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1.
Am J Drug Alcohol Abuse ; 44(1): 129-139, 2018.
Article in English | MEDLINE | ID: mdl-28032801

ABSTRACT

BACKGROUND: Alcohol-related blackouts are a common consequence of heavy drinking, and these blackouts pose risk for injury and other adverse health outcomes. OBJECTIVE: To examine the prevalence and correlates of blackouts among underage drinkers. METHODS: Youth (ages 14-20) presenting to a suburban Emergency Department (ED) completed screening surveys. Among those reporting past-year alcohol consumption, we examined past 3-month blackouts in relation to: background characteristics (e.g., demographics, fraternity/sorority involvement), substance use, sexual risk behaviors and incapacitated sexual assault (unaware/unable to consent due to alcohol/drugs), forced sexual assault, positive depression screening, and reason for ED visit (injury vs. medical). RESULTS: In total, 2,300 past-year drinkers participated: 58% female, 75% Caucasian, and mean age = 18.4. Regarding past 3-month blackouts, 72.7% reported none, 19.3% reported monthly or less, and 8% reported monthly or more. Multivariate cumulative logit regression indicated that blackout frequency was positively associated with: college involvement in Greek life, alcohol use severity, prescription drug misuse, marijuana, screening positive for depression, incapacitated sexual assault, and a gender by alcohol use severity interaction. CONCLUSION: With one-quarter of this clinical sample reporting recent blackouts, as well as the association between blackout frequency and health risk behaviors and other outcomes, findings underscore the need for programs focusing on substance use, depression, and preventing sexual assault. Interventions should also address poly-substance use and drinking motives. Although findings highlight how college students in Greek life may be at high risk for blackouts, many participants not in college also reported blackouts, suggesting that interventions in other settings are also needed.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Emergency Service, Hospital/statistics & numerical data , Underage Drinking/statistics & numerical data , Adolescent , Depression/epidemiology , Female , Humans , Male , Michigan/epidemiology , Risk Factors , Sex Offenses/statistics & numerical data , Young Adult
2.
Rev. medica electron ; 39(supl.1): 772-780, 2017.
Article in Spanish | CUMED | ID: cum-77043

ABSTRACT

La psicosis de Korsakoff (PK) es una de las causas más frecuentes de amnesia. Se caracteriza por confusión mental, deterioro de la memoria reciente y confabulación. Se presenta el caso de un paciente masculino de 53 años de edad, fumador de un paquete al día, durante más de 35 años, bebedor de riesgo, con antecedentes de hipertensión arterial e hipercolesterolemia. Se diagnosticó como psicosis de Korsakoff debido al déficit de tiamina o vitamina B1. La psicosis de Korsakoff es un síndrome amnésico que puede presentarse precedido o no de encefalopatía de Wernicke (EW), por lo que se diagnostican menos casos de los que en realidad existen. Por ello, es un problema frecuentemente infradiagnosticado en los centros de salud lo que resulta interesante el conocimiento de esta patología (AU).


Korsakoff psychosis is one of the most frequent causes of amnesia. It is characterized by mental confusion, impairment of the recent memory and confabulation. It is presented the case of a male patient, aged 53 years, who smoked 1 packet of cigarettes a day during more than 35 years, risk drinker with antecedents of arterial hypertension and hypercholesterolemia. He was diagnosed as Korsakoff psychosis due to the thiamine or B1 vitamin deficit. Korsakoff psychosis is an amnesic syndrome that may be preceded or not by Wernicke encephalopathy, so there are diagnosed fewer cases than those truly existing. That is why it is a problem frequently underdiagnosed in health care institutions, making interesting this disease´s knowledge (AU).


