Isopropyl alcohol pad use for blood ethanol sampling does not cause false-positive results

This was a retrospective analysis of prospective data collected from a study of blood ethanol levels after the use of the alcohol-based hand sanitizer (ABHS). A total of 5 male volunteers were enrolled. Eight of the 10 total blood ethanol level measurements were drawn after skin preparation with Kendall WEBCOL Alcohol Preps (APP) containing 70% isopropyl alcohol. All had an initial and post-ABHS application blood alcohol level (BAL) drawn, for a total of 10 BAL measurements. Measurements upon completion of the study were <5 mg/dL in all 5 study participants and in each of the 10 blood draws regardless of skin preparation technique. This study demonstrates that the use of isopropyl skin prep pads is unlikely to cause significant false-positive blood ethanol levels.     

Tracking Inner City Substance Users from the Emergency Department: How Many Contacts Does It Take?

Background: Longitudinal studies of substance users report difficulty in locating and completing 12‐month interviews, which may compromise study validity. Objectives: This study examined rates and predictors of contact difficulty and in‐person follow‐up completion among patients presenting with cocaine‐related chest pain to an inner‐city emergency department (ED). The authors hypothesize that less staff effort in contacting patients and lower follow‐up rates would bias subsequent substance use analysis by missing those with heavier substance misuse. Methods: A total of 219 patients aged 19 to 60 years (65% males; 78% African American) with cocaine‐related chest pain were interviewed in the ED and then in person at 3, 6, and 12 months. Demographics, substance use measures, and amount/type of research staff contacts (telephone, letters, home visits, and locating patient during return ED visits) were recorded. Poisson and negative binomial regression analyses were conducted to predict quantity of patient contacts for the 12‐month follow‐up. Results: Interview completion rates at 3, 6, and 12 months were 78, 82, and 80%, respectively. Average contact attempts to obtain each interview were 10 at 3 months (range 3–44), 8 at 6 months (1–31), and 8 at 12 months (1–49); 13% of patients required a home visit to complete the 12‐month interview. Participants requiring more contact attempts by staff were younger and reported more frequent binge drinking at baseline (p < 0.05), but were less likely to meet criteria for substance abuse or dependence (p < 0.5), or to report prior mental health treatment (p < 0.05). Comparisons of parallel regressions predicting contact difficulty based on the entire sample, the low‐effort group, and the difficult‐to‐reach group showed variation in findings. Conclusions: This study demonstrates that substantial staff effort is required to achieve adequate retention over 12 months of patients with substance misuse. Without these extensive efforts at follow‐up, longitudinal analyses may be biased.     

Women and alcohol: misrepresented and misunderstood

Women's use of alcohol has been increasing over the last few decades. The physical, psychological and social effects of alcohol are more severe for women than for men. The underlying causes of women's drinking differ from those of men, which poses a challenge to nurses working in the specialist field of alcohol misuse. This article explored women's relationship with alcohol and treatment services, and identified that these treatment services are not specific to women's needs. To conclude, in order to offer women sensitive services, practitioners need knowledge of gender issues.     

臭牡丹根正丁醇提取物镇痛作用的研究

目的:研究臭牡丹根正丁醇提取物对疼痛小鼠的影响。方法:化学方法制备臭牡丹根正丁醇提取物。镇痛试验中,采用扭体实验和热板法,在热板法中小鼠分别注射臭牡丹正丁醇与纳洛酮或吗啡与纳洛酮,探测药物对不良刺激的延迟时间。炎性疼痛试验中,采用角叉菜胶诱发大鼠脚趾肿胀模型,前列腺素类含量的测定通过紫外可见光分光光度法,经过0.5mol/L氢氧化钾甲醇溶液,在50℃的温度中为异构后,在波长为278nm处检测。结果:腹腔注射臭牡丹提取物,发现能明显抑制0.6%醋酸诱发疼痛(P<0.01),在热板法中,在给臭牡丹药15分钟、30分钟、60分钟、90分钟后小鼠明显延长对不良刺激反应时间。实验表明同时给予臭牡丹提取物与纳洛酮15分钟、30分钟、60分钟、90分钟后小鼠明显延长对不良刺激反应时间,提示纳洛酮不能翻转其镇痛作用。在抗炎试验中,臭牡丹提取物呈剂量依赖性地抑制由角叉菜胶诱发炎性肿胀的前列腺素生成。结论:臭牡丹正丁醇提取物具有镇痛作用,该作用阿片受体无关,与抑制前列腺素合成有关。     

