Aerobic Physical Exercise as a Neuroprotector Strategy for Ethanol Binge-Drinking Effects in the Hippocampus and Systemic Redox Status in Rats.

The heavy and episodic EtOH drinking pattern, equivalent to weekend consumption, characterizes the binge-drinking pattern and promotes a misbalance of encephalic metabolic functions, concurring to neurodegeneration and cerebral dysfunction. And for being a legal drug, it has global public health and social relevance. In this way, we aimed to investigate the effects of physical training, in a treadmill, on the deleterious effects of EtOH on hippocampal functions, related to memory and learning. For this, we used 40 Wistar rats, divided into four groups: Control group, Trained group (trained animals with doses of distilled water), EtOH group (nontrained animals with doses of 3 g/kg/day of EtOH, 20% w/v), and Trained+EtOH group (trained animals exposed to EtOH). The physical exercise was performed by running on a treadmill for 5 days a week for 4 weeks, and all doses of EtOH were administered through intragastric gavage in four repeated cycles of EtOH in binge. After the experimental period, the animals were submitted to the object recognition task and Morris water maze test, and after being euthanized, the blood and hippocampus were collected for Trolox Equivalent Antioxidant Capacity (TEAC), Reduced Glutathione Content (GSH), and Nitrite and Lipid Peroxidation (LPO) level measurements. Our results showed that EtOH caused marked oxidative stress and mnemonic damage, and the physical exercise promoted neuroprotective effects, among them, the modulation of oxidative biochemistry in plasma (by restoring GSH levels) and in the hippocampus (by reducing LPO levels and increasing antioxidant parameters) and cognitive function improvement. Therefore, physical exercise can be an important prophylactic and therapeutic tool in order to ameliorate and even prevent the deleterious effects of EtOH on cognitive functions.

Extremely dilution of strychnos Nux vomica mitigates alcohol-induced reduction in enthalpies associated with free water molecules in a fish brain

Introduction: Alcohol intoxication affects aquaporins in the glial cells of brain resulting in oedema. Nux vomica, a homeopathic drug of plant origin, is known to counteract alcohol effect. The objective of this present study is to find out the level of free water molecules in the brain of a teleost fish under ethanol intoxication. The second objective is to determine whether Nux vomica could restore the level of free water in the alcohol treated fish. Materials and methods: One group of fish was exposed to 456 mM ethanol for 30 min, another exposed first to a solution of Nux vomica 200c for 20 min and then to 456 mM ethanol for 30 min. The third group served as an untreated control. The mid brain of each fish was kept in an aluminium sample pan and its free water level was assessed by differential scanning calorimetry (DSC). Results: All alcohol treated fish showed significant reduction in the level of free water molecules as compared to the untreated control. Treatment with Nux vomica increased the level of free water in the brain significantly as compared to the untreated alcoholic group. Conclusion: Alcohol intoxication reduces free water molecules in the fish brain. Nux vom might have acted on aquaporins in the glial cells thereby increasing the level of free water in the brain. (AU)

Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room.

OBJECTIVE: To review the screening, diagnosis, evaluation, and treatment of intoxication by alcohol and other drugs in children and adolescents in the emergency scenario. DATA SOURCE: This was a narrative literature review. DATA SUMMARY: The detection of this problem in the emergency room can be a challenge, especially when its assessment is not standardized. The intentional and episodic use of large amounts of psychoactive substances by adolescents is a usual occurrence, and unintentional intoxication is more common in children younger than 12 years. The clinical picture in adolescents and children differs from that in adults and some particularities are important in the emergency scenario. After management of the acute condition, interventions targeting the adolescent at risk may be effective. CONCLUSION: The diagnosis and treatment of intoxication by alcohol and other drugs in adolescents and children in the emergency scenario requires a systematic evaluation of the use of these drugs. There are few specific treatments for intoxication, and the management comprehends support measures and management of related clinical complications.