Subject(s)
Humans , Male , Female , Wernicke Encephalopathy/epidemiology , Korsakoff Syndrome/epidemiology , Wernicke Encephalopathy/diagnosis , Korsakoff Syndrome/complications , Korsakoff Syndrome/diagnosis , Korsakoff Syndrome/genetics , Korsakoff Syndrome/pathology , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/rehabilitation , Alcohol Amnestic Disorder/epidemiology , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology
3.
Rev. medica electron ; 39(supl.1): 772-780, 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-902256

ABSTRACT

La psicosis de Korsakoff (PK) es una de las causas más frecuentes de amnesia. Se caracteriza por confusión mental, deterioro de la memoria reciente y confabulación. Se presenta el caso de un paciente masculino de 53 años de edad, fumador de un paquete al día, durante más de 35 años, bebedor de riesgo, con antecedentes de hipertensión arterial e hipercolesterolemia. Se diagnosticó como psicosis de Korsakoff debido al déficit de tiamina o vitamina B1. La psicosis de Korsakoff es un síndrome amnésico que puede presentarse precedido o no de encefalopatía de Wernicke (EW), por lo que se diagnostican menos casos de los que en realidad existen. Por ello, es un problema frecuentemente infradiagnosticado en los centros de salud lo que resulta interesante el conocimiento de esta patología (AU).


Korsakoff psychosis is one of the most frequent causes of amnesia. It is characterized by mental confusion, impairment of the recent memory and confabulation. It is presented the case of a male patient, aged 53 years, who smoked 1 packet of cigarettes a day during more than 35 years, risk drinker with antecedents of arterial hypertension and hypercholesterolemia. He was diagnosed as Korsakoff psychosis due to the thiamine or B1 vitamin deficit. Korsakoff psychosis is an amnesic syndrome that may be preceded or not by Wernicke encephalopathy, so there are diagnosed fewer cases than those truly existing. That is why it is a problem frequently underdiagnosed in health care institutions, making interesting this disease´s knowledge (AU).


Subject(s)
Humans , Male , Female , Wernicke Encephalopathy/epidemiology , Korsakoff Syndrome/epidemiology , Wernicke Encephalopathy/diagnosis , Korsakoff Syndrome/complications , Korsakoff Syndrome/diagnosis , Korsakoff Syndrome/genetics , Korsakoff Syndrome/pathology , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/rehabilitation , Alcohol Amnestic Disorder/epidemiology , Nervous System Diseases/diagnosis , Nervous System Diseases/epidemiology
4.
Emerg Med Clin North Am ; 32(2): 293-301, 2014 May.
Article in English | MEDLINE | ID: mdl-24766933

ABSTRACT

Ethanol intoxication and ethanol use are associated with a variety of metabolic derangements encountered in the Emergency Department. In this article, the authors discuss alcohol intoxication and its treatment, dispel the myth that alcohol intoxication is associated with hypoglycemia, comment on electrolyte derangements and their management, review alcoholic ketoacidosis, and end with a section on alcoholic encephalopathy.


Subject(s)
Acidosis/etiology , Alcoholic Intoxication , Emergencies , Hypoglycemia/etiology , Acidosis/epidemiology , Acidosis/therapy , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/etiology , Alcohol Amnestic Disorder/metabolism , Alcoholic Intoxication/complications , Alcoholic Intoxication/epidemiology , Alcoholic Intoxication/metabolism , Global Health , Humans , Hypoglycemia/epidemiology , Hypoglycemia/therapy , Incidence , Risk Factors , Survival Rate/trends
6.
Aust N Z J Psychiatry ; 45(11): 985-92, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21961480

