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Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism

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https://www.readbyqxmd.com/read/23580049/focus-on-structural-and-functional-brain-abnormalities-in-fetal-alcohol-spectrum-disorders
#1
REVIEW
C Christopher Nunez, Florence Roussotte, Elizabeth R Sowell
Children exposed to alcohol prenatally can experience significant deficits in cognitive and psychosocial functioning as well as alterations in brain structure and function related to alcohol's teratogenic effects. These impairments are present both in children with fetal alcohol syndrome (FAS) and in children with heavy in utero alcohol exposure who do not have facial dysmorphology required for the FAS diagnosis. Neuropsychological and behavioral studies have revealed deficits in most cognitive domains measured, including overall intellectual functioning, attention/working memory, executive skills, speed of processing, and academic skills in children and adolescents across the range of fetal alcohol spectrum disorders (FASD)...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580048/focus-on-neurotransmitter-systems
#2
REVIEW
C Fernando Valenzuela, Michael P Puglia, Stefano Zucca
Neurotransmitter systems have been long recognized as important targets of the developmental actions of alcohol (i.e., ethanol). Short- and long-term effects of ethanol on amino acid (e.g., γ-aminobutyric acid and glutamate) and biogenic amine (e.g., serotonin and dopamine) neurotransmitters have been demonstrated in animal models of fetal alcohol spectrum disorders (FASD). Researchers have detected ethanol effects after exposure during developmental periods equivalent to the first, second, and third trimesters of human pregnancy...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580047/focus-on-magnetic-resonance-based-studies-of-fetal-alcohol-spectrum-disorders-in-animal-models
#3
REVIEW
Shonagh K O'Leary-Moore, Scott E Parnell, Elizabeth A Godin, Kathleen K Sulik
The imaging techniques magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and magnetic resonance spectroscopy (MRS) provide valuable tools for studying brain structure and neurochemistry in fetal alcohol spectrum disorders (FASD). Although the application of magnetic resonance-based methodologies to the study of FASD in animal models is in its infancy, it already has provided new clinically relevant insights and holds significant promise to further extend our understanding of alcohol's effects on the developing fetus...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580046/focus-on-the-use-of-animal-models-for-the-study-of-fetal-alcohol-spectrum-disorders
#4
REVIEW
Shannon E Wilson, Timothy A Cudd
Considerable efforts to educate women not to abuse alcohol during pregnancy have failed to reduce the incidence of fetal alcohol syndrome. Therefore, other approaches to limit the effects of prenatal alcohol exposure are under consideration, including the development of prevention programs and interventions. For these strategies to be as successful as possible, it also is important to improve methods for identifying affected children. The use of animal models in prenatal alcohol exposure research is critical because of the practical and ethical limitations of using human subjects for such studies...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580045/prenatal-alcohol-exposure-and-miscarriage-stillbirth-preterm-delivery-and-sudden-infant-death-syndrome
#5
REVIEW
Beth A Bailey, Robert J Sokol
In addition to fetal alcohol syndrome and fetal alcohol spectrum disorders, prenatal alcohol exposure is associated with many other adverse pregnancy and birth outcomes. Research suggests that alcohol use during pregnancy may increase the risk of miscarriage, stillbirth, preterm delivery, and sudden infant death syndrome. This research has some inherent difficulties, such as the collection of accurate information about alcohol consumption during pregnancy and controlling for comorbid exposures and conditions...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580044/fetal-alcohol-spectrum-disorders-experimental-treatments-and-strategies-for-intervention
#6
REVIEW
Nirelia M Idrus, Jennifer D Thomas
Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol's teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580043/behavioral-interventions-for-children-and-adolescents-with-fetal-alcohol-spectrum-disorders
#7
REVIEW
Blair Paley, Mary J O'Connor
Exposure to alcohol in utero is considered to be a leading cause of developmental disabilities of known causation. The most severe consequence of such exposure, fetal alcohol syndrome (FAS), is characterized by a distinct constellation of facial anomalies, growth retardation, and central nervous system dysfunction. Both animal and human studies, however, suggest that there may be considerable variability in the manifestations of in utero alcohol exposure across individuals, and, consequently, the term fetal alcohol spectrum disorders (FASD) has come into usage to reflect the entire continuum of effects associated with such exposure...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580042/focus-on-biomarkers-of-fetal-alcohol-exposure-and-fetal-alcohol-effects
#8
REVIEW
Ludmila N Bakhireva, Daniel D Savage
One of the ongoing challenges for the accurate diagnosis and treatment of children with fetal alcohol spectrum disorders (FASD) is the difficulty of confirming whether a mother drank during her pregnancy. Commonly used screening questionnaires often are unreliable, and current established biomarkers of alcohol consumption are not sensitive enough for use with many pregnant women. These limitations underscore the critical need to develop novel biomarkers with greater sensitivity for detecting moderate levels of drinking during pregnancy for longer periods of time after the last drinking episode...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580041/the-quest-for-a-neurobehavioral-profile-of-heavy-prenatal-alcohol-exposure
#9
REVIEW
Sarah N Mattson, Edward P Riley
The devastating consequences of fetal alcohol syndrome (FAS) are well established, and, as a leading cause of intellectual disabilities (Pulsifer 1996), FAS has significant societal and public health implications. Importantly, FAS is associated with a broad range of neurobehavioral deficits (for more information, see the article by Coles, pp. 42-50 in this issue). However, FAS is only the most serious possible consequence of heavy prenatal alcohol exposure, and many individuals who do not meet diagnostic criteria for FAS also are severely impacted by gestational alcohol exposure...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580040/discriminating-the-effects-of-prenatal-alcohol-exposure-from-other-behavioral-and-learning-disorders
#10
REVIEW
Claire D Coles
Fetal alcohol syndrome and fetal alcohol spectrum disorders are underdiagnosed in general treatment settings. Among the factors involved in identifying the effects of prenatal alcohol exposure are (1) the evidence for prenatal alcohol exposure; (2) the effects of the postnatal, caregiving environment; (3) comorbidities; and (4) differential diagnosis, which includes identifying the neurodevelopmental effects of alcohol and discriminating these effects from those characterizing other conditions. This article reviews findings on the neurodevelopmental effects of prenatal alcohol exposure, including learning and memory, motor and sensory/motor effects, visual/spatial skills, and executive functioning and effortful control...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580039/understanding-the-effects-of-prenatal-alcohol-exposure-using-three-dimensional-facial-imaging
#11
REVIEW
Leah Wetherill, Tatiana Foroud
One of the (at least theoretically) most easily detectable features of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD) is a distinct pattern of facial characteristics. However, in many children prenatally exposed to alcohol, these characteristics are expressed only subtly, making it difficult to correctly identify children with these disorders. To date, several studies have used conventional two-dimensional images to develop computerized programs assisting in the identification of individuals with FAS or FASD...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580038/focus-on-epigenetics-and-fetal-alcohol-spectrum-disorders
#12
REVIEW
Michael S Kobor, Joanne Weinberg
Epigenetic changes-stable but potentially reversible alterations in a cell's genetic information that result in changes in gene expression but do not involve changes in the underlying DNA sequence-may mediate some of the detrimental effects of prenatal alcohol exposure and contribute to the deficits and abnormalities associated with fetal alcohol spectrum disorders. These epigenetic processes are linked to the chromatin (i.e., DNA, histone proteins, and other associated proteins) and commonly involve chemical modifications (e...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580037/combination-drug-use-and-risk-for-fetal-harm
#13
REVIEW
Weijung A Chen, Susan E Maier
Alcohol and other drugs are frequently used in combination. Based on data from the National Epidemiologic Survey on Alcohol and Related Conditions, Falk and colleagues (2006, 2008) reported that 21.7 percent of the sampled population used both alcohol and tobacco and 5.6 percent used alcohol and another drug. Among women aged 18 to 24 the rates were 25.5 percent and 12.5 percent, respectively. Individually, alcohol, tobacco products, and a number of illicit drugs (such as cocaine or amphetamine) are known to be harmful to the developing fetus during pregnancy...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580036/maternal-risk-factors-for-fetal-alcohol-spectrum-disorders-not-as-simple-as-it-might-seem
#14
REVIEW
Philip A May, J Phillip Gossage
