Blood Alcohol Research Articles

Blood alcohol concentration and road accidents: Underestimation due to time of the arrival to the emergency department (ED) or delay in blood sampling. A 4-Year Retrospective Study in Rome.

Alcohol is a significant public health issue, according to the World Health Organization. Our study aims to analyze the correlation between blood alcohol concentrations (BACs) of drivers, their demographic features, and the possible underestimation of BACs due to the time elapsed between hospital admission and blood sampling. Methods: This study includes patients evaluated for BAC levels in the emergency department (ED) of Fondazione Policlinico Universitario A. Gemelli IRCCS from January 2013 to December 2016. BAC levels were compared in patients involved in road crashes according to age group, sex, and time of the accident. The delays in blood sampling and BAC measurement in the ED were recorded for each patient. The time between the accident and access to the hospital in most cases was unknown. Results: A total of 398 patients were included in the analysis, 107 of them had BACs more than 0.05 g/L., and 86 of these individuals had BAC levels more than 0.5 g/L. Road accident patients had higher rates of positive BAC readings at night and on weekends. A significant delay in blood sampling for BAC determination was observed. Discussion: This study demonstrates a critical bias due to the arrival time at the ED and the delay in blood sampling that inevitably influences and underestimates the BAC, resulting in possible false negative results (BAC values below the cutoff). Zero tolerance or a retrospective BAC calculation could mitigate this bias. It is necessary to implement preventive strategies to reduce instances of driving under the influence (DUI) of alcohol.

The Impact of Acetic Acid on Measuring Ethanol Concentrations in Water and Human Serum Using Short-Wave Infrared Spectroscopy.

Ethanol intoxication, although an elemental part of life in many places around the world, still presents several issues associated with excessive consumption. These issues range from drunk driving, violence, and antisocial behavior to self-harm, all exerting an increased cost on the society. Monitoring of intoxication levels can help to limit the impact of these issues by preventing the use of automobiles or heavy machinery and personal monitoring. Previous works on noninvasive measurement of ethanol tissue concentration for estimation of blood alcohol concentration (BAC) performed worst during the first hour of intoxication. Gas chromatography research of intoxication shows that levels of acetic acid rise together at a similar rate as those of ethanol after initial imbibement. In this research, short-wave infrared (SWIR) spectroscopy was utilized with the aim of establishing the interaction between ethanol and acetic acid in water and serum mixtures. The most consistent and clear correlation between ethanol and acetic acid was recorded at 2262 and 2302 nm wavelengths. Partial least-squares (PLS) analysis indicates that the most effective region for consideration in measurement of ethanol is the therapeutic window four (IV) due to high variance in vibration of carbon bonds. The behavior of spectra at different concentration ranges was examined and described in detail in relation to the consequence of alcohol measurement. The investigation concluded that ethanol shows distinctive regions of absorbance at wavelengths of 2262 and 2302 nm, with variations arising from increasing concentrations of acetic acid, whilst also showing that therapeutic window four is amongst the most influential regions of the spectrum for SWIR.

Prevalence of alcohol and drugs among drivers killed in road traffic crashes in Norway during 2011–2020

Objective Driving under the influence of alcohol or drugs is one of the main contributing causes of serious road traffic crashes (RTCs). This study aimed to investigate the involvement of alcohol and drugs in driver fatalities in Norway during 2011–2020 and compare the findings with data from the previous decade. Methods We linked the results of forensic toxicology testing for alcohol and the 17 most commonly used drugs assigned with legal limits with data on fatal road traffic crashes obtained from Statistics Norway and the Norwegian Public Roads Administration. Results The number of fatalities had decreased significantly since the previous decade, while the proportion of drivers and riders tested for alcohol and drug use increased. Blood alcohol concentrations at the legal limit or higher were found in 14.4% and psychoactive drugs were detected in 15.8% of the cases; 10.7% tested positive for illicit drugs, and 10.1% for medicinal drugs. The most prevalent illicit drugs were tetrahydrocannabinol (7.9%) and amphetamine/methamphetamine (4.7%), whereas the most prevalent medicinal drugs were clonazepam (3.7%) and diazepam (2.2%). Conclusions There was a marked reduction in the number of motor vehicle drivers killed in RTCs compared with the previous decade, and also a reduction in the prevalence of alcohol. For other substances, there were no marked changes in the prevalence.

