in larger, community-based populations where screening for FASD would be appropriate. 展开更多
关键词 Fetal alcohol Spectrum disorders (FASDs) CHILDREN SCREENING PREVALENCE
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Gut microbiome in alcohol use disorder:Implications for health outcomes and therapeutic strategies-a literature review
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作者 Ilias Koutromanos Evangelia Legaki +3 位作者 Maria Gazouli Efthimios Vasilopoulos Anastasios Kouzoupis Elias Tzavellas 《World Journal of Methodology》 2024年第1期33-44,共12页
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 microbiom... 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. 展开更多
关键词 alcohol use disorder Gut microbiome DYSBIOSIS
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Alcohol and drug use disorders in adult attentiondeficit/hyperactivity disorder:Prevalence and associations with attention-deficit/hyperactivity disorder symptom severity and emotional dysregulation
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作者 Espen Anker Jan Haavik Trond Heir 《World Journal of Psychiatry》 SCIE 2020年第9期202-211,共10页
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 prevale... 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. 展开更多
关键词 Attention-deficit/hyperactivity disorder Adult ADHD Self Report Scale Emotional dysregulation Substance use disorder alcohol use disorder Drug use disorder
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Alcohol Use Disorders and Associated Factors among an Elderly Community Sample in Nigeria: A Cross-Sectional Survey
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作者 Kingsley Mayowa Okonoda Bawo Onesirosan James +1 位作者 Christopher Goson Piwuna Esther Awazzi Envuladu 《Open Journal of Psychiatry》 2020年第3期114-126,共13页
<strong>Background:</strong> 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 dri... <strong>Background:</strong> 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. <strong>Methods:</strong> 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). <strong>Results:</strong> 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 (<em>χ</em><sup>2</sup> = 0.34, 0.56), cardiovascular (<em>χ</em><sup>2</sup> = 0.42, p = 0.52), respiratory (<em>χ</em><sup>2</sup> = 0.55, p = 0.46), and digestive (<em>χ</em><sup>2</sup> = 0.17, p = 0.68) problems, though not statistically significant. Similarly, no significant associations were seen with probable psychiatric co-morbidity (<em>χ</em><sup>2</sup> = 2.35, p = 0.13) and chronic pain (<em>χ</em><sup>2</sup> = 0.52, p = 0.47). <strong>Conclusions:</strong> Alcohol use and use disorders were common in this elderly cohort. AUDs were associated with poorer health indices. 展开更多
关键词 alcohol Use disorders PREVALENCE ELDERLY CORRELATES NIGERIA
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Neurobiology of Neuronal Network Alteration in Intellectual Disability Related to Fetal Alcohol Spectrum Disorders
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作者 Abdoulaye Bâ 《Journal of Behavioral and Brain Science》 2022年第3期43-81,共39页
The molecular and cellular mechanisms by which alcohol produces its deleterious effects on neuronal networks are only now beginning to be understood. This review focused on alcohol-induced neurobiological alterations ... The molecular and cellular mechanisms by which alcohol produces its deleterious effects on neuronal networks are only now beginning to be understood. This review focused on alcohol-induced neurobiological alterations on neuronal network components underlying information processing, for further understanding of intellectual disability related to FASD. Abnormal neurodevelopmental events related to alcohol-damaged fetal brain included neurogenesis inhibition, aberrant migration, impaired differentiation, exacerbated apoptosis, impaired axon outgrowth and branching altering synaptogenesis and synaptic plasticity, abnormal GABAergic interneurons triggering synaptic inhibitory/excitatory imbalance, reduced myelinogenesis causing injured white matter in prefrontal lobe and atrophied corpus callosum compromising interhemispheric information transfer, the whole compromising neuronal network scaffolding which may lead to biased information processing with deficits in executive function. What added to these abnormalities are smaller gray matter and reduced hippocampus, resulting in cognition and memory failures. As a whole, these developmental disorders may underlie intellectual disability related to FASD. In rodents, these neuronal network components matured mainly during the second and third trimesters equivalents of human gestation. Transferability of results from animal to human was also discussed. It was hoped that the understanding of alcohol-induced neuronal networks failure mechanisms during the developing brain may lay a foundation for prospective new treatments and interventions. 展开更多
关键词 Fetal alcohol Spectrum disorders Intellectual Disability Neuronal Network Axogenesis SYNAPTOGENESIS Myelinogenesis
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Construction and evaluation of an alcohol vapor chamber system
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作者 Wan Jiang Jiajia Chen +6 位作者 Olivia Ewi Vidjro Yingying Zhang Gengni Guo Ziyi Li Yize Qi Rouli Dai Tengfei Ma 《The Journal of Biomedical Research》 CAS CSCD 2023年第2期115-124,共10页
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 chron... 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. 展开更多
关键词 alcohol use disorders alcohol vapor model ANXIETY DEPRESSION NMDA receptor
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Fetal alcohol spectrum disorder: molecular insights into neural damage reduction 被引量:1