ABSTRACT

OBJECTIVES: The aim of this study was to describe the principal reasons for admission, medical comorbidities, interventions and outcomes of patients admitted to New South Wales hospitals with alcohol-related cognitive impairment. METHODS: We extracted data from the NSW Admitted Patient Care Database for nearly 410 000 multi-day hospital admissions from 222 public hospitals ending between July 2006 and June 2007 for people aged 50 and over. Data linkage using a unique patient identifier, derived by the Centre for Health Record Linkage identified hospital transfers and readmissions for individual patients. Using ICD10-AM codes, we identified patients with alcohol-related dementia, amnesic syndrome due to alcohol, and Wernicke's encephalopathy, their principal reasons for admission and medical comorbidities, and procedures undertaken. Outcomes were length of stay, mortality, discharge destination, and readmission. RESULTS: A total of 462 patients diagnosed with alcohol-related dementia (n = 300; 82% male, mean age 63.9 years), Wernicke's encephalopathy (n = 77) or amnesic syndrome due to alcohol (n = 126) were identified with overlap between diagnoses. Alcohol-related dementia occurred in 1.4% of dementia patients, and was more likely to occur in younger age groups and men than other types of dementia. Alcohol-related mental disorder was recorded in 70% of alcohol-related dementia multi-day admissions: dependence (52%), 'harmful use' (11%) and withdrawal (12%). Principal reasons for admission for multi-day stays included alcohol-related mental disorder (18%), liver disease (11%) and injuries/poisonings (10%). Medical comorbidity was common. Like other dementia patients, alcohol-related dementia patients had longer length of stay (mean of 15 days) than non-dementia patients and more transfers to residential care (7%). However, mortality was similar to non-dementia patients (5%). Discharge at own risk was high (3.7%). CONCLUSIONS: Alcohol-related dementia is a preventable and potentially reversible condition. Investigation of intervention strategies initiated during hospitalization are warranted.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Dementia/epidemiology , Ethanol/toxicity , Wernicke Encephalopathy/epidemiology , Age Factors , Aged , Aged, 80 and over , Comorbidity , Dementia/chemically induced , Female , Humans , Male , Middle Aged , New South Wales/epidemiology , Outcome Assessment, Health Care/statistics & numerical data , Patient Admission/statistics & numerical data , Sex Characteristics
7.
Am J Geriatr Psychiatry ; 17(7): 542-55, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19546653

ABSTRACT

The relationships between alcohol consumption and dementia and cognitive decline were investigated in a systematic review including meta-analyses of 15 prospective studies. Follow-ups ranged from 2 to 8 years. Meta-analyses were conducted on samples including 14,646 participants evaluated for Alzheimer disease (AD), 10,225 participants evaluated for vascular dementia (VaD), and 11,875 followed for any type of dementia (Any dementia). The pooled relative risks (RRs) of AD, VaD, and Any dementia for light to moderate drinkers compared with nondrinkers were 0.72 (95% CI = 0.61-0.86), 0.75 (95% CI = 0.57-0.98), and 0.74 (95% CI = 0.61-0.91), respectively. When the more generally classified "drinkers," were compared with "nondrinkers," they had a reduced risk of AD (RR = 0.66, 95% CI = 0.47-0.94) and Any dementia (RR = 0.53, 95% CI = 0.53-0.82) but not cognitive decline. There were not enough data to examine VaD risk among "drinkers." Those classified as heavy drinkers did not have an increased risk of Any dementia compared with nondrinkers, but this may reflect sampling bias. Our results suggest that alcohol drinkers in late life have reduced risk of dementia. It is unclear whether this reflects selection effects in cohort studies commencing in late life, a protective effect of alcohol consumption throughout adulthood, or a specific benefit of alcohol in late life.


Subject(s)
Alcohol Amnestic Disorder/etiology , Alcohol Drinking/adverse effects , Alcoholism/complications , Alzheimer Disease/etiology , Cognition Disorders/etiology , Dementia, Vascular/etiology , Dementia/etiology , Aged , Aged, 80 and over , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/psychology , Alcohol Drinking/epidemiology , Alcohol Drinking/psychology , Alcoholism/epidemiology , Alcoholism/psychology , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Alzheimer Disease/psychology , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Cognition Disorders/psychology , Comorbidity , Cross-Sectional Studies , Dementia/diagnosis , Dementia/epidemiology , Dementia/psychology , Dementia, Vascular/diagnosis , Dementia, Vascular/epidemiology , Dementia, Vascular/psychology , Follow-Up Studies , Humans , Risk
8.
Neurology ; 65(8): 1210-7, 2005 Oct 25.
Article in English | MEDLINE | ID: mdl-16247047

