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1.
J Forensic Leg Med ; 80: 102171, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33873001

RESUMEN

Toxicology tests and medical expert opinions are part of routine work in drunk driving cases in both domestic and international practice. The greatest challenge to forming an opinion is that the perpetrator claims to have consumed alcohol after the act of driving. To determine the time of consumption, it is essential to establish whether the alcohol in the body was in the absorption phase or in the elimination phase when the sample was collected. In domestic practice, breath alcohol content can be measured several times, two blood samples can be collected, and both blood and urine samples can be taken almost simultaneously. A recent Swedish study showed that taking a single blood sample and two urine samples allows for a more accurate examination of consumption after the fact. This study aimed to examine the applicability of such model to the domestic environment. We conducted a controlled drinking experiment involving 15 Hungarian casual drinker volunteers aged 18-25 years who consumed different amounts of alcohol at specified times while providing regular breath alcohol measurements as well as blood and urine samples. These measurement results provided accurate information about the changes in alcohol metabolism compared to the time of drinking and allowed us to draw the necessary conclusions, offering further evidence that alcohol metabolism can vary significantly between different ethnic groups. The results showed that the absorption and excretion of ethyl alcohol in the volunteers were much faster than those in the current Hungarian standards used in practice. In conclusion, the comparison of blood and urine samples collected between 60 min and 120 min cannot be considered suitable for establishing the fact of drinking after driving in Hungarian practice, and a local model is needed.


Asunto(s)
Depresores del Sistema Nervioso Central/análisis , Depresores del Sistema Nervioso Central/farmacocinética , Conducir bajo la Influencia , Etanol/análisis , Etanol/farmacocinética , Adolescente , Adulto , Consumo de Bebidas Alcohólicas , Pruebas Respiratorias , Femenino , Humanos , Hungría , Masculino , Detección de Abuso de Sustancias , Factores de Tiempo , Adulto Joven
2.
Alcohol Clin Exp Res ; 45(4): 697-708, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33619752

RESUMEN

BACKGROUND: Interindividual variation in voluntary ethanol consumption and ethanol response is partially influenced by genetic variation. Discovery of the genes and allelic variants that affect these phenotypes may clarify the etiology and pathophysiology of problematic alcohol use, including alcohol use disorder. Genetically diverse mouse populations, which demonstrate heritable variation in ethanol consumption, can be utilized to discover the genes and gene networks that influence this trait. The Collaborative Cross (CC) recombinant inbred strains, Diversity Outbred (DO) population and their 8 founder strains are complementary mouse resources that capture substantial genetic diversity and can demonstrate expansive phenotypic variation in heritable traits. These populations may be utilized to discover candidate genes and gene networks that moderate ethanol consumption and other ethanol-related traits. METHODS: We characterized ethanol consumption, preference, and pharmacokinetics in the 8 founder strains and 10 CC strains in 12-hour drinking sessions during the dark phase of the circadian cycle. RESULTS: Ethanol consumption was substantially heritable, both early in ethanol access and over a chronic intermittent access schedule. Ethanol pharmacokinetics were also heritable; however, no association between strain-level ethanol consumption and pharmacokinetics was detected. The PWK/PhJ strain was the highest drinking strain, with consumption substantially exceeding that of the C57BL/6J strain, which is commonly used as a model of "high" or "binge" drinking. Notably, we found strong evidence that sex moderated genetic effects on voluntary ethanol drinking. CONCLUSIONS: Collectively, this research serves as a foundation for expanded genetic study of ethanol consumption in the CC/DO and related populations. Moreover, we identified reference strains with extreme consumption phenotypes that effectively represent polygenic models of excessive ethanol use.


Asunto(s)
Consumo de Bebidas Alcohólicas/genética , Depresores del Sistema Nervioso Central/administración & dosificación , Etanol/administración & dosificación , Animales , Depresores del Sistema Nervioso Central/sangre , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/sangre , Etanol/farmacocinética , Femenino , Masculino , Ratones Endogámicos , Carácter Cuantitativo Heredable
3.
Pharmacology ; 106(3-4): 169-176, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32937627

RESUMEN

INTRODUCTION: We aimed to investigate the pharmacokinetic properties and safety of melatonin administered by alternative routes of administration. METHODS: This study employed a cross-over design in healthy female volunteers. Twenty-five milligrams of melatonin was administered intravenously, intravesically, rectally, transdermally, and vaginally. Blood samples were collected at specified time points up to 24 h following intravenous, intravesical, rectal, and vaginal administration, and up to 48 h following transdermal administration. Plasma melatonin concentrations were determined by radioimmunoassay. Sedation was evaluated by a simple reaction-time test, and sleepiness was assessed by the Karolinska Sleepiness Scale. Adverse events were registered for each route of administration. RESULTS: Ten participants were included. We documented a mean (SD) time to maximal concentration of 51 (29) min for intravesical, 24 (20) min for rectal, 21 (8) h for transdermal, and 147 (56) min for vaginal administration. The mean (SD) elimination half-life was 47 (6) min for intravenous, 58 (7) min for intravesical, 60 (18) min for rectal, 14.6 (11.1) h for transdermal, and 129 (17) min for vaginal administration. The mean (SD) bioavailability was 3.6 (1.9)% for intravesical, 36.0 (28.6)% for rectal, 10.0 (5.7)% for transdermal, and 97.8 (31.7)% for vaginal administration. No significant changes in reaction times were observed following administration of melatonin by any of the administration routes. Increased tiredness was documented following transdermal administration only. No serious adverse effects were documented. CONCLUSION: Rectally and vaginally administered melatonin may serve as relevant alternatives to standard oral melatonin therapy. Transdermal delivery of melatonin displayed an extended absorption and can be applied if prolonged effects are intended. Intravesical administration displayed, as expected, a very limited bioavailability. Melatonin administered by these routes of administration was safe.


