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OBJECTIVE: To analyze the contribution of alcohol and drug intoxication to fatal occupational injuries and sudden death at the workplace in Moscow. MATERIAL AND METHODS: A number of death cases of various organizations' employees equal 357 in Moscow in 2023 were investigated. The mean age of the deceased was 48.29±13.9 years, 92.4% of them were men. RESULTS: Ethanol in blood has been determined in 15% of the deceased. Narcotic drugs and psychotropic medications have been found in 6.7% of cases. Signs of chronic intoxication have been established in 16.5% of the deceased. Chronic intoxication accompanied or aggravated the course of 70% of cardiomyopathies. The proportion of deceased in an accident at an industry or construction site equal 23.9%, as well as 1/2 of the deceased in an accident on the street and in a residential building were impaired by alcohol. CONCLUSION: The study of the contribution of alcohol and drug consumption to occupational mortality will allow to plan measures for reducing the mortality of working-age population.

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Alcohol calculations are carried out in many forensic case types. On occasion, individuals under the age of 18 are involved, and alcohol calculations may be beneficial. To date, there are no studies that have determined the best way to estimate total body water (TBW) or alcohol elimination rates in juveniles for alcohol calculations. We utilized a data set of 207 females and 218 males, aged 3-18 years, from a variety of ethnic backgrounds, where TBW had been empirically measured, to evaluate the best anthropometric equation to use to estimate TBW in juveniles. For males aged 3-15 years and females aged 2-13 years, the equation of Wells et al. was the most accurate and precise (RMSE of ≤10.4% in males and ≤9.9% in females). For males aged 16+ years and females aged 14+ years, the equation of Watson et al. was more appropriate (RMSE ≤11.5% and ≤12.4%, respectively). Based on published studies where the alcohol elimination rate was determined in 43 juveniles (aged 10-17 years) who were hospitalized due to alcohol consumption, a mean alcohol elimination rate of 16 mg/100 mL/h should be used. The recommended range being 9-25 mg/100 mL (5th-95th percentile). This study provides evidence that there are valid anthropometric equations to determine TBW and alcohol elimination rates that can be used for alcohol calculations in juveniles between the ages of 10 and 17.

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Background/Objective: The aim of the study was to evaluate the diagnostic usefulness of changes in transferrin isoforms, especially disialo-Tf, in identifying binge drinking children and adolescents admitted to hospital emergency. Methods: The study group consisted of 122 ambulatory children and adolescents below 18 years of age and 30 healthy subjects. From the group of drinkers, those with acute alcohol intoxication (AAI) were identified (ICD-11, code F10.0). The isoforms of transferrin were separated by capillary electrophoresis into five major fractions: asialo-Tf, disialo-Tf, trisialo-Tf, tetrasialo-Tf, and pentasialo-Tf. The differences between binge drinking youth and nondrinking subjects were evaluated by Mann-Whitney U-test. Results: In the total study group and in both genders, the concentration of disialo-Tf was significantly higher in the binge drinkers compared to the nondrinking youth (p = 0.006). With respect to the gender, the level of disialo-Tf was significantly higher in binge drinking than nondrinking girls (p = 0.028) and the value of trisialo-Tf was lower in binge drinking than nondrinking boys (p = 0.011). In the AAI subgroup, the concentrations of disialo-Tf and tetrasialo-Tf were significantly higher in comparison to nondrinking subjects (p = 0.002, p = 0.039, respectively). There were no significant correlations between the BAC and the transferrin isoforms in the total group and the AAI subgroup. The disialo-Tf reached the highest diagnostic power (AUC = 0.718) in identifying binge drinkers at diagnostic specificity and sensitivity of 86.7% and 51.6%, respectively (at cut-off 0.70), in the total group and it was growing up to AUC = 0.761 with the diagnostic sensitivity of 60% in the AAI subgroup. Conclusions: The disialo-Tf might be a useful biomarker to identify binge drinking children and adolescents.