ABSTRACT

OBJECTIVE: To examine the association between alcohol use and cognitive decline in a longitudinal study of a representative elderly community sample free of dementia at baseline. METHODS: Cognitive functions and self-reported drinking habits were assessed at 2-year intervals over an average of 7 years of follow-up. Cognitive measures, grouped into composites, were examined in association with alcohol consumption. Trajectory analyses identified latent homogeneous groups with respect to alcohol use frequency over time, and their association with average decline over the same period in each cognitive domain. Models controlled for age, sex, education, depression, smoking, general mental status (Mini-Mental State Examination [MMSE]), performance on the given test at baseline, and subsequent new-onset dementia during follow-up. RESULTS: The authors found three homogeneous trajectories that they characterized as no drinking, minimal drinking, and moderate drinking. Few heavy drinkers were identified in this elderly cohort. Compared to no drinking, both minimal and moderate drinking were associated with lesser decline on the MMSE and Trailmaking tests. Minimal drinking was also associated with lesser decline on tests of learning and naming. These associations were more pronounced when comparing current drinkers to former drinkers (quitters) than to lifelong abstainers. CONCLUSION: In a representative elderly cohort over an average of 7 years, a pattern of mild-to-moderate drinking, compared to not drinking, was associated with lesser average decline in cognitive domains over the same period.


Subject(s)
Aging/physiology , Alcohol Drinking/adverse effects , Alcohol-Induced Disorders, Nervous System/epidemiology , Cognition Disorders/chemically induced , Cognition Disorders/epidemiology , Age Factors , Aged , Aged, 80 and over , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/psychology , Alcohol-Induced Disorders, Nervous System/psychology , Causality , Cognition Disorders/psychology , Cohort Studies , Disease Progression , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Memory Disorders/chemically induced , Memory Disorders/epidemiology , Memory Disorders/psychology , Neuropsychological Tests , Pennsylvania/epidemiology
9.
Alcohol Clin Exp Res ; 28(4): 667-75, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15100620

ABSTRACT

BACKGROUND: Evidence suggests that alcoholics exhibit particular deficits in brain systems involving the prefrontal cortex, but few studies have directly compared patients with and without Korsakoff's syndrome on measures of prefrontal integrity. METHODS: Neuropsychological tasks sensitive to dysfunction of frontal brain systems were administered, along with standard tests of memory, intelligence, and visuospatial abilities, to 50 healthy, abstinent, nonamnesic alcoholics, 6 patients with alcohol-induced persisting amnestic disorder (Korsakoff's syndrome), 6 brain-damaged controls with right hemisphere lesions, and 82 healthy nonalcoholic controls. RESULTS: Korsakoff patients were impaired on tests of memory, fluency, cognitive flexibility, and perseveration. Non-Korsakoff alcoholics showed some frontal system deficits as well, but these were mild. Cognitive deficits in non-Korsakoff alcoholics were related to age, duration of abstinence (less than 5 years), duration of abuse (more than 20 years), and amount of alcohol intake. CONCLUSIONS: Abnormalities of frontal system functioning are most apparent in alcoholics with Korsakoff's syndrome. In non-Korsakoff alcoholics, factors contributing to cognitive performance are age, duration of abstinence, duration of alcoholism, and amount of alcohol consumed.