Differential effects of UPPS-P impulsivity on subjective alcohol response and craving: An experimental test of acquired preparedness.

Recent studies have extended the acquired preparedness model to experimental data, finding that impulsivity predicts subjective alcohol response, a related yet distinct construct from expectancies. However, studies have not tested whether specific facets of impulsivity predict subjective response, or whether impulsivity indirectly predicts alcohol craving through subjective response. Young adults who reported past-month binge drinking (N = 448) participated in a placebo-controlled alcohol administration study. Mediation models tested whether UPPS-P impulsivity facets indirectly predicted alcohol craving through subjective response on the ascending and descending limbs of the blood alcohol content (BAC). High arousal positive (e.g., sociable), low arousal positive (e.g., relaxed), high arousal negative (e.g., rude), and low arousal negative (e.g., dizzy) subjective effects were measured across limbs. Moderation by beverage condition was not detected, so models were collapsed across beverage condition. Sensation seeking indirectly predicted craving through high arousal positive subjective response on both limbs, whereas positive and negative urgency directly predicted craving. When controlling for baseline subjective response and craving, effects of sensation seeking and negative urgency on subjective response and craving became nonsignificant. The effects of positive urgency on craving remained, and an effect of positive urgency on high arousal positive effects emerged on the ascending limb. Findings suggest that relations among impulsivity, subjective response, and craving are contingent upon the specific facet of impulsivity. Interventions targeting predrink cue exposure and/or positive emotionality may be most effective for sensation seekers, whereas targeting subjective response and/or expectancies may be most efficacious for individuals high in positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Perception of Alcohol Use and Alcohol Use Disorder among Persons Involved in Road Accidents at an Emergency Department: A Cross-Sectional Study.

Alcohol plays a significant role in road traffic accidents in Ghana. However, little is known about the perspectives of victims who suffer road traffic accidents, RTAs, and the extent to which alcohol use disorder is involved. We conducted a three-month cross-sectional study in a teaching hospital involving 102 patients involved in a road accident and presented to the hospital's emergency. The Alcohol Use Disorder Identification Test, AUDIT, was used to assess for Alcohol Use Disorder, AUD, at a score of 8. In addition, we used open-ended questionnaires to assess their perception of alcohol use and road accidents. Of the 102 respondents, 75% were males, and 60% were between 15 and 35 years old. About 69% of respondents admitted to using alcohol, while 31%, including a single female, screened positive for alcohol use disorder. A significant majority of about 90% of respondents believed in some myths of alcohol use in Ghana, and a similar percentage were aware of the risks alcohol use posed to road use. Over 30% of respondents, mainly drivers or riders, had used alcohol within 12 hours of the accident. All but three respondents knew alcohol-induced aggression and poor coordination of movements. A similar number of respondents knew alcohol made people cross roads carelessly and were hyperactive or disinhibited. Alcohol use and alcohol use disorder are significantly high among persons presenting with RTA to the emergency. Knowledge of the deleterious effects of alcohol is high, yet their behavior did not reflect the knowledge. Therefore, a significant reduction in RTA can be achieved by enforcing blood alcohol concentration limits for road users and intensive education to the populace.

Interspecies and regional variability of alcohol action on large cerebral arteries: regulation by KCNMB1 proteins.

