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Older adults continue to drink as they age. Aging changes alcohol kinetics just as with any other drug. Older adults have increased sensitivity to acute alcohol intake that accounts for the increased risk of falls, traffic accidents, and other injury. The Annual Medicare Wellness Exam is an excellent opportunity to introduce screening for unsafe drinking along with accumulated risks and deficits of aging. Older adults have responded well to brief interventions for unhealthy drinking. In the presence of alcohol use disorder or serious comorbidity including psychiatric illness, referral to specialized multidisciplinary care can be lifesaving.

Background Acute alcohol intoxication is a common condition observed in the emergency department (ED). Intravenous fluid therapy (IVF) is often administered to treat this condition, but its effectiveness remains unclear. We therefore conducted a study to evaluate the effect of IVF on length of time from arrival at the ED until awakening, which is a novel and more appropriate variable. Methods This single-center, prospective observational study was conducted in the ED of Self-Defense Forces Central Hospital, a secondary emergency hospital in Tokyo from October 1, 2018 to July 31, 2019. Patients were assigned to groups to receive either a 1,000-mL bolus of lactated Ringer’s solution or only cannulation. The primary outcome was length of until awakening. Secondary outcomes were length of stay in the ED and the occurrence of conditions requiring extra care. Univariate and multivariate regression analyses were performed. Predictors of the occurrence of any event that required extra care were identified using a statistical model. Results The final sample included 201 patients: 109 received IVF and 92 did not. There was no significant difference in baseline characteristics between the groups. Median length of time until awakening was 211 min (interquartile range [IQR], 119 min) in the IVF group and 208 min (IQR, 149 min) in the non-IVF group (p = 0.77). Multivariate regression analysis demonstrated that the regression coefficient of IVF for length of time until awakening was − 9.55 (95% confidence interval [CI], \(-\)36.2 to 17.2). However, hemoglobin (regression coefficient, \(10.1\); 95% CI, \(0.38\)-19.9) and initial Glasgow Coma Scale score (GCS) in the ED (regression coefficient, \(-\)7.51; 95% CI, \(-\)10.8 to \(-\)4.21) were significantly associated with length of time. Conclusions This is the first study to evaluate the effect of IVF therapy on the length of time until awakening. IVF therapy is not effective in shortening the length of time in patients with acute alcohol intoxication in the ED. Routine administration of IVF is unnecessary in these patients. Further research is warranted to investigate who benefit from IVF therapy. A significance difference in Hb and GCS in this study also would give useful tips for the next study.

Introduction. On March 11, 2020, WHO announced the global COVID-19 pandemic. According to literature data, the spread of coronavirus infection COVID-19 affected the structure of acute chemical poisoning. The aim. Assessment of the impact of the COVID-19 pandemic and restrictive measures on the peculiarities of seeking advice and the structure of acute chemical poisoning in Moscow. Material and methods. The data of the registration forms “Card of recording of a consultation of a patient with acute poisoning of chemical etiology” in the period from March 30 to June 30, 2020 and 2019 were studied. The analysis indicators of a hospitalization of patients in the department of acute poisoning and somatopsychiatric disorders of N.V. Sklifosovsky, the Research Institute of Emergency Medicine. Results. It was found that in the analyzed period of 2020 compared to 2019, the proportion of injured people of working age decreased by 11.2%, while it increased at the age of 0-17 years by 3.2 times. An increase in the number of consultations for individuals by 2.1 times was noted. There was an increase in the number of complaints about poisoning with antibiotics, drugs from the T45 group (anticoagulants, vitamins, etc.), T37 (antiviral, anti-microbial, etc.) by 1.7-2 times. In March-June 2020, there was an increase in the number of complaints about the toxic effects of alcohol (T51), an increase in hospitalized patients with acute alcohol poisoning by 4 times, and with combined alcohol poisoning – by 2.7 times. The number of complaints about poisoning with detergents and disinfectants in the first three months of the pandemic increased by 2.7 times. Conclusion. The pandemic and the introduction of restrictive measures for COVID-19 have affected the toxicological situation in Moscow, which must be taken into account when determining the guidelines for organizational measures for the provision of medical care for acute chemical poisoning during the COVID-19 pandemic.

Актуальність. Проблема гострих алкогольних психозів (ГАП) залишається в центрі уваги вітчизняних і закордонних дослідників. В Україні проблема ефективного лікування тяжких форм ГАП, а саме делірію, сьогодні здебільшого залишається невирішеною, зокрема щодо питання досягнення адекватної й ефективної седації пацієнтів. Це обумовлено, з одного боку, тим, що недостатній рівень седації змушує медичний персонал використовувати додаткові методи примусової фіксації (грудна клітка, нижні кінцівки) таких пацієнтів з метою створення певного контролю перебування у відділенні, з іншого боку, надмірна седативна терапія потребує старанного контролю за показниками вітальних функцій, у першу чергу зовнішнього дихання. Збільшення дози препаратів для седації та використання додаткових лікарських засобів із пригнічуючим впливом на роботу центральної нервової системи негативно впливають на діяльність органів, що здійснюють детоксикаційну функцію, зокрема печінку, яка і без того уражена і спровокована алкоголем, що, в свою чергу, впливає не тільки на тривалість перебування пацієнтів у відділенні інтенсивної терапії (ВІТ) і результат лікування, але й збільшує його вартість. Мета. Аналіз впливу застосування різних схем седації у пацієнтів із тяжким перебігом алкогольного делірію (АлД), що діагностований за критеріями шкали діагностики делірію (Delirium Detection Score, DDS), на час перебування у ВІТ, швидкість і частоту досягнення ефективної седації, необхідність додаткової фіксації і тривалість перебування у ВІТ. Матеріали та методи. Упродовж 2016–2017 років на базі ВІТ КЗ «Черкаська обласна психіатрична лікарня» обстежено й проліковано 36 пацієнтів чоловічої статі з тяжким перебігом АлД віком від 35 до 50 років (42,5 ± 7,5 року) і тривалим алкогольним анамнезом від 6 до 12 років (9 ± 3 року). Алкогольний делірій діагностували за критеріями DDS і проводили попереднє опитування згідно з Alcohol Use Disorder Identification Test (AUDIT-тест). Усім хворим проводили комплексне інтенсивне лікування: фармакологічну корекцію синдрому психомоторного збудження, детоксикацію та корекцію порушень водно-електролітного балансу (інфузія збалансованих сольових розчинів об’ємом 40–50 мл/кг у першу добу лікування з подальшою корекцією темпу інфузії згідно з розрахунком добової потреби і патологічних витрат у подальші дні); корекцію дефіциту магнію розчином 25% MgSO4 30–40 мл/добу, тіосульфат натрію внутрішньовенно (в/в) болюсно 30% розчином у дозі 20–30 мл/добу протягом усього періоду лікування; корекцію порушень церебрального метаболізму (вітаміни: В1 5% 12 мл/добу, В6 5% 8 мл/добу, РР 4–6 мл/добу, інозин (рибоксин) 20 мл в/в, альфа-ліпоєва кислота (берлітіон) 600 мг/добу). Залежно від використання схеми седації пацієнти були розподілені на дві групи: група А (n = 18) отримувала діазепам (діазепекс) 0,5% по 4 мл внутрішньом’язово (в/м) кожні 8 годин і натрію оксибутират 20% по 10 мл у вигляді постійної інфузії на 0,9% розчині NaCl 400 мл упродовж 4 годин двічі на добу; група В (n = 18) отримувала діазепам 0,5% по 4 мл в/м кожні 8 годин і фенобарбітал по 200 мг per os 2 рази/добу. Результати. Цільовим результатом було досягнення рівня седації від –2 до 0 за шкалою Річмонда протягом усього періоду введення седативних препаратів (3–4 дні) без застосування допоміжних методів примусової фіксації та інших фармакологічних ад’ювантів. Висновок. Результати свідчать про те, що застосування інфузії натрію оксибутирату в поєднанні з базовим застосуванням препаратів групи бензодіазепінів мало істотну перевагу щодо досягнення цільового рівня седації у пацієнтів із тяжким перебігом алкогольного делірію порівняно з прийомом фенобарбіталу. Причому зросла тривалість перебування хворих групи фенобарбіталу у ВІТ. Такий результат, можливо, пояснюється тим, що при комбінації бензодіазепінів і оксибутирату натрію спочатку відбувається підсумовування седативного ефекту за рахунок дії на ГАМК-рецептори, зв’язані з Cl-іонним каналом, внаслідок чого виникає компенсаторне накопичення глутамату, тому пробудження пацієнта після відміни препаратів настає швидче.

