Blood Alcohol Concentration Levels Research Articles

A fatal case of desvenlafaxine and paroxetine poisoning

Desvenlafaxine (O-desmethylvenlafaxine) and paroxetine are antidepressants that inhibit serotonin reuptake. Despite their relatively safe profiles, several serious side effects, including serotonin syndrome, bleeding, mania, and high blood pressure, are observed. We report the confirmation of the death of a 41-year-old female, with an overdose of desvenlafaxine and paroxetine suspected as the main cause of death. To quantify the level of desvenlafaxine and paroxetine in whole blood and urine, solid phase extraction combined with liquid chromatography–tandem mass spectrometry was developed and validated. Calibration curves were linear with coefficients of determination (r2) >0.999 for desvenlafaxine and paroxetine. The limits of detection and the limits of quantification for both desvenlafaxine and paroxetine were 0.001 µg/mL and 0.02 µg/mL, respectively. Desvenlafaxine and paroxetine were detected in the postmortem samples, along with various psychiatric drugs, and the blood alcohol content level was below 0.010%. The concentrations of desvenlafaxine and paroxetine in the heart blood were 11.0 µg/mL and 2.1 µg/mL, respectively, indicating lethal concentrations. In the urine, the concentrations of desvenlafaxine and paroxetine were 87.7 µg/mL and 3.5 µg/mL, respectively. This is the first report to determine the blood concentration of desvenlafaxine in a fatal intoxication caused by an overdose of desvenlafaxine single formulation.

Alcohol's impact on fine motor skills: Insights from minimally invasive surgical simulation

BackgroundAlcohol misuse among medical professionals poses a significant concern, and there is a lack of clarity in (inter)national guidelines regarding alcohol use during work. Moreover, there exists an insufficient body of research on the specific impact of alcohol on fine motor skills within the medical sector, specifically surgery. This study aims to investigate the impact of alcohol on fine motor skills in a minimally invasive surgical setting. MethodsA cross-sectional study was conducted at Lowland Science on August 19th, 20th, and 21st, 2022, during the Lowlands music festival in Biddinghuizen, the Netherlands. Participants were divided into five groups based on measured alcohol consumption. Exclusion criteria included drug use, prior surgical experience, being underage, and previous participation. The main outcomes were the number of correctly transferred rings during the PEG transfer task and the number of errors. Blood alcohol concentration (BAC) was measured using a breathalyser. ResultsA total of 1056 participants were included in the study. The results indicated an inverse relationship between BAC levels and surgical performance, with higher alcohol levels associated with a decrease in performance (p = 0.023). However, there was no significant difference in the number of errors among the five groups (p = 0.597). The group with the highest alcohol consumption (BAC >0.08 %) exhibited significantly worse performance compared to the group with a BAC of 0.0 % (p = 0.002). ConclusionThis study uncovers a negative impact of increased alcohol intake on fine motor skills in a minimally invasive surgery simulation exercise. While there was no effect on the occurrence of errors. Professional medical organizations should reconsider and explicate their position on alcohol use in (surgical) healthcare.

Couples motivational interviewing with mobile breathalysers to reduce alcohol use in South Africa: a pilot randomised controlled trial of Masibambisane

IntroductionHeavy alcohol use among people living with HIV in sub-Saharan Africa can hinder the success of HIV treatment programmes, impacting progress towards United Nations Programme on HIV/AIDS goals. Primary partners...

Sober up: Time from last drink to a road traffic injury

PurposeThere is no intervention that quickly reduces a person's blood alcohol content (BAC). “Sober up before you drive” may prevent road traffic injury (RTI) caused by alcohol consumption. The aim of this study was to analyze the risk of RTI on an hourly basis (1–6 h) after the last drink and the determinants of this risk. MethodsThis was a case-crossover study of alcohol consumption among 430 patients who suffered an RTI and arrived at an emergency department in a large hospital in Mexico City from January to April 2022. ResultsOf the 430 patients studied, 46 reported drinking within 1 h before the RTI, for a risk ratio (RR) of 7.7 (95% CI [5.6, 10.4]). This RR decreased to 2.2 (95% CI [1.3, 3.7]) for the 12 patients drinking in the second hour before the RTI and was null for those drinking earlier (p ≤ 0.001 for the trend). The induction time was 3 h among those with higher BAC and intoxication levels. The RR for an RTI decreases 71% from the first to second hour from the last drink and 32% from the second to third hour. This decrease was similar among those intoxicated and those with increased BACs. In multiple regression models, higher levels of intoxication and higher BACs remained associated with higher RRs. DiscussionPeople should avoid driving after drinking. Waiting to drive, walking, or riding after drinking reduces the risk of an RTI, especially for people with higher BAC and intoxication levels.

