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Acute intoxication by neurotropic agents in pediatric setting: a monocentre observational study. Eur J Emerg Med 2023; 30:55-57. [PMID: 36542340 DOI: 10.1097/mej.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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2
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Yuen WS, Leung J, Man N, Chiu V, Gisev N, Livingston M, Degenhardt L, Farrell M, Pearson SA, Dobbins T, Dunlop A, Mattick RP, Peacock A. Age at first alcohol-related hospital separation or emergency department presentation and rate of re-admission: A retrospective data linkage cohort of young Australians. Drug Alcohol Rev 2022; 41:1577-1588. [PMID: 36054167 DOI: 10.1111/dar.13529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 07/20/2022] [Accepted: 08/01/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Alcohol is a leading risk factor for death and disease in young people. We compare age-specific characteristics of young people who experience their first ('index') alcohol-related hospitalisation or emergency department (ED) presentation, and whether age at index predicts 12-month rates of readmission. METHODS We used a retrospective linked-data cohort of 10,300 people aged 12-20 years with an index alcohol-related hospital and/or ED record in New South Wales, Australia from 2005 to 2013. Age group (early adolescent [12-14 years], late adolescent [15-17 years], young adult [18-20 years]) and diagnosis fields were used in logistic regression analyses and to calculate incidence rates with adjustment for year of index event, sex, socioeconomic disadvantage and residence remoteness. RESULTS People who experienced their index event in early adolescence (adjusted relative risk ratio [ARRR] 0.45 [95% confidence interval 0.39, 0.52]) or late adolescence (ARRR 0.82 [0.74, 0.90]) were less likely to be male compared to young adults. Early adolescents (ARRR 0.60 [0.51, 0.70]) and late adolescents (ARRR 0.84 [0.76, 0.93]) were less likely to have a hospitalisation index event. Early adolescents (adjusted incidence rate ratio 1.40 [1.15, 1.71]) and late adolescents (adjusted incidence rate ratio 1.16 [1.01, 1.34]) were more likely than young adults to have a subsequent 12-month non-poisoning injury ED presentation. DISCUSSION AND CONCLUSIONS We identified preventable hospital events in young people who have previously experienced an alcohol-related ED presentation or hospitalisation, with age-specific characteristics and outcomes that can be used to inform future health policy and service planning.
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Affiliation(s)
- Wing S Yuen
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Janni Leung
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Nicola Man
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Vivian Chiu
- National Centre for Youth Substance Use Research, The University of Queensland, Brisbane, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia.,Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | | | | | - Adrian Dunlop
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - Richard P Mattick
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.,School of Psychological Sciences, University of Tasmania, Hobart, Australia
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Odeta K, Auge L, Rokas S, Vankeviciene R, Dervinyte-Bongarzoni A, Sigita L. Clinical and Social Characteristics of Deliberately Intoxicated Minors Treated in Pediatric Intensive Care. Clin Med Insights Pediatr 2021; 15:11795565211029258. [PMID: 34349583 PMCID: PMC8287355 DOI: 10.1177/11795565211029258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of the study was to determine and compare the clinical and social characteristics of minors using alcohol and drugs for inebriation, and the same for those using them for suicide. METHODS This study includes an analysis of case histories of adolescents hospitalized in the Pediatric Intensive Care Unit because of acute alcohol or/and drug intoxication in 2015 to 2017. Two groups (group I: inebriation, and group II: suicide) were compared on age, sex, severity of intoxication, used substances, presence of other self-harm evidence, and social status. RESULTS A total of 390 cases were registered: 78.21% in Group I and 21.79% in Group II. The Glasgow-Coma-Scale scores showed that patients from Group I were more severely intoxicated, with an average score of 11.47, whereas patients from Group II averaged 13.45 (P < .001). Self-harm was more prominent among minors from Group II, with an incidence of up to 65.09%. The most common substance used to become inebriated was alcohol (72.79%), and for committing suicide was medication (88.24%). Patients who were living in children's care homes composed 13.33% of all cases included into the study, despite the low frequency of these minors in Lithuania (0.8%). CONCLUSIONS The substance used for deliberate intoxication was mostly alcohol. Minors experiencing inebriation were hospitalized in worse clinical condition in comparison to those who had attempted suicide. Other signs of self-harm were significantly more common among suicidal minors. Living in children's care homes is a possible risk factor for deliberate intoxication among young people in Lithuania.
