Alcoholism

Spider Angioma — NEJM Images in Clinical Medicine

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Compression of the central arteriole caused the entire lesion to blanch, and it quickly refilled once the compression was released  This pattern of blanching and refilling characterizes spider angiomas, which are suggestive of liver disease.

Spider Angioma — NEJM.

For the underwriter who always wondered what one of these things looks like.  For the geekiest underwriters, click on and take a look at the video.  And for the underwriter who thinks she should have a Medical Doctor, the following is from the NEJM Resident E-Bulletin of 02.23.12.

Clinical Pearls

  •   What is the differential diagnosis of a subacute confusional state in a patient with liver disease?

The differential diagnosis includes five major syndromes: hepatic encephalopathy, Wernicke’s encephalopathy, alcohol withdrawal, occult seizures, and infection. Hepatic encephalopathy refers to an alternation in cognitive function that is secondary to a metabolic process caused by liver failure. Wernicke’s encephalopathy refers to the triad of gait ataxia, ophthalmoplegia and confusion caused by thiamine deficiency, commonly seen in chronic alcoholics. Alcohol withdrawal, occult seizures, and underlying infection may also cause a subacute confusional state in a patient with chronic liver disease.

Binge Drinking in Adults United States 2010

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  • Binge drinking causes more than half of the 80,000 deaths and three quarters of the $223.5 billion in economic costs caused by excessive drinking.
  • Approximately one in six (38 million) U.S. adults binge drink, and do so approximately four times a month. On average, the largest number of drinks consumed by binge drinkers is eight drinks per occasion.
  • Prevalence and intensity of binge drinking was highest among persons aged 18–34 years, but the frequency of binge drinking was highest among binge drinkers aged ≥65 years. Binge drinkers with annual household incomes ≥$75,000 had the highest binge drinking prevalence, but binge drinkers with household incomes <$25,000 had the highest frequency and intensity of binge drinking.

via Medical News: Binge Drinking Common Among Adults, CDC Finds – in Public Health & Policy, Public Health from MedPage Today.

Vital Signs: Binge Drinking Prevalence, Frequency, and Intensity Among Adults — United States, 2010.

The first link takes you to the MedPage Today article.  The second link takes you to the source article which is also available in a downloadable PDF format.  This report is well worth sharing with your underwriting staff.

BBC News – Guns N’ Roses’ Duff McKagan’s ‘wake-up call’

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He began drinking heavily because he thought it would help to prevent his panic attacks – which he had suffered from since he was a teenager. At his worst, he says he was drinking “a gallon of vodka a day”, and then 10 bottles of wine a day “when I was trying to taper down”.

via BBC News – Hardtalk – Guns N’ Roses’ bassist Duff McKagan’s ‘wake-up call’.

For the next time someone asks you why entertainers are underwritten cautiously and carefully.