Alcoholic intoxication

酒精中毒
  • 文章类型: Journal Article
    酒精摄入是一种广泛的习惯,随着人口的增长而进化,通过免疫调节功能改变生理条件。有许多研究报告说,低酒精和高酒精水平的消费会导致不同的生物影响,包括细胞损伤,导致全身功能障碍和炎症标志物增加。在专业吞噬细胞的命运中,细胞凋亡是凋亡细胞激活的一种不可避免的机制,从而消除它们并防止微环境中细胞尸体/碎片的积累。随后,它促进组织修复机制并维持细胞稳态。不幸的是,缺陷性红细胞增多广泛存在于几种炎症和年龄相关疾病中,如动脉粥样硬化,自身免疫性疾病,肺损伤,脂肪肝,和神经退行性疾病。酗酒是引起免疫反应的因素之一,其同时增加全身性疾病患者的发病率和死亡率。关于酒精发病过程中免疫调节的出现及其与红细胞增多症的相关性的信息仍然难以捉摸。因此,在这篇评论中,我们讨论了细胞增生的机制,缺陷性红细胞增多在炎症性疾病中的作用,以及酒精对细胞凋亡的影响。
    Alcohol ingestion is a widespread habituation that evolved along with a growing population, altering physiological conditions through immunomodulatory function. There is much research that has reported that consumption of alcohol at low and heavy levels causes different biological impacts, including cellular injury, leading to systemic dysfunction and increased inflammatory markers. In the fate of professional phagocytic cells, efferocytosis is an inevitable mechanism activated by the apoptotic cells, thus eliminating them and preventing the accumulation of cell corpses/debris in the microenvironment. Subsequently, it promotes the tissue repair mechanism and maintains cellular homeostasis. Unfortunately, defective efferocytosis is widely found in several inflammatory and age-related diseases such as atherosclerosis, autoimmune diseases, lung injury, fatty liver disease, and neurodegenerative diseases. Alcohol abuse is one of the factors that provoke an immune response that increases the rate of morbidity and mortality in parallel in systemic disease patients. Information regarding the emergence of immunomodulation during alcoholic pathogenesis and its association with efferocytosis impairment remain elusive. Hence, here in this review, we discussed the mechanism of efferocytosis, the role of defective efferocytosis in inflammatory diseases, and the role of alcohol on efferocytosis impairment.
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  • 文章类型: Journal Article
    背景:相当一部分急性中毒患者存在意识障碍。及早发现那些需要高级医疗护理的病人,如机械通气(MV),可以改善其预后。
    方法:这项研究包括330名意识受损并进入坦塔大学毒物控制中心的急性中毒患者,埃及,在2021年1月至2023年12月期间。患者被纳入衍生(257名患者)和验证(73名患者)队列。分析患者数据以开发和验证预测列线图,以确定急性中毒患者需要MV的可能性。
    结果:MV需求的重要预测因子是平均动脉血压(OR=0.96,p=0.014),PaO2(OR=0.96,p=.001),pH值(OR=0.00,p<。001),和葡萄糖/钾比率(OR=1.59,p=0.030)。这四个参数用于制定床边列线图。对建议的列线图的接收器工作特性(ROC)分析表明,曲线下面积(AUC)=95.7%,准确度=93.4%,灵敏度=88.9%,特异性=95.1%。使用自举方法和校准曲线评估开发的列线图的内部验证。关于外部验证,开发的列线图概率的AUC为96.5%,使用开发的列线图预测概率为97.8%。
    结论:本研究提供了一个经过验证的列线图,可作为一种可靠的工具,用于准确预测意识障碍的急性中毒患者的MV需求。它可以帮助早期识别需要MV的患者,特别是在资源有限的低收入国家。
    BACKGROUND: A considerable portion of acutely intoxicated patients is presented with impaired consciousness. Early identification of those patients who require advanced medical care, such as mechanical ventilation (MV), can improve their prognosis.
