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
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
<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
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
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
Objective: to analyze the mental state and quality of life of patients with mental disorders caused by alcohol after progressive rehabilitation nursing. Methods: 64 patients with mental disorders caused by alcohol who...Objective: to analyze the mental state and quality of life of patients with mental disorders caused by alcohol after progressive rehabilitation nursing. Methods: 64 patients with mental disorders caused by alcohol who were hospitalized from July 2020 to January 2021 were randomly divided into two groups with 32 cases in each group. The reference group received routine nursing, while the observation group received progressive rehabilitation nursing. The anxiety and depression scores and quality of life scores were compared. Results: after nursing, the anxiety and depression scores and quality of life scores of the reference group were worse than those of the observation group, with significant difference (P < 0.05). Conclusion: progressive rehabilitation nursing can flexibly intervene according to the patient's condition, gradually improve the patient's psychology and quality of life, and has great influence on nursing.展开更多
BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS ...BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.展开更多
Background: Neurodevelopmental abnormalities in experimental fetal alcohol spectrum disorder (FASD) are associated with impaired signaling through complex pathways that mediate neuronal survival, growth, migration, en...Background: Neurodevelopmental abnormalities in experimental fetal alcohol spectrum disorder (FASD) are associated with impaired signaling through complex pathways that mediate neuronal survival, growth, migration, energy metabolism, and plasticity. Gestational dietary soy prevents alcohol-related impairments in placentation and FASD-associated fetal anomalies. Objective: This study was designed to determine if gestational dietary soy would be sufficient to normalize cognitive function in young adolescent offspring after chronic in utero exposure to alcohol. In addition, efforts were made to characterize the mechanisms of FASD prevention by maternal dietary soy. Methods: Pregnant Long Evans rats were fed isocaloric liquid diets containing 0% or 26% caloric ethanol with casein or soy isolate as the protein source from gestation day 6 through delivery/postnatal day 0 (P0). From P24 - P28, the offspring were subjected to Morris water maze (MWM) testing, and on P35, they were sacrificed to harvest temporal lobes for histopathologic and molecular studies. Results: The in-utero ethanol-exposed offspring exhibited significant performance impairments on the MWM test, and they had a significantly reduced mean brain weight with neuronal loss in the CA1 hippocampal region and evidence of white matter myelin loss. Gestational dietary soy nearly normalized MWM performance and preserved brain weight, hippocampal CA1 architecture, and white matter myelin staining in alcohol-exposed offspring. Mechanistically, the main positive effects of soy included increased temporal lobe expression of HES-1 and HIF-1α, reflecting enhanced Notch signaling, and broadly increased expression of GnRH network molecules, including Erb1, Gper1, GnRH, GnRH-R, KiSS, and KiSS-R, irrespective of gestational ethanol exposure. Conclusions: Dietary soy intervention early in pregnancy may reduce FASD-associated cognitive deficits. The findings suggest that targeting Notch and GnRH-related networks may help reduce long-term disability with FASD. Additional mechanistic and experimental research is needed to determine if longer-duration, postnatal dietary soy could prevent the adverse neurobehavioral effects of FASD.展开更多
The glymphatic system,a recently discovered cerebrospinal fluid-mediated pathway,plays a crucial role in fluid exchange and waste clearance in the brain.Its dysfunction has been implicated in various neurological diso...The glymphatic system,a recently discovered cerebrospinal fluid-mediated pathway,plays a crucial role in fluid exchange and waste clearance in the brain.Its dysfunction has been implicated in various neurological disorders,including Alzheimer's disease and traumatic brain injury.Recent studies suggest that alcohol intake has a biphasic effect on the glymphatic system:Low doses of alcohol enhance glymphatic function,whereas high doses lead to glymphatic suppression and cognitive decline,mirroring patterns seen in alcohol-related dementia,providing valuable insights into the dose-dependent effects of alcohol on glymphatic function,but significant gaps persist,particularly regarding the mechanistic understanding and the influence of confounding factors such as sex,age,blood pressure,and wakefulness.Here,we synthesize and critically evaluate the important research findings within this field to gauge its progress and identify new research opportunities.We discuss the specific mechanisms by which alcohol affects the glymphatic system,including how alcohol influences cerebrospinal fluid-interstitial fluid exchange and waste removal.We also discuss the potential of the glymphatic system as a new target,such as through pharmacological or lifestyle interventions aimed at enhancing glymphatic function to treat alcohol use disorder and other neurological disorders associated with glymphatic dysfunction.展开更多