Alcohol intake leading to blood ethanol concentrations (BEC) ≥ legal intoxication modifies brain blood flow with increases in some regions and decreases in others. Brain regions receive blood from the Willis' circle branches: anterior, middle (MCA) and posterior cerebral (PCA), and basilar (BA) arteries. Rats and mice have been used to identify the targets mediating ethanol-induced effects on cerebral arteries, with conclusions being freely interchanged, albeit data were obtained in different species/arterial branches. We tested whether ethanol action on cerebral arteries differed between male rat and mouse and/or across different brain regions and identified the targets of alcohol action. In both species and all Willis' circle branches, ethanol evoked reversible and concentration-dependent constriction (EC50s ≈ 37-86 mM; below lethal BEC in alcohol-naïve humans). Although showing similar constriction to depolarization, both species displayed differential responses to ethanol: in mice, MCA constriction was highly sensitive to the presence/absence of the endothelium, whereas in rat PCA was significantly more sensitive to ethanol than its mouse counterpart. In the rat, but not the mouse, BA was more ethanol sensitive than other branches. Both interspecies and regional variability were ameliorated by endothelium. Selective large conductance (BK) channel block in de-endothelialized vessels demonstrated that these channels were the effectors of alcohol-induced cerebral artery constriction across regions and species. Variabilities in alcohol actions did not fully matched KCNMB1 expression across vessels. However, immunofluorescence data from KCNMB1-/- mouse arteries electroporated with KCNMB1-coding cDNA demonstrate that KCNMB1 proteins, which regulate smooth muscle (SM) BK channel function and vasodilation, regulate interspecies and regional variability of brain artery responses to alcohol.

Improving performance on night shift: a study of resident sleep strategies.

To identify sleep strategies of internal medicine residents transitioning to night shift and report their effect on performance. Residents logged hours of sleep and work starting 3 days prior to the first night shift and continuing through the next 8 days. Cohorts were defined by sleep logs and compared separately by transition strategy, total hours of sleep, amount of sleep occurring at work, weekend sleep schedule, and residency training year. Data from logs were entered into the Fatigue Avoidance Scheduling Tool to measure predicted Performance Effectiveness (PE) during each night shift. Twenty-three residents were evaluated. The Sleep Banking transition strategy (n = 2) had higher PE (mean = 88.6%) than all other sleep strategies combined (n = 21, mean = 80.9%; P = .016). Additionally, residents who slept an average of 8-9 hours daily during their week of night shifts had a higher mean PE compared to those who slept < 6 hours (86.8% vs 78.6%; P = .014). Residents who engaged in Sleep Banking prior to the first night shift had higher PE and spent less time above a 0.05% blood alcohol concentration equivalent compared to all other strategies. Similarly, PE and time spent above a 0.05% blood alcohol concentration equivalent improved with increased average hours slept per day during the week of night shifts. Optimizing performance on night shift through the adoption of efficacious sleep strategies is imperative to mitigate patient safety issues that may result from poor alertness and cognitive abilities. Cushman P, Scheuller HS, Cushman J, Markert RJ. Improving performance on night shift: a study of resident sleep strategies. J Clin Sleep Med. 2023;19(5):935-940.

The Self-Rated Effects of Alcohol Are Related to Presystemic Metabolism of Alcohol.

A high number of alcohol units required to feel a subjective effect of alcohol predicts future alcohol use disorders (AUDs). The subjective response to alcohol can be measured using the validated retrospective self-rated effects of alcohol (SRE) questionnaire. Few studies have investigated the specific relationship between SRE and blood alcohol concentration (BAC) in an experimental setting. Twenty healthy young adult male volunteers who had experience with binge drinking, but did not have AUD, filled out the SRE-questionnaire and were served with a fixed amount of alcohol per body weight. BACs were measured throughout a 12-hour period, reaching a maximum BAC of ~0.13%. Median split of SRE-scores was utilized to compare BACs among participants with relatively high effects (low SRE) and relatively low effects (high SRE) of alcohol. Participants reporting a relatively low SRE-score had a statistically significant higher measured BAC at all time points until alcohol was eliminated. This was especially pronounced during the first 2 hours after alcohol (P = 0.015) without a significant difference in the alcohol elimination rate being detected. The study indicates that a self-ated SRE-score is related to BACs after the ingestion of a standardized amount of alcohol per body weight. Reporting a higher number of alcohol units before feeling an effect was related to a lower BAC. As the differences in BAC between relatively high and low self-rated effects appeared rapidly after intake, this could be interpreted as an effect of presystemic metabolism of alcohol.

