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Отсутствие патогномоничных для алкоголизма клинических и морфологических признаков приводит к тому, что связь многих соматических заболеваний с систематическим потреблением алкоголя до появления серьезных социальных последствий часто остается нераспознанной как в клинической, так и в экспертной практике. Результаты судебно-медицинских вскрытий свидетельствуют о том, что в значительном числе случаев смерть прямо или косвенно связана с чрезмерным употреблением алкоголя. Поэтому важно располагать объективными и надежными лабораторными диагностическими инструментами не только для подтверждения факта, но и для определения уровня злоупотребления алкоголем, особенно при отсутствии алкоголемии и недоступности или неадекватности катамнестических сведений.В статье рассмотрены современные возможности лабораторной диагностики злоупотребления алкоголем. Приводится характеристика традиционных непрямых биомаркеров c узким временным диагностическим окном действия, уровень которых может повышаться при различных патологических процессах; прямых биомаркеров, реагирующих только на поступление этанола в организм, и ряда относительно новых кандидатов в биомаркеры или компоненты панелей биомаркеров. Среди всех используемых биомаркеров злоупотребления алкоголем наиболее перспективным представляется определение фосфатидилэтанола (ФЭ) ввиду его достаточно высокой диагностический чувствительности и специфичности, а также возможности включаться в компоненты клеточных мембран, характерно изменяя их структурно-функциональные свойства.Рациональный подход к лабораторной диагностике хронической алкогольной интоксикации должен основываться на комплексной оценке биомаркеров употребления алкоголя с обязательным учетом современных достижений диагностической методологии и ведущей роли клинических и морфологических диагностических критериев. The absence of clinical and morphological signs pathognomonic for alcoholism leads to the fact that the connection of many somatic diseases with systematic alcohol consumption before appearance of serious social consequences often remains unrecognized – both in clinical and expert practice. Forensic autopsy results indicate that a significant number of deaths are directly or indirectly related to excessive alcohol consumption. Therefore, it is important to have objective and reliable laboratory diagnostic tools not only to confirm the fact, but also to determine the level of alcohol abuse, especially in the absence of alcoholism and inaccessibility or inadequacy of background information/catamnesis.In the article, there are discussed the modern possibilities of laboratory diagnostics of alcohol abuse. There is given the characteristics of a) traditional indirect biomarkers with a narrow time window of detection, the level of which can increase in various pathological processes; b) direct biomarkers that react only to the intake of ethanol; c) a number of relatively new “candidates” for biomarkers or components of biomarker panels. Among all the used biomarkers of alcohol abuse, the most promising is the determination of phosphatidylethanol due to its highest diagnostic sensitivity and specificity, as well as the ability to be included in the components of cell membranes, changing their structural and functional properties.A rational approach to the laboratory diagnostics of alcohol abuse should be based on a comprehensive assessment of biomarkers of alcohol use, taking into account current advances in diagnostic methodology and the leading role of clinical and morphological diagnostic criteria.

Anthrasilicosis was experimentally stimulated by inhaled inoculation. Various degrees of morphological changes were detected depending on the time of inoculation and the stage of the pathological process: the changes were early observed in the lung and liver, which became worse by week 12 of inoculation; from week 6 these were in the heart and kidney, which was indicative of systemic disorders in response to dust exposure.

The 7 day-long intragastric administration of ethanol and ethyleneglycol in a dose of 1/3 DL50 was studied for its effect on the circadian variations of the aspartate aminotransferase activity (AST, EC 2.6, 1.1) in the liver, brain, myocardium and kidney of male rats. The ethanol and ethylene glycol administration reduced the mean circadian enzymic activity in the above organs. Moreover, ethanol significantly reduced the amplitude of circadian variations of the AST activity in the liver, brain and kidney, while ethylene glycol--in the liver, myocardium and kidney.

232Th effects and its modifications with caffeine and D, L-buthionine-(S, R)-sulphoximine in Chlorella vulgaris Beijer cells was studied with use an optical density measure after 24 hours growth. Was shown relationship between concentration and toxic effect that is nonlinear and characterized with three parts different in induced damages level. In the first concentration range (0.001-1.551 micromol/l) chlorella growth parameters don't significantly differ from control ones. In the second one (1.724-3.017 micromol/1) statistically significant increase of optical density is but the effect does not dependent on 232Th concentration. The 232Th concentration (>3.448 micromol/l) increase the monotonous decrease in optical density was observed. The main role in 232Th toxic effect decrease make processes of DNA reparation, but not free radical scavenging with glutathione.