Alcohol-associated liver disease(ALD)is a rapidly increasing indication for liver transplantation(LT)globally with a significant rise in transplants for ALD with limited sobriety including patients with alcohol-associ...Alcohol-associated liver disease(ALD)is a rapidly increasing indication for liver transplantation(LT)globally with a significant rise in transplants for ALD with limited sobriety including patients with alcohol-associated hepatitis(AH).This evolution challenges the older paradigm that mandates prolonged periods of alcohol abstinence prior to LT.Due to the limited armamentarium of effective pharmacotherapy to treat severe AH,the mortality rates are significantly higher when LT is not available.In the patients who are transplanted for ALD with limited sobriety including AH,patient and graft survival are equivalent,if not better,compared to patients transplanted for other etiologies.However,due to the risk of alcohol relapse and other psychosocial factors,public opinion regarding early LT may continue to impact how the field moves forward particularly regarding organ stewardship and the need for equitable allocation of organs.Numerous tools for psychosocial evaluations have been developed to assist liver transplant teams to identify appropriate patients in a more uniform manner.In this review,we aim to assess the available evidence to support early LT for alcohol AH and propose directions for the future as the field continues to evolve.展开更多
Chinese Wine Culture influences people’s attitudes toward alcohol.The current study focuses on exploring the main features of a localized digital alcohol consumption intervention mini-program to address the difficult...Chinese Wine Culture influences people’s attitudes toward alcohol.The current study focuses on exploring the main features of a localized digital alcohol consumption intervention mini-program to address the difficulties of abstinence for native drinkers,as a promising way for long-term management of rehabilitation from alcohol use disorder.A mixed-method approach was used in this study.The self-report quantitative questionnaire recruited three groups of participants:89 drinkers,67 drinkers’relatives,and 30 medical staff.The focus group qualitative interview inspected 36 participants’perspectives on the core topics,including 21 drinkers,4 drinkers’relatives,and 11 medical staff.The results of combining the quantitative study and qualitative study indicated that the top difficulties of abstinence for native drinkers are the strong craving from the inside,the environmental influence,and the psychological health status,especially emotional states.Correspondingly,the most desired main features in an alcohol consumption digital intervention tool are the daily track of drinking conditions and craving level,periodic feedback reports that can share with others,and mood improvement training.Moreover,the top factors that influence participants’intention to use/recommend the tool are whether the tool is effective,whether the user experience is good,and whether the tool can replenish the deficiency of the current alcohol treatment.Future work needs to balance what patients want and what others around them expect,so that potential users can benefit best from the digital intervention tool in the context of Chinese culture.展开更多
BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze...BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze development trends and research hotspots in TMS-based addiction treatment using a bibliometric approach.METHODS Articles on TMS-based addiction treatment from 2001 to 2023 were sourced from the Science Citation Index Expanded in the Web of Science Core Collection.CiteSpace software,VOSviewer,the"bibliometrix"R software package,and the bibliometric online analysis platform were used to analyze the current publication trends and hotspots.RESULTS Total 190 articles on TMS-based addiction treatment were identified,with clinical studies being the most prevalent.The United States led in both publication volume and international collaborations.Medical University of South Carolina and Zangen A were the most productive institution and author,respectively.Neurobiology,alcohol use disorder,and repetitive TMS were the most recent research hotspots.CONCLUSION Future research should focus on the neurobiological mechanisms underlying TMS-based addiction treatment.This study offers comprehensive insights and recommendations for advancing research on TMS-based addiction treatment.展开更多
Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,i...Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,intervention,and treatment referral for alcohol-related problems in these settings.We searched the literature published in English from PubMed,ScienceDirect,and the World Health Organization website.We found that while a series of screening tools can be used,screening rates were low.The awareness of screening should be strengthened.Brief interventions and pharmacotherapy are the two main methods used in general hospitals and primary care settings,with complementary and alternative medicine considered under the framework of integrative medicine.Individuals with severe alcohol-related problems or alcohol use disorders should be referred to specialty treatment for alcohol abuse,but referral is sometimes ignored.A gap exists between general hospitals/primary care facilities and specialized alcohol-related treatment providers.In conclusion,screening,intervention,and referral to treatment comprise a continuum for patients with alcohol-related problems.Opportunities to prevent and manage these problems in general hospitals and primary care settings are abundant,and taking action will promote the addressing of this public health issue.展开更多
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
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
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
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
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
In this editorial we comment on the article published in the recent issue of the World Journal of Gastrointestinal Surgery.It investigates the potential mechanism of alcohol use disorder(AUD)following weight loss and ...In this editorial we comment on the article published in the recent issue of the World Journal of Gastrointestinal Surgery.It investigates the potential mechanism of alcohol use disorder(AUD)following weight loss and its future prospects.We are particularly interested in this issue.According to existing research,the occurrence of AUD is closely linked to social factors,and the prevalence of AUD varies across different regions.However,there are limited studies on bariatric surgery and postoperative AUD in the Asian population,leaving ample room for further re-search in this area.Additionally,we believe that postoperative follow-up and dietary management are crucial.A multi-system integrated approach to manage-ment is the future direction for treating obesity.展开更多
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
文摘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.
文摘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.
文摘<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.
文摘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.
文摘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.
文摘Objective: to analyze the mental state and quality of life of patients with mental disorders caused by alcohol after progressive rehabilitation nursing. Methods: 64 patients with mental disorders caused by alcohol who were hospitalized from July 2020 to January 2021 were randomly divided into two groups with 32 cases in each group. The reference group received routine nursing, while the observation group received progressive rehabilitation nursing. The anxiety and depression scores and quality of life scores were compared. Results: after nursing, the anxiety and depression scores and quality of life scores of the reference group were worse than those of the observation group, with significant difference (P < 0.05). Conclusion: progressive rehabilitation nursing can flexibly intervene according to the patient's condition, gradually improve the patient's psychology and quality of life, and has great influence on nursing.
文摘BACKGROUND Patients and providers are often unaware of available treatment options for alcohol use disorder(AUD)and how to pursue them.AIM To improve AUD treatment rates using an educational video module(EVM).METHODS Prospective single-center cohort study evaluating the impact of a novel interactive patient EVM in promoting AUD treatment among hospitalized patients with alcohol-associated liver disease.Treatment was defined as receiving medication or participating in psychosocial treatment within 30 days of discharge.Primary outcome was change in treatment rates after viewing the EVM compared to a retrospective control cohort.Secondary outcomes were predictors of receiving treatment,EVM feedback,30-day hospital readmission,outpatient follow-up,return to alcohol use,and mortality.RESULTS Forty-two patients were included.Mean age was 45 years,50%were female,and mean model for end-stage liver disease score 15.5.After viewing the EVM,treatment rates increased for pharmacologic(50%vs 22%,P=0.0008)and psychosocial treatment(73.8%vs 44%,P=0.01).Return to alcohol use was significantly lower(7.9%vs 35.6%,P=0.003).All 100%of patients would recommend the EVM.CONCLUSION EVM allows hospitalized patients to receive standardized education about AUD treatment.This may address patient and provider knowledge gaps and reduce the growing burden of alcohol-associated liver disease.Future studies should evaluate EVM in larger patient populations using a multi-center study design.
