MedWorm: Alcoholism

Charge transport through a polymer foil

Journal of Applied Physics — Wed, 27 Aug 2008 17:52:09 +0100

P. W. Chudleigh The charge-transport mechanism in FEP (A) polymer foils charged with an ethyl alcohol contact has been studied by measuring the decay of voltage across the foils. Each foil was metallized on one surface and stored at 100 degrees C in an open-circuit configuration. Voltage decay is shown to occur by ... [J. Appl. Phys. 48, 4591 (2008)] published Tue Aug 26, 2008. (Source: Journal of Applied Physics)

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On the glass transition in mixtures between the normal alcohols and various lewis bases

Journal of Chemical Physics — Wed, 27 Aug 2008 15:14:03 +0100

Arnold V. Lesikar The glass transition temperatures (T) of binary mixtures of the lower normal alkanols with several aprotic Lewis bases have been measured as a function of composition. The initial molar slope (IMS) at the pure alcohol end of the curve of T against mole fraction of base was accurately determined for ... [J. Chem. Phys. 66, 4263 (2008)] published Tue Aug 26, 2008. (Source: Journal of Chemical Physics)

Aug 20, 2008 - sports stadiums serve alcohol to minors and intoxicated fans

RWJF - News Releases — Wed, 27 Aug 2008 12:40:57 +0100

Research goes undercover and reveals how easy it is to buy booze in the stands. (Source: RWJF - News Releases)

Global survey highlights cancer misbeliefs

Health News - UPI.com — Wed, 27 Aug 2008 06:12:51 +0100

GENEVA, Switzerland, Aug. 27 (UPI) -- People in high-income countries are the least likely to believe that drinking alcohol increases the risk of cancer, officials of a Swiss non-profit say. (Source: Health News - UPI.com)

Caffeic acid alleviates the increased lipid levels of serum and tissues in alcohol-induced rats

Fundamental and Clinical Pharmacology — Wed, 27 Aug 2008 04:00:00 +0100

Ethanol is one of the most widely used and abused drugs that increases lipid levels in human and experimental animals. The objective of this study was to determine the effect of caffeic acid (CA) on alcohol-induced alterations of lipid levels in serum, liver and kindey of Wistar rats. The alcohol toxicity was induced by oral administration of ethanol (7.9 g/kg/bw) for 45 days through intragastric intubation. The elevation in the levels of lipids upon alcohol administration was accompanied by a significant increase in the levels of cholesterol, phospholipids (PL), free fatty acids (FFA) and triglycerides (TG) in serum, liver and kidney. Oral administration of CA (12 mg/kg/bw) to alcohol fed rats significantly decreased the serum and tissue lipid levels to near those of the control rats. In conclusion, our study suggests that oral administration of CA to alcohol fed rats markedly reduced the accumulation of cholesterol, TG, FFA and PL in circulation, liver and kidney. (Source: Fundamental and Clinical Pharmacology)

A 2-yr national population study of pediatric ketoacidosis in sweden: predisposing conditions and insulin pump use

