The influence of clomethiazol (Heminevrine) on acute ethanol intoxication in abstaining alcoholics. (An experimental study).
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Alcoholic Intoxication↗
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[Treatment of acute intoxication and of alcohol withdrawal reaction].
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Alcohol Withdrawal Delirium↗
Severe frostbite of the upper extremities--a psychosocial problem mostly associated with alcohol abuse.
In the catchment area of Helsinki University Central Hospital (in total 16 surgical hospitals) amputation was performed on 9 patients with frostbite in the upper extremities during 1984-1985. The population during the study period in this area was 1.165,000 inhabitants, corresponding to 24% of the whole population in Finland. All 9 patients were male and the mean age was 49 years (range 31-75). All amputations performed were of the fingers, the third, fourth and fifth fingers most frequently affected. Alcohol was a marked etiologic or contributing factor in most of the frostbites. Two patients were chronic schizophrenics showing no signs of alcohol abuse, but the remaining 7 were either acutely or chronically alcohol intoxicated: 5 patients were chronic alcoholics, one was an alcohol abuser without a definite diagnosis of alcoholism, and one patient with no previous history of alcohol abuse was alcohol intoxicated. Based on the present study it is clear that, in addition to the cold winters in Finland, other factors contribute to severe frostbite. These include many psychosocial factors such as alcoholism or mental disease, unbalanced marital status, occupation handicap and lack of regular residence.
Adult↗
[Occasional alcohol drinkers and chronic alcoholics. Comparison of two patient groups from the viewpoint of accident surgery].
Patients who suffer an accident after alcohol consumption can be differentiated into 2 groups: patients which drink alcohol occasionally and chronic alcoholics. We examined prospectively in-patients treated after suffering a trauma in an alcoholised state. The diagnosis acute alcohol intoxication was made by a breath-alcohol-analysis, the diagnosis chronic alcoholism by a shortened MAST-test. In the average chronic alcoholics were 12 years older than acute intoxicated. Family background of chronic alcoholics was more often disrupted and social status lower than in acute alcoholics. For the acute alcoholics a car crash, for the chronic alcoholics a fall was the main trauma cause. In over 50% both patient groups suffered a minor head injury. Chronic alcoholics had a twice as long hospital stay (16.1 +/- 3.2 vs. 8.5 +/- 1.1 days), needed more specialist consultations (84% vs. 60%) and developed more complications (40% vs 16%) than the acute alcohol intoxicated. The ISS (Injury Severity Score) was the same for both patient groups (6.7 +/- 0.7 vs. 7.1 +/- 0.8) and had no prognostic value for the group of the chronic alcoholics. On the basis of the present findings it is advisable to check the diagnosis alcohol intoxication and to look whether chronic alcoholism is present whenever a drunken patient is admitted.
Accidents↗
Changes in cholinergic activity in human hippocampus following chronic alcohol abuse.
Cholinergic mechanisms in the hippocampus seem to play a role in memory function. Since it is well known that chronic alcoholics often have a disturbed memory function, the cholinergic activity of the hippocampus has been measured in 20 chronic alcoholics and 14 controls, post-mortem. Of the alcoholics, 13 were classified as "intoxicated" alcoholics and 7 as "sober" alcoholics, i.e., without ethanol in blood or urine at the time of death. A lower, although not significantly lower activity of the enzyme choline acetyltransferase (ChAT, presynaptic marker) was measured in the hippocampus of the chronic alcoholics as compared to the control group. A trend towards a lower number of muscarine-like binding sites was also observed for the alcoholic group, but was only significant for the oldest group of alcoholics (59-68 years; -30%; p less than 0.01) in comparison to controls. No significant change in the number of nicotine-like binding sites was found. A normal aging process with degenerative nerve cell changes might, in combination with an excessive intake of ethanol, lead to the more pronounced decrease in muscarine-like binding sites found for the older alcoholics.
