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1.
Sensors (Basel) ; 22(2)2022 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-35062635

RESUMO

From a biological point of view, alcohol human attentional impairment occurs before reaching a Blood Alcohol Content (BAC index) of 0.08% (0.05% under the Italian legislation), thus generating a significant impact on driving safety if the drinker subject is driving a car. Car drivers must keep a safe driving dynamic, having an unaltered physiological status while processing the surrounding information coming from the driving scenario (e.g., traffic signs, other vehicles and pedestrians). Specifically, the identification and tracking of pedestrians in the driving scene is a widely investigated problem in the scientific community. The authors propose a full, deep pipeline for the identification, monitoring and tracking of the salient pedestrians, combined with an intelligent electronic alcohol sensing system to properly assess the physiological status of the driver. More in detail, the authors propose an intelligent sensing system that makes a common air quality sensor selective to alcohol. A downstream Deep 1D Temporal Residual Convolutional Neural Network architecture will be able to learn specific embedded alcohol-dynamic features in the collected sensing data coming from the GHT25S air-quality sensor of STMicroelectronics. A parallel deep attention-augmented architecture identifies and tracks the salient pedestrians in the driving scenario. A risk assessment system evaluates the sobriety of the driver in case of the presence of salient pedestrians in the driving scene. The collected preliminary results confirmed the effectiveness of the proposed approach.


Assuntos
Condução de Veículo , Pedestres , Acidentes de Trânsito/prevenção & controle , Automóveis , Concentração Alcoólica no Sangue , Humanos
2.
Int Emerg Nurs ; 60: 101113, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34942538

RESUMO

BACKGROUND: Risky alcohol consumption can occur from a young age and affects people of all age groups, sometimes requiring the intervention of the emergency medical services. OBJECTIVES: Determining the timing and characteristics of emergency calls (to the "118" emergency number) relating to subjects in all age groups, in which alcohol was a contributing factor, along with the biochemical correlates, in a great metropolitan area. On the basis of these, future interventions would target specific training for nurses and paramedics working in emergency medical services. METHOD: An observational single-centre retrospective study carried out from 1 January 2014 to 31 December 2018 involving patients requiring emergency care and attending the Emergency Department of an University Hospital. RESULTS: Out of a total of 47,252 emergency calls, 2.22% were for alcohol-related conditions and mainly involved male patients (78.4%). A high incidence of alcoholic coma was found in patients aged 11 to 17 years. Emergency medical assistance was required mainly at night on weekdays by patients aged 11-17, 25-44 years and during the weekend and on weekdays by patients aged 18-24 years. A blood alcohol concentration higher than 50 mg/dL was found in more than 67% of patients aged 11-17 and 18-24 years at weekends. CONCLUSIONS: The most alarming finding from our data is that, despite prevention policies, young people requiring emergency medical assistance showed similar alcohol levels as adults and a high incidence of alcoholic coma.


Assuntos
Intoxicação Alcoólica , Serviços Médicos de Emergência , Adolescente , Adulto , Intoxicação Alcoólica/complicações , Intoxicação Alcoólica/epidemiologia , Concentração Alcoólica no Sangue , Serviço Hospitalar de Emergência , Hospitais Universitários , Humanos , Masculino , Estudos Retrospectivos
3.
J Pharm Biomed Anal ; 207: 114426, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34689062

RESUMO

Alcoholism is a severe threat to public health, and there are no adequate treatments for alcoholic liver disease. The aim of this study was to identify bioactive peptides derived from natural proteins that prevent acute alcohol-induced liver injury. We identified a peptide with the sequence Gly-Leu-hydroxyproline-Gly-Glu-Arg (GLpGER) from the hydrolysate of crucian carp swim bladder using size-exclusion chromatography and reversed-phase chromatography. The in vitro EC50 value of GLpGER to activate alcohol dehydrogenase (ADH) was 137.9 ± 9 µM. Molecular docking experiments indicated that the mechanism by which GLpGER activates ADH may be related to the formation of stable complexes with ADH active pockets through hydrogen bonding, and electrostatic and hydrophobic interactions. Oral administration of GLpGER one hour before acute alcohol ingestion significantly increased alcohol metabolism, manifesting as reduced incidence of the loss of righting reflex, increased alcohol tolerance time, shortened sobering time, and decreased blood alcohol concentration level. GLpGER restored liver ADH activity, maintained the typical morphology of hepatocytes, and reduced serum levels of alanine aminotransferase and aspartate aminotransferase. These findings suggest that GLpGER might reduce acute alcohol-induced liver injury and may have the potential to be developed as an anti-inebriation ingredient.