呋喃唑酮厌恶疗法戒酒疗效观察

目的观察呋喃唑酮厌恶疗法戒酒的疗效和安全性。方法将90例酒精依赖患者随机分为厌恶治疗组和对照组,各45例,厌恶治疗组予呋喃唑酮厌恶疗法戒酒,对照组采取一般对症支持治疗,比较厌恶治疗组患者饮酒前后血压、脉搏、呼吸的变化。出院后随访1年,比较两组患者的戒酒成功率。结果呋喃唑酮厌恶疗法组患者的戒酒成功率高于对照组(P<0.05),并且呋喃唑酮厌恶疗法具有较好的安全性。结论呋喃唑酮厌恶疗法戒酒有较好的疗效和安全性。     

A Survey of Oregon Emergency Physicians to Assess Mandatory Reporting Knowledge and Reporting Patterns Regarding Intoxicated Drivers in the State of Oregon

Objectives: To assess emergency physician reporting patterns in Oregon before and after the passage of a mandatory intoxicated driving reporting law. Methods: A one‐page survey was mailed to 504 emergency physicians in Oregon in April 2004. Data on reporting frequency were collected using a four‐point ordinal scale regarding motor vehicle crash–involved drivers (MIDs) and intoxicated persons attempting to drive away from the emergency department (DAEDs). Paired observations were assessed for a stated increase in reporting activity following passage of the law using the Wilcoxon signed‐rank test. Associations of postlaw reporting and demographic and knowledge factors were sought using Spearman rank correlation analysis. Results: Of the 504 surveys mailed, 298 (59%) were adequate for analysis. Many respondents (57%) were already aware of the law. Most (92%) agreed that physicians should be mandated to report some crimes. MIDs were always reported by 18% of physicians before the law and by 47% afterward, whereas DAEDs were always reported by 56% of physicians before the law and by 69% afterward. Emergency medicine–trained physicians, higher emergency department census, and increased years of experience were associated with a significantly higher increase in reporting pattern after passage of the law for both MIDs and DAEDs. Conclusions: Although 44% of responding emergency physicians in Oregon were unaware of a mandated reporting law for intoxicated drivers presenting to the ED, most physicians stated an increase in their reporting practice.     

Genome‐wide and digital polymerase chain reaction epigenetic assessments of alcohol consumption

The lack of readily employable biomarkers of alcohol consumption is a problem for clinicians and researchers. In 2014, we published a preliminary DNA methylation signature of heavy alcohol consumption that remits as a function of abstinence. Herein, we present new genome‐wide methylation findings from a cohort of additional subjects and a meta‐analysis of the data. Using DNA from 47 consecutive heavy drinkers admitted for alcohol detoxification in the context of alcohol treatment and 47 abstinent controls, we replicate the 2014 results and show that 21,221 CpG residues are differentially methylated in active heavy drinkers. Meta‐analysis of all data from the 448,058 probes common to the two methylation platforms shows a similarly profound signature with confirmation of findings from other groups. Principal components analyses show that genome‐wide methylation changes in response to alcohol consumption load on two major factors with one component accounting at least 50% of the total variance in both smokers and nonsmoking alcoholics. Using data from the arrays, we derive a panel of five methylation probes that classifies use status with a receiver operator characteristic area under the curve (AUC) of 0.97. Finally, using droplet digital polymerase chain reaction (PCR), we convert these array‐based findings to two marker assays with an AUC of 0.95 and a four marker set AUC of 0.98. We conclude that DNA methylation assessments are capable of quantifying alcohol use status and suggest that readily employable digital PCR approaches for substance consumption may find widespread use in alcohol‐related research and patient care.     

不同量乙醇对家兔血液流变指标的影响

目的观察不同量乙醇对家兔血液流变指标的影响。方法静注乙醇,按每公斤体重累加注入500mL.L-1浓度乙醇0.5g/kg、1.0g/kg、1.5g/kg三个实验组,造成不同量乙醇注入的动物模型,注入乙醇15min后颈静脉抽血,分别测定其血液流变指标变化情况。结果随着乙醇量的加大,高切还原粘度降低,低切还原粘度降低,红细胞刚性指数降低,血沉稍变慢。红细胞聚集指数、血沉方程K值和血浆粘度值基本不变。结论不同乙醇量对血液流变指标有不同程度的改变。