Aged↗
Impact of alcohol on the ability of Kupffer cells to produce chemokines and its role in alcoholic liver disease.
Chemokines are implicated in the pathogenesis of alcoholic liver disease in humans and in experimental models of alcohol intoxication. The major sources of these chemokines are Kupffer cells which represent more than 80% of tissue macrophages in the body. Kupffer cells are highly responsive to the effects of ethanol, endotoxin and human immunodeficiency virus (HIV)-1 glycoprotein120. These agents, either independently or in combination, may exacerbate the production of chemokines. Chemokines are agents that are highly chemotactic to mononuclear cells and granulocytes. The levels of these chemokines in sera and tissue are elevated in patients with alcoholic hepatitis, alcoholic cirrhosis, diseased livers, viral hepatitis, and in experimental models of chronic alcohol intoxication. Alcohol-induced influx of endotoxin from the gut into the portal circulation is suggested to play an important role in the activation of Kupffer cells which leads to enhanced chemokine release. The up-regulation of chemokines during alcohol consumption is selective. During the early phase of alcoholic liver disease, C-X-C or alpha-chemokines predominate. This is also associated with neutrophilic infiltration of the liver. In the later stage, up-regulation of C-C or beta-chemokine production and migration of mononuclear cells into the liver are observed, and this may lead to liver cirrhosis. Selective up-regulation of chemokine synthesis and release may involve differential modulation of the transcription factors required for chemokine gene expression. Increased cytokine release following alcohol consumption may also regulate chemokine secretion in Kupffer cells via paracrine and autocrine mechanisms and vice versa. In addition, infection with HIV-1 may further compromise the liver to more damage. During HIV-1 infection, a pre-existing liver disease superimposed on chronic alcohol consumption may also exacerbate HIV-1 replication and lymphocytic infiltration in the liver, because of the ability of HIV-1 gp120 to stimulate chemokine production by Kupffer cells and stimulate migration of inflammatory leucocytes in the liver.
Alcohol Drinking↗
Trends of behavioral risk factors in motor vehicle crashes in Utah, 1992-1997.
OBJECTIVE: Measure changes in the prevalence of behavioral factors including police-reported fatigue and alcohol intoxication, as well as self-reported seatbelt use, and assess their effect on hospitalization or death after a motor vehicle crash. METHODS: Probabilistic linkage was used to match drivers in motor vehicle crashes with hospital discharge records for the years 1992-1997. Frequencies of specific behavioral factors were evaluated using the Cochran-Armitage test for trend. Odds ratios and corresponding 95% confidence intervals were calculated using generalized estimating equations (GEEs) with crash and driver characteristics as independent variables and hospitalization or death as the dependent variable. RESULTS: The analysis database consisted of 450,286 crash driver records, which linked to 4219 (0.9%) hospitalizations or deaths. There was an increasing trend for self-reported seatbelt use among crash-involved drivers from 80.5% in 1992 to 89.3% in 1997 (P<0.001). Police-reported alcohol intoxication among crash-involved drivers showed a decreasing trend from 2.4% in 1992 to 1.5% in 1997 (P<0.001). There was no trend for police-reported fatigue-related crashes. Odds ratios of hospitalization or death for seatbelt use, alcohol involvement, and fatigue were significant and did not fluctuate considerably between 1992 and 1997. Seatbelt use offered a protective effect from hospitalization or death, while alcohol intoxication and fatigue contributed to increased likelihood of hospitalization or death. CONCLUSIONS: These results suggest that while some improvement has been made in decreasing seatbelt non-use and driver alcohol intoxication among crash-involved drivers, no improvement has been made in reducing fatigue-related crashes.
Accidents, Traffic↗
Alcohol, sexual arousal, and intentions to use condoms in young men: applying alcohol myopia theory to risky sexual behavior.