Subject(s)
Alcohol Amnestic Disorder/psychology , Alcoholism/psychology , Neuropsychological Tests , Prefrontal Cortex/physiology , Adult , Aged , Aged, 80 and over , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/physiopathology , Alcoholism/epidemiology , Alcoholism/physiopathology , Female , Humans , Male , Middle Aged , Temperance/psychology , Temperance/statistics & numerical data
11.
Nervenarzt ; 73(9): 861-6, 2002 Sep.
Article in German | MEDLINE | ID: mdl-12215877

ABSTRACT

According to several studies in the USA, alcohol abuse is common among elder people, particularly among those admitted to hospital. Corresponding data for Germany are lacking as yet. In this study, the frequency of addiction problems in the elderly admitted to hospital was investigated using the data from 1990 to 1998 of the psychiatric department at the General University Hospital of Lübeck, Germany. Furthermore, the documentations of all consultations in that period were reevaluated. The psychiatric consultation service covers two general hospitals providing inpatient treatment for about 200,000 inhabitants. Diagnoses were made according to the ICD-10 criteria. In 17.7% of the males older than 64 years and in 4.2% of the elderly females admitted to the psychiatric department, alcohol dependency was diagnosed, while 5.8% of the elderly patients showed substance abuse, most often of benzodiazepine. Among the patients visited in the psychiatric consultation service, 10.8% of the elderly males and 3.2% of the elderly females were alcohol addicts and 3.9% substance abusers. The frequency of alcohol-induced neuropsychiatric complications, particularly withdrawal delirium and amnestic syndrome, increased with age. Also, benzodiazepine withdrawal delirium most frequently occurred in older patients. These results underscore that, although the prevalence rate seems to be lower than among the younger population, in the elderly population substance abuse still is a relevant medical problem, since the rate of neuropsychiatric complications increased with age.


Subject(s)
Alcoholism/epidemiology , Substance-Related Disorders/epidemiology , Aged , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/psychology , Alcohol Withdrawal Delirium/diagnosis , Alcohol Withdrawal Delirium/epidemiology , Alcohol Withdrawal Delirium/psychology , Alcoholism/diagnosis , Alcoholism/psychology , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Alzheimer Disease/psychology , Anti-Anxiety Agents/adverse effects , Benzodiazepines , Comorbidity , Cross-Sectional Studies , Delirium/chemically induced , Delirium/diagnosis , Delirium/epidemiology , Delirium/psychology , Female , Germany/epidemiology , Hospitals, General , Humans , Incidence , International Classification of Diseases , Male , Psychiatric Department, Hospital/statistics & numerical data , Referral and Consultation/statistics & numerical data , Substance-Related Disorders/diagnosis , Substance-Related Disorders/psychology
12.
Alcohol Clin Exp Res ; 23(4): 575-7, 1999 Apr.
Article in English | MEDLINE | ID: mdl-10235290

ABSTRACT

The tau protein levels in cerebrospinal fluid (CSF-tau) were examined in 27 patients with alcohol dependence (20 demented and 7 nondemented), 36 age and dementia severity-matched patients with Alzheimer's disease (AD), and 23 age-matched normal control subjects. The CSF-tau levels in the demented alcoholic group (alcohol-induced organic brain disorders, 25.4 +/- 10.2 pg/ml) was significantly lower (p < 0.0001) than that in the AD group (96.1 +/- 53.3 pg/ml), but not significantly different from that in the nondemented alcoholics (18.1 +/- 10.2 pg/ml) or the controls (19.2 +/- 12.9 pg/ml). Using a 44.9 pg/ml as a cut-off value (mean + 2 SD of the normal control group), only one patient with alcohol-induced organic brain disorders exceeded the value, whereas 3 of 36 of the AD group showed CSF-tau levels less than this level. These findings suggest that alcohol-induced organic brain disorders are a group of dementias that are characterized by normal CSF-tau levels, and that the CSF examination for tau in combination with other clinical findings may help in differentiating alcohol-induced organic brain disorders from AD.


