Electrocardiogram Changes in Patients With Acute Ethanol Poisoning

Background: Alcohol consumption leads to a significant number of deaths, mostly in men, worldwide. Considering the effect of ethanol toxicity on the heart, we studied various Electrocardiographic (ECG) changes in patients with acute ethanol poisoning. Methods: A cross-sectional study was performed on patients admitted to Khorshid Hospital (affiliated to Isfahan University of Medical Sciences) due to ethanol poisoning. All 15- to 50-year-old patients with acute ethanol intoxication were included in the study (N=250). The patients’ information, including the demographic characteristics, clinical manifestations, and ECG changes were recorded and analyzed. Different variables were compared between the patients with or without ECG changes. Results: Most of the research patients (n=208) were men (83.82%). The Mean±SD age of the study patients was 26.8±8.87 years. About 54.8% of the patients presented abnormal ECG. The changes in ECG were not significantly different based on the demographic characteristic and clinical manifestations. The time interval between ethanol consumption and admission was significantly higher in patients with abnormal ECG, compared to those with normal ECG (Mean±SD: 7.09±10.67 vs. 4.77± 4.54 hours, respectively) (P=0.03). Conclusion: ECG changes are common in patients with ethanol poisoning. The time interval between ethanol consumption to hospital admission may be an important factor in the occurrence of ECG changes.

Morphometry of Cortical Neurons in Acute Clozapine and Ethanol Poisoning

The aim of the study is to summarize the histology and morphometry of cortical neurons in acute clozapine and ethanol poisoning.Material and methods. Histological examination of the parietal cortical brain samples of 26 patients died during the Day 1 of acute clozapine and ethanol poisoning (23 males and 3 females aged 22-63 years) was performed. The blood ethanol level was 1.4-4.1%o. The level of clozapine in the blood ranged between 0.24 and 5.8 mg%, in the liver between 0.097 and 6.5 mg%, in kidneys between 0.03 and 3.5 mg%. The cortical samples for morphometric examination were placed in 10% neutral paraformaldehyde, the histological sections were done and stained with hematoxylin and eosin, as well as according to Niessl. The morphological analysis was performed using the video light microscopy. The number of damaged neurons (with separate quantification of reversible, intermediate, and irreversible damage) was assessed. The statistical analysis was done using the non-parametric methods.Results. The signs of brain neuronal damage in acute clozapine and ethanol poisoning, as well as forensic chemical tests, might be used for establishing the direct cause of death.

HISTOMORPHOLOGICAL ALTERATIONS IN THE LUNGS IN ACUTE COMBINED BACLOFEN AND ETHANOL POISONING

A generic Baclofen, also known under the brand name of Lioresal, is a derivative of gamma-aminobutyric acid. Due to its psychotropic effect it is often used as a drug of abuse and for criminal poisoning. An experimental study was carried out on 5 Wistar rats (versus 5 intact rats of the control group) exposed to combined Baclofen (at a dose of 85 mg/kg) and ethanol (7 ml/kg of 40% ethanol) poisoning. We have identified a complex of pathological changes in the lungs of the rats in the early period after the experiment. The outcomes included circulatory disorders of the pulmonary microvasculature (plethora of capillaries, venules), emphysema, atelectasis and dystelectasis, infiltration of white blood cells into intraalveolar septa and thickening of intraalveolar septa due to edema. To quantify the severity of histomorphological changes in the lungs a morphometric study is required.

The Activity of N-acetyl-β-hexosaminidase in the Blood, Urine, Cerebrospinal Fluid and Vitreous Humor Died People Due to Alcohol Intoxication

Background: The article aimed to assess the activity of the hexosaminidase (HEX) and its HEX A and HEX B isoenzymes in persons who suddenly died due to ethanol poisoning and explain the cause of their death. Methods: The research involved two groups of the deceased group A—22 people (20 males, 2 females; the average age 46 years) who died due to alcohol intoxication (with the blood alcohol content of 4‰ and above in all biological materials at the time of death—blood, urine, cerebrospinal fluid, and vitreous humor), and group B—30 people (22 males, 8 females; the average age 54 years), who died suddenly due to other reasons than alcohol. Results: The highest activity of the HEX was found in the serum of A and B groups. A significantly lower activity of HEX, HEX A, and HEX B was observed in the urine of group A in comparison to the sober decedents. Conclusion: The lower activity of HEX and its isoenzymes in the dead’s urine due to ethanol poisoning may suggest its usefulness as a potential marker of harmful alcohol drinking. Damage done to the kidneys by ethanol poisoning may be one of the possible mechanisms leading to death. Kidneys may be damaged intravitally via the inflammatory agent. Thus, it is necessary to conduct further research to evaluate the diagnostic usefulness of exoglycosidases while determining the death mechanisms of people who lost their lives due to ethanol poisoning.