Pediatric Diabetes — Wed, 27 Aug 2008 04:00:00 +0100

Hanas R, Lindgren F, Lindblad B. A 2-yr national population study of pediatric ketoacidosis in Sweden: predisposing conditions and insulin pump use.Pediatric Diabetes 2008.Abstract: The aim was to investigate triggering factors and insulin pump usage (continuous subcutaneous insulin infusion, CSII) at diabetic ketoacidosis (DKA). Data from 1999 and 2000 were collected retrospectively from Sweden. In 1999 and 2000, 7.4 and 11.0%, respectively, of children with diabetes used CSII. One hundred and forty-two episodes of DKA (pH < 7.30) were identified in 115 children (DKA at onset not included). Their hemoglobin A1c (HbA1c) was 10.1 ± 2.0%, age 14.6 ± 3.1 yr (range 1.5[ndash]19.9 yr), and diabetes duration 6.6 ± 3.5 yr (range 0.4[ndash]17.7 yr). Fourteen persons (seven girls) had more than one episode of DKA. Reported causes of DKA were missed insulin doses (48.6%), gastroenteritis (14.1%), technical pump problems (12.7%), infection (13.4%), social problems (1.4%), unknown (5.6%), and not stated (4.2%). Alcohol was involved in eight episodes and drugs in one. Thirty of 115 patients (19 girls) used insulin pumps. The overall DKA incidence was 1.4/100 patient years in 1999 and 1.7/100 patient years in 2000. For insulin pump users, the DKA incidence was 3.2/100 patient years in 1999 and 3.6/100 patient years in 2000. HbA1c at DKA admission was lower for CSII users than patients who used injections (9.1 ± 1.5 vs. 10.8 ± 2.2%, p < 0.01), but pH and age did not differ. CSII had been used for 6 months (median) before the DKA episode. In conclusion, the DKA frequency in CSII users was approximately twice that of patients who used injections. Seventy-seven percent of the episodes occurred within 1 yr after CSII start. The high number of events reported to be caused by gastroenteritis is alarming because this may reflect a misinterpretation of DKA symptoms. (Source: Pediatric Diabetes)

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Alcohol consumption can cause too much cell death, fetal abnormalities

ScienceDaily Headlines — Wed, 27 Aug 2008 00:00:00 +0100

The initial signs of fetal alcohol syndrome are slight but classic: facial malformations such as a flat and high upper lip, small eye openings and a short nose. Researchers want to know if those facial clues can help them figure out how much alcohol it takes during what point in development to cause these and other lifelong problems. (Source: ScienceDaily Headlines)

Belief in cancer myths risky: report

CBC | Health — Tue, 26 Aug 2008 21:49:06 +0100

People worldwide have a poor understanding of what causes cancer and therefore underestimate the importance of factors they can control, like diet and alcohol consumption, according to a report released on Wednesday. (Source: CBC | Health)

Alcohol detox helps head and neck cancer patients

Reuters: Health — Tue, 26 Aug 2008 21:16:22 +0100

NEW YORK (Reuters Health) - Early recognition and treatment of alcohol withdrawal syndrome can improve the outcomes of patients with head and neck cancer, researchers report in the Archives of Otolaryngology, Head and Neck Surgery. (Source: Reuters: Health)

New evidence on addiction to medicines diazepam has effect on nerve cells in the brain reward system

Health News from Medical News Today — Tue, 26 Aug 2008 10:00:00 +0100

Addictions to medicines and drugs are thought to develop over a relatively long period of time. The process involves both structural and functional changes in brain nerve cells that are still poorly understood. However, a single drug or alcohol dose is sufficient to generate an initial stage of addiction. (Source: Health News from Medical News Today)

Pub industry issues challenge to bma on "unjust" tax, uk

Public Health News From Medical News Today — Tue, 26 Aug 2008 07:00:00 +0100

The British Medical Association is wrong to argue that responsible drinkers are willing to pay more tax on alcohol to deal with the behaviour of an irresponsible minority, according to the British Beer and Pub Association. (Source: Public Health News From Medical News Today)

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Alcohol consumption can cause too much cell death

Medicineworld.org: New Article Alert — Tue, 26 Aug 2008 04:33:06 +0100

The initial signs of fetal alcohol syndrome are slight but classic: facial malformations such as a flat and high upper lip, small eye openings and a short nose. Scientists want to know if those facial clues can help them figure out how much alcohol it takes during what point in development to cause these and other lifelong problems........ (Source: Medicineworld.org: New Article Alert)

Alcohol can cause too much cell death

United Press International - Consumer Health — Tue, 26 Aug 2008 04:14:45 +0100

AUGUSTA, Ga., Aug. 26 (UPI) -- Pregnant women who drink three or four glasses of wine in a short period elevate the risk of birth defects, U.S. researchers said. (Source: United Press International - Consumer Health)