Asunto(s)
Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/farmacocinética , Melatonina/administración & dosificación , Melatonina/farmacocinética , Administración Cutánea , Administración Intravaginal , Administración Intravenosa , Administración Intravesical , Administración Rectal , Adulto , Área Bajo la Curva , Disponibilidad Biológica , Depresores del Sistema Nervioso Central/efectos adversos , Depresores del Sistema Nervioso Central/sangre , Estudios Cruzados , Femenino , Semivida , Voluntarios Sanos , Humanos , Melatonina/efectos adversos , Melatonina/sangre , Somnolencia , Adulto Joven
4.
Forensic Sci Int ; 316: 110532, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33099270

RESUMEN

During the prosecution and defence of drink-driving cases, forensic practitioners are often required to engage in various blood-alcohol calculations, such as whether or not the statutory limit was exceeded (e.g. 80mg/100mL, 0.08g/100mL or 0.80g/L). For this purpose, most forensic scientists utilize the Widmark equation, or some modification thereof, to calculate a person's blood alcohol concentration (BAC) based on information about the amount of ethanol consumed and the pattern of drinking. This equation comes in two main forms; one of which incorporates the apparent volume of distribution of ethanol (V) and the other a person's total body water (TBW). In this study, we utilised two independent data sets, one involving the determination of V for ethanol in 173 men and 63 women, and the other TBW determined for 582 men and 884 women. Those subjects included in the TBW group represented various racial groups (Caucasians, African Americans, Hispanics, Asians and Puerto Ricans), with body mass index (BMI) ranging from 17 to 80kg/m2. Both versions of the Widmark equation were evaluated in relation to their accuracy and precision in predicting TBW and/or V using the two most common anthropometric equations; those of Watson et al. and Forrest. Both anthropometric equations exhibited good accuracy (<4.3%) for the prediction of both TBW and V. However, the root mean square error was lower TBW was used for prediction (9.09-12.84%) rather than V (11.72-15.08%). Overall, this study has demonstrated (a) that blood-alcohol calculations are more reliable using TBW rather than V (b) that both equations (Watson et al. and Forrest) are applicable to ethnic groups other than Caucasians and (c) the Forrest equation predicts TBW in men and women with BMI from 17 to 35kg/m2 and that the Watson et al. equation works for those with more extreme BMI; females (17-80kg/m2) and males (17-67kg/m2).


Asunto(s)
Nivel de Alcohol en Sangre , Agua Corporal/metabolismo , Toxicología Forense/métodos , Conceptos Matemáticos , Índice de Masa Corporal , Depresores del Sistema Nervioso Central/farmacocinética , Conjuntos de Datos como Asunto , Etanol/farmacocinética , Femenino , Humanos , Masculino
5.
Forensic Sci Int ; 316: 110409, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32871451

RESUMEN

AIM: Claimed intake of alcohol after a traffic incident, called the hip-flask defence, can be objectively assessed by different methods. One of them is the use of two consecutive ethanol concentrations in urine and the ratio between ethanol concentrations in urine and blood. Another one is the concentrations of ethyl glucuronide (EtG) and ethyl sulphate (EtS) in blood and their ratio to ethanol. The experimental basis for both these models is from single dose studies only. The aim of this study was therefore to describe the kinetics of ethanol, EtG and EtS after ingestion of two repeated doses of ethanol and to investigate the usefulness of the different models for the assessment of the hip-flask defence. METHODS: Thirty-five subjects ingested a first dose of 0.51 g of ethanol per kilo body weight, and two hours later a second dose (the hip-flask drink) of 0.25, 0.51 or 0.85 g of ethanol per kilo body weight. Ten urine and 17 blood samples were collected and analysed for ethanol, EtG and EtS using fully validated methods. It was investigated if all subjects fulfilled the criteria for recent drinking, according to the two different models, when using the samples collected 180-240 minutes after start of first dose drinking. According to the first model, increase in urinary ethanol concentrations and a ratio UAC/BAC below 1.3 indicated recent drinking. According to the second model, increase in blood EtG concentrations and a ratio ethanol (g/kg)/EtG (mg/L) above 1 indicated recent drinking. RESULTS: All subjects in the high dose group fulfilled all criteria for recent drinking. One subject in the medium dose group and nine subjects in the low dose group failed to show increasing UAC and/or a UAC/BAC ratio below 1.3. One subject in the low dose group failed to show increasing concentrations of blood EtG, but all subjects showed a ratio ethanol/EtG above 1. CONCLUSIONS: The present study showed, by the use of experimental data, that both two models used to investigate the hip-flask defence can be used, but only when the hip-flask dose is sufficiently high.


Asunto(s)
Etanol , Glucuronatos , Detección de Abuso de Sustancias/métodos , Adulto , Consumo de Bebidas Alcohólicas , Biomarcadores/sangre , Biomarcadores/orina , Nivel de Alcohol en Sangre , Depresores del Sistema Nervioso Central/sangre , Depresores del Sistema Nervioso Central/farmacocinética , Depresores del Sistema Nervioso Central/orina , Conducir bajo la Influencia/legislación & jurisprudencia , Etanol/sangre , Etanol/farmacocinética , Etanol/orina , Femenino , Glucuronatos/sangre , Glucuronatos/orina , Humanos , Masculino , Ésteres del Ácido Sulfúrico/sangre , Ésteres del Ácido Sulfúrico/orina , Factores de Tiempo , Adulto Joven
6.
J Forensic Sci ; 65(5): 1676-1684, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32421216

RESUMEN

The Widmark equation is used forensically for the determination of the amount of ethanol (alcohol) that may have been consumed and also to determine the blood alcohol concentration (BAC) of an individual at a specific time. It is important to be able to estimate the uncertainty associated with Widmark equations. To date, there has been no detailed determination of contribution to the final uncertainty of Widmark calculations of the volume of distribution of ethanol (Vd ), using anthropometric equations, or the contribution of an individual's body mass. Using published data, published literature, and freedom of information data, we determined that the variability (%CV) associated with Vd was ~10% (Watson et al. and Forrest anthropometric equations) and that the %CV associated with estimated body mass was ~15% compared to ~3% when body mass was directly measured. These data allow an estimation of the overall uncertainty of Widmark calculations using general error propagation. The estimated total uncertainty for BAC calculations increased from ~11% (volume consumed) and ~22% (BAC) to ~19% (volume consumed) and ~37% (BAC) when using measured body mass compared to estimated body mass. These results demonstrate that forensic practitioners should be mindful of the increase in estimated uncertainty in calculated Widmark equation results when estimated body mass is used rather than measured body mass. These data further improve the knowledge around the uncertainty of results calculated with the Widmark equation.


Asunto(s)
Nivel de Alcohol en Sangre , Índice de Masa Corporal , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Modelos Biológicos , Consumo de Bebidas Alcohólicas , Depresores del Sistema Nervioso Central/administración & dosificación , Etanol/administración & dosificación , Toxicología Forense/métodos , Humanos , Tasa de Depuración Metabólica , Incertidumbre
7.
Proteomics ; 20(1): e1900266, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31814311

RESUMEN

Dysfunction of glutamate neurotransmission in the nucleus accumbens (NAc) has been implicated in the pathophysiology of alcohol use disorders (AUD). Neurogranin (Ng) is exclusively expressed in the brain and mediates N-methyl-d-aspartate receptor (NMDAR) hypo-function by regulating the intracellular calcium-calmodulin (Ca2+ -CaM) pathway. Ng null mice (Ng-/- mice) demonstrate increased alcohol drinking compared to wild-type mice, while also showing less tolerance to the effect of alcohol. To identify the molecular mechanism related to alcohol seeking, both in vivo microdialysis and label-free quantification proteomics comparing Ng genotype and effects of alcohol treatment on the NAc are utilized. There is significant difference in glutamate and gamma-aminobutyric acid (GABA) neurotransmission between genotypes; however, alcohol administration normalizes both glutamate and GABA levels in the NAc. Using label-free proteomics, 427 protein expression changes are identified against alcohol treatment in the NAc among 4347 total proteins detected. Bioinformatics analyses reveal significant molecular differences in Ng null mice in response to acute alcohol treatment. Ingenuity pathway analysis found that the AKT network is altered significantly between genotypes, which may increase the sensitivity of alcohol in Ng null mice. The pharmacoproteomics results presented here illustrate a possible molecular basis of the alcohol sensitivity through Ng signaling in the NAc.


Asunto(s)
Etanol/farmacología , Neurogranina/genética , Núcleo Accumbens/efectos de los fármacos , Proteoma/metabolismo , Proteómica/métodos , Proteínas Proto-Oncogénicas c-akt/metabolismo , Animales , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/farmacocinética , Depresores del Sistema Nervioso Central/farmacología , Cromatografía Liquida/métodos , Etanol/administración & dosificación , Etanol/farmacocinética , Genotipo , Ácido Glutámico/metabolismo , Masculino , Ratones Noqueados , Microdiálisis/métodos , Neurogranina/metabolismo , Núcleo Accumbens/metabolismo , Transducción de Señal/efectos de los fármacos , Espectrometría de Masas en Tándem/métodos , Ácido gamma-Aminobutírico/metabolismo
8.
Artículo en Inglés | MEDLINE | ID: mdl-31381847

RESUMEN

OBJECTIVE: To evaluate the pharmacokinetic and safety profile of a novel continuous release and absorption melatonin (CRA-melatonin) compared with an immediate-release melatonin (IR-melatonin) product. METHODS: The REM Absorption Kinetics Trial (REMAKT), an open-label, single-center, randomized, single-dose, 2-way crossover trial, compared the pharmacokinetic and safety profile of CRA-melatonin (5 mg) with IR-melatonin (5 mg) in healthy adult volunteers. The study was conducted from March 18, 2016, to April 20, 2016. RESULTS: Ten subjects completed REMAKT. Plasma melatonin levels exceeded the targeted maintenance threshold level of 1,000 pg/mL for a median of 6.7 hours for CRA-melatonin compared with 3.7 hours for IR-melatonin. The median Cmax was 4,690 pg/mL for CRA-melatonin and 23,352 pg/mL for IR-melatonin. In REMAKT, there were no treatment-emergent adverse events reported in the CRA-melatonin arm. Five treatment-emergent adverse events occurred with IR-melatonin. CONCLUSIONS: The novel, well-tolerated CRA-melatonin was shown to achieve quick release and then continuous release and absorption of melatonin for up to 7 hours, making it a significant advancement in the pharmacokinetic release profile of exogenous melatonin delivery and, therefore, an important potential consideration as a baseline therapy for sleep.


Asunto(s)
Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/farmacocinética , Melatonina/administración & dosificación , Melatonina/farmacocinética , Adolescente , Adulto , Depresores del Sistema Nervioso Central/efectos adversos , Estudios Cruzados , Preparaciones de Acción Retardada , Femenino , Humanos , Masculino , Melatonina/efectos adversos , Adulto Joven
9.
Forensic Sci Int ; 302: 109857, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31284201

RESUMEN

This study was conducted to understand alcohol kinetics for Koreans and to determine whether an individual is in absorption phase or elimination phase at the time of blood collection by analyzing of ethyl glucuronide and ethyl sulfate in blood. A total of 50 healthy adults was selected and assigned to drink 1g of ethanol per kg body weight of individual within 1h. Blood samples were then collected every 15min for the first 3h, 30min next 3h, and 1h last 9h. Urine samples were also collected from the individual, but not under the controlled environment. All samples were then analyzed by gas chromatography with a flame ionization detector (GC-FID) for alcohol and liquid chromatography-mass/mass spectrometry (LC-MS/MS) for EtG and EtS. The maximum BAC (Cmax) was 0.138% (g/100mL) in average under the controlled experimental condition. Alcohol elimination rates (ß) in average were 0.020% for male and 0.024% for female, respectively. It was found that the ratio of UAC and BAC was less than 1 in the absorption phase and the average ratio of UAC and BAC was 1.47 in the elimination phase. The comparison of BAC (g/L) and EtG (mg/L) absorption and elimination curves showed that the intersection time was 3.9h in average. It is shown that the ratio of EtG (mg/L)/BAC (g/L) is higher than 1, the individual would be in elimination phase of BAC. At the time of Cmax, the ratio of EtG (mg/L)/BAC (g/L) was 0.255±0.132 (SD) in average.


Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Glucuronatos/sangre , Ésteres del Ácido Sulfúrico/sangre , Adulto , Pueblo Asiatico , Biomarcadores/sangre , Depresores del Sistema Nervioso Central/sangre , Depresores del Sistema Nervioso Central/orina , Cromatografía de Gases , Cromatografía Liquida , Etanol/sangre , Etanol/orina , Femenino , Humanos , Masculino , Espectrometría de Masas , Persona de Mediana Edad , República de Corea , Adulto Joven
10.
Alcohol Clin Exp Res ; 43(9): 1909-1917, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31237691

RESUMEN

BACKGROUND: Animal models are an essential feature of drug and pharmacotherapy development for treating alcohol use disorders (AUDs). The rhesus macaque is a robust animal model for many aspects of AUDs particularly in exploiting individual differences in oral self-administration of ethanol (EtOH), endocrine orchestration of stress response, and menstrual cycle characteristics. However, the clearance rates of EtOH have not been reported in this species, and the GABAA and N-methyl-D-aspartate (NMDA) receptor involvement in EtOH's discriminative stimulus effects has not been fully characterized. METHODS: EtOH clearance rates following 2 doses of EtOH on separate days (0.5 and 1.0 g/kg, i.g.) were determined in 8 young adult male rhesus macaques. The EtOH was given by nasogastric gavage, and repeated blood samples were taken over 5 hours without sedation. Next, all subjects were trained on a 2-choice 1.0 g/kg EtOH (i.g.) versus water discrimination with a 60-minutes pretreatment period to capture peak blood EtOH concentration (BEC). Substitution testing was conducted with GABAA ligands pentobarbital (i.g. and i.m.) and midazolam (i.g.), as well as NMDA antagonist MK-801 (i.m.). RESULTS: Peak BECs were 34 and 87 mg/dl for 0.5 and 1.0 g/kg doses, respectively, and occurred at 66 and 87 minutes following gavage. All GABAA and NMDA ligands tested resulted in responding on the EtOH-appropriate lever with the potency ranking of MK-801 (ED50 : 0.017 mg/kg) > midazolam (ED50 : 1.6 mg/kg) > pentobarbital (ED50 : 3.7 mg/kg) > EtOH (ED50 : 700 mg/kg, or 0.7 g/kg) in these subjects. CONCLUSIONS: These results suggest that the compound discriminative stimulus effects of EtOH are highly consistent across species, providing further support for the rhesus macaque as strong model for pharmacotherapy development for AUD.


Asunto(s)
Depresores del Sistema Nervioso Central/farmacocinética , Discriminación en Psicología/efectos de los fármacos , Etanol/farmacocinética , Macaca mulatta/metabolismo , Animales , Depresores del Sistema Nervioso Central/efectos adversos , Depresores del Sistema Nervioso Central/metabolismo , Etanol/efectos adversos , Etanol/metabolismo , Masculino , Receptores de GABA-A/metabolismo , Receptores de N-Metil-D-Aspartato/metabolismo
11.
Am J Physiol Gastrointest Liver Physiol ; 316(4): G509-G518, 2019 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-30714813

RESUMEN

We are investigating the changes in hepatic lipid catabolism that contribute to alcohol-induced fatty liver. Following chronic ethanol (EtOH) exposure, abstinence from alcohol resolves steatosis. Here, we investigated the hepatocellular events that lead to this resolution by quantifying specific catabolic parameters that returned to control levels after EtOH was withdrawn. We hypothesized that, after its chronic consumption, EtOH withdrawal reactivates lipid catabolic processes that restore lipostasis. Male Wistar rats were fed control and EtOH liquid diets for 6 wk. Randomly chosen EtOH-fed rats were then fed control diet for 7 days. Liver triglycerides (TG), lipid peroxides, key markers of fatty acid (FA) metabolism, lipophagy, and autophagy were quantified. Compared with controls, EtOH-fed rats had higher hepatic triglycerides, lipid peroxides, and serum free fatty acids (FFA). The latter findings were associated with higher levels of FA transporters (FATP 2, 4, and 5) but lower quantities of peroxisome proliferator-activated receptor-α (PPAR-α), which governs FA oxidation. EtOH-fed animals also had lower nuclear levels of the autophagy-regulating transcription factor EB (TFEB), associated with lower hepatic lipophagy and autophagy. After EtOH-fed rats were refed control diet for 7 days, their serum FFA levels and those of FATPs fell to control (normal) levels, whereas PPAR-α levels rose to normal. Hepatic TG and malondialdehyde levels in EtOH-withdrawn rats declined to near control levels. EtOH withdrawal restored nuclear TFEB content, hepatic lipophagy, and autophagy activity to control levels. EtOH withdrawal reversed aberrant FA metabolism and restored lysosomal function to promote resolution of alcohol-induced fatty liver. NEW & NOTEWORTHY Here, using an animal model, we show mechanisms of reversal of fatty liver and injury following EtOH withdrawal. Our data indicate that reactivation of autophagy and lysosome function through the restoration of transcription factor EB contribute to reversal of fatty liver and injury following EtOH withdrawal.


Asunto(s)
Proteínas Relacionadas con la Autofagia/metabolismo , Etanol/farmacocinética , Hígado Graso Alcohólico , Hepatocitos/metabolismo , Regeneración Hepática/fisiología , Abstinencia de Alcohol , Animales , Autofagia/fisiología , Depresores del Sistema Nervioso Central/farmacocinética , Proteína Receptora de AMP Cíclico/metabolismo , Proteínas de Transporte de Ácidos Grasos/metabolismo , Hígado Graso Alcohólico/metabolismo , Hígado Graso Alcohólico/patología , Receptores Activados del Proliferador del Peroxisoma/metabolismo , Ratas , Ratas Wistar
12.
Forensic Sci Int ; 294: 189-195, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30530156