Annotation. Alcohol is a one of the most frequently consumed substances of abuse, which can cause addiction or alcohol use disorders (AUDs). Alcohol addiction leads to decrease of the life quality of patients and considerable economic burden. Neuronal mechanisms of addiction are intensively studied. One of the most important systems involved in this process is a brain reward system that includes lateral septum (LS). Additionally alcohol consumption changes activity of the neurotransmitter systems including the nitric oxide (NO). Recent studies for blockage of nitric oxide synthase (NOS) for cocaine addiction and late stages of AUDs demonstrated that a group of the substances known as blockers of NOS can be referred to as candidates for alcohol addiction therapy. The aim of our research was to investigate histochemical characteristics of NO-system in LS, its response to acute alcohol intoxication including or excluding neuronal NOS (nNOS) blockage with selective inhibitor – 7-nitroindazole (7-NI). This study involved three experimental groups of animals (control group (n=4), group with acute alcohol intoxication (n=4), group of nNOS blockage with acute alcohol intoxication (n=4)). For statistical analysis, one-way Kruskal-Wallis test was implemented to reveal differences between groups (Matlab, Mathworks). We have identified NOS-positive structures in LS consisting of big neurons, medium/small neurons and nerve fibers. Acute alcohol intoxication activated subpopulations of NOS-positive medium/small neurons and nerve fibers. Moreover, we determined that ethanol-induced changes can be blocked with selective nNOS inhibitor 7-NI.

Background. The growth of industrialization is accompanied by a decrease in human motor activity, and chronic stress increases the risk of alcoholism. The combination of these factors has a negative effect on the physiological and biochemical processes in the body. Purpose of work. To determine the state of the components of the dopaminergic system in the hypothalamus and striatum of rats during acute alcoholization against the background of hypodynamia. Material and methods. The experiment was carried out on male rats weighing 180-200 g, which, after hypodynamia for a period of 7, 14 and 28 days, were once injected with 25% alcohol at a dose of 3.5 g / kg. The content of the components of the dopaminergic system was determined by high performance liquid chromatography. Results. The striatum is characterized by a decrease in the activity of the dopaminergic system on the 7th day of hypodynamia, followed by its activation with an increase in the period of immobilization to 28 days. In the hypothalamus in the early stages of hypodynamia with subsequent OAI, the changes are poorly expressed, however, on the 28th day, dopamine turnover is activated. Conclusions. The combined effect of acute alcohol intoxication and hypodynamia leads to more pronounced changes in the dopaminergic system in the striatum than in the hypothalamus. Acute alcohol intoxication has a stimulating effect on the dopaminergic system of the hypothalamus and striatum only for long periods of hypodynamia (28 days).

Moderate alcohol intake may impair stimulus-driven inhibition of motor actions in go/no-go and stop-signal tasks. Exposure to alcohol-related cues has been found to exacerbate this impairment. By contrast, the effect of alcohol use on intentional inhibition, or the capacity to voluntarily suspend an action, has rarely been investigated. We examined whether and how moderate alcohol intake affects stimulus-driven inhibition (stop-signal task) and intentional inhibition (chasing bottles task), during exposure to alcohol-related stimuli. One hundred and eleven participants were randomly assigned to an alcohol (male: 0.55 g/kg, female: 0.45 g/kg), placebo, or control group. For the stop-signal task, ANOVAs were performed on stop-signal reaction time (SSRT) and go RT with Pharmacological and Expectancy Effects of Alcohol, Stimulus Category (alcohol-related or neutral), and Sex as factors. For the chasing bottles task, multilevel survival analysis was performed to predict whether and when intentional inhibition was initiated, with the same factors. For the stop-signal task, Sex moderated the Pharmacological Effect of Alcohol on SSRT: only for females, alcohol consumption shortened SSRT. In the non-alcohol groups, males had shorter SSRT than females. Concerning intentional inhibition, the alcohol group initiated intentional inhibition less often, especially when stimuli were non-alcohol related. These findings indicate that (1) stimulus-driven inhibition and intentional inhibition reflect different aspects of response inhibition; (2) moderate alcohol intake negatively affects intentional inhibition (but not stimulus-driven inhibition). Speculatively, the observed impairment in intentional inhibition might underlie the lack of control over alcohol drinking behavior after a priming dose. This study highlights the potential role of intentional inhibition in the development of addiction. Electronic supplementary material The online version of this article (10.1007/s00426-020-01353-w) contains supplementary material, which is available to authorized users.

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.

Background It is well established that even moderate levels of alcohol affect cognitive functions such as memory, self-related information processing and response inhibition. Nevertheless, the neural mechanisms underlying these alcohol-induced changes are still unclear, especially on the network level. The default mode network (DMN) plays an important role in memory and self-initiated mental activities, hence studying functional interactions of the DMN may provide new insights into the neural mechanisms underlying alcohol-related changes. Methods We investigated resting-state functional connectivity (rsFC) of the DMN in a cohort of 37 heavy drinkers at a breath alcohol concentration of 0.8 g/kg. Alcohol and saline were infused in a single-blind crossover design. Results Intra-network connectivity analyses revealed that participants showed significantly decreased rsFC of the right hippocampus and right middle temporal gyrus under acute alcohol exposure. Moreover, follow-up analyses revealed that these rsFC decreases were more pronounced in participants who reported stronger craving for alcohol. Exploratory inter-network connectivity analyses of the DMN with other resting-state networks showed no significant alcohol-induced changes, but suffered from low statistical power. Conclusions Our results indicate that acute alcohol exposure affects rsFC within the DMN. Functionally, this finding may be associated with impairments in memory encoding and self-referential processes commonly observed during alcohol intoxication. Future resting-state functional magnetic resonance imaging studies might therefore also investigate memory function and test whether DMN-related connectivity changes are associated with alcohol-induced impairments or craving.

RationaleInhibition is a core executive function and refers to the ability to deliberately suppress attention, behavior, thoughts, and/or emotions and instead act in a specific manner. While acute alcohol exposure has been shown to impair response inhibition in the stop-signal and Go/NoGo tasks, reported alcohol effects on attentional inhibition in the Stroop task are inconsistent. Notably, studies have operationalized attentional inhibition variably and there has been intra- and inter-individual variability in alcohol exposure.ObjectiveThis study aimed to examine the acute effects of alcohol on attentional inhibition, considering previous limitations.MethodsIn a single-blind, cross-over design, 40 non-dependent participants with a medium-to-high risk drinking behavior performed a Counting Stroop task (CST) under a baseline and an arterial blood alcohol concentration (aBAC) clamp at 80 mg%. Attentional inhibition was assessed as the alteration of reaction times (RT), error rates (ER), and inverse efficiency scores (IES) between incongruent and congruent trials (interference score). Stroop performance was also assessed regardless of trial-type.ResultsCompared to saline, acute alcohol exposure via an aBAC clamp did not affect CST interference scores but increased RTs and IES in both incongruent and congruent trials.ConclusionsAttentional inhibition (Stroop interference score) was not impaired by clamped moderate alcohol exposure. Acute alcohol impaired Stroop performance evidenced by a general increase in response times. Our findings suggest that response and attentional inhibition do not share the same neurocognitive mechanisms and are affected differently by alcohol. Results could also be explained by automated behaviors known to be relatively unaffected by acute alcohol.

Introduction Despite the association of alcohol use with recurrent suicidal acts, individuals attempting suicide after drinking alcohol face barriers accessing crisis care following emergency assessment, demonstrated by higher odds of inpatient admission for those whose suicide attempt did not feature alcohol. This disparity may be due to suicidality dissipating more rapidly after a suicide attempt involving alcohol. We investigated the effect of acute alcohol use and ongoing suicidality on onward care decisions after emergency assessment. Methods We analysed electronic health records of 650 suicidal adults detained under Section 136 of the Mental Health Act (1983, amended 2007) for up to 36 h at a London psychiatric emergency care centre. We used logistic regression to estimate the association of acute alcohol use and ongoing suicidality (including their interaction) with admission to psychiatric hospital. Results Fifteen percent of previously intoxicated detainees expressed suicidal intent at detention end, compared to 24% of detainees who had not used alcohol prior to detention. Compared to those who were not previously intoxicated and not suicidal at detention end, acute alcohol use was associated with reduced odds of admission amongst those no longer suicidal (AOR 0.4, 95% CI 0.2, 0.6). Where suicidality persisted, odds of admission rose; however, the magnitude of increase when in combination with prior alcohol use (AOR 3.6, 95% CI 1.9, 7.1) was under half that of when alcohol was not involved (AOR 8.2, 95% CI 3.5, 19.1). Discussion and Conclusions Acute alcohol use is associated with transient suicidality, but this only partially accounts for disparities in care following suicide attempts.

Spontaneous rupture of the urinary bladder (SRUB) is a rare clinical condition. Prompt diagnosis is often difficult both clinically and radiologically and necessitates a high index of suspicion as the patients present with non-specific abdominal pain and may not offer a clear history. The depressant effect of alcohol further complicates the diagnosis. We report a case of a young male who was unable to seek medical support and was found dead within 12 hours of the onset of abdominal discomfort following acute alcohol intoxication. At autopsy, rupture of the urinary bladder with blood and blood clots was found in the pelvic cavity with no any corresponding external injury. Spontaneous rupture of the urinary bladder is a rare cause of death in acute alcohol intoxication. In order to further understand this rare condition, the review of related literature has been done.

Background. One of the tasks of the forensic medical examination of acute alcohol intoxication on a corpse is to determine the amount of alcohol taken shortly before death. The disadvantage of existing methods for solving this problem is the need to remove fluid by spinal puncture of the corpse and determine the concentration of ethanol in it. This article shows for the first time the possibility of automated post-mortem determination of the amount of alcohol consumed without knowledge of the parameter ethanol concentration in the spinal fluid. Aim. To develop a mathematical model for postmortem determination of ethanol intake, based on objective parameters of ethanol kinetics and not containing the parameter of ethanol concentration in the spinal fluid, to implement the developed model in the format of a computer program. Material and methods. Regression and simulation mathematical modeling of single-dose ethanol kinetics. Writing the text of a computer program in C#. Results. A set of mathematical models has been developed to enable objective post-mortem determination of the amount of ethanol intake without the need for sampling and chemical-toxicological analysis of the spinal fluid. The set of computational procedures is implemented in the format of the computer program “Alcohol calculator Z 4.0.” Conclusions. The developed method of postmortem determination of ethanol intake and the program “Alcohol calculator Z 4.0” created on its basis are recommended for use in the forensic examination of acute alcohol intoxication on a corpse.

The relevance of a subject is conditioned by the extreme importance of the medical and social issues of providing medical care services to patients with acute alcohol intoxication. This research is conducted to find ways to optimize medical care services for patients with the diagnosis “toxic effect of ethanol” (ICD-10-CM code T51.0). For this study, was analysed: course of 13172 clinical cases and the possibility of treating this pathology in the hospital emergency departments. Statistical and analytical methods were used to study data from the medical information system of The Saint Petersburg Research Institute of Emergency Medicine n. a. I. I. Dzhanelidze. As a result of the study the place of treatment of patients with diagnose “toxic effect of ethanol” was determined: for mild and moderate patient — emergency departments of multi-specialty hospitals, and for severe patient — in specialized acute poisoning treatment Center.

As acute alcohol intake can trigger suicidal ideas and attempts in people already at risk, and self-aggression is more intense after alcohol consumption, the aim of this study is to assess the rela...

Objective: Heightened nocturnal blood pressure (BP) may be attributed to the disruption of sleep, a condition worsened by alcohol ingestion. This study investigated the effects of acute alcohol ing...

Alcoholism is a risk factor for the development of cognitive decline and dementia. Here we demonstrated that the glymphatic function in the brain was impaired by alcohol administration. Acute moderate alcohol administration substantially retarded and reduced the entry of subarachnoid cerebrospinal fluid (CSF) via the paravascular space into the cerebral parenchyma, thus impaired CSF-interstitial fluid (ISF) exchange and parenchymal amyloid β (Aβ) peptide clearance. The elevated release of β-endorphin and reduced cerebrovascular pulsatility after acute alcohol administration may account for the impairment of the glymphatic function. Chronic moderate alcohol consumption led to pronounced activation of astrocytes and a widespread loss of perivascular AQP4 polarization in the brain, which results in an irreversible impairment of the glymphatic function. The results of the study suggest that impaired glymphatic functions and reduced parenchymal Aβ clearance found in both acute and chronic alcohol treatment may contribute to the development of cognitive decline and dementia in alcoholism.

Objectives - statistical estimation of the physiological limits of the quantitative distribution of ethanol in cadaveric blood and bladder urine and development of an automated method for diagnosing postmortem artifacts of forensic medical examination of acute alcohol intoxication on the corpse. Material and methods. We performed a retrospective statistical analysis of the results of toxicological determination of ethanol concentration in a blood and in the urine in 2376 deaths from acute alcohol intoxication. Results. Regression equations have been developed that allow us to determine the physiological limits of the quantitative distribution of ethanol in blood and urine with any confidence probability for any degree of alcohol intoxication and phase of acute alcohol intoxication. The set of computational procedures is implemented in the format of the computer program "Alcohol calculator Z 3.0". Conclusion. If the concentrations of ethanol in the blood or in the urine are beyond their physiological limits, the results of toxicological analysis should be considered as a postmortem artifact.

In Mexico, underage alcohol consumption is a major public health problem. Notwithstanding the complex character of alcohol consumption, evidence indicates that enforcing the policies aimed to control the availability of alcohol has produced positive outcomes and has proved to be one of the most cost-effective strategies for curbing consumption, as well as they have succeeded in reducing health and social problems associated to alcohol use. Evaluate the effect of enforcing compliance with minimum-age restrictions for the sale of alcoholic beverages in the number of cases of acute alcohol intoxication in underage population in Mexico. A controlled interrupted time series analysis (ITSA) model was resorted in order to assess the effect of enforcing the ban of alcohol sales to underage individuals at national level in Mexico. The outcome variable was cases of acute alcohol intoxication (F10.0) discharged in emergency services in the group from 10 to 19 years of age. We found a statistically significant drop (16.4%) in the cases of acute alcohol intoxication immediately after the program implementation. This result suggests that monitoring and enforcing strategies to ban alcohol sales to underage individuals can provide an effective tool to reduce the negative outcomes of underage alcohol consumption.

Alcoholism leads to many diseases, and it is also the social and economic burden of the society. Alcohol intake is the main cause of acute liver injury and chronic liver disease. Here, the ameliorative effect of NADH and dihydronicotinamide riboside (NRH) against alcohol-induced liver damage was studied and its possible mechanism was further clarified. In vitro studies showed that NADH and NRH are effective NAD+ concentration-enhancing agents. Compared with NMN, NADH and NRH can provide greater NAD+ increase at the same concentrations. Intraperitoneal injection of NADH and NRH in C57BL/6J mice also significantly increased the NAD+ content in liver, blood, brain, fat and kidney. Importantly, NADH and NRH significantly increased the liver NAD+/NADH ratio, but did not induce apoptosis markers in cells. The intragastric administration of 500 mg/kg NRH, 500 mg/kg NADH 15 min prior to acute alcohol ingestion (8 ml/kg, 40% w/v, in tap water) could dramatically enhance alcohol metabolism as revealed by the reduced concentrations of ethanol and acetaldehyde in blood as well as the decreased duration of the loss of righting reflex (LORR). Both Pretreatment and posttreatment with NADH or NRH could significantly reduce the increase of serum aspartate transaminase (AST) and alanine transaminase (ALT) after alcohol administration, indicating that they have a certain therapeutic effect on alcoholic hepatotoxicity besides preventing the adverse effects caused by alcohol. NADH and NRH could also alleviate lipid peroxidation as indicated by the repressed malondialdehyde (MDA) level and the elevated activities of superoxide dismutase (SOD) in liver tissues. Additionally, NADH or NRH can mitigate the abnormal lipid metabolism in acute alcoholic liver damage. These benefits obviously suggested that NADH or NRH could be a potential nutraceutical or pharmacological agent for promoting alcohol metabolism and preventing or treating early liver injury caused by acute alcohol exposure.

Background Acute alcohol intake may influence nasal patency; however, there is lack of objective evidence. Objective The aim of this study was to evaluate the effects of acute alcohol intake on nasal patency employing both subjective and objective measures. Methods A total of 31 participants were classified into 2 groups of non-heavy drinkers (n = 17) and heavy drinkers (n = 14). Both groups consumed wine in 1 h and were assessed for subjective nasal symptoms and objective nasal patency, using rhinomanometry and acoustic rhinometry, at baseline and at 0.5, 2, and 6 h post-alcohol consumption. Results Alcohol consumption significantly increased nasal obstruction from baseline values in both heavy and non-heavy drinking groups. Total nasal volume (TNV) and the minimal cross-sectional area (MCA) were significantly decreased and nasal airway resistance (NAR) significantly increased from baseline values by 2 h post-alcohol consumption for both heavy and non-heavy drinking groups ( P Conclusion Acute alcohol consumption may impair nasal patency, independent of the amount consumed. Individuals with allergic rhinitis may be more prone to nasal obstruction after alcohol consumption than those without allergic rhinitis.

Acute alcohol intoxication is a condition frequently defined in childhood, especially in adolescents, and is seen as extremely rare in infants. In this study, acute alcohol intoxication developed after accidentally spilling alcohol with 96% concentration to the face of a 19-day-old neonate during umbilical care is presented because it is a rare case in the neonatal period.

The aim of the study was to investigate the features of damage to the structures of the brain in acute carbon monoxide (CO) poisoning. The results of forensic, microscopic and morphometric studies of the brain of 78 corpses died from acute carbon monoxide poisoning are presented. The peculiarities of damage to the nervous tissue, the glial complex, as well as changes in the structures of blood vessels and the state of intravascular blood with the formation of aggregates, sludge, and blood clots were revealed. These changes along with perivascular and pericellular edema indicate the agonal death of the victims. When the carboxyhemoglobin concentration in the blood is about 30% the brain structures' lesions begin to appear; their intensity increases when the carboxyhemoglobin concentration is more than 60%. According to the authors, the substantiation of the thanatogenesis of various types of carbon monoxide poisoning requires further research taking into account the age of the victims, the carboxyhemoglobin concentration in the blood, the duration of the agonal period, as well as possible (competing) conditions: for example, acute alcohol intoxication, thermal injury, etc. Still urgent the studies of structures of other target organs of CO - heart and lungs.Изучить особенности поражения структур головного мозга при остром отравлении угарным газом (CO). Приведены результаты судебно-медицинских, микроскопических и морфометрических исследований головного мозга 78 трупов погибших от острого отравления угарным газом. Выявили особенности поражения нервной ткани, глиального комплекса, а также изменения в структурах сосудов и состоянии внутрисосудистой крови с формированием агрегатов, сладжей, тромбов. Эти изменения наряду с периваскулярным и перицеллюлярным отеком свидетельствуют об агональном умирании пострадавших. При содержании в крови около 30% карбоксигемоглобина начинают проявляться поражения структур головного мозга, интенсивность их возрастает при содержании карбоксигемоглобина более 60%. По мнению авторов, обоснование танатогенеза различных видов отравления угарным газом требует дальнейшего исследования с учетом возраста пострадавших, содержания карбоксигемоглобина в крови, длительности агонального периода, а также возможных фоновых (конкурирующих) состояний: например, острой алкогольной интоксикации, термической травмы и др. Актуальны исследования структур и других органов-мишеней CO — сердца и легких.

Background The primary objective of this study is to determine whether age at first alcohol use is a determinant for adolescent acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and blood alcohol concentration (BAC) at hospital admission. Around the world, as in the Netherlands, a key aim of alcohol policy is to postpone the age at first alcohol use. This is based on cohort studies that indicate a relationship between a younger age at first alcohol use and subsequent adult alcohol use disorders. Methods This study was conducted using a cohort of data comprising individuals under 18 years of age. Data were collected between 2007 and 2017 by the Dutch Pediatric Surveillance System (NSCK) in order to monitor trends in admissions for acute alcohol intoxication. Multivariate linear regression analyses were used to determine the association between age at first alcohol use and acute alcohol intoxication characteristics, such as age at first acute alcohol intoxication and BAC at admission. Results This study indicates that among adolescents admitted for acute alcohol intoxication, adolescents who started drinking at ≤ 14 years of age are significantly more often female, lower educated, and raised in nontraditional family structures than adolescents who started drinking between 15 and 18 years of age. Multiple linear regression analyses indicated that age at first alcohol use, corrected for covariates, significantly predicted the age at acute alcohol intoxication and BAC at admission. The association between age at first alcohol use and age at intoxication was also found to be clinically relevant. Conclusions Although causation cannot be implied based on the results of these analyses, the results of this study suggest that interventions delaying the age at first alcohol use could be successful in increasing the average age that adolescents are admitted to the hospital for acute alcohol intoxication.

Objective: King County Emergency Medical Services (EMS) and community partners implemented a sobering center pilot to provide an alternative destination outside of the Emergency Department ...

To investigate the effectiveness and safety of Xingnaojing Injection (XNJ, 醒脑静注射 液) compared with naloxone for the treatment of acute alcohol intoxication (AAI), and provide the latest evidence through evidence-based approach. Seven electro-databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure Databases, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database (VIP) and Wanfang Database were searched from the inception to January 2018. Randomized controlled trials (RCTs) comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included: patients' conscious recovery time, stay length in emergency department, disappearance time of the ataxia symptom, the severity of the symptoms, the blood alcohol content as well as the adverse events. Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Collaboration. Meta-analysis was conducted by Review Manager 5.3 software. Totally 141 trials with 13,901 patients were included in this review, all of them were assessed as unclear or high risk of bias. Results showed that on the basis of routine therapy, standard dose XNJ (10–20 mL) may have similar results with naloxone on the recovery time of consciousness (MD 12 min, 95% CI 7.2–17.4 min) and disappearance time of symptoms (MD 6 min, 95% CI–13.8–25.8 min) for patients with AAI. Larger dose of XNJ Injection (21–40 mL) may speed up the time (almost 1 h earlier). Combination of XNJ and naloxone seemed superior to the naloxone alone for all the relevant outcomes. The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50% the combination group than in the control group (RR 1.42, 95% CI 1.29 to 1.56). No severe adverse events or adverse reactions of XNJ were reported in the included trials. Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI. We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review. Registration number. in PROSPERO (No. CRD42018087804)

Currently, nephrectomy is performed for various diseases, and the number of this type of surgery does not have a clear tendency to decrease. Operational stress is accompanied by a triggering mechanism for a wide range of disorders, among which psycho-emotional and vegetative (vascular) reactions are important clinical markers. The study of the systemic adaptive reactivity of the body after nephrectomy will provide an integrated approach to the study of the problem of the postoperative period and the rehabilitation of the patient in clinical practice. Objective: to identify the effect of nephrectomy on the overall adaptive response of animals when white rats are exposed to damaging physical loads (acute hyperthermia) and chemical (acute alcohol poisoning, nephrotoxic agents) of nature, normobaric hypoxia, limiting muscular loads and immobilization stress. The results of the experiment showed that laboratory animals with a single kidney become more sensitive (1.5 times) to nephrotoxic agents. Analysis of the effect of nephrectomy on the overall adaptive response of animals under the influence of various damaging factors to reduce the body’s resistance to hypoxia by 20% (p > 0.05); to limit muscular loads – by 25% (p > 0.05); hyperthermia – by 25% (p < 0.05); chemical agents – by one third (p < 0.05); to immobilization stress – by 28% (p < 0.05). Conclusion. The study demonstrated a significant negative impact of nephrectomy on the overall adaptive capacity of the body and allowed to clarify the functional characteristics of the general adaptation disorders in connection with this operation.

Binge consumption of alcohol results in severe global health problem. This study aimed to explore the potential efficacy of nuciferine (NCF) in protecting acute alcohol-induced liver injury and the underlying molecular mechanisms. We revealed that NCF activated Nrf2/HO-1 signaling in HepG2 hepatocytes and relieved alcohol-induced ROS generation and subsequent cell death. Mechanistically, suppression of miR-144 expression contributed to NCF-mediated activation of Nrf2/HO-1 signaling. Consistently, NCF modulated hepatic miR-144/Nrf2/HO-1 axis and alleviated acute alcohol-induced liver injury as well as concomitant oxidative stress and inflammation in mice. In addition, suppressing the catalytic activity of HO-1 by ZnPP, an inhibitor of HO-1, diminished the hepatoprotective effects of NCF. The ameliorative effects of NCF on acute alcohol-provoked hepatic oxidative stress and inflammation were also crippled by ZnPP. Taken together, our data suggested that NCF is able to relive acute alcohol-induced liver injury and modulating miR-144/Nrf2/HO-1 cascade is implicated in the hepatoprotective activity of NCF.

This study investigated the effect of alcohol consumption on some male reproductive hormone (Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), and Testosterone (TT) levels in Nnewi Metropolis. Seventy two subjects comprising of 41 male (21 acute and 20 chronic) alcohol consumers and 31 controls aged between 18 and 50 years old were recruited for this study. Anthropometric data (height, weight and body mass index (BMI) as well as socio-demographic data of the subjects were obtained. Thereafter, 5mls of blood sample was collected from each subject and dispensed into plain container and used for laboratory analysis. Serum LH, FSH, and TT levels were estimated using Enzyme Linked Immunosorbent Assay (ELISA) method. The result revealed a significantly higher mean weight, BMI as well as serum LH levels respectively in alcohol consumers than in control (p0.05). More so, the mean weight, BMI, as well as serum LH and FSH levels were similar in both acute and chronic alcohol consumers respectively (p>0.05), While there was a significant decrease in the mean serum TT level in chronic alcohol consumers than in acute alcohol consumers (p Keywords: Alcohol consumption, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), Testosterone, Weight, Body mass index, Hypogonadism.

Aims The risk of injury from alcohol consumption was analyzed by gender, controlling for frequency of heavy drinking occasions, and by cause of injury (traffic, violence, fall, other). Methods Case-crossover analysis was conducted on 18,627 injured patients arriving at the emergency department (ED) within six hours of the event. Findings Risk of injury was similar for females and males at ≤3 drinks prior to injury (OR = 2.74 vs. 2.76, respectively). At higher volume levels females were at greater risk than males, and significantly so at 3.1–6 drinks and 6.1–10 drinks (gender by volume interaction: OR = 0.60, CI = 0.39–0.93 and OR = 0.50, CI = 0.27–0.93, respectively). For those reporting 5+ ≥ monthly, females were at higher risk than males at all volume levels, and the gender by volume interaction was stronger than for those consuming 5+ Conclusions Females are at higher risk of injury than males, regardless of frequency of heavy drinking and for all causes other than those related to traffic.

Death due to acute alcohol poisoning lacks specific anatomical characteristics, compared with other deaths due to drug poisoning. We report three forensic cases of death from acute alcohol poisoning due to inhibition of the respiratory centre and eventual asphyxia. Blood alcohol concentrations in the three fatalities were 5.28, 3.33 and 3.78 mg/mL, respectively. Lethal doses and blood alcohol concentrations showed differences between individuals. Detailed auxiliary tests besides autopsy were undertaken. These cases show that forensic scientists should exclude other causes of death, combine the autopsy with auxiliary tests, and then make an appraisal.

Objective This study aimed to clarify the role of acute alcohol use and alcohol use disorder in individuals exhibiting suicidal behaviors, including repetition of suicide attempt. Methods Data pertaining to 691 suicide attempters who had visited an emergency center and had been followed-up from 2010 to 2015 were gathered. Participants were categorized into following three groups according to alcohol use pattern at the time of the suicide attempt: 1) suicide attempters with neither alcohol use disorder nor acute alcohol consumption (NAU), 2) suicide attempters who had used alcohol during the suicide attempt but did not have alcohol use disorder (AAU), and 3) suicide attempters with alcohol use disorder (AUD). Group comparisons and multivariate Cox proportional models for suicidal behavior were used for statistical analysis. Results AUD have been shown to have lower lethality of suicide attempt but higher risk of suicide reattempts in the future. Furthermore, positive relationships between suicide reattempts and AUD persisted throughout the longer period than other groups. Conclusion Suicide attempters with AUD should be considered a high-risk group for suicide reattempts in future, and this group should be followed-up for a longer period with specialized care program.

OBJECTIVE: Despite the substantial number of older adult drinkers, few studies have examined acute alcohol effects in aging samples. We have explored these interactions across a variety of neurobehavioral domains and modalities and have consistently observed age-contingent vulnerabilities to alcohol-associated decrements in neurobehavioral functions. However, these studies have not been sufficiently powered to address sex differences, and, thus far, no attempt has been made to replicate results. The current study addresses these gaps. METHOD: The study used a double-blind, placebo-controlled, factorial design with two age groups (older, 55–70 years; younger, 25–35 years) and three doses (target breath alcohol concentrations: .00, .04, and .065 g/dl). Replication analyses used an independent sample (n = 90) to replicate age-contingent alcohol effects reported by Boissoneault (n = 90). Samples were combined (N = 180; 91 women) to enable sex analyses. The dependent measure was performance efficiency in a visual working memory task. RESULTS: A complex interaction between sex, age, and dose, F(2, 178) = 4.15, p = .02, appeared driven by age-contingent divergence in working memory performance, which was most pronounced between women at the .065 dose, t(28) = 4.61, p < .01, d = 1.68. Replication analyses revealed a pattern of age differences consistent with previous results, although the previously reported age by alcohol interaction failed to reach statistical significance. CONCLUSIONS: Results provide further support for the hypothesis that neurobehavioral effects of acute alcohol are age dependent and offer evidence that this interaction may be moderated by sex. Extensions of this work are needed to identify underlying processes and ascertain the functional impact of these effects on the health and well-being of aging adult drinkers.

Background Prior studies have shown that resting heart rate variability (HRV) is reduced in those with alcohol use disorders (AUD). However, HRV following an acute stressful stimulus (reactive HRV), and the relationship between resting or reactive HRV and drinking, craving and relapse in AUD have received less attention. Methods Studies using HRV in relationship to acute or chronic alcohol consumption were included in this review. Manuscripts that related to alcohol in the context of cardiovascular disease were excluded. Results Thirty-three articles were included and findings are presented in healthy social drinkers, moderate/heavy drinkers without AUD and individuals with AUD. Results on resting and reactive HRV were presented separately. Acute alcohol reduced resting HRV in healthy subjects but healthy controls had higher resting HRV then AUD subjects and moderate/heavy drinkers (in some studies). Resting HRV improved in AUD subjects only after at least 4 months of abstinence. AUD subjects had higher reactive HRV scores when compared to controls. In AUD subjects increased reactivity was related to more craving, faster relapse and more negative mood. Reactive HRV showed slower improvement with abstinence in AUD subjects. Conclusions Chronic, heavy alcohol has a negative effect on the autonomic nervous system and may be a sensitive biomarker of craving and relapse.

Alcoholism is one of the risk factors for cerebrovascular diseases. Our previous study demonstrated that acute alcohol intoxication enhances brain injury and neurological impairment in rats suffering from intracerebral hemorrhage (ICH). We plan to investigate the effect of chronic alcohol consumption (CAC) in rats with ICH by magnetic resonance imaging (MRI).Sixteen Sprague-Dawley male rats were divided into 2 groups: CAC group (fed with 10% alcohol drinking water for 4 weeks, n = 8), and Control group (plain drinking water, n = 8). ICH was induced by collagenase infusion into the right striata of all rats. Coronal T1-weighted imaging, T2-weighted imaging, T2*-weighted imaging, and diffusion-weighted imaging were generated with a 3.0T MRI scanner to investigate the changes of hemorrhagic volume and edema throughout the injury and recovery stages of ICH in rats.T2-weighted imaging is ideal for monitoring hematoma volume in rats. The hematoma volume was larger in the CAC group than in the control group (P.001), however, did not correlate to post-ICH progressive edema formation (P.7), and neurological impairment (P.28) between the 2 groups, respectively.Although our findings indicate that CAC induces larger hematoma in rats with ICH, the underlying mechanism should be studied in the future.

Aims We examined (a) the effect of an acute dose of alcohol on the consumption of energy-dense food and (b) on cognitive bias towards high-energy-dense food cues and (3) whether the effect of an acute dose of alcohol on the consumption of energy-dense food would be mediated by cognitive bias towards high-energy-dense food cues. Methods Heavy social drinkers (n = 40) abstained from drinking for 12 hours before testing. On the test day, participants completed pre-challenge measures of alcohol and food craving, and cognitive bias towards alcohol in a placebo-controlled, double-blind design. Participants performed post-challenge measures of alcohol and food craving, ad lib energy-dense food consumption and cognitive bias. Results We did not observe any of the hypothesized interactions between challenge condition, consumption of energy-dense food and cognitive bias towards high-energy-dense food cues. Conclusions Our data suggest that acute alcohol consumption does not influence the consumption of energy-dense food or cognitive bias towards high-energy-dense food cues. These findings may reflect that alcohol does not increase the appetitive value of food and food-related cues or that the measures used in this study were not sensitive to detect an effect. Further research is required to determine whether alcohol at higher doses and/or food cues that are frequently paired with alcohol intake stimulates changes in food intake and the reward value of food cues.

Non-invasive continuous alcohol (ethanol) monitoring has potential applications in both population research and in clinical management of acute alcohol intoxication or chronic alcoholism. Current wearable monitors based on transdermal alcohol content (TAC) sensing have limited accessibility and blood alcohol content (BAC) quantification accuracy. Here we describe the development of a self-contained discreet wearable transdermal alcohol (TAC) sensor in the form of a wristband or armband. This sensor can detect vapor-phase alcohol in perspiration from 0.09 ppm (equivalent to 0.09 mg/dL sweat alcohol concentration at 25 °C under Henry’s Law equilibrium) to over 500 ppm at one-minute time resolution. Additionally, a digital sensor was employed to monitor the temperature and humidity levels inside the sensing chamber. Two male human subjects were recruited to conduct studies with alcohol consumption using calibrated prototype TAC sensors to validate the performance. Our preliminary data demonstrated that, under well-controlled conditions, this sensor can acquire TAC curves at low doses (1–2 standard drinks). Moreover, TAC data for different doses can be easily distinguished. However, substantial interpersonal and intrapersonal variabilities in measurement data were also observed in experiments with less controlled conditions. Our observations suggest that perspiration rate might be an important contributing factor to these variabilities. Further studies with sufficient sample sizes are required to validate and characterize the impact of different perspiration rates on TAC sensors, which may inform more reproducible and accurate sensor designs in the future.

Background Although the relationship between acute alcohol consumption and injuries is well recognized, studies exploring how the time of day the drinking commences affects alcohol-related injuries have been scarce. This contribution examines the associations between the time at which the drinking began and the duration of the drinking, the volume of alcohol consumed, the injury type, and the blood alcohol concentration (BAC) level. Method This study employed a cross-sectional survey, which was conducted in two hospital emergency departments (ED) in Chiangmai Province, Thailand. The sample was composed of 519 injured patients aged 18 years and older. Outcome measures included the BAC and type of injury. Exposures included the quantity of alcohol consumed, the time the drinking commenced, and the pattern of drinking involved. Results The injured patients who drank alcohol within six hours prior to sustaining their injury were more likely to get injured and present themselves at the ED at night (20:00–04:00) compared to those who sustained an injury but did not drink in the hours prior. However, this relationship was only true for unintentional injuries, not intentional ones. The majority of participants consumed their first drink between 16:00 and 20:00. On average, among the 104 patients who drank prior to sustaining an injury, the total amount of alcohol consumed was 6.9 drinks, the duration of drinking was 2.6 h, the rate of drinking was 6.0 drinks/hour, and the BAC was 0.119 gm%. Every drink increased the BAC by 0.012 gm% and each year of increasing age increased the BAC by 0.003 gm%. People who were older, less educated, and drank more frequently tended to have their first drink earlier than other drinkers. An earlier start to their drinking resulted in a faster pace of drinking and a higher BAC. Conclusions BAC increased with the total amount of alcohol consumed and the age of the drinker. Different groups of people had their first drink at different times of the day, resulting in differences in the rate of drinking, the BAC, the time of injury, and the time they presented to the ED after injury.

Aim Although decreased level of consciousness (DLOC) while driving may lead to serious accidents involving drivers and people around them, including passengers and pedestrians, few studies have assessed traffic injuries attributable to preceding DLOC. We aimed to identify factors suggestive of a DLOC preceding traffic injury during initial examination. Methods This study included 193 drivers who were brought to our facility during the 1‐year period from January to December 2018. The drivers were divided into those with and without DLOC for comparison and analysis. Data on age, sex, causes of DLOC, and medical history were retrospectively reviewed from medical records. Results Of these 193 drivers, 58 (30.1%) had experienced preceding DLOC. The following factors suggested possible episodes of preceding DLOC: a single‐vehicle accident (odds ratio [OR] 3.59; 95% confidence interval [CI] 1.76–7.34; P, 30.1% of drivers had decreased level of consciousness before a traffic accident.

