Changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics.

Aims: To assess the changes in cigarette smoking and coffee drinking after alcohol detoxification in alcoholics.

Design: Evaluation at admission and an average 16 days following discharge.

Setting: Alcohol detoxification inpatient programme.

Frontal dysfunction in neurologically normal chronic alcoholic subjects: metabolic and neuropsychological findings.

Background: Neuropsychological and imaging studies suggest that frontal dysfunction may occur in apparently normal chronic alcoholic subjects.

Methods: To investigate this issue further, we performed neuropsychological and fluorodeoxy-glucose-PET studies in 17 chronic alcoholics without patent neurological and psychiatric complications.

Results: Metabolic abnormalities were found in the mediofrontal and in the left dorsolateral prefrontal cortex, but not in the orbitofrontal cortex.

Joint influence of alcohol, tobacco, and coffee on biological markers of heavy drinking in alcoholics.

Background: Recent reports suggest that gamma-glutamyl transferase (GGT) decreases with coffee intake. The aim of this study was to examine the joint influence of alcohol, tobacco, cotinine, coffee, and caffeine on biological markers of heavy drinking in an alcoholic population.

Methods: Subjects were 160 alcohol-dependent inpatients.

How useful is aminolevulinic acid dehydratase as a marker of recent alcohol intake?

Erythroycte delta aminolevulinic acid dehydratase (ALAD) has been suggested as a marker for detecting recent alcohol intake. Unlike other markers, ALAD activity decreases after alcohol intake. Review of the literature suggests that the main interest in this marker is because it increases rapidly after withdrawal.

[Depression and smoking].

Lifetime history of major depressive disorder is more than double in ever smokers than in never smokers. Conversely, adjusted odds ratios of nicotine dependence are significantly elevated for major depressive disorder alone (3,11) or associated with an anxiety disorder (4,38). There is also a significant relationship between depressive symptoms' severity (CES-D) and ever smoking.

Smoking and coffee intake following alcohol withdrawal in alcoholic inpatients.

The aim of this study was to assess alcoholic inpatients' smoking and coffee intake variation following withdrawal. Only moderate smokers (less than 30 cigarettes/day) showed a significant increase of cigarette consumption after alcohol withdrawal. However, their urinary cotinine level did not vary, suggesting a behavioral, and not biological, compensation through smoking following alcohol withdrawal.

[Alcohol withdrawal syndrome and delirium tremens. Their treatment].

The clinical picture of alcohol withdrawal syndrome lies somewhere on a continuum that ranges from slight morning tremor to genuine delirium tremens. The diagnosis, usually easy, may be beset with several traps: alcoholism may be unrecognized, or a diagnosis other than withdrawal syndrome may be wrongly made, or again a complication may be either overlooked or erroneously suspected. An acute withdrawal syndrome normally regresses in less than one week, but a subacute withdrawal syndrome, which presents as signs of residual hyperexcitability of the central nervous system, must be recognized, as it may persist for several months.

[Alcohol, sleep and biological rhythms].

Alcohol reduces sleep latency but notably alters sleep structure: sleep is fragmented, particularly at the end of the night. Slow wave sleep duration is enhanced in the first part of the night and REM sleep duration and density are diminished. Alcohol withdrawal provokes inverse effects in alcoholic patients: sleep onset is delayed, slow wave sleep durations diminished and REM sleep duration is enhanced.

[Lipids and lipoproteins in chronic alcoholism. Outcome after alcohol withdrawal].

The plasma lipids and lipoproteins changes observed in chronic alcoholic subjects and their modifications after cessation of drinking were studied in 379 patients admitted for alcohol withdrawal. The modifications were evaluated after one month (n = 348), 6 months (n = 56) and one year (n = 29) of abstinence. A significant decrease of HDL-cholesterol and apo A-I levels was noted after one year.

Abstention from alcohol in dilated cardiomyopathy: complete regression of the clinical disease but persistence of myocardial perfusion defects on exercise thallium-201 tomography.

This case report describes a 43-year-old man with dilated cardiomyopathy reversed by abstention from alcohol over 1 year but with persistence of previous myocardial perfusion defects on exercise thallium-201 tomography. This suggests that despite the near normalization of left ventricular function, a permanent myocardial disease seems to persist.

Tianeptine and its main metabolite pharmacokinetics in chronic alcoholism and cirrhosis.

The effect of chronic alcoholism (with or without associated moderate cirrhosis) on the disposition of the antidepressant tianeptine, which is devoid of substantial first-pass metabolism, was examined in 21 patients and 11 age-matched controls. Pharmacokinetic parameters for tianeptine and its C5 acid analogue metabolite (MC5 metabolite) were estimated by non-compartmental analysis. The area under the curve (AUC) for tianeptine, following a 12.

Pharmacokinetic and metabolic parameters of tianeptine in healthy volunteers and in populations with risk factors.

Following oral administration in the fasting healthy subject, the mean maximum concentration of tianeptine is 334 +/- 79 ng/ml. Absorption of tianeptine from the tablet form is rapid and complete. Maximum plasma concentration is obtained by the first hour following administration (0.

Tianeptine and amitriptyline. Controlled double-blind trial in depressed alcoholic patients.

129 chronic alcoholic patients, withdrawn from alcohol and presenting major depression or dysthymic disorder, were treated for 4-8 weeks under double-blind conditions either with a new antidepressant, tianeptine (37.5 mg per day), or with amitriptyline (75 mg per day). Both groups presented steady improvement of the symptoms of depression during treatment, as scored on the Montgomery and Asberg Depression Rating Scale and the Hopkins Symptom Checklist self-evaluation; for the latter scale, the improvement was significantly greater in the tianeptine group.

[Therapy and suggestion].

Therapy and suggestion are closely related. That is clear for the ancient time: primitive medicine gives a good place to the Word. In plant, animal or mineral remedies, the suggestion is clearly preponderant.

[Current concepts on therapeutic possibilities in alcohology].

Therapeutic possibilities in the field of alcoholism are certainly more extensive than accepted by most general practitioners and internists whose attitude is, according to an inquiry, rather fatalistic. The actual therapy of alcoholism proves to be effective, the earlier the therapy being started the better are the results. On this account, the necessity of preventive measures and of an early treatment is to be underlined.

[Benzodiazepines, alcohol and effects on vigilance].

It is evident, and has been confirmed by epidemiological and experimental data, that ingestion of alcohol can reduce alertness and disturb the concentration of drivers. However, there is still some confusion on this question, since it is impossible to predict what will be the exact level of alcoholemia following ingestion of a given quantity of alcohol, and because disturbances in alertness vary greatly from one individual to another for the same level of alcoholemia . The essential distinction between acute alcoholisation and chronic alcoholisation (due to notions of alcohol tolerance and dependance ) must also be taken into account.

[Is the primary lesion in Behcet's disease a venous "tropism" vascularity? (author's transl)].

The authors studied eight cases of Behcet's disease, all of which were characterized by different degrees of phlebitis disorders. They also reviewed the anatomical and clinical features of a similar type, reported in the published literature. They stress the frequency and severity of changes in the veins in the localization of the various symptomatic lesions of the affection.

[Landouzy-Dejerine syndrome. Evolution of the concept of facio-scapulo-humeral amyotrophia].

Detailed analysis of the literature and the study of personal cases have led the authors to propose a new concept for facio-scapulo-humeral dystrophy. They consider it to be a syndrome, embracing under the same clinical picture both muscular disease (classical hereditary muscular dystrophy, congenital and acquired myopathies) and neurological disease (in particular progressive pseudomyopathic amyotrophy).