RESUMEN

Driving under the influence of alcohol is a major problem for traffic-safety and a popular defence argument is alleged consumption after driving, commonly referred to as the hip-flask defence. Forensic toxicologists are often called as expert witnesses in drinking and driving cases where the suspect has claimed the hip-flask defence, to assess the credibility of the explanation. Several approaches to help the expert have been introduced but the scientific data used to support or challenge this is solely based on data from controlled single doses of ethanol administered during a short time and in abstinent subjects. In reality, we believe that even in drinking after driving cases, the subject many times has alcohol on board at time of the hip-flask drink. This questions the applicability of the data used as basis to investigate the hip-flask defence. To fill this knowledge gap, we aimed to investigate how blood and urine ethanol kinetics vary after an initial drinking session of beer and then a subsequent hip-flask drink of three different doses of whiskey. Fifteen subjects participated in the study and each provided 10 urine samples and 17 blood samples over 7h. The initial drink was 0.51g ethanol/kg and the second was either 0.25, 0.51, or 0.85g/kg. Our data suggested that the difference between the ethanol concentrations in two consecutive urine samples is a more sensitive parameter than the ratio between urine and blood alcohol to detect a recent intake when ethanol from previous intakes are already present in the body. Twelve subjects presented results that fully supported a recent intake using the criteria developed from a single intake of ethanol. Three subjects showed unexpected results that did not fully support a recent intake. We conclude that data from one blood sample and two urine samples provide good evidence for investigating the hip-flask defence even if alcohol was on board at the time of the hip-flask drink.


Asunto(s)
Conducir bajo la Influencia/legislación & jurisprudencia , Etanol/sangre , Etanol/orina , Adulto , Anciano , Consumo de Bebidas Alcohólicas/sangre , Consumo de Bebidas Alcohólicas/orina , Depresores del Sistema Nervioso Central/sangre , Depresores del Sistema Nervioso Central/farmacocinética , Depresores del Sistema Nervioso Central/orina , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Etanol/farmacocinética , Femenino , Humanos , Masculino , Persona de Mediana Edad , Detección de Abuso de Sustancias , Suecia , Adulto Joven
13.
Forensic Sci Int ; 294: 124-131, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30553124

RESUMEN

The Widmark equation is commonly used when blood alcohol calculations are required in forensic and legal medicine, such as in road-traffic cases and alcohol-related deaths. An important biological variable in this connection is the volume of distribution (Vd) of ethanol, which is commonly referred to as the rho-factor. Although a person's Vd can be determined empirically through controlled drinking experiments, this approach is not very practical in reality. For this reason, a number of anthropometric equations have been developed that utilize sex, age, height and weight to estimate the person's total body water (TBW) and hence Vd of ethanol. To date, there are not any studies that compare Vd derived from anthropometric data with robust values measured empirically. From the literature we compiled information about the Vd of ethanol from drinking studies with 173 Caucasian males and 63 Caucasian females from Western Europe. These empirically derived values of Vd were then compared with estimates derived from various anthropometric equations. In males the Watson, Watson and Batt regression equation involving age, height and weight gave the most accurate results (bias was 0.00L/kg) and 95% range ±0.13L/kg. The equation derived by Forrest, which took into consideration a person's body mass index (BMI), gave the best estimates of Vd for females; mean bias -0.01L/kg and range ±0.15L/kg.


Asunto(s)
Antropometría , Nivel de Alcohol en Sangre , Etanol/farmacocinética , Modelos Estadísticos , Adolescente , Adulto , Anciano , Agua Corporal , Depresores del Sistema Nervioso Central/farmacocinética , Femenino , Toxicología Forense/métodos , Humanos , Masculino , Persona de Mediana Edad , Distribución Tisular , Adulto Joven
14.
J Forensic Sci ; 63(6): 1634-1640, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30005144

RESUMEN

Testing for phosphatidylethanol (PEth) is a relatively new tool for detecting and grossly quantifying a person's use of alcohol in a variety of security, medical, and legal environments. The basic chemistry of PEth is explained with a particular focus on factors that make it highly suitable as a biomarker for alcohol use in such situations. This article meets the need for a literature review that synthesizes PEth laboratory findings and suggests updated guidelines for interpretation. Several ethanol biomarkers have been used for detection or monitoring alcohol use but have significant limitations. Based on this review, the authors propose three guidelines for evaluating PEth values: Light or no Consumption (<20 ng/mL), Significant Consumption (20-199 ng/mL), and Heavy Consumption (>200 ng/mL). These guidelines are important in employment and security environments, but also have applicability in such diverse activities as alcohol treatment programs, organ transplant decisions, and monitoring impaired medical professionals.


Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Glicerofosfolípidos/sangre , Detección de Abuso de Sustancias/métodos , Alanina Transaminasa/análisis , Alcoholismo/diagnóstico , Aspartato Aminotransferasas/análisis , Biomarcadores/sangre , Pruebas Respiratorias , Depresores del Sistema Nervioso Central/farmacocinética , Índices de Eritrocitos , Etanol/farmacocinética , Toxicología Forense , Glucuronatos/análisis , Cabello/química , Humanos , Valores de Referencia , Ésteres del Ácido Sulfúrico/orina , Transferrina/análisis , gamma-Glutamiltransferasa/sangre
15.
Ugeskr Laeger ; 180(19)2018 May 07.
Artículo en Danés | MEDLINE | ID: mdl-29761771

RESUMEN

Treatment for insomnia with melatonin (MT) in children and adolescents aged 0-17 years has doubled since 2011. The efficacy and safety profile for MT in children has not been determined. Recent clinical trials indicate, that MT only has a clinical effect on sleep latency, not on total sleep time. Furthermore, it has emerged, that proper sleep hygiene can cure the sleep problem in 50% of the children. Typically, the safety evaluation only entails an unclassified report of adverse events. Two long-term studies investigate and dispel the potential influence of MT on puberty.


