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. PARTICIPANTS: Seventy-three alcohol dependent (DSM-III-R) inpatients. MEASUREMENTS: Average number of cigarettes and of cups of coffee per day; urine cotinine level. Smokers were classified as moderate on the basis of consuming fewer than 30 cigarettes per day at the time of admission; heavy smokers were those who smoked 30 cigarettes per day or more. FINDINGS: As a group, the smokers (N = 58) did not significantly change their cigarette consumption and there was no change in urine cotinine level. Heavy smokers (N = 34), however, significantly decreased their cigarette consumption, but urine cotinine was unchanged. Moderate smokers (N = 24) significantly increased their cigarette consumption but urine cotinine was not significantly changed. All patients--non-smokers, moderate and heavy smokers--significantly increased their coffee intake. CONCLUSIONS: The results suggest that heavy smokers may react to alcohol cues and thus reduce smoking activity when sober. Moderate smokers may increase their smoking rate to cope with alcohol abstinence. These changes appear only to reflect a behavioural adjustment, without modification of patients' nicotine-seeking. Alcoholics may increase their coffee intake to cope with alcohol abstinence.

Copper oxidation of in vitro dioleolylphosphatidylcholine-enriched high-density lipoproteins: physicochemical features and cholesterol effluxing capacity.

Susceptibility of lipoproteins to oxidation is partly determined by their content in endogenous antioxidants, but also by the polyunsaturated fatty acids (PUFA)/monounsaturated fatty acids (MUFA) ratio. The aim of our study was to enrich human high-density lipoproteins (HDLs) with dioleoylphosphatidylcholine (DOPC) in order to modify the PUFA/MUFA ratio while maintainig the alpha-tocopherol/PUFA ratio constant and to appreciate the consequences of this enrichment before and after copper-induced oxidation. The enrichment of HDLs with DOPC was obtained by incubation of these lipoproteins with DOPC liposomes and further reisolation of HDLs. The consequent 40% HDL enrichment in MUFA was concomitant with a 35% loss in PUFA (MUFA/PUFA ratio = 1.43). The enrichment of HDLs with DOPC led to a 40% decrease in alpha-tocopherol content, which kept a constant alpha-tocopherol/PUFA ratio. The DOPC-HDLs exhibited a lower oxidizability by copper than the nonenriched HDLs (NE-HDLs), as shown by their twofold longer lag phase and the threefold lower propagation rate. Moreover, DOPC-HDLs led to a six- to sevenfold lower production of hydroperoxide molecular species from phosphatidylcholine and cholesteryl esters than NE-HDLs after 24 h copper oxidation. With regard to the cholesterol effluxing capacity, copper oxidation of HDLs led to a decrease of this property. However, our results clearly showed that DOPC enrichment of HDLs allowed us to keep a better effluxing capacity than in NE-HDLs after 24 h oxidation (22.3% vs 17.4%, respectively). Since apo A-I was degraded as well in DOPC-HDLs as in NE-HDLs, the better effluxing capacity of DOPC-HDLs could not come from a preserved integrity of apo A-I. It could be partly related to the improved fluidity of oxidized DOPC-HDLs compared to oxidized NE-HDLs, as shown by electron spin resonance data (correlation-relaxation time at 24 degreesC = 2.20 ns vs 3.00 ns after 24 h oxidation, in DOPC-HDLs and in NE-HDLs, respectively). Besides, it could also be hypothesized that the sevenfold lower content of phosphatidylcholine hydroperoxides in DOPC-HDLs than in NE-HDLs after 24 h copper oxidation could be involved in the better ability of oxidized DOPC-HDLs to mobilize cellular cholesterol.

