Press Release - Moderate Doses of Alcohol Increase Social Bonding in Groups

A new study led by University of Pittsburgh researchers reveals that moderate amounts of alcohol—consumed in a social setting—can enhance positive emotions and social bonding and relieve negative emotions among those drinking.

While it is usually taken for granted that people drink to reduce stress and enhance positive feelings, many studies have shown that alcohol consumption has an opposite effect. In a new paper titled “Alcohol and Group Formation: A Multimodal Investigation of the Effects of Alcohol on Emotion and Social Bonding,” research shows that moderate doses of alcohol have a powerful effect on both male and female social drinkers when they are in a group. > > > > Read More

HHS HealthBeat (June 29, 2012) Binge drinking and burns

From the U.S. Department of Health and Human Services, I’m Nicholas Garlow with HHS HealthBeat.

Binge drink, and you can expect big trouble – a study says getting burned can be one of those troubles. Researchers at Loyola University Stritch School of Medicine in Chicago looked at hospital admissions for burns. Nearly 50 percent of adult burn patients they observed had been binge drinking before being injured.

Elizabeth Kovacs is director of the Alcohol Research Program at Loyola University. > > > > Read More

EUROCARE RECOMMENDATIONS FOR A FUTURE EU ALCOHOL STRATEGY

Eurocare presents its view and recommendation for a comprehensive alcohol policy in the European Union 2013-2020

At the time when European Commission is evaluating the current European Union strategy to support Member States in reducing alcohol related harmthe European Alcohol Policy Alliance (Eurocare) wishes to present its view and recommendations for a comprehensive alcohol policy in the European Union (EU) 2013 - 2020. The Eurocare recommendations were presented at an event last week in the European Parliament (Brussels) which was hosted by MEPs Anna Hedh and attended by nearly 100 participants.

Despite all the progress achieved over last years, our work to tackle alcohol related harm and raise it on the political agenda is by no means finished. Europe is still the heaviest drinking region in the world and harm caused by alcohol to the individual and society at large is too high. In the current context of economic crisis keeping the focus on public health is crucial. Eurocare would like to take this opportunity to emphasise the need to place the health and social wellbeing of European citizens above purely economic interests. Eurocare, and its broader civil society network, would like to appeal to all DGs of the European Commission to commit to prioritising health issues.

The Eurocare recommendations aim to contribute to a constructive and action oriented discussion on the future Alcohol Strategy for the EU (2013-2020). Eurocare is dedicated to working together towards reduction of harm caused by alcohol, to the individual, others and the society. Due to the size of the problem and the universal impact of alcohol-related harm, is too big for governments to solve alone. It requires a comprehensive, coordinated response from policy and decisions makers at the European and national levels.

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An Evaluation of the BASICS Alcohol Risk Reduction Model Among Predominantly Hispanic College Students

Although Hispanic college students consume alcohol in equal proportion to other ethnic groups, studies have not examined whether established alcohol-risk-reduction approaches are effective in this population.

Accordingly, this study examined effectiveness of the Brief Alcohol Screening and Intervention for College Students (BASICS) risk-reduction model for reducing alcohol consumption and related problems in two samples of predominantly Hispanic college students (N = 206 and 405).

The study also examined whether factors such as gender, baseline risk level, and readiness to change moderated program impact.

Students first participated in an in-depth assessment of drinking patterns followed by relatively brief intervention including psychoeducation and personalized normative feedback. Behavioral outcomes were assessed six months after the intervention and included alcohol-risk scores, alcohol consumption-related problems, consumption, drinking and driving frequency, and stage of change.

Supporting the effectiveness of BASICS, both samples showed significant improvement across all these outcomes. Moderator analyses suggested greater program impact among heavier drinkers and among high in change contemplation at assessment.

Overall, the results strongly support use of the BASICS intervention model among Hispanic students. The study's limitations are noted.


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Request Reprint E-Mail: jtomaka@utep.edu.

Impaired processing of emotion in music, faces and voices supports a generalized emotional decoding deficit in alcoholism

To test the generalized emotional decoding impairment hypothesis in alcoholism.

Cross-sectional behavioural study comparing emotion recognition conveyed by faces, voices, and musical excerpts.

Alcohol Detoxification Unit of Brugmann University Hospital

Twenty-five recently detoxified alcohol dependent patients were compared to 25 normal controls matched for sex, age and educational level.

