scholarly journals Fatal Cardiovascular Collapse during Ethanol Sclerotherapy of a Venous Malformation

2002 ◽  
Vol 8 (3) ◽  
pp. 321-324 ◽  
Author(s):  
R. Chapot ◽  
A. Laurent ◽  
O. Enjolras ◽  
D. Payen ◽  
E. Houdart

We report a case of fatal cardiovascular collapse that occurred during Ethanol sclerotherapy of a venous malformation in a 21-year-old woman. The malformation was located on the anterior part of the thigh. Fifty ml of a mixture of Ethanol, Ethibloc and Lipiodol containing 35 ml of Ethanol (0.52 ml / kg) were injected under fluoroscopy. A major drop in arterial pressure was recorded after release of the tourniquet placed at the thigh root. The patient died after four hours of intensive cardiac reanimation. Her blood alcohol level was 0.4 g/l one hour after the end of the intervention. The cardiac toxicity of ethanol depends more on the potential acute venous contamination than on the blood alcohol concentration. The currently admitted “safety limit” of 1 ml/kg of bodyweight for ethanol sclerotherapy of venous malformations is certainly unsafe and must be redefined.

2018 ◽  
Vol 69 (9) ◽  
pp. 2407-2410
Author(s):  
Dan Perju Dumbrava ◽  
Carmen Corina Radu ◽  
Sofia David ◽  
Tatiana Iov ◽  
Catalin Jan Iov ◽  
...  

Considering the growing number of requests from the criminal investigations authorities addressed to the institutions of legal medicine, testing of blood alcohol concentration both in the living person and in the corpse, we believe that a presentation of the two methods which are used in our country, is a topic of interest at present. The purpose of this article is to provide the reader with the technical details on how blodd alcohol concentration is realised by means of the gas chromatographic method and the classical one, (Cordebard modified by D. Banciu and I. Droc) respectively. Another purpose of this article is to also show, in a comparative way, the elements that make the gas chromatographic method superior to the former one.


Author(s):  
R. Wade Allen ◽  
Zareh Parseghian ◽  
Anthony C. Stein

There is a large body of research that documents the impairing effect of alcohol on driving behavior and performance. Some of the most significant alcohol influence seems to occur in divided attention situations when the driver must simultaneously attend to several aspects of the driving task. This paper describes a driving simulator study of the effect of a low alcohol dose, .055 BAC (blood alcohol concentration %/wt), on divided attention performance. The simulation was mechanized on a PC and presented visual and auditory feedback in a truck cab surround. Subjects were required to control speed and steering on a rural two lane road while attending to a peripheral secondary task. The subject population was composed of 33 heavy equipment operators who were tested during both placebo and drinking sessions. Multivariate Analysis of Variance showed a significant and practical alcohol effect on a range of variables in the divided attention driving task.


1994 ◽  
Vol 34 (3) ◽  
pp. 265-270 ◽  
Author(s):  
A W Jones

This article describes a drink-driving scenario where a woman was apprehended for driving under the influence (DUI) with a blood alcohol concentration (BAC) of 256mg/dl1 The correctness of this result was vigorously challenged by a medical expert witness for the defence, who was actually a specialist in alcohol diseases. Despite reanalysis to confirm the BAC as well as a DNA profile to prove the identity of the blood specimen, the woman was acquitted of the charge of drunk driving by the lower court. However, she was subsequently found guilty in the High Court of Appeals with a unanimous decision and sentenced to four weeks imprisonment. This case report illustrates some of the problems surrounding the use of expert medical evidence by the defence to challenge the validity of the prosecution evidence based solely on a suspect's BAC. In situations such as these, an expert witness should be called by the prosecution to clarify and, if necessary, rebut medical and/or scientific opinions that might mislead the court and influence the outcome of the trial.


2013 ◽  
Vol 58 (5) ◽  
pp. 1238-1250 ◽  
Author(s):  
Teri L. Martin ◽  
Patricia A. M. Solbeck ◽  
Daryl J. Mayers ◽  
Robert M. Langille ◽  
Yvona Buczek ◽  
...  

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Karen Hughes ◽  
Zara Quigg ◽  
Mark A Bellis ◽  
Ninette van Hasselt ◽  
Amador Calafat ◽  
...  

1975 ◽  
Vol 36 (3) ◽  
pp. 977-978 ◽  
Author(s):  
John V. Compton ◽  
Roger E. Vogler

The Alco-calculator was validated by comparing its blood alcohol estimates with actual breath samples (N = 48). The Alco-calculator overestimated the blood alcohol concentration by 20 mg % and showed an accuracy confidence interval of ± 26 mg.% ( p = .95) The utility of the calculator for training in discrimination of blood alcohol levels is discussed.


2015 ◽  
Vol 122 (1) ◽  
pp. 211-218 ◽  
Author(s):  
Nils Petter Rundhaug ◽  
Kent Gøran Moen ◽  
Toril Skandsen ◽  
Kari Schirmer-Mikalsen ◽  
Stine B. Lund ◽  
...  

OBJECT The influence of alcohol is assumed to reduce consciousness in patients with traumatic brain injury (TBI), but research findings are divergent. The aim of this investigation was to study the effects of different levels of blood alcohol concentration (BAC) on the Glasgow Coma Scale (GCS) scores in patients with moderate and severe TBI and to relate the findings to brain injury severity based on the admission CT scan. METHODS In this cohort study, 265 patients (age range 16–70 years) who were admitted to St. Olavs University Hospital with moderate and severe TBI during a 7-year period were prospectively registered. Of these, 217 patients (82%) had measured BAC. Effects of 4 BAC groups on GCS score were examined with ordinal logistic regression analyses, and the GCS scores were inverted to give an OR > 1. The Rotterdam CT score based on admission CT scan was used to adjust for brain injury severity (best score 1 and worst score 6) by stratifying patients into 2 brain injury severity groups (Rotterdam CT scores of 1–3 and 4–6). RESULTS Of all patients with measured BAC, 91% had intracranial CT findings and 43% had BAC > 0 mg/dl. The median GCS score was lower in the alcohol-positive patients (6.5, interquartile range [IQR] 4–10) than in the alcohol-negative patients (9, IQR 6–13; p < 0.01). No significant differences were found between alcohol-positive and alcohol-negative patients regarding other injury severity variables. Increasing BAC was a significant predictor of lower GCS score in a dose-dependent manner in age-adjusted analyses, with OR 2.7 (range 1.4–5.0) and 3.2 (range 1.5–6.9) for the 2 highest BAC groups (p < 0.01). Subgroup analyses showed an increasing effect of BAC group on GCS scores in patients with Rotterdam CT scores of 1–3: OR 3.1 (range 1.4–6.6) and 6.7 (range 2.7–16.7) for the 2 highest BAC groups (p < 0.01). No such relationship was found in patients with Rotterdam CT scores of 4–6 (p = 0.14–0.75). CONCLUSIONS Influence of alcohol significantly reduced the GCS score in a dose-dependent manner in patients with moderate and severe TBI and with Rotterdam CT scores of 1–3. In patients with Rotterdam CT scores of 4–6, and therefore more CT findings indicating increased intracranial pressure, the brain injury itself seemed to overrun the depressing effect of the alcohol on the CNS. This finding is in agreement with the assumption of many clinicians in the emergency situation.


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