Prediction of controlled drinking by alcoholics and problem drinkers.

Recent research was reviewed on the following factors as predictors of controlled drinking (CD) by alcoholics and problem drinkers: severity of dependence, client attitudes and beliefs about controlled drinking and abstinence, previous treatment, pretreatment drinking style, psychological and social stability, demographic characteristics, family history of drinking, referral source, and posttreatment adjustment and drinking. No single personal characteristic has been consistently predictive, but there is convincing evidence that a lower severity of dependence and a persuasion that CD is possible are associated with CD after treatment. Prediction of CD might be improved by an approach that assesses the influence of 3 types of variables: enduring personal characteristics, changeable social and psychological characteristics, and transient precipitating events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cue reactivity as a predictor of drinking among male alcoholics.

Social learning theories suggest that conditioned responses may increase the risk for relapse. Responses to alcohol use cues (cue reactivity) are associated with variables suggestive of risk but little research exists on the relationship of cue reactivity to treatment outcome. Alcoholic men admitted for detoxification to a treatment program (n?=?45) underwent a cue reactivity assessment protocol, and 91% received 3-mo follow-up interviews. Greater salivary reactivity predicted greater frequency of drinking during follow-up. Attentional factors added independent variance to the prediction of drinking outcome, with greater attention to stimulus or to response predicting less drinking. Cue reactivity did not predict length of hospital stay or latency to first drink. Results are discussed in the context of information processing, social learning theories, and clinical implications for relapse prevention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Development of systemic lupus erythematosus in a male patient after 14 years on hemodialysis

Graves' disease (GD), myasthenia gravis (MG), and polymyositis (PM) are organ-specific autoimmune diseases. The association between GD and MG is well known, and an association between MG and PM has been reported. However, only one patient with all three diseases has been reported. We describe a patient with GD and PM developing 6 and 29 years, respectively after the onset of MG. This case suggests that the expression of autoimmunity occurred over a prolonged period of time and these organ-specific autoimmune diseases may be induced by a similar mechanism.     

Reactivity of alcoholics and nonalcoholics to drinking cues.

An interest in reducing relapse among alcoholics has led to a consideration of stimulus control factors in drinking. Research suggests that through classical conditioning alcoholics may develop reactions to cues previously associated with drinking and that these reactions might be an important determinant of relapse. Although this model indicates the potential for cue exposure treatment methods to alter conditioned reactions, data on reactivity to alcohol cues by alcoholics and nonalcoholics are scarce. Two studies are presented that address this issue and provide evidence for the validity of salivation as a measure of cue reactivity. Alcoholics and nonalcoholics were presented with the sight and smell of their preferred brand of alcohol and a control beverage. Self-report, behavioral, and psychophysiological data were collected. Alcoholics salivated more than nonalcoholics to alcohol cues and more to alcohol than to the control beverage. Alcoholics salivated differentially to cues, whereas nonalcoholics did not. Patterns of reactivity were consistent with a conditioning model. Both groups reported greater urges to drink alcohol in the presence of alcohol, but neither group reported more thoughts about alcohol in the presence of alcohol as compared with the control beverage. Implications of salivary reactivity for theory and treatment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Bone mass improves in alcoholics after 2 years of abstinence

To evaluate the effect of abstinence on bone mass and bone mineral metabolism in chronic alcoholics, a 2 year longitudinal follow-up study was carried out in a group of 30 chronic alcoholic males who started a rehabilitation program. Lumbar and femoral bone mineral density (BMD) and serum levels of osteocalcin and 25-hydroxyvitamin D were measured at entry and after 1 and 2 years in all patients. Circulating cortisol and parathyroid hormone were measured in 14 and 6 patients, respectively, at entry and every year. Testosterone was measured in 18 patients at entry and after 1 year. At entry, lumbar BMD was significantly lower in alcoholics (1.06 +/- 0.03 g/cm2) than in age-matched healthy men (1.22 +/- 0.03 g/cm2; p < 0.001). Circulating osteocalcin and vitamin D levels were also significantly lower in alcoholics than in controls. Lumbar and femoral neck BMD increased in alcoholics after 2 years of abstinence (lumbar BMD, mean +/- SEM, 1.06 +/- 0.03 to 1.10 +/- 0.04 g/cm2, p < 0.05; femoral BMD, 0.82 +/- 0.02 to 0.84 +/- 0.02 g/cm2; p < 0.02). Moreover, lumbar BMD increased in alcoholics (2.9 +/- 1.4%) and decreased in controls (-1.1 +/- 0.2%; p < 0.02). Femoral BMD also increased in alcoholics (2.8 +/- 1.0%) but the expected mean decrease of -0.92% was found in healthy age-matched males. Baseline low osteocalcin levels (5.1 +/- 0.6 ng/ml) increased after 1 year (8.6 +/- 0.5 ng/ml, p < 0.001) and 2 years of abstinence (9.5 +/- 0.7 ng/ml, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

