Experiences of family members of drivers who violate the law against rinking and driving and its repercussions / Experiencias de familiares de conductores infractores de la ley seca y sus repercusiones / Vivências de familiares de motoristas infratores da Lei Seca e suas repercussões

ABSTRACT Objectives: to understand the experiences of family members of drivers who violate the law against drinking and driving and the post-penal repercussions. Methods: a qualitative study, with family members of drivers who violated the law against drinking and driving who participated in the Projeto Justiça e Sobriedade no Trânsito de Maringá - PR (Traffic Justice and Sobriety Project in Maringá - PR). Data collection was carried through semi-structured interviews, analyzed through thematic analysis. Results: it was observed in the family members' reports: the suffering of families due to the consumption of alcohol and other drugs; the violation of the law against drinking and driving meaning turning point, with positive and negative changes in the family context; and the meanings of the Traffic Justice and Sobriety Project. Final Considerations: the law against drinking and driving penalties triggered unemployment and financial expenses, but the positive aspects were quitting alcohol use and/or not drinking and driving anymore. The Traffic Justice and Sobriety Project was informed as solidarity and a trigger for changing the offenders' behavior.

RESUMEN Objetivos: comprender las experiencias de los familiares de conductores infractores de la Ley seca y las repercusiones después de las sanciones Métodos: estudio cualitativo, realizado con familiares de conductores infractores de la Ley Seca participantes del Proyecto Justicia y Sobriedad en el Tráfico de la ciudad de Maringá, Paraná. La recolección de datos se llevó a cabo una entrevista semiestructurada, analizadas mediante análisis temático. Resultados: se observó en los relatos de los miembros de la familia: el sufrimiento de las familias por el consumo de alcohol y otras drogas; la violación de la Ley Seca que significa un punto de inflexión, con cambios positivos y negativos en el contexto familiar; y los significados del Proyecto Justicia y Sobriedad en el Tráfico. Consideraciones Finales: las penalidades de la Ley Seca provocaron desempleo y gastos financieros, pero hubo aspectos positivos como el cese del consumo de alcohol y/o el no conducir más en estado de embriaguez. El Proyecto Justicia y Sobriedad en el Tráfico es tenido como solidario y como detonante para cambiar el comportamiento de los infractores.

RESUMO Objetivos: compreender as vivências dos familiares de motoristas infratores da Lei Seca e as repercussões pós-penalidades. Métodos: estudo de cunho qualitativo, com membros da famílias de motoristas infratores da, Lei Seca participantes do Projeto Justiça e Sobriedade no Trânsito de Maringá - PR. A coleta de dados foi realizada por entrevista semiestruturada, analisadas mediante análise temática. Resultados: observou-se nos relatos dos familiares: o sofrimento das famílias pelo consumo de álcool e outras drogas; a infração da Lei Seca significando turning point, com mudanças positivas e negativas no contexto familiar; e os significados do Projeto Justiça e Sobriedade no Trânsito. Considerações Finais: as penalidades da Lei Seca desencadearam desempregos e gastos financeiros, mas os aspectos positivos foram a cessação do uso de álcool e/ou não dirigir mais embriagado. O Projeto Justiça e Sobriedade no Trânsito foi informado como solidário e um gatilho para mudança de comportamento dos infratores.

Análisis de los efectos del consumo de alcohol en la morbi-mortalidad por trauma craneoencefálico / Analysis of the effects of alcohol consumption in traumatic brain injury´s morbidity and mortality

Resumen La intoxicación con alcohol está frecuentemente asociada con trauma craneoencefálico (TCE), pero el impacto del alcohol en la patogénesis y el pronóstico del TCE sigue siendo poco clara. La literatura actual provee evidencia en términos de datos clínicos y experimentales que respaldan los efectos neuroprotectores del alcohol en pacientes con TCE. Para establecer de manera significativa esta relación es necesario el desarrollo de estudios prospectivos observacionales fuertes, con el fin de comprender los efectos del alcohol en los resultados clínicos a largo plazo (incluyendo el resultado neurológico) en pacientes con TCE con una apropiada selección y ajuste del riesgo basal.

Abstract Alcohol intoxication is often associated with traumatic brain injuries (TBIs), but the impact of alcohol on the pathogenesis and prognosis of TBIs remains unclear. Current literature provides evidence in terms of experimental and clinical data supporting alcohol's neuroprotective effects in patients with TBIs. To establish in a significative way this association, there lies a need for strong prospective observational studies, in order to comprehend the effects of alcohol on the long-term outcomes (including the neurological outcome) in patients with TBI with proper selection and baseline risk adjustment.