Background:Prospective memory is a critical neurocognitive capacity that refers to the ability to execute delayed intentions. To date, few studies have investigated the effects of acute alcohol consumption on prospective memory, and important questions remain about the mechanisms that might underpin acute alcohol-induced prospective memory impairment.Aims:The current study sought to clarify the nature and magnitude of prospective memory difficulties following acute alcohol consumption and to test the degree to which any problems with prospective remembering might be a secondary consequence of broader cognitive impairment. This study also investigated whether there were potential sex differences.Methods:In all, 124 healthy adult social drinkers were assigned to either the alcohol ( n = 61) or placebo ( n = 63) condition. Participants were administered a dose of 0.6 g/kg alcohol or a matched placebo drink and then asked to complete a measure of prospective memory. A broader neurocognitive test battery was also administered.Results:Relative to the placebo condition, acute alcohol intoxication led to significant impairment on all prospective memory tasks, with effects mostly large in magnitude. These difficulties could not be explained by broader problems in retrospective memory, executive function or episodic future thinking. In addition, females recorded a higher blood alcohol concentration than males; however, no sex differences in prospective memory performance were identified following acute alcohol use.Conclusion:The results show that acutely, even a moderate dose of alcohol substantially impairs prospective memory function. These findings have potentially important implications for understanding many of the maladaptive behaviours associated with acute alcohol consumption.

Binge drinking, i.e., heavy episodic drinking in a short time, has recently become an alarming societal problem with negative health impact. However, the harmful effects of acute alcohol injury in the gut-liver axis remain elusive. Hence, we focused on the physiological and pathological changes and the underlying mechanisms of experimental binge drinking in the context of the gut-liver axis. Eight-week-old mice with a C57BL/6 background received a single dose (p.o.) of ethanol (EtOH) [6 g/kg b.w.] as a preclinical model of acute alcohol injury. Controls received a single dose of PBS. Mice were sacrificed 8 h later. In parallel, HepaRGs and Caco-2 cells, human cell lines of differentiated hepatocytes and intestinal epithelial cells intestinal epithelial cells (IECs), respectively, were challenged in the presence or absence of EtOH [0-100 mM]. Extracellular vesicles (EVs) isolated by ultracentrifugation from culture media of IECs were added to hepatocyte cell cultures. Increased intestinal permeability, loss of zonula occludens-1 (ZO-1) and MUCIN-2 expression, and alterations in microbiota-increased Lactobacillus and decreased Lachnospiraceae species-were found in the large intestine of mice exposed to EtOH. Increased TUNEL-positive cells, infiltration of CD11b-positive immune cells, pro-inflammatory cytokines (e.g., tlr4, tnf, il1β), and markers of lipid accumulation (Oil Red O, srbep1) were evident in livers of mice exposed to EtOH, particularly in females. In vitro experiments indicated that EVs released by IECs in response to ethanol exerted a deleterious effect on hepatocyte viability and lipid accumulation. Overall, our data identified a novel mechanism responsible for driving hepatic injury in the gut-liver axis, opening novel avenues for therapy. This work was supported by the MINECO Retos SAF2016-78711, SAF2017-87919-R, EXOHEP-CM S2017/BMD-3727, NanoLiver-CM Y2018/NMT-4949, ERAB Ref. EA 18/14, AMMF 2018/117, UCM-25-2019 and COST Action CA17112, the German Research Foundation (SFB/TRR57/P04, SFB 1382-403224013/A02, and DFG NE 2128/2-1). FC and YN are Ramón y Cajal Researchers RYC-2014-15242 and RYC-2015-17438. FC is a Gilead Liver Research 2018. KZ is a recipient of a Chinese Scholarship Council (CSC). BK20170127 from the Natural Science Foundation of Jiangsu Province to JP. Sí

Adolescents with substance use disorders are often diagnosed with co-occurring mental disorders. However, it is unknown if adolescent hospital admission for acute alcohol intoxication is also associated with co-occurring mental disorders. Therefore, the primary aim of this study is to estimate the prevalence of co-occurring mental disorders among Dutch adolescents admitted for acute alcohol intoxication. Secondly, this study aims to explore the cross-sectional relationship between the co-occurrence of mental disorders and patient characteristics, such as sex, age and blood alcohol concentration at admittance. Data were retrospectively collected from 726 adolescents admitted for acute alcohol intoxication. Overall, 245 (34%) of the 726 adolescents treated for acute alcohol intoxication were diagnosed with a co-occurring mental health disorder, such as attention-deficit hyperactivity disorder (13%) or autism spectrum disorder (2.1%). Attention-deficit hyperactivity disorder in particular seems to be more prevalent in the study population than in the general Dutch adolescent population.Conclusion: This study demonstrates that among adolescents admitted for acute alcohol intoxication, the prevalence of co-occurring mental disorders is a common and a relevant issue for treatment and prevention strategies. What is Known:• Alcohol consumption among adolescents has been associated with negative psychosocial effect.• Among adolescents admitted for acute alcohol intoxication, risk factors for psychological dysfunction appear to be inadequately assessed, documented and followed up. What is New:• The current study reports on the prevalence of co-occurring mental disorders among a substantial sample of adolescents admitted for acute alcohol intoxication.• Understanding the prevalence of co-occurring mental disorders is clinically relevant for the outpatient follow-up of adolescents admitted for acute alcohol intoxication.

AIM: In our study, we assessed the possibility of using the serum neutrophil gelatinase-associated lipocalin (NGAL) for the early detection of kidney damage in patients with acute alcohol poisoning (AAP). METHODS: The study included 89 patients and 30 healthy donors. All participants in the study were mostly represented by men (90%) aged between 20 and 40 years. The influence of alcohol poisoning severity was also taken into account in the study. The Human NGAL ELISA Kit was used for the quantitative detection of serum NGAL. We also evaluated the main laboratory indicators of kidney functions, including eGFR (calculated according to serum creatinine). RESULTS: We did not find a correlation between blood alcohol concentration and serum NGAL level; also, alcohol poisoning severity did not affect the NGAL values. The results of our study showed the possibility of using the serum NGAL in patients with AAP to detect the preclinical stage of reduced renal function, until the moment when it can be diagnosed with using only serum creatinine. CONCLUSION: We propose to consider an increase in eGFR together with an increase in serum NGAL in this group of patients as a stage, preceding nephropathy, even in the absence of clinical and laboratory signs of impaired renal function.

A patient presenting an ST-segment elevation could represent a life-threatening condition in Emergency Department (ED). This case shows how sometimes, a chronic, and more often, an acute abuse of alcohol is related to important harmful effects on myocardial contractility. The authors present a case of a 19-year-old male of oriental-Asiatic origin admitted unconscious to ED with alcoholic fetor: on electrocardiogram a significant and widespread STsegment elevation was observed. A bedside echocardiography showed no abnormalities in segmental kinetics; therefore electrocardiogram- alterations could be related to a coronary spasm. The literature is poor about this effect induced by acute alcohol ingestion: the pathophysiological mechanism at the base of the abnormal muscle contractility, seems to be related to an impairment in cyclic guanosine monophosphate production, although a second and less probable hypothesis could be an altered intracellular concentration of calcium levels.