Autopsy study of alcohol-associated unnatural deaths in Thailand, 2007-2019.

To date, there have been no major studies of alcohol-associated unnatural deaths in Thailand or South East Asia. Thailand leads South East Asia in per capita alcohol consumption. The objectives of this study were to determine the incidence of alcohol-associated unnatural deaths in Thailand and their relation to post-mortem blood alcohol concentration (BAC); to investigate correlations between BAC and selected demographic variables; and to evaluate the incidence of co-use of alcohol and illicit substances. We conducted a retrospective register-based study of alcohol-investigated unnatural deaths in Thailand for the period 2007-2019. The core study sample (n = 77,006) was derived from a Thai government computerized database of unnatural-death autopsies. Of the total autopsy sample 32.49% was alcohol positive (BAC ≥0.20 g/L). The rate at which male autopsy cases were alcohol positive (35.52%) was approximately twice that of female autopsy cases (16.62%), with males having significantly higher median BAC levels, 1.64 and 1.31 g/L, respectively. The incidence of female alcohol-positive cases with extremely high BACs (≥3.50 g/L) was comparable to that of male alcohol-positive autopsies. The rates at which victims of accidents, homicides, and suicides were alcohol positive were 42.44%, 38.81%, and 33.25%, respectively. Drowning fatalities had the highest rate of alcohol detection (49.12%) and the highest median BAC (2.47 g/L). The next highest rate (48.47%) was among road traffic fatalities (RTFs, BAC 1.92 g/L), which accounted for about one-half of all RTFs and one-third of all alcohol-positive autopsies. Of the total alcohol-positive population, 8.33% tested positive for illicit substances, most commonly methamphetamine/amphetamine. BAC results for the majority of male and female alcohol-positive victims exceeded the generally accepted threshold for Heavy Episodic Drinking (0.8 g/L) and provided a rare BAC-documented (≥3.50 g/L) example of gender parity in the incidence of heavy alcohol consumption. The median BAC value for alcohol-positive RTFs (1.92 g/L) was about 10% higher than in studies in most other countries and about four times greater the Thai legal limit for motor-vehicle operation (0.50 g/L).

Analysis of Injuries and Cause of Death in Fatal Accidents with Farm Tractors

Abstract Farm tractor accidents are a frequent cause of death for people in agricultural field of work. The aim of this study was to evaluate the characteristics of the fatal farm tractor accidents, as well as the most significant types of injuries and causes of death. Research is based on epidemiological criteria of subjects, traffic participation, cause of death, distribution of injury, outliving period and toxicological details. The study included 22 (4.2%) farm tractor related fatalities out of all 525 subjects who died from sustained injuries or complications of the injuries sustained in road traffic accidents. The highest number of deaths was reported in men in 95.5%. The highest percentage died of bleeding out (41%), while in 18% of cases, complications that occurred during the outliving period were the cause of death. Analyzing injuries through organ systems, it is observed that the highest number of farm tractor drivers had a chest injury (90%), and the most common chest injury was a rib fracture (82%). When determining the outliving period, the highest number of fatal farm tractor drivers died at the scene of accidents (68.2%). Of all of the subjects, 32% were under the influence of alcohol, while 23% had blood alcohol concentration level greater than 0.5 ‰. The high mortality of farm tractor drivers can be reduced by introducing a mandatory rollover protective structures system and the use of a seat belt in farm tractors with cabs, which would reduce the possibility of the driver falling out of the farm tractor seat and additional injuries due to rollover.

Which risk factors significantly influence the outcome of traumatic brain injured patients with alcohol use disorder?