The aim of this work was to test the usage of infusion of hepatoprotector "remaxol" in intensive therapy of acute ethanol poisoning accompanied with severe alcohol affections of the lever. In the result of the examination and treatment of 130 patients it was established that severe alcohol poisonings registered on alcohol abused patients with toxic hepatopathy, are always accompanied with serious metabolic violations. In the process of a comparative valuation of the using of heptral (ademethionin) and remaxol in the intensive therapy of alcohol poisonings it has been revealed that the using of remaxol led to improvement of the clinic of that poisonings, what had been registered as a decrease of frequency and duration of an alcohol delirium from 33,9% to 10,8%, a decrease of frequency of secondary lung complication from 18,5 to 3,1%, a decrease of a duration of treatment in intensive care unit from 7,3 +/- 0,6 to 5,6 +/- 0,3 and a hospital treatment duration from 11,8 +/- 0,5 to 9,0 +/- 0,3 days. Biochemical investigation has shown that using as heptral, as remaxol led to improvement of lever damages due to alcohol. However remaxol compared with heptral was better in the treatment of metabolic violations.

The morphological appearance and morphometric indicators (the content of RNA, protein, glycogen and fat) of the internal organs of random-bred male rats were studied 10 days, 6 and 12 months after voluntary consumption of 15% ethanol. Alcohol consumption for 12 months provoked marked pathological alterations of the animals' internal organs, similar to organ pathology in alcoholic patients. The time course of these changes was marked by stages which correlated with the stages of experimental alcoholism formation, classified according to the behavioral criteria. The conclusion is made about adequacy of the model in question for screening and study of the pharmacological agents fit for the treatment of alcoholism.

Hormones level and lipid peroxidation processes under influence of acute alcohol intoxication are tested in testes and adrenals of rats. Ethanol marker effects--the rise of corticosterone biosynthesis and depression of testosterone concentration--were reproduced in the experiment. At the moment of maximal changes in steroid levels indices characterising lipid peroxidation didn't differ from the control. At the early stage of the experiment transient shifts in malonic dialdehyde and dienic conjugates levels were noted. The data obtained does not agree with the hypothesis of acute ethanol effects in testes and adrenals being mediated through the changes of lipid peroxidation rate.

Forced alcoholization of rats according to Majchrowicz led to the development of fatty liver. The subsequent ethanol withdrawal was accompanied by amino acid imbalance in the pool of free sulfur-containing and glycogenic amino acids in liver and blood plasma. Similar changes were observed after prolonged alcohol intoxication. Intragastric administration of the amino acid composition containing branched-chain amino acids and taurine corrected the amino acid imbalance and reduced the development of the steatosis of the liver.

The time course (0.5-24 hours) of incorporation of labelled cholesterol in the tissues of guinea pig hearts, aortas, livers, and brains was examined on acute and chronic (3 months) administration of ethanol (3 g/kg). It was found that at the onset of the experiments, the hearts from control and experimental animals displayed higher radioactivity that did the other tissue under study. Within the first 24 hours, there was a linear increase in specific radioactivity of [3H]-cholesterol in the sera of intact animals. Acute and chronic ethanol caused enhanced incorporation of [3H]-cholesterol and its delayed release in all tissues, except the liver tissue. The latter showed unchanged relative specific radioactivity two hours after [3H]-cholesterol incorporation.

For mitigating the toxic effects of alcohol on the brain cortex and promoting the formation of aversion to alcohol in chronic alcoholics in the course of the reflex therapy the alcohol was given in drops making 1/20 of a gulp. This method is technically simple, causes no complications, and enables one to attain deeper and more stable remissions. Of 400 patients observed remissions of under 3 months were obtained in 12%; of 3 to 6 months, in 9%; of 6 to 9 months, in 10%; of 9 to 12 months, in 7%; and of over a year in 62% of the patients.