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- Document 0044
- DOCN M9620044
- TI Beta-carbolines in chronic alcoholics undergoing elective tumor
- resection.
- DT 9602
- AU Spies CD; Rommelspacher H; Schnapper C; Muller C; Marks C; Berger G;
- Conrad C; Blum S; Specht M; Hannemann L; et al; Department of
- Anesthesiology, Benjamin Franklin Medical Center,; Berlin, Germany.
- SO Alcohol Clin Exp Res. 1995 Aug;19(4):969-76. Unique Identifier :
- AIDSLINE MED/96026615
- AB The prevalence of chronic alcoholism in patients with carcinomas of the
- upper digestive tract exceeds 60%. The patient's history and laboratory
- markers, preoperatively, are often not sensitive or specific enough to
- detect alcohol-dependent patients, preoperatively, who are at risk of
- developing alcohol withdrawal syndrome (AWS) during their postoperative
- intensive care unit (ICU) stay. Previously, it was found that plasma
- norharman was elevated in chronic alcoholics, suggesting marker
- characteristics for chronic ethanol misuse and possibly alcohol
- dependence. We investigated whether beta-carbolines (i.e., harman and
- norharman) were different between chronic alcoholics and nonalcoholics
- with carcinoma, and how the levels change in alcohol-dependent patients
- during their hospital stay. Ninety-seven patients with oral, pharyngeal,
- laryngeal, or esophageal carcinomas were evaluated regarding their
- drinking habits. Sixty patients were transferred to the ICU following
- tumor resection. Chronic alcoholics met the DSM-III-R and ICD-10
- criteria for alcohol dependence or chronic alcohol abuse/harmful use.
- The daily ethanol intake in chronic alcoholics was > or = 60 g. Blood
- samples were collected on admission to the hospital, preoperatively, on
- admission to the ICU and on days 2, 4, and 7 in the ICU. Harman and
- norharman were determined by HPLC. Elevated norharman was found in
- chronic alcoholics on admission to the hospital, whereas harman did not
- differ between groups. On admission, the area under the receiver
- operating characteristics curve was significantly larger for
- carbohydrate-deficient transferrin and preoperatively for norharman. The
- preoperative norharman levels were significantly correlated with the
- period of mechanical ventilation and the length of ICU stay.
- Postoperatively, norharman decreased in all patients, except a group of
- 11 alcohol-dependent patients who developed AWS during their ICU stay.
- The finding that elevated norharman levels were found in chronic
- alcoholics on admission to the hospital and preoperatively supports the
- view of a specific marker for alcoholism. Preoperative norharman was
- superior to carbohydrate-deficient transferrin and was associated with a
- prolonged ICU stay and a prolonged period of mechanical ventilation.
- Further studies are required to determine whether norharman aids in the
- preoperative diagnosis of chronic alcohol misuse with respect to the
- prevention of postoperative complications.
- DE Adult Aged Aged, 80 and over Alcoholism/BLOOD/*DIAGNOSIS Biological
- Markers/BLOOD Carbolines/*BLOOD Critical Care Esophageal
- Neoplasms/BLOOD/*SURGERY Harmine/ANALOGS & DERIVATIVES/BLOOD Human
- Male Middle Age Otorhinolaryngologic Neoplasms/BLOOD/*SURGERY
- Postoperative Complications/BLOOD/*PREVENTION & CONTROL Risk Factors
- Support, Non-U.S. Gov't JOURNAL ARTICLE
-
- SOURCE: National Library of Medicine. NOTICE: This material may be
- protected by Copyright Law (Title 17, U.S.Code).
-
-