ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01912.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The steady decline in tuberculosis case rate reversed in the mid‐1980s, and tuberculosis cases have increased dramatically since that time. Important factors contributing to this increase are the human immunodeficiency virus (HIV) epidemic and tuberculosis occurring in foreign‐born persons. Tuberculosis outbreaks have occurred in HIV clinics and wards, prisons, homeless shelters, nursing homes, and health care facilities. Some of the outbreaks have involved strains of tuberculosis resistant to multiple antituberculosis drugs. Recent recommendations for initial therapy of tuberculosis include the use of four drugs and directly observed therapy in an effort to prevent the emergence of further drug resista

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01464.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01913.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Well functioning host defenses in the respiratory tract effectively remove microbes and other debris that reach the conducting airways and alveoli, and this usually prevents infections. People with acute and chronic illnesses can experience failure of any number of these defense mechanisms that allow pneumonia (and bacteremia) to occur, often with considerable morbidity and mortality. People with alcohol‐related illnesses are a susceptible group for infections, and many strategies are needed to help them such as moderating alcohol abuse and dependence, providing timely immunizations to create antibody against encapsulated bacteria, anticipating microbial colonization of mucosal areas that can promote infection, giving excellent supporting medical care in crisis situations, and prescribing appropriate antibiotics. New approaches to boosting inflammatory reactions to control lung infections better with cytokines and new immunomodulator therapies must be investigated no

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01465.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Alcohol abuse has been associated with an increase in infectious diseases caused by pathogenic and opportunistic microorganisms. Study results obtained from this laboratory and other laboratories have shown that consumption of large amounts of ethanol is associated with numerous changes in the immune system. The purpose of this article is to report findings obtained from this laboratory, as well as review those obtained from other laboratories, from experiments designed to evaluate the effects of ethanol on various components of antimicrobial host‐defense mechanisms. The effects of ethanol on various aspects of immunity obtained with the use of in vivo and in vitro model systems are reviewed as they pertain to antimicrobial defenses. All current data would support the suggestion that ethanol affects both the development of an antigen‐specific immune response and the effector mechanisms of the cellular immune response. Findings obtained from animal models show that ethanol prevents the formation of granulomas in infected tissues, perhaps by inhibiting the response of macrophages to T‐cell cytokines. Data obtained from this laboratory also support the suggestion that the inability of the immune system to control the intracellular growth of microorganisms results in an exaggerated inflammatory response that is responsible for at least a part of the tissue d

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01466.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Alcohol exerts potent suppressive effects on the immune system that significanty increase host susceptibility to a variety of infections, particularly pneumonia. Historically, tuberculosis has been strongly associated with alcohol abuse. Although the relationship between alcohol abuse and tuberculosis is widely appreciated, the basic mechanisms by which alcohol immunosuppresses the host remain to be clarified. A major obstacle in furthering our understanding of this association has been the difficulty in distinguishing between the effects of alcohol per se and the other frequent sequelae of alcoholism such as nutritional deficiencies, liver disease, cigarette smoking, hygienic factors, and lifestyle. This article focuses on the role of tumor necrosis factor‐alpha (TNF) in host defense and how alcohol modulates the activity of this important cytokine. While TNF's role in mediating the lethal consequences of infection has been the subject of much conjecture, this review focuses on the emerging evidence that TNF is an essential factor in the normal immune response to numerous infections, including tuberculosi

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01467.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

The purpose of this study was to assess racial differences in the risk of alcohol‐related problems associated with alcohol consumption, regular psychoactive drug use, a family history of alcohol‐related problems, sociodemographic factors (age and education), and social roles (work, marital, and parental) among nonabstaining African‐American and White gynecologic outpatients. In addition, work, marital, and parental roles were investigated to determine whether they mediated or explained racial differences observed in relationships between these factors and alcohol‐related problems. Respondents were 630 African‐American women and 769 White women aged 13–77 who were systematically sampled from three obstetric/gynecologic clinics and two private practices in Erie County, New York. Hierarchical multiple regression analysis was used to test the significance of main effects of these factors on alcohol‐related problems, to test the interactive effects of race with each factor, and to test the interactive effects of social roles with alcohol consumption, the only factor for which a racial difference was observed in its relationship with alcohol‐related problems.Overall, results indicated that correlates of alcohol‐related problems were similar for African‐American and White women. Higher risk of alcohol‐related problems was associated with lower levels of education and lack of work and parental roles. In addition, married women who drank heavily were at higher risk of alcohol‐related problems than unmarried women who drank heavily. The fact that White women were more likely than African‐American women to be married contributed to the observation that the relationship between alcohol consumption and alcohol‐related problems was stronger among White women than a