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Affiliation(s)
- Kinciniene Odeta
- Vilnius University Faculty of Medicine,
Vilnius, Lithuania
- Institute of Clinical Medicine,
Vilnius, Lithuania
- Clinic of Children’s Diseases, Vilnius,
Lithuania
| | | | - Sambaras Rokas
- Vilnius University Faculty of Medicine,
Vilnius, Lithuania
| | - Ramune Vankeviciene
- Vilnius University Faculty of Medicine,
Vilnius, Lithuania
- Institute of Clinical Medicine,
Vilnius, Lithuania
- Clinic of Children’s Diseases, Vilnius,
Lithuania
| | - Asta Dervinyte-Bongarzoni
- Vilnius University Faculty of Medicine,
Vilnius, Lithuania
- Institute of Clinical Medicine,
Vilnius, Lithuania
- Clinic of Psychiatry, Vilnius,
Lithuania
| | - Lesinskiene Sigita
- Vilnius University Faculty of Medicine,
Vilnius, Lithuania
- Institute of Clinical Medicine,
Vilnius, Lithuania
- Clinic of Psychiatry, Vilnius,
Lithuania
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Croese EM, Hoof JJV. Alcohol Intoxication and Psychological Problems Among Adolescents. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2020. [DOI: 10.1080/1067828x.2020.1789524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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5
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Trends of Hospitalization for Acute Alcohol Intoxication in Slovenian Children and Adolescents with and without Dual Disorder. Implications for a Correct Intervention. J Clin Med 2020; 9:jcm9072122. [PMID: 32640558 PMCID: PMC7408642 DOI: 10.3390/jcm9072122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/29/2020] [Accepted: 07/02/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Binge drinking and other forms of ethanol abuse are, when present, a serious problem in preteens and adolescents worldwide. Aim: The present study has analyzed the trend in alcohol-related intoxications requiring the hospitalization of children, adolescents and young adults aged less than 21 years in Slovenia in the 1999–2018 period. Methods: We performed a retrospective study on patients discharged after hospitalizations due to mental and behavioral disorders due to acute alcohol intoxication (MBDAAI) or hospitalizations due to the toxic effects of alcohol (TEA We considered three groups: children (aged 10–14), adolescents (aged 15–19) and young adults (20–21 years old). Hospitalization rates and time trends were analyzed using joinpoint regression to obtain the annually calculated age- and sex-specific rates and the annual percentage of change (APC). Results: Considering a total of 2912 MBDAAI-hospitalizations, 15–19-year-old subjects showed a significantly higher hospitalization rate compared to the immediately younger and older age groups and a significant increase in hospitalization rates in the period 1999–2011, followed by a significant decrease. Considering 1143 TEA-hospitalizations, we observed a continuous decrease in the hospitalization rates for children and young adults and, conversely, a continuous even if less than significant increase for adolescents aged 15–19. Conclusions: Alcohol consumption in Slovenian children and adolescents is a highly important health concern. Special attention to public health problem of severe alcohol abuse requiring hospitalization in children and adolescents is needed, especially with possible crisis of SARS-CoV-2/Covid-19 situation.
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de Wit N, Nagelhout GE, Meerkerk GJ, Ooms J, Le Net-van Bruggen AP, Gruppen M, Lasham C, van Loon M, van de Mheen D. Drinking until Intoxication: A Qualitative Study among Underage Adolescents Admitted to the Emergency Room. ALCOHOLISM TREATMENT QUARTERLY 2019. [DOI: 10.1080/07347324.2019.1693314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Gera E. Nagelhout
- Department of Health Promotion and department of Family Medicine, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | | | - Johanna Ooms
- Department of Emergency Medicine, Erasmus MC, Rotterdam, The Netherlands
| | | | - Mariken Gruppen
- Department of Pediatric Nephrology, Emma Children’s Hospital, Academic Medical Centre, Amsterdam, The Netherlands
| | - Carole Lasham
- Pediatrics department, Tergooi Hospital, Blaricum, The Netherlands
| | - Merel van Loon
- Emergency Department, Haaglanden Medical Center, The Hague, The Netherlands
| | - Dike van de Mheen
- Tranzo Scientific Center for Care and Welfare, Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Acker A, Norris ML, Coo H, Santos A, Allain D, Dow K. Severe alcohol intoxication among Canadian Youth: A 2-year surveillance study. Paediatr Child Health 2019; 26:e82-e88. [PMID: 33747315 DOI: 10.1093/pch/pxz152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/23/2019] [Indexed: 11/14/2022] Open
Abstract
Purpose To obtain data on Canadian youth, aged 11 to 15 years, presenting to paediatric emergency departments, with severe alcohol intoxication and to describe demographics, presentations to hospital, concurrent substance use, comorbidities, and short-term outcomes of admission to emergency departments. Methods Between March 2013 and February 2015, through the established methodology of the Canadian Paediatric Surveillance Program, Canadian paediatricians and paediatric subspecialists were surveyed monthly to identify cases of young adolescents presenting to paediatric emergency departments across Canada with severe alcohol intoxication. Those that identified cases were subsequently sent a detailed questionnaire. The detailed questionnaires were then screened to ensure the reported cases met the study's inclusion criteria. Results A total of 39 cases (18 females and 21 males) were included in the final analysis. Overall, results indicate over 90% of presenting youth had consumed spirits, 39% had concurrent substance use and 46% experienced serious medical morbidity. Almost two-thirds of youth were admitted to hospital for a period ranging from 10 hours to 5 days; 12 youth required intubation. Follow-up referrals were provided to two-thirds of youth, with variable supports given. No statistically significant differences between sexes were noted for blood alcohol level or concurrent substance use. Conclusion Although rates of alcohol use in adolescents have been steadily decreasing, results from this surveillance study suggest that severe intoxication arising from the use of alcohol alone, and with concurrent substance use, results in significant immediate health consequences in young adolescents. Results from this study also highlight characteristics of patients, initial treatments and initial referrals across Canadian paediatric healthcare facilities, the results of which highlight variability and may aid in the guidance of a future longitudinal study, prevention strategies, and public health messaging.
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Affiliation(s)
- Amy Acker
- Department of Pediatrics, Queen's University, Kingston, Ontario
| | - Mark L Norris
- Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Helen Coo
- Department of Pediatrics, Queen's University, Kingston, Ontario
| | - Alexandre Santos
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario
| | - Dominic Allain
- Department of Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, Alberta
| | - Kimberly Dow
- Department of Pediatrics, Queen's University, Kingston, Ontario
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Trefan L, Gartner A, Alcock A, Farewell D, Morgan J, Fone D, Paranjothy S. Epidemiology of alcohol-related emergency hospital admissions in children and adolescents: An e-cohort analysis in Wales in 2006-2011. PLoS One 2019; 14:e0217598. [PMID: 31163052 PMCID: PMC6548373 DOI: 10.1371/journal.pone.0217598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 05/14/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Harmful levels of alcohol consumption in young people are prevalent and of increasing public concern in the western world. Rates of alcohol-related emergency hospital admissions in children and young people between 10 to 17 years were described, and the reasons for these admissions and their association with socio-demographic factors were examined. METHODS E-cohort data were extracted from the Secure Anonymised Information Linkage Databank, which contained alcohol-related emergency hospital admissions (N = 2968) from 2006 to 2011 in children and adolescents aged 10 to 17 years in Wales. A generalised linear mixed model was fitted using a log-link with a population offset to the data to calculate incident rate ratios (IRRSs). RESULTS There was a general decreasing trend from 2006 to 2011 in the number and rate of alcohol-related emergency hospital admissions; the mean age of admission was 15.4 (standard deviation 1.4) years. In each of the four youngest age groups (10-13,14,15,16 years), females had higher IRRs than males. Males had slightly higher IRR compared to females only in the oldest age group (17 years). IRRs increased with increasing deprivation. The majority (92%) of the admissions lasted one day and most of the admissions (70%) occured during the last three days of the week with a peak on Saturday. The length of stay in hospital was longer in cases when self-harm were present. Multiple admissions showed high prevalance of serious self-harm cases in females. The number of admissions with injuries and falls were higher for males than females. CONCLUSION Female children and adolescents were more likely to be admitted to hospital for alcohol-related reasons. These data illustrate the significant burden of alcohol-related harm in young people and highlight the need for interventions and policies that promote safe drinking practices among young people to prevent future alcohol-related harm during the life-course.
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Affiliation(s)
- Laszlo Trefan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Andrea Gartner
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Amy Alcock
- Royal Gwent Hospital, Newport, United Kingdom
| | - Daniel Farewell
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | | | - David Fone
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Shantini Paranjothy
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, United Kingdom
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Vanschoenbeek GM, Hautekiet T, Calle S, Cornelis C, François H, Hautekiet A, Sundahl N, De Paepe P, Devriese D, De Graeve K, Damen J, Calle P. Alcohol-related emergency department admissions in an elderly population. Acta Clin Belg 2019; 74:194-199. [PMID: 29916305 DOI: 10.1080/17843286.2018.1482039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Alcohol abuse remains a major health concern. This study aimed to describe the characteristics of alcohol-related emergency department (ED) admissions in an elderly population. METHODS Between 1 September 2013 and 31 August 2014, we retrospectively analyzed patient charts of patients admitted with a blood alcohol concentration (BAC) of at least 0.5 g/L to the EDs of all five hospitals in two distinct areas. We focused on the population ≥65 years, divided in three subgroups (65-74, 75-84 and ≥85, respectively) and compared them to the 55-64 year group. RESULTS Of the 3918 included patients 645 (16.5%) were between 55 and 64, and 406 (10.4%) were ≥65 years (65-74: 267, 6.8%; 75-84: 128, 3.3%; ≥85: 11, 0.3%). The male-to-female ratio ranged between 2.1:1 and 2.7:1. BACs decreased with increasing age. In all age groups the majority of patients (71.0-77.8%) were transported by emergency medical services. The chief presenting complaint was trauma and its relative importance increased with age. Contextual factors consisted mostly of chronic abuse (43.1-57.8%). Most frequently patients could be discharged within 24 h, although hospital admission rates increased with age. CONCLUSION Our study shows that alcohol-related ED admissions in the elderly are common, but less frequent than in younger age groups. More (preferentially prospective) studies are needed to give more insight in the living environment, prescription medication, socioeconomic cost, etc. Nonetheless, it is clear that a national action plan should be developed to tackle the alcohol abuse problem in all age groups.
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Affiliation(s)
| | - Thor Hautekiet
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Simon Calle
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Charlotte Cornelis
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Heleen François
- Emergency Department, Nikolaas General Hospital, Sint-Niklaas, Belgium
| | - Arne Hautekiet
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Nora Sundahl
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter De Paepe
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Emergency Department, University Hospital, Ghent, Belgium
| | - Dieter Devriese
- Emergency Department, Sint Lucas General Hospital, Ghent, Belgium
| | - Koen De Graeve
- Emergency Department, Jan Palfijn General Hospital, Ghent, Belgium
| | - Jorn Damen
- Emergency Department, Nikolaas General Hospital, Sint-Niklaas, Belgium
| | - Paul Calle
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Emergency Department, Maria Middelares General Hospital, Ghent, Belgium
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Alcohol-related Emergency Department Visits Among Adolescents and Young Adults in Sherbrooke, Canada. CANADIAN JOURNAL OF ADDICTION 2018. [DOI: 10.1097/cxa.0000000000000033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vrkić Boban I, Vrca A, Saraga M. Changing Pattern of Acute Alcohol Intoxications in Children. Med Sci Monit 2018; 24:5123-5131. [PMID: 30036885 PMCID: PMC6067040 DOI: 10.12659/msm.908841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background In many countries, the number of children hospitalized for alcohol intoxication is increasing. This study analyzed changes in the number of hospitalizations for alcohol intoxication in children aged 0–18 years at the Department of Pediatrics, University Hospital of Split, from 2008 to 2015. Material/Methods Data were collected retrospectively from hospital medical records. Risk groups were classified according to sex, age, drinking habits, and possible benefits of early psychological or psychiatric interventions. Children were divided into 4 age groups: 0–5 years, 6–9 years, 10–13 years, and 14–18 years. Statistics 12.00 was used for statistical analyses, with P-value <0.05 considered as statistically significant. Results Out of 24 651 hospitalized children, 488 were treated for acute intoxication: 36.40% were girls and 63.60% were boys. Among them, 272 children (55.74%) were acutely intoxicated with alcohol, with the average age of 15.95 years and the average blood alcohol concentration of 2.00%. The proportion of children hospitalized for alcohol intoxication decreased from 1.33% in 2008 to 0.75% in 2015. Alcohol intoxications occurred in most cases outside children’s homes (92.42%, P=0.001), and on weekends and holidays (81.62%). Among all intoxicated children, 17 children (6.25%) were positive for drugs. A total of 51.29% of children received psychological support (58.59% of girls and 47.09% of boys). Conclusions In this study, the number of children hospitalized for alcohol intoxication decreased, possibly as a result of preventive, educational, and psychotherapeutic measures or changing drinking habits. Acute alcohol intoxication was most common in the group of children aged 14 to 18 years, and a significant number of these children were positive for drugs, thus, further preventive interventions should be provided.