From faces, voices and musical excerpts, participants were instructed to rate the intensity of several emotions on a scale from 0 for ‘absent’ up to 9 for ‘highly present’. Depression, anxiety, and sustained/selective attention capacities were controlled for.

Alcohol dependent patients were less accurate than controls in identifying the target emotion in faces (P < 0.001), voices (P < 0.001), and musical excerpts (P < 0.001).

Alcohol dependent patients who are completing detoxification are impaired in recognizing emotions conveyed by faces, voices, and music; these results suggest a generalized emotional decoding impairment. Hypothetically, deficits in the fronto-parietal mirror neuron system could link all these disturbances together.

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Request Reprint E-Mail: ckornrei@ulb.ac.be

Prevalence of Alcohol and Other Drugs in Fatally Injured Drivers

This study aims to examine the prevalence of alcohol and/or other drugs (AOD) in a large sample of fatally injured drivers.

Using data from the Fatality Analysis Reporting System for 2005–2009, the authors examined the prevalence of AOD detected in fatally injured drivers in the United States.

Fatal motor vehicle crashes occurring on public roads.

Drivers who died within one hour of the crash in 14 states that performed toxicological testing on more than 80% of these drivers.

Prevalence of AOD and multivariable-adjusted prevalence ratios (aPR).

Of the 20,150 fatally injured drivers studied, 57.3% tested positive for AOD, including 19.9% being positive for two or more substances. Alcohol was the most commonly detected substance, present in 40.2% of the fatally injured drivers, followed by cannabinols (10.5%), stimulants (9.0%), narcotics (5.7%), and depressants (4.0%). Multivariable analysis revealed that AOD was significantly more prevalent among drivers who died in single-vehicle crashes [aPR 1.69, 95% confidence interval (CI): 1.62–1.76], or nighttime crashes (aPR 1.43, 95% CI: 1.39–1.47), or who had a driving-while-intoxicated conviction within the past three years (aPR 1.41, 95% CI: 1.35–1.47), and less prevalent among drivers who were 65 years or older (aPR 0.45, 95% CI: 0.42–0.49), Asian (aPR 0.47, 95% CI 0.41–0.53), or female (aPR 0.88, 95% CI: 0.85–0.91), or who were operating a motor carrier (aPR 0.41, 95% CI 0.34–0.48).

More than half of fatally injured drivers in the United States had been using AOD and approximately 20% had been using polydrugs. The prevalence of AOD use varies significantly with driver and crash characteristics.

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Affordability of alcohol as a key driver of alcohol demand in New Zealand: a cointegration analysis

To investigate whether affordability of alcohol is an important determinant of alcohol consumption along with price. This will inform effective tax policy to influence consumption.

Cointegration analysis was used to analyse relationship between real price, affordability and consumption. Changes in retail availability of wine in 1990 and beer in 1999 were also included in the models. The econometric approach taken allows identification of short and long run responses. Separate analyses were done for wine, beer, spirits and ready-to-drinks (spirits based pre-mixed drinks).

New Zealand 1988-2011.

Quarterly data on price and alcohol available for consumption for wine, beer, spirits and ready to drinks. Price data was analysed as: real price (own price of alcohol relative to the price of other goods) and affordability (average earnings relative to own price).

There was strong evidence for cointegration between wine and beer consumption and affordability. There was weaker evidence for cointegration between consumption and real price.

The affordability of alcohol is more important than real price in determining consumption of alcohol. This suggests that affordability needs to be considered by policy makers when determining tax and pricing policies to reduce alcohol related harm.

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Request Reprint E-Mail: m.wall@massey.ac.nz

Effects of exposure to moderate levels of ethanol during prenatal brain development on dendritic length, branching, and spine density in the nucleus a

Reductions in measures of dendritic morphology in the agranular insular cortex have been identified as consequences of prenatal exposure to moderate levels of ethanol in the rat.

Motivated by the strong connectivity between this region of frontal cortex and the striatum and a growing body of data linking specific components of the mesocortical/limbic system to effects of ethanol and ethanol self-administration, the current study investigated the effects of moderate fetal ethanol exposure on the dendritic morphology of medium spiny neurons (MSNs) in several regions of the striatum.