Comparison between Xingnaojing Injection () and Naloxone in Treatment of Acute Alcohol Intoxication: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials / 中国结合医学杂志

OBJECTIVES@#To investigate the effectiveness and safety of Xingnaojing Injection (XNJ, ) compared with naloxone for the treatment of acute alcohol intoxication (AAI), and provide the latest evidence through evidence-based approach.@*METHODS@#Seven electro-databases including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure Databases, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Database (VIP) and Wanfang Database were searched from the inception to January 2018. Randomized controlled trials (RCTs) comparing XNJ with naloxone for patients with AAI and reporting at least one of the below outcomes were included: patients' conscious recovery time, stay length in emergency department, disappearance time of the ataxia symptom, the severity of the symptoms, the blood alcohol content as well as the adverse events. Methodological quality of included trials was assessed using the risk of bias tool which recommended by the Cochrane Collaboration. Meta-analysis was conducted by Review Manager 5.3 software.@*RESULTS@#Totally 141 trials with 13,901 patients were included in this review, all of them were assessed as unclear or high risk of bias. Results showed that on the basis of routine therapy, standard dose XNJ (10-20 mL) may have similar results with naloxone on the recovery time of consciousness (MD 12 min, 95% CI 7.2-17.4 min) and disappearance time of symptoms (MD 6 min, 95% CI-13.8-25.8 min) for patients with AAI. Larger dose of XNJ Injection (21-40 mL) may speed up the time (almost 1 h earlier). Combination of XNJ and naloxone seemed superior to the naloxone alone for all the relevant outcomes. The average difference of time in consciousness recovery was 2 h and the number of AAI patients whose consciousness recovery within 1 h was above 50% the combination group than in the control group (RR 1.42, 95% CI 1.29 to 1.56). No severe adverse events or adverse reactions of XNJ were reported in the included trials.@*CONCLUSIONS@#Low quality of evidence showed XNJ may have equal effect as naloxone and may achieve better effect as add-on intervention with naloxone for patients with AAI. We failed to evaluate the safety of XNJ Injection due to the insufficient evidence in this review. Registration number. in PROSPERO (No. CRD42018087804).

Acidosis láctica por intoxicación alcohólica / Lactic acidosis by alcohol intoxication

La acidosis metabólica láctica es un trastorno severo del metabolismo intermediario, que conlleva una elevada tasa de mortalidad. Pueden presentarse en el contexto de isquemia tisular extensa, fallo cardiocirculatorio, shock séptico, o desencadenarse por determinados tóxicos (metanol, etanol, etc) y fármacos (metformina y otros). El etanol es un depresor del sistema nervioso central que provoca un cuadro clínico caracterizado por euforia, alteraciones de la conducta, pérdida de la inhibición, ataxia, verborrea y, finalmente, estupor y coma, dependiendo del grado de intoxicación además pueden presentar cuadros convulsivos. En este reporte se presenta el caso de una paciente joven con intoxicación alcohólica

Lactic acidosis is a severe disorder of intermediary metabolism, which leads to a high mortality rate. It can occur in the context of extensive tissue ischemia, cardiocirculatory failure, septic shock or triggered by certain toxins (methanol, ethanol, etc.) and drugs (metformin and others). Ethanol is a central nervous system depressant that causes a clinical picture characterized by euphoria, behavioral changes, loss of inhibition, ataxia, verbiage and, finally, stupor and coma, depending on the degree of intoxication can also present seizures. In this report we present, the case of a young patient with alcohol intoxication

Incidence, clinical profile and outcome of poisoning patients in a tertiary care hospital, Chennai

Poisoning is one of the commonest health problems in patients who present to Emergency Department, causing significant morbidity and mortality in them. The present study is aimed at assessing the incidence, clinical profile and outcome of poisoning patients admitted during a 2- month period of December 2016 - January 2017 in Government Royapettah Hospital, Chennai. 132 cases of acute poisoning in adults due to drugs and chemicals were included. Data on age, sex, type of poison, route of exposure, associated co-morbid conditions and outcome of poisoning were recorded and analysed by descriptive method. Among 132 cases, 90 cases were of intentional poisoning and 42 cases were of accidental poisoning. In all the cases the route of exposure was oral. The percentage of poisoning patients was equal in both males & females. Peak occurrence was in the age group 21-30 years. Rat killer was the commonest toxic agent. Associated comorbidities were found in 11 patients. The incidence of acute poisoning, morbidity and mortality can be substantially reduced by implementing effective strategies that prevent the easy availability of pesticides & over-the-counter medications.

Intoxicação alcóolica aguda: complicação rara associada a neurólise do plexo celíaco durante procedimento cirúrgico a céu aberto em paciente com dor oncológica refratária. Relato de caso / Acute alcohol intoxication: uncommon complication associated to celiac plexus neurolysis during open surgical procedure in patient with refractory cancer pain. Case report

RESUMO JUSTIFICATIVA E OBJETIVOS: A neurólise do plexo celíaco é uma opção de tratamento da dor para pacientes com câncer abdominal refratário a outras abordagens. É acompanhada de reações adversas que são diagnosticadas e tratadas desde que o paciente receba monitorização e acompanhamento imediato após o procedimento. O objetivo deste estudo foi relatar o caso de uma paciente submetida a neurólise de plexo celíaco, evoluindo com sintomas de intoxicação alcoólica aguda diagnosticada na sala de recuperação pós-anestésica. RELATO DO CASO: Paciente do gênero feminino, 43 anos, com neoplasia de cabeça de pâncreas submetida a neurólise de plexo celíaco intraoperatório com 40mL de álcool a 98%, evolui na sala de recuperação pós-anestésica com hipotensão, hipoxemia e confusão mental, sintomas esses revertidos com hidratação por via venosa e elevação de membros inferiores. CONCLUSÃO: A alcoolização do plexo celíaco bloqueia definitivamente a dor visceral de pacientes com neoplasia de pâncreas, porém não está isenta de reações adversas, as quais podem evoluir para complicações graves caso não sejam prontamente diagnosticadas, tornando-se imprescindível o acompanhamento do paciente na sala de recuperação pós-anestésica.

ABSTRACT BACKGROUND AND OBJECTIVES: Celiac plexus neurolysis is a pain management option for patients with abdominal cancer refractory to other approaches. It is followed by adverse reactions which may be diagnosed and treated, provided patients are monitored and followed up immediately after the procedure. This study aimed at reporting the case of a patient submitted to celiac plexus neurolysis who evolved with acute alcohol intoxication diagnosed in the post-anesthetic care unit. CASE REPORT: Female patient, 43 years old, with pancreatic head cancer, submitted to intraoperative celiac plexus neurolysis with 40 mL of 98% alcohol. Patient evolved in the post-anesthetic care unit with hypotension, hypoxemia and mental confusion, which were reverted with intravenous hydration and elevation of lower limbs. CONCLUSION: Celiac plexus alcoholization permanently blocks visceral pain of pancreatic cancer patients, however it is not free of adverse reactions, which may evolve to severe complications if not promptly diagnosed, making mandatory the follow up of patients in the post-anesthetic care unit.

Two cases of methyl alcohol intoxication by sub-chronic inhalation and dermal exposure during aluminum CNC cutting in a small-sized subcontracted factory

BACKGROUND: Methyl alcohol poisoning has been mainly reported in community. Two cases of methyl alcohol poisoning occurred in a small-sized subcontracted factory which manufactured smartphone parts in Korea. CASE PRESENTATION: One young female patient presented with dyspnea and visual disturbance. Another young male patient presented with visual disturbance and myalgia. They treated with sodium bicarbonate infusion and hemodialysis for metabolic acidosis. In addition, he received ethyl alcohol per oral treatment. Her and his urinary methyl alcohol concentration was detected as 7.632 mg/L, 46.8 mg/L, respectively, although they were treated hemodialysis. Results of the working environment measurement showed that the concentration of methyl alcohol (1030.1–2220.5 ppm) in the air exceeded the time weighted average (200 ppm). They were diagnosed with optic neuropathy due to methyl alcohol poisoning and still have visual impairment. CONCLUSIONS: Workers who hired as dispatched employees in a small-sized subcontracted factory were exposed to high concentrations of methyl alcohol. The workplace had poor ventilation system. In addition, workers did not wear proper personal protect equipment. Working environment measurement and annual chekups for workers were not performed. They were in a blind spot to occupational safety and health. More attention is needed to protect vulnerable workers’ health.

Consumo abusivo de álcool no Brasil: resultados da pesquisa nacional de saúde 2013 / Heavy drinking in Brazil: results from the 2013 national health survey

OBJETIVO: Descrever a prevalência do consumo abusivo de álcool na população brasileira, segundo características sociodemográficas e de saúde, em 2013. MÉTODOS: estudo descritivo com dados da Pesquisa Nacional de Saúde (PNS), referentes ao consumo abusivo de álcool nos 30 dias anteriores à entrevista, entre indivíduos com idade ≥18 anos. Foram estimadas as prevalências e intervalos de confiança de 95 por cento (IC95 por ento). RESULTADOS: a prevalência foi 13,7 por cento (IC95 por cento 13,1; 14,2 por cento), superior entre os homens (21,6 por cento; IC95 por cento 20,7; 22,5 por cento) em relação às mulheres (6,6 por cento; IC95 por cento 6,1; 7,1 por cento). Prevalências maiores foram observadas entre adultos jovens (18 a 29 anos de idade: 18,8 por cento; IC95 por cento 17,5; 20,0 por cento), de cor da pele preta (16,6 por cento; IC95 por cento 14,9; 18,4 por cento), fumantes ocasionais (35,2 por cento; IC95 por cento 30,4; 40,0 por cento), que avaliaram sua saúde como boa ou muito boa (15,6 por cento; IC95 por cento 14,9; 16,3 por cento), e sem morbidades referidas. CONCLUSÃO: a prevalência do consumo abusivo de álcool apresentou diferenças segundo características sociodemográficas e de saúde.

OBJETIVO: Describir la prevalencia del consumo excesivo de alcohol en la población brasileña, según características sociodemográficas y de salud, en 2013. MÉTODOS: estudio descriptivo, con datos de la Encuesta Nacional de Salud (PNS) sobre el consumo excesivo de alcohol en los 30 días anteriores, entre personas con edad ≥18 años. Se estimó la prevalencia e intervalos de confianza del 95 por ciento (IC95 por ciento). RESULTADOS: la prevalencia fue del 13,7 por ciento (IC del 95 por ciento: 13,1; 14,2 por ciento), más elevada en los hombres (21,6 por ciento; IC del 95 por ciento: 20,7; 22,5 por ciento) en comparación con las mujeres (6,6 por ciento; IC 95 por ciento 6,1; 7,1 por ciento), entre adultos jóvenes (18 a 29 años: 18,8 por ciento; IC del 95 por ciento: 17,5; 20,0 por ciento), de piel negra (16,6 por ciento; IC del 95 por ciento: 14,9; 18 4 por ciento), fumadores ocasionales (35,2 por ciento, IC 95 por ciento 30,4; 40,0 por ciento), que calificaron su salud como buena o muy buena (15,6 por ciento; 95 por ciento IC 14,9 por ceinto, 16,3 por ciento) y sin morbilidades. CONCLUSIÓN: la prevalencia de consumo abusivo de alcohol mostró diferencias según las características sociodemográficas y de salud.

OBJECTIVE: To describe the prevalence of heavy drinking in the Brazilian population, according to sociodemographic and health-related characteristics, in 2013. METHODS: a descriptive study was conducted with National Health Survey (PNS) data regarding heavy drinking in the 30 days prior to interview, among individuals aged≥18 years. Prevalence and 95 per cent confidence intervals (95 per cent CI) were estimated. RESULTS: overall prevalence was 13.7 per cent (95 per cent CI 13.1; 14.2 per cent). It was higher among men (21.6 per cent; 95 per cent CI 20.7; 22.5 per cent) compared to women (6.6 per cent; 95 per cent CI 6.1; 7.1 per cent). Higher prevalence was found among young adults (18-29 years: 18.8 per cent; 95 per cent CI 17.5; 20.0 per cent), those with black skin color (16.6 per cent; 95 per cent CI 14.9; 18.4 per cent), occasional smokers (35.2 per cent; 95 per cent CI 30.4; 40.0 per cent), individuals who rated their health as good or very good (15.6 per cent; 95 per cent CI 14.9, 16.3 per cent) and with no reported morbidities. CONCLUSION: prevalence of heavy drinking showed notable differences according to sociodemographic and health-related characteristics.