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Affiliation(s)
- Ivona Vrkić Boban
- Department of Pediatrics, University Hospital of Split, Split, Croatia
| | - Andjelko Vrca
- School of Medicine, University of Mostar, Mostar, Bosnia and Herzegovina
| | - Marijan Saraga
- Department of Pediatrics, University Hospital of Split, Split, Croatia.,School of Medicine, University of Split, Split, Croatia
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Kabíček P, Kobr J, Šašek L, Obdržálková Z, Svitálková L, Hůrková V, Zeman J. Alcohol and drug intoxications in adolescents admitted to paediatric wards in the Czech Republic: 5-year retrospective study 2006-2010. Cent Eur J Public Health 2018; 26:39-44. [PMID: 29684296 DOI: 10.21101/cejph.a4644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/06/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to establish frequency, severity and circumstances of alcohol and drug intoxications in adolescents admitted to inpatient wards in the Czech Republic. METHODS Chief physician of each participating ward (or their designated deputy) searched the patient records for required information. The data was then statistically processed. RESULTS Thirty inpatient paediatric wards participated in the study (27 district wards and 3 university hospital wards), amounting to more than a third of all paediatric wards in the country. The total number of intoxications reported was 2,176, the majority of which were alcohol-related (84.5%), followed by cannabinoids and, to a lesser degree, amphetamines. The number of alcohol intoxications increased by 22% during the 5-year observation period, whilst the frequency of illegal drugs intoxications remained the same. We also observed an increase in the percentage of alcohol intoxications in girls - from 42% to 45.5%. The mean age at intoxication was low - 15.5 years. The Glasgow Coma Scale in individual episodes of intoxication increased during the study duration/follow up period. The proportion of alcohol intoxications originating in pubs, clubs or other public institutions was 25%. CONCLUSION The number of alcohol intoxications has risen during the observation period. The age at which these intoxications occurred is very low. Of serious concern is the fact, that 25% of alcohol intoxications originated in places where alcohol is sold, despite the fact that majority of the adolescents were under the legal drinking age limit of 18 years.
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Affiliation(s)
- Pavel Kabíček
- Department of Paediatrics, Thomayer Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiří Kobr
- Department of Paediatrics, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Lumír Šašek
- Department of Paediatrics, Faculty of Medicine, Charles University, Pilsen, Czech Republic
| | - Zita Obdržálková
- Department of Paediatrics, Faculty Hospital Ostrava, Ostrava, Czech Republic
| | - Ludmila Svitálková
- Department of Paediatrics, District Hospital of T. Bata, Zlín, Czech Republic
| | - Věra Hůrková
- Department of Paediatrics, District Hospital of T. Bata, Zlín, Czech Republic
| | - Jiří Zeman
- Department of Paediatrics, General Faculty Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
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Thijssen MA, de Boo GM, Plötz FB. Single episode of alcohol intoxication in adolescents has no long-term psychosocial effects. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1430198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Maartje A. Thijssen
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, the Netherlands
| | - Gerly M. de Boo
- Department of Medical Psychology, Tergooi Hospitals, Blaricum, the Netherlands
| | - Frans B. Plötz
- Department of Paediatrics, Tergooi Hospitals, Blaricum, the Netherlands
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Lamy L, Fischer-Lokou J, Guéguen N. With a Little Help From Adults: Positive Emotion as an Excuse for Underage Drinking. BASIC AND APPLIED SOCIAL PSYCHOLOGY 2017. [DOI: 10.1080/01973533.2017.1351973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Puuskari V, Aalto-Setälä T, Komulainen E, Marttunen M. Low self-esteem and high psychological distress are common among depressed adolescents presenting to the Pediatric Emergency Department. Scand J Child Adolesc Psychiatr Psychol 2017. [DOI: 10.21307/sjcapp-2017-004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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[Psychosocial Characteristics of Adolescents Treated for Alcohol Intoxication in Emergency Departments]. Prax Kinderpsychol Kinderpsychiatr 2016; 65:516-33. [PMID: 27595810 DOI: 10.13109/prkk.2016.65.7.516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Psychosocial Characteristics of Adolescents Treated for Alcohol Intoxication in Emergency Departments In Germany, every year a substantial number of adolescents is treated in emergency departments for acute alcohol intoxication. Until now, only few studies have been published investigating psychosocial aspects in this group of adolescents. In the present study 316 adolescents were surveyed in the emergency department regarding their problematic use of alcohol and illicit drugs, their patterns of alcohol consumption, their alcohol-related and mental problems. We reported results for the whole sample. Additionally, the sample was divided in two groups based on the result in an established screening instrument for problematic alcohol use (CRAFFT-d). To compare the two groups we conducted unpaired t tests, chi-square tests and logistic regression analyses. Compared to the other group the adolescents exceeding the cut-off value of the CRAFFT-d reported a statistically significant higher past 30-day binge drinking frequency and number of standard-drinks consumed on a typical drinking occasion, more alcohol-related problems, more frequently a problematic use of illicit drugs and more mental problems (regarding antisocial behavior, anger control problems and self-esteem). Antisocial behavior was the most important factor for the affiliation to one of the two groups. The application of the screening instrument for problematic alcohol use (CRAFFT-d) in the emergency department seems to be a promising approach to identify adolescents with a general higher psychosocial burden.