Prediction of abstinence, controlled drinking, and heavy drinking outcomes following behavioral self-control training.

Examined the prognostic value of client characteristics for 141 problem drinkers treated with an initial goal of controlled drinking. Clients achieving moderation were generally found to have less severe symptoms and less family history of problem drinking than were either abstainers or uncontrolled cases. Females were more successful in attaining moderation, whereas males were overrepresented among abstainers. Lower income and education were associated with successful outcome of both types. The value of predictor variables for a priori differential treatment assignment is found to be limited at present. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital interactions of male versus female alcoholics

This study assessed the interactions of 131 alcoholic and nonalcoholic couples as they engaged in discussions of personally relevant problems. For 50 couples, the husband was alcoholic; for 15 couples, the wife was alcoholic; for 16 couples, both spouses were alcoholics; and for 50 couples, neither spouse was alcoholic. Observations were conducted during sessions when alcohol was consumed and in nondrinking sessions. Female alcoholic couples (with nonalcoholic spouses) demonstrated high negativity in the "no-drink" session, which was normalized in the drink session, suggesting an adaptive function to alcohol use. Concordant couples (both members were alcoholic) also demonstrated high negativity in the no-drink session, but exhibited increased negativity in the drink session, suggesting that concordance has a maladaptive impact on marital interaction. All alcoholic groups demonstrated greater negativity and lower positivity and congeniality in their marital interactions compared to nonalcoholic couples. Couples with male alcoholics were the least divergent from normal control couples. Unique female patterns in alcoholism are discussed in terms of adaptive and reinforcing patterns and spousal influences.     

Discriminant analysis of MMPI profiles for demographic classifications of male alcoholics

White leghorn cockerels of the same age with combs of about equal size and raised under identical conditions were injected with melatonin, 5-methoxytryptophol, or with 5-methoxytryptophol in combination with melatonin. Melatonin, injected in animals with small comb sizes, has no effect on testicular growth, whereas an inhibiting effect is noticed in animals with larger comb sizes. The 5-methoxytryptophol treated animals demonstrated stimulated testicular growth, which can be interpreted as an acceleration of the rhythm of growth. The stimulatory effect on testicular growth is more distinct if 5-methoxytryptophol is injected in combination with melatonin.     

Late hematologic status after chemotherapy observed in patients 3 to 10 years after treatment

The aim of the present study is the evaluation of late hematological complication in patients who received aggressive chemotherapy, and were observed 3, 5 and 10 years after treatment was completed. In the group of 35 patients, besides high percent of early hematological complications, there was only one case of anemia grade 2 (acc. to WHO score). We concluded that the hematological recovery after aggressive chemotherapy was satisfactory. No secondary hematological malignancies have been found.     

Inherited predisposition to alcoholism: Characteristics of sons of male alcoholics.

Sons of male alcoholics (SOMAs) are at markedly heightened genetic risk for the development of alcohol abuse. Study of SOMAs could therefore conceivably increase the efficiency of research aimed at uncovering those heritable factors that predispose to alcoholism. SOMAs manifest observable behavioral, cognitive, and psychophysiological abnormalities while sober and react idiosyncratically to alcohol intoxication. They are most commonly described as conduct disordered and hyperactive, appear heir to a variety of deficits in verbal and abstract cognition, and perform more poorly in the academic environment. SOMAs are characterized by abnormal patterns of cued psychophysiological response, and appear more sensitive to the putatively reinforcing aspects of alcohol intoxication. Various methodological weaknesses permeate the relevant literature. Some straightforward improvements are suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Urethral diverticula in the male. Our experience over 10 years