Social and economic profile of young trauma victims and alcohol addicts / Perfil socioeconômico de jovens vítimas de trauma e usuários de álcool

The social and economic profile of alcohol-traumatized young people and alcohol users is provided through an exploratory and transversal analysis with 10-24- year- old young people attended to at the Emergency Section of a hospital in the western region of the state of Paraná, Brazil. Data were processed by Statistica 8.0. One hundred and twelve young people were classified in three groups according to alcohol intake: trauma associated with alcoholic beverage consumption; alcohol consumers without any alcohol intake during the previous six hours; teetotalers. Alcohol trauma was predominant in male young people with complete primary schooling, family income between R$ 901 and R $ 1500, without any personal income and working regularly. Higher occurrence lay within the 15-20 years age bracket regardless of their alcohol intake pattern. Results show that young people's social and economical profile affects the capacity of people in acknowledging and managing the dangers to which they are exposed. Interventions are relevant when the historical and social contexts are taken into account so that changes in health, disease and care processes could be enhanced.

O estudo teve como objetivo estabelecer o perfil socioeconômico dos jovens vítimas de trauma e usuários de álcool. O estudo foi exploratório e transversal, com jovens na faixa etária de 10 a 24 anos atendidos no Pronto Socorro de um hospital de ensino do Oeste do Paraná. Os dados foram analisados a partir do Programa de Computação Statistica 8.0. Foram entrevistados 112 jovens, classificados em três grupos de padrão de consumo de álcool: trauma associado ao consumo de bebida alcoólica; consumidores de álcool, mas nas 06h anteriores ao trauma não referiram consumo; e abstinentes na vida. O trauma predominou nos jovens do sexo masculino, com Ensino Fundamental completo, com renda mensal familiar entre R$ 901,00 e R$ 1.500,00, sem renda pessoal e com trabalho formal. A maior ocorrência de trauma aconteceu na faixa etária dos 15 aos 20 anos, independente do padrão de consumo de bebida alcoólica. Os resultados apontaram que o perfil socioeconômico dos jovens exerce influência na capacidade dos indivíduos conhecerem e administrarem os perigos a que estão expostos, devendo-se propor intervenções que levem em consideração contexto histórico e social, com vistas a promover mudanças nos processos de saúde, doença e cuidado.

Padrão de consumo do álcool por jovens vítimas de trauma e usuários de álcool / Nivel de consumo de alcohol entre jovenes victimas de trauma y demas usuarios de alcohol / Alcohol consumption pattern among young victims of trauma and alcohol users

O abuso do álcool constitui fator de risco para o trauma e um problema social e sanitário de grande magnitude. Oobjetivo com esta pesquisa exploratória e transversal foi investigar o padrão de consumo de álcool em jovens vítimasde trauma residentes em Cascavel-PR. O instrumento de coleta de dados foi um roteiro de entrevista adaptado doQuestionário Hispanic Americans Alcohol Survey (Hablas), desenvolvido na Universidade do Texas-EUA. Com base noPrograma de Computação Statística 8.0, os dados foram submetidos ao teste de Pearson e regressão logística. Foramentrevistados 112 jovens, classificados em três grupos de padrão de consumo de álcool: trauma com consumo, traumasem consumo e trauma em abstinentes na vida. O trauma predominou nos jovens do sexo masculino e na faixa etáriaentre 15 e 20 anos. Identificou-se o início precoce do consumo de bebida alcoólica. A maioria dos jovens iniciou oconsumo regular entre 15 e 20 anos. A frequência de consumo mais citada pelos jovens foi de uma a duas vezes porsemana, sendo o consumo abusivo maior para os jovens na faixa etária entre 21 e 24 anos, os quais fazem uso emforma de binge. Os locais onde habitualmente os jovens consumiram bebida alcoólica foram as festas e bares, sendoos amigos e familiares as companhias preferidas para o consumo.

Alcohol abuse constitutes a risk factor for trauma and a social and sanitary problem of considerable magnitude. The present study had the objective to investigate alcohol consumption pattern among young victims of trauma and alcohol users aged between 10 and 24 years old and residents in Cascavel - PR. Data was collected via structured interview, adapted from the HABLAS questionnaire, analysed by the SPSS version 8.0 and submitted to Pearson's Test and logistic regression. A total of 112 young people were interviewed and classified in three groups according to alcohol use pattern: trauma with consumption, trauma without consumption and trauma in abstinence. The trauma was predominant in males aged 15 to 20 years old. An early initiation to alcohol consumption was detected. Most young people started drinking regularly between 15 and 20 years old. Frequency of alcohol intake was one to two times per week. Binge drinking was higher among youngsters between the ages of 21 and 24 years old. Alcohol consuming usually takes place at parties and bars, and they prefer drinking with friends and family. Nurses should be trained to work with young people and their family so they can lead a safe and healthy life.