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Wurdak M, Wolstein J, Kuntsche E. Effectiveness of a drinking-motive-tailored emergency-room intervention among adolescents admitted to hospital due to acute alcohol intoxication - A randomized controlled trial. Prev Med Rep 2016; 3:83-9. [PMID: 26844193 PMCID: PMC4733092 DOI: 10.1016/j.pmedr.2015.12.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study is to develop and test the effectiveness of a drinking-motive-tailored intervention for adolescents hospitalized due to alcohol intoxication in eight cities in Germany between December 2011 and May 2012 against a similar, non-motive-tailored intervention. In a randomized controlled trial, 254 adolescents received a psychosocial intervention plus motive-tailored (intervention group; IG) or general exercises (control group; CG). Adolescents in the IG received exercises in accordance with their drinking motives as indicated at baseline (e.g. alternative ways of spending leisure time or dealing with stress). Exercises for the CG contained alcohol-related information in general (e.g. legal issues). The data of 81 adolescents (age: M = 15.6, SD = 1.0; 42.0% female) who participated in both the baseline and the follow-up were compared using ANOVA with repeated measurements and effect sizes (available case analyses). Adolescents reported lower alcohol use at the four-week follow-up independently of the kind of intervention. Significant interaction effects between time and IG were found for girls in terms of drinking frequency (F = 7.770, p < 0.01) and binge drinking (F = 7.0005, p < 0.05) but not for boys. For the former, the proportional reductions and corresponding effect sizes of drinking frequency (d = - 1.18), binge drinking (d = - 1.61) and drunkenness (d = - 2.87) were much higher than the .8 threshold for large effects. Conducting psychosocial interventions in a motive-tailored way appears more effective for girls admitted to hospital due to alcohol intoxication than without motive-tailoring. Further research is required to address the specific needs of boys in such interventions. (German Clinical Trials Register, DRKS ID: DRKS00005588).
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Affiliation(s)
- Mara Wurdak
- University of Bamberg, Germany, Markusplatz 8a, 96047 Bamberg, Germany
| | - Jörg Wolstein
- University of Bamberg, Germany, Markusplatz 8a, 96047 Bamberg, Germany
| | - Emmanuel Kuntsche
- University of Bamberg, Germany, Markusplatz 8a, 96047 Bamberg, Germany
- Sucht Schweiz, Research Institute, Switzerland, Av. Ruchonnet 14, 1001 Lausanne, Switzerland
- Behavioural Science Institute, University of Nijmegen, The Netherlands
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18
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Smith CC, Guévremont D, Williams JM, Napper RMA. Apoptotic cell death and temporal expression of apoptotic proteins Bcl-2 and Bax in the hippocampus, following binge ethanol in the neonatal rat model. Alcohol Clin Exp Res 2016; 39:36-44. [PMID: 25623404 DOI: 10.1111/acer.12606] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 10/03/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Binge-like ethanol (EtOH) exposure during the early rat neonatal period results in acute cell loss in specific brain regions, but such acute cell death has not been well established in the hippocampus. Binge alcohol exposure can also result in protein expression changes in the cerebellum that could alter cell fate, but this has not been reported for the hippocampal subregions. This study investigates acute apoptotic cell death in hippocampal regions CA1, CA3, and dentate gyrus (DG) following a binge EtOH exposure on postnatal day (PN) 6, PN8, or PN6 + 8 and the alteration in pro- and anti-apoptotic proteins following a single EtOH binge on PN6. METHODS Apoptotic cell death was quantified 12 hours after EtOH binge exposure using the optical fractionator method. Western blot analysis determined expression of pro-apoptotic Bax and anti-apoptotic Bcl-2, 12, 24, and 48 hours after binge EtOH exposure on PN6. The Bcl-2:Bax ratio was used as a measure of vulnerability to apoptosis. RESULTS Acute apoptosis increased significantly 12 hours following PN6 or 8 EtOH exposure in CA1, CA3, and DG, but the magnitude of apoptotic cell death was significantly greater in CA1 than in CA3 and DG, which did not differ. Significant cell death was not detected when a PN8 EtOH exposure was preceded by exposure on PN6. Binge EtOH exposure on PN6 resulted in a significant increase in expression of Bcl-2 and the Bcl-2:Bax ratio in the CA1/DG region at 24 hours after EtOH exposure on PN6. The Bcl-2:Bax ratio in the CA3 region was not altered. CONCLUSIONS This study shows that repeated binge exposure does not have a cumulative effect on the magnitude of acute apoptotic cell death. This finding may be explained in part by changes in the Bcl-2:Bax ratio after a single binge EtOH exposure.