文摘Background: Neurodevelopmental abnormalities in experimental fetal alcohol spectrum disorder (FASD) are associated with impaired signaling through complex pathways that mediate neuronal survival, growth, migration, energy metabolism, and plasticity. Gestational dietary soy prevents alcohol-related impairments in placentation and FASD-associated fetal anomalies. Objective: This study was designed to determine if gestational dietary soy would be sufficient to normalize cognitive function in young adolescent offspring after chronic in utero exposure to alcohol. In addition, efforts were made to characterize the mechanisms of FASD prevention by maternal dietary soy. Methods: Pregnant Long Evans rats were fed isocaloric liquid diets containing 0% or 26% caloric ethanol with casein or soy isolate as the protein source from gestation day 6 through delivery/postnatal day 0 (P0). From P24 - P28, the offspring were subjected to Morris water maze (MWM) testing, and on P35, they were sacrificed to harvest temporal lobes for histopathologic and molecular studies. Results: The in-utero ethanol-exposed offspring exhibited significant performance impairments on the MWM test, and they had a significantly reduced mean brain weight with neuronal loss in the CA1 hippocampal region and evidence of white matter myelin loss. Gestational dietary soy nearly normalized MWM performance and preserved brain weight, hippocampal CA1 architecture, and white matter myelin staining in alcohol-exposed offspring. Mechanistically, the main positive effects of soy included increased temporal lobe expression of HES-1 and HIF-1α, reflecting enhanced Notch signaling, and broadly increased expression of GnRH network molecules, including Erb1, Gper1, GnRH, GnRH-R, KiSS, and KiSS-R, irrespective of gestational ethanol exposure. Conclusions: Dietary soy intervention early in pregnancy may reduce FASD-associated cognitive deficits. The findings suggest that targeting Notch and GnRH-related networks may help reduce long-term disability with FASD. Additional mechanistic and experimental research is needed to determine if longer-duration, postnatal dietary soy could prevent the adverse neurobehavioral effects of FASD.
文摘The glymphatic system,a recently discovered cerebrospinal fluid-mediated pathway,plays a crucial role in fluid exchange and waste clearance in the brain.Its dysfunction has been implicated in various neurological disorders,including Alzheimer's disease and traumatic brain injury.Recent studies suggest that alcohol intake has a biphasic effect on the glymphatic system:Low doses of alcohol enhance glymphatic function,whereas high doses lead to glymphatic suppression and cognitive decline,mirroring patterns seen in alcohol-related dementia,providing valuable insights into the dose-dependent effects of alcohol on glymphatic function,but significant gaps persist,particularly regarding the mechanistic understanding and the influence of confounding factors such as sex,age,blood pressure,and wakefulness.Here,we synthesize and critically evaluate the important research findings within this field to gauge its progress and identify new research opportunities.We discuss the specific mechanisms by which alcohol affects the glymphatic system,including how alcohol influences cerebrospinal fluid-interstitial fluid exchange and waste removal.We also discuss the potential of the glymphatic system as a new target,such as through pharmacological or lifestyle interventions aimed at enhancing glymphatic function to treat alcohol use disorder and other neurological disorders associated with glymphatic dysfunction.
文摘Alcohol-associated liver disease(ALD)is a rapidly increasing indication for liver transplantation(LT)globally with a significant rise in transplants for ALD with limited sobriety including patients with alcohol-associated hepatitis(AH).This evolution challenges the older paradigm that mandates prolonged periods of alcohol abstinence prior to LT.Due to the limited armamentarium of effective pharmacotherapy to treat severe AH,the mortality rates are significantly higher when LT is not available.In the patients who are transplanted for ALD with limited sobriety including AH,patient and graft survival are equivalent,if not better,compared to patients transplanted for other etiologies.However,due to the risk of alcohol relapse and other psychosocial factors,public opinion regarding early LT may continue to impact how the field moves forward particularly regarding organ stewardship and the need for equitable allocation of organs.Numerous tools for psychosocial evaluations have been developed to assist liver transplant teams to identify appropriate patients in a more uniform manner.In this review,we aim to assess the available evidence to support early LT for alcohol AH and propose directions for the future as the field continues to evolve.
