The yin and yang of alcohol intoxication: implications for research on the social consequences of drinking.
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Exceptions from the withdrawal of permission to drive should be allowed primarily to first offenders. In case of alcohol conspicuous first offenders a post-schooling course has a positive influence to exceptions, if a favourable prognosis for the future can be made especially in case of total abstinence instead of "Controlled Drinking": In spite of longstanding good reputation (minimum 25 years) exceptions to the withdrawal of permission to drive are excluded if the blood alcohol concentration exceeded 1.8/1000.
We report a five month retrospective analysis of 204 consecutive patients seen in an adult medical emergency department with blood alcohol concentrations (BAC) in excess of 400 mg/dl. The average BAC was 467 mg/dl with a range of 400-719 mg/dl. In 153 patients (75%) the BAC was 400-500 mg/dl, in 47 patients (23%) the BAC was 500-600 mg/dl and in 4 patients (2%) the BAC was greater than 600 mg/dl. Eighty-eight percent of the patients were oriented to person, place, and time upon questioning, 12% were disoriented or unresponsive to noxious stimuli. None of the four patients whose BAC was greater than 600 mg/dl were initially alert and oriented and only eight of the unresponsive patients had a BAC below 500 mg/dl (p less than .001). Sixteen patients (8%) were admitted. Three of the admissions were for continued unresponsiveness presumed due to ethanol, the other thirteen were for coexistent medical conditions. There were no significant associations between BAC and vital sign abnormalities.
Sensorimotor cortex in the offspring of female rats alcoholized in the prepregnancy period revealed signs of delayed neuronal development and dystrophic changes in the neurons especially on the 14th day after birth. In 21-day-old animals the reparative changes increased, but normalization of neuronal ultrastructure was not observed. The dystrophic changes suggest that prenatal brain hypoxia plays an important role in the pathogenesis of alcohol-induced neuronal lesions in the offspring.
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FROM STEATOSIS TO CIRRHOSIS: Obesity is frequently associated with steatosis. The latter may provoke inflammatory manifestations and steatohepatitis, the clinical biological and histological characteristics of which are identical to lesions of alcoholic origin. A fibrosis may appear after several years, particularly if the obesity is severe, the patient is elderly and suffering from diabetes and that the increase in transaminase exceeds twice the normal value. It is therefore justified to propose a hepatic biopsy in an obese patient when abnormalities in transaminase levels exceed twice the normal values and notably if other fibrosis risk factors exist. THERAPEUTIC ATTEMPTS: Treatment is aimed at correcting the metabolic disorders and the obesity. Other treatments are currently proposed (anti-oxidants, insulin-resistance modulators), but none of them have presently been completely validated. IN THE FUTURE: With the increase in obesity in industrialised countries, the prevalence of steatosis and steatohepatitis will also increase and there is a risk that they will become, within a few years, one of the principle causes of cirrhosis.
Histophysiological changes of hypophyseal pars intermedia of rats were investigated in a condition of acute ethanol treatment. 20 male Wistar rats, aged 3 months, were intraperitoneally applicated 15% solution of ethyl alcohol in a different amount and time sacrifice after ethanol treatment (1 g/kg body weight-1 hour; 1 g/kg body weight-3 hours, 3 g/kg body weight-1 hour; 3 g/kg body weight-3 hours). For alcohol analysis blood was collected by method of Widmark at the moment of sacrifice. During the investigation classic light microscopy methods were applicated; then histological analysis was realized and average volume of nuclei glandular cells was monitored; a significance of statistics was showed, too. Changes of glandular cells were in the sense of decreased synthetic activity and inhibition of the secretory process. It was found high significant decreased value of nuclei volume. The hormonal secretion of the intermedial lobe is influenced with transmitter substances. These changes could be interpreted as a result of the increased activities of the inhibitory neurotransmitter dopamine under the influence of ethanol. At the same time acetyl-choline as stimulative factor is decreased.