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Discriminative Stimulus Effects and Metabolism of Ethanol in Rhesus Monkeys. 恒河猴的辨别刺激效应和乙醇代谢
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-16 DOI: 10.1111/acer.14142
Daicia C Allen, Kathleen A Grant

Background: Animal models are an essential feature of drug and pharmacotherapy development for treating alcohol use disorders (AUDs). The rhesus macaque is a robust animal model for many aspects of AUDs particularly in exploiting individual differences in oral self-administration of ethanol (EtOH), endocrine orchestration of stress response, and menstrual cycle characteristics. However, the clearance rates of EtOH have not been reported in this species, and the GABAA and N-methyl-D-aspartate (NMDA) receptor involvement in EtOH's discriminative stimulus effects has not been fully characterized.

Methods: EtOH clearance rates following 2 doses of EtOH on separate days (0.5 and 1.0 g/kg, i.g.) were determined in 8 young adult male rhesus macaques. The EtOH was given by nasogastric gavage, and repeated blood samples were taken over 5 hours without sedation. Next, all subjects were trained on a 2-choice 1.0 g/kg EtOH (i.g.) versus water discrimination with a 60-minutes pretreatment period to capture peak blood EtOH concentration (BEC). Substitution testing was conducted with GABAA ligands pentobarbital (i.g. and i.m.) and midazolam (i.g.), as well as NMDA antagonist MK-801 (i.m.).

Results: Peak BECs were 34 and 87 mg/dl for 0.5 and 1.0 g/kg doses, respectively, and occurred at 66 and 87 minutes following gavage. All GABAA and NMDA ligands tested resulted in responding on the EtOH-appropriate lever with the potency ranking of MK-801 (ED50 : 0.017 mg/kg) > midazolam (ED50 : 1.6 mg/kg) > pentobarbital (ED50 : 3.7 mg/kg) > EtOH (ED50 : 700 mg/kg, or 0.7 g/kg) in these subjects.

Conclusions: These results suggest that the compound discriminative stimulus effects of EtOH are highly consistent across species, providing further support for the rhesus macaque as strong model for pharmacotherapy development for AUD.

背景:动物模型是开发治疗酒精使用障碍(AUD)的药物和药物疗法的基本特征。猕猴是一种强有力的动物模型,可用于研究酒精使用障碍的许多方面,特别是在利用乙醇(EtOH)口服自我给药的个体差异、应激反应的内分泌协调和月经周期特征方面。然而,该物种的乙醇清除率尚未见报道,GABAA和N-甲基-D-天冬氨酸(NMDA)受体参与乙醇分辨刺激效应的情况也尚未完全确定:方法:测定了 8 只年轻的成年雄性猕猴在不同日期服用 2 次 EtOH(0.5 和 1.0 g/kg,静脉注射)后的 EtOH 清除率。EtOH通过鼻胃灌胃给药,在5小时内重复采集血液样本,无需镇静剂。然后,对所有受试者进行 1.0 克/千克乙醇(i.g.)与水的二选一辨别训练,并进行 60 分钟的预处理,以捕捉血液中乙醇的峰值浓度(BEC)。用GABAA配体戊巴比妥(静脉注射和静注)和咪达唑仑(静脉注射)以及NMDA拮抗剂MK-801(静注)进行了替代测试:结果:0.5和1.0克/千克剂量的BEC峰值分别为34和87毫克/分升,出现在灌胃后66和87分钟。测试的所有 GABAA 和 NMDA 配体都会导致受试者在与 EtOH 适当的杠杆上做出反应,在这些受试者中的效力排序为:MK-801(ED50:0.017 毫克/千克)>咪达唑仑(ED50:1.6 毫克/千克)>戊巴比妥(ED50:3.7 毫克/千克)> EtOH(ED50:700 毫克/千克,或 0.7 克/千克):这些结果表明,EtOH的复合分辨刺激效应在不同物种之间高度一致,进一步支持了将猕猴作为开发AUD药物疗法的有力模型。
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引用次数: 0
Convergent Evidence From Humans and Drosophila melanogaster Implicates the Transcription Factor MEF2B/Mef2 in Alcohol Sensitivity. 人类和黑腹果蝇的共同证据表明转录因子 MEF2B/Mef2 对酒精敏感
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-16 DOI: 10.1111/acer.14138
Rebecca E Schmitt, Brandon C Shell, Kristen M Lee, Keith L Shelton, Laura D Mathies, Alexis C Edwards, Mike Grotewiel

Background: Self-Rating of the Effects of Alcohol (SRE) measures level of response to ethanol (EtOH) in humans. Interestingly, there is a positive relationship between the SRE and risk for abusing alcohol, suggesting mechanistic connections between SRE and alcohol abuse.

Methods: To identify candidate genes with a role in SRE and alcohol-related behavior more generally, we coupled human genetic analyses with studies in Drosophila melanogaster. We first performed a gene-based analysis of Genomewide association studies (GWAS) summary statistics for SRE in the Avon Longitudinal Study of Parents and Children sample. Based on prior findings in humans, orthology to fly genes, and the availability of genetic reagents, we selected a subset of these genes for studies on EtOH behavior in Drosophila.

Results: We found 37 genes with nominal associations in our SRE GWAS. We explored the role of 6 orthologous genes in Drosophila EtOH sedation and rapid tolerance. We found that the transcription factor Mef2 is required for normal EtOH sedation in flies. Pan-neuronal expression of 2 independent Mef2 RNAi transgenes significantly reduced Mef2 expression and made flies resistant to EtOH sedation. Additionally, flies with multiple independent mutant alleles of Mef2 were also resistant to EtOH sedation, confirming a role for Mef2 in this behavior. Altered expression of Mef2 did not change EtOH rapid tolerance or cause a net change in internal EtOH concentrations.

Conclusions: Our studies indicate that MEF2B influences SRE in humans and that Mef2 impacts EtOH sedation in Drosophila.

