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European Journal of Emergency Medicine... Apr 2021Acute alcohol intoxication is very common in patients with severe traumatic brain injury (TBI). Whether there is an independent association between alcohol intoxication... (Observational Study)
Observational Study
BACKGROUND
Acute alcohol intoxication is very common in patients with severe traumatic brain injury (TBI). Whether there is an independent association between alcohol intoxication and mortality is debated. This study hypothesized that alcohol intoxication is independently associated with less mortality after severe TBI (sTBI).
METHODS
This retrospective observational cohort study included all patients with sTBI [head-Abbreviated Injury Score (AIS) ≥3, corresponding to serious head injury or worse] admitted from 1 January 2011 to 31 December 2016 in an academic level I trauma center. Patients were classified as with alcohol intoxication or without intoxication based on blood alcohol concentration or description of alcohol intoxication on admission. The primary endpoint was in-hospital mortality. Multivariable logistic regression analysis, including patient and injury characteristics, was used to assess independent association with alcohol intoxication.
RESULTS
Of the 2865 TBI patients, 715 (25%) suffered from alcohol intoxication. They were younger (mean age 46 vs. 68 years), more often male (80 vs. 57%) and had a lower median Glasgow Coma Scale upon arrival (14 vs. 15) compared to the no-intoxication group. There was no difference in injury severity by head AIS or Rotterdam CT. Alcohol intoxication had an unadjusted association with in-hospital mortality [unadjusted odds ratio (OR) 0.51; 95% confidence interval (CI), 0.38-0.68]; however, there was no independent association after adjusting for potentially confounding patient and injury characteristics (adjusted OR 0.72; 95% CI, 0.48-1.09).
CONCLUSION
In this retrospective study, there was no independent association between alcohol intoxication and higher in-hospital mortality in emergency patients with sTBI.
Topics: Alcoholic Intoxication; Blood Alcohol Content; Brain Injuries; Brain Injuries, Traumatic; Cohort Studies; Emergency Service, Hospital; Glasgow Coma Scale; Hospital Mortality; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 32941201
DOI: 10.1097/MEJ.0000000000000754 -
Alcoholism, Clinical and Experimental... Dec 2021Day drinking, or drinking during the daytime, is a term used colloquially in the media and among college students based on anecdotal evidence. Drinking at tailgate...
BACKGROUND
Day drinking, or drinking during the daytime, is a term used colloquially in the media and among college students based on anecdotal evidence. Drinking at tailgate parties, generally thought to be a type of day drinking, tends to be particularly heavy and to achieve levels comparable to drinking on holidays and special occasions. The objective of this study was to assess how many and how often students day drink and whether day drinking days (i.e., days drinking began before 4:00 p.m.) were associated with heavy drinking, legal intoxication, negative alcohol-related consequences, and three risky substance use behaviors.
METHODS
We conducted a longitudinal daily diary study of college students who were followed for their first seven semesters of college. The analytic sample includes 7,633 drinking days nested with 619 student drinkers. We used logistic and Poisson multilevel models to test associations between day drinking days and substance use outcomes and negative consequences.
RESULTS
Approximately 50% of drinkers drank durinng the day at least once, and day drinking occurred on 9% of drinking days. Greek organization participants reported significantly more day drinking days than non-participants. Day drinking days were characterized by heavy drinking as evidenced by strong, positive associations between day drinking and drinking to heavy episodic drinking (HED) and high-intensity drinking (HID) thresholds on a given day. In contrast, students were less likely to reach legal intoxication and experienced fewer negative alcohol-related consequences on day drinking days than days on which drinking began in the evening or nighttime. Students who reported day drinking more often throughout the study also reported having more days of drinking at the HED and HID thresholds and playing drinking games and mixed alcohol with energy drinks more frequently.
CONCLUSIONS
Day drinking was common among this sample of college students. Findings suggest that day drinking days may be characterized by heavy drinking and may be a behavior most typically engaged in by heavy drinkers, including members of Greek organizations.
Topics: Adolescent; Adult; Alcohol Drinking; Alcohol Drinking in College; Alcoholic Intoxication; Attitude to Health; Female; Humans; Male; Sex Factors; Students; Universities; Young Adult
PubMed: 34932227
DOI: 10.1111/acer.14736 -
Alcoholism, Clinical and Experimental... Jan 2014Crossed high-alcohol-preferring (cHAP) mice were selectively bred from a cross of the HAP1 × HAP2 replicate lines and demonstrate blood ethanol concentrations (BECs)...
Selectively bred crossed high-alcohol-preferring mice drink to intoxication and develop functional tolerance, but not locomotor sensitization during free-choice ethanol access.