Identification and initial management of intoxication by alcohol and other drugs in the pediatric emergency room / Identificação e manejo inicial de intoxicações por álcool e outras drogas na sala de emergência pediátrica

Abstract Objective: To review the screening, diagnosis, evaluation, and treatment of intoxication by alcohol and other drugs in children and adolescents in the emergency scenario. Data source: This was a narrative literature review. Data summary: The detection of this problem in the emergency room can be a challenge, especially when its assessment is not standardized. The intentional and episodic use of large amounts of psychoactive substances by adolescents is a usual occurrence, and unintentional intoxication is more common in children younger than 12 years. The clinical picture in adolescents and children differs from that in adults and some particularities are important in the emergency scenario. After management of the acute condition, interventions targeting the adolescent at risk may be effective. Conclusion: The diagnosis and treatment of intoxication by alcohol and other drugs in adolescents and children in the emergency scenario requires a systematic evaluation of the use of these drugs. There are few specific treatments for intoxication, and the management comprehends support measures and management of related clinical complications.

Resumo Objetivo: Revisar o rastreamento, o diagnóstico, a abordagem e o tratamento das intoxicações por álcool e outras drogas de crianças e adolescentes no contexto de emergência. Fontes dos dados: Foi feita uma revisão narrativa da literatura. Sumário dos achados: A detecção desse problema na sala de emergência pode ser um desafio, especialmente quando sua avaliação não é padronizada. O uso intencional e em grandes quantidades episódicas de substâncias psicoativas é o padrão em adolescentes e a intoxicação não intencional é mais comum em crianças menores de 12 anos. O quadro clínico em adolescentes e em crianças difere dos adultos e algumas particularidades são importantes no contexto de emergência. Após o manejo do quadro agudo, intervenções com vistas ao adolescente de risco podem ser efetivas. Conclusão: O diagnóstico e o tratamento das intoxicações por álcool e outras drogas em adolescentes e crianças em emergência requer uma avaliação sistemática do uso dessas drogas. Há poucos tratamentos específicos para intoxicação e o manejo é de apoio e das complicações clínicas relacionadas.

An unexpected clinical course in a 29-day-old infant with ethanol exposure.

Ethanol exposure can affect all pediatric age groups but occurs most commonly in ambulatory children and adolescents. Infants are less likely to ingest ethanol because they have limited ability to explore their environments. However, ethanol exposures in infants can occur. We report the case of a 29-day-old (3.5 kg) baby girl who presented with a blood alcohol level of 301 mg/dL after ingesting formula that had been prepared with gin. To our knowledge, she is the youngest reported child with such an elevated ethanol level in the medical literature. Despite her markedly elevated blood alcohol level, she had an unexpectedly mild clinical course, exhibiting subtle neurologic symptoms but no hypothermia, hypoglycemia, or cardiorespiratory impairment. This case demonstrates that the ethanol-exposed infant may lack typical or clear symptoms of acute intoxication. Therefore, the clinician must have a low threshold for pursuing blood alcohol testing in infants and young children with altered mental status. A prompt diagnosis of ethanol exposure is important for ensuring the health and safety of the child.

Guía de práctica clínica (GPC) para la detección temprana, diagnóstico y tratamiento de la fase aguda de intoxicación de pacientes con abuso o dependencia del alcohol / Clinical Practice Guideline for the early detection, diagnosis and treatment of the acute phase of intoxication of patients with alcohol abuse or dependence

La guía busca contestar las siguientes preguntas clínicas elaborando recomendaciones basadas en evidencia, En pacientes mayores de 18 años con abuso o dependencia del alcohol, ¿cuáles son los criterios clínicos más importantes para predecir el desarrollo de un síndrome de abstinencia? En pacientes mayores de 18 años con abuso o dependencia del alcohol, ¿cuáles son los factores de riesgo para el desarrollo de encefalopatía de Wernicke? En pacientes mayores de 18 años con síndrome de abstinencia, ¿cuáles son los factores de riesgo más importantes para evaluar la probabilidad de que se presente un delirium tremens? En personas mayores de 18 años con abuso o dependencia del alcohol que presentan intoxicación.