Following mobilising chemotherapy and myeloid growth factors, some heavily pretreated patients do not mobilise adequate numbers of peripheral blood progenitor cells (PBPC). It would be clinically useful to identify such patients in advance. A recent scoring system based on previous therapy may be useful in predicting CD34-positive cell yield. In this study we validated this scoring system on an independent group of 99 patients undergoing 103 harvesting episodes. In 61 patients mobilised with cyclophosphamide 1.5 g/m2 and G-CSF, those with treatment scores less than 21 yielded significantly more CD34-positive cells than patients with scores greater than 63 (P = 0.0012). Previous treatment with melphalan or carmustine was associated with a significantly lower yield of CD34-positive cells (P= 0.0001). No relationship was seen between the time from previous chemoradiotherapy and harvest outcome. Patients with treatment scores less than 21 required a shorter duration of G-CSF therapy (P = 0.05). Similar findings were seen in 42 further mobilisation cycles undertaken with alternative mobilisation schedules. The present data suggest that a score summarising previous treatment can be used to predict CD34 yields, and could be of clinical use to identify poor PBPC mobilisers in advance.     

Broad-spectrum behavioral treatment for chronic alcoholics: Effects of training controlled drinking skills.

Evaluated drinking skills training for 62 male chronic alcoholic veterans (mean age 46.1 yrs) by assigning 10 successive cohorts to trained or untrained conditions in a randomized block experimental design. All Ss received broad-spectrum behavioral treatment consisting of alcohol education, group therapy, individual therapy, self-management training, job-seeking and interpersonal-skills training, drink-refusal-skills training, and relaxation training. Cohorts assigned to the controlled drinking skills condition received 15 hrs of blood-alcohol-level discrimination training, responsible-drinking-skills training, and social-drinking practice sessions. Six-month posttreatment follow-up revealed that Ss in the drinking skills condition had significantly fewer abstinent days and more abusive drinking days than Ss in the untrained condition. Differences between groups were not significant in follow-up Months 7–22, although trends continued. No differences were obtained on moderate drinking days or any adjunctive measures of psychosocial adjustment. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Some factors affecting the likelihood of moderate drinking by treated alcoholics

The 1-year outcome in alcoholics who participated in an outpatient alcoholism treatment program which stressed moderate drinking as the ultimate treatment goal was investigated. The results suggest that such an approach, in an otherwise conventional treatment program, is likely to result in a higher rate of moderate drinking and a lower rate of abstinence but not in a higher over-all recovery rate than a total-abstinence orientation.     

Loss of control drinking in alcoholics: An experimental analogue.

Presented 2 groups of 32 male 23-65 yr old nonabstinent alcoholics and social drinkers with an ad-lib supply of either alcoholic or nonalcoholic beverages in a taste-rating task. Ss were assigned to 1 of 2 instructional set conditions in which they were led to expect that the beverage to be rated contained alcohol (vodka and tonic) or consisted only of tonic. The actual beverage administered consisted of either vodka and tonic or tonic only. Results show that instructional set is a significant determinant of the amount of beverage consumed and posttask estimates of the alcoholic content of the drinks. The actual beverage administered did not significantly affect the drinking rates of either alcoholics or social drinkers. Loss-of-control drinking, in the form of increased consumption by alcoholics who were administered alcohol, did not occur during the drinking task. Results are discussed in terms of implications for treatment and for the conception of alcoholism as a disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preliminary screening for the potential of drinking water disinfection byproducts to alter male reproduction

