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Chronic pancreatitis: aetiology, epidemiology and clinical presentation

Goh KL

Med J Malaysia, 2005 Jul;60 Suppl B:94-8.
PMID: 16108185

Chronic pancreatitis is a difficult disease to treat. Worldwide, alcohol is the most common aetiology but based on recent studies it is clear that genetic susceptibility plays an important role in determining disease. Several important genetic mutations have been identified. The prevalence of chronic pancreatitis appears to be lower in Asia although very high rates have been reported in parts of India. Severe intractable pain is the predominant presenting complaint of patients. The natural history of the disease and the onset of exocrine and endocrine insufficiency depend on the classification of disease as early onset, late-onset or alcohol associated. Complications of chronic pancreatitis are important and include pseudocyst formation, bile duct and duodenal strictures.

Matched MeSH terms: Alcoholism/complications
Fulltext Pattern of alcoholism in the General Hospital, Kuala Lumpur

Saroja KI, Kyaw O

Med J Malaysia, 1993 Jun;48(2):129-34.
PMID: 8350787

This study establishes the prevalence rate for alcoholism among the inpatients of the General Hospital, Kuala Lumpur, as 11%, but as 25% among the drinking population. It also describes the demographic profile of the alcoholic as compared to the non-alcoholic drinker and the non-drinker and suggests that certain vulnerability factors could contribute to the development of alcoholism. A trend noted is also the changing racial trends in the use of alcohol.

Matched MeSH terms: Alcoholism/complications
An analysis of the teratagenic effects that could possibly be due to alcohol consumption by pregnant mothers

Chaudhuri JD

Indian J Med Sci, 2000 Oct;54(10):425-31.
PMID: 11262858

It can be concluded that alcohol is definitely harmful to the developing fetus. The effect can manifest in various ways, the most extreme of which is a condition called Fetal Alcohol Syndrome (FAS). The diagnosis of maternal alcoholism leading onto cases of FAS is difficult due to absence of accurate diagnostic tests. The diagnosis of FAS in a child is easier by a proper examination. There is no specific treatment of FAS in a child. The only management is by institution of corrective and rehabilitative measures. The exact mechanism of the teratogenic action of alcohol is not known. It is probably due to the harmful effect of alcohol on the epiblast layer of the bilaminar germ disc. In the absence of adequate knowledge regarding FAS, not much can be done to remedy the deleterious effects of alcohol. Hence, a word of advice to all pregnant women is to avoid drinking during pregnancy.

Matched MeSH terms: Alcoholism/complications
Fulltext A 3 year case study of alcohol related psychotic disorders at Hospital Seremban

George S, Chin CN

Med J Malaysia, 1998 Sep;53(3):223-6.
PMID: 10968157

This paper reports the characteristics and psychopathology of alcohol dependents with alcohol induced psychotic disorder admitted to the Seremban Hospital. The method is that of a case study of all alcohol dependents with alcohol induced psychotic disorder admitted to the Psychiatric Ward, Hospital Seremban over 3 years (1993-1995). There were 34 subjects, 30 Indians, 3 Chinese and 1 Malay with a mean age of 43 years. 32 were men and predominantly of Social Class IV and V (91%). They had a mean duration of drinking of 14.2 years and had a mean weekly consumption of 69.5 units of alcohol. There was a family history of alcohol dependence in (44%). The majority (68%) consumed samsu with beer the second choice. Auditory hallucinations (26) and delusions (16) were common while visual hallucinations (3) and depression (2) were less frequent. Speech disorder occurred in 4 subjects. 2 developed delirium tremens and 1 died. Liver function test was normal in 55%. All except the death from delirium tremens responded to treatment with a combination of anxiolytics, thiamine and antipsychotics and were rapidly discharged. The mean stay was 7 days. However, (68%) did not return for follow up and only 4 were abstinent from alcohol at the time of follow up.

Matched MeSH terms: Alcoholism/complications*
Pathogenesis of alcohol-induced osteoporosis and its treatment: a review

Abukhadir SS, Mohamed N, Mohamed N

Curr Drug Targets, 2013 Dec;14(13):1601-10.
PMID: 24138635

Osteoporosis is the most common bone disease in humans; it represents a major public health problem. This chronic disease is characterized by increase in bone fracture due to: reduced bone mass, deterioration of micro architectural and decreased bone strength, bone fragility; and bone mineral density 2.5 or more standard deviations below the normal mean. Secondary osteoporosis is a common cause of osteoporosis, and there are many underlying risk factors for osteoporosis. Chronic alcohol abuse is one of the modifiable risk factors in osteoporosis. There is evidence of correlation between chronic alcohol abuse and low bone mass. Alcohol is directly toxic to the bone; with increased incidence of fractures and complications. Although there is a paucity of studies regarding alcohol induced osteoporosis therapy, it can be classified into antiresorptive therapy and anabolic therapy. Bisphosphonates have been demonstrated to be clinically relevant to prevent bone damage associated with alcohol use while parathyroid hormone increased bone mineralization as well as bone formation in alcohol treated rats. Vitamin D supplementation could prevent bone toxicity in chronic drinkers. This review discussed the pathogenesis of alcohol-induced osteoporosis and the agents available for its treatment. Other potential therapies are also discussed.