Rabdomiolisis secundaria a intoxicación etílica: caso clínico / Rhabdomyolysis following alcohol intoxication: a case report

Introduction: rhabdomyolysis is a potentially lethal syndrome characterized by disintegration of striated muscle fibers. In children Rhabdomyolysis is caused mostly by trauma, nonketotic hyperosmolar coma, viral myositis, dystonia and malignant hyperthermia. Case report: a 14 year old male was brought into the emergency room because of a decreased level of consciousness following alcohol and cannabis. An initial assessment indicated the presence of hypothermia and a Glasgow Coma Scale of 9. A blood biochemical analysis showed a mixed acidosis and CPK levels of 12260 U/L (CK-MB 132 U/L). After diagnosing alcohol induced coma and rhabdomyolysis, intravenous fluids and urinary alkalinization are administered. The patient presented a rapid neurological improvement reaching normal within 12 hours. He remained normotensive, adequate diuresis, negative balances, normal blood gas values and urine test strips presented no pathological changes. A maximum level of serum CPK was observed 24 hours after ingestion (20820 U/L), with subsequent decline to 6261 U/L at day 5, once he was discharged. Discussion: alcohol poisoning is a rare cause of rhabdomyolysis in pediatrics. The main therapeutic goal is to prevent acute renal failure, aggressive fluid therapy and urine alkalinization then must be administered, monitoring possible electrolyte abnormalities and the presence of myoglobinuria. In conclusion, rhabdomyolysis is one of the possible complications after alcohol poisoning. Given its potential morbidity, it should always be considered.

Introducción: la rabdomiolisis es un síndrome potencialmente letal caracterizado por la destrucción de fibras musculares estríadas. En niños es producido fundamentalmente por traumatismos, coma hiperosmolar no cetósico, miositis vírica, distonía o hipertermia maligna. Caso clínico: varón de 14 años que es traído al servicio de Urgencias por disminución del nivel de conciencia secundaria a consumo de alcohol y cannabis. En la valoración inicial en nuestro centro se constatan hipotermia y una puntuación según la escala de Glasgow de 9. En el análisis bioquímico sanguíneo destacan una acidosis mixta y niveles de CPK de 12.260 U/L (CK-MB 132 U/L). Con los diagnósticos de coma etílico y rabdomiolisis se inicia administración de fluidoterapia intravenosa y alcalinización urinaria. Presentó una rápida mejoría neurológica con normalización en las primeras 12 h. Se mantuvo normotenso, con adecuada diuresis, balances negativos, normalización de los valores gasométricos y tiras reactivas de orina seriadas sin hallazgos patológicos. Se objetivó un nivel máximo de CPK sérica 24 h tras la ingesta (20.820 U/L), con descenso posterior hasta 6.261U/L a los 5 días, cuando se dio de alta. Discusión: la intoxicación etílica constituye una causa infrecuente de rabdomiolisis en pediatría. El principal objetivo terapéutico es evitar el fracaso renal agudo, por lo que se deben iniciar fluidoterapia agresiva y eventual alcalinización de la orina, manteniendo monitorizados las posibles alteraciones electrolíticas así como la presencia de mioglobinuria. En conclusión, la rabdomiolisis es una de las posibles complicaciones de la intoxicación etílica. Dada su potencial morbimortalidad, siempre debe ser tenida en cuenta.

Un rubro poco considerado: borrachera condilomatosis perianal, caso clínico / A rubric scanty considerated: drunkenness perianal condylomata, a clinical case

Se trata de una enorme condilomatosis perianal, donde fallaron Thuja y Nitric acid, habiendo curado el caso el medicamento de fondo, el cual fue hallado al considerar modalidades del rubro BORRACHERA. El mismo medicamento resolvió satisfactoriamente un cuadro clínico agudo que aconteció varios años más tarde, el cual poseía síntomas característicos con las modalidades del medicamento de fondo

Un rubro poco considerado: borrachera condilomatosis perianal, caso clínico / A rubric scanty considerated: drunkenness perianal condylomata, a clinical case

