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BACKGROUND: Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk. METHODS: Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11-36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones. RESULTS: Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20). CONCLUSIONS: Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.

Background: Substance use is a global health concern and early onset among adolescents increases health risks. We explore national overall trends in prevalence and trends in socioeconomic inequalities in past year alcohol intoxication, cannabis use, and use of other illicit drugs among Norwegian adolescents (ages ∼ 15–19 years of age) between 2014 and 2022. Method: The present study builds on data from a nationwide repeated cross-sectional survey collected in 2014–2016 (T1), 2017–2019 (T2), 2021 (T3) and 2022 (T4). In total 415,560 adolescents (50.3% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results: While the prevalence of alcohol intoxication remained fairly stable, the prevalence of cannabis and other illicit drug use increased between 2014 and 2022 among upper secondary school boys (13.3–17.6%, and 2.0–5.2%, respectively) and girls (8.8–12.8%, and 1.1–2.7%, respectively). Similar trends were observed among 10th-grade adolescents. Boys were more likely than girls to use cannabis or other illicit drugs, but the gender gap in cannabis use narrowed during the study period. Among upper secondary girls, use of cannabis and other illicit drugs was higher among those from less affluent backgrounds, with absolute and relative inequalities in cannabis use increasing between 2014 and 2022. Small inequalities in cannabis use and decreasing relative inequalities in the use of other illicit drug were observed among upper secondary boys. Conclusions: The increasing use of cannabis and other illicit drugs among Norwegian adolescents is concerning. Future studies should explore the underlying causes of this rise and explore the complex factors influencing adolescent substance use behaviours. A comprehensive understanding of these factors is essential for developing targeted and effective interventions. [ABSTRACT FROM AUTHOR]

The popularity of electric scooters (ES) during the last five years due to climate neutrality and public availability led to increased numbers in traffic accidents with significant injuries. This study was conducted to overview e-scooter related computed tomography (CT) positive traumatic brain injuries, exploring circumstances, clinical course, outcomes and possible relations to behavioral patterns. We retrospectively reviewed medical data of all patients treated in our center during the period 2019 to 2023, medical records were analysed and statistically processed. This review included 45 patients, 75.7% were males and median age was 40 years old. Patient numbers did not differ between weekdays, working days versus weekends and time of the day. Eighty percent of patients were injured from falling off the scooter, the rest were hit by another vehicle while riding. None of the patients were known using helmet, significant alcohol intoxication was found in 68.8% of cases. The most common traumatic intracranial features were subarachnoid hemorrhage (55.6%), followed by brain contusions (48.9%), epidural (26.7%), subdural (26.7%) hemorrhages. Age had a positive correlation with alcohol intoxication (r = 0.596, p = 0.007) and poor outcomes (r = 0.522, p = 0.004), also, men over 40 years old were more likely to undergo surgery (p = 0.024), meanwhile operated patients suffered more infections (p = 0.011) and more often ended with poor outcomes (p < 0.001). [ABSTRACT FROM AUTHOR]

Key Clinical Message: Consideration of spontaneous urinary bladder rupture in the differential diagnosis of acute abdominal pain for alcohol‐abusing patients is crucial for ensuring timely surgical intervention and preventing life‐threatening complications due to its high associated morbidity and mortality. Spontaneous rupture of the urinary bladder (SRUB) is a rare but critical urological emergency, typically associated with malignancy, neurogenic dysfunction, or previous radiation therapy. Here, we present a unique case of SRUB in a 65‐year‐old chronic alcoholic male who presented with acute lower abdominal pain following heavy alcohol consumption. Initial evaluations revealed leukocytosis, elevated serum creatinine levels, and ultrasound findings suggestive of bladder rupture. Computed tomography confirmed the diagnosis, indicating an intraperitoneal rupture with associated hematoma. Immediate surgical repair was performed, leading to a successful outcome. This case underscores the importance of considering SRUB in patients with acute abdominal pain, especially in the context of alcohol intoxication, and highlights the diagnostic and therapeutic challenges associated with this condition. Early recognition and intervention are crucial to prevent life‐threatening complications associated with urinary bladder rupture. [ABSTRACT FROM AUTHOR]

We sought to quantify and describe the volume of emergency department visits related to alcohol intoxication at the Veterans Health Administration (VHA), the largest healthcare system in the United States. This is a retrospective cohort study of patients with VHA emergency department visits for alcohol intoxication from 2010 to 2019 as identified via ICD-9/10 code and/or serum ethanol concentration >50 mg/dL. Encounters were identified and demographic and clinical data were acquired by automated query of the VHA Corporate Data Warehouse. Descriptive statistics and univariate analysis were performed. We identified 95,123 patients with a total of 251,310 emergency department visits. The annual number of visits increased over the study period, reaching 32,333 in 2019. Men aged 40–60 were the most common demographic group in the cohort (48% of all patients), and men made up a higher proportion of patients in the database (94%) than the VHA population overall (90%). A disproportionate number of visits (32%) came from the top 4.4% of most frequent visitors. Most of the emergency department visits in the database (68%) were associated with medical or psychiatric admission, or interfacility transfer for admission elsewhere. Patients in the cohort accounted for 1.3% of all VHA emergency department visits during the study period, a proportion that is somewhat smaller than what has been reported at non-VHA facilities, despite the high prevalence of addiction disorders in the VHA patient population. We submit that this lower-than-expected proportion of alcohol-related emergency department visits may be due to the access to primary and mental care which is afforded by VHA patient benefits. • From 2010 to 2019, there were 251,300 Veterans Health Administration emergency department visits for alcohol intoxication. • The annual rate of visits increased during the study period. • The majority of visits (68%) resulted in medical or psychiatric admission. • Visits for intoxication accounted for 1.3% of patients volume in the system, which is lower than other US health systems. [ABSTRACT FROM AUTHOR]

Background: Benzodiazepines are the preferred treatment for alcohol withdrawal. Phenobarbital is an alternative in the setting of prescriber expertise or benzodiazepine contraindication. Objective: To evaluate the efficacy and safety of a phenobarbital dosing strategy aimed at treating a spectrum of alcohol withdrawal symptoms across various patient populations. Methods: Retrospective review of patients admitted with concerns of alcohol withdrawal between May 2018 and November 2022. Patients were separated into a before-after cohort of lorazepam or phenobarbital. The primary outcome was hospital length of stay (LOS). Secondary outcomes were intensive care unit (ICU) LOS, escalation of respiratory support, increased level of care (LOC), and incidence of delirium tremens and/or seizures. Results: Two hundred and seventy-seven patients received lorazepam and 198 received phenobarbital. Hospital LOS was longer in the phenobarbital cohort compared with the lorazepam cohort (6.9 vs 9.3 days). There was no difference in ICU LOS. Level of care increases were fewer in the phenobarbital cohort (4 events vs 19 events). There were higher rates of non-invasive respiratory interventions in the lorazepam cohort and higher rates of mechanical ventilation in the phenobarbital cohort. Utilization of phenobarbital was attributed to a reduction in delirium tremens and seizures. Conclusion and Relevance: This study is novel because of the broad application of a phenobarbital order set across multiple levels of care and patient admission diagnoses. A risk targeted split load intravenous phenobarbital order set can safely be administered to patients with fewer escalations of care, seizures, delirium tremens, and respiratory care escalation. [ABSTRACT FROM AUTHOR]

Alcohol abuse is dangerous to one's health and contributes to disorders such as neurotoxicity and hepatotoxicity worldwide. Twenty-five male albino rats, each weighing 200 ± 10 g, were divided into five groups. For 4 weeks, rats in the control group were given only a regular chow diet and ad libitum. Rats in the alcohol group received an oral gavage of alcohol at a dose of 40 mg/kg body weight each day. Rats in the alcohol and avocado extract group received oral gavage doses of 250 mg/kg b. wt./day of avocado extract and 40 mg/kg b. wt. of alcohol. Rats in the alcohol and mustard seed extract group received oral gavage doses of 250 mg/kg/day of mustard seed extract and 40 mg/kg/day of alcohol, respectively. Rats were given alcohol and a mixture of avocado and mustard seed extract at a dose of 250 mg/kg body weight each day by oral gavage for 4 weeks. Our results showed increased levels of hydrogen peroxide (H2O2) and lipid peroxidation in the liver and brain tissues, decreased glutathione content, glutathione peroxidase, superoxide dismutase, catalase, and glutathione-S-transferase. In rats consumed excessive alcohol, there was an increase in the activity of the tumor marker α-l-fucosidase in sera. Additionally, the liver and brain tissues of the alcoholic group showed decreased cytochrome c oxidase activity. Furthermore, changes in the expression levels of the genes for brain α-secretase and liver alcohol dehydrogenase (ADH) were observed. The administration of extracts from avocado and mustard seeds improved the state of oxidative stress and restored antioxidant enzyme activity. The expression levels of brain α-secretase and liver ADH genes were almost fully recovered at the molecular level. [ABSTRACT FROM AUTHOR]

Abstract Background Substance use is a global health concern and early onset among adolescents increases health risks. We explore national overall trends in prevalence and trends in socioeconomic inequalities in past year alcohol intoxication, cannabis use, and use of other illicit drugs among Norwegian adolescents (ages ∼ 15–19 years of age) between 2014 and 2022. Method The present study builds on data from a nationwide repeated cross-sectional survey collected in 2014–2016 (T1), 2017–2019 (T2), 2021 (T3) and 2022 (T4). In total 415,560 adolescents (50.3% girls) completed the questionnaire during the study period. Trends in socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII). Results While the prevalence of alcohol intoxication remained fairly stable, the prevalence of cannabis and other illicit drug use increased between 2014 and 2022 among upper secondary school boys (13.3–17.6%, and 2.0–5.2%, respectively) and girls (8.8–12.8%, and 1.1–2.7%, respectively). Similar trends were observed among 10th-grade adolescents. Boys were more likely than girls to use cannabis or other illicit drugs, but the gender gap in cannabis use narrowed during the study period. Among upper secondary girls, use of cannabis and other illicit drugs was higher among those from less affluent backgrounds, with absolute and relative inequalities in cannabis use increasing between 2014 and 2022. Small inequalities in cannabis use and decreasing relative inequalities in the use of other illicit drug were observed among upper secondary boys. Conclusions The increasing use of cannabis and other illicit drugs among Norwegian adolescents is concerning. Future studies should explore the underlying causes of this rise and explore the complex factors influencing adolescent substance use behaviours. A comprehensive understanding of these factors is essential for developing targeted and effective interventions.

To drive safely, one must be attentive, coordinated, have good judgment, and be able to respond quickly to changing conditions. In certain countries, improving safety may depend largely on reducing the number of impaired drivers on the road. Therefore, solutions are required to reduce the risk that is posed on the road by drivers who have been consuming alcohol while driving. Previous research has proposed the use of sensors for detecting driver impairment caused by alcohol intoxication. However, relying on a gas sensor alone may not be appropriate for detection. To reduce drunk driving, this study proposes an Internet of Things (IoT)-based tool that measures heart rate and analyzes the breath of a driver for traces of alcohol. The tool represents a vehicle that is made up of a DC motor. In the circumstance that the tool detects a higher than resting heart rate in the driver as well as an amount of alcohol in the driver’s breath sample, the tool will immediately power down the DC motor and send an SMS to the registered emergency contact with the driver’s precise position using the GPS module. The initial prototype demonstrates the tool as a potential aftermarket accessory for vehicles. The implication of this paper is that the designed tool might be of practical use to researchers in their attempts to determine and obtain information on alcohol intoxication. Doi: 10.28991/HIJ-2024-05-02-012 Full Text: PDF

Abstract Background Most Norwegian adolescents experience their first sexual intercourse during late adolescence. Use of contraception is important to avoid unwanted pregnancy, while condoms can also protect against sexually transmitted diseases. There are few studies on the use of contraception at first sexual intercourse, most with varying results, and some studies have only examined the use of contraception among girls. In our study, we aimed to determine the use of contraception at first sexual intercourse, and to investigate associations between use of contraceptives at first sexual intercourse, sociodemographic factors, and alcohol and other substance use. Methods The study was based on data from the national electronic youth survey Ungdata, conducted in 2020–2022 among 113 049 upper secondary pupils (15–19 years) in Norway, which was around 65% of pupils attending upper secondary school during the study period. Descriptive analysis was used to estimate the prevalence of contraceptive use at first sexual intercourse, and multivariate logistic regression analyses to investigate the association between contraceptive use, sociodemographic factors, and alcohol intoxication and substance use. Result 32% of Norwegian adolescents did not use contraception at first sexual intercourse. More girls (57.4%) than boys (42.6%) reported use of contraception. Factors associated with non-use of contraception during first sexual intercourse among boys were having parents with no college /university education (OR = 1.22: CI 1.13–1.32), perceived poor family finances (OR = 1.22: CI 1.06–1.40), alcohol intoxication, and use of cannabis or other narcotic substances during the past 12 months. The same factors were associated with non-use of contraception among girls. Additionally, being older than 16 years (OR = 1.13: CI 1.06–1.19) was also associated with non-use of contraception at first sexual intercourse. Conclusion Many adolescents did not use contraception at first sexual intercourse. Alcohol intoxication and use of cannabis or other narcotic substances were associated with a lower likelihood of using contraceptives. This highlights the importance of preventive efforts including earlier prevention education that focuses more on the consequences of not using contraception in order to prevent unwanted pregnancies and sexually transmitted infections.

Having sex under the influence of alcohol is a risky behavior and this study explored its prevalence and correlates among school-going Thai adolescents. The data from the 2021 Thailand Global School-based Student Health Survey (GSHS), including a nationally representative sample of students in grades 7–12th, was used to extract the relevant variables including demographic, psychosocial, substance use, and risky sex behaviors. Logistic regression was used to assess the odds of engaging in sex while intoxicated across the independent variables while accounting for age and sex differences. Approximately 30.45 % of respondents reported alcohol intoxication and 37.75 % reported engaging in sexual intercourse while intoxicated at least once. Older adolescents (>14 years), males, and those in 11 and 12 grades were more likely to engage in sexual intercourse while intoxicated. Psychosocial factors such as loneliness and anxiety-induced insomnia were associated with increased likelihood, particularly among females. Substance use, including marijuana and amphetamine use, as well as cigarette smoking, correlated with higher odds of engaging in sexual intercourse while intoxicated. Both genders who engaged in sex while intoxicated reported having multiple sexual partners, with males more likely to use condoms. The intricate relationship between poor mental health, substance use, and risky sex behaviors along with their association with sex under alcohol influence emphasizes the need for a holistic approach to address the common risk factors and implement effective school-based screening strategies to identify the risk groups, educate them, and prevent the burden of risky sex under alcohol intoxication. [ABSTRACT FROM AUTHOR]

The liver is the main organ responsible for the metabolism of ethanol, which suffers significantly as a result of tissue damage due to oxidative stress. It is known that C60 fullerenes are able to efficiently capture and inactivate reactive oxygen species in in vivo and in vitro systems. Therefore, the purpose of this study is to determine whether water-soluble C60 fullerene reduces the level of pathological process development in the liver of rats induced by chronic alcohol intoxication for 3, 6, and 9 months, depending on the daily dose (oral administration; 0.5, 1, and 2 mg/kg) of C60 fullerene throughout the experiment. In this context, the morphology of the C60 fullerene nanoparticles in aqueous solution was studied using atomic force microscopy. Such biochemical parameters of experimental animal blood as ALT (alanine aminotransferase), AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase) and ALP (alkaline phosphatase) enzyme activities, CDT (carbohydrate-deficient transferrin) level, values of pro-antioxidant balance indicators (concentrations of H2O2 (hydrogen peroxide) and GSH (reduced glutathione), activities of CAT (catalase), SOD (superoxide dismutase) and GPx (selenium-dependent glutathione peroxidase)), and pathohistological and morphometric features of liver damage were analyzed. The most significant positive change in the studied biochemical parameters (up to 29 ± 2% relative to the control), as markers of liver damage, was recorded at the combined administration of alcohol (40% ethanol in drinking water) and water-soluble C60 fullerenes in the optimal dose of 1 mg/kg, which was confirmed by small histopathological changes in the liver of rats. The obtained results prove the prospective use of C60 fullerenes as powerful antioxidants for the mitigation of pathological conditions of the liver arising under prolonged alcohol intoxication. [ABSTRACT FROM AUTHOR]

Background: Most Norwegian adolescents experience their first sexual intercourse during late adolescence. Use of contraception is important to avoid unwanted pregnancy, while condoms can also protect against sexually transmitted diseases. There are few studies on the use of contraception at first sexual intercourse, most with varying results, and some studies have only examined the use of contraception among girls. In our study, we aimed to determine the use of contraception at first sexual intercourse, and to investigate associations between use of contraceptives at first sexual intercourse, sociodemographic factors, and alcohol and other substance use. Methods: The study was based on data from the national electronic youth survey Ungdata, conducted in 2020–2022 among 113 049 upper secondary pupils (15–19 years) in Norway, which was around 65% of pupils attending upper secondary school during the study period. Descriptive analysis was used to estimate the prevalence of contraceptive use at first sexual intercourse, and multivariate logistic regression analyses to investigate the association between contraceptive use, sociodemographic factors, and alcohol intoxication and substance use. Result: 32% of Norwegian adolescents did not use contraception at first sexual intercourse. More girls (57.4%) than boys (42.6%) reported use of contraception. Factors associated with non-use of contraception during first sexual intercourse among boys were having parents with no college /university education (OR = 1.22: CI 1.13–1.32), perceived poor family finances (OR = 1.22: CI 1.06–1.40), alcohol intoxication, and use of cannabis or other narcotic substances during the past 12 months. The same factors were associated with non-use of contraception among girls. Additionally, being older than 16 years (OR = 1.13: CI 1.06–1.19) was also associated with non-use of contraception at first sexual intercourse. Conclusion: Many adolescents did not use contraception at first sexual intercourse. Alcohol intoxication and use of cannabis or other narcotic substances were associated with a lower likelihood of using contraceptives. This highlights the importance of preventive efforts including earlier prevention education that focuses more on the consequences of not using contraception in order to prevent unwanted pregnancies and sexually transmitted infections. [ABSTRACT FROM AUTHOR]

Aim: To investigate how young Danes construct sexual consent generally, but also specifically in relation to heavy alcohol intoxication. Methods: Drawing on 30 qualitative in-depth interviews with young people, aged 19–25 years, and adopting a critical discursive psychological framework, we explored the interpretative repertoires that the participants made use of to construct sexual consent and the subject positions those repertoires enabled. Results: The participants made use of three interpretative repertoires that we named as follows: (1) sexual consent as an agreement between rational individuals; (2) sexual consent as a heteronormative practice; and (3) intoxicated sexual consent. Discussion: Young people draw on different repertoires when discussing sexual consent in general, sexual consent in relation to gendered practices and expectations, and sexual consent in relation to heavy alcohol intoxication. Conclusion: It is vital to keep the situational nature of young people's constructions of sexual consent in mind if we wish to understand and eventually reduce the number of non-consensual sexual experiences. [ABSTRACT FROM AUTHOR]

Bicycling accidents are a major traffic safety problem and are deemed ‘an unacceptable human and social price for EU citizens’. One of the major causes for bicycling accidents is loss of balance. A related influencing factor is alcohol intoxication. It is a primary, long term, safety objective to develop safety systems for the cyclist. The present work aimed to understand how to measure cyclists’ instability via steering and leaning inputs, while considering that steering and leaning might vary depending on the cycling task being performed. Of 28 participants, 19 were given doses of alcohol up to 1.0‰ and 9 remained sober (control group). Breath alcohol concentration was measured. The participants repeated the cycling test track session five times (with each block lasting 35 minutes). The track session contained three different tasks: cycling slalom, straight, and slowly. Speed, yaw rate, and roll rate were assessed continuously. Yaw rate and roll rate were relatively sensitive for the different cycling tasks. The threshold level of the angular velocity measurements was related to the cycling task performed. Alcohol intoxication at 0.7‰ had a significant impact on performance. The rather simple measurements used can detect instability. Instability should be measured differently depending on the cycling task performed. The study represents a small step towards a safety system for cyclists.

Key Clinical Message Consideration of spontaneous urinary bladder rupture in the differential diagnosis of acute abdominal pain for alcohol‐abusing patients is crucial for ensuring timely surgical intervention and preventing life‐threatening complications due to its high associated morbidity and mortality. Abstract Spontaneous rupture of the urinary bladder (SRUB) is a rare but critical urological emergency, typically associated with malignancy, neurogenic dysfunction, or previous radiation therapy. Here, we present a unique case of SRUB in a 65‐year‐old chronic alcoholic male who presented with acute lower abdominal pain following heavy alcohol consumption. Initial evaluations revealed leukocytosis, elevated serum creatinine levels, and ultrasound findings suggestive of bladder rupture. Computed tomography confirmed the diagnosis, indicating an intraperitoneal rupture with associated hematoma. Immediate surgical repair was performed, leading to a successful outcome. This case underscores the importance of considering SRUB in patients with acute abdominal pain, especially in the context of alcohol intoxication, and highlights the diagnostic and therapeutic challenges associated with this condition. Early recognition and intervention are crucial to prevent life‐threatening complications associated with urinary bladder rupture.

Background. The mechanisms underlying the development of the heart contractile apparatus and the distribution of myofibrils in cardiomyocytes following intrauterine ethanol intoxication continue to be a topic of significant debate. The aim of this paper is to determine the dynamics of postnatal changes in the ultrastructure of ventricular contractile cardiomyocytes in the rat heart after chronic alcoholization of the maternal organism. Methods. The study focused on the hearts of rat offspring from birth to adulthood. Transmission electron microscopy was utilized to examine the ultrastructure of cardiomyocytes in various zones of the ventricular myocardium. Results. It has been observed that prenatal alcohol exposure induces cardiomyocyte heteromorphism, characterized by varying degrees of damage throughout postnatal ontogenesis in rat offspring. Specifically, cells exhibiting critical signs of destruction in the myocardium of intramural and subepicardial zones of both ventricles aggregate into clusters surrounded by morphologically intact cardiomyocytes, while irreversibly damaged cells with subendocardial localization appear isolated. Following birth, there is a progressive accumulation of mitochondria exhibiting signs of limited functional activity. These polymorphic organelles, featuring a matrix of moderate or low electron density with sporadically developed cristae, primarily concentrate in paranuclear regions and are dispersed along the interstices of myofibril dissociation. Conclusion. Maternal chronic alcohol intoxication results in enduring harm to the contractile apparatus of ventricular cardiomyocytes in rat offspring. This damage manifests as sarcomere structure disorganization, myofibril fragmentation and misalignment, notable suppression of sarcomerogenesis, and reduced myofibril content, all closely linked to mitochondrial alterations.

Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance. [ABSTRACT FROM AUTHOR]

Integrating students into their college community is viewed as essential for student retention. However, these efforts may expose students to a drinking subculture, which potentially threatens their academic success. This threat appears even more pronounced for students of color, who must also navigate racial obstacles such as prejudice and discrimination, which further predispose them to greater levels of problem drinking. Drawing off survey data from a Latino sample of college students, I examine the importance of peer socialization messages about ethnicity and race (peer ethnic-racial socialization; peer ERS) and how they influence levels of alcohol intoxication. A confirmatory factor analysis identified three dimensions of peer ERS: cultural socialization, preparation for bias, and promotion of mistrust. Peer messages stressing cultural socialization reduced levels of alcohol intoxication by promoting a strong ethnic identity. In addition, respondents actively involved in fraternities/sororities and student clubs/organizations reported reduced prevalence of alcohol intoxication when exposed to greater levels of all three dimensions of peer ERS. I discuss these findings within the broader ethnic-racial socialization literature as well as how they might be used by administrators to improve retention for students of color. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the complications of transvaginal ethanol sclerotherapy for the treatment of endometriomas? SUMMARY ANSWER Sclerotherapy is a reliable, minimally invasive method applicable in outpatient procedures but with specific and potential life-threatening complications that need to be identified and prevented. WHAT IS KNOWN ALREADY There are currently few data on the use of transvaginal ethanol sclerotherapy, and we mainly note septic complications. STUDY DESIGN, SIZE, DURATION A retrospective observational cohort study was carried out. The study was conducted at an academic hospital and included 126 women aged 31.9 ± 5.5 years (mean ± SD), between November 2013 and June 2021. We analyzed a total of 157 ethanol sclerotherapy treatment (EST), treated by 131 EST procedures, in 126 women. PARTICIPANTS/MATERIALS, SETTING, METHODS The study included women with an indication for transvaginal ethanol sclerotherapy. Indications were women with at least one endometrioma over 10 mm, isolated or associated with other endometriosis locations, requiring treatment for pain or infertility before assisted reproductive treatment. We followed a standardized transvaginal ethanol sclerotherapy procedure consisting of an ultrasound-guided transvaginal puncture of one or more endometriomas under general anesthesia. The cyst content was completely removed and flushed with saline solution. Ethanol (96%) was injected at 60% of the initial volume of the endometrioma, remained in the cyst for 10 min and was then completely removed. Ethanol loss was defined as a loss of 5 ml or more than 10% of the initial volume of the injected ethanol. Failure was defined by the contraindication of endometrioma puncture because of interposition of the digestive tract, ethanol loss in the previous endometrioma treated (in case of multiple ESTs), failure to aspirate the endometriotic fluid, contraindication to start ethanol injection owing to saline solution leakage, or contraindication to continue ethanol injection owing to suspicions of ethanol leakage at sonography. Intraoperative complications were defined by ethanol loss, positive blood alcohol level, and ethanol intoxication. Postoperative complications were defined by fever, biological inflammatory syndrome, and ovarian abscess. Complications were classified according to the Clavien and Dindo surgical classification, which is a system for classifying postoperative complications in five grades of increasing severity. MAIN RESULTS AND THE ROLE OF CHANCE We reported a total of 17/157 (10.8%) transvaginal ethanol sclerotherapy failures during 14/131 (10.7%) transvaginal ethanol sclerotherapy procedures in 13/126 (10.3%) women. In the same sets of data, complication was reported for 15/157 (9.5%) transvaginal ethanol sclerotherapy in 13/131 (9.9%) transvaginal ethanol sclerotherapy procedures in 13/126 (10.3%) women. Nine of 126 women (7.1%) had a grade I complication, one (0.8%) had a grade II complication (medical treatment for suspicion of pelvic infection), two (1.6%) had a grade III complication (ovarian abscess) and one (0.8%) had a grade IV complication (ethanol intoxication). We did not observe any grade V complications. LIMITATIONS, REASONS FOR CAUTION This was a retrospective study and pain assessment not considered. The benefit-risk balance of endometrioma transvaginal ethanol sclerotherapy was not evaluated. WIDER IMPLICATIONS OF THE FINDINGS Our study is the first to evaluate the complications of transvaginal ethanol sclerotherapy with such a large cohort of women in a standardized protocol. Transvaginal ethanol sclerotherapy seems to be an effective alternative to laparoscopic surgery in the management of endometriomas and limits the alteration of ovarian reserve. Transvaginal ethanol sclerotherapy is a reliable, minimally invasive method applicable on an outpatient basis. The majority of complications are Clavien–Dindo ≤IV, for which preventative measures, or at least early diagnosis and treatment, can be easily performed. The risk of ethanol intoxication is rare, but it is a life-threatening risk that must be avoided by appropriate implementation and promotion of the sclerotherapy procedures. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER Aix Marseille University's ethics committee registration number 2021-06-03-01. [ABSTRACT FROM AUTHOR]

The intricate relationship between alcohol consumption and intracerebral hemorrhage (ICH) presents a nuanced field of study, especially concerning the dose-dependent impact on secondary brain injury (SBI). Recognizing the established risks associated with heavy drinking, this review delves deeper into the less understood territories of low to moderate alcohol consumption. By systematically analyzing recent studies, we uncover critical insights into how varying alcohol intake levels modulate ICH risk through mechanisms such as microglial activation, oxidative stress, and the protective potential of polyphenols. This analysis extends beyond the hypertensive effects of heavy alcohol use to explore the complex molecular pathophysiology involved in alcohol-related ICH. Our findings indicate that while heavy alcohol use unequivocally exacerbates ICH risk, moderate consumption and its associated polyphenols may offer neuroprotective effects against SBI, albeit within a finely balanced threshold. This review highlights the significant gaps in current understanding and underscores the urgent need for targeted research to elucidate these complex interactions. Through this comprehensive examination, we aim to inform more nuanced public health policies and intervention strategies, taking into account the diverse effects of alcohol consumption on ICH risk. [ABSTRACT FROM AUTHOR]

We investigated the relationship between preloading motivations, alcohol consumption, intoxication, and alcohol related harms (ARHs), sampled in a night-time entertainment district (NED). The sample comprised 2,159 (1,109 males; 1,050 females) patrons entering Brisbane NEDs (Queensland, Australia) on Thursday, Friday, and Saturday nights between 9:00 pm and 1:00 am. We measured the patrons primary preloading motivations, their estimations of standard drinks consumed at preloading, their level of alcohol intoxication by breathalyser and their past experience of ARHs in the NED. 'Socialising' (29.98%) and 'saving money' (25.17%) were the most prominent preloading motivations followed by 'multiple' motivations (12.52%), and then by emotional motivations (2.46–4.02%). Minor significant differences were observed between preloading motivations in alcohol intoxication, but not for alcohol consumption. 'Get as drunk as possible' and 'feel comfortable/relaxed' preloading motivations were associated with higher occurrences of past ARHs. Individuals who preload often exceed recommended drinking guidelines to prevent ARHs before the night-out begins. Our findings suggest that it is the emotionally motivated alcohol consumers who are more likely to have experienced past harms in the NED. Implications for theoretical developments of preloading and the prevention of harmful preloading are discussed. [ABSTRACT FROM AUTHOR]

Background Previous preclinical and human studies have shown that a high-fat ketogenic diet and ketone supplements (KS) are efficacious in reducing alcohol craving, alcohol consumption, and signs of alcohol withdrawal. However, the effects of KS on alcohol sensitivity are unknown. Methods In this single-blind, cross-over study, 10 healthy participants (3 females) were administered a single, oral dose of a KS (25 g of ketones from D-β-hydroxybutyric acid and R-1,3-butanediol) or placebo 30 minutes before an oral alcohol dose (0.25 g/kg for women; 0.31 g/kg for men). Assessments of breath alcohol concentration and blood alcohol levels (BAL) and responses on the Drug Effect Questionnaire were repeatedly obtained over 180 minutes after alcohol consumption. In a parallel preclinical study, 8 Wistar rats (4 females) received an oral gavage of KS (0.42 g ketones/kg), water, or the sweetener allulose (0.58 g/kg) followed 15 minutes later by an oral alcohol dose (0.8 g/kg). BAL was monitored for 240 minutes after alcohol exposure. Results In humans, the intake of KS before alcohol significantly blunted breath alcohol concentration and BAL, reduced ratings of alcohol liking and wanting more, and increased disliking for alcohol. In rats, KS reduced BAL more than either allulose or water. Conclusion KS altered physiological and subjective responses to alcohol in both humans and rats, and the effects were likely not mediated by the sweetener allulose present in the KS drink. Therefore, KS could potentially reduce the intoxicating effects of alcohol. [ABSTRACT FROM AUTHOR]

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The purpose of the article consists in revealing foreign experience of responsibility for driving vehicles in condition of alcohol intoxication (international standards, administrative and criminal aspect). Considered is the legislation of some European countries (Great Britain and Germany), Australia and the USA regarding responsibility for driving vehicles in condition of alcohol intoxication. Attention is drawn to the fact that among the possible measures, legislation of some states provides for mandatory equipment of the offender’s vehicle with an alcohol blocking device or mandatory rehabilitation or rehabilitation programs (the so-called “therapeutic jurisprudence”). It has been concluded that the legislation of the European Union countries, the United States and other countries of the world try to deter serious violators and so-called “repeat offenders” by means of creating specialized courts (organizational factor), strengthening punishment sanctions (jurisdictional factor), spreading educational and therapeutic programs (medical educational factor) and using vehicle blocking devices in case of identification of alcohol in the driver’s organism (technical factor).

Photo ID 143764115 © Chris Dorney | Dreamstime.com INTRODUCTION Since the repeal of the 18th Amendment in 1933, alcohol consumption has become prevalent among many Americans. Alcohol intoxication is an increasing contributor to emergency room visits wherein individuals present to the emergency department (ED) in an inebriated state, often with secondary injuries or severe medical co-morbidities related to alcohol poisoning. The ED is a stressful environment with providers working under taxing conditions while triaging difficult cases. Alcohol related visits contribute to this added stress for staff given that intoxicated individuals increase wait times for the ED, use up valuable resources, and have the capacity to act violently towards providers. As one nurse puts it, some intoxicated individuals present with “an aggressive state, perhaps have been in a fight, blood everywhere, careening around the place – it can make things very difficult.”[1] To combat these circumstances, thirty-four States including the District of Columbia have implemented a countermeasure recognized as Alcohol Exclusion Laws (AELs). AELs reduce or cut insurance coverage of certain visits to the ED if the cause of the visit is due to alcohol intoxication.[2] The vast implementation of this law is derived from the idea of individual decision making, that it is an individual’s choice to consume alcohol, and therefore they hold a personal responsibility for their intoxication. By using insurance coverage as a leverage, the law aims at reducing the number of ED visits relating to alcohol intoxication, saving resources, and deterring irresponsible drinking. While the intention behind AELs aims for positive change, it is unethical to use AELs, a form of financial leverage, to address certain problems within emergency medicine. ANALYSIS Stigma is prominent in almost all substance abuse cases including those seen with alcohol intoxication. Many patients feel embarrassment or shame when seeking medical attention for a condition that was brought on by alcohol misuse. A personal account by Jonathan Hunt Glassman, a former alcoholic and NBC contributor, emphasizes on this negative bias. He knows firsthand how unsettling an ED visit can be. He felt demoralized from a superficial prognosis made by a nurse on his complex alcohol abuse condition, in which the nurse said, “You need to stop drinking.”[3] Whether it be from shame or insecurities about an individual’s condition, the stigma behind substance abuse cases in the emergency department and the daunting task of asking for help can turn a lot of patients away from seeking and receiving medical treatment. The implementation of Alcohol Exclusion Laws can amplify this already present stigma. A study conducted by the National Institute of Health (NIH) analyzed States that implemented and continued to enforce Alcohol Exclusion Laws and the stigma in those states surrounding alcohol-related ED visits. The result from the study showed that AELs correlated with an increase in stigmatization regarding medical attention for alcohol-related incidents, and that AELs “negatively impact people’s willingness to seek medical care after alcohol-related injuries or illnesses.”[4] Both the NIH study and the personal account by Hunt-Glassman go on to show that AELs have the adverse effect of reinforcing the stigma surrounding alcohol cases in the ED. While the idea behind AELs is in good faith, it contributes to the stigma. This contribution ethically challenges the idea that the emergency room is a space where the treatment of injuries is carried out without biases infringing on such medical care. The mission of EDs is to provide medical care to anyone in need. AELs have the effect of discouraging these patients from seeking help with the unintended consequence of doing them harm. A point of argument for the implementation of AELs is that it is the individual’s choice to be intoxicated and therefore justifiable that an individual receives less insurance coverage for medical expenses from a preventable intoxication. The idea of it being an individual choice to become intoxicated is one of the strongest supports for these exclusion laws. However, it is unjust to assume that all alcohol intoxications come by choice. Instances that disprove this assumption include both the college party scene and bar scene. Spiked drinks significantly increase alcohol concentration and can cause any responsible drinker to become intoxicated without intention or against their will. Additionally, alcoholic beverages served in various social gatherings like those in or around college campuses may not have a clear percentage of alcohol determination. Liquor containing high percentages of alcohol, such as Everclear which contains up to 190 proofs, are often masked by sweeteners and flavorings. Cocktails like these can cause a person to become dangerously intoxicated without their realization or intention. Some may argue that consuming an alcoholic beverage still holds accountability, that the person should be aware of the potential for a tampered drink, and therefore AELs should remain in use to deter this. However, like any law, AELs needs to have defined restrictions and/or exemptions. If the individual choice argument is used in favor for AELs, then how far reaching can the laws be applied? An attorney who specializes in these exclusion laws believes that AELs often offer more ambiguity than clarification when it comes to insurance policy, which leads to further ways insurance claims can be denied.[5] CONCLUSION In summary, the idea behind the use of Alcohol Exclusion Laws aims to reduce intoxication cases in the ED, however, there are drawbacks and aspects of this law that challenge the ethics of seeking medical care from the emergency department. The present stigma surrounding going to the ED for alcohol-related emergencies is already prevalent in hospitals across the country. When applying AELs, the present stigma may be magnified and further push the idea that seeking help for alcohol-related emergencies is shameful and embarrassing for patients, and therefore should be punished via financial means. Secondly, one of the main justifications for AELs is the idea that it is a deliberate intention to become intoxicated. It isn’t always the intention of individuals to get drunk when they choose to consume alcohol. There are additional factors that may play a part to exonerate a person’s accountability. It is difficult for people to recall the specifics of a situation when they become intoxicated; in some cases, accountability cannot be determined and the used of AELs can become unjustified. Overall, Alcohol Exclusion Laws try to solve the issue of alcohol incidents in a way that produces more detriment than progress. A method to combat the issue of irresponsible drinking and intoxication in the emergency room within the US should not use AELs and financial leverage as one of its forefronts. In fact, a study that based its findings obtained from the Behavioral Risk Factor Surveillance System nationwide survey that spanned twenty-four years from 1993-2017, showed no real impact on binge drinking or increased alcohol consumption.[6] Given the downsides to AELs and its proven non-significant effects, several States have already repealed their AELs. For all these reasons, it would be beneficial to find an alternate method to address alcohol related issues within healthcare. - [1] Gregory, A. (16 Jun 2014). Nurses say drunk patients should be banned from A&E as ‘waste of resources’ UK: Mirror. https://www.mirror.co.uk/news/uk-news/nurses-say-drunk-patients-should-3706280 2(Jan 2008). [2] Alcohol Exclusion Laws. National Highway Traffic Safety Administration. https://www.nhtsa.gov/sites/nhtsa.gov/files/810885.pdf. [3] Glassman, J.H. (28 Apr 2022). Why don’t alcoholics get prescribed the medication they need?. NBC. https://www.nbcnews.com/think/opinion/alcohol-related-deaths-er-visits-rose-covid-solution-use- rcna26425. [4] Azagba, S., Ebling, T., Hall, M., (2023). Health claims denial for alcohol intoxication: State laws and structural stigma. Wiley Online Library. https://onlinelibrary.wiley.com/doi/10.1111/acer.15153. [5] (7 Sep 2021). The Alcohol Exclusion Chart Denied Life Insurance Claim. https://www.lifeinsuranceattorney.com/blog/2021/september/the-alcohol-exclusion-state-chart-denied-life-in/. [6] Azagba, S., Shan, L., Ebling, T., Wolfson, M., Hall, M., Chaloupka, F., (26 Nov 2022). Does state repeal of alcohol exclusion laws increase problem drinking? National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10099925/.

The liver is the main organ responsible for the metabolism of ethanol, which suffers significantly as a result of tissue damage due to oxidative stress. It is known that C60 fullerenes are able to efficiently capture and inactivate reactive oxygen species in in vivo and in vitro systems. Therefore, the purpose of this study is to determine whether water-soluble C60 fullerene reduces the level of pathological process development in the liver of rats induced by chronic alcohol intoxication for 3, 6, and 9 months, depending on the daily dose (oral administration; 0.5, 1, and 2 mg/kg) of C60 fullerene throughout the experiment. In this context, the morphology of the C60 fullerene nanoparticles in aqueous solution was studied using atomic force microscopy. Such biochemical parameters of experimental animal blood as ALT (alanine aminotransferase), AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase) and ALP (alkaline phosphatase) enzyme activities, CDT (carbohydrate-deficient transferrin) level, values of pro-antioxidant balance indicators (concentrations of H2O2 (hydrogen peroxide) and GSH (reduced glutathione), activities of CAT (catalase), SOD (superoxide dismutase) and GPx (selenium-dependent glutathione peroxidase)), and pathohistological and morphometric features of liver damage were analyzed. The most significant positive change in the studied biochemical parameters (up to 29 ± 2% relative to the control), as markers of liver damage, was recorded at the combined administration of alcohol (40% ethanol in drinking water) and water-soluble C60 fullerenes in the optimal dose of 1 mg/kg, which was confirmed by small histopathological changes in the liver of rats. The obtained results prove the prospective use of C60 fullerenes as powerful antioxidants for the mitigation of pathological conditions of the liver arising under prolonged alcohol intoxication.

In this study, we have estimated alcohol consumption and alcohol-associated incidence in the RF regions in the ‘before crisis’ (2017–2019) and ‘crisis’ (2020–2022) periods. We identified types of the RF regions using hierarchical cluster analysis (Ward’s method) and relying on indirect indicators of alcohol consumption. As a result, we established considerable differences between the macro-regions (the Federal Districts) and RF regions as per alcohol consumption and severity of its outcomes. Poles in this differentiation are represented by ‘favorable’ regions in the Southern Russia where alcohol sales, alcohol-associated crime and incidence are low and ‘unfavorable’ regions located in the Far East and southern Siberia where alcohol-associated crime and incidence are high. We have shown in this study that retail alcohol sales cannot be considered a sufficient indicator to describe alcohol use in a given region. Thus, considerable volumes of alcohol sales involve severe socially significant outcomes in some regions (for example, the Khabarovsk region and Primorye) whereas such outcomes do not occur in other regions with similarly high alcohol sales (Moscow, Saint Petersburg, the Moscow region and the Leningrad region). The level of socioeconomic welfare on a given territory is confirmed as a significant determinant of alcohol consumption. We have also analyzed a correlation between economic vulnerability of RF regions during the ‘pandemic’ and ‘sanction’ crises and levels of alcohol consumption. The analysis revealed that large industrial regions, though expected to be vulnerable, turned out to be quite stable (it is probable due to delayed macroeconomic effects). We have not been able to identify any resources of improving a tense situation with alcohol consumption in economically unfavorable but less vulnerable subsidized agricultural regions. In general, the crisis period of 2020–2022 can be considered a source of additional health risks for the population in the RF regions where the situation with alcohol consumption was rather unfavorable in the ‘before crisis’ period.

Bicycling accidents are a well-known problem for traffic safety globally. Alcohol intoxication is one possible factor, although the exact number of accidents due to intoxication is difficult to establish. Not all bicyclists act in the same way, particularly when under the influence of alcohol, i.e., bicycling performance might be related to a bicyclist's personal characteristics. This study aimed to investigate if the bicyclist's characteristics (bicycling experience, physical fitness, or sensation seeking scores) influence bicycling stability, cognitive performance, or self-rated bicycling ability ratings at different levels of alcohol intoxication. The experiment was completed on a wide treadmill, which allowed control of several influencing factors such as speed and physical effort. Intoxicated and sober participants bicycled on the treadmill five times for 10 minutes each time, and breath alcohol concentration (BrAC) levels were measured five times. Participants were given doses of alcohol up to a BrAC level of 0.8%. The results revealed that alcohol intoxication had a significant effect on stability, cognitive executive functions, and self-rated ability to bicycle on the treadmill. Group characteristics had an effect on bicycling performance and on self-ratings of bicycling ability when intoxicated. Alcohol intoxication affects stability, cognitive performance, and perceived ability to bicycle. Group characteristics are important for examining possible self-regulated behavior, as some groups rate that they can bicycle safely, even when there is an objective decrease in stability and executive functions.

Introduction In Brazil, there are 125,000 hospitalizations a year for traumatic brain injuries (TBI) at a high socio-economic cost, causing serious and permanent sequelae, often associated with the use of alcohol, cocaine and marijuana.

Real-life driving studies evaluating the impact of alcohol influence on the ability to park a car are rare but necessary to assess a possible impairment to drive a car in the event of prosecution. In this study, 29 test persons (13 m, 16 f) completed three test drives with real cars, each made up of three different parking situations. While four test persons remained sober, the majority drank a previously calculated amount of alcohol before the second drive; the aim was to reach a blood alcohol concentration (BAC) of 1.1 g/kg. The third drive took place about 2 h later without any further ingestion of alcohol. The impact of BAC on the number of accidents, time needed to finish the drive, the amount of correction moves and quality of the final parking position (in the centre of the parking space) were analysed. Furthermore, pressure measuring films were applied to the test cars, measuring the average pressure and load in the areas of the accident impact. A significant increase of accidents could be noted with rising BAC. While a single accident happened to both sober and drivers under the influence of alcohol, more than one accident was only seen in drivers after the ingestion of alcohol (> 0.63 g/kg). The BAC had no impact on the other considered aspects. Concludingly, more than one impact site or accident while parking a car can serve as an indication for alcohol impairment of the driver at the time of the accident. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Brugada syndrome (BrS), a genetically inherited ion channelopathy, has been linked to a considerable number of unexplained sudden cardiac deaths in patients without structural heart defects, and Brugada phenocopy (BrP) is a condition where there is an identical electrocardiogram (ECG) pattern to a congenital BrS, but this is due to other reversible etiologies. A 37‐year‐old male patient with a documented history of hypertension presented with vomiting after taking 43, 10 mg, melatonin pills and binge drinking locally made alcohol 2 days before. ECG showed right ventricular conduction delay with a "saddleback" appearance, with the J point elevated more than 2 mm and the terminal portion of the ST‐segment elevated more than 1 mm in leads V1 and/or V2. Which returned to normal after a few hours. The association between the use of melatonin and the finding of the Brugada pattern (BP) in a patient with normal heart structure or abnormal ECGs has been documented in much literature, and although no official melatonin dosage is recommended for adults, melatonin has been reported to cause and protect from arrhythmias through different mechanisms. In our patient, after alcohol intoxication was ruled out as a cause, melatonin was the only significant risk factor related to his ECG findings. The BP can be found in patients with otherwise normal heart structure and ECG records, and an overdose of melatonin, which is used as an over‐the‐counter sleep medication, was found to be a possible cause of finding this pattern in these patients after excluding other known causes. [ABSTRACT FROM AUTHOR]

Background. Women are underrepresented in research focused on alcohol (e.g., Brighton, Moxham & Traynor, 2016; DOI 10.1097/JAN.0000000000000136) despite the changing patterns of alcohol consumption, which has been increasing in women in recent decades. The purpose of this study was to analyse the relationship between habitual alcohol consumption and centre of pressure (CoP) parameters during stance and gait while intoxicated by alcohol. Methods. Thirty women (24.39 ± 2.93 years) participated in this study. All participants were asked to answer the AUDIT questionnaire. Stance and gait analysis were repeated under two conditions on a Zebris platform (FDM GmbH; Munich, Germany): when the participants were sober (0.00% breath alcohol concentration, BrAC) and when they were in an intoxicated state (0.11% BrAC). Participants were divided by their AUDIT score into a low-risk alcohol consumption group (n = 15; AUDIT score: 3 to 6) and a hazardous alcohol consumption group (n = 15; AUDIT score: 7 to 13). Results. No statistical difference was observed in stance and gait parameters when comparing the low-risk and hazardous groups under 0.00% BrAC and 0.11% BrAC conditions. A statistically significant difference was observed when comparing 0.00% BrAC and 0.11% BrAC conditions within each group. This significant difference was found in CoP path length and CoP average velocity during quiet stance. However, no statistically significant differences were observed in CoP parameters during gait. An alcohol intoxication of 0.11% BrAC was not sufficient to cause statistically significant impairments in butterfly parameters of gait. [ABSTRACT FROM AUTHOR]

Biomechanical changes in the contraction of the muscle gastrocnemius of rats after chronic alcoholization for 3, 6, and 9 months are studied. Oral consumption of water-soluble C60 fullerenes at a dose of 1 mg.kg-1 is used as a corrective agent throughout the experiment. Administration of the drug in the experimental groups is carried out in three ways: 1 h before drinking alcohol, together with alcohol, and 1 h after drinking alcohol. It is established that the usage of water-soluble C60 fullerenes reduces the time of fatigue processes in alcoholised muscle by 11–39% and is most effective in the long-term development of alcoholic myopathy. The positive effect of the drug in the therapeutic regimen of usage (together with alcohol) exceeded by 6–10% its effect in prophylactic (1 h before alcohol consumption) and therapeutic (1 h after alcohol consumption) regimens, the difference in effects between which is not observed. [ABSTRACT FROM AUTHOR]

The biomechanical parameters of muscle gastrocnemius contraction and biochemical parameters of blood and muscle tissue in rats after chronic alcoholization for 3, 6, and 9 months were studied. The oral administration of C60 fullerene aqueous solution (C60FAS) at doses of 0.5, 1, and 2 mg/kg throughout the experiment was used as a therapeutic agent. C60FAS in each of the experimental groups was administered in three ways: 1 h before alcohol intake, together with alcohol, and 1 h after alcohol intake. The most significant positive effects were recorded when alcohol and C60FAS were administered together at the optimal dose of 1 mg/kg. So, the increase in muscle gastrocnemius contraction force was 20 ± 1%, 33 ± 2% and 65 ± 3% (p < 0.05) compared with control at 3, 6, and 9 months alcoholization, respectively, as well as a high level of its fluctuations correction was observed throughout the experiment. Biochemical parameters such as blood levels of creatinine, creatine phosphokinase, lactate and lactate dehydrogenase as well as pro- and antioxidant balance (content of hydrogen peroxide and reduced glutathione, as well as catalase, selenium-dependent glutathione peroxidase and superoxide dismutase activities) in muscle gastrocnemius tissues decreased from 15 ± 2% (3 months of alcoholization) to 45 ± 2% (9 months of alcoholization) (p < 0.05) compared to controls. The results indicate promising prospects for the use of water-soluble C60 fullerenes, as powerful antioxidants, for the correction of pathological conditions of the muscular system arising from alcohol intoxication. [ABSTRACT FROM AUTHOR]

Alcohol has long been known as the demon drink; an epithet owed to the numerous social ills it is associated with. Our lab‐in‐the‐field experiment assesses the extent to which changes in intoxication and an individual's environment lead to changes in overconfidence or cognitive ability that are, in turn, often linked to problematic behaviours. Results indicate that it is the joint effect of being intoxicated in a bar, rather than simply being intoxicated, that matters. Subjects systematically underestimated the magnitude of their behavioural changes, suggesting that they cannot be held fully accountable for their actions. [ABSTRACT FROM AUTHOR]

Biochemical indices of blood and tissue of the gastrocnemius muscle chronically alcoholized (for 3, 6 and 9 months) rats were studied. С60 fullerene aqueous solution (C60FAS) was administered orally as a pharmacological agent at a dose of 1 mg/kg daily throughout the experiment in a three routes: 1 h before alcohol intake (preventive regimen), together with alcohol (therapeutic regimen I) and 1 h after alcohol intake (therapeutic regimen II). Creatine phosphokinase (CPK), lactate dehydrogenase (LDH), catalase, superoxide dismutase, glutathione peroxidase (GPx) activity and the level of creatinine, lactate, hydrogen peroxide, reduced glutathione were estimated with clinical diagnostic kits. A pronounced upward trend in creatinine and lactate content, CPK and LDH activity with increasing degree of alcoholic myopathy during experiment was detected. Administration of C60FAS was shown to reduce the biochemical indices of muscle injury and to reduce oxidative processes by maintaining the balance between pro-oxidant and antioxidant systems. The maximum positive effect was observed when C60FAS was administered together with alcohol (therapeutic regimen I). The results indicate on C60 fullerene ability to correct the pathological condition of the muscular system arising from alcohol intoxication.

The article examines the pathological effect of alcohol on the human body, as well as the types of pathological conditions caused by the effect of alcohol, and modern general issues regarding the provision of emergency medical assistance to persons in critical condition due to the effects of alcohol. An overview of the toxicological situation in the country and the world has been presented. Algorithms for providing emergency medical aid for various types and severity of alcohol intoxication have been described.

Background Women are underrepresented in research focused on alcohol (e.g., Brighton, Moxham & Traynor, 2016; DOI 10.1097/JAN.0000000000000136) despite the changing patterns of alcohol consumption, which has been increasing in women in recent decades. The purpose of this study was to analyse the relationship between habitual alcohol consumption and centre of pressure (CoP) parameters during stance and gait while intoxicated by alcohol. Methods Thirty women (24.39 ± 2.93 years) participated in this study. All participants were asked to answer the AUDIT questionnaire. Stance and gait analysis were repeated under two conditions on a Zebris platform (FDM GmbH; Munich, Germany): when the participants were sober (0.00% breath alcohol concentration, BrAC) and when they were in an intoxicated state (0.11% BrAC). Participants were divided by their AUDIT score into a low-risk alcohol consumption group (n = 15; AUDIT score: 3 to 6) and a hazardous alcohol consumption group (n = 15; AUDIT score: 7 to 13). Results No statistical difference was observed in stance and gait parameters when comparing the low-risk and hazardous groups under 0.00% BrAC and 0.11% BrAC conditions. A statistically significant difference was observed when comparing 0.00% BrAC and 0.11% BrAC conditions within each group. This significant difference was found in CoP path length and CoP average velocity during quiet stance. However, no statistically significant differences were observed in CoP parameters during gait. An alcohol intoxication of 0.11% BrAC was not sufficient to cause statistically significant impairments in butterfly parameters of gait.

Key Clinical Message Brugada syndrome (BrS), a genetically inherited ion channelopathy, has been linked to a considerable number of unexplained sudden cardiac deaths in patients without structural heart defects, and Brugada phenocopy (BrP) is a condition where there is an identical electrocardiogram (ECG) pattern to a congenital BrS, but this is due to other reversible etiologies. A 37‐year‐old male patient with a documented history of hypertension presented with vomiting after taking 43, 10 mg, melatonin pills and binge drinking locally made alcohol 2 days before. ECG showed right ventricular conduction delay with a “saddleback” appearance, with the J point elevated more than 2 mm and the terminal portion of the ST‐segment elevated more than 1 mm in leads V1 and/or V2. Which returned to normal after a few hours. The association between the use of melatonin and the finding of the Brugada pattern (BP) in a patient with normal heart structure or abnormal ECGs has been documented in much literature, and although no official melatonin dosage is recommended for adults, melatonin has been reported to cause and protect from arrhythmias through different mechanisms. In our patient, after alcohol intoxication was ruled out as a cause, melatonin was the only significant risk factor related to his ECG findings. The BP can be found in patients with otherwise normal heart structure and ECG records, and an overdose of melatonin, which is used as an over‐the‐counter sleep medication, was found to be a possible cause of finding this pattern in these patients after excluding other known causes.

