[On the course of alcoholic intoxication with special reference to pharmacopsychological factors during the resorption phase in addicts].
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By collecting the blood coming exclusively from the stomach or intestine of rats, it has been shown that ethanol can be oxidized in the digestive mucosa on the basis of the appearance, during its absorption, of acetaldehyde and acetate. This has been shown to be the result of the action of alcohol- and aldehyde-dehydrogenases present in these tissues. The metabolic ability of these enzymes was tested after chronic alcoholic intoxication in association with various treatments with "anti-alcoholic" drugs. The modifications observed correspond to the effects of the treatments on the levels of the enzyme activities but are less clearcut in the in vivo conditions.
Biopsies from 35 patients and autopsy material from 20 patients who died of chronic hepatopathy were studied. Hydropic dystrophy and inflammation were predominant in HCV infection. Chronic alcoholic intoxication (CAI) was characterized by diffuse large-droplet fat dystrophy and liver fibrosis. In combination of HCV-infection with CAI sclerotic processes were pronounced and therefore liver cirrhosis is more frequent than in other groups.
UNLABELLED: Cocaine and alcohol are frequently used simultaneously and this combination is associated with enhanced toxicity. We recently showed that active cocaine abusers have a markedly enhanced sensitivity to benzodiazepines. Because both benzodiazepines and alcohol facilitate GABAergic neurotransmission we questioned whether cocaine abusers would also have an enhanced sensitivity to alcohol that could contribute to the toxicity. In this study we compared the effects of alcohol (0.75 g/kg) on regional brain glucose metabolism between cocaine abusers (n = 9) and controls (n = 10) using PET and FDG. Alcohol significantly decreased whole brain metabolism and this effect was greater in controls (26+/-6%) than in abusers (17+/-10%) even though they had equivalent levels of alcohol in plasma. Analysis of the regional measures showed that cocaine abusers had a blunted response to alcohol in limbic regions, cingulate gyrus, medial frontal and orbitofrontal cortices. CONCLUSIONS: The blunted response to alcohol in cocaine abusers contrasts with their enhanced sensitivity to benzodiazepines suggesting that targets other than GABA-benzodiazepine receptors are involved in the blunted sensitivity to alcohol and that the toxicity from combined cocaine-alcohol use is not due to an enhanced sensitivity to alcohol in cocaine abusers. The blunted response to alcohol in limbic regions and in cortical regions connected to limbic areas could result from a decreased sensitivity of reward circuits in cocaine abusers.
Acute alcohol intake may be of potential hazard in anaesthesia emergency procedures because of consciousness alterations. Alcohol ingestion alters indeed the functions of upper airway muscles and increases the risk of obstructive sleep apnea. However, no data are available on the effects of alcohol on the swallowing reflex (SR), which is a major protective mechanism against pulmonary inhalation and on upper airway resistances (UAR) following external inspiratory load application. This study was designed to investigate the effects of acute alcohol intake on SR and UAR in healthy volunteers. After informed consent, 8 male volunteers (29 +/- 3 years) were studied in the supine position. The tip of a catheter was placed through the naris at the epipharynx level for injection of 3 series of 2 volumes of distilled water (0.25 and 1 ml respectively). Swallows were identified by a submental electromyogram. SR efficiency was assessed by recording 1) the latency (L) between injection and the first swallow, and 2) the number of swallows (N) elicited by each bolus. The subjects were breathing through a facial mask connected to a pneumotachograph. Supraglottic airway pressures (UAP) were recorded using a small balloon catheter placed at the tip of the epiglottis. UAR were calculated as the ration of UAP (cmH2O) on air-flow (l.s-1) at the airflow's peak. After a control set of measurements (TC), including SR assessment and UAR at rest (UARo) and during application of an external inspiratory resistive load (12 cmH2O.l-1 x s-1) (UARr) to sensitize the experiment, the subjects ingested 1 ml.kg-1 of alcohol as 40 degrees vodka.(ABSTRACT TRUNCATED AT 250 WORDS)
The deposits of cholesterol in hepatocytes in alcoholic rats were studied by means of cytochemical method. It was shown the localization of cholesterol in intracellular as well as extracellular compartment. In numerous hepatocytes there was observed a destruction of mitochondria, rough endoplasmic reticulum and plasma membranes. It was observed two structural forms of digitonin cholesterol complexes: structures like "crinkles" and small cylinders and multilamellar ones.