背景:酒精影响自评量(SRE)测量人类对乙醇(EtOH)的反应水平。有趣的是,SRE 与酗酒风险之间存在正相关,这表明 SRE 与酗酒之间存在机理联系:为了确定在 SRE 和酒精相关行为中发挥作用的候选基因,我们将人类基因分析与黑腹果蝇研究结合起来。我们首先对雅芳父母与子女纵向研究(Avon Longitudinal Study of Parents and Children)样本中SRE的全基因组关联研究(GWAS)摘要统计进行了基于基因的分析。根据先前在人类中的发现、与蝇类基因的同源性以及遗传试剂的可用性,我们选择了这些基因的一个子集,用于研究果蝇的乙醇行为:结果:我们在 SRE GWAS 中发现了 37 个具有名义关联的基因。我们探讨了 6 个同源基因在果蝇乙醇镇静和快速耐受中的作用。我们发现,转录因子Mef2是果蝇正常EtOH镇静所必需的。泛神经元表达两个独立的Mef2 RNAi转基因可显著降低Mef2的表达,并使果蝇对EtOH镇静产生耐受性。此外,具有多个独立Mef2突变等位基因的苍蝇也对EtOH镇静具有抗性,这证实了Mef2在这种行为中的作用。Mef2表达的改变不会改变EtOH的快速耐受性,也不会导致体内EtOH浓度的净变化:我们的研究表明,MEF2B会影响人类的SRE,而Mef2会影响果蝇的EtOH镇静。
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引用次数: 0
Alcohol Effects on Colon Epithelium are Time-Dependent. 酒精对结肠上皮细胞的影响具有时间依赖性。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-22 DOI: 10.1111/acer.14141
Faraz Bishehsari, Lijuan Zhang, Robin M Voigt, Natalie Maltby, Bita Semsarieh, Eyas Zorub, Maliha Shaikh, Sherry Wilber, Andrew R Armstrong, Seyed Sina Mirbagheri, Nailliw Z Preite, Peter Song, Alessia Stornetta, Silvia Balbo, Christopher B Forsyth, Ali Keshavarzian

Background: Alcohol intake increases the risk of developing colon cancer. Circadian disruption promotes alcohol's effect on colon carcinogenesis through unknown mechanisms. Alcohol's metabolites induce DNA damage, an early step in carcinogenesis. We assessed the effect of time of alcohol consumption on markers of tissue damage in the colonic epithelium.

Methods: Mice were treated by alcohol or phosphate-buffered saline (PBS), at 4-hour intervals for 3 days, and their colons were analyzed for (i) proliferation (Ki67) and antiapoptosis (Bcl-2) markers, (ii) DNA damage (γ-H2AX), and (iii) the major acetaldehyde (AcH)-DNA adduct, N2 -ethylidene-dG. To model circadian disruption, mice were shifted once weekly for 12 h and then were sacrificed at 4-hour intervals. Samples of mice with a dysfunctional molecular clock were analyzed. The dynamics of DNA damage repair from AcH treatment as well as role of xeroderma pigmentosum, complementation group A (XPA) in their repair were studied in vitro.

Results: Proliferation and survival of colonic epithelium have daily rhythmicity. Alcohol induced colonic epithelium proliferation in a time-dependent manner, with a stronger effect during the light/rest period. Alcohol-associated DNA damage also occurred more when alcohol was given at light. Levels of DNA adduct did not vary by time, suggesting rather lower repair efficiency during the light versus dark. XPA gene expression, a key excision repair gene, was time-dependent, peaking at the beginning of the dark. XPA knockout colon epithelial cells were inefficient in repair of the DNA damage induced by alcohol's metabolite.

Conclusions: Time of day of alcohol intake may be an important determinant of colon tissue damage and carcinogenicity.

背景:酒精摄入会增加患结肠癌的风险。昼夜节律紊乱通过未知机制促进酒精对结肠癌发生的影响。酒精的代谢物会诱发 DNA 损伤,这是致癌的早期步骤。我们评估了饮酒时间对结肠上皮组织损伤标志物的影响:方法:用酒精或磷酸盐缓冲盐水(PBS)对小鼠进行为期 3 天、每隔 4 小时一次的处理,然后分析小鼠结肠中(i)增殖(Ki67)和抗凋亡(Bcl-2)标记物、(ii)DNA 损伤(γ-H2AX)和(iii)主要乙醛(AcH)-DNA 加合物 N2-亚乙基-dG。为了模拟昼夜节律紊乱,小鼠每周换班一次,每次 12 小时,然后每隔 4 小时处死一次。对分子钟失调的小鼠样本进行了分析。在体外研究了AcH处理引起的DNA损伤修复的动态以及A互补组色素性红斑(XPA)在其修复中的作用:结果:结肠上皮细胞的增殖和存活具有日节律性。酒精诱导结肠上皮细胞增殖与时间有关,在光照/休息期间影响更大。在光照下饮酒时,与酒精相关的 DNA 损伤也更严重。DNA 加合物的水平并不随时间而变化,这表明在光照和黑暗条件下的修复效率更低。XPA基因是一种关键的切除修复基因,其表达与时间有关,在黑暗开始时达到高峰。XPA基因敲除的结肠上皮细胞对酒精代谢物诱导的DNA损伤的修复效率较低:结论:每天摄入酒精的时间可能是决定结肠组织损伤和致癌性的重要因素。
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引用次数: 0
Chronic Ethanol Exposure Disrupts Lactate and Glucose Homeostasis and Induces Dysfunction of the Astrocyte-Neuron Lactate Shuttle in the Brain. 慢性乙醇暴露会破坏乳酸和葡萄糖的稳态,并诱导大脑中星形细胞神经元乳酸穿梭机的功能障碍。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-16 DOI: 10.1111/acer.14137
Daniel Lindberg, Ada Man Choi Ho, Lee Peyton, Doo-Sup Choi

Background: Impairment of monocarboxylate transporter (MCT)-dependent astrocyte-neuron lactate transfer disrupts long-term memory and erases drug-associated memories in mice. However, few studies have examined how drugs of abuse alter astrocyte-neuron lactate transfer in neurocircuits related to addiction. This is particularly pertinent for ethanol (EtOH), which has been demonstrated to impair central nervious system (CNS) glucose uptake and significantly alter peripheral levels of glucose, lactate, acetate, and ketones.