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INTRODUCTION: Almost a third of car accidents involve driving after alcohol consumption. Autonomous vehicles (AVs) may offer accident-prevention benefits, but at current automation levels, drivers must still perform manual driving tasks when automated systems fail. Therefore, understanding how alcohol affects driving in both manual and automated contexts offers insight into the role of future vehicle design in mediating crash risks for alcohol-impaired driving. METHOD: This study conducted a systematic review on alcohol effects on manual and automated (takeover) driving performance. Fifty-three articles from eight databases were analyzed, with findings structured based on the information processing model, which can be extended to the AV takeover model. RESULTS: The literature indicates that different Blood Alcohol Concentration (BAC) levels affect driving skills essential for traffic safety at various information processing stages, such as delayed reacting time, impaired cognitive abilities, and hindered execution of driving tasks. Additionally, the driver's driving experience, drinking habits, and external driving environment play important roles in influencing driving performance. CONCLUSIONS: Future work is needed to examine the effects of alcohol on driving performance, particularly in AVs and takeover situations, and to develop driver monitoring systems. PRACTICAL APPLICATIONS: Findings from this review can inform future experiments, AV technology design, and the development of driver state monitoring systems.

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Objective: To evaluate the correlation between blood alcohol levels and the severity of injuries assessed by the Injury Severity Score (ISS) in patients who were victims of traffic accidents admitted to the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). Methods: Cross-sectional study carried out between July 2018 and June 2019, at the Central Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (PSC-HCFMUSP). A total of 172 hospitalized patients victims of traffic accidents were included in this study. Blood samples were analyzed by the FMUSP Toxicology Laboratory. Results: 36 patients (20.9%) had positive BAC (≥ 0.2 g/L) with a mean of 1.21 g/L. Overall, patients had a mean age of 37.2 years old, and 136 (79.1%) were men. The ISS of the total casuistry was 15.6; regarding the external cause, the motorcycle was ranked first with 100 cases (58.1%), and drivers were the majority with 57.4% of the sample. Conclusion: There was no correlation between the severity of the injuries and the blood alcohol levels of traffic accident victims admitted to a reference hospital. Level of Evidence II, Cross-Sectional Study.

Objetivo: Avaliar a correlação entre a alcoolemia e a gravidade das lesões avaliadas pelo Índice de Gravidade da Lesão ( Injury Severity Score* ­ ISS) em vítimas de acidentes de trânsito internadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). Método: Estudo transversal realizado entre julho de 2018 e junho de 2019, no Pronto Socorro Central do HC-FMUSP. Foram incluídas 172 vítimas de acidentes de trânsito. Amostras de sangue foram analisadas pelo Laboratório de Toxicologia da FMUSP. Resultados: 36 pacientes (20,9%) apresentaram alcoolemia positiva (≥ 0,2 g/L), com valor médio de 1,21 g/L. No geral, os pacientes tinham uma idade média de 37,2 anos, e 136 (79,1%) eram homens. O ISS da casuística total foi 15,6; quanto à causa externa, a motocicleta ficou em primeiro lugar com 100 casos (58,1%); e os condutores foram prevalentes entre as vítimas (57,4%). Conclusão: Não houve correlação entre a gravidade das lesões e a alcoolemia das vítimas de acidente de trânsito internadas em um hospital de referência. Nível de Evidência II, Estudo de Corte Transversal.

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Swabbing with ethanol to disinfect the skin before venipuncture does not bias measurements of blood ethanol, as previously suspected. International evidence-based theory may not always be successfully integrated into local practices, where old customs may remain. So how are the local protocols for swabbing in practice - if they even do swab? Not disinfecting may risk patient safety. We aim to put a focus on the venipuncture disinfection procedure in practice when measuring blood alcohol for clinical matters and if their procedure refers to a guideline. Specialized biomedical laboratory scientists (BLS) are typically responsible for the phlebotomy procedure in Denmark, thus questionnaires were sent to the relevant BLS in 2020 to map disinfection procedures in all Danish hospitals and affiliated blood draw clinics (n = 58). The response rate was 93% (54/58). We observed an inter-laboratory dissimilarity in swabbing procedures, when measuring blood alcohol: A quarter did not use any disinfectant (26%), while the remaining disinfected with ethanol 55%, isopropanol 13%, and 6% with ethanol/chlorhexidine. Of the five Danish regions, three had a regional guideline (3/5), otherwise the swabbing protocol was locally based. There was a regional difference in disinfecting or not (Chi2 p < 0,0001). Danish protocols do not always parallel international literature and international guidelines. Not applying disinfectant may jeopardize patient safety. Laboratories are encouraged to work with evidence-based practice or follow newest standardized international guidelines.