Ultra-brief intervention for problem drinkers: research protocol

BMC Public Health - Latest articles — Tue, 26 Aug 2008 04:00:00 +0100

Background: Helping the large number of problem drinkers who will never seek treatment is a challenging issue. Public health initiatives employing educational materials or mass media campaigns have met with mixed success. However, clinical research has developed effective brief interventions to help problem drinkers. This project will employ an intervention that has been validated in clinical settings and then modified into an ultra-brief format suitable for use as a public health intervention. The major objective of this study is to conduct a randomized controlled trial to establish the effectiveness of an ultra-brief, personalized feedback intervention for problem drinkers. Methods: Problem drinkers recruited on a baseline population telephone survey conducted in a major metropolitan city in Canada will be randomized to one of three conditions - a personalized feedback pamphlet condition, a control pamphlet condition, or a no intervention control condition. In the week after the baseline survey, households in the two pamphlet conditions will be sent their respective pamphlets. Changes in drinking will be assessed post intervention at three-month and six-month follow-ups. Drinking outcomes will be compared between experimental conditions using Structural Equation Modeling. The primary hypothesis is that problem drinkers from households who receive the personalized feedback pamphlet intervention will display significantly improved drinking outcomes at three and six-month follow-ups as compared to problem drinkers from households in the no intervention control condition. Secondary hypotheses will test the impact of the intervention on help seeking, and explore the mediating or moderating role of perceived drinking norms, perceived alcohol risks and the problem drinker's social reasons for drinking.DiscussionThis trial will provide information on the effectiveness of a pamphlet-based personalized feedback intervention for problem drinkers in a community setting. Trial registration: ClinicalTrials.gov registration #NCT00688584. (Source: BMC Public Health - Latest articles)

Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study

BMC Geriatrics — Tue, 26 Aug 2008 04:00:00 +0100

Background: Fracture after falling has been identified as an important problem in public health. Most studies of risk factors for fractures due to falls have been carried out in developed countries, although the size of the elderly population is increasing fast in middle income countries. The objective of this paper is to identify risk factors for fall related to severe fractures in those aged 60 or more in a middle-income country. Methods: A case-control study was carried out in Rio de Janeiro-Brazil based general hospitals between 2002-2003. Two hundred-fifty hospitalised cases of fracture were matched with 250 community controls by sex, age group and living area. Data were collected for socio-demographic variables, health status and drugs used before the fall. A conditional logistic regression model was fitted to identify variables associated with the risk of fall related severe fracture. Results: Low body mass index, cognitive impairment, stroke and lack of urine control were associated with increased risk of severe fall related fractures. Benzodiazepines and muscle relaxants were also related to an increased risk of severe fractures while moderate use of alcohol was associated with reduced risk. Conclusions: Although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxants drugs. The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs. (Source: BMC Geriatrics)

Structure and permeation of organic-inorganic hybrid membranes composed of poly(vinyl alcohol) and polysilisesquioxane

RSC - J. Mater. Chem. latest articles — Tue, 26 Aug 2008 04:00:00 +0100

Qiu Gen Zhang, Qing Lin Liu, Feng Feng Shi, Ying Xiong (Paper from J. Mater. Chem.) Qiu Gen Zhang, J. Mater. Chem., 2008, DOI: 10.1039/b806303f To cite this article before page numbers are assigned, use the DOI form of citation above. The content of this RSS Feed (c) The Royal Society of Chemistry (Source: RSC - J. Mater. Chem. latest articles)

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Global survey highlights need for cancer prevention campaigns to correct misbeliefs

EurekAlert! - Cancer — Tue, 26 Aug 2008 04:00:00 +0100

(International Union Against Cancer) Many people hold mistaken beliefs about what causes cancer, tending to inflate the threat from environmental factors that have relatively little impact while minimizing the hazards of behaviors well established as cancer risk factors, according to the first global survey on the topic. People in high-income countries were the least likely to believe that drinking alcohol increases the risk of cancer. (Source: EurekAlert! - Cancer)

[influential publications] stimulant therapy and risk for subsequent substance use disorders in male adults with adhd: a naturalistic controlled 10-year follow-up study