Methods: We subjected C57BL/6J mice to a chronic intermittent EtOH (CIE) exposure paradigm to investigate how chronic EtOH exposure alters the concentration of glucose and lactate within the serum and CNS during withdrawal. Next, we determine how chronic injections of lactate (1 g/kg, twice daily for 2 weeks) influence central and peripheral glucose and lactate concentrations. Finally, we determine how CIE and chronic lactate injection affect astrocyte-neuron lactate transfer by analyzing the expression of MCTs.

Results: Our results show that CIE induces lasting changes in CNS glucose and lactate concentrations, accompanied by increased expression of MCTs. Interestingly, although chronic lactate injection mimics the effect of EtOH on CNS metabolites, chronic lactate injection is not associated with increased expression of MCTs.

Conclusion: CIE increases CNS concentrations of glucose and lactate and augments the expression of MCTs. Although we found that chronic lactate injection mimics EtOH-induced increases in CNS lactate and glucose, lactate failed to alter the expression of MCTs. This suggests that although lactate may influence the homeostasis of bioenergetic molecules in the CNS, EtOH-associated increases in lactate are not responsible for increased MCT expression.

背景:单羧酸盐转运蛋白(MCT)依赖性星形胶质细胞神经元乳酸转移的损伤会破坏小鼠的长期记忆并消除药物相关记忆。然而,很少有研究检测滥用药物如何改变与成瘾相关的神经回路中星形胶质细胞-神经元乳酸转移。这与乙醇(EtOH)特别相关,乙醇已被证明会损害中枢神经系统(CNS)的葡萄糖摄取,并显著改变外周葡萄糖、乳酸、乙酸盐和酮的水平。方法:我们让C57BL/6J小鼠接受慢性间歇性EtOH(CIE)暴露模式,以研究慢性EtOH暴露如何在停药期间改变血清和中枢神经系统中的葡萄糖和乳酸浓度。接下来,我们确定长期注射乳酸(1g/kg,每天两次,持续两周)如何影响中枢和外周葡萄糖和乳酸浓度。最后,我们通过分析MCTs的表达来确定CIE和慢性乳酸盐注射如何影响星形胶质细胞-神经元的乳酸盐转移。结果:我们的结果表明,CIE诱导中枢神经系统葡萄糖和乳酸盐浓度的持久变化,并伴有MCTs表达的增加。有趣的是,尽管慢性乳酸盐注射模拟了EtOH对中枢神经系统代谢产物的影响,但慢性乳酸盐注射液与MCTs表达增加无关。结论:CIE增加了中枢神经系统葡萄糖和乳酸盐的浓度,并增加了MCTs的表达。尽管我们发现慢性乳酸盐注射模拟EtOH诱导的中枢神经系统乳酸盐和葡萄糖的增加,但乳酸盐未能改变MCTs的表达。这表明,尽管乳酸可能影响中枢神经系统中生物能量分子的稳态,但与EtOH相关的乳酸增加并不是MCT表达增加的原因。
{"title":"Chronic Ethanol Exposure Disrupts Lactate and Glucose Homeostasis and Induces Dysfunction of the Astrocyte-Neuron Lactate Shuttle in the Brain.","authors":"Daniel Lindberg,&nbsp;Ada Man Choi Ho,&nbsp;Lee Peyton,&nbsp;Doo-Sup Choi","doi":"10.1111/acer.14137","DOIUrl":"10.1111/acer.14137","url":null,"abstract":"<p><strong>Background: </strong>Impairment of monocarboxylate transporter (MCT)-dependent astrocyte-neuron lactate transfer disrupts long-term memory and erases drug-associated memories in mice. However, few studies have examined how drugs of abuse alter astrocyte-neuron lactate transfer in neurocircuits related to addiction. This is particularly pertinent for ethanol (EtOH), which has been demonstrated to impair central nervious system (CNS) glucose uptake and significantly alter peripheral levels of glucose, lactate, acetate, and ketones.</p><p><strong>Methods: </strong>We subjected C57BL/6J mice to a chronic intermittent EtOH (CIE) exposure paradigm to investigate how chronic EtOH exposure alters the concentration of glucose and lactate within the serum and CNS during withdrawal. Next, we determine how chronic injections of lactate (1 g/kg, twice daily for 2 weeks) influence central and peripheral glucose and lactate concentrations. Finally, we determine how CIE and chronic lactate injection affect astrocyte-neuron lactate transfer by analyzing the expression of MCTs.</p><p><strong>Results: </strong>Our results show that CIE induces lasting changes in CNS glucose and lactate concentrations, accompanied by increased expression of MCTs. Interestingly, although chronic lactate injection mimics the effect of EtOH on CNS metabolites, chronic lactate injection is not associated with increased expression of MCTs.</p><p><strong>Conclusion: </strong>CIE increases CNS concentrations of glucose and lactate and augments the expression of MCTs. Although we found that chronic lactate injection mimics EtOH-induced increases in CNS lactate and glucose, lactate failed to alter the expression of MCTs. This suggests that although lactate may influence the homeostasis of bioenergetic molecules in the CNS, EtOH-associated increases in lactate are not responsible for increased MCT expression.</p>","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"43 9","pages":"1838-1847"},"PeriodicalIF":3.2,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/acer.14137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37367320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 12
Social and Situational Party Characteristics Associated With High-Intensity Alcohol Use Among Youth and Young Adults. 青年和年轻人中与高强度饮酒相关的社会和情境派对特征。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-16 DOI: 10.1111/acer.14143
Melissa J Cox, Kathleen L Egan, Cynthia K Suerken, Beth A Reboussin, Eunyoung Y Song, Kimberly G Wagoner, Mark Wolfson

Background: Rates of high-intensity drinking, which is alcohol consumption that exceeds standard heavy drinking levels, have increased in recent years and peak in young adulthood. To identify modifiable environmental targets for prevention of high-intensity drinking, we identified characteristics of parties attended by youth and young adults that were associated with high-intensity drinking and the consequences of this excessive form of drinking.