Elevated creatinine kinase levels amongst Dutch adolescents with acute alcohol intoxication

This study aims to explore the prevalence of creatinine kinase elevation amongst a sample of Dutch adolescents admitted for acute alcohol intoxication. The data on all admitted adolescents < 18 years old with acute alcohol intoxication between 2008 and 2021 were collected from a Dutch major district general hospital, Reinier de Graaf Gasthuis, in Delft. Overall, 495 adolescents who were treated for symptoms of acute alcohol intoxication during this period were included in the study. When evaluating the blood samples of the included patients, elevated creatinine kinase levels were found in 60% of the cases, with a mean of 254 U/I (normal value ≤ 145 U/I). A confirmed diagnosis of rhabdomyolysis (increase in CK > fivefold the upper limit of normal) was present in 4.4% of cases. Moreover, using a linear regression this study found that a higher blood alcohol concentration was associated with higher creatinine kinase levels, when adjusted for positive drug screenings amongst the adolescents with acute alcohol intoxication (p = 0.027; β = 66.88; 95% CI 7.68 − 126.08). Conclusions: This is the first study focusing on how acute alcohol intoxication affects adolescents’ muscle tissue. The results could potentially help to prevent alcohol use within the sports world. It could also aid understanding of how acute alcohol intoxication influences the breakdown of adolescents’ muscle tissue.What is Known:• Alcohol, alongside pharmaceutical agents and illicit drugs, is a significant cause of rhabdomyolysis (increase in creatinine kinase > fivefold the upper limit of normal).• Creatinine kinase elevation in alcohol intoxicated patients may be as a result of direct “muscular” toxicity” (myotoxicity) or from prolonged immobilization and ischemic compression induced by coma.What is New:• Our retrospective cohort study is a pioneer in addressing the effect of acute alcohol intoxication amongst adolescents (< 18 years) upon muscle tissue (creatinine kinase level) within a large population. When evaluating the blood samples of the included population, elevated creatinine kinase levels were found in 60% of the cases, with a mean of 254 U/I (normal value ≤ 145 U/I).• There is an association between alcohol intoxication and elevated creatinine kinase levels amongst adolescents. Future research is needed to further understand the pathophysiology and causality of this interaction.

Lipidomic changes of cerebral cortex in aldehyde dehydrogenase-2 knock-in heterozygote mice after chronic alcohol exposure.

Alcohol is the main legal drug in the world, and excessive consumption of alcohol seriously damages the morphological structure and function of various organs. The insufficiency of an essential enzyme in ethanol metabolism, aldehyde dehydrogenase-2 (ALDH2), will aggravate the alcohol-induced brain injury. The effect of ALDH2 after chronic alcohol exposure on global lipid profiling of the brain remains unclear. In this study, ALDH2*2 knock-in mice were fed the Lieber-DeCarli liquid diet containing ethanol for 8 weeks. Blood alcohol and acetaldehyde levels were examined, and the mice were tested through novel object recognition and the Y-maze test to evaluate cognitive impairment toward the end of the study. The lipidome profiling of cerebral cortex samples was investigated using a lipidomics method based on ultra-high performance liquid tandem chromatography quadrupole time of flight mass spectrometry (UHPLC-QTOFMS). Compared with similarly treated wild-type (WT) mice, ALDH2*2 mice exhibited poor cognitive performance, though the result did not achieve statistical significance. The lipidomics results indicated that 74 differential lipid species were selected in WT mice, of which 57 species were up-regulated, and 17 were down-regulated. Moreover, 99 differential lipids were identified in ALDH2*2 mice, of which 73 were up-regulated, and 26 were down-regulated. For ALDH2*2 mice, the number of changed significantly glycerophospholipids (GPs) subtypes was lower than that of WT mice. Interestingly, compared with WT mice, a lower proportion of polyunsaturated fatty acids (PUFAs) was found in ALDH2*2 mice. Collectively, the results provide clear evidence for a lipidomic signature of marked changes in the cerebral cortex of ALDH2*2 mice after chronic alcohol exposure. • The cerebral cortex of heterozygous ALDH2*2 mice showed more significant changes in lipidome profiles after chronic alcohol exposure than wild-type mice.• Most lipids were significantly up-regulated in both groups of mice, whereas the increase in TAG was restricted to WT mice.• For ALDH2*2 mice, GPs substances changed significantly, and SHexCer and SM subclasses in sphingolipids also deserved attention.