FOCUS — Tue, 26 Aug 2008 04:00:00 +0100

Objective: The extant literature does not provide definite answers pertaining to whether stimulant treatment increases, decreases, or does not affect the risk for subsequent substance use disorders in youths with attention deficit hyperactivity disorder (ADHD). The authors examined the association between stimulant treatment in childhood and adolescence and subsequent substance use disorders (alcohol, drug, and nicotine) into the young adult years. Method: The authors conducted a 10-year prospective follow-up study. One hundred forty male Caucasian children with ADHD, ages 6 to 17, were examined at baseline. Of these, 112 (80%) were reassessed at the 10-year follow-up (mean age at follow-up=22 years). Assessments were made using Cox proportional hazards survival models. All models were adjusted for conduct disorder, since conduct disorder is a potent predictor of subsequent substance use disorders. Results: Of the 112 ADHD subjects who were reassessed at the 10-year follow-up, 82 (73%) had been treated previously with stimulants and 25 (22%) were undergoing stimulant treatment at the time of the follow-up assessment. There were no statistically significant associations between stimulant treatment and alcohol, drug, or nicotine use disorders. Conclusions: The findings revealed no evidence that stimulant treatment increases or decreases the risk for subsequent substance use disorders in children and adolescents with ADHD when they reach young adulthood. (Reprinted with permission from the American Journal of Psychiatry 2008; 165:597–603) (Source: FOCUS)

[neuroscience] nucleus accumbens ags3 expression drives ethanol seeking through g{beta}{gamma}

Proceedings of the National Academy of Sciences — Tue, 26 Aug 2008 04:00:00 +0100

Approximately 90% of alcoholics relapse within 4 years, in part because of an enhanced motivation to seek alcohol (EtOH). A... (Source: Proceedings of the National Academy of Sciences)

Integrated specialty mental health care among older minorities improves access but not outcomes: results of the prisme study

International Journal of Geriatric Psychiatry — Tue, 26 Aug 2008 04:00:00 +0100

In this secondary data analysis of Primary Care Research in Substance Abuse and Mental Health for the Elderly (PRIMSe) study, we hypothesized that older minorities who receive mental health services integrated in primary care settings would have greater service use and better mental health outcomes than older minorities referred to community services.We identified 2,022 (48% minorities) primary care patients 65 years and older, who met study inclusion criteria and had either alcohol misuse, depression, and/or anxiety. They were randomized to receive treatment for these disorders in the primary care clinic or to a brokerage case management model that linked patients to community-based services. Service use and clinical outcomes were collected at baseline, three months and six months post randomization on all participants.Access to and participation in mental health /substance abuse services was greater in the integrated model than in referral; there were no treatment by ethnicity effects. There were no treatment effects for any of the clinical outcomes; Whites and older minorities in both integrated and referral groups failed to show clinically significant improvement in symptoms and physical functioning at 6 months.While providing services in primary care results in better access to and use of these services, accessing these services is not enough for assuring adequate clinical outcomes. Copyright © 2008 John Wiley & Sons, Ltd. (Source: International Journal of Geriatric Psychiatry)

Alcohol consumption can cause too much cell death, fetal abnormalities

News-Medical News Feed — Tue, 26 Aug 2008 00:43:00 +0100

The initial signs of fetal alcohol syndrome are slight but classic: facial malformations such as a flat and high upper lip, small eye openings and a short nose. (Source: News-Medical News Feed)

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On the rounds

Scotsman.com News - Health — Tue, 26 Aug 2008 00:00:00 +0100

VOLUNTARY measures have failed to stop alcohol misuse and legislation is now required to halt the problem, according to the British Medical Association Scotland. (Source: Scotsman.com News - Health)

Isles drink abuse too widespread to target one group

Scotsman.com News - Health — Tue, 26 Aug 2008 00:00:00 +0100

ALCOHOL problems in the Western Isles are so widespread that experts find it difficult to decide which section of the population to target. (Source: Scotsman.com News - Health)

Could low doses of a drug for alcoholics ease the agony for sufferers of ms?

the Mail online | Health — Mon, 25 Aug 2008 20:13:55 +0100

For some multiple sclerosis sufferers, just getting out of bed is tough. For 43-year-old father-of-three Jon Salisbury, getting up took an hour and involved the help of his wife. (Source: the Mail online | Health)

Could low doses of a drug for alcoholics ease the agony for sufferers of ms?