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In December 2022, the Ministry of Health, Labour and Welfare (MHLW) of Japan issued and implemented the guideline for evaluating the effects of psychotropic drugs on motor vehicle driving performance. This guideline recommends the use of a tiered approach to assess clinically meaningful driving impairment. It is noted that adverse events cannot be solely explained by pharmacokinetics, as the onset and duration of these events vary. Among these adverse events, those affecting alertness, such as drowsiness caused by psychotropic drugs on driving performance, are more frequently observed during initial treatment stages and dose escalation. Hence, when evaluating the effects of psychotropic drugs on driving performance, it becomes crucial to assess the persistence of clinically meaningful impairment. Therefore, the MHLW guideline, developed by the authors, emphasizes the need to assess the temporal profile of adverse events affecting driving in all clinical trials. Additionally, the guideline states that when conducting driving studies, the timing of multiple dosing should consider not only the pharmacokinetics of the investigational drug but also its tolerance.

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Although they comprise a relatively small subset of all traffic deaths, hit-and-run (HR) fatalities are both contemptible and preventable. We analyze longitudinal data from 1982 to 2008 to examine the effects of blood alcohol concentration (BAC) laws on HR traffic fatalities. Our results suggest that lower BAC limits may have an unintended consequence of increasing HR fatalities, whereas a similar effect is absent for non-HR fatalities. Specifically, we find that the adoption of a 0.08 BAC limit is associated to an 8.3% increase in HR fatalities. This unintended effect is more pronounced in urban areas and during weekends, which are typical settings for HR incidents.

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Ethanol is the most commonly encountered substance in forensic toxicology. Determining blood alcohol concentration (BAC) in autopsies accounts for the majority of work in forensic diagnosis. The most common method to assess BAC is the enzymatic oxidation method because of its low cost, easy operation, and high throughput. Still, the elevated lactate and lactate dehydrogenase (LDH) levels in postmortem blood may affect accuracy. This study uses headspace gas chromatography with a flame ionization detector (HS-GC/FID) to assess the interference of lactate and LDH levels on BAC in 110 autopsied blood samples determined by the enzymatic oxidation method. The results showed that lactate and LDH levels in postmortem blood were higher than in normal blood. There was a weak correlation between the lactate levels and BAC difference (r = 0.23, p < 0.05) and a strong correlation between LDH levels and BAC difference (r = 0.67, p < 0.001). The differentiation of BAC between the enzymatic oxidation method and HS-GC/FID was significant (p < 0.001), confirming the interference significantly. All postmortem blood samples with lactate and LDH levels higher than regular lead to a positive error in determining BAC by enzymatic oxidation method. The study results suggest that the HS-GC/FID method should be used to determine BAC in postmortem blood samples instead of the enzymatic oxidation method to avoid mistakes in forensic diagnosis.

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OBJECTIVE: To measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non-transport injuries who presented to an adult major trauma centre. METHODS: This registry-based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non-transport injuries; and (ii) met predefined trauma call-out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in-hospital blood alcohol and urine drug screens. RESULTS: A total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine-type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self-harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%). CONCLUSION: AOD detections were common in trauma patients with non-transport injury causes. Population-level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.

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The analysis of blood alcohol concentration (BAC), a pivotal toxicological test, concerns acute alcohol intoxication (AAI) and driving under the influence (DUI). As such, BAC presents an organizational challenge for clinical laboratories, with unique complexities due to the need for forensic defensibility as part of the diagnostic process. Unfortunately, a significant number of scientific investigations dealing with the subject present discrepancies that make it difficult to identify optimal practices in sample collection, transportation, handling, and preparation. This review provides a systematic analysis of the preanalytical phase of BAC that aims to identify and explain the chemical, physiological, and pharmacological mechanisms underlying controllable operational factors. Nevertheless, it seeks evidence for the necessity to separate preanalytical processes for diagnostic and forensic BAC testing. In this regard, the main finding of this review is that no literature evidence supports the necessity to differentiate preanalytical procedures for AAI and DUI, except for the traceability throughout the chain of custody. In fact, adhering to correct preanalytical procedures provided by official bodies such as European federation of clinical chemistry and laboratory medicine for routine phlebotomy ensures both diagnostic accuracy and forensic defensibility of BAC. This is shown to depend on the capability of modern pre-evacuated sterile collection tubes to control major factors influencing BAC, namely non-enzymatic oxidation and microbial contamination. While certain restrictions become obsolete with such devices, as the use of sodium fluoride (NaF) for specific preservation of forensic BAC, this review reinforces the recommendation to use non-alcoholic disinfectants as a means to achieve "error-proof" procedures in challenging operational environments like the emergency department.