Assuntos
Carpas , Doença Hepática Crônica Induzida por Substâncias e Drogas , Álcool Desidrogenase , Animais , Concentração Alcoólica no Sangue , Etanol , Fígado , Camundongos , Simulação de Acoplamento Molecular , Peptídeos , Bexiga Urinária
4.
Med Clin North Am ; 106(1): 43-60, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34823734

RESUMO

In the United States, alcohol is the most common substance used and the spectrum of unhealthy alcohol use is highly prevalent. Complications of unhealthy alcohol use affect nearly every organ system. One of the most frequent and potentially life-threatening of these complications is alcohol withdrawal syndrome for which benzodiazepines remain first-line therapy. Pharmacologic treatment of alcohol use disorder, the most severe form of unhealthy alcohol use, is underutilized despite the availability of multiple effective medications. Although behavioral therapies are an important component of treatment, they are overemphasized at the expense of pharmacotherapy.


Assuntos
Alcoolismo/diagnóstico , Alcoolismo/terapia , Benzodiazepinas/uso terapêutico , Terapia Cognitivo-Comportamental/métodos , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Idoso , Síndrome Alcóolica de Korsakoff/diagnóstico , Síndrome Alcóolica de Korsakoff/epidemiologia , Alcoolismo/complicações , Alcoolismo/epidemiologia , Biomarcadores/sangue , Concentração Alcoólica no Sangue , Tratamento Farmacológico/economia , Feminino , Humanos , Hepatopatias Alcoólicas/diagnóstico , Hepatopatias Alcoólicas/epidemiologia , Masculino , Síndrome de Abstinência a Substâncias/etiologia , Estados Unidos
5.
Artigo em Inglês | MEDLINE | ID: mdl-34769922

RESUMO

Road trauma remains a significant public health problem. We aimed to identify sub-groups of motor vehicle collisions in Victoria, Australia, and the association between collision characteristics and outcomes up to 24 months post-injury. Data were extracted from the Victorian State Trauma Registry for injured drivers aged ≥16 years, from 2010 to 2016, with a compensation claim who survived ≥12 months post-injury. People with intentional or severe head injury were excluded, resulting in 2735 cases. Latent class analysis was used to identify collision classes for driver fault and blood alcohol concentration (BAC), day and time of collision, weather conditions, single vs. multi-vehicle and regional vs. metropolitan injury location. Five classes were identified: (1) daytime multi-vehicle collisions, no other at fault; (2) daytime single-vehicle predominantly weekday collisions; (3) evening single-vehicle collisions, no other at fault, 36% with BAC ≥ 0.05; (4) sunrise or sunset weekday collisions; and (5) dusk and evening multi-vehicle in metropolitan areas with BAC < 0.05. Mixed linear and logistic regression analyses examined associations between collision class and return to work, health (EQ-5D-3L summary score) and independent function Glasgow Outcome Scale - Extended at 6, 12 and 24 months. After adjusting for demographic, health and injury characteristics, collision class was not associated with outcomes. Rather, risk of poor outcomes was associated with age, sex and socioeconomic disadvantage, education, pre-injury health and injury severity. People at risk of poor recovery may be identified from factors available during the hospital admission and may benefit from clinical assessment and targeted referrals and treatments.


Assuntos
Concentração Alcoólica no Sangue , Ferimentos e Lesões , Acidentes de Trânsito , Humanos , Veículos Automotores , Sobreviventes , Vitória/epidemiologia , Ferimentos e Lesões/epidemiologia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34682508

RESUMO

This study aimed to investigate the predictors of recidivism in first-time driving under the influence (DUI) offenders, analyzing variables derived from medico-legal and toxicological examinations. The research was structured as a comparative study for the period 2012-2019. DUI offenders with a blood alcohol concentration >0.5 were included in the study. The case group consisted of recidivist offenders, while the comparison group consisted of first-time offenders. Personal data, socioeconomics, and parameters linked to the DUI were compared between the two groups. Significance was determined by chi-square and Mann-Whitney tests. To prevent confounding effects, multivariate binary logistic regression analysis was performed. Our sample encompassed 1678 subjects (196 in the case group, 1482 in the comparison group). Gender, driving license category, education, and tobacco use resulted in significant differences between the groups. In a model including age at DUI, education, and smoking habit as independent variables, higher educational levels (high school, bachelor's) and older age protected against recidivism, whereas smoking >20 cigarettes/day was an independent risk factor for recidivism. Recidivist offenders have specific characteristics indicating different therapeutic programs and carefulness in driving license regranting. A higher tobacco consumption in recidivists suggests that the use of this substance could influence the risk of DUI for reasons that will need to be explored.