Every year, approximately 10 million people worldwide suffer a traumatic brain injury that leads to hospitalization or mortality. Chronic and acute alcohol intoxication increase the risk of developing traumatic brain injury. Alcohol use disorder (AUD) as a predictor of outcome in neurosurgical patients and the definition of risk factors have been sparsely addressed so far. This study aims to improve the understanding of the effects of alcohol use disorder in the context of neurosurgical therapy. This study included patients admitted to Münster University Hospital with a traumatic brain injury and alcohol use disorder from January 1, 2010, to December 31, 2018. Univariate and multivariate analyses were performed to identify risk factors for a poorer outcome, assessed by the Glasgow Outcome Score. Of the 197 patients included, 156 (79%) were male, and 41 (21%) were female, with a median age of 49 years (IQR 38-58 years). In multivariate analyses, age (p < 0.001), the occurrence of a new neurologic deficit (p < 0.001), the development of hydrocephalus (p = 0.005), and CT-graphic midline shift due to intracerebral hemorrhage (p = 0.008) emerged as significant predictors of a worse outcome (GOS 1-3). In addition, the level of blood alcohol concentration correlated significantly with the occurrence of seizures (p = 0.009). Early identification of risk factors in patients with alcohol use disorder and traumatic brain injury is crucial to improve the outcome. In this regard, the occurrence of hydrocephalus or seizures during the inpatient stay should be considered as cause of neurological deterioration in this patient group.

Magnitude of Road Traffic Accidental (RTA) Death and Its associated factors among Adult Emergency Visit Patients at ALERT Hospital, A 2 Year Retrospective Review Study

Introduction: In low income countries, Road Traffic Accident (RTA) Death remains high. This describes that RTA are a major public health challenge. And also, the problem is increasing from time to time in resource-limited countries. The most economically active age groups (18-50) are at the greatest risk of dying as a result of RTA. This affects economically, social and political stability of the countries. Therefore, this study aimed to describe the pattern of RTA death and associated factors in the adult emergency department. Methods: A two-year retrospective chart review of RTA injury was conducted at ALERT Hospital. The data were collected by using a structured checklist. Descriptive statistic like frequencies, percentage, means, standard division, and proportion was computed for selected variables using SPSS version 21. Logistic regression was used to predict the measure of association between interest independent variables and death due to RTA injuries. Result: - The proportion rate of RTA death was 27(17.4%) from 155 of RTA injury patients presented Adult Emergency Department of ALERT Hospital. This result translates to a mortality rate of RTA was 34.8 deaths per 1000 patients per year. Multivariate analysis indicated that individuals who drank alcohol while driving were three times more likely to be died in RTA as compared to those who didn’t drink alcohol. And also, victims who had more year of experience in driving been less likely or reduced by a 65% chance of died in RTA than their counter parts. Conclusion: The prevalence of RTA death was high in this study. Use of alcohol while driving and year of experience in driving was most significant associated with road traffic accident-related death. To alleviate these problems awareness creation and measuring blood alcohol content levels and breathe analyzers for the driver during driving is more recommended.

Alcohol and driving—How bad is the combination? A meta-analysis

Objective The objective of this study was to summarize existing knowledge on the association between driving under the influence of alcohol and road safety outcomes and to assess factors that may explain why these estimates vary. Methods Based on studies of the association between blood alcohol concentration (BAC) levels and crashes, we used multilevel metaregression to calculate summary effects of BAC level and analyze potential moderators of the association. Results Based on 60 studies and 393 effect estimates, we found that BAC level, outcome severity, use of hospital data, and geographical region contributed to heterogeneity in results. Conclusion The effect of BAC on crash and injury risk and culpability is stronger at higher BAC levels and for more serious outcomes. The relationship between BAC level and outcome is approximately exponential. The relationship is stronger in studies from Nordic countries than in studies from other countries, possibly because of the relatively low level of drunk driving in these countries. Studies based on hospital data and studies using non-crash-involved control groups find smaller effects on average.

Hepatoprotective Effect of Albumin Peptide Fractions from Corn Germ Meal against Alcohol-Induced Acute Liver Injury in Mice.