Effect of reconstituted glutathione preparations on bioelectric brain activity in severe ethanol poisoning

Fifty patients with acute severe ethanol poisoning (depression of consciousness at the time of admission was up to the level of coma) were examined. Based on the purpose of the study, patients were divided into two groups. In the first group, basic etiopathogenetic therapy was supplemented by the intravenous administration of a drug based on reduced glutathione: inosine glycyl-cysteinyl-glutamate disodium (IGCGD). In the second group, only basic therapy was performed. All patients underwent in the intensive care long-term continuous EEG monitoring, which was started at the end of basic resuscitation and stopped when the patient was clearly awake. Based on the nature of spontaneous EEG and reactivity, patients were divided into subgroups: patients with theta coma pattern and patients with delta coma pattern.It was found that the introduction of IGCGD in the treatment of severe ethanol poisoning in the group of patients with a reactive delta pattern significantly increased the rate of formation of awakening in the EEG: in the subgroup with basic therapy, the formation time of the awakening pattern was about 3 hours, and in the subgroup of patients to whom the drug was administered 1,5 hours. In the group of patients with depression of EEG to the level of theta coma, IGCGD had no effect on the time of formation of the EEG pattern of awakening. The inclusion of inosine IGCGD in the treatment of severe alcohol intoxication was not accompanied by more frequent formation of epileptiform activity in the EEG.

Principal characteristics of patients acutely poisoned by ethanol in the region of Belgrade (Serbia)

Background/Aim. Acute intoxication by ethanol constitutes a significant part of the acute pathology caused by toxic chemicals, which require medical care in specialized health care institutions. The aim of the study was to determine some principal characteristics of the patients treated after acute ethanol poisoning, such as: participation in the total number of patients treated after acute poisoning by all chemical agents, age, sex, severity of poisoning and capacities for ambulatory or hospital treatment. Methods. A five-year retrospective case study was conducted on 20,891 acute poisoned patients, of which 10,731 were treated after acute ethanol poisoning during the period 2011?2015. All the subjects satisfied the diagnostic criteria of poisoning according to the World Health Organization International Classification of Diseases-10 and standardized Poison Severity Score scale. Results. Monitored parameters were analyzed in 10,731 patients acutely poisoned by ethanol, and their average number during one study year was 2146.2 ? 437.95. The average number of treated patients due to poisoning by ethanol (51.47 ? 2.86%) was statistically significantly higher than that of other causes of acute poisoning (p < 0.001). The majority of poisoned patients were men, aged 19 to 65 years, with mild to moderate symptoms of acute ethanol intoxication. The highest number of patients poisoned by ethanol had Poison Severity Score 1 (70.25 ? 5.04%, p < 0.001). Very few acute poisoned with ethanol required hospital treatment (1.05%). Anticipated number of patients acutely poisoned by ethanol had high percentage of increase for the period 2016?2020 (slightly more than 20%), which is worrying, primarily due to their high absolute number. Conclusion. Acute alcohol poisoning represents a significant part of the pathology in the total number of patients treated due to acute poisoning with various chemical substances. The results of this analysis showed that certain populations are particularly vulnerable to abuse of alcohol to the level requiring health care (male population, age 19?65 years). Only a small number of patients (1% of all patients treated for acute alcohol poisoning) required clinical treatment. The obtained data provided the basis for a more targeted preventive action in certain population groups, as well as the adequate planning of professional medical staff engagement, material, spatial and other capacities. These data, also, provided the basis for additional detailed social, economic, health and other researches in this area as well as a more detailed registration of this type of poisoning and establishing a monitoring system and database.