Introduction: The sex difference in alcohol use disorder (AUD) is ingrained in distinctive neurobiological responses between men and women, which necessitates further investigation for a more tailored management. Methods: Minding the findings of iron dysregulation in AUD and the sex difference in iron homeostasis in multiple physiological and pathological settings, we examined the sex difference in the association between serum ferritin and blood alcohol concentration (BAC) in intoxicated males (n = 125) and females (n = 59). We included patients with both serum ferritin tested of any value and a BAC above the level of detection during the same hospital admission period. We investigated sex difference in the relationship between BAC, serum ferritin and liver enzymes in intoxicated critically ill and noncritically ill patients. Results: We found a negative association between serum ferritin and BAC in critically ill, intoxicated females [R2 = 0.44, F(1,14) = 11.02, p = 0.005], with much attenuated serum ferritin in females compared to their male counterparts (194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L, p = 0.002). We found a positive association between serum ferritin and liver enzymes [alanine transaminase (ALT) and aspartate transferase (AST)] in critically ill intoxicated females [ALT: R2 = 0.48, F(1,10) = 9.1, p = 0.013; AST: R2 = 0.68, F(1,10) = 21.2, p = 0.001] and in noncritically ill intoxicated males [ALT: R2 = 0.1, F(1,83) = 9.4, p = 0.003; AST: R2 = 0.1, F(1,78) = 10.5, p = 0.002]. The effect of BAC on serum ferritin was not mediated by ALT [indirect effect: (B = 0.13, p = 0.1)]. We also found a significant effect of sex, anemia, intensive care unit (ICU) admission and mortality on serum ferritin. Discussion: Our results suggest that high BAC in intoxicated female patients is associated with attenuated serum ferritin levels, questioning the role of low serum ferritin in female vulnerability to alcohol. [ABSTRACT FROM AUTHOR]

Background: Research has not identified which patients optimally benefit from brief Motivational Interviewing (bMI) for heavy drinking when delivered to young adults in the Emergency Department (ED). Methods: We conducted secondary analyses of data from a randomized controlled trial in which 344 young adults (18–35 years) presenting to the ED with alcohol intoxication received either bMI or Brief Advice (BA, control group). We used Latent Class Analysis to derive participants' profiles from baseline characteristics (i.e., sex, age, severity of alcohol use disorder, attribution of ED admission to alcohol use, importance, and confidence to change, cognitive discrepancy, anxiety, depression, and trait reactance). We then conducted a moderation analysis to assess the number of heavy drinking days at short‐term (1‐month) and long‐term (12‐month) follow‐up using negative binomial regressions with interactions between the intervention and derived classes. Results: Fit statistics indicated that a 4‐class solution best fit the data. Class 3 (high severity, importance and discrepancy, and low confidence and anxiety) benefitted more from bMI than BA at short‐ and long‐term follow‐up than Class 1 (younger; lowest severity, importance, discrepancy, reactance, anxiety and depression, and highest confidence). Class 2 (older; highest severity, importance, discrepancy, reactance, anxiety and depression, and lowest confidence) also benefitted more from bMI than BA than did Class 1 at short‐term follow‐up. In these significant contrasts, Class 1 benefitted more from BA than bMI. There were no significant interactions involving Class 4 (more likely to be women; low severity; high levels of anxiety, depression, and reactance). Conclusions: This study identified the patient profiles that benefitted more from bMI than BA among nontreatment‐seeking young adults who present intoxicated to the ED. The findings have implications for intervention design and argue for the importance of research aimed at developing intervention content tailored to patient profiles. [ABSTRACT FROM AUTHOR]

Binge drinking among adolescents is common in Belgium, posing a risk of serious health consequences. Until today, only estimations of the prevalence of acute alcohol intoxication (AAI) in adolescents have been made. Research into potential risk factors has not yet been conducted in Belgium. Therefore, this study aims to gain more insight into the prevalence, medical characteristics and potential risk factors of AAI among adolescents. A retrospective multicentre chart study was performed on adolescents aged 10–17 years with AAI in Antwerp, Belgium (2015–2021). Patient's demographics, medical characteristics and information regarding the context of the AAI were collected from medical charts. Over the study period, a total of 1016 patients were admitted with AAI in Antwerp, having a median age of 16.6 years old, a median blood alcohol concentration of 1.95 g/L and combined drug use in 10% of cases. These findings did not significantly change over the study period. Multiple linear regression analysis indicated that after correcting for covariates, higher age, no combined drug use and decreased consciousness at admission were associated with more severe AAI cases (higher blood alcohol concentration). This study shows that AAI is prevalent among Belgian adolescents, and better targeted preventive measures and policies are needed. Our findings could be taken into account when developing preventive measures. However, data addressing the demographics and context of AAI were mostly missing. Therefore, prospective research is required to further investigate potential risk factors associated with AAI. [ABSTRACT FROM AUTHOR]

Alcohol consumption is known to cause several brain anomalies. The pathophysiological changes associated with alcohol intoxication are mediated by various factors, most notable being inflammation. Alcohol intoxication may cause inflammation through several molecular mechanisms in multiple organs, including the brain, liver and gut. Alcohol-induced inflammation in the brain and gut are intricately connected. In the gut, alcohol consumption leads to the weakening of the intestinal barrier, resulting in bacteria and bacterial endotoxins permeating into the bloodstream. These bacterial endotoxins can infiltrate other organs, including the brain, where they cause cognitive dysfunction and neuroinflammation. Alcohol can also directly affect the brain by activating immune cells such as microglia, triggering the release of pro-inflammatory cytokines and neuroinflammation. Since alcohol causes the death of neural cells, it has been correlated to an increased risk of neurodegenerative diseases. Besides, alcohol intoxication has also negatively affected neural stem cells, affecting adult neurogenesis and causing hippocampal dysfunctions. This review provides an overview of alcohol-induced brain anomalies and how inflammation plays a crucial mechanistic role in alcohol-associated pathophysiology. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether dexmedetomidine (DEX), as adjunctive therapy to benzodiazepine (BZD), is superior to BZD alone in critically ill patients with alcohol withdrawal syndrome (AWS). Data Sources: PubMed Central, Cochrane CENTRAL, ClinicalTrials.gov and Google Scholar were used as search databases. Specific keywords and MeSH terms were "dexmedetomidine," "benzodiazepine," and "alcohol withdrawal syndrome." The last search was on September 16, 2022. Study Selection and Data Extraction: Randomized controlled trials (RCTs) and nonrandomized/cohort studies exploring the use of DEX in the management of AWS were included. A total of 12 studies were included in the systematic review and 7 in the meta-analysis. Data Synthesis: The intensive care unit length of stay (ICU LOS) was found to have a mean difference (MD) of 48.06 [37.48, 58.64], P = <0.001 for the cohort subgroup, significantly favoring the DEX arm, but, in contrast, pooled RCT data showed a result of –20.07 [–36.86, –3.28], P = 0.02, a shorter ICU LOS for the DEX arm. Bradycardia and hypotension incidence significantly favored the BZD arm in both subgroups. This study compares the effectiveness of adjunctive DEX in clinical practice and aims to help providers in critical decision-making by compiling and analyzing the best current available evidence of its use in AWS. Conclusions: Based on low to very low level of evidence, adjunctive DEX showed no significant difference for ICU LOS when compared with BZD alone. Pooled randomized trials potentially show a benefit but are similarly limited by their low quality of evidence. [ABSTRACT FROM AUTHOR]

The movement of a motorcycle is one of the critical factors that influences the stability of the ride. It has been established that the gait patterns of drunk and sober people are distinct. However, drunk motorcycle (MC) drivers' balance has not been investigated as a predictor of intoxication. This paper characterized and used MC and head movements, such as pitch and roll, to predict intoxication while riding. Two separate experiments were conducted to monitor MC and head movement. Male participants were recruited between the ages of 23 and 50 to participate in the study. Participants used alcohol intoxication goggles (AIG) to simulate blood alcohol content (BAC) while driving on a straight path. Placebo goggles were used for control. Results showed that pitch and roll amplitudes of the MC could distinguish drivers wearing placebo and AIGs, as well as the pitch and roll frequency of the head. Deep learning can be used to predict the intoxication of MC riders. The predictive accuracy of the algorithm shows a viable opportunity for the use of movement to monitor drunk riders on the road. [ABSTRACT FROM AUTHOR]