Gathering information about drinking during pregnancy is one of the most difficult aspects of studying fetal alcohol spectrum disorders (FASD). This information is critical to linking specific risk factors to any particular diagnosis within the FASD continuum. This article reviews highlights from the literature on maternal risk factors for FASD and illustrates that maternal risk is multidimensional, including factors related to quantity, frequency, and timing of alcohol exposure; maternal age; number of pregnancies; number of times the mother has given birth; the mother's body size; nutrition; socioeconomic status; metabolism; religion; spirituality; depression; other drug use; and social relationships...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580035/fetal-alcohol-spectrum-disorders-research-challenges-and-opportunities
#15
REVIEW
Kenneth R Warren, Brenda G Hewitt, Jennifer D Thomas
The adverse effects of prenatal alcohol consumption have long been known; however, a formal description and clinical diagnosis of these effects was not introduced until 1973. Since then, the distinction of the wide range of effects that can be induced by prenatal alcohol exposure, and, consequently, the terminology to describe these effects has continued to evolve. Although much progress has been made in understanding the consequences of prenatal alcohol exposure, challenges still remain in properly identifying all affected individuals as well as their individual patterns of alcohol-induced deficits...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580023/health-services-and-financing-of-treatment
#16
REVIEW
Maureen T Stewart, Constance H Horgan
Financing, payment, and organization and management of alcohol and other drug (AOD) treatment services are closely intertwined and together determine whether people have access to treatment, how the treatment system is designed, and the quality and cost of treatment services. Since the 1960s, changes in these arrangements have driven changes in the delivery of AOD treatment, and recent developments, including the passage of Federal parity legislation and health reform, as well as increasing use of performance contracting, promise to bring additional changes...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580022/the-community-reinforcement-approach-an-update-of-the-evidence
#17
REVIEW
Robert J Meyers, Hendrik G Roozen, Jane Ellen Smith
The Community Reinforcement Approach (CRA), originally developed for individuals with alcohol use disorders, has been successfully employed to treat a variety of substance use disorders for more than 35 years. Based on operant conditioning, CRA helps people rearrange their lifestyles so that healthy, drug-free living becomes rewarding and thereby competes with alcohol and drug use. Consequently, practitioners encourage clients to become progressively involved in alternative non-substance-related pleasant social activities, and to work on enhancing the enjoyment they receive within the "community" of their family and job...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580021/the-recovery-spectrum-from-self-change-to-seeking-treatment
#18
REVIEW
Jalie A Tucker, Cathy A Simpson
Recent innovations in alcohol-focused interventions are aimed at closing the gap between population need and the currently uncommon use of alcohol treatment services. Guided by population data showing the heterogeneity of alcohol problems and the occurrence of natural remissions from problem drinking without treatment, alcohol services have begun to expand beyond clinical treatment to offer the untreated majority of individuals with alcohol-related problems accessible, less-intensive services that use the tools of public health practice...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580020/treating-alcoholism-as-a-chronic-disease-approaches-to-long-term-continuing-care
#19
REVIEW
James R McKay, Susanne Hiller-Sturmhofel
For many patients, alcohol and other drug (AOD) use disorders are chronic, recurring conditions involving multiple cycles of treatment, abstinence, and relapse. To disrupt this cycle, treatment can include continuing care to reduce the risk of relapse. The most commonly used treatment approach is initial intensive inpatient or outpatient care based on 12-step principles, followed by continuing care involving self-help groups, 12-step group counseling, or individual therapy. Although these programs can be effective, many patients drop out of initial treatment or do not complete continuing care...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
https://www.readbyqxmd.com/read/23580019/the-role-of-mutual-help-groups-in-extending-the-framework-of-treatment
#20
REVIEW
John F Kelly, Julie D Yeterian
Alcohol use disorders (AUDs) are highly prevalent in the United States and often are chronic conditions that require ongoing episodes of care over many years to achieve full sustained remission. Despite substantial scientific advances in specialized care, professional resources alone have not been able to cope with the immense burden of disease attributable to alcohol. Perhaps in tacit recognition of this, peer-run mutual-help groups (MHGs), such as Alcoholics Anonymous (AA), have emerged and proliferated in the past 75 years and continue to play an important role in recovery from AUDs...
2011: Alcohol Research & Health: the Journal of the National Institute on Alcohol Abuse and Alcoholism
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