Etiology of alcoholism

Opisane su razlike i sličnosti između sistema klasifikacije bolesti povezanih s alkoholom u Europi i Americi. Epidemiološki gledano uzorci pijenja imaju vrlo bitnu ulogu u nastanku bolesti povezanih s alkoholom. Osim obitelji alkoholičara na kojoj se prvoj vide posljedice, cijelo društvo ima opću štetu koja se također odražava i na deficit gospodarskog stanja u državi. Tokom ovog rada imali smo priliku vidjeti mnogo dispozitivnih uzroka alkoholizma. Počevši od nasljedne strane očito je da se sklonost alkoholizmu poligenski nasljeđuje. Nadalje, prikazana je također snažna uloga okoline koja utječe na čovjeka. Način utjecaja može biti kroz modeliranje, permisivnim stavom prema abuzusu alkohola itd. Neki bihevioristički teoretičari su s pravom istaknuli da takozvana „očekivanja od efekata alkohola” mogu u određenoj mjeri nastati operantnim uvjetovanjem- zbog toga ih treba svrstati instrumentalne uzroke alkoholizma. Na konkretnom primjeru učenja istaknuto je da zbog kognicije čovjek za razliku od životinja može spoznati apstraktne pojmove koji su univerzalno primjenjivi. Od strane neurobiologije opisana je važnost etanola u utjecaju na formiranje neuronskih projekcija preko dopamina koji je instrumentalan u stvaranju čežnje za određenom psihoaktivnom tvari. Ukazano je na to da su psihološki uzroci ovdje principalni i ne postoji razlog da bi bili u kontradikciji s gore navedenim dispozitivnim i instrumentalnim uzrocima.Differences between "European" and "American" classification of alcohol related diseases have been described. From epidemiological aspect, drinking patterns have a very important role in development of alcohol related diseases. Besides the family of the alcoholic, which is first to feel consequences, the whole society will have general damage which also reflects in the economical deficit of the state. In this paper we had opportunity to see many disponitive causes of alcoholism. First one being heredity- it is obvious that vulnerability to alcoholism is poligenetically inherited. Furthermore strong influence of environment on man was demonstrated. The way of influence can be through modeling, societies permissive to alcohol abuse etc. Some behavioristic theoreticians have rightly pointed out that so called "alcohol expectancy effect" is to be traced to a certain measure to operant conditioning- because of this some of them should be relegated to instrumental causes of alcoholism. On concrete example it was pointed out that because of cognition, man can comprehend abstract notions which can be universally applied. From neurobiological aspect, the importance of ethanol was shown in influence on modifying neurological pathways through dopamine which is instrumental in craving for psychoactive substances. It was pointed out that psychological causes are principal ones and that there is no reason that they should be in contradiction with above named disponitive and instrumental causes

Etiology of alcoholism

Opisane su razlike i sličnosti između sistema klasifikacije bolesti povezanih s alkoholom u Europi i Americi. Epidemiološki gledano uzorci pijenja imaju vrlo bitnu ulogu u nastanku bolesti povezanih s alkoholom. Osim obitelji alkoholičara na kojoj se prvoj vide posljedice, cijelo društvo ima opću štetu koja se također odražava i na deficit gospodarskog stanja u državi. Tokom ovog rada imali smo priliku vidjeti mnogo dispozitivnih uzroka alkoholizma. Počevši od nasljedne strane očito je da se sklonost alkoholizmu poligenski nasljeđuje. Nadalje, prikazana je također snažna uloga okoline koja utječe na čovjeka. Način utjecaja može biti kroz modeliranje, permisivnim stavom prema abuzusu alkohola itd. Neki bihevioristički teoretičari su s pravom istaknuli da takozvana „očekivanja od efekata alkohola” mogu u određenoj mjeri nastati operantnim uvjetovanjem- zbog toga ih treba svrstati instrumentalne uzroke alkoholizma. Na konkretnom primjeru učenja istaknuto je da zbog kognicije čovjek za razliku od životinja može spoznati apstraktne pojmove koji su univerzalno primjenjivi. Od strane neurobiologije opisana je važnost etanola u utjecaju na formiranje neuronskih projekcija preko dopamina koji je instrumentalan u stvaranju čežnje za određenom psihoaktivnom tvari. Ukazano je na to da su psihološki uzroci ovdje principalni i ne postoji razlog da bi bili u kontradikciji s gore navedenim dispozitivnim i instrumentalnim uzrocima.Differences between "European" and "American" classification of alcohol related diseases have been described. From epidemiological aspect, drinking patterns have a very important role in development of alcohol related diseases. Besides the family of the alcoholic, which is first to feel consequences, the whole society will have general damage which also reflects in the economical deficit of the state. In this paper we had opportunity to see many disponitive causes of alcoholism. First one being heredity- it is obvious that vulnerability to alcoholism is poligenetically inherited. Furthermore strong influence of environment on man was demonstrated. The way of influence can be through modeling, societies permissive to alcohol abuse etc. Some behavioristic theoreticians have rightly pointed out that so called "alcohol expectancy effect" is to be traced to a certain measure to operant conditioning- because of this some of them should be relegated to instrumental causes of alcoholism. On concrete example it was pointed out that because of cognition, man can comprehend abstract notions which can be universally applied. From neurobiological aspect, the importance of ethanol was shown in influence on modifying neurological pathways through dopamine which is instrumental in craving for psychoactive substances. It was pointed out that psychological causes are principal ones and that there is no reason that they should be in contradiction with above named disponitive and instrumental causes