Data from 7 studies were aggregated to examine how reported sexual arousal and alcohol intoxication interact to affect attitudes and intentions toward engaging in unprotected sexual intercourse in college-age men (N = 358). When participants were in a sober or placebo condition, their self-reports of sexual arousal had no effect on their responses. When participants were intoxicated, however, those who felt sexually aroused reported more favorable attitudes, thoughts, and intentions toward having unprotected sex than did those who did not feel aroused. These findings support alcohol myopia theory (C. M. Steele & R. A. Josephs, 1990), which states that alcohol intoxication restricts attentional capacity so that people are highly influenced by the most salient cues in their environment. It is suggested that sexual arousal is a powerful internal cue that interacts with alcohol intoxication to enhance attitudes and intentions toward risky sexual behaviors.
Adolescent↗
Effects of Ro15-4513 and other benzodiazepine receptor inverse agonists on alcohol-induced intoxication in the rat.
The ability of the imidazobenzodiazepine Ro15-4513 to antagonize the behavioral intoxication produced by ethanol and related short-chain alcohols was examined in the rat. Ro15-4513 dose dependently (0.5-10 mg/kg i.p.: IC50, 1.5 mg/kg) inhibited the intoxication induced by ethanol (2 g/kg), as well as t-amyl alcohol (0.36 g/kg) and methanol (4.66 g/kg). The effects of Ro15-4513 in blocking ethanol-induced intoxication were blocked by the benzodiazepine receptor antagonists Ro15-1788 and CGS-8216. However, Ro15-4513 was ineffective in antagonizing the intoxication observed after higher doses of ethanol (4 g/kg). In contrast, ethanol-induced intoxication was not antagonized by the benzodiazepine receptor antagonists Ro15-1788 (10 mg/kg) or CGS-8216 (20 mg/kg), nor by the inverse agonists FG-7142 (10-30 mg/kg) or beta CCE (10 mg/kg). When administered after ethanol, Ro15-4513 also reversed ethanol-induced intoxication in a dose-dependent manner (2.5-10 mg/kg i.p.: IC50, 5 mg/kg), an effect which was also blocked by Ro15-1788 and CGS-8216. However, neither beta CCE (10 mg/kg) or FG-7142 (less than or equal to 30 mg/kg) alone reversed ethanol-induced intoxication. Moreover, beta CCE (10 mg/kg), when administered just before Ro15-4513, completely antagonized the actions of Ro15-4513 in reversing ethanol-induced intoxication. These data suggest that the ability of Ro15-4513 to antagonize, and to reverse, ethanol-induced intoxication is mediated via central benzodiazepine receptors.(ABSTRACT TRUNCATED AT 250 WORDS)
Alcoholic Intoxication↗
Lithium antagonizes ethanol intoxication in alcoholics.
Thirty-five detoxified alcoholics given lithium in a placebo-controlled, double-blind study reported less intoxication, a decrease in the desire to continue drinking, and less cognitive dysfunction when challenged by standardized doses of ethanol. Lithium also appeared to antagonize the ethanol-induced decrement in cognitive and perceptual motor performance. No differential lithium effect was noted when alcoholics were divided by diagnoses of affective disorder versus no affective disorder. The authors suggest that, in addition to mood normalization, lithium's capacity to directly affect ethanol intoxication may help explain its potential therapeutic efficacy in alcoholism, providing further confirmatory evidence that lithium may be useful in the treatment of alcoholism.
Adult↗
Alcohol-induced salivary hyperamylasemia.
The effects of alcohol intoxication on serum amylase levels were tested in both normal subjects and chronic alcoholics. Paired samples of ethanol levels and isoamylase levels in the normal subjects (n = 11) showed a rise in both total serum amylase (P less than 0.01) and nonpancreatic isoamylase (P less than 0.05) after drinking. Unpaired cohort groups of sober chronic alcoholics at a rehabilitation facility (n = 46) and intoxicated chronic alcoholics in an emergency room (n = 58) were also compared. Average blood alcohol levels in the intoxicated controls were 93 mg% compared to a level of 301 mg% in the intoxicated chronic alcoholic. Intoxication superimposed on chronic alcoholism caused a moderate rise in the total serum amylase (NS) and a significant elevation of the nonpancreatic isoamylase (P less than 0.01). Sober chronic alcoholics had a significantly greater average total serum amylase (P less than 0.001) and nonpancreatic isoamylase (P less than 0.01) than the normal controls. No difference in the average pancreatic isoamylase levels was seen in any group. These data suggest a biphasic response to alcohol on the serum amylase level. Acute and chronic changes appear to operate independently. The cause for these effects is speculative. Isoamylase analysis is needed in the alcoholic population to sort out the meaning of hyperamylasemia.