El abuso de alcohol es factor de riesgo para el trauma y constituye un problema social y sanitario de gran magnitud. El presente estudio tuvo como objetivo investigar el nivel de consumo de alcohol entre jóvenes víctimas de trauma y usuarios de alcohol con edad de 10 a 24 años, que viven en Cascavel - PR. El instrumento de recogida de datos fue una guía de entrevistas adaptada del Cuestionario Hablas. Los datos fueron analizados a partir del programa de computación estadística, versión 8.0. Fueron entrevistados 112 jóvenes, clasificados en tres grupos según el nivel de consumo de alcohol: trauma con consumo, trauma sin consumo y trauma en abstemios durante la vida. El trauma predominó en los varones entre 15 y 20 años. Se identificó que el consumo de bebida alcohólica comienza temprano, la mayoría entre 15 y 20 años. La frecuencia de consumo de alcohol era de una a dos veces por semana y siendo más abusivo en los jóvenes entre 21 a los 24 años, que consumen binge. Generalmente consumen alcohol en fiestas y bares, de preferencia, acompañados de amigos y familiares. Los enfermeros necesitan capacitación para trabajar con los jóvenes y sus familias de manera que ellos vivan una juventud segura y sin perjudicar la salud.

Alcohol and violence in the emergency department: a regional report from the WHO collaborative study on alcohol and injuries

OBJECTIVE: To determine the relative risk (RR) of non-fatal unintentional and violence-related injury associated with alcohol consumption in three emergency departments in Latin America (2001-2002). MATERIAL AND METHODS: Pair-matched case-crossover was used to obtain RR estimates for alcohol in non-fatal injuries among 447 patients in Argentina (A), 489 in Brazil (B) and 455 in Mexico (M). Intentional (violence) or unintentional (non-violence) injury status were the main outcomes. RESULTS: About 46 percent of violence-related cases involved alcohol (versus 11.5 percent for non-violence related cases). The risk of violence-related injury increased with drinking and had an OR= 15.0 (95 percent confidence interval (CI), 5.8-39.1), with an OR= 4.2 (CI= 2.7-6.5) for unintentional injuries. CONCLUSIONS: Increasing amounts of drinking may have pronounced consequences on the risk of triggering an injury, especially for a violence-related injury. The RR estimates provided here can be useful for new estimates on alcohol and the burden of disease.

OBJETIVO: Determinar el riesgo relativo (RR) de lesiones no intencionales y relacionadas con la violencia, asociadas al consumo de alcohol en tres Servicios de Urgencia de América Latina (2001-2002). MATERIAL Y MÉTODOS: Se usó un diseño case-crossover en 447 pacientes de Argentina (A), 489 de Brasil (B) y 455 de México (M). RESULTADOS: El 46 por ciento de los casos relacionados a la violencia consumieron alcohol (vs. 11.5 por ciento de los no-violentos). El riesgo de una lesión relacionada con la violencia se incrementó con el consumo, y tuvo una RM= 15.0, intervalo de confianza al 95 por ciento (IC= 5.8-39.1), pero correspondió a 4.2 (IC= 2.7-6.5) para las lesiones no-intencionales. CONCLUSIONES: Mayores cantidades de alcohol tienen consecuencias en el riesgo de desencadenar una lesión, especialmente en lesiones relacionadas con la violencia. Los estimadores del RR que se presentan pueden ser usados como nuevas fuentes para estimadores de la carga de la enfermedad asociada al consumo de alcohol.

ALCOHOL DRINKING AND HEALTH / 体力科学

The present article briefly overviews the principal pathway of ethanol metabolism in the liver cell and hormonal regulations of ethanol metabolism, and a relationship between alcohol drinking volume (=alcohol consumption) and the degree of alcohol intoxication. This article also focuses on a possible mechanism of sex difference in rat liver cytosolic alcohol dehydrogenase (ADH) activity, and the effects of bile, bile acids, vegetable oils and unsaturated fatty acids on plasma ethanol levels and gastric emptying in ethanol-administered rats. Finally, the recent findings concernig a relationship between alcohol drinking and human health are described.

A Case of Severe Hypothermia with Cerebral Hemorrhage

Hypothermia is not an uncommon condition that emergency physicians meet in their emergency department services. Most cases involve mild hypothermia and are rewarmed well without any complication or sequelae. Hypothermia is well known to be correlated with drug intoxication, such as with alcohol. Since alcohol adds to the suppressive effect on central nervous system due to hypothermia, most intoxicated patients are so deeply drunk that they look comatous. We report the case of a 41-year old male drunk and semi-comatous and who had been left in his car for more than 12 hours on a freezing cold night. He arrived at our emergency department with a body temperature of 27.3degrees C. The patient was warmed with active rewarming, and during the procedure, the patient appeared markedly hypertensive, instead of showing rewarming shock. After initial stabilization the patient was taken for a cerebral CT scan and was found to have a large amount of intracranial hemorrhage. He was treated conservatively in the intensive care unit and was discharged as a hopeless case.

The Pattern of Self Reported Assessment(Alcohol Use Inventory and Michigan Alcohol Screening Test) according to Receptive and Awareness of Drinking Problem and the Relation to the Alcoholic Type / 신경정신의학

OBJECTIVES: This Study was designed to investigate the pattern of AUI(Alcohol Use Inventory) and MAST(Michigan Alcohol Screening Test) according to the awareness of drinking problem and receptiveness to treatment, and to know whether the type(type1 and type 2 according to Barbor's typology) has effects on the RECPAWAR(acknowledgement and awareness of use problem and receptive to treatment of these problem) score. METHODS: Subjects were 134 alcoholic patients from Alcoholic treatment ward. They were requested to fill up the questionnaires of Korean version of AUI and MAST(MAST for patient and MAST for caretaker). At first, based on the RECPAWAR, they divided into high RECPAWAR group(above 30 percentile) and low RECPAWAR group(below 30 percentile). According to typology, they divided into type 1 and type 2. The data was analyzed by T-test, Correlation, and Regression Analysis. RESULTS: 1) Significant negative correlation was observed between RECPAWAR score and MAST difference score(patient's MAST-caretaker's MAST). 2) High RECPAWAR group had significantly higher scores in the most scales than low RECP-AWAR group, except ENHANCED scale in AUI. 3) There was not significant difference on RECPAWAR score between type 1 and type 2. CONCLUSION: Except ENHANCED scale, the high RECPAWAR group had higher score in the second level scale. As compared with the low RECPAWAR group, the high RECPAWAR group responds more negative in drinking, and is more anxious about their drinking problems. So, they seem to have the objective view about their drinking problems. However the type was not related to receptive and awareness of drinking problem.

Acute Alcohol Intoxication in a Child

Information on ethyl alcohol intoxication in children is scarce. It is generally believed that children are more vulnerable to ethyl alcohol intoxication than adults. However, little information has been published on the effects of ethanol in the pediatric age group. The incidence of hypoglycemia and convulsions following ethanol intoxication is not known. We report a fatal case of acute alcohol intoxication associated with hypoglycemia, convulsion and coma.

Blood Alcohol Concentration and Traumatic Brain Damage

Alcohol intoxication is often a contributory factor to the accidental head injury and may greatly aggravate the situation due to respiratory depression, cerebral edema and alteration in clotting mechanisms. Blood alcohol level was measured in 1261 patients with head injury attending the emergency room of Chung-Ang university hospital during one year from July, 1988. Blood alcohol concentration over 0.5g/L was defined as positive. The results are as followed : 1) Among 1261 patients of head injury, 89 patients showed positive blood alcohol level(7.05%). The mean blood alcohol concentration was 1.673g/L. 2) The male to female ration was 8.9 : 1 and majority of patients were 3rd and 4th decade. 76.6 percent of blood alcohol positive patients were attended between 8pm and 4am. 3) The common mechanisms of injury in blood alcohol positive group were pedestrian road traffic accidents(27.1%), fall down(24.7%) and home accidents(14.6%). 4) The level of consciousness on admission was significantly worse in the blood alcohol positive group than in the control group(P<0.01). 5) The common associated injuries were mostly in the extremities(22.5%) and chest(6.7%), but there was no significant difference in both group. 6) The prognosis was worse in the blood alcohol postive group than in the control group(P<0.01).