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Affiliation(s)
- Caine C Smith
- Department of Anatomy, University of Otago, Dunedin, New Zealand
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Groß C, Reis O, Kraus L, Piontek D, Zimmermann US. Long-term outcomes after adolescent in-patient treatment due to alcohol intoxication: A control group study. Drug Alcohol Depend 2016; 162:116-23. [PMID: 26996744 DOI: 10.1016/j.drugalcdep.2016.02.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Revised: 02/21/2016] [Accepted: 02/24/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND The long-term psychosocial development of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) is largely unknown. METHODS We invited all 1603 AIAs and 641 age- and sex-matched controls, who had been hospitalized in one of five pediatric departments between 2000 and 2007, to participate in a telephone interview. 277 cases of AIA and 116 controls (mean age 24.2 years (SD 2.2); 46% female) could be studied 5-13 years (mean 8.3, SD 2.3) after the event. The control group consisted of subjects who were admitted due to conditions other than alcohol intoxication. Blood alcohol concentration on admission was systematically measured in the AIA but, owing to the retrospective study design, not in the control group. Subtle alcohol intoxication could therefore not be entirely ruled out in the control group. Long-term outcome measures included current DSM-5 alcohol use disorders (AUD), drinking patterns, illicit substance use, regular smoking, general life satisfaction, use of mental health treatment, and delinquency. RESULTS AIA had a significantly elevated risk to engage in problematic habitual alcohol use, to exhibit delinquent behaviors, and to use illicit substances in young adulthood compared to the control group. Severe AUD also occurred considerably more often in the AIA than the control group. CONCLUSIONS In the majority of AIAs, further development until their mid-twenties appears to be unremarkable. However, their risk to develop severe AUD and other problematic outcomes is significantly increased. This finding calls for a diagnostic instrument distinguishing between high- and low-risk AIAs already in the emergency room.
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Affiliation(s)
- Cornelius Groß
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Olaf Reis
- Clinic for Child and Adolescent Psychiatry, University Medicine Rostock, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Parzivalstr. 25, 80804 Munich, Germany; Centre for Social Research on Alcohol and Drugs, SoRAD, Stockholm University, Sveavägen 160, 10691 Stockholm, Sweden
| | - Daniela Piontek
- IFT Institut für Therapieforschung, Parzivalstr. 25, 80804 Munich, Germany
| | - Ulrich S Zimmermann
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
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Binder C, Knibbe K, Kreissl A, Repa A, Thanhaeuser M, Greber-Platzer S, Berger A, Jilma B, Haiden N. Does acute alcohol intoxication cause transaminase elevations in children and adolescents? Alcohol 2016; 51:57-62. [PMID: 26992701 DOI: 10.1016/j.alcohol.2015.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 11/29/2015] [Accepted: 12/08/2015] [Indexed: 02/07/2023]
Abstract
Several long-term effects of alcohol abuse in children and adolescents are well described. Alcohol abuse has severe effects on neurodevelopmental outcome, such as learning disabilities, memory deficits, and decreased cognitive performance. Additionally, chronic alcohol intake is associated with chronic liver disease. However, the effects of acute alcohol intoxication on liver function in children and adolescents are not well characterized. The aim of this study was to determine if a single event of acute alcohol intoxication has short-term effects on liver function and metabolism. All children and adolescents admitted to the Department of Pediatrics and Adolescent Medicine between 2004 and 2011 with the diagnosis "acute alcohol intoxication" were included in this retrospective analysis. Clinical records were evaluated for age, gender, alcohol consumption, blood alcohol concentration, symptoms, and therapy. Blood values of the liver parameters, CK, creatinine, LDH, AP, and the values of the blood gas analysis were analyzed. During the 8-year study period, 249 children and adolescents with the diagnosis "acute alcohol intoxication" were admitted, 132 (53%) girls and 117 (47%) boys. The mean age was 15.3 ± 1.2 years and the mean blood alcohol concentration was 0.201 ± 0.049%. Girls consumed significantly less alcohol than boys (64 g vs. 90 g), but reached the same blood alcohol concentration (girls: 0.199 ± 0.049%; boys: 0.204 ± 0.049%). The mean values of liver parameters were in normal ranges, but AST was increased in 9.1%, ALT in 3.9%, and γGT in 1.4%. In contrast, the mean value of AST/ALT ratio was increased and the ratio was elevated in 92.6% of all patients. Data of the present study showed significant differences in the AST/ALT ratio (p < 0.01) in comparison to a control group. Data of the present study indicate that there might be an effect of acute alcohol intoxication on transaminase levels. The AST/ALT ratio seems to reflect the damage in hepatocytes after intensive alcohol consumption. The present study indicates a sex-specific difference in alcohol metabolism and effects between girls and boys: girls need less alcohol than boys to achieve the same blood alcohol levels than boys, and are more prone to loss of consciousness.