Subject(s)
Alcoholism/cerebrospinal fluid , Dementia/cerebrospinal fluid , tau Proteins/cerebrospinal fluid , Adolescent , Adult , Aged , Alcohol Amnestic Disorder/cerebrospinal fluid , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/epidemiology , Alcoholism/diagnosis , Alcoholism/epidemiology , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/diagnosis , Alzheimer Disease/epidemiology , Cognition Disorders/cerebrospinal fluid , Cognition Disorders/diagnosis , Cognition Disorders/epidemiology , Comorbidity , Dementia/diagnosis , Dementia/epidemiology , Diagnosis, Differential , Female , Humans , Japan/epidemiology , Male , Middle Aged , Severity of Illness Index , Wernicke Encephalopathy/cerebrospinal fluid , Wernicke Encephalopathy/diagnosis , Wernicke Encephalopathy/epidemiology
14.
Alcohol Alcohol ; 32(3): 281-5, 1997.
Article in English | MEDLINE | ID: mdl-9199729

ABSTRACT

A retrospective analysis of all admissions between 1990 and 1995 in a population of 160,000 identified 47 new cases of Korsakoff's psychosis only seven of which were preceded by Wernicke's encephalopathy. There was a higher ratio of females to males, relative to admissions for severe alcohol dependence. It postulated that the increasing incidence may be related to the warning of anaphylaxis and subsequent withdrawal of high-potency parenteral multivitamins with thiamine.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Cross-Cultural Comparison , Urban Population/statistics & numerical data , Adult , Aged , Alcohol Amnestic Disorder/etiology , Alcohol Amnestic Disorder/prevention & control , Cross-Sectional Studies , Dose-Response Relationship, Drug , Female , Humans , Incidence , Infusions, Intravenous , Male , Middle Aged , Patient Admission/statistics & numerical data , Retrospective Studies , Risk Factors , Scotland/epidemiology , Thiamine/administration & dosage , Thiamine/adverse effects , Wernicke Encephalopathy/epidemiology , Wernicke Encephalopathy/etiology , Wernicke Encephalopathy/prevention & control
15.
Med J Aust ; 163(10): 531-4, 1995 Nov 20.
Article in English | MEDLINE | ID: mdl-8538524

ABSTRACT

OBJECTIVE: To estimate the incidence of Wernicke-Korsakoff syndrome (WKS) before and after the introduction of thiamine enrichment of bread flour in 1991. DESIGN: Retrospective survey of hospital records. Patient records with the diagnostic codes for Wernicke's encephalopathy (WE) or Korsakoff's psychosis (KP) were reviewed and details of acceptable cases were entered onto a data form. SETTING: All 17 major public general hospitals in the Sydney area (New South Wales), between 1978 and 1993. OUTCOME MEASURES: Numbers of confirmed or probable diagnoses of WE, KP or WKS and associated deaths, patient demographic and social characteristics and alcohol intake. RESULTS: 1,267 patients with WKS were found, with 1,012 acute cases. Although numbers of acute cases may have started to fall before 1991, numbers for the last two years were the lowest of all the 16 years (P = 0.004). Cases of KP outnumbered those of WE by about 3:1 and men outnumbered women 4:1. The peak age was 60-64 years (17%) and beer was the most commonly cited alcoholic drink (71%). The red-cell transketolase test was seldom used for diagnosis (3% of acute cases). CONCLUSIONS: The lower number of "acute" cases in 1992 and 1993 is consistent with a preventive effect of mandatory enrichment of bread with thiamine, but is not conclusive evidence. Longer follow-up of Sydney hospitals, results of postmortem examinations and follow-up in other areas of Australia are required.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Bread , Food, Fortified , Thiamine/administration & dosage , Wernicke Encephalopathy/epidemiology , Adult , Aged , Aged, 80 and over , Alcohol Amnestic Disorder/complications , Alcoholism/complications , Female , Humans , Incidence , Inpatients/statistics & numerical data , Male , Middle Aged , New South Wales/epidemiology , Wernicke Encephalopathy/complications , Wernicke Encephalopathy/prevention & control
16.
Metab Brain Dis ; 10(1): 17-24, 1995 Mar.
Article in English | MEDLINE | ID: mdl-7596325