Assuntos
Condução de Veículo , Fumar Cigarros , Dirigir sob a Influência , Reincidência , Idoso , Consumo de Bebidas Alcoólicas , Concentração Alcoólica no Sangue , Humanos , Masculino
7.
BMJ Open ; 11(10): e053619, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34598990

RESUMO

OBJECTIVES: In alcohol intoxicated patients, the decision for or against airway protection can be challenging and is often based on the Glasgow Coma Scale (GCS). Primary aim of this study was to analyse the aspiration risk in relation to the GCS score and clinical parameters in patients with severe acute alcohol monointoxication. Secondary aim was the association between the blood alcohol level and the GCS score. SETTING: Single-centre, retrospective study of alcoholised patients admitted to a German intensive care unit between 2006 and 2020. PARTICIPANTS: A total of n=411 admissions were eligible for our analysis. CLINICAL MEASURES AND ANALYSIS: The following data were extracted: age, gender, admission time, blood alcohol level, blood glucose level, initial GCS score, GCS score at admission, vital signs, clinical signs of aspiration and airway management measures. The empirical distribution of continuous and categorical data was calculated. Binary multivariable logistic regression analysis was used to identify possible risk factors for aspiration. RESULTS: The mean age was 35 years. 72% (n=294) of the admissions were male. The blood alcohol level (mean 2.7 g/L±1.0, maximum 5.9 g/L) did not correlate with the GCS score but with the age of the patient. In univariate analysis, the aspiration risk correlated with blood alcohol level, age, GCS score, oxygen saturation, respiratory rate and blood glucose level and was significantly higher in male patients, on vomiting, and in patients requiring airway measures. Aspiration rate was 45% (n=10) in patients without vs 6% (n=3) in patients with preserved protective reflexes (p=0.0001). In the multivariate analysis, only age and GCS score were significantly associated with the risk of aspiration. CONCLUSION: Although in this single-centre, retrospective study the aspiration rate in severe acute alcohol monointoxicated patients correlates with GCS and protective reflexes, the decision for endotracheal intubation might rather be based on the presence of different risk factors for aspiration.


Assuntos
Intoxicação Alcoólica , Adulto , Intoxicação Alcoólica/complicações , Concentração Alcoólica no Sangue , Etanol , Escala de Coma de Glasgow , Humanos , Masculino , Estudos Retrospectivos
8.
J Stud Alcohol Drugs ; 82(5): 553-563, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34546901

RESUMO

OBJECTIVE: Research concerning the combined effects of alcohol and benzodiazepines on driving-related skills is largely inconsistent. Because as many as 88% of benzodiazepine users report the additional consumption of alcohol, this review aims to provide an updated and concise synthesis of the available high-quality research. METHOD: We searched EBSCOhost, PubMed, Scopus, and Web of Science until April 1, 2020, for double-blind, placebo-controlled, repeated-measures intervention trials that examined the effects of alcohol (any dose provided as blood alcohol concentration [BAC]) in combination with oral benzodiazepines on neurocognitive tasks related to driving. RESULTS: We identified evidence of a substance and timing-dependent interaction for measures of reaction time, tracking, divided attention, and visual functioning. Administering alcohol in conjunction with or shortly after a benzodiazepine resulted in a stronger interactive effect than when administration occurred further apart. An additive and/or synergistic effect often occurred when a therapeutic dose of benzodiazepine was combined with alcohol at a BAC below .05%. CONCLUSIONS: Combined alcohol and benzodiazepine use was associated with significant impairments in driving-related neurocognitive skills. There is a clear need for more high-quality research in this area to better elucidate the mechanisms of alcohol and benzodiazepine interactions. Drivers may be unaware of impairments following the combination of these drugs at legal driving limits. Thus, drivers should be warned to take caution when consuming even small amounts of alcohol while under treatment with benzodiazepines.