Acute alcoholic liver disease can cause serious liver damage. This study reports on the hepatoprotective effect of albumin peptide fractions from corn germ meal (MW < 1 kDa) (APF4) on acute alcohol hepatic damage in mice. In the mice model, the results indicated that APF4 at a dose of 800 mg/kg/bw could markedly boost alcohol metabolism, which was shown in the reduced duration of the loss of the righting reflex; the reduced level of blood alcohol concentration (BAC), cytochrome P450 2E1 (CYP2E1), alanine aminotransferase (ALT), aminotransferase (AST), triglycerides (TG), and malondialdehyde (MDA) (p < 0.01); the enhanced activity of aldehyde dehydrogenase (ALDH); and the superoxide dismutase (SOD) and glutathione (GSH) levels being increased by up to 84.02% and 193.22% (p < 0.01) compared to the control group. The antioxidant capability and lipid peroxidation inhibition activity of APF4 may be responsible for its protective effect against liver damage induced by alcohol. The findings suggested that APF4 had the hepatoprotective property against liver damage induced by alcohol.

The Burden of Alcohol-Related Emergency Department Visits in a Hospital of a Large European City

(1) Alcohol consumption contributes to the development of numerous diseases and is a big organizational burden on emergency departments (EDs). (2) We examined data on alcohol-related ED admissions in Poznan, Poland between 1 April 2019 and 31 March 2022. A total of 2290 patients' records were collected and analysed. The main goal was to determine the impact that these visits had on the functioning of the ED and the hospital. (3) The alcohol-related admission rate was significantly higher in males (78.95% vs. 21.05%), and the median blood alcohol concentration (BAC) level was 2.60 (1.78-3.38) ‱. Most of the visits took place at weekends and in the evening. Patients with higher BAC tended to stay longer in the ED, but had a lower chance of being admitted. A majority of patients required radiology and laboratory testing, 20.44% needed psychiatric examination, and 19.69% suffered trauma, mainly to the head. (4) Injuries and mental problems were the most common medical emergencies. This study presents trends in alcohol-related ED attendances, examines reasons for visits, and makes an attempt to assess overall burden on EDs.

“Alcohol use and suicide in Lithuania: proximity shouting out loud”

AbstractIn the recent past, the standardized suicide mortality rate (SMR) in Lithuania was more than double the global SMR and nearly one and a half higher than in the EU. Herewith Lithuania has high male-to-female SMR ratios e.g., at 7.1 in 2016. Autopsy studies in Lithuania revealed that approximately two thirds of men and one third of women who died by suicide had a blood alcohol con-centration level above 0.04 g/dL. Although suicide is a complex phenomenon, heavy alcohol use has been considered as it’s important risk factor though the relationship was never systematically studied before in Lithuania. Experts have suggested that gender differences in excessive alcohol consumption can explain the gender disparity in suicide mortality and linked tackling the harmful use of alcohol as an opportunity for suicide prevention. Alcohol control policies may cause immediate effect on excessive alcohol consumption at both the population and individual-level and may be capable of impacting suicide mortality rates by altering alcohol use patterns at both domains. Implementation of alcohol taxation policy in Lithuania provided an opportunity to evaluate it‘s impact on suicide mortality in a country comparable to other high income countries with a comparable health care and medical education systems.Disclosure of InterestNone Declared

Predictive Factors for the Necessity of Hospitalization of Patients With Acute Alcohol Intoxication.

The aim of the study was to identify factors related to the need for hospitalization due to acute alcohol intoxication. The data of 42 patients with acute alcohol intoxication who visited our hospital from April 1, 2014 to September 30, 2015 were available for analysis. Factors related to outcome included hospitalization or release to home, Glasgow coma scale (GCS), temperature, pulse rate, blood pressure, oxygen saturation of the peripheral artery (SpO2), and respiratory rate. A retrospective survey was done that included estimated blood alcohol concentration, osmotic pressure, and serum lactate level. The following formula was used to estimate blood alcohol concentration: (measured osmotic pressure - estimated osmotic pressure × 4.6 mg/dL). Univariate analysis of each variable was done for the two outcome groups, hospital admission or release to home, then statistically significant items were subjected to multivariate analysis. Of the 42 patients (average age 22.8 ± 8.6 years, 33 men, six women), 29 were admitted and 13 were released to home. There was a weak correlation between estimated blood alcohol concentration and GCS. There was no significant difference in alcohol concentration or GCS between the hospitalized and released to home groups. In multivariate analysis using the outcome as the objective variable, a serum lactate level of 26 mg/dL or higher was associated with the need for hospitalization (odds ratio: 6.7). A serum lactate level of 26 mg/dL would be useful for deciding if hospitalization is necessary for patients with acute alcohol intoxication.