Throughout gestation, pregnant rat dams either consumed a saccharin solution (control) or achieved average daily blood ethanol concentrations of 84 mg% via voluntary consumption of a 5% ethanol solution. The brains of adult male offspring were extracted and processed for Golgi-Cox staining. MSNs from the dorsomedial striatum, dorsolateral striatum and the nucleus accumbens core and shell were sampled for analysis.

Relative to saccharin controls, robust reductions in dendritic length and branching, but not spine density, were observed in the shell of the nucleus accumbens in fetal-ethanol-exposed rats. No significant prenatal ethanol effects were found in the other regions of the striatum.

These findings suggest that exposure to moderate levels of ethanol in utero can have profound effects on brain regions related to reward processing and provide possible clues relevant to understanding increased self-administration of drugs of abuse in animals exposed to ethanol during brain development.



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Request Reprint E-Mail: dahamilt@unm.edu

Alcohol and epigenetic changes: Summary of the 2011 Alcohol and Immunology Research Interest Group (AIRIG) meeting

On November 18, 2011, the 16th annual Alcohol and Immunology Research Interest Group (AIRIG) meeting was held at Loyola University Medical Center in Maywood, Illinois.

The focus of this year's meeting was alcohol's effect on epigenetic changes and possible outcomes induced by these changes. Two sessions, which consisted of talks from invited speakers as well as presentations of selected abstracts, were held in addition to a poster session.

Participants presented information on alcohol-induced alterations in histone modifications and gene expression along with immunologic responses to alcohol. Speakers shared new research specifically on histone deacetylase enzyme expression and modifications due to alcohol and the downstream effect of these modifications may have on gene expression and tissue damage.

Additional studies suggested that alcohol exacerbates inflammation when combined with other insults such as infection, trauma, inhalation injury, and disease.

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Request Reprint E-Mail: ekovacs@lumc.edu

Effect of Age and Gender on the Relationship between Alcohol Consumption and Serum GGT: Time to Recalibrate Goals for Normal Ranges

While serum gamma-glutamyltransferase (GGT) enzyme activity is a well established biomarker of excessive alcohol consumption and liver dysfunction, recent studies have also implicated it as a predictor of morbidity due to extrahepatic causes. Therefore, further information on the associations between ethanol intake and GGT activities in apparently healthy individuals appears warranted.

Data on alcohol consumption and serum GGT activities were collected from 18,899 individuals (8807 men, 10,092 women), mean age 48 years and range 25–74 years, who participated in a national cross-sectional health survey. Alcohol use was assessed by detailed questionnaires and the study population was subsequently divided into subgroups according to age and gender. Body mass index and smoking were used as covariates in all analyses.

In men over 40 years, a reported regular consumption of 8 standard ethanol doses (‘dose’ = 12 g ethanol) or more per week was found to lead to a significant elevation in serum GGT activities, whereas those below 40 showed first significant changes not until the reported ethanol intake exceeded 14 doses per week. For women, the corresponding threshold levels were four and seven standard ethanol doses, respectively.

The data pertaining to the present population sample indicate that rather low levels of reported regular ethanol consumption lead to elevated levels of GGT and that age over 40 markedly enhances the impact of alcohol consumption on GGT activity. The present findings should form the basis for defining safe levels of ethanol consumption and in recalibrating goals for normal limits in the clinical use of GGT measurements.



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Request Reprint E-Mail: onni.niemela@epshp.fi

Eurocare warns of alcohol-related cancer risks

The European Alcohol Policy Alliance has launched a new website to flag up the risks associated with alcohol consumption and cancer.

Alcohol is a carcinogenic (cancer causing) substance, yet only 1 in 5 people are aware of the risks that alcohol can bring. 10% of the total cancers in males and 3% of the total cancers in females are thought to be associated with alcohol consumption. A range of cancers are linked to alcohol, including liver cancer and prostate cancer. Any alcohol can increase the risk, so there isn't a "safer" alcoholic drink to gravitate to.

Other lifestyle behaviours, when combined with drinking alcohol, also can increase the risks - last year Cancer Research UK suggested 40% of cancers could be prevented by improved lifestyles. Alcohol can contribute to weight gain, which increases the risks of developing cancers of the oesophagus, pancreas, bowel, endometrium, kidney and breast. Smoking combined with drinking can increase the risks of developing cancers of the mouth and throat significantly. > > > > Read More

Current Issue: May–June 2012

Interventions and Assessments

• Illicit-Drug Brief Intervention Reduced Risk Score among Some Patients in a Randomized Trial
• Brief Intervention Reduces Drinking among Emergency Department Patients with Nondependent Unhealthy Use
• Alcohol and Other Drug Discussions in Primary Care: Not Rare, but Numerous Challenges
• Naloxone Distribution Programs for Opioid Overdose Prevention: Time to Scale Up?
• Naltrexone Implants Reduced Opioid Use in People with Co-occurring Heroin and Amphetamine Dependence
• Adding Telephone Support to Office-Based Buprenorphine Treatment for Opioid Dependence Has Modest Effects

Health Outcomes

• Ongoing Use of Analgesics after Low-Risk Surgery
• Severity of Alcohol Problems Predicts Recurrence and Persistence of Alcohol Dependence
  
• Change in Heavy Drinking among Alcohol-Dependent Individuals
  
• Light Alcohol Consumption Prior to and Following Myocardial Infarction Is Associated with Lower Risk of Mortality

HIV and HCV

• Rates of HCV Reinfection Are Low among People with Injection Drug Use Who Receive HCV Treatment
• Availability of Viral Hepatitis Services in US Drug Treatment Programs
• Providing Directly-Observed Hepatitis C Treatment at a Methadone Maintenance Program is Feasible and May Improve Treatment Outcomes
• People with Injection Drug Use Who Also Use Noninjecting Routes of Drug Administration Are Less Likely to Be HIV Positive

Resource Alert

• BAP Releases New Guidelines on the Pharmacologic Management of Substance Use Disorders

Slide Presentations

• Update on Alcohol, Other Drugs, and Health
• Journal Club

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Resources for the prevention and treatment of substance use disorders

The global burden of disease attributable to alcohol and illicit drug use amounts to 5.4% of the total burden of disease. Effective interventions and strategies exist to prevent and treat substance use disorders. The Global Information System on Resources for the Prevention and Treatment of Substance Use Disorders maps and monitors health system resources at the country level to respond to the health problems due to substance use. Data from 147 countries (88% of the world population), collected in 2008, show that the main location for treatment of substance use disorders is the specialist substance abuse system, followed by the mental health system, the general health system, and primary care.

View interactive graph

MORE DATA PRODUCTS ON RESOURCES FOR THE PREVENTION AND TREATMENT OF SUBSTANCE USE DISORDERS

• Maps
• Atlas on substance use (ATLAS-SU) report
• Country profiles
• Indicator book
  pdf, 214kb
• Management of Substance Abuse web pages
• Global Information System on Alcohol and Health (GISAH)

Addiction Medicine: Closing the Gap between Science and Practice

WHAT'S IN THIS REPORT:

CASA Columbia’s new five year national study reveals that addiction treatment is largely disconnected from mainstream medical practice. While a wide range of evidence-based screening, intervention, treatment and disease management tools and practices exist, they rarely are employed. The report exposes the fact that most medical professionals who should be providing treatment are not sufficiently trained to diagnose or treat addiction, and most of those providing addiction treatment are not medical professionals and are not equipped with the knowledge, skills or credentials necessary to provide the full range of evidence-based services, including pharmaceutical and psychosocial therapies and other medical care.

This landmark report examines the science of addiction--a complex disease that involves changes in the structure and function of the brain--and the profound gap between what we know about the disease and how to prevent and treat it versus current health and medical practice.

HIGHLIGHTS FROM THE REPORT:

• Forty million Americans ages 12 and older (16 percent) have the disease of addiction involving nicotine, alcohol or other drugs, a disease affecting more Americans than heart conditions, diabetes or cancer; another 80 million people are risky substance users – using tobacco, alcohol and other drugs in ways that threaten health and safety.
• About 7 in 10 people with diseases like hypertension, major depression and diabetes receive treatment; only about 1 in 10 people who need treatment for addiction involving alcohol or other drugs receive it while the number receiving treatment for nicotine is not even known.
• Addiction treatment facilities and programs are not adequately regulated or held accountable for providing treatment consistent with medical standards and proven treatment practices.
• In 2010 only $28 billion was spent to treat the 40 million people with addiction. In comparison, the United States spent:
  • $44 billion to treat diabetes which affects 26 million people;
  • $87 billion to treat cancer which affects 19 million people;
  • $107 billion to treat heart conditions which affect 27 million people.