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Driving under the influence (DUI) remains an important threat to public health in the United States, and a substantial literature has evaluated the effectiveness of state-mandated penalties. Researchers have overlooked accelerated use of obscured fees and surcharges levied by local and state court systems added to penalties in the past 15 years. We present data regarding DUI penalties for offenders with a blood alcohol content (BAC of 0.08) and the fees and surcharges attached to them in Minnesota, Illinois, Wisconsin, Michigan, and Iowa, and variation in these within Wisconsin at four BAC levels. In all states, surcharges and fees exceed penalty fines substantially. Variation within Wisconsin is also meaningful. Our data suggest that opaque costs in state court systems add a substantial financial burden to DUI penalties, particularly for those with lower incomes. An appraisal of the deterrent role of these added costs is warranted.

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Substance use is a risk factor for being both a perpetrator and a victim of violence. The aim of this systematic review was to report the prevalence of acute pre-injury substance use in patients with violence-related injuries. Systematic searches were used to identify observational studies that included patients aged ≥15 years presenting to hospital after violence-related injuries and used objective toxicology measures to report prevalence of acute pre-injury substance use. Studies were grouped based on injury cause (any violence-related, assault, firearm, and other penetrating injuries including stab and incised wounds) and substance type (any substance, alcohol only, drugs other than alcohol only), and they were summarized using narrative synthesis and meta-analyses. This review included 28 studies. Alcohol was detected in 13%-66% of any violence-related injuries (five studies), 4%-71% of assaults (13 studies), 21%-45% of firearm injuries (six studies; pooled estimate = 41%, 95% CI: 40%-42%, n = 9,190), and 9%-66% of other penetrating injuries (nine studies; pooled estimate = 60%, 95% CI: 56%-64%, n = 6,950). Drugs other than alcohol were detected in 37% of any violence-related injuries (one study), 39% of firearm injuries (one study), 7%-49% of assaults (five studies), and 5%-66% of penetrating injuries (three studies). The prevalence of any substance varied across injury categories: any violence-related injuries = 76%-77% (three studies), assaults = 40%-73% (six studies), firearms = n/a, other penetrating injuries = 26%-45% (four studies; pooled estimate = 30%, 95% CI: 24%-37%, n = 319).Overall, substance use was frequently detected in patients presenting to hospital for violence-related injuries. Quantification of substance use in violence-related injuries provides a benchmark for harm reduction and injury prevention strategies.

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ABSTRACT Objective: To evaluate the correlation between blood alcohol levels and the severity of injuries assessed by the Injury Severity Score (ISS) in patients who were victims of traffic accidents admitted to the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP). Methods: Cross-sectional study carried out between July 2018 and June 2019, at the Central Emergency Room of the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (PSC-HCFMUSP). A total of 172 hospitalized patients victims of traffic accidents were included in this study. Blood samples were analyzed by the FMUSP Toxicology Laboratory. Results: 36 patients (20.9%) had positive BAC (≥ 0.2 g/L) with a mean of 1.21 g/L. Overall, patients had a mean age of 37.2 years old, and 136 (79.1%) were men. The ISS of the total casuistry was 15.6; regarding the external cause, the motorcycle was ranked first with 100 cases (58.1%), and drivers were the majority with 57.4% of the sample. Conclusion: There was no correlation between the severity of the injuries and the blood alcohol levels of traffic accident victims admitted to a reference hospital. Level of Evidence II, Cross-Sectional Study.