    METHODS: This study included 330 acutely intoxicated patients who were presented with impaired consciousness and admitted to Tanta University Poison Control Center, Egypt, in the period from January 2021 to December 2023. Patients were enrolled in derivation (257 patients) and validation (73 patients) cohorts. Patients\' data were analyzed to develop and validate a predictive nomogram to determine the probability of MV need in acutely intoxicated patients.
    RESULTS: Significant predictors for MV need were mean arterial blood pressure (OR = 0.96, p = .014), PaO2 (OR = 0.96, p = .001), pH (OR = 0.00, p < . 001), and glucose/potassium ratio (OR = 1.59, p = .030). These four parameters were used to formulate a bedside nomogram. Receiver-operating characteristic (ROC) analysis for the proposed nomogram shows that area under the curve (AUC) = 95.7%, accuracy = 93.4%, sensitivity = 88.9%, and specificity = 95.1%. The internal validation for the developed nomogram was assessed using a bootstrapping method and calibration curve. Regarding external validation, AUCs for the developed nomogram probability was 96.5%, and for predicted probability using the developed nomogram was 97.8%.
    CONCLUSIONS: The current study provides a validated nomogram that could be used as a reliable tool for the accurate prediction of MV need among acutely intoxicated patients with impaired consciousness. It could assist in the early identification of patients who will require MV, especially in low-income countries with limited resources.
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  • 文章类型: Journal Article
    最近,酒精宿醉已被接受的国际疾病分类-第11版作为一个单独的“儿童实体”酒精中毒,一种疾病。目前没有市售的支持临床疗效的宿醉治疗。此外,医疗保健专业人员之间存在不同的观点,政策制定者,和酒精消费者关于开发这种治疗的必要性和可取性。
    Recently, the alcohol hangover has been accepted by the International Classification of Diseases - 11th revision as a separate \'child entity\' to alcohol intoxication, a disease. Currently there are no marketed hangover treatments with support for clinical efficacy. Furthermore, diverse perspectives exist among healthcare professionals, policymakers, and alcohol consumers regarding the necessity and desirability of developing such treatments.
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  • 文章类型: Journal Article
    目的:我们检查了五类当天饮酒意向和意愿的饮酒和后果,并测试了当天动机和保护策略是否预测了不同意向和意愿类别的结果差异。
    方法:在为期14周的生态瞬时评估设计中,本科生参与者(N=196)每周进行13次调查(4次上午调查[周四至周日];3次中午,早期,和深夜调查[周四至周六])。平均而言,参与者为20.61岁(SD=1.50;范围17-25),63%被确认为女性(n=124),29%为男性(n=57),8%的人既不是男性也不是女性(n=15;即,非二元;变性人;性别同性恋;agender)。参与者报告了晚上(过去2小时)和早上(前一天)的饮料消耗数量调查。多层次广义线性模型测试了饮酒意愿/意愿类别的影响,动机,保护策略,以及几个模型中酒精使用的关键变量和后果之间的相互作用。
    结果:在计划饮酒日,饮酒率和饮酒量最高,尤其是当学生打算喝醉时。当增强和社会动机被提升时,即使在计划外的饮酒日,学生也更有可能喝酒和喝更多的饮料,尤其是与他人交往时。应对动机的影响较弱且稀疏。减少危害的保护策略与更积极和消极的后果相关,在计划内和计划外饮酒日几乎没有变化。
    结论:共同考虑饮酒意向和意愿缩小了学生饮酒中的意向行为差距,并提出了围绕负责任饮酒传达信息的潜在关注领域。(PsycInfo数据库记录(c)2024APA,保留所有权利)。
    OBJECTIVE: We examined alcohol use and consequences across five categories of same-day drinking intentions and willingness and tested whether same-day motives and protective strategies predicted differences in outcomes across categories of intentions and willingness.
    METHODS: In a 14-week ecological momentary assessment design, undergraduate student participants (N = 196) reported drinking intentions and behaviors over 13 surveys weekly (four morning surveys [Thursday through Sunday]; three midday, early, and late evening surveys [Thursday through Saturday]). On average, participants were 20.61 years old (SD = 1.50; range 17-25), 63% identified as female (n = 124), 29% as male (n = 57), and 8% identified as neither male nor female (n = 15; i.e., nonbinary; transgender; genderqueer; agender). Participants reported numbers of drinks consumed on the evening (past 2 hr) and morning (previous day) surveys. Multilevel generalized linear models tested effects of drinking intentions/willingness categories, motives, protective strategies, and interactions between key variables on alcohol use and consequences in several models.