Asunto(s)
Depresores del Sistema Nervioso Central/uso terapéutico , Melatonina/uso terapéutico , Trastornos del Inicio y del Mantenimiento del Sueño/tratamiento farmacológico , Adolescente , Depresores del Sistema Nervioso Central/administración & dosificación , Depresores del Sistema Nervioso Central/efectos adversos , Depresores del Sistema Nervioso Central/farmacocinética , Niño , Preescolar , Humanos , Melatonina/administración & dosificación , Melatonina/efectos adversos , Melatonina/farmacocinética , Pubertad/efectos de los fármacos , Sueño/efectos de los fármacos , Sueño/fisiología , Higiene del Sueño , Latencia del Sueño/efectos de los fármacos , Trastornos del Sueño-Vigilia/tratamiento farmacológico
16.
Surg Obes Relat Dis ; 14(3): 277-283, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29305304

RESUMEN

BACKGROUND: While it is well established that Roux-en-Y gastric bypass (RYGB) causes a rapid and heightened peak blood alcohol concentration (BAC), results from previous studies on the effects of sleeve gastrectomy (SG) on alcohol pharmacokinetics are conflicting. Data from 2 studies found SG did not affect BAC, whereas another study found SG caused a heightened peak BAC after alcohol ingestion. Moreover, these 3 studies estimated BAC from breathalyzers, which might not reliably estimate peak BAC. OBJECTIVES: The aims of this study were to evaluate (1) the effect of SG, relative to RYGB and a presurgery group, on alcohol pharmacokinetics and subjective effects, and (2) whether breathalyzers are reliable in this population. SETTING: Single-center prospective nonrandomized trial. METHODS: We performed alcohol challenge tests in 11 women who had SG surgery 1.9 ± .1 years ago (body mass index = 35.1 ± 6.6 kg/m2), 8 women who had RYGB surgery 2.2 ± .4 years ago (body mass index = 30.0 ± 5.2 kg/m2), and 9 women who were scheduled for bariatric surgery (body mass index = 44.1 ± 4.0 kg/m2). BACs were estimated from breath samples and measured by gas chromatography at various times after consuming approximately 2 standard drinks. RESULTS: BAC increased faster, peak BAC was approximately 2-fold higher, and feelings of drunkenness were heightened in both SG and RYGB groups relative to the presurgery group (P values<.001). BAC estimated from breath samples underestimated BAC by 27% (standard deviation = 13%) and missed peak BACs postsurgery. CONCLUSIONS: SG, similar to RYGB, causes marked alterations in the response to alcohol ingestion manifested by a faster and higher peak BAC. The breathalyzer is invalid to assess effects of gastric surgeries on pharmacokinetics of ingested alcohol.


Asunto(s)
Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Gastrectomía/efectos adversos , Derivación Gástrica/efectos adversos , Adulto , Intoxicación Alcohólica/etiología , Nivel de Alcohol en Sangre , Pruebas Respiratorias , Femenino , Humanos , Persona de Mediana Edad , Obesidad Mórbida/sangre , Obesidad Mórbida/cirugía , Cuidados Posoperatorios , Cuidados Preoperatorios , Estudios Prospectivos
17.
Exp Clin Psychopharmacol ; 26(2): 168-176, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29355349

RESUMEN

Variability in subjective response (SR) to alcohol predicts drinking and the development of Alcohol Use Disorders (AUDs). Although both alcohol pharmacokinetics (i.e., absorption and metabolism) and SR are impacted by aspects of the drinking situation (e.g., rate of consumption), relations between individual differences in pharmacokinetics and SR have received little attention. The current study examined the extent to which alcohol pharmacokinetics impact SR and drinking during a single alcohol administration session. A total of 119 (67% male) social drinkers were administered a dose of alcohol with a target blood alcohol concentration (BAC) of 0.08g%. The Biphasic Alcohol Effects Scale was administered twice at matched ascending and descending limb BACs following alcohol consumption to assess SR. Pharmacokinetic properties (absorption and metabolism) were inferred using multiple BAC readings to calculate the area under the curve during the ascending limb (absorption) and descending limb (metabolism). Following completion of SR measures, an ad libitum taste rating task utilizing nonalcoholic beer was implemented to assess voluntary 'alcohol' consumption. Results indicated that participants who metabolized alcohol more quickly maintained a greater level of subjective stimulation on the descending limb. Faster metabolism was indirectly related to ad lib nonalcoholic beer consumption through greater maintenance of stimulant effects. Absorption did not significantly predict SR or within session drinking. The results increase understanding of SR variability and suggest that heightened stimulation that is sustained across limbs of the BAC curve may increase risk for excessive consumption. Individual differences in alcohol metabolism may be an identifiable biomarker of this high risk pattern of SR. (PsycINFO Database Record