Comparative evaluation of toxicology and sociodemographic characteristics in homicide and suicide victims

Background/Aim. Suicide and homicide are crucial social problems, especially frequent among the population younger than 40 years. The aim of this study was to assess the influence of different sociodemographic factors and relevant psychoactive substances on the difference between homicide and suicide victims. Methods. A cross-sectional study analyzed autopsy reports of 714 suicide and 166 homicide cases autopsied in five years (2011?2016). Out of these, 666 suicide and 127 homicide cases met the inclusion criteria for this study. Blood-ethanol concentration was determined by headspace gas chromatography with flame ionization detection. Analysis of substances other than ethanol was accomplished by gas chromatography-mass spectrometry and liquid chromatography with tandem mass spectrometry. Results. There was a significant difference in age, level of education, and employment rate between suicide and homicide cases (p &lt; 0.05). The distribution of suicide and homicide cases differed significantly on weekdays compared to week-ends [odds ratio(OR) = 1.5; 95 % confidence interval (CI) = 1?2.3; p &lt; 0.05]. The presence of a psychoactive substance remained a nonsignificant predictor of whether a person would become a homicide or suicide victim (p &gt; 0.05). Homicide victims were more likely to have significantly higher blood alcohol concentration (0.2?0.3 g/dL) than suicide victims (OR = 2.2; 95 % CI = 1?5; p &lt; 0.05). Conclusion. The age, level of education, employment status, and high blood alcohol concentration (0.2?0.3 g/dL) of the victim were significantly different between suicide and homicide cases.

Mental and Physical Symptoms of Alcohol Hangover

Alcohol hangover can be defined as the combination of mental and physical symptoms that are experienced the day after an episode of heavy alcohol drinking, launching when blood alcohol concentration approaches zero and characterized by the constellation of unpleasant physical and mental symptoms that occur after heavy alcohol drinking. Significant changes observed on endocrine parameters (elevated concentrations of vasopressin, aldosterone, and renin) and metabolic acidosis (lowered blood potential hydrogen values due to elevated concentrations of lactate, ketone bodies, and free fatty acids) occurred during hangover and eventually causes dehydration and symptoms such as dry mouth and thirst. Females have more body fat and less water than men of the same body weight. Since alcohol is dispensed in body water, women reach higher blood alcohol concentrations levels than men despite consuming an identical number of alcohol units. Alcohol gets metabolized to an intermediate product, acetaldehyde, by the enzyme alcohol dehydrogenase, and then acetaldehyde is converted to acetate by a second enzyme aldehyde dehydrogenase. Acetaldehyde at higher concentrations causes toxic effects, such as rapid pulse, sweating, skin flushing, nausea, and vomiting. In most people, aldehyde dehydrogenase metabolizes acetaldehyde quickly and efficiently, so that this intermediate metabolite does not accumulate in high concentrations.

On Detecting Drunk Drivers in Mixed Autonomous Platoons Using Vehicles Velocity Measurements