BACKGROUND
Crossed high-alcohol-preferring (cHAP) mice were selectively bred from a cross of the HAP1 × HAP2 replicate lines and demonstrate blood ethanol concentrations (BECs) during free-choice drinking reminiscent of those observed in alcohol-dependent humans. In this report, we investigated the relationship between free-choice drinking, intoxication, tolerance, and sensitization in cHAP mice. We hypothesized that initially mice would become ataxic after drinking alcohol, but that increased drinking over days would be accompanied by increasing tolerance to the ataxic effects of ethanol (EtOH).
METHODS
Male and female cHAP mice had free-choice access to 10% EtOH and water (E), while Water mice (W) had access to water alone. In experiment 1, the first drinking experience was monitored during the dark portion of the cycle. Once E mice reached an average intake rate of ≥1.5 g/kg/h, they, along with W mice, were tested for footslips on a balance beam, and BECs were assessed. In experiments 2, 3, and 4, after varying durations of free-choice 10% EtOH access (0, 3, 14, or 21 days), mice were challenged with 20% EtOH and tested for number of footslips on a balance beam or locomotor stimulant response. Blood was sampled for BEC determination.
RESULTS
We found that cHAP mice rapidly acquire alcohol intakes that lead to ataxia. Over time, cHAP mice developed behavioral tolerance to the ataxic effects of alcohol, paralleled by escalating alcohol consumption. However, locomotor sensitization did not develop following 14 days of free-choice EtOH access.
CONCLUSIONS
Overall, we observed increases in free-choice drinking with extended alcohol access paralleled by increases in functional tolerance, but not locomotor sensitization. These data support our hypothesis that escalating free-choice drinking over days in cHAP mice is driven by tolerance to alcohol's behavioral effects. These data are the first to demonstrate that escalating free-choice consumption is accompanied by increasing alcohol tolerance. In addition to buttressing the hypothesized importance of tolerance in drinking, our findings suggest that cHAP mice may be a unique, translational resource for studying tolerance as a contributor to and consequence of chronic, excessive EtOH consumption.
Topics: Alcohol Drinking; Alcoholic Intoxication; Animals; Choice Behavior; Ethanol; Female; Hybridization, Genetic; Male; Mice; Motor Activity
PubMed: 23909817
DOI: 10.1111/acer.12216 -
Psychopharmacology Dec 2020Alcohol intoxication produces effects that can impair judgment and increase engagement in risky behaviors, including alcohol-impaired driving (AID). Real-world AID...
RATIONALE
Alcohol intoxication produces effects that can impair judgment and increase engagement in risky behaviors, including alcohol-impaired driving (AID). Real-world AID decisions are informed by contextual circumstances and judgments of associated risk. How individuals vary in their AID decision-making across contexts and whether subjective alcohol responses (stimulation, sedation, acute tolerance) differentially affect AID decisions are critical, but under-studied research questions.
OBJECTIVES
We systematically investigated predictors of AID decisions at different hypothetical driving distances across the blood alcohol concentration (BAC) curve.
METHODS
Young adults (n = 40; 55% female) completed two laboratory sessions in a within-subjects alcohol/placebo design. At multiple points along the BAC curve (M peak BAC = 0.101 g%), participants rated their subjective intoxication, stimulation, sedation, and perceived dangerousness of driving prior to indicating their willingness to drive distances of 1, 3, and 10 miles. Multilevel mixed models assessed within- and between-person predictors of the maximum distance participants were willing to drive at matched BACs on the ascending and descending limb.
RESULTS
Under intoxication (but not placebo), participants were willing to drive greater distances on the descending versus ascending limb. At the momentary level, participants were willing to drive further when they felt less intoxicated, stimulated, and sedated, and perceived driving as less dangerous.
CONCLUSIONS
Individuals differed in the distance they were willing to drive as a function of indicators of intoxication, implicating driving distance as an important contextual factor relevant to AID decisions. Individuals may simultaneously perceive themselves as "unsafe" to drive, but "safe enough" to drive short distances, particularly when BAC is falling.
Topics: Female; Humans; Male; Young Adult; Alcohol Drinking; Alcoholic Intoxication; Blood Alcohol Content; Decision Making; Driving Under the Influence; Ethanol; Risk-Taking
PubMed: 32851420
DOI: 10.1007/s00213-020-05639-0 -
Deutsches Arzteblatt International May 2009Episodic excessive alcohol consumption ("binge drinking") among children and adolescents has become a serious public health problem in Germany and is associated with a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Episodic excessive alcohol consumption ("binge drinking") among children and adolescents has become a serious public health problem in Germany and is associated with a variety of risks.
METHODS
Selective literature search of the Ovid Medline database from 1998 to 2008.