Matched MeSH terms: Alcoholism/complications*
Fulltext Extended-release Naltrexone Improves Viral Suppression Among Incarcerated Persons Living with HIV and Alcohol use Disorders Transitioning to the Community: Results From a Double-Blind, Placebo-Controlled Trial

Springer SA, Di Paola A, Barbour R, Azar MM, Altice FL

J Acquir Immune Defic Syndr, 2018 09 01;79(1):92-100.
PMID: 29781884 DOI: 10.1097/QAI.0000000000001759

OBJECTIVE: To determine whether extended-release naltrexone (XR-NTX) would improve or maintain viral suppression (VS) among incarcerated individuals with HIV and alcohol use disorders (AUDs) transitioning to the community.
DESIGN: A randomized, double-blind, placebo-controlled trial was conducted among incarcerated individuals with HIV and AUDs transitioning to the community from 2010 through 2016.
METHODS: Eligible participants (N = 100) were randomized 2:1 to receive 6 monthly injections of XR-NTX (n = 67) or placebo (n = 33) starting at release and continued for 6 months. The primary and secondary outcomes were the proportion that maintained or improved VS at <200 and <50 copies per milliliter from baseline to 6 months, respectively, using an intention-to-treat analysis.
RESULTS: Participants allocated to XR-NTX improved VS from baseline to 6 months for <200 copies per milliliter (48.0%-64.2%, P = 0.024) and for <50 copies per milliliter (31.0%-56.7%, P = 0.001), whereas the placebo group did not (<200 copies/mL: 64%-42.4%, P = 0.070; <50 copies/mL: 42.0%-30.3%, P = 0.292). XR-NTX participants were more likely to achieve VS than the placebo group at 6 months (<200 copies/mL: 64.2% vs. 42.4%; P = 0.041; <50 copies/mL: 56.7% vs. 30.3%; P = 0.015). XR-NTX independently predicted VS [<200 copies/mL: adjusted odds ratio (aOR) = 2.68, 95% confidence interval (CI) = 1.01 to 7.09, P = 0.047; <50 copies/mL: aOR = 4.54; 95% CI = 1.43 to 14.43, P = 0.009] as did receipt of ≥3 injections (<200 copies/mL: aOR = 3.26; 95% CI = 1.26 to 8.47, P = 0.010; <50 copies/mL: aOR = 6.34; 95% CI = 2.08 to 19.29, P = 0.001). Reductions in alcohol consumption (aOR = 1.43, 95% CI = 1.03 to 1.98, P = 0.033) and white race (aOR = 5.37, 95% CI = 1.08 to 27.72, P = 0.040) also predicted VS at <50 copies per milliliter.
CONCLUSIONS: XR-NTX improves or maintains VS after release to the community for incarcerated people living with HIV and AUDs.

Matched MeSH terms: Alcoholism/complications
Fulltext Lifetime and baseline alcohol intakes and risk of pancreatic cancer in the European Prospective Investigation into Cancer and Nutrition study

Naudin S, Li K, Jaouen T, Assi N, Kyrø C, Tjønneland A, et al.

Int J Cancer, 2018 Aug 15;143(4):801-812.
PMID: 29524225 DOI: 10.1002/ijc.31367

Recent evidence suggested a weak relationship between alcohol consumption and pancreatic cancer (PC) risk. In our study, the association between lifetime and baseline alcohol intakes and the risk of PC was evaluated, including the type of alcoholic beverages and potential interaction with smoking. Within the European Prospective Investigation into Cancer and Nutrition (EPIC) study, 1,283 incident PC (57% women) were diagnosed from 476,106 cancer-free participants, followed up for 14 years. Amounts of lifetime and baseline alcohol were estimated through lifestyle and dietary questionnaires, respectively. Cox proportional hazard models with age as primary time variable were used to estimate PC hazard ratios (HR) and their 95% confidence interval (CI). Alcohol intake was positively associated with PC risk in men. Associations were mainly driven by extreme alcohol levels, with HRs comparing heavy drinkers (>60 g/day) to the reference category (0.1-4.9 g/day) equal to 1.77 (95% CI: 1.06, 2.95) and 1.63 (95% CI: 1.16, 2.29) for lifetime and baseline alcohol, respectively. Baseline alcohol intakes from beer (>40 g/day) and spirits/liquors (>10 g/day) showed HRs equal to 1.58 (95% CI: 1.07, 2.34) and 1.41 (95% CI: 1.03, 1.94), respectively, compared to the reference category (0.1-2.9 g/day). In women, HR estimates did not reach statistically significance. The alcohol and PC risk association was not modified by smoking status. Findings from a large prospective study suggest that baseline and lifetime alcohol intakes were positively associated with PC risk, with more apparent risk estimates for beer and spirits/liquors than wine intake.

Matched MeSH terms: Alcoholism/complications