the Mail online | Diet — Mon, 25 Aug 2008 20:13:55 +0100

Alcohol consumption can cause too much cell death

Huliq Health News — Mon, 25 Aug 2008 18:20:43 +0100

The initial signs of fetal alcohol syndrome are slight but classic: facial malformations such as a flat and high upper lip, small eye openings and a short nose. (Source: Huliq Health News)

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Alcohol dependence delays childbearing

Medical Headlines From Ivanhoe.com — Mon, 25 Aug 2008 05:00:00 +0100

Women with alcohol dependence (AD) may end up having fertility problems. (Source: Medical Headlines From Ivanhoe.com)

Tips from the journals of the american society for microbiology

EurekAlert! - Infectious and Emerging Diseases — Mon, 25 Aug 2008 04:00:00 +0100

(American Society for Microbiology) The following are tips from the journals of the American Society for Microbiology: "New Alcohol-Based Hand Sanitizer May Minimize Viral Transmission, Including Norovirus"; "New Oral Vaccine May Protect Against Bubonic Plague"; and "Oral Administration of Lactobacillus from Breast Milk May Treat Common Infection in Lactating Mothers." (Source: EurekAlert! - Infectious and Emerging Diseases)

Alcohol consumption can cause too much cell death, fetal abnormalities

EurekAlert! - Social and Behavioral Science — Mon, 25 Aug 2008 04:00:00 +0100

(Medical College of Georgia) The initial signs of fetal alcohol syndrome are slight but classic: facial malformations such as a flat and high upper lip, small eye openings and a short nose.Researchers want to know if those facial clues can help them figure out how much alcohol it takes during what point in development to cause these and other lifelong problems. (Source: EurekAlert! - Social and Behavioral Science)

Independent clinical predictors of impaired response to hepatitis b vaccination in hiv-infected persons

International Journal of STD and AIDS — Mon, 25 Aug 2008 04:00:00 +0100

Protective response rates to hepatitis B (HB) vaccination have been reported as low as 18–62% in HIV-infected persons. The relative importance of various predictors for this poor response has not been fully characterized. In this retrospective cohort study, we examined the relationship between clinical characteristics and vaccine non-response (HB surface antibody <10 IU/L) among patients attending an urban HIV clinic. Among the 97 patients who met the inclusion criteria, 43 (44%) developed a protective antibody response. In multivariate analyses, age >40 years (odds ratio [OR] 3.03 [95% confidence interval [CI], 1.14–8.06]; P = 0.026) and alcohol abuse (OR 4.92 [95% CI, 1.72–20.89]; P = 0.007) were independent predictors of failure to develop vaccine response. In addition, CD4 nadir <200 (OR 7.24 [95% CI, 1.91–27.41]; P = 0.004), rather than CD4 current to vaccination, remained a strong independent risk factor. Patients with HIV viral suppression on highly active antiretroviral therapy had a significantly lower rate of vaccine failure (OR 0.31 [95% CI, 0.11–0.91]; P = 0.033), after adjusting for these other covariates. Our findings underscore the importance of confirming seroconversion after HB vaccination in HIV-infected patients and initiating vaccination early in the course of HIV infection. (Source: International Journal of STD and AIDS)

Ras pathway activation in gliomas: a strategic target for intranasal administration of perillyl alcohol

Archivum Immunologiae et Therapiae Experimentalis — Sun, 24 Aug 2008 17:02:43 +0100