Abdomen↗
Effect of chronic alcohol consumption on the ethanol- and acetaldehyde-metabolizing systems in the rat gastrointestinal tract.
The activities of alcohol dehydrogenase (ADH), catalase, microsomal ethanol-oxidizing system (MEOS) and aldehyde dehydrogenase (ALDH) were measured in gastric, small intestinal, colonic and rectal mucosal samples of rats fed on a liquid alcohol diet for 1 month. In the rectum and large intestine of control animals, the activities of ADH, MEOS and catalase were maximal, whereas the activity of ALDH was minimal. After chronic alcohol intoxication, MEOS activity increased significantly in the stomach. An activation of catalase and MEOS and a decrease of the low-K(M) ALDH activity were observed in the rectum of experimental animals. In rats consuming the alcohol diet, hypertrophy of crypts and an increased number of mitoses were noticed in colonic and rectal mucosa. Acute alcohol intoxication (2 g/kg, intragastrically) produced significantly higher acetaldehyde concentrations in the contents of the large intestine and rectum of rats receiving alcohol chronically compared to controls. Thus, after chronic alcohol intoxication, the large intestine regions showed a greater imbalance between the activities of acetaldehyde-producing and -oxidizing enzymes, which resulted in accumulation of acetaldehyde. This mechanism can account for the local toxicity of ethanol after its chronic consumption, and relates the development of mucosal damage and compensatory hyper-regenerative processes, and possibly carcinogenesis, in the colonic and rectal mucosae of alcoholics to the effects of acetaldehyde.
Acetaldehyde↗
[The diagnostic value of determining the level of acetaldehyde in blood, urine, and cerebrospinal fluid].
The contents of acetaldehyde (AA) in biological fluids obtained from the dead with the confirmed lethality causes, i.e. ischemic heart disease (IHD), alcoholic cardiomyopathy (ACMP) and mechanical traumas (MT), were examined on an actual forensic-medical material (AFMM). 14 death cases of males, aged 18 to 45, were studied. The method of gas-liquid chromatography (GLC), or rather its variation of vaporphase analysis, was used to state the presence and to assess the concentration of acetaldehyde. The results revealed differences between concentrations of acetaldehyde in the examined groups depending on the presence or absence of alcoholemia. Thus, the AA concentrations were found in trace quantities in the MT group free of alcoholic intoxication; while, when it was present in this group, the concentrations went up several-fold. A higher AA content was typical of the ACMP group in all examined subjects both with and without alcoholic intoxication. The final study results are suggestive of that the AA determination in blood, urine and liquor by GLC could be used, within the forensic medical practice, in assessing a severity degree of alcoholic intoxication while establishing the lethal outcome cause due to chronic pathologies and MT.
Acetaldehyde↗
Intoxicated behavioral disinhibition and the heart rate response to alcohol.
This study examined the association between the heart rate (HR) response to alcohol intoxication, which is thought to reflect sensitivity to alcohol-induced reward and alcohol-induced behavioral disinhibition. High- and low-HR responders to alcohol participated in a go/no-go task, under sober and intoxicated conditions. Errors of commission on this task have previously been related to behavioral disinhibition. High-HR responders made more intoxicated commission errors as compared with low-HR responders. High-HR responders also reported increased alcohol consumption, and controlling for the latter did not alter the significant association between high-HR responders and increased intoxicated errors of commission. These results are consistent with previous findings of an increased risk for addictive and disinhibited behavioral propensities in individuals with a high-HR response to alcohol intoxication.
