ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05324.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Cupro‐zinc superoxide dismutase (SOD‐1) was measured by competition radioimmune assay of erythrocyte lysates of alcoholic and control subjects. Normal amounts of SOD‐1 were found in the extract from control subjects (815 ng/mg Hb) and from white alcoholics (874 ng/mg Hb). However, the level of SOD‐1 in lysates from black alcoholics (1033 ng/mg Hb) was significantly increased (p= 0.0001, rank‐sum test) compared with black and white controls. This increase was not related to any other observed hematologic disorder or to any historical, demographic, or laboratory value

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05325.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Mean red blood cell volume (MCV), plasma gamma glutamyl transpeptidase (GGTP), and plasma alpha amino‐n‐butyric acid (AANB) were measured in 245 patients undergoing treatment for alcoholism at the V.A. Medical Center, Bronx, N.Y. and Raleigh Hills Hospitals, Denver, Colo. AANB and GGTP, but not MCV, decreased following withdrawal from alcohol and during a period of abstinence. Among patients who relapsed, AANB and GGTP, but not MCV, increased in a majority of subjects. The combined use of AANB and GGTP identified 28/33 heavy drinkers, while 4/33 patients in remission had positive tests. In conclusion, measurement of AANB and GGTP are useful in documenting the success of treatment for alcoholism and in identifying patients who relapse following treatment for alcohol

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05326.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Basal levels of serum thyroid‐stimulating hormone (TSH). T3, T4, free T3and free T4were measured in 40 chronic alcoholic men and in 31 normal volunteers. Their serum TSH responses to provocative thyrotropin‐releasing hormone (TRH) stimulation were then examined serially: in chronic alcoholics, every 5 days for a total of 3 studies; in 25 of the normal volunteers, before and 72 hr after daily ingestion of ethanol (2 cc/kg/day). Basal serum TSH levels were increased in the alcoholic men (3.5 ± 0.2 μU/ml) (mean ± SEM) compared to those of the normal controls (1.7 ± 0.1) (p<0.01). Both basal serum T3and T4levels (T3, 0.89 ± 0.10 ng/ml; T4, 7.0 ± 0.4 μg/dl) were reduced in the alcoholic men when compared to those of the normal controls (T3,1.20 ± 0.03 ng/ml; T4, 8.6 ± 0.3 μg/dl) (p<0.01 andp<0.05, respectively). Basal serum free T3levels were reduced in the alcoholic men (169 ± 22 pg/dl) compared to the normal controls (380 ± 18) (p<0.01). In contrast, basal serum free T4levels were increased in the alcoholics (4.0 ± 0.2 ng/dl) compared to those of the normal controls (2.9 ± 0.1) (p<0.01). In response to TRH, the serum TSH levels of the alcoholic men achieved a peak of 13.5 ± 0.9 μU/ml compared to 14.9 ± 0.9 for the normal controls (no significant difference). Despite better nutrition and alcohol abstinence associated with hospitalization for 10 days, no improvement in either the basal levels of TSH, T3, and T4or the TSH responses to provocative TRH was observed in the alcoholic men studied. In normal volunteers, ethanol had no effect on the basal or TRH‐stimulated levels of serum TS

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05327.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

This study assesses the statistical effects of the physical availability of alcohol as measured by the number of liquor store employees per 100,000 persons. Controlling for the effects of per capita income and urbanism, it is found that there are effects of physical availability on current tangible consequences but not on alcoholism rates or frequent heavy drinking.

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05328.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

TheEva difficulties involved in attempting to evaluate the effects of treatment for alcohol‐related problems are, in complexity and subtlety, second only to the process of treatment itself. Much of the research done in the past utilizes a simple input—output model of evaluation. People presumed to be “alcoholic” by some criteria are studied upon entry into a specific in‐or outpatient setting. This is defined as “day 1” of treatment, regardless of how little or how much care the subjects have had in the past. Treatment is categorized rather grossly by quantity or type. The people leaving treatment are followed a

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05329.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Most alcoholism treatment evaluations do not use adequate evaluation research designs or an adequate array of outcome measures whose reliability and validity have been established. Data about the durability of treatment effects are also missing. As a result, many evaluation study findings are open to question. Measures of alcohol addiction, general morbidity, and mortality are proposed as essential in evaluating treatment effects, along with the more usual reports of work and criminal history. Estimates of quantity and frequency of alcohol consumption are deemed preferable to current categorizations of alcohol consumption after treatment into moderate or heavy drinking. A large proportion of alcoholics who seek treatment seem to do well even when they do not continue in it. The type of treatment provided does not seem to improve chances of success. Lifestyle and community factors are probably influencing outcomes of treatment; however, these have not been taken into account in most studies. Attempts to improve treatment program management by evaluation studies hold promise. Review by professional standards, management by exception, and cost effectiveness studies have been undertaken in isolated instances. Several cost effectiveness indicators for state alcoholism and treatment programs are proposed for use with available data.

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05330.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

Benefit‐cost analysis as a form of “social profitability analysis” can be a powerful tool in the overall evaluation of alcoholism treatment efforts. Alcoholism treatment potentially leads to a multiplicity of benefits in addition to sobriety. Benefit‐cost analysis provides a methodology for converting many of these diverse benefits into a common metric (dollars). thereby allowing the comparison of aggregate benefits and treatment costs. The analysis thus leads to the expression of treatment outcome in terms of the return on investment. A benefit‐cost analysis conducted on 3034 clients from the Oklahoma data base indicated a return to society of $1.98 for every $1 invested in alcoholism treatment. Such data may represent a critical portion of the information required for responsible resource allocation

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05331.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

We define a halfway house as a transitional residence where patients learn skills and acquire confidence to function independently after discharge to a noninstitutionalized setting. Accordingly, our residents are provided shelter, food, counseling, group therapy, and medical care, but are expected to do assigned housework, attend AA, take disulfiram, obtain outside work, pay some rent, and find a place to live. The life‐table method examines outcome for all patients seen up to the time of analysis and allows for different lengths of time that patients are known to the program. With this method, we calculated probability of not drinking (“survival“) for successive 2‐mo intervals after discharge from the house, based on the fate of all 185 patients known to us in August 1977. At least 101 patients drank during the first 2 mo. Cumulative probabilities of abstinence were 0.37 at 2 mo, 0.28 at 4 mo, 0.21 at 6 mo. and 0.19 for several months thereafter. Survival curves calculated for subsets of the population were similar when we classified for race, sex, prior inpatient rehabilitation, or employment at discharge. Patients older than 40 did slightly better. We conclude that (1) most patients will do well while in a sheltered environment, no matter what it is called, and (2) social rehabilitation itself does not produce sobriety. We will prevent relapses more effectively only when we better understand the physiology of alcohol

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05332.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

The need to synthesize clinical and empirical considerations in naturalistic studies of psychologically oriented alcoholism treatment is discussed. Well done naturalistic studies are viewed as a necessary complement to more traditional controlled studies of treatment in order to maintain an interface of clinical reality with scientific respectability. A general clinical framework and scientific model for naturalistic study are proposed by which scientific and clinical considerations may be reconciled.

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1979.tb05333.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY