Clinical Signs of Alcohol Intoxication and Importance of Blood Alcohol Concentration Testing in Alcohol Dependence.
Clinical signs of alcohol intoxication and importance of blood alcohol concentration testing in alcohol dependence.
Filed under: Addiction Rehab
Bratisl Lek Listy. 2013; 114(3): 136-9
Okruhlica L, Slezakova S
Objectives: The goal of the study was to find out if and what is a difference between clinical signs of alcohol intoxication (AI) and a detected blood alcohol concentration (BAC) among the patients with syndrome of alcohol dependence. Background: The relation between BAC and clinical assessment of AI is a complicated issue. People with dependence form a special group due to their altered tolerance to alcohol. Methods: Clinical, prospective study of 1,277 patients seeking treatment for alcohol-related problems. The average age was 43.1 (SD ± 11.8) years, 74 % males. Alcohol dependence and diagnosis of AI was done by a psychiatrist during a standard examination. This was followed by a laboratory testing for the presence of alcohol in the exhaled air calculated into BAC. The clinical and laboratory findings were compared in a descriptive and statistical way under codes Y 91 and Y 90 in accordance with the ICD-10/WHO diagnostic criteria. Results: The clinical signs of AI were found in 275 (22 %) patients. Of these, 57 (21 %) showed no presence of alcohol in blood laboratory testing. Alcohol was found in blood in 383 (30 %) patients, of whom 165 (43 %) did not show the clinical signs of AI. 21 % had no clinical signs of AI at BAC ? 2 ‰. Conclusions: Our findings showed that there was a substantial discrepancy between the clinical signs of AI and the detected BAC in people with dependence. These differences do not seem to result from insufficient diagnostic skills of the physicians but they are rather due to the non-specific nature of the signs, which can be of different etiology. Therefore, an enhanced diagnostic alertness and routine laboratory testing for the presence of alcohol is important, especially in the emergency and addiction medicine (Fig. 2, Ref. 19). Keywords: alcohol intoxication, alcohol dependence, tolerance, laboratory diagnostic, signs.
HubMed – addiction
Genotyping the Mu-Opioid Receptor A118G Polymorphism Using the Real-time Amplification Refractory Mutation System: Allele Frequency Distribution Among Brazilians.
Filed under: Addiction Rehab
Pain Pract. 2013 Feb 14;
Daher M, Costa FM, Neves FA
BACKGROUND: The mu-opioid receptor (OPRM1) A118G polymorphism has been associated with decreased analgesic effects of opioids and predisposition to addiction. However, its role in specific clinical scenarios and in different ethnicities must be better defined. No studies evaluating the A118G polymorphism in the Brazilian population have yet been published. METHODS: Genomic DNA was isolated from peripheral leukocytes of 200 surgical patients of the Center-West region of Brazil. Our genotyping protocol was developed based on the real-time amplification refractory mutation system and validated by comparison with cycle sequencing. Functional consequences of the A118G polymorphism were studied by comparing tobacco smoking prevalence and exposure between genotype groups. RESULTS: We observed perfect correlation between genotyping and sequencing results. Frequency of the G allele was 16% (IC 95% 12.7-19.9%) in our sample. Genotype distribution revealed 146 (73%) patients 118A homozygous, 44 (22%) heterozygous, and 10 (5%) homozygous for the G variant. After grouping patients according to the presence of the G allele, we did not observe differences in smoking prevalence; however, patients with one or two copies of the 118G allele reported higher tobacco exposure than patients 118A homozygous measured in pack-years (28.9 ± 12.5 vs. 21.5 ± 10.8, respectively, P = 0.02). CONCLUSIONS: We developed a fast and reliable genotyping method to identify the allele frequency distribution of the OPRM1 A118G polymorphism among patients from Center-West Brazil. Our preliminary results suggest functional consequences of the polymorphism on smoking behavior among Brazilians.
HubMed – addiction
[In Process Citation].
Filed under: Addiction Rehab
G Ital Med Lav Ergon. 2012 Jul-Sep; 34(3 Suppl): 469-70
Marano G
The specialist who is appointed by an employer as a competent physician in an occupational medicine service, has been charged of new public legal tasks, as a result of the changes introduced by Legislative Decree No. 81/08, setting him in a direct relationship with the National Health Service; in particular the Article 40 of decree 81 assigns a strategic role for prevention of new occupational diseases and injuries to the competent physician, as a primary source of epidemiological information, able to bring out “sentinel events” in the population of workers undergoing health surveillance, by the communication to the relevant public health services of combined aggregate data as required by Annex 3B. In a second step such information shall be processed and analyzed on a national scale by Italian Workers’Compensation Authority (INAIL), in order to improve the knowledge useful to a more effective and prompt prevention. The new possibility, introduced by Legislative Decree 106/09, to carry out pre-employment visits as a part of health surveillance, allows the competent physician to establish the fitness to the work of involved persons, a task that was previously assigned by law 300/70 to public bodies only, allowing him to check for alcohol and drug addiction at such stage too, provided the involvement of public health facilities of II level (referred to State/Regions Agreement of September 18, 2008) for relevant clinical examinations for verification purposes.
HubMed – addiction
[Drugs use assessment in a group of bus drivers].
Filed under: Addiction Rehab
G Ital Med Lav Ergon. 2012 Jul-Sep; 34(3 Suppl): 350-2
Maccà I, Maso S, Marcuzzo G, Bartolucci GB
Bus driver is one of those tasks inherent transport activity, which involves special risks to safety and health of others and for which it is necessary, according to art. 41 of Decree No. 81/08, to check the consumption of psychoactive substances during the health surveillance. This assumption was investigated in a group of 461 bus drivers of a large trucking company. In medical history, one subject reported a previous history of opiate addiction and another, in the past, occasional taking of cannabis, and at the time of the visit, in no cases the objectivity has shown intoxication or abstinence signs, or signs of parenteral injection. Laboratory tests were found positive in one case of screening texts, not confirmed by subsequent laboratory analysis and a case of positive analysis for confirmation. The worker, temporarily suspended from driving and taken over by the Service for Drug Addiction of competence, was then reinstated in his job, having held that the absence of drug addiction.
HubMed – addiction
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