ABSTRACT

In the Western world previous studies have shown that the majority of cases of the Wernicke-Korsakoff syndrome (WKS), which is caused by thiamine deficiency, occur in alcoholics. However, in France, a country with one of the highest per capita consumptions of alcohol, the prevalence of the WKS was found to be only 0.4% in a small retrospective autopsy study. This figure is compared with data sent to the authors by a number of neuropathologists from the U.S.A., Europe, Scandinavia and Australia. There was no obvious correlation between the prevalence rates of the WKS, which were highest in Australia (2.8%-previously published), and per capita consumption of alcohol. Other issues such as diet, National programs for supplementation of foods with thiamine, and drinking habits are considered. The pathological diagnosis of the WKS can often be made on macroscopic examination of the brain after fixation in formalin. The mammillary bodies are smaller than normal in most cases of chronic WKS. However in this study it was found that the most common causes of small mammillary bodies were Alzheimer's disease and atrophy due to transneuronal degeneration secondary to lesions in the hippocampus.


Subject(s)
Wernicke Encephalopathy/epidemiology , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/pathology , Alzheimer Disease/epidemiology , Alzheimer Disease/pathology , Autopsy , Hippocampus/pathology , Humans , Mammillary Bodies/pathology , Prevalence , Thiamine Deficiency/epidemiology , Thiamine Deficiency/pathology , Wernicke Encephalopathy/pathology , tau Proteins
17.
Vestn Ross Akad Med Nauk ; (2): 28-30, 1994.
Article in Russian | MEDLINE | ID: mdl-7513575

ABSTRACT

To study the alcohol consumption pattern and mitochondrial aldehyde dehydrogenase (ALDH2) genotype, a random sample consisting of 170 native males (Chukchee and the Eskimo), residents of 4 Chukotka settlements, was studied. According to interviews, most residents (68%) consumed alcohol once or twice a month; however during an alcohol uptake episode they consumed very high (intoxicating) doses exceeding 150 g of pure alcohol. The rates of control loss, alcohol amnesia and withdrawal syndrome were more than 50%. Twelve per cent reported inconsistent facial flushing after drinking and positive ethanol-patch test was found only in 2% of cases. Direct genotyping, using specific oligonucleotide probes, showed no atypical oriental type ALDH2. The normal genotype (ALDH2-1) was present in all the examinees from Chukotka natives (n = 87). These results explain the ability of Chukotka natives to consume high amounts of alcohol per occasion and they are in disagreement with the hypothesis that the drinking pattern among the natives is explained by specific features of alcohol-metabolising enzymes.


Subject(s)
Alcohol Drinking/genetics , Aldehyde Dehydrogenase/genetics , Ethanol , Mitochondria/enzymology , Adult , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/genetics , Alcohol Amnestic Disorder/metabolism , Alcohol Drinking/epidemiology , Alcohol Drinking/metabolism , Alcoholism/epidemiology , Alcoholism/genetics , Alcoholism/metabolism , Aldehyde Dehydrogenase/metabolism , Genotype , Humans , Male , Middle Aged , Siberia , Substance Withdrawal Syndrome/epidemiology , Substance Withdrawal Syndrome/genetics , Substance Withdrawal Syndrome/metabolism
18.
Ugeskr Laeger ; 153(40): 2819-22, 1991 Sep 30.
Article in Danish | MEDLINE | ID: mdl-1926615

