Alcohol and medication interactions

Many medications can interact with alcohol, thereby altering the metabolism or effects of alcohol and/or the medication. Some of these interactions can occur even at moderate drinking levels and result in adverse health effects for the drinker. Two types of alcohol-medication interactions exist: (1) pharmacokinetic interactions, in which alcohol interferes with the metabolism of the medication, and (2) pharmacodynamic interactions, in which alcohol enhances the effects of the medication, particularly in the central nervous system (e.g., sedation). Pharmacokinetic interactions generally occur in the liver, where both alcohol and many medications are metabolized, frequently by the same enzymes. Numerous classes of prescription medications can interact with alcohol, including antibiotics, antidepressants, antihistamines, barbiturates, benzodiazepines, histamine H2 receptor antagonists, muscle relaxants, nonnarcotic pain medications and anti-inflammatory agents, opioids, and warfarin. In addition, many over-the-counter and herbal medications can cause negative effects when taken with alcohol

Catheter-based local analgesia for the fractured mandible in a patient with a history of hereditary angioedema

Hereditary angioedema is a rare genetic condition causing episodes of angioedema-including life-threatening laryngeal oedema. Episodes can be unpredictable, or triggered by factors such as trauma, drugs or dental treatment. When faced with a patient with a fractured mandible, who has had a severe attack of angioedema when prescribed either ibuprofen or codeine based analgesia, this required an alternative approach to analgesia. Using a catheter and local anaesthesia, we were able to keep the patient comfortable, and pain free

Alcohol consumption after health deterioration in older adults: a mixed-methods study

Objective To examine if and how older adults modify their drinking after health deterioration, and the factors that motivate changing or maintaining stable drinking behaviour. Study design Explanatory follow-up mixed-methods research. Methods The association between health deterioration and changes in alcohol consumption was examined using secondary data from the English Longitudinal Study of Ageing, a biennial prospective cohort study of a random sample of adults aged 50 years and older living in England. Data were collected through a personal interview and self-completion questionnaire across three waves between 2004 and 2009. The sample size (response rate) across the three waves was 8781 (49.9%), 7168 (40.3%) and 6623 (37.3%). The Chi-squared test was used to examine associations between diagnosis with a long-term condition or a worsening of self-rated health (e.g. from good to fair or fair to poor) and changes in drinking frequency (e.g. everyday, 5–6 days per week, etc.) and volume (ethanol consumed on a drinking day) between successive waves. In-depth interviews with 19 older adults recently diagnosed with a long-term condition were used to explore the factors that influenced change or maintenance in alcohol consumption over time. A purposive sampling strategy was used to recruit a diverse sample of current and former drinkers from voluntary and community organizations in the north of England. An inductive approach was used to analyze the data, facilitating the development of an a posteriori framework for understanding drinking change. Results There was no significant relationship between health deterioration and changes in drinking volume over time. There was however a significant association between health deterioration and changes in drinking frequency between successive waves (χ2 = 15.24, P < 0.001 and χ2 = 17.28, P < 0.001). For example, of participants reporting health deterioration between the first two waves, 47.6% had stable drinking frequency, 23.4% increased their drinking frequency and 29% reported decreased drinking frequency. In comparison, of participants reporting no health deterioration, 52.7% reported stable frequency, 20.8% increased frequency and 26.4% decreased frequency. In qualitative interviews, older adults described a wide range of factors that influence changes in drinking behaviour: knowledge gained from talking to healthcare professionals, online and in the media; tangible negative experiences that were attributed to drinking; mood and emotions (e.g. joy); the cost of alcohol; pub closures; and changes in social roles and activities. Health was just one part of a complex mix of factors that influenced drinking among older adults. Conclusion Patterns of drinking change after health deterioration in older adults are diverse, including stable, increasing and decreasing alcohol consumption over time. Although health motivations to change drinking influence behaviour in some older adults, social and financial motivations to drink are also important in later life and thus a holistic approach is required to influence behaviour

The home backgrounds of writers

This study investigates whether or not some characteristics of students home environments are associated with writing skill. A sample of 160 grade six and seven students who were judged by their teachers as more effective or less effective writers was selected from four elementary schools in a large British Columbia Interior School District. The parents of students in the sample were asked to complete a questionnaire concerning the home situation and experiences of their children. As a way of gathering other important information, a stratified random sample of ten parents was selected from the larger sample to be interviewed concerning other aspects of their home situations. Questionnaire results were presented in tabular form with frequencies and percentages reported for the responses of both groups. Differences between the responses from parents of more effective writers and responses from parents of less effective writers were then analyzed for significance by a Kolmogorov-Smirnov Two-Sample test. This study suggests that a good environment for an aspiring young writer would be a home in which 1) reading and writing activities take place regularly and are often discussed, 2) parents and siblings regularly model language skills and have positive attitudes toward the acquisition of these skills 3) the educational level and occupational skill level of parents are high and reading and writing materials are readily accessible; and k) a portion of the writer's leisure time is devoted to quiet, indoor, creative activities including reading and writing while excluding large amounts of television viewing.Education, Faculty ofLanguage and Literacy Education (LLED), Department ofGraduat

iScout: an intelligent scout for navigating large image sets

A new intelligent software tool for PACS systems called 'iScout' has been developed that constructs and displays an overview of large series or studies before downloading the set of images to a PACS workstation. The overview consists of two orthogonal cross-section images that allow the user to select and download a subset of images, avoiding long delays that can occur while downloading hundreds or even thousands of images. The iScout also provides a navigational tool, allowing the user to click on anatomical regions and view the relevant slices, while displaying the anatomical location of the image currently being displayed by the PACS workstation software. The construction of an iScout can be done on either a workstation or a server with only minimal overhead that does not significantly affect the speed of loading. A working iScout tool has been integrated with multi-modality PACS workstation software (McKesson Medical Imaging Solutions), and it was found that the iScout can be generated on the workstation with a maximum added overhead of only 3.4 seconds while downloading a study containing 433 512x512 CT images. The iScout is flexible and can generate scouts for virtually all types of CT and MR images, as well as 3D Ultrasound. Copyright 2003 Society of Photo-Optical Instrumentation Engineers. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.Applied Science, Faculty ofElectrical and Computer Engineering, Department ofMechanical Engineering, Department ofReviewedFacult