Methods: Data are from 15- to 20-year-old participants in an online survey (n = 2,442; 55.4% female, 74.8% White) who resided in 24 communities across 7 states that were a part of a community randomized intervention trial to reduce the incidence and consequences of underage drinking parties. We used multinomial logistic regression to predict level of drinking by 6 party characteristics (size, location, age and gender composition, supervision, others' drinking behavior), and to predict 6 consequences (hangover, not remember event, passed out, punished by parents, broke something/got in fight, and sex against will) from level of drinking. We tested study hypotheses in 2 models, one that used a single binge drinking threshold (below binge vs. at or above binge level) and one that additionally used a high-intensity drinking level (below binge, 1 to 2 times binge, 2+ times binge level).

Results: We found that larger party size and a mostly male composition were unique predictors of high-intensity drinking when compared to those who consumed 1 to 2 times the binge drinking level. Odds of passing out, not remembering the drinking event, breaking/damaging property, or getting in a fight were more than double for high-intensity drinkers compared to standard binge level drinkers.

Conclusions: Results from this study indicate there are unique precursors and consequences of high-intensity alcohol consumption among youth and young adults. These environmental factors associated with high-risk drinking contexts can be used to develop prevention strategies to mitigate the harms associated with excessive alcohol consumption.

背景:近年来,高强度饮酒率有所上升,在年轻时达到峰值。为了确定预防高强度饮酒的可改变的环境目标,我们确定了青年和年轻人参加的与高强度饮酒有关的聚会的特征以及这种过度饮酒的后果。方法:数据来自一项在线调查的15至20岁参与者(n=2442;55.4%为女性,74.8%为白人),他们居住在7个州的24个社区,这是一项社区随机干预试验的一部分,旨在减少未成年人饮酒聚会的发生率和后果。我们使用多项逻辑回归,通过6个方面的特征(规模、地点、年龄和性别组成、监督、他人饮酒行为)来预测饮酒水平,并从饮酒水平预测6个后果(宿醉、不记得事件、昏倒、父母惩罚、摔坏东西/打架和违背意愿的性行为)。我们在两个模型中检验了研究假设,一种是使用单一的狂饮阈值(低于狂饮与处于或高于狂饮水平),另一种是额外使用高强度饮酒水平(低于狂喝,1到2倍狂饮,2倍以上狂饮水平数量与标准狂饮水平的饮酒者相比,高强度饮酒者昏倒、不记得饮酒事件、破坏/损坏财产或打架的几率增加了一倍多。结论:这项研究的结果表明,在青年和年轻人中,高强度饮酒有其独特的前兆和后果。这些与高风险饮酒环境相关的环境因素可用于制定预防策略,以减轻与过度饮酒相关的危害。
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引用次数: 9
Associations Between Drinking and Cortical Thickness in Younger Adult Drinkers: Findings From the Human Connectome Project. 年轻成年人饮酒与皮质厚度之间的关系:人类连接组项目的发现
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-09-01 Epub Date: 2019-07-31 DOI: 10.1111/acer.14147
Vanessa L Morris, Max M Owens, Sabrina K Syan, Tashia D Petker, Lawrence H Sweet, Assaf Oshri, James MacKillop, Michael Amlung

Background: Previous neuroimaging studies examining relations between alcohol misuse and cortical thickness have revealed that increased drinking quantity and alcohol-related problems are associated with thinner cortex. Although conflicting regional effects are often observed, associations are generally localized to frontal regions (e.g., dorsolateral prefrontal cortex [DLPFC], inferior frontal gyrus [IFG], and anterior cingulate cortex). Inconsistent findings may be attributed to methodological differences, modest sample sizes, and limited consideration of sex differences.

Methods: This study examined neuroanatomical correlates of drinking quantity and heavy episodic drinking in a large sample of younger adults (N = 706; Mage  = 28.8; 51% female) using magnetic resonance imaging data from the Human Connectome Project. Exploratory analyses examined neuroanatomical correlates of executive function (flanker task) and working memory (list sorting).

Results: Hierarchical linear regression models (controlling for age, sex, education, income, smoking, drug use, twin status, and intracranial volume) revealed significant inverse associations between drinks in past week and frequency of heavy drinking and cortical thickness in a majority of regions examined. The largest effect sizes were found for frontal regions (DLPFC, IFG, and the precentral gyrus). Follow-up regression models revealed that the left DLPFC was uniquely associated with both drinking variables. Sex differences were also observed, with significant effects largely specific to men.

Conclusions: This study adds to the understanding of brain correlates of alcohol use in a large, gender-balanced sample of younger adults. Although the cross-sectional methodology precludes causal inferences, these findings provide a foundation for rigorous hypothesis testing in future longitudinal investigations.

