Biomedical subjects

E. Jane Marshall

Publications and source records attributed to E. Jane Marshall.

3 recordsLinked to original sources

PubMed2001

Hepatitis B and C in alcohol-dependent patients admitted to a UK alcohol inpatient treatment unit.

The prevalence of hepatitis B and C infection was studied in a sample of alcohol-dependent patients admitted to a specialist alcohol inpatient unit to identify factors associated with hepatitis B and C infection. Laboratory, clinical and socio-demographic data were collected from 277 admissions over a 3-year period who were tested routinely for markers of hepatitis B and C infection. Of the 275 subjects tested for hepatitis C, 27 (9.8%) were positive to the hepatitis anti-HCV IgG antibody. Of the 275 subjects tested for hepatitis B, 30 (10.9%) were positive to the hepatitis anti-HBc IgG antibody. Few differences were found between hepatitis B positive and negative subjects. Hepatitis C positive individuals were more likely than Hepatitis C negative patients to have also been infected with the hepatitis B virus (p < 0.001), to have an unplanned discharge (p < 0.005) and to have ever used cannabis (p < 0.005), cocaine (p < 0.001), amphetamines (p < 0.001) or heroin (p < 0.001). They were also more likely to have a co-morbid antisocial personality disorder (p < 0.001), a lifetime diagnosis of opiate dependence (p < 0.001) and cocaine dependence (p < 0.005), higher serum gamma glutamyl transferase (GGT) levels (p < 0.05) and a lower platelet count (p < 0.05). These findings may help clinicians to identify those alcohol dependent patients with risk factors for hepatitis virus infection.

Journal Article↗

PubMed2001

Information processing deficits in withdrawing alcoholics.

Prepulse inhibition (PPI) of the acoustic startle response (a reduction in response to an intense, startling stimulus (the pulse) if preceded by 30-150 ms by a weaker, non-startling stimulus) is an established model to index information processing deficits in thought-disordered schizophrenic patients. The present study aimed to investigate the influence of alcohol withdrawal on the PPI effect. Eight withdrawing alcoholic patients underwent testing for PPI of the acoustic startle response (defined as percentage reduction of the response over pulse-alone stimulus; prepulses 15 dB above the background) on three occasions (1, 3 and 7 days following the last drink). The results demonstrated remarkably low levels of PPI on days 1 and 3, with this being very robust in three patients who had a history of delirium tremens; there was a trend towards normalization of PPI on day 7. This study, although preliminary, suggests strongly that there is a deficit in the filtering of sensory information in alcohol-dependent patients undergoing alcohol withdrawal. This was most apparent in those with a history of delirium tremens. Further studies are needed to define the cause and chronicity of these deficits.

Journal Article↗

PubMed2001

Salivary cortisol measurements during a medically assisted alcohol withdrawal.

Previous studies using plasma cortisol estimations have suggested that hypothalmo-pituitary-axis (HPA) activation occurs in alcohol-dependent patients during alcohol withdrawal. The present study set out to confirm this finding using salivary cortisol assays, which are a better indicator of plasma free cortisol, the fraction which exerts its physiological effects. Nine alcohol dependent patients provided four saliva samples (at 10 a.m., 2 p.m., 6 p.m. and 10 p.m.) on days 1, 3 and 7 of a medically assisted alcohol withdrawal (corresponding to 1, 3 and 7 days following the last drink, respectively).Withdrawal symptom severity, craving and mood disturbance were also measured. A group of non-alcohol-dependent individuals, without psychiatric or medical disorder, gave four samples at the same times on one day only. Mean daily cortisol levels in our alcohol-dependent population, as calculated by the area under the curve (AUC), decreased significantly over time (mean AUC (nmol/l/hour) on day 1 = 149, on day 7 = 85.7, p = 0.009) and were significantly higher than controls on each day (mean AUC in controls = 28.3, p = 0.001). The cortisol response showed a similar temporal trend to withdrawal symptom severity and mood disturbance. This is consistent with previous studies measuring plasma cortisol in alcohol withdrawal. However, the magnitude of the effect in our study was greater, and in contrast to some previous studies, levels were far from normal by day 7. The comparatively low cortisol response in our one mildly dependent patient suggests that there may be a relationship between dependence severity and the size of the cortisol response to withdrawal. Salivary cortisol sampling could prove to be a useful prognostic tool, with implications for subsequent withdrawal symptom severity, mood disturbances, risk of relapse and alcohol-related cognitive decline. There are implications for developing new treatments for alcohol withdrawal but more studies are needed.

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