    RESULTS: Rates and quantities of drinking were highest on planned drinking days, and especially high when students planned to get drunk. When enhancement and social motives were elevated, students were more likely to drink and consumed more drinks even on unplanned drinking days, and especially when socializing with others. Effects of coping motives were weaker and sparse. Harm reduction protective strategies were associated with more positive and negative consequences with little variation across planned and unplanned drinking days.
    CONCLUSIONS: Jointly considering drinking intentions and willingness narrows the intention-behavior gap in student drinking and suggests potential areas of focus for messaging around responsible drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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  • 文章类型: Case Reports
    一名41岁有高血压病史的黑人男性发生车祸,之后他表现出说话缓慢和不连贯等症状,不稳定的步态,头晕,困倦,缓慢思考,四肢失去了力量.尽管多次酒精测试呈阴性,他的症状模仿急性酒精中毒。在向急诊室介绍时,体格检查和脑成像显示右前丘脑缺血性梗死。两天后他完全康复,没有后遗症。该病例强调了将中风作为与酒精中毒症状相似的患者的鉴别诊断的重要性。特别是在高血压个体中。
    A 41-year-old Black male with a history of hypertension was involved in a car accident, after which he exhibited symptoms such as slow and incoherent speech, unstable gait, dizziness, drowsiness, slow thinking, and loss of strength in his limbs. Despite multiple negative alcohol tests, his symptoms mimicked those of acute alcohol intoxication. Upon presentation to the emergency room, physical examination and brain imaging revealed a right anterior thalamic ischemic infarction. He was discharged completely recovered after two days without sequelae. This case underscores the importance of considering stroke as a differential diagnosis in patients presenting with symptoms similar to alcohol intoxication, particularly in hypertensive individuals.
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  • 文章类型: Journal Article
    肝脏是负责乙醇代谢的主要器官,由于氧化应激导致的组织损伤而遭受严重损害。已知C60富勒烯能够有效地捕获和灭活体内和体外系统中的活性氧。因此,这项研究的目的是确定水溶性C60富勒烯是否降低慢性酒精中毒3、6和9个月大鼠肝脏病理过程发展的水平,取决于在整个实验中C60富勒烯的日剂量(口服给药;0.5、1和2mg/kg)。在这种情况下,用原子力显微镜研究了C60富勒烯纳米颗粒在水溶液中的形貌。实验动物血液的生化参数如ALT(丙氨酸氨基转移酶),AST(天冬氨酸转氨酶),GGT(γ-谷氨酰转移酶)和ALP(碱性磷酸酶)酶活性,CDT(碳水化合物缺乏转铁蛋白)水平,促抗氧化剂平衡指标的值(H2O2(过氧化氢)和GSH(还原型谷胱甘肽)的浓度,CAT(过氧化氢酶)的活性,SOD(超氧化物歧化酶)和GPx(硒依赖性谷胱甘肽过氧化物酶),并对肝损伤的病理组织学和形态学特征进行分析。研究的生化参数中最显著的积极变化(相对于对照高达29±2%),作为肝损伤的标志,在酒精(饮用水中40%乙醇)和水溶性C60富勒烯以1mg/kg的最佳剂量联合给药时记录,大鼠肝脏的小组织病理学改变证实了这一点。获得的结果证明了C60富勒烯作为强效抗氧化剂的预期用途,可缓解长期酒精中毒引起的肝脏病理状况。
    The liver is the main organ responsible for the metabolism of ethanol, which suffers significantly as a result of tissue damage due to oxidative stress. It is known that C60 fullerenes are able to efficiently capture and inactivate reactive oxygen species in in vivo and in vitro systems. Therefore, the purpose of this study is to determine whether water-soluble C60 fullerene reduces the level of pathological process development in the liver of rats induced by chronic alcohol intoxication for 3, 6, and 9 months, depending on the daily dose (oral administration; 0.5, 1, and 2 mg/kg) of C60 fullerene throughout the experiment. In this context, the morphology of the C60 fullerene nanoparticles in aqueous solution was studied using atomic force microscopy. Such biochemical parameters of experimental animal blood