背景:以往对酒精滥用与皮层厚度之间关系的神经影像学研究表明,饮酒量增加和酒精相关问题与皮层变薄有关。尽管经常观察到相互矛盾的区域效应,但相关性通常被定位在额叶区域(如背外侧前额叶皮层[DLPFC]、额下回[IFG]和前扣带回皮层)。不一致的研究结果可能是由于方法上的差异、样本量不大以及对性别差异的考虑有限:本研究利用人类连接组计划(Human Connectome Project)的磁共振成像数据,对大量年轻成年人(N = 706; Mage = 28.8; 51%为女性)的饮酒量和重度偶发性饮酒的神经解剖相关性进行了研究。探索性分析检验了执行功能(侧翼任务)和工作记忆(列表排序)的神经解剖相关性:层次线性回归模型(控制了年龄、性别、教育程度、收入、吸烟、吸毒、双胞胎状况和颅内容积)显示,过去一周的饮酒量和大量饮酒的频率与大多数受检区域的皮层厚度之间存在显著的反比关系。额叶区域(DLPFC、IFG和前中央回)的效应大小最大。后续回归模型显示,左侧 DLPFC 与两个饮酒变量都有独特的关联。研究还观察到了性别差异,男性在很大程度上受到显著影响:这项研究加深了人们对大量性别均衡的年轻成年人饮酒的大脑相关性的了解。尽管横断面研究方法不能得出因果推论,但这些发现为今后的纵向调查提供了严格的假设检验基础。
{"title":"Associations Between Drinking and Cortical Thickness in Younger Adult Drinkers: Findings From the Human Connectome Project.","authors":"Vanessa L Morris, Max M Owens, Sabrina K Syan, Tashia D Petker, Lawrence H Sweet, Assaf Oshri, James MacKillop, Michael Amlung","doi":"10.1111/acer.14147","DOIUrl":"10.1111/acer.14147","url":null,"abstract":"<p><strong>Background: </strong>Previous neuroimaging studies examining relations between alcohol misuse and cortical thickness have revealed that increased drinking quantity and alcohol-related problems are associated with thinner cortex. Although conflicting regional effects are often observed, associations are generally localized to frontal regions (e.g., dorsolateral prefrontal cortex [DLPFC], inferior frontal gyrus [IFG], and anterior cingulate cortex). Inconsistent findings may be attributed to methodological differences, modest sample sizes, and limited consideration of sex differences.</p><p><strong>Methods: </strong>This study examined neuroanatomical correlates of drinking quantity and heavy episodic drinking in a large sample of younger adults (N = 706; M<sub>age</sub>  = 28.8; 51% female) using magnetic resonance imaging data from the Human Connectome Project. Exploratory analyses examined neuroanatomical correlates of executive function (flanker task) and working memory (list sorting).</p><p><strong>Results: </strong>Hierarchical linear regression models (controlling for age, sex, education, income, smoking, drug use, twin status, and intracranial volume) revealed significant inverse associations between drinks in past week and frequency of heavy drinking and cortical thickness in a majority of regions examined. The largest effect sizes were found for frontal regions (DLPFC, IFG, and the precentral gyrus). Follow-up regression models revealed that the left DLPFC was uniquely associated with both drinking variables. Sex differences were also observed, with significant effects largely specific to men.</p><p><strong>Conclusions: </strong>This study adds to the understanding of brain correlates of alcohol use in a large, gender-balanced sample of younger adults. Although the cross-sectional methodology precludes causal inferences, these findings provide a foundation for rigorous hypothesis testing in future longitudinal investigations.</p>","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":" ","pages":"1918-1927"},"PeriodicalIF":3.2,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721970/pdf/nihms-1040196.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40451511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense. 随机临床试验研究首次酒后驾车犯罪个体的认知行为疗法。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-08-31 DOI: 10.1111/acer.14161
K. Osilla, S. Paddock, Colleen M. McCullough, Lisa Jonsson, K. Watkins
BACKGROUNDDriving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence-based therapy in these programs may help prevent DUI recidivism.METHODSWe conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first-time DUI offense who screened positive for at-risk drinking in the past year. Participants were randomly assigned to a 12-session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent-to-treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol-related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.RESULTSParticipants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4- and 10-month follow-ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10-month follow-up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4- and 10-month follow-ups. Participants in both UC and CBT reported significant within-group reductions in 2 of 5 outcomes, binge drinking and alcohol-related consequences, at 10-month follow-up (p < 0.001).CONCLUSIONSIn the short-term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short-term reductions in impaired driving.
酒后驾驶(DUI)计划是一个独特的环境,可以减少那些可能无法获得治疗的人在获得治疗方面的差距。在这些项目中提供循证治疗可能有助于防止酒后驾车再犯。方法我们进行了一项随机临床试验,共有312名参与者参加了加州3个DUI项目中的1个。参与者年龄在21岁及以上,首次酒后驾车,在过去一年中检测出有饮酒风险。参与者被随机分配到12个疗程的手动认知行为疗法(CBT)或常规护理(UC)组,然后在4个月和10个月后接受调查。我们进行了意向治疗分析,以验证接受CBT的参与者会报告减少驾驶障碍、饮酒(每周饮酒、戒酒和酗酒)以及与酒精相关的负面后果的假设。我们还探讨了种族/民族和性别是否会影响CBT的结果。结果参与者中男性72.3%,西班牙裔51.7%,平均年龄33.2岁(SD = 12.4)。相对于UC,在4个月和10个月的随访中,接受CBT的参与者与接受UC的参与者相比,酒后驾驶的几率更低(比值比[OR] = 0.37, p = 0.032, OR = 0.29, p = 0.065)。在10个月的随访中,这种干预效果在女性中更为明显。在4个月和10个月的随访中,UC和CBT的其余4项结果没有显著差异。在10个月的随访中,UC和CBT的参与者报告了5个结局中2个的组内显著减少,即酗酒和酒精相关后果(p < 0.001)。结论在短期内,接受CBT治疗的个体报告的重复酒驾率明显低于接受UC治疗的个体,这可能表明学习认知行为策略来预防酒后驾驶可能有助于在短期内减少酒后驾驶。