  
  

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Sequence of Alcohol Involvement from Early Onset to Young Adult Alcohol Abuse: Differential Predictors and Moderation by Family-Focused Preventive Int

This study tests risk factors for four dimensions of alcohol use in the sequence from (a) early onset prior to age 13 to (b) adolescent alcohol use and (c) alcohol problems to (d) young adult alcohol abuse. It also examines whether family-focused preventive interventions buffer predictive relationships.

Data were from a randomized prevention trial extending from ages 11 to 21.

Families of sixth graders enrolled in 33 rural schools in the Midwestern United States were invited to participate.

Families (N = 667) were pretested and randomly assigned to a control group (n = 208) or to family interventions (n = 459). The average age of participating youth was 11.3 years when the study began (52% female). Measurements: Questionnaire data were collected on alcohol dimensions during adolescence (early onset, alcohol use, alcohol problems) and young adulthood (alcohol abuse), and on risk factors in early adolescence (male gender, impulsive behaviors, aggression-hostility, peer deviance, and parent problem drinking).

Impulsive behaviors predicted early onset, peer deviance predicted alcohol use, and parent problem drinking predicted alcohol problems (p <.05). Aggression-hostility and alcohol problems predicted alcohol abuse in the control group (p <.05), but not in the family interventions group (p >.05).

Different dimensions of alcohol use and problems from before age 13 to young adulthood are predicted by different risk factors. Family-focused preventive interventions can reduce the influence of some of these risk factors, including early adolescent aggression-hostility and late adolescent alcohol problems.

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Request Reprint E-Mail: masonwa@boystown.org

Alcohol dependence a significant predictor for depression and anxiety disorders

The British Journal of Psychiatry (BJP) has published research which suggests that alcohol dependence is a significant predictor of future episodes of anxiety or depressive disorders, whereas alcohol abuse is not.

The study explored whether the course of depression or anxiety disorders were conditional upon the type and severity of alcohol problem. Severe dependency was linked to the persistence of anxiety and depressive disorder incidences at 2 year follow-up. However, the study found no significant difference in people with alcohol abuse (or moderate problems), compared to people with no lifestyle problems at a 2 year follow- up.

This study is the latest in a long line of research aimed at teasing out the complex nature of the links between alcohol and depression/anxiety disorders. A 2005 study by Haynes et al found that alcohol was not a significant risk factor for the onset of anxiety and depression, whereas abstinence was associated with a lowered risk of onset. A study in 2011 by Liang et al found that common mental health disorders, such as anxiety and depression, may increase the risk of alcohol dependency and misuse. > > > > Read More

Effects of Intoxicating Free-Choice Alcohol Consumption During Adolescence on Drinking and Impulsivity During Adulthood in Selectively Bred High-Alcoh

Abuse of alcohol during adolescence continues to be a problem, and it has been shown that earlier onset of drinking predicts increased alcohol abuse problems later in life. High levels of impulsivity have been demonstrated to be characteristic of alcoholics, and impulsivity has also been shown to predict later alcohol use in teenage subjects, showing that impulsivity may precede the development of alcohol use disorders. These experiments examined adolescent drinking in a high-drinking, relatively impulsive mouse population and assessed its effects on adult drinking and adult impulsivity.

Experiment 1: Selectively bred high-alcohol preferring (HAPII) mice were given either alcohol (free-choice access) or water only for 2 weeks during middle adolescence or adulthood. All mice were given free-choice access to alcohol 30 days later, in adulthood. Experiment 2: Adolescent HAPII mice drank alcohol and water, or water alone, for 2 weeks, and were then trained to perform a delay discounting task as adults to measure impulsivity. In each experiment, effects of volitional ethanol (EtOH) consumption on later behavior were assessed. We expected adolescent alcohol exposure to increase subsequent drinking and impulsivity.

Mice consumed significant quantities of EtOH, reaching average blood ethanol concentrations (BECs) of 142 mg/dl (adolescent) or 154 mg/dl (adult) in Experiment 1. Adolescent mice in Experiment 2 reached an average of 108 mg/dl. Mice exposed to alcohol in either adolescence or adulthood showed a transient increase in EtOH consumption, but we observed no differences in impulsivity in adult mice as a function of whether mice drank alcohol during adolescence.

These findings indicate that HAPII mice drink intoxicating levels of alcohol during both adolescence and adulthood and that this volitional intake has long-term effects on subsequent drinking behavior. Nonetheless, this profound exposure to alcohol during adolescence does not increase impulsivity in adulthood, indicating that long-term changes in drinking are mediated by mechanisms other than impulsivity.