Alcoholic Intoxication↗
Clinical management of acute intoxication in the chronic alcoholic.
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Alcoholic Intoxication↗
[Alcohol and pregnancy. Negative and positive effects of acute and chronic effect of alcohol on the course and outcome of pregnancy].
The attitude towards alcohol is ambiguous and mainly depending upon the role attributed to it:as a stimulant, as a pharmacon or as a drug the person may be addicted to. Acute and chronic alcohol intoxication may be followed by psychic and somatic leasons. As far as pregnancy is concerned, leasons due to chronic alcohol consume have to be considered as maternal factors of high risk to the pregnancy. Acute alcohol intoxication may be harmful for the pregnancy as well as gametogenesis and gametes and embryo. Alcohol has been used in obstetrics as an analgetic during delivery, for premedication in obstetrical operations, for elimination of edema in toxicosis, as an abortifacient and as adjuvant in termination of lactation. Critical evaluation shows that these indications are only of historical value. Today more effective and specific compounds are available and as for the narcotic effect is concerned the dosage of the new narcotics of course is more exact. Alcohol recently has been proposed as a tocolytic agent. Although today other tocolytics are available, it should be kept in mind as a substitute if the use of beta-mimetic substances is not possible. The controversy about the value of alcohol in therapy or prevention of newborn hyperbilirubinaemie is not yet resolved, but should be clarified since this therapy--if of value--would constitute one of the rare possibilities to interfere with the fetal metabolism.
Abortion, Habitual↗
Alcohol and suicidal behavior.
Alcohol dependence and alcohol intoxication are important risk factors for suicidal behavior. However, the mechanism for the relationship remains unclear. This review presents a conceptual framework relating alcohol to suicidal behavior. Distal risk factors create a statistical potential for suicide. Alcohol dependence, as well as associated comorbid psychopathology and negative life events, act as distal risk factors for suicidal behavior. Proximal risk factors determine the timing of suicidal behavior by translating the statistical potential of distal risk factors into action. The acute effects of alcohol intoxication act as important proximal risk factors for suicidal behavior among the alcoholic and nonalcoholic alike. Mechanisms responsible for alcohol's ability to increase the proximal risk for suicidal behavior include alcohol's ability to: (1) increase psychological distress, (2) increase aggressiveness, (3) propel suicidal ideation into action through suicide-specific alcohol expectancies, and (4) constrict cognition which impairs the generation and implementation of alternative coping strategies. Moreover, the proximal risk factors associated with acute intoxication are consistent with Baumeister's (1990) escape theory of suicide. Suggestions for additional research are discussed, including the possibility that a nonlinear cusp catastrophe model characterizes the relationship between alcohol intoxication and suicidal behavior.
Adaptation, Psychological↗
[Cellular immunity and enzyme activity of xenobiotic metabolism in the lymphocytes of normal minipigs and in alcohol and anabol exposures].
Immunological indices and activity of xenobiotic metabolism enzymes in lymphocytes were studied on minipigs under normal conditions, under conditions of chronic alcoholic intoxication and after administration of anabol (an immunomodulator) to normal healthy animals and to animals with alcohol intoxication. Age-related differences with respect to the number of T-lymphocytes and activity of lymphocyte glutathione S-transferase were observed in the normal animals, the other indices such as activity of natural killer cells, K-cells, blast cell transformation with concanavalin A and activity of cytochrome c-reductase being independent of the age. Administration of anabol to healthy animals did not alter their immunoenzymatic status. Chronic alcohol intoxication was accompanied by development of secondary immune deficiency characterized by lower immunological indices and lower activity of xenobiotic metabolism enzymes in lymphocytes. Daily exposure to 0.8 g of anabol for 12 days at this background resulted in normalization of the above indices.
Adjuvants, Immunologic↗