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Diestelkamp S, Kriston L, Arnaud N, Wartberg L, Sack PM, Härter M, Thomasius R. Drinking patterns of alcohol intoxicated adolescents in the emergency department: A latent class analysis. Addict Behav 2015; 50:51-9. [PMID: 26101078 DOI: 10.1016/j.addbeh.2015.06.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 04/27/2015] [Accepted: 06/04/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The increasing number of children and adolescents in need of emergency medical treatment following acute alcohol intoxication has been a major public health concern in Europe in recent years. However, little is known about drinking habits and associated risks in this population. To our knowledge, this is the first study to examine drinking patterns and associated risks in adolescent emergency department patients following alcohol intoxication. The aim of this study is to establish a classification system for admitted adolescents METHODS Latent class analysis was used to identify subgroups of adolescents with distinct patterns of habitual drinking as defined by the quantity of consumed alcohol on a typical drinking occasion, frequency of binge drinking and drunkenness, alcohol-related problems, prior alcohol-related hospitalizations and alcohol-related risk behaviors. Subgroup characteristics were examined with regard to sociodemographics, other substance use and psychosocial problems using analysis of variance (ANOVA) and chi-square tests. RESULTS A total of 316 adolescents aged 12-17 treated in 6 urban emergency departments in Germany were analyzed. Five classes of drinking patterns were identified: one class representing low-risk drinking (class 1 "low-risk" (61.2%)), two classes representing risky drinking (class 2 "moderate-risk" (5.7%) and class 3 "frequent drunk" (15.8%)), as well as two classes representing high-risk drinking (class 4 "alcohol-related problems" (11.4%) and class 5 "excessive drinking" (5.1%)). Membership of classes 4 and 5 was associated with the most severe psychosocial problems, especially with regard to aggressive-dissocial behaviors. The CRAFFT-d and brief RAPI screening tools allowed identifying the two risky drinking classes and two high-risk drinking classes. CONCLUSIONS Our findings provide the first in-depth analysis of habitual drinking in this study population and may help practitioners to better tailor interventions to patients' needs by using the identified classes as a form of classification system for admitted adolescents.
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Calle P, Hautekiet A, François H, Sundahl N, Cornelis C, Calle S, Damen J, Vanbrabant P, De Turck B, De Graeve K, Mpotos N, De Paepe P. Alcohol-related emergency department admissions among adolescents in the Ghent and Sint-Niklaas areas. Acta Clin Belg 2015; 70:345-9. [PMID: 25984783 DOI: 10.1179/2295333715y.0000000031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Alcohol abuse is a major health concern. The aim of this retrospective study was to analyse the alcohol-related emergency department (ED) admissions among adolescents in all hospitals of distinct areas during a 1-year period. In each hospital, all ED patients with a blood alcohol concentration (BAC) of at least 0.5 g/l were surveyed in a standardised way. Of the 3918 included patients, only 146 (3.7%) were < 18 years. The male-to-female ratio was 1.5:1. There was a strong preponderance of weekend and night time admissions. Most of the patients were transported by ambulance (77% of 138 patients with information on this item). The main reason for ED admittance was depressed level of consciousness (64%), trauma (12%), vomiting and/or abdominal pain (12%), agitation or aggression (4%), syncope (4%) and psychological problems (4%). The context of the alcohol intoxication was related to some kind of festivity in 85%, mental problems in 14% and chronic abuse in 1%. Median BAC values (and range) were 2.08 g/l (0.73-3.70 g/l) for boys and 1.51 g/l (0.73-2.90 g/l) for girls. Most patients (87%) could be discharged home within 24 hours. Our study confirms that problematic alcohol use leading to ED admissions starts in adolescence. Although the numbers of cases below 18 years are low when compared to adults, the phenomenon is alarming as it is associated with substantial health problems. Therefore, Belgium urgently needs a global national alcohol plan, with youngsters being one of the target groups.
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Affiliation(s)
- P Calle
- Emergency Department, Maria Middelares General Hospital , Ghent, Belgium
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23
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Groß C, Kraus L, Piontek D, Reis O, Zimmermann US. Prediction of Long-Term Outcomes in Young Adults with a History of Adolescent Alcohol-Related Hospitalization. Alcohol Alcohol 2015; 51:47-53. [PMID: 26113489 DOI: 10.1093/alcalc/agv072] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 05/31/2015] [Indexed: 11/15/2022] Open
Abstract
AIMS Empirical data concerning the long-term psychosocial development of adolescents admitted to inpatient treatment with alcohol intoxication (AIA) are lacking. The aim of this study was to identify the factors that, at the time of admission, predict future substance use, alcohol use disorders (AUD), mental health treatment, delinquency and life satisfaction. METHODS We identified 1603 cases of AIA treated between 2000 and 2007 in one of five pediatric departments in Germany. These former patients were invited to participate in a telephone interview. Medical records were retrospectively analyzed extracting potential variables predicting long-term outcomes. RESULTS Interviews were conducted with 277 individuals, 5-13 [mean 8.3 (SD 2.3)] years after treatment, with a response rate of 22.7%; of these, 44.8% were female. Mean age at the interview was 24.4 (SD 2.2) years. Logistic and linear regression models revealed that being male, using illicit substances and truancy or runaway behavior in adolescence predicted binge drinking, alcohol dependence, use of illicit substances and poor general life satisfaction in young adulthood, explaining between 13 and 24% of the variance for the different outcome variables. CONCLUSIONS This naturalistic study confirms that known risk factors for the development of AUD also apply to AIA. This finding facilitates targeted prevention efforts for those cases of AIA who need more than the standard brief intervention for aftercare.