Etiology of alcoholism

Opisane su razlike i sličnosti između sistema klasifikacije bolesti povezanih s alkoholom u Europi i Americi. Epidemiološki gledano uzorci pijenja imaju vrlo bitnu ulogu u nastanku bolesti povezanih s alkoholom. Osim obitelji alkoholičara na kojoj se prvoj vide posljedice, cijelo društvo ima opću štetu koja se također odražava i na deficit gospodarskog stanja u državi. Tokom ovog rada imali smo priliku vidjeti mnogo dispozitivnih uzroka alkoholizma. Počevši od nasljedne strane očito je da se sklonost alkoholizmu poligenski nasljeđuje. Nadalje, prikazana je također snažna uloga okoline koja utječe na čovjeka. Način utjecaja može biti kroz modeliranje, permisivnim stavom prema abuzusu alkohola itd. Neki bihevioristički teoretičari su s pravom istaknuli da takozvana „očekivanja od efekata alkohola” mogu u određenoj mjeri nastati operantnim uvjetovanjem- zbog toga ih treba svrstati instrumentalne uzroke alkoholizma. Na konkretnom primjeru učenja istaknuto je da zbog kognicije čovjek za razliku od životinja može spoznati apstraktne pojmove koji su univerzalno primjenjivi. Od strane neurobiologije opisana je važnost etanola u utjecaju na formiranje neuronskih projekcija preko dopamina koji je instrumentalan u stvaranju čežnje za određenom psihoaktivnom tvari. Ukazano je na to da su psihološki uzroci ovdje principalni i ne postoji razlog da bi bili u kontradikciji s gore navedenim dispozitivnim i instrumentalnim uzrocima.Differences between "European" and "American" classification of alcohol related diseases have been described. From epidemiological aspect, drinking patterns have a very important role in development of alcohol related diseases. Besides the family of the alcoholic, which is first to feel consequences, the whole society will have general damage which also reflects in the economical deficit of the state. In this paper we had opportunity to see many disponitive causes of alcoholism. First one being heredity- it is obvious that vulnerability to alcoholism is poligenetically inherited. Furthermore strong influence of environment on man was demonstrated. The way of influence can be through modeling, societies permissive to alcohol abuse etc. Some behavioristic theoreticians have rightly pointed out that so called "alcohol expectancy effect" is to be traced to a certain measure to operant conditioning- because of this some of them should be relegated to instrumental causes of alcoholism. On concrete example it was pointed out that because of cognition, man can comprehend abstract notions which can be universally applied. From neurobiological aspect, the importance of ethanol was shown in influence on modifying neurological pathways through dopamine which is instrumental in craving for psychoactive substances. It was pointed out that psychological causes are principal ones and that there is no reason that they should be in contradiction with above named disponitive and instrumental causes

Drohende Corona-Endemie in einer rheumatologischen Spezialklinik

Die SARS-CoV-2-Pandemie hält die meisten Länder der Welt anhaltend in Atem. In Deutschland liegt die Prävalenz von SARS-CoV-2-Infektionen zwar noch unter 2 %, die Zahlen steigen aber seit Wochen auch in Deutschland wieder an. Die rheumatologische Versorgung wurde durch die 1. Welle der Pandemie vorübergehend beeinträchtigt. Wir berichten über die Infektionssituation in der größten deutschen Rheumaspezialklinik, dem Rheumazentrum Ruhrgebiet, weil es hier vor Kurzem während der 2. Welle erstmals zum Auftreten von mehreren SARS-CoV-2-Infektionen an einem Wochenende gekommen ist, was zu einer erheblichen Unruhe bei vielen Beteiligten führte. Die Situation konnte durch konsequentes Testen von Patienten und Mitarbeitern mit dem Antigenschnelltest aufgeklärt und die Lage beruhigt werden. Letztlich waren nur wenige Getestete positiv, und die Verläufe bei den Patienten blieben bis jetzt blande. Dies zeigt auch die Effektivität der seit April konsequent durchgeführten hygienischen Schutzmaßnahmen.The severe acute respiratory coronavirus type 2 (SARS-CoV-2) pandemic is keeping most countries of the world in suspense. In Germany the prevalence of SARS-CoV‑2 infections is under 2% but for weeks the numbers in Germany have also been increasing. The care in rheumatology was temporarily impaired by the first wave of the pandemic. This article reports the infection situation in the largest specialized rheumatology clinic in Germany, the Rheumatism Center Ruhrgebiet, because recently during the second wave for the first time several SARS-CoV‑2 infections occurred here over one weekend, which led to considerable anxiety in many of those involved. The situation could be clarified by consistent testing of patients and personnel with the rapid antigen test and the situation could be mollified. Ultimately, only a few persons were tested positive and the courses by the patients have so far remained bland. This shows the effectiveness of the protective hygiene measures consistently implemented since April

