06 May 2014 In Cardiovascular System

OBJECTIVES: This study examined the association between alcohol use, the occurrence of cardiovascular events, and plaque phenotype in patients after femoral or carotid endarterectomy for arterial occlusive disease. Alcohol has been shown to have cardiovascular protective effects in patients with cardiovascular disease as well as in healthy individuals. Whether alcohol consumption induces changes in atherosclerotic plaque composition has not been investigated.

METHODS: Consecutive femoral (n = 224) and carotid (n = 693) endarterectomy specimens underwent histologic examination for the presence of collagen, calcifications, smooth muscle cells, macrophages, fat, and intraplaque thrombus. Patients were monitored for 3 years after the initial operation and investigated for the occurrence of cardiovascular events. Primary outcome was the composite end point "major cardiovascular event." Alcohol consumption was categorized as no alcohol use, 1 to 10 U/wk, or >10 U/wk.

RESULTS: The Kaplan-Meier estimate of the major cardiovascular event rate after 3 years of follow-up in the femoral group was 35% for no alcohol use and 21% for 1 to 10 U/wk, whereas only 10% of the group >10 U/wk sustained a major cardiovascular event (P = .010). The plaques of alcohol consumers in the femoral group contained significantly smaller lipid cores and less macrophage infiltration than in abstainers. In the carotid group, the major cardiovascular event rate was similar in all three groups, and in addition, no difference in plaque composition was observed.

CONCLUSIONS: This study shows an inverse relationship between alcohol use and major cardiovascular events after endarterectomy for lower extremity arterial occlusive disease, accompanied by a more stable plaque phenotype. However, no such relationship could be observed for patients with cerebrovascular disease.

06 May 2014 In Cancer

OBJECTIVE: Alcohol consumption is a strong risk factor for oral cancer however; an ambiguous biphasic impact of moderate and excessive alcohol intake on the risk of upper aerodigestive tract cancers has also been published. The aim of the present study was to clarify the dose-related risk of alcohol consumption for oral cancer, in male and female cases.

MATERIALS AND METHODS: Six-hundred and eight non-smoker patients (466 males and 142 females) with squamous cell oral carcinomas (OCs) and 406 non-smoker tumor free controls (264 males and 142 females) were included into the study. Data of three groups; abstinent cases, moderate and excessive alcohol consumers were recorded according to the drinking habits of both OC cases and their controls. Blood glucose levels in male and female cases and menopausal state of women were also registered.

RESULTS: Mean age of female patients was significantly higher than of male cases (p<0.01). Excessive alcohol consumption was a strong risk factor for both sexes, however moderate alcohol intake proved to be an OC risk for men (OR: 1.4) and decreased the OC risk for women (OR: 0.7). Elevated blood glucose level proved to be an OC risk factor for the predominantly postmenopausal women (OR: 1.6), whereas did not affect the OC risk among men.

CONCLUSION: The presented findings are controversial to the hypothesis that women are more vulnerable to alcohol-induced carcinogenesis as compared with men. Increased insulin sensitivity and higher estrogen levels are advantageous systemic effects of moderate ethanol intake and they might reduce the risk for OC in postmenopausal women.




06 May 2014 In Cancer




PURPOSE: While some studies have indicated that alcohol consumption is associated with a decreased risk of benign prostatic hyperplasia, others have not. We evaluated associations of alcohol consumption with benign prostatic hyperplasia and male lower urinary tract symptoms.

MATERIALS AND METHODS: We performed a meta-analysis of published studies pertaining to alcohol intake, benign prostatic hyperplasia and lower urinary tract symptoms. We analyzed abstracted data with random effects models to obtain pooled odds ratios of adjusted effects estimates.

RESULTS: A total of 19 studies (120,091 men) met selection criteria and of these studies 14 revealed a significantly decreased likelihood of benign prostatic hyperplasia or lower urinary tract symptoms with increased alcohol intake. Sixteen studies were eligible for pooled analyses, of which 12 used benign prostatic hyperplasia as the primary outcome. We stratified total alcohol intake by gm per day into 6 strata. Alcohol intake was associated with a significantly or marginally significantly decreased likelihood of benign prostatic hyperplasia in all 6 strata (p values 0.08, 0.01, <0.001, 0.02, 0.001 and <0.001, respectively). Compared to no alcohol intake, an alcohol intake of 36 gm daily or greater was associated with a 35% decreased likelihood of benign prostatic hyperplasia (OR 0.65, 95% CI 0.58-0.74, p <0.001). Of the 4 studies that used lower urinary tract symptoms as the primary outcome 3 demonstrated a significantly increased likelihood of lower urinary tract symptoms with alcohol consumption.

CONCLUSIONS: Alcohol consumption is associated with a decreased likelihood of benign prostatic hyperplasia but not of lower urinary tract symptoms. Further studies are needed to determine the mechanisms by which alcohol modifies the risk of benign prostatic hyperplasia.




06 May 2014 In Cancer




BACKGROUND: Adult alcohol consumption during the previous year is related to breast cancer risk. Breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. No study has characterized the contribution of alcohol consumption during this interval to risks of proliferative benign breast disease (BBD) and breast cancer.

METHODS: We used data from 91005 parous women in the Nurses' Health Study II who had no cancer history, completed questions on early alcohol consumption in 1989, and were followed through June 30, 2009, to analyze breast cancer risk. A subset of 60093 women who had no history of BBD or cancer in 1991 and were followed through June 30, 2001, were included in the analysis of proliferative BBD. Relative risks (RRs) were estimated using Cox proportional hazard regression.

RESULTS: We identified 1609 breast cancer cases and 970 proliferative BBD cases confirmed by central histology review. Alcohol consumption between menarche and first pregnancy, adjusted for drinking after first pregnancy, was associated with risks of breast cancer (RR = 1.11 per 10g/day intake; 95% confidence interval [CI] = 1.00 to 1.23) and proliferative BBD (RR = 1.16 per 10g/day intake; 95% CI = 1.02 to 1.32). Drinking after first pregnancy had a similar risk for breast cancer (RR = 1.09 per 10g/day intake; 95% CI = 0.96 to 1.23) but not for BBD. The association between drinking before first pregnancy and breast neoplasia appeared to be stronger with longer menarche to first pregnancy intervals.

CONCLUSIONS: Alcohol consumption before first pregnancy was consistently associated with increased risks of proliferative BBD and breast cancer.




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