Assuntos
Condução de Veículo , Benzodiazepinas , Benzodiazepinas/efeitos adversos , Concentração Alcoólica no Sangue , Cognição , Etanol/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Subst Use Misuse ; 56(13): 1923-1932, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34347564

RESUMO

BACKGROUND: Among high school students, seniors report the highest levels of alcohol use and hazardous drinking. Technology-based interventions are a promising approach for reducing alcohol use among this age group. Objectives: This randomized controlled trial investigated the efficacy of the eCHECKUP TO GO, an online personalized feedback intervention, on reducing alcohol use among high school seniors across the academic year (ClinicalTrials.gov Identifier NCT03613818). Drinker risk status, with students classified as high- or low-risk drinkers based on baseline reports binge drinking, was examined as a moderator of intervention effects. Method: Participants (N = 311) were recruited from two high schools. Class periods were randomized to the intervention condition or an assessment-only control condition. Participants completed online surveys at baseline, 30-day, and 6-month assessments. Results: Intervention effects were moderated by drinker risk status. Among high-risk drinkers, those in the intervention condition reported a significant reduction in weekly drinking quantity and estimated blood alcohol concentration (eBAC) at the 30-day follow-up relative to students in the control condition. By 6 months, reductions in alcohol outcomes among high-risk students in the intervention condition were sustained, but high-risk students in the control condition also reported reductions in weekly drinking. In contrast, for eBAC, intervention effects were significantly greater among students in the intervention condition relative to the control condition at 6 months. Conclusions: Results support the efficacy of the eCHECKUP TO GO for decreasing short-term alcohol use among seniors who are high-risk drinkers and provide preliminary evidence that reductions are sustained across the academic year.


Assuntos
Concentração Alcoólica no Sangue , Estudantes , Consumo de Bebidas Alcoólicas/prevenção & controle , Etanol , Humanos , Instituições Acadêmicas , Inquéritos e Questionários
10.
J Forensic Sci ; 66(6): 2283-2288, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34363394

RESUMO

New Mexico's oil and natural gas industry has the second highest occupational fatality rate among oil and gas workers in the nation. There is currently limited data available regarding the top contributing factors to occupational mortality specific to the state's oil and gas industry. This study seeks to understand causes of mortality among oil and gas workers in New Mexico between 2008 and 2018. To facilitate this study, case reports were obtained from the New Mexico Office of the Medical Investigator, and population data was acquired from the US Department of Labor. In this 11-year span, there were 73 cases, with an average annual mortality rate of 37 deaths per 100,000 oil and gas workers. Leading causes of death were vehicle accidents (36%), cardiovascular incidents (22%), and crush injuries (19%). The majority of vehicle accidents involved single vehicle accidents, and correct seat belt use was only documented 23% of the time. The majority of cardiovascular deaths were due to arteriosclerotic and atherosclerotic cardiovascular disease. Alcohol was present in 18% of cases, and drugs were present in 19% of cases with methamphetamine present in 10% of investigated deaths. This is the first study to directly include cardiovascular incidents in the leading causes of death; otherwise, this study reflects national data reporting vehicle accidents and crush injuries as the leading causes of death. Going forward, prevention measures should effectively target safe driving practices focusing on seatbelt use, and mitigation of workplace drug and alcohol consumption.


Assuntos
Acidentes de Trabalho/mortalidade , Doenças Cardiovasculares/mortalidade , Indústria de Petróleo e Gás , Ferimentos e Lesões/mortalidade , Adolescente , Adulto , Idoso , Concentração Alcoólica no Sangue , Serviços Médicos de Emergência/estatística & dados numéricos , Humanos , Drogas Ilícitas/análise , Masculino , Pessoa de Meia-Idade , New Mexico/epidemiologia , Estações do Ano , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
11.
Int J Legal Med ; 135(6): 2555-2565, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34373945

RESUMO

A quite intriguing subject being intensively researched in the forensic toxicology field is the source of postmortem determined blood ethanol concentration: antemortem ingestion or postmortem microbial production. Our previous research on microbial ethanol production has reported a quantitative relationship between the ethanol and the higher alcohols and 1-butanol produced by Escherichia coli, Clostridium perfrigens, and Clostridium sporogenes. In this contribution, we continue our research reporting on the following: (i) the patterns of ethanol, higher alcohols, and 1-butanol production by the microbes Klebsiella pneumoniae, Staphylococcus aureus, and Enterococcus faecalis (all being aerobic/facultative anaerobic species, common corpse's colonizers, and ethanol producers), under controlled laboratory conditions, (ii) the mathematical modeling, with simple mathematical equations, of the correlation between ethanol concentration and the other studied alcohols' concentrations, by performing multiple linear regression analysis of the results, and (iii) the applicability of the constructed models in microbial cultures developed under different temperature than that used to build the models, in denatured blood cultures and in real postmortem cases. The aforementioned alcohols were proved to be all indicators of ethanol production, both in qualitative and quantitative terms. 1-Propanol was the most significant alcohol in modeling microbial ethanol production, followed by methyl-butanol. The K. pneumoniae's models achieved the best scoring in applicability (E < 40%) compared to the S. aureus and E. faecalis models, both at laboratory microbial cultures at 37 °C and real postmortem cases. Overall, a noteworthy accuracy in estimating the microbial ethanol in cultures and autopsy blood is achieved by the employed simple linear models.