as ALT (alanine aminotransferase), AST (aspartate aminotransferase), GGT (gamma-glutamyl transferase) and ALP (alkaline phosphatase) enzyme activities, CDT (carbohydrate-deficient transferrin) level, values of pro-antioxidant balance indicators (concentrations of H2O2 (hydrogen peroxide) and GSH (reduced glutathione), activities of CAT (catalase), SOD (superoxide dismutase) and GPx (selenium-dependent glutathione peroxidase)), and pathohistological and morphometric features of liver damage were analyzed. The most significant positive change in the studied biochemical parameters (up to 29 ± 2% relative to the control), as markers of liver damage, was recorded at the combined administration of alcohol (40% ethanol in drinking water) and water-soluble C60 fullerenes in the optimal dose of 1 mg/kg, which was confirmed by small histopathological changes in the liver of rats. The obtained results prove the prospective use of C60 fullerenes as powerful antioxidants for the mitigation of pathological conditions of the liver arising under prolonged alcohol intoxication.
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  • 文章类型: Journal Article
    背景:酒精中毒是一个重要的全球性问题,已成为一种流行病。因此,确定酒精类型至关重要,因为它可能会影响治疗过程;但是,除乙醇外,没有针对酒精类型的常规实验室诊断方法。在这项研究中,我们的目的是通过结合呼吸测醉器和分光光度法测定的血清乙醇结果来定义一种简单的酒精类型区分方法。
    方法:使用呼吸测醉器和分光光度法测量四种不同类型的酒精:乙醇,异丙醇,甲醇,和乙二醇。进行血清酒精分析,创建了四个血清池,每种都含有不同类型的酒精。使用分光光度法和酶促乙醇测试试剂盒分析池。使用浸渍棉和气球进行了一项实验,以测量不同类型的酒精,模拟酒精测试。基于测量创建算法。
    结果:根据结果,如果呼吸测醉器测试表明读数为阳性且血液乙醇测量为阴性,则消耗的物质可能是甲醇或异丙醇。如果呼吸测醉器和血液测量结果都是阴性,该物质可能是乙二醇。
    结论:这种简单的方法可以确定甲醇或异丙醇的摄入量。这种简单而创新的方法可以帮助不同领域的医疗保健专业人员诊断酒精中毒,更确切地说,有助于降低相关的发病率和死亡率。
    BACKGROUND: Alcohol poisoning is a significant global problem that has become an epidemic. The determination of the alcohol type is hereby essential as it may affect the course of the treatment; however, there is no routine laboratory diagnostic method for alcohol types other than for ethanol. In this study, we aimed to define a simple method for alcohol type differentiation by utilizing a combination of breathalyzer and spectrophotometrically measured serum ethanol results.
    METHODS: A breathalyzer and spectrophotometry were used to measure four different types of alcohol: ethanol, isopropanol, methanol, and ethylene glycol. To conduct serum alcohol analysis, four serum pools were created, each containing a different type of alcohol. The pools were analyzed using the spectrophotometric method with an enzymatic ethanol test kit. An experiment was conducted to measure the different types of alcohol using impreg-nated cotton and a balloon, simulating a breathalyzer test. An algorithm was created based on the measurements.
    RESULTS: Based on the results, the substance consumed could be methanol or isopropanol if the breathalyzer test indicates a positive reading and if the blood ethanol measurement is negative. If both the breathalyzer and the blood measurements are negative, the substance in question may be ethylene glycol.
    CONCLUSIONS: This simple method may determine methanol or isopropanol intake. This straightforward and innovative approach could assist healthcare professionals in different fields with diagnosing alcohol intoxication and, more precisely, help reducing related morbidity and mortality.
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  • 文章类型: Journal Article
    在SPF雄性近交ICR小鼠的研究中,测试了乙基甲基羟基吡啶琥珀酸酯(EMHPS)在急性酒精中毒中的有效性。以4g/kg的剂量对动物腹膜内施用乙醇(浓度40%)一次。对照动物注射等体积的盐水。在酒精给药后15分钟,以50或100mg/kg的剂量静脉内或肌内注射EMHPS,或通过相同的途径以相等的体积注射生理盐水.在施用所述物质后3和24小时测试动物行为。3和24小时后,病理对照组中的小鼠出现半下垂,步态和翻身反射受损,着陆时后肢的力量下降,后肢之间的距离增加;在野外测试中,第一次运动的延迟增加了,饲养姿势的数量减少。以50和100mg/kg的剂量静脉和肌肉内施用EMHPS在急性酒精中毒中具有明显的抗毒和神经保护作用:所有研究的参数与对照组没有显着差异。
    The effectiveness of ethylmethylhydroxypyridine succinate (EMHPS) in acute alcohol intoxication was tested in a study on SPF male outbred ICR mice. Ethanol (concentration 40%) was administered to animals once intraperitoneally at a dose of 4 g/kg. Control animals were injected with saline in an equivalent volume. In 15 min after the administration of alcohol, the animals were injected intravenously or intramuscularly with EMHPS at a dose of 50 or 100 mg/kg or with saline via the same route in an equivalent volume. Animal behavior was tested 3 and 24 h later after administration of the substances. After 3 and 24 h, mice in the pathological control groups developed semiptosis, the gait and the turning over reflex were impaired, the strength of the hind limbs decreased and the distance between the hind limbs increased when landing; in the open-field test, the latency of the first movement increased, and the number of rearing postures decreased. Intravenous and intramuscular administration of EMHPS in doses of 50 and 100 mg/kg had a pronounced antitoxic and neuroprotective effect in acute alcohol intoxication: all studied parameters did not differ significantly from the control.
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  • 文章类型: Case Reports
    背景横纹肌溶解症,选择性5-羟色胺再摄取抑制剂(SSRI)抗抑郁药的罕见但公认的不良反应,可以诱发急性肾损伤(AKI),特别是与饮酒等危险因素相结合时。该报告描述了一名68岁的男性,在服用低剂量艾司西酞普兰时,由于与酒精中毒相关的横纹肌溶解而导致急性肾功能衰竭,SSRI抗抑郁药.病例报告病人,有双相情感障碍病史的艾司西酞普兰治疗,出现全身不适的症状,腹泻,肌痛,以及大量消耗乙醇后短暂的意识丧失。实验室检查提示严重的横纹肌溶解症,肌酸激酶水平为37672U/L,肌红蛋白水平>5710ng/ml,导致AKI诊断。停用依他普仑,除了补水和肾脏替代疗法,促进肾脏恢复。然而,艾司西酞普兰的重新引入导致横纹肌溶解的复发,暗示了可能的因果关系,使用Naranjo药物不良反应概率量表进行确认。结论本报告强调了确定急性肾功能衰竭和横纹肌溶解症患者的用药史以及与SSRIs的相关性的重要性。酒精会加剧这种情况。该病例强调了对AKI和横纹肌溶解症患者进行警惕用药史评估的重要性。特别是关于使用SSRIs如艾司西酞普兰,这在饮酒的背景下可能会带来更高的风险。它强调了在管理长期SSRI治疗患者时需要临床谨慎,尤其是在横纹肌溶解症发作后重新引入此类药物时。
    BACKGROUND Rhabdomyolysis, an uncommon but recognized adverse effect of selective serotonin reuptake inhibitor (SSRI) antidepressants, can precipitate acute renal injury (AKI), especially when combined with risk factors such as alcohol consumption. This report describes a 68-year-old man with acute renal failure due to rhabdomyolysis associated with alcohol intoxication while taking low-dose escitalopram, an SSRI antidepressant. CASE REPORT The patient, with a history of bipolar affective disorder managed with escitalopram, presented with symptoms of general malaise, diarrhea, myalgias, and transient loss of consciousness following substantial ethanol consumption. Laboratory tests indicated severe rhabdomyolysis with a creatine kinase level of 37 672 U/L and myoglobin level >5710 ng/ml, leading to an AKI diagnosis. The discontinuation of escitalopram, along with hydration and renal replacement therapy, facilitated renal recovery. However, the reintroduction of escitalopram resulted in the recurrence of rhabdomyolysis, suggesting a probable causal link, confirmed using the Naranjo Adverse Drug Reaction Probability Scale. CONCLUSIONS This report highlights the importance of identifying the medication history in patients presenting with acute renal failure and rhabdomyolysis and the association with SSRIs, which can be exacerbated by alcohol. This case underscores the importance of vigilant medication history assessment in patients presenting with AKI and rhabdomyolysis, particularly concerning the use of SSRIs like escitalopram, which can pose heightened risks in the context of alcohol use. It highlights the need for clinical caution in managing patients on long-term SSRI therapy, especially when reintroducing such medications after an episode of rhabdomyolysis.
