Alcohol and/or benzodiazepine use: different accidents--different impacts?

1611 patients were included in this investigation. 16.7% of the patients were involved in traffic accidents, 38.2% were injured by a sudden fall, 3.5% were involved in an act of violence, 22.8% were injured by a sports related accident and 18.9% were hurt within a work-related accident. 19.5% of the patients tested positive for alcohol, 5.2% tested positive for benzodiazepines and 1.4% tested positive for both substances. Blood samples were positive for alcohol in 27% males and 7.7% females and for benzodiazepines in 6.3% males and in 3.5% females. The mean blood alcohol concentration (BAC) as well as the mean benzodiazepine plasma level were higher in patients injured in violent accidents compared to the other injury groups. This study provides epidemiologic information about the relationship between specific kinds of accidents and alcohol and/or benzodiazepine use in a large probability sample of emergency room patients. We found a high number of patients using alcohol, and a lower but still relavant number of benzodiazepine users in this large and unselected traumatology ER sample. This study adds evidence to the existing literature about the co-occurance of alcohol and/or benzodiazepine consumption and accident-related injuries.

Alcohol and benzodiazepines in falls: an epidemiological view.

Falls are common at all ages and especially in the elderly; it is important to understand contributing causes. Over a 1-year period we studied blood alcohol (BAC) and benzodiazepine concentrations in patients attending an emergency department because of a fall. The 22% of 615 patients tested were positive for alcohol, 55% were positive for benzodiazepines (BZD) and 1.5% were positive for both substances. A significantly larger proportion of males tested positive for alcohol (40.2%) than females (7.6%). Both in males and females the percentage as well as the extent of blood alcohol levels decreased significantly with age. Benzodiazepines were also consumed more frequently in males (8.5%) than in females (3.2%, p=0.007). Concerning BAC there was no difference between males (1.75+/-0.81 g/l) and females (1.66+/-0.91 g/l). In patients older than 70 years the BAC (1.30+/-0.80 g/l) was lower in comparison to younger ones. All blood samples positive for benzodiazepines could be traced back to diazepam consumption. We found a high number of young and middle aged patients using alcohol (males=49.7%; females=18.9%) and a lower but still relevant number of benzodiazepine users (males=9.5%; females=2.4%). In addition, this study shows that alcohol plays a more important role in patients up to 70 years in fall-related accidents when compared to accidents of other causes.

Alcohol and/or benzodiazepine use in injured road users.

Blood samples of all patients (269) involved in a traffic accident and admitted to the Emergency Room of the University Hospital of Trauma Surgery in Innsbruck were analysed for alcohol and benzodiazepines. The large majority were drivers (55%) followed by passengers (19.7%), cyclists (12.6%) and pedestrians (12.3%). Alcohol was obviously the most commonly found drug in all groups (drivers: 36.9%; passengers: 15.1%; cyclists: 29.4%; pedestrians: 18.2%), with a mean BAC (blood alcohol concentration) high above the legal limit at the time of the study in Austria of 0.8 g/l (drivers: 1.49 +/- 54 g/l; passengers: 1.52 +/- 71 g/l; cyclists: 1.72 +/- 51 g/l; pedestrians: 1.67 +/- 25 g/l). The percentage of alcohol users was highest in drivers. Concerning BAC levels no significant differences were found between the groups. The most commonly detected benzodiazepine was diazepam. Benzodiazepine consumption (drivers: 8.1%; passengers: 5.7%; cyclists: 8.8%; pedestrians: 3%) as well as plasma levels (drivers: 68.7 +/- 62.6 microg/l; passengers: 61.0 +/- 69.3 microg/l; cyclists: 135.7 +/- 118.3 microg/l; pedestrians: 18 microg/l) were nearly equal in all groups. Concerning alcohol or benzodiazepine use, females showed lower frequencies of both alcohol and benzodiazepine positive blood samples. The frequency of alcohol use was higher in patients

Cloning of an emopamil-binding protein (EBP)-like protein that lacks sterol delta8-delta7 isomerase activity.

EBP (emopamil-binding protein) is a high-affinity binding protein for [3H]emopamil and belongs to the family of so-called sigma receptors. Mutations that disrupt EBP's 3beta-hydroxysteroid sterol delta8-delta7 isomerase activity (EC 5.3.3.5) impair cholesterol biosynthesis and cause X-chromosomal dominant chondrodysplasia punctata. We identified a human cDNA for a novel EBPL (EBP-like protein) with a calculated mass of 23.2 kDa. Amino acid sequence alignments and phylogenetic analysis revealed that EBPL is distantly related to EBP (31% identity and 52% similarity) and found in animals but not in plants. EBPL is encoded by four exons on human chromosome 13q14.2 covering 30.7 kb, and a partially processed EBPL pseudogene was found on 16q21. The EBPL mRNA was expressed ubiquitously and most abundant in liver, lung and kidney. Upon heterologous expression in yeast EBPL had no detectable 3beta-hydroxysteroid sterol delta8-delta7 isomerase and sigma-ligand-binding activity. Nine out of ten amino acid residues essential for catalytic activity of EBP were conserved in EBPL. Replacement of the only differing residue (EBP-Y111W) reduced catalytic activity of EBP. Transfer of the divergent residue from EBP to EBPL (EBPL-W91Y) and chimaerization of EBP and EBPL at various positions failed to restore catalytic activity of EBPL. Chemical cross-linking induced homodimerization of EBPL and EBP. Whereas mevinolin increased the mRNA for EBP and DHCR7 (delta7-sterol reductase) in HepG2 cells, it had no effect on mRNAs for EBPL and sigma1 receptor, indicating that EBP and EBPL expression are not co-ordinated. We propose that EBPL has a yet-to-be-discovered function other than cholesterol biosynthesis.