Drunk drivers, who critically and continuously threaten road safety, are usually detected using biological sensors within the same vehicle or after drunk driving behavior is observed by police patrols. Observing an obvious drunk driving behavior indicates a relatively high blood alcohol concentration, and thus, detecting drunk drivers with a relatively low blood alcohol concentration is difficult. This study uses output-only measurements available from motion sensors in the longitudinal drive of mixed autonomous and human-driven platoons to detect drunk drivers’ behavior in human-driven vehicles within the same platoon. The human-driven vehicle is assumed to be between two autonomous vehicles that are able to share information with each other. The proposed approach relates a set of motion sensor measurements with another within the platoon and does not require the knowledge of the excitation signal or the dynamics of the platoon. Numerical simulations are first implemented to test the proposed approach, and then, VISSIM software is implemented to simulate realistic road topography. Further validations on laboratory mobile robots are presented in this article, where a class of abnormal driving conditions that includes human-driven vehicles is simulated. Experiments are carried out by measuring abnormal human-driven vehicles within connected autonomous robots. This method is shown to deal with various system uncertainties, and the approach can deal with the drunk driver case. The drunken driving conditions are modeled mathematically with different blood alcohol concentration levels, which correspond to different effects and different drunk driving behaviors. The proposed transmissibility-based drunk driver detection algorithm is shown to detect drivers with risky relatively low alcohol concentrations.

Preloading, exit intoxication related to energy drink usage, and gender differences within night-time entertainment districts for young people

BackgroundGovernments frequently introduce legislation to reduce drunkenness and violence in night-time entertainment districts (NEDs). However, there is no study which has looked at inebriation of a large sample of young people exiting a NED. We investigated Breath Approximated Blood Alcohol Concentration (BrAC; grams per decilitre, g/dl) levels as people left Brisbane (Australia) NEDs and measured the effects of preloading, energy drink usage, time of night and gender differences on exit intoxication. MethodsWe systematically assessed patrons between November 2015 to March 2019 by administering surveys and breathalysing them as they exited the NEDs. We then analysed only those under the age of 26 years old (n = 3,211) as there was a natural break in the data on energy drink usage for those aged over 25 years old. FindingsThis study found that young drinkers leave the NED with an average BrAC of 0.094 g/dl. Consistent with hypotheses, the exit BrAC was significantly and meaningfully higher in preloaders (medium effect size). These preloaders also came into the NEDs later but stayed for the same length of time as non-preloaders. BrAC levels did not significantly differ for those who did or did not use energy drinks during the night. As predicted, gender was not associated with a meaningful difference in alcohol intoxication and consumption. The time of night that patrons were interviewed was positively associated with inebriation levels, however, this association was small (r ≈ 0.1). DiscussionWith preloading being such a strong predictor for end of night intoxication, and length of time spent in the NED equal between those who do or do not preload, we suggest that to have people less inebriated, they should be encouraged into the NED earlier rather than focusing on their leaving time.

S3412 Functional Medicine Approach to Care Improves Quality of Life and Blood Alcohol Levels in a Patient With Autobrewery Syndrome

Introduction: Autobrewery syndrome, or gut fermentation syndrome (GFS), is a rare condition characterized by elevated blood alcohol concentration (BAC) in the absence of alcohol consumption. Treatment involves antifungals and a low carb diet, which are often ineffective. In this case, we describe a patient with GFS who failed traditional therapy, was unable to complete activities of daily living due to high BAC, and responded well to a functional medicine approach to care with sustained improvement in BAC. Case Description/Methods: In 7/2020, a 58-year-old man with T2D, obesity, HTN and gout developed recurrent episodes of dysarthria, behavioral changes, and somnolence. On multiple occasions in the ER, his BAC level was found to be elevated. The patient and family denied alcohol use. He was ultimately diagnosed with GFS. He self-initiated a strict low-carb diet with initial success in controlling his BAC from 11/2020 to 12/2020. From 10/2020 to 10/2021, he underwent multiple courses of antifungal medications (nystatin, fluconazole, micafungin, and oral amphotericin). The longest period of remission (BAC 0) was 41 days while on micafungin. After 41 days on micafungin and a restricted diet, his BAC increased. Over this time, he lost 80 lbs. In 11/2021, he established with a functional medicine GI and dietitian. Stool metabolomics showed no obvious abnormalities. The 5 R protocol (remove, replace, repair, reinoculate, rebalance) was introduced. He started with an aggressive bowel regimen with prucalopride and lactulose. He completed 15 days of high-potency Bacillus subtilis probiotic, followed by a transition to a more diverse probiotic. He added daily intake of a medical food to his restricted diet. New foods were then introduced, one at a time, in the evening, with subsequent monitoring of BAC. In 2/2022, he started Undecylenic acid (10-Undecenoic Acid) as fatty acid support. Lifestyle modifications were added to emphasize more exercise, daily outdoor walks, optimal sleep, and decreasing stress. He did well until BAC levels spiked in 3/2022 due to consumption of alcohol, triggered by cravings that developed when the gut production of alcohol decreased. After alcohol cessation, BAC levels have remained undetectable for 60+ days with continued diet modifications and supplements (Figure). Discussion: GFS is difficult to treat with minimal traditional treatment options. This case is a patient with GFS that failed all medical options and is now thriving after a functional medicine approach to care.Figure 1.: BAC levels continued to spike with medical therapies and have sustained improvement with functional medicine care.