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  • 文章类型: Case Reports
    背景技术乙醇中毒非常常见,几种形式的酒精中毒会导致急诊就诊。过量饮酒,当退出时,可能会寻求替代酒精饮料;乙醇的常见来源之一是洗手液,其中含有45-95%的酒精。当酒精使用障碍患者在医院内寻找这些替代产品时,处理他们变得更具挑战性,自COVID-19大流行以来,医疗诊所和医院增加了乙醇基洗手液的使用。案例报告我们报告了一名26岁的酒精依赖男子,患有虚构的疾病,导致急诊科(ED)入院和使用乙醇基洗手液。患者最初报告严重腹痛,尽管药物治疗,但仍持续。最初的实验室检查和影像学检查无统计学意义。病人后来被抓到偷洗手液瓶,在4-6小时内食用它们。COVID-19大流行增加了酒精中毒,尤其是在ED。洗手液,包括乙醇,被滥用时是有毒和危险的,主要是青少年和年轻人。治疗包括葡萄糖测定,葡萄糖输注,和硫胺素灌注。减少酒精中毒的策略包括消除洗手液,使用墙壁固定的消毒剂,和使用消毒湿巾。结论已知患有酒精使用障碍的患者会出现寻求酒精的行为。这份报告强调,医疗保健专业人员应该意识到,乙醇基洗手液的可用性增加,其中一些含有有毒的抗病毒化学剂,可能是酒精依赖者的目标。
    BACKGROUND Ethanol intoxication is very common, and several forms of alcohol intoxication can lead to emergency department visits. Excessive alcohol users, when in withdrawal, might seek replacement alcoholic beverages; one of the common sources of ethanol is hand sanitizer, which contains 45-95% alcohol. It becomes even more challenging to deal with alcohol use disorder patients when they seek these replacement products inside hospital premises, and medical clinics and hospitals have increased their use of ethanol-based hand sanitizer since the start of the COVID-19 pandemic. CASE REPORT We report the case of a 26-year-old man with alcohol dependence presenting with a fictitious illness leading to hospital admission and consumption of ethanol-based hand sanitizer in the emergency department (ED). The patient initially presented reporting severe abdominal pain that persisted despite medications. The initial laboratory tests and imaging were non-significant. The patient was later caught stealing hand sanitizer bottles, consuming them within 4-6 h. The COVID-19 pandemic has increased alcohol intoxication, especially in EDs. Hand sanitizers, including ethanol, are toxic and hazardous when misused, mostly by adolescents and young adults. Treatments include glucose determination, dextrose infusion, and thiamine perfusion. Strategies to reduce ethanol intoxication include eliminating hand sanitizers, using wall-fixed sanitizers, and using sanitizer wipes. CONCLUSIONS Patients with alcohol use disorder are known to develop alcohol-seeking behaviors. This report has highlighted that healthcare professionals should be aware that the increased availability of ethanol-based hand sanitizers, some of which contain toxic antiviral chemical agents, may be targeted by individuals with alcohol dependency.
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