{"title":"Randomized Clinical Trial Examining Cognitive Behavioral Therapy for Individuals With a First-Time DUI Offense.","authors":"K. Osilla, S. Paddock, Colleen M. McCullough, Lisa Jonsson, K. Watkins","doi":"10.1111/acer.14161","DOIUrl":"https://doi.org/10.1111/acer.14161","url":null,"abstract":"BACKGROUND\u0000Driving under the influence (DUI) programs are a unique setting to reduce disparities in treatment access to those who may not otherwise access treatment. Providing evidence-based therapy in these programs may help prevent DUI recidivism.\u0000\u0000\u0000METHODS\u0000We conducted a randomized clinical trial of 312 participants enrolled in 1 of 3 DUI programs in California. Participants were 21 and older with a first-time DUI offense who screened positive for at-risk drinking in the past year. Participants were randomly assigned to a 12-session manualized cognitive behavioral therapy (CBT) or usual care (UC) group and then surveyed 4 and 10 months later. We conducted intent-to-treat analyses to test the hypothesis that participants receiving CBT would report reduced impaired driving, alcohol consumption (drinks per week, abstinence, and binge drinking), and alcohol-related negative consequences. We also explored whether race/ethnicity and gender moderated CBT findings.\u0000\u0000\u0000RESULTS\u0000Participants were 72.3% male and 51.7% Hispanic, with an average age of 33.2 (SD = 12.4). Relative to UC, participants receiving CBT had lower odds of driving after drinking at the 4- and 10-month follow-ups compared to participants receiving UC (odds ratio [OR] = 0.37, p = 0.032, and OR = 0.29, p = 0.065, respectively). This intervention effect was more pronounced for females at 10-month follow-up. The remaining 4 outcomes did not significantly differ between UC versus CBT at 4- and 10-month follow-ups. Participants in both UC and CBT reported significant within-group reductions in 2 of 5 outcomes, binge drinking and alcohol-related consequences, at 10-month follow-up (p < 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000In the short-term, individuals receiving CBT reported significantly lower rates of repeated DUI than individuals receiving UC, which may suggest that learning cognitive behavioral strategies to prevent impaired driving may be useful in achieving short-term reductions in impaired driving.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78116244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Systemic administration of the cyclin-dependent kinase inhibitor (S)-CR8 selectively reduces escalated ethanol intake in dependent rats. 周期蛋白依赖性激酶抑制剂(S)-CR8的全身给药选择性地减少依赖大鼠的乙醇摄入量。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-08-30 DOI: 10.1111/acer.14177
S. P. Goulding, G. de Guglielmo, L. Carrette, O. George, C. Contet
BACKGROUNDChronic exposure to ethanol and other drugs of abuse can alter the expression and activity of cyclin-dependent kinase 5 (CDK5) and its cofactor p35, but the functional implication of CDK5 signaling in the regulation of ethanol-related behaviors remains unknown. In the present study, we sought to determine whether CDK5 activity plays a role in the escalation of ethanol self-administration triggered by dependence.METHODSWe tested the effect of systemically administered (S)-CR8, a non-selective CDK inhibitor, on operant responding for ethanol or saccharin, a highly palatable reinforcer, in adult male Wistar rats. Half of the rats were made ethanol-dependent via chronic intermittent ethanol inhalation (CIE). We then sought to identify a possible neuroanatomical locus for the behavioral effect of (S)-CR8 by quantifying protein levels of CDK5 and p35 in subregions of the extended amygdala and prefrontal cortex from ethanol-naïve, non-dependent, and dependent rats at the expected time of ethanol self-administration. We also analyzed the phosphorylation of four CDK5 substrates and of the CDK substrate consensus motif.RESULTS(S)-CR8 dose-dependently reduced ethanol self-administration in dependent rats. It had no effect on water or saccharin self-administration, nor in non-dependent rats. The abundance of CDK5 or p35 was not altered in any of the brain regions analyzed. In the bed nucleus of the stria terminalis, CDK5 abundance was negatively correlated with intoxication levels during ethanol vapor exposure but there was no effect of dependence on the phosphorylation ratio of CDK5 substrates. In contrast, ethanol dependence increased the phosphorylation of low-molecular weight CDK substrates in the basolateral amygdala.CONCLUSIONSThe selective effect of (S)-CR8 on excessive ethanol intake has potential therapeutic value for the treatment of alcohol use disorders. Our data do not support the hypothesis that this effect would be mediated by the inhibition of upregulated CDK5 activity in the extended amygdala nor prefrontal cortex. However, increased activity of CDKs other than CDK5 in the basolateral amygdala may contribute to excessive ethanol consumption in alcohol dependence. Other (S)-CR8 targets may also be implicated. This article is protected by copyright. All rights reserved.
背景:长期暴露于乙醇和其他滥用药物可改变细胞周期蛋白依赖性激酶5 (CDK5)及其辅助因子p35的表达和活性,但CDK5信号在调节乙醇相关行为中的功能意义尚不清楚。在本研究中,我们试图确定CDK5活性是否在依赖引发的乙醇自我给药升级中发挥作用。方法我们测试了系统给药(S)-CR8(一种非选择性CDK抑制剂)对成年雄性Wistar大鼠对乙醇或糖精(一种非常可口的强化物)的操作反应的影响。一半的大鼠通过慢性间歇乙醇吸入(CIE)使乙醇依赖。然后,我们试图通过量化ethanol-naïve、非依赖和依赖大鼠的扩展杏仁核和前额叶皮层亚区CDK5和p35的蛋白水平,在预期的乙醇自我给药时间内,确定(S)-CR8行为效应的可能神经解剖学位点。我们还分析了四种CDK5底物和CDK底物共识基元的磷酸化。结果(S)-CR8剂量依赖性地减少了依赖大鼠的乙醇自我给药。它对水或糖精的自我给药没有影响,对非依赖性大鼠也没有影响。在分析的任何大脑区域中,CDK5或p35的丰度都没有改变。在终纹床核中,CDK5丰度与乙醇蒸气暴露期间的中毒水平呈负相关,但对CDK5底物磷酸化比例的依赖没有影响。相反,乙醇依赖性增加了杏仁核基底外侧低分子量CDK底物的磷酸化。结论(S)-CR8对过量乙醇摄入的选择性作用对治疗酒精使用障碍具有潜在的治疗价值。我们的数据不支持这种效应是通过抑制扩展杏仁核或前额叶皮层中上调的CDK5活性来介导的假设。然而,除了CDK5外,基底外侧杏仁核中CDKs活性的增加可能导致酒精依赖中过量的乙醇消耗。其他(S)-CR8靶点也可能参与其中。这篇文章受版权保护。版权所有。
