Addressing the challenges of chronic viral infections and addiction in prisons: the PRODEPIST study.

OBJECTIVES: In 2010 only 30.9%, of the Puy-de-Dome prison detainees were screened for human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV). Our goal was then to promote these assesments, as well as to identify addictive behaviour using FAGERSTROM, Cannabis Abuse Screening Test and CAGE tests, diagnose fibrosis by means of Fibrometer or Fibroscan in hepatic virus carriers and heavy drinkers, and perform HBV vaccinations. SETTING: This prospective study of adult detainees in the prisons of Puy-de-Dome, France, took place from June 2012 to December 2013. RESULTS: Of the 702 incarcerated individuals, 396(56.4%) were screened and 357(50.9%) enrolled. HIV prevalence was 0.3%, HCV 4.7% and HBV 0.6%. While 234/294(79.6%) smokers and 115/145(79.3%) cannabis users were screened for dependence, excessive alcohol consumption was tested for in 91/179(50.8%) cases. Fibrosis was screened for in 75/80(93.7%) individuals selected with 16.0% presenting with moderate to severe fibrosis, 4/9(44.4%) HCV carriers and 8/65(12.3%) excessive alcohol consumers. HBV vaccination was given to 81/149(54.4%) individuals with no serological markers. A total of nine HIV tests were conducted at the 57 discharge consultations, involving 215 detainees being released, all of which were negative. CONCLUSION: The promotion of these evaluations proved beneficial, although viral screening could be achieved for only approaching half of the detainees, as could alcohol consumption assessment and HBV vaccination for those concerned. Fibrosis screening revealed lesions in HCV carriers yet also in heavy drinkers, who are typically less likely to be assessed. Consultations and HIV screening on release were found to be rarely possible.

Differential associations between problem and pathological gambling and psychiatric disorders in individuals with and without alcohol abuse or dependence.

BACKGROUND: Alcohol abuse and/or dependence, alcohol use disorders (AUDs), and problem and/or pathological gambling (PPG) frequently co-occur with each other and other psychiatric disorders. However, prior studies have not investigated the relative influence of AUDs on the associations between PPG and other psychiatric disorders, METHODS: Nationally representative data froni the National Epidemiologic Survey on Alcohol and Related Conditions (n=43,093; United States residents > or = 18 years of age) was used to examine the influence of AUDs on the associations between gambling and other psychiatric disorders and behaviors. The main outcome measures were co-occurrence of past-year AUD and Axis I and II disorders and severity of gambling based on the 10 inclusionary diagnostic criteria for pathological gambling. RESULTS: Among non-AUD respondents, increasing gambling severity was associ- ated with increasingly elevated odds for the majority of Axis I and II disorders. Among AUD respondents, this pattern was typically not observed. Alcohol-by-gambling-group interactions for PPG were also found and the odds of these disorders was significantly increased in non-AUD respondents with PPG, but either unchanged or significantly lower in AUD respondents with PPG. CONCLUSIONS: Gambling-related associations exist with multiple psychiatric disorders, but particularly in those without AUD. These associations have important implications with respect to conceptualization, prevention, and treatment of psychiatric disorders in individuals with gambling and/or AUDs.

Caracterización de mujeres consumidores de alcohol / Alcohol women consumers: characterization

Se realiza estudio en 150 pacientes femeninas consumidores de alcohol, pertenecientes a 10 consultorios de la Parroquia Carlos Soublette, estado Vargas, Venezuela, en el período comprendido desde octubre de 2006 a marzo de 2007. El universo queda constituido por el 100 por ciento de las mujeres identificadas en consulta. La muestra es de 150, seleccionadas de los diferentes consultorios. Se utilizan variables tales como: vías que las condujo a este mal hábito, efectos provocados y frecuencia de embriaguez (AU)

A practical method of chronic ethanol administration in mice.