RESUMO Objetivo: Avaliar a correlação entre a alcoolemia e a gravidade das lesões avaliadas pelo Índice de Gravidade da Lesão ( Injury Severity Score* - ISS) em vítimas de acidentes de trânsito internadas no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP).* Método: Estudo transversal realizado entre julho de 2018 e junho de 2019, no Pronto Socorro Central do HC-FMUSP. Foram incluídas 172 vítimas de acidentes de trânsito. Amostras de sangue foram analisadas pelo Laboratório de Toxicologia da FMUSP. Resultados: 36 pacientes (20,9%) apresentaram alcoolemia positiva (≥ 0,2 g/L), com valor médio de 1,21 g/L. No geral, os pacientes tinham uma idade média de 37,2 anos, e 136 (79,1%) eram homens. O ISS da casuística total foi 15,6; quanto à causa externa, a motocicleta ficou em primeiro lugar com 100 casos (58,1%); e os condutores foram prevalentes entre as vítimas (57,4%). Conclusão: Não houve correlação entre a gravidade das lesões e a alcoolemia das vítimas de acidente de trânsito internadas em um hospital de referência. Nível de Evidência II, Estudo de Corte Transversal.

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Introduction: Alcohol consumption is a key driver of the burden of violence and injury in South Africa (SA). Hence, we aim to validate various alcohol assessment tools against a blood test to assess their utility for improving national health practice and policy. Methods: We conducted a cross-sectional pilot study from 3 to 19 August 2022 at Groote Schuur Hospital in Cape Town, SA. This was to test logistics for the time of venous blood centrifugation and validation of alcohol assessment tools used in injured patients ahead of the main validation study. Adults aged 18 years and older, who were injured <8 h before arrival were included. Consent was obtained for venous blood alcohol testing to validate, as the gold standard, against the following: active- and passive breath alcohol testing, clinical screening and a finger prick test. Descriptive statistics were reported for the pilot study. Results: The active breath alcohol test's digital reading and the passive test's 'yes/no' results corresponded well against the venous blood alcohol results. The average time to centrifugation was within the laboratory's 2-h cut-off requirement to preserve the alcohol in the serum. Discussion and Conclusion: The pilot study was helpful in identifying challenges with one of the alcohol assessment tools and prevented further costs ahead of the main validation study. We also determined that the selected tertiary hospital site caused a delay in recruiting eligible patients due to other hospital referrals. Hence, the main validation study is in progress at a district-level hospital for a larger sample of eligible patients for testing.

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Excessive alcohol consumption is one of the most important factors in a substantial number of violent deaths. The aim of our study was to investigate alcohol-related deaths in the Republic of North Macedonia in the period from 2007 to 2020, in order to study the influence of elevated blood alcohol levels in violent deaths. Five hundred sixty-four post-mortem blood samples from alcohol-related death cases-natural deaths and violent deaths (suicides, accidents, and homicides)-were analyzed, and the results were evaluated according to sex, age, and cause of death. Among 564 cases, traffic accidents were the leading cause of violent death (54.3% of the cases) followed by suicides (19.9% of the cases). In the examined post-mortem samples, BAC values ranged from 0.15-6.20 g/L. The average age was 45 ± 16 years for the male and 49 ± 19 years for the female group. The biggest proportion of high BAC values was found in the group of accidents specifically road traffic accidents and accidental intoxication as well as in the group of bolus deaths. The analysis of BAC in the cases of violent deaths in the Republic of North Macedonia confirmed that consumption of alcohol is strongly related to violent deaths. The data obtained from this study could raise caution and give aid in a national strategy for the prevention of alcohol-related violent deaths.

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Few studies have explored the correlation between the severity of alcohol withdrawal and blood alcohol level at the time of admission. Specifying prognostic factors for life-threatening withdrawal necessitating inpatient pharmacologic management over the course of days would be useful to identify at-risk patients at the time of admission. Hence, we present the case of a 34-year-old Caucasian male with a past medical history of poly-substance abuse who has presented to our emergency department 11 times over the past four years with a mean blood alcohol level (BAL) of 287 mg/dL upon withdrawal. BAL at the time of withdrawal is highly variable depending on the chronicity of abuse; however, a BAL this elevated is highly unusual and indicative of severe and long-term use. While in the unit at this admission, the patient's BAL was 437 and his withdrawal symptoms were severe, necessitating ICU admission and strong sedating medications to control his symptoms. Even after these interventions, he still demonstrated severe withdrawal symptoms including full body tremors, vital sign instability, and continuous visual, auditory, and tactile hallucinations. This patient presents an interesting case of severe alcohol withdrawal at an abnormally elevated blood alcohol level progressing to a prolonged withdrawal course in the ICU. Alcohol level at the time of withdrawal could be a helpful predictor of the course of severity of alcohol withdrawal; however, more studies are required to prove this relationship.