{"title":"Systemic administration of the cyclin-dependent kinase inhibitor (S)-CR8 selectively reduces escalated ethanol intake in dependent rats.","authors":"S. P. Goulding, G. de Guglielmo, L. Carrette, O. George, C. Contet","doi":"10.1111/acer.14177","DOIUrl":"https://doi.org/10.1111/acer.14177","url":null,"abstract":"BACKGROUND\u0000Chronic exposure to ethanol and other drugs of abuse can alter the expression and activity of cyclin-dependent kinase 5 (CDK5) and its cofactor p35, but the functional implication of CDK5 signaling in the regulation of ethanol-related behaviors remains unknown. In the present study, we sought to determine whether CDK5 activity plays a role in the escalation of ethanol self-administration triggered by dependence.\u0000\u0000\u0000METHODS\u0000We tested the effect of systemically administered (S)-CR8, a non-selective CDK inhibitor, on operant responding for ethanol or saccharin, a highly palatable reinforcer, in adult male Wistar rats. Half of the rats were made ethanol-dependent via chronic intermittent ethanol inhalation (CIE). We then sought to identify a possible neuroanatomical locus for the behavioral effect of (S)-CR8 by quantifying protein levels of CDK5 and p35 in subregions of the extended amygdala and prefrontal cortex from ethanol-naïve, non-dependent, and dependent rats at the expected time of ethanol self-administration. We also analyzed the phosphorylation of four CDK5 substrates and of the CDK substrate consensus motif.\u0000\u0000\u0000RESULTS\u0000(S)-CR8 dose-dependently reduced ethanol self-administration in dependent rats. It had no effect on water or saccharin self-administration, nor in non-dependent rats. The abundance of CDK5 or p35 was not altered in any of the brain regions analyzed. In the bed nucleus of the stria terminalis, CDK5 abundance was negatively correlated with intoxication levels during ethanol vapor exposure but there was no effect of dependence on the phosphorylation ratio of CDK5 substrates. In contrast, ethanol dependence increased the phosphorylation of low-molecular weight CDK substrates in the basolateral amygdala.\u0000\u0000\u0000CONCLUSIONS\u0000The selective effect of (S)-CR8 on excessive ethanol intake has potential therapeutic value for the treatment of alcohol use disorders. Our data do not support the hypothesis that this effect would be mediated by the inhibition of upregulated CDK5 activity in the extended amygdala nor prefrontal cortex. However, increased activity of CDKs other than CDK5 in the basolateral amygdala may contribute to excessive ethanol consumption in alcohol dependence. Other (S)-CR8 targets may also be implicated. This article is protected by copyright. All rights reserved.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"26 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81501510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Chronic alcohol consumption, but not acute intoxication, decreases in vitro skeletal muscle contractile function. 慢性酒精消费,但不是急性中毒,降低体外骨骼肌收缩功能。
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-08-30 DOI: 10.1111/acer.14179
K. Crowell, L. Laufenberg, C. Lang
BACKGROUNDSkeletal muscle myopathy accompanying chronic alcohol misuse results in part from a decrease in protein synthesis typically observed in type II-rich muscles that leads to muscle weakness. However, there are a paucity of studies investigating whether the alcohol-induced weakness is intrinsic to the muscle or results primarily from the loss of muscle mass. The present study determines whether acute alcohol (ethanol) intoxication or chronic alcohol consumption decreases the intrinsic contractile function of muscle.METHODSAdult male mice were randomly assigned to the chronic alcohol group or given a binge dose of alcohol, and contractile characteristics of the extensor digitorum longus (EDL) determined in vitro.RESULTSThe weight and physiological cross-sectional area (PCSA) of the EDL were decreased in alcohol-fed mice. Maximum twitch and tetanic tension were also reduced, and there was a downward shift of the absolute force-frequency curve in alcohol-fed mice. However, no alcohol-induced changes were noted when these contractile parameters were normalized for the lower PCSA. Alcohol-fed mice demonstrated greater fatigability, and alcohol-induced decreases in post-fatigue specific twitch and tetanic force were independent of a decreased PCSA. Furthermore, post-fatigue recovery of muscle force over time was reduced. While alcohol did not alter the content of high-energy phosphates or oxidative phosphorylation complexes I-V, it did reduce myosin heavy chain and troponin-T content. In contrast, contractile properties were not altered when examined 2 hours after binge alcohol.CONCLUSIONThese data demonstrate chronic alcohol consumption decreases isometric and tetanic tension development due to a reduction in muscle CSA, whereas the increased fatigability observed was independent of muscle mass. As none of the functional changes were produced by acute alcohol, which produced higher blood alcohol levels than chronic ingestion, our data suggest defects in intrinsic muscle contractility require sustained intake and appear independent of defects in basal energy production.