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Request Reprint E-Mail: ngrahame@iupui.edu

Sensitivity and Specificity of Urinary Ethyl Glucuronide and Ethyl Sulfate in Liver Disease Patients

It is important to monitor alcohol use in the care of patients with liver disease, but patient self-report can be unreliable. We therefore evaluated the performance of urine ethyl glucuronide (EtG) and ethyl sulfate (EtS) in detecting alcohol use in the days preceding a clinical encounter.

Subjects (n = 120) were recruited at a university-based hepatology clinic or during hospitalization. Alcohol consumption was ascertained by validated self-report measures. Urine EtG (cutoff 100 ng/ml) and EtS (cutoff 25 ng/ml) concentrations were assayed by a contracted laboratory using tandem mass spectrometry. The sensitivity and specificity of each biomarker in the detection of drinking during the 3 and 7 days preceding the clinic visit were determined, as well as the influence of liver disease severity on these results.

Urine EtG (sensitivity 76%, specificity 93%) and urine EtS (sensitivity 82%, specificity 86%) performed well in identifying recent drinking, and liver disease severity does not affect biomarker performance. After elimination of 1 false-negative self-report, urine EtG > 100 ng/ml was 100% specific for drinking within the past week, whereas 9% of the subjects without evidence of alcohol drinking for at least 1 week had EtS > 25 ng/ml.

Urine EtG and EtS can objectively supplement the detection of recent alcohol use in patients with liver disease. Additional research may determine optimal methods for integrating these tests into clinical care.

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Request Reprint E-Mail: stewarsh@musc.edu

Dynamic and Persistent Effects of Ethanol Exposure on Development: An In Vivo Analysis During and After Embryonic Ethanol Exposure in Caenorhabditis e

Defects caused by ethanol (EtOH) exposure during development can be different depending on the time of observation. To investigate this temporal component of developmental delay, we use the fast-developing nematode model Caenorhabditis elegans. We first defined the longitudinal effects of EtOH on development using age-appropriate markers and then closely followed embryonic development before, during, and after EtOH exposure.

C. elegans embryos were bathed in 0 to 20% EtOH (w/w in ddH₂O) for 8 hours or were left untreated during embryonic development. Development was followed longitudinally and scored as embryonic stage at the end of the exposure, hatch time, hatching probability (mortality), body length, postembryonic stage, and egg-laying pattern. The rate of in vivo embryonic development was observed hourly for 24 hours covering times before, during, and after EtOH exposure.

After exposure to 10% EtOH, embryos were at younger embryonic stages, hatched later, and had higher mortality compared to unexposed controls. Embryos exposed to 5% EtOH were at normal embryonic stages, showed no change in mortality, but hatched later than controls. Both EtOH groups showed shorter mean body lengths and slower postembryonic development; however, the 5% group recovered to control levels faster than the 10% group. The pattern of egg laying was delayed in the 10% group, but not in the 5% group. Hourly in vivo observations revealed that a developmental delay was first visible a few hours into 10% EtOH exposure and that the delay increased after the removal of EtOH exposure.

Developmental delays occurred during and immediately after exposure and were not uniform but rather dynamic. This article highlights the importance of investigating EtOH-induced defects using different markers and at multiple time points. Attention to temporal effects during and immediately after EtOH exposure can provide understanding of these sensitive time points for observation and treatment.

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Request Reprint E-Mail: crankin@psych.ubc.ca

Vascular Effects of Maternal Alcohol Consumption

Maternal alcohol consumption during pregnancy is a significant field of scientific exploration primarily because of its negative effects on the developing fetus which is specifically defined as Fetal Alcohol Spectrum Disorders (FASD).

Though the effects on the mother are less explored compared to those on the fetus, alcohol produces multiple effects on the maternal vascular system. Alcohol has major effects on systemic hemodynamic variables, endocrine axes and paracrine factors regulating vascular resistance, as well as vascular reactivity. Alcohol is also reported to have significant effects on the reproductive vasculature including alterations in blood flow, vessel remodeling, and angiogenesis.

Data presented in this Review will illustrate the importance of the maternal vasculature in the pathogenesis of FASD and that more studies are warranted in this field.



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Request Reprint E-Mail: jaramado@utmb.edu