Mice provide a useful model for the study of immune deficiency caused by chronic alcohol abuse. Their suitability is related to several factors, including in particular the extensive knowledge base in the immunology of mice already existing in the literature. Specific modeling of the immunodeficiency of the chronic human alcoholic requires that ethanol must be administered to the model for a significant portion of its life span. In mice, it has proven to be necessary to administer ethanol daily for up to 32 wk or longer to observe all the immune abnormalities that occur in middle-aged alcoholic humans. Such time spans are problematic with many of the common protocols for ethanol administration. It has been shown by others and confirmed by our group that the most practical way of accomplishing such long protocols is by administering ethanol in water as the only choice of water. Details of management of the chronic ethanol mouse colony are described here that are necessary for the success of such studies, including methods for initiating ethanol administration, maintenance of barrier protection, monitoring weight gain, strain differences and fetal alcohol exposure.

Hormonal mechanisms underlying aberrant sexual differentiation in male rats prenatally exposed to alcohol, stress, or both.

The male offspring of rats exposed to restraint stress, alcohol, or both during late pregnancy show normally masculinized genitalia; however, sexual differentiation of behavior is dissociated from the external morphology. In contrast to controls, males exposed prenatally to stress, alcohol, or a combination of these factors exhibited the female lordotic pattern. Thus, all 3 prenatal treatments led to incomplete behavioral defeminization. Behavioral masculinization was not altered by fetal alcohol exposure alone, but a significant number of males that experienced prenatal stress alone failed to copulate. A more severe disruption of behavioral masculinization occurred when stress and alcohol were combined. Very few males exposed to the combination treatment mated with females. This study attempted to relate the effects of these treatments on sexual behavior to the postparturitional surge in plasma testosterone (T) that is known to influence the process of sexual differentiation. Prenatally stressed males, like control males showed a large, brief surge in plasma T that peaked 1 hr after delivery. Altered defeminization and masculinization were seen in prenatally stressed males, despite a normal postparturitional T surge. Fetal alcohol exposure, with or without concomitant stress, depressed T to the same extent right after birth and led to a similarly blunted T surge 1 hr later. Thus, equal disruption of the neonatal T pattern occurred in alcohol-alone males, who showed normal male copulatory behavior, and in alcohol-plus-stress males, whose behavior was severely attenuated. The results suggest that consideration of abnormal exposure to T during prenatal ontogeny may be required to understand the atypical sexual behaviors associated with these treatments.

Ultrastructural changes in preputial neural tissues: effects of maternal drinking.

Peripheral nerves in the prepuces of eight newborns were studied in this investigation. The mothers of four of these newborns were alcohol abusers but did not smoke or take coffee. The other four mothers did not drink alcohol or coffee, nor did they smoke. Using a transmission electron microscope, the peripheral nerves in preputial specimens were studied for pathological changes. In samples taken from the prepuces of those newborns with drinking mothers, the neuropathological changes seen were mainly in the unmyelinated axons. These demonstrated increased vesicular and tubular elements of agranular endoplasmic reticulum and dense bodies not found in the specimens taken from the non-drinking group. Other significant findings in the fetal preputial specimens from the alcohol group were aggregations of mitochondria and collagen entrapment.

The effect of ethanol upon early development in mice and rats. I. In vivo effect upon preimplantation and early postimplantation stages.

The preimplantation and early postimplantation effect of chronic alcohol consumption (at least a month before mating and during pregnancy until killing) and of acute ethanol intoxication during the preimplantation period (i.v. infection of ethanol) was studied on albino rats (Wistar) and albino mice (RAP). The main results were as follows: Chronic alcoholization. Rats: significant retardation of preimplantation development and in early postimplantation stages; a tendency of lowering of the mean litter size. Mice: significant increase of the number of preimplantation pathological forms; a tendency of lowering of the mean litter size. Pathological changes show, both in rats and mice, an obvious "litter effect". Acute ethanol intoxication. Rats: significant retardation in some litters, normal or even advanced development in others. This effect differs from the previously reported effect of acute ethanol intoxication during early postimplantation stages. The results obtained attest the prenatal noxious effect of chronic ethanol consumption in both species used and of acute ethanol intoxication during preimplantation development upon early postimplantation development in rats. Within the limits of extrapolation possibilities, they represent a risk signal for other species (including human).