Interstrain differences in adolescent fear conditioning after acute alcohol exposure

Adolescent sensitivity to alcohol is a predictor of continued alcohol use and misuse later in life. Thus, it is important to understand the many factors that can impact alcohol sensitivity. Data from our laboratory suggested that susceptibility to alcohol-associated contextual fear learning deficits varied among adolescent and adult mice from two mouse strains. To investigate the extent of genetic background’s influences on adolescent learning after alcohol exposure, we examined how 9 inbred mouse strains differed in vulnerability to alcohol-induced contextual and cued fear conditioning deficits. We demonstrated significant strain- and sex-dependent effects of acute alcohol exposure on adolescent fear learning, with alcohol having most pronounced effects on contextual fear learning. Female adolescents were more susceptible than males to alcohol-induced impairments in contextual, but not cued, fear learning, independent of genetic background. Heritability for contextual and cued fear learning after alcohol exposure was estimated to be 31 % and 18 %, respectively. Learning data were compared to Blood Ethanol Concentrations (BEC) to assess whether strain differences in alcohol metabolism contributed to strain differences in learning after alcohol exposure. There were no clear relationships between BEC and learning outcomes, suggesting that strains differed in learning outcomes for reasons other than strain differences in alcohol metabolism. Genetic analyses revealed polymorphisms across strains in notable genes, such as Chrna7, a promising genetic candidate for susceptibility to alcohol-induced fear conditioning deficits. These results are the first to demonstrate the impact of genetic background on alcohol-associated fear learning deficits during adolescence and suggest that the mechanisms underlying this sensitivity are distinct from alcohol metabolism.

Risk factors associated with 1-week revisit among emergency department patients with alcohol withdrawal

Approximately one-quarter of emergency department (ED) visits for alcohol withdrawal result in unscheduled 1-week ED return visits, but it is unclear what patient and clinical factors may impact this outcome METHODS: From January 1, 2015, to December 31, 2018, at three urban EDs in Vancouver, Canada, we studied patients who were discharged with a primary or secondary diagnosis of alcohol withdrawal. We performed a structured chart review to ascertain patient characteristics, ED treatments, and the outcome of an ED return within 1week of discharge. We used univariable and multivariable Bayesian binomial regression to identify characteristics associated with being in the upper quartile of 1-week ED revisits. We collected 935 ED visits among 593 unique patients. Median age was 45years (interquartile range 34 to 55years) and 71% were male. The risk of a 1-week ED revisit was 15.0% (IQR 12.3; 19.5%). After adjustment, factors independently associated with a high risk for return included any prior ED visit within 30days, no fixed address, initial blood alcohol level > 45mmol/L, and initial Clinical Institute Withdrawal Assessment-alcohol revised score > 23. These factors explained 41% of the overall variance in revisits. Among discharged ED patients with alcohol withdrawal, we describe high-risk patient characteristics associated with 1-week ED revisits, and these findings may assist clinicians to facilitate appropriate discharge planning with access to integrated follow-up support.

Unhelmeted Riding, Drunk Riding, and Unlicensed Riding among Motorcyclists: A Population Study in Taiwan during 2011-2016.

