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Alcohol Poisoning (alcohol + poisoning)
Selected AbstractsAll-cause mortality and fatal alcohol poisoning in Belarus, 1970,2005DRUG AND ALCOHOL REVIEW, Issue 5 2008YURY E. RAZVODOVSKY Abstract Introduction and Aims. Although alcohol appears to be an important contributor to the burden of disease in the countries of eastern Europe, little systematic research has been undertaken on its impact on mortality in the former Soviet republic of Belarus. There may be a number of factors underlying the particularly negative effect of alcohol on mortality in Belarus, including the pattern of drinking and use of surrogates. A solid body of research and empirical evidence suggests that hazardous patterns of alcohol consumption (binge drinking) lead to quicker and deeper intoxication, increasing the propensity for alcohol-related mortality. Design and Method. To estimate the aggregate level effect of binge drinking on the all-cause mortality rate, trends in the all-cause mortality and fatal alcohol poisoning rates (as a proxy for binge drinking) in Belarus from 1970 to 2005 were analysed employing AutoRegressive Integrated Moving Average (ARIMA) time,series analysis in order to assess a bivariate relationship between the two time,series. Results. The results of time,series analysis suggest a close relationship between all-cause mortality and fatal alcohol poisoning rates at the population level. Conclusions. This study supports the hypothesis that alcohol and all-cause mortality are connected closely in countries where the drinking culture is characterised by heavy drinking episodes and adds to the growing body of evidence that a substantial proportion of total mortality in Belarus is due to acute effects of binge drinking. [source] Deliberate induction of alcohol tolerance: empirical introduction to a novel health riskADDICTION, Issue 10 2010Julia A. Martinez ABSTRACT Aims Alcohol tolerance is a hallmark indicator of alcohol dependence. Even so, the allure of peers' admiration for having the ability to drink heavily may lead some adolescents and young adults to practice, or ,train', to increase their tolerance (particularly at US colleges, where heavy drinking is highly prevalent and central to the social culture). This is a potential health hazard that has not been documented empirically. Thus, we initiated a study of tolerance ,training' and its association to risky and heavy drinking. Design, setting and participants A cross-sectional online survey of 990 college student life-time drinkers at a large Midwestern US university. Findings Of the sample, 9.9% (n = 97) reported deliberately ,training' to increase tolerance. On average, they reported increasing from approximately seven to 10 US standard drinks in a night prior to ,training' to 12,15 drinks at the end of ,training,' over approximately 2,3 weeks' duration. Although the proportion of frequent binge drinking among ,non-trainers' (34.4%) was similar to national rates, ,trainers' were much more likely to be frequent bingers (76.3%; OR = 6.15). Conclusions A number of students report deliberately inducing alcohol tolerance, probably directly increasing the risk for alcohol poisoning and other acute harms and/or dependence. This phenomenon might additionally be applicable to other populations, and deserves further study and attention as a potential personal and public health risk. Prevention efforts might aim to reduce the perceived importance of heavy-drinking abilities. [source] Bedside Detection of Urine ,-Hydroxybutyrate in Diagnosing Metabolic AcidosisACADEMIC EMERGENCY MEDICINE, Issue 8 2008Silas W. Smith MD Abstract Objectives:, While critically important, the rapid identification of the etiology of metabolic acidosis (MA) may be labor-intensive and time-consuming. Alcoholic, starvation, and severe diabetic ketoacidosis (AKA, SKA, and DKA, respectively) may produce ,-hydroxybutyrate (BOHB) in marked excess of acetone (ACET) and acetoacetate (AcAc). Unfortunately, current urine dipstick technology poorly detects ACET and cannot measure BOHB. The inability to detect BOHB might delay therapy for ketoacidoses or provoke unnecessary evaluation or empiric treatment of other causes of MA, such as toxic alcohol poisoning. The authors tested the previous assertion that commonly available hydrogen peroxide (H2O2) would improve BOHB detection. The effectiveness of alkalinization and use of a silver nitrate (AgNO3) catalyst was also assessed. Methods:, Control and urine test specimens containing from 0.5 to 800 mmol/L ACET, AcAc, and BOHB were prepared. Urine specimens were oxidized with H2O2 (3%) 1:9 (H2O2:urine), alkalinized with potassium hydroxide (KOH; 10%), exposed to AgNO3 sticks, or altered with a combination of these methods in a random fashion. Three emergency physicians (EPs) blinded to the preparation technique evaluated urine dipsticks (Multistix, Bayer Corp.) placed in the specimens for "ketones." Results:, Multistix detected AcAc appropriately; ACET was detected only at high concentrations of ,600 mmol/L. Multistix failed to measure BOHB at all concentrations tested. H2O2 improved urinary BOHB detection, although not to clinically relevant levels (40 mmol/L). Alkalinization and AgNO3 sticks did not improve BOHB detection beyond this threshold. Conclusions:, Addition of H2O2 (3%), alkalinization, or AgNO3 sticks did not improve clinically meaningful urine BOHB detection. Clinicians should use direct methods to detect BOHB when suspected. [source] A Rapid Qualitative Test for Suspected Ethylene Glycol PoisoningACADEMIC EMERGENCY MEDICINE, Issue 7 2008Heather Long MD Abstract Objectives:, Many hospitals must send out ethylene glycol (EG) samples to a reference laboratory, and delays in diagnosis and treatment may occur. A qualitative colorimetric test (ethylene glycol test [EGT] kit), already in use by veterinarians, gives results in 30 minutes with little expertise or cost. The EGT reliably detects the presence of EG in spiked human serum samples. The objective of this study was to prospectively assess the sensitivity and specificity of the EGT kit in actual clinical samples submitted for EG testing by the criterion standard gas chromatography (GC). Methods:, Blood samples from patients with suspected toxic alcohol poisoning submitted to a reference laboratory were tested by GC. An investigator blinded to the GC results tested the same sample with the EGT kit following the manufacturer's instructions and using the internal control. Three physicians also blinded to the GC results categorized the sample as positive for EG, negative, or inconclusive. Interrater reliability was assessed with a kappa statistic (,). Results of the EGT kit testing were then compared to those from GC testing. Results:, Data are reported on 24 samples submitted. By GC, 15 samples were confirmed for EG (range 27,281 mg/dL), 5 were confirmed for methanol (ME; range 64,101 mg/dL), and 4 were negative for both alcohols. The EGT was unanimously positive in all confirmed EG samples and negative in all ME samples. In one of the negative samples, an ambiguous result occurred and was counted as a false-positive. Interobserver agreement with the EGT was high (, = 0.909; 95% confidence interval [CI] = 0.735 to 1.0). Sensitivity and specificity were 100% (95% CI = 70% to 100%) and 88.8% (95% CI = 52% to 100%), respectively. Conclusions:, The EGT appears to be a reliable qualitative test in cases of suspected human EG poisoning. [source] Paediatric poisonings treated in one Finnish main university hospital between 2002 and 2006ACTA PAEDIATRICA, Issue 6 2008Juho E Kivistö Abstract Aim: Acute poisonings are a major cause of morbidity among children. This study aims to describe the incidence and nature of emergency visits for acute paediatric poisoning among Finnish children. Methods: All patients younger than 16 years admitted to the Tampere University Hospital's emergency department with a diagnosis of poisoning during 2002,2006 were identified from the Hospital Information System using the International Classification of Diseases (ICD-10). Results: Altogether 369 emergency visits were diagnosed with poisoning, the overall incidence being 8.1 per 10 000 person,years (95% CI 7.3,9.0). A majority of patients were adolescents aged 10,15 years (48%) and children under 5 years (45%). Boys represented 55% of the cases. Nonpharmaceutical agents were suspected to be the cause in 60.4% and pharmaceuticals in 30.6% of the intoxications. Multiple agents were involved in 8.4% of the cases. Ethanol was the agent in 30.9% of the poisonings. Most patients (78.9%) were hospitalized (median length of stay 1 day). Overall mortality was 0.3%. Conclusion: Acute paediatric poisonings represent a relatively frequent problem in Finland, and remain a life-threatening problem. The high proportion of alcohol poisonings highlights the necessity to develop more effective primary prevention programs. [source] |