RESULTS
Episodic excessive alcohol consumption is associated not only with somatic complications, but also with traffic accidents and other types of accident, violent behavior, and suicide. The more frequently a child or adolescent drinks to excess, and the younger he or she is, the greater is the risk of developing an alcohol-related disorder (alcohol misuse or dependence syndrome). In the USA, brief motivational interventions have been shown to have a small to medium-sized beneficial effect in reducing further binge drinking and its complications.
CONCLUSIONS
The intervention HaLT ("Stop," also an acronym for Hart am Limit--"near the limit") is performed in a number of regions in Germany. Further types of brief motivating intervention should be developed and evaluated to prevent the development of alcohol-related disorders, where indicated, in children and adolescents that engage in binge drinking.
Topics: Adolescent; Adolescent Behavior; Alcohol Drinking; Alcoholic Intoxication; Child; Child Behavior; Germany; Health Behavior; Humans; Incidence; Risk Assessment; Risk Factors; Risk-Taking
PubMed: 19547732
DOI: 10.3238/arztebl.2009.0323 -
F1000Research 2021Although candiduria is an expected encounter and should not be surprising in uncontrolled diabetes with glucose-enriched urine, urinary auto-brewery is rarely... (Review)
Review
Although candiduria is an expected encounter and should not be surprising in uncontrolled diabetes with glucose-enriched urine, urinary auto-brewery is rarely thought of by diabetologists. Moreover, endogenous ethanol production in humans from gut microbiome, urinary tract fungi and bacteria, and intermediary metabolism, has been reported for a long time, particularly in diabetics. To alert physicians to the overlooked implication of endogenously produced ethanol both as a biomarker for poor control of diabetes and as a complicating factor, we report this case of an elderly male smoker alcohol-abstinent insulin-dependent Type 2 diabetic patient. Because of circumstantial treatment and incompliance for one week, he developed endogenously produced alcohol intoxication. We proposed candidal urinary auto-brewery evidence sourced from the case history, urinalysis, and culture/identification tests - without excluding other sources. Fortunately, his diet and glycemic control were fairly controlled and, liver and kidney functions were almost normal. Amphotericin B I/V for five days, insulin, and a fluid therapy regimen greatly improved the case and cleared both the candiduria and ethanol from the urine and blood and the patient regained his base-line normal life. Symptoms of alcohol intoxication should be expected in patients with uncontrolled diabetes that most often correlates with candiduria and/or constipation. These symptoms can be exaggerated in those already suffering a degree of dementia and/or comorbid psychiatric/neurologic affections. Direct wet mount examination of urine under phase contrast microscopy would show the budding yeast cells. Appropriate antifungal, insulin and fluid therapies regained the base-line norms.
Topics: Aged; Alcoholic Intoxication; Amphotericin B; Diabetes Mellitus; Ethanol; Humans; Insulin; Kidney Diseases; Male; Urinary Tract Infections
PubMed: 35284058
DOI: 10.12688/f1000research.52461.1 -
BMC Pediatrics May 2021This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication...
BACKGROUND
This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated.
METHODS
The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information.
RESULTS
During the period 2007-2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0-23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9-12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission.
CONCLUSIONS
Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians' attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents' alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.
Topics: Adolescent; Alcohol Drinking; Alcoholic Intoxication; Blood Alcohol Content; Child; Humans; Illicit Drugs; Substance-Related Disorders; Tobacco Smoking
PubMed: 34001049
DOI: 10.1186/s12887-021-02710-3 -
ImmunoHorizons Aug 2022Alcohol intoxication combined with burn injury can lead to life-threatening complications, including sepsis, multiple organ failure, and death. After an acute burn, the...
Alcohol intoxication combined with burn injury can lead to life-threatening complications, including sepsis, multiple organ failure, and death. After an acute burn, the gastrointestinal system becomes hypoxic because of fluid loss and reduction of intestinal blood flow. This can cause perturbations in the intestinal epithelial barrier, immune function, and the composition of the gut microbiome. Increased gut permeability leads to proinflammatory signaling, contributing to further damage to the intestinal barrier. Recent studies have suggested that IL-27 plays an anti-inflammatory role, which may be beneficial in intestinal barrier repair. Therefore, in this study, we examined the effect of ethanol and burn injury on IL-27 in the small intestine, as well as the potential beneficial role of IL-27 in restoring the intestinal barrier after intoxication and burn. Male C57BL/6 mice were gavaged with 2.9 g/kg ethanol before receiving a ∼12.5% total body surface area scald burn with or without rIL-27 in resuscitation fluid. Our results demonstrate that IL-27-producing cells are reduced in the small intestine after injury. When IL-27 is supplemented in resuscitation fluid, we were able to restore intestinal barrier integrity and transit, mediated through increased intestinal epithelial cell proliferation, reduced inflammatory cytokines, and increased anti-inflammatory cytokine IL-10. We also observed increased gene expression of tight junction proteins. These findings suggest that IL-27 may be a contributor to maintaining proper intestinal barrier function after injury through multiple mechanisms, including preventing excess inflammation and promoting intestinal epithelial cell proliferation and tight junction integrity.