This study aimed to investigate the association between drunk riding, unhelmeted riding, unlicensed riding, and running-off-road (ROR) crashes. Multiple logistic regression was used to calculate the adjusted odds ratio (AOR) by using the National Taiwan Traffic Crash Dataset for 2011-2016. The results revealed that unhelmeted riding was associated with 138% (AOR = 2.38; CI (confidence interval) = 2.34-2.42) and 47% (AOR = 1.47; CI = 1.45-1.49) higher risks of drunk riding and unlicensed riding, respectively. The risk of unhelmeted riding increased with blood alcohol concentrations (BACs), and riders with the minimum BAC (0.031-0.05%) had nearly five times (AOR = 4.99; CI = 4.74-5.26) higher odds of unlicensed riding compared with those of riders with a negative BAC. Unhelmeted riding, drunk riding, and unlicensed riding were associated with 1.21 times (AOR = 1.21; CI = 1.13-1.30), 2.38 times (AOR = 2.38; CI = 2.20-2.57), and 1.13 times (AOR = 1.13; CI = 1.06-1.21) higher odds of ROR crashes, respectively. The three risky riding behaviours (i.e., unhelmeted riding, drunk riding, and unlicensed riding) were significantly related to ROR crashes. The risk of unhelmeted riding and ROR crashes increased with BACs.

Stigma and the Couple: How Daily Stigma Experiences Influence Relationship Functioning and Alcohol Use in Female Cisgender Couples.

Minority stress is the leading explanation for sexual minority women's (SMW) higher rates of, and heavier, alcohol use compared to heterosexual women. Little is known about how both partners' sexual minority stressors impact alcohol consumption in a dyadic context, and even less research has considered these effects at the day-level. This study utilizes dyadic daily diary data to test associations of each partner's sexual minority stress events with drinking outcomes (day-level alcohol use, heavy episodic drinking [HED], and estimated blood alcohol content [eBAC]) among women in same-gender relationships (N = 159 couples). Because high-quality relationships may buffer adverse effects of minority stress on alcohol use outcomes, effect modification was also considered. Results differed across alcohol use outcomes. One's own experience of sexual minority stress was associated with one's own greater odds of drinking that day, OR = 1.33, 95% CI 1.10, 1.61, p = .003, whereas one's partner's experience of sexual minority stress was associated with greater odds of same-day HED, OR = 1.60, 95% CI 1.24, 2.01, p < .001 (no significant effects emerged for eBAC). Relationship functioning was associated with lower eBAC only, B = -0.01, 95% CI -0.01, -0.00, p = .031. No significant effect modification emerged. This initial exploration of how both partners' exposure to sexual minority stressors impact SMW's alcohol use demonstrates nuanced effects across different alcohol outcomes, and is among the first to demonstrate some degree of sexual minority stress contagion on HED.

Оцінка виживання за методом Каплана-Майєра серед пацієнтів з отруєннями опіоїдними наркотиками, ускладненими гострим пошкодженням нирок

RESUME. Despite the fact that opioids do not have direct nephrotoxicity, a significant overdose, or their combination with alcohol and other psychotropic substances, contributes to the development of critical changes in many organs and systems of the body, which leads, in particular, to acute kidney injury (AKI). Aim. Using comparative analysis and the Kaplan-Meier method, to investigate the survival rates of patients with opioid drug poisoning complicated by acute respiratory distress syndrome treated with hemodialysis. Materials and Methods. A cohort retrospective analysis of the medical data of 128 patients (107 men, 21 women) aged 18 to 39 years who received treatment in the intensive care and extracorporeal detoxification department of the "Kyiv City Emergency Hospital" in the period 2017–2021 with a diagnosis of "Acute drug poisoning" (МКХ-10:Т40.0-Т40.3), complicated by the development of acute renal failure. Statistical analysis of the study results was performed using the Kaplan-Meier survival estimate; p≤0.05; the statistical analysis application package from Microsoft Excel 2019 was used. Results. Kaplan-Meier graphs indicated that patients with AKI due to morphine, heroin, and methadone poisoning have a statistically significant difference in survival rates (p &lt; 0.05). The highest survival rates were shown by patients with morphine poisoning (100 %), the lowest were in groups with methadone (82.7 %) and heroin poisoning (48.3 %). Kaplan-Meier curves showed that all deaths occurred within 3–18 days of starting treatment, with most deaths (90 %) occurring within 3–12 days. Cumulative survival rates among patients with methadone-induced AKI stratified by blood alcohol content showed that among patients with methadone poisoning where alcohol was not detected, the survival rate was 100 %, and among patients with combined methadone and alcohol poisoning it was 75.2 %. Conclusions. Despite the similarity of the clinical picture in poisoning with natural and synthetic opioids (opioid syndrome), the causes of development of AKI and its course differ in patients with poisoning by different groups of drugs. Survival rates among patients with methadone poisoning are adversely affected by the presence of alcohol in the blood. Key Words: combined drug poisoning, renal failure.