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01468.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Alcohol‐dependent patients with antisocial, aggressive, and impulsive behaviors form a subgroup, in which a dysfunction of the brain serotonin system is discussed as a pathogenetic factor. Early onset and a transmission from fathers to sons (type II alcoholism; Clon‐inger, 1987) are supposedly further characteristics of this subgroup. The response pattern of primary auditory cortices to auditory stimuli with different intensities is discussed as a noninvasive indicator of the level of central serotonergic neurotransmission. A strong intensity dependence of these responses is supposed to indicate low serotonergic neurotransmission and vice versa. A strong intensity dependence is therefore expected to characterize patients with antisocial tendencies. Auditory‐evoked potentials (N1/P2 component) to stimuli in five different intensities were recorded in 53 hospitalized patients after 1 week of withdrawal. Dipole source analysis was performed to separate responses of primary and secondary auditory cortices. Patients with antisocial tendencies showed a significantly stronger intensity dependence of their evoked responses of primary auditory cortices (tangential dipoles). Age at onset and family history were not related to the intensity dependence of the evoked responses. The results support the notion that alcohol‐dependent patients with strong intensity dependence and antisocial tendencies form a subgroup with a serotonergic hypofunction. These patients may respond favorably to a relapse prevention with serotonergi

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01469.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Research indicates that biological relatives of alcoholics are more likely to develop alcoholism than individuals without alcoholic relatives. Most research on these groups has focused on individuals who were relatively young (i.e., under 30 years old). In the present study, we evaluated middle‐aged and elderly nonalcoholic men and women who did and did not have alcoholic biological relatives to assess factors that might be involved in a later, rather than an earlier, onset of alcoholism. Psychological characteristics were assessed using the Tridimensional Personality Questionnaire. Biological characteristics were assessed using quantitative measures of the spontaneous electroencephalogram. The psychological measures did not distinguish the groups, but biological measures did. The results indicated that nonalcoholic individuals with alcoholic relatives showed elevated β as compared with sex‐ and age‐matched control subjects. Factors that might have mediated these findings are discussed, as are the implications of these ou

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01470.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Studies of consumers' use of alcohol beverage outlets have provided a basis for understanding drinking behaviors in different drinking environments. These studies have shown that drinking environments are related to both demographic and drinking pattern measures. Absent from these studies has been a theoretical basis on which to make predictions regarding drinking patterns and choices of drinking environments under the various social, economic, and environmental constraints typically confronting alcohol consumers. This study presents one such theoretical approach.The approach assumes that, in the context of individual preferences for alcohol, drinking choices are constrained by consumers' economic and time‐energy budgets for consumption. All other things being equal, it is suggested that greater budgets for consumption will be related to greater alcohol use, quality of beverages purchased, amenity values of purchase locations, or all three. Because on‐premise drinking entails greater economic costs, greater drinking levels will be related to lower utilization of on‐premise establishments.The predictions of this approach were tested using data obtained from telephone surveys of consumers conducted in 1990 and 1991. The results showed that controlling for income, variables related to greater time‐energy budgets for consumption (i.e., marital status and household composition) were related to greater consumption levels and greater utilization of on‐premise establishments. Controlling for demographic measures, greater income was related to greater utilization of restaurants and increased beverage quality. Controlling for all other measures, frequencies of consumption were inversely related to consumption at on‐premise establishments, reflecting the expected moderation in costs for heavier consumers on a limited alc

ISSN:0145-6008    

DOI:10.1111/j.1530-0277.1995.tb01471.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY