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1.
Forensic Sci Int ; 316: 110409, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32871451

ABSTRACT

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


Subject(s)
Ethanol , Glucuronates , Substance Abuse Detection/methods , Adult , Alcohol Drinking , Biomarkers/blood , Biomarkers/urine , Blood Alcohol Content , Central Nervous System Depressants/blood , Central Nervous System Depressants/pharmacokinetics , Central Nervous System Depressants/urine , Driving Under the Influence/legislation & jurisprudence , Ethanol/blood , Ethanol/pharmacokinetics , Ethanol/urine , Female , Glucuronates/blood , Glucuronates/urine , Humans , Male , Sulfuric Acid Esters/blood , Sulfuric Acid Esters/urine , Time Factors , Young Adult
2.
J Wound Care ; 13(6): 230-4, 2004 Jun.
Article in English | MEDLINE | ID: mdl-15214141

ABSTRACT

OBJECTIVE: To determine if oral nutritional supplementation improved wound healing in malnourished patients with diabetic foot ulcers when compared with a placebo. METHOD: This prospective randomised controlled double-blind trial involved patients aged over 60 with diabetes mellitus and a Wagner grade I-II foot ulcer of over four weeks' duration. Patients received either 400 ml (400 kcal) oral nutritional supplementation (n = 26) or 400 ml placebo (n = 27) daily for six months. Patients were followed monthly for six months and after one and two years. RESULTS: A third of the patients were classified as having protein-energy malnutrition at inclusion, with no difference between the two groups. Critical leg ischaemia was more common in the intervention group than in the placebo group (p = 0.008). Nine patients in the intervention group (35%) and four in the placebo group (15%) dropped out of the study (not significant). Of those who completed the study, the wound had healed at six months in eight out of 23 patients (41%) (placebo) and in seven out of 17 (35%) (intervention) (not significant). Twenty-four per cent of patients with protein-energy malnutrition at inclusion had healed at six months compared with 50% of those without it (not significant). CONCLUSION: This is the first study to evaluate the possible benefits of nutritional supplementation on diabetic foot ulcers. A third of patients were malnourished. We encountered several methodological problems and were unable to demonstrate an improved wound healing rate in these patients.


Subject(s)
Diabetic Foot/diet therapy , Dietary Supplements , Protein-Energy Malnutrition/diet therapy , Aged , Aged, 80 and over , Diabetic Foot/complications , Double-Blind Method , Female , Humans , Male , Middle Aged , Prospective Studies , Protein-Energy Malnutrition/complications , Statistics, Nonparametric , Wound Healing
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