One and ahalf years of e-scooters in Hamburg

Since electric scooters were introduced as an urban means of transportation in Hamburg in June 2019, ahigh number of violations of the current laws regarding alcohol consumption by e‑scooter riders have been recorded. The aim of this study is to obtain an overview of traffic offences committed by e‑scooter drivers under the influence of alcohol, to classify their relevance in relation to other road user groups, and to draw afirst interim balance with respect to their frequency after 1.5 years. The data of all e‑scooter drivers (n = 342) examined concerning their blood alcohol values analyzed at the Institute of Legal Medicine of the University Medical Centre Hamburg-Eppendorf between 15.06.2019 and 31.12.2020 were retrospectively evaluated with respect to their demographic information and the medical examination results. These were brought into context with the total number of offences against the road traffic regulations with subsequent blood alcohol measurement. 9.6% of the total number of offences against the road traffic regulations in connection with subsequent determination of the blood alcohol concentration were committed by e‑scooter drivers. 87.7% of those examined were male. The blood alcohol concentration was above the limit of 1.10 ‰ for absolute driving incapacity when using apassenger car in 76.9% of those examined. An accumulation of cases was particularly noticeable at night and at weekends.Due to imprecise records, acertain number of unreported e‑scooter incidents can be assumed among the unspecified motor vehicles. As e‑scooter drivers make up aconsiderable proportion of drunken road users and the accidents mostly occur at night and at weekends, increased education and, if necessary, adriving ban at these times would seem to make sense.

Excessive Ethanol Intake in Mice Does Not Impair Recovery of Torque after Repeated Bouts of Eccentric Contractions.

Alcoholics develop muscle atrophy and weakness from excessive ethanol (EtOH) intake. To date, most research has examined outcomes of alcohol-induced atrophy and weakness under basal or unstressed conditions despite physical stress being a normal occurrence in a physiological setting. Therefore, this study set out to determine if recovery of torque is impaired after repetitive bouts of physical stress in skeletal muscle during excessive short-term (experiment 1) and long-term (experiment 2) EtOH consumption. Twenty male and female mice were assigned to receive either 20% EtOH in their drinking water or 100% water. Short- and long-term consumption was predetermined to be EtOH intake starting at 4 and 26 wk, respectively. Anterior crural muscles performed repeated bouts of physical stress using in vivo eccentric contractions, with tetanic isometric torque being measured immediately pre- and postinjury. A total of 10 bouts were completed with 14 d between each bout within bouts 1-5 (experiment 1) and bouts 6-10 (experiment 2), and 12 wk between bouts 5 and 6. Mice consuming EtOH had blood alcohol concentrations up to 270 mg·dL -1 . In experiment 1, five bouts of eccentric contractions did not reduce recovery of torque, regardless of sex or EtOH treatment ( P ≥ 0.173). Similarly, in experiment 2, preinjury torques did not differ from day 14 values regardless of sex or treatment ( P ≥ 0.322). However, there was a group effect in female mice for bouts 6 and 10 during experiment 2, with female EtOH mice being weaker than controls ( P ≤ 0.002). Excessive short- or long-term EtOH misuse in a mouse model did not affect the muscle's ability to regain strength after repeated bouts of eccentric contractions, suggesting that EtOH may not be as detrimental to recovery as once predicted.