Topics: Alcoholic Intoxication; Animals; Burns; Cytokines; Ethanol; Interleukin-27; Interleukins; Male; Mice; Mice, Inbred C57BL
PubMed: 35973751
DOI: 10.4049/immunohorizons.2200032 -
Journal of Studies on Alcohol and Drugs Mar 2011Alcohol use in China has substantially increased during the last three decades. The objectives of this study were to examine the sociodemographic patterning of alcohol...
OBJECTIVE
Alcohol use in China has substantially increased during the last three decades. The objectives of this study were to examine the sociodemographic patterning of alcohol consumption and to explore the relationship between (a) heavy drinking and frequent acute intoxication and (b) type of alcohol consumed.
METHOD
A cross-sectional survey of 18- to 60-year-old men in Hunan and Henan Provinces in 2007 used multistage, randomized clustered sampling to identify 11,884 subjects; 9,866 (83.0%) of them were interviewed.
RESULTS
The weighted prevalence of 3-month drinking was 61.4% in Hunan and 68.2% in Henan. Among current drinkers, the median daily consumption of pure alcohol in Hunan and Henan were 16.5 ml and 17.9 ml, respectively; 16.6% in Hunan and 22.3% in Henan met criteria for heavy drinking (average daily pure alcohol consumption ≥ 50 ml); and 3.0% in Hunan and 7.3% in Henan reported frequent intoxication. Adult men with lower education in Hunan and those with higher family incomes in Henan were more likely to engage in heavy drinking; those who were unmarried in Hunan and those with higher incomes in Henan were more likely to be intoxicated frequently. In both provinces, those who consumed distilled spirits were at higher risk for heavy drinking and frequent intoxication.
CONCLUSIONS
The majority of rural adult men in both provinces drink alcohol and a substantial minority-particularly those who consume distilled spirits-are heavy drinkers and report more frequent acute intoxication. The consumption of distilled spirits may be a useful target of intervention to reduce the prevalence of heavy drinking and the experience of intoxication.
Topics: Adult; Alcohol Drinking; Alcoholic Beverages; Alcoholic Intoxication; Alcoholism; China; Cross-Sectional Studies; Ethanol; Humans; Male; Middle Aged; Rural Population; Socioeconomic Factors; Young Adult
PubMed: 21388606
DOI: 10.15288/jsad.2011.72.333 -
Drug and Alcohol Dependence Apr 2018Previous research demonstrated that urinary ethanol concentrations were significantly lower in hangover resistant individuals compared to drinkers who reported having a... (Comparative Study)
Comparative Study
BACKGROUND
Previous research demonstrated that urinary ethanol concentrations were significantly lower in hangover resistant individuals compared to drinkers who reported having a hangover. This finding suggests that the rate of ethanol metabolism is faster in drinkers who do not experience an alcohol hangover. This study aimed to directly compare alcohol metabolism after administering a low dose of ethanol to hangover sensitive drinkers and hangover resistant drinkers.
METHODS
Social drinkers who previously participated in hangover trials at Utrecht University were invited to participate. It was aimed to include 12 hangover resistant drinkers and 12 hangover sensitive drinkers. Participants consumed alcohol to reach a breath alcohol concentration (BrAC) of 0.05%. Every 5 min BrAC was determined, until BrAC reached zero. Every 15 min, the Karolinska Sleeping Scale (KSS) was administered to assess subjective sleepiness, and subjective intoxication was measured.
RESULTS
Data of N = 23 participants with a mean age of 22.4 (±1.9) years was included in the analyses. No significant difference in BrAC over time was found between the hangover resistant group and the hangover sensitive group. In line, subjective sleepiness scores and subjective intoxication ratings did not significantly differ between the groups at any point in time after alcohol consumption.
CONCLUSION
Hangover resistant individuals and hangover sensitive drinkers did not significantly differ on BrAC, subjective sleepiness, and subjective intoxication after consuming a moderate amount of alcohol. These findings suggest that drinkers who usually experience hangovers after a heavy drinking occasion do not experience alcohol intoxication differently than hangover resistant drinkers.
Topics: Adult; Alcohol Drinking; Alcoholic Intoxication; Breath Tests; Ethanol; Female; Humans; Inactivation, Metabolic; Male; Netherlands; Sleep; Young Adult
PubMed: 29500954
DOI: 10.1016/j.drugalcdep.2017.11.040