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. Biological assessments, performed at admission, were plasma levels of GGT, apolipoprotein AI, aspartate aminotransferase, and mean corpuscular volume (MCV), and urine cotinine and caffeine indexes. Years of alcohol abuse and of smoking, alcohol and coffee intake, and smoking rate were estimated in a semistructured interview, and Fagerström Tolerance Questionnaire was completed by inpatients. RESULTS: Coffee intake, but not caffeine, correlated negatively with biological markers of heavy drinking, after controlling for alcohol and tobacco intake. Years of smoking correlated positively to MCV, after controlling for alcohol and coffee intake. CONCLUSIONS: Concerning the effect of coffee, the most likely hypothesis is that noncaffeine coffee fractions have a protective effect on liver cells. Concerning the effect of smoking, one can propose that the increase of MCV with smoking could be a consequence of carbon monoxide inhalation, leading to hypoxemia, or of folate deficiency.

alpha-tocopherol enrichment of high-density lipoproteins: stabilization of hydroperoxides produced during copper oxidation.

In the aim to study the effect of an in vitro enrichment of high-density lipoprotein (HDL) with alpha-tocopherol in alcoholic solution on a copper-induced peroxidation, we monitored several markers of lipid peroxidation (alpha-tocopherol consumption, formation of conjugated dienes and of fatty acid hydroperoxides, production of thiobarbituric acid-reactive substances) and the integrity of apolipoprotein A-I. High-density lipoproteins (1.063 < d < 1.21) with a mean of 0.58 alpha-tocopherol molecules per HDL particle were enriched with alpha-tocopherol in alcoholic solution to obtain an average of 3.7 and 21 alpha-tocopherol molecules per HDL particle. HDL oxidation with 5 microM CuSO4 at 37 degrees C resulted in the total disappearance of endogenous alpha-tocopherol after 2 h, but after 24 h about 19% of alpha-tocopherol remained in the most enriched HDL. In agreement with the tocopherol-mediated peroxidation, the formation of conjugated dienes and of fatty acid hydroperoxides was very fast and increased with alpha-tocopherol concentration, whereas TBARS production decreased. These results showed that alpha-tocopherol enrichment stabilized the production of hydroperoxides in HDL and decreased the formation of secondary oxidation products. These latter products are known for deleterious effects towards apolipoproteins. This could explain why we observed that the apolipoprotein A-I of the most enriched HDL was only slightly altered after incubation with CuSO4.

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. The present study investigated the changes in erythrocyte ALAD and serum gamma-glutamyltransferase activities after alcohol withdrawal in 120 alcoholics. Our data showed that ALAD is less sensitive than GGT as an indicator of recent alcohol intake (56% and 84% abnormal, respectively). The increase in ALAD activity was greater between day 12 and 18 after withdrawal (11%) than between day 1 and 12 after withdrawal (5%). There were as many patients returning to normal values 12 and 18 days after withdrawal, for GGT as for ALAD. Thus, our results contradict the claim that ALAD rises rapidly after withdrawal. ALAD shows no advantage over GGT as a marker of recent alcohol intake.

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. Heavy smokers (30 cigarettes/day or more) showed no significant clinical or biological variation of smoking behavior. Coffee consumption increased after alcohol withdrawal in all patients, irrespective of smoking habits.

[Stability of alpha-tocopherol: pre-analytical conditions in its determination in blood samples]. / Stabilité de l'alpha-tocophérol: conditions préanalytiques à son dosage dans les prélèvements sanguins.

Incomplete and controversial data exist concerning vitamin E or alpha-tocopherol stability in biological samples. Recent clinical interest in the protective function of alpha-tocopherol provided another reason for the setting-up of a multicenter study by the Sociéte Française de Biologie Clinique. Our purpose was to examine the effects on alpha-tocopherol stability, firstly, of collection and transportation of blood samples, and, secondly, of the temperature (-20 degrees C and -80 degrees C) and period of storage of serum or plasma. alpha-tocopherol was determined in serum or plasma by isocratic liquid chromatography with UV detection at 292 nm. Our results established that alpha-tocopherol was extremely stable in blood, serum or plasma over 8 hours without special handling conditions (light, temperature). Pools of serum or plasma were stable for at least 3 months at -20 degrees C and -80 degrees C. They are suitable for use in the quality control of alpha-tocopherol. On the other hand, in some samples, we observed great variability in the rate of alpha-tocopherol degradation. However, there was lesser degradation when these plasma samples were stored at -80 degrees C instead of -20 degrees C. We therefore do not advise storing serum or plasma for more than 1 month at -20 degrees C for more than 3 months at -80 degrees C. This latter temperature is recommended in epidemiological studies.