Assuntos
Sangue/microbiologia , Enterococcus faecalis/química , Etanol/análise , Klebsiella pneumoniae/química , Staphylococcus aureus/química , 1-Butanol/análise , 1-Propanol/análise , Aerobiose , Anaerobiose , Autopsia , Concentração Alcoólica no Sangue , Butanóis/análise , Humanos , Modelos Teóricos , Pentanóis/análise
12.
Sensors (Basel) ; 21(12)2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34199235

RESUMO

One third of fatal car accidents and so many tragedies are due to alcohol abuse. These sad numbers could be mitigated if everyone had access to a breathalyzer anytime and anywhere. Having a breathalyzer built into a phone or wearable technology could be the way to get around reluctance to carry a separate device. With this goal, we propose an inexpensive breathalyzer that could be integrated in the screens of mobile devices. Our technology is based on the evaporation rate of the fog produced by the breath on the phone screen, which increases with increasing breath alcohol content. The device simply uses a photodiode placed on the side of the screen to measure the signature of the scattered light intensity from the phone display that is guided through the stress layer of the Gorilla glass screen. A part of the display light is coupled to the stress layer via the evanescent field induced at the edge of the breath microdroplets. We demonstrate that the intensity signature measured at the detector can be linked to blood alcohol content. We fabricated a prototype in a smartphone case powered by the phone's battery, controlled by an application installed on the smartphone, and tested it in real-world environments. Limitations and future work toward a fully operational device are discussed.


Assuntos
Smartphone , Dispositivos Eletrônicos Vestíveis , Concentração Alcoólica no Sangue , Testes Respiratórios , Luz
13.
Drug Alcohol Depend ; 226: 108906, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34315104

RESUMO

BACKGROUND: Research indicates alcohol (AUD) or substance (SUD) use disorders and acute alcohol or drug use serve as risk factors for suicidal behaviors and death both distally and proximally to a suicidal event. However, limited research has investigated these relationships among medically serious suicide attempters at the time of injury without relying on cohorts of substance users only or by examining suicide decedent characteristics. METHODS: Data were collected from the National Trauma Data Bank (NTDB) for 2017. The sample comprised patients who engaged in suicidal and self-injurious acts that were medically serious enough to require trauma admission and were tested for alcohol (N = 9,196) or drug (N = 8,121) exposure upon admission. Logistic regression determined relationships between acute alcohol/substance use, presence of AUDs and SUDs and suicide mortality risk, while linear regression evaluated substance conditions and injury severity and length of stay (LOS). RESULTS: AUDs (OR = 0.59[0.42-0.83]) and SUDs (OR = 0.66[0.48-0.90]) had reduced odds of death but increased LOS (ß = 1.7, p < .001; ß = 0.82, p = .024). Blood alcohol concentration (BAC) was positively associated with reduced odds of death (OR = 0.20[0.06-0.61]), injury severity (ß = -5.3, p < .001), and LOS (ß = -7.5, p < .001). Presence of cocaine (ß = -0.80, p = .044) and opioids (ß = -1.4, p < .001) were associated lower injury severity, while MDMA (ß = 3.6, p = .016) and methamphetamine (ß = 1.5, p = .025) were associated with increased injury severity. CONCLUSIONS: While higher BAC may be associated with lower odds of mortality during a single high-risk suicide event, substance users may be at increased risk for worse outcomes over time. Targeted interventions should be considered to interrupt and develop healthy alternatives for survivors with substance use conditions.


Assuntos
Transtornos Relacionados ao Uso de Substâncias , Suicídio , Consumo de Bebidas Alcoólicas , Concentração Alcoólica no Sangue , Humanos , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Ideação Suicida
14.
Scand J Trauma Resusc Emerg Med ; 29(1): 101, 2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34315518