Abstract Introduction: Targeted therapy directed at specific molecular alterations is already creating a shift in the treatment of cancer patients. Malignant gliomas commonly overexpress the oncogenes EGFR and PDGFR and contain mutations and deletions of the tumor suppressor genes PTEN and TP53. Some of these alterations lead to activation of the P13K/Akt and Ras/MAPK pathways, which provide targets for therapy. Perillyl alcohol (POH), the isoprenoid of greatest clinical interest, was initially considered to inhibit farnesyl protein transferase. Follow-up studies revealed that POH suppresses the synthesis of small G proteins, including Ras. Intranasal delivery allows drugs that do not cross the blood-brain barrier to enter the central nervous system. Moreover, it eliminates the need for systemic delivery, thereby reducing unwanted systemic side effects. Materials and Methods: Applying this method, a phase I/II clinical trial of POH was performed in patients with relapsed malignant gliomas after standard treatment: surgery, radiotherapy, and chemotherapy. POH was administrated in a concentration of 0.3% volume/volume (55 mg) four times daily in an interrupted administration schedule. The objective was to evaluate toxicity and progression-free survival (PFS) after six months of treatment. The cohort consisted of 37 patients, including 29 with glioblastoma multiforme (GBM), 5 with grade III astrocytoma (AA), and 3 with anaplastic oligodendroglioma (AO). Neurological examination and suitable image analysis (computed tomography (CT), magnetic resonance imaging (MRI)) established disease progression. Complete response was defined as neurological stability or improvement of conditions, disappearance of CT/MRI tumor image, and corticosteroid withdraw; partial response (PR) as ≥50 reduction of CT/MRI tumor image, neurological stability, or improvement of conditions and corticosteroid requirement; progressive course (PC) as ≥25 increase in CT/MRI tumor image or the appearance of a new lesion; and stable disease as a lack of any changes in the CT/MR tumor image or neurological status. Results: After six months of treatment, PR was observed in 3.4% (n=1) of the patients with GBM and 33.3% (n=1) with AO; stable disease in 44.8% (n=13) with GBM, 60% (n=3) with AA, and 33.3% (n=1) with AO; and PC in 51.7% (n=15) with GBM, 40% (n=2), with AA and 33.3% (n=1) AO. PFS (sum of PRs and stable disease) was 48.2% for GBM, 60% for AA, and 66.6% for AO patients. Conclusions: The preliminary results indicate that intranasal administration of the signal transduction inhibitor POH is a safe, noninvasive, and low-cost method. There were no toxicity events and the regression of tumor size in some patients is suggestive of antitumor activity. Content Type Journal ArticleCategory ORIGINAL ARTICLEDOI 10.1007/s00005-008-0027-0Authors Clovis Orlando da Fonseca, Centro de Ciências Médicas Serviço de Neurocirurgia, Hospital Universitário Antônio Pedro, Departamento de Cirurgia Geral e Especializada CEP 24030-210 Niterói RJ BrazilRafael Linden, Universidade Federal do Rio de Janeiro Laboratório de Neurogênese Rio de Janeiro R.J BrazilDébora Futuro, Universidade Federal Fluminense Faculdade de Farmácia Niterói 24030-210 RJ BrazilCerli Rocha Gattass, Universidade Federal do Rio de Janeiro Laboratorio de Imunologia Celular 21949-900 Rio de Janeiro RJ BrazilThereza Quirico-Santos, Universidade Federal do Rio de Janeiro Laboratorio de Imunologia Celular 21949-900 Rio de Janeiro RJ Brazil Journal Archivum Immunologiae et Therapiae ExperimentalisOnline ISSN 1661-4917Print ISSN 0004-069X Journal Volume Volume 56 Journal Issue Volume 56, Number 4 / August, 2008 (Source: Archivum Immunologiae et Therapiae Experimentalis)

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The effects of body mass index on cerebral blood flow velocity

