In the present study, we investigated the frequency of polyneuropathy in a sample of 296 alcoholics who were admitted to the 'S. Maugeri' Medical Centre for detoxification from October 1997 to November 1999. Results revealed a high frequency of polyneuropathy in the sample under study. The disorder was often clinically asymptomatic and demonstrable only on electroneurographic investigation. Significant correlations were found between polyneuropathy, the duration of alcoholism, the type of alcoholic beverage consumed (wine) and the presence of liver disease and macrocytosis.

The neural bases of cognitive impairment(s) in alcohol use disorders (AUDs) might reflect either a global brain damage underlying different neuro-cognitive alterations, or the involvement of specific regions mostly affected by alcohol neuro-toxic effects. While voxel-based-morphometry (VBM) studies have shown a distributed atrophic pattern in fronto-limbic and cerebellar structures, the lack of comprehensive neuro-cognitive assessments prevents previous studies from drawing robust inferences on the specificity of the association between neuro-structural and cognitive impairments in AUDs. To fill this gap, we addressed the neuro-structural bases of cognitive impairment in AUDs, by coupling VBM with an in-depth neuropsychological assessment. VBM results highlighted a diffuse pattern of grey matter reduction in patients, involving the key-nodes of the meso-cortico-limbic (striatum, hippocampus, medial prefrontal cortex), salience (insular and dorsal anterior cingulate cortex) and executive (inferior frontal cortex) networks. Grey matter density in the insular and anterior cingulate sectors of the salience network, significantly decreased in patients, explained almost half of variability in their defective attentional and working-memory performance. The multiple cognitive and neurological impairments observed in AUDs might thus reflect a specific executive deficit associated with the selective damage of a salience-based neural mechanism enhancing access to cognitive resources required for controlled cognition and behaviour.

No abstract

Study objective-To investigate the utility of capture-recapture methods to estimate prevalence of subjects with alcohol related disorders using multiple incomplete lists. Design-This was a cross sectional study of alcohol related disorders in a large community. Setting-During 1997 identified cases with known alcohol related disorders were independently flagged by four sources (self help volunteering groups; psychiatric ambulatory; public alcohology service; hospital discharges). Patients-381 records were flagged, corresponding to 349 individual cases from a target population resident in a northern Italy area. Main results-The two sample capturerecapture estimates were clearly biased because of dependencies among sources. Estimates based on log-linear models showed prevalent counts ranged from 2297 (95% confidence intervals: 1524, 3794) to 2523 (95% confidence intervals: 1623, 4627) after adjustment for dependence among sources only or also for heterogeneity in catchability among age categories (< 50 and > 50 years), respectively. Conclusions-The study suggests that capture-recapture is an appropriate approach for estimating prevalence of subjects with alcohol related problems who seek or need treatment and assistance when diVerent lists of alcoholics can be obtained from diVerent types of agencies involved with problematic use of alcohol. Critical factors are the complexity in case definition and the analysis of heterogeneity among people. Accurate estimates are needed to plan and evaluate public health interventions. (J Epidemiol Community Health 2000;54:603-610) Ascertaining the size of alcohol related problems (ARP) in a community has strong implications in medical and public health issues.

BackgroundAlcohol-dependent patients usually experience negative affects under the influence of alcohol, and these affective symptoms have been shown to decrease as a result of alcohol-withdrawal treatment. A recent cognitive–affective model suggests an interaction between drug motivation and affective symptoms. The aim of this multicenter study was to evaluate the psychological changes in subjects undergoing a residential rehabilitation program specifically designed for alcohol addiction, and to identify at discharge patients with greater affective symptoms and therefore more at risk of relapse.Materials and methodsThe sample included 560 subjects (mean age 46.91±10.2 years) who completed 28-day rehabilitation programs for alcohol addiction, following a tailored routine characterized by short duration and high intensity of medical and psychotherapeutic treatment. The psychological clinical profiles of anxiety, depression, psychological distress, psychological well-being, and self-perception of a positive change were assessed using the Cognitive Behavioral Assessment – Outcome Evaluation questionnaire at the beginning and at the end of the program. The changes in the psychological variables of the questionnaire were identified and considered as outcome evaluation of the residential intervention. Moreover, differences in the psychological functioning between patients with different characteristics were investigated.ResultsThe score measured by the Cognitive Behavioral Assessment – Outcome Evaluation showed significant improvements in all the psychological characteristics assessed, and the profile at discharge was within the normal scores. Some significant differences were found in relation to specific characteristics of the sample, such as age, sex, level of education, type of intervention, and polysubstance use.ConclusionThis study shows the changes in psychological profile in subjects undergoing residential rehabilitation from alcohol and how this profile may permit identification of subjects requiring more psychosocial support after discharge.