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作者 Diana Le Duc 《Neural Regeneration Research》 SCIE CAS CSCD 2015年第11期1764-1766,共3页
Fetal alcohol spectrum disorders(FASD)is a group of entirely preventable,lifelong conditions,which occur upon maternal alcohol use during pregnancy.This can result in severe consequences for the newborn and ultimate... Fetal alcohol spectrum disorders(FASD)is a group of entirely preventable,lifelong conditions,which occur upon maternal alcohol use during pregnancy.This can result in severe consequences for the newborn and ultimately the family.It is usually characterized by delays in development and motor function,craniofacial abnormalities,and difficulties with learning,memory,speech,and academic achievement.According to the German guidelines for fetal alcohol syndrome (FAS) diagnosis, the prevalence of FASD ranges between 0.02-0.8% of all annual births and often the disorder is not recognized (Landgraf et al., 2013). The U.S. National Institutes of Health regard FAS as the most common nonhereditary cause of mental retardation. Thus, preventing programs, like the one undertaken by the Aus- tralian Government, which appointed a National FASD Techni- cal Network (Elliott, 2015), may seem a very reasonable strategy. 展开更多
关键词 Fetal alcohol spectrum disorder FIGURE OGD
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Diagnostic challenges in alcohol use disorder and alcoholic liver disease 被引量:1
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作者 Luisa Vonghia Peter Michielsen +1 位作者 Geert Dom Sven Francque 《World Journal of Gastroenterology》 SCIE CAS 2014年第25期8024-8032,共9页
Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of... Alcohol use disorders represent a heterogeneous spectrum of clinical manifestations that have been defined by the Diagnostic and Statistical Manual of Mental Disorders-5. Excessive alcohol intake can lead to damage of various organs, including the liver. Alcoholic liver disease includes different injuries ranging from steatosis to cirrhosis and implicates a diagnostic assessment of the liver disease and of its possible complications. There is growing interest in the possible different tools for assessing previous alcohol consumption and for establishing the severity of liver injury, especially by noninvasive methods. 展开更多
关键词 alcoholic liver disease alcohol use disorder Diagnosis Diagnostic and Statistical Manual of Mental disorders-5 Screening tests Markers of previous alcohol consumption Non-invasive fibrosis assessment
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Alcohol use disorder and liver injury related to the COVID-19 pandemic
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作者 Giuseppe Marano Gianandrea Traversi +3 位作者 Eleonora Gaetani Roberto Pola Angelo Emilio Claro Marianna Mazza 《World Journal of Hepatology》 2022年第10期1875-1883,共9页
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 alterat... 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. 展开更多
关键词 alcohol use disorder alcoholic liver disease Liver injury COVID-19 alcohol abuse alcohol dependence
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Predicting Alcohol Consumption in Hospitality Populations Using Sense of Coherence
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作者 Carl P. Borchgrevink 《Journal of Tourism and Hospitality Management》 2017年第1期38-46,共9页
This paper aims to introduce the claim that hospitality students and hospitality employees drink more alcohol than other students and employee groups and to explore and explain this alcohol consumption disparity using... This paper aims to introduce the claim that hospitality students and hospitality employees drink more alcohol than other students and employee groups and to explore and explain this alcohol consumption disparity using the sense of coherence (SOC) construct. Using a web-based questionnaire, college students were recruited, surveyed, and classified into hospitality and non-hospitality majors. Self-reported alcohol consumption, SOC, and a variety of demographic variables were measured. A total of 930 students participated of which 59.4% were female and 28% were hospitality majors. About 47% of hospitality students, 33% of other majors, 43% of women, and 38% of men were classified as at-risk consumers of alcohol. The overall SOC score was about 139 with a range of 69-191. None of the sub-populations differed significantly in SOC. While SOC does not predict major or occupational choice, SOC is a predictor of risky alcohol consumption. 展开更多
关键词 sense of coherence (SOC) alcohol consumption ADDICTION hospitality industry and hospitality students alcohol Use disorders Identification Test (AUDIT)
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Relationships between Fetal Alcohol Spectrum Disorder, Adverse Childhood Experiences, and Neurodevelopmental Diagnoses
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作者 Bradley J. Conant Anne Sandstrom +2 位作者 Mariah Jorda Marilyn G. Klug Larry Burd 《Open Journal of Pediatrics》 2021年第4期580-596,共17页
<strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal... <strong>Objectiv</strong><strong>e</strong><strong>:</strong><span style="font-family:""><span style="font-family:Verdana;"> Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. </span><b><span style="font-family:Verdana;">Methods:</span> </b><span style="font-family:Verdana;">A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. </span><b><span style="font-family:Verdana;">Results:</span> </b><span style="font-family:Verdana;">Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). </span><b><span style="font-family:Verdana;">Conclusion:</span> </b><span style="font-family:Verdana;">This study demonstrates that all children being considered for placement in foster care or residential should be screened for FASD.</span></span> 展开更多
关键词 Fetal alcohol Spectrum Disorder Adverse Childhood Experiences Foster Care Residential Care Developmental Diagnosis
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Marchiafava-Bignami disease:A case report
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作者 Monica Gupta Swati Garg +1 位作者 Saurabh Gaba Rekha Gupta 《Journal of Acute Disease》 2021年第3期126-129,共4页
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 alcohol... 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. 展开更多
关键词 Marchiafava-Bignami disease alcohol use disorder Magnetic resonance imaging
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Perception and Attitude of Employers towards Employees with AUD in an Emerging Economy: A Qualitative Enquiry
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作者 Eugene Kobla Dordoye Lilian Ama Afun Thelma Mpoku Alalbila 《Open Journal of Psychiatry》 2021年第2期107-123,共17页
<strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:n... <strong>Background:</strong> The disease, addiction to chemical substances or drugs such as alcohol (<i>ethanol, C<sub>2</sub>H<sub>5</sub>OH<span style="white-space:normal;"></span></i>) 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. <strong>Methods: </strong>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. <strong>Results:</strong> 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. <strong>Conclusions:</strong> 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. 展开更多
关键词 PERCEPTION ATTITUDE alcohol Use Disorder (AUD) Employee Assistance Programs (EAPs)
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The Protective Effect of a Puerariae flos Extract (Thomsonide) against Ethanol-Induced Gastric Lesions in Rats
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作者 Takashi Yamazaki Yoshijiro Nakajima +1 位作者 Junei Kinjo Toshihiro Nohara 《Pharmacology & Pharmacy》 2016年第5期208-215,共8页
Objectives: Puerariae flos has popularly been used to treat alcoholic disorders. However, the effect of Puerariae flos on alcoholic disorders in the gastrointestinal system has not been identified. We investigated the... Objectives: Puerariae flos has popularly been used to treat alcoholic disorders. However, the effect of Puerariae flos on alcoholic disorders in the gastrointestinal system has not been identified. We investigated the protective effect of an extract of Puerariae flos against the murine gastric mucosa. Methods: Thomsonide, the extracts containing large amounts of isoflavonoid and triterpenoid saponin, was obtained fr om Puerriae flos via Diaion HP-20 column chromatography using water and 99.5% ethanol. It was investigated whether thomsonide, as well as geranylgeranylacetone (teprenone), a popular anti-ulcer agent developed in Japan, had a cytoprotective effect that might be related to endogenous prostaglandins, which played an important role in preventing gastric mucosal lesions. Results: Thomsonide and teprenone inhibited ethanol-induced gastric lesions. Furthermore, thomsonide increased the production of PGE2 and 6-ketoPGF1α, a stable metabolite of PGI2, in the gastric mucosa, and protective effects of thomsonide, as well as teprenone, against ethanol-induced gastric lesions were attenuated by pretreatment with indomethacin. Conclusions: These findings suggest that thomsonide, as well as teprenone, has the gastro protective effect which may be related to the cytoprotective activity of endogenous prostaglandins. The results of this study also suggest that the gastro protective effect of thomsonide may partially mitigate alcoholic disorders in the gastrointestinal tract, and support our pharmacological belief that Puerariae flos is useful for treatment of alcoholic disorders. 展开更多
关键词 alcoholic disorders ETHANOL Gastric Mucosal Lesions PROSTAGLANDINS Puerariae flos
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Current and emerging therapies for alcohol-associated hepatitis
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作者 Francisco Idalsoaga Gustavo Ayares +5 位作者 Luis Antonio Díaz Jorge Arnold María Ayala-Valverde David Hudson Marco Arrese Juan Pablo Arab 《Liver Research》 CSCD 2023年第1期35-46,共12页
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... 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. 展开更多
关键词 alcohol-associated hepatitis(AH) alcohol-related liver disease(ALD) alcohol use disorder(AUD) AUD treatment Nutritional therapy Steroids therapy CIRRHOSIS FIBROSIS
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Telehealth interventions for alcohol use disorder:A systematic review
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作者 Arpad Kelemen Elizabeth Minarcik +1 位作者 Christopher Steets Yulan Liang 《Liver Research》 CSCD 2022年第3期146-154,共9页
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 ... 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. 展开更多
关键词 alcohol use disorder(AUD) Liver disease Cognitive behavioral therapy(CBT) TELEHEALTH Digitally delivered Systematic review
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Advances in neuroimaging studies of alcohol use disorder(AUD)
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作者 Ji-Yu Xie Rui-Hua Li +6 位作者 Wei Yuan Jiang Du Dong-Sheng Zhou Yu-Qi Cheng Xue-Ming Xu Heng Liu Ti-Fei Yuan 《Psychoradiology》 2022年第4期146-155,共10页
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 curr... 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. 展开更多
关键词 alcohol use disorder structural magnetic resonance imaging functionalmagnetic resonance imaging ELECTROENCEPHALOGRAPHY transcranial magnetic stimulation prefrontal cortex
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