Homicide Victims and Alcohol Related Consumption in Brazil

Introduction: Deaths due to external causes, mainly homicides, are a serious public health problem in Brazil. There is evidence that the tendency to impulsive and / or violent behavior is exacerbated after alcohol consumption. Otherwise, the relationship between alcohol and violent deaths is described in the medical literature without much precision. Objective: Analyze the relationship between victims' blood alcohol levels and homicides, in the micro-region formed by some municipalities in Greater São Paulo. Methods: Retrospectively, we reviewed the data from the medical records of 805 necropsies performed at the Medical Legal Institute of Sao Paulo (IML-SP) in Franco da Rocha, Brazil, from 2001 to 2017. Descriptive statistics were calculated to assess BAC testing status among decedents overall. The variables studied were sex, age, manner of death and blood alcohol level (BAC). Results: Of the 230 individuals analyzed, 200 (86.9%) were male and 30 (13.04%) female. The most prevalent age range for males was between 18 and 23 years (19.5%). For the women group it was between 12 and 23 years (33.2%). The vast majority of homicides (n = 162, 70.4%) was due to firearms, followed by sharp force and blunt force trauma (13% each one). Of the 230 cases of homicide victims analyzed, 205 (89,1%) presented a positive blood alcohol level (BAC), e.g, over 0,3 mg/dl. In the group of homicide victims by firearm, 57 (24,7%) of them presented a median value of BAC of 1.3 mg/ml. Discussion and Conclusions: The results of this study indicate that alcohol intoxication was common in homicide victims in Franco da Rocha from 2001-2017. It also confirms some findings from other researchers linking blood alcohol and deaths from unnatural causes. Our study showed that majority of victims are young adults, and most of them were under alcohol effect when they were murdered. So, the fact that the victims were drunk can contribute to the fatal outcome, in cases of homicide. This approach alone cannot establish that alcohol consumption is a risk factor for become a victim of homicide and further studies are necessary to a better comprehension of the effect of alcohol in homicide victims.

Individual Tolerance to Acute Ethanol Intoxication

Relevance: In order to figure out the cause of death and present the evidences to the court, law enforcement authorities instructed forensic medicine experts to carried out differential diagnosis, by using the posthumous exogenous alcoholemia to differentiated between the severity of acute ethanol intoxication, and death caused by alcohol poisoning. However, the experts are difficult to carried out the assessment to determine the severity of alcohol intoxication, even using the following criteria: exogenous alcoholemia level, signs of conditionally fatal ethanol poisoning with trauma. There are differences in the ethanoloxidizing dehydrogenase enzymatic activity, make it easier to determine individual ethanol tolerance, which can be used for forensic medical substantiation to determine severity of acute alcohol intoxication and fatal ethanol poisoning. Purpose of the Study: We carried out the research by evaluating the severity of the acute alcohol intoxication, by taking into account the blood ethanol concentration level and the death caused by the fatal ethanol poisoning; we use the 2 indicators of the ethanol- oxidizing enzymatic activity, which are the alcohol dehydrogenase in liver, and acetaldehyde dehydrogenase in the brain. Material and Methods: Forensic medical experts using 72 corpses to carried out the research, we had identified ethanoloxidizing enzymatic activities in the brain stem and liver and divided into 3 observation groups : Group I – death from fatal ethanol poisoning (FEP) with blood ethanol concentration between the range from 3.0 to 5.3 g/L (22 cases); Group II – death caused by car accidents as the drivers who are having severe ethanol intoxication with vehicle’s mechanical damage, the blood ethanol concentration between the range from 3.0 to 4.8 g/L (25 cases); Group III (controlled group) – death caused by car accidents with vehicle’s mechanical damage without exogenous alcoholemia (25 cases). Results: In the fatal ethanol poisoning group, we compared with the controlled group, there are decrease in enzymatic activities, and there were significant statistically decreases (P&lt;0.05). When comparing these enzymatic activities between IInd and IIIrd group , there were no significant statistically differences (P&gt;0.05).

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.

Clinical Practice Guidelines for Assessment and Management of Patients with Substance Intoxication Presenting to the Emergency Department.