Metabolic effects of combined cyproterone acetate and percutaneous 17 beta oestradiol after six and twelve months therapy in 61 patients.

The metabolic effects of combined cyproterone acetate (50 mg) and percutaneous 17 beta oestradiol were studied during one year in 61 patients admitted for hyperandrogenia. Before treatment and at 6 and 12 months the following tests were performed: oral glucose tolerance test (OGTT) with insulinemia dosage, determination of total cholesterol, LDL, VLDL and HDL fractions, triglycerids, A1 and B apoproteins, liver function tests: bilirubinemia, alkaline phosphatases, transaminases and gamma glutamyl transferases. The patients' mean age was 27.0 +/- 6.8 years, the body mass index was 22.4 +/- 3.5 kg/m2. After one year of treatment the body mass index was not modified. Blood glucose slightly increased during OGTT; at 6 months this was significant at +30 minutes, at 12 months at +30, +60 and +90 minutes (P less than 0.05). There was no variation in insulinemia during OGTT. Total cholesterol decreased significantly at 6 and 12 months (P less than 0.001), this was associated with a decrease in HDL cholesterol, but without modification of the LDL + VLDL/HDL ratio. Decrease in HDL cholesterol was associated with a significant decrease in A1 apoproteins. No change in triglycerids and in liver function tests was observed at either date. In conclusion the metabolic effects of this association are described. These effects are minimal compared to those observed with cyproterone acetate and ethinyl oestradiol association in the literature. However, attention should be drawn to the possibility of glucose intolerance and decrease in HDL cholesterol and A1 apoproteins.

[Changes in several plasma and urinary components in marathon runners]. / Variations de quelques constituants plasmatiques et urinaires chez les marathoniens.

33 blood and urinary components were titrated in 11 men 5 days before a marathon race (42 km), just before the start of the race, 1/4 hour after the arrival, the following day and 5 days after the race. On arrival, or/and the following day, even still 5 days later, we observed an increase of: natremia, kaliemia, blood proteins, hematocrit, aldosteronemia, plasma renin activity, uricemia, creatininemia, blood cortisol, myoglobinemia, blood lactic acid, total enzymatic CK activity, enzymatic ASAT activity, urinary elimination of creatinin, urea and 3 methylhistidine. On the contrary, a decrease of plasma total CO2 and blood testosterone levels were observed. These biochemical modifications are the consequence of hydro-mineral losses, muscular necroses, alteration of energetic metabolism with increase of the protein catabolism.

[Effect of marathons on neuromuscular excitability; comparison of electromyographic and biochemical findings]. / Effet du marathon sur l'excitabilité neuromusculaire; comparaison de données électromyographiques et biochimiques.

The aim of this paper is to study the neuromuscular excitability of a group of marathon runners and to see how it can be modified right after the marathon. Spontaneously appearing multiplets in EMG signal under ischaemia served as a test of the neuromuscular hyperexcitability. The percentage of positive tests is much higher than in the control population; as a rule, the effect of the marathon is to diminish the neuromuscular hyperexcitability. The concentrations of Ca, Mg and P in the plasma as well as the globular concentration of Mg have been determined several times, both before and after the marathon; no correlation has been found with the neuromuscular hyperexcitability.

[Value of the detection of myoglobin by immunoagglutination in myocardial infarction]. / Intérêt de la détection de la myoglobine par immunoagglutination au cours de l'infarctus du myocarde.

The abnormally elevated quantity of myoglobin present in the plasma of 11 patients suffering of myocardial infarction was demonstrated by a rapid immunoagglutination slide-test. The results of this qualitative test were compared to the myoglobin concentrations measured by radioimmunology. Although the immunoagglutination test is less sensitive than the myoglobin assay, it proved to be very specific. Its rapidity of use, its reliability shown on 121 plasma specimens collected during the myocardial infarction evolution in the patients under study, will enable the clinician to use advantageously the very rapid myoglobinemia taking place in the first hours of infarction. Indeed, we have shown in agreement with the literature that the rise of myoglobin during the first hours of infarction occurs at a much earlier stage than does the increase of creatine kinase activity which was equally assayed during this work.