骨骼肌肌病伴随慢性酒精滥用,部分原因是在ii型富肌中观察到的蛋白质合成减少,导致肌肉无力。然而,关于酒精引起的虚弱是肌肉固有的还是主要由肌肉质量损失引起的研究很少。本研究确定急性酒精(乙醇)中毒或慢性酒精消费是否会降低肌肉的内在收缩功能。方法将成年雄性小鼠随机分为慢性酒精组和暴灌酒精组,测定其体外指长伸肌(EDL)的收缩特性。结果酒精喂养小鼠EDL的重量和生理截面积(PCSA)均降低。酒精喂养小鼠的最大抽搐张力和破伤风张力也降低,绝对力-频率曲线向下移动。然而,当这些收缩参数被归一化为较低的PCSA时,没有注意到酒精引起的变化。酒精喂养的小鼠表现出更大的疲劳性,并且酒精引起的疲劳后特异性抽搐和破伤风力的降低与PCSA的降低无关。此外,随着时间的推移,疲劳后肌肉力量的恢复也减少了。虽然酒精没有改变高能磷酸盐或氧化磷酸化复合物I-V的含量,但它确实降低了肌球蛋白重链和肌钙蛋白t的含量。相比之下,狂饮2小时后,收缩特性没有改变。结论:这些数据表明,由于肌肉CSA的减少,慢性饮酒会减少等长张力和破伤风张力的发展,而观察到的疲劳性增加与肌肉质量无关。由于急性饮酒比慢性饮酒产生更高的血液酒精水平,没有任何功能变化产生,我们的数据表明,内在肌肉收缩力的缺陷需要持续摄入,并且似乎独立于基础能量产生的缺陷。
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引用次数: 10
Five-Year Incidence of Hospital-Based Emergencies Related to Acute Recreational Intoxication in Minors. 与未成年人急性娱乐性中毒相关的5年医院急诊发生率
IF 3.2 3区 医学 Q1 Medicine Pub Date : 2019-08-27 DOI: 10.1111/acer.14166
A. Sanvisens, Irina Sanjeevan, P. Zuluaga, Adrià Túnez, A. de Francisco, E. Papaseit, L. García-Eroles, R. Muga
BACKGROUNDAlcohol or other drug (AOD) intoxication in minors is a public health challenge. We characterized underage patients admitted to an emergency department (ED) with acute, recreational AOD intoxication.METHODSWe conducted a 5-year (2012 to 2016) analysis of minors admitted to the only hospital-based pediatric ED in an urban area. Episodes of AOD intoxication were selected using ICD-9-CM diagnostic codes. Sociodemographics, substance use and clinical characteristics, laboratory parameters, and discharge dispositions were collected through the revision of clinical charts.RESULTSA total of 266 admissions related to recreational AOD intoxication in 258 patients occurred during the study period. Among the 258 patients, 127 (49.2%) were men, median age 16 years [IQR: 15 to 17 years], and 234 (90.7%) of episodes were alcohol-related. At admission, 202/256 (78.9%) patients had a Glasgow Coma Scale ≥ 13 points, the median systolic and diastolic blood pressure was 109 mmHg (IQR: 101 to 118 mmHg) and 67 mmHg (IQR: 60 to 73 mmHg), respectively, and the median blood glucose level was 112 mg/dl (IQR: 99 to 127 mg/dl). Only 72/258 (27.9%) patients underwent urine screening (22/72 (30.5%) were positive for cannabis), and only 30/258 (11.6%) were tested for blood ethanol (median: 185 mg/dl, IQR: 163 to 240 mg/dl). There was a trend in admissions occurring early in the morning of weekend days, and 249 (96.5%) patients were discharged home the day of admission.CONCLUSIONSThough the severity of AOD intoxication seems to be mild to moderate, assessment of substance exposure is low and may underestimate polydrug use in underage populations.
未成年人酒精或其他药物(AOD)中毒是一个公共卫生挑战。我们描述了在急诊科(ED)接受急性娱乐性AOD中毒的未成年患者。方法:我们对某城市地区唯一一家医院儿科急诊科收治的未成年人进行了为期5年(2012 - 2016年)的分析。使用ICD-9-CM诊断代码选择AOD中毒发作。通过修订临床图表收集社会人口统计、物质使用和临床特征、实验室参数和出院处置。结果258例患者中266例因娱乐性AOD中毒入院。258例患者中,127例(49.2%)为男性,中位年龄16岁[IQR: 15 ~ 17岁],234例(90.7%)发作与酒精有关。入院时,202/256(78.9%)患者的格拉斯哥昏迷评分≥13分,中位收缩压和舒张压分别为109 mmHg (IQR: 101 ~ 118 mmHg)和67 mmHg (IQR: 60 ~ 73 mmHg),中位血糖水平为112 mg/dl (IQR: 99 ~ 127 mg/dl)。只有72/258(27.9%)患者接受了尿液筛查(22/72(30.5%)大麻阳性),只有30/258(11.6%)接受了血液乙醇检测(中位数:185 mg/dl, IQR: 163至240 mg/dl)。入院时间以周末清晨为主,入院当日出院249例(96.5%)。结论虽然AOD中毒的严重程度似乎是轻至中度,但对物质暴露的评估较低,可能低估了未成年人群的多种药物使用。
{"title":"Five-Year Incidence of Hospital-Based Emergencies Related to Acute Recreational Intoxication in Minors.","authors":"A. Sanvisens, Irina Sanjeevan, P. Zuluaga, Adrià Túnez, A. de Francisco, E. Papaseit, L. García-Eroles, R. Muga","doi":"10.1111/acer.14166","DOIUrl":"https://doi.org/10.1111/acer.14166","url":null,"abstract":"BACKGROUND\u0000Alcohol or other drug (AOD) intoxication in minors is a public health challenge. We characterized underage patients admitted to an emergency department (ED) with acute, recreational AOD intoxication.\u0000\u0000\u0000METHODS\u0000We conducted a 5-year (2012 to 2016) analysis of minors admitted to the only hospital-based pediatric ED in an urban area. Episodes of AOD intoxication were selected using ICD-9-CM diagnostic codes. Sociodemographics, substance use and clinical characteristics, laboratory parameters, and discharge dispositions were collected through the revision of clinical charts.\u0000\u0000\u0000RESULTS\u0000A total of 266 admissions related to recreational AOD intoxication in 258 patients occurred during the study period. Among the 258 patients, 127 (49.2%) were men, median age 16 years [IQR: 15 to 17 years], and 234 (90.7%) of episodes were alcohol-related. At admission, 202/256 (78.9%) patients had a Glasgow Coma Scale ≥ 13 points, the median systolic and diastolic blood pressure was 109 mmHg (IQR: 101 to 118 mmHg) and 67 mmHg (IQR: 60 to 73 mmHg), respectively, and the median blood glucose level was 112 mg/dl (IQR: 99 to 127 mg/dl). Only 72/258 (27.9%) patients underwent urine screening (22/72 (30.5%) were positive for cannabis), and only 30/258 (11.6%) were tested for blood ethanol (median: 185 mg/dl, IQR: 163 to 240 mg/dl). There was a trend in admissions occurring early in the morning of weekend days, and 249 (96.5%) patients were discharged home the day of admission.\u0000\u0000\u0000CONCLUSIONS\u0000Though the severity of AOD intoxication seems to be mild to moderate, assessment of substance exposure is low and may underestimate polydrug use in underage populations.","PeriodicalId":7410,"journal":{"name":"Alcoholism, clinical and experimental research","volume":"77 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2019-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81187693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
期刊
Alcoholism, clinical and experimental research
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