O Oc cc cu up pa at ti io on na al l a as st th hm ma a, , r rh hi in ni it ti is s a an nd d u ur rt ti ic ca ar ri ia a d du ue e t to o p pi ip pe er ra ac ci il ll li in n s so od di iu um m i in n a a p ph ha ar rm ma ac ce eu ut ti ic ca al l w wo or rk ke er r G. Moscato, E. Galdi, J. Scibilia, A. Dellabianca, P. Omodeo, G. Vittadini, G.P. BiscaldiOccupational asthma, rhinitis and urticaria due to piperacillin sodium in a pharmaceutical worker. G. Moscato, E. Galdi, J. Scibilia, A. Dellabianca, P. Omodeo, G. Vittadini, G.P. Biscaldi. ©ERS Journals Ltd 1995. ABSTRACT: A 28 year old man with no history of atopy was referred to our hospital for possible work-related asthma. He had been employed in the production section of a pharmaceutical company for 2 yrs, and in the last 2 months he had complained of dyspnoea, wheezing, chest tightness, symptoms of rhinitis and a cutaneous rash when exposed to powdered antibiotics. Symptoms disappeared after being transferred to the packaging section. When the subject was admitted to our department he was asymptomatic. Basal lung function tests were in the normal range. Bronchial challenges with methacholine and with ultrasonically-nebulized distilled water were negative. Skin-prick test with piperacillin sodium gave a strong positive response at a very low concentration. Specific inhalation challenge with piperacillin sodium resulted in an immediate asthmatic reaction, and also reproduced rhinitis symptoms and the cutaneous rash. A control challenge with lactose, and the specific challenge test with cefuroxime sodium (another antibiotic to which the patient was exposed at the workplace) were negative.We conclude that piperacillin sodium is an agent that can cause occupational asthma. Eur Respir J., 1995, 8, 467-679 Case reportA 28 year old man was referred to our department because of suspected occupational asthma. The subject had worked as a driver from the age of 23 to 25 yrs. In the last 30 months he had worked in a pharmaceutical company. He was first assigned to work in the production department, where different drugs, including cefuroxime sodium and piperacillin sodium (a semi-synthetic broad-spectrum penicillin) ( fig. 1) were produced. His job consisted of pouring the drug powders from a can into the feed chute of the machine, which later poured small quantities of the powder in vials. He also checked that the machine operated properly. The production process was enclosed and the machine was equipped with local exhaust fans on the feed chute for lowering the dispersed powder concentration. During his work, the subject wore protective clothing which did not protect the mouth and nose. The mouth and nose were covered by a mask (without particle filter), the eyes were protected by goggles, and the hands by gloves.Twenty two months after starting his job, the patient noticed the appearance of a cutaneous rash, sneezing, rhinorrhoea, nasal stuffiness and itching whilst present at the workplace. On one occasion, outside the production department, whilst handling an...

The proposed approach could be useful in the functional assessment of deconditioned subjects with alcohol dependence in working age, and could monitor the changes in work capacity following training.

MAO-B can be regarded as a state marker of alcohol consumption. The temporal pattern of platelet MAO-B activity may be used for the diagnostic assessment of alcoholism and early abstinence, regardless of gender and smoking status.