Fatal alcohol poisoning: medico-legal practices and mortality statistics

Lahti, R.A; Vuori, Erkki

doi:10.1016/s0379-0738(02)00057-9

Cited by 40 publications

(31 citation statements)

References 10 publications

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“…This trend is completely different from that found in other countries, where alcohol, illegal drugs or CO are involved in most fatal poisoning cases [9][10][11]30,32]. However, this is typical for the Brazilian case, as reported in other data sources [29,33].…”

Section: Discussioncontrasting

confidence: 81%

“…During this period, 13 cases fatal cases were reported to the Toxicological Information and Assistance Center of the Federal District [12] and the Brazilian Mortality System contains only 7 deaths classified as ICD-10:X48 (accidental poisoning by or exposure to pesticides) in the region [33]. Underreporting of fatal poisonings in the compiled ICD statistics compared with medicolegal statements based on forensic toxicological examinations has also been reported in Finland [32].…”

Section: Discussionmentioning

confidence: 99%

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Postmortem data related to drug and toxic substance use in the Federal District, Brazil, from 2006 to 2008

Campelo¹,

Caldas²

2010

Forensic Science International

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Section: Discussioncontrasting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Postmortem data related to drug and toxic substance use in the Federal District, Brazil, from 2006 to 2008

Campelo¹,

Caldas²

2010

Forensic Science International

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“…All MR data presented, including decreased tissue water T2, thalamic diffusivity, NAA, and increased Cho, along with relations among these variables and their reversibility with recovery, can be reconciled with a process in which transient, high BALs cause redistribution of water in the brain and compensatory ventriculomegaly. We acknowledge that the average BALs of B292 mg/dl achieved in this animal model are more common among experienced than inexperienced users of alcohol (Lahti and Vuori, 2002). We nevertheless believe it is important to understand what might explain the profound and reversible ventricular enlargement we observed following a single cycle of binge EtOH treatment and recovery before studying a more complex model including repeated binge EtOH exposure cycles.…”

Section: Discussionmentioning

confidence: 87%

A Mechanism of Rapidly Reversible Cerebral Ventricular Enlargement Independent of Tissue Atrophy

Zahr

Mayer

Rohlfing

et al. 2013

Neuropsychopharmacol

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Ventricular enlargement, a common in vivo marker of aging, disease, and insult, is presumed to reflect atrophy of surrounding brain regions. Pathological mechanisms underlying ventricular enlargement, however, are likely specific to the condition under investigation. Here, multimodal imaging, incorporating structural magnetic resonance imaging (MRI), MR spectroscopy (MRS), and diffusion weighted imaging (DWI), was used in rats exposed to binge ethanol (EtOH) to provide insight into a mechanism of reversible ventricular enlargement. During intoxication, MRI revealed expansion of ventricles, but volume changes in dorsal or ventral hippocampi, caudateputamen, or thalamus were not detectible. MRS of whole-brain parenchyma showed decreases in N-acetylasparate (NAA) and tissue water T2, and increases in choline-containing compounds (Cho). DWI showed decreased diffusivity selective to the thalamus. All MR parameters returned to baseline with 7 days of recovery. Rapid recovery of ventricular volume and the absence of detectable tissue volume reductions in brain regions adjacent to ventricles argue against atrophy as a mechanism of ventricular expansion. Decreased tissue water T2 and decreased thalamic diffusivity suggest lower tissue water content and a role for both NAA and Cho, as osmolytes is proposed. Together, these data support a model of fluid redistribution during acute EtOH intoxication and recovery to account for rapid ventricular volume changes.

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“…Measurement of ethanol is one of the most routine analyses in forensic examinations and blood ethanol concentrations have been well characterized to evaluate possible toxic concentrations. A fatal blood concentration is generally said to be more than 3.5 mg/ml [1], but this varies between cases [2][3][4][5]. Liquor that contain high proof of ethanol, such as vodka or spirits, have strong effects and are able to quickly achieve high blood concentrations.…”

Section: Introductionmentioning

confidence: 99%