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Affiliation(s)
- Cornelius Groß
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich 80804, Germany Centre for Social Research on Alcohol and Drugs, SoRAD, Stockholm University, Stockholm 10691, Sweden
| | | | - Olaf Reis
- Clinic for Child and Adolescent Psychiatry, University Medicine of Rostock, Rostock 18147, Germany
| | - Ulrich S Zimmermann
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany
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van Hoof JJ, van Zanten E, van der Lely N. Four Years of Reports of Alcohol-Related Harm to Pediatricians in the Netherlands. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2015. [DOI: 10.1080/1067828x.2013.803943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Wurdak M, Kuntsche E, Kraus L, Wolstein J. Effectiveness of a brief intervention with and without booster session for adolescents hospitalized due to alcohol intoxication. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.951415] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mara Wurdak
- Institute for Psychology, University of Bamberg, Kempten, Germany,
| | - Emmanuel Kuntsche
- Addiction Switzerland, Research Institute, Lausanne, Switzerland,
- Behavioural Science Institute, University of Nijmegen, Nijmegen, The Netherlands,
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, München, Germany, and
- Centre for Social Research on Alcohol and Drugs, SoRAD, Stockholm University, Stockholm, Sweden
| | - Jörg Wolstein
- Institute for Psychology, University of Bamberg, Kempten, Germany,
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Tõnisson M, Tillmann V, Kuudeberg A, Lepik D, Väli M. Acute alcohol intoxication characteristics in children. Alcohol Alcohol 2013; 48:390-5. [PMID: 23632804 DOI: 10.1093/alcalc/agt036] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIMS To describe clinical, mental and physical signs in children with different severity acute alcohol intoxication (AAI) determined either by serum alcohol concentration (SAC) or by blood alcohol concentration (BAC) to study the diagnostic performance characteristics of clinical assessment and to establish the ratio of SAC:BAC in children. METHODS Data were analysed from 256 children aged 8.4-17.9 years who were hospitalized at Estonia's two children's hospitals over a 3-year period. In each case, the on-call paediatrician completed a special form about the clinical, mental (consciousness, balance and speech) and physical (muscle tone, blood pressure, pulse and body temperature) signs of AAI. Blood samples were drawn for measurements of SAC and BAC. Diagnostic performance characteristics (sensitivity, specificity, efficiency) of the clinical assessments and the SAC:BAC ratio were calculated. RESULTS The most correctly described signs in children in different SAC groups were consciousness (rs = 0.16) and speech (rs = 0.13) (P < 0.0001). The severity of alteration of consciousness and degrees of disturbance in balance and speech were positively correlated with SAC (P < 0.001). The clinical judgment matched better with AAI determined by SAC rather than by BAC with the mean efficiency. The mean ratio between SAC and BAC was 1.19 ± 0.13 (P < 0.001) in children. CONCLUSION The level of consciousness is the leading sign in the clinical evaluation of children with AAI and correlates well with SAC. The severity of AAI judged by clinical assessment matched better with AAI severity stages determined by SAC than by BAC. For legal cases where BAC is required, the SAC:BAC ratio of 1.19:1 should be used in children regardless of their gender or age.
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Affiliation(s)
- Mailis Tõnisson
- Department of Pathological Anatomy and Forensic Medicine, University of Tartu, Biomedicum, Ravila 19, Tartu, Estonia.
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Van Zanten E, Van der Ploeg T, Van Hoof JJ, Van der Lely N. Gender, Age, and Educational Level Attribute to Blood Alcohol Concentration in Hospitalized Intoxicated Adolescents; A Cohort Study. Alcohol Clin Exp Res 2013; 37:1188-94. [DOI: 10.1111/acer.12090] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 11/21/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Eva Van Zanten
- Department of Pediatrics ; Reinier de Graaf Hospital; Delft; The Netherlands
| | - Tjeerd Van der Ploeg
- Statistician at Foreest Medical School ; Alkmaar Medical Centre; Alkmaar; The Netherlands
| | - Joris J. Van Hoof
- Faculty of Behavioral Sciences; University of Twente; Enschede; The Netherlands
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van Hoof JJ, Mulder J, Korte J, Postel MG, Pieterse ME. Dutch adolescent private drinking places: prevalence, alcohol consumption, and other risk behaviors. Alcohol 2012; 46:687-93. [PMID: 22819120 DOI: 10.1016/j.alcohol.2012.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2011] [Revised: 07/09/2012] [Accepted: 07/10/2012] [Indexed: 11/15/2022]
Abstract
The aim of this research was to explore the increasingly popular Dutch health phenomenon of 'gathering in private peer group settings (barracks)', with a focus on the prevalence and characteristics of barracks, alcohol consumption, and other (risk) behaviors of their visitors. Three studies were conducted. The first consisted of field research in which 51 barracks were visited and group-interviews were held. The second was an Internet study in which 442 barracks' websites were analyzed using content analysis. The third consisted of a questionnaire completed by 1457 adolescents, aged 15-17, in order to explore differences in behavior between barracks visitors and non-visitors. There was wide variation in barracks' characteristics and culture. Barracks' members and visitors also organize diverse activities that are publicly shown on the websites. Barracks are associated with various legal issues, such as alcohol sales to minors, lack of parental supervision, and illicit drug use. Barracks' visitors drink alcohol more frequently, drink more alcohol per occasion (up to fifteen bottles of beer a night), and have been drunk more frequently than non-visitors. Policymakers must be aware of the barracks phenomenon and use their powers in adjacent political and legal areas (such as in binge drinking, illicit drug use, and public safety) to intervene and create solid, responsible, and tailor-made policies.
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Affiliation(s)
- Joris J van Hoof
- Faculty of Behavioral Sciences, University of Twente, AE Enschede, The Netherlands.
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Heavy alcohol consumption in children and adolescents: characteristics and gender differences. Eur J Pediatr 2011; 170:951-2; author reply 953-4. [PMID: 21424405 DOI: 10.1007/s00431-011-1448-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 03/03/2011] [Indexed: 10/18/2022]
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