There is increasing epidemiologic interest in the role drinking water disinfection byproducts (DBPs) may play in adverse reproductive outcomes such as inability to conceive, spontaneous abortion, and low birth weight. Although dozens of DBPs already have been identified, only a few studies have attempted to determine whether DBPs alter male reproductive parameters such as testicular and epididymal histology, testicular and epididymal sperm numbers, and epididymal sperm morphology and motility in laboratory animals. In these studies, alterations in epididymal sperm motility seemed to be predictive of more generalized toxicity of the male reproductive system. Because there is a need to prioritize DBPs for thorough reproductive and developmental toxicity testing, preliminary screening for the potential of DBPs to alter reproductive function seems warranted. Here, we elected to examine only cauda epididymal sperm motion parameters and testicular and epididymal histopathology. The effects of exposure to two commonly occurring DBPs, bromodichloromethane (BDCM) and chloral hydrate (CH), via drinking water were evaluated in F344 rats at an interim (52 week) necropsy during cancer bioassay studies. Exposure to 22 and 39 mg/kg BDCM and 55 and 188 mg/kg CH did not produce any systemic toxicity. Histopathologic evaluation revealed no gross lesions in the reproductive organs, and no tumors were detected in any tissues. In contrast, exposure to 39 mg/kg BDCM significantly decreased the mean straight-line, average path, and curvilinear velocities of sperm recovered from the cauda epididymidis. This BDCM exposure shifted the average path velocity distribution to a lower modal velocity range. Exposure to 188 mg/kg CH significantly decreased both the percentage of motile and progressively motile sperm. This CH exposure shifted the straight-line velocity distribution to a lower modal velocity range. These are the first reproductive toxicity data from exposure to BDCM and CH. The observed effects on sperm motion occurred in the absence of carcinogenesis. Because the effects of BDCM on sperm motility occurred at a lower exposure than that of other DBPs that compromise sperm motility, a thorough reproductive evaluation now is underway.     

First melanoma metastases after 10 years and more of remission

The aim of this study was to combine immunomagnetic capture and a polymerase chain reaction (PCR) followed by hybridization with a DNA probe for the detection of Bacteroides forsythus. Magnetic beads were coated with the immunoglobulin G fraction of an antiserum specific for B. forsynthus. Aliquots were incubated with various concentrations of a suspension of B. forsythus or with a suspension containing 16 bacterial species, at a concentration of 10(10) cells/ml, spiked with dilutions of B. forsythus. Beads with bound bacteria were boiled, and the target DNA in the supernatant was amplified to generate a 392-bp PCR fragment specific for B. forsythus. The amplified product was detected by dot-blot hybridization with a digoxigenin-labeled 392-bp probe. The detection limit was determined to be 10 cells/ml using immunocapture on a suspension of B. forsythus and 100 on spiked bacterial suspensions. Subgingival plaque samples were obtained from 39 Bolivian individuals with poor oral hygiene. Each sample was analyzed by the above procedure and by immunofluorescence. The overall prevalence of individuals harboring B. forsythus was 62% by immunofluorescence and 82% by PCR-DNA probe assay. The immunocapture, PCR. DNA-probe procedure should be useful for the detection of B. forsythus, particularly in false-negative samples obtained by less sensitive techniques.     

Effects of alcohol on sexual arousal in male alcoholics.

During successive daily sessions, each of 8 29–44 yr old chronic male alcoholics received, in counterbalanced order, doses of beverage alcohol (.08, .4, .8, and 1.2 g/kg) prior to viewing nonerotic and erotic films. Measures of penile tumescence obtained by means of a penile plethysmograph showed a significant negative linear effect of increasing alcohol doses during the heterosexual and homosexual films. Ss' expectations about the effect of alcohol on sexual arousal and behavior were discrepant with these physiological findings. Consistently, Ss reported that alcohol would have no effect on their sexual arousal or would increase it. Results are discussed with reference to other studies, and it is concluded that penile tumescence is a convenient, reliable, and discriminating measure of male sexual arousal. (27 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From in-session behaviors to drinking outcomes: A causal chain for motivational interviewing.

Client speech in favor of change within motivational interviewing sessions has been linked to treatment outcomes, but a causal chain has not yet been demonstrated. Using a sequential behavioral coding system for client speech, the authors found that, at both the session and utterance levels, specific therapist behaviors predict client change talk. Further, a direct link from change talk to drinking outcomes was observed, and support was found for a mediational role for change talk between therapist behavior and client drinking outcomes. These data provide preliminary support for the proposed causal chain indicating that client speech within treatment sessions can be influenced by therapists, who can employ this influence to improve outcomes. Selective eliciting and reinforcement of change talk is proposed as a specific active ingredient of motivational interviewing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)