基金the National Natural Science Foundation of China(No.82171484)the Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2023ZD25)。
文摘Chinese Wine Culture influences people’s attitudes toward alcohol.The current study focuses on exploring the main features of a localized digital alcohol consumption intervention mini-program to address the difficulties of abstinence for native drinkers,as a promising way for long-term management of rehabilitation from alcohol use disorder.A mixed-method approach was used in this study.The self-report quantitative questionnaire recruited three groups of participants:89 drinkers,67 drinkers’relatives,and 30 medical staff.The focus group qualitative interview inspected 36 participants’perspectives on the core topics,including 21 drinkers,4 drinkers’relatives,and 11 medical staff.The results of combining the quantitative study and qualitative study indicated that the top difficulties of abstinence for native drinkers are the strong craving from the inside,the environmental influence,and the psychological health status,especially emotional states.Correspondingly,the most desired main features in an alcohol consumption digital intervention tool are the daily track of drinking conditions and craving level,periodic feedback reports that can share with others,and mood improvement training.Moreover,the top factors that influence participants’intention to use/recommend the tool are whether the tool is effective,whether the user experience is good,and whether the tool can replenish the deficiency of the current alcohol treatment.Future work needs to balance what patients want and what others around them expect,so that potential users can benefit best from the digital intervention tool in the context of Chinese culture.
基金Supported by National Natural Science Foundation of China,No.81973620Wenzhou Municipal Science and Technology Bureau,No.Y20220091.
文摘BACKGROUND The prevalence of addiction makes it a significant public health issue.Recently,transcranial magnetic stimulation(TMS)has garnered significant attention as a promising treatment for addiction.AIM To analyze development trends and research hotspots in TMS-based addiction treatment using a bibliometric approach.METHODS Articles on TMS-based addiction treatment from 2001 to 2023 were sourced from the Science Citation Index Expanded in the Web of Science Core Collection.CiteSpace software,VOSviewer,the"bibliometrix"R software package,and the bibliometric online analysis platform were used to analyze the current publication trends and hotspots.RESULTS Total 190 articles on TMS-based addiction treatment were identified,with clinical studies being the most prevalent.The United States led in both publication volume and international collaborations.Medical University of South Carolina and Zangen A were the most productive institution and author,respectively.Neurobiology,alcohol use disorder,and repetitive TMS were the most recent research hotspots.CONCLUSION Future research should focus on the neurobiological mechanisms underlying TMS-based addiction treatment.This study offers comprehensive insights and recommendations for advancing research on TMS-based addiction treatment.
基金Supported by Shandong Province Medical and Health Technology Development Plan Project,No.202203090753.
文摘Alcohol use has contributed to large disease burdens,and alcohol-related problems are prevalent among patients in general hospitals and primary care settings.This review aims to deepen the understanding of screening,intervention,and treatment referral for alcohol-related problems in these settings.We searched the literature published in English from PubMed,ScienceDirect,and the World Health Organization website.We found that while a series of screening tools can be used,screening rates were low.The awareness of screening should be strengthened.Brief interventions and pharmacotherapy are the two main methods used in general hospitals and primary care settings,with complementary and alternative medicine considered under the framework of integrative medicine.Individuals with severe alcohol-related problems or alcohol use disorders should be referred to specialty treatment for alcohol abuse,but referral is sometimes ignored.A gap exists between general hospitals/primary care facilities and specialized alcohol-related treatment providers.In conclusion,screening,intervention,and referral to treatment comprise a continuum for patients with alcohol-related problems.Opportunities to prevent and manage these problems in general hospitals and primary care settings are abundant,and taking action will promote the addressing of this public health issue.
文摘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.
文摘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.
基金supported by the National Natural Science Foundation of China(Grant No.81971246)College Students’innovation and entrepreneurship training program in Jiangsu Province(Grant No.202010312042Y)。
文摘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.
文摘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.
文摘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.
文摘In this editorial we comment on the article published in the recent issue of the World Journal of Gastrointestinal Surgery.It investigates the potential mechanism of alcohol use disorder(AUD)following weight loss and its future prospects.We are particularly interested in this issue.According to existing research,the occurrence of AUD is closely linked to social factors,and the prevalence of AUD varies across different regions.However,there are limited studies on bariatric surgery and postoperative AUD in the Asian population,leaving ample room for further re-search in this area.Additionally,we believe that postoperative follow-up and dietary management are crucial.A multi-system integrated approach to manage-ment is the future direction for treating obesity.
文摘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.