Different humoral but similar cellular responses of patients with autoimmune inflammatory rheumatic diseases under disease-modifying antirheumatic drugs after COVID-19 vaccination

Objectives The effect of different modes of immunosuppressive therapy in autoimmune inflammatory rheumatic diseases (AIRDs) remains unclear. We investigated the impact of immunosuppressive therapies on humoral and cellular responses after two-dose vaccination.Methods Patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with TNFi, IL-17i (biological disease-modifying antirheumatic drugs, b-DMARDs), Janus-kinase inhibitors (JAKi) (targeted synthetic, ts-DMARD) or methotrexate (MTX) (conventional synthetic DMARD, csDMARD) alone or in combination were included. Almost all patients received mRNA-based vaccine, four patients had a heterologous scheme. Neutralising capacity and levels of IgG against SARS-CoV-2 spike-protein were evaluated together with quantification of activation markers on T-cells and their production of key cytokines 4 weeks after first and second vaccination.Results 92 patients were included, median age 50 years, 50% female, 33.7% receiving TNFi, 26.1% IL-17i, 26.1% JAKi (all alone or in combination with MTX), 14.1% received MTX only. Although after first vaccination only 37.8% patients presented neutralising antibodies, the majority (94.5%) developed these after the second vaccination. Patients on IL17i developed the highest titres compared with the other modes of action. Co-administration of MTX led to lower, even if not significant, titres compared with b/tsDMARD monotherapy. Neutralising antibodies correlated well with IgG titres against SARS-CoV-2 spike-protein. T-cell immunity revealed similar frequencies of activated T-cells and cytokine profiles across therapies.Conclusions Even after insufficient seroconversion for neutralising antibodies and IgG against SARS-CoV-2 spike-protein in patients with AIRDs on different medications, a second vaccination covered almost all patients regardless of DMARDs therapy, with better outcomes in those on IL-17i. However, no difference of bDMARD/tsDMARD or csDMARD therapy was found on the cellular immune response

Different humoral but similar cellular responses of patients with autoimmune inflammatory rheumatic diseases under disease-modifying antirheumatic drugs after COVID-19 vaccination

$\bf Objectives$ The effect of different modes of immunosuppressive therapy in autoimmune inflammatory rheumatic diseases (AIRDs) remains unclear. We investigated the impact of immunosuppressive therapies on humoral and cellular responses after two-dose vaccination. $\bf Methods$ Patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis treated with TNFi, IL-17i (biological disease-modifying antirheumatic drugs, b-DMARDs), Janus-kinase inhibitors (JAKi) (targeted synthetic, ts-DMARD) or methotrexate (MTX) (conventional synthetic DMARD, csDMARD) alone or in combination were included. Almost all patients received mRNA-based vaccine, four patients had a heterologous scheme. Neutralising capacity and levels of IgG against SARS-CoV-2 spike-protein were evaluated together with quantification of activation markers on T-cells and their production of key cytokines 4 weeks after first and second vaccination. $\bf Results$ 92 patients were included, median age 50 years, 50% female, 33.7% receiving TNFi, 26.1% IL-17i, 26.1% JAKi (all alone or in combination with MTX), 14.1% received MTX only. Although after first vaccination only 37.8% patients presented neutralising antibodies, the majority (94.5%) developed these after the second vaccination. Patients on IL17i developed the highest titres compared with the other modes of action. Co-administration of MTX led to lower, even if not significant, titres compared with b/tsDMARD monotherapy. Neutralising antibodies correlated well with IgG titres against SARS-CoV-2 spike-protein. T-cell immunity revealed similar frequencies of activated T-cells and cytokine profiles across therapies. $\bf Conclusions$ Even after insufficient seroconversion for neutralising antibodies and IgG against SARS-CoV-2 spike-protein in patients with AIRDs on different medications, a second vaccination covered almost all patients regardless of DMARDs therapy, with better outcomes in those on IL-17i. However, no difference of bDMARD/tsDMARD or csDMARD therapy was found on the cellular immune response