A Smart Wristband Integrated with an IoT-Based Alarming System for Real-Time Sweat Alcohol Monitoring.

Breathalyzer is a common approach to measuring blood alcohol concentration (BAC) levels of individuals suspected of drunk driving. Nevertheless, this device is relatively high-cost, inconvenient for people with limited breathing capacity, and risky for COVID-19 exposure. Here, we designed and developed a smart wristband integrating a real-time noninvasive sweat alcohol metal oxide (MOX) gas sensor with a Drunk Mate, an Internet of Thing (IoT)-based alarming system. A MOX sensor acquired transdermal alcohol concentration (TAC) which was converted to BAC and sent via the IoT network to the Blynk application platform on a smartphone, triggering alarming messages on LINE Notify. A user would receive an immediate alarming message when his BAC level reached an illegal alcohol concentration limit (BAC 50 mg%; TAC 0.70 mg/mL). The sensor readings showed a high linear correlation with TAC (R2 = 0.9815; limit of detection = 0.045 mg/mL) in the range of 0.10–1.05 mg/mL alcohol concentration in artificial sweat, achieving an accuracy of 94.66%. The sensor readings of ethanol in water were not statistically significantly different (p > 0.05) from the measurements in artificial sweat and other sweat-related solutions, suggesting that the device responded specifically to ethanol and was not affected by other electrolytes in the artificial sweat. Moreover, the device could continuously monitor TAC levels simulated in real-time in an artificial sweat testing system. With the integration of an IoT-based alarming system, the smart wristband developed from a commercial gas sensor presented here offers a promising low-cost MOX gas sensor monitoring technology for noninvasive and real-time sweat alcohol measurement and monitoring.

Alcohol Intoxication Is Associated With Bladder Injury and Bladder Surgical Repair in Patients Sustaining Motor Vehicle Collisions.

Alcohol intoxication is a known risk factor for motor vehicle collisions. We hypothesize ethanol intoxication increases the risk of bladder injury and surgical repair, especially at higher blood alcohol content levels. We identified all patients involved in motor vehicle collisions from the National Trauma Data Bank from 2017-2019. Patients were categorized into an intoxication and intoxication negative group. Variables collected included age, sex, blood alcohol content level, driver status, seat belt restraint use, nonalcoholic intoxication, pelvic fracture, and Injury Severity Scale. Primary outcome measures of bladder injury and bladder surgical repair were assessed and interaction with pelvic fracture and restraint use were measured. We identified 594,484 patients and 97,831 (16.5%) had a positive alcohol screen. Patients in the intoxication group were more likely to be intoxicated with other substances (32.8% vs 14.6%, P < .001), have a bladder injury (1% vs 0.4%, P < .001) and receive bladder surgical repair (0.7% vs 0.15%, P < .001). Injury Severity Scale and pelvic fracture were statistically significant predictors of bladder injury. In adjusted analysis, higher blood alcohol content was associated with both outcomes. Above the legal limit, alcohol intoxication was more predictive of bladder surgical repair than pelvic fracture. The association of alcohol intoxication with both outcomes did not differ by pelvic fracture, but strengthened with seat belt use at higher intoxication levels. Alcohol intoxication is independently associated with increased risk of bladder injury and subsequent bladder surgical repair following motor vehicle collisions. Trauma providers should have a high index of suspicion for bladder injuries in alcohol intoxicated patients, particularly those using seat belt restraints.