ABSTRACT

Wernicke encephalopathy and Korsakoff psychosis are two facets of the same disease with well-determined cerebral lesions caused by thiamine deficiency. The disease occurs mainly in alcoholics, but other conditions (malabsorption or severe malnutrition) also predispose to the risk of Wernicke-Korsakoff syndrome. The incidence in Denmark is unknown. In the period 1.1.1979-31.12.1988, 24 patients (18 men and six women) were discharged from Rigshospitalet with the diagnosis Wernicke encephalopathy or Korsakoff psychosis. This represents about 0.05% of all admissions in the period. Eighteen out of the 24 cases (75%) were admitted in the past three years (1986-88). The mean age was 55 years. Twenty patients admitted alcohol abuse. The presenting symptoms and the patients' complaints showed great variety and were often related to other alcoholic complications, which could mask the disease. The classic symptom combination: eye movement abnormalities- ataxia and disorders of consciousness were found in seven patients (29%). Sixteen patients had disorders of consciousness or orientation. All the patients were treated with thiamine. The eye-movement disorder has recovered in eight out of ten known cases (80%), nystagmus--in six out of seven cases (86%) while ataxia, disorders of orientation and confabulation recovered in about 50% of cases. The average duration of hospitalisation was 50 days. Altogether nine patients died during the observation period. The condition is most probably underdiagnosed and the traditional diagnostic criteria are considered too rigid. The diagnosis should be considered in alcoholics who present even only one of the classical symptoms and in patients with alcohol dementia. Thiamine should be given on wide indications.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Wernicke Encephalopathy/epidemiology , Adult , Aged , Alcohol Amnestic Disorder/diagnosis , Alcohol Amnestic Disorder/psychology , Denmark/epidemiology , Female , Humans , Male , Middle Aged , Retrospective Studies , Wernicke Encephalopathy/diagnosis , Wernicke Encephalopathy/psychology
19.
An Otorrinolaringol Ibero Am ; 18(6): 575-82, 1991.
Article in Spanish | MEDLINE | ID: mdl-1663705

ABSTRACT

Prospective study of about 42 chronic alcoholics and evaluation, by means of auditory evoked potentials, of their auditive pathways. Checking of the damage at the outmost degree of the pathway, in alcoholic encephalopathy. Discussion and evaluation of the tracings.


Subject(s)
Alcoholism/physiopathology , Evoked Potentials, Auditory , Adult , Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/physiopathology , Alcoholism/epidemiology , Female , Humans , Male , Middle Aged , Peripheral Nervous System Diseases/epidemiology , Peripheral Nervous System Diseases/physiopathology , Prospective Studies , Reaction Time/physiology , Wernicke Encephalopathy/epidemiology , Wernicke Encephalopathy/physiopathology
20.
Alcohol Alcohol Suppl ; 1: 381-4, 1991.
Article in English | MEDLINE | ID: mdl-1845567

ABSTRACT

Although easily preventable, Wernicke's encephalopathy (WE) remains a regrettably frequent and largely undiagnosed disorder in alcoholics. Unselected autopsy materials from the United States and Australia give prevalence figures of 2%. In Oslo, Norway, the corresponding figures are somewhat lower, 0.6%-0.8%. Only a fraction of the cases discovered at autopsy have been diagnosed clinically (1%-20%). One third of the cases in postmortem materials have been acute with signs of ongoing thiamine deficiency. In contrast to classical concepts, stupor and coma have been predominating symptoms in such cases. Two thirds have had chronic disease with marked variations in severity of the lesions and corresponding variations in severity of the symptoms, from Korsakoff's psychosis or global dementia in severe cases to a slight memory reduction in mild ones. The wide spectrum of the clinical symptoms has not been fully appreciated and this may in part explain the low level of diagnostic accuracy of the disease.


Subject(s)
Alcohol Amnestic Disorder/epidemiology , Alcohol Amnestic Disorder/physiopathology , Wernicke Encephalopathy/epidemiology , Wernicke Encephalopathy/physiopathology , Acute Disease , Alcohol Amnestic Disorder/pathology , Brain/pathology , Chronic Disease , Humans , Norway/epidemiology , Prevalence , Wernicke Encephalopathy/pathology
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