RESUMO

BACKGROUND: Blood alcohol level (BAL) has previously been considered as a factor influencing the outcome of injured patients. Despite the well-known positive correlation between alcohol-influenced traffic participation and the risk of accidents, there is still no clear evidence of a positive correlation between blood alcohol levels and severity of injury. The aim of the study was to analyze data of the TraumaRegister DGU® (TR-DGU), to find out whether the blood alcohol level has an influence on the type and severity of injuries as well as on the outcome of multiple-trauma patients. METHODS: Datasets from 11,842 trauma patients of the TR-DGU from the years 2015 and 2016 were analyzed retrospectively and 6268 patients with a full dataset and an AIS ≥ 3 could be used for evaluation. Two groups were formed for data analysis. A control group with a BAL = 0 ‰ (BAL negative) was compared to an alcohol group with a BAL of ≥0.3‰ to < 4.0‰ (BAL positive). Patients with a BAL >  0‰ and <  0.3‰ were excluded. They were compared with regard to various preclinical, clinical and physiological parameters. Additionally, a subgroup analysis with a focus on patients with a traumatic brain injury (TBI) was performed. A total of 5271 cases were assigned to the control group and 832 cases to the BAL positive group. 70.3% (3704) of the patients in the control group were male. The collective of the control group was on average 5.7 years older than the patients in the BAL positive group (p < .001). The control group showed a mean ISS of 20.3 and the alcohol group of 18.9 (p = .007). In terms of the injury severity of head, the BAL positive group was significantly higher on average than the control group (p <  0.001), whereas the control group showed a higher AIS to thorax and extremities (p <  0.001). The mean Glasgow Coma Scale (GCS) was 10.8 in the BAL positive group and 12.0 in the control group (p <  0.001). Physiological parameters such as base excess (BE) and International Normalized Ratio (INR) showed reduced values ​​for the BAL positive group. However, neither the 24-h mortality nor the overall mortality showed a significant difference in either group (p = 0.19, p = 0.14). In a subgroup analysis, we found that patients with a relevant head injury (AIS: Abbreviated Injury Scale head ≥3) and positive BAL displayed a higher survival rate compared to patients in the control group with isolated TBI (p < 0.001). CONCLUSIONS: This retrospective study analyzed the influence of the blood alcohol level in severely injured patients in a large national dataset. BAL positive patients showed worse results with regard to head injuries, the GCS and to some other physiological parameters. Finally, neither the 24-h mortality nor the overall mortality showed a significant difference in either group. Only in a subgroup analysis the mortality rate in BAL negative patients with TBI was significantly higher than the mortality rate of BAL positive patients with TBI. This mechanism is not yet fully understood and is discussed controversially in the literature.


Assuntos
Concentração Alcoólica no Sangue , Traumatismo Múltiplo , Escala Resumida de Ferimentos , Alemanha , Escala de Coma de Glasgow , Humanos , Escala de Gravidade do Ferimento , Masculino , Sistema de Registros , Estudos Retrospectivos
15.
Alcohol Clin Exp Res ; 45(7): 1494-1503, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34086367

RESUMO

BACKGROUND: As many as 35% of college students report having been drunk in the past month, and greater alcohol use and alcohol-related problems are associated with a positive attitude toward heavy drinking. One serious consequence of heavy drinking is alcohol-induced blackout. When they occur, alcohol-induced blackouts present a unique opportunity to increase motivation to change drinking. However, it is unclear under what conditions an alcohol-related heavy drinking attitude and experiencing a blackout represent an opportunity to change and how experiencing a blackout(s) influences an individual's motivation to reduce drinking and actual behavior. METHODS: This study tested the interplay between one's positive attitude toward heavy drinking and experiencing a blackout in the past year in predicting motivation to reduce drinking (Study 1) and its impact on drinking over time (Study 2). Data were derived from complementary datasets collected at two universities (Study 1 n = 703, mean age = 20.63 years, 44% male, 52% White; Study 2 n = 568, mean age = 19.18 years, 72% male, 84% White). Drinking behavior was measured using a modified Daily Drinking Questionnaire, the Drinking Norms Rating Form, the Alcohol Use Disorders Identification Test (AUDIT), and estimated peak blood alcohol concentration (BAC). Regression analyses were conducted to determine whether a blackout would moderate the association between attitude and motivation to reduce drinking (Study 1) and drinking over time (Study 2). RESULTS: Results revealed a significant interaction between attitude and blackout, such that individuals who experience a blackout (vs. those who do not) and positively evaluate heavy drinking evidenced lower motivation to reduce drinking (Study 1) and higher levels of estimated peak BAC (Study 2). CONCLUSIONS: Drinkers with a negative attitude toward heavy drinking who have experienced a blackout have the strongest motivation to reduce drinking and the greatest reductions in peak drinking behavior over time. These effects are over and above that related to the level of alcohol consumed. For young adults who do not positively endorse heavy drinking, blackouts may present a "moment of opportunity" for intervention.