Asunto(s)
Consumo de Bebidas Alcohólicas/metabolismo , Alcoholismo , Nivel de Alcohol en Sangre , Etanol , Adulto , Alcoholismo/etiología , Alcoholismo/metabolismo , Alcoholismo/prevención & control , Área Bajo la Curva , Depresores del Sistema Nervioso Central/metabolismo , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/metabolismo , Etanol/farmacocinética , Femenino , Humanos , Masculino , Tasa de Depuración Metabólica , Medición de Riesgo
18.
Alcohol Clin Exp Res ; 42(2): 260-269, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29121399

RESUMEN

BACKGROUND: It is widely assumed that the amount of alcohol in the blood reflects the amount of alcohol consumed. However, several factors in addition to amount of alcohol consumed can influence blood alcohol concentration (BAC). This study examines the effect of alcohol dose, concentration, and volume on BAC in rats with a high-alcohol-drinking (HAD) phenotype. METHODS: Study 1 examined the relationship between the amount of alcohol consumed and BAC. Alcohol-naïve, male, HAD rats (N = 7) were given access to alcohol for 2 h/d for 9 consecutive days with food and water ad libitum. Alcohol intake and BAC were measured at 30, 60, and 90 minutes after onset of access. Study 2 examined the effects of altering alcohol dose, concentration, and volume on BAC (as measured by area under the curve). Alcohol-naïve, male, HAD rats (N = 39) were infused, via an intragastric cannulus, with 1.16, 2.44, or 3.38 g alcohol/kg body weight (BW), produced by varying alcohol volume while holding concentration constant or by holding volume constant while varying concentration. Other rats were infused with 10, 15, or 20% v/v alcohol solutions while holding dose constant. RESULTS: BAC was more strongly correlated with the ratio of alcohol intake (g/kg BW) to total fluid intake (mls) (R = 0.85 to 0.97, p < 0.05 to p < 0.001) than it was with the amount of alcohol consumed (g/kg BW) (R = 0.70 to 0.81, p < 0.05). No effect of alcohol dose was seen during the first hour following the onset of an alcohol infusion regardless of whether dose was achieved by altering alcohol volume or concentration. After 1 hour, higher alcohol doses were predictive of greater BACs. CONCLUSIONS: The fact that a 3-fold difference in alcohol dose did not result in significant differences in BACs during the first 30 minutes after ingestion of alcohol has potentially important implications for interpretation of studies that measure alcohol-sensitive end points during this time.


Asunto(s)
Consumo de Bebidas Alcohólicas/sangre , Nivel de Alcohol en Sangre , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Animales , Depresores del Sistema Nervioso Central/sangre , Etanol/sangre , Masculino , Ratas
19.
Sci Justice ; 57(5): 321-330, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28889860

RESUMEN

The Widmark equation is probably the most commonly used calculation for medicolegal purposes. Recently the National Research Council (USA) and the Forensic Science Regulator (UK) have called for the uncertainty of all results to be given with all forensic measurements and calculations. To improve the uncertainty of measurement of results from Widmark calculations we have concentrated on the uncertainties of measurement involved in the calculation of amount of alcohol, that of the volume of alcohol, the concentration of alcohol and the density of alcohol as previous studies have investigated some of the other factors involved. Using experimental studies, the scientific literature and legal statutes, we have determined revised and improved uncertainties of the concentration of ethanol for Widmark calculations for both the USA and UK. Based on the calculations that we have performed we recommend the use of Monte Carlo Simulation for the determination of uncertainty of measurement for Widmark Calculations.


Asunto(s)
Bebidas Alcohólicas , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Conceptos Matemáticos , Depresores del Sistema Nervioso Central/química , Etanol/química , Toxicología Forense , Humanos , Método de Montecarlo , Etiquetado de Productos , Incertidumbre , Pesos y Medidas
20.
S D Med ; 70(5): 225-227, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28813755

RESUMEN

Consuming excessive amounts of alcohol has the potential to modify an individual's brain and lead to alcohol dependence. Alcohol use leads to 88,000 deaths every year in the U.S. alone and can lead to other health issues including cancers, such as colorectal cancer, and mental health problems. While drinking behavior varies due to environmental factors, genetic factors also contribute to the risk of alcoholism. Certain genes affecting alcohol metabolism and neurotransmitters have been found to contribute to or inhibit the risk. Geneenvironment interactions may also play a role in the susceptibility of alcoholism. With a better understanding of the different components that can contribute to alcoholism, more personalized treatment could cater to the individual. This review discusses the major genetic factors and some small variants in other genes that contribute to alcoholism, as well as considers the gene-environmental interactions.


Asunto(s)
Alcoholismo/genética , Predisposición Genética a la Enfermedad , Depresores del Sistema Nervioso Central/farmacocinética , Etanol/farmacocinética , Interacción Gen-Ambiente , Humanos , Receptores de Hormona Liberadora de Corticotropina/genética , Receptores de GABA/genética
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