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Introduction: The sex difference in alcohol use disorder (AUD) is ingrained in distinctive neurobiological responses between men and women, which necessitates further investigation for a more tailored management. Methods: Minding the findings of iron dysregulation in AUD and the sex difference in iron homeostasis in multiple physiological and pathological settings, we examined the sex difference in the association between serum ferritin and blood alcohol concentration (BAC) in intoxicated males (n = 125) and females (n = 59). We included patients with both serum ferritin tested of any value and a BAC above the level of detection during the same hospital admission period. We investigated sex difference in the relationship between BAC, serum ferritin and liver enzymes in intoxicated critically ill and noncritically ill patients. Results: We found a negative association between serum ferritin and BAC in critically ill, intoxicated females [R2 = 0.44, F(1,14) = 11.02, p = 0.005], with much attenuated serum ferritin in females compared to their male counterparts (194.5 ± 280.4 vs. 806.3 ± 3405.7 ng/L, p = 0.002). We found a positive association between serum ferritin and liver enzymes [alanine transaminase (ALT) and aspartate transferase (AST)] in critically ill intoxicated females [ALT: R2 = 0.48, F(1,10) = 9.1, p = 0.013; AST: R2 = 0.68, F(1,10) = 21.2, p = 0.001] and in noncritically ill intoxicated males [ALT: R2 = 0.1, F(1,83) = 9.4, p = 0.003; AST: R2 = 0.1, F(1,78) = 10.5, p = 0.002]. The effect of BAC on serum ferritin was not mediated by ALT [indirect effect: (B = 0.13, p = 0.1)]. We also found a significant effect of sex, anemia, intensive care unit (ICU) admission and mortality on serum ferritin. Discussion: Our results suggest that high BAC in intoxicated female patients is associated with attenuated serum ferritin levels, questioning the role of low serum ferritin in female vulnerability to alcohol.

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Fetal alcohol syndrome represents the leading known preventable cause of mental retardation. FAS is on the most severe side of fetal alcohol spectrum disorders that stem from the deleterious effects of prenatal alcohol exposure. Affecting as many as 1 to 5 out of 100 children, FASD most often results in brain abnormalities that extend to structure, function, and cerebral hemodynamics. The present review provides an analysis of high-resolution imaging techniques that are used in animals and human subjects to characterize PAE-driven changes in the developing brain. Variants of magnetic resonance imaging such as magnetic resonance microscopy, magnetic resonance spectroscopy, diffusion tensor imaging, along with positron emission tomography, single-photon emission computed tomography, and photoacoustic imaging, are modalities that are used to study the influence of PAE on brain structure and function. This review briefly describes the aforementioned imaging modalities, the main findings that were obtained using each modality, and touches upon the advantages/disadvantages of each imaging approach.

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Problematic alcohol use is prevalent in Russia and is deleterious for individuals with HIV and Hepatitis C Virus (HCV). Ethyl glucuronide (EtG) and blood alcohol content (BAC) provide objective biomarkers of drinking that can be compared to self-reported alcohol use. This paper describes patterns of alcohol use measured by biomarkers and self-report along with concordance across measures. Participants were Russian women with HIV and HCV co-infection (N = 200; Mean age = 34.9) from two Saint Petersburg comprehensive HIV care centers enrolled in an alcohol reduction intervention clinical trial. Measures were: (a) urine specimen analyzed for EtG; (b) breathalyzer reading of BAC; and (c) self-reported frequency of drinking, typical number of drinks consumed, and number of standard drinks consumed in the past month. At baseline, 64.0% (n = 128) had a positive EtG (> 500 ng/mL) and 76.5% (n = 153) had a positive breathalyzer reading (non-zero reading). There was agreement between EtG and BAC (kappa = 0.66, p < .001; Phi coefficient = 0.69, p < .001); self-reported alcohol measures were positively correlated with positive EtG and BAC (p's < 0.001). There was concordance between EtG and BAC measures, which have differing alcohol detection windows. Most participants endorsed frequent drinking at high quantities, with very few reporting no alcohol consumption in the past month. Concordance between biomarkers and self-reported alcohol use suggests that underreporting of alcohol use was minimal. Results highlight the need for alcohol screening within HIV care. Implications for alcohol assessment within research and clinical contexts are discussed.

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