Induction of NO-synthase and acetaldehyde dehydrogenase in Purkinje cells, basket-like neurons, and microvascular endothelium of human cerebellar cortex was detected in patients with chronic alcohol intoxication. It was hypothesized that the neuromodulating effect of NO is associated with mechanisms protecting neurons from toxic effects of ethanol and acetaldehyde.
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Data, received in investigation of the lungs of 45 newborn rats, show, that there is the suppression of the surface active properties of surfactant in animals, born from female rats with simulated alcoholic intoxication in pregnancy period. The decrease of the surface activity of surfactant may be connected with direct injury influence of alcohol on surfactant as well as with inactivation of surfactant with serum proteins, which appear in the alveolar space because of the increase of the permeability of components of air-haematic barrier. The suppression of the surface active properties of surfactant is accompanied by reinforcement of the functional activity of the 2nd type pneumocytes and appearance of the hypertrophic forms of these cells.
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In a retrospective analysis of 391,973 outpatient visits for acute injuries in 1971-1981 in the Casualty Department of the Department of Orthopaedics and Traumatology, Helsinki University Central Hospital, a mean proportion in alcohol intoxication of 13.4% was found when clinical detection of inebriation was used for assessment. The proportion of alcohol intoxication in 2458 patients in a prospective study during a six week period in Autumn 1983 was considerably higher compared to that observed in the retrospective series. In Autumn 1983 series, clinical detection of alcohol intoxication was combined with breath alcohol analysis resulting alcohol intoxication proportion of 29.7%. The good correlation (r = 0.889) observed in the prospective study between clinical detection of alcohol intoxication and breath alcohol analysis is probably explained by the prudence to staff in the Casualty Department during the study period since they were aware of the importance of the results for specific research purposes. The prospective study (Autumn 1983 series) disclosed that the incidence of intoxication in men was higher than that in women (35% vs 18%, p less than 0.001). In particular, divorced and unemployed patients were frequently intoxicated, in 45.2 and 68.5% of the cases, respectively. The proportion of alcohol intoxication was particularly low in patients of the first social class (executive position) being only 14.3% and in patients aged 54 years or more. The visits of alcohol intoxicated injured patients occurred most frequently between 14.30 and 08.00 and at week-ends. Nearly one third of the injured patients arrived after a delay of 9 hours or more.(ABSTRACT TRUNCATED AT 250 WORDS)
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Experiments on C57Bl/6, CBA and DBA/2 mice characterized by different preferences for ethanol have shown that during chronic administration of alcohol to animals with natural ethanol motivation (strain C57Bl/6) the level of antibodies to catecholamines and serotonin was increased on the 3rd month of ethanol intoxication, with the voluntary alcohol consumption in mice decreased by this time. On the contrary in mice rejecting alcohol (strains DBA/2, CBA) no antibodies to catecholamines and serotonin have been found.
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STUDY OBJECTIVE: To determine the relationship among helmet use, alcohol use, and ethnicity in people killed on motorcycles. DESIGN: Retrospective review of all motorcycle fatalities in New Mexico from 1984 through 1988. SETTING: Office of the Medical Investigator, State of New Mexico. TYPE OF PARTICIPANTS: All decedents of motorcycle crashes in New Mexico from 1984 through 1988. INTERVENTIONS: Review of all autopsies, medical investigator reports, traffic fatality reports, and toxicological studies on fatally injured motorcyclists. RESULTS: Nine of the helmeted drivers (18%) were legally intoxicated compared with 67 of the nonhelmeted drivers (51%) (chi 2 = 15.7, P less than .0001); 42 of the white nonHispanic decedents (37%), ten of Hispanic decedents (12%), and none of the Native-American decedents were wearing helmets. The head and neck region was the most severely injured body region in 42 of the nonhelmeted cases (84%) and in eight of the helmeted cases (50%) (Fisher's exact test, P less than .02). CONCLUSION: There is an association between nonuse of helmets and alcohol intoxication in fatally injured motorcyclists in New Mexico. Strategies for preventing motorcycle fatalities should address alcohol abuse and ethnicity in conjunction with helmet use.