Clinical Autonomic Research — Sun, 24 Aug 2008 16:52:27 +0100

Abstract Objective Obesity is a risk factor for cerebrovascular disease. We aimed to determine the effects of high body mass index (BMI) on cerebral blood flow regulation in patients with type-2 diabetes mellitus, hypertension, and stroke. Methods We analyzed data from 90 controls, 30 diabetics, 45 hypertensives, and 32 ischemic stroke patients who underwent transcranial Doppler for evaluation of blood flow velocities (BFV) in the middle cerebral arteries (MCA) and cerebrovascular resistance (CVR) during supine rest and head-up tilt. This study was a cross-sectional analysis. We used a structural equation multiple indicators modeling to determine the effects of BMI and other background variables (age, sex, race, smoking, alcohol use, and systolic blood pressure) on cerebral BFV. Results Higher BMI (P = 0.02) and age (P = 0.004) were associated with lower mean BFV during baseline, independent of diagnosis of diabetes mellitus, hypertension or stroke, and after adjusting for all background variables and vessel diameters. Men, especially those with stroke, had a lower mean BFV than women (P = 0.01). CVR increased with BMI (P = 0.001) at baseline and during head-up tilt (P = 0.02), and was elevated in obese subjects (P = 0.004) compared to normal weight subjects across all groups. Interpretation High BMI is associated with a reduction in cerebral BFV and increased CVR. These findings indicate that obesity can adversely affect cerebral blood flow and resistance in the cerebrovascular bed, independent of diagnosis of type-2 diabetes, hypertension or stroke. Obesity may contribute to cerebromicrovascular disease, and affect clinical functional outcomes of the older population. Content Type Journal ArticleCategory RESEARCH ARTICLEDOI 10.1007/s10286-008-0490-zAuthors Magdy Selim, Beth Israel Deaconess Medical Center Dept. of Neurology, Stroke Division Boston MA USARichard Jones, Institute for Aging Research Hebrew Senior Life Boston MA USAPeter Novak, University of Massachusetts Dept. of Neurology Worcester MA USAPeng Zhao, Beth Israel Deaconess Medical Center Division of Gerontology 330 Brookline Avenue Boston MA 02215 USAVera Novak, Beth Israel Deaconess Medical Center Division of Gerontology 330 Brookline Avenue Boston MA 02215 USA Journal Clinical Autonomic ResearchOnline ISSN 1619-1560Print ISSN 0959-9851 (Source: Clinical Autonomic Research)

Fetal therapy in twin reserve arterial perfusion sequence pregnancies with alcohol ablation or bipolar cord coagulation

Archives of Gynecology and Obstetrics — Sun, 24 Aug 2008 16:39:41 +0100

Abstract Objective We aimed to evaluate perinatal outcome of seven pregnancies with twin reserve arterial perfusion sequence. Materials and methods Study group included seven cases of acardiac twins. Out of seven acardiac twins, two cases were followed without interventions. We performed four alcohol ablation and one bipolar caogulation. For alcohol ablation, a 20-gauge needle guided with color Doppler USG was directed to abdominal insertion site of the single umbilical artery of the acardiac twin, and 1.0–2.0 mL of absolute alcohol was injected. For bipolar coagulation of the umbilical cord, we used 3.5 mm laparoscopic trocar and 3.0 mm bipolar forceps. The procedures were performed under the guidance of transabdominal ultrasonography. Results Gestational age of the cases at diagnosis and at delivery was 15–32 and 17–38 weeks, respectively. Two cases without intervention were lost at 17 and 32 weeks. The mean time of procedure for bipolar coagulation and alcohol ablation were 30 and 10 min, respectively. One of the four cases of alcohol ablation group was aborted although alcohol ablation was succesful. Another one case was aborted after alcohol ablation due to lost of fetal cardiac activity of the pump fetus. In two other cases, umbilical cord ablation with alcohol was successful, and they delivered live birth at 36 and 38 weeks. In one case, we performed bipolar cord coagulation successfully, and the case delivered live birth at 39 weeks. The overall survival rate for intrauterine surgery was 60% (N 3/5). Conclusion In twin reserve arterial perfusion sequence pregnancies with findings of poor prognosis, alcohol ablation or bipolar cord coagulation as fetal therapy under the guidance of ultrasonography can be done successfully, and should be offered as a choice to families upon discussion of intervention or follow-up with own complications. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00404-008-0746-9Authors Ahmet Gul, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul TurkeyKemal Gungorduk, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul TurkeyGokhan Yildirim, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul TurkeyAli Gedikbasi, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul TurkeyDogukan Yildirim, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul TurkeyYavuz Ceylan, Women and Children Hospital Maternal and Fetal Unit, Department of Obstetrics and Gynecology, Istanbul Bakirkoy Istanbul Turkey Journal Archives of Gynecology and ObstetricsOnline ISSN 1432-0711Print ISSN 0932-0067 (Source: Archives of Gynecology and Obstetrics)

Alcohol outlet density, perceived availability and adolescent alcohol use: a multilevel structural equation model. - kuntsche e, kuendig h, gmel g.