Se trata de una enorme condilomatosis perianal, donde fallaron Thuja y Nitric acid, habiendo curado el caso el medicamento de fondo, el cual fue hallado al considerar modalidades del rubro BORRACHERA. El mismo medicamento resolvió satisfactoriamente un cuadro clínico agudo que aconteció varios años más tarde, el cual poseía síntomas característicos con las modalidades del medicamento de fondo (AU)

Intoxicaciones y envenenamientos en el Servicio de Emergencia del H.E.E (ene.-jun. 1996) / Poisonings and envenenamientos in the Service of Emergency of H.E.E (ene.-jun. 1996)

Presenta un estudio retrospectivo de 350 casos de intoxicaciones entre ene. y jun. 1996, tomando en cuenta el sexo, el tipo de sustancia y la evolución durante su permanencia en el servicio de emergencia. Se determinó que la intoxicación más común es la alcohólica, seguida por la ingestión de órganos fosforados y de fósforo blanco: la evaluación de los pacientes en un alto porcentaje es muy satisfactoria.

Mielinolisis central pontina: reporte de un caso

La mielinólisis Central Pontina (MCP) fue descrita por primera vez Adams, Victor y Mancall en 1959 en cuatro pacientes alcohólicos y desnutridos (1,2,3,4,5). La etiología de la MCP es desconocida; en la mayoría de reportes se la relaciona con la corrección rápida de la hiponatremia y enfermedades crónicas (3,4,5,6,7,8,9). Reportamos un paciente alcoholico que ingresó al Hospital Eugenio Espejo con diagnóstico de colera y desarrolló una mielinólisis Central Pontina luego de la corrección de su hiponatremia.

Uso da glicose hipertônica na intoxicaçäo alcoólica aguda: um estudo duplo-cego / Use of hypertonic glucose solution in acute alcoholic intoxication: a double-blind study

Os autores realizaram um estudo duplo-cego, avalindo a glicemia, a alcoolemia e o estado neurológico de 83 pacientes que procuraram atendimento no Pronto Socorro Municipal de Porto Alegre por se apresentarem alcoolizados. A aferiçäo foi realizada no momento do ingresso no serviço e repetida 40 minutos após. A glicemia média foi 90,16mg/dl, com desvio-padräo 21,15, a maior parte dentro da faixa normal de 70 a 105mg/dl. Apenas um paciente apresentou sintomatologia compatível com hipoglicemia, acompahada de níveis glicêmicos de 63mg/dl. Näo foi encontrada correlaçäo linear entre a glicemia e a alcoolemia. Após a avaliaçäo inicial, foram administrados 20ml de soluçäo fisiológica, como placebo. Näo foi verificada diferença significativa entre os dois grupos quanto à queda da alcoolemia após o intervalo controlado. O estado neurológico dos pacientes foi aferido por um teste adaptado pelos autores. Os dois grupos apresentaram melhora semelhante no escore do teste. Os resultados obtidos pelos autores reforçam a idéia de que a administraçäo de glicose a pacientes alcoolizados deve ser indicada pela presença de sinais de hipoglicemia

[The use of hypertonic glucose solution in acute alcoholic intoxication: a double-blind study]. / Uso da glicose hipertônica na intoxicação alcoólica aguda: um estudo duplo-cego.

The authors have performed a double-blind study, evaluating blood levels of glucose and ethanol and the neurologic status of 83 alcoholized patients who were admitted to an emergency hospital in Porto Alegre, Brazil. The patients were evaluated and admittance to the service and 40 minutes later. The mean glycemia was 90 +/- 21mg/dl, with most patients with the normal range. One patient, whose blood glucose level was 63mg/dl, presented hypoglycemic symptoms. Blood glucose and ethanol concentrations were not found to have linear correlation. Immediately after the first evaluation, 20ml of 50% glucose was administrated to 41 patients. The others received the same volume of 0.9% NaCl solution as placebo. No statistic difference was found between the two groups with regard to the lowering of ethanol levels after the 40min interval. The neurologic status was evaluated through a score test adapted by the authors. Both groups presented similar score improvement. The results reinforce the idea that glucose should be administered to alcoholized patients only when hypoglycemia signs are present.