Assuntos
Consumo de Álcool na Faculdade/psicologia , Consumo de Bebidas Alcoólicas/prevenção & controle , Consumo de Bebidas Alcoólicas/psicologia , Atitude Frente a Saúde , Estudantes/psicologia , Inconsciência/psicologia , Adolescente , Intoxicação Alcoólica/psicologia , Terapia Comportamental , Concentração Alcoólica no Sangue , Feminino , Humanos , Masculino , Motivação , Inconsciência/induzido quimicamente , Universidades , Adulto Jovem
16.
PLoS One ; 16(6): e0253296, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34157027

RESUMO

Human behavior lies somewhere between purely self-interested homo economicus and socially-motivated homo reciprocans. The factors that cause people to choose self-interest over costly cooperation can provide insights into human nature and are essential when designing institutions and policies that are meant to influence behavior. Alcohol consumption can shed light on the inflection point between selfish and selfless because it is commonly consumed and has global effects on the brain. The present study administered alcohol or placebo (N = 128), titrated to sex and weight, to examine its effect on cooperation in a standard task in experimental economics, the public goods game (PGG). Alcohol, compared to placebo, doubled the number of free-riders who contributed nothing to the public good and reduced average PGG contributions by 32% (p = .005). This generated 64% higher average profits in the PGG for those who consumed alcohol. The degree of intoxication, measured by blood alcohol concentration, linearly reduced PGG contributions (r = -0.18, p = .05). The reduction in cooperation was traced to a deterioration in mood and an increase in physiologic stress as measured by adrenocorticotropic hormone. Our findings indicate that moderate alcohol consumption inhibits the motivation to cooperate and that homo economicus is stressed and unhappy.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Comportamento Cooperativo , Comportamento Social , Afeto/fisiologia , Concentração Alcoólica no Sangue , Feminino , Teoria do Jogo , Jogos Experimentais , Humanos , Relações Interpessoais , Masculino , Adulto Jovem
17.
J Forensic Sci ; 66(6): 2478-2483, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34156093

RESUMO

Since the accuracy of headspace gas chromatographic analysis of blood for ethanol concentration has been so well established over the past several decades, it has become commonplace in court proceedings to attack preanalytical handling of the blood samples including the lack of measuring sample temperature prior to sample preparation. The impact on measured ethanol concentration of allowing refrigerated (~4℃) samples varying amounts of time to equilibrate with room temperature, 24, 4, 3, 2, and 1 h, prior to sample preparation was evaluated. Samples were diluted 1:10 with an internal standard using a diluter/dispenser and analyzed using headspace gas chromatography. The mean ethanol concentration measured for the sixteen samples at each of the five equilibration times was 0.153 g/dl. The F-critical from the one-way ANOVA was 2.4937. The calculated F value was 0.4209. Additionally, the effect on measured ethanol concentration of having calibrators at different temperatures than case samples was investigated. Three groups were analyzed: all calibrators, controls, and samples given 24 h to equilibrate with room temperature, all calibrators, controls, and samples prepared immediately after removal from refrigeration, and calibrators sampled immediately after removal from refrigerator with samples and controls allowed 24 h to equilibrate with room temperature. The mean ethanol concentration measured for the thirty blood samples in each of the three groups was 0.197 g/dl. The F-critical from the one-way ANOVA was 3.1013. The calculated F value was 0.0188. Measured ethanol concentrations were insensitive to the variations in preanalytical conditions evaluated in this study.


Assuntos
Concentração Alcoólica no Sangue , Etanol/sangue , Toxicologia Forense/métodos , Manejo de Espécimes/métodos , Temperatura , Depressores do Sistema Nervoso Central/sangue , Cromatografia Gasosa , Humanos , Fatores de Tempo
18.
Traffic Inj Prev ; 22(6): 425-430, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34133250

RESUMO

OBJECTIVE: To understand how knowledgeable and equipped the law enforcement agents in Nigeria are to enforce the drink-drive law. METHOD: We conducted a descriptive cross-sectional study of Law Enforcement Agents in four Nigerian states selected by convenient sampling. The study utilized a pre-tested questionnaire designed to obtain subjects' demographic data, elicit their knowledge about drink-drive law, and understand how equipped the subjects are. A team member walked respondents through the questions to ensure comprehension and accuracy with completion of the questions. RESULT: 496 law enforcement agents were studied. They were 414(83.5%) male and 82(16.5%) females, mostly aged 21-40 years (64.3%). Close to half (48.2%) were police officers, while 35.7% were officers in the Federal Road Safety Corp (FRSC). 45% of respondents had secondary/high school education, while 39.5% had bachelor's degree; with a significant majority in the FRSC. 269(54.2%) respondents had convicted a road user of drunk driving/riding on the basis of subjective assessment. The use of breathalyzers and awareness of permissible Blood Alcohol Concentration (BAC)/Breath Alcohol Concentration (BrAC), was reported by a few respondents (5%), mostly FRSC officers, and others with relatively higher educational attainment. The majority were ignorant of the approved BAC limit in Nigeria (0.05 g/100 dl) and objective methods of assessing breath alcohol concentrations. CONCLUSION: In Nigeria, there is a huge knowledge gap on the drink-drive law and the acceptable penalties for offenders in Nigeria among law enforcement agents. The law enforcement agents lack equipment for objectively detecting drunk driving among road users. Our findings call for an urgent intervention in the training and practice of law enforcement agents if the prevalence of RTC arising from drunk driving will be reduced in Nigeria.


Assuntos
Dirigir sob a Influência , Conhecimento , Aplicação da Lei , Polícia , Adulto , Concentração Alcoólica no Sangue , Estudos Transversais , Dirigir sob a Influência/legislação & jurisprudência , Feminino , Humanos , Masculino , Nigéria , Polícia/psicologia , Polícia/estatística & dados numéricos , Adulto Jovem
19.
Drug Alcohol Depend ; 225: 108847, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34182375

RESUMO

BACKGROUND: Alcohol consumption is responsible for a significant number of road fatalities. To contrast this phenomenon, a more responsible attitude to the wine consumption, especially among young, inexperienced drivers prone to risky behaviour on the road must be promoted. METHOD: This is a simplified single-blind, placebo-controlled experiment aimed at evaluating 44 young drivers monitored during a driving simulation following the consumption of natural and conventional wines, with a reference blood alcohol concentration (BAC) of 0.5 g/l. Two hypotheses are tested: (1) the legal consumption of wine has no significant impact on young drivers' performance in both ordinary and unusual road events; (2) natural and conventional wines are expected to produce negligible and acceptable impairments in young drivers the same BAC. Two reference groups (BAC = 0 g/l), one a placebo-controlled group with drivers treated with a dealcoholized wine, were included. RESULTS AND CONCLUSIONS: Significant differences between the groups in terms of perception and reaction times (PRT) to visual and auditory stimuli, and to speeding were observed, with young drivers treated with conventional wine displaying more aggressive behaviours. In contrast, participants treated with natural wine showed PRT which were not significantly different from those belonging to control groups. The gaze attention levels of wine treated drivers were found to be dose dependant, with young drivers of the two control groups and those of the treated ones with BAC < 0.3 g/l able to focus on wider area ahead and, thereby, collect more information from the road environment.


Assuntos
Condução de Veículo , Vinho , Acidentes de Trânsito/prevenção & controle , Consumo de Bebidas Alcoólicas/epidemiologia , Concentração Alcoólica no Sangue , Humanos , Método Simples-Cego
20.
Psychol Addict Behav ; 35(7): 840-851, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34110840

RESUMO

Objective: The Brief Alcohol Screening and Intervention for College Students (BASICS; Dimeff et al., 1999) is an evidence-based approach to reduce high-risk drinking and associated harms; however, implementation may present challenges for community colleges (CCs) that have limited budgets and mostly non-residential students. We examined feasibility, acceptability, and efficacy of BASICS for CC students (BASICCS) delivered remotely via web-conferencing with supporting automated text messages. Method: Participants included 142 CC students who reported exceeding National Institute on Alcohol Abuse and Alcoholism (NIAAA's) weekly low-risk drinking recommendations and/or heavy episodic drinking (HED). Participants were randomized to BASICCS or assessment-only control (AOC) and completed 1- and 3-month follow-up assessments. Results: Most students liked the personalized information in the program and found the web-conferencing platform useful, however intervention completion rate was 56%. Significant differences were found between BASICCS and AOC. At 1-month, individuals in BASICCS had 33% fewer alcohol consequences than those in AOC. At 3-month follow-up, individuals in BASICCS had lower estimated peak blood alcohol concentration, 29% fewer drinks per week, 62% fewer episodes of HED, and 24% fewer consequences than those in AOC. Conclusions: BASICCS showed evidence of being acceptable and the technology proved feasible, although the intervention completion rate in the non-treatment-seeking volunteer sample was modest. Preliminary evidence does suggest BASICCS shows promise in reducing alcohol use and consequences. Technology-based platforms could be a viable prevention solution for CC students. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Envio de Mensagens de Texto , Consumo de Bebidas Alcoólicas , Concentração Alcoólica no Sangue , Estudos de Viabilidade , Humanos , Estudantes , Universidades
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